716 results on '"Weinacker A"'
Search Results
102. Hospital Length of Stay Following Lung Transplantation for Connective Tissue Disease-Associated Interstitial Lung Disease and Idiopathic Pulmonary Fibrosis
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Mary K. Porteous, Chadi A. Hage, Vibha N. Lama, John F. McDyer, Jake G. Natalini, J.B. Orens, Michael S. Brown, Jonathan P. Singer, Keith M. Wille, David J. Lederer, Laurie D. Snyder, S.M. Kawut, Michelle Oyster, Jason D. Christie, Lorraine B. Ware, Ann Weinacker, Joshua M. Diamond, Palak Shah, and Edward Cantu
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Pathology ,medicine.medical_specialty ,Idiopathic pulmonary fibrosis ,business.industry ,medicine.medical_treatment ,Interstitial lung disease ,medicine ,Length of hospitalization ,Lung transplantation ,medicine.disease ,business ,Connective tissue disease - Published
- 2019
103. Association of Protein C and Type 1 Plasminogen Activator Inhibitor with Primary Graft Dysfunction
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Christie, Jason D., Robinson, Nancy, Ware, Lorraine B., Plotnick, Michael, De Andrade, Joao, Lama, Vibha, Milstone, Aaron, Orens, Jonathan, Weinacker, Ann, Demissie, Ejigayehu, Bellamy, Scarlett, and Kawut, Steven M.
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- 2007
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104. Predicting PGD after Lung Transplantation
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Vibha N. Lama, Carolyn S. Calfee, Jonathan P. Singer, Michelle Oyster, Chadi A. Hage, Russell Localio, B. Koons, Luke Benvenuto, John F. McDyer, M.G. Hartwig, M. Crespo, Ann Weinacker, Keith M. Wille, Laurie D. Snyder, J. Hsu, Michael G.S. Shashaty, J.B. Orens, Edward Cantu, John R. Greenland, Jasleen Kukreja, Joshua M. Diamond, Jason D. Christie, Pali D. Shah, and Laurel Kalman
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Pulmonary and Respiratory Medicine ,Transplantation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Primary Graft Dysfunction ,respiratory system ,Logistic regression ,Lower risk ,Internal medicine ,medicine ,Lung transplantation ,lipids (amino acids, peptides, and proteins) ,Surgery ,Risk factor ,Cardiology and Cardiovascular Medicine ,business ,Prospective cohort study ,Body mass index ,Lung allocation score - Abstract
Purpose Primary graft dysfunction (PGD) is the leading cause of early morbidity and mortality after lung transplantation. Prior studies highlight the role of donor smoking in poor post-transplant outcomes. We therefore aimed to identify clinical risk factors for PGD after lung transplantation, more accurately assess the impact of donor smoking, and develop an accurate, generalizable PGD prediction model. Methods We performed a 10-center prospective cohort study of patients in the Lung Transplant Outcomes Group from 2012-2018. PGD was defined as grade 3 PGD at 48 or 72 hours after lung reperfusion. We defined donor smoking history by clinical documentation, UNOS-reported donor smoking, or donor cotinine >9 mg/ml from urine collected at organ procurement. Building on our prior PGD prediction models, multivariable logistic regression was used to identify PGD risk factors and develop regularized predictive models with a simple user interface (R shiny). Results Of 1180 patients, 26% developed PGD and 633 (53%) received an organ from a previously smoking donor. The PGD predictive model included novel predictors of center and donor distance plus recipient age, lung allocation score (LAS), body mass index, pulmonary artery pressure, sex, and indication for transplant; donor age, sex, mechanism of death, and donor distance; and interaction terms for LAS and donor distance. The interface allows for real-time assessment of PGD risk for any donor/recipient combination. The predictive model offers decision making benefit in the PGD risk range of 0.15-0.5. Donor smoking was associated with increased risk of PGD but not patient mortality (Figure 1). Conclusion We developed a clinically applicable PGD predictive algorithm based on modern lung transplant practices to aid in transplant decision making, post-transplant care, and to facilitate development of enriched PGD treatment trials. Donor smoking is a risk factor for PGD development but is not associated with increased mortality, potentially because of a lower risk phenotype of PGD occurring in smoking donor recipients.
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- 2021
105. High-dose cyclophosphamide in refractory myasthenia gravis with MuSK antibodies
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Lin, Peter T., Martin, Beth A., Weinacker, Ann B., and So, Yuen T.
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- 2006
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106. Smoking in Movies
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Omidvari, Karan, Lessnau, Klaus, Mason, Carol, and Weinacker, Ann
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- 2006
107. Smoking in Contemporary American Cinema*
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Omidvari, Karan, Lessnau, Klaus, Kim, Jeannie, Mercante, Donald, Weinacker, Ann, and Mason, Carol
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- 2005
108. Suizidalität im Alter
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Schmidtke, A., primary, Weinacker, B., additional, and Schaller, S., additional
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- 2000
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109. Anaerobic Blood Cultures: Useful in the ICU?
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Weinacker, Ann and Shafazand, Shirin
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- 2003
110. Modification of Blood Culture Recommendations?
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Weinacker, Ann and Shafazand, Shirin
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- 2003
111. Variability in Antibiotic Prescribing Patterns and Outcomes in Patients With Clinically Suspected Ventilator-Associated Pneumonia*
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Fowler, Robert A., Flavin, Kara E., Barr, Juliana, Weinacker, Ann B., Parsonnet, Julie, and Gould, Michael K.
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- 2003
112. Blood Cultures in the Critical Care Unit*: Improving Utilization and Yield
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Shafazand, Shirin and Weinacker, Ann B.
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- 2002
113. Ethical Issues in the Long-Term Management of Progressive Degenerative Neuromuscular Diseases
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Vaszar, Laszlo T., Weinacker, Ann B., Henig, Noreen R., and Raffin, Thomas A.
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- 2002
114. Suicide and Suicide Attempt Rates in Europe, 1989–1993
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Schmidtke, A., primary, Fricke, S., additional, Weinacker, B., additional, Bille-Brahe, U., additional, De Leo, D., additional, Kerkhof, A., additional, Bjerke, T., additional, Crepet, P., additional, Haring, C., additional, Hawton, K., additional, Lönnqvist, J., additional, Michel, K., additional, Philippe, A., additional, Pommereau, X., additional, Querejeta, I., additional, Salander-Renberg, E., additional, Temesváry, B., additional, Wasserman, D., additional, and Sampaio-Faria, J. G., additional
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- 1998
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115. A Cystic Upper Lobe Lesion in a Healthy Nonsmoking Man*
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Leonard, Colm T., Weinacker, Ann, Berry, Gerald, and Whyte, Richard I.
