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Valero-Cuevas FJ, Finley J, Orsborn A, Fung N, Hicks JL, Huang HH, Reinkensmeyer D, Schweighofer N, Weber D, Steele KM. NSF DARE-Transforming modeling in neurorehabilitation: Four threads for catalyzing progress. J Neuroeng Rehabil 2024; 21:46. [PMID: 38570842 PMCID: PMC10988973 DOI: 10.1186/s12984-024-01324-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/09/2024] [Indexed: 04/05/2024] Open
Abstract
We present an overview of the Conference on Transformative Opportunities for Modeling in Neurorehabilitation held in March 2023. It was supported by the Disability and Rehabilitation Engineering (DARE) program from the National Science Foundation's Engineering Biology and Health Cluster. The conference brought together experts and trainees from around the world to discuss critical questions, challenges, and opportunities at the intersection of computational modeling and neurorehabilitation to understand, optimize, and improve clinical translation of neurorehabilitation. We organized the conference around four key, relevant, and promising Focus Areas for modeling: Adaptation & Plasticity, Personalization, Human-Device Interactions, and Modeling 'In-the-Wild'. We identified four common threads across the Focus Areas that, if addressed, can catalyze progress in the short, medium, and long terms. These were: (i) the need to capture and curate appropriate and useful data necessary to develop, validate, and deploy useful computational models (ii) the need to create multi-scale models that span the personalization spectrum from individuals to populations, and from cellular to behavioral levels (iii) the need for algorithms that extract as much information from available data, while requiring as little data as possible from each client (iv) the insistence on leveraging readily available sensors and data systems to push model-driven treatments from the lab, and into the clinic, home, workplace, and community. The conference archive can be found at (dare2023.usc.edu). These topics are also extended by three perspective papers prepared by trainees and junior faculty, clinician researchers, and federal funding agency representatives who attended the conference.
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Affiliation(s)
- Francisco J Valero-Cuevas
- Alfred E. Mann Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, Los Angeles, 90089, CA, USA.
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 Alcazar St 155, Los Angeles, 90033, CA, USA.
- Thomas Lord Department of Computer Science, University of Southern California, 941 Bloom Walk, Los Angeles, 90089, CA, USA.
| | - James Finley
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 Alcazar St 155, Los Angeles, 90033, CA, USA
| | - Amy Orsborn
- Department of Electrical and Computer Engineering, University of Washington, 185 W Stevens Way NE, Box 352500, Seattle, 98195, WA, USA
- Department of Bioengineering, University of Washington, 3720 15th Ave NE, Box 355061, Seattle, 98195, WA, USA
- Washington National Primate Research Center, University of Washington, 3018 Western Ave, Seattle, 98121, WA, USA
| | - Natalie Fung
- Thomas Lord Department of Computer Science, University of Southern California, 941 Bloom Walk, Los Angeles, 90089, CA, USA
| | - Jennifer L Hicks
- Department of Bioengineering, Stanford University, 443 Via Ortega, Stanford, 94305, CA, USA
| | - He Helen Huang
- Joint Department of Biomedical Engineering, North Carolina State University, 1840 Entrepreneur Dr Suite 4130, Raleigh, 27606, NC, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, 333 S Columbia St, Chapel Hill, 27514, NC, USA
| | - David Reinkensmeyer
- Department of Mechanical and Aerospace Engineering, UCI Samueli School of Engineering, 3225 Engineering Gateway, Irvine, 92697, CA, USA
| | - Nicolas Schweighofer
- Alfred E. Mann Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, Los Angeles, 90089, CA, USA
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 Alcazar St 155, Los Angeles, 90033, CA, USA
| | - Douglas Weber
- Department of Mechanical Engineering and the Neuroscience Institute, Carnegie Mellon University, 5000 Forbes Avenue, B12 Scaife Hall, Pittsburgh, 15213, PA, USA
| | - Katherine M Steele
- Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Box 352600, Seattle, 98195, WA, USA
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Souza Oliveira D, Ponfick M, Braun DI, Osswald M, Sierotowicz M, Chatterjee S, Weber D, Eskofier B, Castellini C, Farina D, Kinfe TM, Del Vecchio A. A direct spinal cord-computer interface enables the control of the paralysed hand in spinal cord injury. Brain 2024:awae088. [PMID: 38501612 DOI: 10.1093/brain/awae088] [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] [Received: 12/24/2023] [Revised: 01/24/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
The paralysis of the muscles controlling the hand dramatically limits the quality of life of individuals living with spinal cord injury (SCI). Here, with a non-invasive neural interface, we demonstrate that eight motor complete SCI individuals (C5-C6) are still able to task-modulate in real-time the activity of populations of spinal motor neurons with residual neural pathways. In all SCI participants tested, we identified groups of motor units under voluntary control that encoded various hand movements. The motor unit discharges were mapped into more than 10 degrees of freedom, ranging from grasping to individual hand-digit flexion and extension. We then mapped the neural dynamics into a real-time controlled virtual hand. The SCI participants were able to match the cue hand posture by proportionally controlling four degrees of freedom (opening and closing the hand and index flexion/extension). These results demonstrate that wearable muscle sensors provide access to spared motor neurons that are fully under voluntary control in complete cervical SCI individuals. This non-invasive neural interface allows the investigation of motor neuron changes after the injury and has the potential to promote movement restoration when integrated with assistive devices.
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Affiliation(s)
- Daniela Souza Oliveira
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Matthias Ponfick
- Querschnittzentrum Rummelsberg, Krankenhaus Rummelsberg GmbH, 90592 Schwarzenbruck, Germany
| | - Dominik I Braun
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Marius Osswald
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Marek Sierotowicz
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
- Institute of Robotics and Mechatronics, German Aerospace Center (DLR), 82234 Oberpfaffenhofen, Germany
| | - Satyaki Chatterjee
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
| | - Douglas Weber
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA 15213, USA
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Bjoern Eskofier
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
- Translational Digital Health Group, Institute of AI for Health, Helmholtz Zentrum München - German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Claudio Castellini
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
- Institute of Robotics and Mechatronics, German Aerospace Center (DLR), 82234 Oberpfaffenhofen, Germany
| | - Dario Farina
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| | - Thomas Mehari Kinfe
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
- Division of Functional Neurosurgery and Stereotaxy, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Alessandro Del Vecchio
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91052 Erlangen, Germany
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Capogrosso M, Balaguer JM, Prat-Ortega G, Verma N, Yadav P, Sorensen E, de Freitas R, Ensel S, Borda L, Donadio S, Liang L, Ho J, Damiani A, Grigsby E, Fields D, Gonzalez-Martinez J, Gerszten P, Weber D, Pirondini E. Supraspinal control of motoneurons after paralysis enabled by spinal cord stimulation. Res Sq 2024:rs.3.rs-3650257. [PMID: 38260333 PMCID: PMC10802737 DOI: 10.21203/rs.3.rs-3650257/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Spinal cord stimulation (SCS) restores motor control after spinal cord injury (SCI) and stroke. This evidence led to the hypothesis that SCS facilitates residual supraspinal inputs to spinal motoneurons. Instead, here we show that SCS does not facilitate residual supraspinal inputs but directly triggers motoneurons action potentials. However, supraspinal inputs can shape SCS-mediated activity, mimicking volitional control of motoneuron firing. Specifically, by combining simulations, intraspinal electrophysiology in monkeys and single motor unit recordings in humans with motor paralysis, we found that residual supraspinal inputs transform subthreshold SCS-induced excitatory postsynaptic potentials into suprathreshold events. We then demonstrated that only a restricted set of stimulation parameters enables volitional control of motoneuron firing and that lesion severity further restricts the set of effective parameters. Our results explain the facilitation of voluntary motor control during SCS while predicting the limitations of this neurotechnology in cases of severe loss of supraspinal axons.
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Affiliation(s)
| | - Josep-Maria Balaguer
- Rehab and Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
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Abstract
Better integration of assistive robots with humans and adoption of a user-centric approach in their development will improve performance.
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Affiliation(s)
- Douglas Weber
- Douglas Weber is a professor at Neuroscience Institute and Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Amos Matsiko is the Editor of Science Robotics.
| | - Amos Matsiko
- Douglas Weber is a professor at Neuroscience Institute and Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Amos Matsiko is the Editor of Science Robotics.
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Schlenk RF, Weber D, Krzykalla J, Kindler T, Wulf G, Hertenstein B, Salih HR, Südhoff T, Krauter J, Martens U, Wessendorf S, Runde V, Tischler HJ, Bentz M, Koller E, Heuser M, Thol F, Benner A, Ganser A, Döhner K, Döhner H. Randomized phase-III study of low-dose cytarabine and etoposide + /- all-trans retinoic acid in older unfit patients with NPM1-mutated acute myeloid leukemia. Sci Rep 2023; 13:14809. [PMID: 37684299 PMCID: PMC10491626 DOI: 10.1038/s41598-023-41964-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/04/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of this randomized clinical trial was to evaluate the impact of all-trans retinoic acid (ATRA) in combination with non-intensive chemotherapy in older unfit patients (> 60 years) with newly diagnosed NPM1-mutated acute myeloid leukemia. Patients were randomized (1:1) to low-dose chemotherapy with or without open-label ATRA 45 mg/m2, days 8-28; the dose of ATRA was reduced to 45 mg/m2, days 8-10 and 15 mg/m2, days 11-28 after 75 patients due to toxicity. Up to 6 cycles of cytarabine 20 mg/day s.c., bid, days 1-7 and etoposide 100 mg/day, p.o. or i.v., days 1-3 with (ATRA) or without ATRA (CONTROL) were intended. The primary endpoint was overall survival (OS). Between May 2011 and September 2016, 144 patients (median age, 77 years; range, 64-92 years) were randomized (72, CONTROL; 72, ATRA). Baseline characteristics were balanced between the two study arms. The median number of treatment cycles was 2 in ATRA and 2.5 in CONTROL. OS was significantly shorter in the ATRA compared to the CONTROL arm (p = 0.023; median OS: 5 months versus 9.2 months, 2-years OS rate: 7% versus 10%, respectively). Rates of CR/CRi were not different between treatment arms; infections were more common in ATRA beyond treatment cycle one. The addition of ATRA to low-dose cytarabine plus etoposide in an older, unfit patient population was not beneficial, but rather led to an inferior outcome.The clinical trial is registered at clinicaltrialsregister.eu (EudraCT Number: 2010-023409-37, first posted 14/12/2010).
