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Lew A, Berghmans T, Andratschke N, Dempsey C, Flackett L, Leonetti G, Koller M, Faivre-Finn C. 174TiP PRIMALung (EORTC-1901): Prophylactic cerebral irradiation or active brain magnetic resonance imaging surveillance in small cell lung cancer patients. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00428-8] [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: 04/03/2023]
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Layton JB, Forns J, McQuay LJ, Danysh HE, Dempsey C, Anthony MS, Turner ME. Mortality in Patients with Parkinson's Disease-Related Psychosis Treated with Pimavanserin Compared with Other Atypical Antipsychotics: A Cohort Study. Drug Saf 2023; 46:195-208. [PMID: 36517664 PMCID: PMC9883317 DOI: 10.1007/s40264-022-01260-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Accepted: 11/22/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Pimavanserin is approved in the USA to treat hallucinations and delusions associated with Parkinson's disease psychosis (PDP). OBJECTIVES We evaluated mortality in patients with PDP after initiation of pimavanserin or comparator atypical antipsychotics, overall, over time, and across subgroups. METHODS A cohort of patients aged ≥65 years in the USA with PDP newly initiating pimavanserin or a comparator atypical antipsychotic (clozapine, quetiapine, risperidone, olanzapine, aripiprazole, brexpiprazole) was identified in 2016-2019 Medicare claims data. All-cause mortality in the propensity score-matched treatment groups was compared with hazard ratios (HRs) and 95% confidence intervals (CIs) estimated with Cox-proportional hazards models. Cumulative incidence curves and time period-specific models evaluated risk over time. Subgroup and sensitivity analyses were performed, including a sub-cohort of long-term care (LTC) or skilled nursing facility (SNF) residents. RESULTS We identified 2892 pimavanserin initiators and 19,083 comparator initiators (overall 47% female, mean age = 80.9 years, LTC/SNF residents = 30%). Before matching, pimavanserin users had fewer severe comorbidities and more anti-Parkinson medication use than comparators. Matching resulted in 2891 patients in both groups, and all covariates were well balanced. In the matched cohort, the HR for mortality for pimavanserin versus comparator was 0.78 (95% CI 0.67-0.91), with the lowest time period-specific HRs in the first 180 days. Hazard ratios were similar across sensitivity analyses and subgroups. In LTC/SNF residents, the HR was 0.78 (95% CI 0.60-1.01). CONCLUSION The observed mortality rates were lower among patients treated with pimavanserin compared with those treated with other atypical antipsychotics. STUDY REGISTRATION European Union Post-authorization Study (EU PAS) register number 46331.
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Affiliation(s)
- J. Bradley Layton
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC 27709-2194 USA
| | - Joan Forns
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
| | - Lisa J. McQuay
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC 27709-2194 USA
| | - Heather E. Danysh
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Waltham, MA USA
| | - Colleen Dempsey
- Drug Safety and Pharmacovigilance, Acadia Pharmaceuticals Inc, Princeton, NJ USA
| | - Mary S. Anthony
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, 3040 East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC 27709-2194 USA
| | - Mary Ellen Turner
- Drug Safety and Pharmacovigilance, Acadia Pharmaceuticals Inc, Princeton, NJ USA
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Forns J, Danysh HE, McQuay LJ, Turner ME, Dempsey C, Anthony MS, Demos G, Layton JB. Clinical outcomes and treatment patterns of older adults with dementia-related psychosis by dementia type in the United States. BMC Geriatr 2022; 22:784. [PMID: 36203129 PMCID: PMC9541053 DOI: 10.1186/s12877-022-03489-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/28/2022] [Indexed: 11/28/2022] Open
Abstract
Background Little is known about the incidence of clinical events and treatment patterns among older adults with dementia-related psychosis. Given that dementia-related psychosis comprises various dementia types, this study describes the incidence of clinical events and treatment patterns by dementia type after patients with dementia are diagnosed with psychosis. Methods Adults aged ≥ 65 years with dementia and newly diagnosed with psychosis were identified in US Medicare claims during 2013–2018. Baseline characteristics were evaluated at the time of the psychosis diagnosis. After the initial psychosis diagnosis, incidence rates (IRs) of clinical events (e.g., falls/fractures, infections, healthcare utilization), mortality, and patterns of antipsychotic treatment were described for each dementia type (Alzheimer’s disease [AD], Parkinson’s disease dementia [PDD], dementia with Lewy bodies [DLB], frontotemporal dementia [FTD], vascular dementia [VD], and unspecified dementia). Daily mean cumulative counts were estimated to describe the incidence of recurrent events over time. Mortality was described using Kaplan–Meier survival curves. Results We identified 484,520 patients with dementia-related psychosis: mean age, 84 years (standard deviation, 7.8); female, 66%. At the time of psychosis diagnosis, the most prevalent type of dementia was unspecified dementia (56%), followed by AD (31%), VD (12%), PDD (10%), DLB (3%), and FTD (< 1%), and most patients had scores indicating severe illness on the Charlson Comorbidity Index (71%) and frailty index (62%). Across all dementia types, IRs (per 100 person-years) were high for emergency department visits, oral anti-infective use, and urinary tract infections after the initial psychosis diagnosis. Patients with DLB had the highest incidence of most clinical outcomes. After 1 year of follow-up, the cumulative probability of death was about 30% for all dementia types, and after 5 years, was about 80% among patients with DLB, VD, AD, or PDD and about 60%-65% among patients with FTD or unspecified dementia. Conclusions Patients with dementia-related psychosis had a high burden of comorbidities, frailty, emergency department visits, infections, and death. Specifically, after DRP diagnosis, patients with DLB and VD had the highest burden of clinical events of interest. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03489-3.
