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Lean I, Arnold J, Duddy C, Church S, Rose R, Hodgson D. Kristin Arnold 1956-2023. Aust Vet J 2023; 101:462. [PMID: 37918953 DOI: 10.1111/avj.13286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 11/04/2023]
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Zahler D, Arnold J, Rozenbaum Z, Banai S, Arbel Y, Topilsky Y, Laufer-Perl M. Valvular changes following anthracycline therapy: is it time to look beyond ejection fraction? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Advancements in early detection and treatment of breast cancer have improved survival, but with the costs of side effects, with cardiotoxicity being the most significant one. Anthracycline (ANT) is the most recognized therapy leading to cardiotoxicity, mainly manifested as left ventricle (LV) dysfunction. While the changes in LV ejection fraction (LVEF) are well studied, little is known about the effect of ANT on valvular function. We aimed to evaluate the change in valvular function following ANT therapy in patients diagnosed with breast cancer.
Methods
The study population is part of the Israel Cardio-Oncology Registry (ICOR). All patients performed serial echocardiography; before (T1), during (T2), at the end (T3), and following (T4) ANT therapy, assessing valvular changes. Exclusion criteria included age below 18 and baseline LVEF <55%.
Results
The study included 141 female patients diagnosed with breast cancer and treated with ANT with a mean age of 51±12 years (Table 1). During a median follow-up of 255 [IQR 214–313] days, from T1 to T4, we observed a significant increase in the portion of patients developing new mitral regurgitation (MR) (3.5% to 18.7%, p<0.0001), with a trend for developing moderate and above MR (0.7% to 3.3%, p=0.13). While a statistically significant reduction in mean LVEF (60.2%±1.5 to 59.2%±2.7, p=0.0004) and median LV global longitudinal strain (LV GLS) (−21.6% [−20.0 to −23.0] to −20.0% [−19.1 to −21.1], p<0.0001) was observed (Figure 1), the values remain within the normal range with no significant clinical change. In a multivariate binary logistic regression model, age (OR 1.06, 95% CI: 1.01–1.11) and trastuzumab therapy (OR 5.59, 95% CI: 1.95–16.6) were strong independent predictors for MR development, while medical history was not.
Conclusions
MR development following ANT exposure is frequent, increasingly after the completion of ANT therapy. The parallel reduction in LV function might imply a functional mechanism. Larger trials are needed to evaluate the MR prognostic clinical role in cancer patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Zahler
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
| | - J Arnold
- University of Illinois at Chicago, Department of Medicine , Chicago , United States of America
| | - Z Rozenbaum
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
| | - S Banai
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
| | - Y Arbel
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
| | - Y Topilsky
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
| | - M Laufer-Perl
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
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Md. Yusof MY, Arnold J, Saleem B, Vandevelde C, Dass S, Savic S, Vital E, Emery P. OP0250 BREAKTHROUGH INFECTIONS AND PREDICTING SEVERE COVID OUTCOMES DURING RITUXIMAB THERAPY IN AUTOIMMUNE RHEUMATIC DISEASES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAs rituximab (RTX) is a B-cell depleting agent, there are concerns regarding its safety during the COVID pandemic. Data from registries during pre-vaccination period reported increased risk of poor outcomes in RTX-treated patients vs TNFi. However, registry data could be limited by reporting bias in determining true incidence. There are also limited data on breakthrough infections following COVID vaccination.ObjectivesTo assess the incidence of breakthrough infections and predictors of severe COVID outcomes in RTX-treated autoimmune rheumatic diseases (ARDs) with a view to establishing a treatment algorithm for safe RTX administration.MethodsAn observational cohort study was undertaken in the first consecutive 300 ARD patients in a single centre between index date 01/09/2019 (i.e. 6 months prior to pandemic) and 31/01/2022. Only PCR positive cases were included. COVID outcomes were categorised as Mild (i.e. not hospitalised) or Moderate/Severe (i.e. hospitalised and requiring at least oxygenation or death). Predictors of moderate/severe outcomes were analysed using Cox-regression proportional hazard.ResultsMean (SD) at index date was 59 (14) years, 226/300 (75%) patients were female and 254 (85%) were Caucasians. The diagnoses were RA=212 (71%), SLE=33 (11%), AAV=26 (9%), Sjogren=9 (3%), IIM=8 (3%) and others=12 (4%). Therapy included concomitant DMARDs = 205 (68%) and oral prednisolone = 84 (28%). Median (range) no. of previous RTX courses was 4 (0-19). 534 RTX courses were administered. Of 294 patients with available vaccine data, 17 (6%) were unvaccinated, 4 (1%) had a single dose, 47 (16%) were double-vaccinated, 217 (74%) triple-vaccinated and 9 (3%) quadruple-vaccinated. Of those who were vaccinated, for the first dose, 11% were given within 12 weeks post-RTX, 15% within 26 weeks and 74% were >26 weeks post-RTX. The rate of overall COVID and moderate/severe infections were 11.2/100 PYs and 2.6/100 PYs respectively. Vaccinated patients had lower rate of moderate/severe infection (2.6/100 PYs) vs unvaccinated (18.6/100 PYs) [Table 1]. Over 650.7 PY follow-up, 17/300 patients (5.7%) had moderate/severe COVID including 2 deaths. Factors associated with time-to-infection in imputed multivariable analysis were number of comorbidities [HR 1.46 (95% CI 1.05-2.04)] and low IgG (<6g/L) [6.15 (1.95-19.41)]. A history of COVID vaccination reduced risk [HR 0.13 (0.03-0.51)]. Demographics including concomitant prednisolone, RTX- and vaccine-associated factors (e.g. RTX dose, time from RTX to vaccine, vaccine mode, peripheral B-cell depletion) were not predictive.Table 1.Incidence of COVID infectionPre-Vaccination ProgrammePost-Vaccination ProgrammeOverall Follow-upOverall COVID rate3.3/100 PYNon-vaccinated = 37.7/100 PY73 cases in 650.7 years] = 11.2/100 PYVaccinated = 18.6/100 PYModerate/Severe COVID rate2.1/100 PYNon-Vaccinated = 15.1/100 PY17 cases in 650.7 years] = 2.6/100 PYVaccinated = 2.6/100 PYConclusionThe rate of moderate/severe COVID infection in this cohort is comparable to the pre-pandemic severe infection rate in rituximab trials in RA. The high vaccination uptake in our cohort was effective in preventing severe infection despite the termination of national shielding programme in March 2021 and the spread of the Delta and Omicron variants. Individualised risk–benefit assessment should be undertaken in those with comorbidities, low IgG and unvaccinated when scheduling rituximab therapy.ReferencesNoneAcknowledgementsThis research was funded/supported by the the Wellcome Trust Institutional Strategic Support Fund to MYMY (204825/Z/16/Z), National Institute for Health Research (NIHR) Doctoral Research Fellowship to MYMY (DRF-2014-07-155) and NIHR Clinician Scientist to EMV (CS-2013-13-032). PE is a Versus Arthritis Professor of Rheumatology. This article/paper/report also presents independent research funded/supported by the NIHR Leeds Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.Disclosure of InterestsMd Yuzaiful Md Yusof Consultant of: Aurinia Pharmaceuticals, Jack Arnold: None declared, Benazir Saleem: None declared, Claire Vandevelde: None declared, Shouvik Dass: None declared, Sinisa Savic Speakers bureau: Novartis, Swedish Orphan Biovitrum (SOBI) and Sire, Grant/research support from: Novartis, Swedish Orphan Biovitrum, Octapharma and CSL Behring, Edward Vital Speakers bureau: Roche, GSK and AstraZeneca, Grant/research support from: Roche, GSK and AstraZeneca, Paul Emery Consultant of: BMS, Abbott, Pfizer, MSD, Novartis, Roche and UCB, Grant/research support from: Abbott, BMS, Pfizer, MSD and Roche.
