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Lean I, Arnold J, Duddy C, Church S, Rose R, Hodgson D. Kristin Arnold 1956-2023. Aust Vet J 2023; 101:462. [PMID: 37918953 DOI: 10.1111/avj.13286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 11/04/2023]
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Zahler D, Arnold J, Rozenbaum Z, Banai S, Arbel Y, Topilsky Y, Laufer-Perl M. Valvular changes following anthracycline therapy: is it time to look beyond ejection fraction? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Advancements in early detection and treatment of breast cancer have improved survival, but with the costs of side effects, with cardiotoxicity being the most significant one. Anthracycline (ANT) is the most recognized therapy leading to cardiotoxicity, mainly manifested as left ventricle (LV) dysfunction. While the changes in LV ejection fraction (LVEF) are well studied, little is known about the effect of ANT on valvular function. We aimed to evaluate the change in valvular function following ANT therapy in patients diagnosed with breast cancer.
Methods
The study population is part of the Israel Cardio-Oncology Registry (ICOR). All patients performed serial echocardiography; before (T1), during (T2), at the end (T3), and following (T4) ANT therapy, assessing valvular changes. Exclusion criteria included age below 18 and baseline LVEF <55%.
Results
The study included 141 female patients diagnosed with breast cancer and treated with ANT with a mean age of 51±12 years (Table 1). During a median follow-up of 255 [IQR 214–313] days, from T1 to T4, we observed a significant increase in the portion of patients developing new mitral regurgitation (MR) (3.5% to 18.7%, p<0.0001), with a trend for developing moderate and above MR (0.7% to 3.3%, p=0.13). While a statistically significant reduction in mean LVEF (60.2%±1.5 to 59.2%±2.7, p=0.0004) and median LV global longitudinal strain (LV GLS) (−21.6% [−20.0 to −23.0] to −20.0% [−19.1 to −21.1], p<0.0001) was observed (Figure 1), the values remain within the normal range with no significant clinical change. In a multivariate binary logistic regression model, age (OR 1.06, 95% CI: 1.01–1.11) and trastuzumab therapy (OR 5.59, 95% CI: 1.95–16.6) were strong independent predictors for MR development, while medical history was not.
Conclusions
MR development following ANT exposure is frequent, increasingly after the completion of ANT therapy. The parallel reduction in LV function might imply a functional mechanism. Larger trials are needed to evaluate the MR prognostic clinical role in cancer patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Zahler
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
| | - J Arnold
- University of Illinois at Chicago, Department of Medicine , Chicago , United States of America
| | - Z Rozenbaum
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
| | - S Banai
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
| | - Y Arbel
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
| | - Y Topilsky
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
| | - M Laufer-Perl
- Tel Aviv Sourasky Medical Center, Cardiology , Tel Aviv , Israel
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Md. Yusof MY, Arnold J, Saleem B, Vandevelde C, Dass S, Savic S, Vital E, Emery P. OP0250 BREAKTHROUGH INFECTIONS AND PREDICTING SEVERE COVID OUTCOMES DURING RITUXIMAB THERAPY IN AUTOIMMUNE RHEUMATIC DISEASES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAs rituximab (RTX) is a B-cell depleting agent, there are concerns regarding its safety during the COVID pandemic. Data from registries during pre-vaccination period reported increased risk of poor outcomes in RTX-treated patients vs TNFi. However, registry data could be limited by reporting bias in determining true incidence. There are also limited data on breakthrough infections following COVID vaccination.ObjectivesTo assess the incidence of breakthrough infections and predictors of severe COVID outcomes in RTX-treated autoimmune rheumatic diseases (ARDs) with a view to establishing a treatment algorithm for safe RTX administration.MethodsAn observational cohort study was undertaken in the first consecutive 300 ARD patients in a single centre between index date 01/09/2019 (i.e. 6 months prior to pandemic) and 31/01/2022. Only PCR positive cases were included. COVID outcomes were categorised as Mild (i.e. not hospitalised) or Moderate/Severe (i.e. hospitalised and requiring at least oxygenation or death). Predictors of moderate/severe outcomes were analysed using Cox-regression proportional hazard.ResultsMean (SD) at index date was 59 (14) years, 226/300 (75%) patients were female and 254 (85%) were Caucasians. The diagnoses were RA=212 (71%), SLE=33 (11%), AAV=26 (9%), Sjogren=9 (3%), IIM=8 (3%) and others=12 (4%). Therapy included concomitant DMARDs = 205 (68%) and oral prednisolone = 84 (28%). Median (range) no. of previous RTX courses was 4 (0-19). 534 RTX courses were administered. Of 294 patients with available vaccine data, 17 (6%) were unvaccinated, 4 (1%) had a single dose, 47 (16%) were double-vaccinated, 217 (74%) triple-vaccinated and 9 (3%) quadruple-vaccinated. Of those who were vaccinated, for the first dose, 11% were given within 12 weeks post-RTX, 15% within 26 weeks and 74% were >26 weeks post-RTX. The rate of overall COVID and moderate/severe infections were 11.2/100 PYs and 2.6/100 PYs respectively. Vaccinated patients had lower rate of moderate/severe infection (2.6/100 PYs) vs unvaccinated (18.6/100 PYs) [Table 1]. Over 650.7 PY follow-up, 17/300 patients (5.7%) had moderate/severe COVID including 2 deaths. Factors associated with time-to-infection in imputed multivariable analysis were number of comorbidities [HR 1.46 (95% CI 1.05-2.04)] and low IgG (<6g/L) [6.15 (1.95-19.41)]. A history of COVID vaccination reduced risk [HR 0.13 (0.03-0.51)]. Demographics including concomitant prednisolone, RTX- and vaccine-associated factors (e.g. RTX dose, time from RTX to vaccine, vaccine mode, peripheral B-cell depletion) were not predictive.Table 1.Incidence of COVID infectionPre-Vaccination ProgrammePost-Vaccination ProgrammeOverall Follow-upOverall COVID rate3.3/100 PYNon-vaccinated = 37.7/100 PY73 cases in 650.7 years] = 11.2/100 PYVaccinated = 18.6/100 PYModerate/Severe COVID rate2.1/100 PYNon-Vaccinated = 15.1/100 PY17 cases in 650.7 years] = 2.6/100 PYVaccinated = 2.6/100 PYConclusionThe rate of moderate/severe COVID infection in this cohort is comparable to the pre-pandemic severe infection rate in rituximab trials in RA. The high vaccination uptake in our cohort was effective in preventing severe infection despite the termination of national shielding programme in March 2021 and the spread of the Delta and Omicron variants. Individualised risk–benefit assessment should be undertaken in those with comorbidities, low IgG and unvaccinated when scheduling rituximab therapy.ReferencesNoneAcknowledgementsThis research was funded/supported by the the Wellcome Trust Institutional Strategic Support Fund to MYMY (204825/Z/16/Z), National Institute for Health Research (NIHR) Doctoral Research Fellowship to MYMY (DRF-2014-07-155) and NIHR Clinician Scientist to EMV (CS-2013-13-032). PE is a Versus Arthritis Professor of Rheumatology. This article/paper/report also presents independent research funded/supported by the NIHR Leeds Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.Disclosure of InterestsMd Yuzaiful Md Yusof Consultant of: Aurinia Pharmaceuticals, Jack Arnold: None declared, Benazir Saleem: None declared, Claire Vandevelde: None declared, Shouvik Dass: None declared, Sinisa Savic Speakers bureau: Novartis, Swedish Orphan Biovitrum (SOBI) and Sire, Grant/research support from: Novartis, Swedish Orphan Biovitrum, Octapharma and CSL Behring, Edward Vital Speakers bureau: Roche, GSK and AstraZeneca, Grant/research support from: Roche, GSK and AstraZeneca, Paul Emery Consultant of: BMS, Abbott, Pfizer, MSD, Novartis, Roche and UCB, Grant/research support from: Abbott, BMS, Pfizer, MSD and Roche.
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Arnold J, Dass S, Twigg S, Jones C, Rhodes B, Hewins P, Chakravorty M, Courtney P, Ehrenstein M, Md. Yusof MY, Vital E. AB0434 EFFICACY AND SAFETY OF OBINUTUZUMAB IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS WITH SECONDARY NON-RESPONSE TO RITUXIMAB. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSecondary inefficacy characterized by infusion reactions and anti-drug antibodies occur in 14% of SLE patients treated with repeat rituximab courses(1). Obinutuzumab is a next-generation humanized type-2 anti-CD20 therapy licensed for hematological malignancies which may overcome this issue(2).ObjectivesWe set out to evaluate the clinical efficacy and safety of obinutuzumab in a cohort of rituximab resistant SLE patients.MethodsWe collated data from SLE patients receiving obinutuzumab for secondary non-response to rituximab in BILAG centres. Disease activity was assessed using BILAG-2004, SLEDAI-2K and serology before, and 6 months after, obinutuzumab 2x1000mg infusions alongside methylprednisolone 100mg. Flow cytometry where possible was carried out using a multiple gating highly sensitive strategy.ResultsAll 9 patients included in the study received obinutuzumab alongside concomitant oral immunosuppression. At 6 months post-obinutuzumab, there were significant reductions in median SLEDAI-2K from 12 to 6 (p=0.014) and total BILAG-2004 score from 21 to 2 (p=0.009). Complement C3 and dsDNA titres improved significantly (both p=0.04). Non statistically significant numerical improvements were seen in C4 levels.Of 8/9 patients receiving concomitant oral prednisolone at baseline (all >10mg/day), 5/9 had their dose reduced at 6 months; 4/8 were on 5mg/day and were in Lupus Low Disease Activity State. After obinutuzumab, 6/9 patients with peripheral B-cell data achieved complete depletion including 4/4 assessed with highly sensitive assays. 1/9 obinutuzumab non-responder required cyclophosphamide therapy. 1 unvaccinated patient died from COVID-19.Table 1.Baseline characteristics, disease activity and steroid doses before and after last obinutuzumab/rituximab.PatientEthnicityDisease duration (Years)Age (Years)Total BILAG-2004 before ObiTotal BILAG-2004 after ObiSLEDAI-2K before ObiSLEDAI-2K after ObiPrednisolone before Obi (mg)Prednisolone after Obi (mg)1South Asian10.836.41821481052South Asian6.324.424212430103South Asian11.934.829110410104South Asian8.241.92116015155South Asian6.829.43221181450606White European17.537.0128881557White European16.930.01211281058Caribbean6.244.225213010159Caribbean2.621.092166105Median (Q1, Q3)NA8.2 (6, 12)34.8 (29,37)21 (12, 25)2 (1, 2)12 (10, 14)6 (4, 8)10 (10, 15)10 (5, 15)ConclusionObinutuzumab appears to be effective and steroid-sparing in renal and non-renal SLE patients with secondary non-response to rituximab. Obinutuzumab was shown to be effective in patients with severe renal and non-renal disease. Therefore, in those with previous responsiveness to B-cell depletion, switching to humanised type-2 anti-CD20 therapy is a logical approach following loss off efficacy.References[1]Vital EM, Dass S, Buch MH, Henshaw K, Pease CT, Martin MF, et al. B cell biomarkers of rituximab responses in systemic lupus erythematosus. Arthritis Rheum [Internet]. 2011 Oct [cited 2020 Oct 12];63(10):3038–47. Available from: https://pubmed.ncbi.nlm.nih.gov/21618204/[2]Hassan SU, Md Yusof MY, Emery P, Dass S, Vital EM. Biologic Sequencing in Systemic Lupus Erythematosus: After Secondary Non-response to Rituximab, Switching to Humanised Anti-CD20 Agent Is More Effective Than Belimumab. Front Med [Internet]. 2020 Aug 27 [cited 2020 Sep 2];7:498. Available from: https://www.frontiersin.org/article/10.3389/fmed.2020.00498/fullDisclosure of InterestsJack Arnold: None declared, Shouvik Dass Consultant of: Roche, Abbvie, UCB & Chugai, Employee of: Honoraria from Roche, Abbvie, UCB & Chugai, Sarah Twigg: None declared, Colin Jones: None declared, Benjamin Rhodes: None declared, Peter Hewins: None declared, Mithun Chakravorty: None declared, Philip Courtney: None declared, Michael Ehrenstein Grant/research support from: GSK, Employee of: Has received honoraria from GSK, Md Yuzaiful Md Yusof: None declared, Edward Vital Employee of: Has received honoraria from Roche
