1,202 results on '"L. Leach"'
Search Results
2. Potential value of a rapid syndromic multiplex PCR for the diagnosis of native and prosthetic joint infections: a real-world evidence study
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S. Pascual, B. Noble, N. Ahmad-Saeed, C. Aldridge, S. Ambretti, S. Amit, R. Annett, S. A. O'Shea, A. M. Barbui, G. Barlow, L. Barrett, M. Berth, A. Bondi, N. Boran, S. E. Boyd, C. Chaves, M. Clauss, P. Davies, I. T. Dianzo-Delgado, J. Esteban, S. Fuchs, L. Friis-Hansen, D. Goldenberger, A. Kraševac Glaser, J. O. Groonroos, I. Hoffmann, T. Hoffmann, H. Hughes, M. Ivanova, P. Jezek, G. Jones, Z. Ceren Karahan, C. Lass-Flörl, F. Laurent, L. Leach, M. L. Horsbøll Pedersen, C. Loiez, M. Lynch, R. J. Maloney, M. Marsh, O. Milburn, S. Mitchell, L. S. P. Moore, L. Moffat, M. Murdjeva, M. E. Murphy, D. Nayar, G. Nigrisoli, F. O'Sullivan, B. Öz, T. Peach, C. Petridou, M. Prinz, M. Rak, N. Reidy, G. M. Rossolini, A.-L. Roux, P. Ruiz-Garbajosa, K. Saeed, L. Salar-Vidal, C. Salas Venero, M. Selvaratnam, E. Senneville, P. Starzengruber, B. Talbot, V. Taylor, R. Trebše, D. Wearmouth, B. Willinger, M. Wouthuyzen-Bakker, B. Couturier, and F. Allantaz
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Orthopedic surgery ,RD701-811 - Abstract
Introduction: The BIOFIRE Joint Infection (JI) Panel is a diagnostic tool that uses multiplex-PCR testing to detect microorganisms in synovial fluid specimens from patients suspected of having septic arthritis (SA) on native joints or prosthetic joint infections (PJIs). Methods: A study was conducted across 34 clinical sites in 19 European and Middle Eastern countries from March 2021 to June 2022 to assess the effectiveness of the BIOFIRE JI Panel. Results: A total of 1527 samples were collected from patients suspected of SA or PJI, with an overall agreement of 88.4 % and 85 % respectively between the JI Panel and synovial fluid cultures (SFCs). The JI Panel detected more positive samples and microorganisms than SFC, with a notable difference on Staphylococcus aureus, Streptococcus species, Enterococcus faecalis, Kingella kingae, Neisseria gonorrhoeae, and anaerobic bacteria. The study found that the BIOFIRE JI Panel has a high utility in the real-world clinical setting for suspected SA and PJI, providing diagnostic results in approximately 1 h. The user experience was positive, implying a potential benefit of rapidity of results' turnover in optimising patient management strategies. Conclusion: The study suggests that the BIOFIRE JI Panel could potentially optimise patient management and antimicrobial therapy, thus highlighting its importance in the clinical setting.
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- 2024
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3. A Metacognitive Teaching Intervention to Overcome Student Misunderstandings about Negligence
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Judd L. Leach, Lesley F. Leach, and Kyle Post
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Negligence can be a difficult concept for business law students to understand, likely due to faulty schemas and naïve theories formed by their prior experiences. In this article, we describe a metacognitive teaching intervention used in a business law course to potentially overcome students' misconceptions regarding negligence. On average, students who received the teaching intervention experienced greater growth in their understanding of negligence than students who did not receive the teaching intervention. These initial results provide support for the development of additional metacognitive strategies to overcome student obstacles to understanding negligence.
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- 2024
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4. MONUMENTE EN GEDENKTEKENS OP WEERMAGSTERREINE
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D. De Klerk and L. Leach
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SA Lugmaggedenkteken ,Baysheuwel ,Lugmagbasis Swartkop ,SA Lugmag ,1920 ,Instituut van SA Argitekte ,SA Lugmagfonds ,SA Lugmagvereniging ,Professor John Fassler ,Fakulteit van Argitektuur van die Witwatersrand Universiteit ,Military Science - Abstract
Die SA Lugmaggedenkteken te Baysheuwel het 'n asemrowende uitsig oor Lugmagbasis Swartkop waar die SA Lugmag in 1920 sy ontstaan gehad het. 'n Kompetisie is deur die Instituut van SA Argitekte in 1958 in samewerking met SA Lugmagfonds en SA Lugmagvereniging geloods. Die beoordeling was onder leiding van Professor John Fassler, Dekaan van die Fakulteit van Argitektuur van die Witwatersrand Universiteit, Johannesburg. Die wenner nl. "Taylor and Taylor" is uit 40 inskrywings gekies.
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- 2012
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5. Linearisation of a second-order nonlinear ordinary differential equation
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Adhir Maharaj, Peter G. L. Leach, Megan Govender, and David P. Day
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lie symmetries ,integrability ,linearisation ,Engineering (General). Civil engineering (General) ,TA1-2040 - Abstract
We analyse nonlinear second-order differential equations in terms of algebraic properties by reducing a nonlinear partial differential equation to a nonlinear second-order ordinary differential equation via the point symmetry f(v)∂v. The eight Lie point symmetries obtained for the second-order ordinary differential equation is of maximal number and a representation of the sl(3,R) algebra. We extend this analysis to a more general nonlinear second-order differential equation and we obtain similar interesting algebraic properties.
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- 2023
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6. Symmetries and solutions for the inviscid oceanic Rossby wave equation.
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Amlan K. Halder, C. T. Duba, and Peter G. L. Leach
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- 2023
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7. A CRISPR-Cas9-mediated F0 screen to identify pro-regenerative genes in the zebrafish retinal pigment epithelium
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Fangfang Lu, Lyndsay L. Leach, and Jeffrey M. Gross
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Medicine ,Science - Abstract
Abstract Ocular diseases resulting in death of the retinal pigment epithelium (RPE) lead to vision loss and blindness. There are currently no FDA-approved strategies to restore damaged RPE cells. Stimulating intrinsic regenerative responses within damaged tissues has gained traction as a possible mechanism for tissue repair. Zebrafish possess remarkable regenerative abilities, including within the RPE; however, our understanding of the underlying mechanisms remains limited. Here, we conducted an F0 in vivo CRISPR-Cas9-mediated screen of 27 candidate RPE regeneration genes. The screen involved injection of a ribonucleoprotein complex containing three highly mutagenic guide RNAs per target gene followed by PCR-based genotyping to identify large intragenic deletions and MATLAB-based automated quantification of RPE regeneration. Through this F0 screening pipeline, eight positive and seven negative regulators of RPE regeneration were identified. Further characterization of one candidate, cldn7b, revealed novel roles in regulating macrophage/microglia infiltration after RPE injury and in clearing RPE/pigment debris during late-phase RPE regeneration. Taken together, these data support the utility of targeted F0 screens for validating pro-regenerative factors and reveal novel factors that could regulate regenerative responses within the zebrafish RPE.
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- 2023
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8. Strategies and best practices that enhance participation in regular physical activities among undergraduate university students: a systematic review protocol
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Chante Johannes, Sunday O Onagbiye, Nicolette V Roman, and Lloyd L Leach
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Medicine - Abstract
Introduction Physical activity has health benefits, including lowered obesity, diabetes and hypertension levels. However, participation in regular physical activities among undergraduate students is declining and, instead, physical inactivity sets the path for sedentarism. Strategies and best practices used to enhance participation in regular physical activities among undergraduate students are beneficial for mitigating sedentariness and promoting healthy lifestyles. Therefore, this study aims to present a systematic review protocol that focuses on the strategies and best practices used to enhance participation in regular physical activities among undergraduate university students.Methods and analysis Quantitative, qualitative and mixed-methods design studies will be included and appraised. The following databases will be searched: PubMed, Science Direct, Academic Search Complete, ERIC, Web of Science, SAGE, CINAHL Plus and SPORTDiscus. Database searches on physical activities among undergraduate university students will be generated to answer the following research question: What are the strategies and best practices used to enhance participation in regular physical activities among undergraduate university students? Two independent reviewers will conduct the primary screening of articles from 2011 to 2022. A third reviewer will be consulted to solve any disagreements. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and study quality will be assessed by the Johanna Biggs Institute checklist. Results from the selected articles will be extracted, summarised and categorised based on the type of study participants, study design and setting, and methodological quality. A narrative description will synthesise the findings to answer the objectives of this review.Ethics and dissemination Ethics approval for this study was granted by the Humanities and Social Science Research Ethics Committee at the University of the Western Cape, reference number: HS21/10/24. The results will be disseminated through a peer-reviewed publication and conference presentation.