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Arnold J, Dass S, Twigg S, Jones C, Rhodes B, Hewins P, Chakravorty M, Courtney P, Ehrenstein M, Md. Yusof MY, Vital E. AB0434 EFFICACY AND SAFETY OF OBINUTUZUMAB IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS WITH SECONDARY NON-RESPONSE TO RITUXIMAB. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSecondary inefficacy characterized by infusion reactions and anti-drug antibodies occur in 14% of SLE patients treated with repeat rituximab courses(1). Obinutuzumab is a next-generation humanized type-2 anti-CD20 therapy licensed for hematological malignancies which may overcome this issue(2).ObjectivesWe set out to evaluate the clinical efficacy and safety of obinutuzumab in a cohort of rituximab resistant SLE patients.MethodsWe collated data from SLE patients receiving obinutuzumab for secondary non-response to rituximab in BILAG centres. Disease activity was assessed using BILAG-2004, SLEDAI-2K and serology before, and 6 months after, obinutuzumab 2x1000mg infusions alongside methylprednisolone 100mg. Flow cytometry where possible was carried out using a multiple gating highly sensitive strategy.ResultsAll 9 patients included in the study received obinutuzumab alongside concomitant oral immunosuppression. At 6 months post-obinutuzumab, there were significant reductions in median SLEDAI-2K from 12 to 6 (p=0.014) and total BILAG-2004 score from 21 to 2 (p=0.009). Complement C3 and dsDNA titres improved significantly (both p=0.04). Non statistically significant numerical improvements were seen in C4 levels.Of 8/9 patients receiving concomitant oral prednisolone at baseline (all >10mg/day), 5/9 had their dose reduced at 6 months; 4/8 were on 5mg/day and were in Lupus Low Disease Activity State. After obinutuzumab, 6/9 patients with peripheral B-cell data achieved complete depletion including 4/4 assessed with highly sensitive assays. 1/9 obinutuzumab non-responder required cyclophosphamide therapy. 1 unvaccinated patient died from COVID-19.Table 1.Baseline characteristics, disease activity and steroid doses before and after last obinutuzumab/rituximab.PatientEthnicityDisease duration (Years)Age (Years)Total BILAG-2004 before ObiTotal BILAG-2004 after ObiSLEDAI-2K before ObiSLEDAI-2K after ObiPrednisolone before Obi (mg)Prednisolone after Obi (mg)1South Asian10.836.41821481052South Asian6.324.424212430103South Asian11.934.829110410104South Asian8.241.92116015155South Asian6.829.43221181450606White European17.537.0128881557White European16.930.01211281058Caribbean6.244.225213010159Caribbean2.621.092166105Median (Q1, Q3)NA8.2 (6, 12)34.8 (29,37)21 (12, 25)2 (1, 2)12 (10, 14)6 (4, 8)10 (10, 15)10 (5, 15)ConclusionObinutuzumab appears to be effective and steroid-sparing in renal and non-renal SLE patients with secondary non-response to rituximab. Obinutuzumab was shown to be effective in patients with severe renal and non-renal disease. Therefore, in those with previous responsiveness to B-cell depletion, switching to humanised type-2 anti-CD20 therapy is a logical approach following loss off efficacy.References[1]Vital EM, Dass S, Buch MH, Henshaw K, Pease CT, Martin MF, et al. B cell biomarkers of rituximab responses in systemic lupus erythematosus. Arthritis Rheum [Internet]. 2011 Oct [cited 2020 Oct 12];63(10):3038–47. Available from: https://pubmed.ncbi.nlm.nih.gov/21618204/[2]Hassan SU, Md Yusof MY, Emery P, Dass S, Vital EM. Biologic Sequencing in Systemic Lupus Erythematosus: After Secondary Non-response to Rituximab, Switching to Humanised Anti-CD20 Agent Is More Effective Than Belimumab. Front Med [Internet]. 2020 Aug 27 [cited 2020 Sep 2];7:498. Available from: https://www.frontiersin.org/article/10.3389/fmed.2020.00498/fullDisclosure of InterestsJack Arnold: None declared, Shouvik Dass Consultant of: Roche, Abbvie, UCB & Chugai, Employee of: Honoraria from Roche, Abbvie, UCB & Chugai, Sarah Twigg: None declared, Colin Jones: None declared, Benjamin Rhodes: None declared, Peter Hewins: None declared, Mithun Chakravorty: None declared, Philip Courtney: None declared, Michael Ehrenstein Grant/research support from: GSK, Employee of: Has received honoraria from GSK, Md Yuzaiful Md Yusof: None declared, Edward Vital Employee of: Has received honoraria from Roche
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Arnold J, Carter LM, MD Yusof MY, Wigston Z, Hassan SU, Dutton K, Dass S, Psarras A, Vital E. AB0510 IMMUNOPHENOTYPIC RECLASSIFICATION OF ANA ASSOCIATED AUTOIMMUNE DISEASE: PRELIMINARY ANALYSIS OF FLOW CYTOMETRIC DATA IN A MULTI-DISEASE COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe heterogeneity within the connective tissue disease patient cohort is not adequately reflected by current diagnostic labels(1,2). An immunophenotypic classification may be more appropriate for targeting therapy and basket therapeutic trials. DEFINITION is a multi-disease cohort (n=300) containing multiple clinical and immune datasets.ObjectivesTo perform preliminary clustering analysis using the flow cytometric dataset from DEFINITION.Methods142 patients with comprehensive flow cytometry data available were selected from the DEFINITION cohort. Highly sensitive flow cytometry was used to identify 7 B cell, T cell, NK cell and monocyte subsets and tetherin/SIGLEC1 expression on each subset.ANA and ENA titres were assessed via the Bioplex assay. Demographic and clinical data was obtained from the DEFINITION cohort. Multiple classification algorithms were applied to flow cytometry data using R. Including K-means, hierachical, model-based and partitioning around medioids (PAM). Output clusters were retrospectively compared to their legacy diagnoses and serology.ResultsIn the first 142 patients, PAM identified 3 clusters with memberships of 45, 49 and 48 patients respectively (Table 1).Table 1.Key legacy diagnoses and ENA positivity for the identified clusters.DiagnosisTotalCluster 1Cluster 2Cluster 3P valueSLE57221025>0.01UCTD2512850.06Sjogren’s152490.06Systemic sclerosis70520.07MCTD92430.76Myositis83320.86Antibody positivitydsDNA431611160.33Ro604512726>0.01Ro5236107190.01La182214>0.01Sm141490.02Sm_RNP2375110.23RNP143560.64SCL-7010010.37Jo-141210.80Centromere51400.08Chromatin29108110.68Ribosomal P41120.78Cluster 1 (UCTD/CD3+ dominant) was characterised by a higher proportion of UCTD patients (27%) and larger populations of CD3+ T cells and NK bright cells.Cluster 2 (SSc dominant/Tetherin low) was characterised by a higher population of systemic sclerosis (SSc) patients (10%) and a lower proportion of SLE patients (20%). High levels of classical and non-classical monocytes were demonstrated alongside low plasmablast populations and low SIGLEC1/Tetherin expression.Cluster 3 (SLE/pSS high, Ro/Tetherin high) included a higher proportion of SLE and primary Sjogren’s syndrome (pSS) patients (52% and 19%). This cluster showed larger plasmablast numbers and higher SIGLEC1/Tetherin expression. Serologically this cluster had higher levels of Ro60, Ro52, Sm-RNP and La positivity.There were statistically significant differences in Ro60, Ro52, La, and Sm antibody positivity between the 3 clusters. Significant differences in CD19+CD27+ memory B cell tetherin expression and CD14+CD16- classical monocyte SIGLEC1 expression were observed (both p < 0.05). A significant difference in SLE distribution was noted between the clusters (p < 0.01).ConclusionThis preliminary study identified of a flow cytometric dataset identified 3 immunophenotypically distinct subgroups, each comprised of multiple legacy diagnoses within spectrum of ANA+ disease. Future work will evaluate other datasets within the full cohort with a view to conduct basket trials in the baskets defined.References[1]Mucke J, Alarcon-Riquelme M, Andersen J, Aringer M, Bombardieri S, Brinks R, et al. What are the topics you care about making trials in lupus more effective? Results of an Open Space meeting of international lupus experts. Lupus Sci Med [Internet]. 2021 May 20 [cited 2021 Jul 12];8(1):506. Available from: /pmc/articles/PMC8141446/[2]Barturen G, Beretta L, Cervera R, Van Vollenhoven R, Alarcón-Riquelme ME. Moving towards a molecular taxonomy of autoimmune rheumatic diseases [Internet]. Vol. 14, Nature Reviews Rheumatology. Nature Publishing Group; 2018 [cited 2021 Jun 28]. p. 75–93. Available from: https://pubmed.ncbi.nlm.nih.gov/29362467/AcknowledgementsFunding: AstraZenecaDisclosure of InterestsJack Arnold: None declared, Lucy Marie Carter: None declared, Md Yuzaiful Md Yusof: None declared, Zoe Wigston: None declared, Sabih-Ul Hassan: None declared, Katherine Dutton: None declared, Shouvik Dass Speakers bureau: Honoraria from Roche, Consultant of: Roche, Abbvie, UCB & Chugai, Antonios Psarras: None declared, Edward Vital Speakers bureau: GSK, AstraZeneca, Consultant of: AstraZeneca, Lilly, Roche, GSK, Aurinia, Iltoo, Novartis, Grant/research support from: Research grants paid to the employer: AstraZeneca and Sandoz
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Carter LM, Md Yusof MY, Plant D, Alase A, Arnold J, Psarras A, Wigston Z, Vital E. OP0234 RNA-Seq IN PERIPHERAL BLOOD IMMUNE CELLS IDENTIFIES MODULAR NETWORKS PREDICTIVE AND PROTECTIVE FOR PROGRESSION FROM ANA POSITIVITY TO CLASSIFIABLE SYSTEMIC AUTOIMMUNE DISEASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAnti-nuclear antibody (ANA) positivity represents a complex ‘At-Risk’ state for development of connective tissue disease (CTD). While ANA may become positive years in advance of clinically manifest CTD, they are also harboured in at least low titre by up to 25% of the wider population, of whom only a small fraction ultimately develop systemic autoimmunity. Complex immune disturbances including plasmacytoid dendritic cell exhaustion and non-haematopoietic interferon (IFN) production are evident even among ANA positive individuals who do not ultimately progress to overt disease [1].In a prospective observational cohort of ANA positive individuals At-Risk for CTD we have shown that a validated blood IFN-Score was predictive of progression to classifiable SLE [2]. However, the wider transcriptional fingerprint of the At-Risk state and other factors modifying risk of progression are not known. We hypothesise that diverse immune processes, both independent and interacting with IFN pathway activation, could modulate risk of progression.ObjectivesTo investigate how peripheral blood immune cell transcriptional signatures derived by RNA Seq associate with progression or non-progression from At-Risk ANA positivity to clinically apparent CTD.MethodsPeripheral blood mononuclear cells (PBMCs) were isolated at baseline from ANA-positive At-Risk individuals demonstrating ≤1 clinical criterion for classifiable CTD, symptom duration <12 months and naive of glucocorticoid or immunosuppressive therapy. Progression was prospectively adjudicated at 12 months and defined as accrual of clinical/ immunological criteria sufficient to meet classification for SLE (SLICC 2012) or other relevant CTDs. Bulk RNASeq was performed on PMBCs from 16 progressors and 19 non-progressors. Weighted gene co-expression network analysis (WGCNA) was performed using WGCNA package and gene ontology enrichment was evaluated using ClusterProfiler, in R Bioconductor. The top 20% genes ranked by connectivity were defined as hub genes. Major cell subsets were quantified in parallel by multiparameter flow cytometry.Results29 modules were identified by WGCNA. Eigengenes for 3 modules were significantly associated with progression status. A single, 152 gene module showed strong positive correlation with progression (R=0.55, p<0.001). Hub genes were significantly enriched for type I IFN-signalling pathway and included established interferon stimulated genes such as IFI44 and IRF7.Two further modules had a negative, i.e. protective, association with progression; a smaller 37 gene module, correlated negatively with both blood interferon score (R=-0.46, p=0.005) and with progression (R=-0.43, p=0.01). A larger 252 gene module was also negatively related to progression (R=-0.43, p=0.009) and demonstrated significant pathway enrichment for regulation of cell morphogenesis and actin cyctoskeleton organisation.ConclusionWe identify novel modular transcriptomic signatures implicated in SLE disease initiation. We show (i) IFN-pathway activation is the single strongest transcriptomic risk marker of progression from the ANA positive At Risk state and (ii) we identify 2 novel protective signatures in peripheral blood immune cells for which further network-based characterization is ongoing.References[1]Psarras et al. 2020 Nat Commun 11: 6149.[2]Md Yusof MY, et al. Ann Rheum Dis 2018;77:1432–1439.Disclosure of InterestsLucy Marie Carter: None declared, Md Yuzaiful Md Yusof Consultant of: Aurinia Pharmaceuticals, Darren Plant: None declared, Adewonuola Alase: None declared, Jack Arnold: None declared, Antonios Psarras: None declared, Zoe Wigston: None declared, Edward Vital Consultant of: AstraZeneca, Genentech, Aurinia, Lilly, ILTOO and Modus Therapeutics., Grant/research support from: Astra Zeneca and Sandoz
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Abstract
OBJECTIVE In our canine scent detection research involving a specific volatile organic compound (VOC) associated with human epileptic seizure, we began to suspect involvement of the primitive neural networks associated with production of a previously undescribed human alarm pheromone as the origin of our seizure scent. We hypothesized that if we presented fear-scented sweat to our canine seizure scent detection team, and they identified the fear scent as their seizure scent, then that would suggest that they are identical compounds. METHODS Following consent and approval, sweat samples taken from volunteers associated with the Brooke Gordon Comprehensive Epilepsy Center at Denver Health were processed by the Canine Assistants (CA) service dog team that had been imprinted to recognize the unique seizure scent from our previous study. In part one, sweat samples were collected from subjects, who had no prior history of epilepsy or seizures, under two different testing environments: watching a scary movie (It) and a neutral/comedy movie (Airplane!). In part two, a larger follow-up study utilizing fear sweat, exercise sweat, epilepsy sweat, and other distractor scents were provided in a multiple choice paradigm to better understand the inter-rater reliability of the canine responses. RESULTS In part one, our canine seizure scent detection team identified fear-scented sweat samples as their seizure scent in 4 of 5 study participants. There was almost perfect agreement of seizure scent detection during fear scent trials between the canine seizure scent detectors with a kappa value of 0.814 (95% CI: 0.668-0.960). In part two, (utilizing eleven different subjects) our canine scent detection team identified samples of either fear or seizure sweat with a sensitivity of 82% and a specificity of 100% (no false positives) from among the multiple choices offered. Additionally, there was 92% agreement between the members of the canine scent detection team. SIGNIFICANCE While this hypothesis testing study is small and deserves replication, it confirms that the Canine Assistants seizure scent detection team consistently and accurately identified fear-scented sweat as their seizure scent, implying that the VOC, menthone, is common to both conditions. This further implies that human seizure propagation and fear network circuitry may share a common anatomy, and that menthone may not only be an early seizure biomarker, but a newly described human alarm pheromone.
