11 results
164 Pooled Analyses of Patient-Reported Sleep Onset and Maintenance from Two Phase 3 Studies of Lemborexant
- Russell Rosenberg, Gary Zammit, Jane Yardley, Kate Pinner, Carlos Perdomo, Margaret Moline, Norman Atkins
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- Journal:
- CNS Spectrums / Volume 25 / Issue 2 / April 2020
- Published online by Cambridge University Press:
- 24 April 2020, pp. 304-305
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Study Objective(s):
The dual orexin receptor antagonist, lemborexant (LEM), is being investigated for the treatment of insomnia disorder. Drugs targeting the orexin system, like LEM, may decrease wakefulness and promote sleep with fewer potential adverse effects (AEs) than some currently available pharmacological insomnia therapies. LEM has been studied in 2 pivotal phase 3 trials for insomnia disorder, SUNRISE-1 (NCT02783729; E2006-G000-304) and SUNRISE-2 (NCT02952820; E2006-G000-303). Analyses presented here are derived from patient-reported (subjective) efficacy data pooled from SUNRISE-1 and SUNRISE-2 during 1-month of treatment in adult and elderly (age ≥65y) subjects with DSM-5 insomnia disorder.
Method:SUNRISE-1 was a 1-month, double-blind, randomized, placebo (PBO)- and active-controlled (zolpidem tartrate extended-release 6.25mg [ZOL; not reported), parallel-group study in 1006 subjects (age ≥55y). SUNRISE-2 was a 12-month (6-month PBO-controlled, 6-month active treatment), double-blind study in 949 subjects (age ≥18y). In both studies, subjects were randomized to PBO, LEM5, or LEM10 (SUNRISE-1 subjects could also be randomized to ZOL; not included in pooled analysis) following a 2-week PBO run-in. Changes from baseline (BL) in subjective sleep onset latency (sSOL), subjective sleep efficiency (sSE), and subjective wake after sleep onset (sWASO) were analyzed using mixed effect model repeated measurement analysis. Sleep onset and sleep maintenance responders were analyzed via Cochran–Mantel–Haenszel test stratified by study, region and age group.
Results:The pooled analysis set comprised 1693 subjects (PBO, n=527; LEM5, n=582; LEM10, n=584). Reductions from BL in sSOL were significantly greater for LEM5 and LEM10 vs PBO during the first 7 days of treatment and at the end of Month 1 (all comparisons P<0.0001). Both doses of LEM significantly increased sSE from BL (P<0.001 both time points) more than PBO and reduced sWASO from BL (P<0.0001 first 7 days [both doses]; P<0.05 [LEM5] and P<0.001 [LEM10] at Month 1) more than PBO. After the first 7 days and at the end of Month 1, the proportion of sSOL responders (≤20 min if BL >30 min) was statistically significantly larger for LEM5 and LEM10 vs PBO (first 7 days: both P<0.0001; last 7 days of Month 1: both P<0.001) and the proportion of sWASO responders (≤60 minutes and a reduction from BL by >10 min, if BL >60 min) was statistically significantly larger for LEM5 and LEM10 vs PBO (first 7 days: both P<0.01; last 7 days of Month 1: both P<0.05). LEM was well tolerated. Most AEs were mild to moderate in severity, and rates of severe or serious AEs were low.
Conclusions:LEM improved sleep onset and sleep maintenance in adult and elderly subjects with insomnia disorder, and was well tolerated. Average values on sleep maintenance endpoints showed that subjects treated with LEM obtained >1 hour of additional sleep per night vs subjects who received PBO.
Funding Acknowledgements:Supported by Eisai Inc.
Growth rhythms in the brachiopod Rafinesquina alternata from the Late Ordovician of southeastern Indiana
- Gary D. Rosenberg
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- Journal:
- Paleobiology / Volume 8 / Issue 4 / Fall 1982
- Published online by Cambridge University Press:
- 08 April 2016, pp. 389-401
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Growth rhythms are described in the accretionary skeletons of Rafinesquina alternata, a Late Ordovician brachiopod from southeastern Indiana. Contiguous growth increments widen and narrow in repeating series, giving the appearance of adjacent clusters of increments. Fourier analyses of growth increment widths and counts of the number of increments within individual clusters yield similar periodicities. Increments vary in width over a period of approximately 19 increments, modulated with a lower amplitude oscillation of 27 increments. The number of increments per cluster falls into two groups; clusters having between 8 and 17 increments outnumber those having between 18 and 30 increments.
