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1. Myeloid-derived miR-6236 potentiates adipocyte insulin signaling and prevents hyperglycemia during obesity

Author

Bam D. Paneru, Julia Chini, Sam J. McCright, Nicole DeMarco, Jessica Miller, Leonel D. Joannas, Jorge Henao-Mejia, Paul M. Titchenell, David M. Merrick, Hee-Woong Lim, Mitchell A. Lazar, and David A. Hill

Subjects
Science
Abstract

Abstract Adipose tissue macrophages (ATMs) influence obesity-associated metabolic dysfunction, but the mechanisms by which they do so are not well understood. We show that miR-6236 is a bona fide miRNA that is secreted by ATMs during obesity. Global or myeloid cell-specific deletion of miR-6236 aggravates obesity-associated adipose tissue insulin resistance, hyperglycemia, hyperinsulinemia, and hyperlipidemia. miR-6236 augments adipocyte insulin sensitivity by inhibiting translation of negative regulators of insulin signaling, including PTEN. The human genome harbors a miR-6236 homolog that is highly expressed in the serum and adipose tissue of obese people. hsa-MIR-6236 expression negatively correlates with hyperglycemia and glucose intolerance, and positively correlates with insulin sensitivity. Together, our findings establish miR-6236 as an ATM-secreted miRNA that potentiates adipocyte insulin signaling and protects against metabolic dysfunction during obesity.

Published
2024
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2. Left hemisphere dominance for bilateral kinematic encoding in the human brain

Author

Christina M Merrick, Tanner C Dixon, Assaf Breska, Jack Lin, Edward F Chang, David King-Stephens, Kenneth D Laxer, Peter B Weber, Jose Carmena, Robert Thomas Knight, and Richard B Ivry

Subjects
lateralization, left hemisphere, motor control, praxis, ipsilateral, electrocorticography, Medicine, Science, Biology (General), QH301-705.5
Abstract

Neurophysiological studies in humans and nonhuman primates have revealed movement representations in both the contralateral and ipsilateral hemispheres. Inspired by clinical observations, we ask if this bilateral representation differs for the left and right hemispheres. Electrocorticography was recorded in human participants during an instructed-delay reaching task, with movements produced with either the contralateral or ipsilateral arm. Using a cross-validated kinematic encoding model, we found stronger bilateral encoding in the left hemisphere, an effect that was present during preparation and was amplified during execution. Consistent with this asymmetry, we also observed better across-arm generalization in the left hemisphere, indicating similar neural representations for right and left arm movements. Notably, these left hemisphere electrodes were centered over premotor and parietal regions. The more extensive bilateral encoding in the left hemisphere adds a new perspective to the pervasive neuropsychological finding that the left hemisphere plays a dominant role in praxis.

Published
2022
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3. Hybrid dedicated and distributed coding in PMd/M1 provides separation and interaction of bilateral arm signals.

Author

Tanner C Dixon, Christina M Merrick, Joni D Wallis, Richard B Ivry, and Jose M Carmena

Subjects
Biology (General), QH301-705.5
Abstract

Pronounced activity is observed in both hemispheres of the motor cortex during preparation and execution of unimanual movements. The organizational principles of bi-hemispheric signals and the functions they serve throughout motor planning remain unclear. Using an instructed-delay reaching task in monkeys, we identified two components in population responses spanning PMd and M1. A "dedicated" component, which segregated activity at the level of individual units, emerged in PMd during preparation. It was most prominent following movement when M1 became strongly engaged, and principally involved the contralateral hemisphere. In contrast to recent reports, these dedicated signals solely accounted for divergence of arm-specific neural subspaces. The other "distributed" component mixed signals for each arm within units, and the subspace containing it did not discriminate between arms at any stage. The statistics of the population response suggest two functional aspects of the cortical network: one that spans both hemispheres for supporting preparatory and ongoing processes, and another that is predominantly housed in the contralateral hemisphere and specifies unilateral output.

