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Joseph C, Nazari J, Zagrodzky J, Sherman J, Zagrodzky W, Bailey S, Ro A, Fisher W, Metzl M. Esophageal cooling during ablation of persistent atrial fibrillation is associated with improved freedom from arrhythmia at one-year follow up. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.461] [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: 11/15/2022] Open
Abstract
Abstract
Background
Various factors influence successful freedom from atrial arrhythmia after pulmonary vein isolation (PVI) with radiofrequency (RF) ablation for the treatment of atrial fibrillation (AF). Lesion transmurality and continuity (as measured by the Continuity Index) are two important factors, and these can be worsened by pauses in RF energy application due to esophageal overheating. Proactive esophageal cooling precludes the need for premature cessation of power, avoiding partially-formed lesions and the need to “hop-scotch” in the left atrium. The resulting improvement in lesion continuity may improve long-term freedom from atrial arrhythmia after PVI, particularly in patients with persistent AF, where more posterior wall ablation is often necessary.
Purpose
Determine differences in freedom from arrhythmia at one year between patients receiving LET monitoring and those receiving esophageal cooling during PVI for persistent AF.
Methods
We reviewed data from two healthcare systems for patient rhythm status at one-year follow up after PVI for the treatment of persistent or long-standing persistent AF. We then determined Kaplan-Meier estimates of freedom from arrhythmia (AF, atrial flutter, and atrial tachycardia), and compared these between patients receiving esophageal cooling and those treated with traditional LET monitoring.
Results
A total of 252 patients received PVI for persistent or long-standing persistent AF and had data available for review. Of these, 148 received LET monitoring (with either a single or multi-sensor temperature probe), and 104 received active cooling with a dedicated esophageal cooling device. Mean age and gender for each group was similar (67.2, range 21 to 88 years, 36% female for LET monitoring, and 67.8, range 32 to 89 years, 30% female for esophageal cooling). KM estimates for freedom from AF at the one-year follow-up were 44.2% for LET monitored patients and 79.3% for actively cooled patients (P=0.01).
Conclusions
Freedom from atrial arrhythmia at one-year after PVI for persistent AF is associated with significant improvement when using active esophageal cooling rather than LET monitoring.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Attune Medical
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Affiliation(s)
- C Joseph
- University of Texas Southwestern Medical Center , Dallas , United States of America
| | - J Nazari
- NorthShore University Health System , Chicago , United States of America
| | - J Zagrodzky
- Texas cardiac Arrhythmia , Austin , United States of America
| | - J Sherman
- Washington University in St. Louis , St. Louis , United States of America
| | - W Zagrodzky
- Colorado College , Colorado Springs , United States of America
| | - S Bailey
- Texas cardiac Arrhythmia , Austin , United States of America
| | - A Ro
- NorthShore University Health System , Chicago , United States of America
| | - W Fisher
- NorthShore University Health System , Chicago , United States of America
| | - M Metzl
- NorthShore University Health System , Chicago , United States of America
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Joseph C, Francisco G, Ruppert A, Willms D, Nazari J, Fisher W, Ro A, Sherman J, Zagrodzky J, Bailey S, Zagrodzky W, Athill C, Metzl M. Arrhythmia recurrence reduction with an active esophageal cooling device during radiofrequency ablation. Europace 2022. [DOI: 10.1093/europace/euac053.096] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
As the burden of atrial fibrillation continues to rise with an aging population, there have been contrasting positions on the efficacy of left atrial ablation. While ablation techniques have continued to improve over the past decades, arrhythmia recurrence rates must be further reduced given the burden of ablation on patients. Since continuity of lesion sets has been associated with greater lesion durability, it has been theorized that the use of active esophageal cooling may facilitate greater freedom from arrhythmia.
Purpose
In order to investigate the association between use of active esophageal cooling and arrhythmia recurrence, we performed a multicenter retrospective study of arrhythmia recurrence rates in patients that received active cooling and compared them to those that received luminal esophageal temperature (LET) monitoring.
Methods
In this study, follow up data were collected from patients that underwent pulmonary vein isolation (PVI) at three separate large medical centers. Data were contained in a prospective hospital registry, a prospective physician registry, or the electronic health record, depending on the center. For each patient included, we recorded whether their ablation utilized LET monitoring or active esophageal cooling, along with their rhythm status at 1-year follow up. Rhythm status at follow-up was determined by either electrocardiogram, Holter monitor, or wearable heart rate monitor. Kaplan-Meier (KM) curves were created for freedom-from-arrhythmia at one year comparing those in the LET monitoring group to those in the active cooling group.
Results
Follow up data were collected from 1035 patients. There were 560 patients that received LET monitoring during their original ablation, and 475 patients that underwent active esophageal cooling. KM estimates for freedom-from-arrhythmia at one year were 42% in the LET monitored group and 65% in the actively cooled group (P<.001).
Conclusion
In this large multicenter study, there is a significant increase in freedom-from-arrhythmia at one year follow-up among patients that received active esophageal cooling as compared to those that underwent LET monitoring.
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Affiliation(s)
- C Joseph
- University of Texas Southwestern Medical Center, Dallas, United States of America
| | - G Francisco
- Sharp Memorial, San Diego, United States of America
| | - A Ruppert
- Sharp Memorial, San Diego, United States of America
| | - D Willms
- Sharp Memorial, San Diego, United States of America
| | - J Nazari
- NorthShore University Health System, Chicago, United States of America
| | - W Fisher
- NorthShore University Health System, Chicago, United States of America
| | - A Ro
- NorthShore University Health System, Chicago, United States of America
| | - J Sherman
- NorthShore University Health System, Chicago, United States of America
| | - J Zagrodzky
- Texas cardiac Arrhythmia, Austin, United States of America
| | - S Bailey
- Texas cardiac Arrhythmia, Austin, United States of America
| | - W Zagrodzky
- Texas cardiac Arrhythmia, Austin, United States of America
| | - C Athill
- Sharp Memorial, San Diego, United States of America
| | - M Metzl
- NorthShore University Health System, Chicago, United States of America
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Joseph C, Francisco G, Ruppert A, Willms D, Metzl M, Fisher W, Nazari J, Ro A, Zagrodzky J, Zagrodzky W, Sherman J, Bailey S, Athill C. Effect of a proactive esophageal cooling device on procedure length - a multicenter comparison of persistent and paroxysmal atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.086] [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: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
During left atrial ablation for the treatment of atrial fibrillation (AF), effective esophageal protection is essential for reducing or preventing thermal injury. Traditional methods include luminal esophageal temperature (LET) monitoring that lead to frequent pauses in the procedure when temperature alarms alert operators to dangerous temperature levels. While there have been recent studies that demonstrate an association between active esophageal cooling and a reduction in procedure duration regardless of AF type, these retrospective studies have been conducted at single or joint centers which may lead to confounding from other time-saving variables that have changed over time.
