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Zeraouli G, Mariscal DA, Hollinger R, Anaraki SZ, Folsom EN, Grace E, Rusby D, Hill MP, Williams GJ, Scott GG, Sullivan B, Wang S, King J, Swanson KK, Simpson RA, Djordjevic BZ, Andrews S, Costa R, Cauble B, Albert F, Rocca JJ, Ma T. Flexible tape-drive target system for secondary high-intensity laser-driven sources. Rev Sci Instrum 2023; 94:123306. [PMID: 38117203 DOI: 10.1063/5.0180715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
We present the development of a flexible tape-drive target system to generate and control secondary high-intensity laser-plasma sources. Its adjustable design permits the generation of relativistic MeV particles and x rays at high-intensity (i.e., ≥1 × 1018 W cm-2) laser facilities, at high repetition rates (>1 Hz). The compact and robust structure shows good mechanical stability and a high target placement accuracy (<4 μm RMS). Its compact and flexible design allows for mounting in both the horizontal and vertical planes, which makes it practical for use in cluttered laser-plasma experimental setups. The design permits ∼170° of access on the laser-driver side and 120° of diagnostic access at the rear. A range of adapted apertures have been designed and tested to be easily implemented to the targetry system. The design and performance testing of the tape-drive system in the context of two experiments performed at the COMET laser facility at the Lawrence Livermore National Laboratory and at the Advanced Lasers and Extreme Photonics (ALEPH) facility at Colorado State University are discussed. Experimental data showing that the designed prototype is also able to both generate and focus high-intensity laser-driven protons at high repetition rates are also presented.
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Affiliation(s)
- G Zeraouli
- Colorado State University, Fort Collins, Colorado 80523, USA
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D A Mariscal
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Hollinger
- Colorado State University, Fort Collins, Colorado 80523, USA
| | | | - E N Folsom
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - E Grace
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D Rusby
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M P Hill
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G J Williams
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G G Scott
- Colorado State University, Fort Collins, Colorado 80523, USA
- STFC Central Laser Facility, Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 OQX, United Kingdom
| | - B Sullivan
- Colorado State University, Fort Collins, Colorado 80523, USA
- XUV Lasers, Fort Collins, Colorado 80523, USA
| | - S Wang
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J King
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - K K Swanson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R A Simpson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Z Djordjevic
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Andrews
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Costa
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Cauble
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - F Albert
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J J Rocca
- Colorado State University, Fort Collins, Colorado 80523, USA
- XUV Lasers, Fort Collins, Colorado 80523, USA
| | - T Ma
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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2
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Zeraouli G, Mariscal D, Grace E, Scott GG, Swanson KK, Simpson R, Djordjevic BZ, Nedbailo R, Song H, Morrison J, Park J, Hollinger R, Wang S, Rocca JJ, Ma T. Ultra-compact x-ray spectrometer for high-repetition-rate laser-plasma experiments. Rev Sci Instrum 2022; 93:113508. [PMID: 36461516 DOI: 10.1063/5.0100970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/28/2022] [Indexed: 06/17/2023]
Abstract
We present in this work the development of an ultra-compact, multi-channel x-ray spectrometer (UCXS). This diagnostic has been specially built and adapted to perform at high-repetition-rate (>1 Hz) for high-intensity, short-pulse laser plasma experiments. X-ray filters of varying materials and thicknesses are chosen to provide spectral resolution up to ΔE ≈ 1 keV over the x-ray energy range of 1-30 keV. These filters are distributed over a total of 25 channels, where each x-ray filter is coupled to a single scintillator. The UCXS is designed to detect and resolve a large variety of laser-driven x-ray sources such as low energy bremsstrahlung emission, fluorescence, and betatron radiation (up to 30 keV). Preliminary results from commissioning experiments at the ABL laser facility at Colorado State University are provided.
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Affiliation(s)
- G Zeraouli
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - D Mariscal
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - E Grace
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G G Scott
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - K K Swanson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Simpson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Z Djordjevic
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Nedbailo
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - H Song
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J Morrison
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J Park
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - R Hollinger
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - S Wang
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J J Rocca
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Ma
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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Grace E, Tran C, Long C, Rech M. 256 Trends in Opioid Overdoses During the COVID-19 Pandemic. Ann Emerg Med 2022. [PMCID: PMC9519216 DOI: 10.1016/j.annemergmed.2022.08.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Danielson RW, Grace E, White AJ, Kelton ML, Owen JP, Fisher KS, Martinez AD, Mozo M. Facilitating Systems Thinking Through Arts-Based STEM Integration. Front Educ (Lausanne) 2022; 7:915333. [PMID: 38283981 PMCID: PMC10817773 DOI: 10.3389/feduc.2022.915333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Engaging with socio-scientific issues often involves making sense of how - and for whom - actions, choices, and policies might affect aspects of daily life. Understanding the complexity of socio-scientific issues also requires recognizing the interconnectedness of - and working across - multiple communities and professions. We suggest that art, whether musical composition, illustrations, or sculpture / collage across materials would promote the synthesis of different types of knowledge across different scales and systems. The present investigation seeks to understand how arts integration into STEM curriculum could support systems thinking around socio-scientific issues, specifically around the issue of pathogen transmission in rural-agricultural communities. Our after-school program, which works with 3rd - 5th grade students in rural-agricultural communities, leverages the arts to promote systems-level understanding of zoonotic diseases and ecosystem dynamics. A total of 23 students across two sites located in rural communities in the Western United States participated in our afterschool program. We found that after completing the program students expanded their understanding of both the connections between concepts and an understanding of careers related to ecosystem dynamics. We suggest that educators can integrate both arts and sciences together to enhance systems thinking and expand student perception of the interconnectedness of STEM disciplines and their everyday lives.
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Affiliation(s)
- Robert William Danielson
- Department of Kinesiology and Educational Psychology, College of Education, Washington State University, Spokane, WA, United States
| | - Elizabeth Grace
- Department of Teaching and Learning, College of Education, Washington State University, Spokane, WA, United States
| | - Alison Joanne White
- 4-H Youth Development Regional Specialist (Extension), College of Agricultural, Human, and Natural Resource Sciences, Washington State University, Yakima, WA, United States
| | - Molly Louise Kelton
- Department of Teaching and Learning, College of Education, Washington State University, Pullman, WA, United States
| | - Jeb P. Owen
- Department of Entomology, College of Agricultural, Human, and Natural Resource Sciences, Washington State University, Pullman, WA, United States
| | - Kristin Saba Fisher
- Department of Teaching and Learning, College of Education, Washington State University, Pullman, WA, United States
| | - AnaMaria Diaz Martinez
- Human and Family Development Regional Specialist (Extension), College of Agricultural, Human, and Natural Resource Sciences, Washington State University, Pasco, WA, United States
| | - Maria Mozo
- Biotechnology, MiraCosta College, Oceanside, CA, United States
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Egeberg A, Iversen L, Kimball AB, Kelly S, Grace E, Patel H, Xu W, Gallo G, Riedl E, Feldman SR. Pregnancy outcomes in patients with psoriasis, psoriatic arthritis, or axial spondyloarthritis receiving ixekizumab. J DERMATOL TREAT 2021; 33:2503-2509. [PMID: 34547967 DOI: 10.1080/09546634.2021.1976375] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Psoriasis, psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are chronic inflammatory diseases that often affect women of childbearing age. Detailed information about pregnancy and related outcomes across these indications in patients exposed to ixekizumab is lacking. OBJECTIVES To evaluate pregnancy outcomes after maternal or paternal exposure to ixekizumab in patients with psoriasis, PsA, or axSpA. METHODS Pregnancy cases from clinical trials and post-marketing reports, associated with either maternal or paternal exposure to ixekizumab cumulatively through 22 March 2019, were identified in the Eli Lilly Global Safety Database and described separately. RESULTS One hundred and ninety-three ixekizumab-exposed pregnancies were identified. Maternal exposure occurred in 51.3% of pregnancies (clinical trials: n = 58; post-marketing: n = 41). The majority of paternal exposure pregnancies occurred in clinical trials (91 of 94). Live births were reported for 53.8 and 61.1% of known outcomes in maternal exposure pregnancies during clinical trials and post-marketing surveillance, respectively. No congenital malformations resulting from maternal exposure were reported in clinical trials: one case, not causally related to ixekizumab therapy, was recorded in the post-marketing setting. CONCLUSIONS This integrated safety analysis provides relevant information for clinicians treating patients with psoriasis, PsA, or axSpA with ixekizumab. No new safety signals were identified in patients receiving ixekizumab.
