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Qi X, Bertling K, Torniainen J, Kong F, Gillespie T, Primiero C, Stark MS, Dean P, Indjin D, Li LH, Linfield EH, Davies AG, Brünig M, Mills T, Rosendahl C, Soyer HP, Rakić AD. Terahertz in vivo imaging of human skin: Toward detection of abnormal skin pathologies. APL Bioeng 2024; 8:016117. [PMID: 38476403 PMCID: PMC10932572 DOI: 10.1063/5.0190573] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
Terahertz (THz) imaging has long held promise for skin cancer detection but has been hampered by the lack of practical technological implementation. In this article, we introduce a technique for discriminating several skin pathologies using a coherent THz confocal system based on a THz quantum cascade laser. High resolution in vivo THz images (with diffraction limited to the order of 100 μm) of several different lesion types were acquired and compared against one another using the amplitude and phase values. Our system successfully separated pathologies using a combination of phase and amplitude information and their respective surface textures. The large scan field (50 × 40 mm) of the system allows macroscopic visualization of several skin lesions in a single frame. Utilizing THz imaging for dermatological assessment of skin lesions offers substantial additional diagnostic value for clinicians. THz images contain information complementary to the information contained in the conventional digital images.
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Affiliation(s)
- X. Qi
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane QLD 4072, Australia
| | - K. Bertling
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane QLD 4072, Australia
| | - J. Torniainen
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane QLD 4072, Australia
| | - F. Kong
- Dermatology Research Centre, Frazer Institute, The University of Queensland, Woolloongabba QLD 4102, Australia
| | - T. Gillespie
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane QLD 4072, Australia
| | - C. Primiero
- Dermatology Research Centre, Frazer Institute, The University of Queensland, Woolloongabba QLD 4102, Australia
| | - M. S. Stark
- Dermatology Research Centre, Frazer Institute, The University of Queensland, Woolloongabba QLD 4102, Australia
| | - P. Dean
- School of Electronic and Electrical Engineering, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - D. Indjin
- School of Electronic and Electrical Engineering, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - L. H. Li
- School of Electronic and Electrical Engineering, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - E. H. Linfield
- School of Electronic and Electrical Engineering, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - A. G. Davies
- School of Electronic and Electrical Engineering, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - M. Brünig
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane QLD 4072, Australia
| | - T. Mills
- OscillaDx Pty Ltd, Brisbane, Queensland, Australia
| | - C. Rosendahl
- General Practice Clinical Unit, Faculty of Medicinee, The University of Queensland, Herston QLD 4029, Australia
| | - H. P. Soyer
- Dermatology Research Centre, Frazer Institute, The University of Queensland, Woolloongabba QLD 4102, Australia
| | - A. D. Rakić
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane QLD 4072, Australia
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Brassard J, Hughes MR, Dean P, Hernaez DC, Thornton S, Banville AC, Smazynski J, Warren M, Zhang K, Milne K, Gilks CB, Mes-Masson AM, Huntsman DG, Nelson BH, Roskelley CD, McNagny KM. A tumor-restricted glycoform of podocalyxin is a highly selective marker of immunologically cold high-grade serous ovarian carcinoma. Front Oncol 2023; 13:1286754. [PMID: 38188285 PMCID: PMC10771318 DOI: 10.3389/fonc.2023.1286754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Targeted-immunotherapies such as antibody-drug conjugates (ADC), chimeric antigen receptor (CAR) T cells or bispecific T-cell engagers (eg, BiTE®) all aim to improve cancer treatment by directly targeting cancer cells while sparing healthy tissues. Success of these therapies requires tumor antigens that are abundantly expressed and, ideally, tumor specific. The CD34-related stem cell sialomucin, podocalyxin (PODXL), is a promising target as it is overexpressed on a variety of tumor types and its expression is consistently linked to poor prognosis. However, PODXL is also expressed in healthy tissues including kidney podocytes and endothelia. To circumvent this potential pitfall, we developed an antibody, named PODO447, that selectively targets a tumor-associated glycoform of PODXL. This tumor glycoepitope is expressed by 65% of high-grade serous ovarian carcinoma (HGSOC) tumors. Methods In this study we characterize these PODO447-expressing tumors as a distinct subset of HGSOC using four different patient cohorts that include pre-chemotherapy, post-neoadjuvant chemotherapy (NACT) and relapsing tumors as well as tumors from various peritoneal locations. Results We find that the PODO447 epitope expression is similar across tumor locations and negligibly impacted by chemotherapy. Invariably, tumors with high levels of the PODO447 epitope lack infiltrating CD8+ T cells and CD20+ B cells/plasma cells, an immune phenotype consistently associated with poor outcome. Discussion We conclude that the PODO447 glycoepitope is an excellent biomarker of immune "cold" tumors and a candidate for the development of targeted-therapies for these hard-to-treat cancers.
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Affiliation(s)
- Julyanne Brassard
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Michael R. Hughes
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Pamela Dean
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Diana Canals Hernaez
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Shelby Thornton
- Molecular and Advanced Pathology Core (MAPcore), University of British Columbia, Vancouver, BC, Canada
| | | | | | - Mary Warren
- British Columbia Cancer Agency, Victoria, BC, Canada
| | - Kevin Zhang
- British Columbia Cancer Agency, Victoria, BC, Canada
| | - Katy Milne
- British Columbia Cancer Agency, Victoria, BC, Canada
| | - C. Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Anne-Marie Mes-Masson
- Centre de Recherche du Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - David G. Huntsman
- Molecular and Advanced Pathology Core (MAPcore), University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada
| | | | - Calvin D. Roskelley
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Kelly M. McNagny
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
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Thomas EO, Manara A, Dineen RA, Mortimer A, Aziz O, Dean P, Elliott P, Summers DM, Whitfield PC, Hutchinson PJ, Gardiner D. The use of cerebral computed tomographic angiography as an ancillary investigation to support a clinical diagnosis of death using neurological criteria: a consensus guideline. Anaesthesia 2023; 78:330-336. [PMID: 36709511 DOI: 10.1111/anae.15950] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 01/30/2023]
Abstract
This multidisciplinary consensus statement was produced following a recommendation by the Faculty of Intensive Care Medicine to develop a UK guideline for ancillary investigation, when one is required, to support the diagnosis of death using neurological criteria. A multidisciplinary panel reviewed the literature and UK practice in the diagnosis of death using neurological criteria and recommended cerebral CT angiography as the ancillary investigation of choice when death cannot be confirmed by clinical criteria alone. Cerebral CT angiography has been shown to have 100% specificity in supporting a diagnosis of death using neurological criteria and is an investigation available in all acute hospitals in the UK. A standardised technique for performing the investigation is described alongside a reporting template. The panel were unable to make recommendations for ancillary testing in children or patients receiving extracorporeal membrane oxygenation.
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Affiliation(s)
- E O Thomas
- Department of Intensive Care Medicine, University Hospitals NHS Trust Plymouth, UK
| | - A Manara
- Department of Intensive Care Medicine, North Bristol NHS Trust, Bristol, UK
| | - R A Dineen
- Faculty of Medicine and Health Sciences, University of Nottingham, UK.,Department of Radiology, Nottingham University Hospital NHS Trust, Nottingham, UK
| | - A Mortimer
- Department of Radiology, North Bristol NHS Trust, Bristol, UK
| | - O Aziz
- Bristol Royal Hospital for Children and University Hospital Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - P Dean
- Department of Intensive Care Medicine and Anaesthesia, East Lancashire Hospitals NHS Trust, Lancashire, UK
| | - P Elliott
- Royal College of Anaesthetists, London, UK
| | - D M Summers
- Department of Neuroradiology, NHS Lothian, Edinburgh, UK.,University of Edinburgh, UK
| | - P C Whitfield
- South West Neurosurgery Centre, University Hospitals NHS Trust Plymouth, UK
| | - P J Hutchinson
- Department of Neurosurgery, University of Cambridge, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - D Gardiner
- Department of Intensive Care Medicine, Nottingham University Hospital NHS Trust, Nottingham, UK
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Timperlake E, Pick L, Morere D, Dean P. A-218 Development of an American Sign Language Cognitive Screening Measure for Deaf Adults. Arch Clin Neuropsychol 2022. [DOI: 10.1093/arclin/acac060.218] [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: 11/13/2022] Open
Abstract
Abstract
Objective: The Deaf community in the United States is recognized as a unique linguistic and cultural minority group. However, there are almost no American Sign Language (ASL) cognitive screening measures for this population (Dean et al., 2009; Atkinson et al., 2015). This study approached the development of a valid and conceptually equivalent measure of cognitive functioning with the involvement of Deaf community support and feedback.
Method: Measure development was conducted by a team of neuropsychologists and clinical psychology PhD students with expertise in ASL linguistics and Deaf culture. The formal linguistic development included two native Deaf signers, one Deaf Interpreter, and one Certified Deaf Interpreter. The measure was then administered to a pilot sample of 20, cognitively intact, Deaf adults (Age: M=40.10, SD=5.50) fluent in ASL.
Results: The measure showed good internal reliability for preliminary analyses (α= .72, λ-2 = .77, KR20 = .75) and it positively correlated with ASL fluency as determined by the ASL-Comprehension Test (r(18)= .54, p=.01; Hauser et al., 2016). There were no significant correlations with self-reported educational attainment (r(18)=-.21, p= .39) or race/ethnicity (r(18)=-.11, p= .64).