Purpose
Consequently, we sought to perform a large-scale multicenter comparison to better elucidate the association between procedure length and the use of active cooling in patients with persistent and paroxysmal atrial fibrillation.
Methods
In this study, we collected data from three large hospital centers, one hospital-maintained registry, one physician-maintained registry, and one through EHR data review and aggregated in groups separated by AF type as well as whether the patients received active cooling or LET monitoring. We then compared median procedure durations in each group.
Results
There were a total of 753 patients included in this study. Of the 360 patients with paroxysmal AF, 179 received active esophageal cooling while 181 underwent LET monitoring. In the persistent AF group with 393 patients, 157 received active esophageal cooling and 236 underwent LET monitoring. Among patients with paroxysmal AF, the median mean procedure duration was 137 minutes in the LET monitored group, and 90 minutes in the actively cooled group with an overall reduction of 47 minutes (P<.001). In patients with persistent AF, the median procedure duration was 148 minutes in the LET monitored group and 94 minutes in the actively cooled group with an overall reduction of 54 minutes (P<.001). The relative reduction as a percent of total procedure time was 34%, and 36%, for paroxysmal and persistent AF cases, respectively.
Conclusion
In this large multicenter review, there is a significant reduction in procedure length when using active esophageal cooling, regardless of AF type.
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Affiliation(s)
- C Joseph
- University of Texas Southwestern Medical Center, Dallas, United States of America
| | - G Francisco
- Sharp Memorial, San Diego, United States of America
| | - A Ruppert
- Sharp Memorial, San Diego, United States of America
| | - D Willms
- Sharp Memorial, San Diego, United States of America
| | - M Metzl
- NorthShore University Health System, Chicago, United States of America
| | - W Fisher
- NorthShore University Health System, Chicago, United States of America
| | - J Nazari
- NorthShore University Health System, Chicago, United States of America
| | - A Ro
- NorthShore University Health System, Chicago, United States of America
| | - J Zagrodzky
- Texas cardiac Arrhythmia, Austin, United States of America
| | - W Zagrodzky
- Texas cardiac Arrhythmia, Austin, United States of America
| | - J Sherman
- NorthShore University Health System, Chicago, United States of America
| | - S Bailey
- Texas cardiac Arrhythmia, Austin, United States of America
| | - C Athill
- Sharp Memorial, San Diego, United States of America
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Bobholz SA, Lowman AK, Brehler M, Kyereme F, Duenweg SR, Sherman J, McGarry SD, Cochran EJ, Connelly J, Mueller WM, Agarwal M, Banerjee A, LaViolette PS. Radio-Pathomic Maps of Cell Density Identify Brain Tumor Invasion beyond Traditional MRI-Defined Margins. AJNR Am J Neuroradiol 2022; 43:682-688. [PMID: 35422419 PMCID: PMC9089258 DOI: 10.3174/ajnr.a7477] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/07/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Currently, contrast-enhancing margins on T1WI are used to guide treatment of gliomas, yet tumor invasion beyond the contrast-enhancing region is a known confounding factor. Therefore, this study used postmortem tissue samples aligned with clinically acquired MRIs to quantify the relationship between intensity values and cellularity as well as to develop a radio-pathomic model to predict cellularity using MR imaging data. MATERIALS AND METHODS This single-institution study used 93 samples collected at postmortem examination from 44 patients with brain cancer. Tissue samples were processed, stained with H&E, and digitized for nuclei segmentation and cell density calculation. Pre- and postgadolinium contrast T1WI, T2 FLAIR, and ADC images were collected from each patient's final acquisition before death. In-house software was used to align tissue samples to the FLAIR image via manually defined control points. Mixed-effects models were used to assess the relationship between single-image intensity and cellularity for each image. An ensemble learner was trained to predict cellularity using 5 × 5 voxel tiles from each image, with a two-thirds to one-third train-test split for validation. RESULTS Single-image analyses found subtle associations between image intensity and cellularity, with a less pronounced relationship in patients with glioblastoma. The radio-pathomic model accurately predicted cellularity in the test set (root mean squared error = 1015 cells/mm2) and identified regions of hypercellularity beyond the contrast-enhancing region. CONCLUSIONS A radio-pathomic model for cellularity trained with tissue samples acquired at postmortem examination is able to identify regions of hypercellular tumor beyond traditional imaging signatures.
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Affiliation(s)
- S A Bobholz
- From the Departments of Biophysics (S.A.B., S.R.D., J.S., S.D.M.)
| | | | - M Brehler
- Radiology (A.L., M.B., M.A., P.S.L.)
| | | | - S R Duenweg
- From the Departments of Biophysics (S.A.B., S.R.D., J.S., S.D.M.)
| | - J Sherman
- From the Departments of Biophysics (S.A.B., S.R.D., J.S., S.D.M.)
| | - S D McGarry
- From the Departments of Biophysics (S.A.B., S.R.D., J.S., S.D.M.)
| | | | | | | | - M Agarwal
- Radiology (A.L., M.B., M.A., P.S.L.)
| | | | - P S LaViolette
- Radiology (A.L., M.B., M.A., P.S.L.)
- Biomedical Engineering (P.S.L.), Medical College of Wisconsin, Milwaukee, Wisconsin
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Sherman J, Richardson J, Vedora J. The Use of Behavioral Skills Training to Teach Components of Direct Instruction. Behav Anal Pract 2021; 14:1085-1091. [PMID: 34868816 DOI: 10.1007/s40617-021-00594-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2021] [Indexed: 10/21/2022] Open
Abstract
Behavioral skills training (BST) has been demonstrated to be an effective method for training staff to perform skills with high fidelity in a relatively short amount of time. In the current study, three components of direct instruction (DI) were trained using BST. The participants were two classroom instructors with prior experience implementing DI with students with autism. The targets for staff training were accuracy with signal delivery, error correction, and delivery of praise. A multiple-baseline design across skills was used to evaluate the effects of BST for each participant. Generalization probes were conducted with a student with autism during baseline and after mastery with each skill was demonstrated. BST rapidly increased staff performance across skills, with generalization demonstrated during classroom probes. This study extends the use of BST to training staff to implement DI, and the results suggest that BST resulted in improved teacher performance of the targeted skills during generalization probes with students.