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- 2022
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9. Prolonged phloem feeding by the spotted lanternfly, an invasive planthopper, alters resource allocation and inhibits gas exchange in grapevines
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Andrew D. Harner, Heather L. Leach, Lauren Briggs, and Michela Centinari
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gas exchange ,invasive insect ,Lycorma delicatula ,nonstructural carbohydrates ,plant‐insect interactions ,source‐sink relationships ,Botany ,QK1-989 - Abstract
Abstract Spotted lanternfly (Lycorma delicatula White; SLF) is a phloem‐feeding planthopper invasive to the Eastern United States that can feed on a range of wild and cultivated plant species. Since its 2014 introduction in the United States, large infestations and subsequent economic damage have been reported in cultivated grapevines, but no studies have detailed grapevine physiological responses to SLF phloem feeding. This study investigated grapevine‐SLF interactions, detailing how different infestation densities affect leaf gas exchange and end‐season concentrations of nonstructural carbohydrates and nitrogen in vegetative and perennial tissues of two Vitis species. Effects on fruit ripeness parameters and dormant bud freeze tolerance were examined, in addition to other year‐after effects. Phloem feeding by low densities (≤4 SLF shoot−1) had minimal effects, whereas greater densities (5–15 SLF shoot−1) increasingly affected carbohydrate and nitrogen dynamics in both Vitis species. Phloem feeding substantially affected starch and, to a lesser extent, total nitrogen concentrations of woody roots. Prolonged exposure strongly reduced leaf gas exchange. We conclude that intensive late‐season phloem feeding by large adult SLF population densities (≥8 SLF shoot−1) can induce carbon limitation, with the potential for negative year‐after effects in cases of severe belowground carbon depletion. This work presents novel insights into SLF‐grapevine interactions, identifies avenues of future SLF‐plant research, and assists the development of action thresholds for SLF management in vineyards.
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- 2022
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10. A pilot radiogenomic study of DIPG reveals distinct subgroups with unique clinical trajectories and therapeutic targets
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Xiaoting Zhu, Margot A. Lazow, Austin Schafer, Allison Bartlett, Shiva Senthil Kumar, Deepak Kumar Mishra, Phillip Dexheimer, Mariko DeWire, Christine Fuller, James L. Leach, Maryam Fouladi, and Rachid Drissi
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Radiogenomics ,DIPG ,Serial MR imaging ,Overall survival ,Molecular subgrouping ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract An adequate understanding of the relationships between radiographic and genomic features in diffuse intrinsic pontine glioma (DIPG) is essential, especially in the absence of universal biopsy, to further characterize the molecular heterogeneity of this disease and determine which patients are most likely to respond to biologically-driven therapies. Here, a radiogenomics analytic approach was applied to a cohort of 28 patients with DIPG. Tumor size and imaging characteristics from all available serial MRIs were evaluated by a neuro-radiologist, and patients were divided into three radiographic response groups (partial response [PR], stable disease [SD], progressive disease [PD]) based on MRI within 2 months of radiotherapy (RT) completion. Whole genome and RNA sequencing were performed on autopsy tumor specimens. We report several key, therapeutically-relevant findings: (1) Certain radiologic features on first and subsequent post-RT MRIs are associated with worse overall survival, including PD following irradiation as well as present, new, and/or increasing peripheral ring enhancement, necrosis, and diffusion restriction. (2) Upregulation of EMT-related genes and distant tumor spread at autopsy are observed in a subset of DIPG patients who exhibit poorer radiographic response to irradiation and/or higher likelihood of harboring H3F3A mutations, suggesting possible benefit of upfront craniospinal irradiation. (3) Additional genetic aberrations were identified, including DYNC1LI1 mutations in a subgroup of patients with PR on post-RT MRI; further investigation into potential roles in DIPG tumorigenesis and/or treatment sensitivity is necessary. (4) Whereas most DIPG tumors have an immunologically “cold” microenvironment, there appears to be a subset which harbor a more inflammatory genomic profile and/or higher mutational burden, with a trend toward improved overall survival and more favorable radiographic response to irradiation, in whom immunotherapy should be considered. This study has begun elucidating relationships between post-RT radiographic response with DIPG molecular profiles, revealing radiogenomically distinct subgroups with unique clinical trajectories and therapeutic targets.
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- 2021
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11. Neuronal Circuits Supporting Development of Visual Naming Revealed by Intracranial Coherence Modulations
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Ravindra Arya, Brian Ervin, Jason Buroker, Hansel M. Greiner, Anna W. Byars, Leonid Rozhkov, Jesse Skoch, Paul S. Horn, Clayton Frink, Craig Scholle, James L. Leach, Francesco T. Mangano, Tracy A. Glauser, and Katherine D. Holland
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language development ,brain networks ,intracranial EEG ,neuronal connectivity ,stereo EEG ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
BackgroundImprovement in visual naming abilities throughout the childhood and adolescence supports development of higher-order linguistic skills. We investigated neuronal circuits underlying improvement in the speed of visual naming with age, and age-related dynamics of these circuits.MethodsResponse times were electronically measured during an overt visual naming task in epilepsy patients undergoing stereo-EEG monitoring. Coherence modulations among pairs of neuroanatomic parcels were computed and analyzed for relationship with response time and age.ResultsDuring the overt visual naming task, mean response time (latency) significantly decreased from 4 to 23 years of age. Coherence modulations during visual naming showed that increased connectivity between certain brain regions, particularly that between left fusiform gyrus/left parahippocampal gyrus and left frontal operculum, is associated with improvement in naming speed. Also, decreased connectivity in other brain regions, particularly between left angular and supramarginal gyri, is associated with decreased mean response time. Further, coherence modulations between left frontal operculum and both left fusiform and left posterior cingulate gyri significantly increase, while that between left angular and supramarginal gyri significantly decrease, with age.ConclusionNaming speed continues to improve from pre-school years into young adulthood. This age-related improvement in efficiency of naming environmental objects occurs likely because of strengthened direct connectivity between semantic and phonological nodes, and elimination of intermediate higher-order cognitive steps.
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- 2022
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12. mTOR activity is essential for retinal pigment epithelium regeneration in zebrafish.
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Fangfang Lu, Lyndsay L Leach, and Jeffrey M Gross
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Genetics ,QH426-470 - Abstract
The retinal pigment epithelium (RPE) plays numerous critical roles in maintaining vision and this is underscored by the prevalence of degenerative blinding diseases like age-related macular degeneration (AMD), in which visual impairment is caused by progressive loss of RPE cells. In contrast to mammals, zebrafish possess the ability to intrinsically regenerate a functional RPE layer after severe injury. The molecular underpinnings of this regenerative process remain largely unknown yet hold tremendous potential for developing treatment strategies to stimulate endogenous regeneration in the human eye. In this study, we demonstrate that the mTOR pathway is activated in RPE cells post-genetic ablation. Pharmacological and genetic inhibition of mTOR activity impaired RPE regeneration, while mTOR activation enhanced RPE recovery post-injury, demonstrating that mTOR activity is essential for RPE regeneration in zebrafish. RNA-seq of RPE isolated from mTOR-inhibited larvae identified a number of genes and pathways dependent on mTOR activity at early and late stages of regeneration; amongst these were components of the immune system, which is emerging as a key regulator of regenerative responses across various tissue and model systems. Our results identify crosstalk between macrophages/microglia and the RPE, wherein mTOR activity is required for recruitment of macrophages/microglia to the RPE injury site. Macrophages/microglia then reinforce mTOR activity in regenerating RPE cells. Interestingly, the function of macrophages/microglia in maintaining mTOR activity in the RPE appeared to be inflammation-independent. Taken together, these data identify mTOR activity as a key regulator of RPE regeneration and link the mTOR pathway to immune responses in facilitating RPE regeneration.
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- 2022
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13. Solutions of Magnetohydrodynamics Equation through Symmetries.
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Rangasamy Sinuvasan, Amlan K. Halder, Rajeswari Seshadri, Andronikos Paliathanasis, and Peter G. L. Leach
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- 2023
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14. Altered Functional and Structural Connectomes in Female High School Soccer Athletes After a Season of Head Impact Exposure and the Effect of a Novel Collar.
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Jonathan Dudley, Weihong Yuan, Jed A. Diekfuss, Kim D. Barber Foss, Christopher A. Dicesare, Mekibib Altaye, Kelsey Logan, James L. Leach, and Gregory D. Myer
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- 2020
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15. Ice Sheets and Fresh Water Reservoirs as Natural Dielectric Resonators.