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- 2001
116. Protein Quantitative Trait Loci Analysis Identifies Genetic Variation in the Innate Immune Regulator TOLLIP
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Nuala J. Meyer, Maria Crespo, Laurie D. Snyder, Sangeeta Bhorade, Pali D. Shah, John E. Ellis, Y. Suzuki, Rupal J. Shah, Ann Weinacker, Keith M. Wille, Matthew G. Hartwig, Lorraine B. Ware, B. Beduhn, David S. Wilkes, Ejigayehu Demissie, Joshua M. Diamond, Jaya Tiwari, Vibha N. Lama, Fan Wang, Jonathan B. Orens, Jason D. Christie, Rui Feng, Steven M. Kawut, Edward Cantu, Scott M. Palmer, David J. Lederer, James R. Nellen, David W. Roe, and David Weill
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0301 basic medicine ,Transplantation ,TOLLIP ,respiratory system ,Quantitative trait locus ,Biology ,Lung injury ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,030228 respiratory system ,Genetic variation ,Genotype ,Immunology ,Immunology and Allergy ,Biomarker (medicine) ,lipids (amino acids, peptides, and proteins) ,Pharmacology (medical) ,Toll-Interacting Protein ,Genotyping - Abstract
The authors previously identified plasma plasminogen activator inhibitor-1 (PAI-1) level as a quantitative lung injury biomarker in primary graft dysfunction (PGD). They hypothesized that plasma levels of PAI-1 used as a quantitative trait could facilitate discovery of genetic loci important in PGD pathogenesis. A two-stage cohort study was performed. In stage 1, they tested associations of loci with PAI-1 plasma level using linear modeling. Genotyping was performed using the Illumina CVD Bead Chip v2. Loci meeting a p < 5 × 10(-4) cutoff were carried forward and tested in stage 2 for association with PGD. Two hundred ninety-seven enrollees were evaluated in stage 1. Six loci, associated with PAI-1, were carried forward to stage 2 and evaluated in 728 patients. rs3168046 (Toll interacting protein [TOLLIP]) was significantly associated with PGD (p = 0.006). The increased risk of PGD for carrying at least one copy of this variant was 11.7% (95% confidence interval 4.9-18.5%). The false-positive rate for individuals with this genotype who did not have PGD was 6.1%. Variants in the TOLLIP gene are associated with higher circulating PAI-1 plasma levels and validate for association with clinical PGD. A protein quantitative trait analysis for PGD risk prioritizes genetic variations in TOLLIP and supports a role for Toll-like receptors in PGD pathogenesis.
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- 2016
117. Withdrawing Life Support From the Critically III
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McGee, David C., Weinacker, Ann B., and Raffin, Thomas A.
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- 2000
118. The Patient's Response to Medical Futility
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McGee, David C., Weinacker, Ann B., and Raffin, Thomas A.
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- 2000
119. Psychologie
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Schmidtke, A., primary, Weinacker, B., additional, and Fricke, S., additional
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- 1995
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120. Inhalational Anthrax*: Epidemiology, Diagnosis, and Management
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Shafazand, Shirin, Doyle, Ramona, Ruoss, Stephen, Weinacker, Ann, and Raffin, Thomas A.
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- 1999
121. Cell-free hemoglobin promotes primary graft dysfunction through oxidative lung endothelial injury
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Chadi A. Hage, Hiromasa Nagata, J. Brennan McNeil, Steven M. Kawut, David J. Lederer, Scott M. Palmer, Maria M. Crespo, Joshua M. Diamond, Jason D. Christie, Pali D. Shah, Keith M. Wille, Mary K. Porteous, Ciara M. Shaver, Vibha N. Lama, Adam Miller, Jonathan B. Orens, John F. McDyer, Jamie L. Kuck, Gundeep Dhillon, Edward Cantu, Julie A. Bastarache, Nancy E. Wickersham, Stuart R. Landstreet, Ann Weinacker, and Lorraine B. Ware
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Primary Graft Dysfunction ,Vascular permeability ,Hyperoxia ,030230 surgery ,Lung injury ,Cell Line ,Capillary Permeability ,Hemoglobins ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Lung transplantation ,Lung ,Acetaminophen ,business.industry ,Endothelial Cells ,General Medicine ,Middle Aged ,respiratory system ,Allografts ,eye diseases ,Extravasation ,respiratory tract diseases ,Transplantation ,Oxidative Stress ,Endocrinology ,medicine.anatomical_structure ,030228 respiratory system ,Case-Control Studies ,Microvessels ,Female ,medicine.symptom ,business ,Lung Transplantation ,Research Article - Abstract
Primary graft dysfunction (PGD) is acute lung injury within 72 hours of lung transplantation. We hypothesized that cell-free hemoglobin (CFH) contributes to PGD by increasing lung microvascular permeability and tested this in patients, ex vivo human lungs, and cultured human lung microvascular endothelial cells. In a nested case control study of 40 patients with severe PGD at 72 hours and 80 matched controls without PGD, elevated preoperative CFH was independently associated with increased PGD risk (odds ratio [OR] 2.75, 95%CI, 1.23–6.16, P = 0.014). The effect of CFH on PGD was magnified by reperfusion fraction of inspired oxygen (FiO2) ≥ 0.40 (OR 3.41, P = 0.031). Isolated perfused human lungs exposed to intravascular CFH (100 mg/dl) developed increased vascular permeability as measured by lung weight (CFH 14.4% vs. control 0.65%, P = 0.047) and extravasation of Evans blue–labeled albumin dye (EBD) into the airspace (P = 0.027). CFH (1 mg/dl) also increased paracellular permeability of human pulmonary microvascular endothelial cell monolayers (hPMVECs). Hyperoxia (FiO2 = 0.95) increased human lung and hPMVEC permeability compared with normoxia (FiO2 = 0.21). Treatment with acetaminophen (15 μg/ml), a specific hemoprotein reductant, prevented CFH-dependent permeability in human lungs (P = 0.046) and hPMVECs (P = 0.037). In summary, CFH may mediate PGD through oxidative effects on microvascular permeability, which are augmented by hyperoxia and abrogated by acetaminophen.
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- 2018
122. Patterns of Disrespectful Physician Behavior at an Academic Medical Center: Implications for Training, Prevention, and Remediation
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Manisha Desai, Joseph Hopkins, Ann Weinacker, and Haley Hedlin
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Male ,medicine.medical_specialty ,Medical psychology ,Faculty, Medical ,Students, Medical ,Attitude of Health Personnel ,education ,Specialty ,MEDLINE ,Psychological intervention ,01 natural sciences ,Education ,03 medical and health sciences ,Patient safety ,0302 clinical medicine ,Epidemiology ,medicine ,Humans ,030212 general & internal medicine ,0101 mathematics ,Retrospective Studies ,Academic Medical Centers ,business.industry ,Aggression ,010102 general mathematics ,Retrospective cohort study ,General Medicine ,Social Dominance ,Family medicine ,Female ,medicine.symptom ,business - Abstract
PURPOSE Physician disrespectful behavior affects quality of care, patient safety, and collaborative clinical team function. Evidence defining the demographics, ethnography, and epidemiology of disrespectful behavior is lacking. METHOD The authors conducted a retrospective analysis of reports of disrespectful physician behavior at Stanford Hospital and Clinics from March 2011 through February 2015. Events were stratified by role, gender, specialty, and location in the hospital or clinics where the event occurred. Event rate ratios were estimated using a multivariable negative binomial regression model. Correlation of rates of faculty and trainees in the same specialty was assessed. RESULTS One hundred ninety-nine events concerned faculty; 160 concerned trainees. Events were concentrated among a small number of physicians in both groups. The rates of faculty and trainee events within the same specialty were highly correlated (Spearman's rho: 0.90; P < .001). Male physicians had an adjusted event rate 1.86 (95% CI = 1.33-2.60; P < .001) times that of females. Procedural physicians were 3.67 times (95% CI = 2.63-5.13; P < .001) more likely to have a disrespectful behavior event than nonprocedural physicians when adjusting for other covariates. Most common location for faculty was the operating rooms (69 events, 34%); for trainees, the medical/surgical units (43 events, 27%). CONCLUSIONS Patterns of physician disrespectful behavior differed by role, gender, specialty, and location. Rates among faculty and trainees of the same specialty were highly correlated. These patterns can be used to create more focused education and training for specific physician groups and individualized remediation interventions.