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Affiliation(s)
- A Egeberg
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
| | - L Iversen
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - A B Kimball
- Harvard Medical School and Beth Israel Deaconess Hospital, Boston, MA, USA
| | - S Kelly
- Eli Lilly and Company, Indianapolis, IN, USA
| | - E Grace
- Eli Lilly and Company, Indianapolis, IN, USA
| | - H Patel
- Eli Lilly and Company, Indianapolis, IN, USA
| | - W Xu
- Eli Lilly and Company, Indianapolis, IN, USA
| | - G Gallo
- Eli Lilly and Company, Indianapolis, IN, USA
| | - E Riedl
- Eli Lilly and Company, Indianapolis, IN, USA
| | - S R Feldman
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Simpson RA, Mariscal D, Williams GJ, Scott GG, Grace E, Ma T. Development of a deep learning based automated data analysis for step-filter x-ray spectrometers in support of high-repetition rate short-pulse laser-driven acceleration experiments. Rev Sci Instrum 2021; 92:075101. [PMID: 34340437 DOI: 10.1063/5.0043835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/12/2021] [Indexed: 06/13/2023]
Abstract
We present a deep learning based framework for real-time analysis of a differential filter based x-ray spectrometer that is common on short-pulse laser experiments. The analysis framework was trained with a large repository of synthetic data to retrieve key experimental metrics, such as slope temperature. With traditional analysis methods, these quantities would have to be extracted from data using a time-intensive and manual analysis. This framework was developed for a specific diagnostic, but may be applicable to a wide variety of diagnostics common to laser experiments and thus will be especially crucial to the development of high-repetition rate (HRR) diagnostics for HRR laser systems that are coming online.
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Affiliation(s)
- R A Simpson
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - D Mariscal
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G J Williams
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G G Scott
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - E Grace
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - T Ma
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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Grace E, Ma T, Guang Z, Alessi D, Herriot S, Rhodes M, Park J, Trebino R. Simulations of wavelength-multiplexed holography for single-shot spatiotemporal characterization of NIF's advanced radiographic capability (ARC) laser. Rev Sci Instrum 2021; 92:053003. [PMID: 34243266 DOI: 10.1063/5.0043659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/17/2021] [Indexed: 06/13/2023]
Abstract
We simulate the use of a newly developed single-shot wavelength-multiplexed holography-based diagnostic, STRIPED FISH, to fully characterize the as-delivered laser pulses of the National Ignition Facility's Advanced Radiographic Capability (NIF-ARC) laser. To that end, we have performed simulations of the NIF-ARC pulse incorporating (a) a time-integrated spatial-profile measurement and a complete temporal-intensity-and-phase measurement using a frequency resolved optical gating, but without any spatiotemporal pulse characterizations, and (b) simulated first-order spatiotemporal distortions, which could be measured on a single shot if a STRIPED FISH device were deployed.
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Affiliation(s)
- E Grace
- School of Physics, Georgia Institute of Technology, 837 State St. NW, Atlanta, Georgia 30332, USA
| | - T Ma
- Lawrence Livermore National Laboratory, 7000 East Ave., Livermore, California 94550, USA
| | - Z Guang
- School of Physics, Georgia Institute of Technology, 837 State St. NW, Atlanta, Georgia 30332, USA
| | - D Alessi
- Lawrence Livermore National Laboratory, 7000 East Ave., Livermore, California 94550, USA
| | - S Herriot
- Lawrence Livermore National Laboratory, 7000 East Ave., Livermore, California 94550, USA
| | - M Rhodes
- Lawrence Livermore National Laboratory, 7000 East Ave., Livermore, California 94550, USA
| | - J Park
- Electrical and Computer Engineering, Colorado State University, 400 Isotope Dr., Fort Collins, Colorado 80523, USA
| | - R Trebino
- School of Physics, Georgia Institute of Technology, 837 State St. NW, Atlanta, Georgia 30332, USA
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8
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Grace E, Kelton ML, Owen JP, Martinez AD, White A, Danielson RW, Butterfield P, Fallon M, Medina GS. Integrating Arts with STEM to Foster Systems Thinking. Afterschool Matters 2021; 34:11-19. [PMID: 35386308 PMCID: PMC8982989] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Interest is growing among out-of-school time (OST) educators in integrating the arts into STEM (science, technology, engineering, and mathematics) programming (e.g., Kelton & Saraniero, 2018). Arts-integrated STEM-or STEAM-programming now takes place in a wide variety of OST environments, from relatively institutional learning settings, such as a library, to emergent or fluid settings, such as a pop-up program in a housing development community room.
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Affiliation(s)
| | - Molly L Kelton
- College of Education at Washington State University Pullman
| | - Jeb P Owen
- Department of Entomology at Washington State University Pullman
| | - AnaMaria Diaz Martinez
- human and family development regional specialist at Washington State University Extension
| | - Alison White
- youth development regional specialist at Washington State University Extension
| | | | - Patricia Butterfield
- College of Nursing and professor emerita at the Elson S. Floyd College of Medicine at Washington State University Spokane
| | - Michaela Fallon
- Elson S. Floyd College of Medicine at Washington State University Spokane
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9
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Danielson RW, Grace E, White AJ, Kelton ML, Martinez AD, Fallon M, Owen JP, Butterfield P. Assessing Science Learning and Systems Thinking Through Arts. WERA Educ J 2020; 13:36-45. [PMID: 35387282 PMCID: PMC8982988] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We present two interventions aimed at promoting science learning. We utilize arts-based assessments alongside traditional measures to examine systems thinking. Taking place in rural communities in Washington State and focusing on students in third through fifth grades, our results indicate that arts-based assessment in STEM can support demonstration of systems thinking about socio-scientific issues. We conclude by illustrating the viability of arts-based approaches for assessment and how these methods can complement and extend more traditional measures of learning in and out of the classroom.