Published
2021
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4. Clinical and radiographic predictors of successful therapeutic bronchoscopy for the relief of malignant central airway obstruction

Author

Coral X. Giovacchini, Edward R. Kessler, Christopher M. Merrick, Junheng Gao, Xiaofei Wang, Momen M. Wahidi, Scott L. Shofer, George Z. Cheng, and Kamran Mahmood

Subjects
Airway obstruction, Bronchial neoplasms, Bronchoscopy, Pulmonary surgical procedures, Tracheal stenosis, Diseases of the respiratory system, RC705-779
Abstract

Abstract Background Malignant central airway obstruction (CAO) occurs in approximately 20–30% of patients with lung cancer and is associated with debilitating symptoms and poor prognosis. Multimodality therapeutic bronchoscopy can relieve malignant CAO, though carries risk. Evidence to guide clinicians regarding which patients may benefit from such interventions is sparse. We aimed to assess the clinical and radiographic predictors associated with therapeutic bronchoscopy success in relieving malignant CAO. Methods We reviewed all cases of therapeutic bronchoscopy performed for malignant CAO at our institution from January 2010–February 2017. Therapeutic bronchoscopy success was defined as establishing airway patency of > 50%. Patient demographics and baseline characteristics, oncology history, degree of airway obstruction, procedural interventions, and complications were compared between successful and unsuccessful groups. Univariate and multivariate logistic regression identified the significant clinical and radiographic predictors for therapeutic success. The corresponding simple and conditional odds ratio were calculated. A time-to-event analysis with Kaplan–Meier plots was performed to estimate overall survival. Results During the study period, 301 therapeutic bronchoscopies were performed; 44 (14.6%) were considered unsuccessful. Factors associated with success included never vs current smoking status (OR 5.36, 95% CI:1.45–19.74, p = 0.010), patent distal airway on CT imaging (OR 15.11, 95% CI:2.98–45.83, p