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- 2018
123. La bicicleta como medio de transporte hacia la Universidad Andrés Bello, Sede Casona, Las Condes
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Allendes Hurtado, Macarena, Martinez Cristi, Felipe, Olave Campos, Raúl, Toledo Weinacker, Nicolás, Fuentes Núñez, Julieta, and Facultad de Educación y Ciencias Sociales
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Bicicletas ,Actividad Física - Abstract
Tesis (Profesor de Educación Física para la Enseñanza Básica, Licenciado en Educación) Este estudio comienza observando la demanda de la bicicleta como medio de transporte hacia y desde la Universidad Andrés Bello Sede Casona Las Condes. Para ello se recopiló información de los registros del bicicletero, otorgados por el servicio de seguridad de dicho establecimiento. Información tal, fue propicia como herramienta para una visualización, análisis y reflexión sobre los porcentajes de la muestra de la población, donde se obtuvo importantes resultados según género y ocupación dentro de un tiempo espacio determinado. En el caso género se observa una clara diferencia entre usuarios femeninos (23.4%) y masculinos (76,6%) siendo estos últimos dominantes en las cifras. En el caso de las carreras Pedagogía en Educación Física encabeza la lista teniendo una amplia diferencia con las que le siguen. Estos datos se obtuvieron dentro de una muestra del 84 días hábiles de clases de este establecimiento durante el año 2018. Los cuales se ocuparon con el propósito de develar e informar a la comunidad el estado actual del transporte en bicicleta, y la importancia de los efectos que este puede tener en beneficio de una comunidad mas activa, sana y saludable.
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- 2018
124. Letter to the Editor: Characteristics of Academic Physicians Associated With Patient Satisfaction
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James O. Kahn, Mickey Trockel, Randall Smith, Paul A. Heidenreich, Latha Palaniappan, Tait D. Shanafelt, Magali Fassiotto, Ann Weinacker, and Lisa Shieh
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Physician-Patient Relations ,medicine.medical_specialty ,Academic Success ,Time Factors ,Letter to the editor ,business.industry ,Health Policy ,Age Factors ,Internship and Residency ,Job Satisfaction ,Sex Factors ,Patient satisfaction ,Patient Satisfaction ,Physicians ,Family medicine ,medicine ,Humans ,business ,Specialization - Published
- 2019
125. Letter to the Editor: Characteristics of Academic Physicians Associated With Patient Satisfaction
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Heidenreich, Paul, primary, Shieh, Lisa, additional, Fassiotto, Magali, additional, Kahn, James, additional, Weinacker, Ann, additional, Smith, Randall, additional, Trockel, Mickey Todd, additional, Shanafelt, Tait, additional, and Palaniappan, Latha, additional
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- 2019
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126. Hospital Length of Stay Following Lung Transplantation for Connective Tissue Disease-Associated Interstitial Lung Disease and Idiopathic Pulmonary Fibrosis
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Natalini, J.G., primary, Porteous, M., additional, Lederer, D.J., additional, Wille, K.M., additional, Weinacker, A.B., additional, Orens, J.B., additional, Shah, P.M., additional, Lama, V.N., additional, McDyer, J.F., additional, Snyder, L.D., additional, Hage, C.A., additional, Singer, J.P., additional, Ware, L.B., additional, Cantu, E., additional, Oyster, M., additional, Brown, M., additional, Christie, J.D., additional, Diamond, J., additional, and Kawut, S.M., additional
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- 2019
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127. Risk Factors for Primary Graft Dysfunction in Patients with Cystic Fibrosis Receiving Lung Transplants
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Martin, J.A., primary, Porteous, M.K., additional, Cantu, E., additional, Lederer, D.J., additional, Snyder, L., additional, Weinacker, A., additional, Orens, J.B., additional, Shah, P.D., additional, Lama, V.N., additional, McDyer, J., additional, Wille, K.M., additional, Hage, C.A., additional, Singer, J., additional, Ware, L.B., additional, Oyster, M., additional, Brown, M., additional, Christie, J.D., additional, and Diamond, J.M., additional
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- 2019
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128. Patterns of Disrespectful Physician Behavior at an Academic Medical Center
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Hopkins, Joseph, primary, Hedlin, Haley, additional, Weinacker, Ann, additional, and Desai, Manisha, additional
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- 2018
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129. Antitumor Activity with the HSV-tk-gene-modified Cell Line PA-1-STK in Malignant Mesothelioma
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Schwarzenberger, Paul, Lei, Dinghua, Freeman, Scott M., Ye, Peng, Weinacker, Ann, Theodossiou, Chris, Summer, Warren, and Kolls, Jay K.
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- 1998
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130. Objective Estimates Improve Risk Stratification for Primary Graft Dysfunction after Lung Transplantation
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Jason D. Christie, Joshua M. Diamond, Scarlett L. Bellamy, Vibha N. Lama, Judd D. Flesch, David W. Roe, Sangeeta Bhorade, Keith M. Wille, J. Sonnet, David J. Lederer, Jonathan B. Orens, Rupal J. Shah, Ann Weinacker, Ejigayehu Demissie, A R. Localio, Steven M. Kawut, James C. Lee, Lorraine B. Ware, Scott M. Palmer, Maria Crespo, Edward Cantu, David S. Wilkes, and Ashish S. Shah
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Primary Graft Dysfunction ,Logistic regression ,Medical and Health Sciences ,lung transplantation / pulmonology ,Article ,lung (allograft) function / dysfunction ,Rare Diseases ,Clinical Research ,Risk Factors ,Internal medicine ,clinical research / practice ,medicine ,Humans ,Immunology and Allergy ,Lung transplantation ,Pharmacology (medical) ,Derivation ,Intensive care medicine ,Prospective cohort study ,Lung ,Transplantation ,COPD ,business.industry ,Prevention ,Organ Transplantation ,respiratory system ,medicine.disease ,lung failure / injury ,medicine.anatomical_structure ,Risk stratification ,Respiratory ,Surgery ,Female ,lipids (amino acids, peptides, and proteins) ,Patient Safety ,business ,Lung Transplantation - Abstract
Primary graft dysfunction (PGD) is a major cause of early mortality after lung transplant. We aimed to define objective estimates of PGD risk based on readily available clinical variables, using a prospective study of 11 centers in the Lung Transplant Outcomes Group (LTOG). Derivation included 1255 subjects from 2002 to 2010; with separate validation in 382 subjects accrued from 2011 to 2012. We used logistic regression to identify predictors of grade 3 PGD at 48/72 h, and decision curve methods to assess impact on clinical decisions. 211/1255 subjects in the derivation and 56/382 subjects in the validation developed PGD. We developed three prediction models, where low-risk recipients had a normal BMI (18.5-25 kg/m(2) ), chronic obstructive pulmonary disease/cystic fibrosis, and absent or mild pulmonary hypertension (mPAP
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- 2015
131. Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters during the period 1989-1992. Results of the WHO/EURO Multicentre Study on Parasuicide
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Schmidtke, A., Bille-Brahe, U., DeLeo, D., Kerkhof, A., Bjerke, T., Crepet, P., Haring, C., Hawton, K., Lönnqvist, J., Michel, K., Pommereau, X., Querejeta, I., Phillipe, I., Salander-Renberg, E., Temesváry, B., Wasserman, D., Fricke, S., Weinacker, B., and Sampaio-Faria, J. G.
