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Wang L, Wang HQ, Ding S, Garofalo AM, Gong XZ, Eldon D, Guo HY, Leonard AW, Hyatt AW, Qian JP, Weisberg DB, McClenaghan J, Fenstermacher ME, Lasnier CJ, Watkins JG, Shafer MW, Xu GS, Huang J, Ren QL, Buttery RJ, Humphreys DA, Thomas DM, Zhang B, Liu JB. Integration of full divertor detachment with improved core confinement for tokamak fusion plasmas. Nat Commun 2021; 12:1365. [PMID: 33649306 PMCID: PMC7921092 DOI: 10.1038/s41467-021-21645-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/29/2021] [Indexed: 11/24/2022] Open
Abstract
Divertor detachment offers a promising solution to the challenge of plasma-wall interactions for steady-state operation of fusion reactors. Here, we demonstrate the excellent compatibility of actively controlled full divertor detachment with a high-performance (βN ~ 3, H98 ~ 1.5) core plasma, using high-βp (poloidal beta, βp > 2) scenario characterized by a sustained core internal transport barrier (ITB) and a modest edge transport barrier (ETB) in DIII-D tokamak. The high-βp high-confinement scenario facilitates divertor detachment which, in turn, promotes the development of an even stronger ITB at large radius with a weaker ETB. This self-organized synergy between ITB and ETB, leads to a net gain in energy confinement, in contrast to the net confinement loss caused by divertor detachment in standard H-modes. These results show the potential of integrating excellent core plasma performance with an efficient divertor solution, an essential step towards steady-state operation of reactor-grade plasmas.
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Affiliation(s)
- L Wang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | - H Q Wang
- General Atomics, San Diego, CA, USA.
| | - S Ding
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
- Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | | | - X Z Gong
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | - D Eldon
- General Atomics, San Diego, CA, USA
| | - H Y Guo
- General Atomics, San Diego, CA, USA
| | | | | | - J P Qian
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | | | | | | | - C J Lasnier
- Lawrence Livermore National Laboratory, Livermore, CA, USA
| | - J G Watkins
- Sandia National Laboratories, Livermore, CA, USA
| | - M W Shafer
- Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - G S Xu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | - J Huang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | - Q L Ren
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | | | | | | | - B Zhang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | - J B Liu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
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2
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Demetri GD, Antonescu CR, Bjerkehagen B, Bovée JVMG, Boye K, Chacón M, Dei Tos AP, Desai J, Fletcher JA, Gelderblom H, George S, Gronchi A, Haas RL, Hindi N, Hohenberger P, Joensuu H, Jones RL, Judson I, Kang YK, Kawai A, Lazar AJ, Le Cesne A, Maestro R, Maki RG, Martín J, Patel S, Penault-Llorca F, Premanand Raut C, Rutkowski P, Safwat A, Sbaraglia M, Schaefer IM, Shen L, Serrano C, Schöffski P, Stacchiotti S, Sundby Hall K, Tap WD, Thomas DM, Trent J, Valverde C, van der Graaf WTA, von Mehren M, Wagner A, Wardelmann E, Naito Y, Zalcberg J, Blay JY. Diagnosis and management of tropomyosin receptor kinase (TRK) fusion sarcomas: expert recommendations from the World Sarcoma Network. Ann Oncol 2020; 31:1506-1517. [PMID: 32891793 PMCID: PMC7985805 DOI: 10.1016/j.annonc.2020.08.2232] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/22/2022] Open
Abstract
Sarcomas are a heterogeneous group of malignancies with mesenchymal lineage differentiation. The discovery of neurotrophic tyrosine receptor kinase (NTRK) gene fusions as tissue-agnostic oncogenic drivers has led to new personalized therapies for a subset of patients with sarcoma in the form of tropomyosin receptor kinase (TRK) inhibitors. NTRK gene rearrangements and fusion transcripts can be detected with different molecular pathology techniques, while TRK protein expression can be demonstrated with immunohistochemistry. The rarity and diagnostic complexity of NTRK gene fusions raise a number of questions and challenges for clinicians. To address these challenges, the World Sarcoma Network convened two meetings of expert adult oncologists and pathologists and subsequently developed this article to provide practical guidance on the management of patients with sarcoma harboring NTRK gene fusions. We propose a diagnostic strategy that considers disease stage and histologic and molecular subtypes to facilitate routine testing for TRK expression and subsequent testing for NTRK gene fusions.
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Affiliation(s)
- G D Demetri
- Dana-Farber Cancer Institute and Ludwig Center at Harvard Medical School, Boston, USA
| | - C R Antonescu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - B Bjerkehagen
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - J V M G Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - K Boye
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - M Chacón
- Oncology Service Chair, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - A P Dei Tos
- Department of Pathology, University of Padua, Padova, Italy
| | - J Desai
- Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - J A Fletcher
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - H Gelderblom
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - S George
- Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - A Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - R L Haas
- Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N Hindi
- Institute of Biomedicine of Sevilla (IBIS, HUVR, CSIC, Universidad de Sevilla), Sevilla, Spain; Medical Oncology Department, University Hospital Virgen del Rocio, Sevilla, Spain
| | - P Hohenberger
- Division of Surgical Oncology and Thoracic Surgery, Mannheim University Medical Center, Mannheim, Germany
| | - H Joensuu
- Department of Oncology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - R L Jones
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - I Judson
- Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - Y-K Kang
- Department of Oncology, University of Ulsan College of Medicine, Seoul, Korea
| | - A Kawai
- Department of Musculoskeletal Oncology, National Cancer Center, Tokyo, Japan
| | - A J Lazar
- Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Le Cesne
- Medical Oncology, Insitut Gustave Roussy, Villejuif, Ile-de-France, France
| | - R Maestro
- Unit of Oncogenetics and Functional Oncogenomics, Centro di Riferimento Oncologico di Aviano (CRO Aviano) IRCCS, National Cancer Institute, Aviano, Italy
| | - R G Maki
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - J Martín
- Institute of Biomedicine of Sevilla (IBIS, HUVR, CSIC, Universidad de Sevilla), Sevilla, Spain; Medical Oncology Department, University Hospital Virgen del Rocio, Sevilla, Spain
| | - S Patel
- Department of Sarcoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | | | - C Premanand Raut
- Division of Surgical Oncology, Brigham and Women's Hospital, Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - A Safwat
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - M Sbaraglia
- Department of Pathology, University of Padua, Padova, Italy
| | - I-M Schaefer
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - L Shen
- Department of GI Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - C Serrano
- Sarcoma Translational Research Program, Vall d'Hebron Institute of Oncology, Barcelona, Spain; Medical Oncology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - P Schöffski
- Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - S Stacchiotti
- Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - K Sundby Hall
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - W D Tap
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - D M Thomas
- The Kinghorn Cancer Centre and Cancer Theme, Garvan Institute of Medical Research, Darlinghurst, Australia
| | - J Trent
- Sylvester Comprehensive Cancer Center at University of Miami Miller School of Medicine, Miami, USA
| | - C Valverde
- Medical Oncology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - W T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M von Mehren
- Department of Hematology and Medical Oncology, Fox Chase Cancer Center, Philadelphia, USA
| | - A Wagner
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
| | - E Wardelmann
- Gerhard Domagk Institute of Pathology, University of Münster, Münster, Germany
| | - Y Naito
- National Cancer Center Hospital East, Kashiwa, Japan
| | - J Zalcberg
- Department of Epidemiology and Preventative Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Medical Oncology, Alfred Health, Melbourne, Australia
| | - J-Y Blay
- Centre Léon Bérard, Unicancer, LYRICAN and Université Claude Bernard Lyon 1, Lyon, France.
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3
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Turcotte JJ, Thomas DM, Lashgari CJ, Zaidi S, York JJ, Gelfand JM, Petre BM, Redziniak DE. Early postoperative pain and opioid consumption after arthroscopic shoulder surgery with or without open subpectoral biceps tenodesis and interscalene block. J Orthop 2020; 22:372-376. [PMID: 32952329 DOI: 10.1016/j.jor.2020.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/23/2020] [Indexed: 11/29/2022] Open
Abstract
Objective The addition of open subpectoral biceps tenodesis to arthroscopic shoulder surgery with interscalene block has been anecdotally observed to result in increased postoperative pain. This study aims to evaluate the impact of tenodesis on early postoperative pain and recovery. Methods A retrospective review of patients undergoing arthroscopic shoulder surgery with general anesthesia and interscalene block was conducted. Results Patients undergoing tenodesis experienced longer OR time, pain numeric rating scale (NRS), and consumed more morphine milligram equivalents (MME) in PACU. After controlling for confounding factors, tenodesis was significantly associated with increased opioid MME consumption in the PACU (β = 1.045, p = .028) and last PACU pain NRS (β = 0.541, p = .009). Conclusion Overall, pain scores and narcotic consumption were low after surgery, making these differences potentially clinically insignificant. Further study is required to evaluate whether these trends are consistent among this population.
