1
|
Mukherjee A, Andrés Jeske Y, Becam I, Taïeb A, Brooks P, Aouad J, Monguillon C, Conduit PT. γ-TuRCs and the augmin complex are required for the development of highly branched dendritic arbors in Drosophila. J Cell Sci 2024; 137:jcs261534. [PMID: 38606636 DOI: 10.1242/jcs.261534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/05/2024] [Indexed: 04/13/2024] Open
Abstract
Microtubules are nucleated by γ-tubulin ring complexes (γ-TuRCs) and are essential for neuronal development. Nevertheless, γ-TuRC depletion has been reported to perturb only higher-order branching in elaborated Drosophila larval class IV dendritic arborization (da) neurons. This relatively mild phenotype has been attributed to defects in microtubule nucleation from Golgi outposts, yet most Golgi outposts lack associated γ-TuRCs. By analyzing dendritic arbor regrowth in pupae, we show that γ-TuRCs are also required for the growth and branching of primary and secondary dendrites, as well as for higher-order branching. Moreover, we identify the augmin complex (hereafter augmin), which recruits γ-TuRCs to the sides of pre-existing microtubules, as being required predominantly for higher-order branching. Augmin strongly promotes the anterograde growth of microtubules in terminal dendrites and thus terminal dendrite stability. Consistent with a specific role in higher-order branching, we find that augmin is expressed less strongly and is largely dispensable in larval class I da neurons, which exhibit few higher-order dendrites. Thus, γ-TuRCs are essential for various aspects of complex dendritic arbor development, and they appear to function in higher-order branching via the augmin pathway, which promotes the elaboration of dendritic arbors to help define neuronal morphology.
Collapse
Affiliation(s)
- Amrita Mukherjee
- Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 3EJ, UK
- MRC Toxicology Unit, Gleeson Building, Tennis Court Road, Cambridge CB2 1QR, UK
| | - Yaiza Andrés Jeske
- Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 3EJ, UK
| | - Isabelle Becam
- Université Paris Cité, CNRS, Institut Jacques Monod, F-75013 Paris, France
| | - Anaelle Taïeb
- Université Paris Cité, CNRS, Institut Jacques Monod, F-75013 Paris, France
| | - Paul Brooks
- Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 3EJ, UK
| | - Joanna Aouad
- Université Paris Cité, CNRS, Institut Jacques Monod, F-75013 Paris, France
| | | | - Paul T Conduit
- Department of Zoology, University of Cambridge, Downing Street, Cambridge CB2 3EJ, UK
- Université Paris Cité, CNRS, Institut Jacques Monod, F-75013 Paris, France
| |
Collapse
|
2
|
Mayer-Pinto M, Caley A, Knights AM, Airoldi L, Bishop MJ, Brooks P, Coutinho R, Crowe T, Mancuso P, Naval-Xavier LPD, Firth LB, Menezes R, de Messano LVR, Morris R, Ross DJ, Wong JXW, Steinberg P, Strain EMA. Complexity-functioning relationships differ across different environmental conditions. J Environ Manage 2024; 354:120370. [PMID: 38387353 DOI: 10.1016/j.jenvman.2024.120370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/23/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
Habitat complexity is widely considered an important determinant of biodiversity, and enhancing complexity can play a key role in restoring degraded habitats. However, the effects of habitat complexity on ecosystem functioning - as opposed to biodiversity and community structure - are relatively poorly understood for artificial habitats, which dominate many coastlines. With Greening of Grey Infrastructure (GGI) approaches, or eco-engineering, increasingly being applied around the globe, it is important to understand the effects that modifying habitat complexity has on both biodiversity and ecological functioning in these highly modified habitats. We assessed how manipulating physical (primary substrate) and/or biogenic habitat (bivalves) complexity on intertidal artificial substrata affected filtration rates, net and gross primary productivity (NPP and GPP, respectively) and community respiration (CR) - as well as abundance of filter feeders and macro-algae and habitat use by cryptobenthic fish across six locations in three continents. We manipulated both physical and biogenic complexity using 1) flat or ridged (2.5 cm or 5 cm) settlement tiles that were either 2) unseeded or seeded with oysters or mussels. Across all locations, increasing physical and biogenic complexity (5 cm seeded tiles) had a significant effect on most ecological functioning variables, increasing overall filtration rates and community respiration of the assemblages on tiles but decreasing productivity (both GPP and NPP) across all locations. There were no overall effects of increasing either type of habitat complexity on cryptobenthic fish MaxN, total time in frame or macro-algal cover. Within each location, there were marked differences in the effects of habitat complexity. In Hobart, we found higher filtration, filter feeder biomass and community respiration on 5 cm tiles compared to flat tiles. However, at this location, both macro-algae cover and GPP decreased with increasing physical complexity. Similarly in Dublin, filtration, filter feeder biomass and community respiration were higher on 5 cm tiles compared to less complex tiles. In Sydney, filtration and filter feeder biomass were higher on seeded than unseeded tiles, and fish MaxN was higher on 5 cm tiles compared to flat tiles. On unseeded tiles in Sydney, filter feeder biomass also increased with increasing physical complexity. Our findings suggest that GGI solutions via increased habitat complexity are likely to have trade-offs among potentially desired functions, such as productivity and filtration rates, and variable effects on cryptobenthic fish communities. Importantly, our results show that the effects of GGI practices can vary markedly according to the environmental context and therefore should not be blindly and uniformly applied across the globe.
Collapse
Affiliation(s)
- Mariana Mayer-Pinto
- Centre of Marine Science and Innovation, Evolution and Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, Australia.
| | - Amelia Caley
- Centre of Marine Science and Innovation, Evolution and Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, Australia
| | - Antony M Knights
- School of Biological and Marine Sciences, University of Plymouth, Plymouth, PL4 8AA, United Kingdom
| | - Laura Airoldi
- Chioggia Hydrobiological Station "Umberto D'Ancona", Department of Biology, University of Padova, UO CoNISMa, Chioggia, Italy; NBFC, National Biodiversity Future Center, Palermo, 90133, Italy
| | - Melanie J Bishop
- School of Natural Sciences, Macquarie University, NSW, 2109, Australia
| | - Paul Brooks
- Earth Institute & School of Biology and Environmental Science, University College Dublin, Dublin 4, Ireland
| | - Ricardo Coutinho
- Marine Biotechnology Program, Instituto de Estudos do Mar Almirante Paulo Moreira (IEAPM), Arraial do Cabo, Brazil and Federal Fluminense University, Niterói, Brazil; Marine Biotechnology Department, Instituto de Estudos do Mar Almirante Paulo Moreira, Arraial do Cabo, Brazil
| | - Tasman Crowe
- Earth Institute & School of Biology and Environmental Science, University College Dublin, Dublin 4, Ireland
| | - Paolo Mancuso
- Chioggia Hydrobiological Station "Umberto D'Ancona", Department of Biology, University of Padova, UO CoNISMa, Chioggia, Italy; NBFC, National Biodiversity Future Center, Palermo, 90133, Italy
| | - Lais P D Naval-Xavier
- Marine Biotechnology Program, Instituto de Estudos do Mar Almirante Paulo Moreira (IEAPM), Arraial do Cabo, Brazil and Federal Fluminense University, Niterói, Brazil; Marine Biotechnology Department, Instituto de Estudos do Mar Almirante Paulo Moreira, Arraial do Cabo, Brazil
| | - Louise B Firth
- School of Biological and Marine Sciences, University of Plymouth, Plymouth, PL4 8AA, United Kingdom
| | - Rafael Menezes
- Marine Biotechnology Program, Instituto de Estudos do Mar Almirante Paulo Moreira (IEAPM), Arraial do Cabo, Brazil and Federal Fluminense University, Niterói, Brazil; Marine Biotechnology Department, Instituto de Estudos do Mar Almirante Paulo Moreira, Arraial do Cabo, Brazil
| | - Luciana V R de Messano
- Marine Biotechnology Department, Instituto de Estudos do Mar Almirante Paulo Moreira, Arraial do Cabo, Brazil
| | - Rebecca Morris
- National Centre for Coasts and Climate, School of BioSciences, The University of Melbourne, VIC, 3010, Australia
| | - Donald J Ross
- Institute for Marine and Antarctic Science, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Joanne X W Wong
- Centro Interdipartimentale di Ricerca per le Scienze Ambientali (CIRSA), Alma Mater Studiorum - Universita' di Bologna, Via S. Alberto 163, 48123, Ravenna, Italy
| | - Peter Steinberg
- Centre of Marine Science and Innovation, Evolution and Ecology Research Centre, School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, Australia
| | - Elisabeth M A Strain
- Institute for Marine and Antarctic Science, University of Tasmania, Hobart, TAS, 7000, Australia; Centre for Marine Socioecology, University of Tasmania, Hobart, Tasmania, 7053, Australia
| |
Collapse
|
3
|
Schlegel P, Yin Y, Bates AS, Dorkenwald S, Eichler K, Brooks P, Han DS, Gkantia M, Dos Santos M, Munnelly EJ, Badalamente G, Capdevila LS, Sane VA, Pleijzier MW, Tamimi IFM, Dunne CR, Salgarella I, Javier A, Fang S, Perlman E, Kazimiers T, Jagannathan SR, Matsliah A, Sterling AR, Yu SC, McKellar CE, Consortium F, Costa M, Sebastian Seung H, Murthy M, Hartenstein V, Bock DD, Jefferis GSXE. A consensus cell type atlas from multiple connectomes reveals principles of circuit stereotypy and variation. bioRxiv 2023:2023.06.27.546055. [PMID: 37425808 PMCID: PMC10327018 DOI: 10.1101/2023.06.27.546055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
The fruit fly Drosophila melanogaster combines surprisingly sophisticated behaviour with a highly tractable nervous system. A large part of the fly's success as a model organism in modern neuroscience stems from the concentration of collaboratively generated molecular genetic and digital resources. As presented in our FlyWire companion paper 1 , this now includes the first full brain connectome of an adult animal. Here we report the systematic and hierarchical annotation of this ∼130,000-neuron connectome including neuronal classes, cell types and developmental units (hemilineages). This enables any researcher to navigate this huge dataset and find systems and neurons of interest, linked to the literature through the Virtual Fly Brain database 2 . Crucially, this resource includes 4,179 cell types of which 3,166 consensus cell types are robustly defined by comparison with a second dataset, the "hemibrain" connectome 3 . Comparative analysis showed that cell type counts and strong connections were largely stable, but connection weights were surprisingly variable within and across animals. Further analysis defined simple heuristics for connectome interpretation: connections stronger than 10 unitary synapses or providing >1% of the input to a target cell are highly conserved. Some cell types showed increased variability across connectomes: the most common cell type in the mushroom body, required for learning and memory, is almost twice as numerous in FlyWire than in the hemibrain. We find evidence for functional homeostasis through adjustments of the absolute amount of excitatory input while maintaining the excitation-inhibition ratio. Finally, and surprisingly, about one third of the cell types recorded in the hemibrain connectome could not be robustly identified in the FlyWire connectome, cautioning against defining cell types based on single connectomes. We propose that a cell type should be robust to inter-individual variation, and therefore defined as a group of cells that are more similar to cells in a different brain than to any other cell in the same brain. We show that this new definition can be consistently applied to whole connectome datasets. Our work defines a consensus cell type atlas for the fly brain and provides both an intellectual framework and open source toolchain for brain-scale comparative connectomics.