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Arnold J, Carter LM, MD Yusof MY, Wigston Z, Hassan SU, Dutton K, Dass S, Psarras A, Vital E. AB0510 IMMUNOPHENOTYPIC RECLASSIFICATION OF ANA ASSOCIATED AUTOIMMUNE DISEASE: PRELIMINARY ANALYSIS OF FLOW CYTOMETRIC DATA IN A MULTI-DISEASE COHORT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe heterogeneity within the connective tissue disease patient cohort is not adequately reflected by current diagnostic labels(1,2). An immunophenotypic classification may be more appropriate for targeting therapy and basket therapeutic trials. DEFINITION is a multi-disease cohort (n=300) containing multiple clinical and immune datasets.ObjectivesTo perform preliminary clustering analysis using the flow cytometric dataset from DEFINITION.Methods142 patients with comprehensive flow cytometry data available were selected from the DEFINITION cohort. Highly sensitive flow cytometry was used to identify 7 B cell, T cell, NK cell and monocyte subsets and tetherin/SIGLEC1 expression on each subset.ANA and ENA titres were assessed via the Bioplex assay. Demographic and clinical data was obtained from the DEFINITION cohort. Multiple classification algorithms were applied to flow cytometry data using R. Including K-means, hierachical, model-based and partitioning around medioids (PAM). Output clusters were retrospectively compared to their legacy diagnoses and serology.ResultsIn the first 142 patients, PAM identified 3 clusters with memberships of 45, 49 and 48 patients respectively (Table 1).Table 1.Key legacy diagnoses and ENA positivity for the identified clusters.DiagnosisTotalCluster 1Cluster 2Cluster 3P valueSLE57221025>0.01UCTD2512850.06Sjogren’s152490.06Systemic sclerosis70520.07MCTD92430.76Myositis83320.86Antibody positivitydsDNA431611160.33Ro604512726>0.01Ro5236107190.01La182214>0.01Sm141490.02Sm_RNP2375110.23RNP143560.64SCL-7010010.37Jo-141210.80Centromere51400.08Chromatin29108110.68Ribosomal P41120.78Cluster 1 (UCTD/CD3+ dominant) was characterised by a higher proportion of UCTD patients (27%) and larger populations of CD3+ T cells and NK bright cells.Cluster 2 (SSc dominant/Tetherin low) was characterised by a higher population of systemic sclerosis (SSc) patients (10%) and a lower proportion of SLE patients (20%). High levels of classical and non-classical monocytes were demonstrated alongside low plasmablast populations and low SIGLEC1/Tetherin expression.Cluster 3 (SLE/pSS high, Ro/Tetherin high) included a higher proportion of SLE and primary Sjogren’s syndrome (pSS) patients (52% and 19%). This cluster showed larger plasmablast numbers and higher SIGLEC1/Tetherin expression. Serologically this cluster had higher levels of Ro60, Ro52, Sm-RNP and La positivity.There were statistically significant differences in Ro60, Ro52, La, and Sm antibody positivity between the 3 clusters. Significant differences in CD19+CD27+ memory B cell tetherin expression and CD14+CD16- classical monocyte SIGLEC1 expression were observed (both p < 0.05). A significant difference in SLE distribution was noted between the clusters (p < 0.01).ConclusionThis preliminary study identified of a flow cytometric dataset identified 3 immunophenotypically distinct subgroups, each comprised of multiple legacy diagnoses within spectrum of ANA+ disease. Future work will evaluate other datasets within the full cohort with a view to conduct basket trials in the baskets defined.References[1]Mucke J, Alarcon-Riquelme M, Andersen J, Aringer M, Bombardieri S, Brinks R, et al. What are the topics you care about making trials in lupus more effective? Results of an Open Space meeting of international lupus experts. Lupus Sci Med [Internet]. 2021 May 20 [cited 2021 Jul 12];8(1):506. Available from: /pmc/articles/PMC8141446/[2]Barturen G, Beretta L, Cervera R, Van Vollenhoven R, Alarcón-Riquelme ME. Moving towards a molecular taxonomy of autoimmune rheumatic diseases [Internet]. Vol. 14, Nature Reviews Rheumatology. Nature Publishing Group; 2018 [cited 2021 Jun 28]. p. 75–93. Available from: https://pubmed.ncbi.nlm.nih.gov/29362467/AcknowledgementsFunding: AstraZenecaDisclosure of InterestsJack Arnold: None declared, Lucy Marie Carter: None declared, Md Yuzaiful Md Yusof: None declared, Zoe Wigston: None declared, Sabih-Ul Hassan: None declared, Katherine Dutton: None declared, Shouvik Dass Speakers bureau: Honoraria from Roche, Consultant of: Roche, Abbvie, UCB & Chugai, Antonios Psarras: None declared, Edward Vital Speakers bureau: GSK, AstraZeneca, Consultant of: AstraZeneca, Lilly, Roche, GSK, Aurinia, Iltoo, Novartis, Grant/research support from: Research grants paid to the employer: AstraZeneca and Sandoz
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Carter LM, Md Yusof MY, Plant D, Alase A, Arnold J, Psarras A, Wigston Z, Vital E. OP0234 RNA-Seq IN PERIPHERAL BLOOD IMMUNE CELLS IDENTIFIES MODULAR NETWORKS PREDICTIVE AND PROTECTIVE FOR PROGRESSION FROM ANA POSITIVITY TO CLASSIFIABLE SYSTEMIC AUTOIMMUNE DISEASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAnti-nuclear antibody (ANA) positivity represents a complex ‘At-Risk’ state for development of connective tissue disease (CTD). While ANA may become positive years in advance of clinically manifest CTD, they are also harboured in at least low titre by up to 25% of the wider population, of whom only a small fraction ultimately develop systemic autoimmunity. Complex immune disturbances including plasmacytoid dendritic cell exhaustion and non-haematopoietic interferon (IFN) production are evident even among ANA positive individuals who do not ultimately progress to overt disease [1].In a prospective observational cohort of ANA positive individuals At-Risk for CTD we have shown that a validated blood IFN-Score was predictive of progression to classifiable SLE [2]. However, the wider transcriptional fingerprint of the At-Risk state and other factors modifying risk of progression are not known. We hypothesise that diverse immune processes, both independent and interacting with IFN pathway activation, could modulate risk of progression.ObjectivesTo investigate how peripheral blood immune cell transcriptional signatures derived by RNA Seq associate with progression or non-progression from At-Risk ANA positivity to clinically apparent CTD.MethodsPeripheral blood mononuclear cells (PBMCs) were isolated at baseline from ANA-positive At-Risk individuals demonstrating ≤1 clinical criterion for classifiable CTD, symptom duration <12 months and naive of glucocorticoid or immunosuppressive therapy. Progression was prospectively adjudicated at 12 months and defined as accrual of clinical/ immunological criteria sufficient to meet classification for SLE (SLICC 2012) or other relevant CTDs. Bulk RNASeq was performed on PMBCs from 16 progressors and 19 non-progressors. Weighted gene co-expression network analysis (WGCNA) was performed using WGCNA package and gene ontology enrichment was evaluated using ClusterProfiler, in R Bioconductor. The top 20% genes ranked by connectivity were defined as hub genes. Major cell subsets were quantified in parallel by multiparameter flow cytometry.Results29 modules were identified by WGCNA. Eigengenes for 3 modules were significantly associated with progression status. A single, 152 gene module showed strong positive correlation with progression (R=0.55, p<0.001). Hub genes were significantly enriched for type I IFN-signalling pathway and included established interferon stimulated genes such as IFI44 and IRF7.Two further modules had a negative, i.e. protective, association with progression; a smaller 37 gene module, correlated negatively with both blood interferon score (R=-0.46, p=0.005) and with progression (R=-0.43, p=0.01). A larger 252 gene module was also negatively related to progression (R=-0.43, p=0.009) and demonstrated significant pathway enrichment for regulation of cell morphogenesis and actin cyctoskeleton organisation.ConclusionWe identify novel modular transcriptomic signatures implicated in SLE disease initiation. We show (i) IFN-pathway activation is the single strongest transcriptomic risk marker of progression from the ANA positive At Risk state and (ii) we identify 2 novel protective signatures in peripheral blood immune cells for which further network-based characterization is ongoing.References[1]Psarras et al. 2020 Nat Commun 11: 6149.[2]Md Yusof MY, et al. Ann Rheum Dis 2018;77:1432–1439.Disclosure of InterestsLucy Marie Carter: None declared, Md Yuzaiful Md Yusof Consultant of: Aurinia Pharmaceuticals, Darren Plant: None declared, Adewonuola Alase: None declared, Jack Arnold: None declared, Antonios Psarras: None declared, Zoe Wigston: None declared, Edward Vital Consultant of: AstraZeneca, Genentech, Aurinia, Lilly, ILTOO and Modus Therapeutics., Grant/research support from: Astra Zeneca and Sandoz
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Abstract
OBJECTIVE In our canine scent detection research involving a specific volatile organic compound (VOC) associated with human epileptic seizure, we began to suspect involvement of the primitive neural networks associated with production of a previously undescribed human alarm pheromone as the origin of our seizure scent. We hypothesized that if we presented fear-scented sweat to our canine seizure scent detection team, and they identified the fear scent as their seizure scent, then that would suggest that they are identical compounds. METHODS Following consent and approval, sweat samples taken from volunteers associated with the Brooke Gordon Comprehensive Epilepsy Center at Denver Health were processed by the Canine Assistants (CA) service dog team that had been imprinted to recognize the unique seizure scent from our previous study. In part one, sweat samples were collected from subjects, who had no prior history of epilepsy or seizures, under two different testing environments: watching a scary movie (It) and a neutral/comedy movie (Airplane!). In part two, a larger follow-up study utilizing fear sweat, exercise sweat, epilepsy sweat, and other distractor scents were provided in a multiple choice paradigm to better understand the inter-rater reliability of the canine responses. RESULTS In part one, our canine seizure scent detection team identified fear-scented sweat samples as their seizure scent in 4 of 5 study participants. There was almost perfect agreement of seizure scent detection during fear scent trials between the canine seizure scent detectors with a kappa value of 0.814 (95% CI: 0.668-0.960). In part two, (utilizing eleven different subjects) our canine scent detection team identified samples of either fear or seizure sweat with a sensitivity of 82% and a specificity of 100% (no false positives) from among the multiple choices offered. Additionally, there was 92% agreement between the members of the canine scent detection team. SIGNIFICANCE While this hypothesis testing study is small and deserves replication, it confirms that the Canine Assistants seizure scent detection team consistently and accurately identified fear-scented sweat as their seizure scent, implying that the VOC, menthone, is common to both conditions. This further implies that human seizure propagation and fear network circuitry may share a common anatomy, and that menthone may not only be an early seizure biomarker, but a newly described human alarm pheromone.