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Affiliation(s)
- Joan Forns
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain.
| | - Heather E Danysh
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Waltham, MA, USA
| | - Lisa J McQuay
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Research Triangle Park, NC, USA
| | - Mary Ellen Turner
- Drug Safety and Pharmacovigilance, ACADIA Pharmaceuticals Inc, Princeton, NJ, USA
| | - Colleen Dempsey
- Drug Safety and Pharmacovigilance, ACADIA Pharmaceuticals Inc, Princeton, NJ, USA
| | - Mary S Anthony
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Research Triangle Park, NC, USA
| | - George Demos
- Drug Safety and Pharmacovigilance, ACADIA Pharmaceuticals Inc, San Diego, CA, USA
| | - J Bradley Layton
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Research Triangle Park, NC, USA
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Greer P, Dempsey C, Kaur G, Zwan B, Kandasamy K, Calvo-Ortega J, Ostwald P. OC-0618 Comprehensive 3D verification of SRS treatments with virtual spherical phantom EPID dosimetry. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02640-8] [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: 10/18/2022]
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5
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Yorke A, Hunthausen N, Paly J, Carter R, Yang F, Jhingran A, Della Biancia C, Dempsey C, Shulman A, Ford E, Li B. Needs and Strengths Assessment for Radiotherapy Centers in Africa Transitioning to IMRT. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1052] [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: 11/26/2022]
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Chesny DL, Orange NB, Dempsey C. Method for creating a three-dimensional magnetic null point topology with an accurate spine axis. Rev Sci Instrum 2021; 92:054710. [PMID: 34243277 DOI: 10.1063/5.0033786] [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: 10/19/2020] [Accepted: 05/04/2021] [Indexed: 06/13/2023]
Abstract
Three-dimensional magnetic null points (3D nulls) are sites of dynamic activity in a wide range of naturally-occurring and laboratory plasma environments. The topology of a 3D null is defined by a two-dimensional fan plane of radial field lines and a one-dimensional, collimated spine axis. Here, we build on previous work that was able to form an extended 3D null topology using an assembly of circular conducting coils, with each coil carrying a constant current. While that magnetic field design decayed from the mathematically pure form away from the central null, this paper introduces an algorithm for modulating the current through each coil to form a more mathematically pure spine axis along the entirety of the coil assembly. By the method of solving an inverse problem, we demonstrate that unique currents exist for any arbitrary distribution of axially-aligned circular coils for creating an accurate spine axis in a 3D null topology. Tests of this algorithm are performed on spherical, cylindrical, and cone-shaped coil assemblies. Vector magnetic field mapping of these small-scale demonstrators verifies that an accurate spine axis is maintained along the entire central axis of the coil assemblies. The magnetic field accuracy is roughly maintained along the fan plane but decays strongly toward the outer extents of the coils. The inverse method presented here is not limited to 3D null topologies but can be adapted to match any theoretical form of the magnetic field along a single axis.
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Affiliation(s)
- D L Chesny
- Department of Research & Development, SpaceWave, LLC, Satellite Beach, Florida 32937, USA
| | - N B Orange
- Department of Research & Development, SpaceWave, LLC, Satellite Beach, Florida 32937, USA
| | - C Dempsey
- Department of Research & Development, OrangeWave Innovative Science, LLC, Moncks Corner, South Carolina 29461, USA
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Forns J, Layton JB, Bartsch J, Turner ME, Dempsey C, Anthony M, Ritchey ME, Demos G. Increased risk of falls and fractures in patients with psychosis and Parkinson disease. PLoS One 2021; 16:e0246121. [PMID: 33503061 PMCID: PMC7840029 DOI: 10.1371/journal.pone.0246121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 01/10/2021] [Indexed: 12/16/2022] Open
Abstract
Objective Evaluate whether the risk of falls and fractures differs between patients with Parkinson disease with psychosis (PDP) and patients with Parkinson disease (PD) without psychosis at similar disease stages. Methods Patients with PD without psychosis were identified in the Medicare claims databases (2008–2018) and followed from the first PD diagnosis date during the study period. Patients with a subsequent diagnosis of psychosis were included in the PDP group. Patients with PDP and PD without psychosis were propensity score-matched based on characteristics within blocks of time since cohort entry. The incidence rates (IRs), expressed per 100 person-years, and 95% confidence intervals (CIs) of falls and fractures were evaluated as composite and separate outcomes. Incidence rate ratios (IRRs) were used to compare patients with PDP and PD without psychosis in the matched cohort. Results 154,306 patients had PD without psychosis and no falls or fractures before cohort entry; the IR for falls and fractures was 11.41 events (95% CI, 11.29–11.53). 12,127 patients (7.8%) had a subsequent PDP diagnosis. PDP patients had a higher prevalence of most comorbidities and risk factors for falls and fractures than those without psychosis. The crude IR for falls and fractures among PDP patients was 29.03 events (95% CI, 28.27–29.81). PD without psychosis and PDP groups had more falls than fractures. After matching, 24,144 PD patients without psychosis (15.6%) and 12,077 PDP patients (99.6%) were retained. Matched PDP patients had a higher incidence of falls and fractures than PD patients without psychosis (IRR = 1.44; 95% CI, 1.39–1.49). The higher increased rate was noted separately for falls (IRR = 1.48; 95% CI, 1.43–1.54) and any fractures (IRR = 1.17; 95% CI, 1.08–1.27) as well as within specific types of fracture, including pelvis and hip fractures. Conclusions Our findings suggest a modest but consistently higher increased risk of falls and fractures in PDP patients compared with PD patients without psychosis.