- Published
- 1996
132. Distribution of integrins alpha v beta 6 and alpha 9 beta 1 and their known ligands, fibronectin and tenascin, in human airways.
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Weinacker, A, Ferrando, R, Elliott, M, Hogg, J, Balmes, J, and Sheppard, D
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- 1995
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133. Upper and Middle Lobe Bronchoalveolar Lavage to Diagnose Pneumocystis carinii Pneumonia
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Yung, Rex C., Weinacker, Ann B., Steiger, David J., Miller, Theodore R., Stern, Eric J., Salmon, Christopher J., Chernoff, David N., Luistro, Minda G., Kuntz, Sue, and Golden, Jeffrey A.
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- 1993
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134. Algorithmen für die automatische Erkennung von Blattstörungen - eine geometrische Merkmalsextraktion zur Bewertung der Zustände einzelner Blätter
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Stemmler, Simon, Weinacker, Holger, Reiterer, Alexander, Koch, Barbara, and Publica
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unmanned aerial vehicle ,high resolution imagery ,Blob Detection ,image processing - Abstract
Die schnelle Entwicklung im Bereich unbemannter Flugsysteme (UAV) eröffnete neue Möglichkeiten für die Untersuchung von Bäumen. Mithilfe von UAVs die auf geringer Flughöhe agieren, können sehr hoch auflösende Aufnahmen von Bäumen und Baumkronen angefertigt werden. Durch die Bearbeitung dieser Bilder mit den gängigen Methoden der digitalen Bildbearbeitung ist es möglich, den Zustand einzelner Blätter zu beurteilen. Dies erfolgt durch die Extraktion von geometrischen Merkmalen von Irritationen auf den Blättern. In diesem Beitrag wird eine effiziente Methode zur Identifizierung von kleinen Störungen auf einzelnen Blättern vorgestellt. Zum Auffinden dieser Störungen werden ein Blob-detection-Algorithmus und verschiedene Filter verwendet. Untersucht werden im Speziellen die Blätter des Spitzahorn Acer platanoides mit weißen Flecken auf deren Oberfläche. Diese weißen Flecken können verschiedene Ursachen haben. Durch die Auftrennung der RGB-Bilder in einzelne Graustufenbilder für Rot, Grün und Blau ist es möglich mit dem zuvor erwähnten Algorithmus diese weißen Flecken zu lokalisieren. Dabei sind vor allem die Graustufenbilder des roten und grünen Kanals von Bedeutung. Eine Kombination des roten und grünen Kanals, anschließender Filterung und Glättung der Bilder erhöhte die Genauigkeit und führte zu guten Ergebnissen. Des Weiteren wurden verschiedene Eigenschaften der weißen Flecken genutzt, um fälschlicherweise gefundene Treffer des Blob-detection-Algorithmus zu eliminieren. Diese Arbeit wurde im Rahmen des Sustainability Center Freiburg im Projekt MulDiScan realisiert.
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- 2017
135. Plasma Complement Levels Are Associated with Primary Graft Dysfunction and Mortality after Lung Transplantation
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David W. Roe, Sangeeta Bhorade, Scott M. Palmer, Edward Cantu, A. Emtiazjoo, Patricia Smith, Lorraine B. Ware, David J. Lederer, Ann Weinacker, Maria Crespo, Joshua M. Diamond, Keith M. Wille, Vibha N. Lama, Jonathan B. Orens, David S. Wilkes, Rupal J. Shah, George J. Eckert, and Jason D. Christie
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Male ,Pulmonary and Respiratory Medicine ,Anaphylatoxins ,medicine.medical_specialty ,medicine.medical_treatment ,Primary Graft Dysfunction ,Lung injury ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Internal medicine ,Correspondence ,medicine ,Humans ,Lung transplantation ,Anaphylatoxin ,Prospective Studies ,Prospective cohort study ,Proportional Hazards Models ,medicine.diagnostic_test ,business.industry ,Hazard ratio ,respiratory system ,Transplantation ,Bronchoalveolar lavage ,Immunology ,Female ,business ,Biomarkers ,Lung Transplantation - Abstract
To the Editor: Primary graft dysfunction (PGD) is a form of acute lung injury occurring within 72 hours of lung transplantation (1, 2). We have previously demonstrated an increase in early mortality in subjects with PGD (2). Understanding of the mechanisms leading to PGD and early mortality is important in identifying potential therapeutic targets and interventions. The complement system defines a group of plasma and cell membrane proteins that play a key role in innate immunity as well as regulating adaptive immune response. C3a, C4a, and C5a, downstream products of the activated complement cascade, are potent neutrophil and lymphocyte chemoattractants (3–5). In animal models, activation of the complement system during lung ischemia and reperfusion can lead to cellular injury and lung allograft failure (6, 7). Based on the relationship between complement activation and ischemia reperfusion injury in the lung allograft, we hypothesized that plasma levels of C3a, C4a, and C5a would be associated with both PGD and mortality after lung transplantation. We performed a prospective cohort study of 190 lung transplant recipients from 10 centers enrolled between 2008 and 2010 in the Lung Transplant Outcomes Group (LTOG) cohort. We included consecutive subjects who had plasma samples available at the preoperative, 6-hour, and 24-hour time points (see Figure E1 in the online supplement). Clinical and mortality data were collected as described elsewhere (2). Informed consent was obtained from each subject. The Investigational Review Board at each center approved our study. The primary outcome was grade 3 PGD within 72 hours after transplantation, which has demonstrated construct validity for survival (8). Grade 3 PGD at 24 hours was used to evaluate the relationship between concurrent lung injury, and grade 3 PGD at 48 or 72 hours was used to evaluate a severe lung injury phenotype (2). We evaluated all-cause mortality as an additional end point. Plasma C3a, C4a, and C5a concentrations were measured using a commercially available cytometric bead array (BD Biosciences, San Jose, CA) in a manner devised to ensure stability of complement (see online supplement). We evaluated absolute differences in levels between each time point to assess changes during the early transplant period. The association between complement and PGD was determined using Wilcoxon rank sum testing. We used Cox regression to evaluate associations between complement levels and time to death, conditioned on 90-day survival, to exclude bias from the effect of PGD and sepsis on early mortality. We adjusted for recipient, donor, and surgical variables (see online supplement). Of the 190 subjects enrolled, 82 developed PGD (43%) within 72 hours post-transplant, and 33 had PGD at 48 or 72 hours (17%). Demographics of the cohort are in Table E1. There were no differences between subjects enrolled with blood samples at all three time points and other subjects enrolled in LTOG (Table E2). The median change in plasma C5a levels between 6 and 24 hours post transplantation was significantly greater in subjects with PGD than in those without (867 vs. −156 pg/ml, P = 0.01) (Figure 1A). The median change in plasma C4a levels between preoperative and 6 hours was greater in subjects with PGD (72,075 vs. −79,501, P = 0.01) (Figure 1B). There was no significant difference in change in plasma C3a levels between the PGD and non-PGD group at any individual time point (Table E3). In sensitivity analyses, there was no difference in complement levels using grade 3 PGD at 24 hours (Table E4). However, there was a similar relationship between change in plasma C5a levels between 6 and 24 hours (1,164 vs.113, P = 0.24) and change in plasma C4a levels between preoperative and 6 hours (109,654 vs. −8,185, P = 0.04) using grade 3 PGD at 48 or 72 hours. Figure 1. (A) Plasma C5a concentration at each