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Affiliation(s)
- E H Maa
- Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, United States; Department of Neurology, University of Colorado, 1635 Aurora Court, Aurora, CO 80045, United States.
| | - J Arnold
- Canine Assistants, 3160 Francis Road, Milton, GA 30004, United States
| | - C K Bush
- Department of Neurology, University of Colorado, 1635 Aurora Court, Aurora, CO 80045, United States
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Pepple S, Arnold J, Vital E, Rawstron A, Pease C, Dass S, Emery P, MD Yusof MY. AB0293 IDENTIFYING PREDICTORS OF SHORT-TERM RESPONSE TO RITUXIMAB IN PRIMARY SJOGREN’S SYNDROME. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Randomised controlled trials of rituximab (RTX) in primary Sjogren’s syndrome (pSS) have aimed to alleviate glandular symptoms and fatigue with only limited data on efficacy/effectiveness of the initial and repeat cycles of RTX on extra-glandular pSS.Objectives:To assess the effectiveness of RTX on extra-glandular symptoms and identify predictors of short-term response with a view to personalised B-cell depleting therapy in patients with pSS.Methods:An observational study was conducted in 40 consecutive RTX-treated pSS patients in a single centre for over 15 years. All patients fulfilled the 2002 AEG criteria and were CCP negative. Clinical response at 6 months was defined as ≥3 reduction of ESSDAI from baseline. B-cell subsets were measured using highly sensitive flow cytometry. Predictors of short-term response were analysed using penalised logistic regression.Results:38/40 (95%) patients were female, mean (SD) Age 54 (13.7) years, median (IQR) disease duration 5 (2-9) years, 39/40 (98%) had positive ANA, 26/40 (65%) were on concomitant immunosuppressant (IS). Mean (SD) ESSDAI at RTX initiation was 11.5 (6.7); main domains for RTX were articular (73%), skin (23%), PNS (15%) and muscular (15%). 169 RTX cycles were administered with a total follow-up of 165PY. In Cycle 1 (C1) RTX, the proportion of patient achieving ESSDAI response from baseline was 29/40 (73%; 95% CI 58-87). There were significant reductions in ESSDAI, daily prednisolone dose and IgG levels at 6 months (all p<0.05). Of C1 responders, 23/29 received retreatment on clinical relapse; of which 8/23 (35%) lost response [secondary non-depletion non response (2NDNR) associated with anti-RTX antibodies=4 (17%) as we previously observed in SLE[1], side effects=2, ineffective=2]. Of C1 non-responders, 9/11 were retreated but only 2/9 responded in C2. Overall, 13/40 (33%) discontinued RTX within two cycles. In multivariable analysis, concomitant IS and achieving compete B-cell depletion in C1 reduced non-response to RTX (Table 1).Conclusion:All pSS patients should be prescribed concomitant immunosuppressant with RTX and therapy should aim to achieve complete depletion. About 1 in 6 pSS patients lose response in repeat cycles which is associated with 2NDNR phenomenon. The use of humanised or type 2 anti-CD20mAbs should overcome these issues and improve the clinical response of extra-glandular pSS.References:[1]Md Yusof et al. ARD 2017 (2520 characters – allowed around 2600 as Table 1 is included too)Table 1.MVA logistic regression of risk factors for RTX non-responsePredictorsContinued Response (N=27)Non-response within 2 RTX Cycles (N=13)UnivariableOR (95% CI); p-valueMultivariableOR (95% CI); p-valueAge, mean (SD) per 10 years55 (14)52 (12)0.87 (0.53-1.41); 0.572Excluded from final modelDisease duration, median (IQR)5 (2-9)6 (3-9)0.97 (0.87-1.08); 0.565Excluded from final modelConcomitant IS, %81.5%30.8%0.10 (0.02-0.46); 0.0030.07 (0.01-0.52); 0.010IgG, mean (SD), g/L15.5 (6.3)18.4 (5.8)1.08 (0.97-1.20); 0.1751.13 (0.97-1.32); 0.116Clinical ESSDAI, median (IQR)10 (6-16)8 (6-10)0.96 (0.85-1.08); 0.4870.91 (0.79-1.05); 0.185Baseline Plasmablast (x1000),109 cells/L, median(IQR)2.6 (1 -5.2)2.3 (1.6-9.5)1.00 (0.94-1.07); 0.885Excluded from final modelComplete B-cell depletion post-RTX, %55.6%8.5%0.07 (0.01-0.64); 0.0180.04 (0.02-0.82); 0.036Disclosure of Interests:Sophanit Pepple: None declared, Jack Arnold: None declared, Edward Vital Grant/research support from: Dr Vital has received honoraria and research grant support from Roche, Andrew Rawstron: None declared, Colin Pease: None declared, Shouvik Dass Grant/research support from: Dr Dass has received honoraria from Roche, Paul Emery Consultant of: Professor Emery has received consultant fees from Roche., Grant/research support from: Professor Emery has received research grants paid to his employer from Roche., Md Yuzaiful Md Yusof: None declared
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Arnold J, Vital E, Dass S, Aslam A, Rawstron A, Savic S, Emery P, MD Yusof MY. OP0057 A PERSONALISED RITUXIMAB RETREATMENT APPROACH BASED ON CLINICAL AND B-CELL BIOMARKERS IN ANCA-ASSOCIATED VASCULITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Time-to-relapse after rituximab for ANCA-associated vasculitis (AAV) is variable and optimal retreatment strategy has been unclear. We previously showed that repopulation of naïve B-cells at 6 months predicts sustained response [1].Objectives:In AAV following rituximab induction, to evaluate clinical and B-cell predictors of relapse in order to develop a retreatment algorithm.Methods:An observational study was conducted in 60 rituximab-treated AAV patients followed for over 10 years. Complete response (CR) was defined as Birmingham Vasculitis Activity Score v3.0 = 0. Retreatment was given on clinical relapse, defined as new features or worsening of persistent disease (not by biomarker status). Peripheral B-cell subsets were measured using highly sensitive flow cytometry. Predictors were tested using multivariable Cox-Regression.Results:Median times-to-retreatment for rituximab cycles 1-5 were 87, 71, 65, 59 and 86 weeks. Over 417 patient-years follow-up, 137 relapses occurred in 50 patients; 16 (in 14 patients) were major (renal=7, neurological=4, ENT=3 and respiratory=2). The major-relapse rate was 3.8/100 patient-years. In multivariable analysis, concomitant immunosuppressant [HR 0.48 (95% CI 0.24–0.94)], achieving CR [0.24 (0.12–0.50)] and naïve B-cell repopulation at 6 months [0.43 (0.22–0.84)] were associated with longer time-to-relapse. Higher baseline memory B-cells [1.01 (1.00–1.02)] were associated with a shorter time-to-relapse. AUROC for prediction of time-to-relapse was greater if guided by naïve B-cell repopulation than if ANCA and/or CD19+ return at 6 months had been used, 0.82 and 0.52 respectively.Conclusion:These data suggest that all patients should receive concomitant oral immunosuppressant. Those with incomplete response or with absent naïve B-cells should be retreated at 6 months. Patients with complete response and naïve repopulation at 6 months should not receive fixed retreatment. This algorithm could reduce hypogammaglobulinaemia due to unnecessary retreatment.Figure 1.A personalised retreatment algorithm for rituximab in ANCA-associated vasculitisReferences:[1]Md Yusof et al. Annals of rheumatic diseases (2015) PMID: 25854586.Disclosure of Interests:Jack Arnold: None declared, Edward Vital Speakers bureau: Roche, GSK and AstraZeneca, Consultant of: Roche, GSK and AstraZeneca, Grant/research support from: Roche, GSK and AstraZeneca, Shouvik Dass Speakers bureau: Roche and GSK, Aamir Aslam: None declared, Andrew Rawstron: None declared, Sinisa Savic: None declared, Paul Emery Speakers bureau: BMS, Abbott, Pfizer, MSD, Novartis, Roche and UCB, Consultant of: BMS, Abbott, Pfizer, MSD, Novartis, Roche and UCB, Grant/research support from: Abbott, BMS, Pfizer, MSD and Roche., Md Yuzaiful Md Yusof: None declared
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Arnold J, Lee H. Variable Impedance Control for pHRI: Impact on Stability, Agility, and Human Effort in Controlling a Wearable Ankle Robot. IEEE Robot Autom Lett 2021. [DOI: 10.1109/lra.2021.3062015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Arnold J, Kanagala P, Budgeon C, Jerosch-Herold M, Singh A, Khan J, Gulsin G, Squire I, Ng L, McCann G. Prevalence of microvascular dysfunction and association with clinical outcomes in heart failure with preserved ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of symptomatic heart failure. A recently proposed paradigm for the pathophysiology of HFpEF postulates a central inflammatory aetiology with coronary microvascular function at its core. However, the pathophysiological and clinical significance of microvascular dysfunction in HFpEF remains uncertain.
Purpose
Utilising cardiovascular magnetic resonance (CMR), we sought to (1) quantify coronary microvascular function, (2) evaluate the impact of microvascular dysfunction and fibrosis on long-term clinical outcomes and (3) examine the relationship between myocardial perfusion and fibrosis.
Methods
In a prospective, observational study, 147 subjects (104 HFpEF without a prior history or CMR evidence of coronary artery disease, and 43 asymptomatic controls) underwent multiparametric CMR, comprising left ventricular volumetric assessment, absolute quantitation of myocardial blood flow [MBF] during adenosine stress (140mcg/kg/min) and at rest, and evaluation of diffuse myocardial fibrosis (extracellular volume [ECV]). The primary endpoint was the composite of death or hospitalisation with heart failure.
Results
104 HFpEF patients (mean age 73±9 years, mean ejection fraction 56%) and 43 controls (mean age 73±5 years, mean ejection fraction 58%) were studied. There was no significant difference in resting MBF (1.10±0.42ml/min/g in HFpEF subjects vs 1.00±0.38 ml/min/g in controls, p=0.23), though hyperaemic MBF was lower in HFpEF subjects (1.66±0.68 ml/min/g vs 1.97±0.59 ml/min/g, p=0.01). Myocardial perfusion reserve [MPR] was also lower in HFpEF subjects (1.73±0.75 vs 2.22±0.76; p<0.01). Microvascular dysfunction (defined as MPR<2.0) was present in 70% of HFpEF patients (versus 33% of controls, p<0.01). During median follow-up of 3.4 years, there were 46 composite events. MPR was predictive of clinical outcome (one unit increase – hazard ratio [HR] 0.57; 95% CI 0.35–0.92; p=0.02), as was ECV (one standard deviation [SD] increase – HR 1.65; 95% CI 1.14–2.39; p=0.01). However, there was no significant linear correlation between MPR and diffuse fibrosis (r<0.01, p=0.99).
Conclusion
Microvascular dysfunction is highly prevalent in HFpEF and is associated with adverse clinical outcomes. The lack of correlation between abnormal myocardial perfusion and fibrosis challenges the assertion of a direct causal link between these entities.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): NIHR, BHF
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Affiliation(s)
- J Arnold
- University of Leicester, Leicester, United Kingdom
| | - P Kanagala
- University of Leicester, Leicester, United Kingdom
| | - C.A Budgeon
- University of Leicester, Leicester, United Kingdom
| | | | - A.S Singh
- University of Leicester, Leicester, United Kingdom
| | - J.N Khan
- University of Leicester, Leicester, United Kingdom
| | - G.S Gulsin
- University of Leicester, Leicester, United Kingdom
| | - I.B Squire
- University of Leicester, Leicester, United Kingdom
| | - L.L Ng
- University of Leicester, Leicester, United Kingdom
| | - G.P McCann
- University of Leicester, Leicester, United Kingdom
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Arnold J, Leung AKC, Lam JM. Violaceous tender nodules symmetrically distributed over the pretibial area. Paediatr Child Health 2020; 25:201-202. [DOI: 10.1093/pch/pxz030] [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] [Received: 09/21/2018] [Accepted: 02/16/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- James Arnold
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia
| | - Alexander K C Leung
- Department of Pediatrics, University of Calgary, Alberta Children’s Hospital, Calgary, Alberta
| | - Joseph M Lam
- Departments of Paediatrics and Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia
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Kumar D, Vachharajani AJ, Wertheimer F, Vergales B, Glass K, Dannaway D, Winter L, Delaney H, Ganster A, Arnold J, Urban A, Johnston L, Bruno C, Gray MM, Sawyer T. Boot camps in neonatal-perinatal medicine fellowship programs: A national survey. J Neonatal Perinatal Med 2020; 12:231-237. [PMID: 30829620 DOI: 10.3233/npm-18117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Simulation is widely used in graduate medical education. A prior survey showed that 80% of Neonatal-Perinatal Medicine (NPM) fellowship programs in the U.S. use simulation. There are multiple ways to provide simulation-based education. One such method is through intensive simulation-based education sessions held at the beginning of a training program, common called 'boot camps'. The aim of this study was to describe the use of simulation-based boot camps in NPM fellowship programs. METHODS Survey study of Accreditation Council for Graduate Medical Education (ACGME) accredited NPM fellowships in the U.S. RESULTS Fifty-nine of 98 programs (60%) responded. Thirty six (61%) participated in 1st year fellow boot camps, which focused on procedural skills and newborn resuscitation. Nearly half of programs participated in regional boot camps. Most boot camps were one or two days long. Eleven programs (19%) held 2nd or 3rd year fellow boot camps, which focused on advanced resuscitation and communication. Barriers included lack of faculty protected time (57%), funding (39%), and lack of faculty experience (31%). CONCLUSIONS A majority of ACGME accredited NPM fellowships participate in 1st year fellows' boot camps. Many participate in regional boot camps. A few programs have 2nd or 3rd year fellow boot camps. Lack of time, funding, and faculty experience were common barriers.