Collapse
|
4
|
Affiliation(s)
- O Bagshaw
- Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - P Brooks
- Chelsea and Westminster Hospital, London, UK
| | - A Baxter
- Royal Hospital for Sick Children, Edinburgh, UK
| |
Collapse
|
5
|
Vetten Z, Auld B, Brooks P, Robertson T, Lee-Tannock A, Yim D, Han D, Alsweiler J, Gentles T. Inter-Rater Reliability and Agreement of Fetal Echocardiography Measurements Among Investigators From Multiple Sites. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.456] [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]
|
6
|
Drakard VF, Brooks P, Crowe TP, Earp HS, Thompson B, Bourke N, George R, Piper C, Moore PJ. Fucus vesiculosus populations on artificial structures have potentially reduced fecundity and are dislodged at greater rates than on natural shores. Mar Environ Res 2021; 168:105324. [PMID: 33845257 DOI: 10.1016/j.marenvres.2021.105324] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
Artificial structures are widespread features of coastal marine environments. These structures, however, are poor surrogates of natural rocky shores, meaning they generally support depauperate assemblages with reduced population sizes. Little is known about sub-lethal effects of such structures, for example, in terms of demographic properties and reproductive potential that may affect the dynamics and long-term viability of populations. Such understanding is particularly important for ecosystem engineer species, such as the intertidal seaweed Fucus vesiculosus. In this study, F. vesiculosus was sampled on eight artificial structures and eight natural shores along the east coast of Ireland and the west coast of Wales. Algal percentage cover, biomass, density of individuals, and growth rate did not differ between artificial and natural shores. Growth and reproductive cycles were consistent with previous studies for this species. While there was considerable variation from site to site, on average, populations on natural shores produced a higher number of mature receptacles during the peak reproductive period in April, and lower rates of dislodgement than on artificial structures. As F. vesiculosus reach peak reproductive output after 24 months, this suggests that individuals may be removed from populations on artificial structures before reaching their full reproductive potential. In this case, this did not influence density, percentage cover, or biomass, which suggests that F. vesiculosus populations on artificial structures may function similarly to those on natural shores if supported by suitable source populations, but potentially may not persist otherwise.
Collapse
Affiliation(s)
- Veronica Farrugia Drakard
- UCD Earth Institute and School of Biology and Environmental Science, Science Centre West, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Paul Brooks
- UCD Earth Institute and School of Biology and Environmental Science, Science Centre West, University College Dublin, Belfield, Dublin 4, Ireland
| | - Tasman P Crowe
- UCD Earth Institute and School of Biology and Environmental Science, Science Centre West, University College Dublin, Belfield, Dublin 4, Ireland
| | - Hannah S Earp
- Institute of Biological, Environmental & Rural Sciences (IBERS), Aberystwyth University, Aberystwyth, SY23 3DA, UK
| | - Bryan Thompson
- UCD Earth Institute and School of Biology and Environmental Science, Science Centre West, University College Dublin, Belfield, Dublin 4, Ireland
| | - Nathan Bourke
- UCD Earth Institute and School of Biology and Environmental Science, Science Centre West, University College Dublin, Belfield, Dublin 4, Ireland
| | - Ruby George
- Institute of Biological, Environmental & Rural Sciences (IBERS), Aberystwyth University, Aberystwyth, SY23 3DA, UK
| | - Chloe Piper
- Institute of Biological, Environmental & Rural Sciences (IBERS), Aberystwyth University, Aberystwyth, SY23 3DA, UK
| | - Pippa J Moore
- Institute of Biological, Environmental & Rural Sciences (IBERS), Aberystwyth University, Aberystwyth, SY23 3DA, UK; School of Natural and Environmental Sciences, Newcastle University, Newcastle-Upon-Tyne, NE1 7RU, UK
| |
Collapse
|
7
|
Birch GF, Lee JH, Tanner E, Fortune J, Munksgaard N, Whitehead J, Coughanowr C, Agius J, Chrispijn J, Taylor U, Wells F, Bellas J, Besada V, Viñas L, Soares-Gomes A, Cordeiro RC, Machado W, Santelli RE, Vaughan M, Cameron M, Brooks P, Crowe T, Ponti M, Airoldi L, Guerra R, Puente A, Gómez AG, Zhou GJ, Leung KMY, Steinberg P. Sediment metal enrichment and ecological risk assessment of ten ports and estuaries in the World Harbours Project. Mar Pollut Bull 2020; 155:111129. [PMID: 32469765 DOI: 10.1016/j.marpolbul.2020.111129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/31/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
Ten global harbours were assessed for sediment quality by quantifying the magnitude of anthropogenic change and ecological risk. Anthropogenic change (enrichment) was high for Derwent River and Sydney estuary, moderate for Santander Harbour, Rio de Janeiro and Dublin Port, slight for Hong Kong, minimal for Darwin. All 10 enrichment indices used showed similar results. Derwent River sediment was rated at high ecological risk, followed by Sydney and Santander estuaries with moderate risk. Auckland and Darwin sediments exhibited minimal ecological risk and sediment in the remaining harbours (Dublin, Hong Kong, Ravenna, Ria de Vigo and Rio de Janeiro) were assessed at slight ecological risk. The extraordinary variety of environments and types/quantities/qualities of data investigated resulted in as much a critique and development of methodology, as an assessment of human impact, including unique techniques for elemental normalisation and contaminant classification. Recommendations for an improved technical framework for sediment quality assessment are provided.
Collapse
Affiliation(s)
- G F Birch
- School of Geosciences, The University of Sydney, NSW, Australia.
| | - J-H Lee
- School of Geosciences, The University of Sydney, NSW, Australia; Lotsearch, 3/68 Alfred Street, Milsons Point, NSW, 2061, Australia
| | - E Tanner
- Sydney Institute of Marine Science, Mosman, NSW, Australia
| | - J Fortune
- Aquatic Health Unit, Department of Environment and Natural Resources, Northern Territory, Australia
| | - N Munksgaard
- Research Institute for the Environment and Livelihoods (RIEL), Charles Darwin University, Darwin, Northern Territory, Australia
| | - J Whitehead
- Derwent River Program, DPIPWE, Tasmania, Australia
| | - C Coughanowr
- Derwent River Program, DPIPWE, Tasmania, Australia
| | - J Agius
- Derwent River Program, DPIPWE, Tasmania, Australia
| | - J Chrispijn
- Derwent River Program, DPIPWE, Tasmania, Australia
| | - U Taylor
- Derwent River Program, DPIPWE, Tasmania, Australia
| | - F Wells
- Derwent River Program, DPIPWE, Tasmania, Australia
| | - J Bellas
- Centro Oceanográfico de Vigo, 36390, Vigo, Pontevedra, Spain
| | - V Besada
- Centro Oceanográfico de Vigo, 36390, Vigo, Pontevedra, Spain
| | - L Viñas
- Centro Oceanográfico de Vigo, 36390, Vigo, Pontevedra, Spain
| | - A Soares-Gomes
- Federal Fluminense University, Marine Biology Department, Valonguinho Campus, Niterói, RJ, Brazil
| | - R C Cordeiro
- Federal Fluminense University, Geochemistry Department, Valonguinho Campus, Niterói, RJ, Brazil
| | - W Machado
- Federal Fluminense University, Geochemistry Department, Valonguinho Campus, Niterói, RJ, Brazil
| | - R E Santelli
- Rio de Janeiro Federal University, Chemistry Institute, Rio de Janeiro, RJ, Brazil
| | - M Vaughan
- Research and evaluation unit, Auckland Council, New Zealand
| | - M Cameron
- Research and evaluation unit, Auckland Council, New Zealand
| | - P Brooks
- UCD Earth Institute and School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - T Crowe
- UCD Earth Institute and School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - M Ponti
- Department of Biological, Geological and Environmental Sciences and Interdepartmental Research Centre for Environmental Sciences, University of Bologna, 48123 Ravenna, Italy
| | - L Airoldi
- Department of Biological, Geological and Environmental Sciences and Interdepartmental Research Centre for Environmental Sciences, University of Bologna, 48123 Ravenna, Italy
| | - R Guerra
- Department of Physics and Astronomy and Interdepartmental Research Centre of Environmental Sciences, University of Bologna, 48123 Ravenna, Italy
| | - A Puente
- IHCantabria - Instituto de Hidráulica Ambiental de la Universidad de Cantabria Avda. Isabel Torres, 15, 39011, Santander, Spain
| | - A G Gómez
- IHCantabria - Instituto de Hidráulica Ambiental de la Universidad de Cantabria Avda. Isabel Torres, 15, 39011, Santander, Spain
| | - G J Zhou
- The Swire Institute of Marine Science and School of Biological Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - K M Y Leung
- The Swire Institute of Marine Science and School of Biological Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China; State Key Laboratory of Marine Pollution, City University of Hong Kong, Kowloon, Hong Kong, China
| | - P Steinberg
- Sydney Institute of Marine Science, Mosman, NSW, Australia
| |
Collapse
|
8
|
Eckersley LG, Howley LW, van der Velde ME, Khoo NS, Mah K, Brooks P, Colen T, Hornberger LK. Quantitative Assessment of Left Ventricular Dysfunction in Fetal Ebstein's Anomaly and Tricuspid Valve Dysplasia. J Am Soc Echocardiogr 2019; 32:1598-1607. [PMID: 31551185 DOI: 10.1016/j.echo.2019.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Fetal Ebstein's anomaly and tricuspid valve dysplasia (EA/TVD) are associated with high perinatal mortality relative to pulmonary atresia with intact ventricular septum (PAIVS), despite both requiring redistribution of the cardiac output (CO) to the left ventricle (LV). LV dysfunction is suspected to contribute to adverse outcomes in EA/TVD. OBJECTIVE We sought to examine global and segmental LV function in fetal EA/TVD with comparison to normal controls and PAIVS. We hypothesized that LV dysfunction in EA/TVD is associated with abnormal LV remodeling and interventricular mechanics. METHODS We retrospectively identified 63 cases of fetal EA/TVD (40 with retrograde ductal flow) and 22 cases of PAIVS encountered from 2004 to 2015 and compared findings to 77 controls of comparable gestational age. We measured the combined CO and global LV function using two-dimensional, Doppler-derived, deformational (six-segmental vector velocity imaging) and dyssynchrony indices (DIs; SD of time to peak), and a novel global DI. RESULTS EA/TVD fetuses demonstrated abnormal LV global systolic function with reduced ejection fraction, fractional area change, and CO, while in PAIVS we observed a normal ejection fraction, fractional area change, and CO. PAIVS, but not EA/TVD, demonstrated increased LV sphericity, suggestive of remodeling, and associated enhanced radial function in the third trimester. In contrast, while EA/TVD fetuses had normal LV segmental longitudinal strain, there was abnormal radial segmental deformation and LV dyssynchrony with increased SD of time to peak and DI. CONCLUSIONS Fetal EA/TVD is associated with a lack of spherical remodeling and presence of mechanical dyssynchrony, which likely contribute to reduced CO and ejection fraction. Clinical monitoring of LV function is warranted in fetal EA/TVD. Further studies incorporating quantification of LV function into prediction models for adverse outcomes are required.