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Affiliation(s)
- Joan Forns
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
- * E-mail:
| | - J. Bradley Layton
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Research Triangle Park, North Carolina, United States of America
| | - Jennifer Bartsch
- Biometrics, RTI Health Solutions, Research Triangle Park, North Carolina, United States of America
| | - Mary Ellen Turner
- ACADIA Pharmaceuticals Inc., San Diego, California, United States of America
| | - Colleen Dempsey
- ACADIA Pharmaceuticals Inc., San Diego, California, United States of America
| | - Mary Anthony
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Research Triangle Park, North Carolina, United States of America
| | - Mary E. Ritchey
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Research Triangle Park, North Carolina, United States of America
| | - George Demos
- ACADIA Pharmaceuticals Inc., San Diego, California, United States of America
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Seow TXF, Benoit E, Dempsey C, Jennings M, Maxwell A, McDonough M, Gillan CM. A dimensional investigation of error-related negativity (ERN) and self-reported psychiatric symptoms. Int J Psychophysiol 2020; 158:340-348. [PMID: 33080287 PMCID: PMC7612131 DOI: 10.1016/j.ijpsycho.2020.09.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 11/07/2019] [Revised: 08/05/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022]
Abstract
Alterations in error processing are implicated in a range of DSM-defined psychiatric disorders. For instance, obsessive-compulsive disorder (OCD) and generalised anxiety disorder show enhanced electrophysiological responses to errors-i.e. error-related negativity (ERN)-while others like schizophrenia have an attenuated ERN. However, as diagnostic categories in psychiatry are heterogeneous and also highly intercorrelated, the precise mapping of ERN enhancements/impairments is unclear. To address this, we recorded electroencephalograms (EEG) from 196 participants who performed the Flanker task and collected scores on 9 questionnaires assessing psychiatric symptoms to test if a dimensional framework could reveal specific transdiagnostic clinical manifestations of error processing dysfunctions. Contrary to our hypothesis, we found non-significant associations between ERN amplitude and symptom severity of OCD, trait anxiety, depression, social anxiety, impulsivity, eating disorders, alcohol addiction, schizotypy and apathy. A transdiagnostic approach did nothing to improve signal; there were non-significant associations between all three transdiagnostic dimensions (anxious-depression, compulsive behaviour and intrusive thought, and social withdrawal) and ERN magnitude. In these same individuals, we replicated a previously published transdiagnostic association between goal-directed learning and compulsive behaviour and intrusive thought. Possible explanations discussed are (i) that associations between the ERN and psychopathology might be smaller than previously assumed, (ii) that these associations might depend on a greater level of symptom severity than other transdiagnostic cognitive biomarkers, or (iii) that task parameters, such as the ratio of compatible to incompatible trials, might be crucial for ensuring the sensitivity of the ERN to clinical phenomena.