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Affiliation(s)
- D Kumar
- Department of Pediatrics, Division of Neonatology, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, OH, USA
| | - A J Vachharajani
- Department of Pediatrics, Division of Newborn Medicine, Washington University in St. Louis and St. Louis Children's Hospital, St. Louis, MO, USA
| | - F Wertheimer
- Department of Pediatrics, Division of Neonatology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - B Vergales
- Department of Pediatrics, Division of Neonatology, University of Virginia Health System, Charlottesville, VA, USA
| | - K Glass
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, PA, USA
| | - D Dannaway
- Department of Pediatrics, Section of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - L Winter
- Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - H Delaney
- Department of Pediatrics, Division of Neonatology, Brooke Army Medical Center, San Antonio, TX, USA
| | - A Ganster
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - J Arnold
- Department of Pediatrics, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - A Urban
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Johnston
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - C Bruno
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - M M Gray
- Department of Pediatrics, Division of Neonatology, University of Washington School of Medicine and Seattle Children's Hospital. Seattle, WA, USA
| | - T Sawyer
- Department of Pediatrics, Division of Neonatology, University of Washington School of Medicine and Seattle Children's Hospital. Seattle, WA, USA
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Ramirez-Peña E, Arnold J, Shivakumar V, Joseph R, Vidhya Vijay G, den Hollander P, Bhangre N, Allegakoen P, Prasad R, Conley Z, Matés JM, Márquez J, Chang JT, Vasaikar S, Soundararajan R, Sreekumar A, Mani SA. The Epithelial to Mesenchymal Transition Promotes Glutamine Independence by Suppressing GLS2 Expression. Cancers (Basel) 2019; 11:cancers11101610. [PMID: 31652551 PMCID: PMC6826439 DOI: 10.3390/cancers11101610] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 10/05/2019] [Accepted: 10/18/2019] [Indexed: 12/17/2022] Open
Abstract
Identifying bioenergetics that facilitate the epithelial to mesenchymal transition (EMT) in breast cancer cells may uncover targets to treat incurable metastatic disease. Metastasis is the number one cause of cancer-related deaths; therefore, it is urgent to identify new treatment strategies to prevent the initiation of metastasis. To characterize the bioenergetics of EMT, we compared metabolic activities and gene expression in cells induced to differentiate into the mesenchymal state with their epithelial counterparts. We found that levels of GLS2, which encodes a glutaminase, are inversely associated with EMT. GLS2 down-regulation was correlated with reduced mitochondrial activity and glutamine independence even in low-glucose conditions. Restoration of GLS2 expression in GLS2-negative breast cancer cells rescued mitochondrial activity, enhanced glutamine utilization, and inhibited stem-cell properties. Additionally, inhibition of expression of the transcription factor FOXC2, a critical regulator of EMT in GLS2-negative cells, restored GLS2 expression and glutamine utilization. Furthermore, in breast cancer patients, high GLS2 expression is associated with improved survival. These findings suggest that epithelial cancer cells rely on glutamine and that cells induced to undergo EMT become glutamine independent. Moreover, the inhibition of EMT leads to a GLS2-directed metabolic shift in mesenchymal cancer cells, which may make these cells susceptible to chemotherapies.
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Affiliation(s)
- Esmeralda Ramirez-Peña
- National Cancer Institute, Cancer Prevention Fellowship Program, Division of Cancer Prevention, Bethesda, MD 20892, USA.
| | - James Arnold
- Department of Molecular and Cell Biology, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Vinita Shivakumar
- Wiess School of Natural Sciences, Rice University, Houston, TX 77005, USA.
| | - Robiya Joseph
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
| | | | - Petra den Hollander
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Neeraja Bhangre
- Department of Fibrosis Biology, Gilead Sciences, Foster City, CA 94404, USA.
| | - Paul Allegakoen
- Department of Medicine, University of California-San Francisco, San Francisco, CA 94143, USA.
| | - Rishika Prasad
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Zachary Conley
- Center for Science Outreach, Department of Teaching and Learning, Vanderbilt University, Nashville, TN 37235, USA.
| | - José M Matés
- Canceromics Lab, Department of Molecular Biology and Biochemistry, University of Málaga and Instituto de Investigación Biomedica de Málaga (IBIMA), 29071 Málaga, Spain.
| | - Javier Márquez
- Canceromics Lab, Department of Molecular Biology and Biochemistry, University of Málaga and Instituto de Investigación Biomedica de Málaga (IBIMA), 29071 Málaga, Spain.
| | - Jeffrey T Chang
- Department of Integrative Biology and Pharmacology, University of Texas Health Science Center, Houston, TX 77030, USA.
| | - Suhas Vasaikar
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Rama Soundararajan
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Arun Sreekumar
- Department of Molecular and Cell Biology, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Sendurai A Mani
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
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Coutts LV, Plant KL, Smith M, Bolton L, Parnell KJ, Arnold J, Stanton NA. Future technology on the flight deck: assessing the use of touchscreens in vibration environments. Ergonomics 2019; 62:286-304. [PMID: 30470162 DOI: 10.1080/00140139.2018.1552013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 11/15/2018] [Accepted: 11/16/2018] [Indexed: 06/09/2023]
Abstract
Use of touchscreens in the flight deck has been steadily increasing, however, their usability may be severely impacted when turbulent conditions arise. Most previous research focusses on using touchscreens in static conditions; therefore, this study assessed touchscreen use whilst undergoing turbulent representative motion, generated using a 6-axis motion simulator. Touchscreens were tested in centre, side and overhead positions, to investigate how turbulence affected: (1) error rate, movement times and accuracy, (2) arm fatigue and discomfort. Two touchscreen technologies were compared: a 15" infra-red and a 17.3" projected capacitive touchscreen with force sensing capability. The potential of the force sensing capability to minimise unintentional interactions was also investigated. Twenty-six participants undertook multi-direction tapping (ISO 9241; ISO 2010 ) and gesture tasks, under four vibration conditions (control, light chop, light turbulence and moderate turbulence). Error rate, movement time and workload increased and usability decreased significantly, with screen position and increasing turbulence level. Practitioner Summary: This study evaluated the use of infra-red and projected capacitive touchscreen technologies using multi-directional tapping and gesture tasks, whilst being subjected to different levels of turbulence representative motion. Performance degraded significantly with increasing turbulence level and touchscreen location. This has implications for future flight deck design.
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Affiliation(s)
- Louise V Coutts
- a Transportation Research Group, Faculty of Engineering and Environment , University of Southampton , Southampton , UK
| | - Katherine L Plant
- a Transportation Research Group, Faculty of Engineering and Environment , University of Southampton , Southampton , UK
| | - Mark Smith
- b GE Aviation Systems Ltd , Cheltenham, Gloucestershire , UK
| | - Luke Bolton
- b GE Aviation Systems Ltd , Cheltenham, Gloucestershire , UK
| | - Katie J Parnell
- a Transportation Research Group, Faculty of Engineering and Environment , University of Southampton , Southampton , UK
| | - James Arnold
- a Transportation Research Group, Faculty of Engineering and Environment , University of Southampton , Southampton , UK
| | - Neville A Stanton
- a Transportation Research Group, Faculty of Engineering and Environment , University of Southampton , Southampton , UK
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Abstract
Crystallographic restraints are widely used during refinement of small-molecule and macromolecular crystal structures. They can be especially useful for introducing additional observations and information into structure refinements against low-quality or low-resolution data (e.g. data obtained at high pressure) or to retain physically meaningful parameter values in disordered or unstable refinements. However, despite the fact that the anisotropic displacement parameters (ADPs) often constitute more than half of the total model parameters determined in a structure analysis, there are relatively few useful restraints for them, examples being Hirshfeld rigid-bond restraints, direct equivalence of parameters and SHELXL RIGU-type restraints. Conversely, geometric parameters can be subject to a multitude of restraints (e.g. absolute or relative distance, angle, planarity, chiral volume, and geometric similarity). This article presents a series of new ADP restraints implemented in CRYSTALS [Parois, Cooper & Thompson (2015), Chem. Cent. J.
9, 30] to give more control over ADPs by restraining, in a variety of ways, the directions and magnitudes of the principal axes of the ellipsoids in locally defined coordinate systems. The use of these new ADPs results in more realistic models, as well as a better user experience, through restraints that are more efficient and faster to set up. The use of these restraints is recommended to preserve physically meaningful relationships between displacement parameters in a structural model for rigid bodies, rotationally disordered groups and low-completeness data.
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Dai C, Arceo J, Arnold J, Wu J, Dovichi NJ, Sreekumar A, Li J, Littlepage LE. Abstract 3475: Novel correlation-based network analysis of breast tumor metabolism identifies the glycerol channel protein Aquaporin-7 as a regulator of breast cancer metastasis. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-3475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The complex yet interrelated connections between cancer metabolism, gene expression, and oncogenic driver genes have the potential to identify novel biomarkers and drug targets with prognostic and therapeutic value. Using GC-MS, LC-MS/MS, and capillary zone electrophoresis (CZE)-MS platforms, we quantified and compared the levels of 374 metabolites in breast tumor tissue from normal tissue and transgenic mouse breast cancer models overexpressing a panel of oncogenes (PyMT, PyMT-DB, Wnt1, Neu, and C3-TAg). Comparison of the metabolite profiles from the tumors identified oncogene-induced metabolic reprogramming of the tumor tissues. To develop a higher order understanding of the driver genes and metabolites in breast cancer, we next developed a discovery-based correlation network analysis that captured interactions between both metabolite and gene expression data. This analysis uniquely identified a metabolic network of metabolites and genes with prognostic value in breast cancer patients, identifying 35 metabolite and 33 gene hubs that are likely integral to breast tumor metabolism. Further MALDI-MS based imaging revealed heterogeneous distribution of hub metabolites between stromal and epithelial tissue in breast tumors from transgenic mouse models, as well as heterogeneity within the tumor epithelium, suggesting complex metabolic landscape even within the tumor epithelium. We initially focused on the gene hub aquaporin-7 (Aqp7), a water and glycerol channel protein, as a novel regulator of breast cancer. AQP7 deficiency in animal models is associated with adipocyte hypertrophy, increased glycerol and triglyceride accumulation, insulin resistance, and obesity. We discovered that AQP7 is a prognostic marker of overall survival and metastasis in breast cancer patients. Aqp7 is expressed in the epithelium and adipocytes in normal and tumor breast tissue. Reduced Aqp7 expression in mouse breast cancer cells decreased both proliferation and lung metastatic burden. These data suggest AQP7 promotes invasive phenotypes of breast cancer progression. Using an unbiased, discovery-based approach, this study shed light on important players in breast cancer metabolism from a new perspective that complements current guided network analyses.
Citation Format: Chen Dai, Jennifer Arceo, James Arnold, Junmin Wu, Norman J. Dovichi, Arun Sreekumar, Jun Li, Laurie E. Littlepage. Novel correlation-based network analysis of breast tumor metabolism identifies the glycerol channel protein Aquaporin-7 as a regulator of breast cancer metastasis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3475.
