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Feldman C, Fredericks-Younger J, Desjardins P, Malmstrom H, Miloro M, Warburton G, Ward B, Ziccardi V, Fine D, Greenberg P, Andrews T, Matheson P, Lu SE. The Opioid Analgesic Reduction Study (OARS) Pilot: A Double-Blind Randomized Multicenter Trial. JDR Clin Trans Res 2024; 9:72-84. [PMID: 36680313 PMCID: PMC10850879 DOI: 10.1177/23800844221144031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND With addiction rates and opioid deaths increasing, health care providers are obligated to help stem the opioid crisis. As limited studies examine the comparative effectiveness of fixed-dose combination nonopioid analgesia to opioid-containing analgesia, a comparative effectiveness study was planned and refined by conducting a pilot study. METHODS The Opioid Analgesic Reduction Study (OARS) pilot, a stratified, randomized, multisite, double-blind clinical trial, was designed to test technology and procedures to be used in the full OARS trial. Participants engaged in the full protocol, enabling the collection of OARS outcome data. Eligible participants reporting to 1 of 5 sites for partial or full bony impacted mandibular third molar extraction were stratified by biologic sex and randomized to 1 of 2 treatment groups, OPIOID or NONOPIOID. OPIOID participants were provided 20 doses of hydrocodone 5 mg/acetaminophen 300 mg. NONOPIOID participants were provided 20 doses of ibuprofen 400 mg/acetaminophen 500 mg. OARS outcomes data, including pain experience, adverse effects, sleep quality, pain interference, overall satisfaction, and remaining opioid tablets available for diversion, were collected via surveys, electronic medication bottles, eDiary, and activity/sleep monitor. RESULTS Fifty-three participants were randomized with 50 completing the OARS pilot protocol. Across all outcome pain domains, in all but 1 time period, NONOPIOID was better in managing pain than OPIOID (P < 0.05 level). Other outcomes suggest less pain interference, less adverse events, better sleep quality, better overall satisfaction, and fewer opioid-containing tablets available for diversion. DISCUSSION Results suggest patients requiring impacted mandibular third molar extraction would benefit from fixed-dose combination nonopioid analgesia. KNOWLEDGE TRANSFER STATEMENT Study results suggest fixed-dose nonopioid combination ibuprofen 400 mg/acetaminophen 500 mg is superior to opioid-containing analgesic (hydrocodone 5 mg/acetaminophen 500 mg). This knowledge should inform surgeons and patients in the selection of postsurgical analgesia.
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Affiliation(s)
- C.A. Feldman
- School of Dental Medicine, Rutgers University, Newark, NJ, USA
- School of Public Health, Rutgers University, Newark, NJ, USA
| | | | - P.J. Desjardins
- School of Dental Medicine, Rutgers University, Newark, NJ, USA
| | - H. Malmstrom
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - M. Miloro
- College of Dentistry, University of Illinois, IL, USA
| | - G. Warburton
- School of Dentistry, University of Maryland, MD, USA
| | - B. Ward
- School of Dentistry, University of Michigan, MI, USA
| | - V. Ziccardi
- School of Dental Medicine, Rutgers University, Newark, NJ, USA
| | - D.H. Fine
- School of Dental Medicine, Rutgers University, Newark, NJ, USA
| | - P. Greenberg
- School of Public Health, Rutgers University, Newark, NJ, USA
| | - T. Andrews
- School of Public Health, Rutgers University, Newark, NJ, USA
| | - P.B. Matheson
- School of Dental Medicine, Rutgers University, Newark, NJ, USA
| | - S.-E. Lu
- School of Public Health, Rutgers University, Newark, NJ, USA
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Andrews T, Seravallic J, Powers R. The reversible low-temperature instability of human DJ-1 oxidative states. Biopolymers 2024; 115:e23534. [PMID: 36972340 PMCID: PMC10948107 DOI: 10.1002/bip.23534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/21/2023] [Accepted: 03/07/2023] [Indexed: 03/29/2023]
Abstract
DJ-1 is a homodimeric protein that is centrally involved in various human diseases including Parkinson disease (PD). DJ-1 protects against oxidative damage and mitochondrial dysfunction through a homeostatic control of reactive oxygen species (ROS). DJ-1 pathology results from a loss of function, where ROS readily oxidizes a highly conserved and functionally essential cysteine (C106). The over-oxidation of DJ-1 C106 leads to a dynamically destabilized and biologically inactivated protein. An analysis of the structural stability of DJ-1 as a function of oxidative state and temperature may provide further insights into the role the protein plays in PD progression. NMR spectroscopy, circular dichroism, analytical ultracentrifugation sedimentation equilibrium, and molecular dynamics simulations were utilized to investigate the structure and dynamics of the reduced, oxidized (C106-SO2 - ), and over-oxidized (C106-SO3 - ) forms of DJ-1 for temperatures ranging from 5°C to 37°C. The three oxidative states of DJ-1 exhibited distinct temperature-dependent structural changes. A cold-induced aggregation occurred for the three DJ-1 oxidative states by 5°C, where the over-oxidized state aggregated at significantly higher temperatures than both the oxidized and reduced forms. Only the oxidized and over-oxidized forms of DJ-1 exhibited a mix state containing both folded and partially denatured protein that likely preserved secondary structure content. The relative amount of this denatured form of DJ-1 increased as the temperature was lowered, consistent with a cold-denaturation. Notably, the cold-induced aggregation and denaturation for the DJ-1 oxidative states were completely reversible. The dramatic changes in the structural stability of DJ-1 as a function of oxidative state and temperature are relevant to its role in PD and its functional response to oxidative stress.
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Affiliation(s)
- Tessa Andrews
- Department of Chemistry, University of Nebraska-Lincoln, Lincoln NE 68588-0304, USA
| | - Javier Seravallic
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln NE 68588-0664, USA
| | - Robert Powers
- Department of Chemistry, University of Nebraska-Lincoln, Lincoln NE 68588-0304, USA
- Redox Biology Center, University of Nebraska-Lincoln, Lincoln, NE 68588-0664,USA
- Nebraska Center for Integrated Biomolecular Communication, University of Nebraska-Lincoln, Lincoln NE 68588-0304, USA
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Eijwoudt S, Andrews T, McErlain-Naylor SA, Stewart T, Spencer K. Internal and external workload in national and international netball competition. J Sports Sci 2023; 41:1573-1579. [PMID: 38078436 DOI: 10.1080/02640414.2023.2283661] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/08/2023] [Indexed: 12/18/2023]
Abstract
Differences in workload exist between netball playing positions and competition levels, but no research has compared workloads experienced by the same elite players during national and international competitions. This study collected internal (heart rate) and external (PlayerLoad·min-1) workload data per match quarter from 44 players during a national competition and 12 players during an international competition. Nine players played in both competitions. Linear mixed models compared percentage of match quarter in each heart rate zone and PlayerLoad·min-1 between competitions for each playing position. Workloads against low- and high-ranked international opponents were also compared. Internal workloads were greater in national compared to international competition for GD and WD positions. PlayerLoad·min-1 was significantly higher by 8-13% in the national competition for positions WD and C, and by 5-8% in the international competition for GD and GA. Positional differences may indicate a role of the team's tactical style of play. Workloads were generally greater against higher- rather than lower-ranked international opponents. These results indicate that tactical factors in combination with playing position and opposition characteristics should be considered when preparing physically for matches.
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Affiliation(s)
- S Eijwoudt
- Faculty of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T Andrews
- School of Sport and Recreation, Sport Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - S A McErlain-Naylor
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - T Stewart
- School of Sport and Recreation, Sport Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
- Human Potential Centre, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - K Spencer
- School of Sport and Recreation, Sport Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
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Martin A, Andrews T, Goldbart J, Landers M. Reconciling communication repertoires: navigating interactions involving persons with severe/profound intellectual disability, a classic grounded theory study. J Intellect Disabil Res 2022; 66:332-352. [PMID: 35194869 PMCID: PMC9305890 DOI: 10.1111/jir.12921] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND A rights-based agenda, informed by the UNCRPD, that advocates person-centredness, inclusion, empowerment and self-determination is shaping service provision to people with intellectual disability (ID). Listening to their perspectives is fundamental to meeting these goals. However, communication with people with severe/profound ID is challenging and difficult. Therefore, this study aims to generate a theory that explains how people communicate with and understand each other in these interactions. METHODS Classic grounded theory (CGT) methodology was used as it recognises that knowledge can be captured rather than interpreted. According to CGT, capturing rather than interpreting experiences strengthens findings, particularly in relation to participants with severe/profound ID. Concurrent theoretical sampling, data collection and analysis were undertaken. Twenty-two individuals participated in the study: 3 people with severe/profound ID and 19 people with whom they interact. Data were collected over a 9-month period and involved video recordings, field notes, individual and group interviews. Data were analysed using CGT methods of coding, constant comparison and memoing. RESULTS The Theory of Reconciling Communication Repertoires was generated. Nurturing a sense of belonging emerged as the main concern and core category that is resolved by reconciling communication repertoires. A communication repertoire refers to the cache of communication skills a person has available to them. To reconcile repertoires is to harmonise or make them compatible with each other in order to communicate. Interactions are navigated through five stages: motivation to interact, connection establishment, reciprocally engaging, navigating understanding and confusion resolution. CONCLUSIONS The Theory of Reconciling Communication Repertoires explains how interactions involving people with severe/profound ID are navigated. While this is a substantive rather than formal theory, it has the potential to inform practice, policy, management, education and research as it outlines how communication with people with severe/profound ID can take place to design, inform and plan person-centred care.