time point in subjects without primary graft dysfunction (PGD) (dashed line) and with grade 3 PGD (solid line). The P value indicates that the difference in C5a concentration (represented by the slope of the line) ... Of 175 patients with available mortality data, 32 died (17%). The change in C5a levels from 6 to 24 hours was associated with an increased risk of death (hazard ratio [HR], 1.81; 95% confidence interval [CI], 1.16, 2.83; P = 0.01). C5a levels measured preoperatively and 24 hours after transplantation were also associated with an increased risk of death (HR, 1.64; 95% CI, 1.29, 2.09; P < 0.01; and HR, 1.94; 95% CI, 1.39, 2.72; P < 0.01; respectively). C3a levels measured at 6 hours were associated with an increased risk of death (HR, 1.68; 95% CI, 1.04, 2.71; P = 0.03). There was no association between change in C3a or C4a levels and mortality (Tables E5 and E6). These associations were independent of adjustment for all tested confounders, including PGD (Table 1). Table 1. Association of C3a and C5a at Different Time Points with Mortality Our study demonstrates that early changes in plasma C4a and C5a are associated with PGD, and there is an association between C3a and C5a levels with mortality, independent of PGD. Collectively, these data suggest that systemic complement activation is important in both short- and long-term outcomes after transplantation. The increase in C5a between 6 and 24 hours is associated with both PGD and mortality. This suggests a role for an early systemic complement response in both early and late outcomes. Prior work has implicated complement activation in lung ischemia–reperfusion injury (9). The change in C5a level was observed early after transplant and was not associated with concurrent lung injury (grade 3 at 24 h), indicating it may be driving lung injury and not just a marker of injury. Complement may be important in the pathogenesis PGD by attracting neutrophils and accelerating both the innate and adaptive immune responses within the first 24 hours after injury (10, 11). The association of complement with mortality was independent of PGD. Prior work found an association between C3a, C5a, and obliterative bronchiolitis in a mouse model (12). Our findings in humans suggest a role for complement activation that continues after the early reperfusion period, potentially a signal of chronic immune activation starting in the early post-transplant period and leading to formation of autoantibodies, leading to chronic graft dysfunction and mortality. These findings support the study of blockade of complement activation to improve clinical outcomes after transplantation. Our study had limitations. We were unable to measure complement levels in bronchoalveolar lavage; therefore, we could not link the plasma and lung compartments. The incidence of PGD in this study was 40%, which is higher than previous reports; however, we observed a similar trend in sensitivity analyses using a more restrictive definition of PGD. Finally, we were unable to adjust for center effect given small numbers. In conclusion, our study suggests a role for early, systemic activation of the complement pathway in development of severe PGD and mortality after lung transplantation.
- Published
- 2014
136. Applications of recombinant Pichia pastoris in the healthcare industry
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Andrea B. Zepeda, Adalberto Pessoa, Daniel Weinacker, Claudia Rabert, Carolina A. Figueroa, and Jorge G. Farías
- Subjects
heterologous expression system ,lcsh:QR1-502 ,Health Care Sector ,Review ,yeast ,Microbiology ,lcsh:Microbiology ,Pichia ,Pichia pastoris ,law.invention ,Industrial Microbiology ,law ,Production (economics) ,Humans ,Technology, Pharmaceutical ,biology ,Organisms, Genetically Modified ,business.industry ,Industrial scale ,Industrial microbiology ,biology.organism_classification ,Biotechnology ,Biopharmaceutical ,Recombinant DNA ,Healthcare industry ,production ,business ,scale up ,recombinant protein - Abstract
Since the 1970s, the establishment and development of the biotech industry has improved exponentially, allowing the commercial production of biopharmaceutical proteins. Nowadays, new recombinant protein production is considered a multibillion-dollar market, in which about 25% of commercial pharmaceuticals are biopharmaceuticals. But to achieve a competitive production process is not an easy task. Any production process has to be highly productive, efficient and economic. Despite that the perfect host is still not discovered, several research groups have chosen Pichia pastoris as expression system for the production of their protein because of its many features. The attempt of this review is to embrace several research lines that have adopted Pichia pastoris as their expression system to produce a protein on an industrial scale in the health care industry.
- Published
- 2014
137. Genetic Variation in the Prostaglandin E2 Pathway Is Associated with Primary Graft Dysfunction
- Author
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Tatiana Akimova, Selim M. Arcasoy, Joshua M. Diamond, Jason D. Christie, Maria Crespo, Keith M. Wille, Matthew H. Levine, Richard Aplenc, Ejigayehu Demissie, David J. Lederer, Edward Cantu, Wayne W. Hancock, Scott M. Palmer, Jonathan B. Orens, Steven M. Kawut, Rupal J. Shah, Rui Feng, Sangeeta Bhorade, Vibha N. Lama, Nuala J. Meyer, Altaf S. Kazi, Ann Weinacker, James C. Lee, and Lorraine B. Ware
- Subjects
Genetic Markers ,Male ,Pulmonary and Respiratory Medicine ,Candidate gene ,Genotype ,Genotyping Techniques ,Prostaglandin E2 receptor ,Prostaglandin ,Biology ,Critical Care and Intensive Care Medicine ,Polymorphism, Single Nucleotide ,T-Lymphocytes, Regulatory ,Dinoprostone ,chemistry.chemical_compound ,Genetic variation ,medicine ,Humans ,Prospective Studies ,Prostaglandin E2 ,Gene ,Genetic Association Studies ,Prostaglandin-E Synthases ,Genetics ,PTGER4 Gene ,Computational Biology ,Middle Aged ,Intramolecular Oxidoreductases ,chemistry ,Genetic marker ,Female ,Primary Graft Dysfunction ,Receptors, Prostaglandin E, EP4 Subtype ,Biomarkers ,Lung Transplantation ,medicine.drug - Abstract
Rationale: Biologic pathways with significant genetic conservation across human populations have been implicated in the pathogenesis of primary graft dysfunction (PGD). The evaluation of the role of recipient genetic variation in PGD has thus far been limited to single, candidate gene analyses. Objectives: We sought to identify genetic variants in lung transplant recipients that are responsible for increased risk of PGD using a two-phase large-scale genotyping approach. Methods: Phase 1 was a large-scale candidate gene association study of the multicenter, prospective Lung Transplant Outcomes Group cohort. Phase 2 included functional evaluation of selected variants and a bioinformatics screening of variants identified in phase 1. Measurements and Main Results: After genetic data quality control, 680 lung transplant recipients were included in the analysis. In phase 1, a total of 17 variants were significantly associated with PGD, four of which were in the prostaglandin E2 family of genes. Among these were a coding variant in the gene encoding prostaglandin E2 synthase (PTGES2; P = 9.3 × 10−5) resulting in an arginine to histidine substitution at amino acid position 298, and three variants in a block containing the 5′ promoter and first intron of the PTGER4 gene (encoding prostaglandin E2 receptor subtype 4; all P < 5 × 10−5). Functional evaluation in regulatory T cells identified that rs4434423A in the PTGER4 gene was associated with differential suppressive function of regulatory T cells. Conclusions: Further research aimed at replication and additional functional insight into the role played by genetic variation in prostaglandin E2 synthetic and signaling pathways in PGD is warranted.