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Affiliation(s)
- T X F Seow
- School of Psychology, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
| | - E Benoit
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - C Dempsey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - M Jennings
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - A Maxwell
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - M McDonough
- St. Patrick's University Hospital, Dublin, Ireland
| | - C M Gillan
- School of Psychology, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Barry R, Dempsey C, Barry L, Hooton C, O' Connor A, Reynolds C, Cremin M, Felsenstein SF, Cunney R, Dean J, Corcoran GD. On-site Multiplex PCR for CSF diagnostics in an Acute Hospital versus Referral to Reference Laboratories: Assessing Economic Factors, Length of Stay and Antimicrobial Stewardship. J Infect 2020; 82:414-451. [PMID: 33039500 DOI: 10.1016/j.jinf.2020.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 11/25/2022]
Affiliation(s)
- R Barry
- Department of Clinical Microbiology, Cork University Hospital, Wilton Road, Cork, Ireland
| | - C Dempsey
- Department of Clinical Microbiology, Cork University Hospital, Wilton Road, Cork, Ireland
| | - L Barry
- Department of Clinical Microbiology, Cork University Hospital, Wilton Road, Cork, Ireland
| | - C Hooton
- Department of Clinical Microbiology, Cork University Hospital, Wilton Road, Cork, Ireland
| | - A O' Connor
- Department of Clinical Microbiology, Cork University Hospital, Wilton Road, Cork, Ireland
| | - C Reynolds
- Department of Paediatrics, Cork University Hospital, Wilton Road, Cork, Ireland
| | - M Cremin
- Department of Paediatrics, Cork University Hospital, Wilton Road, Cork, Ireland
| | - S F Felsenstein
- Department of Paediatrics, Cork University Hospital, Wilton Road, Cork, Ireland
| | - R Cunney
- Irish Meningitis and Sepsis Reference Laboratory, Temple Street Children's University Hospital, Temple Street, Rotunda, Dublin 1, Ireland
| | - J Dean
- National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
| | - G D Corcoran
- Department of Clinical Microbiology, Cork University Hospital, Wilton Road, Cork, Ireland
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Johnston TE, Dempsey C, Gilman F, Tomlinson R, Jacketti AK, Close J. Physiological Factors of Female Runners With and Without Stress Fracture Histories: A Pilot Study. Sports Health 2020; 12:334-340. [PMID: 32525466 PMCID: PMC7787571 DOI: 10.1177/1941738120919331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Female runners are at increased risk of stress fractures (SFs) compared with men. Literature is lacking with regard to best practice for preventing and treating SFs in women. The purpose of the study was to compare physiological measures and running-related factors between women of various ages and running abilities with and without a history of running-related SFs. HYPOTHESIS Women with and without SF histories will differ with regard to medical and menstrual history, bone health, body composition, nutrition, and running history. STUDY DESIGN Prospective cohort study. LEVEL OF EVIDENCE Level 2. METHODS A total of 20 female runners with SF histories were matched based on age and running distance with 20 women without SF histories. Data included medical, menstrual, running, injury, and nutritional histories; blood histology related to nutritional, hormonal, and bone-related risk factors; and bone density, fat, and lean tissue using dual energy x-ray absorptiometry. Paired t tests were used to examine differences between women with and without SF histories, and Spearmen correlations were conducted to examine relationships between physiological factors. RESULTS Women with SF histories had lower hip bone mineral density compared with women without SF histories (P < 0.05). SF history was moderately correlated with menstrual changes during increased training times (r = 0.580; P < 0.0001) but was not correlated with any other physiological factor. There was a moderate correlation within the SF group (r = 0.65; P = 0.004) for bone markers for resorption and formation both increasing, indicating increased bone turnover. CONCLUSION Female runners with low hip bone mineral density, menstrual changes during peak training, and elevated bone turnover markers may be at increased risk of SF. CLINICAL RELEVANCE Female runners need routine screening for risks associated with SF occurrence. As bone mineral density and bone turnover markers are not routinely assessed in this population, important risk factors may be missed.
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Affiliation(s)
| | | | | | | | | | - Jeremy Close
- Thomas Jefferson University, Philadelphia, Pennsylvania
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11
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Cao N, Kalet A, Fang L, Dempsey C, Young L, Kim J, Mayr N, Lavilla M, Richardson H, McClure R, Meyer J. SU-G-TeP1-11: Predictors of Cardiac and Lung Dose Sparing in DIBH for Left Breast Treatment. Med Phys 2016. [DOI: 10.1118/1.4957001] [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: 11/07/2022] Open
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12
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Kalet A, Richardson H, Cao N, Meyer J, Dempsey C. SU-F-T-501: Dosimetric Comparison of Single Arc-Per-Beam and Two Arc-Per-Beam VMAT Optimization in the Monaco Treatment Planning System. Med Phys 2016. [DOI: 10.1118/1.4956686] [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: 11/07/2022] Open
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13
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Lapuz C, Simpson P, Dempsey C. Determination of Standardized Objective and Constraint Settings for Inverse Planning Using IPSA and HIPO for HDR Brachytherapy Multichannel Vaginal Cylinders. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Dempsey C, Govindarajulu G, Sridharan S, Dempsey S, Capp A, O'Brien P. The Changing Nature of HDR Brachytherapy for Cervix Cancer: How the Clinical Target Volume Affects the Historical Prescription Dose. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1480] [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: 11/29/2022]
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15
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Dempsey C, Simpson P, Lapuz C. EP-1925: Dosimetric comparison of multi-channel gynaecological cylinders using IPSA and HIPO optimisation methods. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)32043-0] [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: 10/23/2022]