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Affiliation(s)
- A.‐M. Martin
- School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - T. Andrews
- School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - J. Goldbart
- Department of PsychologyManchester Metropolitan UniversityManchesterUK
| | - M. Landers
- School of Nursing and MidwiferyUniversity College CorkCorkIreland
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Sherwood SC, Webb MJ, Annan JD, Armour KC, Forster PM, Hargreaves JC, Hegerl G, Klein SA, Marvel KD, Rohling EJ, Watanabe M, Andrews T, Braconnot P, Bretherton CS, Foster GL, Hausfather Z, von der Heydt AS, Knutti R, Mauritsen T, Norris JR, Proistosescu C, Rugenstein M, Schmidt GA, Tokarska KB, Zelinka MD. An Assessment of Earth's Climate Sensitivity Using Multiple Lines of Evidence. Rev Geophys 2020; 58:e2019RG000678. [PMID: 33015673 PMCID: PMC7524012 DOI: 10.1029/2019rg000678] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 04/22/2020] [Accepted: 06/24/2020] [Indexed: 05/10/2023]
Abstract
We assess evidence relevant to Earth's equilibrium climate sensitivity per doubling of atmospheric CO2, characterized by an effective sensitivity S. This evidence includes feedback process understanding, the historical climate record, and the paleoclimate record. An S value lower than 2 K is difficult to reconcile with any of the three lines of evidence. The amount of cooling during the Last Glacial Maximum provides strong evidence against values of S greater than 4.5 K. Other lines of evidence in combination also show that this is relatively unlikely. We use a Bayesian approach to produce a probability density function (PDF) for S given all the evidence, including tests of robustness to difficult-to-quantify uncertainties and different priors. The 66% range is 2.6-3.9 K for our Baseline calculation and remains within 2.3-4.5 K under the robustness tests; corresponding 5-95% ranges are 2.3-4.7 K, bounded by 2.0-5.7 K (although such high-confidence ranges should be regarded more cautiously). This indicates a stronger constraint on S than reported in past assessments, by lifting the low end of the range. This narrowing occurs because the three lines of evidence agree and are judged to be largely independent and because of greater confidence in understanding feedback processes and in combining evidence. We identify promising avenues for further narrowing the range in S, in particular using comprehensive models and process understanding to address limitations in the traditional forcing-feedback paradigm for interpreting past changes.
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Affiliation(s)
- S C Sherwood
- Climate Change Research Centre and ARC Centre of Excellence for Climate Extremes University of New South Wales Sydney Sydney New South Wales Australia
| | - M J Webb
- Met Office Hadley Centre Exeter UK
| | | | | | - P M Forster
- Priestley International Centre for Climate University of Leeds Leeds UK
| | | | - G Hegerl
- School of Geosciences University of Edinburgh Edinburgh UK
| | | | - K D Marvel
- Department of Applied Physics and Applied Math Columbia University New York NY USA
- NASA Goddard Institute for Space Studies New York NY USA
| | - E J Rohling
- Research School of Earth Sciences Australian National University Canberra ACT Australia
- Ocean and Earth Science, National Oceanography Centre University of Southampton Southampton UK
| | - M Watanabe
- Atmosphere and Ocean Research Institute The University of Tokyo Tokyo Japan
| | | | - P Braconnot
- Laboratoire des Sciences du Climat et de l'Environnement, unité mixte CEA-CNRS-UVSQ Université Paris-Saclay Gif sur Yvette France
| | | | - G L Foster
- Ocean and Earth Science, National Oceanography Centre University of Southampton Southampton UK
| | | | - A S von der Heydt
- Institute for Marine and Atmospheric Research, and Centre for Complex Systems Science Utrecht University Utrecht The Netherlands
| | - R Knutti
- Institute for Atmospheric and Climate Science Zurich Switzerland
| | - T Mauritsen
- Department of Meteorology Stockholm University Stockholm Sweden
| | - J R Norris
- Scripps Institution of Oceanography La Jolla CA USA
| | - C Proistosescu
- Department of Atmospheric Sciences and Department of Geology University of Illinois at Urbana-Champaign Urbana IL USA
| | - M Rugenstein
- Max Planck Institute for Meteorology Hamburg Germany
| | - G A Schmidt
- NASA Goddard Institute for Space Studies New York NY USA
| | - K B Tokarska
- School of Geosciences University of Edinburgh Edinburgh UK
- Institute for Atmospheric and Climate Science Zurich Switzerland
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Pendyala P, Almeldin D, Andrews T, Maloney-Patel N, August D, Anderson C, Jabbour S, Chundury A. Exploring the Dose-response Relationship in Locally Advanced Rectal Cancer Utilizing Dosimetric Parameters. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1900] [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: 11/28/2022]
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Udeh-Momoh C, Price G, Ropacki MT, Ketter N, Andrews T, Arrighi HM, Brashear HR, Robb C, Bassil DT, Cohn M, Curry LK, Su B, Perera D, Giannakopoulou P, Car J, Ward HA, Perneczky R, Novak G, Middleton L. Prospective Evaluation of Cognitive Health and Related Factors in Elderly at Risk for Developing Alzheimer's Dementia: A Longitudinal Cohort Study. J Prev Alzheimers Dis 2020; 6:256-266. [PMID: 31686098 DOI: 10.14283/jpad.2019.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The CHARIOT PRO Main study is a prospective, non-interventional study evaluating cognitive trajectories in participants at the preclinical stage of Alzheimer's disease (AD) classified by risk levels for developing mild cognitive impairment due to AD (MCI-AD). OBJECTIVES The study aimed to characterize factors and markers influencing cognitive and functional progression among individuals at-risk for developing MCI-AD, and examine data for more precise predictors of cognitive change, particularly in relation to APOE ε4 subgroup. DESIGN This single-site study was conducted at the Imperial College London (ICL) in the United Kingdom. Participants 60 to 85 years of age were classified as high, medium (amnestic or non-amnestic) or low risk for developing MCI-AD based on RBANS z-scores. A series of clinical outcome assessments (COAs) on factors influencing baseline cognitive changes were collected in each of the instrument categories of cognition, lifestyle exposure, mood, and sleep. Data collection was planned to occur every 6 months for 48 months, however the median follow-up time was 18.1 months due to early termination of study by the sponsor. RESULTS 987 participants were screened, among them 690 participants were actively followed-up post baseline, of whom 165 (23.9%) were APOE ε4 carriers; with at least one copy of the allele. The mean age was 68.73 years, 94.6% were white, 57.4% were female, and 34.8% had a Family History of Dementia with a somewhat larger percentage in the APOE ε4 carrier group (42.4%) compared to the non-carrier group (32.4%). Over half of the participants were married and 53% had a Bachelor's or higher degree. Most frequently, safety events typical for this population consisted of upper respiratory tract infection (10.4%), falls (5.2%), hypertension (3.5%) and back pain (3.0%). Conclusion (clinical relevance): AD-related measures collected during the CHARIOT PRO Main study will allow identification and evaluation of AD risk factors and markers associated with cognitive performance from the pre-clinical stage. Evaluating the psycho-biological characteristics of these pre-symptomatic individuals in relation to their natural neurocognitive trajectories will enhance current understanding on determinants of the initial signs of cognitive changes linked to AD.
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Affiliation(s)
- C Udeh-Momoh
- Gerald Novak, MD, Janssen Research and Development, LLC, 1125 Trenton-Harbourton Rd., Titusville, NJ 08560, USA, Tel.:+1 609 730 4416, Fax: +1 908 730 2069,
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Richardson TB, Forster PM, Smith CJ, Maycock AC, Wood T, Andrews T, Boucher O, Faluvegi G, Fläschner D, Hodnebrog Ø, Kasoar M, Kirkevåg A, Lamarque J, Mülmenstädt J, Myhre G, Olivié D, Portmann RW, Samset BH, Shawki D, Shindell D, Stier P, Takemura T, Voulgarakis A, Watson‐Parris D. Efficacy of Climate Forcings in PDRMIP Models. J Geophys Res Atmos 2019; 124:12824-12844. [PMID: 32025453 PMCID: PMC6988499 DOI: 10.1029/2019jd030581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 11/15/2019] [Accepted: 11/16/2019] [Indexed: 05/04/2023]
Abstract
Quantifying the efficacy of different climate forcings is important for understanding the real-world climate sensitivity. This study presents a systematic multimodel analysis of different climate driver efficacies using simulations from the Precipitation Driver and Response Model Intercomparison Project (PDRMIP). Efficacies calculated from instantaneous radiative forcing deviate considerably from unity across forcing agents and models. Effective radiative forcing (ERF) is a better predictor of global mean near-surface air temperature (GSAT) change. Efficacies are closest to one when ERF is computed using fixed sea surface temperature experiments and adjusted for land surface temperature changes using radiative kernels. Multimodel mean efficacies based on ERF are close to one for global perturbations of methane, sulfate, black carbon, and insolation, but there is notable intermodel spread. We do not find robust evidence that the geographic location of sulfate aerosol affects its efficacy. GSAT is found to respond more slowly to aerosol forcing than CO2 in the early stages of simulations. Despite these differences, we find that there is no evidence for an efficacy effect on historical GSAT trend estimates based on simulations with an impulse response model, nor on the resulting estimates of climate sensitivity derived from the historical period. However, the considerable intermodel spread in the computed efficacies means that we cannot rule out an efficacy-induced bias of ±0.4 K in equilibrium climate sensitivity to CO2 doubling when estimated using the historical GSAT trend.