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Affiliation(s)
- James Sherman
- Evergreen Center, 345 Fortune Blvd., Milford, MA 01757 USA
| | | | - Joseph Vedora
- Evergreen Center, 345 Fortune Blvd., Milford, MA 01757 USA
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Messing I, Goyal S, Sherman J, Thakkar P, Siegel R, Joshi A, Goodman J, Ojong-Ntui M, Rao Y. Incidence And Prognosis Of Brain Metastases In Head And Neck Cancer Patients At Diagnosis: A Population Based Study. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ghossein N, Wilson C, Halstead B, Albanese J, Sherman J. 82 Geographic Information System-Assisted Pediatric Surge Planning: Preparing Connecticut’s Hospitals to Respond to a Significant Storm Event. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.092] [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: 11/30/2022]
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Abstract
This article provides an introduction to environmentally sustainable dentistry and offers perspectives on managing drivers to reduce carbon emissions and make dentistry more environmentally sustainable. A sustainable world must meet the needs of the present without compromising the ability of future generations to meet their own needs. Global commitment to sustainability and demands for a sustainable world are growing. Within dentistry, travel creates the highest carbon emissions and also contributes to human health damage. Internally, there are a number of ways to reduce impact by decreasing travel and energy use, as well as carefully considering the types of items purchased (and how they are disposed of). Larger dental organizations can influence their suppliers and industry by choosing to purchase from sustainable companies with environmentally friendly products. From an external driver perspective policy, guidance and research are essential. Governments need to reevaluate decontamination policy from an environmental perspective. Decontamination documents need revision to consider both planetary and public health. Dental organizations need to support dental teams in this area. Insurance providers and health care purchasers should review policies to influence the sustainability of dental providers. Sustainability education needs to be considered as part of the curriculum of undergraduate and postgraduate students. Guidance could also be developed for the dental industry to produce sustainable products. Research needs to be prioritized. Identifying hot spots or areas of high environmental contributions using other assessments such as life cycle analysis (LCA) would allow dentistry to identify products or practices that have a disproportionate adverse impact on the environment and might be prioritized for change. This should include an analysis of single-use instruments, chemicals, and products. Building research capacity by training students and creating virtual or physical centers for sustainability is essential. Financial support is needed for priority areas of research.
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Affiliation(s)
| | - R. Stancliffe
- Centre for Sustainable Healthcare, Oxford, Oxfordshire, UK
| | - F.A. Miller
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - J. Sherman
- Yale School of Medicine, New Haven, CT, USA
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Burgos MA, Andrews E, Titos G, Alados-Arboledas L, Baltensperger U, Day D, Jefferson A, Kalivitis N, Mihalopoulos N, Sherman J, Sun J, Weingartner E, Zieger P. A global view on the effect of water uptake on aerosol particle light scattering. Sci Data 2019; 6:157. [PMID: 31439840 PMCID: PMC6706437 DOI: 10.1038/s41597-019-0158-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 01/24/2019] [Accepted: 07/18/2019] [Indexed: 11/17/2022] Open
Abstract
A reference dataset of multi-wavelength particle light scattering and hemispheric backscattering coefficients for different relative humidities (RH) between RH = 30 and 95% and wavelengths between λ = 450 nm and 700 nm is described in this work. Tandem-humidified nephelometer measurements from 26 ground-based sites around the globe, covering multiple aerosol types, have been re-analysed and harmonized into a single dataset. The dataset includes multi-annual measurements from long-term monitoring sites as well as short-term field campaign data. The result is a unique collection of RH-dependent aerosol light scattering properties, presented as a function of size cut. This dataset is important for climate and atmospheric model-measurement inter-comparisons, as a means to improve model performance, and may be useful for satellite and remote sensing evaluation using surface-based, in-situ measurements. Design Type(s) | spectral data collection and processing objective • data integration objective • time series design | Measurement Type(s) | light scattering | Technology Type(s) | Nephelometry | Factor Type(s) | geographic location • instrument • Environment • temporal_interval | Sample Characteristic(s) | United States of America • climate system • Canada • The Netherlands • Greece • Germany • Portuguese Republic • South Korea • China • United Kingdom • Finland • Switzerland • Maldives Archipelago • Brazil • Republic of Ireland • Niger • India • Kingdom of Spain • Kingdom of Norway |
Machine-accessible metadata file describing the reported data (ISA-Tab format)
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Affiliation(s)
- María A Burgos
- Department of Environmental Science and Analytical Chemistry, Stockholm University, SE-10691, Stockholm, Sweden. .,Bolin Centre for Climate Research, SE-10691, Stockholm, Sweden.
| | - Elisabeth Andrews
- Cooperative Institute for Research in Environmental Studies, University of Colorado, Boulder, USA
| | - Gloria Titos
- Andalusian Institute for Earth System Research, University of Granada, Granada, Spain
| | | | - Urs Baltensperger
- Laboratory of Atmospheric Chemistry, Paul Scherrer Institute, Villigen, Switzerland
| | - Derek Day
- Cooperative Institute for Research in the Atmosphere, Colorado State University, Fort Collins, USA
| | - Anne Jefferson
- Cooperative Institute for Research in Environmental Studies, University of Colorado, Boulder, USA.,Earth Systems Research Laboratory, National Oceanic and Atmospheric Administration, Boulder, Colorado, USA
| | - Nikos Kalivitis
- Environmental Chemical Processes Laboratory, Department of Chemistry, University of Crete, Heraklion, Greece
| | - Nikos Mihalopoulos
- Environmental Chemical Processes Laboratory, Department of Chemistry, University of Crete, Heraklion, Greece
| | - James Sherman
- Department of Physics and Astronomy, Appalachian State University, Boone, USA
| | - Junying Sun
- Key Laboratory for Atmospheric Chemistry, Institute of Atmospheric Composition, Chinese Academy of Meteorological Sciences, Beijing, China
| | - Ernest Weingartner
- Institute for Sensing and Electronics, University of Applied Sciences, Windisch, Switzerland
| | - Paul Zieger
- Department of Environmental Science and Analytical Chemistry, Stockholm University, SE-10691, Stockholm, Sweden. .,Bolin Centre for Climate Research, SE-10691, Stockholm, Sweden.