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Affiliation(s)
- E H Maa
- Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, United States; Department of Neurology, University of Colorado, 1635 Aurora Court, Aurora, CO 80045, United States.
| | - J Arnold
- Canine Assistants, 3160 Francis Road, Milton, GA 30004, United States
| | - C K Bush
- Department of Neurology, University of Colorado, 1635 Aurora Court, Aurora, CO 80045, United States
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Pepple S, Arnold J, Vital E, Rawstron A, Pease C, Dass S, Emery P, MD Yusof MY. AB0293 IDENTIFYING PREDICTORS OF SHORT-TERM RESPONSE TO RITUXIMAB IN PRIMARY SJOGREN’S SYNDROME. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Randomised controlled trials of rituximab (RTX) in primary Sjogren’s syndrome (pSS) have aimed to alleviate glandular symptoms and fatigue with only limited data on efficacy/effectiveness of the initial and repeat cycles of RTX on extra-glandular pSS.Objectives:To assess the effectiveness of RTX on extra-glandular symptoms and identify predictors of short-term response with a view to personalised B-cell depleting therapy in patients with pSS.Methods:An observational study was conducted in 40 consecutive RTX-treated pSS patients in a single centre for over 15 years. All patients fulfilled the 2002 AEG criteria and were CCP negative. Clinical response at 6 months was defined as ≥3 reduction of ESSDAI from baseline. B-cell subsets were measured using highly sensitive flow cytometry. Predictors of short-term response were analysed using penalised logistic regression.Results:38/40 (95%) patients were female, mean (SD) Age 54 (13.7) years, median (IQR) disease duration 5 (2-9) years, 39/40 (98%) had positive ANA, 26/40 (65%) were on concomitant immunosuppressant (IS). Mean (SD) ESSDAI at RTX initiation was 11.5 (6.7); main domains for RTX were articular (73%), skin (23%), PNS (15%) and muscular (15%). 169 RTX cycles were administered with a total follow-up of 165PY. In Cycle 1 (C1) RTX, the proportion of patient achieving ESSDAI response from baseline was 29/40 (73%; 95% CI 58-87). There were significant reductions in ESSDAI, daily prednisolone dose and IgG levels at 6 months (all p<0.05). Of C1 responders, 23/29 received retreatment on clinical relapse; of which 8/23 (35%) lost response [secondary non-depletion non response (2NDNR) associated with anti-RTX antibodies=4 (17%) as we previously observed in SLE[1], side effects=2, ineffective=2]. Of C1 non-responders, 9/11 were retreated but only 2/9 responded in C2. Overall, 13/40 (33%) discontinued RTX within two cycles. In multivariable analysis, concomitant IS and achieving compete B-cell depletion in C1 reduced non-response to RTX (Table 1).Conclusion:All pSS patients should be prescribed concomitant immunosuppressant with RTX and therapy should aim to achieve complete depletion. About 1 in 6 pSS patients lose response in repeat cycles which is associated with 2NDNR phenomenon. The use of humanised or type 2 anti-CD20mAbs should overcome these issues and improve the clinical response of extra-glandular pSS.References:[1]Md Yusof et al. ARD 2017 (2520 characters – allowed around 2600 as Table 1 is included too)Table 1.MVA logistic regression of risk factors for RTX non-responsePredictorsContinued Response (N=27)Non-response within 2 RTX Cycles (N=13)UnivariableOR (95% CI); p-valueMultivariableOR (95% CI); p-valueAge, mean (SD) per 10 years55 (14)52 (12)0.87 (0.53-1.41); 0.572Excluded from final modelDisease duration, median (IQR)5 (2-9)6 (3-9)0.97 (0.87-1.08); 0.565Excluded from final modelConcomitant IS, %81.5%30.8%0.10 (0.02-0.46); 0.0030.07 (0.01-0.52); 0.010IgG, mean (SD), g/L15.5 (6.3)18.4 (5.8)1.08 (0.97-1.20); 0.1751.13 (0.97-1.32); 0.116Clinical ESSDAI, median (IQR)10 (6-16)8 (6-10)0.96 (0.85-1.08); 0.4870.91 (0.79-1.05); 0.185Baseline Plasmablast (x1000),109 cells/L, median(IQR)2.6 (1 -5.2)2.3 (1.6-9.5)1.00 (0.94-1.07); 0.885Excluded from final modelComplete B-cell depletion post-RTX, %55.6%8.5%0.07 (0.01-0.64); 0.0180.04 (0.02-0.82); 0.036Disclosure of Interests:Sophanit Pepple: None declared, Jack Arnold: None declared, Edward Vital Grant/research support from: Dr Vital has received honoraria and research grant support from Roche, Andrew Rawstron: None declared, Colin Pease: None declared, Shouvik Dass Grant/research support from: Dr Dass has received honoraria from Roche, Paul Emery Consultant of: Professor Emery has received consultant fees from Roche., Grant/research support from: Professor Emery has received research grants paid to his employer from Roche., Md Yuzaiful Md Yusof: None declared
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Arnold J, Vital E, Dass S, Aslam A, Rawstron A, Savic S, Emery P, MD Yusof MY. OP0057 A PERSONALISED RITUXIMAB RETREATMENT APPROACH BASED ON CLINICAL AND B-CELL BIOMARKERS IN ANCA-ASSOCIATED VASCULITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Time-to-relapse after rituximab for ANCA-associated vasculitis (AAV) is variable and optimal retreatment strategy has been unclear. We previously showed that repopulation of naïve B-cells at 6 months predicts sustained response [1].Objectives:In AAV following rituximab induction, to evaluate clinical and B-cell predictors of relapse in order to develop a retreatment algorithm.Methods:An observational study was conducted in 60 rituximab-treated AAV patients followed for over 10 years. Complete response (CR) was defined as Birmingham Vasculitis Activity Score v3.0 = 0. Retreatment was given on clinical relapse, defined as new features or worsening of persistent disease (not by biomarker status). Peripheral B-cell subsets were measured using highly sensitive flow cytometry. Predictors were tested using multivariable Cox-Regression.Results:Median times-to-retreatment for rituximab cycles 1-5 were 87, 71, 65, 59 and 86 weeks. Over 417 patient-years follow-up, 137 relapses occurred in 50 patients; 16 (in 14 patients) were major (renal=7, neurological=4, ENT=3 and respiratory=2). The major-relapse rate was 3.8/100 patient-years. In multivariable analysis, concomitant immunosuppressant [HR 0.48 (95% CI 0.24–0.94)], achieving CR [0.24 (0.12–0.50)] and naïve B-cell repopulation at 6 months [0.43 (0.22–0.84)] were associated with longer time-to-relapse. Higher baseline memory B-cells [1.01 (1.00–1.02)] were associated with a shorter time-to-relapse. AUROC for prediction of time-to-relapse was greater if guided by naïve B-cell repopulation than if ANCA and/or CD19+ return at 6 months had been used, 0.82 and 0.52 respectively.Conclusion:These data suggest that all patients should receive concomitant oral immunosuppressant. Those with incomplete response or with absent naïve B-cells should be retreated at 6 months. Patients with complete response and naïve repopulation at 6 months should not receive fixed retreatment. This algorithm could reduce hypogammaglobulinaemia due to unnecessary retreatment.Figure 1.A personalised retreatment algorithm for rituximab in ANCA-associated vasculitisReferences:[1]Md Yusof et al. Annals of rheumatic diseases (2015) PMID: 25854586.Disclosure of Interests:Jack Arnold: None declared, Edward Vital Speakers bureau: Roche, GSK and AstraZeneca, Consultant of: Roche, GSK and AstraZeneca, Grant/research support from: Roche, GSK and AstraZeneca, Shouvik Dass Speakers bureau: Roche and GSK, Aamir Aslam: None declared, Andrew Rawstron: None declared, Sinisa Savic: None declared, Paul Emery Speakers bureau: BMS, Abbott, Pfizer, MSD, Novartis, Roche and UCB, Consultant of: BMS, Abbott, Pfizer, MSD, Novartis, Roche and UCB, Grant/research support from: Abbott, BMS, Pfizer, MSD and Roche., Md Yuzaiful Md Yusof: None declared
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Arnold J, Kanagala P, Budgeon C, Jerosch-Herold M, Singh A, Khan J, Gulsin G, Squire I, Ng L, McCann G. Prevalence of microvascular dysfunction and association with clinical outcomes in heart failure with preserved ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of symptomatic heart failure. A recently proposed paradigm for the pathophysiology of HFpEF postulates a central inflammatory aetiology with coronary microvascular function at its core. However, the pathophysiological and clinical significance of microvascular dysfunction in HFpEF remains uncertain.
Purpose
Utilising cardiovascular magnetic resonance (CMR), we sought to (1) quantify coronary microvascular function, (2) evaluate the impact of microvascular dysfunction and fibrosis on long-term clinical outcomes and (3) examine the relationship between myocardial perfusion and fibrosis.
Methods
In a prospective, observational study, 147 subjects (104 HFpEF without a prior history or CMR evidence of coronary artery disease, and 43 asymptomatic controls) underwent multiparametric CMR, comprising left ventricular volumetric assessment, absolute quantitation of myocardial blood flow [MBF] during adenosine stress (140mcg/kg/min) and at rest, and evaluation of diffuse myocardial fibrosis (extracellular volume [ECV]). The primary endpoint was the composite of death or hospitalisation with heart failure.
Results
104 HFpEF patients (mean age 73±9 years, mean ejection fraction 56%) and 43 controls (mean age 73±5 years, mean ejection fraction 58%) were studied. There was no significant difference in resting MBF (1.10±0.42ml/min/g in HFpEF subjects vs 1.00±0.38 ml/min/g in controls, p=0.23), though hyperaemic MBF was lower in HFpEF subjects (1.66±0.68 ml/min/g vs 1.97±0.59 ml/min/g, p=0.01). Myocardial perfusion reserve [MPR] was also lower in HFpEF subjects (1.73±0.75 vs 2.22±0.76; p<0.01). Microvascular dysfunction (defined as MPR<2.0) was present in 70% of HFpEF patients (versus 33% of controls, p<0.01). During median follow-up of 3.4 years, there were 46 composite events. MPR was predictive of clinical outcome (one unit increase – hazard ratio [HR] 0.57; 95% CI 0.35–0.92; p=0.02), as was ECV (one standard deviation [SD] increase – HR 1.65; 95% CI 1.14–2.39; p=0.01). However, there was no significant linear correlation between MPR and diffuse fibrosis (r<0.01, p=0.99).