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Alexander G. Voronovich, Scott W. Abbott, Paul E. Johnston, Richard J. Lataitis, Jesse L. Leach, and Robert J. Zamora
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- 2020
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16. Singularity analysis of a variant of the Painlevé-Ince equation.
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Amlan K. Halder, Andronikos Paliathanasis, and Peter G. L. Leach
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- 2019
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17. The Greenland Ice Sheet as a Dielectric Resonator.
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Alexander G. Voronovich, Scott W. Abbott, Paul E. Johnston, Richard J. Lataitis, Jesse L. Leach, and Robert J. Zamora
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- 2018
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18. Symmetries, travelling-wave and self-similar solutions of the Burgers hierarchy.
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Rangasamy Sinuvasan, K. M. Tamizhmani, and Peter G. L. Leach
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- 2017
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19. Eliciting an offence narrative: what types of questions do forensic mental health practitioners ask?
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Chelsea L. Leach, Francesca Brown, Luke Pryor, Martine Powell, and Scott Harden
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Psychiatry and Mental health ,Psychology (miscellaneous) ,Law ,Pathology and Forensic Medicine - Published
- 2022
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20. Comparing electrical stimulation functional mapping with subdural electrodes and stereoelectroencephalography
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Gewalin Aungaroon, Kishore Vedala, Anna W. Byars, Brian Ervin, Leonid Rozhkov, Paul S. Horn, S. K. Z. Ihnen, Katherine D. Holland, Jeffrey R. Tenney, Kelly Kremer, Susan L. Fong, Nan Lin, Wei Liu, Todd M. Arthur, Hisako Fujiwara, Jesse Skoch, James L. Leach, Francesco T. Mangano, Hansel M. Greiner, and Ravindra Arya
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Neurology ,Neurology (clinical) - Published
- 2023
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21. Algebraic resolution of the Burgers equation with a forcing term
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SINUVASAN, R, TAMIZHMANI, K M, and L LEACH, P G
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- 2017
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22. Regeneration of the zebrafish retinal pigment epithelium after widespread genetic ablation.
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Nicholas J Hanovice, Lyndsay L Leach, Kayleigh Slater, Ana E Gabriel, Dwight Romanovicz, Enhua Shao, Ross Collery, Edward A Burton, Kira L Lathrop, Brian A Link, and Jeffrey M Gross
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Genetics ,QH426-470 - Abstract
The retinal pigment epithelium (RPE) is a specialized monolayer of pigmented cells within the eye that is critical for maintaining visual system function. Diseases affecting the RPE have dire consequences for vision, and the most prevalent of these is atrophic (dry) age-related macular degeneration (AMD), which is thought to result from RPE dysfunction and degeneration. An intriguing possibility for treating RPE degenerative diseases like atrophic AMD is the stimulation of endogenous RPE regeneration; however, very little is known about the mechanisms driving successful RPE regeneration in vivo. Here, we developed a zebrafish transgenic model (rpe65a:nfsB-eGFP) that enabled ablation of large swathes of mature RPE. RPE ablation resulted in rapid RPE degeneration, as well as degeneration of Bruch's membrane and underlying photoreceptors. Using this model, we demonstrate for the first time that zebrafish are capable of regenerating a functional RPE monolayer after RPE ablation. Regenerated RPE cells first appear at the periphery of the RPE, and regeneration proceeds in a peripheral-to-central fashion. RPE ablation elicits a robust proliferative response in the remaining RPE. Subsequently, proliferative cells move into the injury site and differentiate into RPE. BrdU incorporation assays demonstrate that the regenerated RPE is likely derived from remaining peripheral RPE cells. Pharmacological disruption using IWR-1, a Wnt signaling antagonist, significantly reduces cell proliferation in the RPE and impairs overall RPE recovery. These data demonstrate that the zebrafish RPE possesses a robust capacity for regeneration and highlight a potential mechanism through which endogenous RPE regenerate in vivo.
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- 2019
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23. Volumetric endpoints in diffuse intrinsic pontine glioma: comparison to cross-sectional measures and outcome correlations in the International DIPG/DMG Registry
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Margot A Lazow, Martijn T Nievelstein, Adam Lane, Pratiti Bandopadhayhay, Mariko DeWire-Schottmiller, Maryam Fouladi, John W Glod, Robert J Greiner, Lindsey M Hoffman, Trent R Hummel, Lindsay Kilburn, Sarah Leary, Jane E Minturn, Roger Packer, David S Ziegler, Brooklyn Chaney, Katie Black, Peter de Blank, and James L Leach
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Cancer Research ,Cross-Sectional Studies ,Glutamates ,Oncology ,Diffuse Intrinsic Pontine Glioma ,Brain Stem Neoplasms ,Humans ,Glioma ,Registries ,Neurology (clinical) ,Astrocytoma ,Pediatric Neuro-Oncology - Abstract
Background Cross-sectional tumor measures are traditional clinical trial endpoints; however volumetric measures may better assess tumor growth. We determined the correlation and compared the prognostic impact of cross-sectional and volumetric measures of progressive disease (PD) among patients with DIPG. Methods Imaging and clinical data were abstracted from the International DIPG Registry. Tumor volume and cross-sectional product (CP) were measured with mint Lesion™ software using manual contouring. Correlation between CP and volume (segmented and mathematical [ellipsoid] model) thresholds of PD were assessed by linear regression. Landmark analyses determined differences in survival (via log-rank) between patients classified as PD versus non-PD by CP and volumetric measurements at 1, 3, 5, 7, and 9 months postradiotherapy (RT). Hazard ratios (HR) for survival after these time points were calculated by Cox regression. Results A total of 312 MRIs (46 patients) were analyzed. Comparing change from the previous smallest measure, CP increase of 25% (PD) correlated with a segmented volume increase of 30% (R2 = 0.710), rather than 40% (spherical model extrapolation). CP-determined PD predicted survival at 1 month post-RT (HR = 2.77), but not other time points. Segmented volumetric-determined PD (40% threshold) predicted survival at all imaging timepoints (HRs = 2.57, 2.62, 3.35, 2.71, 16.29), and 30% volumetric PD threshold predicted survival at 1, 3, 5, and 9 month timepoints (HRs = 2.57, 2.62, 4.65, 5.54). Compared to ellipsoid volume, segmented volume demonstrated superior survival associations. Conclusions Segmented volumetric assessments of PD correlated better with survival than CP or ellipsoid volume at most time points. Semiautomated tumor volume likely represents a more accurate, prognostically-relevant measure of disease burden in DIPG.
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- 2022
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24. Accuracy of central neuro-imaging review of DIPG compared with histopathology in the International DIPG Registry
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Jane E. Minturn, Ayman El-Sheikh, Gustavo Sevlever, Michelle Monje-Deisseroth, Hetal Dholaria, Karen Tsui, Maryam Fouladi, Pratiti Bandopadhayay, Cynthia Hawkins, Scott L Coven, Lindsay Kilburn, Christopher L. Tinkle, David S. Ziegler, Eric Sandler, Yvan Samson, Jordan R. Hansford, Eric Bouffet, Sylvia Cheng, Sridharan Gururangan, Kathleen Dorris, Tim Hassall, Mohamed S. Zaghloul, Carl Koschmann, Sarah Leary, Mercedes Garcia Lombardi, Blaise V. Jones, Paul G. Fisher, Anthony Asher, Rachid Drissi, Blanca Diez, Kenneth J. Cohen, Jie Ma, Adriana Fonseca, Katie Black, Nicholas G. Gottardo, Stewart Goldman, Christine E. Fuller, Tabitha Cooney, Moatasem El-Ayadi, Adam Lane, Brooklyn Chaney, Mariko DeWire, Robert J. Greiner, Ute Bartels, Margot A Lazow, James L. Leach, Lars M. Wagner, and Roger J. Packer
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Cancer Research ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Cancer ,Autopsy ,Glioma ,Astrocytoma ,medicine.disease ,Tissue acquisition ,Glutamates ,Oncology ,Neuroimaging ,Biopsy ,medicine ,Medical imaging ,Brain Stem Neoplasms ,Humans ,Histopathology ,Registries ,Neurology (clinical) ,Radiology ,Medical diagnosis ,business ,Pediatric Neuro-Oncology - Abstract
Background Diffuse intrinsic pontine glioma (DIPG) remains a clinico-radiologic diagnosis without routine tissue acquisition. Reliable imaging distinction between DIPG and other pontine tumors with potentially more favorable prognoses and treatment considerations is essential. Methods Cases submitted to the International DIPG registry (IDIPGR) with histopathologic and/or radiologic data were analyzed. Central imaging review was performed on diagnostic brain MRIs (if available) by two neuro-radiologists. Imaging features suggestive of alternative diagnoses included nonpontine origin, Results Among 286 patients with pathology from biopsy and/or autopsy, 23 (8%) had histologic diagnoses inconsistent with DIPG, most commonly nondiffuse low-grade gliomas and embryonal tumors. Among 569 patients with centrally-reviewed diagnostic MRIs, 40 (7%) were classified as non-DIPG, alternative diagnosis suspected. The combined analysis included 151 patients with both histopathology and centrally-reviewed MRI. Of 77 patients with imaging classified as characteristic of DIPG, 76 (99%) had histopathologic diagnoses consistent with DIPG (infiltrating grade II-IV gliomas). Of 57 patients classified as likely DIPG with some unusual imaging features, 55 (96%) had histopathologic diagnoses consistent with DIPG. Of 17 patients with imaging features suggestive of an alternative diagnosis, eight (47%) had histopathologic diagnoses inconsistent with DIPG (remaining patients were excluded due to nonpontine tumor origin). Association between central neuro-imaging review impression and histopathology was significant (p < 0.001), and central neuro-imaging impression was prognostic of overall survival. Conclusions The accuracy and important role of central neuro-imaging review in confirming the diagnosis of DIPG is demonstrated.
