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Larson EG, Hasley I, Post EG, Cali MG, Clark SC, McPherson AL, Noble-Taylor KE, Robinson DM, Anderson T, Finnoff J, Adams WM. Incidence of staff injury and illness at the Tokyo 2020 and Beijing 2022 Olympic and Paralympic Games. BMJ Open Sport Exerc Med 2024; 10:e001835. [PMID: 38645762 PMCID: PMC11029204 DOI: 10.1136/bmjsem-2023-001835] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 04/23/2024] Open
Abstract
Objective To report epidemiological data regarding injury and illness among the Team USA staff during the Tokyo 2020 Summer Olympic and Paralympic Games and Beijing 2022 Winter Olympic and Paralympic Games. Methods A retrospective review of all Team USA staff (total staff, N=1703 (62.5% female); total staff days (SD)=34 489) medical encounters during the Tokyo 2020 Games and Beijing 2022 Games was conducted. Details related to injury and illness were evaluated. Incidence with 95% CI per 1000 staff days were calculated. Results A total of 32 illnesses (incidence [95% CI] 0.9 [0.6, 1.2]) and 23 injuries (incidence 0.7 [0.4, 0.9]) were sustained by the Team USA delegation staff members during the Tokyo 2020 Games and Beijing 2022 Games. Female staff reported more illnesses (illnesses proportion (IP) 2.9%; incidence 1.4 [0.8, 2.0]), while male staff incurred more injuries (IP 1.8%; incidence 0.9 [0.5, 1.3]). When stratified by physiological system, dermatological and infectious were the most common systems involved with illness (IP 0.5%; incidence 0.2 [0.1, 0.4]). Injuries to the upper limb were most common (IP 0.3%; incidence 0.3 [0.1, 0.5]). Conclusion Injury and illness rates among the Team USA staff during the Tokyo 2020 Games and Beijing 2022 Games were low, but notable. Knowledge of injury and illness risks contributes to staffing decisions and prevention strategies for staff supporting athletes during competition.
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Affiliation(s)
- Emily G Larson
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Ike Hasley
- Summit Orthopedics and Sports Medicine, Woodbury, Minnesota, USA
| | - Eric G Post
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
| | - Malia G Cali
- Department of Physical Medicine and Rehabilitation, Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Stephanie C Clark
- Family Medicine, Rehabilitation and Performance Medicine Swedish Medical Group, Seattle, Washington, USA
| | - April L McPherson
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Department of Orthopedics, The Ohio State University, Columbus, Ohio, USA
| | | | - David M Robinson
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital Boston, Boston, Massachusetts, USA
| | - Travis Anderson
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
| | - Jonathan Finnoff
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
| | - William M Adams
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Vu K, Rhim HC, McCormack M, Fee J, Gureck A, DeLuca S, Robinson DM, Tenforde AS. Patient-reported outcomes during telehealth versus in-person follow-up visits for patients treated with extracorporeal shockwave therapy. PM R 2024; 16:323-330. [PMID: 37574919 DOI: 10.1002/pmrj.13057] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/02/2023] [Accepted: 07/28/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND The limited research describing clinical outcomes using telehealth for management of musculoskeletal conditions is primarily within orthopedic surgery care. OBJECTIVE To characterize differences in patient reported outcomes using telehealth compared with in-person follow-up visits in patients with Achilles tendinopathy (AT) or plantar fasciitis (PF) treated using extracorporeal shockwave therapy (ESWT). DESIGN Retrospective chart review. SETTING Outpatient sports medicine clinic. PATIENTS 82 patients with AT and 46 patients with PF. INTERVENTIONS In-person (n = 76) and telehealth (n = 52) follow-up visits. MAIN OUTCOME MEASUREMENTS Victorian Institute of Sports Assessment-Achilles (VISA-A) for AT and Foot and Ankle Ability Measure (FAAM) for PF as well as billing level. RESULTS There was significant improvement from baseline to final VISA-A (p < .01) and FAAM (p < .01) following ESWT. No significant difference existed in the proportion of patients who met the minimal clinically important difference based on in-person (71.1%) versus telehealth (71.2%) follow-up (p = .99). The in-person group demonstrated higher billing levels compared to the telehealth group (Level: 3.5 ± 0.6 vs. 2.8 ± 0.7, p < .01). CONCLUSIONS Given no significant differences in outcomes between two modes of follow-ups, telehealth may serve as an alternative method to guide management of musculoskeletal injuries with ESWT and other procedures.
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Affiliation(s)
- Kevin Vu
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Molly McCormack
- Spaulding National Running Center, Cambridge, Massachusetts, USA
| | - Jonathan Fee
- Spaulding National Running Center, Cambridge, Massachusetts, USA
| | - Ashley Gureck
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Stephanie DeLuca
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - David M Robinson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
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Rhim HC, Ruiz J, Taseh A, Afunugo W, Crockett Z, Schon J, Pan X, Shin J, Schowalter S, Jang KM, Robinson DM. Nonsteroidal Anti-Inflammatory Drug Injections versus Steroid Injections in the Management of Upper and Lower Extremity Orthopedic Conditions: A Systematic Review with Meta-Analysis. J Clin Med 2024; 13:1132. [PMID: 38398445 PMCID: PMC10889729 DOI: 10.3390/jcm13041132] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 01/31/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Although corticosteroid injections are an effective treatment for musculoskeletal pathologies, they may not be suitable for all patients. The purpose of this systematic review was to compare clinical outcomes between patients who received NSAID and corticosteroid injections for various orthopedic conditions. METHODS Medline, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched, and meta-analyses were performed using a random-effects model for outcomes presented in three or more studies. Other studies were qualitatively analyzed. RESULTS A total of 28 articles with 2113 patients were included. A meta-analysis of five studies in patients with shoulder impingement syndrome demonstrated that there was no significant difference in the pain visual analogue scale (VAS) between subacromial NSAID injections and corticosteroid injections at 1 month [weighted mean difference (WMD) -0.244; 95% CI, -1.232 to 0.745; I2, 94.5%]. For patients with knee osteoarthritis, a meta-analysis of three studies demonstrated that there was no significant difference between intraarticular NSAID injections and corticosteroid injections in pain VAS at 1 month (WMD 0.754; 95% CI, -0.413 to 1.921; I2, 90.2%) and 3 months (WMD-0.089; 95% CI, -0.345 to 0.166; I2, 0%). A review of the studies assessing pain outcomes for hip osteoarthritis, adhesive capsulitis, and plantar fasciitis showed no significant differences between the NSAID and corticosteroid groups. CONCLUSION NSAID injections may be safe and effective alternatives to steroid injections, especially in shoulder impingement syndrome and knee osteoarthritis.
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Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA 02115, USA; (H.C.R.); (J.R.); (W.A.); (Z.C.); (J.S.); (D.M.R.)
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02115, USA; (A.T.); (J.S.)
| | - Joseph Ruiz
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA 02115, USA; (H.C.R.); (J.R.); (W.A.); (Z.C.); (J.S.); (D.M.R.)
| | - Atta Taseh
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02115, USA; (A.T.); (J.S.)
| | - Wilma Afunugo
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA 02115, USA; (H.C.R.); (J.R.); (W.A.); (Z.C.); (J.S.); (D.M.R.)
| | - Zack Crockett
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA 02115, USA; (H.C.R.); (J.R.); (W.A.); (Z.C.); (J.S.); (D.M.R.)
| | - Jason Schon
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA 02115, USA; (H.C.R.); (J.R.); (W.A.); (Z.C.); (J.S.); (D.M.R.)
| | - Xiaoyu Pan
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jaehyung Shin
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02115, USA; (A.T.); (J.S.)
| | - Sean Schowalter
- Department of Sports Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Ki-Mo Jang
- Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - David M Robinson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA 02115, USA; (H.C.R.); (J.R.); (W.A.); (Z.C.); (J.S.); (D.M.R.)
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Rhim HC, Crockett Z, Schowalter S, Robinson DM. Cramp and a Pop 61-Year-Old Man With Acute Thigh Pain. Am J Phys Med Rehabil 2024; 103:e1-e3. [PMID: 37405900 DOI: 10.1097/phm.0000000000002309] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Charlestown, Massachusetts
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Post EG, Anderson T, Shilt JS, Dugan EL, Clark SC, Larson EG, Noble-Taylor KE, Robinson DM, Donaldson AT, Finnoff JT, Adams WM. Incidence of injury and illness among paediatric Team USA athletes competing in the 2020 Tokyo and 2022 Beijing Olympic and Paralympic Games. BMJ Open Sport Exerc Med 2023; 9:e001730. [PMID: 38143720 PMCID: PMC10749061 DOI: 10.1136/bmjsem-2023-001730] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 12/26/2023] Open
Abstract
Objective To describe the incidence of injuries and illnesses among paediatric Team USA athletes competing in the Tokyo 2020 Olympic and Paralympic Games, and the 2022 Beijing Olympic and Paralympic Games. Methods An electronic medical record system documented all injuries and illnesses that occurred while competing in the four Games periods. Incidence (IR) with 95% CI per 1000 athlete days were calculated for both injuries and illnesses. Incidence rate ratios (IRR) were calculated to compare injury and illness rates based on age (paediatric vs non-paediatric) sex, Games period and sport type. Results Two hundred paediatric athletes (age range, 15-21 years) competed across the four Games periods, representing 16.1% of all Team USA athletes. The overall injury IR (95% CI) was 13.4 (9.8 to 18.1), and the overall illness IR was 5.5 (3.3 to 8.7). There were no differences in incidence between paediatric and non-paediatric athletes for either injury (IRR (95% CI): 0.9 (0.6 to 1.2)) or illness (IRR (95% CI): 0.9 (0.5 to 1.5)). Female paediatric athletes were more likely to sustain an injury compared with male paediatric athletes (IRR (95% CI): 2.4 (1.1 to 5.3)). The most common mechanism of injury was gradual onset (IR, 4.3 (2.3 to 7.2)), and injuries most commonly occurred during practices (IR, 7.0 (4.5 to 10.5)). Conclusion Paediatric athletes account for a substantial proportion of Team USA athletes. It is essential that paediatric sports medicine experts are included in the medical team given that paediatric Team USA athletes are just as likely as their adult teammates to sustain an injury or illness.