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Affiliation(s)
- R F Schlenk
- NCT-Trial Center, National Center of Tumor Diseases, Heidelberg University Hospital and German Cancer Research Center, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.
| | - D Weber
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - J Krzykalla
- Division of Biostatistics, German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - T Kindler
- Department of Hematology, Medical Oncology and Pneumology, University Medical Center Mainz, Mainz, Germany
| | - G Wulf
- Department of Hematology and Oncology, University Hospital of Göttingen, Göttingen, Germany
| | - B Hertenstein
- Department of Hematology and Oncology, Klinikum Bremen Mitte, Bremen, Germany
| | - H R Salih
- Department of Hematology and Oncology, Eberhard-Karls University, Tübingen, Germany
| | - T Südhoff
- Department of Hematology and Oncology, Klinikum Passau, Passau, Germany
| | - J Krauter
- Department Hematology and Oncology, Braunschweig Municipal Hospital, Braunschweig, Germany
| | - U Martens
- Department of Hematology and Oncology, Klinikum am Gesundbrunnen, Heilbronn, Germany
| | - S Wessendorf
- Department of Hematology and Oncology, Klinikum Esslingen, Esslingen, Germany
| | - V Runde
- Department of Hematology/Oncology, Wilhelm-Anton Hospital Goch, Goch, Germany
| | - H J Tischler
- Department of Hematology and Oncology, University Hospital of Minden, Minden, Germany
| | - M Bentz
- Department of Hematology and Oncology, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - E Koller
- Department of Internal Medicine III, Hanuschkrankenhaus Wien, Wien, Austria
| | - M Heuser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - F Thol
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - A Benner
- Division of Biostatistics, German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - A Ganser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - K Döhner
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - H Döhner
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
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Mitchell P, Lee SCM, Yoo PE, Morokoff A, Sharma RP, Williams DL, MacIsaac C, Howard ME, Irving L, Vrljic I, Williams C, Bush S, Balabanski AH, Drummond KJ, Desmond P, Weber D, Denison T, Mathers S, O’Brien TJ, Mocco J, Grayden DB, Liebeskind DS, Opie NL, Oxley TJ, Campbell BCV. Assessment of Safety of a Fully Implanted Endovascular Brain-Computer Interface for Severe Paralysis in 4 Patients: The Stentrode With Thought-Controlled Digital Switch (SWITCH) Study. JAMA Neurol 2023; 80:270-278. [PMID: 36622685 PMCID: PMC9857731 DOI: 10.1001/jamaneurol.2022.4847] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [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: 06/24/2022] [Accepted: 10/18/2022] [Indexed: 01/10/2023]
Abstract
Importance Brain-computer interface (BCI) implants have previously required craniotomy to deliver penetrating or surface electrodes to the brain. Whether a minimally invasive endovascular technique to deliver recording electrodes through the jugular vein to superior sagittal sinus is safe and feasible is unknown. Objective To assess the safety of an endovascular BCI and feasibility of using the system to control a computer by thought. Design, Setting, and Participants The Stentrode With Thought-Controlled Digital Switch (SWITCH) study, a single-center, prospective, first in-human study, evaluated 5 patients with severe bilateral upper-limb paralysis, with a follow-up of 12 months. From a referred sample, 4 patients with amyotrophic lateral sclerosis and 1 with primary lateral sclerosis met inclusion criteria and were enrolled in the study. Surgical procedures and follow-up visits were performed at the Royal Melbourne Hospital, Parkville, Australia. Training sessions were performed at patients' homes and at a university clinic. The study start date was May 27, 2019, and final follow-up was completed January 9, 2022. Interventions Recording devices were delivered via catheter and connected to subcutaneous electronic units. Devices communicated wirelessly to an external device for personal computer control. Main Outcomes and Measures The primary safety end point was device-related serious adverse events resulting in death or permanent increased disability. Secondary end points were blood vessel occlusion and device migration. Exploratory end points were signal fidelity and stability over 12 months, number of distinct commands created by neuronal activity, and use of system for digital device control. Results Of 4 patients included in analyses, all were male, and the mean (SD) age was 61 (17) years. Patients with preserved motor cortex activity and suitable venous anatomy were implanted. Each completed 12-month follow-up with no serious adverse events and no vessel occlusion or device migration. Mean (SD) signal bandwidth was 233 (16) Hz and was stable throughout study in all 4 patients (SD range across all sessions, 7-32 Hz). At least 5 attempted movement types were decoded offline, and each patient successfully controlled a computer with the BCI. Conclusions and Relevance Endovascular access to the sensorimotor cortex is an alternative to placing BCI electrodes in or on the dura by open-brain surgery. These final safety and feasibility data from the first in-human SWITCH study indicate that it is possible to record neural signals from a blood vessel. The favorable safety profile could promote wider and more rapid translation of BCI to people with paralysis. Trial Registration ClinicalTrials.gov Identifier: NCT03834857.
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Affiliation(s)
- Peter Mitchell
- Department of Radiology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
| | - Sarah C. M. Lee
- Neurology, Calvary Healthcare Bethlehem, Parkdale, Australia
| | | | - Andrew Morokoff
- Parkville Neurosurgery, The University of Melbourne, Royal Melbourne Hospital, Parkville, Australia
| | - Rahul P. Sharma
- Stanford Healthcare Cardiovascular Medicine, Stanford University, Stanford, California
| | - Daryl L. Williams
- Department of Anaesthesia and Pain Management, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
| | - Christopher MacIsaac
- Intensive Care Department, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
| | - Mark E. Howard
- Victorian Respiratory Support Service, Austin Health, Heidelberg, Australia
| | - Lou Irving
- Peter MacCallum Cancer Centre, The University of Melbourne, The Royal Melbourne Hospital, Melbourne, Australia
| | - Ivan Vrljic
- Department of Radiology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
| | - Cameron Williams
- Department of Neurology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
| | - Steven Bush
- Department of Neurology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
| | - Anna H. Balabanski
- Department of Neurology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
- Melbourne Brain Centre, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
- Department of Neuroscience, Alfred Brain, Alfred Health, Melbourne, Australia
| | - Katharine J. Drummond
- Department of Neurosurgery, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
| | - Patricia Desmond
- Department of Radiology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
| | - Douglas Weber
- Department of Biomedical Engineering, College of Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Timothy Denison
- Institute of Biomedical Engineering, The University of Oxford, Oxford, United Kingdom
| | - Susan Mathers
- Neurology, Calvary Healthcare Bethlehem, Parkdale, Australia
| | - Terence J. O’Brien
- Department of Neurology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
- Department of Medicine, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
- Department of Neuroscience, The Central Clinical School, Monash University and Alfred Health, Melbourne, Australia
| | - J. Mocco
- Department of Neurosurgery, Klingenstein Clinical Center, The Mount Sinai Hospital, New York, New York
| | - David B. Grayden
- Department of Biomedical Engineering, Faculty of Engineering and Information Technology, The University of Melbourne, Parkville, Australia
| | - David S. Liebeskind
- UCLA Comprehensive Stroke Center, Department of Neurology, University of California, Los Angeles
| | - Nicholas L. Opie
- Vascular Bionics Laboratory, Department of Medicine, The University of Melbourne, Melbourne, Australia
- Synchron, Carlton, Australia
| | - Thomas J. Oxley
- Synchron Inc, New York, New York
- Vascular Bionics Laboratory, Department of Medicine, The University of Melbourne, Melbourne, Australia
| | - Bruce C. V. Campbell
- Department of Neurology, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
- Melbourne Brain Centre, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia
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Weber D, de Souza Bastos L, Winkler M, Ni Y, Aliev AE, Hailes HC, Rother D. Multi-enzyme catalysed processes using purified and whole-cell biocatalysts towards a 1,3,4-substituted tetrahydroisoquinoline †‡. RSC Adv 2023; 13:10097-10109. [PMID: 37006360 PMCID: PMC10053099 DOI: 10.1039/d3ra01210g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/21/2023] [Indexed: 03/31/2023] Open
Abstract
In this work, two multi-enzyme catalysed processes to access a 1,3,4-substituted tetrahydroisoquinoline (THIQ), using either purified enzymes or lyophilised whole-cell catalysts, are presented. A key focus was the first step in which the reduction of 3-hydroxybenzoic acid (3-OH-BZ) into 3-hydroxybenzaldehyde (3-OH-BA) was catalysed by a carboxylate reductase (CAR) enzyme. Incorporation of the CAR-catalysed step enables substituted benzoic acids as the aromatic components, which can potentially be obtained from renewable resources by microbial cell factories. In this reduction, the implementation of an efficient cofactor regeneration system of both ATP and NADPH was crucial. Two different recycling approaches, either using purified enzymes or lyophilised whole-cells, were established and compared. Both of them showed high conversions of the acid into 3-OH-BA (>80%). However, the whole-cell system showed superior performance because it allowed the combination of the first and second steps into a one-pot cascade with excellent HPLC yields (>99%, enantiomeric excess (ee) ≥ 95%) producing the intermediate 3-hydroxyphenylacetylcarbinol. Moreover, enhanced substrate loads could be achieved compared to the system employing only purified enzymes. The third and fourth steps were performed in a sequential mode to avoid cross-reactivities and the formation of several side products. Thus, (1R,2S)-metaraminol could be formed with high HPLC yields (>90%, isomeric content (ic) ≥ 95%) applying either purified or whole-cell transaminases from Bacillus megaterium (BmTA) or Chromobacterium violaceum (Cv2025). Finally, the cyclisation step was performed using either a purified or lyophilised whole-cell norcoclaurine synthase variant from Thalictrum flavum (ΔTfNCS-A79I), leading to the formation of the target THIQ product with high HPLC yields (>90%, ic > 90%). As many of the educts applied are from renewable resources and a complex product with three chiral centers can be gained by only four highly selective steps, a very step- and atom efficient approach to stereoisomerically pure THIQ is shown. In this work, two multi-enzyme catalysed processes to access a 1,3,4-substituted tetrahydroisoquinoline (THIQ), using either purified enzymes or lyophilised whole-cell catalysts, are presented.![]()