Collapse
Affiliation(s)
- Luke G Eckersley
- Division of Cardiology, Department of Pediatrics, Fetal and Neonatal Cardiology Program, Women's and Children Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa W Howley
- Division of Cardiology, Department of Pediatrics, University of Colorado, Denver, Colorado
| | - Mary E van der Velde
- Division of Cardiology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Nee S Khoo
- Division of Cardiology, Department of Pediatrics, Fetal and Neonatal Cardiology Program, Women's and Children Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Kandice Mah
- Division of Cardiology, Department of Pediatrics, Fetal and Neonatal Cardiology Program, Women's and Children Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Paul Brooks
- Division of Cardiology, Department of Pediatrics, Fetal and Neonatal Cardiology Program, Women's and Children Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Timothy Colen
- Division of Cardiology, Department of Pediatrics, Fetal and Neonatal Cardiology Program, Women's and Children Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa K Hornberger
- Division of Cardiology, Department of Pediatrics, Fetal and Neonatal Cardiology Program, Women's and Children Health Research Institute, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
9
|
Alvarez SGV, Khoo NS, Colen T, McBrien A, Eckersley L, Brooks P, Savard W, Hornberger LK. The Incremental Benefit of Color Tissue Doppler in Fetal Arrhythmia Assessment. J Am Soc Echocardiogr 2018; 32:145-156. [PMID: 30340890 DOI: 10.1016/j.echo.2018.08.009] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Accurate fetal arrhythmia (FA) diagnosis is key for effective management. Currently, FA assessment relies on standard echocardiography-based techniques (M mode and spectral Doppler), which require adequate fetal position and cursor alignment to define temporal relationships of mechanical events. Few data exist on the application of color Doppler tissue imaging (c-DTI) in FA assessment. The aim of this study was to examine the feasibility and clinical applicability of c-DTI in FA assessment in comparison with standard techniques. METHODS Pregnancies with diagnosed FA were prospectively recruited to undergo c-DTI following fetal echocardiography. Multiple-cycle four-chamber clips in any orientation were recorded (mean frame rate, 180 ± 16 frames/sec). With offline analysis, sample volumes were placed on atrial (A) and ventricular (V) free walls for simultaneous recordings. Atrial and ventricular rates, intervals (for atrial-ventricular conduction and tachyarrhythmia mechanism), and relationships were assessed to decipher FA mechanism. FA diagnosis by c-DTI, conventional echocardiographic techniques, and postnatal electrocardiography and/or Holter monitoring were compared. RESULTS FA was assessed by c-DTI in 45 pregnancies at 15 to 39 weeks, including 16 with atrial and/or ventricular ectopic beats; 18 with supraventricular tachyarrhythmias, including ectopic atrial tachycardia in 11, atrioventricular reentrant tachycardia in four, atrial flutter in two, and intermittent atrial flutter and junctional ectopic rhythm in one; three with ventricular tachycardias; and eight with bradycardias or atrioventricular conduction pathology, including five with complete atrioventricular block (AVB), one with first-degree AVB evolving into complete AVB, one with second-degree AVB, and one with sinus bradycardia. After training, FA diagnosis by c-DTI could be made irrespective of fetal orientation within 10 to 15 min. FA diagnosis by c-DTI concurred with standard techniques in 41 cases (91%), with additional findings identified by c-DTI in 10. c-DTI led to new FA diagnoses in four cases (9%) not definable by standard techniques. FA diagnosis by c-DTI was confirmed in all 20 with persistent arrhythmias after birth, including three with new diagnoses defined by c-DTI. c-DTI was particularly helpful in deciphering SVT mechanism (long vs short ventricular-atrial interval) in all 18 cases, whereas standard techniques permitted definition in only half. CONCLUSIONS c-DTI with offline analysis permits rapid and accurate definition of FA mechanism, providing new information in nearly one-third of affected pregnancies.
Collapse
Affiliation(s)
- Silvia G V Alvarez
- Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, Women's & Children's Health Research Institute, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada; Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
| | - Nee S Khoo
- Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, Women's & Children's Health Research Institute, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Timothy Colen
- Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, Women's & Children's Health Research Institute, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Angela McBrien
- Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, Women's & Children's Health Research Institute, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Luke Eckersley
- Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, Women's & Children's Health Research Institute, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Paul Brooks
- Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, Women's & Children's Health Research Institute, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada; Western Health, Melbourne, Australia
| | - Winnie Savard
- Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, Women's & Children's Health Research Institute, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Lisa K Hornberger
- Fetal and Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, Women's & Children's Health Research Institute, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada.
| |
Collapse
|
10
|
Hoy DG, Raikoti T, Smith E, Tuzakana A, Gill T, Matikarai K, Tako J, Jorari A, Blyth F, Pitaboe A, Buchbinder R, Kalauma I, Brooks P, Lepers C, Woolf A, Briggs A, March L. Use of The Global Alliance for Musculoskeletal Health survey module for estimating the population prevalence of musculoskeletal pain: findings from the Solomon Islands. BMC Musculoskelet Disord 2018; 19:292. [PMID: 30115055 PMCID: PMC6097436 DOI: 10.1186/s12891-018-2198-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/17/2018] [Indexed: 12/13/2022] Open
Abstract
Background Musculoskeletal (MSK) conditions are common and the biggest global cause of physical disability. The objective of the current study was to estimate the population prevalence of MSK-related pain using a standardized global MSK survey module for the first time. Methods A MSK survey module was constructed by the Global Alliance for Musculoskeletal Health Surveillance Taskforce and the Global Burden of Disease MSK Expert Group. The MSK module was included in the 2015 Solomon Islands Demographic and Health Survey. The sampling design was a two-stage stratified, nationally representative sample of households. Results A total of 9214 participants aged 15–49 years were included in the analysis. The age-standardized four-week prevalence of activity-limiting low back pain, neck pain, and hip and/or knee pain was 16.8, 8.9, and 10.8%, respectively. Prevalence tended to increase with age, and be higher in those with lower levels of education. Conclusions Prevalence of activity-limited pain was high in all measured MSK sites. This indicates an important public health issue for the Solomon Islands that needs to be addressed. Efforts should be underpinned by integration with strategies for other non-communicable diseases, aging, disability, and rehabilitation, and with other sectors such as social services, education, industry, and agriculture. Primary prevention strategies and strategies aimed at self-management are likely to have the greatest and most cost-effective impact. Electronic supplementary material The online version of this article (10.1186/s12891-018-2198-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- D G Hoy
- University of Sydney, Sydney, Australia. .,Global Alliance for Musculoskeletal Health, Truro, UK. .,Pacific Community (SPC), Noumea, New Caledonia.
| | - T Raikoti
- Pacific Community (SPC), Noumea, New Caledonia
| | - E Smith
- University of Sydney, Sydney, Australia
| | - A Tuzakana
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | - T Gill
- University of Adelaide, Adelaide, Australia
| | - K Matikarai
- Pacific Community (SPC), Noumea, New Caledonia
| | - J Tako
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | - A Jorari
- Pacific Community (SPC), Noumea, New Caledonia
| | - F Blyth
- University of Sydney, Sydney, Australia
| | - A Pitaboe
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | | | - I Kalauma
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | - P Brooks
- University of Melbourne, Melbourne, Australia
| | - C Lepers
- Pacific Community (SPC), Noumea, New Caledonia
| | - A Woolf
- Global Alliance for Musculoskeletal Health, Truro, UK.,Royal Cornwall Hospital, Truro, UK
| | - A Briggs
- Curtin University, Perth, Australia
| | - L March
- University of Sydney, Sydney, Australia.,Global Alliance for Musculoskeletal Health, Truro, UK
| |
Collapse
|
11
|
Zhou YH, Brooks P, Wang X. A two-stage hidden Markov model design for biomarker detection, with application to microbiome research. Stat Biosci 2018; 10:41-58. [PMID: 30174757 PMCID: PMC6116560 DOI: 10.1007/s12561-017-9187-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 10/27/2016] [Accepted: 01/20/2017] [Indexed: 10/20/2022]
Abstract
It has been recognized that for appropriately ordered data, hidden Markov models (HMM) with local false discovery rate (FDR) control can increase the power to detect significant associations. For many high-throughput technologies, the cost still limits their application. Two-stage designs are attractive, in which a set of interesting features or biomarkers is identified in a first stage, and then followed up in a second stage. However, to our knowledge no two-stage FDR control with HMMs has been developed. In this paper, we study an efficient HMM-FDR based two-stage design, using a simple integrated analysis procedure across the stages. Numeric studies show its excellent performance when compared to available methods. A power analysis method is also proposed. We use examples from microbiome data to illustrate the methods.