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- 2021
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25. Evaluation of the Effectiveness of Newer Helmet Designs with Emergent Shell and Padding Technologies Versus Older Helmet Models for Preserving White Matter Following a Season of High School Football
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Eric A. Nauman, Joseph F. Clark, Gregory D. Myer, Mekibib Altaye, Jed A. Diekfuss, Thomas M. Talavage, Matthew B. Panzer, Alexis B. Slutsky-Ganesh, James L. Leach, Christopher A. DiCesare, Scott Bonnette, Marc Galloway, Manish Anand, Mathew W Pombo, Kyle E. Hammond, Jonathan Dudley, Joseph D. Lamplot, and Weihong Yuan
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medicine.medical_specialty ,biology ,business.industry ,Head impact ,Athletes ,Radial diffusivity ,Biomedical Engineering ,Football ,biology.organism_classification ,White matter ,medicine.anatomical_structure ,Physical medicine and rehabilitation ,Fractional anisotropy ,Medicine ,business ,human activities ,Diffusion MRI - Abstract
We aimed to objectively compare the effects of wearing newer, higher-ranked football helmets (HRank) vs. wearing older, lower-ranked helmets (LRank) on pre- to post-season alterations to neuroimaging-derived metrics of athletes' white matter. Fifty-four high-school athletes wore an HRank helmet, and 62 athletes wore an LRank helmet during their competitive football season and completed pre- and post-season diffusion tensor imaging (DTI). Longitudinal within- and between-group DTI metrics [fractional anisotropy (FA) and mean/axial/radial diffusivity (MD, AD, RD)] were analyzed using tract-based spatial statistics. The LRank helmet group exhibited significant pre- to post-season reductions in MD, AD, and RD, the HRank helmet group displayed significant pre- to post-season increases in FA, and both groups showed significant pre- to post-season increases in AD (p's < .05 [corrected]). Between-group analyses revealed the pre- to post-season increase in AD was significantly less for athletes wearing HRank compared to LRank (p < .05 [corrected]). These data provide in vivo evidence that wearing an HRank helmet may be efficacious for preserving white matter from head impact exposure during high school football. Future prospective longitudinal investigations with complimentary imaging and behavioral outcomes are warranted to corroborate these initial in vivo findings.
- Published
- 2021
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26. Lie algebra of coupled higher-dimensional forced Burgers’ equation
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P. G. L. Leach, R. Sinuvasan, Kyriakos Charalambous, and Amlan K. Halder
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Physics ,Forcing (recursion theory) ,General Mathematics ,Lie algebra ,Symmetry (physics) ,Burgers' equation ,Term (time) ,Mathematical physics - Abstract
Symmetry analysis of coupled higher-dimensional forced Burgers’ equation is investigated for various cases. The Lie algebra for the various cases of forcing terms is investigated. Interestingly, for a linear forcing term, the symmetry analysis leads to the Ermakov–Pinney equation and time-dependent oscillator equation.
- Published
- 2021
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27. Does central nervous system dysfunction underlie patellofemoral pain in young females? Examining brain functional connectivity in association with patient‐reported outcomes
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Jonathan Dudley, Paul J. Gubanich, Scott Bonnette, Gregory D. Myer, Weihong Yuan, Alexis B. Slutsky-Ganesh, Robert C. Coghill, Emma Hansen, Kelsey Logan, Kate Berz, Jed A. Diekfuss, Kim D. Barber Foss, Dustin R. Grooms, Anna J. Saltman, James L. Leach, and Katharine S. Nissen
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Functional connectivity ,Central nervous system ,Brain ,Pain ,medicine.disease ,Magnetic Resonance Imaging ,Knee pain ,medicine.anatomical_structure ,Physical medicine and rehabilitation ,Patellofemoral Pain Syndrome ,medicine ,Musculoskeletal injury ,Humans ,Female ,Orthopedics and Sports Medicine ,Clinical significance ,Patient Reported Outcome Measures ,medicine.symptom ,Abnormality ,business ,Association (psychology) ,Functional magnetic resonance imaging - Abstract
Patellofemoral pain (PFP) is defined as retro- or peri-patellar knee pain without a clear structural abnormality. Unfortunately, many current treatment approaches fail to provide long-term pain relief, potentially due to an incomplete understanding of pain-disrupted sensorimotor dysfunction within the central nervous system. The purposes of this study were to evaluate brain functional connectivity in participants with and without PFP, and to determine the relationship between altered brain functional connectivity in association with patient-reported outcomes. Young female patients with PFP (n = 15; 14.3 ± 3.2 years) completed resting-state functional magnetic resonance imaging (rs-fMRI) and patient-reported outcome measures. Each patient with PFP was matched with two controls (n = 30, 15.5 ± 1.4 years) who also completed identical rs-fMRI testing. Six bilateral seeds important for pain and sensorimotor control were created, and seed-to-voxel analyses were conducted to compare functional connectivity between the two groups, as well as to determine the relationship between connectivity alterations and patient-reported outcomes. Relative to controls, patients with PFP exhibited altered functional connectivity between regions important for pain, psychological functioning, and sensorimotor control, and the connectivity alterations were related to perceived disability, dysfunction, and kinesiophobia. The present results support emergent evidence that PFP is not localized to structural knee dysfunction, but may actually be resultant to altered central neural processes. Clinical significance: These data provide potential neuro-therapeutic targets for novel therapies aimed to reorganize neural processes, improve neuromuscular function, and restore an active pain-free lifestyle in young females with PFP.
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- 2021
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28. New insights into singularity analysis
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Amlan K. Halder, Peter G. L. Leach, and Andronikos Paliathanasis
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Surface (mathematics) ,Integrable system ,Applied Mathematics ,Constant of integration ,Mathematical analysis ,Computational Mechanics ,General Physics and Astronomy ,Statistical and Nonlinear Physics ,Lie point symmetry ,Complex space ,Mechanics of Materials ,Consistency (statistics) ,Modeling and Simulation ,Closed-form expression ,Constant (mathematics) ,Engineering (miscellaneous) ,Mathematics - Abstract
In this work, we emphasize the use of singularity analysis in obtaining analytic solutions for equations for which standard Lie point symmetry analysis fails to make any lucid decision. We study the higher-dimensional Kadomtsev–Petviashvili, Boussinesq, and Kaup–Kupershmidt equations in a more general sense. With higher-order equations, there can be a commensurate number of resonances and when consistency for the full equation is examined at each resonance the constant of integration is supposed to vanish from the expression so that it remains arbitrary, but if there is an instance of this not happening, the consistency can be partially established by giving the offending constant the value from the defining equation. If consistency is otherwise not compromised, the equation can be said to be partially integrable, i.e., integrable on a surface of the complex space. Furthermore, we propose an approach that is meant to magnify the scope of singularity analysis for equations admitting higher values for resonances or positive leading-order exponent.
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- 2021
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29. Application of symmetry and singularity analyses to mathematical models of biological systems.
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A. Maharaj and Peter G. L. Leach
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- 2014
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30. Algebraic resolution of equations of the Black-Scholes type with arbitrary time-dependent parameters.