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Affiliation(s)
- Douglas Weber
- Institute of Bio- and Geosciences (IBG-1): Biotechnology, Forschungszentrum Juelich GmbH52425 JuelichGermany
- Aachen Biology and Biotechnology (ABBt), RWTH Aachen UniversityWorringer Weg 152062 AachenGermany
| | - Lucas de Souza Bastos
- Institute of Bio- and Geosciences (IBG-1): Biotechnology, Forschungszentrum Juelich GmbH52425 JuelichGermany
| | - Margit Winkler
- acib GmbHKrenngasse 37A-8010 GrazAustria
- Institute of Molecular Biotechnology, Graz University of TechnologyPetersgasse 148010 GrazAustria
| | - Yeke Ni
- Department of Chemistry, University College LondonLondonWC1H 0AJUK
| | - Abil E. Aliev
- Department of Chemistry, University College LondonLondonWC1H 0AJUK
| | - Helen C. Hailes
- Department of Chemistry, University College LondonLondonWC1H 0AJUK
| | - Doerte Rother
- Institute of Bio- and Geosciences (IBG-1): Biotechnology, Forschungszentrum Juelich GmbH52425 JuelichGermany
- Aachen Biology and Biotechnology (ABBt), RWTH Aachen UniversityWorringer Weg 152062 AachenGermany
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Manzar G, Wu S, Khan M, Corrigan K, Yoder A, Gunther J, Thomas S, Manasanch E, Lee H, Lim T, Amini B, Lin P, Orlowski R, Patel K, Becnel M, Kaufman G, Weber D, Dabaja B, Pinnix C, Fang P. Outcome of Patients with Central Nervous System Multiple Myeloma (CNS-MM) Treated with CNS-Directed Radiation Therapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Carlotto FM, Gelain AP, Zanotelli C, Weber D. LEUCEMIA MEGACARIOBLÁSTICA AGUDA: UM RELATO DE CASO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.285] [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: 11/06/2022] Open
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Carlotto FM, Gelain AP, Zanotelli C, Weber D. LINFOMA EM ÓRBITA OCULAR: RARA LOCALIZAÇÃO DE LINFOMA NÃO HODGKIN. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.182] [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: 11/11/2022] Open
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Carlotto FM, Gelain AP, Zanotelli C, Weber D. LINFOMA DE CÉLULAS T DO ADULTO: UM RELATO DE CASO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.181] [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: 11/05/2022] Open
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Weber D, Gesswein H, Bianchini M, Brezesinski T. Tracking the high-temperature synthesis of LiNiO 2 under oxygen gas flow by laboratory-based X-ray diffraction. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322090258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Weber D, Ibn-Salem J, Sorn P, Suchan M, Holtsträter C, Lahrmann U, Vogler I, Schmoldt K, Lang F, Schrörs B, Löwer M, Sahin U. Accurate detection of tumor-specific gene fusions reveals strongly immunogenic personal neo-antigens. Nat Biotechnol 2022; 40:1276-1284. [PMID: 35379963 PMCID: PMC7613288 DOI: 10.1038/s41587-022-01247-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/02/2022] [Indexed: 02/03/2023]
Abstract
Cancer-associated gene fusions are a potential source for highly immunogenic neoantigens, but the lack of computational tools for accurate, sensitive identification of personal gene fusions has limited their targeting in personalized cancer immunotherapy. Here we present EasyFuse, a machine learning computational pipeline for detecting cancer-specific gene fusions in transcriptome data obtained from human cancer samples. EasyFuse predicts personal gene fusions with high precision and sensitivity, outperforming previously described tools. By testing immunogenicity with autologous blood lymphocytes from patients with cancer, we detected pre-established CD4+ and CD8+ T cell responses for 10 of 21 (48%) and for 1 of 30 (3%) identified gene fusions, respectively. The high frequency of T cell responses detected in patients with cancer supports the relevance of individual gene fusions as neoantigens that might be targeted in personalized immunotherapies, especially for tumors with low mutation burden.
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Affiliation(s)
- D Weber
- TRON − Translational Oncology at the University Medical Center of Johannes Gutenberg University Mainz gGmbH, Mainz, Germany
| | - J Ibn-Salem
- TRON − Translational Oncology at the University Medical Center of Johannes Gutenberg University Mainz gGmbH, Mainz, Germany
| | - P Sorn
- TRON − Translational Oncology at the University Medical Center of Johannes Gutenberg University Mainz gGmbH, Mainz, Germany
| | - M Suchan
- TRON − Translational Oncology at the University Medical Center of Johannes Gutenberg University Mainz gGmbH, Mainz, Germany
| | - C Holtsträter
- TRON − Translational Oncology at the University Medical Center of Johannes Gutenberg University Mainz gGmbH, Mainz, Germany
| | | | | | | | - F Lang
- TRON − Translational Oncology at the University Medical Center of Johannes Gutenberg University Mainz gGmbH, Mainz, Germany
| | - B Schrörs
- TRON − Translational Oncology at the University Medical Center of Johannes Gutenberg University Mainz gGmbH, Mainz, Germany
| | - M Löwer
- TRON − Translational Oncology at the University Medical Center of Johannes Gutenberg University Mainz gGmbH, Mainz, Germany
| | - U Sahin
- TRON − Translational Oncology at the University Medical Center of Johannes Gutenberg University Mainz gGmbH, Mainz, Germany,BioNTech SE, Mainz, Germany,Johannes Gutenberg University Mainz, Mainz, Germany,corresponding author:
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14
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Fisher L, Nanivadekar A, Farooqui J, Weber D, Gaunt R, Capogrosso M, Lempka S. ID:16233 Selective Stimulation of the Dorsal Root Ganglia With Epineural Macroelectrodes. Neuromodulation 2022. [DOI: 10.1016/j.neurom.2022.02.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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15
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Ruecker FG, Corbacioglu A, Theis F, Christopeit M, Germing U, Wulf G, Abu Samra M, Teichmann L, Lübbert M, Kühn MW, Bentz M, Westermann J, Bullinger L, Gaidzik VI, Jahn E, Gröger M, Kapp-Schwoerer S, Weber D, Thol F, Heuser M, Ganser A, Döhner H, Döhner K. P448: PROGNOSTIC IMPACT OF SOMATIC CEBPA BZIP DOMAIN MUTATIONS IN ACUTE MYELOID LEUKEMIA. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000844680.77570.26] [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: 11/25/2022] Open
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16
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Bachtiary B, Veraguth D, Roos N, von Felten S, Weber D. PD-0826 Hearing in cancer patients with skull base tumors undergoing pencil beam scanning proton therapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02967-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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17
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Guo M, Batin E, Bolsi A, Safai S, Weber D, Lomax A, Chen Z, Zhang Y. PD-0402 Impact of CBCT-based patient positioning uncertainty due to the ROI/DOF selection for proton therapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02837-7] [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: 11/25/2022]
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18
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Zhang Y, Vatterodt N, Duetschler A, Safai S, Weber D, Lomax A. OC-0039 Improving 4D optimized Pencil Beam Scanned proton plan robustness using motion guided dose delivery. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02458-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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D'Ancona G, Arslan F, Safak E, Weber D, Ince H. Percutaneous left atrial appendage closure reduces cost of care independent of the institutional cumulative caseload in patients with non-valvular atrial fibrillation. Neth Heart J 2022; 30:481-485. [PMID: 35352274 PMCID: PMC9474975 DOI: 10.1007/s12471-022-01675-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2022] [Indexed: 11/30/2022] Open
Abstract
Background Data on the impact of the cumulative percutaneous left atrial appendage closure (LAAC) caseload on cardiovascular outpatient and hospitalisation costs are limited. Methods The present single-institution analysis includes patients treated consecutively from the beginning of our LAAC experience in January 2012 until December 2016. Pre- and post-LAAC costs for hospitalisation and ambulatory visits were included. Results A total of 676 patients underwent percutaneous LAAC (using the Watchman device): 49 (2012), 78 (2013), 211 (2014), 210 (2015), and 129 (2016). LAAC procedural costs were stable over the years (overall median €9639; 2012: €9630; 2013: €10,003; 2014: €9841; 2015: €9394; 2016: €9530; p = 0.8) and there was no correlation between cumulative caseload and procedural costs (p = 0.9). Although annualised cardiovascular management costs after LAAC were lower than before LAAC (median difference between pre-LAAC and post-LAAC yearly costs: €727; 2012: €235; 2013: €1187; 2014: €716; 2015: €527; 2016: €1052; p = 0.5 among years analysed) from the beginning of the cumulative procedural experience, a significant reduction in costs was observed only from 2014 onwards. Institutional cumulative LAAC caseload and year of procedure were not related to the amount of reduction in the costs for cardiovascular care. Conclusion LAAC led to cost-of-care savings from the beginning of our institutional procedural experience.