All specimens were obtained from a Maysvillian facies of the Dillsboro Formation, previously inferred to represent a shallow subtidal environmental setting. The growth periodicities described here are consistent with this interpretation. The intensity of tidal parameters such as emersion-immersion cycles, substrate shifts, changes in nutrient supply or in oxygen tension declines with depth as would the number of growth increments added each month in response to these factors. Thus, for these specimens, the maximum number of increments per cluster probably approximates the true number of “tidal” days in the Late Ordovician synodic month (period between full moons).
The paleoecological model derived from these analyses can be used in future studies to predict the rate of the earth's rotation and the motion of the moon in the Late Ordovician and, equally importantly, to evaluate the limits of uncertainty of such studies.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Contributors
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- By Krista Adamek, Ana Luisa K. Albernaz, J. Marcio Ayres†, Andrew J. Baker, Karen L. Bales, Adrian A. Barnett, Christopher Barton, John M. Bates, Jennie Becker, Bruna M. Bezerra, Júlio César Bicca-Marques, Richard Bodmer, Jean P. Boubli, Mark Bowler, Sarah A. Boyle, Christini Barbosa Caselli, Janice Chism, Elena P. Cunningham, José Maria C. da Silva, Lesa C. Davies, Nayara de Alcântara Cardoso, Manuella A. de Souza, Stella de la Torre, Ana Gabriela de Luna, Thomas R. Defler, Anthony Di Fiore, Eduardo Fernandez-Duque, Stephen F. Ferrari, Wilsea M.B. Figueiredo-Ready, Tracy Frampton, Paul A. Garber, Brian W. Grafton, L. Tremaine Gregory, Maria L. Harada, Amy Harrison-Levine, Walter C. Hartwig, Stefanie Heiduck, Eckhard W. Heymann, André Hirsch, Leandro Jerusalinsky, Gareth Jones, Richard F. Kay, Martin M. Kowalewski, Shawn M. Lehman, Laura Marsh, Jesús Martinez, William A. Mason, Hope Matthews, Wynlyn McBride, Shona McCann-Wood, W. Scott McGraw, D. Jeffrey Meldrum, Sally P. Mendoza, Nohelia Mercado, Russell A. Mittermeier, Mirjam N. Nadjafzadeh, Marilyn A. Norconk, Robert Gary Norman, Marcela Oliveira, Marcelo M. Oliveira, Maria Juliana Ospina Rodríguez, Erwin Palacios, Suzanne Palminteri, Liliam P. Pinto, Marcio Port-Carvalho, Leila Porter, Carlos Portillo-Quintero, George Powell, Ghillean T. Prance, Rodrigo C. Printes, Pablo Puertas, P. Kirsten Pullen, Helder L. Queiroz, Luis Reginaldo R. Rodrigues, Adriana Rodríguez, Alfred L. Rosenberger, Anthony B. Rylands, Ricardo R. Santos, Horacio Schneider, Eleonore Z.F. Setz, Suleima S.B. Silva, José S. Silva Júnior, Andrew T. Smith, Marcelo C. Sousa, Antonio S. Souto, Wilson R. Spironello, Masanaru Takai, Marcelo F. Tejedor, Cynthia L. Thompson, Diego G. Tirira, Raul Tupayachi, Bernardo Urbani, Liza M. Veiga, Marianela Velilla, João Valsecchi, Jean-Christophe Vié, Tatiana M. Vieira, Suzanne E. Walker-Pacheco, Rob Wallace, Patricia C. Wright, Charles E. Zartman
- Edited by Liza M. Veiga, Universidade Federal do Pará, Brazil, Adrian A. Barnett, Roehampton University, London, Stephen F. Ferrari, Universidade Federal de Sergipe, Brazil, Marilyn A. Norconk, Kent State University, Ohio
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- Evolutionary Biology and Conservation of Titis, Sakis and Uacaris
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- 05 April 2013
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- 11 April 2013, pp xii-xv
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53 - Jewish bioethics
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- By Gary Goldsand, Clinical Ethicist Royal Alexandra Hospital Edmonton Canada, R. S. Zahava Rosenberg-Yunger, University of Toronto Canada, Michael Gordon, Vice President University of Toronto Canada
- Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
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- The Cambridge Textbook of Bioethics