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16
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Pogson E, McNamara J, Jameson M, McDowall R, Lim A, Dempsey C, Metcalfe P, Holloway L. SU-E-J-213: An Evaluation of the Reproducibility of Radiotherapy Contouring Utilizing Multiple Institutions and Treatment Planning Systems. Med Phys 2013. [DOI: 10.1118/1.4814425] [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: 11/07/2022] Open
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Bostanci Z, Dempsey C, Soybel DI, Kelleher SL. Marginal zinc deficiency impairs ductal growth and alveologenesis in mammary glands leading to compromised secretory function. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.122.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Zeynep Bostanci
- Nutritional SciencesThe Pennsylvania State UniversityUniversity ParkPA
- SurgeryThe Pennsylvania State UniversityHersheyPA
| | - Colleen Dempsey
- Nutritional SciencesThe Pennsylvania State UniversityUniversity ParkPA
| | - David I Soybel
- Nutritional SciencesThe Pennsylvania State UniversityUniversity ParkPA
- SurgeryThe Pennsylvania State UniversityHersheyPA
| | - Shannon L Kelleher
- Nutritional SciencesThe Pennsylvania State UniversityUniversity ParkPA
- SurgeryThe Pennsylvania State UniversityHersheyPA
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Lapuz C, Dempsey C, O'Brien P. PO-238 DOSIMETRIC COMPARISON OF OPTIMISATION METHODS FOR MULTICHANNEL INTRACAVITARY VAGINAL BRACHYTHERAPY. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72204-1] [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: 10/28/2022]
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19
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Dempsey C, McCormick NH, Croxford TP, Seo YA, Grider A, Kelleher SL. Marginal maternal zinc deficiency in lactating mice reduces secretory capacity and alters milk composition. J Nutr 2012; 142:655-60. [PMID: 22357740 PMCID: PMC3301987 DOI: 10.3945/jn.111.150623] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [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] [Received: 08/22/2011] [Revised: 09/16/2011] [Accepted: 12/27/2011] [Indexed: 11/14/2022] Open
Abstract
Dietary analysis predicts that marginal Zn deficiency is common in women of reproductive age. The lack of reliable biomarkers limits the capacity to assess Zn status and consequently understand effects of maternal Zn deficiency. We determined effects of marginal maternal Zn deficiency on mammary gland function, milk secretion, and milk composition in mice. Mice (n = 12/diet) were fed marginal (ZD; 15 mg Zn/kg diet) or adequate (ZA; 30 mg Zn/kg diet) Zn diets for 30 d prior to conception through mid-lactation. Mice fed the ZD had a higher plasma Zn concentration (~20%; P < 0.05) but lower milk Zn concentration (~15%; P < 0.05) compared with mice fed the ZA. ZnT2 abundance was higher (P < 0.05) in mice fed the ZD compared with mice fed the ZA; no effect on ZnT4 abundance was detected. The Zn concentration of mammary gland mitochondria tended to be ~40% greater in mice fed ZD (P = 0.07); this was associated with apoptosis and lower milk secretion (~80%; P < 0.01). Total milk protein was ~25% higher (P < 0.05), although the abundance of the major milk proteins (caseins and whey acidic protein) was lower (P < 0.05) in mice fed the ZD. Proteomic analysis of milk proteins revealed an increase (P < 0.05) in four proteins in mice fed the ZD. These findings illustrate that marginal maternal Zn deficiency compromises mammary gland function and milk secretion and alters milk composition. This suggests that lactating women who consume inadequate Zn may not produce and/or secrete an adequate amount of high quality milk to provide optimal nutrition to their developing infant.
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Affiliation(s)
| | | | | | | | - Arthur Grider
- Department of Foods and Nutrition, University of Georgia, Athens, GA
| | - Shannon L. Kelleher
- Department of Nutritional Sciences
- Department of Surgery, and
- Department of Cell and Molecular Physiology, The Pennsylvania State University, University Park, PA; and
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Dempsey C, Lapuz C, O'Brien P, Capp A. 637 poster DOSIMETRY OF SINGLE, MULTI-CHANNEL INTRACAVITARY AND INTERSTITIAL HDR BRACHYTHERAPY USING 3D INVERSE PLANNING. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70759-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Garden A, Chen A, Curran W, Harari P, Murphy B, Wong S, Schwartz M, Dawson D, Dempsey C, Ang K. Longitudinal Oncology Registry of Head and Neck Carcinoma (LORHAN): Preliminary Report Regarding Radiation Patterns of Care. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1305] [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: 11/28/2022]
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Abstract
This study aims to determine the in vitro susceptibility of Helicobacter pylori to clarithromycin, metronidazole, amoxycillin and tetracycline, the four antibiotics commonly used in eradication therapies. These data are used to evaluate the efficacy of current empiric treatment of H. pylori infection in the Southern Region of Ireland. Culture is performed on gastric biopsy samples obtained from 147 consecutive patients undergoing gastroscopy for investigation of dyspepsia. Susceptibility testing to metronidazole, clarithromycin, amoxycillin and tetracycline is performed on the isolates by Etest. Isolates demonstrating clarithromycin resistance are subjected to polymerase chain reaction (PCR) amplification and nucleotide sequence analysis to identify the presence of point mutations in the peptidyltransferase region of the 23S rRNA gene previously associated with resistance to clarithromycin. Prevalence of H. pylori in the population studied was 31% (45 isolates). Antimicrobial resistance to metronidazole and clarithromycin was detected in nine (20%) and four (8.9%) of the isolates, respectively. A single isolate demonstrated co-resistance to metronidazole and clarithromycin (2.2%). No resistance was detected to either amoxycillin or tetracycline. The low level of resistance demonstrated among this group of isolates indicates that the empiric treatment currently in place in the Southern Region of Ireland is likely to be successful.