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Affiliation(s)
| | | | | | - Sohail Zaidi
- Division of Anesthesiology, Anne Arundel Medical Center, United States
| | - James J York
- Anne Arundel Medical Center Orthopedics, United States
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Wang HQ, Guo HY, Xu GS, Leonard AW, Wu XQ, Groth M, Jaervinen AE, Watkins JG, Osborne TH, Thomas DM, Eldon D, Stangeby PC, Turco F, Xu JC, Wang L, Wang YF, Liu JB. First Evidence of Local E×B Drift in the Divertor Influencing the Structure and Stability of Confined Plasma near the Edge of Fusion Devices. Phys Rev Lett 2020; 124:195002. [PMID: 32469565 DOI: 10.1103/physrevlett.124.195002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 04/17/2020] [Indexed: 06/11/2023]
Abstract
The structure of the edge plasma in a magnetic confinement system has a strong impact on the overall plasma performance. We uncover for the first time a magnetic-field-direction dependent density shelf, i.e., local flattening of the density radial profile near the magnetic separatrix, in high confinement plasmas with low edge collisionality in the DIII-D tokamak. The density shelf is correlated with a doubly peaked density profile near the divertor target plate, which tends to occur for operation with the ion B×∇B drift direction away from the X-point, as currently employed for DIII-D advanced tokamak scenarios. This double-peaked divertor plasma profile is connected via the E×B drifts, arising from a strong radial electric field induced by the radial electron temperature gradient near the divertor target. The drifts lead to the reversal of the poloidal flow above the divertor target, resulting in the formation of the density shelf. The edge density shelf can be further enhanced at higher heating power, preventing large, periodic bursts of the plasma, i.e., edge-localized modes, in the edge region, consistent with ideal magnetohydrodynamics calculations.
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Affiliation(s)
- H Q Wang
- General Atomics, Post Office Box 85608, San Diego, California 92186-5608, USA
| | - H Y Guo
- General Atomics, Post Office Box 85608, San Diego, California 92186-5608, USA
| | - G S Xu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, China
| | - A W Leonard
- General Atomics, Post Office Box 85608, San Diego, California 92186-5608, USA
| | - X Q Wu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, China
| | - M Groth
- Department of Applied Physics, Aalto University, FI-00076, Aalto, Finland
| | - A E Jaervinen
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J G Watkins
- Sandia National Laboratories, Post Office Box 969, Livermore, California 94551, USA
| | - T H Osborne
- General Atomics, Post Office Box 85608, San Diego, California 92186-5608, USA
| | - D M Thomas
- General Atomics, Post Office Box 85608, San Diego, California 92186-5608, USA
| | - D Eldon
- General Atomics, Post Office Box 85608, San Diego, California 92186-5608, USA
| | - P C Stangeby
- University of Toronto Institute for Aerospace Studies, 4925 Dufferin St., Toronto M3H 5T6, Canada
| | - F Turco
- Columbia University, 500 West 120th St., New York, New York 10027, USA
| | - J C Xu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, China
| | - L Wang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, China
| | - Y F Wang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, China
| | - J B Liu
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031, China
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Abstract
This study compares bioabsorbable nail to metal screw fixation of shell osteochondral allograft (OCAs) for compression and shear strength. Cadaveric distal femurs (n = 5) yielding six 1.5 cm shell grafts (n = 30) were used. Three different fixation methods (2.0 and 2.4 mm headed screws, and copolymer absorbable nail) were compared for statistically significant differences (p < 0.05) in contact area, contact pressure, and shear load-to-failure. No significant differences in contact areas existed among groups (224 ± 33.5 mm2; 233.9 ± 20.8 mm2, 220.6 ± 22.7 mm2; p = 0.509 for 2.4, 2.0 mm screw, and nail, respectively). No significant differences in contact pressures existed (1.7 ± 0.6 MPa/mm2, 1.5 ± 0.8 MPa/mm2, 1.4 ± 0.9 MPa/mm2; p = 0.73 for 2.4, 2.0 mm screw, and nail, respectively). Load-to-failure for each was: 280.7 ± 48.4 N for 2.4 mm screws, 245.1 ± 70.6 N for 2.0 mm screws, and 215.2 ± 39.4 N for nails. There were no statistically significant differences in load-to-failure between 2.4 and 2.0 mm screws (p = 0.29) or between 2.0 mm screws and nails (p = 0.23); however, load-to-failure in shear was significantly higher for 2.4 mm screws compared with nails (p = 0.036). Fixation of shell OCAs using a copolymer headed nail provides initial graft-recipient compression similar to fixation using 2.0 and 2.4 mm headed screws. Nails failed in shear at significantly lower load than 2.4 mm screws but not 2.0 mm screws which have proven adequate for clinical healing. This study has clinical relevance, as a copolymer bioabsorbable headed nail (SmartNail) has graft-recipient compression and shear load-to-failure properties that suggest it is viable for shell OCA fixation.
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Affiliation(s)
- Dimitri M Thomas
- The Orthopedic and Sports Medicine Center, Anne Arundel Medical Center, Annapolis, Maryland
| | - James P Stannard
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri Columbia, Columbia, Missouri.,Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri Columbia, Columbia, Missouri
| | - Ferris M Pfeiffer
- Department of Biological Engineering, University of Missouri, Columbia, Missouri
| | - James L Cook
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri Columbia, Columbia, Missouri.,Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri Columbia, Columbia, Missouri
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Smith PA, Thomas DM, Pomajzl RJ, Bley JA, Pfeiffer FM, Cook JL. A Biomechanical Study of the Role of the Anterolateral Ligament and the Deep Iliotibial Band for Control of a Simulated Pivot Shift With Comparison of Minimally Invasive Extra-articular Anterolateral Tendon Graft Reconstruction Versus Modified Lemaire Reconstruction After Anterior Cruciate Ligament Reconstruction. Arthroscopy 2019; 35:1473-1483. [PMID: 30926192 DOI: 10.1016/j.arthro.2018.11.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 11/02/2018] [Accepted: 11/04/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine whether the deep fibers of the iliotibial band (dITB) or the anterolateral ligament (ALL) provides more control of a simulated pivot shift and whether a minimally invasive anterolateral reconstruction (ALR) designed to functionally restore the ALL and dITB is mechanically equivalent to a modified Lemaire reconstruction (MLR). METHODS Six matched pairs of cadaveric knees (N = 12) were subjected to a simulated pivot shift to evaluate anteroposterior translation; internal rotation; and valgus laxity at 0°, 30°, and 90° of flexion. The anterior cruciate ligament (ACL) was sectioned in all specimens, and retesting was performed. Within each pair, sequential sectioning of the ALL and dITB was performed, followed by testing; the contralateral knee was sectioned in reverse order. Knees underwent ACL reconstruction (ACLR) and repeat testing. Then, MLR (n = 6) or ALR (n = 6) was performed on matched pairs for final testing. RESULTS Sectioning of the dITB versus ALL (after ACL sectioning) produced significantly more anterior translation at all flexion angles (P = .004, P = .012, and P = .011 for 0°, 30°, and 90°, respectively). The ACL-plus-dITB sectioned state had significantly more internal rotation at 0° versus ACL plus ALL (P = .03). ACLR plus ALR restored native anterior translation at all flexion angles. ACLR plus MLR restored anterior translation to native values only at 0° (P = .34). We found no statistically significant differences between ACLR plus ALR and ACLR plus MLR at any flexion angle for internal rotation or valgus laxity compared with the native state. CONCLUSIONS ALR of the knee in conjunction with ACLR can return the knee to its native biomechanical state without causing overconstraint. The dITB plays a more critical role in controlling anterior translation and internal rotation at 0° than the ALL. The minimally invasive ALR was functionally equivalent to MLR for restoration of knee kinematics after ACLR. CLINICAL RELEVANCE The dITB is more important than the ALL for control of the pivot shift. A minimally invasive extra-articular tendon allograft reconstruction was biomechanically equivalent to a modified Lemaire procedure for control of a simulated pivot shift.
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Affiliation(s)
- Patrick A Smith
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A.; Columbia Orthopaedic Group, Columbia, Missouri, U.S.A..
| | - Dimitri M Thomas
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A
| | - Ryan J Pomajzl
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A.; SSM Health Medical Group, Bridgeton, Missouri, U.S.A
| | - Jordan A Bley
- Columbia Orthopaedic Group, Columbia, Missouri, U.S.A
| | - Ferris M Pfeiffer
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A
| | - James L Cook
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A.; Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri, U.S.A
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7
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Liao KT, Austin ME, Rowan WL, Thomas DM, Zhao BZ. Estimating the performance of lithium beam measurements of current density and electron density in an H-mode pedestal. Rev Sci Instrum 2018; 89:10D135. [PMID: 30399706 DOI: 10.1063/1.5035294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/22/2018] [Indexed: 06/08/2023]
Abstract
The lithium beam is an effective diagnostic tool for investigation of stability and particle transport in the pedestal. It was used successfully to measure edge current density on DIII-D, achieving qualitative agreement with neoclassical models. Electron density profiles were also measured. Proposed upgrades will continue these measurements with higher reliability as well as explore edge current measurements using spectroscopy. The optics will be redesigned to optimize throughput and aperture broadening and to replace the photomultiplier tubes with avalanche photodiodes. The new system will yield detailed measurements of the pedestal, complementing existing diagnostics for investigating pedestal stability, edge localized mode cycle, and particle transport through the pedestal.