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Affiliation(s)
- T. B. Richardson
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | - P. M. Forster
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | - C. J. Smith
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | - A. C. Maycock
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | - T. Wood
- Priestley International Centre for ClimateUniversity of LeedsLeedsUK
| | | | - O. Boucher
- Institut Pierre‐Simon LaplaceCNRS/Sorbonne UniversitéParisFrance
| | - G. Faluvegi
- NASA Goddard Institute for Space Studies and Center for Climate Systems ResearchColumbia UniversityNew YorkNYUSA
| | - D. Fläschner
- Atmosphere in the Earth SystemMax‐Planck‐Institut für MeteorologieHamburgGermany
| | - Ø. Hodnebrog
- CICERO Center for International Climate and Environmental ResearchOsloNorway
| | - M. Kasoar
- Department of PhysicsImperial College LondonLondonUK
| | - A. Kirkevåg
- Research and Development DepartmentNorwegian Meteorological InstituteOsloNorway
| | | | - J. Mülmenstädt
- Clouds and Global ClimateUniversität LeipzigLeipzigGermany
| | - G. Myhre
- CICERO Center for International Climate and Environmental ResearchOsloNorway
| | - D. Olivié
- Research and Development DepartmentNorwegian Meteorological InstituteOsloNorway
| | - R. W. Portmann
- Earth System Research LaboratoryNational Oceanic and Atmospheric AdministrationBoulderCOUSA
| | - B. H. Samset
- CICERO Center for International Climate and Environmental ResearchOsloNorway
| | - D. Shawki
- Department of PhysicsImperial College LondonLondonUK
| | - D. Shindell
- Earth & Ocean SciencesDuke UniversityDurhamNCUSA
| | - P. Stier
- Atmospheric, Oceanic and Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
| | - T. Takemura
- Center for Oceanic and Atmospheric ResearchKyushu UniversityFukuokaJapan
| | | | - D. Watson‐Parris
- Atmospheric, Oceanic and Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
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Ondhia M, Tamvakeras P, O'Toole P, Montazerri A, Andrews T, Farrell C, Ahmed S, Slawik S, Ahmed S. Transanal endoscopic microsurgery for rectal lesions in a specialist regional early rectal cancer centre: the Mersey experience. Colorectal Dis 2019; 21:1164-1174. [PMID: 31207005 PMCID: PMC6900238 DOI: 10.1111/codi.14730] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 06/14/2019] [Indexed: 12/13/2022]
Abstract
AIM Organ-preserving local excision by transanal endoscopic microsurgery (TEM) for early rectal cancer offers significantly lower morbidity as compared to formal rectal cancer resection with acceptable outcomes. This study presents our 6-year experience of TEM for rectal lesions referred to a specialist early rectal cancer centre in the UK. METHOD Data were collected for all patients referred for TEM of suspected early rectal cancer to a regional specialist early rectal cancer multidisciplinary team (MDT) over a 6-year period. RESULTS One hundred and forty-one patients who underwent full-thickness TEM for suspected or confirmed early rectal cancer were included. Thirty patients were referred for TEM following incomplete endoscopic polypectomy. Final pathology was benign in 77 (54.6%) cases and malignant in 64 (45.4%). Of the 61 confirmed adenocarcinomas, TEM resections were pT0 in 17 (27.9%), pT1 in 32 (51.7%), pT2 in 11 (18.0%) and pT3 in 1 (1.6%). Thirty-eight of 61 patients (62.3%) had one or more poor histological prognostic features and these patients were offered further treatment. Twenty-three of 61 (37.7%) patients with rectal adenocarcinoma required no further treatment following TEM. Forty-three cases of rectal adenocarcinoma were available for establishing recurrence rates. Two of 43 patients (4.7%) developed a recurrence at a median follow-up of 28.7 months (12.1-66.5 months). The overall estimated 5-year overall survival rate was 87.9% and the disease-free survival rate was 82.9%. CONCLUSION Acceptable outcomes are possible for TEM surgery with appropriate patient selection, effective technique, expert histopathology, appropriate referral for adjuvant treatment and meticulous follow-up. This can be achieved through an early rectal cancer MDT in a dedicated specialist regional centre.
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Affiliation(s)
- M. Ondhia
- Royal Liverpool and Broadgreen University Hospital NHS TrustLiverpoolUK
| | - P. Tamvakeras
- Aintree University Hospital NHS Foundation TrustLiverpoolUK
| | - P. O'Toole
- Royal Liverpool and Broadgreen University Hospital NHS TrustLiverpoolUK
| | - A. Montazerri
- Clatterbridge Cancer Centre NHS Foundation TrustWirralUK
| | - T. Andrews
- Royal Liverpool and Broadgreen University Hospital NHS TrustLiverpoolUK
| | - C. Farrell
- Royal Liverpool and Broadgreen University Hospital NHS TrustLiverpoolUK
| | - S. Ahmed
- Aintree University Hospital NHS Foundation TrustLiverpoolUK
| | - S. Slawik
- Aintree University Hospital NHS Foundation TrustLiverpoolUK
| | - S. Ahmed
- Royal Liverpool and Broadgreen University Hospital NHS TrustLiverpoolUK
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Gorelik M, Lee Y, Abe M, Andrews T, Davis L, Patterson J, Chen S, Crother TR, Aune GJ, Noval Rivas M, Arditi M. IL-1 receptor antagonist, anakinra, prevents myocardial dysfunction in a mouse model of Kawasaki disease vasculitis and myocarditis. Clin Exp Immunol 2019; 198:101-110. [PMID: 31099056 PMCID: PMC6718290 DOI: 10.1111/cei.13314] [Citation(s) in RCA: 45] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2019] [Indexed: 12/11/2022] Open
Abstract
Kawasaki disease (KD) vasculitis is an acute febrile illness of childhood characterized by systemic vasculitis of unknown origin, and is the most common cause of acquired heart disease among children in the United States. While histological evidence of myocarditis can be found in all patients with acute KD, only a minority of patients are clinically symptomatic and a subset demonstrate echocardiographic evidence of impaired myocardial function, as well as increased left ventricular mass, presumed to be due to myocardial edema and inflammation. Up to a third of KD patients fail to respond to first-line therapy with intravenous immunoglobulin (IVIG), and the use of interleukin (IL)-1 receptor antagonist (IL-1Ra, anakinra) is currently being investigated as an alternative therapeutic approach to treat IVIG-resistant patients. In this study, we sought to investigate the effect of IL-1Ra on myocardial dysfunction and its relation to myocarditis development during KD vasculitis. We used the Lactobacillus casei cell-wall extract (LCWE)-induced murine model of KD vasculitis and investigated the effect of IL-1Ra pretreatment on myocardial dysfunction during KD vasculitis by performing histological, magnetic resonance imaging (MRI) and echocardiographic evaluations. IL-1Ra pretreatment significantly reduced KD-induced myocardial inflammation and N-terminal pro B-type natriuretic peptide (NT-proBNP) release. Both MRI and echocardiographic studies on LCWE-injected KD mice demonstrated that IL-1Ra pretreatment results in an improved ejection fraction and a normalized left ventricular function. These findings further support the potential beneficial effects of IL-1Ra therapy in preventing the cardiovascular complications in acute KD patients, including the myocarditis and myocardial dysfunction associated with acute KD.
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Affiliation(s)
- M Gorelik
- Department of Virology and Immunology, Texas Biomedical Research Institute, San Antonio, TX, USA.,Pediatric Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Y Lee
- Division of Pediatric Infectious Diseases and Immunology, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - M Abe
- Division of Pediatric Infectious Diseases and Immunology, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - T Andrews
- Division of Pediatric Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX, USA
| | - L Davis
- Division of Pediatric Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX, USA
| | - J Patterson
- Department of Virology and Immunology, Texas Biomedical Research Institute, San Antonio, TX, USA
| | - S Chen
- Division of Pediatric Infectious Diseases and Immunology, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - T R Crother
- Division of Pediatric Infectious Diseases and Immunology, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - G J Aune
- Division of Pediatric Hematology and Oncology, University of Texas Health Science Center, San Antonio, TX, USA
| | - M Noval Rivas
- Division of Pediatric Infectious Diseases and Immunology, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - M Arditi
- Division of Pediatric Infectious Diseases and Immunology, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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11
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Bodas‐Salcedo A, Mulcahy JP, Andrews T, Williams KD, Ringer MA, Field PR, Elsaesser GS. Strong Dependence of Atmospheric Feedbacks on Mixed-Phase Microphysics and Aerosol-Cloud Interactions in HadGEM3. J Adv Model Earth Syst 2019; 11:1735-1758. [PMID: 31598189 PMCID: PMC6774284 DOI: 10.1029/2019ms001688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/09/2019] [Accepted: 05/09/2019] [Indexed: 05/13/2023]
Abstract
We analyze the atmospheric processes that explain the large changes in radiative feedbacks between the two latest climate configurations of the Hadley Centre Global Environmental model. We use a large set of atmosphere-only climate change simulations (amip and amip-p4K) to separate the contributions to the differences in feedback parameter from all the atmospheric model developments between the two latest model configurations. We show that the differences are mostly driven by changes in the shortwave cloud radiative feedback in the midlatitudes, mainly over the Southern Ocean. Two new schemes explain most of the differences: the introduction of a new aerosol scheme and the development of a new mixed-phase cloud scheme. Both schemes reduce the strength of the preexisting shortwave negative cloud feedback in the midlatitudes. The new aerosol scheme dampens a strong aerosol-cloud interaction, and it also suppresses a negative clear-sky shortwave feedback. The mixed-phase scheme increases the amount of cloud liquid water path (LWP) in the present day and reduces the increase in LWP with warming. Both changes contribute to reducing the negative radiative feedback of the increase of LWP in the warmer climate. The mixed-phase scheme also enhances a strong, preexisting, positive cloud fraction feedback. We assess the realism of the changes by comparing present-day simulations against observations and discuss avenues that could help constrain the relevant processes.