Published
2019
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5. Abstracts

Author

C. A. Botero, C. E. Smith, C. Holbrook, A. C. Pinchak, David Johnson, Dorothy Thomson, Taras Mycyk, M. Burbridge, Irvin Mayers, nR. W. M. Wahba, F. Belque, S. J. Kleiman, Steven Parker, Peter Cox, Helen Holtby, Lawrence Roy, Marc A. St-Amand, John M. Murkin, Donna Baird, Donal B. Downey, Alan H. Menkis, Fan Yang, Éric Troncy, Martin Francœur, Marc Charbonneau, Patrick Vinay, Gilbert Blaise, William M. Splinter, David J. Roberts, Elliot J. Rhine, Helen B. MacNeill, Craig W. Reid, William PS McKay, Miklavs Erjavec, Benjamin W. S. McKay, Peter H. Gregson, Travis Blanchet, Guy Kember, Josée Lavoie, Daniel Vischoff, Louise Cyrenne, Edith Villeneuve, Pierre Williot, A. K. Raghupathy, R. Haug, B. Punjabi, F. Ditzig, Howard Melnik, Michael J. Tessler, L. Jill Krasner, David M. Corda, Kal Solanki, A. Joseph Layon, T. James Gallagher, Daniel P. Stoltzfus, Shannon L. Rabuka, Carol A. Moote, Robert J. B. Chen, Doreen A. Yee, Ellen Harrington, Beverley A. Orser, D. Mitch Giffin, Kenneth W. Gow, P. Terry Phang, Keith R. Walley, C. Brian Warriner, Matthew H. Cohen, Andrew J. Klahsen, Deirdre O’Reilly, John McBride, Margaret Ballantyne, Blair D. Goranson, Scott Lang, William N. Dust, Jeff McKerrell, Guy Martin, René Martin, Daniel Martin, Philippe Valet, Jean-Pierre Tétrault, Caroline Dagenais, Martine Pirlet, Dominique Dansereau, Pedro D’Orléans-Justes, Agnès Jankowska, Yves Veillette, Angela L. Mathieson, Howard Intrater, Lionel Cruickshank, P. C. Duke, B. Y. Ong, Vincent Woo, Donna Schimnowski, Sharon Trosky, Linda Dalton, Ibrahim Zabani, Colin R. Chilvers, Himat Vaghadia, Pamela M. Merrick, Ibrahim Kashkari, Hossam Al-Oufi, D. Jolly, B. T. Finucane, Wolfgang Weyland, Ulrich Fritz, Heike Landmann, Ingrid Schumacher, Michael English, Dietrich Kettler, Catherine M. Duffy, Pirjo H. Manninen, Frances Chung, Shanthini Sundar, Emilio B. Lobato, Orlando Florete, Glenn B. Paige, Thierry Daloze, Daniel A. Chartrand, Denis St-Laurent, Gordon S. Fox, Murray L. Rice, D. John Doyle, George A. Volgyesi, Joseph A. Fisher, Arthur Slutsky, Igor Salazkin, Karen A. Brown, Pradeep Kulkarni, Bibiana Cujec, Randy McCuaig, Tom Hurst, David Antecol, François Bellemare, Jacques Couture, Manon Marchand, Peter McNeil, Orlando Hung, Lily M. Ho-Tai, J. Hugh Devitt, Alva G. Noel, Michael P. O’Donnell, Robert J. Greenhow, Frank W. Cervenko, Brian Milne, Mark D. Peterson, Ian R. Thomson, Robert J. Hudson, Morley Rosenbloom, Michael Moon, Jitender Sareen, H. Locke Bingham, Steven B. Backman, Reuben D. Stein, C. Polosa, Michael Tessler, Salvatore M. Spadafora, John G. Fuller, Lisa Kim, Keyvan Karkouti, D. Keith Rose, Lorraine E. Ferris, DK Rose, MM Cohen, F. E. Ralley, B. DeVarennes, M. Robitaille, Norman Searle, Raymond Martineau, Peter Conzen, A. Al-Hasani, Tom Ebert, Michael Muzi, Jean-François Hardy, Sylvain Bélisle, André Couturier, Danielle Robitaille, Micheline Roy, Lyne Gagnon, Elisabeth J. Avraamides, P. J. Dryden, J. P. O’Connor, W. R. E. Jamieson, I. Reid, D. Ansley, H. Sadeghi, L. H. Burr, A. I. Munro, P. M. Merrick, Mark Benaroia, Andrew Baker, C. David Mazer, Lee Errett, Luc Frenette, Jerry Cox, Donna Kerns, Steve Pearce, David Mark, Paul McDonagh, Lulz DeLlma, Howard Nathan, Jean-Yves Dupuls, J.Earl Wynands, G. C. Moudgil, J. G. Johnson, G. M. Moudgil, Richard I. Hall, Connie MacLaren, M. J. Ali, M. Ballantyne, D. Norris, Stephen D. Beed, Eugene A. Menard, Leon P. Noel, Gary G. Bonn, William Clarke, H. Marion Gould, Leslie E. Hall, Philippe Bernard, Juan Bass, Ramona A. Kearney, Cheryl A. Mack, Lucy M. Entwistle, Joan C. Bevan, Andrew J. Macnab, Guy Veall, Colin Marsland, Craig R. Ries, Shahnaz K. Hamid, Ian R. Selby, Nancy Sikich, Elizabeth Hsu, Patricia McCarthy, Ching-Yue Yang, Wun-Chin Wu, Jiunn-Jye Huang, Shyu-Yin Chen, Hsiang-Ning Luk, Chok-Yung Chai, Gina K. Lafreniere, Donald G. Brunet, Joel L. Parlow, Hossam El-Beheiry, Aviv Ouanounou, Mary Morris, Peter Carlen, Pamela J. Morgan, Roger Chapados, Marlene Gauthier, John W. D. Knox, Jacques LeLorier, Roddy Lin, Keith Rose, Bernadette Garvey, Robert McBrobm, L. C. McAdam, J. F. MacDonald, B. A. Orser, Georgios koutsoukos, Susan Belo, Christopher A. Chin, Brendan O’Hare, Jerrold Lerman, Junko Endo, Arthur E. Schwartz, Oktavijan Minanov, J. Gilbert Stone, David C. Adams, Aqeel A. Sandhu, Mark E. Pearson, William L. Young, Robert E. Michler, Ernest Cutz, Matt M. Kurrek, Marsha M. Cohen, Kevin Fish, Pamela Fish, Patricia Murphy, Donald Fung, Alva Noel, John-Paul Szalai, Ari Robicsek, Joshua Rucker, Joshua Kruger, Mark Slutsky, Leeor Sommer, Jeff Silverman, Jodi Dickstein, Viren Naik, Douglas J. Hemphill, Regina Kurian, Khursheed N. Jeejeebhoy, Osama A. Alahdal, N. H. Badner, W. E. Komar, R. Bhandari, R. Craen, D. Cuillerier, W. B. Dobkowski, M. H. Smith, A. N. Vannelli, R. B. Bourne, C. H. Rorabeck, J. A. Doyle, Antoinette Corvo, Richard M. Wahba, Nathalie Scheffer, John Y. C. Tsang, Brad A. Brush, N. Q. N’Guyen, C. Orain, S. Tougui, G. Lavenac, D. Milon, Ewan D. Ritchie, Doris Tong, Andrew Norris, Anthony Miniaci, Santhira D. Vairavanathan, Timothy FitzPatrick, Mark Stafford-Smith, Ken Kardash, Toula Trihas, Simcha J. Kleiman, Michel Rossignol, Dominique Bérard, Brent Martel, J. P. Tétrault, Peter G. Lunt, Dennis W. Coombs, Stephen Halpern, Elizabeth A. Peter, Patricia Janssen, Jill Mahy, M. Joanne Douglas, Caroline S. Grange, Timothy J. Adams, Louis Wadsworth, Holly Muir, Romesh Shukla, Desmond Writer, Richard McLaren, Robert Liston, Don Paetkau, Bill Y. Ong, Ron Segstro, Judy Littleford, Cristina Hurtado, Ananthan Krishnathas, Marcelo Lannes, Joanne Fortier, Jun Su, Rubini Jeganathan, and Suzanne Vaillancourt