Conclusion: Preliminary analysis of an ASL cognitive screening measures developed for use with culturally Deaf signers shows promise. This is one of the first attempts to create such a measure in the United States and next requires further development and piloting with a sample of cognitively intact older adult Deaf signers.
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Canals Hernaez D, Hughes MR, Li Y, Mainero Rocca I, Dean P, Brassard J, Bell EM, Samudio I, Mes-Masson AM, Narimatsu Y, Clausen H, Blixt O, Roskelley CD, McNagny KM. Targeting a Tumor-Specific Epitope on Podocalyxin Increases Survival in Human Tumor Preclinical Models. Front Oncol 2022; 12:856424. [PMID: 35600398 PMCID: PMC9115113 DOI: 10.3389/fonc.2022.856424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Podocalyxin (Podxl) is a CD34-related cell surface sialomucin that is normally highly expressed by adult vascular endothelia and kidney podocytes where it plays a key role in blocking adhesion. Importantly, it is also frequently upregulated on a wide array of human tumors and its expression often correlates with poor prognosis. We previously showed that, in xenograft studies, Podxl plays a key role in metastatic disease by making tumor initiating cells more mobile and invasive. Recently, we developed a novel antibody, PODO447, which shows exquisite specificity for a tumor-restricted glycoform of Podxl but does not react with Podxl expressed by normal adult tissue. Here we utilized an array of glycosylation defective cell lines to further define the PODO447 reactive epitope and reveal it as an O-linked core 1 glycan presented in the context of the Podxl peptide backbone. Further, we show that when coupled to monomethyl auristatin E (MMAE) toxic payload, PODO447 functions as a highly specific and effective antibody drug conjugate (ADC) in killing ovarian, pancreatic, glioblastoma and leukemia cell lines in vitro. Finally, we demonstrate PODO447-ADCs are highly effective in targeting human pancreatic and ovarian tumors in xenografted NSG and Nude mouse models. These data reveal PODO447-ADCs as exquisitely tumor-specific and highly efficacious immunotherapeutic reagents for the targeting of human tumors. Thus, PODO447 exhibits the appropriate characteristics for further development as a targeted clinical immunotherapy.
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Affiliation(s)
- Diana Canals Hernaez
- The Biomedical Research Centre and School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Michael R Hughes
- The Biomedical Research Centre and School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Yicong Li
- The Biomedical Research Centre and School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Ilaria Mainero Rocca
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark
| | - Pamela Dean
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Julyanne Brassard
- The Biomedical Research Centre and School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Erin M Bell
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Ismael Samudio
- Centre for Drug Research and Development, Vancouver, BC, Canada
| | | | - Yoshiki Narimatsu
- Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine (ICMM), University of Copenhagen, Copenhagen, Denmark
| | - Henrik Clausen
- Copenhagen Center for Glycomics, Department of Cellular and Molecular Medicine (ICMM), University of Copenhagen, Copenhagen, Denmark
| | - Ola Blixt
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark
| | - Calvin D Roskelley
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Kelly M McNagny
- The Biomedical Research Centre and School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
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Brassard J, Hernaez DC, Hughes MR, Milne K, Dean P, Warren M, Zhang K, Banville AC, Smazynski J, Bond D, Nelson BH, Roskelley CD, McNagny KM. A tumor-restricted glycoepitope of podocalyxin correlates with immune evasion in high-grade serous ovarian carcinoma. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.177.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Abstract
High-grade serous ovarian carcinoma (HGSOC) is an aggressive tumor with a 5-year disease-free survival of roughly 15%, partly because it is usually diagnosed at an advanced stage. Podocalyxin (Podxl) is a highly glycosylated sialomucin normally expressed by vascular endothelia and kidney podocytes. Strikingly, Podxl expression is frequently upregulated by a variety of tumors (including HGSOC) and is consistently associated with poor prognosis. We capitalized on the fact that glycosylation pathways are frequently dysregulated in cancer to develop an antibody, PODO447, that recognizes a tumor-restricted glycoform of Podxl not expressed on normal tissue. While the exact epitope remains to be identified, our results suggest that PODO447 binds an epitope comprising a peptide domain of Podxl in combination with the core 1 O-GalNAc glycan (T-antigen). When coupled to a cytotoxin, a PODO447-antibody-drug conjugate (ADC) effectively kills human tumor cells in vitro and in xenografted mice. While the vast majority of ovarian tumors highly express the Podxl core protein, only a subset of these express the PODO447 epitope. Strikingly, tumors that express a high level of PODO447 epitope tend to be those that lack infiltrating CD8+ T cells and CD20+ B cells: a phenotype that has previously been linked to immune evasion and poorest disease-free survival. Furthermore, we find that PODO447 is a more consistent marker of these immunologically “cold” tumors than a number of other markers, including CA125, mesothelin and folate receptor α. These results highlight the PODO447-epitope as a highly selective diagnostic marker of poor outcome tumors and the PODO447-ADC as a novel strategy for therapeutic intervention.
This research was supported by the Canadian Institutes of Health Research (Grant Number: PJT-166180), the School of Biomedical Engineering (The University of British Columbia) postdoctoral fellowship and the Michael Smith Foundation for Health Research (MSFHR) research trainee award.
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Affiliation(s)
- Julyanne Brassard
- 1School of Biomedical Engineering, Univ. of British Columbia, Canada
| | | | - Michael R Hughes
- 1School of Biomedical Engineering, Univ. of British Columbia, Canada
| | - Katy Milne
- 2Trev and Joyce Deeley Research Centre, British Columbia Cancer Agency, Canada
| | - Pamela Dean
- 3Department of Cellular and Physiological Sciences, Univ. of British Columbia, Canada
| | - Mary Warren
- 2Trev and Joyce Deeley Research Centre, British Columbia Cancer Agency, Canada
| | - Kevin Zhang
- 2Trev and Joyce Deeley Research Centre, British Columbia Cancer Agency, Canada
| | - Allyson C Banville
- 2Trev and Joyce Deeley Research Centre, British Columbia Cancer Agency, Canada
| | - Julian Smazynski
- 2Trev and Joyce Deeley Research Centre, British Columbia Cancer Agency, Canada
| | - David Bond
- 2Trev and Joyce Deeley Research Centre, British Columbia Cancer Agency, Canada
| | - Brad H Nelson
- 2Trev and Joyce Deeley Research Centre, British Columbia Cancer Agency, Canada
| | - Calvin D Roskelley
- 3Department of Cellular and Physiological Sciences, Univ. of British Columbia, Canada
| | - Kelly M McNagny
- 1School of Biomedical Engineering, Univ. of British Columbia, Canada
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Hogan WJ, Punn R, Dean P, Strainic J, Rychik J, Williams RV, Moon-Grady AJ, Silverman NH. Prenatally diagnosed pseudoaneurysm of mitral-aortic intervalvular fibrous area. Ultrasound Obstet Gynecol 2022; 59:682-686. [PMID: 34494326 DOI: 10.1002/uog.24762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 06/13/2023]
Abstract
The mitral-aortic intervalvular fibrosa (MAIVF) is an avascular, fibrous structure that provides continuity between the anterior leaflet of the mitral valve and the aortic valve. Pseudoaneurysm of the MAIVF is rare and has been most commonly described in adults and, more rarely, in children following cardiac surgery or endocarditis. Few reports have been published on cases with congenital pseudoaneurysm of the MAIVF. Here, we describe five cases of congenital pseudoaneurysm of the MAIVF identified prenatally and an additional six cases diagnosed postnatally. This is an unusual finding of varying clinical significance, which can be isolated or associated with complex congenital heart disease but, importantly, can be identified and monitored in the fetus. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- W J Hogan
- Department of Pediatrics, Division of Pediatric Cardiology, The University of California, San Francisco, CA, USA
| | - R Punn
- Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - P Dean
- Division of Pediatric Cardiology, Department of Pediatrics, University of Virginia, Charlottesville, VA, USA
| | - J Strainic
- Rainbow Babies and Children's Hospital Division of Pediatric Cardiology, University Hospitals, Cleveland, OH, USA
| | - J Rychik
- Division of Cardiology, Departments of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - R V Williams
- University of Utah and Primary Children's Hospital, Salt Lake City, UT, USA
| | - A J Moon-Grady
- Department of Pediatrics, Division of Pediatric Cardiology, The University of California, San Francisco, CA, USA
| | - N H Silverman
- Department of Pediatrics, Division of Pediatric Cardiology, The University of California, San Francisco, CA, USA
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Payne S, Shofer JB, Shutes-David A, Li G, Jankowski A, Dean P, Tsuang D. Correlates of Conversion from Mild Cognitive Impairment to Dementia with Lewy Bodies: Data from the National Alzheimer's Coordinating Center. J Alzheimers Dis 2022; 86:1643-1654. [PMID: 35213374 PMCID: PMC9536845 DOI: 10.3233/jad-215428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many patients with dementia with Lewy bodies (DLB) miss out on the best standards of care and psychosocial support due to diagnostic delays or inaccuracies following symptom onset. OBJECTIVE This study seeks to identify baseline characteristics in individuals with mild cognitive impairment (MCI) that correlate with eventual conversion to DLB or Alzheimer's disease (AD). METHODS Baseline neuropsychological and neuropsychiatric data were analyzed in National Alzheimer's Coordinating Center participants who completed the Uniform Data Set between 2006 and 2020 and subsequently converted from MCI to DLB or AD (n = 1632). RESULTS Only 6% of participants with MCI converted to DLB. Among those who converted to DLB, multidomain amnestic MCI (aMCI) was the most common subtype at study entry. As part of logistic regression analyses, odds ratios (ORs) were estimated for conversion to DLB versus AD based on study-entry characteristics, adjusting for age, sex, education, and years to diagnosis. The strongest predictors of conversion to DLB (p≤0.0001) were nonamnestic MCI versus aMCI (OR 8.2, CI [5.0, 14]), multidomain MCI versus single-domain MCI (OR 2.7, CI [1.7. 4.2]), male sex (OR 4.2, CI [2.5, 7.1]), and presence of nighttime behaviors (OR 4.4 CI [2.8, 6.9]). CONCLUSION A diagnosis of prodromal DLB should be considered in individuals with MCI who present with prominent executive/visuospatial deficits, neuropsychiatric symptoms, and less memory impairment. Early diagnosis of DLB may guide treatment planning, including the avoidance of antipsychotic medications in patients who develop psychotic symptoms, caregiver support, and initiation of early treatment(s) once medications become available.