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Affiliation(s)
| | | | | | | | | | | | - G. S. Elsaesser
- Goddard Institute for Space StudiesColumbia University/NASANew YorkNYUSA
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12
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Smith CJ, Kramer RJ, Myhre G, Forster PM, Soden BJ, Andrews T, Boucher O, Faluvegi G, Fläschner D, Hodnebrog Ø, Kasoar M, Kharin V, Kirkevåg A, Lamarque J, Mülmenstädt J, Olivié D, Richardson T, Samset BH, Shindell D, Stier P, Takemura T, Voulgarakis A, Watson‐Parris D. Understanding Rapid Adjustments to Diverse Forcing Agents. Geophys Res Lett 2018; 45:12023-12031. [PMID: 30686845 PMCID: PMC6334512 DOI: 10.1029/2018gl079826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/10/2018] [Accepted: 10/15/2018] [Indexed: 05/04/2023]
Abstract
Rapid adjustments are responses to forcing agents that cause a perturbation to the top of atmosphere energy budget but are uncoupled to changes in surface warming. Different mechanisms are responsible for these adjustments for a variety of climate drivers. These remain to be quantified in detail. It is shown that rapid adjustments reduce the effective radiative forcing (ERF) of black carbon by half of the instantaneous forcing, but for CO2 forcing, rapid adjustments increase ERF. Competing tropospheric adjustments for CO2 forcing are individually significant but sum to zero, such that the ERF equals the stratospherically adjusted radiative forcing, but this is not true for other forcing agents. Additional experiments of increase in the solar constant and increase in CH4 are used to show that a key factor of the rapid adjustment for an individual climate driver is changes in temperature in the upper troposphere and lower stratosphere.
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Affiliation(s)
- C. J. Smith
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - R. J. Kramer
- Rosenstiel School of Marine and Atmospheric ScienceUniversity of MiamiMiamiFLUSA
| | - G. Myhre
- CICERO Center for International Climate and Environmental Research in OsloOsloNorway
| | - P. M. Forster
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - B. J. Soden
- Rosenstiel School of Marine and Atmospheric ScienceUniversity of MiamiMiamiFLUSA
| | | | - O. Boucher
- Institut Pierre‐Simon Laplace, CNRS/Sorbonne UniversitéParisFrance
| | - G. Faluvegi
- NASA Goddard Institute for Space StudiesNew YorkNYUSA
- Center for Climate Systems ResearchColumbia UniversityNew YorkNYUSA
| | - D. Fläschner
- Max‐Planck‐Institut für MeteorologieHamburgGermany
| | - Ø. Hodnebrog
- CICERO Center for International Climate and Environmental Research in OsloOsloNorway
| | - M. Kasoar
- Department of PhysicsImperial College LondonLondonUK
- Grantham Institute – Climate Change and the EnvironmentImperial College LondonLondonUK
| | - V. Kharin
- Canadian Centre for Climate Modelling and AnalysisVictoriaBritish ColumbiaCanada
| | - A. Kirkevåg
- Norwegian Meteorological InstituteOsloNorway
| | | | - J. Mülmenstädt
- Institute of MeteorologyUniversität LeipzigLeipzigGermany
| | - D. Olivié
- Norwegian Meteorological InstituteOsloNorway
| | - T. Richardson
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - B. H. Samset
- CICERO Center for International Climate and Environmental Research in OsloOsloNorway
| | - D. Shindell
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
| | - P. Stier
- Atmospheric, Oceanic and Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
| | | | | | - D. Watson‐Parris
- Atmospheric, Oceanic and Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
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13
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Myhre G, Kramer RJ, Smith CJ, Hodnebrog Ø, Forster P, Soden BJ, Samset BH, Stjern CW, Andrews T, Boucher O, Faluvegi G, Fläschner D, Kasoar M, Kirkevåg A, Lamarque J, Olivié D, Richardson T, Shindell D, Stier P, Takemura T, Voulgarakis A, Watson‐Parris D. Quantifying the Importance of Rapid Adjustments for Global Precipitation Changes. Geophys Res Lett 2018; 45:11399-11405. [PMID: 30774164 PMCID: PMC6360531 DOI: 10.1029/2018gl079474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/09/2018] [Accepted: 10/12/2018] [Indexed: 05/04/2023]
Abstract
Different climate drivers influence precipitation in different ways. Here we use radiative kernels to understand the influence of rapid adjustment processes on precipitation in climate models. Rapid adjustments are generally triggered by the initial heating or cooling of the atmosphere from an external climate driver. For precipitation changes, rapid adjustments due to changes in temperature, water vapor, and clouds are most important. In this study we have investigated five climate drivers (CO2, CH4, solar irradiance, black carbon, and sulfate aerosols). The fast precipitation responses to a doubling of CO2 and a 10-fold increase in black carbon are found to be similar, despite very different instantaneous changes in the radiative cooling, individual rapid adjustments, and sensible heating. The model diversity in rapid adjustments is smaller for the experiment involving an increase in the solar irradiance compared to the other climate driver perturbations, and this is also seen in the precipitation changes.
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Affiliation(s)
- G. Myhre
- CICERO Center for International Climate ResearchOsloNorway
| | - R. J. Kramer
- Rosenstiel School of Marine and Atmospheric ScienceUniversity of MiamiMiamiFLUSA
| | - C. J. Smith
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - Ø. Hodnebrog
- CICERO Center for International Climate ResearchOsloNorway
| | - P. Forster
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - B. J. Soden
- Rosenstiel School of Marine and Atmospheric ScienceUniversity of MiamiMiamiFLUSA
| | - B. H. Samset
- CICERO Center for International Climate ResearchOsloNorway
| | - C. W. Stjern
- CICERO Center for International Climate ResearchOsloNorway
| | | | - O. Boucher
- Institut Pierre‐Simon LaplaceCNRS/Sorbonne UniversitéParisFrance
| | - G. Faluvegi
- NASA Goddard Institute for Space StudiesNew YorkNYUSA
- Center for Climate Systems ResearchColumbia UniversityNew YorkNYUSA
| | - D. Fläschner
- Max‐Planck‐Institut für MeteorologieHamburgGermany
| | - M. Kasoar
- Department of PhysicsImperial College LondonLondonUK
- Grantham Institute‐Climate Change and the EnvironmentImperial College LondonLondonUK
| | - A. Kirkevåg
- Norwegian Meteorological InstituteOsloNorway
| | | | - D. Olivié
- Norwegian Meteorological InstituteOsloNorway
| | - T. Richardson
- School of Earth and EnvironmentUniversity of LeedsLeedsUK
| | - D. Shindell
- Nicholas School of the EnvironmentDuke UniversityDurhamNCUSA
| | - P. Stier
- Atmospheric, Oceanic & Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
| | - T. Takemura
- Research Institute for Applied MechanicsKyushu UniversityFukuokaJapan
| | | | - D. Watson‐Parris
- Atmospheric, Oceanic & Planetary Physics, Department of PhysicsUniversity of OxfordOxfordUK
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14
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Ogedegbe C, Unawane R, Uceda V, Finefrock D, Zodda D, Andrews T, Admani I, Nierenberg H, Hewitt K, Landers D. 24 The HEART Pathway, Possible Impact of an Emergency Department Stationed Cardiologist on Disposition of Risk Stratified Chest Pain Patients Presenting to the Emergency Department Compared to Standard Emergency Department Care. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Martinez-Martin P, Rizos AM, Wetmore J, Antonini A, Odin P, Pal S, Sophia R, Carroll C, Martino D, Falup-Pecurariu C, Kessel B, Andrews T, Paviour D, Trenkwalder C, Chaudhuri KR. First comprehensive tool for screening pain in Parkinson's disease: the King's Parkinson's Disease Pain Questionnaire. Eur J Neurol 2018; 25:1255-1261. [PMID: 29806962 DOI: 10.1111/ene.13691] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/11/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Pain is highly prevalent in Parkinson's disease (PD), impacting patients' ability, mood and quality of life. Detecting the presence of pain in its multiple modalities is necessary for adequate personalized management of PD. A 14-item, PD-specific, patient-based questionnaire (the King's Parkinson's Disease Pain Questionnaire, KPPQ) was designed corresponding to the rater-based KPP Scale (KPPS). The present multicentre study was aimed at testing the validity of this screening tool. METHODS First, a comparison between the KPPQ scores of patients and matched controls was performed. Next, convergent validity, reproducibility (test-retest) and diagnostic performance of the questionnaire were analysed. RESULTS Data from 300 patients and 150 controls are reported. PD patients declared significantly more pain symptoms than controls (3.96 ± 2.56 vs. 2.17 ± 1.39; P < 0.0001). The KPPQ convergent validity was high with KPPS total score (rS = 0.80) but weak or moderate with other pain assessments. Test-retest reliability was satisfactory with kappa values ≥0.65 except for item 5, Dyskinetic pains (κ = 0.44), and the intraclass correlation coefficient (ICC) for the KPPQ total score was 0.98. After the scores of the KPPS were adapted for screening (0, no symptom; ≥1, symptom present), a good agreement was found between the KPPQ and the KPPS (ICC = 0.88). A strong correlation (rS = 0.80) between the two instruments was found. The diagnostic parameters of the KPPQ were very satisfactory as a whole, with a global accuracy of 78.3%-98.3%. CONCLUSIONS These results suggest that the KPPQ is a useful, reliable and valid screening instrument for pain in PD to advance patient-related outcomes.