Conclusion
Microvascular dysfunction is highly prevalent in HFpEF and is associated with adverse clinical outcomes. The lack of correlation between abnormal myocardial perfusion and fibrosis challenges the assertion of a direct causal link between these entities.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): NIHR, BHF
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Affiliation(s)
- J Arnold
- University of Leicester, Leicester, United Kingdom
| | - P Kanagala
- University of Leicester, Leicester, United Kingdom
| | - C.A Budgeon
- University of Leicester, Leicester, United Kingdom
| | | | - A.S Singh
- University of Leicester, Leicester, United Kingdom
| | - J.N Khan
- University of Leicester, Leicester, United Kingdom
| | - G.S Gulsin
- University of Leicester, Leicester, United Kingdom
| | - I.B Squire
- University of Leicester, Leicester, United Kingdom
| | - L.L Ng
- University of Leicester, Leicester, United Kingdom
| | - G.P McCann
- University of Leicester, Leicester, United Kingdom
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Kumar D, Vachharajani AJ, Wertheimer F, Vergales B, Glass K, Dannaway D, Winter L, Delaney H, Ganster A, Arnold J, Urban A, Johnston L, Bruno C, Gray MM, Sawyer T. Boot camps in neonatal-perinatal medicine fellowship programs: A national survey. J Neonatal Perinatal Med 2020; 12:231-237. [PMID: 30829620 DOI: 10.3233/npm-18117] [Citation(s) in RCA: 4] [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: 11/15/2022]
Abstract
BACKGROUND Simulation is widely used in graduate medical education. A prior survey showed that 80% of Neonatal-Perinatal Medicine (NPM) fellowship programs in the U.S. use simulation. There are multiple ways to provide simulation-based education. One such method is through intensive simulation-based education sessions held at the beginning of a training program, common called 'boot camps'. The aim of this study was to describe the use of simulation-based boot camps in NPM fellowship programs. METHODS Survey study of Accreditation Council for Graduate Medical Education (ACGME) accredited NPM fellowships in the U.S. RESULTS Fifty-nine of 98 programs (60%) responded. Thirty six (61%) participated in 1st year fellow boot camps, which focused on procedural skills and newborn resuscitation. Nearly half of programs participated in regional boot camps. Most boot camps were one or two days long. Eleven programs (19%) held 2nd or 3rd year fellow boot camps, which focused on advanced resuscitation and communication. Barriers included lack of faculty protected time (57%), funding (39%), and lack of faculty experience (31%). CONCLUSIONS A majority of ACGME accredited NPM fellowships participate in 1st year fellows' boot camps. Many participate in regional boot camps. A few programs have 2nd or 3rd year fellow boot camps. Lack of time, funding, and faculty experience were common barriers.
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Affiliation(s)
- D Kumar
- Department of Pediatrics, Division of Neonatology, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, OH, USA
| | - A J Vachharajani
- Department of Pediatrics, Division of Newborn Medicine, Washington University in St. Louis and St. Louis Children's Hospital, St. Louis, MO, USA
| | - F Wertheimer
- Department of Pediatrics, Division of Neonatology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - B Vergales
- Department of Pediatrics, Division of Neonatology, University of Virginia Health System, Charlottesville, VA, USA
| | - K Glass
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, PA, USA
| | - D Dannaway
- Department of Pediatrics, Section of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - L Winter
- Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - H Delaney
- Department of Pediatrics, Division of Neonatology, Brooke Army Medical Center, San Antonio, TX, USA
| | - A Ganster
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - J Arnold
- Department of Pediatrics, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - A Urban
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Johnston
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - C Bruno
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - M M Gray
- Department of Pediatrics, Division of Neonatology, University of Washington School of Medicine and Seattle Children's Hospital. Seattle, WA, USA
| | - T Sawyer
- Department of Pediatrics, Division of Neonatology, University of Washington School of Medicine and Seattle Children's Hospital. Seattle, WA, USA
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Opzoomer J, Caron J, Muliaditan T, Okesola M, Kordasti S, Spicer J, Arnold J. PO-322 Investigating co-expression of the immune checkpoints heme oxygenase-1 and PD-L in breast cancer. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.835] [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: 11/03/2022] Open
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Caranica C, Al-Omari A, Deng Z, Griffith J, Nilsen R, Mao L, Arnold J, Schüttler HB. Ensemble methods for stochastic networks with special reference to the biological clock of Neurospora crassa. PLoS One 2018; 13:e0196435. [PMID: 29768444 PMCID: PMC5955539 DOI: 10.1371/journal.pone.0196435] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/12/2018] [Indexed: 11/18/2022] Open
Abstract
A major challenge in systems biology is to infer the parameters of regulatory networks that operate in a noisy environment, such as in a single cell. In a stochastic regime it is hard to distinguish noise from the real signal and to infer the noise contribution to the dynamical behavior. When the genetic network displays oscillatory dynamics, it is even harder to infer the parameters that produce the oscillations. To address this issue we introduce a new estimation method built on a combination of stochastic simulations, mass action kinetics and ensemble network simulations in which we match the average periodogram and phase of the model to that of the data. The method is relatively fast (compared to Metropolis-Hastings Monte Carlo Methods), easy to parallelize, applicable to large oscillatory networks and large (~2000 cells) single cell expression data sets, and it quantifies the noise impact on the observed dynamics. Standard errors of estimated rate coefficients are typically two orders of magnitude smaller than the mean from single cell experiments with on the order of ~1000 cells. We also provide a method to assess the goodness of fit of the stochastic network using the Hilbert phase of single cells. An analysis of phase departures from the null model with no communication between cells is consistent with a hypothesis of Stochastic Resonance describing single cell oscillators. Stochastic Resonance provides a physical mechanism whereby intracellular noise plays a positive role in establishing oscillatory behavior, but may require model parameters, such as rate coefficients, that differ substantially from those extracted at the macroscopic level from measurements on populations of millions of communicating, synchronized cells.
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Affiliation(s)
- C. Caranica
- Department of Statistics, University of Georgia, Athens, Georgia
| | - A. Al-Omari
- Department of Biomedical Systems and Informatics Engineering, Yarmouk University, Irbid, Jordan
| | - Z. Deng
- School of Electrical and Computer Engineering, College of Engineering, University of Georgia, Athens, Georgia
| | - J. Griffith
- Genetics Department, University of Georgia, Athens, Georgia
- College of Agricultural and Environmental Sciences, University of Georgia, Athens, Georgia
| | - R. Nilsen
- Genetics Department, University of Georgia, Athens, Georgia
| | - L. Mao
- School of Electrical and Computer Engineering, College of Engineering, University of Georgia, Athens, Georgia
| | - J. Arnold
- Genetics Department, University of Georgia, Athens, Georgia
- * E-mail:
| | - H.-B. Schüttler
- Department of Physics and Astronomy, University of Georgia, Athens, Georgia
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Parker BF, Hohloch S, Pankhurst JR, Zhang Z, Love JB, Arnold J, Rao L. Interactions of vanadium(iv) with amidoxime ligands: redox reactivity. Dalton Trans 2018; 47:5695-5702. [PMID: 29632905 DOI: 10.1039/c7dt04069e] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The use of amidoxime-functionalized polymer fibers as a sorbent for uranium has attracted recent interest for the extraction of uranium from seawater. Vanadium is one of the main competing ions for uranium sorption as V(v) species, however, vanadium is also present as V(iv) in seawater. In the present study, the interactions of V(iv) with amidoxime and similar ligands were explored. Attempts were made to synthesize V(iv) complexes of glutaroimide-dioxime, a molecular analogue of polymer sorbents. However, V(iv) was found to react irreversibly with glutaroimide-dioxime and other oxime groups, oxidizing to the V(v) oxidation state. We have explored the reactions and propose mechanisms, as well as characterized the redox behavior of the vanadium-glutaroimide-dioxime complex.
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Affiliation(s)
- B F Parker
- Department of Chemistry, University of California - Berkeley, Berkeley, CA 94720, USA.
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Abstract
This review provides a brief background on the extraction of uranium from seawater as well as recent work by the United States Department of Energy on this project. The world's oceans contain uranium at 3 parts per billion, and despite this low concentration, there has been historical interest in harvesting it, mainly in Japan in the 1980s and the United States in this decade. Improvements in materials, chemistry, and deployment methods have all been made, with the ultimate goal of lower cost. This has been partially realized, dropping from approximately $2000 per kg U3O8 extracted in 1984 to $500 per kg today, although this is not yet competitive with terrestrial uranium. This technology may become cost-competitive if the cost of land-based uranium rises, especially if seawater extraction technology is improved further. The coordination chemistry aspects of the project are described in more detail, exploring the functional groups that are present on typical polymer sorbents as well as small-molecule analogues of these ligands. Selectivity for uranium over other metals, particularly vanadium, remains problematic, and techniques to both quantify binding strength and selectivity in order to overcome this issue are essential for future cost improvements.
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Affiliation(s)
- B F Parker
- Department of Chemistry, University of California - Berkeley, Berkeley, CA 94720, USA.
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16
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Abstract
Homoleptic U(iv) and U(iii) amidate complexes have been isolated and characterized; these species undergo an unusual and reversible change in coordination number upon reduction/oxidation.