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- 30 October 2009
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- 31 January 2008, pp 424-429
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Summary
Mrs. G is an 85-year-old resident of a Jewish long-term care facility who has vascular dementia, controlled heart failure, and diabetes mellitus. She is bed bound and occasionally recognizes her daughter with a slight smile. The gastrostomy feeding tube she received two years ago has begun leaking and needs to be replaced. Her daughter, who has become her surrogate since the recent death of Mrs. G's husband, has indicated that if the tube were to come out, she would not consent to the insertion of a new tube: a decision she feels would be in accord with her mother's wishes. She would not, however, request that the tube be deliberately removed. The staff are concerned that, by not replacing the tube, they would be failing to maintain the current level of treatment, and she would starve. They feel that this would amount to taking the mother's life, without any substantial decline in her clinical condition. The daughter acknowledges the concern and devotion of the staff and her mother's unchanged clinical status, but reiterates her belief that her mother would prefer to be allowed to die rather than be force fed through a gastrostomy tube.
What is Jewish bioethics?
Judaism
Judaism is the religion of the Jewish People. Judaism is a 3500-year-old tradition based on foundational stories in the Pentateuch – the five books that make up the Torah.
19 - Hydrocephalus and dementia
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- By Margaret M. Esiri, Department of Neuropathology The Radcliffe Infirmary, Oxford, UK, Gary A. Rosenberg, Department of Neurology University of New Mexico, USA
- Edited by Margaret M. Esiri, University of Oxford, Virginia M. -Y. Lee, University of Pennsylvania School of Medicine, John Q. Trojanowski, University of Pennsylvania School of Medicine
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- The Neuropathology of Dementia
- Published online:
- 12 October 2009
- Print publication:
- 22 July 2004, pp 442-456
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Summary
Introduction
The ancient term hydrocephalus refers to an excessive accumulation of fluid (water) inside the head. It is most readily detected in infants and children with congenital hydrocephalus since its existence before the skull sutures are closed causes the formation of an enlarged head. Such children have long been recognized commonly to have mental impairment, manifest as mental retardation, although the extent of this is very variable. Morgagni (1769) first described hydrocephalus due to enlarged cerebral ventricles in an adult without head enlargement. If this condition develops insidiously during adult life, dementia is an almost invariable accompaniment, though not the only one. More familiarly hydrocephalus in adults develops acutely or subacutely and presents with symptoms of raised intracranial pressure – headache, vomiting and drowsiness. However, in this chapter we are concerned with chronic hydrocephalus in adults, a condition in which symptoms and signs of raised intracranial pressure are commonly clinically absent and in which the cerebrospinal fluid (CSF) pressure is often normal when measured randomly – hence the commonly used term – normal pressure hydrocephalus (NPH). The recognition of this condition, and the realization that it is responsible for some cases of progressive dementia in adults are recent (Riddoch, 1936; Foltz & Ward 1956; McHugh, 1964; Hakim & Adams, 1965; Adams et al., 1965). Cases of NPH, some of which respond well to a shunting procedure, are to be distinguished from cases of dementia due to neurodegenerative diseases in which the ventricles dilate as a consequence of cerebral atrophy (hydrocephalus ex vacuo).