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Affiliation(s)
- P Martinez-Martin
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - A M Rizos
- Institute of Psychiatry, Psychology & Neuroscience at King's College, King's College Hospital NHS Foundation Trust, London, UK
| | - J Wetmore
- National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - A Antonini
- Neurology, University of Padua, Venice, Italy
| | - P Odin
- Neurology, University of Lund, Lund, Sweden
| | - S Pal
- Neurology, Forth Valley Royal Hospital, Larbert, Scotland, UK
| | - R Sophia
- Geriatric Medicine, Yeovil Hospital, Somerset, UK
| | - C Carroll
- Neurology, Derriford Hospital, Plymouth, UK
| | - D Martino
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
| | | | - B Kessel
- Medicine for the Elderly, Princess Royal University Hospital site, King's College Hospital, Kent, UK
| | - T Andrews
- Neurology, Guy's Hospital, London, UK
| | - D Paviour
- Neurology, St Georges's Hospital, London, UK
| | - C Trenkwalder
- Department of Neurosurgery, University Medical Center, Goettingen, Germany
| | - K R Chaudhuri
- Institute of Psychiatry, Psychology & Neuroscience at King's College, King's College Hospital NHS Foundation Trust, London, UK
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16
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Myhre G, Samset BH, Hodnebrog Ø, Andrews T, Boucher O, Faluvegi G, Fläschner D, Forster PM, Kasoar M, Kharin V, Kirkevåg A, Lamarque JF, Olivié D, Richardson TB, Shawki D, Shindell D, Shine KP, Stjern CW, Takemura T, Voulgarakis A. Sensible heat has significantly affected the global hydrological cycle over the historical period. Nat Commun 2018; 9:1922. [PMID: 29765048 PMCID: PMC5954152 DOI: 10.1038/s41467-018-04307-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 04/17/2018] [Indexed: 11/15/2022] Open
Abstract
Globally, latent heating associated with a change in precipitation is balanced by changes to atmospheric radiative cooling and sensible heat fluxes. Both components can be altered by climate forcing mechanisms and through climate feedbacks, but the impacts of climate forcing and feedbacks on sensible heat fluxes have received much less attention. Here we show, using a range of climate modelling results, that changes in sensible heat are the dominant contributor to the present global-mean precipitation change since preindustrial time, because the radiative impact of forcings and feedbacks approximately compensate. The model results show a dissimilar influence on sensible heat and precipitation from various drivers of climate change. Due to its strong atmospheric absorption, black carbon is found to influence the sensible heat very differently compared to other aerosols and greenhouse gases. Our results indicate that this is likely caused by differences in the impact on the lower tropospheric stability.
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Affiliation(s)
- G Myhre
- CICERO Center for International Climate Research - Oslo, 0318, Oslo, Norway.
| | - B H Samset
- CICERO Center for International Climate Research - Oslo, 0318, Oslo, Norway
| | - Ø Hodnebrog
- CICERO Center for International Climate Research - Oslo, 0318, Oslo, Norway
| | - T Andrews
- Met Office Hadley Centre, Devon, EX1 3PB, United Kingdom
| | - O Boucher
- Institut Pierre-Simon Laplace, CNRS/Sorbonne Université, 75252, Paris, Cedex 05, France
| | - G Faluvegi
- NASA Goddard Institute for Space Studies, New York, NY, 10025, USA
- Center for Climate Systems Research, Columbia University, New York, NY, 10027, USA
| | - D Fläschner
- Max-Planck-Institut für Meteorologie, 20146, Hamburg, Germany
| | - P M Forster
- University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - M Kasoar
- Department of Physics, Imperial College London, London, SW7 2AZ, United Kingdom
| | - V Kharin
- Canadian Centre for Climate Modelling and Analysis, V8P 5C2, Victoria, BC,, Canada
| | - A Kirkevåg
- Norwegian Meteorological Institute, 0313, Oslo, Norway
| | | | - D Olivié
- Norwegian Meteorological Institute, 0313, Oslo, Norway
| | | | - D Shawki
- Department of Physics, Imperial College London, London, SW7 2AZ, United Kingdom
| | | | - K P Shine
- University of Reading, Reading, RG6 6BB, United Kingdom
| | - C W Stjern
- CICERO Center for International Climate Research - Oslo, 0318, Oslo, Norway
| | - T Takemura
- Kyushu University, 816-8580, Kasuga, Japan
| | - A Voulgarakis
- Department of Physics, Imperial College London, London, SW7 2AZ, United Kingdom
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17
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Richardson TB, Forster PM, Andrews T, Boucher O, Faluvegi G, Fläschner D, Kasoar M, Kirkevåg A, Lamarque JF, Myhre G, Olivié D, Samset BH, Shawki D, Shindell D, Takemura T, Voulgarakis A. Carbon dioxide physiological forcing dominates projected Eastern Amazonian drying. Geophys Res Lett 2018; 45:2815-2825. [PMID: 33041385 PMCID: PMC7546038 DOI: 10.1002/2017gl076520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Future projections of east Amazonian precipitation indicate drying, but they are uncertain and poorly understood. In this study we analyse the Amazonian precipitation response to individual atmospheric forcings using a number of global climate models. Black carbon is found to drive reduced precipitation over the Amazon due to temperature-driven circulation changes, but the magnitude is uncertain. CO2 drives reductions in precipitation concentrated in the east, mainly due to a robustly negative, but highly variable in magnitude, fast response. We find that the physiological effect of CO2 on plant stomata is the dominant driver of the fast response due to reduced latent heating, and also contributes to the large model spread. Using a simple model we show that CO2 physiological effects dominate future multi-model mean precipitation projections over the Amazon. However, in individual models temperature-driven changes can be large, but due to little agreement, they largely cancel out in the model-mean.
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Affiliation(s)
| | | | - T Andrews
- Met Office Hadley Centre, United Kingdom
| | - O Boucher
- Institut Pierre-Simon Laplace, Université Pierre et Marie Curie / CNRS, Paris, France
| | - G Faluvegi
- NASA Goddard Institute for Space Studies and Center for Climate Systems Research, Columbia University, New York, USA
| | - D Fläschner
- Max-Planck-Institut für Meteorologie, Hamburg, Germany
| | - M Kasoar
- Imperial College London, London, United Kingdom
| | - A Kirkevåg
- Norwegian Meteorological Institute, Oslo, Norway
| | | | - G Myhre
- CICERO Center for International Climate and Environmental Research - Oslo, Norway
| | - D Olivié
- Norwegian Meteorological Institute, Oslo, Norway
| | - B H Samset
- CICERO Center for International Climate and Environmental Research - Oslo, Norway
| | - D Shawki
- Imperial College London, London, United Kingdom
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18
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Catazaro J, Andrews T, Milkovic NM, Lin J, Lowe AJ, Wilson MA, Powers R. 15N CEST data and traditional model-free analysis capture fast internal dynamics of DJ-1. Anal Biochem 2017; 542:24-28. [PMID: 29169778 DOI: 10.1016/j.ab.2017.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/24/2017] [Accepted: 11/18/2017] [Indexed: 11/24/2022]
Abstract
Previous studies have shown that relaxation parameters and fast protein dynamics can be quickly elucidated from 15N-CEST experiments [1]. Longitudinal R1 and transverse R2 values were reliably derived from fitting of CEST profiles. Herein we show that 15N-CEST experiments and traditional modelfree analysis provide the internal dynamics of three states of human protein DJ-1 at physiological temperature. The chemical exchange profiles show the absence of a minor state conformation and, in conjunction with 1H-15N NOEs, show increased mobility. R1 and R2 values remained relatively unchanged at the three naturally occurring oxidation states of DJ-1, but exhibit striking NOE differences. The NOE data was, therefore, essential in determining the internal motions of the DJ-1 proteins. To the authors' knowledge, we present the first study that combines 15N CEST data with traditional model-free analyses in the study of a biological system and affirm that more 'lean' model-free approaches should be used cautiously.