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Affiliation(s)
- Eric G Post
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, CO, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, CO, USA
| | - Travis Anderson
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, CO, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, CO, USA
| | - Jeffrey S Shilt
- Texas Children's Hospital, Houston, Texas, USA
- Baylor College of Medicine, Houston, Texas, USA
| | - Eric L Dugan
- Texas Children's Hospital, Houston, Texas, USA
- Baylor College of Medicine, Houston, Texas, USA
| | - Stephanie C Clark
- Family Medicine, Rehabilitation and Performance Medicine Swedish Medical Group, Seattle, Washington, USA
| | - Emily G Larson
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, New York, USA
| | - Kayle E Noble-Taylor
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - David M Robinson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
| | - Amber T Donaldson
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, CO, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, CO, USA
| | - Jonathan T Finnoff
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, CO, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, CO, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado, Denver, CO, USA
| | - William M Adams
- Department of Sports Medicine, United States Olympic and Paralympic Committee, Colorado Springs, CO, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, CO, USA
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UK
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Anderson T, Cali MG, Clark SC, Hasley I, Larson EG, Noble-Taylor KE, Robinson DM, Post E, Finnoff JT, Adams WM. Team USA injury and illness incidence at the 2022 Beijing Winter Olympic and Paralympic Games. Br J Sports Med 2023:bjsports-2023-107185. [PMID: 37890965 DOI: 10.1136/bjsports-2023-107185] [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] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the injury and illness incidence from Team USA athletes from the 2022 Beijing Winter Olympic and Paralympic Games and assess any sex-based differences or differences between Olympic and Paralympic athletes. METHODS Team USA Olympic (n=231, 48.5% female) and Team USA Paralympic (n=63, 22.2% female) athletes had medical encounters documented during the Games. Injuries and illnesses were defined according to the 2020 International Olympic Committee Consensus Statement and reviewed for accuracy by a physician. Incidence rates were calculated per 1000 athlete-days and further analysed by sex, sport, anatomical location, type of illness, injury event and injury mechanism, with incident rate ratios (IRRs) used for group comparisons. RESULTS There were no differences in illness (Olympic illness, IRR=0.99 (95% CI 0.48 to 2.07), p=0.998; Paralympic illness, IRR=1.43 (95% CI 0.41 to 4.97), p=0.572) or injury rates (Olympic injury, IRR=0.63 (95% CI 0.39 to 1.03), p=0.062; Paralympic injury, IRR=1.01 (95% CI 0.43 to 2.35), p=0.988) between male and female (reference group) athletes. However, Olympic athletes had significantly lower illness (IRR=0.41 (95% CI 0.22 to 0.76), p=0.003) and injury (IRR=0.56 (95% CI 0.37 to 0.87), p=0.009) risks compared with Paralympic athletes. CONCLUSION No significant sex-related differences in injury or illness were detected in Team USA Olympic or Paralympic participating in the 2022 Beijing Winter Games. However, Paralympic athletes exhibited higher rates of injury and illness compared with their Olympic counterparts. This study highlights delegation-specific epidemiological data which may facilitate more focused approaches for injury and illness prevention.
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Affiliation(s)
- Travis Anderson
- Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
| | - Malia G Cali
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Stephanie C Clark
- Family Medicine, Rehabilitation and Performance Medicine Swedish Medical Group, Seattle, Washington, USA
| | - Ike Hasley
- Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Minneapolis, Minnesota, USA
| | - Emily G Larson
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Kayle E Noble-Taylor
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David M Robinson
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Eric Post
- Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
| | - Jonathan T Finnoff
- Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Denver, CO, USA
| | - William M Adams
- Department of Sports Medicine, United States Olympic & Paralympic Committee, Colorado Springs, Colorado, USA
- United States Coalition for the Prevention of Illness and Injury in Sport, Colorado Springs, Colorado, USA
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
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Robinson DM, McInnis KC, Rhim HC, Tsitsilianos N. Lavage treatments for calcific rotator cuff tendinopathy. BMJ 2023; 383:2248. [PMID: 37821118 DOI: 10.1136/bmj.p2248] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Affiliation(s)
- David M Robinson
- Department of Physical Medicine and Rehabilitation and Division of Sports Medicine, Mass General Brigham and Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
| | - Kelly C McInnis
- Department of Physical Medicine and Rehabilitation and Division of Sports Medicine, Mass General Brigham and Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
| | - Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Nicholas Tsitsilianos
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA, USA
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Beal CM, Robinson DM, Smith J, Gerber Van Doren L, Tabler GT, Rochell SJ, Kidd MT, Bottje WG, Lei X. Economic and environmental assessment of U.S. broiler production: opportunities to improve sustainability. Poult Sci 2023; 102:102887. [PMID: 37572620 PMCID: PMC10428061 DOI: 10.1016/j.psj.2023.102887] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 08/14/2023] Open
Abstract
The United States is the largest broiler producer in the world, and Americans consume about 45 kg of chicken per capita per year, which generates substantial economic and environmental footprints. We conduct techno-economic analysis and life cycle assessment (TEA/LCA) to evaluate the sustainability performance of the U.S. broiler industry and quantify the cost, greenhouse gas (GHG) emissions, energy, water, land, fertilizer, and respiratory impacts of 7 broiler production scenarios for a contract Grower, Integrator, and Combined control volume. The assessment is a farm-gate to farm-gate analysis that includes capital cost of chicken houses, labor, chicks brought into the farm, feeds, on-site fuels, and on-site emissions. We found that economics for the Integrator are profitable and dominated by the cost of corn and soybean meal feeds, payments to the Grower, and revenue from live broilers. Additionally, we found that economics for the Grower generate modest return on investment (ROI) largely based on the cost of houses and labor when compared to contract revenue from the Integrator. Environmental impacts for GHG, energy, and respiratory effects are primarily associated with upstream feed production (roughly 65%-80% of total impacts) and on-site fuel consumption (∼20%-35% of total impacts), while those for water, land, and eutrophication are almost entirely attributable to upstream feed production (litter spreading has a low economic allocation factor). Tradeoffs among sustainability metrics are further explored with a sensitivity analysis and by evaluating cost/environmental benefit scenarios.
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Affiliation(s)
- Colin M Beal
- B&D Engineering and Consulting LLC, Lander, WY 82520, USA; University of Hawaii at Hilo, Pacific Aquaculture & Coastal Resources Center, College of Agriculture, Forestry, and Natural Resource Management, Hilo, HI 95720, USA.
| | | | - Jack Smith
- B&D Engineering and Consulting LLC, Lander, WY 82520, USA
| | | | - George T Tabler
- University of Tennessee, Animal Science Department, Middle Tennessee AgResearch and Education Center, Spring Hill, TN 37174, USA
| | | | - Michael T Kidd
- Poultry Science Department, University of Arkansas, POSC O-114, Fayetteville, AR 72701, USA
| | - Walter G Bottje
- Poultry Science Department, University of Arkansas, POSC O-114, Fayetteville, AR 72701, USA
| | - Xingen Lei
- Animal Science Department, Cornell University, Ithaca, NY 14853, USA
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Robinson DM, Kakar S, Jelsing E. Acute Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injury: Diagnosis, Management, and Return to Sports Considerations. Curr Sports Med Rep 2023; 22:238-244. [PMID: 37294200 DOI: 10.1249/jsr.0000000000001079] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
ABSTRACT Thumb metacarpophalangeal joint ulnar collateral ligament injuries are common in athletes and range from mild sprains to complete retracted tears. The typical injury mechanism of a valgus force directed onto an abducted or extended thumb is frequently seen in certain sporting activities, such as skiing, football, and baseball. Ultrasound and magnetic resonance imaging are excellent imaging supplements to the clinical evaluation for diagnosis confirmation. Positive treatment outcomes have been demonstrated when these injuries are appropriately managed both nonoperatively and surgically. When deciding on a treatment plan, it is paramount to take the athlete's injury severity and sport-specific factors into account. The aim of this review is to summarize the sport epidemiology, diagnosis, treatment options, and return to play considerations for athletes who sustain an acute thumb metacarpophalangeal joint ulnar collateral ligament injury.