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Sherman J, Sun J, Bjelac J. TYPICAL RECURRENT CHILDHOOD INFECTIONS OR PRIMARY IMMUNODEFICIENCY? Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Peereboom D, Nabors L, Kumthekar P, Badruddoja M, Fink K, Lieberman F, Phuphanich S, Dunbar E, Walbert T, Schiff D, Tran D, Ashby L, Butowski N, Iwamoto F, Lindsay R, Bullington J, Schulder M, Sherman J, Brooks C, Reardon D. Results of phase II trial of SL-701, a novel immunotherapy targeting IL-13Ra2, EphA2, and survivin, in adults with second-line recurrent glioblastoma (GBM). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy273.361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Janos A, Duncanson H, Erwin S, Colvin M, Sherman J. A-14Verbal Memory Binding and Markers of Brain Pathology in Preclinical Autosomal-dominant Alzheimer's Disease. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx076.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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13
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Kay C, Leveroni C, Eldaief M, Sherman J. AGR-3Early-Onset Behavioral Variant Frontotemporal Dementia and its Impact on the Family Unit: A Case Study. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx074.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kitching J, Donley EA, Knappe S, Hummon M, Dellis AT, Sherman J, Srinivasan K, Aksyuk VA, Li Q, Westly D, Roxworthy B, Lal A. NIST on a Chip: Realizing SI units with microfabricated alkali vapour cells. ACTA ACUST UNITED AC 2016. [DOI: 10.1088/1742-6596/723/1/012056] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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15
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Norton B, Sherman T, Francis W, Sherman J. Biomechanical flexibility testing of an in situ-cured silicone-based disc nucleus prosthesis. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Morgan WJ, VanDevanter DR, Pasta DJ, Foreman AJ, Wagener JS, Konstan MW, Liou T, McColley S, McMullen A, Quittner A, Regelmann W, Ren C, Rosenfeld M, Sawicki G, Schechter M, VanDevanter D, Wagener J, Woo M, Brasfield D, Lyrene R, Sindel L, Roberts D, Carroll J, Warren R, Nassri L, Anderson P, Brown M, Silverthorn A, Radford P, Gong G, Legris G, Greene G, Sudhakar R, Platzker A, Nickerson B, Hardy K, Harwood I, Shay G, Quick B, Lieberthal A, Moss R, Landon C, Fanous Y, Lieberman J, Spiritus E, Chipps B, McDonald R, Pian M, Cropp G, Lewis N, Nielson D, Shapiro B, Wagener J, Accurso F, Saavedra M, Daigle K, Hen J, Palazzo R, Dodds K, Pad-man R, Goodill J, Winnie G, Davies L, Kriseman T, Sallent J, Chiaro J, Kubiet M, Goldfinger S, Schwartzman M, Diaz C, Maupin K, Riff E, Geller D, Livingston F, Mavunda K, Birriel J, Faverio L, Rosenberg D, Schaeffer D, Sherman J, Wagner M, Light M, Schnapf B, Montgomery G, Kirchner K, Weatherly M, Caplan D, Guill M, Hudson V, Akhter J, Davison D, Boas S, McColley S, Chung Y, Latner R, Aljadeff G, Chan Y, Kraut J, Stone A, Still JL, Sharma G, Eagleton L, Hopkins P, Chatrath U, Lester L, Kim YJ, Anthony V, Eigan H, Howenstine M, James P, Gergesha E, Harris J, Plant R, Zivkovich V, Collins A, Nassif E, Ahrens R, Doornbos D, Kanarek J, Leff R, Shaw P, Demoss E, Riva M, Sullivan L, Anstead M, Kanga J, Eid N, Morton R, Hilman B, Jones K, Davis S, Harder R, Lever T, Cairns AM, Caldwell E, Zuckerman J, Mogayzel P, Rosenstein B, McQuestion J, Perry D, Rosenberg S, Gerstle R, Colin A, Wohl ME, Lapey A, Yee W, O'Sullivan B, Zwerdling R, Abdulhamid I, O'Hagan A, Schuen J, Kurlandsky L, Honicky R, Homnick D, Marks J, Pichurko B, Maxvold N, Nasr S, Simon R, Tsai W, Kissner D, McNamara J, Henry N, Marker S, Pryor M, Regelmann W, Walker L, Woodward J, Mizell L, Miller S, Rosenbluth D, Black P, McCubbin M, Cohen A, Ferkol T, Mallory G, Rejent A, Rubin B, Graff G, Konig P, Colombo J, Murphy P, Boyle W, Parker W, Patton C, Zanni R, Atlas A, Turcios N, Laraya-Cuasay L, Bisberg D, Aguila H, Allen S, James D, Perkett E, Thompson M, Budhecha S, Diaz R, Rosen J, Kaslovsky R, Percciacante R, Borowitz D, Cronin J, McMahon C, Quittell L, Giusti R, Cohen R, DeCelie-Germana J, Gorvoy J, Patel K, Kattan M, Dozor A, DiMango E, Berdella M, Anbar R, Ianuzzi D, Sexton J, Tayag-Kier C, McBride J, Ren C, Voter K, Dimaio M, Georgitis J, Majure JM, Martinez M, McIntosh C, Leigh M, Schechter M, Black H, Hughes J, Kantak A, Wilmott R, Omlor G, Stone R, McCoy K, Acton J, Doershuk C, Konstan M, Fink R, Steffan M, Vauthy P, Joseph P, Reyes S, Kramer J, Royall J, Eisenberg J, Wall M, Fiel S, Scanlin T, Phadke S, Winnie G, Weinberg J, Sexauer W, Wolf S, Holsclaw D, Klein D, Warren S, Kinsey R, Perez C, Ganeshanathan M, Shinnick J, Panitch H, Varlotta L, Robinson C, Santana JR, Passero MA, Gwinn J, Baker R, Bowman M, Flume P, Brown D, Marville R, Wallace J, Parry R, Ellenburg D, Rogers J, Mohon R, Ledbetter J, Hanissian A, Schoumacher R, Campbell P, Harris C, Slovis B, Stokes D, Hale K, Katz M, Seilheimer D, Sockrider M, Frank A, Daniel J, Cunningham J, Browning I, Bray J, Dove A, Mandujano F, Tremper L, Morse M, Willey-Courand D, Copenhaver S, Pohl J, McWilliams B, Martine-Logvinoff M, Wallace M, Klein R, Amaro R, Couch L, Brown M, Prestidge C, Inscore S, Lipton A, Chatfield B, Liou T, Marshall B, Lahiri T, Swartz D, Whittaker L, Karlson K, Ropoll I, Rubio T, Schmidt J, Thomas D, Osborn J, Froh D, Gaston B, Elliott G, Gibson R, Ramsey B, McCarthy M, Larson L, Ricker D, Robbins M, Aitken M, Emerson J, Aronoff S, Moffett K, Biller J, Splaingard M, Sullivan B, Pritchard P, Adair S, Holzwarth P, Dopico G, Meyer K, Green C, Rock M. Forced Expiratory Volume in 1 Second Variability Helps Identify Patients with Cystic Fibrosis at Risk of Greater Loss of Lung Function. J Pediatr 2016; 169:116-21.e2. [PMID: 26388208 DOI: 10.1016/j.jpeds.2015.08.042] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 07/15/2015] [Accepted: 08/20/2015] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate several alternative measures of forced expiratory volume in 1 second percent predicted (FEV1 %pred) variability as potential predictors of future FEV1 %pred decline in patients with cystic fibrosis. STUDY DESIGN We included 13,827 patients age ≥6 years from the Epidemiologic Study of Cystic Fibrosis 1994-2002 with ≥4 FEV1 %pred measurements spanning ≥366 days in both a 2-year baseline period and a 2-year follow-up period. We predicted change from best baseline FEV1 %pred to best follow-up FEV1 %pred and change from baseline to best in the second follow-up year by using multivariable regression stratified by 4 lung-disease stages. We assessed 5 measures of variability (some as deviations from the best and some as deviations from the trend line) both alone and after controlling for demographic and clinical factors and for the slope and level of FEV1 %pred. RESULTS All 5 measures of FEV1 %pred variability were predictive, but the strongest predictor was median deviation from the best FEV1 %pred in the baseline period. The contribution to explanatory power (R(2)) was substantial and exceeded the total contribution of all other factors excluding the FEV1 %pred rate of decline. Adding the other variability measures provided minimal additional value. CONCLUSIONS Median deviation from the best FEV1 %pred is a simple metric that markedly improves prediction of FEV1 %pred decline even after the inclusion of demographic and clinical characteristics and the FEV1 %pred rate of decline. The routine calculation of this variability measure could allow clinicians to better identify patients at risk and therefore in need of increased intervention.