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Affiliation(s)
- M. D. Straub
- Department of Chemistry
- University of California
- Berkeley
- USA
- Chemical Sciences Division
| | - S. Hohloch
- Department of Chemistry
- University of California
- Berkeley
- USA
- Chemical Sciences Division
| | - S. G. Minasian
- Chemical Sciences Division
- Lawrence Berkeley National Laboratory
- Berkeley
- USA
| | - J. Arnold
- Department of Chemistry
- University of California
- Berkeley
- USA
- Chemical Sciences Division
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Daien V, Nguyen V, Essex RW, Morlet N, Barthelmes D, Gillies MC, Gillies M, Hunt A, Essex R, Dayajeewa C, Hunyor A, Fraser-Bell S, Younan C, Fung A, Guymer R, Louis D, Arnold J, Chan D, Cass H, Harper A, O’Day J, Daniell M, Field A, Chow L, Barthelmes D, Cohn A, Young S, Lal S, Ferrier R, Barnes R, Thompson A, Vincent A, Manning L, Lake S, Phillips R, Perks M, Chen J, Landers J, Niladri, Banerjee G, Swamy B, Windle P, Dunlop A, Tang K, McLean I, Amini A, Hunt A, Clark G, McAllister I, Chen F, Squirrell D, Ng C, Hinchcliffe P, Barry R, Ah-Chan J, Steiner H, Morgan M, Thompson C, Game J, Murray N. Incidence and Outcomes of Infectious and Noninfectious Endophthalmitis after Intravitreal Injections for Age-Related Macular Degeneration. Ophthalmology 2018; 125:66-74. [DOI: 10.1016/j.ophtha.2017.07.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/19/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022] Open
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Funnell L, Arnold J. A review of physiotherapy management and interventions provided to CF patients requiring ECMO or ECCO2 removal. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Goldberg D, Kallan MJ, Fu L, Ciccarone M, Ramirez J, Rosenberg P, Arnold J, Segal G, Moritsugu KP, Nathan H, Hasz R, Abt PL. Changing Metrics of Organ Procurement Organization Performance in Order to Increase Organ Donation Rates in the United States. Am J Transplant 2017; 17:3183-3192. [PMID: 28726327 DOI: 10.1111/ajt.14391] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/05/2017] [Accepted: 06/05/2017] [Indexed: 01/25/2023]
Abstract
The shortage of deceased-donor organs is compounded by donation metrics that fail to account for the total pool of possible donors, leading to ambiguous donor statistics. We sought to assess potential metrics of organ procurement organizations (OPOs) utilizing data from the Nationwide Inpatient Sample (NIS) from 2009-2012 and State Inpatient Databases (SIDs) from 2008-2014. A possible donor was defined as a ventilated inpatient death ≤75 years of age, without multi-organ system failure, sepsis, or cancer, whose cause of death was consistent with organ donation. These estimates were compared to patient-level data from chart review from two large OPOs. Among 2,907,658 inpatient deaths from 2009-2012, 96,028 (3.3%) were a "possible deceased-organ donor." The two proposed metrics of OPO performance were: (1) donation percentage (percentage of possible deceased-donors who become actual donors; range: 20.0-57.0%); and (2) organs transplanted per possible donor (range: 0.52-1.74). These metrics allow for comparisons of OPO performance and geographic-level donation rates, and identify areas in greatest need of interventions to improve donation rates. We demonstrate that administrative data can be used to identify possible deceased donors in the US and could be a data source for CMS to implement new OPO performance metrics in a standardized fashion.
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Affiliation(s)
- D Goldberg
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA.,Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Philadelphia, PA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - M J Kallan
- Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Philadelphia, PA
| | - L Fu
- The Bridgespan Group, New York, NY
| | | | | | | | | | | | - K P Moritsugu
- Former Acting Surgeon General of the United States, Great Falls, MT
| | - H Nathan
- Gift of Life Institute, Philadelphia, PA
| | - R Hasz
- Gift of Life Institute, Philadelphia, PA
| | - P L Abt
- Division of Transplant Surgery, University of Pennsylvania, Philadelphia, PA
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Woodhams R, Evans J, Edwards J, Metcalfe S, Murray P, Arnold J, Wyeth J. Real World Outcomes from Funded Cancer Medicines in New Zealand (NZ) Compared with Published Clinical Trials. Clin Ther 2017. [DOI: 10.1016/j.clinthera.2017.05.141] [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: 11/24/2022]
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Lee A, Keating O, Crawley A, Arnold J. Safe surgical ward rounds, a completed quality improvement cycle. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Blauth C, Brady A, Arnold J, Brannan J, Schulenburg WE, Frackowiak R, Taylor KM. A double blind clinical trial of Iloprost during cardiopulmonary bypass. Perfusion 2016. [DOI: 10.1177/026765918700200405] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Twenty patients undergoing elective coronary surgery were randomized to receive either the prostacyclin analogue Iloprost (Zk 36374) 5 ng/kg/min for 30 minutes before cardiopulmonary bypass (CPB) increasing to 10 ng/kg/min during CPB, or placebo, to investigate any beneficial effect on platelet preservation, or protection of the central nervous system during clinical CPB. Originally 50 patients were to have entered the trial, but unacceptable hypotensive effects occu rred in five patients who received Iloprost, lead i ng to early data analysis. No significant improvement in platelet number, volume or function; bleeding time; arterial line filter δ dry weight; retinal microembolism; or neuropsychological function, attributable to Iloprost, could be identified. The role and optimal dose of Iloprost in clinical CPB remains to be established.
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Affiliation(s)
- C. Blauth
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - A. Brady
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - J. Arnold
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - J. Brannan
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - WE Schulenburg
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - R. Frackowiak
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - KM Taylor
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
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Sammut L, Clayton P, Arnold J, Davidson B. FRI0644-HPR Perceived Physical Activity Benefits and Barriers in Rheumatoid Arthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1338] [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: 11/03/2022]
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Arnold J, Bruce-Low S, Henderson S, Davies J. Mapping and evaluation of physical activity interventions for school-aged children. Public Health 2016; 136:75-9. [PMID: 27080582 DOI: 10.1016/j.puhe.2016.02.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 02/22/2016] [Accepted: 02/26/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES A high degree of de-regulation, organisational fragmentation and funding cuts throughout UK schools in recent years has obscured the definitive structure and effectiveness of physical activity (PA) provision offered to children. This pilot study aimed to map the current structure and context of PA provision offered to school children in Southampton, and its alignment with existing empirical evidence about the likely effectiveness of such interventions. STUDY DESIGN Utilising a qualitative approach, the study focused upon school-based PA provision, since this setting was conjectured to show greater diversity when compared to settings outside of school, lending itself to further interventions than non-school PA provision. METHODS Interventions offered across nine schools (three junior, two primary, four secondary) were investigated and mapped through semi-structured interviews. Findings were benchmarked against other cities similar to Southampton in indices of multiple deprivation status via interviews with city council workers. RESULTS Interviews highlighted only three formal PA specific interventions currently operating, and a hand full of informal interventions. Limited PA provision was attributed to a lack of time, money, and priority devoted towards PA within schools. Considerable disparity exists between the high prevalence of sport-oriented provision compared with the low prevalence of PA specific provision. Interviews with Portsmouth and Bristol city councils suggest that such findings may not be unique to Southampton. CONCLUSIONS In contrast to the extensive literature base detailing numerous PA interventions in school-aged children, our data suggest that a very small amount of such knowledge appears to translate into PA provision offered in Southampton schools. Our data highlight a significant discrepancy between sport and PA provision across schools. It is possible that the inability to successfully differentiate between sport and PA may present a further obstacle to the successful uptake of PA in the future. An extension of the PA mapping carried out, both countywide and nationally, provides a possible avenue for future research to confirm or contrast these initial insights.
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Affiliation(s)
- J Arnold
- School of Sport, Health and Social Sciences, Southampton Solent University, UK.
| | - S Bruce-Low
- School of Sport, Health and Social Sciences, Southampton Solent University, UK.
| | - S Henderson
- School of Sport, Health and Social Sciences, Southampton Solent University, UK.
| | - J Davies
- Southampton Public Health Team, Southampton City Council, UK.
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Arnold J, Vorwerk D, Dabitz R. Klinische Relevanz des THRIVE-Scores für die Outcome-Prognose nach mechanischer Rekanalisation bei akutem Schlaganfall. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581729] [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: 10/22/2022]
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Arnold J, Vorwerk D, Dabitz R. Vergleich von Behandlungserfolg und Outcome nach mechanischer Rekanalisation bei akutem Schlaganfall hinsichtlich der Verschlusslokalisation. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581730] [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: 10/22/2022]
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Leggett CJ, Parker BF, Teat SJ, Zhang Z, Dau PD, Lukens WW, Peterson SM, Cardenas AJP, Warner MG, Gibson JK, Arnold J, Rao L. Structural and spectroscopic studies of a rare non-oxido V(v) complex crystallized from aqueous solution. Chem Sci 2016; 7:2775-2786. [PMID: 28660055 PMCID: PMC5477013 DOI: 10.1039/c5sc03958d] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/14/2016] [Indexed: 11/21/2022] Open
Abstract
A non-oxido V(v) complex with glutaroimide-dioxime (H3L), a ligand for recovering uranium from seawater, was synthesized from aqueous solution as Na[V(L)2]·2H2O, and the structure determined by X-ray diffraction.
A non-oxido V(v) complex with glutaroimide-dioxime (H3L), a ligand for recovering uranium from seawater, was synthesized from aqueous solution as Na[V(L)2]·2H2O, and the structure determined by X-ray diffraction. It is the first non-oxido V(v) complex that has been directly synthesized in and crystallized from aqueous solution. The distorted octahedral structure contains two fully deprotonated ligands (L3–) coordinating to V5+, each in a tridentate mode via the imide N (RV–N = 1.96 Å) and oxime O atoms (RV–O = 1.87–1.90 Å). Using 17O-labelled vanadate as the starting material, concurrent 17O/51V/1H/13C NMR, in conjunction with ESI-MS, unprecedentedly demonstrated the stepwise displacement of the oxido V
Created by potrace 1.16, written by Peter Selinger 2001-2019
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O bonds by glutaroimide-dioxime and verified the existence of the “bare” V5+/glutaroimide-dioxime complex, [V(L)2]–, in aqueous solution. In addition, the crystal structure of an intermediate 1 : 1 V(v)/glutaroimide-dioxime complex, [VO2(HL)]–, in which the oxido bonds of vanadate are only partially displaced, corroborates the observations by NMR and ESI-MS. Results from this work provide important insights into the strong sorption of vanadium on poly(amidoxime) sorbents in the recovery of uranium from seawater. Also, because vanadium plays important roles in biological systems, the syntheses of the oxido and non-oxido V5+ complexes and the unprecedented demonstration of the displacement of the oxido V
Created by potrace 1.16, written by Peter Selinger 2001-2019
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O bonds help with the on-going efforts to develop new vanadium compounds that could be of importance in biological applications.