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Affiliation(s)
- David M Robinson
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Sanjeev Kakar
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN
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Chou RC, Robinson DM, Homer S. Ultrasound-guided percutaneous carpal tunnel release: A systematic review. PM R 2023; 15:363-379. [PMID: 35254722 DOI: 10.1002/pmrj.12801] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/08/2022] [Accepted: 02/25/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Carpal tunnel syndrome (CTS) is the most common peripheral entrapment mononeuropathy. The purpose of this systematic review is to evaluate the reported clinical effectiveness and safety of ultrasound-guided percutaneous carpal tunnel release (USCTR) for the treatment of CTS. LITERATURE SURVEY PubMed, EMBASE, and ScienceDirect databases were queried from database inception to February 20, 2021, to identify clinical studies on USCTR. METHODOLOGY Two reviewers independently completed title, abstract, and full-text screening, and they extracted data in duplicate for analysis. Procedure techniques, outcome measures, and complications were descriptively analyzed. SYNTHESIS Eighty-seven studies were eligible for screening. Twenty studies (three randomized controlled trials, three prospective cohort studies, and 14 case series) met inclusion criteria, with a total of 1772 USCTR cases. The overall level of evidence was very low, with seven studies with at least moderate risk of bias. Thirteen studies exceeded the minimal clinically important difference (MCID) for the Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SS) and Boston Carpal Tunnel Questionnaire Functional Status Scale (BCTQ-FS), and six studies exceeded the MCID for the Quick Disabilities of Arm, Shoulder & Hand (QDASH). Five studies reported statistically significant improvement in these functional outcome measures as early as the first week post-procedure. A major complication occurred in one patient who developed suspected compartment syndrome, and minor complications were reported in 24 patients. CONCLUSIONS Based on very low level of evidence, early studies suggest that USCTR may be an effective treatment for CTS, with potential for short post-procedure recovery times.
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Affiliation(s)
- Raymond C Chou
- Physical Medicine and Rehabilitation Division, Department of Orthopaedic Surgery, Stanford University, Redwood City, California, USA
| | - David M Robinson
- Sports Medicine Division, Department of Orthopedic Surgery, Mayo Clinic, Minneapolis, Minnesota, USA
| | - Scott Homer
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, Massachusetts, USA
- Department of Orthopaedic Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA
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Cali MG, Adams WM, Clark SC, Hasley IB, Larson EG, McPherson AL, Noble-Taylor KE, Robinson DM, Finnoff JT. Incidence Of Injuries Among Us Paralympic Athletes Competing In The Tokyo 2020 Paralympic Games. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000879076.41289.8f] [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: 11/21/2022]
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12
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Robinson DM, Adams WM, Cali MG, Clark SC, Hasley IB, Larson EG, McPherson AL, Noble-Taylor KE, Finnoff JT. Incidence Of Illness Among Team USA Paralympic Athletes Competing In The Tokyo 2020 Paralympic Games. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000883376.63356.62] [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: 11/21/2022]
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13
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Larson EG, Adams WM, Cali MG, Clark SC, Hasley IB, McPherson AL, Noble-Taylor KE, Robinson DM, Finnoff JT. Incidence Of Team USA Staff Illnesses And Injuries During The Tokyo 2020 Summer Paralympic Games. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000883368.14934.d2] [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: 11/21/2022]
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14
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Clark SC, Adams WM, Cali MG, Hasley IB, Larson EG, Noble-Taylor KE, McPherson AL, Robinson DM, Finnoff JT. Incidence Of Illness Among Team USA Athletes During The Tokyo 2020 Summer Olympic Games. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000883384.82776.bd] [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: 11/21/2022]
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15
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Hasley IB, Adams WM, Cali MG, Clark SC, Larson EG, McPherson AL, Noble-Taylor KE, Robinson DM, Finnoff JT. Incidence Of Injuries And Illnesses Among Team USA Staff During The Tokyo 2020 Summer Olympic Games. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000883360.94384.a1] [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: 11/21/2022]
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16
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Noble-Taylor KE, Adams WM, Cali MG, Clark SC, Hasley IB, Larson EG, McPherson AL, Robinson DM, Finnoff JT. Incidence Of Injuries Among Team USA Athletes Competing In Tokyo 2020 Summer Olympic Games. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000883380.16252.a0] [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: 11/21/2022]
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Kettle JG, Bagal SK, Bickerton S, Bodnarchuk MS, Boyd S, Breed J, Carbajo RJ, Cassar DJ, Chakraborty A, Cosulich S, Cumming I, Davies M, Davies NL, Eatherton A, Evans L, Feron L, Fillery S, Gleave ES, Goldberg FW, Hanson L, Harlfinger S, Howard M, Howells R, Jackson A, Kemmitt P, Lamont G, Lamont S, Lewis HJ, Liu L, Niedbala MJ, Phillips C, Polanski R, Raubo P, Robb G, Robinson DM, Ross S, Sanders MG, Tonge M, Whiteley R, Wilkinson S, Yang J, Zhang W. Discovery of AZD4625, a Covalent Allosteric Inhibitor of the Mutant GTPase KRAS G12C. J Med Chem 2022; 65:6940-6952. [PMID: 35471939 DOI: 10.1021/acs.jmedchem.2c00369] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
KRAS is an archetypal high-value intractable oncology drug target. The glycine to cysteine mutation at codon 12 represents an Achilles heel that has now rendered this important GTPase druggable. Herein, we report our structure-based drug design approach that led to the identification of 21, AZD4625, a clinical development candidate for the treatment of KRASG12C positive tumors. Highlights include a quinazoline tethering strategy to lock out a bio-relevant binding conformation and an optimization strategy focused on the reduction of extrahepatic clearance mechanisms seen in preclinical species. Crystallographic analysis was also key in helping to rationalize unusual structure-activity relationship in terms of ring size and enantio-preference. AZD4625 is a highly potent and selective inhibitor of KRASG12C with an anticipated low clearance and high oral bioavailability profile in humans.
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Affiliation(s)
| | | | | | | | - Scott Boyd
- Oncology R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Jason Breed
- Discovery Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | | | | | | | | | - Iain Cumming
- Oncology R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | | | | | | | - Laura Evans
- Oncology R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Lyman Feron
- Oncology R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | | | - Emma S Gleave
- Discovery Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | | | | | | | | | | | - Anne Jackson
- Discovery Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Paul Kemmitt
- Oncology R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | | | - Scott Lamont
- Oncology R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | | | - Libin Liu
- Pharmaron Beijing Co., Ltd., 6 Taihe Road BDA, Beijing 100176, P. R. China
| | | | | | - Radek Polanski
- Discovery Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Piotr Raubo
- Oncology R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Graeme Robb
- Oncology R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | | | - Sarah Ross
- Oncology R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | | | - Michael Tonge
- Discovery Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | | | | | - Junsheng Yang
- Pharmaron Beijing Co., Ltd., 6 Taihe Road BDA, Beijing 100176, P. R. China
| | - Wenman Zhang
- Pharmaron Beijing Co., Ltd., 6 Taihe Road BDA, Beijing 100176, P. R. China
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Catapano M, Robinson DM, Schowalter S, McInnis KC. Clinical evaluation and management of calcific tendinopathy: an evidence-based review. J Osteopath Med 2022; 122:141-151. [PMID: 35119231 DOI: 10.1515/jom-2021-0213] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 08/25/2021] [Accepted: 11/29/2021] [Indexed: 11/15/2022]
Abstract
Calcific tendinopathy (CT) is an important musculoskeletal condition most commonly seen in the shoulder girdle, accounting for 10-42% of all shoulder pain. Despite the high prevalence within the shoulder region, CT has been demonstrated in many tendons throughout the axial and appendicular skeleton. Unlike degenerative tendinopathies, CT appears to be a self-limiting condition that affects otherwise-healthy tendon with deposition of calcium hydroxyapatite crystals between healthy tenocytes. In patients with functionally limiting symptoms or pain, the clinical course may be accelerated through a multitude of treatments including physical therapy and pain management, extracorporeal shock wave therapy, ultrasound-guided percutaneous lavage (UGPL), and operative debridement. Currently, the most efficacious and frequently utilized treatment for shoulder CT is UGPL due to its ability to effectively reduce calcium burden and pain while limiting soft-tissue damage. However, more evidence regarding the treatment and course of CT is needed before determining the most appropriate treatment at all potential sites of CT.
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Affiliation(s)
- Michael Catapano
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
| | - David M Robinson
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Sean Schowalter
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
| | - Kelly C McInnis
- Department of Physical Medicine and Rehabilitation and Division of Sports Medicine, Massachusetts General Hospital and Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
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19
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Robinson DM, Tan CO, Tenforde AS. Functional Gains Using Radial and Combined Shockwave Therapy in the Management of Achilles Tendinopathy. J Foot Ankle Surg 2022; 61:99-103. [PMID: 34274243 DOI: 10.1053/j.jfas.2021.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 10/15/2020] [Revised: 02/02/2021] [Accepted: 06/08/2021] [Indexed: 02/03/2023]
Abstract
Achilles tendinopathy is a common condition and many patients have functional limitations after initial conservative treatment. Shockwave therapy has been shown to improve function within patients; however, comparative outcomes for different forms of shockwave are poorly described. In this retrospective cohort study, we describe findings from a quality improvement initiative evaluating safety and functional outcomes after treatment with radial shockwave therapy (n = 58) or combined radial and focused shockwave therapy (n = 29) for patients with Achilles tendinopathy refractory to exercise therapy. All patients were prescribed an eccentric exercise program. We hypothesized both groups would see improvements in function quantified using the Victorian Institute of Sports Assessment-Achilles with similar safety outcomes. Overall, the minimal clinically important difference (defined at 7 for insertional and 12 for noninsertional Achilles tendinopathy) was met in a greater proportion of patients treated with combined shockwave compared to radial shockwave (26 [89.7%] vs 37 [63.8%], p = .022). The change in Victorian Institute of Sports Assessment-Achilles from baseline to final treatment was not different between combined and radial-only groups (23.3 ± 12.6 vs 19.9 ± 18.7, p = .2). Within group differences from baseline to final follow-up measures (mean duration 17.9 ± 14.8 weeks) demonstrated overall functional improvement for both groups (both p < .0001). No serious adverse effects were observed. Our findings suggest combined radial and focused shockwave therapy may provide more predictable functional gains for treatment of Achilles tendinopathy compared to radial shockwave therapy.