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Affiliation(s)
- Chen Dai
- 1University of Notre Dame, South Bend, IN
| | | | | | - Junmin Wu
- 1University of Notre Dame, South Bend, IN
| | | | | | - Jun Li
- 1University of Notre Dame, South Bend, IN
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Opzoomer J, Caron J, Muliaditan T, Okesola M, Kordasti S, Spicer J, Arnold J. PO-322 Investigating co-expression of the immune checkpoints heme oxygenase-1 and PD-L in breast cancer. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Caranica C, Al-Omari A, Deng Z, Griffith J, Nilsen R, Mao L, Arnold J, Schüttler HB. Ensemble methods for stochastic networks with special reference to the biological clock of Neurospora crassa. PLoS One 2018; 13:e0196435. [PMID: 29768444 PMCID: PMC5955539 DOI: 10.1371/journal.pone.0196435] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/12/2018] [Indexed: 11/18/2022] Open
Abstract
A major challenge in systems biology is to infer the parameters of regulatory networks that operate in a noisy environment, such as in a single cell. In a stochastic regime it is hard to distinguish noise from the real signal and to infer the noise contribution to the dynamical behavior. When the genetic network displays oscillatory dynamics, it is even harder to infer the parameters that produce the oscillations. To address this issue we introduce a new estimation method built on a combination of stochastic simulations, mass action kinetics and ensemble network simulations in which we match the average periodogram and phase of the model to that of the data. The method is relatively fast (compared to Metropolis-Hastings Monte Carlo Methods), easy to parallelize, applicable to large oscillatory networks and large (~2000 cells) single cell expression data sets, and it quantifies the noise impact on the observed dynamics. Standard errors of estimated rate coefficients are typically two orders of magnitude smaller than the mean from single cell experiments with on the order of ~1000 cells. We also provide a method to assess the goodness of fit of the stochastic network using the Hilbert phase of single cells. An analysis of phase departures from the null model with no communication between cells is consistent with a hypothesis of Stochastic Resonance describing single cell oscillators. Stochastic Resonance provides a physical mechanism whereby intracellular noise plays a positive role in establishing oscillatory behavior, but may require model parameters, such as rate coefficients, that differ substantially from those extracted at the macroscopic level from measurements on populations of millions of communicating, synchronized cells.
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Affiliation(s)
- C. Caranica
- Department of Statistics, University of Georgia, Athens, Georgia
| | - A. Al-Omari
- Department of Biomedical Systems and Informatics Engineering, Yarmouk University, Irbid, Jordan
| | - Z. Deng
- School of Electrical and Computer Engineering, College of Engineering, University of Georgia, Athens, Georgia
| | - J. Griffith
- Genetics Department, University of Georgia, Athens, Georgia
- College of Agricultural and Environmental Sciences, University of Georgia, Athens, Georgia
| | - R. Nilsen
- Genetics Department, University of Georgia, Athens, Georgia
| | - L. Mao
- School of Electrical and Computer Engineering, College of Engineering, University of Georgia, Athens, Georgia
| | - J. Arnold
- Genetics Department, University of Georgia, Athens, Georgia
- * E-mail:
| | - H.-B. Schüttler
- Department of Physics and Astronomy, University of Georgia, Athens, Georgia
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Parker BF, Hohloch S, Pankhurst JR, Zhang Z, Love JB, Arnold J, Rao L. Interactions of vanadium(iv) with amidoxime ligands: redox reactivity. Dalton Trans 2018; 47:5695-5702. [PMID: 29632905 DOI: 10.1039/c7dt04069e] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The use of amidoxime-functionalized polymer fibers as a sorbent for uranium has attracted recent interest for the extraction of uranium from seawater. Vanadium is one of the main competing ions for uranium sorption as V(v) species, however, vanadium is also present as V(iv) in seawater. In the present study, the interactions of V(iv) with amidoxime and similar ligands were explored. Attempts were made to synthesize V(iv) complexes of glutaroimide-dioxime, a molecular analogue of polymer sorbents. However, V(iv) was found to react irreversibly with glutaroimide-dioxime and other oxime groups, oxidizing to the V(v) oxidation state. We have explored the reactions and propose mechanisms, as well as characterized the redox behavior of the vanadium-glutaroimide-dioxime complex.
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Affiliation(s)
- B F Parker
- Department of Chemistry, University of California - Berkeley, Berkeley, CA 94720, USA.
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Dai C, Arceo J, Arnold J, Sreekumar A, Dovichi NJ, Li J, Littlepage LE. Metabolomics of oncogene-specific metabolic reprogramming during breast cancer. Cancer Metab 2018; 6:5. [PMID: 29619217 PMCID: PMC5881178 DOI: 10.1186/s40170-018-0175-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 02/16/2018] [Indexed: 01/01/2023] Open
Abstract
Background The complex yet interrelated connections between cancer metabolism and oncogenic driver genes are relatively unexplored but have the potential to identify novel biomarkers and drug targets with prognostic and therapeutic value. The goal of this study was to identify global metabolic profiles of breast tumors isolated from multiple transgenic mouse models and to identify unique metabolic signatures driven by these oncogenes. Methods Using mass spectrometry (GC-MS, LC-MS/MS, and capillary zone electrophoresis (CZE)-MS platforms), we quantified and compared the levels of 374 metabolites in breast tissue from normal and transgenic mouse breast cancer models overexpressing a panel of oncogenes (PyMT, PyMT-DB, Wnt1, Neu, and C3-TAg). We also compared the mouse metabolomics data to published human metabolomics data already linked to clinical data. Results Through analysis of our metabolomics data, we identified metabolic differences between normal and tumor breast tissues as well as metabolic differences unique to each initiating oncogene. We also quantified the metabolic profiles of the mammary fat pad versus mammary epithelium by CZE-MS/MS. However, the differences between the tissues did not account for the majority of the metabolic differences between the normal mammary gland and breast tumor tissues. Therefore, the differences between the cohorts were unlikely due to cellular heterogeneity. Of the mouse models used in this study, C3-TAg was the only cohort with a tumor metabolic signature composed of ten metabolites that had significant prognostic value in breast cancer patients. Gene expression analysis identified candidate genes that may contribute to the metabolic reprogramming. Conclusions This study identifies oncogene-induced metabolic reprogramming within mouse breast tumors and compares the results to that of human breast tumors, providing a unique look at the relationship between and clinical value of oncogene initiation and metabolism during breast cancer.
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Affiliation(s)
- Chen Dai
- 1Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556 USA.,2Harper Cancer Research Institute, University of Notre Dame, 1234 N Notre Dame Avenue, South Bend, IN 46617 USA
| | - Jennifer Arceo
- 1Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556 USA.,2Harper Cancer Research Institute, University of Notre Dame, 1234 N Notre Dame Avenue, South Bend, IN 46617 USA
| | - James Arnold
- 3Department of Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, TX 77030 USA
| | - Arun Sreekumar
- 3Department of Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, TX 77030 USA
| | - Norman J Dovichi
- 1Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556 USA.,2Harper Cancer Research Institute, University of Notre Dame, 1234 N Notre Dame Avenue, South Bend, IN 46617 USA
| | - Jun Li
- 2Harper Cancer Research Institute, University of Notre Dame, 1234 N Notre Dame Avenue, South Bend, IN 46617 USA.,4Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, Notre Dame, IN 46556 USA
| | - Laurie E Littlepage
- 1Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556 USA.,2Harper Cancer Research Institute, University of Notre Dame, 1234 N Notre Dame Avenue, South Bend, IN 46617 USA
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22
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Abstract
This review provides a brief background on the extraction of uranium from seawater as well as recent work by the United States Department of Energy on this project. The world's oceans contain uranium at 3 parts per billion, and despite this low concentration, there has been historical interest in harvesting it, mainly in Japan in the 1980s and the United States in this decade. Improvements in materials, chemistry, and deployment methods have all been made, with the ultimate goal of lower cost. This has been partially realized, dropping from approximately $2000 per kg U3O8 extracted in 1984 to $500 per kg today, although this is not yet competitive with terrestrial uranium. This technology may become cost-competitive if the cost of land-based uranium rises, especially if seawater extraction technology is improved further. The coordination chemistry aspects of the project are described in more detail, exploring the functional groups that are present on typical polymer sorbents as well as small-molecule analogues of these ligands. Selectivity for uranium over other metals, particularly vanadium, remains problematic, and techniques to both quantify binding strength and selectivity in order to overcome this issue are essential for future cost improvements.
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Affiliation(s)
- B F Parker
- Department of Chemistry, University of California - Berkeley, Berkeley, CA 94720, USA.
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23
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Abstract
Homoleptic U(iv) and U(iii) amidate complexes have been isolated and characterized; these species undergo an unusual and reversible change in coordination number upon reduction/oxidation.
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Affiliation(s)
- M. D. Straub
- Department of Chemistry
- University of California
- Berkeley
- USA
- Chemical Sciences Division
| | - S. Hohloch
- Department of Chemistry
- University of California
- Berkeley
- USA
- Chemical Sciences Division
| | - S. G. Minasian
- Chemical Sciences Division
- Lawrence Berkeley National Laboratory
- Berkeley
- USA
| | - J. Arnold
- Department of Chemistry
- University of California
- Berkeley
- USA
- Chemical Sciences Division
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24
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Daien V, Nguyen V, Essex RW, Morlet N, Barthelmes D, Gillies MC, Gillies M, Hunt A, Essex R, Dayajeewa C, Hunyor A, Fraser-Bell S, Younan C, Fung A, Guymer R, Louis D, Arnold J, Chan D, Cass H, Harper A, O’Day J, Daniell M, Field A, Chow L, Barthelmes D, Cohn A, Young S, Lal S, Ferrier R, Barnes R, Thompson A, Vincent A, Manning L, Lake S, Phillips R, Perks M, Chen J, Landers J, Niladri, Banerjee G, Swamy B, Windle P, Dunlop A, Tang K, McLean I, Amini A, Hunt A, Clark G, McAllister I, Chen F, Squirrell D, Ng C, Hinchcliffe P, Barry R, Ah-Chan J, Steiner H, Morgan M, Thompson C, Game J, Murray N. Incidence and Outcomes of Infectious and Noninfectious Endophthalmitis after Intravitreal Injections for Age-Related Macular Degeneration. Ophthalmology 2018; 125:66-74. [DOI: 10.1016/j.ophtha.2017.07.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/19/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022] Open
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25
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Funnell L, Arnold J. A review of physiotherapy management and interventions provided to CF patients requiring ECMO or ECCO2 removal. Physiotherapy 2017. [DOI: 10.1016/j.physio.2017.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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26
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Goldberg D, Kallan MJ, Fu L, Ciccarone M, Ramirez J, Rosenberg P, Arnold J, Segal G, Moritsugu KP, Nathan H, Hasz R, Abt PL. Changing Metrics of Organ Procurement Organization Performance in Order to Increase Organ Donation Rates in the United States. Am J Transplant 2017; 17:3183-3192. [PMID: 28726327 DOI: 10.1111/ajt.14391] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/05/2017] [Accepted: 06/05/2017] [Indexed: 01/25/2023]
Abstract
The shortage of deceased-donor organs is compounded by donation metrics that fail to account for the total pool of possible donors, leading to ambiguous donor statistics. We sought to assess potential metrics of organ procurement organizations (OPOs) utilizing data from the Nationwide Inpatient Sample (NIS) from 2009-2012 and State Inpatient Databases (SIDs) from 2008-2014. A possible donor was defined as a ventilated inpatient death ≤75 years of age, without multi-organ system failure, sepsis, or cancer, whose cause of death was consistent with organ donation. These estimates were compared to patient-level data from chart review from two large OPOs. Among 2,907,658 inpatient deaths from 2009-2012, 96,028 (3.3%) were a "possible deceased-organ donor." The two proposed metrics of OPO performance were: (1) donation percentage (percentage of possible deceased-donors who become actual donors; range: 20.0-57.0%); and (2) organs transplanted per possible donor (range: 0.52-1.74). These metrics allow for comparisons of OPO performance and geographic-level donation rates, and identify areas in greatest need of interventions to improve donation rates. We demonstrate that administrative data can be used to identify possible deceased donors in the US and could be a data source for CMS to implement new OPO performance metrics in a standardized fashion.
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Affiliation(s)
- D Goldberg
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA.,Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Philadelphia, PA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - M J Kallan
- Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Philadelphia, PA
| | - L Fu
- The Bridgespan Group, New York, NY
| | | | | | | | | | | | - K P Moritsugu
- Former Acting Surgeon General of the United States, Great Falls, MT
| | - H Nathan
- Gift of Life Institute, Philadelphia, PA
| | - R Hasz
- Gift of Life Institute, Philadelphia, PA
| | - P L Abt
- Division of Transplant Surgery, University of Pennsylvania, Philadelphia, PA
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27
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Woodhams R, Evans J, Edwards J, Metcalfe S, Murray P, Arnold J, Wyeth J. Real World Outcomes from Funded Cancer Medicines in New Zealand (NZ) Compared with Published Clinical Trials. Clin Ther 2017. [DOI: 10.1016/j.clinthera.2017.05.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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28
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Abstract
Mini-blades are particularly useful in creating incisional pockets as recipient sites for hair transplants. With the aid of a special mini-blade handle, the length and depth of each incision can be accurately controlled. Surgeons can rapidly produce multiple uniform incisions with the technique described. Mini-blades are thicker than other blades and partially dilate each incision. Graft insertion is simplified by the partial dilation. More substantial dilation of the larger miniblade incisions can be produced with a twisting motion imparted to the mini-blade during the incisional process.