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Affiliation(s)
- G D'Ancona
- Department of Cardiology, Vivantes Klinikum Am Urban, Berlin, Germany.
| | - F Arslan
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - E Safak
- Department of Cardiology, Vivantes Klinikum Wenckebach, Berlin, Germany
| | - D Weber
- Department of Cardiology, Vivantes Klinikum Am Urban, Berlin, Germany
| | - H Ince
- Department of Cardiology, Vivantes Klinikum Am Urban, Berlin, Germany
- Department of Cardiology, Rostock University, Rostock, Germany
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20
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Laux ML, Braun C, Weber D, Moldasheva A, Schroeter F, Albes J. Oxidative Stress of Cardiac Surgery Is Higher in Old and Obese Patients. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M. L. Laux
- Department of Cardiovascular Surgery, Heart Center Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Deutschland
| | - C. Braun
- Department of Cardiovascular Surgery, Heart Center Brandenburg, University Hospital Brandenburg Medical School, Bernau bei Berlin, Deutschland
| | - D. Weber
- Department of Molecular Toxicology, German Institute of Human Nutrition, Nuthetal, Deutschland
| | - A. Moldasheva
- Department of Molecular Toxicology, German Institute of Human Nutrition, Nuthetal, Deutschland
| | - F. Schroeter
- Department of Cardiovascular Surgery, Heart Center Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Deutschland
| | - J. Albes
- Department of Cardiovascular Surgery, Heart Center Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Deutschland
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21
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Haß U, Herpich C, Kochlik B, Weber D, Grune T, Norman K. Dietary Inflammatory Index and Cross-Sectional Associations with Inflammation, Muscle Mass and Function in Healthy Old Adults. J Nutr Health Aging 2022; 26:346-351. [PMID: 35450990 DOI: 10.1007/s12603-022-1753-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Inflammaging is considered a driver of age-related loss of muscle mass and function (sarcopenia). As nutrition might play a role in this process, the Dietary Inflammatory Index® (DII) has been developed to quantify the inflammatory potential of an individual diet. OBJECTIVES We aimed to examine associations between the DII, inflammation, oxidative stress and sarcopenia-related parameters in healthy old compared to young adults. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included data of 79 community-dwelling, healthy old adults (65-85 years) and 59 young adults (18-35 years) who participated in a randomized controlled trial from April to December 2019. MEASUREMENTS The DII was computed with dietary data collected from 24-h recall interviews. Associations between the DII, inflammatory and oxidative stress markers as well as bioimpedance-derived body composition, handgrip strength and gait speed were determined with multiple linear regression analyses adjusted for age, sex, physical activity and insulin resistance. RESULTS Regression analyses revealed significant relationships between a higher interleukin (IL) 6 and IL-6:IL-10-ratio and higher percentage fat mass (%FM), waist-to-height-ratio (WHtR) as well as lower percentage skeletal muscle mass (%SMM) and gait speed exclusively in old adults. Subsequent analyses showed that IL-6 was associated with a pro-inflammatory diet as indicated by a higher DII, again exclusively in old adults (beta coefficient (β)= 0.027, standard error (SE) 0.013, p=0.037). While the DII was not related with handgrip strength or oxidative stress in neither old nor young adults, linear models confirmed that a higher DII was inversely associated with gait speed in old participants (β= -0.022, SE 0.006, p<0.001). Finally, a pro-inflammatory diet was significantly associated with higher %FM, WHtR and lower %SMM in both age groups. CONCLUSION AND RELEVANCE A pro-inflammatory diet reflected by the DII is associated with higher systemic inflammation, slower gait speed as well as lower muscle mass in old adults. Intervention studies are needed to examine whether anti-inflammatory dietary approaches can help to improve muscle mass and function and thus minimize the risk for sarcopenia in the long-term.
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Affiliation(s)
- U Haß
- Prof. Dr. Kristina Norman, University of Potsdam, Institute of Nutritional Science, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany,
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22
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Haß U, Herpich C, Kochlik B, Weber D, Grune T, Norman K. Dietary inflammatory index and associations with inflammaging as well as muscle mass and function in healthy old adults. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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23
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Carlotto FM, Ughini MO, Zanotelli C, Weber D, Almeida DR. LEUCEMIA MIELÓIDE CRÔNICA: REVISÃO DE LITERATURA E ANÁLISE EPIDEMIOLÓGICA DA CIDADE DE PASSO FUNDO, NO RIO GRANDE DO SUL. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.231] [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: 11/30/2022] Open
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24
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Carlotto FM, Corrêa NB, Zanotelli C, Weber D. LINFOMA NÃO HODGKIN DIFUSO DE GRANDES CÉLULAS B ASSOCIADO À DOENÇA DE STILL: RARO RELATO NA LITERATURA. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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25
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Carlotto FM, Corrêa NB, Zanotelli C, Weber D. LINFOMA PRIMÁRIO DE OSSO TEMPORAL: RARO CASO NA LITERATURA. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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26
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Vlachou E, Kümmel S, Künzel N, Breit E, Schindowski D, Pankert K, Hentsch S, Hanf V, Weber D, Graßhoff ST, Müller C, Lucke W, Deuschle P, Engellandt K, Rüland A, Dall P, Harrach H, Bruzas S, Chiari O, Reinisch M. 201TiP Evaluation of the feasibility of ultrasound-guided clipping of suspicious intramammary lesions in primary breast cancer patients receiving neoadjuvant therapy (Ultra3Detect). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.482] [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: 11/25/2022] Open
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27
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Sethi A, Ting J, Allen M, Clark W, Weber D. Advances in motion and electromyography based wearable technology for upper extremity function rehabilitation: A review. J Hand Ther 2021; 33:180-187. [PMID: 32279878 DOI: 10.1016/j.jht.2019.12.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/18/2019] [Accepted: 12/02/2019] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Scoping review. INTRODUCTION With the recent advances in technologies, interactive wearable technologies including inertial motion sensors and e-textiles are emerging in the field of rehabilitation to monitor and provide feedback and therapy remotely. PURPOSE OF THE STUDY This review article focuses on inertial measurement unit motion sensor and e-textiles-based technologies and proposes approaches to augment these interactive wearable technologies. METHODS We conducted a comprehensive search of relevant electronic databases (eg, PubMed, the Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, The Cochrane Central Register of Controlled Trial, and the Physiotherapy Evidence Database). The scoping review included all study designs. RESULTS Currently, there are a numerous research groups and companies investigating inertial motion sensors and e-textiles-based interactive wearable technologies. However, translation of these technologies to the clinic would need further research to increase ease of use and improve clinical validity of the outcomes of these technologies. DISCUSSION The current review discusses the limitations of the interactive wearable technologies such as, limited clinical utility, bulky equipment, difficulty in setting up equipment inertial motion sensors and e-textiles. CONCLUSION There is tremendous potential for interactive wearable technologies in rehabilitation. With the evolution of cloud computing, interactive wearable systems can remotely provide intervention and monitor patient progress using models of telerehabilitation. This will revolutionize the delivery of rehabilitation and make rehabilitation more accessible and affordable to millions of individuals.
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Affiliation(s)
- Amit Sethi
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Jordyn Ting
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marcus Allen
- Department of Mechanical Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - William Clark
- Department of Mechanical Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Douglas Weber
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
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28
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Suzuki H, Liu H, Bertinshaw J, Ueda K, Kim H, Laha S, Weber D, Yang Z, Wang L, Takahashi H, Fürsich K, Minola M, Lotsch BV, Kim BJ, Yavaş H, Daghofer M, Chaloupka J, Khaliullin G, Gretarsson H, Keimer B. Proximate ferromagnetic state in the Kitaev model material α-RuCl 3. Nat Commun 2021; 12:4512. [PMID: 34301938 PMCID: PMC8302668 DOI: 10.1038/s41467-021-24722-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/01/2021] [Indexed: 11/27/2022] Open
Abstract
α-RuCl3 is a major candidate for the realization of the Kitaev quantum spin liquid, but its zigzag antiferromagnetic order at low temperatures indicates deviations from the Kitaev model. We have quantified the spin Hamiltonian of α-RuCl3 by a resonant inelastic x-ray scattering study at the Ru L3 absorption edge. In the paramagnetic state, the quasi-elastic intensity of magnetic excitations has a broad maximum around the zone center without any local maxima at the zigzag magnetic Bragg wavevectors. This finding implies that the zigzag order is fragile and readily destabilized by competing ferromagnetic correlations. The classical ground state of the experimentally determined Hamiltonian is actually ferromagnetic. The zigzag state is stabilized by quantum fluctuations, leaving ferromagnetism – along with the Kitaev spin liquid – as energetically proximate metastable states. The three closely competing states and their collective excitations hold the key to the theoretical understanding of the unusual properties of α-RuCl3 in magnetic fields. RuCl3 has stood out as a prime candidate in the search for quantum spin liquids; however, its antiferromagnetic ordering at low temperature suggests deviations from typical QSL models. Here, using resonant inelastic x-ray scattering, the authors provide a comprehensive determination of the low energy effective Hamiltonian.