Subjects
Anesthesiology and Pain Medicine, General Medicine
Published
1996
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6. Beneficial effect of both tranexamic acid and aprotinin on blood loss reduction in reoperative valve replacement surgery

Author

W R, Jamieson, P J, Dryden, J P, O'Connor, H, Sadeghi, D M, Ansley, and P M, Merrick

Subjects
Adult, Aged, 80 and over, Male, Reoperation, Blood Loss, Surgical, Middle Aged, Heart Valves, Hemostatics, Aprotinin, Double-Blind Method, Tranexamic Acid, Humans, Female, Aged
Abstract

Blood loss after cardiac surgery is a continuing concern of caregivers and patients. The acute inflammatory reaction initiated by the extracorporeal circuitry, necessary to perform the procedure, stimulates the coagulation cascade, and the resultant hyperfibrinolysis is considered to be a major contributing factor of blood loss. The necessity to reduce transfused blood products after cardiac surgery is important, as it reduces the potential transmission of serious viral infections, improves operative outcomes, and provides containment of costs. The purpose of this study was to compare the effect of synthetic antifibrinolytic tranexamic acid with naturally occurring antifibrinolytic aprotinin on blood loss and to study requirements for transfusion of blood products after repeat cardiac valve surgery.Two randomized trials had been previously conducted, each comparing the respective treatment groups, aprotonin (AP group) and transexamic acid (TA group), with a control group [placebo (P)] in double-blind fashion with the same inclusion and exclusion criteria. The number of patients in the four designated groups are as follows: TA, 22; TA-P, 19; AP, 24; and AP-P, 36. The dosage of aprotinin (high-dose) encompassed a 280-mg loading dose infused after induction of anesthesia, 280 mg in the CPB prime solution, and 70 mg/h for a period of 6 hours. The tranexamic acid dose was 10 mg infused in 500 mL of normal saline. The blood loss was measured intraoperatively and postoperatively. The transfusion of homologous blood products was conducted in a standardized fashion. Both the TA and AP groups lost less blood intraoperatively, in total, less than either of the placebo groups, and less blood postoperatively than the TA-P group (P.05). The postoperative blood loss (median) was 538 mL for the TA group, 455 mL for the AP group, and for the respective placebo groups, 1170 mL and 595 mL. The total blood loss was 1340 mL for the TA group, 1383 mL for the AP group, and 3250 mL and 2450 mL, respectively for the placebo groups. The total blood product use revealed no differences between the two placebo groups (P=NS) nor between the two treatment groups (P=NS).Tranexamic acid and aprotinin are both effective in reducing intraoperative and postoperative blood loss and the need for blood product transfusion for patients undergoing reoperative cardiac valvular surgery.