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29
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Lee A, Keating O, Crawley A, Arnold J. Safe surgical ward rounds, a completed quality improvement cycle. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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30
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Bakken TE, Miller JA, Ding SL, Sunkin SM, Smith KA, Ng L, Szafer A, Dalley RA, Royall JJ, Lemon T, Shapouri S, Aiona K, Arnold J, Bennett JL, Bertagnolli D, Bickley K, Boe A, Brouner K, Butler S, Byrnes E, Caldejon S, Carey A, Cate S, Chapin M, Chen J, Dee N, Desta T, Dolbeare TA, Dotson N, Ebbert A, Fulfs E, Gee G, Gilbert TL, Goldy J, Gourley L, Gregor B, Gu G, Hall J, Haradon Z, Haynor DR, Hejazinia N, Hoerder-Suabedissen A, Howard R, Jochim J, Kinnunen M, Kriedberg A, Kuan CL, Lau C, Lee CK, Lee F, Luong L, Mastan N, May R, Melchor J, Mosqueda N, Mott E, Ngo K, Nyhus J, Oldre A, Olson E, Parente J, Parker PD, Parry S, Pendergraft J, Potekhina L, Reding M, Riley ZL, Roberts T, Rogers B, Roll K, Rosen D, Sandman D, Sarreal M, Shapovalova N, Shi S, Sjoquist N, Sodt AJ, Townsend R, Velasquez L, Wagley U, Wakeman WB, White C, Bennett C, Wu J, Young R, Youngstrom BL, Wohnoutka P, Gibbs RA, Rogers J, Hohmann JG, Hawrylycz MJ, Hevner RF, Molnár Z, Phillips JW, Dang C, Jones AR, Amaral DG, Bernard A, Lein ES. A comprehensive transcriptional map of primate brain development. Nature 2016; 535:367-75. [PMID: 27409810 PMCID: PMC5325728 DOI: 10.1038/nature18637] [Citation(s) in RCA: 239] [Impact Index Per Article: 29.9] [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: 08/06/2015] [Accepted: 06/10/2016] [Indexed: 12/20/2022]
Abstract
The transcriptional underpinnings of brain development remain poorly understood, particularly in humans and closely related non-human primates. We describe a high-resolution transcriptional atlas of rhesus monkey (Macaca mulatta) brain development that combines dense temporal sampling of prenatal and postnatal periods with fine anatomical division of cortical and subcortical regions associated with human neuropsychiatric disease. Gene expression changes more rapidly before birth, both in progenitor cells and maturing neurons. Cortical layers and areas acquire adult-like molecular profiles surprisingly late in postnatal development. Disparate cell populations exhibit distinct developmental timing of gene expression, but also unexpected synchrony of processes underlying neural circuit construction including cell projection and adhesion. Candidate risk genes for neurodevelopmental disorders including primary microcephaly, autism spectrum disorder, intellectual disability, and schizophrenia show disease-specific spatiotemporal enrichment within developing neocortex. Human developmental expression trajectories are more similar to monkey than rodent, although approximately 9% of genes show human-specific regulation with evidence for prolonged maturation or neoteny compared to monkey.
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Affiliation(s)
- Trygve E Bakken
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Jeremy A Miller
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Song-Lin Ding
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Susan M Sunkin
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Kimberly A Smith
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Lydia Ng
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Aaron Szafer
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Rachel A Dalley
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Joshua J Royall
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Tracy Lemon
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Sheila Shapouri
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Kaylynn Aiona
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - James Arnold
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Jeffrey L Bennett
- Department of Psychiatry and Behavioral Science, California National Primate Research Center, The M.I.N.D. Institute, University of California, Davis, Sacramento, California 95817, USA
| | | | | | - Andrew Boe
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Krissy Brouner
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Stephanie Butler
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Emi Byrnes
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Shiella Caldejon
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Anita Carey
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Shelby Cate
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Mike Chapin
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Jefferey Chen
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Nick Dee
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Tsega Desta
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Tim A Dolbeare
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Nadia Dotson
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Amanda Ebbert
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Erich Fulfs
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Garrett Gee
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Terri L Gilbert
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Jeff Goldy
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Lindsey Gourley
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Ben Gregor
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Guangyu Gu
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Jon Hall
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Zeb Haradon
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - David R Haynor
- Department of Radiology, University of Washington, Seattle, Washington 98195, USA
| | - Nika Hejazinia
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Anna Hoerder-Suabedissen
- Department of Physiology, Anatomy and Genetics, University of Oxford, South Parks Road, Oxford OX1 3QX, UK
| | - Robert Howard
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Jay Jochim
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Marty Kinnunen
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Ali Kriedberg
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Chihchau L Kuan
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Christopher Lau
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Chang-Kyu Lee
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Felix Lee
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Lon Luong
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Naveed Mastan
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Ryan May
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Jose Melchor
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Nerick Mosqueda
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Erika Mott
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Kiet Ngo
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Julie Nyhus
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Aaron Oldre
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Eric Olson
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Jody Parente
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Patrick D Parker
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Sheana Parry
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | | | - Lydia Potekhina
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Melissa Reding
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Zackery L Riley
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Tyson Roberts
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Brandon Rogers
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Kate Roll
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - David Rosen
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - David Sandman
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Melaine Sarreal
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | | | - Shu Shi
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Nathan Sjoquist
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Andy J Sodt
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Robbie Townsend
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | | | - Udi Wagley
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Wayne B Wakeman
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Cassandra White
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Crissa Bennett
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Jennifer Wu
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Rob Young
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | | | - Paul Wohnoutka
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Richard A Gibbs
- Human Genome Sequencing Center and Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA
| | - Jeffrey Rogers
- Human Genome Sequencing Center and Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77030, USA
| | - John G Hohmann
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | | | - Robert F Hevner
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, Washington 98101, USA
| | - Zoltán Molnár
- Department of Physiology, Anatomy and Genetics, University of Oxford, South Parks Road, Oxford OX1 3QX, UK
| | - John W Phillips
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Chinh Dang
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Allan R Jones
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - David G Amaral
- Department of Psychiatry and Behavioral Science, California National Primate Research Center, The M.I.N.D. Institute, University of California, Davis, Sacramento, California 95817, USA
| | - Amy Bernard
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
| | - Ed S Lein
- Allen Institute for Brain Science, Seattle, Washington 98109, USA
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Blauth C, Brady A, Arnold J, Brannan J, Schulenburg WE, Frackowiak R, Taylor KM. A double blind clinical trial of Iloprost during cardiopulmonary bypass. Perfusion 2016. [DOI: 10.1177/026765918700200405] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Twenty patients undergoing elective coronary surgery were randomized to receive either the prostacyclin analogue Iloprost (Zk 36374) 5 ng/kg/min for 30 minutes before cardiopulmonary bypass (CPB) increasing to 10 ng/kg/min during CPB, or placebo, to investigate any beneficial effect on platelet preservation, or protection of the central nervous system during clinical CPB. Originally 50 patients were to have entered the trial, but unacceptable hypotensive effects occu rred in five patients who received Iloprost, lead i ng to early data analysis. No significant improvement in platelet number, volume or function; bleeding time; arterial line filter δ dry weight; retinal microembolism; or neuropsychological function, attributable to Iloprost, could be identified. The role and optimal dose of Iloprost in clinical CPB remains to be established.
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Affiliation(s)
- C. Blauth
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - A. Brady
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - J. Arnold
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - J. Brannan
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - WE Schulenburg
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - R. Frackowiak
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
| | - KM Taylor
- Cardiac Surgical Unit and Departments of Surgery and Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London
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Sammut L, Clayton P, Arnold J, Davidson B. FRI0644-HPR Perceived Physical Activity Benefits and Barriers in Rheumatoid Arthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Arnold J, Bruce-Low S, Henderson S, Davies J. Mapping and evaluation of physical activity interventions for school-aged children. Public Health 2016; 136:75-9. [PMID: 27080582 DOI: 10.1016/j.puhe.2016.02.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 02/22/2016] [Accepted: 02/26/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES A high degree of de-regulation, organisational fragmentation and funding cuts throughout UK schools in recent years has obscured the definitive structure and effectiveness of physical activity (PA) provision offered to children. This pilot study aimed to map the current structure and context of PA provision offered to school children in Southampton, and its alignment with existing empirical evidence about the likely effectiveness of such interventions. STUDY DESIGN Utilising a qualitative approach, the study focused upon school-based PA provision, since this setting was conjectured to show greater diversity when compared to settings outside of school, lending itself to further interventions than non-school PA provision. METHODS Interventions offered across nine schools (three junior, two primary, four secondary) were investigated and mapped through semi-structured interviews. Findings were benchmarked against other cities similar to Southampton in indices of multiple deprivation status via interviews with city council workers. RESULTS Interviews highlighted only three formal PA specific interventions currently operating, and a hand full of informal interventions. Limited PA provision was attributed to a lack of time, money, and priority devoted towards PA within schools. Considerable disparity exists between the high prevalence of sport-oriented provision compared with the low prevalence of PA specific provision. Interviews with Portsmouth and Bristol city councils suggest that such findings may not be unique to Southampton. CONCLUSIONS In contrast to the extensive literature base detailing numerous PA interventions in school-aged children, our data suggest that a very small amount of such knowledge appears to translate into PA provision offered in Southampton schools. Our data highlight a significant discrepancy between sport and PA provision across schools. It is possible that the inability to successfully differentiate between sport and PA may present a further obstacle to the successful uptake of PA in the future. An extension of the PA mapping carried out, both countywide and nationally, provides a possible avenue for future research to confirm or contrast these initial insights.
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Affiliation(s)
- J Arnold
- School of Sport, Health and Social Sciences, Southampton Solent University, UK.
| | - S Bruce-Low
- School of Sport, Health and Social Sciences, Southampton Solent University, UK.
| | - S Henderson
- School of Sport, Health and Social Sciences, Southampton Solent University, UK.
| | - J Davies
- Southampton Public Health Team, Southampton City Council, UK.
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Arnold J, Vorwerk D, Dabitz R. Klinische Relevanz des THRIVE-Scores für die Outcome-Prognose nach mechanischer Rekanalisation bei akutem Schlaganfall. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Arnold J, Vorwerk D, Dabitz R. Vergleich von Behandlungserfolg und Outcome nach mechanischer Rekanalisation bei akutem Schlaganfall hinsichtlich der Verschlusslokalisation. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Leggett CJ, Parker BF, Teat SJ, Zhang Z, Dau PD, Lukens WW, Peterson SM, Cardenas AJP, Warner MG, Gibson JK, Arnold J, Rao L. Structural and spectroscopic studies of a rare non-oxido V(v) complex crystallized from aqueous solution. Chem Sci 2016; 7:2775-2786. [PMID: 28660055 PMCID: PMC5477013 DOI: 10.1039/c5sc03958d] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/14/2016] [Indexed: 11/21/2022] Open
Abstract
A non-oxido V(v) complex with glutaroimide-dioxime (H3L), a ligand for recovering uranium from seawater, was synthesized from aqueous solution as Na[V(L)2]·2H2O, and the structure determined by X-ray diffraction.
A non-oxido V(v) complex with glutaroimide-dioxime (H3L), a ligand for recovering uranium from seawater, was synthesized from aqueous solution as Na[V(L)2]·2H2O, and the structure determined by X-ray diffraction. It is the first non-oxido V(v) complex that has been directly synthesized in and crystallized from aqueous solution. The distorted octahedral structure contains two fully deprotonated ligands (L3–) coordinating to V5+, each in a tridentate mode via the imide N (RV–N = 1.96 Å) and oxime O atoms (RV–O = 1.87–1.90 Å). Using 17O-labelled vanadate as the starting material, concurrent 17O/51V/1H/13C NMR, in conjunction with ESI-MS, unprecedentedly demonstrated the stepwise displacement of the oxido V
Created by potrace 1.16, written by Peter Selinger 2001-2019
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O bonds by glutaroimide-dioxime and verified the existence of the “bare” V5+/glutaroimide-dioxime complex, [V(L)2]–, in aqueous solution. In addition, the crystal structure of an intermediate 1 : 1 V(v)/glutaroimide-dioxime complex, [VO2(HL)]–, in which the oxido bonds of vanadate are only partially displaced, corroborates the observations by NMR and ESI-MS. Results from this work provide important insights into the strong sorption of vanadium on poly(amidoxime) sorbents in the recovery of uranium from seawater. Also, because vanadium plays important roles in biological systems, the syntheses of the oxido and non-oxido V5+ complexes and the unprecedented demonstration of the displacement of the oxido V
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O bonds help with the on-going efforts to develop new vanadium compounds that could be of importance in biological applications.