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Affiliation(s)
- David M Robinson
- Resident, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA
| | - Can O Tan
- Assistant Professor, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA; Associate Professor, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA
| | - Adam S Tenforde
- Associate Professor, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA.
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20
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Raja AE, Shustorovich A, Robinson DM, Alfonso K, Meyer R, Roemmich RT, Eng C, Wisniewski SJ, Cabahug P. Musculoskeletal Ultrasound as a Motivator for Selecting a Physical Medicine and Rehabilitation Residency Program in the United States: A Multicenter Survey Study. Am J Phys Med Rehabil 2022; 101:97-103. [PMID: 33605576 PMCID: PMC8371081 DOI: 10.1097/phm.0000000000001719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
ABSTRACT This study aimed to determine the influence of musculoskeletal ultrasound (MSKUS) curriculum on applicants during the residency-selection process. A survey of 666 applicants for the Johns Hopkins University, Mayo Clinic, and Harvard/Spaulding Rehabilitation Physical Medicine and Rehabilitation programs was conducted in June 2020. A total of 180 respondents scored the influence of a MSKUS curriculum on their decision making for residency selection. In addition, applicants were asked to rank specific areas of physical medicine and rehabilitation that influenced their decision making. Participants most commonly included MSKUS in their top three areas of interest when constructing their rank order list. When asked whether MSKUS presence within a program had an effect during the interview-selection process, 71% responded with "very important" or "absolutely essential" (P < 0.001). For 74% of applicants, exposure to MSKUS in residency was an important factor when creating their rank order list (P < 0.001). More than 92% of applicants stated that they are "likely" or "very likely" to use MSKUS in their future practice and 83% would recommend a program with MSKUS to future candidates (P < 0.001). Based on these results, a large percentage of physical medicine and rehabilitation applicants intend on using MSKUS in their future practice. Therefore, MSKUS may be an important factor for residency selection.
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Affiliation(s)
- Altamash E Raja
- From the Department of Physical Medicine & Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, Maryland (AER, AS, RM, RTR, PC); Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, Massachusetts (DMR, CE); Department of Physical Medicine & Rehabilitation, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota (KA, SJW); and Center for Movement Studies (RTR) and International Center for Spinal Cord Injury (PC), Kennedy Krieger Institute, Baltimore, Maryland
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21
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DeLuca S, Robinson DM, Yun PH, Rosenberg C, Tan CO, Tenforde AS. Similar Functional Gains Using Radial Versus Combined Shockwave Therapy in Management of Plantar Fasciitis. J Foot Ankle Surg 2021; 60:1098-1102. [PMID: 34023216 DOI: 10.1053/j.jfas.2021.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 11/16/2020] [Revised: 03/09/2021] [Accepted: 04/04/2021] [Indexed: 02/03/2023]
Abstract
Plantar fasciitis is a common condition that causes foot pain. While shockwave therapy has been shown to provide successful results, comparative outcomes from different forms of shockwave therapy have yet to be described for this condition. In this retrospective cohort study, we describe findings from a quality improvement initiative assessing safety and functional outcomes for patients with plantar fasciitis treated with radial shockwave therapy (n = 20) or radial and focused shockwave therapy (combined shockwave, n = 18). Most were runners (n = 31, 81.6%), mean age was 43.3 ± 12.9 years, and average symptom duration 12.1 ± 11.1 months. All patients were prescribed an exercise program focusing on foot intrinsic strengthening. We hypothesized both groups would have improvement in function using the foot and Ankle Ability Measure, with a similar safety profile. Both radial and combined groups received similar number of total treatments (4.9 ± 2.5 and 4.1 ± 2.4, respectively; p = .33). Within group score changes for the Activities of Daily Living and Sports subscales were observed for both the radial (16.5 ± 16.3, p < .001; 31.7 ± 23.1, p < .001) and combined groups (19.8 ± 10.8, p = .001; 26.0 ± 21.5, p = .003). There was no difference in proportion of patients meeting the minimal clinically important difference between radial and combined groups regarding the Activities of Daily Living (14 (70%) vs 14 (77.8%), p = .58) and Sports subscales (17 (85%) vs 12 (75%), p = .45). Collectively, these findings suggest that a majority of patients with chronic plantar fasciitis may achieve functional gains using either form of shockwave therapy.
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Affiliation(s)
- Stephanie DeLuca
- Resident, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA
| | - David M Robinson
- Resident, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA
| | - Phillip H Yun
- Attending Physician, Massachusetts General Hospital, Boston, MA
| | | | - Can Ozan Tan
- Assistant Professor, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA
| | - Adam S Tenforde
- Assistant Professor, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA.
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22
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23
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Robinson DM, Eng C, Makovitch S, Rothenberg JB, DeLuca S, Douglas S, Civitarese D, Borg-Stein J. Non-operative orthobiologic use for rotator cuff disorders and glenohumeral osteoarthritis: A systematic review. J Back Musculoskelet Rehabil 2021; 34:17-32. [PMID: 33361581 DOI: 10.3233/bmr-201844] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/04/2023]
Abstract
BACKGROUND Shoulder pain from rotator cuff pathology and glenohumeral osteoarthritis is a common entity encountered in musculoskeletal practices. Orthobiologic agents are being increasingly used as a treatment option and understanding their safety and efficacy is necessary. OBJECTIVE To systematically evaluate the available evidence for orthobiologic use in rotator cuff and glenohumeral pathology. METHODS A systematic review was undertaken following PRISMA guidelines. Randomized clinical trials (RCTs) and prospective cohort studies evaluating non-operative treatment with prolotherapy, platelet-rich plasma (PRP), or medicinal signaling cells (MSCs) for rotator cuff pathology and glenohumeral osteoarthritis were included. Bias risk assessments used were the Cochrane tool and Newcastle-Ottawa score. RESULTS The search yielded 852 potential articles, of which 20 met the inclusion criteria with a breakdown of 5 prolotherapy, 13 PRP, and 2 MSC. Sixteen studies were RCTs and 4 were cohort studies. Six studies were deemed "low risk of bias or good quality". Efficacy results were mixed, and no serious adverse events were reported from orthobiologic treatment. CONCLUSIONS Orthobiologics offer a relatively safe management option with inconclusive evidence for or against its use for rotator cuff pathology. No studies on glenohumeral osteoarthritis met the inclusion criteria. Adoption of standardized preparation reporting and consistent use of functional outcome measures is imperative for future studies to consider.
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Affiliation(s)
- David M Robinson
- Spaulding Rehabilitation Hospital/Harvard Medical School, Department of Physical Medicine and Rehabilitation, Charlestown, MA, USA
| | - Christine Eng
- Spaulding Rehabilitation Hospital/Harvard Medical School, Department of Physical Medicine and Rehabilitation, Charlestown, MA, USA.,Spaulding Rehabilitation Hospital/Harvard Medical School, Department of Physical Medicine and Rehabilitation, Spaulding Wellesley Outpatient Care Center, Wellesley, MA, USA
| | - Steven Makovitch
- Spaulding Rehabilitation Hospital/Harvard Medical School, Department of Physical Medicine and Rehabilitation, Charlestown, MA, USA
| | - Joshua B Rothenberg
- Boca Raton Regional Hospital, Regenerative Medicine and Orthopedics Biologic Department, Boca Raton, FL, USA
| | - Stephanie DeLuca
- Spaulding Rehabilitation Hospital/Harvard Medical School, Department of Physical Medicine and Rehabilitation, Charlestown, MA, USA
| | - Stephanie Douglas
- Spaulding Rehabilitation Hospital/Harvard Medical School, Department of Physical Medicine and Rehabilitation, Charlestown, MA, USA
| | - David Civitarese
- Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, USA
| | - Joanne Borg-Stein
- Spaulding Rehabilitation Hospital/Harvard Medical School, Department of Physical Medicine and Rehabilitation, Charlestown, MA, USA.,Spaulding Rehabilitation Hospital/Harvard Medical School, Department of Physical Medicine and Rehabilitation, Spaulding Wellesley Outpatient Care Center, Wellesley, MA, USA
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24
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McAulay K, Hoyt EA, Thomas M, Schimpl M, Bodnarchuk MS, Lewis HJ, Barratt D, Bhavsar D, Robinson DM, Deery MJ, Ogg DJ, Bernardes GJL, Ward RA, Waring MJ, Kettle JG. Alkynyl Benzoxazines and Dihydroquinazolines as Cysteine Targeting Covalent Warheads and Their Application in Identification of Selective Irreversible Kinase Inhibitors. J Am Chem Soc 2020; 142:10358-10372. [PMID: 32412754 DOI: 10.1021/jacs.9b13391] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
With a resurgence in interest in covalent drugs, there is a need to identify new moieties capable of cysteine bond formation that are differentiated from commonly employed systems such as acrylamide. Herein, we report on the discovery of new alkynyl benzoxazine and dihydroquinazoline moieties capable of covalent reaction with cysteine. Their utility as alternative electrophilic warheads for chemical biological probes and drug molecules is demonstrated through site-selective protein modification and incorporation into kinase drug scaffolds. A potent covalent inhibitor of JAK3 kinase was identified with superior selectivity across the kinome and improvements in in vitro pharmacokinetic profile relative to the related acrylamide-based inhibitor. In addition, the use of a novel heterocycle as a cysteine reactive warhead is employed to target Cys788 in c-KIT, where acrylamide has previously failed to form covalent interactions. These new reactive and selective heterocyclic warheads supplement the current repertoire for cysteine covalent modification while avoiding some of the limitations generally associated with established moieties.