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Affiliation(s)
- K T Liao
- Institute for Fusion Studies, University of Texas at Austin, Austin, Texas 78702, USA
| | - M E Austin
- Institute for Fusion Studies, University of Texas at Austin, Austin, Texas 78702, USA
| | - W L Rowan
- Institute for Fusion Studies, University of Texas at Austin, Austin, Texas 78702, USA
| | - D M Thomas
- General Atomics, San Diego, California 92186, USA
| | - B Z Zhao
- Institute for Fusion Studies, University of Texas at Austin, Austin, Texas 78702, USA
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8
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Liu Z, Martin J, Orme L, Seddon B, Desai J, Nicholls W, Thomson D, Porter D, McCowage G, Underhill C, Cranswick N, Michael M, Zacharin M, Herschtal A, Sivasuthan J, Thomas DM. Gender differences in doxorubicin pharmacology for subjects with chemosensitive cancers of young adulthood. Cancer Chemother Pharmacol 2018; 82:887-898. [PMID: 30206658 DOI: 10.1007/s00280-018-3683-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/01/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE For many cancers, adolescents and young adults (AYA) have worse outcomes than for children and adults. Many factors may contribute to the AYA survival gap, including differences in biology, therapeutic intent, and adherence to therapy. It has been observed that male AYAs have poorer outcomes than females. The purpose of this work was to test the proposition that gender-related pharmacologic factors may account for a component of the AYA survival gap. PATIENTS AND METHODS A prospective, multi-institutional pharmacologic study of 79 patients in total with chemosensitive cancers (Ewing sarcoma, osteosarcoma and Hodgkin lymphoma) was conducted, with conventional doxorubicin treatment. Pharmacokinetic data of 13 children, 40 AYAs and 13 adults were valid for analysis. Population pharmacokinetics models were developed for doxorubicin and its metabolite doxorubicinol based on the data created in this study. Consequently, model-based analysis was conducted to investigate the relevant topics. RESULTS The clearance of doxorubicinol (normalized to body surface area), the main active metabolite of doxorubicin, appears faster in male AYAs than female (p = 0.04, 95% CI 0.1-3.9 L/h). The exposure of doxorubicinol (normalized to dose) is lower in male AYA than female (p = 0.03, 95% CI - 0.005 to - 0.0002 h/L). These might be correlated to the observed difference on nadir neutrophil count between male AYA and female (p = 0.027, 95% CI 0.09-1.4). CONCLUSION Gender-related differences in doxorubicin pharmacology may account for worse outcomes for male AYAs with chemosensitive cancers compared to females. These findings may reduce the AYA survival gap compared to other age groups.
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Affiliation(s)
- Z Liu
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia. .,Clinical Pharmacology and Department of Medicine, The Royal Children's Hospital, Melbourne, Australia.
| | - J Martin
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - L Orme
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia.,Royal Children's Hospital, Brisbane, QLD, Australia
| | - B Seddon
- University College London Hospital, London, UK
| | - J Desai
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - W Nicholls
- Brisbane Children's Hospital, Brisbane, QLD, Australia.,Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - D Thomson
- Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - D Porter
- Starship Children's Hospital, Auckland, New Zealand
| | - G McCowage
- Children's Hospital Westmead, Sydney, NSW, Australia
| | - C Underhill
- Border Medical Oncology, Albury-Wodonga, VIC, Australia
| | - N Cranswick
- Clinical Pharmacology and Department of Medicine, The Royal Children's Hospital, Melbourne, Australia
| | - M Michael
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - M Zacharin
- Clinical Pharmacology and Department of Medicine, The Royal Children's Hospital, Melbourne, Australia
| | - A Herschtal
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - J Sivasuthan
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
| | - D M Thomas
- Cancer Division, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
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9
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Heymsfield SB, Peterson CM, Bourgeois B, Thomas DM, Gallagher D, Strauss B, Müller MJ, Bosy-Westphal A. Human energy expenditure: advances in organ-tissue prediction models. Obes Rev 2018; 19:1177-1188. [PMID: 30035381 PMCID: PMC6107421 DOI: 10.1111/obr.12718] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/23/2018] [Accepted: 05/09/2018] [Indexed: 01/02/2023]
Abstract
Humans expend energy at rest (REE), and this major energy exchange component is now usually estimated using statistical equations that include weight and other predictor variables. While these formulas are useful in evaluating an individual's or group's REE, an important gap remains: available statistical models are inadequate for explaining underlying organ-specific and tissue-specific mechanisms accounting for resting heat production. The lack of such systems level REE prediction models leaves many research questions unanswered. A potential approach that can fill this gap began with investigators who first showed in animals and later in humans that REE reflects the summated heat production rates of individual organs and tissues. Today, using advanced imaging technologies, REE can be accurately estimated from the measured in vivo mass of 10 organ-tissue mass components combined with their respective mass-specific metabolic rates. This review examines the next frontier of energy expenditure models and discusses how organ-tissue models have the potential not only to better predict REE but also to provide insights into how perturbations in organ mass lead to structure-function changes across other interacting organ systems. The introductory ideas advanced in this review provide a framework for future human energy expenditure modelling research.
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Affiliation(s)
- S B Heymsfield
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - C M Peterson
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - B Bourgeois
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - D M Thomas
- Department of Mathematical Sciences, United States Military Academy West Point, West Point, NY, USA
| | - D Gallagher
- College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - B Strauss
- Dept. of Medicine, School of Clinical Sciences, Monash University, Australia and Institute of Inflammation and Repair, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - M J Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
| | - A Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
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DeGregory KW, Kuiper P, DeSilvio T, Pleuss JD, Miller R, Roginski JW, Fisher CB, Harness D, Viswanath S, Heymsfield SB, Dungan I, Thomas DM. A review of machine learning in obesity. Obes Rev 2018; 19:668-685. [PMID: 29426065 PMCID: PMC8176949 DOI: 10.1111/obr.12667] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/18/2017] [Accepted: 11/28/2017] [Indexed: 12/15/2022]
Abstract
Rich sources of obesity-related data arising from sensors, smartphone apps, electronic medical health records and insurance data can bring new insights for understanding, preventing and treating obesity. For such large datasets, machine learning provides sophisticated and elegant tools to describe, classify and predict obesity-related risks and outcomes. Here, we review machine learning methods that predict and/or classify such as linear and logistic regression, artificial neural networks, deep learning and decision tree analysis. We also review methods that describe and characterize data such as cluster analysis, principal component analysis, network science and topological data analysis. We introduce each method with a high-level overview followed by examples of successful applications. The algorithms were then applied to National Health and Nutrition Examination Survey to demonstrate methodology, utility and outcomes. The strengths and limitations of each method were also evaluated. This summary of machine learning algorithms provides a unique overview of the state of data analysis applied specifically to obesity.
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Affiliation(s)
- K W DeGregory
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - P Kuiper
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - T DeSilvio
- Case Western Reserve University, Cleveland, OH, USA
| | - J D Pleuss
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - R Miller
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - J W Roginski
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - C B Fisher
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - D Harness
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - S Viswanath
- Case Western Reserve University, Cleveland, OH, USA
| | - S B Heymsfield
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - I Dungan
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - D M Thomas
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
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Affiliation(s)
- N J Shaper
- Department of Surgery & Pathology, Joyce Green Hospital, Dartford, England
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Williams N, Coombs NA, Johnson M, Josephs L, Rigge LA, Thomas DM, Wilkinson TMA. S67 Mortality in copd patients following community acquired pneumonia: a population database analysis of linked healthcare records. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Heymsfield SB, Bourgeois B, Thomas DM. Assessment of human energy exchange: historical overview. Eur J Clin Nutr 2016; 71:294-300. [DOI: 10.1038/ejcn.2016.221] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 10/11/2016] [Indexed: 11/09/2022]
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Thomas DM, Bredlau C, Islam S, Armah KA, Kunnipparampil J, Patel K, Redman LM, Misra D, Salafia C. Relationships between misreported energy intake and pregnancy in the pregnancy, infection and nutrition study: new insights from a dynamic energy balance model. Obes Sci Pract 2016; 2:174-179. [PMID: 29071098 PMCID: PMC5523690 DOI: 10.1002/osp4.29] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/11/2015] [Accepted: 01/01/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Providing effective dietary counselling so that pregnancy weight gain remains within the 2009 Institute of Medicine (IOM) guidelines requires accurate maternal energy intake measures. Current practice is based on self-reported intake that has been demonstrated unreliable. This study applies an objective calculation of energy intake from a validated mathematical model to identify characteristics of individuals more likely to misreport during pregnancy. METHODS A validated maternal energy balance equation was used to calculate energy intake from gestational weight gain in 1,368 subjects. The difference between self-reported and model-predicted energy intake was tested for demographics, economic status, education level and maternal health status. RESULTS A weight gain of 15.2 kg resulted in model-predicted intake during pregnancy of 2,882.97 ± 135.71 kcal day-1, which differed from self-reported intake of 2,180.5 ± 856.0 kcal day-1. The achieved weight gain exceeded the IOM guidelines; however, the model predicted weight gain from self-reported energy intake was below IOM guidelines. Higher income (p = 0.004), education (p = 0.003), birth weight (p = 0.017), gestational diabetes (p = 0.008) and pre-existing diabetes (p < 0.001) were associated with under-reported energy intake. More children living at home (p = 0.001) were associated with more accurate self-reported intake. CONCLUSIONS When assessing self-reported energy intake in pregnancy studies, birth weight, gestational diabetes status, pre-existing diabetes, higher income and education predict higher under-reporting. Clinicians providing dietary treatment recommendations during pregnancy should be aware that individuals with pre-existing diabetes and gestational diabetes mellitus are more likely to misreport their intake. Additionally, the systems model approach can be applied early in intervention to objectively monitor dietary compliance to treatment recommendations.