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K. M. Tamizhmani, K. Krishnakumar, and Peter G. L. Leach
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- 2014
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31. Prevalence of potentially inappropriate medications and prescription dynamics in elderly hospitalized patients in Spain
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T. Puig, L. Leache, N. M. González-Senac, E. Carreras, M. Gutiérrez-Valencia, L. Losa, J. L. Revuelta-Herrero, P. Marrero-Álvarez, M. de Miguel, A. Aguirrezabal Arredondo, A. Aranguren, A. Vilariño, V. E. Ruiz, I. Fernández, J. Bilbao, C. González-Guerrero, B. del Pino, N. Garin, and on behalf of the MAPAC-MPC Network
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Inappropriate prescribing ,Aged ,Inpatients ,Patient discharge ,Geriatrics ,RC952-954.6 - Abstract
Abstract Purpose In recent years, the need for a more appropriate prescription of medications in the older population has emerged as a significant public health concern. In this study, we aimed to evaluate the prevalence of potentially inappropriate medications (PIM) in hospitalized adults aged ≥ 75. Patients and methods This was a retrospective descriptive observational study of patients at 16 hospitals in Spain. The study population included inpatients aged ≥ 75 admitted during a 7-day period (May 10 to 16, 2021). Data were obtained from the pharmacy databases of the participating hospitals. The list of PIMs was based on the Beers, STOPP-START, EU-PIM and PRISCUS criteria. Results A total of 4,183 patients were included. PIMs were detected in 23.5% (N = 1,126) of the cohort. The prevalence rates at the participating hospitals ranged from 10% to 42.5%. The PIM/patient ratio was 1.2. The most common PIMs were midazolam, dexketoprofen, diazepam, and doxazosin, all of which (except for doxazosin) were more common in women. Benzodiazepines accounted for 70% of all PIMs. In 35% of cases, the PIMs were initiated before hospital admission. Of the 818 PIMs initiated during hospitalization, the two most common were benzodiazepines (49%) and anti-inflammatory drugs (25%). At discharge, only 4.9% of the PIMs initiated during the hospital stay were still prescribed. Conclusion In this population of older hospitalized patients, the overall prevalence of PIMs was moderate. However, the prevalence rate at the participating hospitals was highly variable. In most cases, PIMs prescribed prior to hospitalization for chronic conditions were not withdrawn during the hospital stay. No significant increase in PIMs was observed from pre-admission to post-discharge. These findings underscore the need for multidisciplinary interventions to optimize the pharmaceutical treatment in older adults in the hospital setting to reduce the consequences of PIMs in patients.
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- 2024
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32. Extraneural Metastases of Diffuse Midline Glioma, H3 K27M-Mutant at Diagnosis: Case Report, Review of the Literature, and Identifying Targetable Alterations
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John C. Breneman, Margot A Lazow, James L. Leach, Christine E. Fuller, Andrew T. Trout, and Maryam Fouladi
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Pathology ,medicine.medical_specialty ,Brain Neoplasms ,business.industry ,Central nervous system ,Pulmonary disease ,Glioma ,Hematology ,Disease ,Astrocytoma ,Tp53 mutation ,Extraneural ,medicine.disease ,Histones ,Pediatric patient ,medicine.anatomical_structure ,Oncology ,Mutation ,Pediatrics, Perinatology and Child Health ,medicine ,Humans ,Child ,business - Abstract
Extraneural metastases are rare in pediatric high-grade gliomas and little is known about the genomic profiles of tumors that disseminate beyond the central nervous system. We describe a pediatric patient with H3 K27M-mutant diffuse midline glioma of the brain and spine with biopsy-confirmed osseous metastases present at diagnosis and suspected metastatic parenchymal pulmonary disease. Several potentially clinically and/or therapeutically relevant genomic alterations were identified, including H3F3A and TP53 mutations as well as MET, CDK6, EMSY, and PIK3CG amplifications. Sequencing is critical to improve our understanding of the molecular drivers of distant metastases and discover therapeutic targets that penetrate all disease sites.
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- 2021
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33. Enrichment of loss-of-function and copy number variants in ventricular cardiomyopathy genes in ‘lone’ atrial fibrillation
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Jacqueline S. Dron, Adam D. McIntyre, Stephen W. Scherer, Julieta Lazarte, Emma L. Leach, Robert A. Hegele, Zachary Laksman, Brett Trost, Jason D. Roberts, John F. Robinson, Jian Wang, Peter Leong-Sit, Lorne J. Gula, Allan C. Skanes, Henian Cao, and Janet Liew
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Heterozygote ,DNA Copy Number Variations ,Cardiomyopathy ,Context (language use) ,030204 cardiovascular system & hematology ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Clinical Research ,Physiology (medical) ,Atrial Fibrillation ,medicine ,Humans ,Genetic Predisposition to Disease ,Copy-number variation ,Loss function ,030304 developmental biology ,Sanger sequencing ,Genetics ,0303 health sciences ,business.industry ,Dilated cardiomyopathy ,Atrial fibrillation ,Odds ratio ,medicine.disease ,3. Good health ,Phenotype ,symbols ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Atrial fibrillation (AF) is a complex heritable disease whose genetic underpinnings remain largely unexplained, though recent work has suggested that the arrhythmia may develop secondary to an underlying atrial cardiomyopathy. We sought to evaluate for enrichment of loss-of-function (LOF) and copy number variants (CNVs) in genes implicated in ventricular cardiomyopathy in ‘lone’ AF. Methods and results Whole-exome sequencing was performed in 255 early onset ‘lone’ AF cases, defined as arrhythmia onset prior to 60 years of age in the absence of known clinical risk factors. Subsequent evaluations were restricted to 195 cases of European genetic ancestry, as defined by principal component analysis, and focused on a pre-defined set of 43 genes previously implicated in ventricular cardiomyopathy. Bioinformatic analysis identified 6 LOF variants (3.1%), including 3 within the TTN gene, among cases in comparison with 4 of 503 (0.80%) controls [odds ratio: 3.96; 95% confidence interval (CI): 1.11–14.2; P = 0.033]. Further, two AF cases possessed a novel heterozygous 8521 base pair TTN deletion, confirmed with Sanger sequencing and breakpoint validation, which was absent from 4958 controls (P = 0.0014). Subsequent cascade screening in two families revealed evidence of co-segregation of a LOF variant with ‘lone’ AF. Conclusion ‘Lone’ AF cases are enriched in rare LOF variants from cardiomyopathy genes, findings primarily driven by TTN, and a novel TTN deletion, providing additional evidence to implicate atrial cardiomyopathy as an AF genetic sub-phenotype. Our results also highlight that AF may develop in the context of these variants in the absence of a discernable ventricular cardiomyopathy.
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- 2021
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34. Symmetry analysis of a model for the exercise of a barrier option.
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John G. O'Hara, Christodoulos Sophocleous, and Peter G. L. Leach
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- 2013
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35. Symmetry and singularity analyses of some equations of the fifth and sixth order in the spatial variable arising from the modelling of thin films.
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K. Charalambous, Christodoulos Sophocleous, and Peter G. L. Leach
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- 2013
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36. Comparison of outcomes after stereoelectroencephalography and subdural grid monitoring in pediatric tuberous sclerosis complex
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Thomas Larrew, Jesse Skoch, S. Katie Z. Ihnen, Ravindra Arya, Katherine D. Holland, Jeffrey R. Tenney, Paul S. Horn, James L. Leach, Darcy A. Krueger, Hansel M. Greiner, and Francesco T. Mangano
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Drug Resistant Epilepsy ,Epilepsy ,Electroencephalography ,General Medicine ,Carotenoids ,Electrodes, Implanted ,Stereotaxic Techniques ,Treatment Outcome ,Seizures ,Tuberous Sclerosis ,Humans ,Surgery ,Anticonvulsants ,Neurology (clinical) ,Child ,Vitamin A ,Retrospective Studies - Abstract
OBJECTIVE Patients with tuberous sclerosis complex (TSC) epilepsy present with unique clinical challenges such as early seizure onset and high rates of intractability and multifocality. Although there are numerous studies about the safety and efficacy of stereoelectroencephalography (SEEG), this topic has not been studied in TSC patients who have distinct epilepsy profiles. The authors investigated subdural grid (SDG) and SEEG monitoring to determine whether these procedures lead to similar seizure and safety outcomes and to identify features unique to this pediatric population. METHODS TSC patients who underwent SDG or SEEG placement and a second epilepsy surgery during the period from 2007 to 2021 were included in this single-center retrospective cohort analysis. Various patient, hospitalization, and epilepsy characteristics were collected. RESULTS A total of 50 TSC patients were included in this study: 30 were included in the SDG cohort and 20 in the SEEG cohort. Baseline weekly seizure count did not significantly differ between the 2 groups (p = 0.412). The SEEG group had a greater mean baseline number of antiepileptic drugs (AEDs) (3.0 vs 2.0, p = 0.003), higher rate of previous surgical interventions (25% vs 0%, p = 0.007), and larger proportion of patients who underwent bilateral monitoring (50% vs 13.3%, p = 0.005). Despite this, there was no significant difference in seizure freedom between the SDG and SEEG cohorts. The mean reduction in seizure count was 84.9% and 47.8% of patients were seizure free at last follow-up (mean 79.4 months). SEEG trended toward being a safer procedure than SDG monitoring, with a shorter mean ICU stay (0.7 days vs 3.9 days, p < 0.001), lower blood transfusion rate (0% vs 13.3%, p = 0.140), and lower surgical complication rate (0% vs 10%, p = 0.265). CONCLUSIONS In the comparison of the SDG and SEEG cohorts, the SEEG group included patients who appeared to receive more aggressive management and have a higher rate of multifocality, more prior surgical interventions, more AEDs at baseline, and a higher rate of bilateral invasive monitoring. Despite this, the SEEG cohort had similar seizure outcomes and a trend toward increased safety. Based on these findings, SEEG appears to allow for monitoring of a wider breadth of TSC patients given its minimally invasive nature and its relative simplicity for monitoring numerous regions of the brain.