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Affiliation(s)
| | - Emily A Hoyt
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, U.K
| | | | - Marianne Schimpl
- Discovery Sciences, R&D BioPharmaceuticals, AstraZeneca, Cambridge CB4 0WG, U.K
| | | | | | - Derek Barratt
- Discovery Sciences, R&D BioPharmaceuticals, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Deepa Bhavsar
- Oncology R&D, AstraZeneca, Waltham, Massachusetts 02451, United States
| | | | - Michael J Deery
- Cambridge Centre for Proteomics, Department of Biochemistry, University of Cambridge, Cambridge CB2 1QW, U.K
| | - Derek J Ogg
- Discovery Sciences, R&D BioPharmaceuticals, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Gonçalo J L Bernardes
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, U.K.,Instituto de Medicina Molecular, Faculdade de Medicina de Universidad de Lisboa, Avenida Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | | | - Michael J Waring
- Northern Institute for Cancer Research, Chemistry, School of Natural and Environmental Sciences, Newcastle University, Bedson Building, Newcastle upon Tyne NE1 7RU, U.K
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25
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Desai MJ, Mansfield JT, Robinson DM, Miller BC, Borg-Stein J. Regenerative Medicine for Axial and Radicular Spine-Related Pain: A Narrative Review. Pain Pract 2020; 20:437-453. [PMID: 31869517 DOI: 10.1111/papr.12868] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 07/30/2019] [Revised: 11/03/2019] [Accepted: 12/16/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Regenerative injection-based therapy has established itself as a therapeutic option for the management of a variety of painful musculoskeletal conditions. The aim of this work was to review the current literature regarding regenerative injection therapy for axial/radicular spine pain. METHODS A comprehensive literature review was conducted on the use of regenerative medicine for axial/radicular spine pain. Eligible articles analyzed the therapeutic injection effects of platelet-rich plasma (PRP), prolotherapy, or mesenchymal signaling cells (MSCs) via intradiscal, facet joint, epidural, or sacroiliac joint delivery. RESULTS Regarding intradiscal PRP, there are level I/IV studies supporting its use. Regarding intradiscal prolotherapy, there are level III to IV studies supporting its use. Regarding intradiscal MSCs, there are level I/IV studies supporting its use with the exception of one level IV study that found no significant improvement at 12 months. Regarding facet joint injections with PRP, there are level I/IV studies supporting its use. Regarding facet joint injections with prolotherapy, there are level IV studies supporting its use, though the one level I study did not demonstrate any statistical significance supporting its use. Regarding epidural injections with PRP, there are level I/IV studies supporting its use. Regarding epidural injections with prolotherapy, there are level IV studies supporting its use, though the one level I study did not demonstrate statistical significance beyond 48 hours. Regarding sacroiliac joint injections with PRP, there are level I/IV studies supporting its use. Regarding sacroiliac joint injections with prolotherapy, there are level I/III studies supporting its use. CONCLUSIONS Currently, there are level I studies to support the use of PRP and MSC injections for discogenic pain; facet joint injections with PRP; epidural injections of autologous conditioned serum and epidural prolotherapy; and PRP and prolotherapy for sacroiliac joint pain. One level I study showed that facet joint prolotherapy has no significant benefit. Notably, no intervention has multiple published level I studies.
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Affiliation(s)
- Mehul J Desai
- International Spine, Pain & Performance Center, Washington, DC, U.S.A.,George Washington University, Washington, DC, U.S.A.,Division of Pain Medicine, Virginia Hospital Center, Arlington, Virginia, U.S.A
| | - John Taylor Mansfield
- Department of Physical Medicine and Rehabilitation, MedStar Georgetown University Hospital, Washington, DC, U.S.A
| | - David M Robinson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, U.S.A
| | - Benjamin C Miller
- Department of Physical Medicine and Rehabilitation, MedStar Georgetown University Hospital, Washington, DC, U.S.A
| | - Joanne Borg-Stein
- Division of Sports and Musculoskeletal Rehabilitation, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, U.S.A
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Aanderud ZT, Bahr J, Robinson DM, Belnap J, Campbell TP, Gill RA, McMillian B, St. Clair S. The Burning of Biocrusts Facilitates the Emergence of a Bare Soil Community of Poorly-Connected Chemoheterotrophic Bacteria With Depressed Ecosystem Services. Front Ecol Evol 2019. [DOI: 10.3389/fevo.2019.00467] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Arens DK, Brady TS, Carter JL, Pape JA, Robinson DM, Russell KA, Staley LA, Stettler JM, Tateoka OB, Townsend MH, Whitley KV, Wienclaw TM, Williamson TL, Johnson SM, Grose JH. Characterization of two related Erwinia myoviruses that are distant relatives of the PhiKZ-like Jumbo phages. PLoS One 2018; 13:e0200202. [PMID: 29979759 PMCID: PMC6034870 DOI: 10.1371/journal.pone.0200202] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 06/21/2018] [Indexed: 12/25/2022] Open
Abstract
Bacteriophages are a major force in the evolution of bacteria due to their sheer abundance as well as their ability to infect and kill their hosts and to transfer genetic material. Bacteriophages that infect the Enterobacteriaceae family are of particular interest because this bacterial family contains dangerous animal and plant pathogens. Herein we report the isolation and characterization of two jumbo myovirus Erwinia phages, RisingSun and Joad, collected from apple trees. These two genomes are nearly identical with Joad harboring two additional putative gene products. Despite mass spectrometry data that support the putative annotation, 43% of their gene products have no significant BLASTP hit. These phages are also more closely related to Pseudomonas and Vibrio phages than to published Enterobacteriaceae phages. Of the 140 gene products with a BLASTP hit, 81% and 63% of the closest hits correspond to gene products from Pseudomonas and Vibrio phages, respectively. This relatedness may reflect their ecological niche, rather than the evolutionary history of their host. Despite the presence of over 800 Enterobacteriaceae phages on NCBI, the uniqueness of these two phages highlights the diversity of Enterobacteriaceae phages still to be discovered.
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Affiliation(s)
- Daniel K. Arens
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - T. Scott Brady
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - John L. Carter
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - Jenny A. Pape
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - David M. Robinson
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - Kerri A. Russell
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - Lyndsay A. Staley
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - Jason M. Stettler
- Plant and Wildlife Sciences Department, Brigham Young University, Provo, Utah, United States of America
| | - Olivia B. Tateoka
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - Michelle H. Townsend
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - Kiara V. Whitley
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - Trevor M. Wienclaw
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - Taryn L. Williamson
- Plant and Wildlife Sciences Department, Brigham Young University, Provo, Utah, United States of America
| | - Steven M. Johnson
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
| | - Julianne H. Grose
- Microbiology and Molecular Biology Department, Brigham Young University, Provo, Utah, United States of America
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Abstract
OBJECTIVES To investigate the frequency of and reasons for readmissions to acute care (RTAC) during inpatient rehabilitation (IPR) after non-traumatic spinal cord injury (NT-SCI). To develop a predictive model for RTAC using identified risk factors. DESIGN Retrospective case-control. SETTING Academic IPR hospital. PARTICIPANTS Individuals with NT-SCI admitted to an academic SCI rehabilitation unit from January 2014-December 2015. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Readmissions to acute care services from IPR. RESULTS Thirty-seven participants (20%) experienced a RTAC for a total of 39 episodes. Thirty-five experienced 1 RTAC, while two had 2. The most common medical reasons for RTAC were infection (27%), neurological (27%), and noninfectious respiratory (16%). Multivariable logistic regression was used to develop a model to predict RTAC. Paraplegia was associated with 3.2 times increase in the odds of RTAC (P = 0.03). For every unit increase in FIM-Motor, there was a 5% reduction in the odds of RTAC (P = 0.03) Body mass index less than 30 decreased odds of RTAC by 61% (P = 0.004). CONCLUSION RTACs were associated with body mass index greater than 30, decreased FIM-Motor subscore on admission, and paraplegia. Physiatrists caring for the non-traumatic SCI patient need be more circumspect of individuals with these parameters to potentially prevent the problems necessitating acute care transfer.