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Affiliation(s)
- H Suzuki
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.
| | - H Liu
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.
| | - J Bertinshaw
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - K Ueda
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.,Department of Applied Physics, University of Tokyo, Tokyo, Japan
| | - H Kim
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.,Department of Physics, Pohang University of Science and Technology, Pohang, South Korea.,Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, South Korea
| | - S Laha
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - D Weber
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.,Institute of Nanotechnology, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Z Yang
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - L Wang
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - H Takahashi
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - K Fürsich
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - M Minola
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - B V Lotsch
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.,Department of Chemistry, University of Munich (LMU), München, Germany
| | - B J Kim
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.,Department of Physics, Pohang University of Science and Technology, Pohang, South Korea.,Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, South Korea
| | - H Yavaş
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany.,SLAC National Accelerator Laboratory, Menlo Park, CA, USA
| | - M Daghofer
- Institute for Functional Matter and Quantum Technologies, University of Stuttgart, Stuttgart, Germany.,Center for Integrated Quantum Science and Technology, University of Stuttgart, Stuttgart, Germany
| | - J Chaloupka
- Department of Condensed Matter Physics, Faculty of Science, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - G Khaliullin
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - H Gretarsson
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.,Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - B Keimer
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.
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29
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El Shafie RA, Seidensaal K, Bozorgmehr F, Kazdal D, Eichkorn T, Elshiaty M, Weber D, Allgäuer M, König L, Lang K, Forster T, Arians N, Rieken S, Heussel CP, Herth FJ, Thomas M, Stenzinger A, Debus J, Christopoulos P. Effect of timing, technique and molecular features on brain control with local therapies in oncogene-driven lung cancer. ESMO Open 2021; 6:100161. [PMID: 34090172 PMCID: PMC8182387 DOI: 10.1016/j.esmoop.2021.100161] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/24/2021] [Accepted: 04/29/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The improved efficacy of tyrosine kinase inhibitors (TKI) mandates reappraisal of local therapy (LT) for brain metastases (BM) of oncogene-driven non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS This study included all epidermal growth factor receptor-mutated (EGFR+, n = 108) and anaplastic lymphoma kinase-rearranged (ALK+, n = 33) TKI-naive NSCLC patients diagnosed with BM in the Thoraxklinik Heidelberg between 2009 and 2019. Eighty-seven patients (62%) received early LT, while 54 (38%) received delayed (n = 34; 24%) or no LT (n = 20; 14%). LT comprised stereotactic (SRT; n = 40; 34%) or whole-brain radiotherapy (WBRT; n = 77; 66%), while neurosurgical resection was carried out in 19 cases. RESULTS Median overall survival (OS) was 49.1 months for ALK+ and 19.5 months for EGFR+ patients (P = 0.001), with similar median intracranial progression-free survival (icPFS) (15.7 versus 14.0 months, respectively; P = 0.80). Despite the larger and more symptomatic BM (P < 0.001) of patients undergoing early LT, these experienced longer icPFS [hazard ratio (HR) 0.52; P = 0.024], but not OS (HR 1.63; P = 0.12), regardless of the radiotherapy technique (SRT versus WBRT) and number of lesions. High-risk oncogene variants, i.e. non-del19 EGFR mutations and 'short' EML4-ALK fusions (mainly variant 3, E6:A20), were associated with earlier intracranial progression (HR 2.97; P = 0.001). The longer icPFS with early LT was also evident in separate analyses of the EGFR+ and ALK+ subsets. CONCLUSIONS Despite preferential use for cases with poor prognostic factors, early LT prolongs the icPFS, but not OS, in TKI-treated EGFR+/ALK+ NSCLC. Considering the lack of survival benefit, and the neurocognitive effects of WBRT, patients presenting with polytopic BM may benefit from delaying radiotherapy, or from radiosurgery of multiple or selected lesions. For SRT candidates, the improved tumor control with earlier radiotherapy should be weighed against the potential toxicity and the enhanced intracranial activity of newer TKI. High-risk EGFR/ALK variants are associated with earlier intracranial failure and identify patients who could benefit from more aggressive management.
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Affiliation(s)
- R A El Shafie
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany; Department of Radiology and Nuclear Medicines, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany.
| | - K Seidensaal
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany; Department of Radiology and Nuclear Medicines, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - F Bozorgmehr
- Department of Thoracic Oncology, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - D Kazdal
- Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany; Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - T Eichkorn
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany; Department of Radiology and Nuclear Medicines, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - M Elshiaty
- Department of Thoracic Oncology, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - D Weber
- Institute of Medical Biometry and Informatics (IMBI), Heidelberg University Hospital, Heidelberg, Germany
| | - M Allgäuer
- Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany; Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - L König
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany; Department of Radiology and Nuclear Medicines, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - K Lang
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany; Department of Radiology and Nuclear Medicines, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - T Forster
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany; Department of Radiology and Nuclear Medicines, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - N Arians
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany; Department of Radiology and Nuclear Medicines, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - S Rieken
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany; University Medical Center Göttingen, Department of Radiation Oncology, Göttingen, Germany
| | - C-P Heussel
- Department of Radiology and Nuclear Medicines, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - F J Herth
- Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany; Department of Pneumology, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - M Thomas
- Department of Thoracic Oncology, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - A Stenzinger
- Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany; Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - J Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Clinical Cooperation Unit Radiation Oncology (E050), German Cancer Research Center (DKFZ), Heidelberg, Germany; Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany; Heidelberger Ionenstrahltherapie-Zentrum (HIT), Heidelberg, Germany
| | - P Christopoulos
- Department of Thoracic Oncology, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Heidelberg, Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany.
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Weber D, Patsch D, Neumann A, Winkler M, Rother D. Production of the Carboxylate Reductase from Nocardia otitidiscaviarum in a Soluble, Active Form for in vitro Applications. Chembiochem 2021; 22:1823-1832. [PMID: 33527702 PMCID: PMC8251736 DOI: 10.1002/cbic.202000846] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/28/2021] [Indexed: 01/22/2023]
Abstract
Accessing aldehydes from carboxylate moieties is often a challenging task. In this regard, carboxylate reductases (CARs) are promising catalysts provided by nature that are able to accomplish this task in just one step, avoiding over-reduction to the alcohol product. However, the heterologous expression of CARs can be quite difficult due to the excessive formation of insoluble protein, thus hindering further characterization and application of the enzyme. Here, the heterologous production of the carboxylate reductase from Nocardia otitidiscaviarum (NoCAR) was optimized by a combination of i) optimized cultivation conditions, ii) post-translational modification with a phosphopantetheinyl transferase and iii) selection of an appropriate expression strain. Especially, the selection of Escherichia coli tuner cells as host had a strong effect on the final 110-fold increase in the specific activity of NoCAR. This highly active NoCAR was used to reduce sodium benzoate to benzaldehyde, and it was successfully assembled with an in vitro regeneration of ATP and NADPH, being capable of reducing about 30 mM sodium benzoate with high selectivity in only 2 h of reaction.
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Affiliation(s)
- Douglas Weber
- Institute of Bio- and Geosciences (IBG-1)Biotechnology Forschungszentrum Jülich GmbHLeo-Brandt-Str. 152425JülichGermany
- Aachen Biology and Biotechnology (ABBt)RWTH Aachen UniversityWorringer Weg 152074AachenGermany
| | - David Patsch
- Institute of Bio- and Geosciences (IBG-1)Biotechnology Forschungszentrum Jülich GmbHLeo-Brandt-Str. 152425JülichGermany
| | - Annika Neumann
- Institute of Bio- and Geosciences (IBG-1)Biotechnology Forschungszentrum Jülich GmbHLeo-Brandt-Str. 152425JülichGermany
| | - Margit Winkler
- acib-Austrian Centre of Industrial BiotechnologyPetersgasse148010GrazAustria
- Institute of MolecularBiotechnology, Graz University of TechnologyPetersgasse148010GrazAustria
| | - Dörte Rother
- Institute of Bio- and Geosciences (IBG-1)Biotechnology Forschungszentrum Jülich GmbHLeo-Brandt-Str. 152425JülichGermany
- Aachen Biology and Biotechnology (ABBt)RWTH Aachen UniversityWorringer Weg 152074AachenGermany
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Oxley TJ, Yoo PE, Rind GS, Ronayne SM, Lee CMS, Bird C, Hampshire V, Sharma RP, Morokoff A, Williams DL, MacIsaac C, Howard ME, Irving L, Vrljic I, Williams C, John SE, Weissenborn F, Dazenko M, Balabanski AH, Friedenberg D, Burkitt AN, Wong YT, Drummond KJ, Desmond P, Weber D, Denison T, Hochberg LR, Mathers S, O'Brien TJ, May CN, Mocco J, Grayden DB, Campbell BCV, Mitchell P, Opie NL. Motor neuroprosthesis implanted with neurointerventional surgery improves capacity for activities of daily living tasks in severe paralysis: first in-human experience. J Neurointerv Surg 2021; 13:102-108. [PMID: 33115813 PMCID: PMC7848062 DOI: 10.1136/neurintsurg-2020-016862] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Implantable brain-computer interfaces (BCIs), functioning as motor neuroprostheses, have the potential to restore voluntary motor impulses to control digital devices and improve functional independence in patients with severe paralysis due to brain, spinal cord, peripheral nerve or muscle dysfunction. However, reports to date have had limited clinical translation. METHODS Two participants with amyotrophic lateral sclerosis (ALS) underwent implant in a single-arm, open-label, prospective, early feasibility study. Using a minimally invasive neurointervention procedure, a novel endovascular Stentrode BCI was implanted in the superior sagittal sinus adjacent to primary motor cortex. The participants undertook machine-learning-assisted training to use wirelessly transmitted electrocorticography signal associated with attempted movements to control multiple mouse-click actions, including zoom and left-click. Used in combination with an eye-tracker for cursor navigation, participants achieved Windows 10 operating system control to conduct instrumental activities of daily living (IADL) tasks. RESULTS Unsupervised home use commenced from day 86 onwards for participant 1, and day 71 for participant 2. Participant 1 achieved a typing task average click selection accuracy of 92.63% (100.00%, 87.50%-100.00%) (trial mean (median, Q1-Q3)) at a rate of 13.81 (13.44, 10.96-16.09) correct characters per minute (CCPM) with predictive text disabled. Participant 2 achieved an average click selection accuracy of 93.18% (100.00%, 88.19%-100.00%) at 20.10 (17.73, 12.27-26.50) CCPM. Completion of IADL tasks including text messaging, online shopping and managing finances independently was demonstrated in both participants. CONCLUSION We describe the first-in-human experience of a minimally invasive, fully implanted, wireless, ambulatory motor neuroprosthesis using an endovascular stent-electrode array to transmit electrocorticography signals from the motor cortex for multiple command control of digital devices in two participants with flaccid upper limb paralysis.