- Published
- 2014
138. A Multidisciplinary Initiative to Increase Inpatient Discharges Before Noon
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Mark L. Welton, Rudolph Arthofer, Mark Ramirez, Timothy Seay-Morrison, James Hereford, David Pickham, Wesley Elfman, Ann Weinacker, Neera Ahuja, and Marlena Kane
- Subjects
Capacity Building ,Time Factors ,Leadership and Management ,education ,Psychological intervention ,MEDLINE ,Plan (drawing) ,Noon ,Multidisciplinary team ,Efficiency, Organizational ,Patient Readmission ,03 medical and health sciences ,Organizational Case Studies ,0302 clinical medicine ,Nursing ,Multidisciplinary approach ,Humans ,Interdisciplinary communication ,030212 general & internal medicine ,Institutional Management Teams ,Hospitals, Teaching ,030503 health policy & services ,General Medicine ,Patient Discharge ,Patient Satisfaction ,Interdisciplinary Communication ,0305 other medical science ,Psychology ,Total Quality Management - Abstract
The aim of this study is to evaluate the effect of 2 hospital-wide interventions on achieving a discharge-before-noon rate of 40%.A multidisciplinary team led by administrative and physician leadership developed a plan to diminish capacity constraints by minimizing late afternoon hospital discharges using 2 patient flow management techniques.The study was a preintervention/postintervention retrospective analysis observing all inpatients discharged across 19 inpatient units in a 484-bed, academic teaching hospital measuring calendar month discharge-before-noon percentage, patient satisfaction, and readmission rates. Patient satisfaction and readmission rates were used as baseline metrics.The discharge-before-noon percentage increased from 14% in the 11-month preintervention period to an average of 24% over the 11-month postintervention period, whereas patient satisfaction scores and readmission rates remained stable.Implementation of the 2 interventions successfully increased the percentage of discharges before noon yet did not achieve the goal of 40%. Patient satisfaction and readmission rates were not negatively impacted by the program.
- Published
- 2016
139. Risk Factors for Primary Graft Dysfunction in Patients with Cystic Fibrosis Receiving Lung Transplants
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M. Brown, Chadi A. Hage, Mary K. Porteous, Ann Weinacker, J.A. Martin, Edward Cantu, Vibha N. Lama, John F. McDyer, Keith M. Wille, J.B. Orens, Laurie D. Snyder, Lorraine B. Ware, Pali D. Shah, David J. Lederer, Michelle Oyster, Joshua M. Diamond, Jonathan P. Singer, and Jason D. Christie
- Subjects
Pulmonary and Respiratory Medicine ,Transplantation ,education.field_of_study ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Population ,Panel reactive antibody ,Odds ratio ,respiratory system ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Lung transplantation ,Surgery ,Risk factor ,Cardiology and Cardiovascular Medicine ,education ,business ,Prospective cohort study ,Lung allocation score - Abstract
Purpose The primary driver of poor outcomes in the early stages of lung transplantation is primary graft dysfunction (PGD). Patients with cystic fibrosis (CF) have unique physiology and demographics compared to other lung transplant recipients. Therefore, we sought to identify risk factors for PGD in the CF patient population undergoing lung transplantation. Methods We utilized clinical data on lung transplant recipients with CF and their donors from the Lung Transplant Outcomes Group cohort, a multi-center prospective cohort study of PGD pathogenesis. The primary outcome was grade 3 PGD within the first 72 hours after transplantation. Potential covariates were identified in univariate analysis and assessed for collinearity. Independent PGD risk factors were identified using multivariate logistic regression. A sensitivity analysis was performed using grade 3 PGD 48 to 72 hours after transplantation. Results We identified 195 patients with CF who received lung transplants between August 2014 and June 2018 across ten centers. Grade 3 PGD developed in 80 subjects (41%). Risk factors for PGD in CF patients based on the multivariable model were white donor race (odds ratio [OR]: 2.6, 95% confidence interval [CI]: 1.4-5.1), any positive panel reactive antibodies (PRA) (OR: 2.2, 95% CI: 1.0-4.7), recipient female gender (OR: 2.1, 95% CI: 1.1-3.9), intraoperative cardiopulmonary bypass use (OR: 2.2, 95% CI: 1.2-4.2), increasing lung allocation score (LAS) (OR: 1.2 per 10 point increase in LAS, 95% CI: 1.0-1.4), and ECMO (extracorporeal membrane oxygenation) bridge to transplant (OR: 2.7, 95% CI: 1.1-6.7). LAS and ECMO were assessed in separate models due to their collinearity. Mean pulmonary artery pressure at the time of transplant was included as a potential confounder. Similar findings were seen in a more severe phenotype of PGD that developed 48 to 72 hours after transplant. Conclusion The CF population is often considered to be at low risk of PGD, however we observed a relatively high rate of PGD in this study. Any positive PRA, female recipient gender, intraoperative bypass, increasing LAS, and ECMO are PGD risk factors that have been identified non-CF transplant populations. We validated these risk factors in recipients with CF. White donor race is a novel risk factor that has not been previously identified in lung transplant recipients with another primary diagnosis.