14 - The role of matrix metalloproteinases and urokinase in blood–brain barrier damage with thrombolysis
- from Part V - Hemorrhage, edema and secondary injury
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- By Gary A. Rosenberg, Departments of Neurology, Neuroscience and Cell Biology and Physiology, University of New Mexico, Albuquerque, NM, Susan Alexander, Department of Neurology, University of New Mexico, Albuquerque, NM, Edward Y. Estrada, Department of Neurology, University of New Mexico, Albuquerque, NM, Mark Grostette, Department of Neurology, University of New Mexico, Albuquerque, NM
- Edited by Pak H. Chan, Stanford University, California
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- Book:
- Cerebrovascular Disease
- Published online:
- 02 November 2009
- Print publication:
- 28 March 2002, pp 161-171
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Summary
Introduction
Recombinant tissue plasminogen activator (rtPA) benefits patients who have had an acute stroke, but a delay in treatment for over 3 hours raises the risk of intracerebral hemorrhage. Reperfusion of blood into an ischemic region, while preserving metabolic function, results in the production of molecules that may damage the injured tissue. The cerebral microvasculature is a major site of injury during reperfusion with a biphasic disruption of the blood–brain barrier (BBB) seen after reperfusion. Multiple factors have been implicated in the damage to the microvasculature by ischemia with reperfusion, including free radicals, blood products and proteases. Matrix metalloproteinases (MMPs) are a gene family of neutral proteases. Once formed and activated, the MMPs attack the basal lamina around the cerebral blood vessels, leading to the opening of the BBB. MMPs are induced in cerebral ischemia.
MMPs are secreted in a latent form that requires activation. Plasminogen activators (PAs) are serine proteases involved in angiogenesis, neuronal growth and regulation of other proteases through activation processes. Brain cells produce PAs in response to an ischemic injury. Urokinase-type plasminogen activator (uPA) is secreted by microglial cells in culture. Urokinase generates plasmin, which activates MMPs. Latent MMP-2 (gelatinase A) is activated by a membrane-type metalloproteinase (MT-MMP), which is activated by plasmin. Latent MMP-9 (gelatinase B) is activated by stromelysin-1 (MMP-3), which also requires plasmin for activation.
Looking Backward, Looking Forward: MLA Members Speak
- April Alliston, Elizabeth Ammons, Jean Arnold, Nina Baym, Sandra L. Beckett, Peter G. Beidler, Roger A. Berger, Sandra Bermann, J.J. Wilson, Troy Boone, Alison Booth, Wayne C. Booth, James Phelan, Marie Borroff, Ihab Hassan, Ulrich Weisstein, Zack Bowen, Jill Campbell, Dan Campion, Jay Caplan, Maurice Charney, Beverly Lyon Clark, Robert A. Colby, Thomas C. Coleman III, Nicole Cooley, Richard Dellamora, Morris Dickstein, Terrell Dixon, Emory Elliott, Caryl Emerson, Ann W. Engar, Lars Engle, Kai Hammermeister, N. N. Feltes, Mary Anne Ferguson, Annie Finch, Shelley Fisher Fishkin, Jerry Aline Flieger, Norman Friedman, Rosemarie Garland-Thomson, Sandra M. Gilbert, Laurie Grobman, George Guida, Liselotte Gumpel, R. K. Gupta, Florence Howe, Cathy L. Jrade, Richard A. Kaye, Calhoun Winton, Murray Krieger, Robert Langbaum, Richard A. Lanham, Marilee Lindemann, Paul Michael Lützeler, Thomas J. Lynn, Juliet Flower MacCannell, Michelle A. Massé, Irving Massey, Georges May, Christian W. Hallstein, Gita May, Lucy McDiarmid, Ellen Messer-Davidow, Koritha Mitchell, Robin Smiles, Kenyatta Albeny, George Monteiro, Joel Myerson, Alan Nadel, Ashton Nichols, Jeffrey Nishimura, Neal Oxenhandler, David Palumbo-Liu, Vincent P. Pecora, David Porter, Nancy Potter, Ronald C. Rosbottom, Elias L. Rivers, Gerhard F. Strasser, J. L. Styan, Marianna De Marco Torgovnick, Gary Totten, David van Leer, Asha Varadharajan, Orrin N. C. Wang, Sharon Willis, Louise E. Wright, Donald A. Yates, Takayuki Yokota-Murakami, Richard E. Zeikowitz, Angelika Bammer, Dale Bauer, Karl Beckson, Betsy A. Bowen, Stacey Donohue, Sheila