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Affiliation(s)
- Sarah Payne
- Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
| | - Jane B. Shofer
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
| | - Andrew Shutes-David
- Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
| | - Ge Li
- Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
| | - Adrienne Jankowski
- Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
| | - Pamela Dean
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
- Mental Health Service, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Debby Tsuang
- Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
- Correspondence to: Debby Tsuang, MD, MS, VA Puget Sound, Health Care System, 1660 S Columbian Way, MS-182, Seattle WA, 98108, USA. Tel.: +1 206 277 1333;
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Arif AA, Huang YH, Freeman SA, Atif J, Dean P, Lai JCY, Blanchet MR, Wiegand KC, McNagny KM, Underhill TM, Gold MR, Johnson P, Roskelley CD. Inflammation-Induced Metastatic Colonization of the Lung Is Facilitated by Hepatocyte Growth Factor-Secreting Monocyte-Derived Macrophages. Mol Cancer Res 2021; 19:2096-2109. [PMID: 34556524 DOI: 10.1158/1541-7786.mcr-21-0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/27/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022]
Abstract
A rate-limiting step for circulating tumor cells to colonize distant organ sites is their ability to locate a microenvironmental niche that supports their survival and growth. This can be achieved by features intrinsic to the tumor cells and/or by the conditioning of a "premetastatic" niche. To determine if pulmonary inflammation promotes the latter, we initiated models for inflammatory asthma, hypersensitivity pneumonitis, or bleomycin-induced sterile inflammation before introducing tumor cells with low metastatic potential into the circulation. All types of inflammation increased the end-stage metastatic burden of the lungs 14 days after tumor cell inoculation without overtly affecting tumor extravasation. Instead, the number and size of early micrometastatic lesions found within the interstitial tissues 96 hours after tumor cell inoculation were increased in the inflamed lungs, coincident with increased tumor cell survival and the presence of nearby inflammation-induced monocyte-derived macrophages (MoDM; CD11b+CD11c+). Remarkably, the adoptive transfer of these MoDM was sufficient to increase lung metastasis in the absence of inflammation. These inflammation-induced MoDM secrete a number of growth factors and cytokines, one of which is hepatocyte growth factor (HGF), that augmented tumor cell survival under conditions of stress in vitro. Importantly, blocking HGF signaling with the cMET inhibitor capmatinib abolished inflammation-induced early micrometastatic lesion formation in vivo. These findings indicate that inflammation-induced MoDM and HGF in particular increase the efficiency of early metastatic colonization in the lung by locally preconditioning the microenvironment. IMPLICATIONS: Inflammation preconditions the distant site microenvironment to increase the metastatic potential of tumor cells that arrive there.
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Affiliation(s)
- Arif A Arif
- Department of Cellular and Physiological Sciences, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Microbiology and Immunology, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yu-Hsuan Huang
- Department of Cellular and Physiological Sciences, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Microbiology and Immunology, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Spencer A Freeman
- Division of Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jawairia Atif
- Department of Microbiology and Immunology, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Pamela Dean
- Department of Cellular and Physiological Sciences, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jacqueline C Y Lai
- Department of Microbiology and Immunology, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Kimberly C Wiegand
- The Biomedical Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly M McNagny
- The Biomedical Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - T Michael Underhill
- Department of Cellular and Physiological Sciences, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada.,The Biomedical Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael R Gold
- Department of Microbiology and Immunology, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Pauline Johnson
- Department of Microbiology and Immunology, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Calvin D Roskelley
- Department of Cellular and Physiological Sciences, the Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada.
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Canals Hernaez D, Hughes MR, Dean P, Bergqvist P, Samudio I, Blixt O, Wiedemeyer K, Li Y, Bond C, Cruz E, Köbel M, Gilks B, Roskelley CD, McNagny KM. PODO447: a novel antibody to a tumor-restricted epitope on the cancer antigen podocalyxin. J Immunother Cancer 2020; 8:jitc-2020-001128. [PMID: 33243933 PMCID: PMC7692987 DOI: 10.1136/jitc-2020-001128] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 12/12/2022] Open
Abstract
Background The success of new targeted cancer therapies has been dependent on the identification of tumor-specific antigens. Podocalyxin (Podxl) is upregulated on tumors with high metastatic index and its presence is associated with poor outcome, thus emerging as an important prognostic and theragnostic marker in several human cancers. Moreover, in human tumor xenograft models, Podxl expression promotes tumor growth and metastasis. Although a promising target for immunotherapy, the expression of Podxl on normal vascular endothelia and kidney podocytes could hamper efforts to therapeutically target this molecule. Since pathways regulating post-translational modifications are frequently perturbed in cancer cells, we sought to produce novel anti-Podxl antibodies (Abs) that selectively recognize tumor-restricted glycoepitopes on the extracellular mucin domain of Podxl. Methods Splenic B cells were isolated from rabbits immunized with a Podxl-expressing human tumor cell line. Abs from these B cells were screened for potent reactivity to Podxl+ neoplastic cell lines but not Podxl+ primary endothelial cells. Transcripts encoding heavy and light chain variable regions from promising B cells were cloned and expressed as recombinant proteins. Tumor specificity was assessed using primary normal tissue and an ovarian cancer tissue microarray (TMA). Mapping of the tumor-restricted epitope was performed using enzyme-treated human tumor cell lines and a glycan array. Results One mAb (PODO447) showed strong reactivity with a variety of Podxl+ tumor cell lines but not with normal primary human tissue including Podxl+ kidney podocytes and most vascular endothelia. Screening of an ovarian carcinoma TMA (219 cases) revealed PODO447 reactivity with the majority of tumors, including 65% of the high-grade serous histotype. Subsequent biochemical analyses determined that PODO447 reacts with a highly unusual terminal N-acetylgalactosamine beta-1 (GalNAcβ1) motif predominantly found on the Podxl protein core. Finally, Ab–drug conjugates showed specific efficacy in killing tumor cells in vitro. Conclusions We have generated a novel and exquisitely tumor-restricted mAb, PODO447, that recognizes a glycoepitope on Podxl expressed at high levels by a variety of tumors including the majority of life-threatening high-grade serous ovarian tumors. Thus, tumor-restricted PODO447 exhibits the appropriate specificity for further development as a targeted immunotherapy.
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Affiliation(s)
- Diana Canals Hernaez
- The Biomedical Research Centre and School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael R Hughes
- The Biomedical Research Centre and School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Pamela Dean
- Department of Cellular and Physiological Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Bergqvist
- Centre for Drug Research and Development, Vancouver, British Columbia, Canada
| | - Ismael Samudio
- Centre for Drug Research and Development, Vancouver, British Columbia, Canada
| | - Ola Blixt
- Copenhagen Center for Glycomics and Department of Cellular and Molecular Medicine (ICMM), University of Copenhagen, Kobenhavn, Denmark
| | - Katharina Wiedemeyer
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Yicong Li
- The Biomedical Research Centre and School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Chris Bond
- Centre for Drug Research and Development, Vancouver, British Columbia, Canada
| | - Eric Cruz
- Centre for Drug Research and Development, Vancouver, British Columbia, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Blake Gilks
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Calvin D Roskelley
- Department of Cellular and Physiological Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly M McNagny
- The Biomedical Research Centre and School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada
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11
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Consoli A, Coskun O, Perier M, Di Maria F, Gratieux J, Dean P, Pizzuto S, Badat N, Condette-Auliac S, Boulin A, Rodesch G. [Therapeutic and endovascular management of cerebral mycotic aneurysms]. Ann Cardiol Angeiol (Paris) 2020; 69:411-414. [PMID: 33131724 DOI: 10.1016/j.ancard.2020.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 11/15/2022]
Abstract
Infective endocardites are associated with both ischemic and hemorrhagic neurological complications and also with cerebral abscesses and the development of "mycotic" aneurysms, which are detected in about 5 % of patients in the acute and sub-acute phase of the infection. Data about their natural history and their hemorrhagic risk are scarce and fragmented. The therapeutic management is represented by the medical treatment of the infection with interventional abstention, the surgical treatment and the endovascular approach by selective embolization of the aneurysm. No evidence is provided concerning the superiority of a specific approach. Mycotic aneurysms remain a diagnostic and therapeutic challenge and their management is necessarily based on a multidiscplinary approach.