- Published
- 2019
140. Integrating LiDAR and high-resolution imagery for object-based mapping of forest habitats in a heterogeneous temperate forest landscape
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Silveyra Gonzalez, Ramiro, primary, Latifi, Hooman, additional, Weinacker, Holger, additional, Dees, Matthias, additional, Koch, Barbara, additional, and Heurich, Marco, additional
- Published
- 2018
- Full Text
- View/download PDF
141. Lean‐Based Redesign of Multidisciplinary Rounds on General Medicine Service
- Author
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Kane, Marlena, primary, Rohatgi, Nidhi, additional, Heidenreich, Paul A., additional, Thakur, Akanksha, additional, Winget, Marcy, additional, Shum, Kenny, additional, Hereford, James, additional, Shieh, Lisa, additional, Lew, Thomas, additional, Hom, Jason, additional, Chi, Jeffrey, additional, Weinacker, Ann, additional, Seay‐Morrison, Timothy, additional, and Ahuja, Neera, additional
- Published
- 2018
- Full Text
- View/download PDF
142. Cell-free hemoglobin promotes primary graft dysfunction through oxidative lung endothelial injury
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Shaver, Ciara M., primary, Wickersham, Nancy, additional, McNeil, J. Brennan, additional, Nagata, Hiromasa, additional, Miller, Adam, additional, Landstreet, Stuart R., additional, Kuck, Jamie L., additional, Diamond, Joshua M., additional, Lederer, David J., additional, Kawut, Steven M., additional, Palmer, Scott M., additional, Wille, Keith M., additional, Weinacker, Ann, additional, Lama, Vibha N., additional, Crespo, Maria M., additional, Orens, Jonathan B., additional, Shah, Pali D., additional, Hage, Chadi A., additional, Cantu, Edward, additional, Porteous, Mary K., additional, Dhillon, Gundeep, additional, McDyer, John, additional, Bastarache, Julie A., additional, Christie, Jason D., additional, and Ware, Lorraine B., additional
- Published
- 2018
- Full Text
- View/download PDF
143. Update of Inpatient Management of Polytrauma Patients
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Ann Weinacker
- Subjects
Inpatient management ,medicine.medical_specialty ,business.industry ,Emergency medicine ,Medicine ,business ,medicine.disease ,Polytrauma - Published
- 2013
144. Bacterial consortium for copper extraction from sulphide ore consisting mainly of chalcopyrite
- Author
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Jorge G. Farías, Andrea B. Zepeda, Daniel Weinacker, P. Chavez-Crooker, Carolina A. Figueroa, and E. Romo
- Subjects
Leptospirillum ferriphilum ,Microbial Consortia ,chemistry.chemical_element ,Microbiology ,Industrial Microbiology ,Acidithiobacillus thiooxidans ,Copper extraction techniques ,Bioleaching ,Bacteria ,biology ,business.industry ,Chalcopyrite ,Extraction (chemistry) ,Acidithiobacillus ferrooxidans ,biology.organism_classification ,Pulp and paper industry ,Copper ,Biotechnology ,chemistry ,visual_art ,visual_art.visual_art_medium ,bioleaching ,business ,Research Paper - Abstract
The mining industry is looking forward for bacterial consortia for economic extraction of copper from low-grade ores. The main objective was to determine an optimal bacterial consortium from several bacterial strains to obtain copper from the leach of chalcopyrite. The major native bacterial species involved in the bioleaching of sulphide ore (Acidithiobacillus ferrooxidans, Acidithiobacillus thiooxidans, Leptospirillum ferrooxidans and Leptospirillum ferriphilum) were isolated and the assays were performed with individual bacteria and in combination with At. thiooxidans. In conclusion, it was found that the consortium integrated by At. ferrooxidans and At. thiooxidans removed 70% of copper in 35 days from the selected ore, showing significant differences with the other consortia, which removed only 35% of copper in 35 days. To validate the assays was done an escalation in columns, where the bacterial consortium achieved a higher percentage of copper extraction regarding to control.
- Published
- 2013
145. Protein Quantitative Trait Loci Analysis Identifies Genetic Variation in the Innate Immune Regulator TOLLIP in Post-Lung Transplant Primary Graft Dysfunction Risk
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Cantu, E, Suzuki, Y, Diamond, JM, Ellis, J, Tiwari, J, Beduhn, B, Nellen, JR, Shah, R, Meyer, NJ, Lederer, DJ, Kawut, SM, Palmer, SM, Snyder, LD, Hartwig, MG, Lama, VN, Bhorade, S, Crespo, M, Demissie, E, Wille, K, Orens, J, Shah, PD, Weinacker, A, Weill, D, Wilkes, D, Roe, D, Ware, LB, Wang, F, Feng, R, Christie, JD, and Lung Transplant Outcomes Group
- Subjects
Adult ,Male ,lung disease ,Genotype ,Quantitative Trait Loci ,inflammatory ,Medical and Health Sciences ,Lung Transplant Outcomes Group ,Rare Diseases ,Clinical Research ,Plasminogen Activator Inhibitor 1 ,lung transplantation ,Genetics ,Humans ,Prospective Studies ,pulmonology ,Acute Respiratory Distress Syndrome ,Lung ,science ,ischemia reperfusion injury ,dysfunction ,Human Genome ,Intracellular Signaling Peptides and Proteins ,Genetic Variation ,Middle Aged ,Prognosis ,lung (allograft) function ,Phenotype ,translational research ,Female ,Surgery ,Primary Graft Dysfunction ,immune ,Biomarkers ,Follow-Up Studies - Abstract
The authors previously identified plasma plasminogen activator inhibitor-1 (PAI-1) level as a quantitative lung injury biomarker in primary graft dysfunction (PGD). They hypothesized that plasma levels of PAI-1 used as a quantitative trait could facilitate discovery of genetic loci important in PGD pathogenesis. A two-stage cohort study was performed. In stage 1, they tested associations of loci with PAI-1 plasma level using linear modeling. Genotyping was performed using the Illumina CVD Bead Chip v2. Loci meeting a p < 5 × 10(-4) cutoff were carried forward and tested in stage 2 for association with PGD. Two hundred ninety-seven enrollees were evaluated in stage 1. Six loci, associated with PAI-1, were carried forward to stage 2 and evaluated in 728 patients. rs3168046 (Toll interacting protein [TOLLIP]) was significantly associated with PGD (p = 0.006). The increased risk of PGD for carrying at least one copy of this variant was 11.7% (95% confidence interval 4.9-18.5%). The false-positive rate for individuals with this genotype who did not have PGD was 6.1%. Variants in the TOLLIP gene are associated with higher circulating PAI-1 plasma levels and validate for association with clinical PGD. A protein quantitative trait analysis for PGD risk prioritizes genetic variations in TOLLIP and supports a role for Toll-like receptors in PGD pathogenesis.
- Published
- 2016
146. Laser- and multi-spectral monitoring of natural objects from UAVs
- Author
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Reiterer, Alexander, Frey, Simon, Koch, Barbara, Stemmler, Simon, Weinacker, Holger, Hoffmann, Annemarie, Weiler, Markus, Hergarten, Stefan, and Publica
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3D measurement ,Lightweight Sensor System ,monitoring ,camera system ,Laserscanner - Abstract
The paper describes the research, development and evaluation of a lightweight sensor system for UAVs. The system is composed of three main components: (1) a laser scanning module, (2) a multi-spectral camera system, and (3) a processing/storage unit. All three components are newly developed. Beside measurement precision and frequency, the low weight has been one of the challenging tasks. The current system has a total weight of about 2.5 kg and is designed as a self-contained unit (incl. storage and battery units). The main features of the system are: laser-based multi-echo 3D measurement by a wavelength of 905 nm (totally eye save), measurement range up to 200 m, measurement frequency of 40 kHz, scanning frequency of 16 Hz, relative distance accuracy of 10 mm. The system is equipped with both GNSS and IMU. Alternatively, a multi-visual-odometry system has been integrated to estimate the trajectory of the UAV by image features (based on this system a calculation of 3D-coordinates without GNSS is possible). The integrated multi-spectral camera system is based on conventional CMOS-image-chips equipped with a special sets of band-pass interference filters with a full width half maximum (FWHM) of 50 nm. Good results for calculating the normalized difference vegetation index (NDVI) and the wide dynamic range vegetation index (WDRVI) have been achieved using the band-pass interference filter-set with a FWHM of 50 nm and an exposure times between 5.000 ms and 7.000 ms. The system is currently used for monitoring of natural objects and surfaces, like forest, as well as for geo-risk analysis (landslides). By measuring 3D-geometric and multi-spectral information a reliable monitoring and interpretation of the data-set is possible. The paper gives an overview about the development steps, the system, the evaluation and first results.