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Affiliation(s)
- David M. Robinson
- School of Medicine, Wayne State University, Detroit, Michigan, USA,Correspondence to: David M. Robinson, MD. 5420 Wessex Ct. Apt 106, Dearborn, MI 48126, USA.
| | - Moussa S. Bazzi
- Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Michigan, Detroit, Michigan, USA
| | - Scott R. Millis
- Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Michigan, Detroit, Michigan, USA
| | - Ali A. Bitar
- Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Michigan, Detroit, Michigan, USA
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Archila D, Farrington ML, Robinson DM, Khan FS, Kwok WW. CD4+ T cell Responses In Cow's Milk allergy. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.251] [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: 11/27/2022]
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30
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Archila LD, DeLong JH, Wambre E, James EA, Robinson DM, Kwok WW. Grass-specific CD4(+) T-cells exhibit varying degrees of cross-reactivity, implications for allergen-specific immunotherapy. Clin Exp Allergy 2015; 44:986-98. [PMID: 24708411 DOI: 10.1111/cea.12324] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 12/03/2013] [Revised: 03/07/2014] [Accepted: 03/21/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Conceptually, allergic responses may involve cross-reactivity by antibodies or T-cells. While IgE cross-reactivity among grass-pollen allergens has been observed, cross-reactivity at the allergen-specific T-cell level has been less documented. Identification of the patterns of cross-reactivity may improve our understanding, allowing optimization of better immunotherapy strategies. OBJECTIVES We use Phleum pratense as model for the studying of cross-reactivity at the allergen-specific CD4(+) T cell level among DR04:01 restricted Pooideae grass-pollen T-cell epitopes. METHODS After in vitro culture of blood mono-nucleated cells from grass-pollen-allergic subjects with specific Pooideae antigenic epitopes, dual tetramer staining with APC-labelled DR04:01/Phleum pratense tetramers and PE-labelled DR04:01/Pooideae grass homolog tetramers was assessed to identify cross-reactivity among allergen-specific DR04:01-restricted T-cells in six subjects. Direct ex vivo staining enabled the comparison of frequency and phenotype of different Pooideae grass-pollen reactive T-cells. Intracellular cytokine staining (ICS) assays were also used to examine phenotypes of these T-cells. RESULTS T-cells with various degrees of cross-reactive profiles could be detected. Poa p 1 97-116 , Lol p 1 221-240 , Lol p 5a 199-218 , and Poa p 5a 199-218 were identified as minimally cross-reactive T-cell epitopes that do not show cross-reactivity to Phl p 1 and Phl p 5a epitopes. Ex vivo tetramer staining assays demonstrated T-cells that recognized these minimally cross-reactive T-cell epitopes are present in Grass-pollen-allergic subjects. CONCLUSIONS Our results suggest that not all Pooideae grass epitopes with sequence homology are cross-reactive. Non-cross-reactive T-cells with comparable frequency, phenotype and functionality to Phl p-specific T-cells suggest that a multiple allergen system should be considered for immunotherapy instead of a mono-allergen system.
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Affiliation(s)
- L D Archila
- Benaroya Research Institute at Virginia Mason, Seattle, WA, USA
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31
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Smith PF, Kaplan C, Sheats JE, Robinson DM, McCool NS, Mezle N, Dismukes GC. What Determines Catalyst Functionality in Molecular Water Oxidation? Dependence on Ligands and Metal Nuclearity in Cobalt Clusters. Inorg Chem 2014; 53:2113-21. [DOI: 10.1021/ic402720p] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Paul F. Smith
- Department of Chemistry and
Chemical Biology, Rutgers University, 610 Taylor Road, Piscataway, New Jersy 08854, United States
| | - Christopher Kaplan
- Department of Chemistry and
Chemical Biology, Rutgers University, 610 Taylor Road, Piscataway, New Jersy 08854, United States
| | - John E. Sheats
- Department of Chemistry and
Chemical Biology, Rutgers University, 610 Taylor Road, Piscataway, New Jersy 08854, United States
| | - David M. Robinson
- Department of Chemistry and
Chemical Biology, Rutgers University, 610 Taylor Road, Piscataway, New Jersy 08854, United States
| | - Nicholas S. McCool
- Department of Chemistry and
Chemical Biology, Rutgers University, 610 Taylor Road, Piscataway, New Jersy 08854, United States
| | - Nicholas Mezle
- Department of Chemistry and
Chemical Biology, Rutgers University, 610 Taylor Road, Piscataway, New Jersy 08854, United States
| | - G. Charles Dismukes
- Department of Chemistry and
Chemical Biology, Rutgers University, 610 Taylor Road, Piscataway, New Jersy 08854, United States
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32
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Loddick SA, Ross SJ, Thomason AG, Robinson DM, Walker GE, Dunkley TPJ, Brave SR, Broadbent N, Stratton NC, Trueman D, Mouchet E, Shaheen FS, Jacobs VN, Cumberbatch M, Wilson J, Jones RDO, Bradbury RH, Rabow A, Gaughan L, Womack C, Barry ST, Robson CN, Critchlow SE, Wedge SR, Brooks AN. AZD3514: a small molecule that modulates androgen receptor signaling and function in vitro and in vivo. Mol Cancer Ther 2013; 12:1715-27. [PMID: 23861347 DOI: 10.1158/1535-7163.mct-12-1174] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Continued androgen receptor (AR) expression and signaling is a key driver in castration-resistant prostate cancer (CRPC) after classical androgen ablation therapies have failed, and therefore remains a target for the treatment of progressive disease. Here, we describe the biological characterization of AZD3514, an orally bioavailable drug that inhibits androgen-dependent and -independent AR signaling. AZD3514 modulates AR signaling through two distinct mechanisms, an inhibition of ligand-driven nuclear translocation of AR and a downregulation of receptor levels, both of which were observed in vitro and in vivo. AZD3514 inhibited testosterone-driven seminal vesicle development in juvenile male rats and the growth of androgen-dependent Dunning R3327H prostate tumors in adult rats. Furthermore, this class of compound showed antitumor activity in the HID28 mouse model of CRPC in vivo. AZD3514 is currently in phase I clinical evaluation.
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Affiliation(s)
- Sarah A Loddick
- Corresponding Author: A. Nigel Brooks, Oncology iMED, AstraZeneca, Mereside, Alderley Park, Macclesfield, Cheshire, SK10 4TG, United Kingdom.
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33
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Robinson DM, Go YB, Mui M, Gardner G, Zhang Z, Mastrogiovanni D, Garfunkel E, Li J, Greenblatt M, Dismukes GC. Photochemical Water Oxidation by Crystalline Polymorphs of Manganese Oxides: Structural Requirements for Catalysis. J Am Chem Soc 2013; 135:3494-501. [DOI: 10.1021/ja310286h] [Citation(s) in RCA: 493] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- David M. Robinson
- Department of Chemistry
and Chemical Biology, Rutgers,
The State University of New Jersey, Piscataway, New Jersey 08854,
United States
| | - Yong Bok Go
- Department of Chemistry
and Chemical Biology, Rutgers,
The State University of New Jersey, Piscataway, New Jersey 08854,
United States
| | - Michelle Mui
- Department of Chemistry
and Chemical Biology, Rutgers,
The State University of New Jersey, Piscataway, New Jersey 08854,
United States
| | - Graeme Gardner
- Department of Chemistry
and Chemical Biology, Rutgers,
The State University of New Jersey, Piscataway, New Jersey 08854,
United States
| | - Zhijuan Zhang
- Department of Chemistry
and Chemical Biology, Rutgers,
The State University of New Jersey, Piscataway, New Jersey 08854,
United States
| | - Daniel Mastrogiovanni
- Department of Chemistry
and Chemical Biology, Rutgers,
The State University of New Jersey, Piscataway, New Jersey 08854,
United States
| | - Eric Garfunkel
- Department of Chemistry
and Chemical Biology, Rutgers,
The State University of New Jersey, Piscataway, New Jersey 08854,
United States
| | - Jing Li
- Department of Chemistry
and Chemical Biology, Rutgers,
The State University of New Jersey, Piscataway, New Jersey 08854,
United States
| | - Martha Greenblatt
- Department of Chemistry
and Chemical Biology, Rutgers,
The State University of New Jersey, Piscataway, New Jersey 08854,
United States
| | - G. Charles Dismukes
- Department of Chemistry
and Chemical Biology, Rutgers,
The State University of New Jersey, Piscataway, New Jersey 08854,
United States
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34
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Gardner GP, Go YB, Robinson DM, Smith PF, Hadermann J, Abakumov A, Greenblatt M, Dismukes GC. Structural Requirements in Lithium Cobalt Oxides for the Catalytic Oxidation of Water. Angew Chem Int Ed Engl 2012. [DOI: 10.1002/ange.201107625] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Gardner GP, Go YB, Robinson DM, Smith PF, Hadermann J, Abakumov A, Greenblatt M, Dismukes GC. Structural Requirements in Lithium Cobalt Oxides for the Catalytic Oxidation of Water. Angew Chem Int Ed Engl 2012; 51:1616-9. [DOI: 10.1002/anie.201107625] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 12/19/2011] [Indexed: 11/09/2022]
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36
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Funk GD, Zwicker JD, Selvaratnam R, Robinson DM. Noradrenergic modulation of hypoglossal motoneuron excitability: developmental and putative state-dependent mechanisms. Arch Ital Biol 2011; 149:426-53. [PMID: 22205594 DOI: 10.4449/aib.v149i4.1271] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Hypoglossal (XII) motoneurons (MNs) contribute to diverse behaviors. Their innervation of the genioglossus muscle, a tongue protruder, plays a critical role in maintaining upper airway patency during breathing. Indeed, reduced activity in these motoneurons is implicated in sleep related disorders of breathing such as obstructive sleep apnea (OSA). The excitability of these MNs is modulated by multiple neurotransmitter systems. The focus of this review is on the modulation of XII MN excitability by norepinephrine (NE), which increases MN excitability through a variety of mechanisms. The level of noradrenergic drive, however, is very dynamic, varying on developmental, sleep-wake and even millisecond timescales relevant to transitions between behaviours. Here we review and provide new data on the maturation of the noradrenergic modulatory system, focusing on those elements specifically relevant to XII MN excitability including the: i) ontogeny of the noradrenergic cell group that provides the majority of the noradrenergic innervation to the XII nucleus, the Locus subcoeruleus (LsC); ii) time course over which the XII nucleus is innervated by noradrenergic nerve fibres, and; iii) ontogeny of XII MN sensitivity to NE. In the context of state-dependent changes in noradrenergic cell activity, we review mechanisms of NE action most relevant to its role in the muscle atonia of REM sleep. We conclude with a discussion of the hypothesis that the dynamics of MN modulation by NE extend to the spatial domain and recent data suggesting that noradrenergic modulation of the dendritic tree is not uniform but compartmentalized. Implications for information processing are discussed.