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- 2022
37. Hidden and Not So Hidden Symmetries.
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Peter G. L. Leach, Keshlan S. Govinder, and K. Andriopoulos
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- 2012
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38. Symmetry analysis of a model of stochastic volatility with time-dependent parameters.
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Christodoulos Sophocleous, John G. O'Hara, and Peter G. L. Leach
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- 2011
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39. A note on the integrability of the classical portfolio selection model.
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Viroshan Naicker, John G. O'Hara, and Peter G. L. Leach
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- 2010
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40. Is it Possible to Protect the Adolescent Brain with Internal Mechanisms from Repetitive Head Impacts: Results from a Phase II Single Cohort, Longitudinal, Self-Control Study
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James L. Leach, Christopher A. DiCesare, Gregory D. Myer, Jed A. Diekfuss, Weihong Yuan, Kim D. Barber Foss, Rhodri S. Lloyd, Kelsey Logan, and Mekibib Altaye
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medicine.medical_specialty ,business.industry ,Blood volume ,Thermal diffusivity ,Collar ,White matter ,medicine.anatomical_structure ,Internal medicine ,Cohort ,Cardiology ,population characteristics ,Medicine ,Clinical significance ,business ,Internal jugular vein ,Diffusion MRI - Abstract
To quantify the effects of an externally worn collar device for mitigating the influence of repetitive head impacts on alterations to diffusion tensor imaging (DTI) metrics of white matter. Fifteen female high-school soccer athletes (age: 14.00–16.98 yrs) completed pre- and post-season DTI over two consecutive years, including measures of diffusivity, changes in which may be associated with brain dysfunction. The collar was worn during year 1 (Yr1) but not during year 2 (Yr2). Athlete exposures (AEs) and head impact exposure were recorded over the competitive seasons. There were no significant differences in AEs or head impact exposures between Yr1 and Yr2 (P > 0.05). In Yr2, there was significant pre- to post-season mean diffusivity and/or axial diffusivity reduction in multiple WM regions (corrected P
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- 2021
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41. Diffusion tensor imaging in children following prenatal myelomeningocele repair and its predictive value for the need and timing of subsequent CSF diversion surgery for hydrocephalus
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Noa Rennert, Blaise V. Jones, Charles B. Stevenson, James L. Leach, Weihong Yuan, Francesco T. Mangano, Mykhailo Lovha, and Mekibib Altaye
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Male ,medicine.medical_specialty ,Meningomyelocele ,Genu of the corpus callosum ,Imaging biomarker ,Neuroimaging ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Fractional anisotropy ,medicine ,Humans ,Retrospective Studies ,Fetal Therapies ,Receiver operating characteristic ,business.industry ,Infant, Newborn ,Gestational age ,General Medicine ,medicine.disease ,Cerebrospinal Fluid Shunts ,Surgery ,Hydrocephalus ,Fetal Diseases ,Diffusion Tensor Imaging ,030220 oncology & carcinogenesis ,Female ,business ,030217 neurology & neurosurgery ,Diffusion MRI - Abstract
OBJECTIVEThe aim of this study was to investigate diffusion tensor imaging (DTI), an objective and noninvasive neuroimaging technique, for its potential as an imaging biomarker to predict the need and timing of CSF diversion surgery in patients after prenatal myelomeningocele (MMC) repair.METHODSThis was a retrospective analysis of data based on 35 pediatric patients after prenatal MMC repair (gestational age at birth 32.68 ± 3.42 weeks, range 24–38 weeks; 15 females and 20 males). A logistic regression analysis was used to classify patients to determine the need for CSF diversion surgery. The model performance was compared between using the frontooccipital horn ratio (FOHR) alone and using the FOHR combined with DTI values (the genu of the corpus callosum [gCC] and the posterior limb of the internal capsule [PLIC]). For patients who needed to be treated surgically, timing of the procedure was used as the clinical outcome to test the predictive value of DTI acquired prior to surgery based on a linear regression analysis.RESULTSSignificantly lower fractional anisotropy (FA) values in the gCC (p = 0.014) and PLIC (p = 0.037) and higher mean diffusivity (MD) values in the gCC (p = 0.013) were found in patients who required CSF diversion surgery compared with those who did not require surgery (all p values adjusted for age). Based on the logistic regression analysis, the FOHR alone showed an accuracy of performance of 0.69 and area under the receiver operating characteristic curve (AUC) of 0.60. The performance of the model was higher when DTI measures were used in the logistic regression model (accuracy = 0.77, AUC = 0.84 for using DTI values in gCC; accuracy = 0.75, AUC = 0.84 for using DTI values in PLIC). Combining the DTI values of the gCC or PLIC and FOHR did not improve the model performance when compared with using the DTI values alone. In patients who needed CSF diversion surgery, significant correlation was found between DTI values in the gCC and the time interval between imaging and surgery (FA: ρ = 0.625, p = 0.022; MD: ρ = −0.6830, p = 0.010; both adjusted for age and FOHR).CONCLUSIONSThe authors’ data demonstrated that DTI could potentially serve as an objective biomarker differentiating patients after prenatal MMC repair regarding those who may require surgery for MMC-associated hydrocephalus. The predictive value for the need and timing of CSF diversion surgery is highly clinically relevant for improving and optimizing decision-making for the treatment of hydrocephalus in this patient population.
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- 2021
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42. Overcoming barriers to establishing autopsy procurement programs in pediatric patients with central nervous system tumors: a call to develop regional centers
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Elizabeth Gilger, Mariko DeWire, Wanda Meriwether, Shiva Senthil Kumar, Dinah Meister, Maureen Gallagher, Trent R. Hummel, Lori Driver, Anthony Asher, Christine Fuller, Natasha Pillay-Smiley, Lindsey Hoffman, Rachid Drissi, Susan Jelinek, Ralph Salloum, Blaise V. Jones, James L. Leach, Lionel M L Chow, Peter de Blank, Satarupa Sengupta, Maryam Fouladi, Heather Ward, Bridget Kikta, Lili Miles, and Craig Erker
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Pediatric CNS tumor ,Cancer Research ,medicine.medical_specialty ,Neurology ,business.industry ,Translational research ,Autopsy ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Procurement ,Oncology ,030220 oncology & carcinogenesis ,Donation ,medicine ,Pediatric Brain Tumor ,Neurology (clinical) ,Medical emergency ,business ,030217 neurology & neurosurgery ,Patient education - Abstract
While autopsy-repository programs with a variety of pediatric central nervous system (CNS) tumor types are a critical resource for preclinical neuro-oncology research, few exist and there is no published guidance on how to develop one. The goal of this prospective Pediatric Brain Tumor Repository (PBTR) study was to develop such a program at Cincinnati Children’s Hospital Medical Center (CCHMC) and then publish the quantitative and experiential data as a guide to support the development of similar programs. Protocols and infrastructure were established—to educate oncologists and families, establish eligibility, obtain consent, address pre- and post-autopsy logistics (e.g., patient and tissue transportation), process and authenticate tissue samples, and collect and analyze data. Of the 129 pediatric CNS tumor patients at CCHMC who died between 2013 and 2018, 109 were eligible for our study. Of these, 74% (81 of 109) were approached for PBTR donation, and 68% (55 of 81) consented. In the final year of the study, approach and consent rates were 93% and 85%, respectively. Median time from death to autopsy (postmortem interval, PMI) was 10 h (range, 1.5–30). In the outpatient setting, PMI increased with distance (from the hospice/home where the patient died to CCHMC). In all patients, PMI appeared to be lower, when consent was obtained more than 24 h before death. Procurement of autopsy specimens need not be a barrier in neuro-oncology research. Regional centers, strict timing-of-consent, patient education, and dedicated staff are all needed to minimize PMI and, thereby, increase the value of the procured tissue for an array of basic and translational research applications.