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Affiliation(s)
- D M Thomas
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - C Bredlau
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - S Islam
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - K A Armah
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - J Kunnipparampil
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - K Patel
- Center for Quantitative Obesity Research Montclair State University Montclair NJ USA
| | - L M Redman
- Pennington Biomedical Research Center Louisiana State University System Baton Rouge LA USA
| | - D Misra
- Department of Family Medicine and Public Health Sciences, School of Medicine Wayne State University Detroit MI USA
| | - C Salafia
- Placental Analytics Larchmont NY USA
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Heymsfield SB, Peterson CM, Thomas DM, Heo M, Schuna JM. Why are there race/ethnic differences in adult body mass index-adiposity relationships? A quantitative critical review. Obes Rev 2016; 17:262-75. [PMID: 26663309 PMCID: PMC4968570 DOI: 10.1111/obr.12358] [Citation(s) in RCA: 228] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/16/2015] [Accepted: 10/19/2015] [Indexed: 12/25/2022]
Abstract
Body mass index (BMI) is now the most widely used measure of adiposity on a global scale. Nevertheless, intense discussion centers on the appropriateness of BMI as a phenotypic marker of adiposity across populations differing in race and ethnicity. BMI-adiposity relations appear to vary significantly across race/ethnic groups, but a collective critical analysis of these effects establishing their magnitude and underlying body shape/composition basis is lacking. Accordingly, we systematically review the magnitude of these race-ethnic differences across non-Hispanic (NH) white, NH black and Mexican American adults, their anatomic body composition basis and potential biologically linked mechanisms, using both earlier publications and new analyses from the US National Health and Nutrition Examination Survey. Our collective observations provide a new framework for critically evaluating the quantitative relations between BMI and adiposity across groups differing in race and ethnicity; reveal new insights into BMI as a measure of adiposity across the adult age-span; identify knowledge gaps that can form the basis of future research and create a quantitative foundation for developing BMI-related public health recommendations.
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Affiliation(s)
- S B Heymsfield
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | - C M Peterson
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | - D M Thomas
- Montclair State University, Montclair, NJ, USA
| | - M Heo
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - J M Schuna
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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Williams N, Coombs NA, Rigge L, Josephs L, Johnson M, Thomas DM, Wilkinson TMA. S121 Co-morbidity and Pneumonia Risk in COPD Patients: A Population Database Analysis of Primary Care Patients. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lewin J, Khamly KK, Young RJ, Mitchell C, Hicks RJ, Toner GC, Ngan SYK, Chander S, Powell GJ, Herschtal A, Te Marvelde L, Desai J, Choong PFM, Stacker SA, Achen MG, Ferris N, Fox S, Slavin J, Thomas DM. A phase Ib/II translational study of sunitinib with neoadjuvant radiotherapy in soft-tissue sarcoma. Br J Cancer 2014; 111:2254-61. [PMID: 25321190 PMCID: PMC4264446 DOI: 10.1038/bjc.2014.537] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 08/29/2014] [Accepted: 09/17/2014] [Indexed: 12/16/2022] Open
Abstract
Background: Preoperative radiotherapy (RT) is commonly used to treat localised soft-tissue sarcomas (STS). Hypoxia is an important determinant of radioresistance. Whether antiangiogenic therapy can ‘normalise' tumour vasculature, thereby improving oxygenation, remains unknown. Methods: Two cohorts were prospectively enrolled. Cohort A evaluated the implications of hypoxia in STS, using the hypoxic tracer 18F-azomycin arabinoside (FAZA-PET). In cohort B, sunitinib was added to preoperative RT in a dose-finding phase 1b/2 design. Results: In cohort A, 13 out of 23 tumours were hypoxic (FAZA-PET), correlating with metabolic activity (r2=0.85; P<0.001). Two-year progression-free (PFS) and overall (OS) survival were 61% (95% CI: 0.44–0.84) and 87% (95% CI: 0.74–1.00), respectively. Hypoxia was associated with radioresistance (P=0.012), higher local recurrence (Hazard ratio (HR): 10.2; P=0.02), PFS (HR: 8.4; P=0.02), and OS (HR: 41.4; P<0.04). In Cohort B, seven patients received sunitinib at dose level (DL): 0 (50 mg per day for 2 weeks before RT; 25 mg per day during RT) and two patients received DL: −1 (37.5 mg per day for entire period). Dose-limiting toxicities were observed in 4 out of 7 patients at DL 0 and 2 out of 2 patients at DL −1, resulting in premature study closure. Although there was no difference in PFS or OS, patients receiving sunitinib had higher local failure (HR: 8.1; P=0.004). Conclusion: In STS, hypoxia is associated with adverse outcomes. The combination of sunitinib with preoperative RT resulted in unacceptable toxicities, and higher local relapse rates.
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Affiliation(s)
- J Lewin
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - K K Khamly
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - R J Young
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - C Mitchell
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - R J Hicks
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia [2] The University of Melbourne, St Vincent's Hospital Campus, Fitzroy, Victoria, Australia
| | - G C Toner
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia [2] The University of Melbourne, St Vincent's Hospital Campus, Fitzroy, Victoria, Australia
| | - S Y K Ngan
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - S Chander
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - G J Powell
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia [2] Department of Orthopaedics, St. Vincent's Hospital, Fitzroy, Victoria, Australia [3] Department of Surgery, The University of Melbourne, St. Vincent's Hospital, Fitzroy, Victoria, Australia
| | - A Herschtal
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - L Te Marvelde
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - J Desai
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - P F M Choong
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia [2] Department of Orthopaedics, St. Vincent's Hospital, Fitzroy, Victoria, Australia [3] Department of Surgery, The University of Melbourne, St. Vincent's Hospital, Fitzroy, Victoria, Australia
| | - S A Stacker
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia [2] Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - M G Achen
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia [2] Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - N Ferris
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - S Fox
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - J Slavin
- The University of Melbourne, St Vincent's Hospital Campus, Fitzroy, Victoria, Australia
| | - D M Thomas
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia [2] The University of Melbourne, St Vincent's Hospital Campus, Fitzroy, Victoria, Australia [3] The Kinghorn Cancer Centre, Garvan Institute of Medical Research, 370 Victoria Street, Darlinghurst, New South Wales 2010, Australia
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Bonini M, Bachert C, Baena-Cagnani CE, Bedbrook A, Brozek JL, Canonica GW, Cruz AA, Fokkens WJ, Gerth van Wijk R, Grouse L, Hellings PW, Howarth P, Kalayci O, Khaltaev N, Kuna P, Larenas Linnemann D, Nekam K, Palkonen S, Papadopoulos NG, Popov TA, Price D, Rosado Pinto J, Rasi G, Ryan D, Samolinski B, Scadding GK, Schünemann HJ, Thomas DM, Triggiani M, Yorgancioglu A, Yusuf OM, Zuberbier T, Pawankar R, Bousquet J, Bonini S. What we should learn from the London Olympics. Curr Opin Allergy Clin Immunol 2013; 13:1-3. [PMID: 23222179 DOI: 10.1097/aci.0b013e32835c1b73] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- M Bonini
- Department of Medicine, Lung Function Unit, Sapienza University of Rome, Rome, Italy.
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Stoschus H, Thomas DM, Hudson B, Watkins M, Finkenthal DF, Moyer RA, Osborne TH. Status and characterization of the lithium beam diagnostic on DIII-D. Rev Sci Instrum 2013; 84:083503. [PMID: 24007061 DOI: 10.1063/1.4816824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The 30 keV lithium beam diagnostic on DIII-D is suitable to measure both the radial electron density and poloidal magnetic field profiles in the pedestal. The refurbished system features a new setup to measure the Doppler shift allowing accurate alignment of the spectral filters. The injector has been optimized to generate a stable lithium neutral beam with a current of I = 15-20 mA and a diameter of 1.9 ± 0.1 cm measured by beam imaging. The typical temporal resolution is Δt = 1-10 ms and the radial resolution of ΔR = 5 mm is given by the optical setup. A new analysis technique based on fast Fourier transform avoids systematic error contributions from the digital lock-in analysis and accounts intrinsically for background light correction. Latest upgrades and a detailed characterization of the system are presented. Proof-of-principle measurements of the poloidal magnetic field with a statistical error of typically 2% show a fair agreement with the predictions modeled with the Grad-Shafranov equilibrium solver EFIT within 4%.