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Bestelmeyer S, Grace E, Haan-Amato S, Pemberton R, Havstad K. Broadening the Impact of K–12 Science Education Collaborations in a Shifting Education Landscape. Bioscience 2018. [DOI: 10.1093/biosci/biy088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Elizabeth Grace
- Science education specialists at the Asombro Institute for Science Education, in Las Cruces, New Mexico
| | - Stephanie Haan-Amato
- Science education specialists at the Asombro Institute for Science Education, in Las Cruces, New Mexico
| | - Ryan Pemberton
- Science education specialists at the Asombro Institute for Science Education, in Las Cruces, New Mexico
| | - Kris Havstad
- Retired research leader at the USDA ARS Jornada Experimental Range, also in Las Cruces
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11
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Amaudruz PA, Baldwin M, Batygov M, Beltran B, Bina CE, Bishop D, Bonatt J, Boorman G, Boulay MG, Broerman B, Bromwich T, Bueno JF, Burghardt PM, Butcher A, Cai B, Chan S, Chen M, Chouinard R, Cleveland BT, Cranshaw D, Dering K, DiGioseffo J, Dittmeier S, Duncan FA, Dunford M, Erlandson A, Fatemighomi N, Florian S, Flower A, Ford RJ, Gagnon R, Giampa P, Golovko VV, Gorel P, Gornea R, Grace E, Graham K, Gulyev E, Hakobyan R, Hall A, Hallin AL, Hamstra M, Harvey PJ, Hearns C, Jillings CJ, Kamaev O, Kemp A, Kuźniak M, Langrock S, La Zia F, Lehnert B, Lidgard JJ, Lim C, Lindner T, Linn Y, Liu S, Majewski P, Mathew R, McDonald AB, McElroy T, McGinn T, McLaughlin JB, Mead S, Mehdiyev R, Mielnichuk C, Monroe J, Muir A, Nadeau P, Nantais C, Ng C, Noble AJ, O'Dwyer E, Ohlmann C, Olchanski K, Olsen KS, Ouellet C, Pasuthip P, Peeters SJM, Pollmann TR, Rand ET, Rau W, Rethmeier C, Retière F, Seeburn N, Shaw B, Singhrao K, Skensved P, Smith B, Smith NJT, Sonley T, Soukup J, Stainforth R, Stone C, Strickland V, Sur B, Tang J, Taylor J, Veloce L, Vázquez-Jáuregui E, Walding J, Ward M, Westerdale S, Woolsey E, Zielinski J. First Results from the DEAP-3600 Dark Matter Search with Argon at SNOLAB. Phys Rev Lett 2018; 121:071801. [PMID: 30169081 DOI: 10.1103/physrevlett.121.071801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 05/17/2018] [Indexed: 06/08/2023]
Abstract
This Letter reports the first results of a direct dark matter search with the DEAP-3600 single-phase liquid argon (LAr) detector. The experiment was performed 2 km underground at SNOLAB (Sudbury, Canada) utilizing a large target mass, with the LAr target contained in a spherical acrylic vessel of 3600 kg capacity. The LAr is viewed by an array of PMTs, which would register scintillation light produced by rare nuclear recoil signals induced by dark matter particle scattering. An analysis of 4.44 live days (fiducial exposure of 9.87 ton day) of data taken during the initial filling phase demonstrates the best electronic recoil rejection using pulse-shape discrimination in argon, with leakage <1.2×10^{-7} (90% C.L.) between 15 and 31 keV_{ee}. No candidate signal events are observed, which results in the leading limit on weakly interacting massive particle (WIMP)-nucleon spin-independent cross section on argon, <1.2×10^{-44} cm^{2} for a 100 GeV/c^{2} WIMP mass (90% C.L.).
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Affiliation(s)
- P-A Amaudruz
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M Baldwin
- Rutherford Appleton Laboratory, Harwell Oxford, Didcot OX11 0QX, United Kingdom
| | - M Batygov
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - B Beltran
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - C E Bina
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - D Bishop
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - J Bonatt
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - G Boorman
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - M G Boulay
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - B Broerman
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - T Bromwich
- University of Sussex, Sussex House, Brighton, East Sussex BN1 9RH, United Kingdom
| | - J F Bueno
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - P M Burghardt
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - A Butcher
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - B Cai
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S Chan
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M Chen
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - R Chouinard
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - B T Cleveland
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Lively, Ontario P3Y 1M3, Canada
| | - D Cranshaw
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - K Dering
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J DiGioseffo
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S Dittmeier
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - F A Duncan
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Lively, Ontario P3Y 1M3, Canada
| | - M Dunford
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - A Erlandson
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
- Canadian Nuclear Laboratories Ltd, Chalk River, Ontario K0J 1J0, Canada
| | - N Fatemighomi
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - S Florian
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - A Flower
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - R J Ford
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Lively, Ontario P3Y 1M3, Canada
| | - R Gagnon
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - P Giampa
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - V V Golovko
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- Canadian Nuclear Laboratories Ltd, Chalk River, Ontario K0J 1J0, Canada
| | - P Gorel
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
- SNOLAB, Lively, Ontario P3Y 1M3, Canada
| | - R Gornea
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - E Grace
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - K Graham
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - E Gulyev
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - R Hakobyan
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - A Hall
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - A L Hallin
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - M Hamstra
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - P J Harvey
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Hearns
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C J Jillings
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Lively, Ontario P3Y 1M3, Canada
| | - O Kamaev
- Canadian Nuclear Laboratories Ltd, Chalk River, Ontario K0J 1J0, Canada
| | - A Kemp
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - M Kuźniak
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - S Langrock
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
| | - F La Zia
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - B Lehnert
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - J J Lidgard
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Lim
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T Lindner
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - Y Linn
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S Liu
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - P Majewski
- Rutherford Appleton Laboratory, Harwell Oxford, Didcot OX11 0QX, United Kingdom
| | - R Mathew
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - A B McDonald
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - T McElroy
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - T McGinn
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - J B McLaughlin
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S Mead
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - R Mehdiyev
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - C Mielnichuk
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - J Monroe
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - A Muir
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - P Nadeau
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- SNOLAB, Lively, Ontario P3Y 1M3, Canada
| | - C Nantais
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Ng
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - A J Noble
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - E O'Dwyer
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Ohlmann
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - K Olchanski
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - K S Olsen
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - C Ouellet
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - P Pasuthip
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S J M Peeters
- University of Sussex, Sussex House, Brighton, East Sussex BN1 9RH, United Kingdom
| | - T R Pollmann
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - E T Rand
- Canadian Nuclear Laboratories Ltd, Chalk River, Ontario K0J 1J0, Canada
| | - W Rau
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - C Rethmeier
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - F Retière
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - N Seeburn
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - B Shaw
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - K Singhrao
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - P Skensved
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - B Smith
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - N J T Smith
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Lively, Ontario P3Y 1M3, Canada
| | - T Sonley
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
- SNOLAB, Lively, Ontario P3Y 1M3, Canada
| | - J Soukup
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - R Stainforth
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - C Stone
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - V Strickland
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - B Sur
- Canadian Nuclear Laboratories Ltd, Chalk River, Ontario K0J 1J0, Canada
| | - J Tang
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - J Taylor
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - L Veloce
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - E Vázquez-Jáuregui
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario P3E 2C6, Canada
- SNOLAB, Lively, Ontario P3Y 1M3, Canada
- Instituto de Física, Universidad Nacional Autónoma de México, A. P. 20-364, México D. F. 01000, Mexico
| | - J Walding
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - M Ward
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S Westerdale
- Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6, Canada
| | - E Woolsey
- Department of Physics, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - J Zielinski
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
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Golmohamadi A, Tome A, Smith M, Loggia M, Grace E. Relationship between the Level of Nutrition Education and Opinions Regarding Elective Gluten-Free Diets. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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13
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Grace E, Turner RM. Use of Procalcitonin in Patients With Various Degrees of Chronic Kidney Disease Including Renal Replacement Therapy. Clin Infect Dis 2014; 59:1761-7. [DOI: 10.1093/cid/ciu732] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Grace E, Shaw C, Whelan K, Andreyev HJN. Review article: small intestinal bacterial overgrowth--prevalence, clinical features, current and developing diagnostic tests, and treatment. Aliment Pharmacol Ther 2013; 38:674-88. [PMID: 23957651 DOI: 10.1111/apt.12456] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 06/10/2013] [Accepted: 07/28/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND The symptoms and signs of small intestinal bacterial overgrowth (SIBO) are often identical to a variety of diseases and can lead to diagnostic confusion. AIMS To review the diagnostic options for SIBO and present new investigative options for the condition. METHODS A literature search was performed on MEDLINE, EMBASE and Web of Science for English articles and abstracts. Search terms included free text words and combinations of the following terms 'small intestinal bacterial overgrowth', 'small bowel bacterial overgrowth', 'diagnostic tests', 'treatment', 'antibiotics', 'probiotics', 'metabonomics', 'proton nuclear magnetic resonance spectroscopy', 'electronic nose' and 'field asymmetric ion mobility spectrometry'. RESULTS All of the available methods to test for SIBO have inherent limitations and no 'gold-standard' diagnostic test for the condition exists. Accurate diagnosis of SIBO requires identification of bacterial species growing inappropriately within the small intestine and symptom response to antibiotics. Proton nuclear magnetic resonance spectroscopy, electronic nose technology and/or field asymmetric ion mobility spectrometry may represent better investigative options for the condition. CONCLUSIONS Novel diagnostic options are needed to supplement or replace available tests.