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Affiliation(s)
- G D Funk
- Department of Physiology and Pediatrics, University of Alberta, Canada.
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37
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Affiliation(s)
- Nicholas S. McCool
- Department of Chemistry and Chemical Biology, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, United States
| | - David M. Robinson
- Department of Chemistry and Chemical Biology, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, United States
| | - John E. Sheats
- Department of Chemistry and Chemical Biology, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, United States
| | - G. Charles Dismukes
- Department of Chemistry and Chemical Biology, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, United States
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38
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Grützenmacher S, Robinson DM, Sevecke J, Mlynski G, Beule AG. Comparative investigations of anatomy and physiology in mammalian noses (Homo sapiens--Artiodactyla). Rhinology 2011; 49:18-23. [PMID: 21468369 DOI: 10.4193/rhino09.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Knowledge of airflow in animal noses is sparse. Such knowledge could be important for selection of animal models used in environmental studies. From the phylogenetic and ontogenetic point of view, a comparison between the animal and human nose is interesting. METHOD Nose models of 5 even-toed ungulate species (he-goat, sheep, cow, roebuck, wild boar) and two humans (new born infant and adult) were examined. Anatomical and physiological features of the nasal cavities of all species were compared. All models were rinsed with water and the flow was visualized for observation. Geometric and rhinoresistometric measurements were then performed. RESULTS AND CONCLUSIONS Even-toed ungulates have two turbinates directly in the main part of the nasal airflow (respiratory turbinates) and a different number of turbinates in a so-called dead space of the nasal airflow above the nasopharyngeal duct (ethmoidal turbinates). The latter correspond with the upper and middle turbinate in analogy to the human nose. Respiratory turbinates of even-toed ungulates insert immediately behind the external nasal ostium. Thus, the whole nasal cavity acts as a functional area with the exception of a small area acting as dead space only detectable in ruminants, possibly indicating a small evolutionary progress from suinae to bovidae. The shape of the animal nasal cavity is stretched and flat. The airflow runs nearly completely turbulent through the nose. The nasal cavity in the adult human is relatively short and high. The area between the external nasal ostium and the head of the inferior turbinate is called inflow area. It distributes the airflow over the whole nasal cross section and generates a turbulent flow. So the airflow is prepared to contact the mucosa in the functional area (turbinate area). The morphology of the inflow area is approximately formed by the shape of the external nose. The nasal cavity of a newborn child is also stretched and flat and more similar to the nasal shape of the investigated animals. The inflow area in the newborn nose is not yet developed and corresponds with the growing external newborn nose. One can hypothesize that the inflow area in human noses is a morphological adaptation in the changed length-height-ratio of the nasal cavity.
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Affiliation(s)
- S Grützenmacher
- Department of Otorhinolaryngology, Head and Neck Surgery, Dietrich-Bonhoeffer-Klinikum, Neubrandenburg, Germany.
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39
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Robinson DM, Go YB, Greenblatt M, Dismukes GC. Water Oxidation by λ-MnO2: Catalysis by the Cubical Mn4O4 Subcluster Obtained by Delithiation of Spinel LiMn2O4. J Am Chem Soc 2010; 132:11467-9. [DOI: 10.1021/ja1055615] [Citation(s) in RCA: 249] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- David M. Robinson
- Department of Chemistry and Chemical Biology, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854
| | - Yong Bok Go
- Department of Chemistry and Chemical Biology, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854
| | - Martha Greenblatt
- Department of Chemistry and Chemical Biology, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854
| | - G. Charles Dismukes
- Department of Chemistry and Chemical Biology, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854
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LaFond RE, Robinson DM, Kwok WW. CD4+ T cells from allergic individuals recognize epitopes from the common household allergens Der p 1 and Alt a 1 and secrete Th2 cytokines (36.8). The Journal of Immunology 2009. [DOI: 10.4049/jimmunol.182.supp.36.8] [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: 01/03/2023]
Abstract
Abstract
Allergy is initiated by adaptive Th2-mediated responses; however, little is known about CD4+ T cell epitopes within many common allergens. The objectives of this study were to utilize MHC class II tetramers to identify CD4+ T cell epitopes within household allergens and to isolate allergen reactive T cells for further phenotypic analysis. PBMCs were isolated from the blood of subjects with dust mite and mold (Alternaria) allergies and from non-allergic control subjects, and CD4+ T cells were assayed for responses to sets of allergen-derived peptides. Dust mite allergen epitopes within the Der p 1 protein were mapped for DRB1*0301, *0401, *0701, and *1501 individuals; Alternaria allergen epitopes within the Alt a 1 protein were mapped for DRB1*0301, *0401, *0701, and *1101 individuals. Tetramer-positive responses to allergen epitopes were frequently seen in CD4+ T cells from allergic subjects. A high proportion of tetramer-positive cells from allergic individuals secreted IL-5 while TNF-α, IL-10 and IFN-γ secretion occurred less frequently, indicating that the cytokine response to these allergens is predominantly Th2 polarized. Identification of CD4+ T cell epitopes and characterization of T cell responses to allergens will further our understanding of allergic disease and may prove helpful to improve specific immunotherapy.
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Affiliation(s)
| | - David M Robinson
- 2Asthma, Allergy and Immunology, Virginia Mason Medical Center, Seattle, WA
| | - William W Kwok
- 1Benaroya Research Institute, Seattle, WA
- 3Immunology, University of Washington, Seattle, WA
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41
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Soule MH, Robinson DM, Price RM, Saunders-Price B. 2nd International China BioPharmaceutical Symposium. Expert Rev Clin Pharmacol 2009; 2:169-71. [PMID: 24410648 DOI: 10.1586/17512433.2.2.169] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the second of what promises to become a biennial event (the first was held at the same time and venue in 2006), the ICBPS-2 was a repeat collaboration between the two principal organizers: the Chinese Pharmaceutical Association (CPA) of Beijing, China, and the Battelle Memorial Institute, headquartered in Columbus, OH, USA. The CPA is the regulatory and professional body for pharmacists and pharmaceutical scientists in China and is closely aligned with China's State Food and Drug Administration (SFDA). Battelle is an international technology development company and is the world's largest nonprofit independent research and development organization. Applied Science and Analysis, Inc. (HI, USA), assisted Battelle and the CPA in organizing and managing the ICBPS-2. The meeting's main objective was to continue the introduction of Western biotech firms and regulatory entities into the Chinese biopharmaceutical industry initiated at the 2006 symposium. The principal themes of the second gathering were vaccines, antibodies and gene therapeutics. Approximately 40 mainly scientific or policy papers were delivered to an audience of approximately 150 participants, including 50 attendees from outside China.
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Affiliation(s)
- Mason H Soule
- Research Leader, Battelle, 505 King Avenue, Columbus, OH 43016, USA.
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42
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Grutzenmacher S, Robinson DM, Grafe K, Lang C, Mlynski G. First Findings Concerning Airflow in Noses with Septal Deviation and Compensatory Turbinate Hypertrophy – A Model Study. ORL J Otorhinolaryngol Relat Spec 2006; 68:199-205. [PMID: 16479147 DOI: 10.1159/000091473] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2005] [Accepted: 06/30/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND The nasal septal deviation is a common cause of nasal obstruction. On the other hand, many septal deviations are asymptomatic. It seems a physiological adaptation occurs on both sides. Septal deviation leads to internal nasal asymmetry, which in turn causes compensatory change in turbinate morphology (e.g. turbinate hypertrophy respectively hypotrophy). This mechanism is investigated with the help of fluid dynamic experiments and functional rhinologic diagnostics. METHODS Functional models of the nose (modified Mink's boxes) were used and assessment was made by acoustic rhinometry and rhinoresistometry, followed by flow dynamic investigations. Septal deviations of varying position, together with turbinates of differing grades of hypertrophy, were simulated and assessed. RESULTS AND CONCLUSIONS We observed in models of septal deviation an increase in flow resistance on the ipsilateral side as a result of friction of flow particles in the narrowing. Furthermore, on the opposite side of the deviation, the enlargement of the stream channel did not generally lead to a reduction in flow resistance, but rather to a 'dead space', where only a slow-circling eddy was observed. This eddy causes an increase in turbulence. In vivo turbinate hypertrophy occurs to fill this dead space, thereby reducing turbulent flow without a significant increase in resistance. In cases of moderate septal deviation, compensatory mechanisms of the turbinates can lead to a normalization of nasal airflow and surgical therapy would not be indicated. Deviations in the anterior part of the septum seem to be more symptomatic, because the mechanism is missing and due to the physiological narrowing of the nasal isthmus. To differ between physiologic and pathologic deviation, functional diagnostics are needed.