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Affiliation(s)
- C J Leggett
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - B F Parker
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA . .,Department of Chemistry , University of California - Berkeley , Berkeley , CA 94720 , USA
| | - S J Teat
- Advanced Light Source , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - Z Zhang
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - P D Dau
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - W W Lukens
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - S M Peterson
- National Security Directorate , Pacific Northwest National Laboratory , 902 Battelle Blvd. , Richland , WA 99352 , USA
| | - A J P Cardenas
- Fundamental and Computational Sciences Directorate , Pacific Northwest National Laboratory , 902 Battelle Blvd. , Richland , WA 99352 , USA
| | - M G Warner
- National Security Directorate , Pacific Northwest National Laboratory , 902 Battelle Blvd. , Richland , WA 99352 , USA
| | - J K Gibson
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - J Arnold
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA . .,Department of Chemistry , University of California - Berkeley , Berkeley , CA 94720 , USA
| | - L Rao
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
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Riphaus A, Wehrmann T, Hausmann J, Weber B, von Delius S, Jung M, Tonner P, Arnold J, Behrens A, Beilenhoff U, Bitter H, Domagk D, In der Smitten S, Kallinowski B, Meining A, Schaible A, Schilling D, Seifert H, Wappler F, Kopp I. Update S3-guideline: "sedation for gastrointestinal endoscopy" 2014 (AWMF-register-no. 021/014). Z Gastroenterol 2016; 54:58-95. [PMID: 26751118 DOI: 10.1055/s-0041-109680] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
| | | | - J Hausmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt
| | - B Weber
- Medizinische Klinik II, KRH Klinikum Siloah-Oststadt, Hannover
| | - S von Delius
- II. Medizinische Klinik, Klinikum rechts der Isar, TU München, München
| | - M Jung
- Klinik für Innere Medizin 2, Katholisches Klinikum Mainz, Mainz
| | - P Tonner
- Klinik für Anaesthesie, operative und allgemeine Intensivmedizin, Notfallmedizin, Klinikum Links der Weser, Bremen
| | - J Arnold
- Klinik für Gastroenterologie, Hepatologie, Diabetologie und Ernährungsmedizin, Agaplesion Diakonieklinikum Rotenburg, Rotenburg
| | - A Behrens
- Klinik für Gastroenterologie und interventionelle Endoskopie, Vivantes Klinikum im Friedrichshain, Berlin
| | | | | | - D Domagk
- Medizinische Klinik I, Josephs-Hospital, Warendorf
| | | | | | - A Meining
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
| | - A Schaible
- Klinik für interdisziplinäre Endoskopie, Universitätsklinikum Heidelberg, Heidelberg
| | - D Schilling
- Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim
| | - H Seifert
- Klinik für Gastroenterologie, Klinikum Oldenburg, Oldenburg
| | - F Wappler
- Klinik für Anaesthesie und operative Intensivmedizin, Kliniken der Stadt Köln gGmbH, Universitätsklinikum Witten/Herdecke, Köln
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Riphaus A, Wehrmann T, Hausmann J, Weber B, von Delius S, Jung M, Tonner P, Arnold J, Behrens A, Beilenhoff U, Bitter H, Domagk D, In der Smitten S, Kallinowski B, Meining A, Schaible A, Schilling D, Seifert H, Wappler F, Kopp I. [S3-guidelines "sedation in gastrointestinal endoscopy" 2014 (AWMF register no. 021/014)]. Z Gastroenterol 2015; 53:E1. [PMID: 26447364 DOI: 10.1055/s-0035-1553971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - J Hausmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt
| | - B Weber
- Medizinische Klinik II, KRH Klinikum Siloah-Oststadt, Hannover
| | - S von Delius
- II. Medizinische Klinik, Klinikum rechts der Isar, TU München, München
| | - M Jung
- Klinik für Innere Medizin 2, Katholisches Klinikum Mainz, Mainz
| | - P Tonner
- Klinik für Anaesthesie, operative und allgemeine Intensivmedizin, Notfallmedizin, Klinikum Links der Weser, Bremen
| | - J Arnold
- Klinik für Gastroenterologie, Hepatologie, Diabetologie und Ernährungsmedizin, Agaplesion Diakonieklinikum Rotenburg, Rotenburg
| | - A Behrens
- Klinik für Gastroenterologie und interventionelle Endoskopie, Vivantes Klinikum im Friedrichshain, Berlin
| | | | | | - D Domagk
- Medizinische Klinik I, Josephs-Hospital, Warendorf
| | | | | | - A Meining
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
| | - A Schaible
- Klinik für interdisziplinäre Endoskopie, Universitätsklinikum Heidelberg, Heidelberg
| | - D Schilling
- Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim
| | - H Seifert
- Klinik für Gastroenterologie, Klinikum Oldenburg, Oldenburg
| | - F Wappler
- Klinik für Anaesthesie und operative Intensivmedizin, Kliniken der Stadt Köln gGmbH, Universitätsklinikum Witten/Herdecke, Köln
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Riphaus A, Wehrmann T, Hausmann J, Weber B, von Delius S, Jung M, Tonner P, Arnold J, Behrens A, Beilenhoff U, Bitter H, Domagk D, In der Smitten S, Kallinowski B, Meining A, Schaible A, Schilling D, Seifert H, Wappler F, Kopp I. [S3-guidelines "sedation in gastrointestinal endoscopy" 2014 (AWMF register no. 021/014)]. Z Gastroenterol 2015; 53:802-42. [PMID: 26284330 DOI: 10.1055/s-0035-1553458] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - J Hausmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt
| | - B Weber
- Medizinische Klinik II, KRH Klinikum Siloah-Oststadt, Hannover
| | - S von Delius
- II. Medizinische Klinik, Klinikum rechts der Isar, TU München, München
| | - M Jung
- Klinik für Innere Medizin 2, Katholisches Klinikum Mainz, Mainz
| | - P Tonner
- Klinik für Anaesthesie, operative und allgemeine Intensivmedizin, Notfallmedizin, Klinikum Links der Weser, Bremen
| | - J Arnold
- Klinik für Gastroenterologie, Hepatologie, Diabetologie und Ernährungsmedizin, Agaplesion Diakonieklinikum Rotenburg, Rotenburg
| | - A Behrens
- Klinik für Gastroenterologie und interventionelle Endoskopie, Vivantes Klinikum im Friedrichshain, Berlin
| | | | | | - D Domagk
- Medizinische Klinik I, Josephs-Hospital, Warendorf
| | | | | | - A Meining
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
| | - A Schaible
- Klinik für interdisziplinäre Endoskopie, Universitätsklinikum Heidelberg, Heidelberg
| | - D Schilling
- Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim
| | - H Seifert
- Klinik für Gastroenterologie, Klinikum Oldenburg, Oldenburg
| | - F Wappler
- Klinik für Anaesthesie und operative Intensivmedizin, Kliniken der Stadt Köln gGmbH, Universitätsklinikum Witten/Herdecke, Köln
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Belfort MA, Arnold J, Clark SL. Practice may not always make perfect (outcomes). BJOG 2015; 123:119. [PMID: 25846485 DOI: 10.1111/1471-0528.13371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M A Belfort
- Baylor College of Medicine, Texas Medical Center, Houston, TX, USA
| | - J Arnold
- Baylor College of Medicine, Texas Medical Center, Houston, TX, USA
| | - S L Clark
- Baylor College of Medicine, Texas Medical Center, Houston, TX, USA
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Arnold JJ, Campain A, Barthelmes D, Simpson JM, Guymer RH, Hunyor AP, McAllister IL, Essex RW, Morlet N, Gillies MC, Gillies M, Hunt A, Hunyor A, Arnold J, Young S, Clark G, Banerjee G, Phillips R, Perks M, Essex R, McAllister I, Constable I, Guymer R, Guymer R, Lim L, Harper A, Chow L, Wickremansinghe S, Wickremasinghe S, Wickremasinghe S. Two-year outcomes of "treat and extend" intravitreal therapy for neovascular age-related macular degeneration. Ophthalmology 2015; 122:1212-9. [PMID: 25846847 DOI: 10.1016/j.ophtha.2015.02.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. DESIGN Database observational study. PARTICIPANTS We included treatment-naïve eyes receiving predominantly ranibizumab for nAMD in routine clinical practice treated using a treat and extend regimen that were tracked in the Fight Retinal Blindness observational registry. METHODS A cohort of eyes treated by practitioners using exclusively a treat and extend regimen was extracted from the Fight Retinal Blindness observational registry. MAIN OUTCOME MEASURES Change in visual acuity (VA) over 2 years and number of injections and visits. RESULTS Data from 1198 eyes from 1011 patients receiving anti-VEGF therapy using a treat and extend regimen for treatment-naïve nAMD between January 2007 and December 2012 and with 24-month follow-up were included in the analysis. Mean VA increased by +5.3 logarithm of the minimum angle of resolution letters from 56.5 letters (20/80+1) at initial visit to 61.8 (20/60+2) letters at 24 months. Mean VA gains improved and number of injections increased with successive years from +2.7 letters for eyes commencing in 2007 after a mean of 9.7 injections in 2 years, to +7.8 letters for eyes commencing in 2012 after a mean of 14.2 injections over 2 years. The proportion of eyes with VA >20/40 increased from 27% when starting treatment to 45% after 24 months; the proportion with vision of <20/200 remained unchanged (13% initial, 11% at 24 months). Of the included eyes, 90.5% avoided a vision loss of ≥15 letters. There was an overall mean of 13.0 injections over the 24 months, 7.5 injections in the first year and 5.5 in the second year, with a mean of 14.8 clinic visits. CONCLUSIONS These data indicate that eyes managed in routine clinical practice with a treat and extend regimen can achieve good visual outcomes while decreasing the burden of treatments and clinic visits.
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Affiliation(s)
| | - Anna Campain
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Barthelmes
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Judy M Simpson
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Robyn H Guymer
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia
| | - Alex P Hunyor
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Retina Associates, Chatswood, New South Wales, Australia
| | - Ian L McAllister
- Lions Eye Institute, Centre for Ophthalmology and Vision Science, University of Western Australia, Western Australia
| | - Rohan W Essex
- Academic Unit of Ophthalmology, Australian National University, Acton, Canberra, Australia
| | - Nigel Morlet
- University of Western Australia Department of Population Health, Perth, Western Australia
| | - Mark C Gillies
- Marsden Eye Specialists, Parramatta, New South Wales, Australia
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Obenhuber AH, Gianetti TL, Bergman RG, Arnold J. Regioselective [2+2] and [4+2] cycloaddition reactivity in an asymmetric niobium(bisimido) moiety towards unsaturated organic molecules. Chem Commun (Camb) 2015; 51:1278-81. [DOI: 10.1039/c4cc07851a] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The asymmetric bis-imido structure and the lability of the diethyl ether linkage in complex 1 provide a niobium complex that undergoes regioselective [4+2] cycloaddition reactions with an α,β-unsaturated ketone and cycloaddition reactions that involve bond formation to the MAD ligand (MAD = monoazabutadiene).
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Affiliation(s)
| | - T. L. Gianetti
- Department of Chemistry
- University of California
- Berkeley
- USA
| | - R. G. Bergman
- Department of Chemistry
- University of California
- Berkeley
- USA
| | - J. Arnold
- Department of Chemistry
- University of California
- Berkeley
- USA
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Bishop C, May T, Arnold J. In pursuit of foot orthotic success: Can we identify biomechanical responses in the clinic? J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abu-Arja RF, Gonzalez BE, Jacobs MR, Cabral L, Egler R, Auletta J, Arnold J, Cooke KR. Disseminated Bacillus Calmette-Guérin (BCG) infection following allogeneic hematopoietic stem cell transplant in a patient with Bare Lymphocyte Syndrome type II. Transpl Infect Dis 2014; 16:830-7. [PMID: 24995715 DOI: 10.1111/tid.12263] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 03/24/2014] [Accepted: 04/18/2014] [Indexed: 11/28/2022]
Abstract
We describe the first case, to our knowledge, of disseminated Mycobacterium bovis Bacillus Calmette-Guérin infection in a child with Bare Lymphocyte Syndrome type II after undergoing hematopoietic stem cell transplantation (HSCT). The patient presented 30 days post HSCT with fever and lymphadenitis. Lymph node, blood, and gastric aspirates were positive for M. bovis. The patient received a prolonged treatment course with a combination of isoniazid, levofloxacin, and ethambutol. Her course was further complicated by granulomatous lymphadenitis and otitis media associated with M. bovis that developed during immune suppression taper and immune reconstitution. Ultimately, the patient recovered fully, in association with restoration of immune function, and has completed 12 months of therapy.