Collapse
Affiliation(s)
- Yi-Hui Zhou
- Department of Biological Sciences, Bioinformatics Research Center, North Carolina State University, North Carolina, United States of America
| | - Paul Brooks
- Department of Statistical Sciences and Operations Research and Department of Supply Chain Management and Analytics, Virginia Commonwealth University, Virginia, United States of America
| | | |
Collapse
|
12
|
Weathered M, Rein J, Anderson M, Brooks P, Coddington B. Characterization of Thermal Striping in Liquid Sodium With Optical Fiber Sensors. Journal of Nuclear Engineering and Radiation Science 2017. [DOI: 10.1115/1.4037118] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study characterized the magnitude, spatial profile, and frequency spectrum of thermal striping at a junction using a novel sodium-deployable optical fiber temperature sensor. Additionally, this study revealed for the first time the capability of performing cross correlation velocimetry (CCV) with an optical fiber to acquire fluid flow rates in a pipe. Optical fibers were encapsulated in stainless steel capillary tubes with an inert cover gas for high-temperature sodium deployment. Plots of temperature oscillation range as a function of two-dimensional space highlighted locations prone to mechanical failure for particular flow momentum ratios. The effect of inlet sodium temperature differential and bulk flow rate on thermal striping behavior was also explored. The power spectral density (PSD) revealed that the striping temperature oscillations occurred at frequencies ranging from 0.1 to 6 Hz. Finally, the bulk flow rate of liquid sodium was calculated from thermal striping's periodic temperature oscillations using cross correlation velocimetry for flow rates of 0.25–5.74 L/min.
Collapse
Affiliation(s)
- Matthew Weathered
- Engineering Physics, University of Wisconsin-Madison, 1500 Engineering Drive, Madison, WI 53715 e-mail:
| | - Jordan Rein
- Engineering Physics, University of Wisconsin-Madison, 1500 Engineering Drive, Madison, WI 53715 e-mail:
| | - Mark Anderson
- Engineering Physics, University of Wisconsin-Madison, 1500 Engineering Drive, Madison, WI 53715 e-mail:
| | - Paul Brooks
- Engineering Physics, University of Wisconsin-Madison, 1500 Engineering Drive, Madison, WI 53715 e-mail:
| | - Bryan Coddington
- Engineering Physics, University of Wisconsin-Madison, 1500 Engineering Drive, Madison, WI 53715 e-mail:
| |
Collapse
|
13
|
Howley LW, Khoo NS, Moon-Grady AJ, Patel SS, Alrais F, Tworetzky W, Colen T, Brooks P, Trines J, Ojala T, Hornberger LK. Right Atrial Dysfunction in the Fetus with Severely Regurgitant Tricuspid Valve Disease: A Potential Source of Cardiovascular Compromise. J Am Soc Echocardiogr 2017; 30:579-588. [DOI: 10.1016/j.echo.2017.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Indexed: 11/28/2022]
|
14
|
Descovich KA, Johnston S, Lisle A, Nicolson V, Janssen T, Brooks P, Phillips CJC. Long-term measurement of body temperature in the southern hairy-nosed wombat (Lasiorhinus latifrons). Aust Mammalogy 2017. [DOI: 10.1071/am15041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The southern hairy-nosed wombat (Lasiorhinus latifrons) is a nocturnal, fossorial marsupial that has evolved a range of physiological and behavioural adaptations to its semiarid environment. This study describes long-term core body temperature (Tb) of L. latifrons in a population with opportunities for behavioural thermoregulation through burrow use. Tb was measured hourly in 12 captive L. latifrons using implanted dataloggers over a 9-month period from late winter to late autumn. Data were examined for daily patterns, seasonal changes, sex differences and the relationship with environmental conditions (ambient temperature, den temperature and relative humidity). Tb ranged from 30.9 to 38.8°C, and had a distinct nychthemeral rhythm, with peak temperatures occurring at night in line with nocturnal activity. Females had a higher mean Tb (34.9°C) than males (34.4°C). The relationship between external ambient temperature and body temperature was negative, with body temperature decreasing as ambient temperature increased. This study is an important step towards a comprehensive picture of thermoregulation in L. latifrons, which may become vulnerable in the future if environmental temperatures rise and water availability decreases.
Collapse
|
15
|
Sur A, Manraj H, Lavoie PM, Lim K, Courtemanche D, Brooks P, Albersheim S. Multiple Successful Angioembolizations for Refractory Cardiac Failure in a Preterm with Rapidly Involuting Congenital Hemangioma. AJP Rep 2016; 6:e99-e103. [PMID: 26929881 PMCID: PMC4737636 DOI: 10.1055/s-0035-1570342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 10/22/2015] [Indexed: 11/06/2022] Open
Abstract
Rapidly involuting congenital hemangiomas (RICH) are the commonest variety of congenital hemangioma, often diagnosed antenatally as high-flow arteriovenous shunts causing hemodynamic compromise to the fetus. The postnatal management of such patients is often challenging. We present the case of an infant boy who was delivered prematurely at 29 weeks of gestation due to fetal compromise by a RICH, with features of high-output cardiac failure and major systemic hemodynamic steal from peripheral organs. Two early angioembolizations were required to manage his high-output cardiac failure. To our knowledge, this infant is the smallest and earliest newborn case of successful angioembolization for a complex, life-threatening vascular anomaly. We discuss the interventional dilemmas regarding the optimal timing of delivery and early embolization.
Collapse
Affiliation(s)
- Amitava Sur
- Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Heran Manraj
- Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Interventional Radiology, University of British Columbia, Vancouver, Canada
| | - Pascal M Lavoie
- Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Ken Lim
- Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Maternal and Fetal Medicine, University of British Columbia, Vancouver, Canada
| | - Douglas Courtemanche
- Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Plastic Surgery, University of British Columbia, Vancouver, Canada
| | - Paul Brooks
- Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Cardiology, University of British Columbia, Vancouver, Canada
| | - Susan Albersheim
- Children's and Women's Health Centre of British Columbia, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada
| |
Collapse
|
16
|
Lavoie PM, Stritzke A, Ting J, Jabr M, Jain A, Kwan E, Chakkarapani E, Brooks P, Brant R, McNamara PJ, Holsti L. A Randomized Controlled Trial of the Use of Oral Glucose with or without Gentle Facilitated Tucking of Infants during Neonatal Echocardiography. PLoS One 2015; 10:e0141015. [PMID: 26496361 PMCID: PMC4619855 DOI: 10.1371/journal.pone.0141015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 05/13/2015] [Accepted: 10/01/2015] [Indexed: 11/18/2022] Open
Abstract
Objective To compare the effect of oral glucose given with or without facilitated tucking (FT), versus placebo (water) to facilitate image acquisition during a targeted neonatal echocardiography (TNE). Design Factorial, double blind, randomized controlled trial. Setting Tertiary neonatal intensive care unit (NICU). Patients Infants born between 26 and 42 weeks of gestation (GA). Interventions One of four treatment groups: oral water (placebo), oral glucose (25%), facilitated tucking with oral water or facilitated tucking with oral glucose, during a single, structured TNE. All infants received a soother. Main Outcome Measure Change in Behavioral Indicators of Infant Pain (BIIP) scores. Results 104 preterm infants were randomized (mean ± SD GA: 33.4 ± 3.5 weeks). BIIP scores remained low during the echocardiography scan (median, [IQ range]: 0, [0 to 1]). There were no differences in the level of agitation of infants amongst the treatment groups, with estimated reductions in mean BIIP relative to control of 0.27 (95%CI -0.40 to 0.94) with use of oral glucose and .04 (-0.63 to 0.70) with facilitated tucking. There were also no differences between treatment groups in the quality and duration of the echocardiography scans. Conclusions In stable infants in the NICU, a TNE can be performed with minimal disruption in a majority of cases, simply by providing a soother. The use of 25% glucose water in this context did not provide further benefit in reducing agitation and improving image acquisition. Clinical Trial Registration Clinical Trials.gov: NCT01253889
Collapse
Affiliation(s)
- Pascal M. Lavoie
- Children’s & Women’s Health Centre of British Columbia, Vancouver, Canada
- Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, Canada
- Child & Family Research Institute, Vancouver, Canada
- * E-mail: (PML); (LH)
| | - Amelie Stritzke
- Children’s & Women’s Health Centre of British Columbia, Vancouver, Canada
- Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, Canada
| | - Joseph Ting
- Children’s & Women’s Health Centre of British Columbia, Vancouver, Canada
- Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, Canada
- Child & Family Research Institute, Vancouver, Canada
| | - Mohammad Jabr
- Children’s & Women’s Health Centre of British Columbia, Vancouver, Canada
- Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, Canada
| | - Amish Jain
- Department of Pediatrics/Division of Neonatology, University of Toronto, Ontario, Canada
| | - Eddie Kwan
- Department of Pharmacy, Children’s & Women’s Health Centre of British Columbia, Vancouver, Canada
| | - Ela Chakkarapani
- Children’s & Women’s Health Centre of British Columbia, Vancouver, Canada
| | - Paul Brooks
- Children’s & Women’s Health Centre of British Columbia, Vancouver, Canada
- Department of Pediatrics/Division of Cardiology, University of British Columbia, Vancouver, Canada
| | - Rollin Brant
- Child & Family Research Institute, Vancouver, Canada
- Department of Statistics, University of British Columbia, Vancouver, Canada
| | - Patrick J. McNamara
- Department of Pediatrics/Division of Neonatology, University of Toronto, Ontario, Canada
| | - Liisa Holsti
- Child & Family Research Institute, Vancouver, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
- * E-mail: (PML); (LH)
| |
Collapse
|
17
|
Kelleher BC, Dolan KP, Brooks P, Anderson MH, Sridharan K. Batch-Scale Hydrofluorination of Li27BeF4 to Support Molten Salt Reactor Development. Journal of Nuclear Engineering and Radiation Science 2015. [DOI: 10.1115/1.4030963] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Li 2 BeF 4 , or flibe, is the primary candidate coolant for the fluoride-salt-cooled high-temperature nuclear reactor (FHR). Kilogram quantities of pure flibe are required for repeatable corrosion tests of modern reactor materials. This paper details fluoride salt purification by the hydrofluorination–hydrogen process, which was used to regenerate 57.4 kg of flibe originating from the secondary loop of the molten salt reactor experiment (MSRE) at Oak Ridge National Laboratory (ORNL). Additionally, it expounds upon necessary handling precautions required to produce high-quality flibe and includes technological advancements which ease the purification and analysis process. Flibe batches produced at the University of Wisconsin are the largest since the MSRE program, enabling new corrosion, radiation, and thermal hydraulic testing around the United States.