Published
1997

7. A North American survey of intravenous regional anesthesia

Author

C B Warriner, Cynthia Henderson, P M Merrick, and James A. McEwen

Subjects
Adult, medicine.medical_specialty, business.industry, medicine.medical_treatment, MEDLINE, Middle Aged, Anesthesiology and Pain Medicine, Regional anesthesia, Anesthesia, Conduction, Anesthesia, Emergency medicine, medicine, Anesthesia, Intravenous, Humans, business, Intravenous regional anesthesia, Aged
Abstract

One thousand questionnaires concerning the techniques and complications of intravenous regional anesthesia (IVRA) were sent to 900 American and 100 Canadian anesthesiologists. Of the 321 respondents, 86% perform IVRA regularly. A wide variation in device-related and clinical aspects was found, ranging from acceptable to falling outside published guidelines. Anesthesiologists perform a median of four upper-limb IVR procedures per month, most often using 50 mL of lidocaine 0.5% at tourniquet pressures of 250 mm Hg or 100 mm Hg greater than the systolic blood pressure. Forearm, thigh, and calf IVRA are occasionally used. Complications, reported infrequently in the literature, were reported by respondents, including mistaken deflation of the cuff; dysphoria, dizziness, or facial tingling; seizures; cardiac arrests; and deaths. Although there was no correlation between complications and deviation from traditional practice, we recommend that IVRA be performed following recognized protocols by anesthesiologists who are familiar with the technique and trained to treat its potential complications. We recommend a protocol for IVRA.Intravenous regional anesthesia is a widely used anesthetic technique. A survey of 321 American and Canadian anesthesiologists indicates a wide variation in technique. Despite no correlation between complications and technique, the authors recommend that recognized protocols be used for this technique.

Published
1997

8. On line ST-segment analysis for detection of myocardial ischaemia during and after coronary revascularization

Author

D R Ricci, P Kapnoudhis, J P O'Connor, P M Merrick, Dolman J, and David M. Ansley

Subjects
education.field_of_study, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Concordance, Population, Myocardial Ischemia, General Medicine, Electrocardiography, Anesthesiology and Pain Medicine, Cohen's kappa, Positive predicative value, Anesthesia, Intensive care, Internal medicine, False positive paradox, medicine, Cardiology, Myocardial Revascularization, ST segment, Humans, education, business, Monitoring, Physiologic
Abstract

A paucity of information exists to validate the accuracy and reliability of ECG monitoring in the operating room or ICU. The purpose of this study was to determine the accuracy, sensitivity, specificity, and predictive values of the Marquette ECG monitor for detection of perioperative myocardial ischaemia (PMI) as measured by ST segment changes in a high risk population. Monitoring for PMI in 28 patients scheduled for aortocoronary bypass surgery was done with the Cardiodata PR® ambulatory continuous electrocardiography (ACECG) monitor lead V5, and compared with lead V5 of the Marquette® Series 7000 ECG/ Surgical operating room monitor, and ECG/Resp ICU monitor. The Marquette lead V5 was evaluated using current criteria for the assessment of diagnostic tests including concordance, sensitivity, specificity, positive and negative predictive values, false positive and false negative rates and compared with the ACECG monitor which served as the reference or “gold standard.” Agreement beyond chance between the two methods was assessed using the Kappa statistic. Of the 53 observation data points, 27 were defined as ischaemic episodes by ACECG. Concordance between lead V5 in each system was 83% (44/53 episodes). Discordance was 17% (9/53 episodes), predominantly in the postbypass interval (77%, 7/9; P = 0.0184). The incidences of false negatives and false positives for Marquette lead V5 was 26% (7/27) and 7.7% ( 2/26), respectively. The sensitivity and specificity of the Marquette was 0.74 and 0.92. Positive predictive value was 0.91, negative predictive value was 0.77, and Kappa statistic was 66%. Automated ST segment analysis with the Marquette® Series 7000 monitoring system demonstrates good diagnostic accuracy, moderate sensitivity, and high specificity. However, clinically significant false negative and false positive rates of ischaemia detection are associated with its use, especially in the postoperative period.

Published
1996

9. CURRENT PRACTICES IN ACUTE MUSCULOSKELETAL INJURY CARE: A NATIONAL SURVEY OF ATHLETIC TRAINERS.

Author

T., Beauregard and M., Merrick

Subjects
MUSCULOSKELETAL system injuries, SPORTS injury prevention, MEDICAL care, PATIENTS
Abstract

The article reviews the study "Current Practices in Acute Musculoskeletal Injury Care: A National Survey of Athletic Trainers" by Beauregard T, Merrick M. which appeared in a Journal of Sports Medicine and Allied Health Science 2020 issue.

Published
2021

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