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Affiliation(s)
- R F Abu-Arja
- Pediatric Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio, USA
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Campisi J, Finn KE, Bravo Y, Arnold J, Benjamin M, Sukiennik M, Shakya S, Fontaine D. Sex and age-related differences in perceived, desired and measured percentage body fat among adults. J Hum Nutr Diet 2014; 28:486-92. [DOI: 10.1111/jhn.12252] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J. Campisi
- Department of Biology; Regis University; Denver CO USA
| | - K. E. Finn
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - Y. Bravo
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - J. Arnold
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - M. Benjamin
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - M. Sukiennik
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - S. Shakya
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - D. Fontaine
- Department of Health Sciences; Merrimack College; North Andover MA USA
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Davids MR, Marais N, Jacobs J, Cohen E, Krause I, Goldberg E, Garty M, Krause I, Dursun B, Sahan Y, Tanriverdi H, Rota S, Uslu S, Senol H, Minutolo R, Gabbai FB, Agarwal R, Chiodini P, Borrelli S, Stanzione G, Nappi F, Bellizzi V, Conte G, De Nicola L, Van De Walle J, Johnson S, Fremeaux-Bacchi V, Ardissino G, Ariceta G, Beauchamp J, Cohen D, Greenbaum LA, Ogawa M, Schaefer F, Licht C, Scalzotto E, Nalesso F, Zaglia T, Corradi V, Neri M, Martino F, Zanella M, Brendolan A, Mongillo M, Ronco C, Chinnappa S, Mooney A, El Nahas AM, Tu YK, Tan LB, Jung JY, Kim AJ, Ro H, Lee C, Chang JH, Lee HH, Chung W, Clarke AL, Young HM, Hull KL, Hudson N, Burton JO, Smith AC, Marx S, Petrilla A, Filipovic I, Lee WC, Meijers B, Poesen R, Storr M, Claes K, Kuypers D, Evenepoel P, Aukland M, Clarke AL, Hull KL, Burton JO, Smith AC, Betriu A, Martinez-Alonso M, Arcidiacono MV, Cannata-Andia J, Pascual J, Valdivielso JM, Fernandez-Giraldez E, Kingswood JC, Zonnenberg B, Sauter M, Zakar G, Biro B, Besenczi B, Varga A, Pekacs P, Pizzini P, Pisano A, Leonardis D, Panuccio V, Cutrupi S, Tripepi G, Mallamaci F, Zoccali C, Arnold J, Baharani J, Rayner H, So BH, Blackwell S, Jardine AG, Macgregor MS, Cunha C, Barreto P, Pereira S, Ventura A, Mota M, Seabra J, Sakaguchi T, Kobayashi S, Yano T, Yoshimoto W, Bancu I, Bonal Bastons J, Cleries Escayola M, Vela Vallespin E, Bustins Poblet M, Magem Luque D, Pastor Fabregas M, Chen JH, Chen SC, Chang JM, Hwang SJ, Chen HC, Ahbap E, Kara E, Basturk T, Sahutoglu T, Koc Y, Sakaci T, Sevinc M, Akgol C, Ozagari AA, Unsal A, Minami S, Hesaka A, Yamaguchi S, Iwahashi E, Sakai S, Fujimoto T, Sasaki K, Fujita Y, Yokoyama K, Marks A, Fluck N, Prescott G, Robertson L, Smith WC, Black C, Ohsawa M, Fujioka T, Omori S, Isurugi T, Tanno K, Onoda T, Omama S, Ishibashi Y, Makita S, Okayama A, Garland JS, Simpson CS, Metangi MF, Parfrey B, Johri AM, Sloan L, McAuley J, Cunningham R, Mullan R, Quinn M, Harron C, Chiu H, Murphy-Burke D, Werb R, Jung B, Chan-Yan C, Duncan J, Forzley B, Lowry R, Hargrove G, Carson R, Levin A, Karim M, Reznik EV, Storozhakov GIV, Rollino C, Troiano M, Bagatella M, Liuzzo C, Quarello F, Roccatello D, Blaslov K, Bulum T, Prka In I, Duvnjak L, Heleniak Z, Ciepli ska M, Szychli ski T, Pryczkowska M, Bartosi ska E, Wiatr H, Kot owska H, Tylicki L, Rutkowski B, Song YR, Kim SGK, Kim HJ, Noh JW, Tong A, Jesudason S, Craig JC, Winkelmayer WC, Hung PH, Huang YT, Hsiao CY, Sung PS, Guo HR, Tsai KJ, Wu CC, Su SL, Kao SY, Lu KC, Lin YF, Lin WH, Lee HM, Cheng MF, Wang WM, Yang LY, Wang MC, Vukovic Lela I, Sekoranja M, Poljicanin T, Karanovic S, Abramovic M, Matijevic V, Stipancic Z, Leko N, Cvitkovic A, Dika Z, Kos J, Laganovic M, Grollman AP, Jelakovic B, Dryl-Rydzynska T, Prystacki T, Malyszko J, Trifiro G, Sultana J, Giorgianni F, Ingrasciotta Y, Muscianisi M, Tari DU, Perrotta M, Buemi M, Canale V, Arcoraci V, Santoro D, Rizzo M, Iheanacho I, Van Nooten FE, Goldsmith D, Grandtnerova B, Berat ova Z, ErvenOva M, cErven J, Markech M, tefanikova A, Engelen W, Elseviers M, Gheuens E, Colson C, Muyshondt I, Daelemans R. CKD GENERAL AND CLINICAL EPIDEMIOLOGY 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Klarenbach S, Gill JS, Knoll G, Caulfield T, Boudville N, Prasad GVR, Karpinski M, Storsley L, Treleaven D, Arnold J, Cuerden M, Jacobs P, Garg AX. Economic consequences incurred by living kidney donors: a Canadian multi-center prospective study. Am J Transplant 2014; 14:916-22. [PMID: 24597854 PMCID: PMC4285205 DOI: 10.1111/ajt.12662] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 12/24/2013] [Accepted: 12/26/2013] [Indexed: 01/25/2023]
Abstract
Some living kidney donors incur economic consequences as a result of donation; however, these costs are poorly quantified. We developed a framework to comprehensively assess economic consequences from the donor perspective including out-of-pocket cost, lost wages and home productivity loss. We prospectively enrolled 100 living kidney donors from seven Canadian centers between 2004 and 2008 and collected and valued economic consequences ($CAD 2008) at 3 months and 1 year after donation. Almost all (96%) donors experienced economic consequences, with 94% reporting travel costs and 47% reporting lost pay. The average and median costs of lost pay were $2144 (SD 4167) and $0 (25th-75th percentile 0, 2794), respectively. For other expenses (travel, accommodation, medication and medical), mean and median costs were $1780 (SD 2504) and $821 (25th-75th percentile 242, 2271), respectively. From the donor perspective, mean cost was $3268 (SD 4704); one-third of donors incurred cost >$3000, and 15% >$8000. The majority of donors (83%) reported inability to perform usual household activities for an average duration of 33 days; 8% reported out-of-pocket costs for assistance with these activities. The economic impact of living kidney donation for some individuals is large. We advocate for programs to reimburse living donors for their legitimate costs.
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Affiliation(s)
- S Klarenbach
- Department of Medicine, Institute of Health EconomicsEdmonton, AB, Canada,
*Corresponding author: Scott Klarenbach,
| | - J S Gill
- Department of Medicine, University of British ColumbiaVancouver, BC, Canada
| | - G Knoll
- Department of Medicine, University of OttawaOttawa, ON, Canada
| | - T Caulfield
- Faculty of Law, School of Population and Public Health, University of AlbertaEdmonton, AB, Canada
| | - N Boudville
- School of Medicine, University of Western AustraliaCrawley, WA, Canada
| | - G V R Prasad
- Department of Medicine, University of TorontoToronto, ON, Canada
| | - M Karpinski
- Department of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - L Storsley
- Department of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - D Treleaven
- Department of Medicine, McMaster UniversityHamilton, ON, Canada
| | - J Arnold
- University of Western OntarioLondon, ON, Canada
| | - M Cuerden
- University of Western OntarioLondon, ON, Canada
| | - P Jacobs
- Department of Medicine, Institute of Health EconomicsEdmonton, AB, Canada
| | - A X Garg
- Department of Medicine and Department of Epidemiology and Biostatistics, University of Western OntarioLondon, ON, Canada,Department of Clinical Epidemiology and Biostatistics, McMaster UniversityHamilton, ON, Canada
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Brown KG, Arnold J, Sarkar S, Flach G, van der Sloot H, Meeussen J, Kosson DS. Modeling Carbonation of High-Level Waste Tank Integrity and Closure. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20135605003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Barcena de Arellano ML, Münch S, Arnold J, Helbig S, Schneider A, Mechsner S. Calcium-binding protein expression in peritoneal endometriosis-associated nerve fibres. Eur J Pain 2013; 17:1425-37. [PMID: 23649874 DOI: 10.1002/j.1532-2149.2013.00323.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2013] [Indexed: 01/08/2023]
Abstract
BACKGROUND Recent studies demonstrated the potential involvement of nerve fibres in the chronic inflammatory process of endometriosis. We aimed to characterize nerve fibres in the proximal and distal areas of the peritoneal endometriotic lesions in order to understand the chronic inflammatory process in endometriosis. METHODS Peritoneal endometriotic lesions (proximal area) (n = 17), the matching unaffected peritoneum (distal area) and healthy peritoneum of patients without endometriosis (n = 15) were analysed with the neuronal markers PGP 9.5, calbindin, calretinin and parvalbumin. Peritoneal fluids of women with and without endometriosis were used for Western blot analysis and for the neuronal growth assay. The protein expression of neuronal PC-12 cells incubated with peritoneal fluids was analysed. RESULTS The overall nerve fibre density was significantly reduced in the distal area of the lesion when compared with the proximal area or with healthy peritoneum. The density of calbindin-, calretinin- and parvalbumin-positive nerve fibres was significantly increased in the endometriosis group. Calretinin expression was elevated in the peritoneal fluid of women with symptomatic endometriosis when compared with women with asymptomatic endometriosis. Furthermore, PC-12 cells incubated with peritoneal fluid of women with endometriosis showed a higher proliferation rate and a stronger neurite outgrowth than the control group. PC-12 cells incubated in peritoneal fluids of women with endometriosis expressed less calretinin but more calbindin than the control group. CONCLUSIONS Calcium-binding proteins seem to be increased in endometriosis-associated nerve fibres and might play an important role in the chronic inflammatory condition and the pain pathogenesis of endometriosis.