Collapse
Affiliation(s)
- Brian C. Kelleher
- Thermal Hydraulics Laboratory, Department of Nuclear Engineering, University of Wisconsin–Madison, 1500 Engineering Drive, Madison, WI 53706
| | - Kieran P. Dolan
- Thermal Hydraulics Laboratory, Department of Nuclear Engineering, University of Wisconsin–Madison, 1500 Engineering Drive, Madison, WI 53706
| | - Paul Brooks
- Thermal Hydraulics Laboratory, Department of Nuclear Engineering, University of Wisconsin–Madison, 1500 Engineering Drive, Madison, WI 53706
| | - Mark H. Anderson
- Thermal Hydraulics Laboratory, Department of Nuclear Engineering, University of Wisconsin–Madison, 1500 Engineering Drive, Madison, WI 53706
| | - Kumar Sridharan
- Thermal Hydraulics Laboratory, Department of Nuclear Engineering, University of Wisconsin–Madison, 1500 Engineering Drive, Madison, WI 53706
| |
Collapse
|
18
|
Meloncelli DM, Windsor SAM, Brooks P. Chemical profiles of honeys originating from different floral sources and geographic locations examined by a combination of three extraction and analysis techniques. J Fundam and Appl Sci 2015. [DOI: 10.4314/jfas.v7i2.3] [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: 11/17/2022] Open
|
19
|
Abstract
Complete heart block (CHB) is a potentially fatal condition occurring in approximately 1:10000 fetuses. Whilst it is well recognised that maternal anti-Ro and La antibodies are associated with fetal CHB, there are multiple other manifestations of fetal exposure to these autoantibodies which are not widely appreciated and rarely diagnosed. The importance of identifying affected fetuses lies in the significantly increased risk of recurrence in future pregnancies, and the potential for treatments which may modify this risk. This paper presents several cases to highlight the varying fetal presentations of maternal anti-Ro and La antibodies.
Collapse
Affiliation(s)
- Paul Brooks
- Melbourne Paediatric CardiologyFitzroy; Royal Children's HospitalParkville; Western Health Sunshine HospitalSunshine MelbourneAustralia
| |
Collapse
|
20
|
Fiddes P, Brooks P, Komesaroff P. Author reply. Intern Med J 2015. [DOI: 10.1111/imj.12837] [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: 11/24/2022]
Affiliation(s)
- P. Fiddes
- Peninsula Clinical School; Monash University; Melbourne Victoria Australia
| | - P. Brooks
- Australian Health Workforce Institute (AHWI); Melbourne Victoria Australia
| | - P. Komesaroff
- Department of Medicine; Alfred Hospital; Monash University; Melbourne Victoria Australia
| |
Collapse
|
21
|
Lavoie PM, Stritzke A, Ting J, Jabr M, Jain A, Kwan E, Chakkarapani E, Brooks P, Brant R, McNamara PJ, Holsti L. Oral glucose during targeted neonatal echocardiography: is it useful? Arch Dis Child Fetal Neonatal Ed 2015; 100:F374-5. [PMID: 26054971 PMCID: PMC5050030 DOI: 10.1136/archdischild-2015-308191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2015] [Indexed: 11/04/2022]
Affiliation(s)
- Pascal M. Lavoie
- Children’s & Women’s Health Centre of British Columbia, Vancouver, British Columbia, Canada,Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amelie Stritzke
- Department of Pediatrics/Division of Neonatology, University of Calgary, Calgary, Alberta, Canada
| | - Joseph Ting
- Children’s & Women’s Health Centre of British Columbia, Vancouver, British Columbia, Canada,Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Jabr
- Department of Neonatology, King Saud University, Riyadh, Saudi Arabia
| | - Amish Jain
- Department of Pediatrics/Division of Neonatology, University of Toronto, Toronto, Ontario, Canada
| | - Eddie Kwan
- Children’s & Women’s Health Centre of British Columbia, Vancouver, British Columbia, Canada,Department of Pharmacy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ela Chakkarapani
- Neonatal Neuroscience, School of Clinical Medicine, University of Bristol, Bristol, UK
| | - Paul Brooks
- Department of Pediatrics/Division of Cardiology, University of British Columbia, British Columbia, Canada
| | - Rollin Brant
- Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Patrick J. McNamara
- Department of Pediatrics/Division of Neonatology, University of Toronto, Toronto, Ontario, Canada
| | - Liisa Holsti
- Children’s & Women’s Health Centre of British Columbia, Vancouver, British Columbia, Canada,Department of Pediatrics/Division of Neonatology, University of British Columbia, Vancouver, British Columbia, Canada,Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
22
|
Bhaskar J, Galati JC, Brooks P, Oppido G, Konstantinov IE, Brizard CP, d'Udekem Y. Survival into adulthood of patients with atrial isomerism undergoing cardiac surgery. J Thorac Cardiovasc Surg 2015; 149:1509-13. [DOI: 10.1016/j.jtcvs.2015.01.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 01/07/2015] [Accepted: 01/21/2015] [Indexed: 11/30/2022]
|
23
|
Tripp R, van der Sanden SM, Wu W, dybdahl-Sissoko N, Weldon W, Brooks P, O'donnell J, Jones L, Brown C, Tompkins S, Oberste M, Karpilow J. Engineering enhanced vaccine cell lines to eradicate vaccine preventable diseases: the polio endgame (VAC9P.1107). The Journal of Immunology 2015. [DOI: 10.4049/jimmunol.194.supp.145.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Advances in genomic screening and gene editing technologies provide a means to create the next generation of vaccine manufacturing cell lines. A genome-wide RNAi screen was used to identify gene knock-down events that enhance poliovirus replication with the aim of increasing vaccine yield and reducing the costs and time associated with vaccine production. Primary screen hits were validated with several attenuated and wild poliovirus strains in a Vero cell line employed in vaccine production. Multiple genes were identified that upon silencing increased titers >20-fold, and in some instances, knockdown of a gene or gene combination increased virus titers by >50-fold. Importantly, stable knockout of top candidates from the screen and validation studies using CRISPR technology provided equivalent or improved viral production of multiple serotypes. Several of these gene knockdowns also enhanced titer of enterovirus 71, a clinically relevant virus for which vaccines are being targeted. Host gene silencing events that facilitate poliovirus replication mapped to several cell pathways, and in all cases, gene silencing did not affect poliovirus antigenicity. This study suggests that modulating host genes to increase vaccine production can significantly enhance vaccine production at reduced costs, a finding that should greatly facilitate global implementation of inactivated poliovirus vaccine for polio eradication, and change the paradigm in mammalian vaccine cell line production.
Collapse
Affiliation(s)
- Ralph Tripp
- 1University of Georgia-College of Veterinary Med, Athens, GA
| | | | - W Wu
- 1University of Georgia-College of Veterinary Med, Athens, GA
| | | | | | - P Brooks
- 1University of Georgia-College of Veterinary Med, Athens, GA
| | - J O'donnell
- 1University of Georgia-College of Veterinary Med, Athens, GA
| | - L Jones
- 1University of Georgia-College of Veterinary Med, Athens, GA
| | - C Brown
- 2Centers for Disease Control, Atlanta, GA
| | | | - M Oberste
- 2Centers for Disease Control, Atlanta, GA
| | | |
Collapse
|
24
|
Hirose A, Khoo NS, Aziz K, Al-Rajaa N, van den Boom J, Savard W, Brooks P, Hornberger LK. Evolution of left ventricular function in the preterm infant. J Am Soc Echocardiogr 2014; 28:302-8. [PMID: 25533193 DOI: 10.1016/j.echo.2014.10.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Indexed: 10/24/2022]
Abstract
BACKGROUND The aim of this study was to evaluate left ventricular function in preterm infants from 28 days to near term using echocardiography. METHODS Thirty clinically stable preterm infants delivered at <30 weeks' gestational age were prospectively enrolled. At 28 days, conventional, tissue Doppler, and speckle-tracking echocardiography evaluations of left ventricular function were performed, with comparison made to findings in 30 healthy term infants of similar postnatal age. Sixteen preterm infants underwent repeat examinations near term. RESULTS Compared with controls, preterm infants at 28 days had decreased peak mitral valve (MV) E-wave velocities (P < .01), E/A ratios (P < .0001), annular e' velocities (P < .0001), and e'/a' ratios (P < .0001); increased MV E/e' ratios (P < .01); and lower basal circumferential early diastolic and higher late diastolic strain rates. No significant differences were found in fractional shortening, ejection fraction, and longitudinal or circumferential strain and strain rate between preterm infants and controls. Although preterm infants at 28 days had higher heart rates compared with controls (161 ± 15 vs 142 ± 16 beats/min), no significant correlations existed between heart rate and MV E, E/A ratio, e', e'/a' ratio, and E/e' ratio. Near term, the differences in diastolic function persisted, including decreased MV e'/a' ratio (P < .05), increased E/e' ratio (P < .01), and increased late diastolic strain rate. CONCLUSIONS Clinically stable preterm infants have normal left ventricular systolic function but altered diastolic function, with greater dependence on atrial contraction, the latter of which persists despite nearing term. These findings may be relevant to the management of preterm infants and may relate to the longer term myocardial dysfunction observed in affected adults.