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Affiliation(s)
- E Grace
- Nutrition and Dietetics, The Royal Marsden NHS Foundation Trust, London, UK
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Raghavendra P, Newman L, Grace E, Wood D. 'I could never do that before': effectiveness of a tailored Internet support intervention to increase the social participation of youth with disabilities. Child Care Health Dev 2013; 39:552-61. [PMID: 23763256 DOI: 10.1111/cch.12048] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Youth use the Internet for a variety of purposes including social networking. Youth with disabilities are limited in their social networks and friendships with peers. The aim was to investigate the effectiveness of tailored one-on-one support strategies designed to facilitate social participation of youth with disabilities through the use of the Internet for social networking. METHODS Eighteen youth aged 10-18 years with cerebral palsy, physical disability or acquired brain injury received support, training and assistive technology at their home to learn to use the Internet for building social networks. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS) were used to evaluate objective changes in performance and satisfaction. Interviews with the youth identified subjective changes they experienced through participation in the programme and to determine whether and how the intervention influenced their social participation. RESULTS Youth showed an increase in performance and satisfaction with performance on identified goals concerning social networking on the COPM; Paired T-test showed that these differences were statistically significant at P < 0.001. GAS T-scores demonstrated successful outcomes (>50) for 78% of the youth. Interviews showed that youth were positive about the benefits of hands-on training at home leading to increased use of the Internet for social networking. CONCLUSIONS The Internet could be a viable method to facilitate social participation for youth with disabilities. Youth identified the benefits of one-to-one support at home and training of the family compared with typical group training at school. Despite its success with this group of youth, the time and effort intensive nature of this approach may limit the viability of such programmes. Further longitudinal research should investigate whether Internet use is sustained post intervention, and to identify the factors that best support ongoing successful and safe use.
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Affiliation(s)
- P Raghavendra
- Disability & Community Inclusion, Faculty of Health Sciences, Flinders University, Adelaide, SA 5001, Australia.
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Grace E. Altered vancomycin pharmacokinetics in obese and morbidly obese patients: what we have learned over the past 30 years. J Antimicrob Chemother 2012; 67:1305-10. [DOI: 10.1093/jac/dks066] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Derk CT, Grace E, Shenin M, Naik M, Schulz S, Xiong W. Comment on: A prospective open-label study of mycophenolate mofetil for the treatment of diffuse systemic sclerosis: reply. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq128] [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: 11/13/2022] Open
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Derk CT, Grace E, Shenin M, Naik M, Schulz S, Xiong W. A prospective open-label study of mycophenolate mofetil for the treatment of diffuse systemic sclerosis. Rheumatology (Oxford) 2009; 48:1595-9. [PMID: 19846575 DOI: 10.1093/rheumatology/kep295] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of mycophenolate mofetil for the treatment of SSc. METHODS We recruited 15 patients with dcSSc to take part in an open-label study using mycophenolate mofetil to treat their disease over a 12-month period. The primary outcome measure was the modified Rodnan skin score (mRSS), whereas secondary outcomes included the Medsger severity score, pulmonary function studies, 2D echocardiograms and the Short Form Health Survey (SF)-36 questionnaire. RESULTS The mRSS significantly improved in those patients who tolerated the medication for >3 months (P < 0.0001), and there was a statistically significant improvement in the Medsger severity scores of the general (P = 0.05), peripheral vascular involvement (P = 0.05) and skin (P = 0.0003) scores. The SF-36 scores improved (P = 0.05) and the pulmonary function studies showed a trend towards improvement, though not of statistical significance. The mean pulmonary artery pressure by 2D echocardiography did not change. CONCLUSIONS In this prospective open-label study of mycophenolate mofetil for the treatment of dcSSc, we observed significant improvements in skin scores, peripheral vascular involvement and patient-perceived health status. Pulmonary function studies did not worsen as expected, but instead showed a trend towards improvement. Controlled trials are needed to further investigate this trend for improved pulmonary function studies.
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Affiliation(s)
- Chris T Derk
- Division of Rheumatology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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Edwards RR, Grace E, Peterson S, Klick B, Haythornthwaite JA, Smith MT. Sleep continuity and architecture: associations with pain-inhibitory processes in patients with temporomandibular joint disorder. Eur J Pain 2009; 13:1043-7. [PMID: 19168380 DOI: 10.1016/j.ejpain.2008.12.007] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Revised: 12/15/2008] [Accepted: 12/17/2008] [Indexed: 11/16/2022]
Abstract
Recent research suggests bi-directional interactions between the experience of pain and the process of sleep; pain interferes with the ability to obtain sleep, and disrupted sleep contributes to enhanced pain perception. Our group recently reported, in a controlled experimental study, that sleep fragmentation among healthy adults resulted in subsequent decrements in endogenous pain inhibition. The present report follows up that observation by extending this line of research to a sample of patients experiencing persistent pain. Patients with chronic temporomandibular joint disorder (TMD) pain were studied using polysomnography and psychophysical evaluation of pain responses. We assessed whether individual differences in sleep continuity and/or architecture were related to diffuse noxious inhibitory controls (DNIC), a measure of central nervous system pain inhibition. Among 53 TMD patients, higher sleep efficiency and longer total sleep time were positively associated with better functioning of DNIC (r=0.42-0.44, p<0.01; ps<0.05 for the multivariate analyses). These results suggest the possibility that disrupted sleep may serve as a risk factor for inadequate pain-inhibitory processing and hint that aggressive efforts to treat sleep disturbance early in the course of a pain condition might be beneficial in reducing the severity or impact of clinical pain.
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Affiliation(s)
- R R Edwards
- Brigham and Women's Hospital, Harvard Medical School, Department of Anesthesiology, USA
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Grace E. Instructional resources for teaching social influence in accounting courses. Social Influence 2006. [DOI: 10.1080/15534510600926811] [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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22
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Grace E, Lackland D. The Lack of Agreement in the Definition of Obesity. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s39-d] [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: 11/12/2022] Open
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Keng WT, Harewood L, Grace E, Paxton C, Lam WWK, Fitzpatrick DR. A balanced reciprocal translocation in a case of hypomelanosis of Ito with confirmation of mosaicism using buccal cell interphase FISH. Am J Med Genet A 2006; 140:1111-3. [PMID: 16596668 DOI: 10.1002/ajmg.a.31190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ma’ayan A, Jenkins SL, Neves S, Hasseldine A, Grace E, Dubin-Thaler B, Eungdamrong NJ, Weng G, Ram PT, Rice JJ, Kershenbaum A, Stolovitzky GA, Blitzer RD, Iyengar R. Formation of regulatory patterns during signal propagation in a Mammalian cellular network. Science 2005; 309:1078-83. [PMID: 16099987 PMCID: PMC3032439 DOI: 10.1126/science.1108876] [Citation(s) in RCA: 261] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We developed a model of 545 components (nodes) and 1259 interactions representing signaling pathways and cellular machines in the hippocampal CA1 neuron. Using graph theory methods, we analyzed ligand-induced signal flow through the system. Specification of input and output nodes allowed us to identify functional modules. Networking resulted in the emergence of regulatory motifs, such as positive and negative feedback and feedforward loops, that process information. Key regulators of plasticity were highly connected nodes required for the formation of regulatory motifs, indicating the potential importance of such motifs in determining cellular choices between homeostasis and plasticity.