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Affiliation(s)
- Wayne J Morgan
- Department of Pediatrics, University of Arizona, Tucson, AZ.
| | - Donald R VanDevanter
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH
| | | | | | - Jeffrey S Wagener
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Michael W Konstan
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH
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Litwak RS, Lukban SB, Jurado RA, Koffsky RM, Ortiz AF, grana VP, Fischer AP, Sherman J. Temporary mechanical support of left ventricular failure following open heart surgery. Adv Cardiol 2015; 20:102-9. [PMID: 848381 DOI: 10.1159/000399858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Patients coming to open heart surgery with advanced cardiac dysfunction may require mechanical cardiac support to avoid life-threatening low cardiac output in the postoperative period. 15 patients who could not be withdrawn from cardiopulmonary bypass because of low cardiac output were supported with a left heart bypass system (left atrium to ascending aorta). Ten were ultimately separated from the device, 6 were dismissed from the hospital and 4 remain well (the longest 2.6 years postoperative). A major asset of the device is that thoracic reentry is not required when support is discontinued.
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Shih H, Sherman J, Nachtigall L, Colvin M, Fullerton B, Winrich B, Batchelor T, Thornton L, Daartz J, Mancuso S, Oh K, Curry W, Loeffler J, Yeap B. AT-52 * PROSPECTIVE EARLY RESULTS OF LOW GRADE GLIOMA PATIENTS TREATED WITH PROTON THERAPY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou237.51] [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: 11/14/2022] Open
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Sherman J, Keall P. SU-E-T-329: An Oracle Solution for Performance Benchmarking of Dynamic Multi-Leaf Collimator Algorithms. Med Phys 2013. [DOI: 10.1118/1.4814763] [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: 11/07/2022] Open
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Sedgwick J, Secomb A, Sherman J, Benjamin A, Denman R, Burstow D, Roper D. The Role of Modern-Era Transthoracic Echocardiography for Detection of Cardiac Device-Related Infective Endocarditis. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.479] [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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Courtemanche A, Schroeder S, Sheldon J, Sherman J, Fowler A. Observing signs of pain in relation to self-injurious behaviour among individuals with intellectual and developmental disabilities. J Intellect Disabil Res 2012; 56:501-515. [PMID: 21954901 DOI: 10.1111/j.1365-2788.2011.01492.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Self-injurious behaviour is a chronic condition among people with intellectual and developmental disabilities for which there is no known cure. The pain hypothesis suggests that individuals who engage in self-injury have altered or diminished pain perception. The purpose of the present study was to assess how frequently individuals diagnosed with an intellectual and developmental disability who engage in chronic self-injury displayed non-verbal signs of pain in relation to their self-injury. METHODS We videotaped four participants (aged 28-50 years) in their homes during times when they were likely to engage in self-injury. Using continuous recording measures, we coded videotapes for the frequency and duration of self-injury and expressions of non-verbal pain-related behaviours. Sequential analyses were conducted to identify temporal relations between pain-related behaviours and self-injury. RESULTS Our data suggest that the existing measures of pain may be systematically related to instances of self-injury. The relationships, however, appear to vary depending on the person who engages in self-injury, the environmental contexts in which the self-injury occurs, and perhaps, the type of self-injury in which the person engages. CONCLUSIONS These results support some of the findings of Symons et al. and they raise questions about the blunted nociception hypothesis of self-injury.
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Affiliation(s)
- A Courtemanche
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS 66045, USA.
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Darula Z, Sherman J, Medzihradszky KF. How to dig deeper? Improved enrichment methods for mucin core-1 type glycopeptides. Mol Cell Proteomics 2012; 11:O111.016774. [PMID: 22393263 DOI: 10.1074/mcp.o111.016774] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Two different workflows were tested in order to develop methods that provide deeper insight into the secreted O-glycoproteome. Bovine serum samples were subjected to lectin affinity-chromatography both at the protein- and peptide-level in order to selectively isolate glycopeptides with the most common, mucin core-1 sugar. This enrichment step was implemented with either protein-level mixed-bed ion-exchange chromatography or with peptide-level electrostatic repulsion hydrophilic interaction chromatography. Both methods led to at least 65% of the identified products being glycopeptides, in comparison to ≈ 25% without the additional chromatography steps [Darula, Z., and Medzihradszky, K. F. (2009) Affinity enrichment and characterization of mucin core-1 type glycopeptides from bovine serum. Mol. Cell. Proteomics 8, 2515-2526]. In order to improve not only the isolation but also the characterization of the glycopeptides exoglycosidases were used to eliminate carbohydrate extensions from the directly peptide-bound GalNAc units. Consequent tandem MS analysis of the mixtures using higher-energy collision-dissociation and electron-transfer dissociation led to the identification of 124 glycosylation sites in 51 proteins. While the electron-transfer dissociation data provided the bulk of the information for both modified sequence and modification site assignment, the higher-energy collision-dissociation data frequently yielded confirmation of the peptide identity, and revealed the presence of some core-2 or core-3 oligosaccharides. More than two-thirds of the sites as well as the proteins have never been reported modified.