Collapse
Affiliation(s)
- Akiko Hirose
- Fetal & Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
| | - Nee S Khoo
- Fetal & Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
| | - Khalid Aziz
- Department of Pediatrics, Division of Neonatology, University of Alberta, Edmonton, Alberta, Canada
| | - Najlaa Al-Rajaa
- Fetal & Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
| | - Jutta van den Boom
- Fetal & Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
| | - Winnie Savard
- Fetal & Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
| | - Paul Brooks
- Fetal & Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa K Hornberger
- Fetal & Neonatal Cardiology Program, Department of Pediatrics, Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada; Department of Obstetrics and Gynecology, Women's & Children's Health Research Institute, Mazankowski Alberta Heart Institute, Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
25
|
Komesaroff P, Kerridge I, Carney S, Brooks P. Is it too late to turn back the clock on managerialism and neoliberalism? Intern Med J 2013; 43:221-2. [PMID: 23441656 DOI: 10.1111/imj.12078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 01/08/2013] [Indexed: 11/29/2022]
|
26
|
Abstract
Femoroacetabular impingement (FAI) is commonly associated with early hip arthritis. We reviewed our series of 1300 hip resurfacing procedures. More than 90% of our male patients, with an average age of 53 years, had cam impingement lesions. In this condition, there are anterior femoral neck osteophytes, and a retroverted femoral head on a normally anteverted neck. It is postulated that FAI results in collision of the anterior neck of the femur against the rim of the acetabulum, causing damage to the acetabular labrum and articular cartilage, resulting in osteoarthritis. Early treatment of FAI involves arthroscopic or open removal of bone from the anterior femoral neck, as well as repair or removal of labral tears. However, once osteoarthritis has developed, hip replacement or hip resurfacing is indicated. Hip resurfacing can re-orient the head and re-shape the neck. This helps to restore normal biomechanics to the hip, eliminate FAI, and improve range of motion. Since many younger men with hip arthritis have FAI, and are also considered the best candidates for hip resurfacing, it is evident that resurfacing has a role in these patients.
Collapse
Affiliation(s)
- P. Brooks
- Cleveland Clinic, 9500
Euclid Ave, A-41, Cleveland, Ohio
44195, USA
| | - B. Bershadsky
- Cleveland Clinic, 9500
Euclid Ave, A-41, Cleveland, Ohio
44195, USA
| |
Collapse
|
27
|
Akhtar N, Brooks P. The use of botulinum toxin in the management of burns itching: preliminary results. Burns 2012; 38:1119-23. [PMID: 22795731 DOI: 10.1016/j.burns.2012.05.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 03/12/2012] [Accepted: 05/26/2012] [Indexed: 11/27/2022]
Abstract
UNLABELLED Itching is a common and well recognised problem following burns. As the underlying pathways involved in burns itch have been identified, different pharmacological agents have been introduced to improve the effectiveness of management regimes. We present preliminary data from an on-going study in the use of botulinum toxin as a novel agent in the treatment of this problem. METHOD Patients with recalcitrant itching secondary to burns treated with Botox(©) were identified. Data pertaining to burn size, depth and management were recorded. The delay in the onset of the itch, its severity and the speed and duration of any improvement in symptoms were also noted. RESULTS 10 patients were identified. 1 patient was excluded. Average follow-up was 11.3 months. All patients had deep partial thickness to full thickness burns. Eight patients underwent grafting. The average burn was 24% TBSA. 87.5% of patients rated their burns itch as being severe (>7 on the pain scale). Following the administration of Botox(©) this fell to 0 out of 10 at 4 weeks. The average duration of the symptom free period was nine months (range 3-18 months). CONCLUSION Botox(©) can successfully be used to treat burns itch that are resistant to conventional therapies.
Collapse
Affiliation(s)
- N Akhtar
- Department of Burns and Plastic Surgery, Nottingham City Hospital, Herries Road, Nottingham, United Kingdom.
| | | |
Collapse
|
28
|
Hannan T, Brooks P. Health workforce changes and the roles of information technology associated with these changes. “The Times They Are A-Changin' ” (Bob Dylan, 1964). Intern Med J 2012; 42:722-7. [DOI: 10.1111/j.1445-5994.2012.02801.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: 11/28/2022]
|
29
|
Colen T, Khoo NS, Brooks P, Yamamoto Y, Kutty S, Jain V, Ojala T, Rajaa NAL, Savard W, Stickland M, Davidge S, Hornberger L. EXPOSURE TO THE DIABETIC INTRAUTERINE ENVIRONMENT IS ASSOCIATED WITH VENTRICULAR HYPERTROPHY IN EARLY & LATE INFANCY. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60768-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
30
|
Redstone L, Shepherd L, Bousfield C, Brooks P. An audit of patients’ experiences and opinions concerning mirrors in a UK burns service. Burns 2011; 37:1248-54. [DOI: 10.1016/j.burns.2011.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 04/22/2011] [Accepted: 04/27/2011] [Indexed: 11/16/2022]
|
31
|
Tang YMJ, Chapman TWL, Brooks P. Use of tranexamic acid to reduce bleeding in burns surgery. J Plast Reconstr Aesthet Surg 2011; 65:684-6. [PMID: 21983540 DOI: 10.1016/j.bjps.2011.09.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 09/06/2011] [Accepted: 09/19/2011] [Indexed: 10/16/2022]
Abstract
We describe, for the first time, the use of topical tranexamic acid as an adjunct to traditional methods in the control of bleeding in burns surgery. We illustrate our use with a case example and continue to discuss the reasons we believe it is a useful, effective and safe means of achieving haemostasis.
Collapse
Affiliation(s)
- Y M J Tang
- Burns & Plastic Surgery Department, Nottingham University Hospitals, City Hospital Campus, Hucknall Road, NG5 1PB Nottingham, United Kingdom.
| | | | | |
Collapse
|
32
|
Liava'a M, Brooks P, Konstantinov I, Brizard C, d'Udekem Y. Changing trends in the management of pulmonary atresia with intact ventricular septum: the Melbourne experience. Eur J Cardiothorac Surg 2011; 40:1406-11. [PMID: 21561788 DOI: 10.1016/j.ejcts.2011.02.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [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: 09/13/2010] [Revised: 02/11/2011] [Accepted: 02/16/2011] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Management of pulmonary atresia with intact ventricular septum (PAIVS) can be directed to either biventricular repair or univentricular palliation. The optimal management strategy has yet to be defined. METHODS All patients operated at the Royal Children's Hospital, Melbourne for PAIVS between 1990 and 2006 (n = 81) were reviewed. Patients were retrospectively stratified into a simple three-tiered classification based on right ventricle (RV) size. Multivariate logistic regression analysis was performed to identify risk factors of mortality. RESULTS The distribution of RV sizes was normal in 11 (14%), moderate hypoplasia in 45 (56%), and severe hypoplasia in 25 (31%) patients. RV-to-coronary-artery connections were present in 33 (41%) and RV coronary dependence in six patients (7%). Sixteen patients died (20%). The end-status of the remaining patients was biventricular repair in 31/81 (38%), 1½-ventricle repair in 10/81 (12%), Fontan circulation in 14/81 (17%), transplantation in 1/81 (1%), and still awaiting repair in 9/81 (11%). Ten-year survival was 80% (95% confidence interval (CI): 71-87%). Independent predictors of mortality were lower tricuspid valve (TV) annulus size Z-score and the presence of RV-to-coronary-artery connections. CONCLUSIONS A simple three-tiered classification based on RV size may allow initial stratification into biventricular or univentricular repair for patients with normal RV size and severe RV hypoplasia. In patients with moderate RV hypoplasia, the presence of RV-to-coronary-artery connections or a TV Z-score<-2 should caution one against attempting biventricular repair.
Collapse
Affiliation(s)
- Matthew Liava'a
- Department of Cardiac Surgery, Royal Children's Hospital and the Murdoch Children's Research Institute, Melbourne, Australia
| | | | | | | | | |
Collapse
|
33
|
|
34
|
Sullivan D, Brooks P, Tindale N, Chapman S, Ahmed W. Faecal sterols analysis for the identification of human faecal pollution in a non-sewered catchment. Water Sci Technol 2010; 61:1355-1361. [PMID: 20220257 DOI: 10.2166/wst.2010.227] [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: 05/28/2023]
Abstract
In this study, faecal sterols were used to identify human faecal pollution in a non-sewered catchment in Southeast Queensland, Australia. In all, 36 water samples were collected from six sites on six occasions and the concentration of sterols were determined using gas chromatography and mass spectrometry. The stanols concentration in water samples generally increased with increased catchment runoff. After moderate rainfall, high coprostanols levels found in water samples indicated human faecal pollution via defective septic systems. In contrast, it appears that during dry weather human faecal pollution is not occurring in the study catchment. Sterol profiles also pointed to a cattle farm polluting during modest catchment runoff. The method used in this study was able to identify the sources of faecal pollution to the catchment due to rainfall.
Collapse
Affiliation(s)
- D Sullivan
- Faculty of Science, Health and Education, University of the Sunshine Coast, Maroochydore, DC 4558, Queensland, Australia
| | | | | | | | | |
Collapse
|
35
|
|
36
|
O’Donnell F, Ramachandran V, Smyth T, Smyth W, Brooks P. An investigation of bioactive phytochemicals in the leaves of Melicope vitiflora by electrospray ionisation ion trap mass spectrometry. Anal Chim Acta 2009; 634:115-20. [DOI: 10.1016/j.aca.2008.11.066] [Citation(s) in RCA: 9] [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] [Received: 10/08/2008] [Revised: 11/21/2008] [Accepted: 11/26/2008] [Indexed: 10/21/2022]
|
37
|
Bisset L, Smidt N, Van der Windt DA, Bouter LM, Jull G, Brooks P, Vicenzino B. Conservative treatments for tennis elbow do subgroups of patients respond differently? Rheumatology (Oxford) 2008; 46:1601-5. [PMID: 17890274 DOI: 10.1093/rheumatology/kem192] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [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: 11/13/2022] Open
Abstract
OBJECTIVES To determine if subgroups of patients with tennis elbow respond differently in treatment. METHODS This study used individual patient data (n = 383) from two randomized controlled trials that investigated a wait-and-see policy, corticosteroid injections and physiotherapy. Common outcome measures were: pain severity, global improvement, severity assessed by a blinded assessor, elbow disability and pain free grip strength. Subgroup analyses for previous history of elbow pain, baseline pain severity, duration of the current episode and employment status were performed at 6 and 52 weeks. RESULTS Patients' age, previous elbow symptoms and baseline pain severity were similar between trials, but other characteristics differed between trial populations. Based on individual patient data from both trials, we found that corticosteroid injections were statistically and clinically superior at 6 weeks, but significantly worse at 52 weeks compared with both wait-and-see and physiotherapy. Subgroup effects were scarce and small. Patients with higher baseline pain score showed less benefit on pain outcomes between physiotherapy and a wait-and-see policy at 6 weeks. It also appeared that non-manual workers who had an injection were the only work subgroup to follow the general trend that injections were significantly worse than a wait-and-see policy on global improvement at 52 weeks. CONCLUSION The treatment outcomes were largely similar between trials and not different between most subgroups studied. In tennis elbow, it would appear that patient characteristics play only a small role in predicting treatment outcomes, which supports the generalizability of individual trial results.