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Affiliation(s)
- A Consoli
- Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, 40, rue Worth, 92151, Suresnes, France.
| | - O Coskun
- Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, 40, rue Worth, 92151, Suresnes, France
| | - M Perier
- Service de cardiologie, hôpital Foch, 40, rue Worth, 92151, Suresnes, France
| | - F Di Maria
- Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, 40, rue Worth, 92151, Suresnes, France
| | - J Gratieux
- Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, 40, rue Worth, 92151, Suresnes, France
| | - P Dean
- Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, 40, rue Worth, 92151, Suresnes, France
| | - S Pizzuto
- Unité de neuroradiologie, ospedale Civile S.Agostino-Estense, CHU Modène, université de Modène et Reggio Emilia, Via Pietro Giardini 1355, Modène, Baggiovara, 41126, Italie
| | - N Badat
- Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, 40, rue Worth, 92151, Suresnes, France
| | - S Condette-Auliac
- Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, 40, rue Worth, 92151, Suresnes, France
| | - A Boulin
- Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, 40, rue Worth, 92151, Suresnes, France
| | - G Rodesch
- Service de neuroradiologie diagnostique et thérapeutique, hôpital Foch, 40, rue Worth, 92151, Suresnes, France
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12
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Bell EM, Graves ML, Dean P, McNagny KM, Roskelley CD. Abstract 4911: Characterizing the role of podocalyxin's cytoplasmic tail domain in collective tumor invasion. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-4911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
High expression of the single-pass transmembrane sialomucin, podocalyxin, has been shown by many groups to correlate with poor disease outcome in a number of solid tumor types, including colorectal, ovarian, pancreatic and breast cancers. We had previously identified that high podocalyxin expression in invasive ductal breast carcinoma was an independent indicator of poor survival (Somasiri et al., 2004, Cancer Res. 64:15). Further analysis of these tumor samples revealed that this decrease in survival occurred without the loss of membranous, junctional E-cadherin, suggesting that these tumors may have invaded collectively without necessitating an overt epithelial to mesenchymal transition (EMT). Experimentally, forced over-expression of podocalyxin in polarity-disrupted human MCF7 breast cancer cells drives the formation of invasive orthotopic xenograft tumors and elongated, cohesive, and E-Cadherin-expressing spheroids in three-dimensional (3D) culture as compared to control (Graves et al., 2016, Breast Canc. Res. 18:11). Further, treatment of these podocalyxin-overexpressing MCF7 cells with the myosin inhibitor, blebbistatin, and the small molecule inhibitor of ezrin-actin binding, NSC668394, resulted in decreased collective invasion and migration, respectively. Together these data suggest that podocalyxin, through interactions with the actin cytoskeleton via its cytoplasmic tail binding partners, can facilitate increased collective epithelial tumor cell motility, at least in some contexts. To test this hypothesis, we generated podocalyxin null MCF7 clones and cell populations using CRISPR-Cas9 genome editing and reconstituted these cells with mutant forms of podocalyxin that are unable to interact with the scaffolding proteins NHERF and/or ezrin and hence with the actin cytoskeleton. Preliminary results from 3D culture and live imaging of these mutant podocalyxin-expressing cells suggests that loss of podocalyxin's cytoplasmic tail results in decreased spheroid invasion that may be a result of deficiencies in actomyosin contractility. Hence, increased expression and mislocalization of podocalyxin may facilitate aberrant interactions with the actin cytoskeleton and contractile machinery, driving enhanced cell motility and, in certain tumor microenvironments, promote collective tumor invasion.
Citation Format: Erin M. Bell, Marcia L. Graves, Pamela Dean, Kelly M. McNagny, Calvin D. Roskelley. Characterizing the role of podocalyxin's cytoplasmic tail domain in collective tumor invasion [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4911.
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Affiliation(s)
- Erin M. Bell
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Marcia L. Graves
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Pamela Dean
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly M. McNagny
- University of British Columbia, Vancouver, British Columbia, Canada
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13
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Arif AA, Freeman SA, Atif J, Dean P, Gilmour M, Blanchet MR, Wiegand K, McNagny KM, Underhill M, Gold M, Johnson P, Roskelley CD. Abstract 978: Monocyte-derived macrophages contribute to the inflammation-induced survival of experimental micrometastases in the lung. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Circulating tumor cells become fully metastatic if they are able to extravasate from the microvasculature and move into microenvironmental niches that facilitate their survival within distant site organs. To determine if inflammation promotes this process in the lungs, inflammatory asthma, hypersensitivity pneumonitis, or bleomycin-induced injury were initiated prior to the intravenous introduction of low malignant potential B16F0 melanoma cells. All three conditions increased end-stage metastatic burden without increasing the initial tumor cell extravasation from the lung microvasculature. There was, however, an increase in the number and size of early micrometastatic lesions within the lung interstitia that were visible 96 hr after melanoma cell introduction. There was also an increase in tumor cell survival within these early lesions located in the inflamed lungs that was associated with the presence of nearby newly recruited CD11c+CD11b+ monocyte-derived macrophages (MoDM). Adoptive transfer experiments indicated that these MoDM cells facilitated B16F0 cell metastasis in the absence of inflammation. Additionally, a factor, or factors, secreted by MoDM promoted B16F0 cell survival under stress-inducing condition. Taken together, these findings demonstrate that inflammation-induced monocyte-derived macrophages act as a modifier of the post-extravasation microenvironment that appears to facilitate the early emergence of distant site metastasis.
Citation Format: Arif A. Arif, Spencer A. Freeman, Jawairia Atif, Pamela Dean, Megan Gilmour, Marie-Renee Blanchet, Kimberly Wiegand, Kelly M. McNagny, Michael Underhill, Michael Gold, Pauline Johnson, Calvin D. Roskelley. Monocyte-derived macrophages contribute to the inflammation-induced survival of experimental micrometastases in the lung [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 978.
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Affiliation(s)
- Arif A. Arif
- 1University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Pamela Dean
- 1University of British Columbia, Vancouver, British Columbia, Canada
| | - Megan Gilmour
- 1University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Kimberly Wiegand
- 1University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly M. McNagny
- 1University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Underhill
- 1University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Gold
- 1University of British Columbia, Vancouver, British Columbia, Canada
| | - Pauline Johnson
- 1University of British Columbia, Vancouver, British Columbia, Canada
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14
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McGrath BA, Ashby N, Birchall M, Dean P, Doherty C, Ferguson K, Gimblett J, Grocott M, Jacob T, Kerawala C, Macnaughton P, Magennis P, Moonesinghe R, Twose P, Wallace S, Higgs A. Multidisciplinary guidance for safe tracheostomy care during the COVID-19 pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP). Anaesthesia 2020; 75:1659-1670. [PMID: 32396986 PMCID: PMC7272992 DOI: 10.1111/anae.15120] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2020] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic is causing a significant increase in the number of patients requiring relatively prolonged invasive mechanical ventilation and an associated surge in patients who need a tracheostomy to facilitate weaning from respiratory support. In parallel, there has been a global increase in guidance from professional bodies representing staff who care for patients with tracheostomies at different points in their acute hospital journey, rehabilitation and recovery. Of concern are the risks to healthcare staff of infection arising from tracheostomy insertion and caring for patients with a tracheostomy. Hospitals are also facing extraordinary demands on critical care services such that many patients who require a tracheostomy will be managed outside established intensive care or head and neck units and cared for by staff with little tracheostomy experience. These concerns led NHS England and NHS Improvement to expedite the National Patient Safety Improvement Programme's 'Safe Tracheostomy Care' workstream as part of the NHS COVID-19 response. Supporting this workstream, UK stakeholder organisations involved in tracheostomy care were invited to develop consensus guidance based on: expert opinion; the best available published literature; and existing multidisciplinary guidelines. Topics with direct relevance for frontline staff were identified. This consensus guidance includes: infectivity of patients with respect to tracheostomy indications and timing; aerosol-generating procedures and risks to staff; insertion procedures; and management following tracheostomy.