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Affiliation(s)
- Z Darula
- Proteomics Research Group, Biological Research Center of Hungarian Academy of Sciences, Szeged, H-6701, Szeged, POB 521, Hungary
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Sherman J, Pearson D, Parsai E. SU-E-T-743: The Comparison of Dose Modification Factors for Two Multi-Lumen Brachytherapy Applicators Used in Partial Breast Irradiation. Med Phys 2011. [DOI: 10.1118/1.3612707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Dohatcu A, Ionita C, Sherman J, Bednarek D, Hoffmann K, Rudin S. SU-GG-I-183: Parameterization of Time-Density Curves (TDC) and Regional-TDC's to Quantify Flow Modification Inside Aneurysms Treated with Flow-Modifying Devices (FMD) Following Endovascular Image-Guided Interventions. Med Phys 2010. [DOI: 10.1118/1.3468219] [Citation(s) in RCA: 2] [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: 11/07/2022] Open
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Aldana PH, Mendez M, Velapatiño B, Santivañez L, Balqui J, Finger S, Sherman J, Zimic M, Cabrera L, Watanabe J, Rodriguez C, Gilman R, Berg D. DNA-Level diversity and relatedness of Helicobacter pylori strains in Shantytown families in Peru and transmission in a developing-country setting. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.1546] [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: 11/16/2022] Open
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Shah A, Ahmed S, Karlapudi K, Sherman J, Mensah P. P277 The use of an indwelling urinary catheter prior to caesarean delivery. Audit at a District General Hospital in the UK. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61767-7] [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: 11/30/2022]
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Sherman J, Gillan G. O.449 Internal flxation of the fractured hemimaxilla across the anterior nasal spine. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71573-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Sherman J. O.134 Bisphosphonates, extractions & ONJ: some good news at last! J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71258-7] [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: 12/01/2022] Open
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Yan K, Podder T, Sherman J, Li L, Joseph J, Rubens D, Messing E, Liao L, Okunieff P, Yu Y. A Real-time Cancer Sensing Technique using Needle Insertion Forces and Patient-specific Criteria during Percutaneous Intervention. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.874] [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: 11/26/2022]
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Sherman J, Khan S, Lynn A. O.545 Parotid duct strictures: a prospective audit evaluating the outcomes of balloon dilatation sialoplasty 2001–2007. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)71669-x] [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: 10/21/2022] Open
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Patel V, Ionita C, Keleshis C, Sherman J, Hoffmann K, Bednarek D, Rudin S. TH-C-332-02: First Implementation of High-Resolution Dual-Detector Region-Of-Interest Cone-Beam Computed Tomography (ROI-CBCT) for a Rotating C-Arm Gantry System. Med Phys 2008. [DOI: 10.1118/1.2962867] [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: 11/07/2022] Open
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Nemec MD, Kirkpatrick DT, Sherman J, Van Miller JP, Pershing ML, Strother DE. Two-generation reproductive toxicity study of inhaled acrylonitrile vapors in Crl:CD(SD) rats. Int J Toxicol 2008; 27:11-29. [PMID: 18293209 DOI: 10.1080/10915810701876463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To assess the effects of acrylonitrile (AN) exposure on reproduction, Sprague-Dawley rats (25/sex/group) were exposed to vapor atmospheres of AN via whole-body inhalation at concentrations of 0, 5, 15, 45 (two offspring generations) and 90 ppm (one offspring generation), 6 h daily, 1 litter/generation, through F2 weanlings on postnatal day 28. After approximately 3 weeks of direct exposure following weaning, exposure of the F1 animals at 90 ppm was terminated due to excessive systemic toxicity in the males. There were no exposure-related mortalities in adult animals, no functional effects on reproduction or effects on reproductive organs, and no evidence of cumulative toxicity or of enhanced toxicity in pregnant and lactating dams or in developing animals. Adult systemic toxicity was limited to body weight and/or food consumption deficits in both sexes and generations (greater in males) at 45 and 90 ppm and increased liver weights in the 90 ppm F0 males and females and 45 ppm F1 males. Neonatal toxicity was expressed by F1 offspring weight decrements at 90 ppm. Clinical signs of local irritation during and immediately following exposure were observed at 90 ppm. Microscopic lesions of the rostral nasal epithelium, representing local site-of-contact irritation, were observed in some animals at 5 to 45 ppm. The no-observed-adverse-effect level (NOAEL) for reproductive toxicity over two generations and neonatal toxicity of AN administered to rats via whole-body inhalation was 45 ppm. The NOAEL for reproduction was 90 ppm for the first generation. The NOAEL for parental systemic toxicity was 15 ppm.
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Affiliation(s)
- M D Nemec
- WIL Research Laboratories, LLC, Ashland, Ohio, USA.
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Yu Y, Podder TK, Zhang YD, Ng WS, Misic V, Sherman J, Fuller D, Rubens DJ, Strang JG, Brasacchio RA, Messing EM. Robotic system for prostate brachytherapy. ACTA ACUST UNITED AC 2008; 12:366-70. [PMID: 18066952 DOI: 10.3109/10929080701746926] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In contemporary brachytherapy procedures, needle placement at the desired target is challenging for a variety of reasons. A robot-assisted brachytherapy system can potentially improve needle placement and seed delivery, resulting in enhanced therapeutic outcome. In this paper we present a robotic system with 16 degrees of freedom (DOF) (9 DOF for the positioning module and 7 DOF for the surgery module) that has been developed and fabricated for prostate brachytherapy. Strategies to reduce needle deflection and target movement were incorporated after extensive experimental validation. Provision for needle motion and force feedback was included in the system to improve robot control and seed delivery. Preliminary experimental results reveal that the prototype system is sufficiently accurate in placing brachytherapy needles.
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Affiliation(s)
- Y Yu
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
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Podder TK, Sherman J, Messing EM, Rubens DJ, Fuller D, Strang JG, Brasacchio RA, Yu Y. Needle insertion force estimation model using procedure-specific and patient-specific criteria. Conf Proc IEEE Eng Med Biol Soc 2008; 2006:555-8. [PMID: 17945984 DOI: 10.1109/iembs.2006.259921] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Placement accuracy of different types of surgical needles in soft biological tissues depends on a variety of factors. The needles used for prostate brachytherapy procedures are typically about 200 mm in length and 1.27-1.47 mm in diameter. These needles are prone to deflection and thereby depositing the seeds at a location other than the planned one. Thus tumorous tissues may not receive the planned dose whereas the critical organs may be over-dosed. A significant amount of needle deflection and target movement is related to some procedure-specific criteria and some patient-specific criteria. In this paper we have developed needle insertion force models taking both procedure-specific criteria and patient-specific criteria. These statistical models can be used to estimate the force that the needle will experience during insertion and thereby control the needle to reduce the needle deflection and enhance seed delivery accuracy.
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Affiliation(s)
- T K Podder
- Dept. of Radiation Oncology, University of Rochester, Rochester, NY 14642, USA
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Siskind JM, Sherman J, Pollak I, Harper MP, Bouman CA. Spatial random tree grammars for modeling hierarchal structure in images with regions of arbitrary shape. IEEE Trans Pattern Anal Mach Intell 2007; 29:1504-19. [PMID: 17627040 DOI: 10.1109/tpami.2007.1169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
We present a novel probabilistic model for the hierarchal structure of an image and its regions. We call this model spatial random tree grammars (SRTGs). We develop algorithms for exact computation of likelihoods and MAP estimates and exact EM updates for model-parameter estimation. We collectively call these algorithms the center-surround algorithm. We use the center-surround algorithm to automatically estimate the ML parameters of SRTGs, classify images based on their likelihood and based on the MAP estimate of the associated hierarchal structure. We apply our method to the task of classifying natural images and demonstrate that the addition of hierarchal structure significantly improves upon the performance of a baseline model that lacks such structure.