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Affiliation(s)
- Thomas J Oxley
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Synchron, Inc, Campbell, California, USA
| | - Peter E Yoo
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Synchron, Inc, Campbell, California, USA
| | - Gil S Rind
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Synchron, Inc, Campbell, California, USA
| | - Stephen M Ronayne
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Synchron, Inc, Campbell, California, USA
| | - C M Sarah Lee
- Neurology, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
| | - Christin Bird
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Rahul P Sharma
- Interventional Cardiology, Cardiovascular Medicine Faculty, Stanford University, Stanford, California, USA
| | - Andrew Morokoff
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Neurosurgery, Melbourne Health, Parkville, Victoria, Australia
| | | | | | - Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Lou Irving
- Respiratory Medicine, Melbourne Health, Parkville, Victoria, Australia
| | - Ivan Vrljic
- Radiology, Melbourne Health, Parkville, Victoria, Australia
| | | | - Sam E John
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Frank Weissenborn
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Madeleine Dazenko
- Neurology, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
| | | | | | - Anthony N Burkitt
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Yan T Wong
- Department of Electrical and Computer Systems Engineering, Monash University, Clayton, Victoria, Australia
| | - Katharine J Drummond
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Neurosurgery, Melbourne Health, Parkville, Victoria, Australia
| | - Patricia Desmond
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Radiology, Melbourne Health, Parkville, Victoria, Australia
| | - Douglas Weber
- Department of Mechanical Engineering and Neuroscience Institute, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Timothy Denison
- Synchron, Inc, Campbell, California, USA
- Institute of Biomedical Engineering, Oxford University, Oxford, Oxfordshire, UK
| | - Leigh R Hochberg
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Harvard University, Cambridge, Massachusetts, USA
| | - Susan Mathers
- Neurology, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
| | - Terence J O'Brien
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Neurology, Melbourne Health, Parkville, Victoria, Australia
| | - Clive N May
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - J Mocco
- Neurosurgery, The Mount Sinai Health System, New York, New York, USA
| | - David B Grayden
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Bruce C V Campbell
- Medicine, University of Melbourne, Parkville, Victoria, Australia
- Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Peter Mitchell
- Radiology, Melbourne Health, Parkville, Victoria, Australia
| | - Nicholas L Opie
- Vascular Bionics Laboratory, Departments of Medicine, Neurology and Surgery, Melbourne Brain Centre at the Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Synchron, Inc, Campbell, California, USA
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El Shafie R, Eichkorn T, Weber D, Bozorgmehr F, König L, Rieken S, Thomas M, Debus J, Christopoulos P. Optimal Timing And Technique Of Local Therapy For Brain Metastases From Non-Small Cell Lung Cancer With Driver Mutations. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.096] [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: 11/30/2022]
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Carlotto F, Weber D, Zanotelli C. SARCOMA GRANULOCÍTICO SEM ENVOLVIMENTO MEDULAR: RELATO DE CASO. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.307] [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: 11/16/2022] Open
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Carlotto F, Eisenreich M, Weber D, Zanotelli C. SÍNDROME DE EVANS COMO MANIFESTAÇÃO INICIAL DE LÚPUS ERITEMATOSO SISTÊMICO. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kasoha M, Bishara L, Hamza A, Weber D, Sklavounos P, Solomayer E, Haj HB. Retrospektive Vergleichsstudie zu geburtshilflichem und neonatalem Outcome bei syrischen Flüchtlingen und deutschen Frauen. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- M Kasoha
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes
| | - L Bishara
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes
| | - A Hamza
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes
| | - D Weber
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes
| | - P Sklavounos
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes
| | - E Solomayer
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes
| | - Hamoud B Haj
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes
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Schuhn A, Nees J, Gahlawat A, Witte-Tobar T, Weber D, Okun JG, Schott S. Plasmametaboliten bei Frauen mit Endometriumspathologien: Ein Vergleich mit Mammakarzinompatientinnen sowie Gesunden. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- A Schuhn
- Frauenklinik, Universitätsklinikum Heidelberg
| | - J Nees
- Frauenklinik, Universitätsklinikum Heidelberg
| | - A Gahlawat
- Frauenklinik, Universitätsklinikum Heidelberg
| | | | - D Weber
- Universitätsklinikum Heidelberg, Institut für medizinische Biometrie und Informatik
| | - JG Okun
- Universitätsklinikum Heidelberg, Zentrum für Kinder- und Jugendmedizin
| | - S Schott
- Frauenklinik, Universitätsklinikum Heidelberg
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Weber D, Neumann A, Winkler M, Turner N, Rother D. Exploring carboxylate reductases to access aldehydes using in vitro and in vivo approaches. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- D. Weber
- Forschungszentrum Jülich IBG-1: Biotechnology Jülich Germany
- RWTH Aachen University, Aachen Germany
| | - A. Neumann
- Forschungszentrum Jülich IBG-1: Biotechnology Jülich Germany
| | | | - N. Turner
- University of Manchester Manchester UK
| | - D. Rother
- Forschungszentrum Jülich IBG-1: Biotechnology Jülich Germany
- RWTH Aachen University, Aachen Germany
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Movahedi M, Weber D, Akhavan P, Keystone E. SAT0046 MODIFIED DISEASE ACTIVITY SCORE AT 3 MONTHS IS A SIGNIFICANT PREDICTOR FOR RAPID RADIOGRAPHIC PROGRESSION AT 12 MONTHS COMPARED WITH OTHER MEASURES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Progressive rheumatoid arthritis (RA) is responsible for joint damage causing disabilities with no agreement on which disease measures best predict radiographic progressionObjectives:We aimed to determine which disease activity measures including disease activity score (DAS), modified (M) DAS28 (CRP), clinical disease activity index (CDAI), and health assessment questionnaire disability index (HAQ-DI) best predict rapid radiographic progression (RRP) in early RA patients at baseline (BL) and 3 months.Methods:PREMIER data, a 2-year, multicenter, double-blind active comparator–controlled study with methotrexate (MTX) naïve RA patients and active disease <3 years, were used. Only patients in the MTX arm were analyzed. RRP was defined as change in modified total Sharp (mTSS) > 3.5 at month 12. Logistic regression analysis assessed impact of measures at BL and 3 months on RRP at 12 months. Best cut-off points of M-DAS28(CRP) was also estimated using area under the receiver operating characteristic curve.Results:149 patients were included: female (n=113; 75.8%), positive RF (n=127; 85.2%), mean (SD) age 52.9 (13.3) years, disease duration 0.8 (0.9) year, DAS28(CRP) 6.3 (0.9). After adjusting for potential confounders, only M-DAS28(CRP) at BL (adjOR=3.29; 95% CI: 1.70-6.36) and 3 months (adjOR=2.56; 95% CI: 1.43-4.56) strongly predicted RRP at 12 months. M-DAS28(CRP) 4.5 and 2.6 at BL and 3 months maximized sensitivity and specificity for prediction of RRP.Conclusion:M-DAS28(CRP) was a stronger predictor at BL and 3 months for RRP compared with other disease activity measures. Removing tender joint count and patient global assessment from DAS28(CRP) improves prediction of RRP.References:[1] Breedveld FC, Weisman MH, Kavanaugh AF, Cohen SB, Pavelka K, van Vollenhoven R, et al. The PREMIER study: A multicenter, randomized, double-blind clinical trial of combination therapy with adalimumab plus methotrexate versus methotrexate alone or adalimumab alone in patients with early, aggressive rheumatoid arthritis who had not had previous methotrexate treatment. Arthritis and rheumatism. 2006;54(1):26-37.Acknowledgments :The authors wish to knowledge AbbVie Canada Inc. for providing patients data.Disclosure of Interests:Mohammad Movahedi Consultant of: Allergan, Deborah Weber: None declared, Pooneh Akhavan: None declared, Edward Keystone Grant/research support from: AbbVie; Amgen; Gilead Sciences, Inc; Lilly Pharmaceuticals; Merck; Pfizer Pharmaceuticals; PuraPharm; Sanofi, Consultant of: AbbVie; Amgen; AstraZeneca Pharma; Bristol-Myers Squibb Company; Celltrion; F. Hoffman-La Roche Ltd.; Genentech, Inc; Gilead Sciences, Inc.; Janssen, Inc; Lilly Pharmaceuticals; Merck; Myriad Autoimmune; Pfizer Pharmaceuticals, Sandoz, Sanofi-Genzyme, Samsung Bioepsis., Speakers bureau: AbbVie; Amgen; Bristol-Myers Squibb; Celltrion; F. Hoffman-La Roche Ltd, Janssen, Inc; Merck; Pfizer Pharmaceuticals; Sanofi-Genzyme; UCB
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Andre P, Bergheim I, Weber D, Brandt A, Helmer C, Féart C. Lipopolysaccharide (LPS)-binding protein, marqueur de l’activation immunitaire en réponse aux LPS, et syndrome métabolique chez la personne âgée. NUTR CLIN METAB 2020. [DOI: 10.1016/j.nupar.2020.02.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Stein-Thoeringer CK, Nichols KB, Lazrak A, Docampo MD, Slingerland AE, Slingerland JB, Clurman AG, Armijo G, Gomes ALC, Shono Y, Staffas A, Burgos da Silva M, Devlin SM, Markey KA, Bajic D, Pinedo R, Tsakmaklis A, Littmann ER, Pastore A, Taur Y, Monette S, Arcila ME, Pickard AJ, Maloy M, Wright RJ, Amoretti LA, Fontana E, Pham D, Jamal MA, Weber D, Sung AD, Hashimoto D, Scheid C, Xavier JB, Messina JA, Romero K, Lew M, Bush A, Bohannon L, Hayasaka K, Hasegawa Y, Vehreschild MJGT, Cross JR, Ponce DM, Perales MA, Giralt SA, Jenq RR, Teshima T, Holler E, Chao NJ, Pamer EG, Peled JU, van den Brink MRM. Lactose drives Enterococcus expansion to promote graft-versus-host disease. Science 2019; 366:1143-1149. [PMID: 31780560 PMCID: PMC7003985 DOI: 10.1126/science.aax3760] [Citation(s) in RCA: 183] [Impact Index Per Article: 36.6] [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: 03/18/2019] [Accepted: 10/22/2019] [Indexed: 12/19/2022]
Abstract
Disruption of intestinal microbial communities appears to underlie many human illnesses, but the mechanisms that promote this dysbiosis and its adverse consequences are poorly understood. In patients who received allogeneic hematopoietic cell transplantation (allo-HCT), we describe a high incidence of enterococcal expansion, which was associated with graft-versus-host disease (GVHD) and mortality. We found that Enterococcus also expands in the mouse gastrointestinal tract after allo-HCT and exacerbates disease severity in gnotobiotic models. Enterococcus growth is dependent on the disaccharide lactose, and dietary lactose depletion attenuates Enterococcus outgrowth and reduces the severity of GVHD in mice. Allo-HCT patients carrying lactose-nonabsorber genotypes showed compromised clearance of postantibiotic Enterococcus domination. We report lactose as a common nutrient that drives expansion of a commensal bacterium that exacerbates an intestinal and systemic inflammatory disease.