Collapse
Affiliation(s)
- L Bisset
- School of Health and Rehabilitation Sciences, University of Queensland, Queensland, Australia
| | | | | | | | | | | | | |
Collapse
|
38
|
Sanders RD, Ma D, Brooks P, Maze M. Balancing paediatric anaesthesia: preclinical insights into analgesia, hypnosis, neuroprotection, and neurotoxicity. Br J Anaesth 2008; 101:597-609. [PMID: 18796440 DOI: 10.1093/bja/aen263] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Logistical and ethical reasons make conducting clinical research in paediatric practice difficult, and therefore safe and efficacious advances are dependent on good preclinical research. For example, notable advances have been made in preclinical studies of pain processing that correlate well with patient data. Other areas of paediatric anaesthetic research remain in their infancy including mechanisms of anaesthesia and anaesthetic neuroprotection and neurotoxicity. Animal data have identified the potential 'double-edged' sword of administering anaesthetic agents in the young; although these agents can be neuroprotective in certain circumstances, they can be neurotoxic in others. The potential for this toxicity must be balanced against the importance of providing adequate anaesthesia for which there can be no compromise. We review the current state of preclinical research in paediatric anaesthesia and identify areas which require further exploration in order to provide the foundations for well-conducted clinical trials.
Collapse
Affiliation(s)
- R D Sanders
- Department of Anaesthetics, Pain Medicine and Intensive Care, Faculty of Medicine, Imperial College London, London, UK.
| | | | | | | |
Collapse
|
39
|
Yu JZ, Christos P, Darvishian F, Yee H, Buckley MT, Liebes LF, Pavlick AC, Polsky D, Brooks P, Osman I. A complex role of insulin-like growth factor binding proteins (IGFBPs) in melanoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.9064] [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: 11/20/2022] Open
|
40
|
Littlefield-Wyer JG, Brooks P, Katouli M. Application of biochemical fingerprinting and fatty acid methyl ester profiling to assess the effect of the pesticide Atradex on aquatic microbial communities. Environ Pollut 2008; 153:393-400. [PMID: 17905493 DOI: 10.1016/j.envpol.2007.08.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Revised: 08/09/2007] [Accepted: 08/10/2007] [Indexed: 05/17/2023]
Abstract
We investigated changes in biomass, biochemical fingerprints, fatty acid methyl ester (FAME) profile and functional status of the natural aquatic microbial communities upon impact of an Atradex pulse. The Atradex was applied to microcosm tanks at concentrations ranging from 24.5microgL(-1) to 245mgL(-1). The biomass of all microbial communities declined to a minimum level on day 4 with the effect being more pronounced in treated groups. Similarity between microbial communities also decreased on day 4 with the greatest change occurring at a concentration of 245mgL(-1) Atradex. After 8 days exposure to Atradex, microbial communities in all treated groups (except tanks spiked with 245mgL(-1) Atradex) recovered and showed similar metabolic fingerprints and FAME profiles to those of controls. Our results indicate that exposure to an Atradex pulse at concentration above 245mgL(-1), may irreversibly change the structure and functional status of aquatic microbial communities.
Collapse
|
41
|
Pounder RJ, Stanford MJ, Brooks P, Richards SP, Dove AP. Metal free thiol–maleimide ‘Click’ reaction as a mild functionalisation strategy for degradable polymers. Chem Commun (Camb) 2008:5158-60. [DOI: 10.1039/b809167f] [Citation(s) in RCA: 177] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
42
|
Brooks P, Namachivayam P, Shekerdemian L, Horton S, Cochrane A, Cheung M, Penny D, Smolich J. Isovolumic Acceleration Reflects Changes in Isovolumic but not Ejection Intraventricular Pressure Gradients in a Lamb Model of Cardio-pulmonary Bypass. Heart Lung Circ 2008. [DOI: 10.1016/j.hlc.2008.05.032] [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]
|
43
|
Ahmed W, Stewart J, Gardner T, Powell D, Brooks P, Sullivan D, Tindale N. Sourcing faecal pollution: a combination of library-dependent and library-independent methods to identify human faecal pollution in non-sewered catchments. Water Res 2007; 41:3771-9. [PMID: 17482658 DOI: 10.1016/j.watres.2007.02.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Revised: 02/15/2007] [Accepted: 02/23/2007] [Indexed: 05/15/2023]
Abstract
Library-dependent (LD) (biochemical fingerprinting of Escherichia coli and enterococci) and library-independent (LI) (PCR detection of human-specific biomarkers) methods were used to detect human faecal pollution in three non-sewered catchments. In all, 550 E. coli isolates and 700 enterococci isolates were biochemically fingerprinted from 18 water samples and compared with metabolic fingerprint libraries of 4508 E. coli and 4833 enterococci isolates. E. coli fingerprints identified human unique biochemical phenotypes (BPTs) in nine out of 18 water samples; similarly, enterococci fingerprints identified human faecal pollution in 10 water samples. Seven samples were tested by PCR for the detection of biomarkers. Human-specific HF134 Bacteroides and enterococci surface protein (esp) biomarkers were detected in five samples. Four samples were also positive for HF183 Bacteroides biomarker. The combination of biomarkers detected human faecal pollution in six out of seven water samples. Of the seven samples analysed for both the indicators/markers, at least one indicator/marker was detected in every sample. Four of the seven PCR-positive samples were also positive for one of the human-specific E. coli or enterococci BPTs. The results indicated human faecal pollution in the studied sub-catchments after storm events. LD and LI methods used in this study complimented each other and provided additional information regarding the polluting sources when one method failed to detect human faecal pollution. Therefore, it is recommended that a combination of methods should be used to identify the source(s) of faecal pollution where possible.
Collapse
Affiliation(s)
- W Ahmed
- Faculty of Science, Health and Education, University of the Sunshine Coast, Maroochydore DC 4558, Queensland, Australia.
| | | | | | | | | | | | | |
Collapse
|
44
|
Pavlick AC, Liebes L, Brooks P, Yoon J, Hamilton A, Yee H, Polsky D, Buckley M, Wright J, Osman I. BAY 43–9006 (sorafenib-BAY) alters proliferation pathways and mutant specific-PCR (MS-PCR) improves detection of BRAF mutations in metastatic melanoma (MM). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8542 Background: Approximately 60% of melanomas carry BRAF mutations (mut). BAY is a multi-kinase inhibitor that inhibits the BRAF pathway. A phase II trial of BAY in MM is being conducted to: 1) determine if treatment (tx) with BAY can alter proliferation as measured by cyclin D1, Ki-67 and ERK, 2) assess for differential anti-tumor responses and 3) to assess a newly developed fluorescent-based PCR assay to detect mutant BRAF. Methods: Eligibility criteria: Biopsy (bx)-accessible, untreated MM. Measurable disease (RECIST). Stratification of tumor BRAF status determined by routine PCR sequencing for codon 600 mut prior to tx and fluorescent MS-PCR sequencing for confirmation. MS-PCR specifically amplified the M-BRAF allele without amplifying the wild-type (WT)allele. Tx: BAY 400 mg po BID D1–28 q4w. Repeat bx on Day 28. Bx assessed for Ki-67, cyclin-D1 and ERK. Serum collagen cryptic epitopes were measured serially. Re-imaging was done every 2 cycles and pts treated until POD. Results: 29 pts (9-M1a, 8-M1b, 12-M1c) enrolled. 26 wild type (WT) and 3 mutant (M) BRAF by routine PCR. Due to the low yield of mut on routine PCR, MS-PCR was done. 6 mutants were detected in the first 16 pts with MS-PCR compared to 2 with routine sequencing. Median age: 68 (range 22–91). 8 pts with LDH ≥ 1.5 × nl. Tox: Gr I-diarrhea(7), alopecia(4), rash(6), mucositis(4), nausea(4), pain(4), hand-foot(2); Gr II- HTN(4), fatigue(2),mucositis(1), rash(3), pain(3), hand-foot(2); Gr III-hand-foot(1), rash(1), fatigue(1) and intestinal perforation(1). Responses: 12 NE (2 WD, 8 early POD, 1 tox, 1 too early); M BRAF- 1 PR (lymph nodes and large SQ arm masses) and 2 PD; WT BRAF- 1 PR, 7 POD after 2 cycles, 6 SD. Matched paired biopsies demonstrated down regulation of tumor ki-67, erk and cyclin-D1. Collagen cryptic epitopes correlated with tumor responses. Conclusions: MM patients with tumors that were molecularly characterized for BRAF mutational status were entered on this single agent BAY trial and responses were seen in both M and WT arms. Down-regulation of Ki-67, cyclin D1 and ERK was demonstrated and MS-PCR improved the sensitivity to detect BRAF mut. Supported by NCI N01-CM17103 and TRI. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- A. C. Pavlick
- NYU Cancer Inst, New York, NY; Sydney Cancer Center, Sydney, Australia; CTEP National Cancer Institute, Bethesda, MD
| | - L. Liebes
- NYU Cancer Inst, New York, NY; Sydney Cancer Center, Sydney, Australia; CTEP National Cancer Institute, Bethesda, MD
| | - P. Brooks
- NYU Cancer Inst, New York, NY; Sydney Cancer Center, Sydney, Australia; CTEP National Cancer Institute, Bethesda, MD
| | - J. Yoon
- NYU Cancer Inst, New York, NY; Sydney Cancer Center, Sydney, Australia; CTEP National Cancer Institute, Bethesda, MD
| | - A. Hamilton
- NYU Cancer Inst, New York, NY; Sydney Cancer Center, Sydney, Australia; CTEP National Cancer Institute, Bethesda, MD
| | - H. Yee
- NYU Cancer Inst, New York, NY; Sydney Cancer Center, Sydney, Australia; CTEP National Cancer Institute, Bethesda, MD
| | - D. Polsky
- NYU Cancer Inst, New York, NY; Sydney Cancer Center, Sydney, Australia; CTEP National Cancer Institute, Bethesda, MD
| | - M. Buckley
- NYU Cancer Inst, New York, NY; Sydney Cancer Center, Sydney, Australia; CTEP National Cancer Institute, Bethesda, MD
| | - J. Wright
- NYU Cancer Inst, New York, NY; Sydney Cancer Center, Sydney, Australia; CTEP National Cancer Institute, Bethesda, MD
| | - I. Osman
- NYU Cancer Inst, New York, NY; Sydney Cancer Center, Sydney, Australia; CTEP National Cancer Institute, Bethesda, MD
| |
Collapse
|
45
|
Zakrzewski J, Ng B, Warycha M, Christos P, Shapiro R, Berman R, Pavlick A, Liebes L, Brooks P, Osman I. Shedding of distinct cryptic epitope (HU177) in sera of melanoma patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8550] [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: 11/20/2022] Open
Abstract