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Affiliation(s)
- J M Siskind
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA
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Stone D, Sherman J, Hofeld E. Arsenic in Oregon community water systems: demography matters. Sci Total Environ 2007; 382:52-8. [PMID: 17532026 DOI: 10.1016/j.scitotenv.2007.04.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Revised: 04/02/2007] [Accepted: 04/10/2007] [Indexed: 05/10/2023]
Abstract
Recently, the maximum contaminate level (MCL) for arsenic was lowered to 10 microg/L in community water systems (CWS) throughout the United States. In this study, CWS in Oregon were assessed for the occurrence and magnitude of arsenic >10 microg/L between the effective and compliance dates for the new MCL. Ten CWS, with a combined population of 49,395, met the criteria for this study. Arsenic levels above the new MCL ranged from 11-25 microg/L. The demographic characteristics of these systems were queried and considered in the context of risk, exposure and outreach. A disproportionate percent of residents in affected CWS were of Hispanic origin (35%) compared to the statewide average (8%). Residents in these CWS had a lower median household income (20% less than the statewide average), a lower median age (32.5 vs. 36.3) and a higher percent of a second language spoken in the home besides English (34.6% vs. 12.1%) compared to the statewide census. These community characteristics have implications for exposure, risk and outreach associated with the occurrence of arsenic in drinking water. Consequently, demographic parameters are informative for risk management and communication and ultimately, beneficial to the affected public.
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Affiliation(s)
- D Stone
- Oregon State University, Department of Environmental and Molecular Toxicology, 1007 ALS Building, Corvallis, OR 97331, United States.
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Uitto PM, Lance BK, Wood GR, Sherman J, Baker MS, Molloy MP. Comparing SILAC and Two-Dimensional Gel Electrophoresis Image Analysis for Profiling Urokinase Plasminogen Activator Signaling in Ovarian Cancer Cells. J Proteome Res 2007; 6:2105-12. [PMID: 17472359 DOI: 10.1021/pr060638v] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Two-dimensional gel electrophoresis (2-DE) image analysis is conventionally used for comparative proteomics. However, there are a number of technical difficulties associated with 2-DE protein separation that limit the depth of proteome coverage, and the image analysis steps are typically labor-intensive and low-throughput. Recently, mass spectrometry-based quantitation strategies have been described as alternative differential proteome analysis techniques. In this study, we investigated changes in protein expression using an ovarian cancer cell line, OVMZ6, 24 h post-stimulation with the relatively weak agonist, urokinase-type plasminogen activator (uPA). Quantitative protein profiles were obtained by MALDI-TOF/TOF from stable isotope-labeled cells in culture (SILAC), and these results were compared to the quantitative ratios obtained using 2-DE gel image analysis. MALDI-TOF/TOF mass spectrometry showed that differential quantitation using SILAC was highly reproducible (approximately 8% coefficient of variation (CV)), and this variance was considerably lower than that achieved using automated 2-DE image analysis strategies (CV approximately 25%). Both techniques revealed subtle alterations in cellular protein expression following uPA stimulation. However, due to the lower variances associated with the SILAC technique, smaller changes in expression of uPA-inducible proteins could be found with greater certainty.
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Affiliation(s)
- Pauliina M Uitto
- Department of Chemistry and Biomolecular Sciences, Macquarie University, 2109, Sydney, NSW, Australia
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Stanley T, Sherman J, McUmber A, Bednarek D, Rudin S. SU-FF-P-02: Monitoring Hospital Entrances to Prevent Radioactive Contamination: Disaster Planning. Med Phys 2007. [DOI: 10.1118/1.2760639] [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: 11/07/2022] Open
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Podder TK, Clark DP, Fuller D, Sherman J, Ng WS, Liao L, Rubens DJ, Strang JG, Messing EM, Zhang YD, Yu Y. Effects of velocity modulation during surgical needle insertion. Conf Proc IEEE Eng Med Biol Soc 2007; 2005:5766-70. [PMID: 17281568 DOI: 10.1109/iembs.2005.1615798] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Precise interstitial intervention is essential for many medical diagnostic and therapeutic procedures. But accurate insertion and placement of surgical needle in soft tissue is quite challenging. The understanding of the interaction between surgical needle and soft tissue is very important to develop new devices and systems to achieve better accuracy and to deliver quality treatment. In this paper we present the effects of velocity (linear, rotational, and oscillatory) modulation on needle force and target deflection. We have experimentally verified our hypothesis that needle insertion with continuous rotation reduces target movement and needle force significantly. We have observed little changes in force and target deflection in rotational oscillation (at least at lower frequency) of the needle.
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Affiliation(s)
- T K Podder
- Departents of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA.
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Nettleblad SC, Soroff HS, Sachs BF, Sharma AN, Bellas AE, Sherman J, Harrison HN, Deterling RA. experimental studies of the response to homotransplantation of pulmonary tissues*. Ann N Y Acad Sci 2006. [DOI: 10.1111/j.1749-6632.1965.tb30695.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Yu Y, Podder T, Zhang Y, Ng W, Sherman J, Fuller D, Fu L, Misic V, Messing E, Rubens D, Strang J, Brasacchio R. SU-FF-T-52: A Robotic Platform for Image-Guided Brachytherapy (IGBT). Med Phys 2006. [DOI: 10.1118/1.2240981] [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: 11/07/2022] Open
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Affiliation(s)
- L Pauling
- Gates Chemical Laboratory, California Institute of Technology
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Quiros PA, Torres RJ, Salomao S, Berezovsky A, Carelli V, Sherman J, Sadun F, De Negri A, Belfort R, Sadun AA. Colour vision defects in asymptomatic carriers of the Leber's hereditary optic neuropathy (LHON) mtDNA 11778 mutation from a large Brazilian LHON pedigree: a case-control study. Br J Ophthalmol 2006; 90:150-3. [PMID: 16424523 PMCID: PMC1860163 DOI: 10.1136/bjo.2005.074526] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To determine if asymptomatic carriers from a previously identified large pedigree of the Leber's hereditary optic neuropathy (LHON) 11778 mtDNA mutation have colour vision deficits. METHODS As part of a comprehensive analysis of over 200 members of a large Brazilian LHON pedigree spanning seven generations, colour vision tests were obtained from 91 members. Colour vision was tested one eye at a time using the Farnsworth-Munsell 100 (FM-100) hue colour vision test. The test was administered under uniform conditions, taking into account: ambient light levels, daylight colour temperature of 6700 kelvin, and neutral uniform background. Tests were scored using the FM-100 MS-Excel computer scoring program. Defects were determined and categorised as tritan, deutan, or protan. Categorisation of each dyschromatopsia was based on review of demonstrated axis computer generated plots and age adjusted error scores which coincided with Verriest 95% confidence intervals. Only the axis with the greatest magnitude error score was used to classify the defect. 55 of the 91 test subjects were LHON mtDNA 11778 J haplotype mutation carriers, proved by mtDNA analysis. The remaining 36 subjects were age matched non-blood relatives (off pedigree), who served as controls. RESULTS 27 of 55 carriers (49.10%) were shown to have colour vision defects in one or both eyes. 13 of the 27 (48%) abnormal tests in the carrier group were tritan defects and the remaining 14 (52%) were deutan defects. Nine of the 27 (33%) abnormals in the carrier group were identified as having bilateral defects. Six of these were deutan, and the remaining three were tritan dyschromatopsias. Only six of the 36 (16.66%) age matched controls were found to have any type of dyschromatopsia. Five (83.3%) of these were deutan defects. The remaining one was a tritan defect. The difference between the two groups using a chi(2) test with one degree of freedom was statistically significant with a p value less that 0.001. CONCLUSIONS Until now, LHON has always been characterised by a sudden, devastating vision loss. Asymptomatic carriers, those without vision loss, were considered unaffected by the disease. It now appears that asymptomatic carriers of the LHON mutation are affected by colour vision defects and may manifest other subtle, yet chronic, changes.