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Affiliation(s)
- C J Leggett
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - B F Parker
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA . .,Department of Chemistry , University of California - Berkeley , Berkeley , CA 94720 , USA
| | - S J Teat
- Advanced Light Source , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - Z Zhang
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - P D Dau
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - W W Lukens
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - S M Peterson
- National Security Directorate , Pacific Northwest National Laboratory , 902 Battelle Blvd. , Richland , WA 99352 , USA
| | - A J P Cardenas
- Fundamental and Computational Sciences Directorate , Pacific Northwest National Laboratory , 902 Battelle Blvd. , Richland , WA 99352 , USA
| | - M G Warner
- National Security Directorate , Pacific Northwest National Laboratory , 902 Battelle Blvd. , Richland , WA 99352 , USA
| | - J K Gibson
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
| | - J Arnold
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA . .,Department of Chemistry , University of California - Berkeley , Berkeley , CA 94720 , USA
| | - L Rao
- Chemical Sciences Division , Lawrence Berkeley National Laboratory , 1 Cyclotron Road , Berkeley , CA 94720 , USA .
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Riphaus A, Wehrmann T, Hausmann J, Weber B, von Delius S, Jung M, Tonner P, Arnold J, Behrens A, Beilenhoff U, Bitter H, Domagk D, In der Smitten S, Kallinowski B, Meining A, Schaible A, Schilling D, Seifert H, Wappler F, Kopp I. Update S3-guideline: "sedation for gastrointestinal endoscopy" 2014 (AWMF-register-no. 021/014). Z Gastroenterol 2016; 54:58-95. [PMID: 26751118 DOI: 10.1055/s-0041-109680] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
| | | | - J Hausmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt
| | - B Weber
- Medizinische Klinik II, KRH Klinikum Siloah-Oststadt, Hannover
| | - S von Delius
- II. Medizinische Klinik, Klinikum rechts der Isar, TU München, München
| | - M Jung
- Klinik für Innere Medizin 2, Katholisches Klinikum Mainz, Mainz
| | - P Tonner
- Klinik für Anaesthesie, operative und allgemeine Intensivmedizin, Notfallmedizin, Klinikum Links der Weser, Bremen
| | - J Arnold
- Klinik für Gastroenterologie, Hepatologie, Diabetologie und Ernährungsmedizin, Agaplesion Diakonieklinikum Rotenburg, Rotenburg
| | - A Behrens
- Klinik für Gastroenterologie und interventionelle Endoskopie, Vivantes Klinikum im Friedrichshain, Berlin
| | | | | | - D Domagk
- Medizinische Klinik I, Josephs-Hospital, Warendorf
| | | | | | - A Meining
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
| | - A Schaible
- Klinik für interdisziplinäre Endoskopie, Universitätsklinikum Heidelberg, Heidelberg
| | - D Schilling
- Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim
| | - H Seifert
- Klinik für Gastroenterologie, Klinikum Oldenburg, Oldenburg
| | - F Wappler
- Klinik für Anaesthesie und operative Intensivmedizin, Kliniken der Stadt Köln gGmbH, Universitätsklinikum Witten/Herdecke, Köln
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Riphaus A, Wehrmann T, Hausmann J, Weber B, von Delius S, Jung M, Tonner P, Arnold J, Behrens A, Beilenhoff U, Bitter H, Domagk D, In der Smitten S, Kallinowski B, Meining A, Schaible A, Schilling D, Seifert H, Wappler F, Kopp I. [S3-guidelines "sedation in gastrointestinal endoscopy" 2014 (AWMF register no. 021/014)]. Z Gastroenterol 2015; 53:E1. [PMID: 26447364 DOI: 10.1055/s-0035-1553971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - J Hausmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt
| | - B Weber
- Medizinische Klinik II, KRH Klinikum Siloah-Oststadt, Hannover
| | - S von Delius
- II. Medizinische Klinik, Klinikum rechts der Isar, TU München, München
| | - M Jung
- Klinik für Innere Medizin 2, Katholisches Klinikum Mainz, Mainz
| | - P Tonner
- Klinik für Anaesthesie, operative und allgemeine Intensivmedizin, Notfallmedizin, Klinikum Links der Weser, Bremen
| | - J Arnold
- Klinik für Gastroenterologie, Hepatologie, Diabetologie und Ernährungsmedizin, Agaplesion Diakonieklinikum Rotenburg, Rotenburg
| | - A Behrens
- Klinik für Gastroenterologie und interventionelle Endoskopie, Vivantes Klinikum im Friedrichshain, Berlin
| | | | | | - D Domagk
- Medizinische Klinik I, Josephs-Hospital, Warendorf
| | | | | | - A Meining
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
| | - A Schaible
- Klinik für interdisziplinäre Endoskopie, Universitätsklinikum Heidelberg, Heidelberg
| | - D Schilling
- Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim
| | - H Seifert
- Klinik für Gastroenterologie, Klinikum Oldenburg, Oldenburg
| | - F Wappler
- Klinik für Anaesthesie und operative Intensivmedizin, Kliniken der Stadt Köln gGmbH, Universitätsklinikum Witten/Herdecke, Köln
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Lloyd SM, Arnold J, Sreekumar A. Metabolomic profiling of hormone-dependent cancers: a bird's eye view. Trends Endocrinol Metab 2015; 26:477-85. [PMID: 26242817 PMCID: PMC4560106 DOI: 10.1016/j.tem.2015.07.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 06/19/2015] [Accepted: 07/01/2015] [Indexed: 01/18/2023]
Abstract
Hormone-dependent cancers present a significant public health challenge, because they are among the most common cancers in the world. One factor associated with cancer development and progression is metabolic reprogramming. By understanding these alterations, we can identify potential markers and novel biochemical therapeutic targets. Metabolic profiling is an advanced technology that allows investigators to assess low-molecular-weight compounds that reflect physiological alterations. Current research in metabolomics on prostate (PCa) and breast cancer (BCa) have made great strides in uncovering specific metabolic pathways that are associated with cancer development, progression, and resistance. In this review, we highlight some of the major findings and potential therapeutic advances that have been reported utilizing this technology.
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Affiliation(s)
- Stacy M Lloyd
- Alkek Center for Molecular Discovery, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - James Arnold
- Alkek Center for Molecular Discovery, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA; Verna and Marrs McLean Department of Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Arun Sreekumar
- Alkek Center for Molecular Discovery, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA; Verna and Marrs McLean Department of Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, TX 77030, USA.
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Riphaus A, Wehrmann T, Hausmann J, Weber B, von Delius S, Jung M, Tonner P, Arnold J, Behrens A, Beilenhoff U, Bitter H, Domagk D, In der Smitten S, Kallinowski B, Meining A, Schaible A, Schilling D, Seifert H, Wappler F, Kopp I. [S3-guidelines "sedation in gastrointestinal endoscopy" 2014 (AWMF register no. 021/014)]. Z Gastroenterol 2015; 53:802-42. [PMID: 26284330 DOI: 10.1055/s-0035-1553458] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - J Hausmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt
| | - B Weber
- Medizinische Klinik II, KRH Klinikum Siloah-Oststadt, Hannover
| | - S von Delius
- II. Medizinische Klinik, Klinikum rechts der Isar, TU München, München
| | - M Jung
- Klinik für Innere Medizin 2, Katholisches Klinikum Mainz, Mainz
| | - P Tonner
- Klinik für Anaesthesie, operative und allgemeine Intensivmedizin, Notfallmedizin, Klinikum Links der Weser, Bremen
| | - J Arnold
- Klinik für Gastroenterologie, Hepatologie, Diabetologie und Ernährungsmedizin, Agaplesion Diakonieklinikum Rotenburg, Rotenburg
| | - A Behrens
- Klinik für Gastroenterologie und interventionelle Endoskopie, Vivantes Klinikum im Friedrichshain, Berlin
| | | | | | - D Domagk
- Medizinische Klinik I, Josephs-Hospital, Warendorf
| | | | | | - A Meining
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
| | - A Schaible
- Klinik für interdisziplinäre Endoskopie, Universitätsklinikum Heidelberg, Heidelberg
| | - D Schilling
- Medizinische Klinik II, Diakonissenkrankenhaus Mannheim, Mannheim
| | - H Seifert
- Klinik für Gastroenterologie, Klinikum Oldenburg, Oldenburg
| | - F Wappler
- Klinik für Anaesthesie und operative Intensivmedizin, Kliniken der Stadt Köln gGmbH, Universitätsklinikum Witten/Herdecke, Köln
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Belfort MA, Arnold J, Clark SL. Practice may not always make perfect (outcomes). BJOG 2015; 123:119. [PMID: 25846485 DOI: 10.1111/1471-0528.13371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M A Belfort
- Baylor College of Medicine, Texas Medical Center, Houston, TX, USA
| | - J Arnold
- Baylor College of Medicine, Texas Medical Center, Houston, TX, USA
| | - S L Clark
- Baylor College of Medicine, Texas Medical Center, Houston, TX, USA
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Arnold JJ, Campain A, Barthelmes D, Simpson JM, Guymer RH, Hunyor AP, McAllister IL, Essex RW, Morlet N, Gillies MC, Gillies M, Hunt A, Hunyor A, Arnold J, Young S, Clark G, Banerjee G, Phillips R, Perks M, Essex R, McAllister I, Constable I, Guymer R, Guymer R, Lim L, Harper A, Chow L, Wickremansinghe S, Wickremasinghe S, Wickremasinghe S. Two-year outcomes of "treat and extend" intravitreal therapy for neovascular age-related macular degeneration. Ophthalmology 2015; 122:1212-9. [PMID: 25846847 DOI: 10.1016/j.ophtha.2015.02.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. DESIGN Database observational study. PARTICIPANTS We included treatment-naïve eyes receiving predominantly ranibizumab for nAMD in routine clinical practice treated using a treat and extend regimen that were tracked in the Fight Retinal Blindness observational registry. METHODS A cohort of eyes treated by practitioners using exclusively a treat and extend regimen was extracted from the Fight Retinal Blindness observational registry. MAIN OUTCOME MEASURES Change in visual acuity (VA) over 2 years and number of injections and visits. RESULTS Data from 1198 eyes from 1011 patients receiving anti-VEGF therapy using a treat and extend regimen for treatment-naïve nAMD between January 2007 and December 2012 and with 24-month follow-up were included in the analysis. Mean VA increased by +5.3 logarithm of the minimum angle of resolution letters from 56.5 letters (20/80+1) at initial visit to 61.8 (20/60+2) letters at 24 months. Mean VA gains improved and number of injections increased with successive years from +2.7 letters for eyes commencing in 2007 after a mean of 9.7 injections in 2 years, to +7.8 letters for eyes commencing in 2012 after a mean of 14.2 injections over 2 years. The proportion of eyes with VA >20/40 increased from 27% when starting treatment to 45% after 24 months; the proportion with vision of <20/200 remained unchanged (13% initial, 11% at 24 months). Of the included eyes, 90.5% avoided a vision loss of ≥15 letters. There was an overall mean of 13.0 injections over the 24 months, 7.5 injections in the first year and 5.5 in the second year, with a mean of 14.8 clinic visits. CONCLUSIONS These data indicate that eyes managed in routine clinical practice with a treat and extend regimen can achieve good visual outcomes while decreasing the burden of treatments and clinic visits.