- Published
- 2016
147. Comparative testing of single-tree detection algorithms under different types of forest
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Vegard Lien, K. Marius Hauglin, Petteri Packalen, Terje Gobakken, Matti Maltamo, Barbara Koch, Jari Vauhkonen, Svein Solberg, Sandeep Gupta, Yunsheng Wang, Johannes Heinzel, Timo Tokola, Liviu Theodor Ene, Johan Holmgren, Holger Weinacker, Juho Pitkänen, and Erik Næsset
- Subjects
Tree (data structure) ,Computer science ,business.industry ,Forestry ,Pattern recognition ,Artificial intelligence ,business - Published
- 2011
148. Effect of Single vs Bilateral Lung Transplantation on Plasma Surfactant Protein D Levels in Idiopathic Pulmonary Fibrosis
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Vibha N. Lama, Sangeeta Bhorade, Ejigayehu Demissie, Scarlett L. Bellamy, Karen Sims, Ann Weinacker, Scott M. Palmer, Vivek N. Ahya, David J. Lederer, Keith M. Wille, Michael F. Beers, Lorraine B. Ware, Michael W. Sims, M. Crespo, Jason D. Christie, Pali D. Shah, Jonathan B. Orens, and Steven M. Kawut
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Cystic Fibrosis ,Hypertension, Pulmonary ,medicine.medical_treatment ,Primary Graft Dysfunction ,Enzyme-Linked Immunosorbent Assay ,Lung injury ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Cystic fibrosis ,Pulmonary Disease, Chronic Obstructive ,Young Adult ,Idiopathic pulmonary fibrosis ,Internal medicine ,medicine ,Humans ,Lung transplantation ,Familial Primary Pulmonary Hypertension ,Original Research ,COPD ,Lung ,business.industry ,Middle Aged ,respiratory system ,Pulmonary Surfactant-Associated Protein D ,medicine.disease ,Pulmonary hypertension ,Idiopathic Pulmonary Fibrosis ,respiratory tract diseases ,Surgery ,surgical procedures, operative ,medicine.anatomical_structure ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Lung Transplantation - Abstract
Background Serum levels of surfactant protein D (SP-D) have been suggested as reflecting epithelial damage in acute lung injury, COPD, and idiopathic pulmonary fibrosis (IPF). However, little is known about SP-D levels in the setting of lung transplantation. Methods We examined plasma SP-D levels in 104 subjects from a prospective, multicenter cohort study of lung allograft recipients. Plasma SP-D was measured by enzyme-linked immunosorbent assay prior to transplant and daily for 3 days after transplant. Results Subjects undergoing transplant for IPF had higher baseline SP-D levels (median, 325 ng/mL) compared with subjects with cystic fibrosis, COPD, and pulmonary hypertension (median, 100, 80, and 82 ng/mL, respectively; P = .0001). Among subjects with IPF undergoing bilateral transplant, SP-D levels declined rapidly postoperatively. In contrast, SP-D levels in subjects undergoing single lung transplant for IPF remained significantly higher than those of bilateral allograft recipients. Among subjects undergoing single lung transplant for IPF, the development of primary graft dysfunction (PGD) was associated with a subsequent rise in SP-D levels, whereas SP-D levels in IPF subjects undergoing bilateral transplant declined, even in the presence of grade 3 PGD. Importantly, single lung allograft recipients without PGD had higher postoperative SP-D levels than bilateral allograft recipients with PGD. Conclusions Subjects undergoing lung transplant for IPF have significantly higher baseline plasma SP-D levels compared with those with other diagnoses. Plasma SP-D is likely a biomarker of the air-blood barrier integrity in the native IPF lung, but may be less useful as a biomarker of PGD after transplant.
- Published
- 2011
149. Prior-knowledge-based single-tree extraction
- Author
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Barbara Koch, Johannes Heinzel, and Holger Weinacker
- Subjects
Watershed ,business.industry ,Temperate forest ,Pattern recognition ,Texture (geology) ,Tree (data structure) ,Deciduous ,Granulometry ,General Earth and Planetary Sciences ,Extraction (military) ,Artificial intelligence ,business ,Smoothing ,Mathematics ,Remote sensing - Abstract
The automatic extraction of single trees from remotely sensed data is approached in numerous studies, but results are still insufficient in areas of dense temperate forest. Common watershed-based algorithms using digital surface models tend to produce erroneous results in difficult constellations because the treetop determination lacks an exact criterion for smoothing. In this article, a new approach is introduced that classifies crown size in advance and uses this information as prior knowledge for single-tree extraction. Crown size is classified from texture with an improved grey-scale granulometry followed by a crown size adapted watershed segmentation of single trees. The method is applied on a large area of 10 km2 and verified on six reference plots reflecting diverse and difficult compositions. The accuracy varies between 64% and 88%, and shows an average improvement of about 30% for deciduous and mixed stands compared to a non-crown-size-dependent algorithm.
- Published
- 2011
150. Elevated Pulmonary Artery Pressure Is a Risk Factor for Primary Graft Dysfunction Following Lung Transplantation for Idiopathic Pulmonary Fibrosis
- Author
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Clifford S. Deutschman, Jonathan B. Orens, Maria Crespo, Jason D. Christie, Adam Fang, Keith M. Wille, Scarlett L. Bellamy, James C. Lee, Scott M. Palmer, Ann Weinacker, David J. Lederer, Steven M. Kawut, Benjamin A. Kohl, Vivek N. Ahya, Vibha N. Lama, Lorraine B. Ware, Ejigayehu Demissie, and Sean Studer
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Elevated pulmonary artery pressure ,business.industry ,medicine.medical_treatment ,respiratory system ,Critical Care and Intensive Care Medicine ,medicine.disease ,Pulmonary hypertension ,Surgery ,Transplantation ,Idiopathic pulmonary fibrosis ,medicine.artery ,Internal medicine ,Pulmonary artery ,Pulmonary fibrosis ,medicine ,Cardiology ,Lung transplantation ,lipids (amino acids, peptides, and proteins) ,Cardiology and Cardiovascular Medicine ,Pulmonary wedge pressure ,business - Abstract
Background Idiopathic pulmonary fibrosis (IPF) is often associated with elevations in pulmonary artery pressures. Although primary pulmonary arterial hypertension (PAH) has been associated with primary graft dysfunction (PGD), the role of secondary PAH in mediating PGD risk in patients with IPF is incompletely understood. The purpose of this study was to evaluate the relationship between mean pulmonary artery pressure (mPAP) and PGD among patients with IPF. Methods We performed a multicenter prospective cohort study of 126 lung transplant procedures performed for IPF between March 2002 and August 2007. The primary outcome was grade 3 PGD at 72 h after lung transplant. The mPAP was measured as the initial reading following insertion of the right-sided heart catheter during lung transplant. Multivariable logistic regression was used to adjust for confounding variables. Results The mPAP for patients with PGD was 38.5 ± 16.3 mm Hg vs 29.6 ± 11.5 mm Hg for patients without PGD (mean difference, 8.9 mm Hg [95% CI, 3.6-14.2]; P = .001). The increase in odds of PGD associated with each 10-mm Hg increase in mPAP was 1.64 (95% CI, 1.18-2.26; P = .003). In multivariable models, this relationship was independent of confounding by other clinical variables, although the use of cardiopulmonary bypass partially attenuated the relationship. Conclusions Higher mPAP in patients with IPF is associated with the development of PGD.
- Published
- 2011
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