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Affiliation(s)
- Jonathan Catazaro
- Department of Chemistry, University of Nebraska-Lincoln, Lincoln, NE 68588-0304, USA
| | - Tessa Andrews
- Department of Chemistry, University of Nebraska-Lincoln, Lincoln, NE 68588-0304, USA
| | - Nicole M Milkovic
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln, NE 68588-0664, USA
| | - Jiusheng Lin
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln, NE 68588-0664, USA
| | - Austin J Lowe
- Department of Chemistry, University of Nebraska-Lincoln, Lincoln, NE 68588-0304, USA
| | - Mark A Wilson
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln, NE 68588-0664, USA
| | - Robert Powers
- Department of Chemistry, University of Nebraska-Lincoln, Lincoln, NE 68588-0304, USA; Nebraska Center for Integrated Biomolecular Communication, University of Nebraska-Lincoln, Lincoln, NE 68588-0304, USA.
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19
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Drevelegkas K, Bangeas P, Paramythiotis D, Andrews T, Zakeri S. Metastatic spread of cutaneous melanoma to the sigmoid colon: a rare but important consideration. Hippokratia 2017; 21:194-196. [PMID: 30944511 PMCID: PMC6441346] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Cutaneous melanoma is known for its aggressive tendency for metastasis, most commonly to lymph nodes, lung, liver, and brain. CASE REPORT We present the case of an 80-year-old male, with a history of cutaneous melanoma, found to have biopsy-proven metastatic melanoma deposits in the sigmoid colon. This rare case was initially thought to be a walled-off perforation secondary to diverticulitis. Although, computed tomography, showed features more strongly suggestive of malignancy. We propose early consideration of bowel metastasis in patients with a history of cutaneous melanoma presenting with lower gastrointestinal symptoms. CONCLUSION Once malignancy is included in the differential for any inflammatory type bowel lesion, arranging endoscopy and biopsy is essential to confirm the diagnosis and guide management. Multidisciplinary team discussion is recommended to determine the most appropriate treatment strategy - radical versus palliative, which must always consider the patient's performance status alongside cancer staging. HIPPOKRATIA 2017, 21(4): 194-196.
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Affiliation(s)
- K Drevelegkas
- Radiology Department Royal Liverpool University Hospital, UK
| | - P Bangeas
- 1 Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University of Thessaloniki, Greece
| | - D Paramythiotis
- 1 Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University of Thessaloniki, Greece
| | - T Andrews
- Histopathology Department, Royal Liverpool University Hospital, UK
| | - S Zakeri
- Radiology Department Royal Liverpool University Hospital, UK
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20
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Myhre G, Forster PM, Samset BH, Hodnebrog Ø, Sillmann J, Aalbergsjø SG, Andrews T, Boucher O, Faluvegi G, Fläschner D, Iversen T, Kasoar M, Kharin V, Lamarque JF, Olivié D, Richardson T, Shindell D, Shine KP, Stjern CW, Takemura T, Voulgarakis A, Zwiers F. PDRMIP: A Precipitation Driver and Response Model Intercomparison Project, Protocol and preliminary results. Bull Am Meteorol Soc 2017; 98:1185-1198. [PMID: 32713957 PMCID: PMC7380094 DOI: 10.1175/bams-d-16-0019.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
As the global temperature increases with changing climate, precipitation rates and patterns are affected through a wide range of physical mechanisms. The globally averaged intensity of extreme precipitation also changes more rapidly than the globally averaged precipitation rate. While some aspects of the regional variation in precipitation predicted by climate models appear robust, there is still a large degree of inter-model differences unaccounted for. Individual drivers of climate change initially alter the energy budget of the atmosphere leading to distinct rapid adjustments involving changes in precipitation. Differences in how these rapid adjustment processes manifest themselves within models are likely to explain a large fraction of the present model spread and needs better quantifications to improve precipitation predictions. Here, we introduce the Precipitation Driver and Response Model Intercomparison Project (PDRMIP), where a set of idealized experiments designed to understand the role of different climate forcing mechanisms were performed by a large set of climate models. PDRMIP focuses on understanding how precipitation changes relating to rapid adjustments and slower responses to climate forcings are represented across models. Initial results show that rapid adjustments account for large regional differences in hydrological sensitivity across multiple drivers. The PDRMIP results are expected to dramatically improve our understanding of the causes of the present diversity in future climate projections.
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Affiliation(s)
- G Myhre
- CICERO Center for International Climate and Environmental Research - Oslo, Norway
| | | | - B H Samset
- CICERO Center for International Climate and Environmental Research - Oslo, Norway
| | - Ø Hodnebrog
- CICERO Center for International Climate and Environmental Research - Oslo Norway
| | - J Sillmann
- CICERO Center for International Climate and Environmental Research - Oslo, Norway
| | - S G Aalbergsjø
- CICERO Center for International Climate and Environmental Research - Oslo, Norway
| | - T Andrews
- Met Office Hadley Centre, Exeter, UK
| | - O Boucher
- Laboratoire de Météorologie Dynamique, IPSL, Univ. P et M. Curie / CNRS, Paris, France
| | | | - D Fläschner
- Max-Planck-Institut fur Meteorologie, Hamburg Germany
| | - T Iversen
- Norwegian Meteorological Institute, Oslo, Norway
| | - M Kasoar
- Imperial College London, London, United Kingdom
| | - V Kharin
- Canadian Centre for Climate Modelling and Analysis, Victoria, BC, Canada A. Kirkevåg, Norwegian Meteorological Institute, Oslo, Norway
| | | | - D Olivié
- Norwegian Meteorological Institute, Oslo, Norway
| | | | | | - K P Shine
- University of Reading, Reading, United Kingdom
| | - Camilla W Stjern
- CICERO Center for International Climate and Environmental Research - Oslo, Norway
| | | | | | - F Zwiers
- Pacific Climate Impacts Consortium University of Victoria, Canada
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Pelletreau KN, Andrews T, Armstrong N, Bedell MA, Dastoor F, Dean N, Erster S, Fata-Hartley C, Guild N, Greig H, Hall D, Knight JK, Koslowsky D, Lemons P, Martin J, McCourt J, Merrill J, Moscarella R, Nehm R, Northington R, Olsen B, Prevost L, Stolzfus J, Urban-Lurain M, Smith MK. A clicker-based case study that untangles student thinking about the processes in the central dogma. ACTA ACUST UNITED AC 2016. [DOI: 10.24918/cs.2016.15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gregory JM, Andrews T, Good P. The inconstancy of the transient climate response parameter under increasing CO2. Philos Trans A Math Phys Eng Sci 2015; 373:rsta.2014.0417. [PMID: 26438279 PMCID: PMC4608037 DOI: 10.1098/rsta.2014.0417] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
In the Coupled Model Intercomparison Project Phase 5 (CMIP5), the model-mean increase in global mean surface air temperature T under the 1pctCO2 scenario (atmospheric CO(2) increasing at 1% yr(-1)) during the second doubling of CO(2) is 40% larger than the transient climate response (TCR), i.e. the increase in T during the first doubling. We identify four possible contributory effects. First, the surface climate system loses heat less readily into the ocean beneath as the latter warms. The model spread in the thermal coupling between the upper and deep ocean largely explains the model spread in ocean heat uptake efficiency. Second, CO(2) radiative forcing may rise more rapidly than logarithmically with CO(2) concentration. Third, the climate feedback parameter may decline as the CO(2) concentration rises. With CMIP5 data, we cannot distinguish the second and third possibilities. Fourth, the climate feedback parameter declines as time passes or T rises; in 1pctCO2, this effect is less important than the others. We find that T projected for the end of the twenty-first century correlates more highly with T at the time of quadrupled CO(2) in 1pctCO2 than with the TCR, and we suggest that the TCR may be underestimated from observed climate change.
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Affiliation(s)
- J M Gregory
- NCAS-Climate, University of Reading, Reading, UK Met Office Hadley Centre, FitzRoy Road, Exeter, UK
| | - T Andrews
- Met Office Hadley Centre, FitzRoy Road, Exeter, UK
| | - P Good
- Met Office Hadley Centre, FitzRoy Road, Exeter, UK
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Martin G, Thomas H, Andrews T, Hasking P, Scott JG. Psychotic experiences and psychological distress predict contemporaneous and future non-suicidal self-injury and suicide attempts in a sample of Australian school-based adolescents. Psychol Med 2015; 45:429-437. [PMID: 25065410 DOI: 10.1017/s0033291714001615] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Recent cross-sectional studies have shown psychotic experiences (PEs) are associated with suicidal ideation and behaviours. We aimed to examine associations between psychotic experiences (including persistent PE), and contemporaneous and incident non-suicidal self-injury (NSSI) and suicide attempts. METHOD Participants were from an Australian longitudinal cohort of 1896 adolescents (12-17 years). NSSI and suicide attempts were measured using the Self-Harm Behaviour Questionnaire. Items from the Diagnostic Interview Schedule for Children were used to assess psychotic experiences, and the General Health Questionnaire-12 measured psychological distress. RESULTS Adolescents both psychologically distressed and endorsing psychotic experiences had increased odds of contemporaneous and incident NSSI and attempted suicide. Psychotic experiences alone did not predict future risk. Persistent psychotic experiences were associated with increased risk of NSSI and suicide attempts. CONCLUSIONS Psychological distress with accompanying psychotic experiences and persistent psychotic experiences are important predictors of NSSI and suicide attempts. Screening these phenotypes in adolescents will assist in discerning those adolescents most at risk, providing opportunities for targeted suicide prevention strategies.