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Affiliation(s)
- Avi Ma’ayan
- Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Sherry L. Jenkins
- Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Susana Neves
- Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Anthony Hasseldine
- Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Elizabeth Grace
- Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY 10029, USA
| | | | - Narat J. Eungdamrong
- Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Gehzi Weng
- Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Prahlad T. Ram
- Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - J. Jeremy Rice
- Functional Genomics and Systems Biology, IBM T. J. Watson Research Center, Yorktown Heights, NY 10598, USA
| | - Aaron Kershenbaum
- Functional Genomics and Systems Biology, IBM T. J. Watson Research Center, Yorktown Heights, NY 10598, USA
| | - Gustavo A. Stolovitzky
- Functional Genomics and Systems Biology, IBM T. J. Watson Research Center, Yorktown Heights, NY 10598, USA
| | - Robert D. Blitzer
- Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY 10029, USA
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Ravi Iyengar
- Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, NY 10029, USA
- To whom correspondence should be addressed.
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Garcia-Miñaur S, Ramsay J, Grace E, Minns RA, Myles LM, FitzPatrick DR. Interstitial deletion of the long arm of chromosome 5 in a boy with multiple congenital anomalies and mental retardation: Molecular characterization of the deleted region to 5q22.3q23.3. Am J Med Genet A 2004; 132A:402-10. [PMID: 15742475 DOI: 10.1002/ajmg.a.30421] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Interstitial deletions of the middle portion of the long arm of chromosome 5 are relatively rare. So far, only 36 cases have been reported. Because of the repetitive banding pattern of this region, the extent and localization of the deleted segment has not been well characterized in the majority of reported cases. This has complicated attempts to establish a definite karyotype-phenotype correlation. We report a further case with a de novo interstitial deletion of the region 5q?15 to 5q?22 identified by standard karyotype analysis. The proband presented with failure to thrive, developmental delay, distinct craniofacial dysmorphic features, and associated structural anomalies (amongst them cleft palate, iris colobomata, and horseshoe kidney, which have previously been reported in 5q deletion cases). In addition, this child had an Arnold-Chiari type I malformation that required surgical decompression. FISH studies using BAC clones spanning the 5q15 to 5q22 region revealed that these were all present in both homologues. Use of more distal clones allowed delineation of the deleted region to 5q22.3q23.3 and to narrow down the breakpoints to approximately 200 kb. The 14 Mb deleted region contains about 60 genes but, with the possible exception of FBN2 and DMXL1, there are no obvious candidate genes for the specific components of the phenotype. This case illustrates the discrepancy between cytogenetic and molecular techniques in trying to delineate 5q interstitial deletions. Molecular studies need to be performed on these patients, to establish genotype-phenotype correlation and to understand the role and influence of genes in this region.
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Affiliation(s)
- Sixto Garcia-Miñaur
- South East of Scotland Genetics Service, Western General Hospital, Edinburgh, United Kingdom.
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Bache I, Assche EV, Cingoz S, Bugge M, Tümer Z, Hjorth M, Lundsteen C, Lespinasse J, Winther K, Niebuhr A, Kalscheuer V, Liebaers I, Bonduelle M, Tournaye H, Ayuso C, Barbi G, Blennow E, Bourrouillou G, Brondum-Nielsen K, Bruun-Petersen G, Croquette MF, Dahoun S, Dallapiccola B, Davison V, Delobel B, Duba HC, Duprez L, Ferguson-Smith M, Fitzpatrick DR, Grace E, Hansmann I, Hultén M, Jensen PK, Jonveaux P, Kristoffersson U, Lopez-Pajares I, McGowan-Jordan J, Murken J, Orera M, Parkin T, Passarge E, Ramos C, Rasmussen K, Schempp W, Schubert R, Schwinger E, Shabtai F, Smith K, Stallings R, Stefanova M, Tranebjerg L, Turleau C, van der Hagen CB, Vekemans M, Vokac NK, Wagner K, Wahlstroem J, Zelante L, Tommerup N. An excess of chromosome 1 breakpoints in male infertility. Eur J Hum Genet 2004; 12:993-1000. [PMID: 15367911 DOI: 10.1038/sj.ejhg.5201263] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
In a search for potential infertility loci, which might be revealed by clustering of chromosomal breakpoints, we compiled 464 infertile males with a balanced rearrangement from Mendelian Cytogenetics Network database (MCNdb) and compared their karyotypes with those of a Danish nation-wide cohort. We excluded Robertsonian translocations, rearrangements involving sex chromosomes and common variants. We identified 10 autosomal bands, five of which were on chromosome 1, with a large excess of breakpoints in the infertility group. Some of these could potentially harbour a male-specific infertility locus. However, a general excess of breakpoints almost everywhere on chromosome 1 was observed among the infertile males: 26.5 versus 14.5% in the cohort. This excess was observed both for translocation and inversion carriers, especially pericentric inversions, both for published and unpublished cases, and was significantly associated with azoospermia. The largest number of breakpoints was reported in 1q21; FISH mapping of four of these breakpoints revealed that they did not involve the same region at the molecular level. We suggest that chromosome 1 harbours a critical domain whose integrity is essential for male fertility.
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Affiliation(s)
- Iben Bache
- Wilhelm Johannsen Centre for Functional Genome Research, Department of Medical Biochemistry and Genetics, The Panum Institute, University of Copenhagen, Denmark.
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Miranda EP, Gertner M, Wall J, Grace E, Kashani-Sabet M, Allen R, Leong SPL. Routine Imaging of Asymptomatic Melanoma Patients With Metastasis to Sentinel Lymph Nodes Rarely Identifies Systemic Disease. ACTA ACUST UNITED AC 2004; 139:831-6; discussion 836-7. [PMID: 15302691 DOI: 10.1001/archsurg.139.8.831] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
HYPOTHESIS The diagnostic yield of chest radiography; computed tomography (CT) of the chest, abdomen, and pelvis; and CT or magnetic resonance imaging of the brain in the initial evaluation of melanoma with metastasis to sentinel lymph nodes may not identify systemic disease. DESIGN Retrospective analysis. SETTING Tertiary care referral center. PATIENTS Of 1183 patients identified from a database of individuals who underwent selective sentinel lymphadenectomy for primary melanoma (Breslow thickness, 0.2-30 mm), we studied 185 with at least 1 sentinel lymph node positive for metastatic melanoma (Breslow thickness, 0.8-14.5 mm). INTERVENTIONS Chest radiography; CT of the chest, abdomen, and pelvis; and CT or magnetic resonance imaging of the brain after selective sentinel lymphadenectomy with positive sentinel lymph nodes. The medical records of the 185 patients were systematically reviewed by 4 physician reviewers, and data were extracted primarily from pathology and radiology reports. When medical records were unavailable, information was taken from formal clinic and inpatient progress notes. MAIN OUTCOME MEASURE Diagnostic yield of imaging studies. RESULTS The results of 0.5% of the imaging studies were positive for metastatic disease, 86% were negative, and 14% were indeterminate. Indeterminate results were confirmed to be negative by additional studies ranging from repeated imaging to invasive procedures, including thoracotomy and brain biopsy. The yields are as follows: chest radiography, 0%; chest CT, 0.7%; abdominal and pelvic CT, 0.7%; brain CT, 0%; and brain magnetic resonance imaging, 0%. Only 1 patient (0.5%) had detectable metastatic disease, and he had symptoms of systemic disease at the time of imaging. CONCLUSIONS Computed tomography of the chest, abdomen and pelvis, and brain rarely reveals systemic metastasis at the time of selective sentinel lymphadenectomy. Routine imaging of asymptomatic patients at the time of selective sentinel lymphadenectomy is not indicated.