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Affiliation(s)
- C Hooton
- Department of Microbiology, Cork University Hospital, Ireland.
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Kempe A, Luberti AA, Hertz AR, Sherman HB, Amin D, Dempsey C, Chandramouli V, MacKenzie T, Hegarty TW. Delivery of pediatric after-hours care by call centers: a multicenter study of parental perceptions and compliance. Pediatrics 2001; 108:E111. [PMID: 11731638 DOI: 10.1542/peds.108.6.e111] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [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: 11/24/2022] Open
Abstract
BACKGROUND Despite the rapid growth of centralized call centers to provide after-hours triage to patients of multiple providers, little is known about the perceptions of parents regarding this type of care and their compliance with triage disposition recommendations. DESIGN/METHODS From August through September 1999, randomized samples of after-hours calls were selected each day from computerized records at 4 pediatric call centers at 1) Children's Hospital, Denver, Colorado; 2) Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; 3) Rainbow Babies and Children's Hospital, Cleveland, Ohio; and 4) All Children's Hospital, St Petersburg, Florida. All participating call centers use the same triage software. Calls were randomly selected to yield at least 250 callers with nonurgent dispositions and 100 with urgent dispositions from each site. Telephone surveys to callers were conducted by an external survey unit 3 to 7 days after the call to the call center. RESULTS Surveys were completed for 70.5% of those sampled (N = 1561). Parents indicated they were very satisfied or satisfied with aspects of care received from 92.6% (waiting time) to 99.4% (nurse courteousness) of the time. Satisfaction did not differ by site or by recommended disposition of the index call. Most parents (65.2%) reported no preference about speaking with a physician or nonphysician for after-hours care, whereas 27.7% preferred to speak with a physician. Usually speaking with a physician during office hours (odds ratio [OR]: 1.48), feeling it was important that provider knows child's medical history (OR: 3.47), and respondent having an educational level of college graduate or higher (OR: 1.30) were significant predictors of preferring to speak with a physician. Of the 37.0% (N = 723) of parents who reported any change in their relationship with their primary provider as a result of the after-hours call center, 95.7% (N = 691) assessed the change to be positive. Reported compliance with the call center disposition recommendation was 83.3% for urgent referral, 41.0% for next day, 4.5% for visit at a later time, and 78.2% for home care. The major reason given by parents for noncompliance was reporting that they heard a different disposition (76.9% for urgent to 100% for visit at a later time). CONCLUSIONS Parental satisfaction with pediatric call centers was uniformly high in 4 different geographic locations, and almost all parents who reported any effect on their relationship with their primary provider assessed it as positive. Compliance with recommendations for urgent evaluation or home care was relatively high but for intermediary dispositions was low. In most cases in which noncompliance occurred, parents reported hearing a different disposition. Additional study is needed to clarify whether noncompliance, especially in cases in which an urgent recommendations was made, is attributable to poor nurse communication of the recommended disposition, parental misinterpretation, or parental difference of opinion.
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Affiliation(s)
- A Kempe
- Department of Pediatrics at University of Colorado Health Sciences Center and Children's Hospital, Denver, Colorado 80218, USA.
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Brown H, Dempsey C. Choosing the right insulin regimen for optimum control. Community Nurse 2000; 6:13-6. [PMID: 11982142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- H Brown
- Worthing Diabetes Centre, West Sussex
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Kempe A, Dempsey C, Hegarty T, Frei N, Chandramouli V, Poole SR. Reducing after-hours referrals by an after-hours call center with second-level physician triage. Pediatrics 2000; 106:226-30. [PMID: 10888697] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES One-third of practices signing-out to The Children's Hospital Call Center in Denver, Colorado, choose to do second-level physician (SLP) triage for calls judged by the Center to require after-hours referral (AHR). We examined: 1) the effect of SLP triage on the rate of AHRs and 2) reasons for physicians' decisions. DESIGN From January 1998 to August 1998 all calls from patients using a 5-member suburban pediatric practice judged by the Call Center to require AHR were referred to the practice's on-call physician who did SLP triage and completed a questionnaire. RESULTS There were 955 eligible calls, 22% (N = 216) of which were initially given an urgent disposition by Call Center nurses. Physician questionnaires were completed for 97% (N = 209). Of patients initially triaged for AHR, 49% (N = 103) were subsequently given an AHR, 17% (N = 35) a next day office referral, and 34% (N = 71) home care and advice. Reasons for not urgently referring included the following: 1) medical problem didn't require urgent evaluation (95%, N = 99); 2) change in the patient's condition; (40% N = 43); 3) prior knowledge of family's ability to evaluate and care for the patient (40%, N = 43); and 4) knowledge of the patient's medical history (18%, N = 19). After SLP triage the overall urgent referral rate was 11%. CONCLUSIONS Signing out to a Call Center decreased physicians' after-hours calls by 77% and SLP triage halved the number of urgent after-hours referrals.