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Affiliation(s)
- H Stoschus
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee 37831-0117, USA
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Thomas DM, Martin CK, Lettieri S, Bredlau C, Kaiser K, Church T, Bouchard C, Heymsfield SB. Can a weight loss of one pound a week be achieved with a 3500-kcal deficit? Commentary on a commonly accepted rule. Int J Obes (Lond) 2013; 37:1611-3. [PMID: 23628852 DOI: 10.1038/ijo.2013.51] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 03/04/2013] [Accepted: 03/10/2013] [Indexed: 02/04/2023]
Abstract
Despite theoretical evidence that the model commonly referred to as the 3500-kcal rule grossly overestimates actual weight loss, widespread application of the 3500-kcal formula continues to appear in textbooks, on respected government- and health-related websites, and scientific research publications. Here we demonstrate the risk of applying the 3500-kcal rule even as a convenient estimate by comparing predicted against actual weight loss in seven weight loss experiments conducted in confinement under total supervision or objectively measured energy intake. We offer three newly developed, downloadable applications housed in Microsoft Excel and Java, which simulates a rigorously validated, dynamic model of weight change. The first two tools available at http://www.pbrc.edu/sswcp, provide a convenient alternative method for providing patients with projected weight loss/gain estimates in response to changes in dietary intake. The second tool, which can be downloaded from the URL http://www.pbrc.edu/mswcp, projects estimated weight loss simultaneously for multiple subjects. This tool was developed to inform weight change experimental design and analysis. While complex dynamic models may not be directly tractable, the newly developed tools offer the opportunity to deliver dynamic model predictions as a convenient and significantly more accurate alternative to the 3500-kcal rule.
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Affiliation(s)
- D M Thomas
- Center for Quantitative Obesity Research, Department of Mathematical Sciences, Montclair State University, Montclair, NJ, USA
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Abstract
BACKGROUND/OBJECTIVES Remarkable improvements in mathematical methodology combined with knowledge and data on the response of the human body to changes in nutrition, activity and environment have led to a rapid expansion of mathematical models that predict, describe and aggregate conclusions in nutrition. Although mathematical models in nutrition have made significant advances in predictive accuracy and physiological descriptions, these advances have compromised model simplicity, introducing obstacles to their widespread application and contribution to clinical care. The challenge of model complexity is moderated by delivery through well-designed software. SUBJECTS/METHODS We reviewed several recent and novel web-based mathematical models related to nutrition and describe the successful application of a dynamic mathematical model to patient care implemented through counseling software in a recent weight-loss intervention. To illustrate the power of model transfer through software, we designed a Visual Basic macro within Microsoft Excel to deliver predictions from six well-established and validated resting energy expenditure formulas in children and adults. RESULTS The six resting energy expenditure models that were deployed using the Visual Basic Application developer ranged in technical complexity requiring decision trees, calculation of nonlinear terms or inclusion of multiple covariates. The developed software allows users to select specific models and desired units. After input of individual height, weight, age and sex data through a user form, individuals can effortlessly view predictions. CONCLUSIONS Advances in web-based and widely accessible software provide the capacity to deliver more accurate and physiologically realistic nutrition-related models, and ultimately translating model results to patient care.
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Affiliation(s)
- D M Thomas
- Center for Quantitative Obesity Research, Montclair State University, Montclair, NJ, USA.
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Thomas DM, Grierson BA, Muñoz Burgos JM, Van Zeeland MA. Determination of neutral beam energy fractions from collisional radiative measurements on DIII-D. Rev Sci Instrum 2012; 83:10D518. [PMID: 23126859 DOI: 10.1063/1.4733614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Neutral beams based on positive ion source technology are a key component of contemporary fusion research. An accurate assessment of the injected beam species mix is important for determining the actual plasma heating and momentum input as well as proper interpretation of beam-based diagnostics. On DIII-D, the main ion charge-exchange spectroscopy system is used to extract well-resolved intensity ratios of the Doppler-shifted D(α) emission from the full, half, and third energy beam components for a variety of beam operational parameters. In conjunction with accurate collisional-radiative modeling, these measurements indicate the assumed species mix and power fractions can vary significantly and should be regularly monitored and updated for the most accurate interpretation of plasma performance. In addition, if stable active control of the power fractions can be achieved through appropriate source tuning, the resulting control over the deposition profile can serve as an additional experimental knob for advanced tokamak studies, e.g., varying the off axis beam current drive without altering the beam trajectory.
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Affiliation(s)
- D M Thomas
- General Atomics, PO Box 85608, San Diego, California 92186-5608, USA.
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Stoschus H, Thomas DM, Hudson B, Muñoz Burgos JM, Schweinzer J. Comparison of collisional radiative models for edge electron density reconstruction from Li I (2s-2p) emission profiles. Rev Sci Instrum 2012; 83:10D508. [PMID: 23126851 DOI: 10.1063/1.4731008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Four collisional radiative models (CRMs) for reconstruction of the edge electron density profile from the measured Li I (2s-2p) emission profile of an accelerated lithium beam are compared using experimental data from DIII-D. It is shown for both L- and H-mode plasmas that edge density profiles reconstructed with the CRMs DDD2, ABSOLUT, [Sasaki et al. Rev. Sci. Instrum. 64, 1699 (1993)] and a new model developed at DIII-D agree in a density scan from n(e) (ped) = (2.0-6.5) × 10(19) m(-3) within 20%, 20%, <5%, and 40%, respectively, of the pedestal density measured with Thomson scattering. Profile shape and absolute density vary in a scan of the effective ion charge Z(eff) = 1-6 up to a factor of two but agree with Thomson data for Z(eff) = 1-2 within the error bars.
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Affiliation(s)
- H Stoschus
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee 37831-0117, USA.
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Thomas DM, Bouchard C, Church T, Slentz C, Kraus WE, Redman LM, Martin CK, Silva AM, Vossen M, Westerterp K, Heymsfield SB. Why do individuals not lose more weight from an exercise intervention at a defined dose? An energy balance analysis. Obes Rev 2012; 13:835-47. [PMID: 22681398 PMCID: PMC3771367 DOI: 10.1111/j.1467-789x.2012.01012.x] [Citation(s) in RCA: 167] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Weight loss resulting from an exercise intervention tends to be lower than predicted. Modest weight loss can arise from an increase in energy intake, physiological reductions in resting energy expenditure, an increase in lean tissue or a decrease in non-exercise activity. Lower than expected, weight loss could also arise from weak and invalidated assumptions within predictive models. To investigate these causes, we systematically reviewed studies that monitored compliance to exercise prescriptions and measured exercise-induced change in body composition. Changed body energy stores were calculated to determine the deficit between total daily energy intake and energy expenditures. This information combined with available measurements was used to critically evaluate explanations for low exercise-induced weight loss. We conclude that the small magnitude of weight loss observed from the majority of evaluated exercise interventions is primarily due to low doses of prescribed exercise energy expenditures compounded by a concomitant increase in caloric intake.
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Affiliation(s)
- D M Thomas
- Center for Quantitative Obesity Research, Montclair State University, Montclair, NJ 07043, USA.
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Thomas DM, Ballinger ML. Inherited and de novo germline TP53 mutations in adult-onset sarcoma. Hered Cancer Clin Pract 2012. [PMCID: PMC3395324 DOI: 10.1186/1897-4287-10-s2-a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Thomas DM, Hansen U, Owens BD. Hook retraction for scapulothoracic arthroscopy. Am J Orthop (Belle Mead NJ) 2011; 40:372-373. [PMID: 22013575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Scapulothoracic arthroscopy is an established method for evaluating the articulation between the thoracic cage and the scapula. The "chicken-wing" position is often used to enhance visualization of the scapulothoracic space. There are situations in which the chicken-wing position is not feasible or practical, such as in simultaneous arthroscopy of both joints. In this article, we describe a new technique that aids in arthroscopy of the scapulothoracic joint, particularly when the chicken-wing position is unavailable.
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Affiliation(s)
- Dimitri M Thomas
- William Beaumont Army Medical Center, El Paso, Texas 79920, USA.
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Thomas DM, Counsell G, Johnson D, Vasu P, Zvonkov A. Active spectroscopic measurements using the ITER diagnostic system. Rev Sci Instrum 2010; 81:10D725. [PMID: 21033918 DOI: 10.1063/1.3491293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Active (beam-based) spectroscopic measurements are intended to provide a number of crucial parameters for the ITER device being built in Cadarache, France. These measurements include the determination of impurity ion temperatures, absolute densities, and velocity profiles, as well as the determination of the plasma current density profile. Because ITER will be the first experiment to study long timescale (∼1 h) fusion burn plasmas, of particular interest is the ability to study the profile of the thermalized helium ash resulting from the slowing down and confinement of the fusion alphas. These measurements will utilize both the 1 MeV heating neutral beams and a dedicated 100 keV hydrogen diagnostic neutral beam. A number of separate instruments are being designed and built by several of the ITER partners to meet the different spectroscopic measurement needs and to provide the maximum physics information. In this paper, we describe the planned measurements, the intended diagnostic ensemble, and we will discuss specific physics and engineering challenges for these measurements in ITER.
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Affiliation(s)
- D M Thomas
- ITER Organization, 13067 St. Paul-lez-Durance Cedex, France.
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Abstract
The optimal management of adolescent and young adult cancer has been the subject of vigorous debate in paediatric and adult cancer community for many years. This debate is rapidly coming to the boil. There is international recognition that not only is cancer in young people on the rise but also that improvements in outcomes of cancer in young people lag well behind the advances that have been achieved for both children and older adults in the past 30 years. The underlying problems appear to relate to a complex set of interactions between the health-care system and the prevalence of cancer in this age group and the unique psychosocial and educational needs of this population. This article explores why we should be concerned about Australian health outcomes in this group and considers how best we might respond to these concerns.