8550 Background: Our preclinical data suggest that a newly identified cryptic epitope HU177 within collagen regulates endothelial and tumor cell adhesion in-vitro and angiogenesis and tumor growth in-vivo. We investigated whether 1) HU177 shedding can be measured in melanoma patients’ sera, and 2) if HU177 concentration correlates with clinicopathological features, recurrence and survival. Methods: Sera from 291 melanoma patients (primary Stage I, n=140; II n=41; III n=29; recurrent/metastatic n=81) and 30 normal volunteers prospectively enrolled at the NYU School of Medicine were analyzed for HU177 epitope concentration (ng/ml) by ELISA. Microtiter plates were incubated overnight with monoclonal antibody (anti-HU177 epitope). Patients’ sera and standards (denatured type-IV collagen) were added in duplicate followed by dilutions of biotinylated anti-collagen type IV polyclonal and HRP-labeled anti-biotin antibodies with multiple washes after each incubation. Absorbance was monitored at 400 nm. Results: The mean concentration of anti-HU177 epitope was 5.8 ng/ml (range 0.1 to 139.8). Normal volunteers were 1.6±0.3 (mean ± SEM). A significant correlation was observed between HU177 concentration and tumor thickness in patients who presented with primary melanoma (=1.00 mm, n=113, 3.8±0.4; 1.01–3.99 mm, n=72, 8.9 ±2.1; =4.00 mm, n=22, 10.3±2.2; P=0.003 by ANOVA test) and nodular melanoma histological subtype (nodular, n=47, 10.5±3.1; superficial spreading, n=95, 4.4±0.5; others, n=68, 6.0±2.1; P=0.02, ANOVA). Multivariate analysis confirmed the independent correlation between higher HU177 concentration and nodular subtype after controlling for tumor thickness (P=0.04). Primary patients with ulcerated melanomas and those who developed recurrences both showed higher HU177 epitope levels, however, the difference was not significant (P>0.05). Conclusions: This is the first study on HU177 epitope shedding in melanoma patients. Data demonstrate the clinical feasibility of HU177 testing in melanoma patients’ sera and suggest that HU177 epitope shedding correlates with thicker primary melanomas. Longer follow-up is required to better define the prognostic value of HU177 epitope shedding in melanoma patients. [Table: see text]
Collapse
Affiliation(s)
- J. Zakrzewski
- New York University School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - B. Ng
- New York University School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - M. Warycha
- New York University School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - P. Christos
- New York University School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - R. Shapiro
- New York University School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - R. Berman
- New York University School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - A. Pavlick
- New York University School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - L. Liebes
- New York University School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - P. Brooks
- New York University School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - I. Osman
- New York University School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| |
Collapse
|
46
|
Yu JZ, Yee H, Warycha M, Christos P, Shapiro R, Berman R, Pavlick A, Liebes L, Brooks P, Osman I. Differential expression of insulin like growth factor binding protein-4 (IGFBP4) in melanoma progression. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8557] [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: 11/20/2022] Open
Abstract
8557 Background: Members of the IGFBP family are thought to regulate tumor progression through both IGF-dependent and independent mechanisms. Moreover, IGFBPs may exhibit distinct functions depending on whether they are present locally in tissue or systemically. Our preclinical data suggest that IGFBP4 serves as an endogenous inhibitor of angiogenesis and melanoma tumor growth. To examine the clinical validity of our observations, we compared IGFBP4 expression in tissue and sera in primary melanoma patients with a low risk of metastases versus patients with established metastatic disease. Methods: Eighty-nine melanoma patients (primary stage IA, n=57; metastatic, n=32; 44 M, 45 F; Median Age=56) prospectively enrolled in the Interdisciplinary Melanoma Cooperative Group at the NYU School of Medicine were studied. IGFBP4 protein expression in tumors was assessed in 83 patients using goat anti-human IGFBP4 antibody (R&D Systems) in an immunohistochemical assay. For each case, the percentage of tumor cells that stained positively was estimated. IGFBP4 concentration in the serum was measured in 64 patients by an ELISA assay (Diagnostic Systems Laboratories, Inc.). Fifty-eight patients had both sera and tumor specimens available for correlation. Results: The median IGFBP4 expression in tumor specimens from primary patients was 70% compared to 5% in metastatic patients (P=0.002, Wilcoxon rank-sum test). The median concentration of IGFBP4 in sera was 43.8 ng/ul in primary patients versus 41.0 ng/ul in metastatic patients (P=0.83). A weak association between IGFBP4 expression in tissue and IGFBP4 shedding in sera was observed (Spearman correlation coefficient=0.16, P=0.24) in the 58 cases with both sera and tissue available. Conclusions: Our data demonstrate that IGFBP4 expression in melanoma clinical specimens decreases in the progression from primary to metastatic melanoma, consistent with its potential role as an inhibitor of angiogenesis. Data also suggest that IGFBP4 tissue expression may be more clinically relevant than its sera shedding. Future studies using a larger sample size and extended follow up are needed to further define the role of IGFBP4 in melanoma progression. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- J. Z. Yu
- NYU School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - H. Yee
- NYU School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - M. Warycha
- NYU School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - P. Christos
- NYU School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - R. Shapiro
- NYU School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - R. Berman
- NYU School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - A. Pavlick
- NYU School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - L. Liebes
- NYU School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - P. Brooks
- NYU School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - I. Osman
- NYU School of Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| |
Collapse
|
47
|
Galasko D, Salmon D, Gamst A, Olichney J, Thal LJ, Silbert L, Kaye J, Brooks P, Adonay R, Craig UK, Schellenberg G, Borenstein AR. Prevalence of dementia in Chamorros on Guam: Relationship to age, gender, education, and APOE. Neurology 2007; 68:1772-81. [PMID: 17515539 DOI: 10.1212/01.wnl.0000262028.16738.64] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [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] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To estimate the prevalence of dementia and its clinical subtypes among Chamorros on Guam aged 65 years or older and to examine associations with age, gender, education, and APOE genotype. BACKGROUND Chamorros, the indigenous people of Guam, had a high incidence of ALS and parkinsonism-dementia complex (PDC), in the 1950s. Over the next 50 years, ALS incidence declined markedly, but PDC only slightly. The prevalence of late life dementia in Chamorros and its relationship to ALS/PDC are unknown. METHODS Island-wide population-based survey of Chamorros aged 65 years or older as of January 1, 2003. Two-stage assessment: cognitive and motor screening, followed by neurologic and psychometric evaluation. Data were reviewed at consensus conference to make clinical diagnoses. RESULTS Of 2,789 Chamorros aged 65 years or older, 73% were enrolled; 27% declined participation, died before contact or screening, or moved off Guam. The point prevalence of all-cause dementia on February 1, 2004, was 12.2%. Prevalence data for subtypes were as follows: Guam dementia (clinically equivalent to AD), 8.8%; PDC, 1.5%; pure vascular dementia, 1.3%; other, 0.6%. The prevalence of dementia rose exponentially with age. Low education was significantly associated with dementia, but gender was not. There was a trend toward higher PDC prevalence among men. The APOE epsilon4 allele was not associated with dementia. CONCLUSIONS The prevalence of dementia among elderly Chamorros is relatively high. Guam dementia is the most common diagnosis and exceeds parkinsonism-dementia complex. Age and low education are strongly associated with dementia, but gender and APOE epsilon4 are not. Incidence studies will allow risk factors for dementia to be clarified.
Collapse
Affiliation(s)
- D Galasko
- Department of Neurosciences, University of California, San Diego, CA, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Brooks P. The modified VAC glove for hand burns. Burns 2007. [DOI: 10.1016/j.burns.2006.10.296] [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]
|
49
|
Pavlick A, Liebes L, Osman I, Brooks P, Yee H, Polsky D, Hamilton A, Wright J, Muggia F. 589 POSTER Alteration of the RAS/BRAF/MEK/MAPK pathway by BAY 43-9006 (sorafenib) in metastatic melanoma. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)70594-8] [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: 10/23/2022] Open
|
50
|
Strand V, Conaghan PG, Lohmander LS, Koutsoukos AD, Hurley FL, Bird H, Brooks P, Day R, Puhl W, Band PA. An integrated analysis of five double-blind, randomized controlled trials evaluating the safety and efficacy of a hyaluronan product for intra-articular injection in osteoarthritis of the knee. Osteoarthritis Cartilage 2006; 14:859-66. [PMID: 16626978 DOI: 10.1016/j.joca.2006.02.012] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2005] [Accepted: 02/24/2006] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Five double-blind, randomized, saline-controlled trials (RCTs) were included in the United States marketing application for an intra-articular hyaluronan (IA-HA) product for the treatment of osteoarthritis (OA) of the knee. We report an integrated analysis of the primary Case Report Form (CRF) data from these trials. METHOD Trials were similar in design, patient population and outcome measures - all included the Lequèsne Algofunctional Index (LI), a validated composite index of pain and function, evaluating treatment over 3 months. Individual patient data were pooled; a repeated measures analysis of covariance was performed in the intent-to-treat (ITT) population. Analyses utilized both fixed and random effects models. Safety data from the five RCTs were summarized. RESULTS A total of 1155 patients with radiologically confirmed knee OA were enrolled: 619 received three or five IA-HA injections; 536 received "placebo" saline injections. In the active and control groups, mean ages were 61.8 and 61.4 years; 62.4% and 58.8% were women; baseline total Lequèsne scores 11.03 and 11.30, respectively. Integrated analysis of the pooled data set found a statistically significant reduction (P < 0.001) in total Lequèsne score with hyaluronan (HA) (-2.68) vs placebo (-2.00); estimated difference -0.68 (95% CI: -0.56 to -0.79), effect size 0.20. Additional modeling approaches confirmed robustness of the analyses. CONCLUSIONS This integrated analysis demonstrates that multiple design factors influence the results of RCTs assessing efficacy of intra-articular (IA) therapies, and that integrated analyses based on primary data differ from meta-analyses using transformed data.
Collapse
Affiliation(s)
- V Strand
- Division of Immunology and Rheumatology, Stanford University, Palo Alto, CA, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|