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Affiliation(s)
- B A McGrath
- Department of Intensive Care Medicine, Wythenshawe Hospital, Manchester University Hospital NHS Foundation Trust, National Tracheostomy Safety Project, Manchester, UK
| | - N Ashby
- Royal College of Nursing, University of Nottingham, Nottingham, UK
| | - M Birchall
- British Laryngological Association, University College London, London, UK
| | - P Dean
- Intensive Care Society, Royal Blackburn Teaching Hospital, Lancashire, UK
| | - C Doherty
- Royal Manchester Children's Hospital, National Tracheostomy Safety Project Paediatric Lead, Manchester University NHS Foundation Trust, Manchester, UK
| | - K Ferguson
- Aberdeen Royal Infirmary, Association of Anaesthetists, Aberdeen, UK
| | | | - M Grocott
- Anaesthesia and Critical Care, Royal College of Anaesthetists, University of Southampton, Southampton, UK
| | - T Jacob
- ENT & Head and Neck surgeon, Lewisham & Greenwich NHS Trust, ENT-UKt, London, UK
| | - C Kerawala
- Maxillofacial & Head and Neck Surgeon, The Royal Marsden Hospital, British Association of Head & Neck Oncologists, London, UK
| | - P Macnaughton
- Intensive Care Medicine at Derriford Hospital, Faculty of Intensive Care Medicine, Plymouth, UK
| | - P Magennis
- Oral and Maxillofacial Surgeon, Aintree University Hospital, NHS Foundation Trust, British Association of Oral and Maxillofacial Surgeons, Liverpool, UK
| | - R Moonesinghe
- Anaesthetics and Critical Care Medicine, NHS England & NHS Improvement, University College London Hospitals, London, UK
| | - P Twose
- Association of Chartered Physiotherapists in Respiratory Care, Cardiff and Vale University Health Board, Cardiff, UK
| | - S Wallace
- Speech & Language Therapist, Royal College of Speech & Language Therapists, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Higgs
- Anaesthesia & Intensive Care Medicine, Warrington & Halton Teaching Hospitals NHS Foundation Trust, Difficult Airway Society, Warrington, UK
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15
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Chao JT, Hollman R, Meyers WM, Meili F, Matreyek KA, Dean P, Fowler DM, Haas K, Roskelley CD, Loewen CJR. A Premalignant Cell-Based Model for Functionalization and Classification of PTEN Variants. Cancer Res 2020; 80:2775-2789. [PMID: 32366478 DOI: 10.1158/0008-5472.can-19-3278] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/16/2019] [Accepted: 04/23/2020] [Indexed: 11/16/2022]
Abstract
As sequencing becomes more economical, we are identifying sequence variations in the population faster than ever. For disease-associated genes, it is imperative that we differentiate a sequence variant as either benign or pathogenic, such that the appropriate therapeutic interventions or surveillance can be implemented. PTEN is a frequently mutated tumor suppressor that has been linked to the PTEN hamartoma tumor syndrome. Although the domain structure of PTEN and the functional impact of a number of its most common tumor-linked mutations have been characterized, there is a lack of information about many recently identified clinical variants. To address this challenge, we developed a cell-based assay that utilizes a premalignant phenotype of normal mammary epithelial cells lacking PTEN. We measured the ability of PTEN variants to rescue the spheroid formation phenotype of PTEN-/- MCF10A cells maintained in suspension. As proof of concept, we functionalized 47 missense variants using this assay, only 19 of which have clear classifications in ClinVar. We utilized a machine learning model trained with annotated genotypic data to classify variants as benign or pathogenic based on our functional scores. Our model predicted with high accuracy that loss of PTEN function was indicative of pathogenicity. We also determined that the pathogenicity of certain variants may have arisen from reduced stability of the protein product. Overall, this assay outperformed computational predictions, was scalable, and had a short run time, serving as an ideal alternative for annotating the clinical significance of cancer-associated PTEN variants. SIGNIFICANCE: Combined three-dimensional tumor spheroid modeling and machine learning classifies PTEN missense variants, over 70% of which are currently listed as variants of uncertain significance. GRAPHICAL ABSTRACT: http://cancerres.aacrjournals.org/content/canres/80/13/2775/F1.large.jpg.
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Affiliation(s)
- Jesse T Chao
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, Canada
| | - Rocio Hollman
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, Canada
| | - Warren M Meyers
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, Canada
| | - Fabian Meili
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, Canada
| | - Kenneth A Matreyek
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Pamela Dean
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, Canada
| | - Douglas M Fowler
- Department of Genome Sciences, University of Washington, Seattle, Washington.,Department of Bioengineering, University of Washington, Seattle, Washington
| | - Kurt Haas
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, Canada
| | - Calvin D Roskelley
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, Canada
| | - Christopher J R Loewen
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, Canada.
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16
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Kundu I, Freeman JR, Dean P, Li LH, Linfield EH, Davies AG. Terahertz photonic integrated circuit for frequency tuning and power modulation. Opt Express 2020; 28:4374-4386. [PMID: 32121675 DOI: 10.1364/oe.380656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/10/2020] [Indexed: 06/10/2023]
Abstract
The quantum cascade laser is a powerful solid-state source of terahertz-frequency radiation. However, integrating multiple photonic functions into a monolithic platform in this frequency range is non-trivial due to the scaling of photonic structures for the long terahertz wavelengths and the low frequency tuning coefficients of the quantum cascade lasers. Here, we have designed a simple terahertz-frequency photonic integrated circuit by coupling a racetrack resonator with a ridge laser in the longitudinal direction to design a notch filter. The transmission properties of this filter structure are dependent on the phase matching and losses in the coupled racetrack and results in a comb of stopband frequencies. We have optimized the comb separation by carefully selecting the cavity dimensions of the racetrack resonator to suppress longitudinal modes in the ridge laser enabling single-mode emission. The emission frequencies and output power from laser are controlled through appropriate control of drive currents to the ridge and the racetrack resonator. The emission frequency is electrically tuned over ∼81 GHz exploiting Stark shift of the gain as a function of drive current at the ridge laser, coinciding with an output power variation of ∼27% of the peak power (at a heat sink temperature of 50 K). The output power from the ridge also varied by ∼30% and the frequency was tuned by a further 10 GHz when the driving conditions at the ridge laser are invariant and the current at the racetrack resonator was varied. To our best knowledge, this is the first report of a frequency engineering, tuning and power modulation of terahertz-frequency quantum cascade lasers using a photonic integrated circuit.
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17
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Meng K, Park SJ, Burnett AD, Gill T, Wood CD, Rosamond M, Li LH, Chen L, Bacon DR, Freeman JR, Dean P, Ahn YH, Linfield EH, Davies AG, Cunningham JE. Increasing the sensitivity of terahertz split ring resonator metamaterials for dielectric sensing by localized substrate etching. Opt Express 2019; 27:23164-23172. [PMID: 31510599 DOI: 10.1364/oe.27.023164] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/11/2019] [Indexed: 05/18/2023]
Abstract
We demonstrate a significant enhancement in the sensitivity of split ring resonator terahertz metamaterial dielectric sensors by the introduction of etched trenches into their inductive-capacitive gap area, both through finite element simulations and in experiments performed using terahertz time-domain spectroscopy. The enhanced sensitivity is demonstrated by observation of an increased frequency shift in response to overlaid dielectric material of thicknesses up to 18 µm deposited on to the sensor surface. We show that sensitivity to the dielectric is enhanced by a factor of up to ∼2.7 times by the incorporation of locally etched trenches with a depth of ∼3.4 µm, for example, and discuss the effect of the etching on the electrical properties of the sensors. Our experimental findings are in good agreement with simulations of the sensors obtained using finite element methods.
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18
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Keeley J, Bertling K, Rubino PL, Lim YL, Taimre T, Qi X, Kundu I, Li LH, Indjin D, Rakić AD, Linfield EH, Davies AG, Cunningham J, Dean P. Detection sensitivity of laser feedback interferometry using a terahertz quantum cascade laser. Opt Lett 2019; 44:3314-3317. [PMID: 31259948 DOI: 10.1364/ol.44.003314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 05/08/2019] [Indexed: 06/09/2023]
Abstract
We report on the high detection sensitivity of a laser feedback interferometry scheme based on a terahertz frequency quantum cascade laser (QCL). We show that variations on the laser voltage induced by optical feedback to the laser can be resolved with the reinjection of powers as low as ∼-125 dB of the emitted power. Our measurements demonstrate a noise equivalent power of ∼1.4 pW/√Hz, although, after accounting for the reinjection losses, we estimate that this corresponds to only ∼1 fW/√Hz being coupled to the QCL active region.
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Han YJ, Partington J, Chhantyal-Pun R, Henry M, Auriacombe O, Rawlings T, Li LH, Keeley J, Oldfield M, Brewster N, Dong R, Dean P, Davies AG, Ellison BN, Linfield EH, Valavanis A. Gas spectroscopy through multimode self-mixing in a double-metal terahertz quantum cascade laser. Opt Lett 2018; 43:5933-5936. [PMID: 30547973 DOI: 10.1364/ol.43.005933] [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] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 10/10/2018] [Indexed: 06/09/2023]
Abstract
A multimode self-mixing terahertz-frequency gas absorption spectroscopy is demonstrated based on a quantum cascade laser. A double-metal device configuration is used to expand the laser's frequency tuning range, and a precision-micromachined external waveguide module is used to enhance the optical feedback. Methanol spectra are measured using two laser modes at 3.362 and 3.428 THz, simultaneously, with more than eight absorption peaks resolved over a 17 GHz bandwidth, which provide the noise-equivalent absorption sensitivity of 1.20×10-3 cm-1 Hz-1/2 and 2.08×10-3 cm-1 Hz-1/2, respectively. In contrast to all previous self-mixing spectroscopy, our multimode technique expands the sensing bandwidth and duty cycle significantly.
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Downie P, Honeychurch J, Dean P, Whittington R, Woodward G, Moore R, Day A, Bayly G, Williams M. Development of a multigene panel screening test for hypertriglyceridaemia using next generation sequencing. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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Han YJ, Li LH, Zhu J, Valavanis A, Freeman JR, Chen L, Rosamond M, Dean P, Davies AG, Linfield EH. Silver-based surface plasmon waveguide for terahertz quantum cascade lasers. Opt Express 2018; 26:3814-3827. [PMID: 29475360 DOI: 10.1364/oe.26.003814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 12/18/2017] [Indexed: 06/08/2023]
Abstract
Terahertz-frequency quantum cascade lasers (THz QCLs) based on ridge waveguides incorporating silver waveguide layers have been investigated theoretically and experimentally, and compared with traditional gold-based devices. The threshold gain associated with silver-, gold- and copper-based devices, and the effects of titanium adhesion layers and top contact layers, in both surface-plasmon and double-metal waveguide geometries, have been analysed. Our simulations show that silver-based waveguides yield lower losses for THz QCLs across all practical operating temperatures and frequencies. Experimentally, QCLs with silver-based surface-plasmon waveguides were found to exhibit higher operating temperatures and higher output powers compared to those with identical but gold-based waveguides. Specifically, for a three-well resonant phonon active region with a scaled oscillator strength of 0.43 and doping density of 6.83 × 1015 cm-3, an increase of 5 K in the maximum operating temperature and 40% increase in the output power were demonstrated. These effects were found to be dependent on the active region design, and greater improvements were observed for QCLs with a larger radiative diagonality. Our results indicate that silver-based waveguide structures could potentially enable THz QCLs to operate at high temperatures.