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Affiliation(s)
- P A Quiros
- Doheny Eye Institute, 1450 San Pablo Street, Los Angeles, CA 90033, USA.
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Deauna-Limayo D, Shik N, Merkel D, Harvey E, Divine C, Folker T, Lewis J, Hoffmann T, Sherman J, Bradley M, Skikne B. A Quality Management Program’s (QMP) favorable impact on a Hematopoietic Stem Cell Transplant (HSCT) practice: The university of kansas medical center experience. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sherman J, Podder TK, Misic V, Fu L, Fuller D, Winey B, Messing EM, Rubens DJ, Strang JG, Brasacchio R, Yu Y. Efficacy of prostate stabilizing techniques during brachytherapy procedure. Conf Proc IEEE Eng Med Biol Soc 2006; 2006:563-566. [PMID: 17945985 DOI: 10.1109/iembs.2006.259930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
During the prostate brachytherapy procedure, multiple needles are inserted into the prostate and radioactive seeds are deposited. Stabilizing needles are first inserted to provide some rigidity and support to the prostate, ideally this will provide better seed placement and an overall improved treatment. However, there is much speculation regarding the effectiveness of using regular brachytherapy needles as stabilizers. In this study, we explored the efficacy of (1) two types of needles--18 gauge brachytherapy needle vs. 18 gauge hooked needle; and (2) parallel vs. angulated needle configurations to stabilize the prostate. Prostate phantom movement and needle insertion progression were imaged using ultrasound (US). The recorded images were analyzed and prostate displacement was computed from images using implanted artifacts. Experimentation allowed us to further understand the mechanics behind prostate stabilization. We observed superior stabilization by the hooked needles compared to the regular brachytherapy needles (more than 40% for parallel stabilization). Prostate movement was also reduced significantly when regular brachytherapy needles were in an angulated configuration as compared to the parallel configuration (approximately 40%). When the hooked needles were angled for stabilization, further improvement in decreased displacement was observed. In general, for convenience of dosimetric planning, all needles are desired to be in parallel and in this case, hooked needles are better suited to improve stabilization of the prostate. On the other hand, both regular and hooked needles appear to be equally effective in reducing prostate movement when they are in angulated configurations, which will be useful in robotic permanent seed implantation (PSI).
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Affiliation(s)
- J Sherman
- Dept. of Radiation Oncology, University of Rochester, NY 14642, USA
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Podder TK, Sherman J, Fuller D, Messing EM, Rubens DJ, Strang JG, Brasacchio RA, Yu Y. In-vivo measurement of surgical needle intervention parameters: a pilot study. Conf Proc IEEE Eng Med Biol Soc 2006; 2006:3652-3655. [PMID: 17946194 DOI: 10.1109/iembs.2006.259917] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Percutaneous intervention is essential in numerous medical diagnostic and therapeutic procedures. In these procedures, accurate insertion of the surgical needle is very important. But precise interstitial intervention is quite challenging. Robot-assisted needle intervention can significantly improve accuracy and consistency of various medical procedures. To design and control any robotic system, the design and control engineers must know the forces that will be encountered by the system and the motion trajectories that the needling mechanism will have to follow. Several researchers have reported needle insertion forces encountered while steering through soft tissue and soft material phantoms, but hardly any in-vivo force measurement data is available in the literature. In this paper, we present needle insertion forces and motion trajectories measured during actual brachytherapy needle insertion while implanting radioactive seeds in the prostate glands of twenty five patients.
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Affiliation(s)
- T K Podder
- Dept. of Radiat. Oncology, Univ. of Rochester Med. Center, NY 14642, USA
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Abstract
BACKGROUND Overlapping symptoms of gastro-oesophageal reflux disease and dyspepsia are a problem for physicians and patients. AIM This study explored comprehension of dyspepsia symptoms and associated medical terminology among women with symptoms of dyspepsia. METHODS The US women aged > or = 18 years with dyspepsia (defined by Rome II criteria) were recruited in two phases, via direct mail, the Internet, clinical investigators and/or gastroenterologists. In phase I, subjects took part in an hour-long telephonic interview comprising open-ended questions relating to symptom frequency/duration, triggers/patterns and severity. During phase II, subjects took part in a 45-min telephonic interview, which explored their understanding of dyspepsia symptoms and their predominant or most bothersome symptom. RESULTS Subjects with 'pure' dyspepsia (without overlapping symptoms of gastro-oesophageal reflux disease or irritable bowel syndrome) were sought, but of 777 subjects screened, most were excluded because of gastrointestinal comorbidities (irritable bowel syndrome, gastro-oesophageal reflux disease). Only 85 (11%) subjects had 'pure' dyspepsia of whom 11 withdrew. Of the 74 subjects interviewed, 70% were unfamiliar with the term 'dyspepsia'. Subjects reported several symptoms, including bloating (65%), gas (50%), nausea (41%) and discomfort (36%). Most subjects could distinguish between symptom bothersomeness and severity, and between pain and discomfort. Terms such as 'satisfactory relief', 'central upper abdominal discomfort', 'early satiety' and 'postmeal fullness' were often misunderstood. CONCLUSIONS Subjects with 'pure' dyspepsia are rare, because of comorbidities. Dyspepsia-related terminology is often misunderstood by subjects.
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Affiliation(s)
- N Vakil
- University of Wisconsin Medical School, Madison, WI, USA.
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Podder T, Clark D, Fuller D, Sherman J, Messing E, Rubens D, Strang J, Ng W, Yu Y. Sci-PM Fri - 05: Effects of coating on friction force during needle insertion in soft materials. Med Phys 2005. [DOI: 10.1118/1.2031037] [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: 11/07/2022] Open
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Podder T, Clark D, Messing E, Fuller D, O'Dell W, Rubens D, Strang J, Ng W, Sherman J, Brasacchio R, zhang Y, Okunieff P, Schell M, Liao L, Yu Y. SU-FF-T-204: In Vivo Force-Torque Measurement During Prostate Brachytherapy. Med Phys 2005. [DOI: 10.1118/1.1997932] [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: 11/07/2022] Open
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