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Affiliation(s)
- D M Thomas
- onTrac@PeterMac Adolescent and Young Adult Cancer Programme, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
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Affiliation(s)
- D M Thomas
- Ian Potter Foundation Center for Cancer Genomics and Predictive Medicine, Peter MacCallum Cancer Center, Melbourne, Australia.
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Thomas DM, Leonard AW, Lao LL, Osborne TH, Mueller HW, Finkenthal DF. Measurement of pressure-gradient-driven currents in tokamak edge plasmas. Phys Rev Lett 2004; 93:065003. [PMID: 15323639 DOI: 10.1103/physrevlett.93.065003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2003] [Indexed: 05/24/2023]
Abstract
Localized currents driven by pressure gradients play a pivotal role in the magnetohydrodynamic stability of toroidal plasma confinement devices. We have measured the currents generated in the edge of L- (low) and H- (high confinement) mode discharges on the DIII-D tokamak, utilizing the Zeeman effect in an injected lithium beam to obtain high resolution profiles of the poloidal magnetic field. We find current densities in excess of 1 MA/m2 in a 1 to 2 cm region near the peak of the edge pressure gradient. These values are sufficient to challenge edge stability theories based on specific current formation models.
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Affiliation(s)
- D M Thomas
- General Atomics, PO Box 85608, San Diego, California 92186-5608, USA
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Abstract
BACKGROUND Cancer patients are at risk of venous thromboembolism (VTE). Currently, management of these patients is based on studies performed in the general population. AIMS To determine whether the natural history of VTE in cancer patients differs sufficiently from patients in general such that a specific management approach is required. METHODS A retrospective survey was conducted using case records from three tertiary referral hospitals (1993-2001). One hundred and forty-seven VTE patients with cancer and 82 control patients matched for age and gender were followed for a median of 24 months (0-104 months). RESULTS The overall prevalence of cancer among patients with VTE was 19.3% (vs 4% in patients with arterial thromboembolic events). In the follow-up groups, cancer conferred a significantly worse functional status, although other risk factors for VTE were similar. Proximal sites of VTE were twice as common in cancer as in non-cancer patients. The majority of patients in both groups were treated with oral anticoagulants. Complications were more common in cancer patients (40% vs 23%) and occurred more frequently despite apparently adequate anticoagulation. Following VTE, cancer patient survival (median 4.1 months, 127 deaths) was markedly worse than non-cancer patients (median not reached, eight deaths). Thirty-five cancer deaths occurred within 5 weeks of VTE. Eleven deaths in cancer patients were directly related to VTE compared to three in patients without cancer. CONCLUSIONS Cancer patients with VTE fare extremely poorly compared to the general hospital population. Prospective treatment studies, specifically in cancer patients with VTE, are needed.
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Affiliation(s)
- N Cook
- Austin and Repatriation Medical Centre, St Vincent's Hospital, Melbourne, Victoria, Australia
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Thomas DM, Carty SA, Piscopo DM, Lee JS, Wang WF, Forrester WC, Hinds PW. The retinoblastoma protein acts as a transcriptional coactivator required for osteogenic differentiation. Mol Cell 2001; 8:303-16. [PMID: 11545733 DOI: 10.1016/s1097-2765(01)00327-6] [Citation(s) in RCA: 290] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The incidence of osteosarcoma is increased 500-fold in patients who inherit mutations in the RB gene. To understand why the retinoblastoma protein (pRb) is specifically targeted in osteosarcoma, we studied its function in osteogenesis. Loss of pRb but not p107 or p130 blocks late osteoblast differentiation. pRb physically interacts with the osteoblast transcription factor, CBFA1, and associates with osteoblast-specific promoters in vivo in a CBFA1-dependent fashion. Association of pRb with CBFA1 and promoter sequences results in synergistic transactivation of an osteoblast-specific reporter. This transactivation function is lost in tumor-derived pRb mutants, underscoring a potential role in tumor suppression. Thus, pRb functions as a direct transcriptional coactivator promoting osteoblast differentiation, which may contribute to the targeting of pRb in osteosarcoma.
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Affiliation(s)
- D M Thomas
- Department of Pathology and, Harvard Medical School, 200 Longwood Avenue, Boston, MA 02115, USA
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Kuhn DM, Arthur RE, Thomas DM, Elferink LA. Tyrosine hydroxylase is inactivated by catechol-quinones and converted to a redox-cycling quinoprotein: possible relevance to Parkinson's disease. J Neurochem 1999; 73:1309-17. [PMID: 10461926 DOI: 10.1046/j.1471-4159.1999.0731309.x] [Citation(s) in RCA: 147] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Quinone derivatives of DOPA, dopamine, and N-acetyldopamine inactivate tyrosine hydroxylase, the initial and rate-limiting enzyme in the biosynthesis of the catecholamine neurotransmitters. The parent catechols are inert in this capacity. The effects of the catecholquinones on tyrosine hydroxylase are prevented by antioxidants and reducing reagents but not by scavengers of hydrogen peroxide, hydroxyl radicals, or superoxide radicals. Quinone modification of tyrosine hydroxylase modifies enzyme sulfhydryl groups and results in the formation of cysteinyl-catechols within the enzyme. Catecholquinones convert tyrosine hydroxylase to a redox-cycling quinoprotein. Quinotyrosine hydroxylase causes the reduction of the transition metals iron and copper and may therefore contribute to Fenton-like reactions and oxidative stress in neurons. The discovery that a phenotypic marker for catecholamine neurons can be converted into a redox-active species is highly relevant for neurodegenerative conditions such as Parkinson's disease.
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Affiliation(s)
- D M Kuhn
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan 48201, USA
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Jacobson TA, Thomas DM, Morton FJ, Offutt G, Shevlin J, Ray S. Use of a low-literacy patient education tool to enhance pneumococcal vaccination rates. A randomized controlled trial. JAMA 1999; 282:646-50. [PMID: 10517717 DOI: 10.1001/jama.282.7.646] [Citation(s) in RCA: 97] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Pneumococcal immunization rates for elderly and high-risk patients are only one third to one half the target rate of 60% established by the US Public Health Service. Limited or marginal literacy, which affects nearly 100 million Americans, especially the elderly, may contribute to these low rates of immunization. OBJECTIVE To determine whether the use of a simple, low-literacy educational tool enhances patient-physician dialogue about pneumococcal vaccination and increases rates of immunization. DESIGN A randomized controlled trial conducted between May and June of 1998. SETTING Ambulatory care clinic of a 900-bed public teaching hospital serving a predominantly indigent, low-literate, African American, inner-city population. PARTICIPANTS Of 433 patients who presented for routine primary care, had vaccine indications (age > or =65 years or chronic disease), and had not been previously vaccinated, 221 were randomly assigned to the intervention group and 212 to the control group. Of the total patient population (mean age, 63 years), 280 (64.7%) had less than a high school education, 401 (92.6%) were African American, and 300 (69.3%) were female. INTERVENTION One-page, low-literacy (below fifth-grade level) educational handout encouraging patients to "ask your doctor about the pneumonia shot" vs a control group (1 -page, low-literacy educational handout conveying information about nutrition). MAIN OUTCOME MEASURES Vaccination rates (documented by chart audit) of patients who received pneumococcal vaccination and rates of patients who self-reported having discussed vaccination with their physicians. RESULTS Patients in the intervention group were 4 times more likely to have discussed the pneumococcal vaccine with their physicians than patients in the control group (87/221 [39.4%] vs 21/212 [9.9%]; relative risk [RR], 3.97 [95% confidence interval [CI], 2.71-5.83]), and were more than 5 times as likely to have received the pneumococcal vaccine than the control group (44/221 [19.9%] vs 8/212 [3.8%]; RR, 5.28 [95% CI, 2.80-9.93]). In a multivariate analysis controlling for race, sex, education, insurance status, age, level of physician training, health status, and vaccine indication, only assignment to the intervention group was statistically significantly related to the probability of being immunized or discussing the issue with their physicians (P<.001 for both trends). CONCLUSIONS A simple, low-literacy educational tool increased pneumococcal vaccination rates and patient-physician discussions about the vaccine in an elderly, low-literate, indigent, minority population.
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Affiliation(s)
- T A Jacobson
- Department of Medicine, Emory University School of Medicine, Grady Health System, Atlanta, GA 30303, USA.
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Abstract
We present a modified harvesting approach for tragal perichondrium, used in tympanic membrane reconstruction. The technique described avoids amputation of the targus thereby facilitating dissection of the perichondrium from the cartilage as compared to the traditional method. The approach described is technically easier, and removes any potential for cosmetic deformity associated with tragal cartilage amputation and reimplantation. Furthermore, both the anterior tragal perichondrium and the temporalis fascia remain intact if further surgery is required. We recommend this approach for permeatal, tragal perichondrial grafting of small to medium sized tympanic membrane perforations.