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Affiliation(s)
- A Kempe
- Department of Pediatrics and Preventive Medicine and Biometrics, University of Colorado Health Sciences Center and Children's Hospital, Denver, Colorado, USA.
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Kempe A, Dempsey C, Whitefield J, Bothner J, MacKenzie T, Poole S. Appropriateness of urgent referrals by nurses at a hospital-based pediatric call center. Arch Pediatr Adolesc Med 2000; 154:355-60. [PMID: 10768672 DOI: 10.1001/archpedi.154.4.355] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To evaluate (1) the appropriateness of the after-hours referral (AHR), (2) clinical characteristics of urgently referred patients, and (3) parental compliance with disposition recommendations by the After-Hours Call Center of the Children's Hospital, Denver, Colo. SUBJECTS Patients of Denver, Colo, pediatricians who called after office hours were triaged by nurses using a computerized triage system, and were referred for after-hours evaluation to 1 of 5 urgent care sites (N = 409). DESIGN Data were collected at each site for 2-week periods every 3 months, from October 1996 to October 1997 (total study period, 10 weeks). Appropriateness of AHRs (diagnoses, clinical interventions, and final dispositions) were determined by a questionnaire that was completed by the evaluating physician. Parental compliance with the AHR was assessed by review of the after-hours site patient database and by telephone survey. RESULTS Of the referred patients, 339 (82.9%) complied with the recommendation for AHR and, of these, physician questionnaires were completed for 332 (97.9%). The mean percentage of evaluated patients judged appropriate was 90.7% and did not differ statistically by site or by physician training. A history indicating a potentially serious condition was the most common reason for judging a referral appropriate (80.1%), followed by patient discomfort (53.3%), findings from a physical examination (42.5%), parental anxiety (41.5%), and an urgent need for diagnostic test or therapy (34.7%). Of evaluated patients, 37.0% had a diagnostic test, and in 43.5% of cases, the evaluating physician thought a therapeutic intervention was necessary that night. Of the total sample, 93.4% were discharged and 6.6% were admitted to the hospital. The major reasons given by families for noncompliance were lack of understanding of the disposition recommendation and disagreement with the need for urgent referral. CONCLUSIONS Approximately 90% of patients who complied with a referral for urgent evaluation by the After-Hours Call Center were judged by the evaluating physician to have been appropriately referred. The appropriateness rate for all referrals may be lower if there is significant self-selection in those families who do not comply.
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Affiliation(s)
- A Kempe
- Department of Pediatrics, University of Colorado Health Sciences Center, Denver, USA
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Abstract
OBJECTIVE To examine the utilization, satisfaction, and parental health-seeking behavior associated with the introduction of the Parent Advice Line (PAL), a collection of 278 recorded health-related messages accessible by telephone, into a private practice. DESIGN Booklets listing PAL topics were mailed to eligible families, and utilization data were collected for all incoming PAL calls from June to August 1996. Satisfaction and effect on health-seeking behavior were assessed using a recorded questionnaire appended to each call (n = 561) and a randomized telephone questionnaire (n = 821). SETTING A suburban, 7-pediatrician practice in Colorado. PATIENTS Families with children younger than 12 years seen in the practice within 2 years (N = 8365). RESULTS Of families who reported receiving the mailed PAL booklet, 32% used PAL. Sixty percent of PAL calls were placed during office hours, 21% from 5 PM to 9 PM, and 8% after midnight; call volume was higher on weekdays than on weekend days (25 calls per day vs 10 calls per day, respectively; P<.05 by chi2 test). The 5 most commonly requested topic categories were toilet training, sexual development, discipline problems, sleep problems, and teenage behavior. Preventive care topics predominated in infants, behavioral topics in preschool children, and acute illness topics in school-aged children. Of users, 88% were satisfied or very satisfied and 98% said that they would use PAL again. Respondents to the 2 questionnaires reported that use of PAL made a call or visit to their child's physician unnecessary 58% to 69% and 61% to 70% of the time, respectively. CONCLUSIONS The PAL was used primarily to access information about behavioral and developmental issues during office hours. Its use was associated with high rates of satisfaction and, by parental report, decreased calls or visits to a physician.
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Affiliation(s)
- A Kempe
- Department of Pediatrics, University of Colorado School of Medicine, and The Children's Hospital, Denver 80218, USA
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Cortez LM, Dempsey C, Simelaro J, Wilson R. Current issues in the selection and use of broad-spectrum antibiotics. Roundtable discussion. Hosp Formul 1994; 29 Suppl 3:S4-12. [PMID: 10136347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Wilde A, Dempsey C, Banting G. The tyrosine-containing internalization motif in the cytoplasmic domain of TGN38/41 lies within a nascent helix. J Biol Chem 1994; 269:7131-6. [PMID: 8125922] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
TGN38 and TGN41 are isoforms of an integral membrane protein (TGN38/41) which is predominantly located in the trans-Golgi network of mammalian cells, but which constitutively recycles between the TGN and the plasma membrane. The cytoplasmic domain tetrapeptide sequence "YQRL" is responsible for the internalization of TGN38/41 from the plasma membrane. This sequence conforms to the tyrosine containing internalization motif ("YXXhydro," where X is any amino acid and hydro is any large bulky hydrophobic amino acid) found in other integral membrane proteins which are internalized from the plasma membrane via clathrin-coated vesicles. Structural predictions have suggested that the YXXhydro motif might adopt a tight turn structure in solution, a prediction supported previously by nuclear magnetic resonance (NMR) studies on short synthetic peptides corresponding to variants of the generic YXXhydro motif. We have synthesized a 21-amino acid peptide which encompasses the TGN38/41 internalization motif and used it as template for two-dimensional NMR analysis. The data from these experiments demonstrate that the internalization motif in the cytoplasmic domain of TGN38/41 lies within a nascent helix, not a tight turn. This is the first study to show that tyrosine containing internalization motifs do not necessarily adopt a beta-turn conformation.