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Affiliation(s)
- S Grutzenmacher
- Department of Otorhinolaryngology, Head and Neck Surgery, Ernst Moritz Arndt University, Greifswald, Germany
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Grützenmacher S, Robinson DM, Lang C, Lebe E, Knape U, Mlynski G. Investigations of the influence of external nose deformities on nasal airflow. ORL J Otorhinolaryngol Relat Spec 2006; 67:154-9. [PMID: 15925912 DOI: 10.1159/000086017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Accepted: 10/15/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND Abnormalities of the external shape of the nose are often felt as cosmetically disturbing. In many cases an additional hampering of the respiratory function of the nose is seen and causes pathological nasal airflow patterns. For the functional outcome of aesthetic-surgery of the nose, knowledge of nasal flow is essential. In the medical literature there are some discrepancies between the relationship of nasal shape and nasal flow. We investigated typical airflow patterns in different abnormalities of the external nose. METHODS We performed fluid dynamic experiments on exact, anatomical nasal models and functional nasal models (so-called modified Mink boxes). We investigated the inspiratory flow pattern in nose-models with typical variations of the shape of the external nose. RESULTS AND CONCLUSIONS There were typical airflow patterns for every external nasal abnormalities. The normal nose shows a disturbance of the streamlines over the entire nasal cavum. Under physiological flow velocities we find laminar and turbulent flow. The pathological variations of the nasal shape show mostly different airflow patterns and characteristics. The main reason for that is a deformed or anatomically false configurated inflow area (vestibulum, isthmus and anterior cavum). During rhinoplasty the reconstruction of the nasal inflow area has to be taken into account.
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Affiliation(s)
- S Grützenmacher
- Department of Otorhinolaryngology, Head and Neck Surgery, Ernst-Moritz-Arndt-University, Greifswald, Germany.
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Kuon E, Dahm JB, Robinson DM, Empen K, Günther M, Wucherer W. Radiation-reducing planning of cardiac catheterisation. ACTA ACUST UNITED AC 2006; 94:663-73. [PMID: 16200481 DOI: 10.1007/s00392-005-0277-3] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2005] [Accepted: 05/13/2005] [Indexed: 11/30/2022]
Abstract
Any radiation exposition for medical purposes should be kept as low as is reasonably achievable. Mean patient radiation exposure of diagnostic cardiac catheterisation is high (16-106 Gy x cm2) and for this reason the International Commission on Radiological Protection (ICRP) recommends credentialing radiation protection training programmes. Twenty cardiologists each documented various dose parameters of 10 cardiac catheterisations, before and after a 90-minute mini-course of the ELICIT study group ("Encourage to Less Irradiating Cardiologic Interventional Techniques"), and could achieve a reduction of the mean dose-area product by 15.9+/-9.0 Gy x cm2, equivalent to 47%. The presented radiation-reducing planning of invasive cardiac catheterisation for this reason is the first one validated in clinical routine and consists of 6 standard runs--one for the left ventricle, 3 and 2 for the left (LCA) and right coronary artery (RCA), respectively--depending on anatomy and findings supplemented by 1...4 special projections. The caudal posteroanterior (PA) view documents the left coronary main stem, proximal and distal left anterior descending artery (LAD), and proximal and mid circumflex segments. The cranial PA view however is suitable for the left coronary orifice, circumflex periphery, LAD, all diagonal bifurcations, and collateral pathways towards the RCA. LCA standard angiography is completed by lateral 90 degrees/0 degrees left anterior oblique (LAO) angulation. The 60 degrees/0 degrees LAO angulation visualises the right posterolateral artery (RPL) and the RCA to its bifurcation. The more proximal one finds the bifurcation, the more the second standard cranial PA view for RCA should vary towards the cranial right anterior oblique (RAO) and finally 30 degrees/0 degrees RAO view. The efficiency of these less-irradiating angulations are improved by radiation-reducing techniques as follows: restriction to essential radiographic frames and runs, consistent collimation to the region of interest--particularly during coronary intubation--, adequate instead of best possible image quality, short skin-to-image-intensifier distance, inspiration during radiography, preference for projections that rotate out the spine, optimisation of fluoroscopy time, well-experienced and well-rested interventionists.
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Affiliation(s)
- E Kuon
- Department of Cardiology, Klinik Fränkische Schweiz, Feuersteinstrasse 2, 91320, Ebermannstadt, Germany.
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Dörr M, Robinson DM, Felix SB, Völzke H. Thyroid function is associated with short rate-adjusted QT intervals. Results from a population-based study. Exp Clin Endocrinol Diabetes 2006. [DOI: 10.1055/s-2006-933047] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Rogers JV, Casbohm SL, Giannunzio LF, Sinnott LT, Rust SW, Brys AM, Durnford JM, Quinn CP, Robinson DM, Hunt RE, Estep JE, Sabourin CLK. Transcriptional analysis of protective antigen-stimulated PBMC from non-human primates vaccinated with the anthrax vaccine absorbed. Vaccine 2006; 24:3609-17. [PMID: 16494973 DOI: 10.1016/j.vaccine.2006.01.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2005] [Revised: 01/24/2006] [Accepted: 01/25/2006] [Indexed: 10/25/2022]
Abstract
The transcriptional responses in recombinant protective antigen (PA)-stimulated peripheral blood mononuclear cells (PBMCs) from Anthrax Vaccine Absorbed (AVA)-vaccinated rhesus macaques were evaluated using Affymetrix HGU133 Plus 2.0 GeneChips. PBMCs from animals vaccinated at 0, 4, and 26 weeks were harvested at week 30, stimulated with PA, and RNA isolated. The expression of 295 unigenes was significantly increased in PA-stimulated compared to non-stimulated PBMCs; no significant decrease in gene expression was observed. These upregulated transcripts encoded for proteins functioning in both innate and adaptive immunity. Results were corroborated for several genes by real-time RT-PCR. This study provides information on the potential underlying transcriptional mechanisms in the immune response to PA in AVA-vaccinated rhesus macaques.
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Affiliation(s)
- James V Rogers
- Battelle Memorial Institute, 505 King Avenue, JM-7, Columbus, OH 43201, USA
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Abstract
OBJECTIVE Little information exists from formerly iodine-deficient areas regarding gender-specific risk factors for goiter and their synergisms. The aim of the present study was to investigate such gender-specific risk factors and their interactions in a large population-based sample. METHODS AND RESULTS The Study of Health in Pomerania (SHIP) comprised 4310 randomly selected participants, aged 20 - 79 years. SHIP was performed in a previously iodine-deficient region. Data from 3915 participants with no known thyroid disorders were analyzed. Goiter was determined by thyroid ultrasound. Sociodemographic characteristics, smoking and alcohol drinking habits, marital status, education level, urine thiocyanate concentrations, and specifically in women, parity and previous or current use of oral contraceptives and hormone replacement therapy, were considered as candidate risk factors for multivariable statistical tests. Only two variables, an advanced age and current smoking, were independently associated with an increased risk for goiter in both genders. Analyses further revealed specific risk factor profiles for goiter which were different among men, pre- and postmenopausal women. CONCLUSION We conclude that besides previous iodine deficiency, other risk factors for goiter exist which differ between gender. Among the avoidable risk factors, current smoking was strongly associated with the risk of goiter in men and women. These findings should influence activities which are intended to prevent thyroid disease.
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Affiliation(s)
- H Völzke
- Institute of Epidemiology and Social Medicine, Ernst Moritz Arndt University Greifswald, Germany.
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Abstract
BACKGROUND The inspiratory medial movement of the nasal wing at high flow velocities is a protective physiologic mechanism. If this collapse of the nasal wing occurs at lower flow velocities, it may result in nasal obstruction. "Nasal wing collapse" is generally a clinical diagnosis. However, in the pressure-flow relationship of rhinomanometry, the medial movement of the nasal wing can be documented in the inspiratory arm of the graph. The diagnostic impact of this hysteresis was investigated. METHODS The pressure-flow curves of three box models and three nasal models with a moveable valve (analogous to the nasal wing) in the entrance area as well as three volunteers with unstable nasal wings were investigated. We recorded synchronously the pressure-flow relationship and by endoscopy the movement of the valve in the box models and the nasal wing in the volunteers on video. For evaluation, we used the frame by frame analysis of the tape. RESULTS AND CONCLUSIONS The medial movement of the nasal wing causes a hysteresis in the inspiratory arm of the pressure-flow curve. At this point, the graph runs on or between two border curves, termed the "no collapse curve" (for the maximally opened valve or a stable nasal wing) and the "collapse curve" (for the subtotally closed valve or a collapsed nasal wing), respectively. Analogous to the nasal wing motion, the descending course of hysteresis runs in two phases, and the ascending course runs in three phases. The medial movement of the nasal wing is expressed by a deviation of the graph from the "no collapse curve." The flow, at which the graph leaves this curve, depends on the elasticity module of the nasal wing. The extent of nasal wing collapse is reflected by the approximation of the pressure-flow curve to the "collapse curve" of the graph. The hysteresis appears because of a late opening of the collapsed nasal wing.
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Affiliation(s)
- S Grützenmacher
- Department of Otorhinolaryngology, Head and Neck Surgery Ernst-Moritz-Arndt-University, Greifswald, Germany.
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Kuon E, Empen K, Robinson DM, Pfahlberg A, Gefeller O, Dahm JB. Efficiency of a minicourse in radiation reducing techniques: a pilot initiative to encourage less irradiating cardiological interventional techniques (ELICIT). Heart 2005; 91:1221-2. [PMID: 16103569 PMCID: PMC1769086 DOI: 10.1136/hrt.2004.048108] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2004] [Indexed: 11/04/2022] Open
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Kuon E, Robinson DM, Baum U. [Chronic dissection of the ascending aorta -- a diagnostic challenge]. Dtsch Med Wochenschr 2005; 130:1756. [PMID: 16049879 DOI: 10.1055/s-2005-871892] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- E Kuon
- Kardiologische Abteilung, Klinik Fraenkische Schweiz, Ebermannstadt.
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