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Affiliation(s)
- G Martin
- Discipline of Psychiatry, School of Medicine,The University of Queensland,Herston, Queensland,Australia
| | - H Thomas
- Discipline of Psychiatry, School of Medicine,The University of Queensland,Herston, Queensland,Australia
| | - T Andrews
- Discipline of Psychiatry, School of Medicine,The University of Queensland,Herston, Queensland,Australia
| | - P Hasking
- Faculty of Health Sciences, School of Psychology and Speech Pathology,Curtin University,Perth, WA,Australia
| | - J G Scott
- The University of Queensland,UQ Centre for Clinical Research, Herston, Queensland,Australia
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Ezhumalai S, Kumar P, Andrews T. OR07-2 * MEDIA EXPOSURE AND AWARENESS ABOUT CONSEQUENCES OF TOBACCO USE AMONG EARLY ADOLESCENTS. Alcohol Alcohol 2014. [DOI: 10.1093/alcalc/agu053.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Flack T, Watson D, Harris R, Hymers M, Gouws A, Young A, Andrews T. Distinct Representations for Rigid and Non-Rigid Facial Movements in Face-Selective Regions of the Human Brain. J Vis 2014. [DOI: 10.1167/14.10.1383] [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: 11/24/2022] Open
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26
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Andrews T. Low-level image properties of visual objects explain category-selective patterns of neural response across the ventral visual pathway. J Vis 2014. [DOI: 10.1167/14.10.1459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Watson D, Hartley T, Andrews T. The Topographic Organization of Scene-Selective Regions in the Human Brain is Closely Linked to the Statistical Properties of the Image. J Vis 2014. [DOI: 10.1167/14.10.1088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Harris R, Young A, Andrews T. Contrast negation reveals a dissociation in the neural representations underlying the perception of facial identity and expression. J Vis 2013. [DOI: 10.1167/13.9.1276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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29
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Sormaz M, Andrews T, Young A. Contrast negation supports the importance of the eye region for holistic representations of facial identity. J Vis 2013. [DOI: 10.1167/13.9.97] [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: 11/24/2022] Open
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Duru N, van der Goes MC, Jacobs JWG, Andrews T, Boers M, Buttgereit F, Caeyers N, Cutolo M, Halliday S, Da Silva JAP, Kirwan JR, Ray D, Rovensky J, Severijns G, Westhovens R, Bijlsma JWJ. EULAR evidence-based and consensus-based recommendations on the management of medium to high-dose glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis 2013; 72:1905-13. [PMID: 23873876 DOI: 10.1136/annrheumdis-2013-203249] [Citation(s) in RCA: 170] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
To develop recommendations for the management of medium to high-dose (ie, >7.5 mg but ≤100 mg prednisone equivalent daily) systemic glucocorticoid (GC) therapy in rheumatic diseases. A multidisciplinary EULAR task force was formed, including rheumatic patients. After discussing the results of a general initial search on risks of GC therapy, each participant contributed 10 propositions on key clinical topics concerning the safe use of medium to high-dose GCs. The final recommendations were selected via a Delphi consensus approach. A systematic literature search of PubMed, EMBASE and Cochrane Library was used to identify evidence concerning each of the propositions. The strength of recommendation was given according to research evidence, clinical expertise and patient preference. The 10 propositions regarded patient education and informing general practitioners, preventive measures for osteoporosis, optimal GC starting dosages, risk-benefit ratio of GC treatment, GC sparing therapy, screening for comorbidity, and monitoring for adverse effects. In general, evidence supporting the recommendations proved to be surprisingly weak. One of the recommendations was rejected, because of conflicting literature data. Nine final recommendations for the management of medium to high-dose systemic GC therapy in rheumatic diseases were selected and evaluated with their strengths of recommendations. Robust evidence was often lacking; a research agenda was created.
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Affiliation(s)
- N Duru
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, , Utrecht, The Netherlands
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Duru N, van der Goes M, Jacobs J, Andrews T, Boers M, Buttgereit F, Caeyers N, Cutolo M, Halliday S, da Silva J, Kirwan J, Ray D, Rovensky J, Severijns G, Westhovens R, Bijlsma J. OP0006 Eular evidence-based recommendations on the management of medium to high dose systemic glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Apps MCP, Skipper M, Skipper J, Basford S, Bryant V, Saines J, Andrews T. P135 Maximum inspiratory flow measured directly with an inspiratory flow metre compared with measurements from flow volume loop traces. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.135] [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: 11/04/2022]
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Baseler H, Andrews T, Burton M, Jenkins R, Young A. Sensitivity of human cortical face selective regions to face shape and texture. J Vis 2011. [DOI: 10.1167/11.11.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
(1)H-MR spectroscopy is an established noninvasive MR imaging technique that can be helpful in the diagnosis of brain lesions and in treatment planning. Claustrophobia and body habitus preclude some patients from routine MR imaging in a closed-bore system. The development of (1)H-MR spectroscopy for use in an open MR imaging system would enable a more complete characterization of brain lesions in these patients.
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Affiliation(s)
- C G Filippi
- Fletcher Allen Health Care, Burlington, Vermont 05401, USA.
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Taylor J, Morris M, Weinman J, Davis B, Andrews T, Hewlett S, Flurey C, Morris M, Pollock J, Hughes R, Richards P, Hewlett S, Collins S, Ryan S. Understanding the patient perspective: IP43. Being Diagnosed with an Inflammatory Arthritis: The Patients' Perspective. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker053] [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: 11/13/2022] Open
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Leschziner G, Rudge P, Lucas S, Andrews T. Lymphomatosis cerebri presenting as a rapidly progressive dementia with a high methylmalonic acid. J Neurol 2011; 258:1489-93. [PMID: 21365456 DOI: 10.1007/s00415-011-5965-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Revised: 01/28/2011] [Accepted: 02/18/2011] [Indexed: 11/30/2022]
Abstract
We report a case of a patient with a rapidly progressive dementing illness and gait disturbance, in whom initial screening demonstrated a high methylmalonic acid level only, suggestive of a functional vitamin B(12) deficiency. Despite B(12) replacement therapy, he continued to decline. Further investigations demonstrated extensive signal change on magnetic resonance imaging involving grey and white matter within the corpus callosum, deep grey matter, brainstem and cerebellar peduncles, and patchy post-contrast enhancement. Laboratory testing revealed a raised erythrocyte sedimentation rate, raised anti-nuclear, intrinsic factor and lupus anticoagulant antibody titres, and a IgG kappa paraprotein. Cerebrospinal fluid was unremarkable. Bone marrow trephine biopsy showed monoclonal gammopathy of unknown significance. The patient initially responded to steroids, and underwent a brain biopsy, which was uninformative. However, 3 weeks following admission, he died due to an aspiration pneumonia. Autopsy findings were consistent with a diffuse primary central nervous system small cell B-cell lymphoma. This has been rarely reported in the medical literature, but our case exhibits typical clinical features, although patchy enhancement on imaging and the high methylmalonic acid have not been previously described. We hypothesise that his functional B(12) deficiency may have resulted from rapid cell turnover, perhaps in conjunction with the presence of intrinsic factor antibodies.
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Affiliation(s)
- G Leschziner
- Department of Neurology, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, SE1 7EH, London, UK.
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van der Goes MC, Jacobs JWG, Boers M, Andrews T, Blom-Bakkers MAM, Buttgereit F, Caeyers N, Cutolo M, Da Silva JAP, Guillevin L, Kirwan JR, Rovensky J, Severijns G, Webber S, Westhovens R, Bijlsma JWJ. Monitoring adverse events of low-dose glucocorticoid therapy: EULAR recommendations for clinical trials and daily practice. Ann Rheum Dis 2010; 69:1913-9. [DOI: 10.1136/ard.2009.124958] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectiveTo develop recommendations on monitoring for adverse events (AEs) of low-dose glucocorticoid (GC) therapy (≤7.5 mg prednisone or equivalent daily) in clinical trials and daily practice.MethodsLiterature was searched for articles containing information on incidence and monitoring of GC-related AEs using PubMed, EMBASE and Cochrane databases. Second, the authors searched for broad accepted guidelines on the monitoring of certain AEs (eg, WHO guidelines on screening for diabetes). Available data were summarised and discussed among experts (rheumatologists and patients) of the EULAR Task Force to decide which potential AEs should be monitored, how and at which interval.ResultsData on monitoring proved to be scarce; most articles were focused on therapeutic effects of GCs, not on occurrence and monitoring of AEs. Most recommendations had to be based on consensus. Those for clinical trials aimed at getting insights into incidence, prevalence and clinical relevance of AEs to create a comprehensive and valid AE-profile of GC therapy. The set of AEs to monitor is therefore more extensive, and often consists of assessments at baseline and at end of trials. Recommendations for daily practice are meant to protect patients from real dangers, which can be prevented or treated. Standard care monitoring needs NOT be extended for patients on low-dose GC therapy, except for osteoporosis (follow national guidelines), and baseline assessments of ankle edema, fasting blood glucose and risk factors for glaucoma.ConclusionGiven the incompleteness of literature data, consensus-based recommendations on monitoring for GC-related AEs were created, separately for daily practice and clinical trials.