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Affiliation(s)
| | - Anna Campain
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Barthelmes
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Judy M Simpson
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Robyn H Guymer
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia
| | - Alex P Hunyor
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Retina Associates, Chatswood, New South Wales, Australia
| | - Ian L McAllister
- Lions Eye Institute, Centre for Ophthalmology and Vision Science, University of Western Australia, Western Australia
| | - Rohan W Essex
- Academic Unit of Ophthalmology, Australian National University, Acton, Canberra, Australia
| | - Nigel Morlet
- University of Western Australia Department of Population Health, Perth, Western Australia
| | - Mark C Gillies
- Marsden Eye Specialists, Parramatta, New South Wales, Australia
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Obenhuber AH, Gianetti TL, Bergman RG, Arnold J. Regioselective [2+2] and [4+2] cycloaddition reactivity in an asymmetric niobium(bisimido) moiety towards unsaturated organic molecules. Chem Commun (Camb) 2015; 51:1278-81. [DOI: 10.1039/c4cc07851a] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The asymmetric bis-imido structure and the lability of the diethyl ether linkage in complex 1 provide a niobium complex that undergoes regioselective [4+2] cycloaddition reactions with an α,β-unsaturated ketone and cycloaddition reactions that involve bond formation to the MAD ligand (MAD = monoazabutadiene).
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Affiliation(s)
| | - T. L. Gianetti
- Department of Chemistry
- University of California
- Berkeley
- USA
| | - R. G. Bergman
- Department of Chemistry
- University of California
- Berkeley
- USA
| | - J. Arnold
- Department of Chemistry
- University of California
- Berkeley
- USA
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Bishop C, May T, Arnold J. In pursuit of foot orthotic success: Can we identify biomechanical responses in the clinic? J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cooper R, Arnold J. Displacement Parameter Restraints for Dealing with Limited Data. Acta Crystallogr A Found Adv 2014. [DOI: 10.1107/s2053273314082710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Standard crystallographic structure refinements employ anisotropic displacement parameters (ADPs) to represent the probability distribution of a scattering atom. Such distributions may be due to thermal motion of the atom and / or a spatial average of multiple discrete atomic positions. An anisotropic description of an atomic distribution requires six parameters, and - in cases where data is limited or poor quality - the optimal values of these parameters may be ill-defined. Application of restraints and constraints can impose some physical and chemical reality on the set of displacement parameters. Examples include those based on the Hirshfeld Rigid Bond Test [1], and more recently SHELXL's RIGU [2]. We have implemented these and other a.d.p. restraints in CRYSTALS [3], for introducing reasonable relationships amongst common arrangements of anisotropic atoms. Use of a priori information in the form of restraints must always be justified, and we present an assessment of the applicability of the new restraints against a large data set of high quality crystal structure determinations.
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Abu-Arja RF, Gonzalez BE, Jacobs MR, Cabral L, Egler R, Auletta J, Arnold J, Cooke KR. Disseminated Bacillus Calmette-Guérin (BCG) infection following allogeneic hematopoietic stem cell transplant in a patient with Bare Lymphocyte Syndrome type II. Transpl Infect Dis 2014; 16:830-7. [PMID: 24995715 DOI: 10.1111/tid.12263] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 03/24/2014] [Accepted: 04/18/2014] [Indexed: 11/28/2022]
Abstract
We describe the first case, to our knowledge, of disseminated Mycobacterium bovis Bacillus Calmette-Guérin infection in a child with Bare Lymphocyte Syndrome type II after undergoing hematopoietic stem cell transplantation (HSCT). The patient presented 30 days post HSCT with fever and lymphadenitis. Lymph node, blood, and gastric aspirates were positive for M. bovis. The patient received a prolonged treatment course with a combination of isoniazid, levofloxacin, and ethambutol. Her course was further complicated by granulomatous lymphadenitis and otitis media associated with M. bovis that developed during immune suppression taper and immune reconstitution. Ultimately, the patient recovered fully, in association with restoration of immune function, and has completed 12 months of therapy.
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Affiliation(s)
- R F Abu-Arja
- Pediatric Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio, USA
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Campisi J, Finn KE, Bravo Y, Arnold J, Benjamin M, Sukiennik M, Shakya S, Fontaine D. Sex and age-related differences in perceived, desired and measured percentage body fat among adults. J Hum Nutr Diet 2014; 28:486-92. [DOI: 10.1111/jhn.12252] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J. Campisi
- Department of Biology; Regis University; Denver CO USA
| | - K. E. Finn
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - Y. Bravo
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - J. Arnold
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - M. Benjamin
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - M. Sukiennik
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - S. Shakya
- Department of Health Sciences; Merrimack College; North Andover MA USA
| | - D. Fontaine
- Department of Health Sciences; Merrimack College; North Andover MA USA
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Davids MR, Marais N, Jacobs J, Cohen E, Krause I, Goldberg E, Garty M, Krause I, Dursun B, Sahan Y, Tanriverdi H, Rota S, Uslu S, Senol H, Minutolo R, Gabbai FB, Agarwal R, Chiodini P, Borrelli S, Stanzione G, Nappi F, Bellizzi V, Conte G, De Nicola L, Van De Walle J, Johnson S, Fremeaux-Bacchi V, Ardissino G, Ariceta G, Beauchamp J, Cohen D, Greenbaum LA, Ogawa M, Schaefer F, Licht C, Scalzotto E, Nalesso F, Zaglia T, Corradi V, Neri M, Martino F, Zanella M, Brendolan A, Mongillo M, Ronco C, Chinnappa S, Mooney A, El Nahas AM, Tu YK, Tan LB, Jung JY, Kim AJ, Ro H, Lee C, Chang JH, Lee HH, Chung W, Clarke AL, Young HM, Hull KL, Hudson N, Burton JO, Smith AC, Marx S, Petrilla A, Filipovic I, Lee WC, Meijers B, Poesen R, Storr M, Claes K, Kuypers D, Evenepoel P, Aukland M, Clarke AL, Hull KL, Burton JO, Smith AC, Betriu A, Martinez-Alonso M, Arcidiacono MV, Cannata-Andia J, Pascual J, Valdivielso JM, Fernandez-Giraldez E, Kingswood JC, Zonnenberg B, Sauter M, Zakar G, Biro B, Besenczi B, Varga A, Pekacs P, Pizzini P, Pisano A, Leonardis D, Panuccio V, Cutrupi S, Tripepi G, Mallamaci F, Zoccali C, Arnold J, Baharani J, Rayner H, So BH, Blackwell S, Jardine AG, Macgregor MS, Cunha C, Barreto P, Pereira S, Ventura A, Mota M, Seabra J, Sakaguchi T, Kobayashi S, Yano T, Yoshimoto W, Bancu I, Bonal Bastons J, Cleries Escayola M, Vela Vallespin E, Bustins Poblet M, Magem Luque D, Pastor Fabregas M, Chen JH, Chen SC, Chang JM, Hwang SJ, Chen HC, Ahbap E, Kara E, Basturk T, Sahutoglu T, Koc Y, Sakaci T, Sevinc M, Akgol C, Ozagari AA, Unsal A, Minami S, Hesaka A, Yamaguchi S, Iwahashi E, Sakai S, Fujimoto T, Sasaki K, Fujita Y, Yokoyama K, Marks A, Fluck N, Prescott G, Robertson L, Smith WC, Black C, Ohsawa M, Fujioka T, Omori S, Isurugi T, Tanno K, Onoda T, Omama S, Ishibashi Y, Makita S, Okayama A, Garland JS, Simpson CS, Metangi MF, Parfrey B, Johri AM, Sloan L, McAuley J, Cunningham R, Mullan R, Quinn M, Harron C, Chiu H, Murphy-Burke D, Werb R, Jung B, Chan-Yan C, Duncan J, Forzley B, Lowry R, Hargrove G, Carson R, Levin A, Karim M, Reznik EV, Storozhakov GIV, Rollino C, Troiano M, Bagatella M, Liuzzo C, Quarello F, Roccatello D, Blaslov K, Bulum T, Prka In I, Duvnjak L, Heleniak Z, Ciepli ska M, Szychli ski T, Pryczkowska M, Bartosi ska E, Wiatr H, Kot owska H, Tylicki L, Rutkowski B, Song YR, Kim SGK, Kim HJ, Noh JW, Tong A, Jesudason S, Craig JC, Winkelmayer WC, Hung PH, Huang YT, Hsiao CY, Sung PS, Guo HR, Tsai KJ, Wu CC, Su SL, Kao SY, Lu KC, Lin YF, Lin WH, Lee HM, Cheng MF, Wang WM, Yang LY, Wang MC, Vukovic Lela I, Sekoranja M, Poljicanin T, Karanovic S, Abramovic M, Matijevic V, Stipancic Z, Leko N, Cvitkovic A, Dika Z, Kos J, Laganovic M, Grollman AP, Jelakovic B, Dryl-Rydzynska T, Prystacki T, Malyszko J, Trifiro G, Sultana J, Giorgianni F, Ingrasciotta Y, Muscianisi M, Tari DU, Perrotta M, Buemi M, Canale V, Arcoraci V, Santoro D, Rizzo M, Iheanacho I, Van Nooten FE, Goldsmith D, Grandtnerova B, Berat ova Z, ErvenOva M, cErven J, Markech M, tefanikova A, Engelen W, Elseviers M, Gheuens E, Colson C, Muyshondt I, Daelemans R. CKD GENERAL AND CLINICAL EPIDEMIOLOGY 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Klarenbach S, Gill JS, Knoll G, Caulfield T, Boudville N, Prasad GVR, Karpinski M, Storsley L, Treleaven D, Arnold J, Cuerden M, Jacobs P, Garg AX. Economic consequences incurred by living kidney donors: a Canadian multi-center prospective study. Am J Transplant 2014; 14:916-22. [PMID: 24597854 PMCID: PMC4285205 DOI: 10.1111/ajt.12662] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 12/24/2013] [Accepted: 12/26/2013] [Indexed: 01/25/2023]
Abstract
Some living kidney donors incur economic consequences as a result of donation; however, these costs are poorly quantified. We developed a framework to comprehensively assess economic consequences from the donor perspective including out-of-pocket cost, lost wages and home productivity loss. We prospectively enrolled 100 living kidney donors from seven Canadian centers between 2004 and 2008 and collected and valued economic consequences ($CAD 2008) at 3 months and 1 year after donation. Almost all (96%) donors experienced economic consequences, with 94% reporting travel costs and 47% reporting lost pay. The average and median costs of lost pay were $2144 (SD 4167) and $0 (25th-75th percentile 0, 2794), respectively. For other expenses (travel, accommodation, medication and medical), mean and median costs were $1780 (SD 2504) and $821 (25th-75th percentile 242, 2271), respectively. From the donor perspective, mean cost was $3268 (SD 4704); one-third of donors incurred cost >$3000, and 15% >$8000. The majority of donors (83%) reported inability to perform usual household activities for an average duration of 33 days; 8% reported out-of-pocket costs for assistance with these activities. The economic impact of living kidney donation for some individuals is large. We advocate for programs to reimburse living donors for their legitimate costs.
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Affiliation(s)
- S Klarenbach
- Department of Medicine, Institute of Health EconomicsEdmonton, AB, Canada,
*Corresponding author: Scott Klarenbach,
| | - J S Gill
- Department of Medicine, University of British ColumbiaVancouver, BC, Canada
| | - G Knoll
- Department of Medicine, University of OttawaOttawa, ON, Canada
| | - T Caulfield
- Faculty of Law, School of Population and Public Health, University of AlbertaEdmonton, AB, Canada
| | - N Boudville
- School of Medicine, University of Western AustraliaCrawley, WA, Canada
| | - G V R Prasad
- Department of Medicine, University of TorontoToronto, ON, Canada
| | - M Karpinski
- Department of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - L Storsley
- Department of Medicine, University of ManitobaWinnipeg, MB, Canada
| | - D Treleaven
- Department of Medicine, McMaster UniversityHamilton, ON, Canada
| | - J Arnold
- University of Western OntarioLondon, ON, Canada
| | - M Cuerden
- University of Western OntarioLondon, ON, Canada
| | - P Jacobs
- Department of Medicine, Institute of Health EconomicsEdmonton, AB, Canada
| | - A X Garg
- Department of Medicine and Department of Epidemiology and Biostatistics, University of Western OntarioLondon, ON, Canada,Department of Clinical Epidemiology and Biostatistics, McMaster UniversityHamilton, ON, Canada
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