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Affiliation(s)
- Edward P Miranda
- Department of Surgery, University of California San Francisco, 94143-1974, USA
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Chiba N, Veldhuyzen Van Zanten SJO, Escobedo S, Grace E, Lee J, Sinclair P, Barkun A, Armstrong D, Thomson ABR. Economic evaluation of Helicobacter pylori eradication in the CADET-Hp randomized controlled trial of H. pylori-positive primary care patients with uninvestigated dyspepsia. Aliment Pharmacol Ther 2004; 19:349-58. [PMID: 14984382 DOI: 10.1111/j.1365-2036.2004.01865.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Adult Helicobacter pylori-positive patients by 13C-urea breath test with uninvestigated dyspepsia symptoms were randomized to 1-week eradication treatment with omeprazole, metronidazole and clarithromycin (OMC) vs. omeprazole and placebo antimicrobials (OPP) in the Canadian Adult Dyspepsia Empiric Treatment-H. pylori-positive (CADET-Hp) study. AIM To perform an economic evaluation of this 1-year study. METHODS Following blind eradication treatment, family practitioners managed patients according to their usual practices. Health resource utilization information was collected prospectively. From the mean costs of the health resources consumed and the treatment outcomes, the incremental cost-effectiveness ratios and incremental net benefits of eradication treatment vs. OPP were determined. RESULTS Eradication therapy significantly improved dyspepsia symptoms (treatment success: OMC, 50%; OPP, 36%; P = 0.02). The incremental cost-effectiveness ratio of OMC vs. OPP was - 387 Canadian dollars (CAD$) per treatment success (90% CI, - CAD$1707, CAD$607), indicating a lower cost with treatment success. The incremental net benefit analysis showed that H. pylori eradication was cost-effective if the willingness-to-pay value exceeded a nominal figure of CAD$100 from a health service perspective or CAD$607 from the societal perspective. CONCLUSION In uninvestigated patients presenting with dyspepsia at the primary care level, eradication of H. pylori in those who are H. pylori positive leads to a cost-effective improvement in dyspepsia symptoms compared with a strategy of not eradicating H. pylori in these patients.
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Affiliation(s)
- N Chiba
- Surrey GI Clinic/Research, Guelph, Ontario, Canada.
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Gordon CM, Dougherty DD, Fischman AJ, Emans SJ, Grace E, Lamm R, Alpert NM, Majzoub JA, Rauch SL. Neural substrates of anorexia nervosa: a behavioral challenge study with positron emission tomography. J Pediatr 2001; 139:51-7. [PMID: 11445794 DOI: 10.1067/mpd.2001.114768] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To delineate functional brain abnormalities associated with anorexia nervosa (AN). STUDY DESIGN Positron emission tomographic measurements of regional cerebral blood flow (rCBF) were performed on 8 female patients with AN and 8 healthy female control subjects during exposure to 3 types of stimuli: high-calorie foods, low-calorie foods, and non-food items. Heart rate and internal state analog scale scores were also obtained. Stereotactic transformation and statistical parametric mapping techniques were used to analyze imaging data. RESULTS During the high-calorie condition, control subjects reported a significant desire to eat, whereas subjects with AN reported elevated anxiety and exhibited increases in heart rate. Patients with AN had elevated bilateral medial temporal lobe rCBF compared with control subjects. Planned comparisons for group-by-condition interactions demonstrated greater activation within left occipital cortex and right temporo-occipital cortex for the high-calorie versus low-calorie contrast in patients with AN compared with control subjects. CONCLUSIONS Our finding of elevated rCBF within bilateral medial temporal lobes is similar to published results in patients with psychotic disorders and may be related to the body image distortion common to AN. The high-calorie food phobia exhibited by patients with AN appears to be associated with exaggerated responses in visual association cortex, as has been previously observed in studies of specific phobias.
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Affiliation(s)
- C M Gordon
- Divisions of Adolescent/Young Adult Medicine and Endocrinology, Children's Hospital, Boston, Massachusetts, USA
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Cohen LA, Romberg E, Grace E. Revisiting the attitudes of dental faculty toward individuals with AIDS. J Dent Educ 2001; 65:249-52. [PMID: 11318090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- L A Cohen
- Department of Oral Health Care Delivery, University of Maryland Dental School, Baltimore 21201, USA
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Gordon CM, Emans SJ, DuRant RH, Mantzoros C, Grace E, Harper GP, Majzoub JA. Endocrinologic and psychological effects of short-term dexamethasone in anorexia nervosa. Eat Weight Disord 2000; 5:175-82. [PMID: 11082797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Patients with anorexia nervosa (AN) have hyperactivity of their hypothalamic-pituitary-adrenal (HPA) axis, sometimes accompanied by elevations of cortisol. We examined whether the normal effects of short-term dexamethasone treatment upon HPA axis suppression and appetite stimulation are observed in these patients. Five young women with AN and ten healthy female controls received one week of high-dose oral dexamethasone (2 mg/m2/d) preceded and followed by hormonal evaluation of sensitivity to glucocorticoids and psychological assessments. No differences in hormone levels of the HPA axis were observed between the two groups and control groups at baseline, after dexamethasone suppression, or following ACTH stimulation testing. However, fasting insulin levels were significantly lower in the AN group, both before and after dexamethasone therapy and their serum leptin levels were also significantly lower. The AN group had significantly lower scores on the Anorexia Nervosa Subtest and the Beck Depression Inventory after dexamethasone compared to controls. On daily analog scales, AN patients had higher anxiety scores while on dexamethasone. Normal sensitivity to glucocorticoids was observed in all parameters examined except for mild abnormalities in pancreatic beta-cell function. These data suggest that AN may represent a state of partial glucocorticoid resistance, as in other states of restricted food intake. Furthermore, these pilot data, including the effects of dexamethasone upon psychological outlook in AN, suggest that glucocorticoids are not an effective therapy for these patients.
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Affiliation(s)
- C M Gordon
- Division of Adolescent/Young Adult Medicine, Children's Hospital, Harvard Medical School, Boston, MA, USA
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Berg J, Grace E, Teik KW, Hammond H, Tidman M, FitzPatrick D. Bullous ichthyosiform erythroderma, developmental delay, aortic and pulmonary stenosis in association with a FRA12A. Clin Dysmorphol 2000; 9:213-9. [PMID: 10955484 DOI: 10.1097/00019605-200009030-00012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present an 11-year-old female with bullous ichthyosiform erythroderma (BIE), learning disability, patent ductus arteriosus and mild stenosis of the aortic and pulmonary arteries. Chromosome analysis showed the expression of the rare folate-sensitive fragile site FRA12A at 12q13 in 8/20 (40%) of blood lymphocytes cultured in folate-deficient medium in the presence of trimethoprim. Her mother and maternal grandmother are phenotypically normal, but her mother shows expression of the same fragile site in 4/20 (20%) of cells cultured under the same conditions. Lymphocytes from the grandmother only showed expression of the fragile site when cultured in the presence of methotrexate in folate deficient medium. Interestingly, two genes (keratin 1 and keratin 2e) which are known to cause BIE map to 12q13. Molecular data is presented excluding three candidate (CCG)n repeats within keratin 1 gene. We present a review of previously reported FRA12A cases and discuss possible molecular explanations for the clinical findings in this patient.
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Affiliation(s)
- J Berg
- South-East of Scotland Clinical Genetics Service, Molecular Medicine Centre, Western General Hospital, Edinburgh
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Cohen LA, Romberg E, Grace E. A revisitation of dental student's attitudes toward individuals with AIDS. J Dent Educ 2000; 64:298-301. [PMID: 10769734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- L A Cohen
- Department of Oral Health Care Delivery, University of Maryland Dental School, Baltimore 21201, USA
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Abstract
OBJECTIVE The mediating neuroanatomy of human appetitive function is poorly understood. A state induction paradigm was employed, in conjunction with positron emission tomography, to test the hypothesis that limbic/paralimbic regions respond to the desirability of food stimuli. METHODS Eight normal subjects were studied during each of three conditions, involving visual exposure to high-caloric food, low-caloric food, and nonfood stimuli. Subjective indices of hunger were measured via analog scales. RESULTS Planned contrasts demonstrated significant increases in desire to eat and decreases in left temporoinsular cortical blood flow during the high-caloric versus control conditions. DISCUSSION Results implicate the temporo-insular cortex in normal appetitive function, suggesting that activity within this region is associated with the desirability or valence of food stimuli, prior to ingestion. These data will provide a broad foundation for future studies of patients with eating disorders.