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Affiliation(s)
- P A Williamson
- Department of Otorhinolaryngology, Royal Devon and Exeter Hospital, UK
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Abstract
Synaptotagmins (Syts) are a family of vesicle proteins that have been implicated in both regulated neurosecretion and general membrane trafficking. Calcium-dependent interactions mediated through their C2 domains are proposed to contribute to the mechanism by which Syts trigger calcium-dependent neurotransmitter release. Syt IV is a novel member of the Syt family that is induced by cell depolarization and has a rapid rate of synthesis and a short half-life. Moreover, the C2A domain of Syt IV does not bind calcium. We have examined the biochemical and functional properties of the C2 domains of Syt IV. Consistent with its non-calcium binding properties, the C2A domain of Syt IV binds syntaxin isoforms in a calcium-independent manner. In neuroendocrine pheochromocytoma (PC12) cells, Syt IV colocalizes with Syt I in the tips of the neurites. Microinjection of the C2A domain reveals that calcium-independent interactions mediated through this domain of Syt IV inhibit calcium-mediated neurotransmitter release from PC12 cells. Conversely, the C2B domain of Syt IV contains calcium binding properties, which permit homo-oligomerization as well as hetero-oligomerization with Syt I. Our observation that different combinatorial interactions exist between Syt and syntaxin isoforms, coupled with the calcium stimulated hetero-oligomerization of Syt isoforms, suggests that the secretory machinery contains a vast repertoire of biochemical properties for sensing calcium and regulating neurotransmitter release accordingly.
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Affiliation(s)
- D M Thomas
- Department of Biological Sciences, Wayne State University, Detroit, Michigan 48202, USA
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Ferguson GD, Thomas DM, Elferink LA, Herschman HR. Synthesis degradation, and subcellular localization of synaptotagmin IV, a neuronal immediate early gene product. J Neurochem 1999; 72:1821-31. [PMID: 10217258 DOI: 10.1046/j.1471-4159.1999.0721821.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Synaptotagmin IV (Syt IV) is an immediate early gene induced by depolarization in rat PC12 cells and in rat hippocampus. We prepared an antiserum to Syt IV protein. The 46-kDa Syt IV protein is nearly undetectable by western blotting in unstimulated PC12 cells. After depolarization, Syt IV increases rapidly, peaks at 4 h, and decays to near baseline levels by 12 h. Forskolin stimulation also leads to rapid Syt IV protein accumulation. The rate of Syt IV protein synthesis, determined by labeling with radioactive amino acids and immunoprecipitation, is low in unstimulated PC12 cells, but increases over the first 3 h after forskolin stimulation and remains elevated for several hours. Syt IV protein is relatively labile; metabolically labeled Syt IV has a half-life of approximately 2 h in PC12 cells. Sucrose density gradient fractionation and vesicle immunoisolation experiments suggest that Syt IV protein is present in both synaptic-like microvesicles and secretory granules. Vesicles immunoisolated from forskolin-treated PC12 cells with anti-Syt I antibody contain radioactively labeled Syt IV, demonstrating that Syt I and Syt IV colocalize in common vesicles. These results suggest that Syt IV protein, after its stimulation-induced synthesis, is rapidly transported to secretory vesicles where it may transiently modulate the exocytotic machinery.
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Affiliation(s)
- G D Ferguson
- Molecular Biology Institute, Department of Biological Chemistry, UCLA, Los Angeles, California 90095, USA
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Abstract
A significant proportion of patients will be long-term survivors of bone marrow transplantation (BMT) and little is known about their risk of late bony complications. We therefore evaluated bone mineral density (BMD) prior to BMT, post-transplantation changes in BMD, and mechanisms of bone loss in long-term survivors. We performed two analyses. The first was a cross-sectional study of 83 consecutive BMT patients (38 F, 45 M), examining the relationship between BMD and bone turnover, measured immediately prior to transplantation, and a number of disease and patient variables. The second was a prospective study of 39 patients (19F, 20 M) followed for a median of 30 months (range 5-64 months) following either allogeneic (allo, n = 29) or autologous (auto, n = 10) BMT to determine if bone loss was related to treatment of graft versus host disease (GVHD) with glucocorticoids and cyclosporine A, high bone turnover rates, or hypogonadism. Auto BMT recipients acted as a control group for effects of GVHD therapy on BMD. Prior to BMT, spinal and femoral neck (FN) BMDs were 8.6% and 14% lower in female auto BMT recipients than in female allo BMT recipients, respectively (p = 0.12 and p = 0. 003). Urinary bone resorption markers were higher than in normal gender- and age-matched control subjects. Patients treated previously with glucocorticoids also had 8% lower FN BMD. Glucocorticoid-pretreated women with amenorrhoea had lower lumbar spine (LS) and FN BMDs than eumenorrheic women and women receiving HRT. Post-allo BMT, patients lost 11.7% of FN BMD compared with a nonsignificant decrease of 1.1% post-auto BMT (p < 0.001). Spinal BMD and total body bone mineral content (TBBMC) decreased by 3.9% and 3.5%, respectively, post-allo, compared with an increase (1.5%, p = 0.03) or nonsignificant decrease (-3.7%, p = NS), respectively, post-auto BMT. Post-allo BMT bone loss correlated best with the cumulative prednisolone dose at the LS and FN, and with average daily prednisolone dose for TBBMC. At the spine, the rate of bone loss was 4%/10 g of prednisolone, while the rate of bone loss at the FN was greater (9%/10 g of prednisolone). Bone loss was also negatively related to the duration of cyclosporine therapy for GVHD and baseline deoxypyridinoline concentrations. Avascular necrosis of the femoral head occurred in four, and vertebral and rib fractures occurred in one of the allo BMT patients, but in no auto BMT patients. In conclusion, BMT recipients are at risk of osteoporosis secondary to bone loss associated with their underlying illness and/or chemotherapy, particularly in female autograft recipients, and in allograft recipients secondary to GVHD and its treatment.
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Affiliation(s)
- P R Ebeling
- Bone and Mineral Service, The Royal Melbourne Hospital, Victoria, Australia.; Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Victoria, Australia
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Abstract
1. Painstaking progress in drug development is well illustrated by 5-fluorouracil (5FU), originally designed 40 years ago as a fluorinated analogue of the naturally occurring base uracil. Innovative pharmacokinetic and pharmacodynamic strategies have seen significant clinical improvements for cancer patients over the past decade. 2. 5-Fluorouracil acts by three main mechanisms. Principally, the intermediate metabolite fluorodeoxyuridine monophosphate inhibits a key enzyme in pyrimidine biosynthesis, namely thymidylate synthase (TS). Additionally, 5FU is metabolized to ribo- and deoxy-ribonucleotides, which act as false bases for incorporation into RNA and DNA. 3. Biomodulation of 5FU has been attempted with methotrexate (MTX), folinic acid, interferons, cisplatin and radiotherapy. Methotrexate augments the actions of 5FU by inhibiting dihydrofolate reductase and decreasing the folate pool required for pyrimidine biosynthesis, inhibiting TS via MTX-polyglutamate and directly inhibiting purine biosynthesis. Interferons increase steady state concentrations of 5FU. 5-Fluorouracil enhances the cytotoxicity of cisplatin and radiotherapy by inhibiting DNA repair. Folinic acid enhances TS inhibition by increasing the intracellular pool of folates that stabilize the 5FU-TS complex. 4. 5-Fluorouracil has a short plasma half-life. Thymidylate synthase inhibition is limited to the S-phase of the cell cycle and only a small fraction of most cancer cells are in S-phase at any one time. Increased response rates seen with infusional protocols may reflect the effective recruitment of additional mechanisms of cytotoxicity, not dependent on cell cycle, including effects on RNA synthesis. 5. Patients with localized metastatic disease may benefit from locoregional treatments. These include hepatic intra-arterial therapy with related compounds, such as floxuridine, which reach high concentrations at sites of tumour, while systemic toxicities are minimized by efficient hepatic clearance. 6. Recent developments include orally bioavailable formulations, such as ftorafur, capecitabine and the combination of 5FU with the dihydropyrimidine phosphate dehydrogenase inhibitor ethynyluracil. Recognition of diurnal variation in the activity of such key enzymes as DPD has led to the administration of 5FU at regulated, variable infusion rates (chronomodulation). These promising pharmacological approaches may further improve clinical outcomes in common cancers.
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Affiliation(s)
- D M Thomas
- Department of Medical Oncology, Royal Melbourne Hospital, Victoria, Australia
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Abstract
Skeletal growth is the net product of coordinated bone formation and resorption. Insulin is known to stimulate bone formation by actions on osteoblasts. It is not known whether insulin receptors are present on osteoclasts, or whether insulin regulates osteoclastic function. We present here immunocytochemical evidence of insulin receptor expression by mature mono- and multinucleated murine osteoclast-like cells generated in vitro, and in primary neonatal rat and mouse osteoclasts. Radiolabeled studies indicated that progressive enrichment of osteoclast-like cells in coculture was associated with increased insulin binding. When osteoclast-like cells generated in vitro were plated onto dentine slices, insulin dose-dependently inhibited pit formation by up to 80%, suggesting a role for insulin in osteoclast function. These data are consistent with an effect of insulin on bone resorption in addition to those previously recognized on bone formation, actions that together result in net bone growth.