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22
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Dean P, Weiskrantz L, Cowey A. An Apparatus for the Automatic Presentation of Object Discriminations to Monkeys. Q J Exp Psychol (Hove) 2018. [DOI: 10.1080/14640747408400452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Object discriminations have traditionally been presented to monkeys by hand in the Wisconsin General Test Apparatus. This method is time-consuming and prone to various kinds of experimenter error. It has proved possible to administer object discriminations automatically by using a modification of the Gloster Saro VM 51 vending machine. This machine, which has space for up to 371 objects, moves them on trays by two electric motors, and the control circuits of these are adapted for external operation by relays and modular programming equipment. A series of simple object discriminations or a concurrent (serial) discrimination task can then be given by remote control. The objects are so treated that by touching either of them the animal completes a circuit, enabling the response to be recorded and appropriately reinforced. Learning in the apparatus seems to be about as efficient as in the Wisconsin General Test Apparatus.
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Affiliation(s)
- P. Dean
- Department of Experimental Psychology, South Parks Road, Waterloo, Oxford 0x1 3PS, England
| | - L. Weiskrantz
- Department of Experimental Psychology, South Parks Road, Waterloo, Oxford 0x1 3PS, England
| | - A. Cowey
- Department of Experimental Psychology, South Parks Road, Waterloo, Oxford 0x1 3PS, England
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Smith G, Chandler M, Locke DE, Fields J, Phatak V, Crook J, Hanna S, Lunde A, Morris M, Graff-Radford M, Hughes CA, Lepore S, Cuc A, Caselli M, Hurst D, Wethe J, Francone A, Eilertsen J, Lucas P, Hoffman Snyder C, Kuang L, Becker M, Dean P, Diehl N, Lofquist M, Vanderhook S, Myles D, Cochran D. Behavioral Interventions to Prevent or Delay Dementia: Protocol for a Randomized Comparative Effectiveness Study. JMIR Res Protoc 2017; 6:e223. [PMID: 29180344 PMCID: PMC5725623 DOI: 10.2196/resprot.8103] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 09/26/2017] [Accepted: 10/11/2017] [Indexed: 01/21/2023] Open
Abstract
Background Currently, people at risk for dementia and their caregivers are confronted with confusing choices about what behavioral interventions are most effective. Objective The objective of this study is to determine which empirically supported behavioral interventions most impact the outcomes highly valued by patients with mild cognitive impairment and their partners. Methods This protocol describes a comparative effectiveness trial targeting 300 participants with mild cognitive impairment and their study partners. The trial is being conducted at the Mayo Clinic campuses in Arizona, Florida, Minnesota, and the University of Washington in Seattle. The study examines the contribution of five behavioral interventions (yoga, memory compensation training, computerized cognitive training, support groups, and wellness education) on primary outcomes of participant and partner quality of life and self-efficacy. In this unique 10-day multicomponent intervention, groups of couples were randomized to have one of the five interventions withheld while receiving the other four. Although the longitudinal follow-up is still under way, enrollment results are available and reported. Results In total, 272 couples have been enrolled in the trial and follow-up visits continue. Outcomes will be assessed at the end-of-intervention and 6-, 12-, and 18-month follow-ups. We anticipate reporting on our primary and secondary outcomes across time points in the next 2 years. Conclusions This paper describes the protocol for a randomized comparative effectiveness study of behavioral interventions to prevent or delay dementia. We describe of the rationale, design, power analysis, and analysis plan. Also because enrollment is complete and we are in follow-up phases of the study, we have included enrollment data from the trial. Trial Registration ClinicalTrials.gov NCT02265757; http://clinicaltrials.gov/ctsshow/ NCT02265757 (Archived by WebCite at http://www.webcitation.org/6ueRfwSYv)
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Affiliation(s)
- Glenn Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Melanie Chandler
- Department of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Dona Ec Locke
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Julie Fields
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, United States
| | - Vaishali Phatak
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States
| | - Julia Crook
- Department of Health Sciences Research, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Sherrie Hanna
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, United States
| | - Angela Lunde
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, United States
| | - Miranda Morris
- Department of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Michelle Graff-Radford
- Department of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Christine A Hughes
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, United States
| | - Susan Lepore
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, MN, United States
| | - Andrea Cuc
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Maria Caselli
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Duane Hurst
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Jennifer Wethe
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Andrea Francone
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Jeanne Eilertsen
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Pauline Lucas
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | | | - LeeAnn Kuang
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | | | | | - Nancy Diehl
- Department of Health Sciences Research, Mayo Clinic Florida, Jacksonville, FL, United States
| | - Marvin Lofquist
- Patient and Partner Advisory Group, Minneapolis, MN, United States
| | | | - Diana Myles
- Patient and Partner Advisory Group, Davis, CA, United States
| | - Denise Cochran
- Patient and Partner Advisory Group, Minneapolis, MN, United States
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Watson E, Honeychurch J, Hills A, Dean P, Yarram-Smith L, Woodward G, Wadsley M, Moore R, Humphries S, Bayly G, Williams M. Genetic testing for Familial Hypercholesterolaemia in the genomic era. The utility of an NGS test for monogenic and polygenic hypercholesterolaemia. ATHEROSCLEROSIS SUPP 2017. [DOI: 10.1016/j.atherosclerosissup.2017.08.007] [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: 11/26/2022]
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Dent C, Hills A, Honeychurch J, Watson E, Dean P, Woodward G, Wadsley M, Davies J, Yarram-Smith L, Humphries S, Leigh S, Haralambos K, Bayly G, Williams M. Standardising genetic variant classification for FH – application of the ACMG guidelines. ATHEROSCLEROSIS SUPP 2017. [DOI: 10.1016/j.atherosclerosissup.2017.08.012] [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: 11/17/2022]
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Glass DC, Mazhar M, Xiang S, Dean P, Simpson P, Priestly B, Plebanski M, Abramson M, Sim MR, Dennekamp M. Immunological effects among workers who handle engineered nanoparticles. Occup Environ Med 2017; 74:868-876. [DOI: 10.1136/oemed-2016-104111] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 01/17/2023]
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Han YJ, Li LH, Grier A, Chen L, Valavanis A, Zhu J, Freeman JR, Isac N, Colombelli R, Dean P, Davies AG, Linfield EH. Extraction-controlled terahertz frequency quantum cascade lasers with a diagonal LO-phonon extraction and injection stage. Opt Express 2016; 24:28583-28593. [PMID: 27958502 DOI: 10.1364/oe.24.028583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We report an extraction-controlled terahertz (THz)-frequency quantum cascade laser design in which a diagonal LO-phonon scattering process is used to achieve efficient current injection into the upper laser level of each period and simultaneously extract electrons from the adjacent period. The effects of the diagonality of the radiative transition are investigated, and a design with a scaled oscillator strength of 0.45 is shown experimentally to provide the highest temperature performance. A 3.3 THz device processed into a double-metal waveguide configuration operated up to 123 K in pulsed mode, with a threshold current density of 1.3 kA/cm2 at 10 K. The QCL structures are modeled using an extended density matrix approach, and the large threshold current is attributed to parasitic current paths associated with the upper laser levels. The simplicity of this design makes it an ideal platform to investigate the scattering injection process.
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Mathew MD, Mathew ND, Miller A, Simpson M, Au V, Garland S, Gestin M, Edgley ML, Flibotte S, Balgi A, Chiang J, Giaever G, Dean P, Tung A, Roberge M, Roskelley C, Forge T, Nislow C, Moerman D. Using C. elegans Forward and Reverse Genetics to Identify New Compounds with Anthelmintic Activity. PLoS Negl Trop Dis 2016; 10:e0005058. [PMID: 27755544 PMCID: PMC5068747 DOI: 10.1371/journal.pntd.0005058] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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: 02/23/2016] [Accepted: 09/20/2016] [Indexed: 12/03/2022] Open
Abstract
Background The lack of new anthelmintic agents is of growing concern because it affects human health and our food supply, as both livestock and plants are affected. Two principal factors contribute to this problem. First, nematode resistance to anthelmintic drugs is increasing worldwide and second, many effective nematicides pose environmental hazards. In this paper we address this problem by deploying a high throughput screening platform for anthelmintic drug discovery using the nematode Caenorhabditis elegans as a surrogate for infectious nematodes. This method offers the possibility of identifying new anthelmintics in a cost-effective and timely manner. Methods/Principal findings Using our high throughput screening platform we have identified 14 new potential anthelmintics by screening more than 26,000 compounds from the Chembridge and Maybridge chemical libraries. Using phylogenetic profiling we identified a subset of the 14 compounds as potential anthelmintics based on the relative sensitivity of C. elegans when compared to yeast and mammalian cells in culture. We showed that a subset of these compounds might employ mechanisms distinct from currently used anthelmintics by testing diverse drug resistant strains of C. elegans. One of these newly identified compounds targets mitochondrial complex II, and we used structural analysis of the target to suggest how differential binding of this compound may account for its different effects in nematodes versus mammalian cells. Conclusions/Significance The challenge of anthelmintic drug discovery is exacerbated by several factors; including, 1) the biochemical similarity between host and parasite genomes, 2) the geographic location of parasitic nematodes and 3) the rapid development of resistance. Accordingly, an approach that can screen large compound collections rapidly is required. C. elegans as a surrogate parasite offers the ability to screen compounds rapidly and, equally importantly, with specificity, thus reducing the potential toxicity of these compounds to the host and the environment. We believe this approach will help to replenish the pipeline of potential nematicides. With over two billion people infected and many billions of dollars of lost crops annually, nematode infections are a serious problem for human health and for agricultural production. While there are drugs to treat infections, many pockets of parasites have been identified worldwide that are developing immunity to the standard treatment regimen. In this study we describe a strategy using the model organism C. elegans as a surrogate parasite to identify several new chemical compounds that may offer additional treatments for infection. We demonstrate how to use our platform to identify compounds that are specific in their effect to nematodes and are not simply biocides. We also show through genetic and molecular analysis in this organism that we can quickly identify the mode of action of any new compound. Most critically, we show that a compound first identified in a free-living nematode, Caenorhabditis elegans, is also effective on a parasitic nematode, Meloidogyne hapla. With this result and considering the level of sequence conservation across much of the nematode phyla we believe our strategy can be more widely applied to find new anthelmintics.