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Affiliation(s)
- A Wilde
- Department of Biochemistry, School of Medical Sciences, University of Bristol, United Kingdom
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Wilde A, Dempsey C, Banting G. The tyrosine-containing internalization motif in the cytoplasmic domain of TGN38/41 lies within a nascent helix. J Biol Chem 1994. [DOI: 10.1016/s0021-9258(17)37257-5] [Citation(s) in RCA: 27] [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] [Indexed: 11/26/2022] Open
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Dempsey C, Harrison RF, Moloney A, Darling M, Walshe J. Characteristics of bacteriuria in a homogeneous maternity hospital population. Eur J Obstet Gynecol Reprod Biol 1992; 44:189-93. [PMID: 1607058 DOI: 10.1016/0028-2243(92)90097-i] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 12/27/2022]
Abstract
Bacteriuria and urinary tract infection are a common cause of morbidity in pregnancy. Recent evidence has, however, questioned the magnitude of this risk and the effectiveness of therapy in reducing it. To clarify matters, a prospective study on 3123 ante-natal women was carried out. Screening for bacteriuria was carried out by culturing a mid-stream specimen of urine. Treatment was given to all patients with a positive culture and was based on antibiotic sensitivity testing. Repeat culture was performed 1 week after completion of therapy. The prevalence of bacteriuria in our population was 4.74%. Over half of these patients were asymptomatic. 67% of those with bacteriuria at screening were symptomatic or had a past history of urinary tract infection. Escherichia coli was the predominant organism cultured. The most effective antibiotic was Nitrofurantoin, which was sensitive in over 90% of isolates. Late urinary tract infection occurred in 3.52% of patients. There was no increase in maternal or foetal complications amongst those with bacteriuria. We concluded that it might be more cost-effective to confine screening to those patients who are symptomatic or have a past history of urinary tract infection.
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Affiliation(s)
- C Dempsey
- RCSI Department of Obstetrics and Gynecology, Rotunda Hospital, Dublin, Ireland
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Abstract
Spectrin from human erythrocytes binds to bilayer dispersions of both DMPC and DMPS:DMPC (1:1, w/w). However, no effect of bound spectrin on the conformation of the lipid head groups, as measured from the deuterium quadrupolar splittings of DMPC or DMPS specifically deuterated in the polar head groups, was detected in 1:1 mixtures of the two lipids containing either deuterated DMPC or DMPS. Neither the phase transition of the DMPS:DMPC mixtures, nor the spin-lattice relaxation time (T1) of the deuterated DMPS head group, was affected by spectrin. These results argue against any strong interaction of spectrin with phosphatidylserine and rule out the possibility that spectrin is responsible for the maintenance of PS in the inner monolayer of the erythrocyte membrane during the whole life-span of this cell.
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Affiliation(s)
- M Bitbol
- Department of Biochemistry, University of Oxford, England
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Abstract
The hydrophobic transbilayer peptide of erythrocyte glycophorin has been purified following exchange of tritium into the backbone amides, and reconstituted in egg phosphatidylcholine micelles. Analysis of tritium exchange from the backbone amides of the membrane-reconstituted peptide shows that about two of the amides are virtually non-exchangeable, about 10 are slowed by factors of 10(7) relative to free amides in unstructured water soluble peptides and the remainder of the amides (about 20) have slowing factors of less than 1000. These classes of amides are proposed to reflect the stability of the peptide with respect to hydrogen bond breaking fluctuations and the accessibility of the amides to exchange catalysts in different regions of the bilayer.
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Affiliation(s)
- M Sami
- Biochemistry Department, Oxford University, England
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Elliott A, Valdez N, Dempsey C, Cooper P. An evaluation of the A4 folder system in general practice. J R Coll Gen Pract 1979; 29:85-9. [PMID: 480299 PMCID: PMC2159121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
All 63 general practices known to have introduced the A4 folder system were asked to complete questionnaires comparing A4 records with the traditional medical records envelope system. Of the 77 per cent who replied, an overwhelming majority favoured the A4 system and felt that it helped them to obtain higher standards of care for patients.
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Dempsey C. A guide to tests of central auditory function. Otolaryngol Clin North Am 1978; 11:677-700. [PMID: 733253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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