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- 2021
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43. Geology and genesis of the Shalipayco evaporite-related Mississippi Valley-type Zn–Pb deposit, Central Peru: 3D geological modeling and C–O–S–Sr isotope constraints
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Craig A. Johnson, Caetano Juliani, Marianna G. N. Caran, Lena Virgínia Soares Monteiro, David L. Leach, and Saulo Batista de Oliveira
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Strontium ,Evaporite ,ISÓTOPOS ,Dolomite ,Geochemistry ,chemistry.chemical_element ,engineering.material ,Diagenesis ,chemistry.chemical_compound ,Geophysics ,Sphalerite ,chemistry ,Geochemistry and Petrology ,Galena ,engineering ,Carbonate ,Carbonate rock ,Economic Geology ,Geology - Abstract
The Shalipayco Zn–Pb deposit, in central Peru, is composed of several stratabound orebodies, the largest of which are the Resurgidora and Intermedios, contained in carbonate rocks of the Upper Triassic Chambara Formation, Pucara group. Petrography suggests that a single ore-forming episode formed sphalerite and galena within vugs, open spaces, and fractures. Three-dimensional (3D) geological modeling has allowed division of the Chambara Formation into four members (Chambara I, II, III, and IV) that better define lithological controls on sulfide formation. Diagenetic replacement of evaporite minerals with the organic matter (OM) presence likely generated secondary porosity and H2S accumulation by bacterial sulfate reduction (BSR), providing ground preparation for the later Zn–Pb mineralizing event. The least-altered host rocks have C–O isotope compositions of 1.8 ± 0.1‰ (VPDB) and 29.9 ± 2.1‰ (VSMOW), respectively, within the Triassic marine carbonate ranges. Early dolomite contains lighter C–O composition (1.1 ± 0.9 and 23.8 ± 2.9‰, respectively) consistent with OM decomposition during burial diagenesis. Post-mineralization calcite has still lighter C–O composition (− 5.1 and 13.3‰, respectively), suggesting meteoric water that had migrated through organic-rich strata. The strontium isotopes of Mitu group basalts (0.709654–0.719669) indicate it as a possible, but not the unique source of strontium and probably of other metals. Highly negative sulfide sulfur isotope values (− 23.3 to − 6.2‰ (VCDT)) indicate a major component of the ore sulfur derived ultimately from BSR. However, multiple lines of evidence suggest that preexisting H2S underwent thermochemical redox cycling prior to ore formation. The influx of hot metalliferous brines to dolomitized zones containing trapped H2S is the preferred model for ore deposition at Shalipayco.
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- 2021
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44. A pilot radiogenomic study of DIPG reveals distinct subgroups with unique clinical trajectories and therapeutic targets
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Austin Schafer, Maryam Fouladi, Phillip J. Dexheimer, Shiva Senthil Kumar, Margot A. Lazow, James L. Leach, Allison L. Bartlett, Rachid Drissi, Mariko DeWire, Xiaoting Zhu, Deepak Kumar Mishra, and Christine E. Fuller
- Subjects
Cytoplasmic Dyneins ,Male ,Oncology ,Radiation-Sensitizing Agents ,Neurology ,medicine.medical_treatment ,Radiogenomics ,Serial MR imaging ,Pilot Projects ,Disease ,medicine.disease_cause ,lcsh:RC346-429 ,Histones ,Proton Therapy ,Tumor Microenvironment ,Brain Stem Neoplasms ,Imaging Genomics ,Overall survival ,Child ,DNA Modification Methylases ,medicine.diagnostic_test ,Magnetic Resonance Imaging ,ErbB Receptors ,Survival Rate ,Chemotherapy, Adjuvant ,Child, Preschool ,Disease Progression ,DIPG ,Female ,Molecular subgrouping ,medicine.medical_specialty ,Epithelial-Mesenchymal Transition ,Adolescent ,Antineoplastic Agents ,Pathology and Forensic Medicine ,Young Adult ,Cellular and Molecular Neuroscience ,Internal medicine ,Biopsy ,medicine ,Humans ,lcsh:Neurology. Diseases of the nervous system ,Radiotherapy ,Whole Genome Sequencing ,Sequence Analysis, RNA ,business.industry ,Tumor Suppressor Proteins ,Research ,Diffuse Intrinsic Pontine Glioma ,Immunotherapy ,medicine.disease ,Radiation therapy ,DNA Repair Enzymes ,Neurology (clinical) ,Carcinogenesis ,business ,Progressive disease - Abstract
An adequate understanding of the relationships between radiographic and genomic features in diffuse intrinsic pontine glioma (DIPG) is essential, especially in the absence of universal biopsy, to further characterize the molecular heterogeneity of this disease and determine which patients are most likely to respond to biologically-driven therapies. Here, a radiogenomics analytic approach was applied to a cohort of 28 patients with DIPG. Tumor size and imaging characteristics from all available serial MRIs were evaluated by a neuro-radiologist, and patients were divided into three radiographic response groups (partial response [PR], stable disease [SD], progressive disease [PD]) based on MRI within 2 months of radiotherapy (RT) completion. Whole genome and RNA sequencing were performed on autopsy tumor specimens. We report several key, therapeutically-relevant findings: (1) Certain radiologic features on first and subsequent post-RT MRIs are associated with worse overall survival, including PD following irradiation as well as present, new, and/or increasing peripheral ring enhancement, necrosis, and diffusion restriction. (2) Upregulation of EMT-related genes and distant tumor spread at autopsy are observed in a subset of DIPG patients who exhibit poorer radiographic response to irradiation and/or higher likelihood of harboring H3F3A mutations, suggesting possible benefit of upfront craniospinal irradiation. (3) Additional genetic aberrations were identified, including DYNC1LI1 mutations in a subgroup of patients with PR on post-RT MRI; further investigation into potential roles in DIPG tumorigenesis and/or treatment sensitivity is necessary. (4) Whereas most DIPG tumors have an immunologically “cold” microenvironment, there appears to be a subset which harbor a more inflammatory genomic profile and/or higher mutational burden, with a trend toward improved overall survival and more favorable radiographic response to irradiation, in whom immunotherapy should be considered. This study has begun elucidating relationships between post-RT radiographic response with DIPG molecular profiles, revealing radiogenomically distinct subgroups with unique clinical trajectories and therapeutic targets.
- Published
- 2021
45. PROPERTIES OF A DIFFERENTIAL SEQUENCE BASED UPON THE KUMMER-SCHWARZ EQUATION
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Kostis Andriopoulos, Peter G. L. Leach, and Adhir Maharaj
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Pure mathematics ,Sequence ,differential sequence ,Singularity analysis ,singularity analysis ,General Engineering ,lie symmetries ,Singularity ,lcsh:TA1-2040 ,Homogeneous space ,Riccati equation ,Element (category theory) ,lcsh:Engineering (General). Civil engineering (General) ,Differential (mathematics) ,Mathematics ,Generator (mathematics) - Abstract
In this paper, we determine a recursion operator for the Kummer-Schwarz equation, which leads to a sequence with unacceptable singularity properties. A different sequence is devised based upon the relationship between the Kummer-Schwarz equation and the first-order Riccati equation for which a particular generator has been found to give interesting and excellent properties. We examine the elements of this sequence in terms of the usual properties to be investigated – symmetries, singularity properties, integrability, alternate sequence – and provide an explanation of the curious relationship between the results of the singularity analysis and a consideration of the solution of each element obtained by quadratures.
- Published
- 2020
46. Numerical Investigation of Natural Convection Viscoelastic Jeffrey’s Nanofluid Flow from a Vertical Permeable Flat Plate with Heat Generation, Thermal Radiation, and Chemical Reaction
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T. M. Agbaje and P. G. L. Leach
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Natural convection ,Article Subject ,Applied Mathematics ,02 engineering and technology ,Mechanics ,021001 nanoscience & nanotechnology ,Boundary layer thickness ,01 natural sciences ,010305 fluids & plasmas ,Boundary layer ,Nanofluid ,Flow velocity ,Thermal radiation ,Heat generation ,0103 physical sciences ,QA1-939 ,Fluid dynamics ,0210 nano-technology ,Mathematics ,Analysis - Abstract
The boundary layer flow of an incompressible viscoelastic Jeffrey’s nanofluid from a vertical permeable flat plate is investigated. We consider the effects of heat generation, thermal radiation, and chemical reaction on the fluid flow. The nonlinear transformed coupled differential equations that describe the transport processes are solved numerically using a multidomain bivariate spectral quasilinearization method (MD-BSQLM). This innovative method involves blending the quasilinearization idea with the bivariate Lagrange interpolation. The solutions of the resulting system of equations are then obtained sequentially on multiple intervals using the Chebyshev spectral collocation method. The method is shown to give accurate solutions for boundary layer-type equations. The influence of various physical parameters on velocity, temperature, and nanoparticle concentration fields, as well as on the skin friction and heat and mass transfer coefficients, is shown and discussed in detail. The range of the values of the governing parameters considered in this study is between 0 , 4 . For qualitative validation of the results and the numerical method used, calculations were carried out to graphically obtain the velocity, temperature, and nanoparticle concentration fields for selected physical parameter values. The results obtained were found to correlate with the results from published literature. For quantitative verification of our findings, the MD-BSQLM numerical solutions were again confirmed against published results reported in the literature, and the results were observed to be in perfect agreement. This study’s findings indicate that the Deborah number and suction parameter have related effects on the velocity profile, which is to suppress both the flow velocity and the momentum boundary layer thickness. Increasing the heat generation and thermal radiation parameters enhances both the temperature and thermal boundary layer depths. In contrast, an increase in the chemical reaction parameter causes a decrease in the fluid concentration.