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Affiliation(s)
- Mark D. Mathew
- Department of Zoology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Neal D. Mathew
- Department of Zoology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Angela Miller
- Department of Zoology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mike Simpson
- Department of Zoology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vinci Au
- Department of Zoology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephanie Garland
- Department of Zoology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Mark L. Edgley
- Department of Zoology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephane Flibotte
- Department of Zoology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Aruna Balgi
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Chiang
- Department of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Guri Giaever
- Department of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Pamela Dean
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Audrey Tung
- Summerland Research and Development Centre, Agriculture and Agri-Food Canada, Summerland, British Columbia, Canada
| | - Michel Roberge
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Calvin Roskelley
- Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tom Forge
- Summerland Research and Development Centre, Agriculture and Agri-Food Canada, Summerland, British Columbia, Canada
| | - Corey Nislow
- Department of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Donald Moerman
- Department of Zoology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
- * E-mail:
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Honeychurch J, Hills A, Dean P, Greenslade M, Buxton C, Woodward G, Dennis G, Bayley G, Gritzmacher L, Haralambos K, Williams M. Modernising workflows for high throughput testing for Familial Hypercholesterolaemia: How to deliver a cost effective genetic testing service. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2015.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Guettier S, Cogez J, Bonnet A, Dean P, Apoil M, Tchoumi T, Dubuc L, Arzur J, Sayette V, Kouassi L, Viader F, Touzé E. Factors associated with timing of early neurological improvement after thrombolysis for ischaemic stroke. Eur J Neurol 2016; 23:664-7. [DOI: 10.1111/ene.12943] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 11/13/2015] [Indexed: 11/26/2022]
Affiliation(s)
- S. Guettier
- Department of Neurology CHU Côte de Nacre Université Caen‐Normandie CaenFrance
| | - J. Cogez
- Department of Neurology CHU Côte de Nacre Université Caen‐Normandie CaenFrance
| | - A.‐L. Bonnet
- Department of Neurology CHU Côte de Nacre Université Caen‐Normandie CaenFrance
| | - P. Dean
- Neuroradiology CHU Côte de Nacre Université Caen‐Normandie CaenFrance
| | - M. Apoil
- Department of Neurology CHU Côte de Nacre Université Caen‐Normandie CaenFrance
| | | | | | | | - V. Sayette
- Department of Neurology CHU Côte de Nacre Université Caen‐Normandie CaenFrance
| | - L.‐K. Kouassi
- Department of Neurology CHU Côte de Nacre Université Caen‐Normandie CaenFrance
| | - F. Viader
- Department of Neurology CHU Côte de Nacre Université Caen‐Normandie CaenFrance
| | - E. Touzé
- Department of Neurology CHU Côte de Nacre Université Caen‐Normandie CaenFrance
- Inserm U919 Université Caen‐Normandie Caen France
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Keeley J, Dean P, Valavanis A, Bertling K, Lim YL, Alhathlool R, Taimre T, Li LH, Indjin D, Rakić AD, Linfield EH, Davies AG. Three-dimensional terahertz imaging using swept-frequency feedback interferometry with a quantum cascade laser. Opt Lett 2015; 40:994-997. [PMID: 25768165 DOI: 10.1364/ol.40.000994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We demonstrate coherent three-dimensional terahertz imaging by frequency modulation of a quantum cascade laser in a compact and experimentally simple self-mixing scheme. Through this approach, we can realize significantly faster acquisition rates compared to previous schemes employing longitudinal mechanical scanning of a sample. We achieve a depth resolution of better than 0.1 μm with a power noise spectral density below -50 dB/Hz, for a sampling time of 10 ms/pixel.
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Dean P, Keeley J, Valavanis A, Bertling K, Lim YL, Taimre T, Alhathlool R, Li LH, Indjin D, Rakić AD, Linfield EH, Davies AG. Active phase-nulling of the self-mixing phase in a terahertz frequency quantum cascade laser. Opt Lett 2015; 40:950-953. [PMID: 25768154 DOI: 10.1364/ol.40.000950] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We demonstrate an active phase-nulling scheme for terahertz (THz) frequency quantum cascade lasers (QCLs) under optical feedback, by active electronic feedback control of the emission frequency. Using this scheme, the frequency tuning rate of a THz QCL is characterized, with significantly reduced experimental complexity compared to alternative approaches. Furthermore, we demonstrate real-time displacement sensing of targets, overcoming the resolution limits imposed by quantization in previously implemented fringe-counting methods. Our approach is readily applicable to high-frequency vibrometry and surface profiling of targets, as well as frequency-stabilization schemes for THz QCLs.
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Yarram-Smith L, Dean P, O'Shea S, Dennis G, Bayly G, Taylor A, Day A, Watson M, Giles P, Ayling R, Haralambos K, Whatley S, McDowell I, Williams M. The impact of routine next generation sequencing testing for familial hypercholesterolaemia – 5 months service experience. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lui HS, Taimre T, Bertling K, Lim YL, Dean P, Khanna SP, Lachab M, Valavanis A, Indjin D, Linfield EH, Davies AG, Rakić AD. Terahertz inverse synthetic aperture radar imaging using self-mixing interferometry with a quantum cascade laser. Opt Lett 2014; 39:2629-2632. [PMID: 24784063 DOI: 10.1364/ol.39.002629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We propose a terahertz (THz)-frequency synthetic aperture radar imaging technique based on self-mixing (SM) interferometry, using a quantum cascade laser. A signal processing method is employed which extracts and exploits the radar-related information contained in the SM signals, enabling the creation of THz images with improved spatial resolution. We demonstrate this by imaging a standard resolution test target, achieving resolution beyond the diffraction limit.
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Haralambos K, Whatley S, Datta B, Townsend D, Gingell R, Edwards R, Lansberg P, Graham C, Palacios L, Dean P, McDowell I. Familial hypercholesterolaemia (FH) in Wales is genetically heterogeneous. Atherosclerosis 2013. [DOI: 10.1016/j.atherosclerosis.2013.07.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Abstract Saccadic accuracy requires that the control signal sent to the motor neurons must be the right size to bring the fovea to the target, whatever the initial position of the eyes (and corresponding state of the eye muscles). Clinical and experimental evidence indicates that the basic machinery for generating saccadic eye movements, located in the brainstem, is not accurate: learning to make accurate saccades requires cerebellar circuitry located in the posterior vermis and fastigial nucleus. How do these two circuits interact to achieve adaptive control of saccades? A model of this interaction is described, based on Kawato's principle of feedback-error-learning. Its three components were (1) a simple controller with no knowledge of initial eye position, corresponding to the superior colliculus; (2) Robinson's internal feedback model of the saccadic burst generator, corresponding to preoculomotor areas in the brain-stem; and (3) Albus's Cerebellar Model Arithmetic Computer (CMK), a neural net model of the cerebellum. The connections between these components were (I) the simple feedback controller passed a (usually inaccurate) command to the pulse generator, and (2) a copy of this command to the CMAC; (3) the CMAC combined the copy with information about initial eye position to (4) alter the gain on the pulse generator's internal feedback loop, thereby adjusting the size of burst sent to the motor neurons. (5) If the saccade were inaccurate, an error signal from the feedback controller adjusted the weights in the CMAC. It was proposed that connection (2) corresponds to the mossy fiber projection from superior colliculus to oculomotor vermis via the nucleus reticularis tegmenti pontis, and connection (5) to the climbing fiber projection from superior colliculus to the oculomotor vermis via the inferior olive. Plausible initialization values were chosen so that the system produced hypometric saccades (as do human infants) at the start of learning, and position-dependent hypermetric saccades when the cerebellum was removed. Simulations for horizontal eye movements showed that accurate saccades from any starting position could be learned rapidly, even if the error signal conveyed only whether the initial saccade were too large or too small. In subsequent tests the model adapted realistically both to simulated weakening of the eye muscles, and to intrasaccadic displacement of the target, thereby mimicking saccadic plasticity in adults. The architecture of the model may therefore offer a functional explanation of hitherto mysterious tectocerebellar projections, and a framework for investigating in greater detail how the cerebellum adaptively controls saccadic accuracy.