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Affiliation(s)
- D M Thomas
- The University of Melbourne Department of Medicine, St. Vincent's Hospital, Victoria, Australia
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Thomas DM, Mitchell PL, Berlangieri SU, Tochon-Danguy H, Knight S, Clarke CP, Scott AM. Positron emission tomography in assessing response to neoadjuvant chemotherapy for non-small-cell lung cancer. Med J Aust 1998; 169:227. [PMID: 9734584 DOI: 10.5694/j.1326-5377.1998.tb140229.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Van Brocklyn JR, Lee MJ, Menzeleev R, Olivera A, Edsall L, Cuvillier O, Thomas DM, Coopman PJ, Thangada S, Liu CH, Hla T, Spiegel S. Dual actions of sphingosine-1-phosphate: extracellular through the Gi-coupled receptor Edg-1 and intracellular to regulate proliferation and survival. J Cell Biol 1998; 142:229-40. [PMID: 9660876 PMCID: PMC2133030 DOI: 10.1083/jcb.142.1.229] [Citation(s) in RCA: 392] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/1998] [Revised: 05/06/1998] [Indexed: 02/08/2023] Open
Abstract
Sphingosine-1-phosphate (SPP), a bioactive lipid, acts both intracellularly and extracellularly to cause pleiotropic biological responses. Recently, we identified SPP as a ligand for the G protein-coupled receptor Edg-1 (Lee, M.-J., J.R. Van Brocklyn, S. Thangada, C.H. Liu, A.R. Hand, R. Menzeleev, S. Spiegel, and T. Hla. 1998. Science. 279:1552-1555). Edg-1 binds SPP with remarkable specificity as only sphinganine-1-phosphate displaced radiolabeled SPP, while other sphingolipids did not. Binding of SPP to Edg-1 resulted in inhibition of forskolin-stimulated cAMP accumulation, in a pertussis toxin-sensitive manner. In contrast, two well-characterized biological responses of SPP, mitogenesis and prevention of apoptosis, were clearly unrelated to binding to Edg-1 and correlated with intracellular uptake. SPP also stimulated signal transduction pathways, including calcium mobilization, activation of phospholipase D, and tyrosine phosphorylation of p125(FAK), independently of edg-1 expression. Moreover, DNA synthesis in Swiss 3T3 fibroblasts was significantly and specifically increased by microinjection of SPP. Finally, SPP suppresses apoptosis of HL-60 and pheochromocytoma PC12 cells, which do not have specific SPP binding or expression of Edg-1 mRNA. Conversely, sphinganine-1-phosphate, which binds to and signals via Edg-1, does not have any significant cytoprotective effect. Thus, SPP is a prototype for a novel class of lipid mediators that act both extracellularly as ligands for cell surface receptors and intracellularly as second messengers.
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Affiliation(s)
- J R Van Brocklyn
- Department of Biochemistry and Molecular Biology, Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA
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Spiegel S, Cuvillier O, Edsall LC, Kohama T, Menzeleev R, Olah Z, Olivera A, Pirianov G, Thomas DM, Tu Z, Van Brocklyn JR, Wang F. Sphingosine-1-phosphate in cell growth and cell death. Ann N Y Acad Sci 1998; 845:11-8. [PMID: 9668339 DOI: 10.1111/j.1749-6632.1998.tb09658.x] [Citation(s) in RCA: 174] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Recent evidence suggests that branching pathways of sphingolipid metabolism may mediate either apoptotic or mitogenic responses depending on the cell type and the nature of the stimulus. While ceramide has been shown to be an important regulatory component of apoptosis induced by tumor necrosis factor alpha and Fas ligand, sphingosine-1-phosphate (SPP), a further metabolite of ceramide, has been implicated as a second messenger in cellular proliferation and survival induced by platelet-derived growth factor, nerve growth factor, and serum. SPP protects cells from apoptosis resulting from elevations of ceramide. Inflammatory cytokines stimulate sphingomyelinase, but not ceramidase, leading to accumulation of ceramide, whereas growth signals also leading to accumulation of ceramide, whereas growth signals also stimulate ceramidase and sphingosine kinase leading to increased SPP levels. We propose that the dynamic balance between levels of sphingolipid metabolites, ceramide, and SPP, and consequent regulation of different family members of mitogen-activated protein kinases (JNK versus ERK), is an important factor that determines whether a cell survives or dies.
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Affiliation(s)
- S Spiegel
- Department of Biochemistry and Molecular Biology, Georgetown University Medical Center, Washington, DC 20007, USA.
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Thomas DM, Elferink LA. Functional analysis of the C2A domain of synaptotagmin 1: implications for calcium-regulated secretion. J Neurosci 1998; 18:3511-20. [PMID: 9570782 PMCID: PMC6793152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Synaptotagmin 1 is proposed to function as a low affinity calcium sensor for calcium-triggered exocytosis from neural and neuroendocrine cells. Because of the calcium-binding properties of the C2A domain of synaptotagmin 1, calcium-dependent interactions through this domain may modulate neurotransmitter release. We addressed this question by using alanine-scanning mutagenesis to generate a series of mutations within the C2A domain of synaptotagmin 1. The effects of these mutations on synaptotagmin 1 C2A function were analyzed for (1) calcium-dependent phospholipid binding, (2) calcium-dependent binding to syntaxin 1A, a plasma membrane protein critical for vesicle docking or fusion, and (3) calcium-regulated secretion after microinjection into neuroendocrine pheochromocytoma (PC12) cells. Our analyses reveal that a polylysine motif at residues 189-192 confers an inhibitory effect on secretion by recombinant synaptotagmin C2A fragments. The synaptotagmin 1 C2A polylysine motif functions independently of calcium-mediated interactions with phospholipids and syntaxin 1A. Furthermore, alpha-latrotoxin reverses the inhibitory effect of injected recombinant C2A fragments, suggesting that they perturb the cellular calcium-sensing machinery by interfering with synaptotagmin 1 activity in vivo. Our results indicate that novel calcium-independent interactions mediated through the C2A polylysine motif of synaptotagmin 1 function to modulate neurotransmitter release.
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Affiliation(s)
- D M Thomas
- Wayne State University, Department of Biological Sciences, Detroit, Michigan 48202, USA
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Thomas DM, Seymour JF, Szer J, Grigg AP, Basser RL, Green MD, Fox RM. Progress in management of acute myeloid leukaemia (AML) in Australia since 1980: a single institution retrospective study. Aust N Z J Med 1998; 28:190-6. [PMID: 9612527 DOI: 10.1111/j.1445-5994.1998.tb02968.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Much research has been conducted into the pathobiology, diagnosis, and management of acute myeloid leukaemia (AML) since 1980, with major contributions from Australian studies in this period. AIMS To determine whether advances in basic and clinical research into AML have translated into improved survival for patients in the community. METHODS A retrospective survey of records of all patients with AML presenting to the Royal Melbourne Hospital (RMH) over a 16 year period, analysed according to induction therapy and established prognostic factors. Between 1980 and December 1996 223 (98%) of 227 patients were evaluable. RESULTS The probability of survival at five years for patients treated since 1990 has improved significantly compared to the cohort treated between 1980-89 (34 +/- 5% vs 4 +/- 2%; mean +/- standard error). This benefit is most evident in patients less than 60 years of age (50 +/- 7% vs 11 +/- 4%). Successive induction protocols in the context of clinical trials conducted since 1985 contributed to improved outcomes. The selective application of bone marrow transplantation, and use of retinoic acid as induction therapy for acute promyelocytic leukaemia has also improved survival. Despite increases in dose-intensity, early death rates for patients undergoing induction therapy fell during the study period. CONCLUSIONS Participation in clinical and basic research with the development of more intense and specific treatments for patients with AML has contributed to better outcomes, underpinned by improvements in supportive care.
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Affiliation(s)
- D M Thomas
- Royal Melbourne Hospital, Department of Haematology and Medical Oncology, Parkville, Vic
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Thomas DM, Seymour JF, Griffiths JD, Szer J, Grigg AP. Prolonged disease-free survival with specific re-induction therapy in acute myeloid leukaemia relapsing following bone marrow transplantation. Aust N Z J Med 1997; 27:712-3. [PMID: 9483245 DOI: 10.1111/j.1445-5994.1997.tb01009.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Toro PA, Passero Rabideau JM, Bellavia CW, Daeschler CV, Wall DD, Thomas DM, Smith SJ. Evaluating an intervention for homeless persons: results of a field experiment. J Consult Clin Psychol 1997. [PMID: 9170771 DOI: 10.1037//0022-006x.65.3.476] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
An intensive case management intervention for homeless persons was evaluated by random assignment of 202 cases (involving 213 adults and 70 children) to the intervention or a control group. Full follow-up data (4 interviews: at baseline and at 6-, 12-, and 18-month follow-ups) were available on 98 cases (105 adults and 37 children). The follow-up rates for the 2 groups were not significantly different. Based on 13 repeated measures analyses, there were 3 statistically significant linear time effects (indicating overall change across the follow-up period) and 3 linear Time x Condition interactions (indicating differential change over time for intervention vs. control participants). Regardless of condition, adult participants improved in terms of their experience of homelessness, as well as on physical health symptoms and stressful life events. Condition x Time interactions indicating positive intervention impact were observed on the quality of housing environments, stressful life events, and interviewer ratings of psychopathology.
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Affiliation(s)
- P A Toro
- Department of Psychology, Wayne State University, Detroit Michigan 48202, USA
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