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Affiliation(s)
- C K Stein-Thoeringer
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K B Nichols
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - A Lazrak
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - M D Docampo
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - A E Slingerland
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - J B Slingerland
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - A G Clurman
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - G Armijo
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - A L C Gomes
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Y Shono
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - A Staffas
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - M Burgos da Silva
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - S M Devlin
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - K A Markey
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D Bajic
- Department of Internal Medicine II, Technical University of Munich, Munich, Germany
| | - R Pinedo
- Gnotobiotic Facility, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A Tsakmaklis
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- German Center for Infection Research, Partner site Bonn-Cologne, Cologne, Germany
| | - E R Littmann
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Section of Infectious Medicine and Global Health, University of Chicago, Chicago, IL, USA
| | - A Pastore
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Y Taur
- Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S Monette
- Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, The Rockefeller University, Weill Cornell Medicine, New York, NY, USA
| | - M E Arcila
- Diagnostic Molecular Pathology Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A J Pickard
- Donald B. and Catherine C. Marron Cancer Metabolism Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M Maloy
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - R J Wright
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - L A Amoretti
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - E Fontana
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D Pham
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M A Jamal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - D Weber
- Internal Medicine III, University Clinic Regensburg, Regensburg, Germany
| | - A D Sung
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - D Hashimoto
- Department of Hematology, Hokkaido University, Faculty of Medicine, Sapporo, Japan
| | - C Scheid
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
| | - J B Xavier
- Computational and Systems Biology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J A Messina
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA
| | - K Romero
- Office of Clinical Research, Duke University School of Medicine, Durham, NC, USA
| | - M Lew
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - A Bush
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - L Bohannon
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - K Hayasaka
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Y Hasegawa
- Department of Hematology, Hokkaido University, Faculty of Medicine, Sapporo, Japan
| | - M J G T Vehreschild
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- German Center for Infection Research, Partner site Bonn-Cologne, Cologne, Germany
- Department of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - J R Cross
- Donald B. and Catherine C. Marron Cancer Metabolism Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D M Ponce
- Weill Cornell Medical College, New York, NY, USA
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M A Perales
- Weill Cornell Medical College, New York, NY, USA
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S A Giralt
- Weill Cornell Medical College, New York, NY, USA
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - R R Jenq
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - T Teshima
- Department of Hematology, Hokkaido University, Faculty of Medicine, Sapporo, Japan
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - E Holler
- Internal Medicine III, University Clinic Regensburg, Regensburg, Germany
| | - N J Chao
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - E G Pamer
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
- Department of Medicine, Section of Infectious Medicine and Global Health, University of Chicago, Chicago, IL, USA
| | - J U Peled
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Weill Cornell Medical College, New York, NY, USA
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M R M van den Brink
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Weill Cornell Medical College, New York, NY, USA
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Anakwenze C, Gunther J, Manasanch E, Noticewala S, Milgrom S, Lee H, Patel K, Thomas S, Iyer S, Weber D, Park C, Amini B, Khoury J, Medeiros L, Orlowski R, Dabaja B, Pinnix C. The Impact of PET-CT on Rates of Progression from Solitary Plasmacytoma to Multiple Myeloma after Definitive Radiation Therapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1368] [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: 11/25/2022]
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Schlenk RF, Weber D, Herr W, Wulf G, Salih HR, Derigs HG, Kuendgen A, Ringhoffer M, Hertenstein B, Martens UM, Grießhammer M, Bernhard H, Krauter J, Girschikofsky M, Wolf D, Lange E, Westermann J, Koller E, Kremers S, Wattad M, Heuser M, Thol F, Göhring G, Haase D, Teleanu V, Gaidzik V, Benner A, Döhner K, Ganser A, Paschka P, Döhner H. Randomized phase-II trial evaluating induction therapy with idarubicin and etoposide plus sequential or concurrent azacitidine and maintenance therapy with azacitidine. Leukemia 2019; 33:1923-1933. [PMID: 30728457 PMCID: PMC6756041 DOI: 10.1038/s41375-019-0395-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/04/2019] [Accepted: 01/11/2019] [Indexed: 01/17/2023]
Abstract
The aim of this randomized phase-II study was to evaluate the effect of substituting cytarabine by azacitidine in intensive induction therapy of patients with acute myeloid leukemia (AML). Patients were randomized to four induction schedules for two cycles: STANDARD (idarubicin, cytarabine, etoposide); and azacitidine given prior (PRIOR), concurrently (CONCURRENT), or after (AFTER) therapy with idarubicin and etoposide. Consolidation therapy consisted of allogeneic hematopoietic-cell transplantation or three courses of high-dose cytarabine followed by 2-year maintenance therapy with azacitidine in the azacitidine-arms. AML with CBFB-MYH11, RUNX1-RUNX1T1, mutated NPM1, and FLT3-ITD were excluded and accrued to genotype-specific trials. The primary end point was response to induction therapy. The statistical design was based on an optimal two-stage design applied for each arm separately. During the first stage, 104 patients (median age 62.6, range 18-82 years) were randomized; the study arms PRIOR and CONCURRENT were terminated early due to inefficacy. After randomization of 268 patients, all azacitidine-containing arms showed inferior response rates compared to STANDARD. Event-free and overall survival were significantly inferior in the azacitidine-containing arms compared to the standard arm (p < 0.001 and p = 0.03, respectively). The data from this trial do not support the substitution of cytarabine by azacitidine in intensive induction therapy.
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Affiliation(s)
- R F Schlenk
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany.
- NCT-Trial Center, National Center of Tumor Diseases, Heidelberg University Hospital and German Cancer Research Center, Heidelberg, Germany.
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.