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Adams M, Dean P, MacDowall K, Stenhouse P, Mackay A. Admission to the ICU overnight: is it really a bad thing? Crit Care 2013. [PMCID: PMC3643176 DOI: 10.1186/cc12458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Dean P, Docking R, Govenden D, Davidson A, Mackay A. Hyponatremia and intensive care outcome. Crit Care 2013. [PMCID: PMC3643017 DOI: 10.1186/cc12381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Dong M, Parsaik AK, Kremers W, Sun A, Dean P, Prieto M, Cosio FG, Gandhi MJ, Zhang L, Smyrk TC, Stegall MD, Kudva YC. Acute pancreas allograft rejection is associated with increased risk of graft failure in pancreas transplantation. Am J Transplant 2013; 13:1019-1025. [PMID: 23432918 DOI: 10.1111/ajt.12167] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 12/18/2012] [Accepted: 12/26/2012] [Indexed: 01/25/2023]
Abstract
The effect of acute allograft rejection (AR) on long-term pancreas allograft function is unclear. We retrospectively studied 227 consecutive pancreas transplants performed at our institution between January 1, 998 and December 31, 2009 including: 56 simultaneous pancreas and kidney (SPK), 69 pancreas transplantation alone (PTA); and 102 pancreas after kidney (PAK) transplants. With a median follow-up of 6.1 (IQR 3-9) years, 57 patients developed 79 episodes of AR, and 19 experienced more than one episode. The cumulative incidence for AR was 14.7%, 19.7%, 26.6% and 29.1% at 1, 2, 5 and 10 years. PTA transplant (hazards ratio [HR]=2.28, p=0.001) and donor age (per 10 years) (HR=1.34, p=0.006) were associated with higher risk for AR. The first AR episode after 3 months post PT was associated with increased risk for complete loss (CL) (HR 3.79, p<0.001), and the first AR episode occurring during 3- to 12-month and 12- to 24-month periods after PT were associated with significantly increased risk for at least partial loss (PL) (HR 2.84, p=0.014; and HR 6.25, p<0.001, respectively). We conclude that AR is associated with increased risk for CL and at least PL. The time that the first AR is observed may influence subsequent graft failure.
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Affiliation(s)
- M Dong
- Division of Endocrinology, Diabetes, Nutrition, and Metabolism, Department of Internal Medicine, Mayo Clinic, Rochester, MN.,Department of Endocrinology and Metabolism, Qilu Hospital of Shandong University, Jinan, Shandong, P. R. China
| | - A K Parsaik
- Division of Endocrinology, Diabetes, Nutrition, and Metabolism, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - W Kremers
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - A Sun
- Division of Endocrinology, Diabetes, Nutrition, and Metabolism, Department of Internal Medicine, Mayo Clinic, Rochester, MN.,Department of Endocrinology and Metabolism, Zibo First People's Hospital, Zibo, Shandong, P. R. China
| | - P Dean
- Division of Transplantation Surgery, Department of Surgery
| | - M Prieto
- Division of Transplantation Surgery, Department of Surgery
| | - F G Cosio
- Division of Nephrology and Hypertension, Department of Internal Medicine
| | - M J Gandhi
- Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology
| | - L Zhang
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - T C Smyrk
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - M D Stegall
- Division of Transplantation Surgery, Department of Surgery
| | - Y C Kudva
- Division of Endocrinology, Diabetes, Nutrition, and Metabolism, Department of Internal Medicine, Mayo Clinic, Rochester, MN
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Dean P, Hughes M, Kinsella J. Don't forget high flow nasal oxygen delivery for emergency oxygen. BMJ 2013; 346:f28. [PMID: 23300033 DOI: 10.1136/bmj.f28] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dean P, Smith G, Parisi J, Dickson D, Petersen R, Josephs K. Neurocognitive Phenotypes across Frontotemporal Lobar Degeneration TDP-43 Subtypes (P05.067). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.067] [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: 11/15/2022] Open
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Machulda M, Whitwell J, Dean P, Micklewright J, Duffy J, Strand E, Josephs K. Neuropsychological Correlates of Parietal Atrophy in Logopenic Progressive Aphasia (P02.029). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p02.029] [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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Maysonnave J, Jukam N, Ibrahim MSM, Maussang K, Madéo J, Cavalié P, Dean P, Khanna SP, Steenson DP, Linfield EH, Davies AG, Tignon J, Dhillon SS. Integrated injection seeded terahertz source and amplifier for time-domain spectroscopy. Opt Lett 2012; 37:731-733. [PMID: 22344163 DOI: 10.1364/ol.37.000731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We used a terahertz (THz) quantum cascade laser (QCL) as an integrated injection seeded source and amplifier for THz time-domain spectroscopy. A THz input pulse is generated inside a QCL by illuminating the laser facet with a near-IR pulse from a femtosecond laser and amplified using gain switching. The THz output from the QCL is found to saturate upon increasing the amplitude of the THz input power, which indicates that the QCL is operating in an injection seeded regime.
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Affiliation(s)
- J Maysonnave
- Laboratoire Pierre Aigrain, Ecole Normale Supérieure, CNRS (UMR 8551), Université Pierre et Marie Curie, Université D. Diderot, Paris, France
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Dean P, Burnett AD, Tych K, Khanna SP, Lachab M, Cunningham JE, Linfield EH, Davies AG. Measurement and analysis of the diffuse reflectance of powdered samples at terahertz frequencies using a quantum cascade laser. J Chem Phys 2011; 134:134304. [DOI: 10.1063/1.3575201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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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Shafer PO, Buelow J, Ficker DM, Pugh MJ, Kanner AM, Dean P, Levisohn P. Risk of adverse events on epilepsy monitoring units: a survey of epilepsy professionals. Epilepsy Behav 2011; 20:502-5. [PMID: 21306957 DOI: 10.1016/j.yebeh.2010.12.048] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 12/28/2010] [Accepted: 12/29/2010] [Indexed: 11/20/2022]
Abstract
In 2008 a workgroup of health care professionals from the American Epilepsy Society (AES) was convened to address the lack of consensus regarding patient care in epilepsy monitoring units (EMUs). The group developed a questionnaire designed to identify the extent to which selected adverse events occurred in EMUs, and it was sent via email to all members of the AES. We asked that only one representative from each center report. Seventy responses were received. The number of centers reporting the following adverse events included: falls by 69%, status epilepticus by 63%, and postictal psychosis by 54%. Infrequent events with serious consequences were also reported including pneumonia by 10%, cardiac arrest by 7%, fractures by 6%, and death by 3% (N=2). Of the 58 respondents who reported using intracranial electrodes, 37.9% (N=22) reported that patients pulled out or dislodged electrodes. This study highlights the need for EMUs to identify and address potential safety risks in their environment, patient population, and system of care.
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Affiliation(s)
- P O Shafer
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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Anderson SR, Pearson MJ, Pipe A, Prescott T, Dean P, Porrill J. Adaptive Cancelation of Self-Generated Sensory Signals in a Whisking Robot. IEEE T ROBOT 2010. [DOI: 10.1109/tro.2010.2069990] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Perry MS, Dunoyer C, Dean P, Bhatia S, Bavariya A, Ragheb J, Miller I, Resnick T, Jayakar P, Duchowny M. Predictors of seizure freedom after incomplete resection in children. Neurology 2010; 75:1448-53. [PMID: 20956789 DOI: 10.1212/wnl.0b013e3181f88114] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Incomplete resection of the epileptogenic zone (EZ) is the most important predictor of poor outcome after resective surgery for intractable epilepsy. We analyzed the contribution of preoperative and perioperative variables including MRI and EEG data as predictors of seizure-free (SF) outcome after incomplete resection. METHODS We retrospectively reviewed patients <18 years of age with incomplete resection for epilepsy with 2 years of follow-up. Fourteen preoperative and perioperative variables were compared in SF and non-SF (NSF) patients. We compared lesional patients, categorized by reason for incompleteness, to lesional patients with complete resection. We analyzed for effect of complete EEG resection on SF outcome in patients with incompletely resected MRI lesions and vice versa. RESULTS Eighty-three patients with incomplete resection were included with 41% becoming SF. Forty-eight lesional patients with complete resection were included. Thirty-eight percent (57/151) of patients with incomplete resection and 34% (47/138) with complete resection were excluded secondary to lack of follow-up or incomplete records. Contiguous MRI lesions were predictive of seizure freedom after incomplete resection. Fifty-seven percent of patients incomplete by MRI alone, 52% incomplete by EEG alone, and 24% incomplete by both became SF compared to 77% of patients with complete resection (p = 0.0005). CONCLUSIONS Complete resection of the MRI- and EEG-defined EZ is the best predictor of seizure freedom, though patients incomplete by EEG or MRI alone have better outcome compared to patients incomplete by both. More than one-third of patients with incomplete resection become SF, with contiguous MRI lesions a predictor of SF outcome.
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Affiliation(s)
- M S Perry
- Department of Neurology and Comprehensive Epilepsy Program, Brain Institute, Miami Children's Hospital, Miami, FL 33155, USA
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Affiliation(s)
- Pamela Dean
- Pamela Dean ST6 Anaesthetics and Critical Care Medicine, Intensive Care Unit, Glasgow Royal Infirmary
| | - Aileen Labram
- Aileen Labram Staff Nurse, Intensive Care Unit, Western Infirmary, Glasgow
| | - Lynn McCarroll
- Lynn McCarroll Staff Nurse, Intensive Care Unit, Western Infirmary, Glasgow
| | - Martin Hughes
- Martin Hughes Consultant Anaesthetics and Intensive Care Medicine, Intensive Care Unit, Glasgow Royal Infirmary
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