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- 2020
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47. Symmetry analysis for a fourth-order noise-reduction partial differential equation
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Andronikos Paliathanasis and Peter G. L. Leach
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Partial differential equation ,Noise reduction ,010102 general mathematics ,Mathematical analysis ,Image processing ,010103 numerical & computational mathematics ,01 natural sciences ,Symmetry (physics) ,Mathematics (miscellaneous) ,Fourth order ,Homogeneous space ,Order (group theory) ,0101 mathematics ,Differential (infinitesimal) ,Mathematics - Abstract
We apply the theory of Lie symmetries in order to study a fourth-order 1+2 evolutionary partial differential equation which has been proposed for the image processing noise reduction. In particular ...
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- 2020
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48. A phase I/II study of ribociclib following radiation therapy in children with newly diagnosed diffuse intrinsic pontine glioma (DIPG)
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Blaise V. Jones, Luke Pater, Adam Lane, Trent R. Hummel, Shiva Senthil Kumar, Adam C. Carle, Ralph Salloum, James L. Leach, Phil Dexheimer, Christine Fuller, Charles B. Stevenson, David P. Witte, Maryam Fouladi, Mariko DeWire, Rachid Drissi, Sarah A. Lawson, Lionel M L Chow, Peter de Blank, John C. Breneman, and Xiaoting Zhu
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Oncology ,Cancer Research ,medicine.medical_specialty ,Neurology ,business.industry ,medicine.medical_treatment ,Ribociclib ,Newly diagnosed ,Neutropenia ,medicine.disease ,Radiation therapy ,03 medical and health sciences ,0302 clinical medicine ,Tolerability ,030220 oncology & carcinogenesis ,Internal medicine ,Glioma ,Toxicity ,medicine ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Cyclin-dependent kinase-retinoblastoma (CDK-RB) pathway is dysregulated in some diffuse intrinsic pontine gliomas (DIPG). We evaluated safety, feasibility, and early efficacy of the CDK4/6-inhibitor ribociclib, administered following radiotherapy in newly-diagnosed DIPG patients. Following radiotherapy, eligible patients received ribociclib in 28-day cycles (350 mg/m2; 21 days on/7 days off). Feasibility endpoints included tolerability for at least 6 courses, and a less than 2-week delay in restarting therapy after 1 dose reduction. Early efficacy was measured by 1-year and median overall survival (OS). Patient/parent-by-proxy reported outcomes measurement information system (PROMIS) assessments were completed prospectively. The study included 10 evaluable patients, 9 DIPG and 1 diffuse midline glioma (DMG)—all 3.7 to 19.8 years of age. The median number of courses was 8 (range 3–14). Three patients required dose reduction for grade-4 neutropenia, and 1 discontinued therapy for hematological toxicity following course 4. The most common grade-3/4 toxicity was myelosuppression. After 2 courses, MRI evaluations in 4 patients revealed increased necrotic volume, associated with new neurological symptoms in 3 patients. The 1-year and median OS for DIPG was 89% and 16.1 months (range 10–30), respectively; the DMG patient died at 6 months post-diagnosis. Five patients donated brain tissue and tumor; 3 were RB+ . Ribociclib administered following radiotherapy is feasible in DIPG and DMG. Increased tumor necrosis may represent a treatment effect. These data warrant further prospective volumetric analyses of tumors with necrosis. Feasibility and stabilization findings support further investigation of ribociclib in combination therapies. NCT02607124.
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- 2020
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49. Electrical stimulation sensorimotor mapping with stereo-EEG
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Jonathan Dudley, James L. Leach, Timothy Holloway, Paul S. Horn, Craig Scholle, Brian Ervin, Ravindra Arya, Leonid Rozhkov, Jason Buroker, Hansel M. Greiner, Francesco T. Mangano, Anna W. Byars, and Katherine D. Holland
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Male ,Drug Resistant Epilepsy ,medicine.medical_specialty ,Adolescent ,media_common.quotation_subject ,Stimulation ,Audiology ,Sensitivity and Specificity ,050105 experimental psychology ,Young Adult ,03 medical and health sciences ,Epilepsy ,0302 clinical medicine ,Neuroimaging ,Stereo eeg ,Physiology (medical) ,Perception ,medicine ,Humans ,0501 psychology and cognitive sciences ,Epilepsy surgery ,Child ,media_common ,Brain Mapping ,business.industry ,05 social sciences ,Motor control ,Electroencephalography ,medicine.disease ,Magnetic Resonance Imaging ,Electric Stimulation ,Sensory Systems ,Neurology ,Child, Preschool ,Diagnostic odds ratio ,Female ,Sensorimotor Cortex ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
We evaluated stereo-EEG electrical stimulation mapping (ESM) for localization of anatomic sensorimotor parcels in pediatric patients with drug-resistant epilepsy. We also analyzed sensorimotor and after-discharge thresholds, and the somatotopy of sensorimotor responses.ESM was performed with 50 Hz, biphasic, 2-3 s trains, using 1-9 mA current. Pre- and post-implant neuroimaging was co-registered and intersected with Neurosynth reference, to classify each electrode contact as lying within/outside an anatomic sensorimotor parcel. Indices of diagnostic performance were computed. Sensorimotor and after-discharge thresholds were analyzed using multivariable linear mixed models.In 15 patients (6 females), aged 5.5-21.2 years, ESM showed high accuracy (0.80), high specificity (0.86), and diagnostic odds ratio (11.4, p 0.0001) for localization of sensorimotor parcels. Mean sensorimotor threshold (3.4 mA) was below mean after-discharge threshold (4.2 mA, p = 0.0004). Sensorimotor and after-discharge thresholds showed a significant decrease with increasing intelligence quotient. Somatotopy of sensorimotor responses was mapped to standardized brain parcels.We provide evidence for diagnostic validity and safety of stereo-EEG sensorimotor ESM.The somatotopy of sensorimotor responses elicited with electrical stimulation provide new insights into mechanisms of motor control and sensory perception.
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- 2020
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50. Lie symmetry analysis and similarity solutions for the Jimbo – Miwa equation and generalisations
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Amlan K. Halder, Peter G. L. Leach, Rajeswari Seshadri, and Andronikos Paliathanasis
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Pure mathematics ,Similarity (geometry) ,010308 nuclear & particles physics ,Group (mathematics) ,Applied Mathematics ,010102 general mathematics ,Computational Mechanics ,General Physics and Astronomy ,Statistical and Nonlinear Physics ,Function (mathematics) ,01 natural sciences ,Hypergeometric distribution ,Symmetry (physics) ,Nonlinear Sciences::Exactly Solvable and Integrable Systems ,Perspective (geometry) ,Mechanics of Materials ,Mathematics::Quantum Algebra ,Modeling and Simulation ,0103 physical sciences ,Order (group theory) ,0101 mathematics ,Closed-form expression ,Engineering (miscellaneous) ,Mathematics - Abstract
We study the Jimbo – Miwa equation and two of its extended forms, as proposed by Wazwaz et al., using Lie’s group approach. Interestingly, the travelling – wave solutions for all the three equations are similar. Moreover, we obtain certain new reductions which are completely different for each of the three equations. For example, for one of the extended forms of the Jimbo – Miwa equation, the subsequent reductions leads to a second – order equation with Hypergeometric solutions. In certain reductions, we obtain simpler first – order and linearisable second – order equations, which helps us to construct the analytic solution as a closed – form function. The variation in the nonzero Lie brackets for each of the different forms of the Jimbo – Miwa also presents a different perspective. Finally, singularity analysis is applied in order to determine the integrability of the reduced equations and of the different forms of the Jimbo – Miwa equation.
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- 2020
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