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Brown L, Sanchez F, Kosson D, Arnold J. Performance of carbon nanofiber-cement composites subjected to accelerated decalcification. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20135602005] [Citation(s) in RCA: 2] [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: 11/15/2022] Open
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Arnold J, Kosson DS, Brown KG, Garrabrants A, Meeussen J, van der Sloot HA. Characterization and modeling of major constituent equilibrium chemistry of a blended cement mortar. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20135601004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hensley B, Martin P, Margrett JA, MacDonald M, Siegler IC, Poon LW, Jazwinski SM, Green RC, Gearing M, Woodard JL, Johnson MA, Tenover JS, Rodgers WL, Hausman DB, Rott C, Davey A, Arnold J. Life events and personality predicting loneliness among centenarians: findings from the Georgia Centenarian Study. J Psychol 2012; 146:173-88. [PMID: 22303619 DOI: 10.1080/00223980.2011.613874] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Regarding the purpose of this study, the researchers analyzed the roles that both life events (life-time positive events and life-time negative events) and personality (Neuroticism, Extraversion, Trust, Competence, and Ideas) played in participants of the Georgia Centenarian Study. The researchers analyzed these variables to determine whether they predicted loneliness. Analyses indicated that life-time negative events significantly predicted loneliness. In essence, the higher was the number of life-time negative life events, the higher was the loneliness score. Moreover, Neuroticism, Competence, and Ideas were all significant predictors of loneliness. The higher was the level of Neuroticism and intellectual curiosity, the higher was the level of loneliness, whereas the lower was the level of Competence, the higher was the level of loneliness. In addition, both life-time positive and life-time negative life events were significant predictors of Neuroticism. The higher was the number of life-time positive events, the lower was the level of Neuroticism, and the higher was the number of life-time negative events, the greater was the level of Neuroticism. These results indicated that life-time negative events indirectly affect loneliness via Neuroticism. Last, our results indicated that the Competence facet mediated the relationship between lifetime negative life events and loneliness. Life-time negative life events significantly affected centenarians' perceived competence, and Competence in turn significantly affected the centenarians' loneliness. These results as a whole not only add to our understanding of the link between personality and loneliness, but also provide new insight into how life events predict loneliness.
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Affiliation(s)
- Bob Hensley
- The College of Saint Scholastica, Duluth, MN 55811, USA.
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Nesbitt-Hawes E, Campbell N, Won H, Maley P, Henry A, Abbott J, Potdar N, Mason-Birks S, Elson CJ, Gelbaya TA, Nardo LG, Stavroulis A, Nnoaham K, Hummelshoj L, Zondervan K, Saridogan E, GSWH Consortium WERF, Chamie LP, Soares ACP, Kimati CT, Gomes C, Fettback P, Riboldi M, Serafini P, Lalitkumar S, Menezes J, Evdokia D, Gemzell-Danielsson K, Lalitkumar PGL, Bailey J, Newman TA, Johnston A, Zisimopoulou K, White M, Sadek K, Shreeve N, Macklon N, Cheong Y, Al-Akoum M, Akoum A, Giles J, Garrido N, Vidal C, Mondion M, Gallo C, Ramirez J, Pellicer A, Remohi J, Ghosh S, Chattopadhyay R, Jana S, Goswami SK, Bose G, Chakravarty M, Chowdhuri K, Chakravarty BN, Kendirci Ceviren A, Ozcelik Tanriverdi N, Urfan A, Donmez L, Isikoglu M, Romano A, Schreinemacher MH, Backes WH, Slenter JM, Xanthoulea SA, Delvoux B, van Winden L, Beets-Tan RG, Evers JLH, Dunselman GAJ, Jana SK, Chaudhury K, Chattopadhyay R, Chakravarty BN, Maruyama T, Yamasaki A, Miyazaki K, Arase T, Uchida H, Yoshimura Y, Kaser D, Ginsburg E, Missmer S, Correia K, Racowsky C, Streuli I, Chouzenoux S, de Ziegler D, Chereau C, Weill B, Chapron C, Batteux F, Arianmanesh M, Fowler PA, Al-Gubory KH, Urata Y, Osuga Y, Izumi G, Nagai M, Takamura M, Yamamoto N, Saito A, Hasegawa A, Takemura Y, Harada M, Hirata T, Hirota Y, Yoshino O, Koga K, Taketani Y, Mohebbi A, Janan A, Nasri S, Lakpour MR, Ramazanali F, Moini A, Aflatoonian R, Germeyer A, Novak O, Renke T, Jung M, Jackus J, Toth B, Strowitzki T, Bhattacharya J, Mitra A, Kundu S, Pal M, Kundu A, Gumusel A, Basar M, Yaprak E, Aslan E, Arda O, Ilvan S, Kayisli U, Guzel E, Haouzi D, Monzo C, Lehmann S, Hirtz C, Tiers L, Hamamah S, Choi D, Choi J, Jo M, Lee E, Shen X, Wang BIN, Li X, Tamura I, Maekawa R, Asada H, Tamura H, Sugino N, Tamura H, Tamura I, Maekawa R, Asada H, Sugino N, Liu H, Jiang Y, Chen J, Zhu L, Shen X, Wang B, Yan G, Sun H, Coughlan C, Sinagra M, Ledger W, Li TC, Laird SM, Dafopoulos K, Vrekoussis T, Chalvatzas N, Messini CI, Kalantaridou S, Georgoulias P, Messinis IE, Makrigiannakis A, Xue Q, Xu Y, Zuo WL, Zhang L, Shang J, Zhu SN, Bulun SE, Tomassetti C, Geysenbergh B, Meuleman C, Fieuws S, D'Hooghe T, Suginami K, Sato Y, Horie A, Matsumoto H, Fujiwara H, Konishi I, Jung Y, Cho S, Choi Y, Lee B, Seo S, Urman B, Yakin K, Oktem O, Alper E, Taskiran C, Aksoy S, Takeuchi K, Kurematsu T, Yu-ki Y, Fukumoto Y, Homan Y, Sata Y, Kuroki Y, Takeuchi M, Awata S, Muneyyirci-Delale O, Charles C, Anopa J, Osei-Tutu N, Dalloul M, Weedon J, Muney A, Stratton P, Yilmaz B, Kilic S, Aksakal O, Kelekci S, Aksoy Y, Lordlar N, Sut N, Gungor T, Chan J, Tan CW, Lee YH, Tan HH, Choolani M, Griffith L, Oldeweme J, Barcena de Arellano ML, Reichelt U, Schneider A, Mechsner S, Barcena de Arellano ML, Munch S, Vercellino GF, Chiantera V, Schneider A, Mechsner S, Santoro L, D'Onofrio F, Campo S, Ferraro PM, Tondi P, Gasbarrini A, Santoliquido A, Jung MH, Kim HY, Barcena de Arellano ML, Arnold J, Vercellino GF, Chiantera V, Schneider A, Mechsner S, Arnold J, Barcena de Arellano ML, Buttner A, Vercellino GF, Chiantera V, Schneider A, Mechsner S, Karaer A, Celik O, Bay Karabulut A, Celik E, Kiran TR, Simsek OY, Yilmaz E, Turkcuoglu I, Tanrikut E, Alieva K, Kulakova E, Ipatova M, Smolnikova V, Kalinina E. ENDOMETRIOSIS, ENDOMETRIUM, IMPLANTATION AND FALLOPIAN TUBE. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.78] [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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Cho J, Martin P, Margrett J, MacDonald M, Johnson MA, Poon LW, Jazwinski SM, Green RC, Gearing M, Woodard JL, Tenover JS, Siegler IC, Rott C, Rodgers WL, Hausman D, Arnold J, Davey A. Multidimensional predictors of fatigue among octogenarians and centenarians. Gerontology 2011; 58:249-57. [PMID: 22094445 DOI: 10.1159/000332214] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 08/18/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Fatigue is a common and frequently observed complaint among older adults. However, knowledge about the nature and correlates of fatigue in old age is very limited. OBJECTIVE This study examined the relationship of functional indicators, psychological and situational factors and fatigue for 210 octogenarians and centenarians from the Georgia Centenarian Study. METHODS Three indicators of functional capacity (self-rated health, instrumental activities of daily living, physical activities of daily living), two indicators of psychological well-being (positive and negative affect), two indicators of situational factors (social network and social support), and a multidimensional fatigue scale were used. Blocked multiple regression analyses were computed to examine significant factors related to fatigue. In addition, multi-group analysis in structural equation modeling was used to investigate residential differences (i.e., long-term care facilities vs. private homes) in the relationship between significant factors and fatigue. RESULTS Blocked multiple regression analyses indicated that two indicators of functional capacity, self-rated health and instrumental activities of daily living, both positive and negative affect, and social support were significant predictors of fatigue among oldest-old adults. The multiple group analysis in structural equation modeling revealed a significant difference among oldest-old adults based on residential status. CONCLUSION The results suggest that we should not consider fatigue as merely an unpleasant physical symptom, but rather adopt a perspective that different factors such as psychosocial aspects can influence fatigue in advanced later life.
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Affiliation(s)
- Jinmyoung Cho
- Scott & White Health Care, Texas A&M Health Science Center, School of Rural Public Health, College Station, TX 77843-1266, USA.
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Barcena de Arellano ML, Arnold J, Rüster C, Vercellino GF, Chiantera V, Ebert AD, Schneider A, Mechsner S. Neurotrophic events in peritoneal endometriotic lesions. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1292729] [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: 10/15/2022] Open
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Abstract
Urine marking is thought to play a pivotal role in territory demarcation by red foxes ( Vulpes vulpes (L., 1758)), but little is known about how individuals respond to alien scent marks, and whether there are sex-related differences in territorial defense. We radio-tracked dominant male and female urban foxes before and after synthetic fox urine was applied to approximately a third of their territories and compared spatial and behavioral reactions both before and after scent application and with foxes on territories where no urine was applied. Home-range boundaries of male foxes shifted towards the scent-marked area, but this change did not affect the total territory size. Larger males shifted their home ranges to a greater degree than small males. Scent application did not affect total activity, but males spent more time in the scent-marked area. Behaviors such as distance moved per night and speed of movement did not differ before and after application, but foxes searched a greater percentage of their home range each night following scent marking. Females showed no significant spatial or behavioral response to the synthetic scent marks. Overall, responses of foxes to synthetic scent marks were male-biased and related to changes in space use rather than movement behaviors.
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Affiliation(s)
- J. Arnold
- School of Biological Sciences, University of Bristol, Woodland Road, Bristol BS8 1UG, UK
| | - C.D. Soulsbury
- School of Biological Sciences, University of Bristol, Woodland Road, Bristol BS8 1UG, UK
| | - S. Harris
- School of Biological Sciences, University of Bristol, Woodland Road, Bristol BS8 1UG, UK
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Arnold J, Barcena de Arellano ML, Rüster C, Mechsner S. Dysbalance zwischen sympathischer und sensibler Innervation in peritonealen Endometrioseläsionen. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1280477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Münch S, Barcena de Arellano ML, Arnold J, Vercellino GF, Chiantera V, Mechsner S. Die Rolle von Neurotrophinen und Kalzium-bindenden Proteinen in der Endometriose-assoziierten Innervation. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1280484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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