| | - D Weber
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - W Herr
- Department of Hematology, Medical Oncology and Pneumology, University Medical Center Mainz, Mainz, Germany
| | - G Wulf
- Department of Hematology and Oncology, University Hospital of Göttingen, Göttingen, Germany
| | - H R Salih
- Department of Hematology and Oncology, Eberhard-Karls University, Tübingen, Germany
| | - H G Derigs
- Department of Internal Medicine III, Hospital Frankfurt-Hoechst, Frankfurt, Germany
| | - A Kuendgen
- Department of Hematology, Oncology and Clinical Immunology, University of Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - M Ringhoffer
- Department of Hematology and Oncology, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - B Hertenstein
- Department of Hematology and Oncology, Klinikum Bremen Mitte, Bremen, Germany
- Department of Hematology and Oncology, Klinikum am Gesundbrunnen, Heilbronn, Germany
| | - U M Martens
- Department of Hematology and Oncology, University Hospital of Minden, Minden, Germany
| | - M Grießhammer
- Department of Hematology and Oncology, University Hospital of Minden, Minden, Germany
| | - H Bernhard
- Department of Hematology and Oncology, Darmstadt, Municipal Hospital, Darmstadt, Germany
| | - J Krauter
- Department Hematology and Oncology, Braunschweig Municipal Hospital, Braunschweig, Germany
| | - M Girschikofsky
- Department of Hematology and Oncology, Hospital Elisabethinen Linz, Linz, Austria
| | - D Wolf
- Internal Medicine III, University Hospital of Bonn, Bonn, Germany
- Department of Internal Medicine V, Medical University Innsbruck, Innsbruck, Austria
| | - E Lange
- Department of Hematology and Oncology, Evangelisches Krankenhaus Hamm, Hamm, Germany
| | - J Westermann
- Department of Hematology, Oncology and Tumor Immunology, Charité - Campus Virchow Clinic, Berlin, Germany
| | - E Koller
- Department of Internal Medicine III, Hanuschkrankenhaus Wien, Wien, Austria
| | - S Kremers
- Department of Internal Medicine, Caritas-Krankenhaus Lebach, Lebach, Germany
| | - M Wattad
- Department of Hematology and Oncology, Hospital Essen-Werden, Essen, Germany
| | - M Heuser
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - F Thol
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - G Göhring
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - D Haase
- Department of Hematology and Oncology, University Hospital of Göttingen, Göttingen, Germany
| | - V Teleanu
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - V Gaidzik
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - A Benner
- Division of Biostatistics, German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - K Döhner
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - A Ganser
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - P Paschka
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - H Döhner
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
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Lamby P, Wolff D, Mielke S, Grigoleit GU, Ljungman P, Hilgendorf I, Holler E, Holler B, Weber D, Herr W, Schiltz D, Klein S, Graf S, Bjornhagen-Safwenberg V, Dolderer J, Prantl L. Allogeneic donor split skin grafts for treatment of refractory ulcers in cutaneous chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation-a retrospective analysis on seven patients. Ann Hematol 2019; 98:1867-1875. [PMID: 30993415 DOI: 10.1007/s00277-019-03687-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/29/2018] [Accepted: 04/06/2019] [Indexed: 12/19/2022]
Abstract
Refractory skin ulcers due to severe chronic graft-versus-host disease (cGVHD) remain to be associated with significant morbidity and mortality.We performed an allogeneic donor skin transplantation in seven adult patients after allogeneic hematopoietic stem cell transplantation for cGVHD-associated refractory skin ulcers. While four patients received a split skin graft (SSG), in one patient, a full thickness skin graft for two small refractory ulcers of the ankle was performed, and one patient received in vitro expanded donor keratinocyte grafts derived from hair roots of the original unrelated donor. In one additional patient, a large deep fascial defect of the lower leg was covered with an autologous greater omentum free graft before coverage with an allogeneic SSG. An additional patient was treated with an autologous scrotal skin graft for a refractory ulcer associated with deep sclerosis of cGVHD after unrelated donor transplantation.All skin grafts engrafted and resulted in permanent coverage of the grafted ulcers without any signs of immunological mediated damage. In the patient receiving in vitro expanded keratinocyte grafts, two localized ulcers were permanently covered by donor skin while this approach failed to cover extensive circular ulcers of the lower legs.Allogeneic donor skin grafts are a valuable treatment option in refractory ulcers due to cGVHD but are restricted mainly to related donors while keratinocyte grafts from unrelated donors remain experimental. In male patients lacking a related donor, autologous scrotal skin graft may be an alternative option.
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Affiliation(s)
- P Lamby
- Department of Plastic, Reconstructive and Hand Surgery, University Hospital, Regensburg, Germany
| | - D Wolff
- Department of Internal Medicine III, University of Regensburg, F.J. Strauss Allee 11, 93053, Regensburg, Germany.
| | - S Mielke
- Allogeneic Stem Cell Transplantation Section, Department of Internal Medicine II, Würzburg University Medical Center, Würzburg, Germany.,Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital and Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - G U Grigoleit
- Allogeneic Stem Cell Transplantation Section, Department of Internal Medicine II, Würzburg University Medical Center, Würzburg, Germany
| | - P Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital and Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - I Hilgendorf
- Universitätsklinikum Jena, Klinik für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Jena, Deutschland, Germany
| | - E Holler
- Department of Internal Medicine III, University of Regensburg, F.J. Strauss Allee 11, 93053, Regensburg, Germany
| | - B Holler
- Department of Internal Medicine III, University of Regensburg, F.J. Strauss Allee 11, 93053, Regensburg, Germany
| | - D Weber
- Department of Internal Medicine III, University of Regensburg, F.J. Strauss Allee 11, 93053, Regensburg, Germany
| | - W Herr
- Department of Internal Medicine III, University of Regensburg, F.J. Strauss Allee 11, 93053, Regensburg, Germany
| | - D Schiltz
- Department of Plastic, Reconstructive and Hand Surgery, University Hospital, Regensburg, Germany
| | - S Klein
- Department of Plastic, Reconstructive and Hand Surgery, University Hospital, Regensburg, Germany
| | - S Graf
- Department of Plastic, Reconstructive and Hand Surgery, University Hospital, Regensburg, Germany
| | | | - J Dolderer
- Department of Plastic, Reconstructive and Hand Surgery, University Hospital, Regensburg, Germany
| | - L Prantl
- Department of Plastic, Reconstructive and Hand Surgery, University Hospital, Regensburg, Germany
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Benazzo A, Schwarz S, Geleff S, Weber D, Murakozy G, Lambers C, Moser B, Matilla J, Lang G, Taghavi S, Klepetko W, Hoetzenecker K, Jaksch P. Donor-Specific Antibodies and Antibody-Mediated Rejection after Alemtuzumab Induction Therapy: A Retrospective Analysis of a High-Volume Lung Transplant Center. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Benazzo A, Schwarz S, Weber D, Murakozy G, Lambers C, Moser B, Matilla J, Lang G, Taghavi S, Klepetko W, Hoetzenecker K, Jaksch P. Ten-Year-Experience with Alemtuzumab as Induction Therapy: A Single-Center Analysis of More Than 500 Patients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Anderson K, Ajiboye A, Denison T, French J, Gustafson K, Kilgore K, Kleitman N, Kusiak A, Litt B, Moynahan M, Perreault E, Weber D, Williams J, Tyler D. Proceedings of the second biennial Cleveland Neural Engineering Workshop 2013. Bioelectron Med 2018; 4:15. [PMID: 32232091 PMCID: PMC7098232 DOI: 10.1186/s42234-018-0016-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 10/08/2018] [Indexed: 11/10/2022] Open
Abstract
The Cleveland Neural Engineering Workshop (NEW) is a biennial meeting started in 2011 as an “unconference” to bring together leaders in the neural engineering and related fields. Since the first iteration of the meeting, NEW has evolved from “just getting together” to a more important purpose of creating, reviewing, and promoting a uniform strategic roadmap for the field. The purpose of this short report, as well as the companion 2015 and 2017 reports, is to provide a historical record of this meeting and the evolution of the roadmap. These reports more importantly establish a baseline for the next meeting to be held in June, 2019. The second Neural Engineering Workshop (NEW) was held in June 2013. The two-day workshop was hosted by the Cleveland Advanced Platform for Technology National Veterans Affairs Center, the Functional Electrical Stimulation National Veterans Affairs Center, and the Case Western Reserve University in Cleveland, Ohio. Participants identified seven areas of future focus in the field of neural engineering: active communications with users, advocacy (regulatory), network building (clinical practice), case studies (clinical and technical), early industrial feedback, value chain resources, engagement, and advocacy (funding). This proceedings document summarizes the meeting outcome.
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Affiliation(s)
- Kim Anderson
- 1Dept of Physical Medicine and Rehabilitation, Case Western Reserve Univ, Cleveland, OH USA.,2Cleveland VA Medical Center, Cleveland, OH USA
| | - Abidemi Ajiboye
- 2Cleveland VA Medical Center, Cleveland, OH USA.,3Dept of Biomedical Engineering Case Western Reserve Univ, Cleveland, OH USA
| | - Timothy Denison
- 4Nuffeild Dept of Clinical Neurosciences Oxford University, Oxford, UK
| | | | - Kenneth Gustafson
- 2Cleveland VA Medical Center, Cleveland, OH USA.,3Dept of Biomedical Engineering Case Western Reserve Univ, Cleveland, OH USA
| | - Kevin Kilgore
- 2Cleveland VA Medical Center, Cleveland, OH USA.,6Dept of Orthopaedics MetroHealth Medical Center, Cleveland, OH USA
| | | | - Audrey Kusiak
- 8Rehabilitation Research and Development Department of Veterans Affairs, Washington, DC, USA
| | - Brian Litt
- 9Dept of Neurology and Dept of Bioengineering Univ of Pennsylvania, Philadelphia, PA USA
| | | | - Eric Perreault
- 11Dept of Biomedical Engineering Northwesten University, Chicago, IL USA
| | - Douglas Weber
- 12Dept of Bio Engineering University of Pittsburgh, Pittsburgh, PA USA
| | - Justin Williams
- 13Dept of Biomedical Engineering Univ of Wisconsin-Madison, Madison, WI USA
| | - Dustin Tyler
- 2Cleveland VA Medical Center, Cleveland, OH USA.,3Dept of Biomedical Engineering Case Western Reserve Univ, Cleveland, OH USA
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Zniva R, Lienbacher E, Weber D. REVISING THE INFLUENCE OF AGING ON THE FOOD SHOPPING ENVIRONMENT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Zniva
- Salzburg University of Applied Sciences
| | | | - D Weber
- Vienna University of Economics and Business
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48
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Elhammali A, Gunther J, Milgrom S, Pinnix C, Andraos T, Weber D, Orlowski R, Manasanch E, Patel K, Lee H, Thomas S, Amini B, Garg N, Dabaja B. Involved Site and Reduced Dose Radiation Therapy for Multiple Myeloma: Should It be the New Standard? Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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49
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Elhammali A, Dabaja B, Gunther J, Yoder A, Moon B, Weber D, Thomas S, Andraos T, Garg N, Amini B, Manasanch E, Patel K, Orlowski R, Lee H, Bird J, Satcher R, Lin P, Pinnix C, Milgrom S. Involved Site vs Extended Field Radiation Therapy for Multiple Myeloma of Long Bones after Internal Fixation. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.705] [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: 11/16/2022]
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50
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Zniva R, Weber D. REVISING THE CONCEPTUALIZATION OF AGING IN CONSUMER BEHAVIOR. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Zniva
- Salzburg University of Applied Sciences
| | - D Weber
- Vienna University of Economics and Business
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