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Andrews T, Ewbank M. fMR-adaptation reveals a view-invariant representation for familiar faces in the fusiform face area. J Vis 2010. [DOI: 10.1167/7.9.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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39
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Andrews T. 92 Poster Women Never Relax: Understanding Diastolic Dysfunction in Women. Eur J Cardiovasc Nurs 2010. [DOI: 10.1016/s1474-5151(10)60074-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- T. Andrews
- Columbia University Medical Center, New York, United States of America
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40
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van der Goes MC, Jacobs JWG, Boers M, Andrews T, Blom-Bakkers MAM, Buttgereit F, Caeyers N, Choy EH, Cutolo M, Da Silva JAP, Guillevin L, Holland M, Kirwan JR, Rovensky J, Saag KG, Severijns G, Webber S, Westhovens R, Bijlsma JWJ. Patient and rheumatologist perspectives on glucocorticoids: an exercise to improve the implementation of the European League Against Rheumatism (EULAR) recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis 2009; 69:1015-21. [PMID: 19762359 DOI: 10.1136/ard.2009.114579] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To explore perspectives among patients and rheumatologists on glucocorticoid (GC) therapy and European League Against Rheumatism (EULAR) recommendations on the management of systemic GC therapy in order to enhance implementation of the recommendations. METHODS Rheumatologists (from eight countries) and patients (from five countries) acquainted with GCs participated in separate meetings, during which positive and negative aspects of GC therapy were discussed and possible adverse events (AEs) were ranked for importance; in addition participants were asked to evaluate the published EULAR recommendations. The reports from these meetings and themes related to implementation of the recommendations were discussed during an international forum of the experts who had formulated the recommendations and patient participants. RESULTS In all, 140 patients (78% women; mean age 53 years; 61% patients with rheumatoid arthritis) and 110 rheumatologists (mean work experience 15 years) participated in the meetings. Osteoporosis, diabetes and cardiovascular diseases were ranked among the five most worrisome AEs by patients and rheumatologists. In both groups, there was agreement with most of the recommendations; the recommendations on GC information cards and GC use during pregnancy scored lowest. Ideas to improve implementation of the recommendations and a research agenda were generated. CONCLUSION The patient and rheumatologist views on GCs corresponded to a large extent, reflected by concerns in both groups about osteoporosis, diabetes and cardiovascular diseases. Specific problems with the EULAR recommendations were identified and addressed to improve their implementation. This exercise shows that patient and rheumatologist perspectives should be included early in the process of formulating recommendations.
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Affiliation(s)
- M C van der Goes
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
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Clayton-smith J, Andrews T, Donnai D. Genetic counselling and parental decisions following antenatal diagnosis of sex chromosome aneuploidies. J OBSTET GYNAECOL 2009. [DOI: 10.3109/01443618909151082] [Citation(s) in RCA: 3] [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: 11/13/2022]
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Zem GC, Khurrum M, Allen J, Petrosyan S, Dayan M, Kawashima R, Goldstein L, Bagerdjian A, Uber L, Nguyen M, Borna L, Adams L, Fukasawa A, Simon C, Karout R, Yaghoubi A, Mesrkhani A, Talebi M, Recinos S, Khojastehfar P, Varvaryan B, Khademi T, Hashemieh M, Shaklian A, Termendjhian A, Kaur Rajal M, Nersesyan A, Adorjan G, Manukyan M, Dadayan R, Andrews T, Gabrielyan Z, Oppenheimer SB. Activity of immobilized lectin stored at different temperatures. FASEB J 2009. [DOI: 10.1096/fasebj.23.1_supplement.693.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- G. C. Zem
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - M. Khurrum
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - J. Allen
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - S. Petrosyan
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - M. Dayan
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - R. Kawashima
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - L. Goldstein
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - A. Bagerdjian
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - L. Uber
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - M. Nguyen
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - L. Borna
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - L. Adams
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - A. Fukasawa
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - C. Simon
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - R. Karout
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - A. Yaghoubi
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - A. Mesrkhani
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - M. Talebi
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - S. Recinos
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - P Khojastehfar
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - B. Varvaryan
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - T. Khademi
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - M. Hashemieh
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - A. Shaklian
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - A. Termendjhian
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - M. Kaur Rajal
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - A. Nersesyan
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - G. Adorjan
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - M. Manukyan
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - R. Dadayan
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - T. Andrews
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - Z. Gabrielyan
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
| | - S. B. Oppenheimer
- Center for Cancer and Developmental BiologyCalifornia State University NorthridgeNorthridgeCA
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Abstract
An HIV-positive man with hepatitis B co-infection, naïve to highly active antiretroviral therapy, with a CD4 of 594 copies/mL and HIV-1 viral load of 140,070 copies, presented with right-sided facial weakness and hearing loss. He had been treated for secondary syphilis three months earlier when his rapid plasma reagin (RPR) result was 1:16, this had fallen to neat. At presentation, his RPR had risen to 1:16 again. A magnetic resonance imaging scan showed enhancement of the internal auditory canal and right cochlea. His cerebrospinal fluid examination was normal. He was treated with acyclovir and prednisolone before the syphilis serology was known. He was then treated for syphilis with doxycycline. He made an excellent recovery.
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Affiliation(s)
- S Y Chan
- Department of Genitourinary Medicine, St Thomas's Hospital, London, UK.
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Abstract
The likelihood of finding significant pathology in a hysterectomy specimen undertaken for clinically benign disease is low. Some data indicate that microscopic examination of these specimens may be abandoned. While this approach may seem attractive, the authors believe that there are a number of practical and clinical governance issues associated with this. Instead a pragmatic approach is advocated, with two tissue blocks (cervix and endomyometrium) being adequate in most cases.
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Affiliation(s)
- T Andrews
- Directorate of Laboratory Medicine (Pathology), Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, UK
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Andrews T, McGintee E, Tyler L, Mittal M, Chew A, Pawlowski N, Zorc J. Efficacy of High-Dose Continuous Nebulized Levalbuterol for Pediatric Status Asthmaticus. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.12.324] [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: 11/27/2022]
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Andrews T, McGintee E, Tyler L, Mittal M, Pawlowski N, Zorc J. Safety of High-Dose Continuous Nebulized Levalbuterol. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bornstein J, La Liberte B, Andrews T, Montermoso J. Notes: Formation of a Cyclic Ester from the Reaction of Di-n-butyltin Dichloride with Ethylene Glycol. J Org Chem 2003. [DOI: 10.1021/jo01088a627] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Phillips WT, Andrews T, Liu H, Klipper R, Landry AJ, Blumhardt R, Goins B. Evaluation of [(99m)Tc] liposomes as lymphoscintigraphic agents: comparison with [(99m)Tc] sulfur colloid and [(99m)Tc] human serum albumin. Nucl Med Biol 2001; 28:435-44. [PMID: 11395317 DOI: 10.1016/s0969-8051(01)00198-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study investigates the use of [(99m)Tc] liposomes for the detection of sentinel lymph nodes. A variety of [(99m)Tc] liposome formulations were compared with common lymphoscintigraphic agents including [(99m)Tc] regular-sulfur colloid (SC), [(99m)Tc] 0.22 microfiltered-SC, [(99m)Tc] reduced heating time 0.22 microfiltered-SC, and [(99m)Tc] human serum albumin (HSA) in rabbits. Images were acquired for the first 60 minutes and at 24 hours, followed by tissue biodistribution study. All agents except [(99m)Tc] regular SC demonstrated good migration from the injection site. Agents were retained in the popliteal node at 24 hours to varying degrees as follows: both [(99m)Tc] filtered SC preparations > [(99m)Tc] regular SC > [(99m)Tc] liposomes > [(99m)Tc] HSA. [(99m)Tc] liposome imaging can be used to develop novel liposome compositions with improved lymph node diagnostic and drug delivery characteristics.
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Affiliation(s)
- W T Phillips
- Radiology Department, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
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Abstract
Shifting of echoplanar images (EPI) in the phase-encoding direction during functional magnetic resonance imaging (fMRI) experiments can be observed due to B(0) drift. These shifts can cause artifacts in functional activation maps that can be corrected using a navigator echo (NE) technique, but the NE correction requires pulse sequence modifications not available on many clinical systems. A fast, postprocessing correction method based on edge root-mean-square error reduction (ERMSR) is introduced and shown to provide an equivalent correction. J. Magn. Reson. Imaging 2000;12:956-959.
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Affiliation(s)
- P V Kochunov
- Research Imaging Center, The University of Texas Health Science Center, San Antonio, Texas 78284, USA
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Abstract
PURPOSE Myxomas are rare, locally infiltrative, benign, connective tissue tumors that are found in bone and somatic soft tissues. This article reports our experience with head and neck myxomas and provides a comprehensive literature review. MATERIALS AND METHODS Retrospective record review of head and neck myxoma cases seen at 2 tertiary referral centers in Houston, Texas, from 1970 to 1994. Comprehensive literature review and compilation of all myxomas reported in the head and neck. RESULTS We identified 7 cases of true head and neck myxoma treated in our centers and identified 169 cases reported in the literature. Most often, myxomas originated in bone (mandible or maxilla) and were most commonly found in adults. All tumors except 1 were treated surgically. Recurrence rates were 6% for local or wide excision and 28% for more conservative surgery such as enucleation or curretage. CONCLUSIONS Myxomas of the head and neck should be treated with complete excision of the tumor with clear margins.
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Affiliation(s)
- T Andrews
- Department of Otolaryngology--Head and Neck Surgery, University of Virginia Medical School, Charlottesville 22908, USA
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