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Affiliation(s)
- C M Gordon
- Division of Adolescent/Young Adult Medicine, Children's Hospital, Boston, Massachusetts 02115, USA
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37
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Wiklund IK, Junghard O, Grace E, Talley NJ, Kamm M, Veldhuyzen van Zanten S, Paré P, Chiba N, Leddin DS, Bigard MA, Colin R, Schoenfeld P. Quality of Life in Reflux and Dyspepsia patients. Psychometric documentation of a new disease-specific questionnaire (QOLRAD). Eur J Surg Suppl 1999:41-9. [PMID: 10027672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To develop a disease-specific QOL instrument (QOLRAD) addressing patient concerns in gastroesophageal reflux disease (GERD) and dyspepsia. Patients. 759 male (45%) and female (55%) patients with a mean age of 48.4 years (sd 15.2) were used in the psychometric evaluation. MAIN OUTCOME MEASURES A pilot version of QOLRAD, the Gastrointestinal Symptoms Rating Scale (GSRS) and the SF-36 were completed prior to endoscopy. Items with a high ceiling effect, items measuring a different construct, i.e. with a low squared multiple correlation (R < 0.5) with the other items, items that showed redundancy by a high correlation (>0.80) with another item were removed. A confirmatory factor analysis was also performed. RESULTS The final questionnaire included 25 items depicting problems with emotions, vitality, sleep, eating/drinking, and physical/social functioning. The internal consistency reliability was high (alpha value overall 0.97, dimensions 0.89-94). Construct validity, i.e. the associations between similar constructs in the QOLRAD, the SF-36 and the GSRS scores was confirmed. Pain and symptom severity were markers of impaired QOL. The impact on health-related QOL was similar across the functional gastrointestinal disorders with the exception of patients with a normal endoscopy, who did slightly worse. CONCLUSION The QOLRAD is a short and user-friendly instrument with excellent psychometric properties. Its responsiveness to change in (AVMC1) clinical trials is currently being explored.
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Gordon CM, Grace E, Emans SJ, Goodman E, Crawford MH, Leboff MS. Changes in bone turnover markers and menstrual function after short-term oral DHEA in young women with anorexia nervosa. J Bone Miner Res 1999; 14:136-45. [PMID: 9893076 DOI: 10.1359/jbmr.1999.14.1.136] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Bone loss is a serious consequence of anorexia nervosa (AN). Subnormal levels of serum dehydroepiandrosterone (DHEA) are seen in patients with AN and may be causally linked to their low bone density. We hypothesized that oral DHEA would decrease markers of bone resorption (urinary N-telopeptides [NTx]), and increase markers of bone formation (serum bone-specific alkaline phosphatase and osteocalcin [OC]). Fifteen young women (age 15-22 years) with AN were enrolled in a 3-month, randomized, double-blinded trial of 50, 100, or 200 mg of daily micronized DHEA. Blood and urinary levels of adrenal and gonadal steroids and bone turnover markers were measured. No adverse clinical side effects of DHEA were noted, and a 50 mg daily dose restored physiologic hormonal levels. At 3 months, NTx levels had decreased significantly in both the 50 mg (p = 0.018) and the 200 mg (p = 0.016) subgroups. OC levels simultaneously increased within treatment groups over time (p = 0.002). Eight out of 15 (53%) subjects had at least one menstrual cycle while on therapy. Short-term DHEA was well-tolerated and appears to normalize bone turnover in young women with AN. Resumption of menses in over half of subjects suggests that DHEA therapy may also lead to estradiol levels sufficient to stimulate the endometrium in this group of patients.
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Affiliation(s)
- C M Gordon
- Division of Adolescent/Young Adult Medicine, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
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39
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Grace E. Dentistry, stress, and substance abuse. MSDA J 1998; 39:77-9. [PMID: 9569879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Dentists have to deal with many significant stressors in their personal and professional lives. It is important for dentists to learn to cope and deal with these stressors and their effects. This paper reviews the nature and causes of addictions, the relationship between addiction and stress, and methods to organize and reduce stress in work environments.
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Affiliation(s)
- E Grace
- Department Oral Health Care Delivery, Baltimore College of Dental Surgery, Dental School, University of Maryland at Baltimore, MD 21201, USA
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Abstract
Molecular genetic investigation of a female infant with Beckwith-Wiedemann syndrome (BWS) showed loss of IGF2 imprinting but no evidence of uniparental disomy. In addition, a deletion of chromosome 18q22.1 was identified in this infant without clinical features of 18q-syndrome (microcephaly, short stature, hypotonia). The association of a chromosome 18 deletion and BWS may be coincidental or may indicate the location of a trans activating regulator element for maintenance of IGF2 imprinting.
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Affiliation(s)
- C M Brewer
- Human Genetics Unit, Western General Hospital, Edinburgh, UK
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Tugwell P, Ludwin D, Gent M, Roberts R, Bensen W, Grace E, Baker P. Interaction between cyclosporin A and nonsteroidal antiinflammatory drugs. J Rheumatol 1997; 24:1122-5. [PMID: 9195520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Although cyclosporin A (CyA) has been shown in a series of controlled trials to be of benefit to patients with rheumatoid arthritis (RA), the majority of patients continue to require nonsteroidal antiinflammatory drugs (NSAID) for relief of joint pain and stiffness. Our aim was to determine whether there is a clinically important difference in calculated creatinine clearance when CyA is given concurrently with NSAID with high cyclooxygenase activity (indomethacin and ketoprofen) compared with sulindac, which has been claimed to have fewer renal effects than other NSAID, and compared with a simple analgesic, paracetamol. METHODS Patients with RA started 2.5 mg/kg CyA/day and dosage was increased cautiously to 5 mg/kg/day or less if the serum creatinine rose by > or = 30% above baseline. The mean stabilized dose was 171.43 +/- 48.94 mg/day. Once CyA dose was stabilized, patients were allocated in random order to possible sequences of 4 week periods of acetaminophen, indomethacin, ketoprofen, and sulindac. Monitoring of cyclosporine levels, nephrotoxicity, and hepatoxicity, and adjustment of doses were by an "unblinded" clinician not in direct contact with study patients. All other assessments were made by a "blinded" clinician. Patients were instructed to take the identical appearing gelatin capsules qid. The multiple crossover design was analyzed using analysis of variance procedures for repeated measures. RESULTS 35 patients were enrolled, of whom 32 patients completed the acetaminophen and at least one course of NSAID. The calculated creatinine clearance was increased by 2.79 ml/min (3.5%) on average for acetaminophen versus all 3 NSAID (6% for indomethacin, 2.3% for ketoprofen, 2.6% for sulindac). The study had adequate power to detect a true difference of more than 10% in mean creatinine clearance for each major comparison. CONCLUSION NSAID studied did not produce a clinically important difference in the calculated creatinine clearance in these patients-the difference with acetaminophen was modest and not of clinical significance. There is no evidence that any of the 3 NSAID studied have an advantage or disadvantage. It seems reasonable to allow patients to continue an NSAID of their or their clinician's choice.
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Affiliation(s)
- P Tugwell
- Department of Medicine, University of Ottawa, Canada
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Brewer CM, Grace E, Stark GD, Gregory DW, Howell RT, Fitzpatrick DR. Genomic instability associated with limb defects: case report and review of the literature. Clin Dysmorphol 1997; 6:99-109. [PMID: 9134289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report a child in whom we observed markedly increased genome-wide spontaneous chromosomal breakage in both leucocytes and fibroblasts associated with severe growth retardation, radial aplasia, leucopenia, mild hydrocephalus and an unusual trichodystrophy. Exposure to DNA cross-linking agents diepoxybutane, mitomycin-C and mustine hydrochloride in this case did not result in the increased chromosome breakage seen in Fanconi anaemia. It may be that this child has a defect in postreplicative DNA repair interacting with the protein components deficient in FA.
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Grace E, Pokorny SF. At what age should a virginal adolescent have her first pelvic examination? J Pediatr Adolesc Gynecol 1996; 9:45-6. [PMID: 9551375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Brown DC, Grace E, Sumner AT, Edmunds AT, Ellis PM. ICF syndrome (immunodeficiency, centromeric instability and facial anomalies): investigation of heterochromatin abnormalities and review of clinical outcome. Hum Genet 1995; 96:411-6. [PMID: 7557962 DOI: 10.1007/bf00191798] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A further patient with the ICF syndrome (immunodeficiency, centromeric heterochromatin instability of chromosomes 1, 9 and 16 and facial anomalies) is described. This case is the second to be reported with consanguinity of the parents. This lends support to the theory of autosomal recessive inheritance. The features of the 15 published cases are reviewed. The clinical and cytogenetic characteristics of the syndrome are discussed, and new evidence provided as to the role of centromeres and centric heterochromatin in the production of chromosome aberrations. Correspondence with other authors has made possible a review of the clinical outcome in this condition.
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Affiliation(s)
- D C Brown
- Cytogenetics Laboratory, Royal Hospital for Sick Children, Edinburgh, UK
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Penny LA, Dell'Aquila M, Jones MC, Bergoffen J, Cunniff C, Fryns JP, Grace E, Graham JM, Kousseff B, Mattina T. Clinical and molecular characterization of patients with distal 11q deletions. Am J Hum Genet 1995; 56:676-83. [PMID: 7887422 PMCID: PMC1801184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Jacobsen syndrome is caused by segmental aneusomy for the distal end of the long arm of chromosome 11. Typical features include mild to moderate psychomotor retardation, trigonocephaly, facial dysmorphism, cardiac defects, and thrombocytopenia, though none of these features are invariably present. To define the critical regions responsible for these abnormalities, we studied 17 individuals with de novo terminal deletions of 11q. The patients were characterized in a loss-of-heterozygosity analysis using polymorphic dinucleotide repeats. The breakpoints in the complete two-generation families were localized with an average resolution of 3.9 cM. Eight patients with the largest deletions extending from 11q23.3 to 11qter have breakpoints, between D11S924 and D11S1341. This cytogenetic region accounts for the majority of 11q- patients and may be related to the FRA11B fragile site in 11q23.3. One patient with a small terminal deletion distal to D11S1351 had facial dysmorphism, cardiac defects, and thrombocytopenia, suggesting that the genes responsible for these features may lie distal to D11S1351. Twelve of 15 patients with deletion breakpoints as far distal as D11S1345 had trigonocephaly, while patients with deletions distal to D11S912 did not, suggesting that, if hemizygosity for a single gene is responsible for this dysmorphic feature, the gene may lie distal to D11S1345 and proximal to D11S912.
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Affiliation(s)
- L A Penny
- Division of Medical Genetics, University of California, San Diego, La Jolla 92093-0639
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Bensen W, Tugwell P, Roberts RM, Ludwin D, Ross H, Grace E, Gent M. Combination therapy of cyclosporine with methotrexate and gold in rheumatoid arthritis (2 pilot studies). J Rheumatol 1994; 21:2034-8. [PMID: 7869306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate the efficacy and toxicity of cyclosporine A (CyA) in combination with gold and methotrexate (MTX) in patients with rheumatoid arthritis (RA). METHODS Twenty patients with RA with partial response to oral MTX and 20 patients with partial response to im gold had CyA added to their regimen for 6 months, withdrawn over 2 months and the patients monitored for 4 months. RESULTS There was a significant improvement in joint count, joint score, joint swelling, grip strength and joint pain in patients taking the combination with no significant increase in adverse reactions. CONCLUSION CyA in combination with gold or MTX may, over a 6 month period, increase efficacy in patients with refractory RA without significant increase in toxicity.
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Affiliation(s)
- W Bensen
- Department of Medicine, St. Joseph's Hospital, Hamilton, ON, Canada
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Abstract
We undertook a prospective study of 300 postmenarcheal female subjects (median age, 18.0 years) to examine (1) the relation of tampon use, sports participation, prior gynecologic examination, and consensual sexual activity to hymenal anatomy, (2) the factors leading to choice of tampons by girls not sexually active, and (3) factors related to ease of gynecologic examination. The sample included 100 subjects in group 1, who denied sexual intercourse and used only pads for menses; 100 subjects in group 2, who denied sexual intercourse and had used tampons; and 100 subjects in group 3, who gave a history of sexual intercourse. Sexually active subjects (81%) were significantly more likely than tampon users and pad users to have "complete clefts" in the lower hymen between the 2 o'clock and 10 o'clock positions (p < 0.001); tampon users were not significantly different from pad users (11% vs 5%). In subjects who were not sexually active, the presence of these complete clefts was not related to participation in sports or to prior pelvic examination. Although median hymenal opening diameter differed in the three groups (1.2 cm for group 1 vs 1.5 cm for group 2 vs 2.5 cm for group 3; p < 0.0001), the ranges of measurements were wide. Tampon users were significantly more likely than pad users to have mothers and friends, but not sisters, who had a favorable attitude toward tampon use. The best predictors of tampon use in a multivariate model were a favorable maternal attitude (odds ratio (OR), 5.3; 95% confidence interval (CI), 2.4, 12.1) and friends' use of tampons (OR 7.9; 95% CI 3.5, 18.1). Only 26% of speculum examinations in pad users were rated as easy compared with 56% of examinations in tampon users and 81% in sexually active young women (p < 0.001). The best predictors of ease of speculum examination were sexual activity (OR 15.9; 95% CI 1.9, 135.3) and tampon use (OR 3.6; 95% CI 1.0, 12.7). This large sample should provide useful data for physicians who testify in sexual assault cases and gives new information on the predictors of tampon use and ease of gynecologic examination in young women.
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Affiliation(s)
- S J Emans
- Division of Adolescent/Young Adult Medicine, Children's Hospital, Boston, MA 02115
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Grace E, Emans S, Havens K, Merola J, Woods E. Contraceptive compliance with a triphasic and a monophasic norethindrone-containing oral contraceptive pill in a private adolescent practice. ACTA ACUST UNITED AC 1994. [DOI: 10.1016/s0932-8610(12)80175-7] [Citation(s) in RCA: 6] [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: 11/29/2022]
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Abstract
A review of the cytogenetic analyses of a cohort of unselected patients with acute lymphoblastic leukemia from a single institution (1981-1989) confirmed hyperdiploidy > 50 as a favorable prognostic feature and pseudodiploidy, especially with chromosomal rearrangements, as an adverse one. In the early years of the study, a high incidence of diploid karyotype was identified, but with time (better banding and more intensive search) the incidence has fallen to 7.7%. Many such patients have been shown to be pseudodiploid. Molecular genetic techniques are increasingly identifying clonal abnormalities.
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Woods ER, Grace E, Klein Havens K, Merola JL, Emans SJ. Contraceptive compliance with a levonorgestrel triphasic and a norethindrone monophasic oral contraceptive in adolescent patients. Int J Gynaecol Obstet 1992. [DOI: 10.1016/0020-7292(92)90695-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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