Emerson, Gwendolyn Audrey Foster, Jay L. Halio, Karl Kroeber, Terence Hawkes, William B. Hunter, Mary Jambus, Willard F. King, Nancy K. Miller, Jody Norton, Ann Pellegrini, S. P. Rosenbaum, Lorie Roth, Robert Scholes, Joanne Shattock, Rosemary T. VanArsdel, Alfred Bendixen, Alarma Kathleen Brown, Michael J. Kiskis, Debra A. Castillo, Rey Chow, John F. Crossen, Robert F. Fleissner, Regenia Gagnier, Nicholas Howe, M. Thomas Inge, Frank Mehring, Hyungji Park, Jahan Ramazani, Kenneth M. Roemer, Deborah D. Rogers, A. LaVonne Brown Ruoff, Regina M. Schwartz, John T. Shawcross, Brenda R. Silver, Andrew von Hendy, Virginia Wright Wexman, Britta Zangen, A. Owen Aldridge, Paula R. Backscheider, Roland Bartel, E. M. Forster, Milton Birnbaum, Jonathan Bishop, Crystal Downing, Frank H. Ellis, Roberto Forns-Broggi, James R. Giles, Mary E. Giles, Susan Blair Green, Madelyn Gutwirth, Constance B. Hieatt, Titi Adepitan, Edgar C. Knowlton, Jr., Emanuel Mussman, Sally Todd Nelson, Robert O. Preyer, David Diego Rodriguez, Guy Stern, James Thorpe, Robert J. Wilson, Rebecca S. Beal, Joyce Simutis, Betsy Bowden, Sara Cooper, Wheeler Winston Dixon, Tarek el Ariss, Richard Jewell, John W. Kronik, Wendy Martin, Stuart Y. McDougal, Hugo Méndez-Ramírez, Ivy Schweitzer, Armand E. Singer, G. Thomas Tanselle, Tom Bishop, Mary Ann Caws, Marcel Gutwirth, Christophe Ippolito, Lawrence D. Kritzman, James Longenbach, Tim McCracken, Wolfe S. Molitor, Diane Quantic, Gregory Rabassa, Ellen M. Tsagaris, Anthony C. Yu, Betty Jean Craige, Wendell V. Harris, J. Hillis Miller, Jesse G. Swan, Helene Zimmer-Loew, Peter Berek, James Chandler, Hanna K. Charney, Philip Cohen, Judith Fetterley, Herbert Lindenberger, Julia Reinhard Lupton, Maximillian E. Novak, Richard Ohmann, Marjorie Perloff, Mark Reynolds, James Sledd, Harriet Turner, Marie Umeh, Flavia Aloya, Regina Barreca, Konrad Bieber, Ellis Hanson, William J. Hyde, Holly A. Laird, David Leverenz, Allen Michie, J. Wesley Miller, Marvin Rosenberg, Daniel R. Schwarz, Elizabeth Welt Trahan, Jean Fagan Yellin
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- Journal:
- PMLA / Publications of the Modern Language Association of America / Volume 115 / Issue 7 / December 2000
- Published online by Cambridge University Press:
- 23 October 2020, pp. 1986-2078
- Print publication:
- December 2000
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The Origin and Evolution of Dino Fest
- Gary D. Rosenberg
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- Journal:
- The Paleontological Society Special Publications / Volume 7 / 1994
- Published online by Cambridge University Press:
- 26 July 2017, pp. 1-6
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- 1994
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Late in the summer of 1993, Robert Hall, Chairman of the Department of Geology, Indiana University-Purdue University at Indianapolis (IUPUI) thought it would be a good idea to invite a couple of dinosaur workers to campus to capitalize on the frenzy of enthusiasm for dinosaurs that the movie, Jurassic Park, had generated. However, what originally was to have been a couple of guest lectures quickly evolved into a three-day affair that was probably the first scientific conference–certainly the first paleontologic conference–for the general public, raising important issues about public involvement in science.
Species diversity of Pliocene-Recent mollusk faunas of the western Atlantic: implications for climatic history
- Warren D. Allmon, Roger Portell, Gary Rosenberg, Kevin Schindler
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- Journal:
- The Paleontological Society Special Publications / Volume 6 / 1992
- Published online by Cambridge University Press:
- 26 July 2017, p. 4
- Print publication:
- 1992
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The late Cenozoic history of mollusks in the tropical and subtropical Western Atlantic has traditionally been viewed as one of decreasing species richness via a series of more or less discrete extinction episodes, from a Mio-Pliocene peak to the depauperate (relative to the Eastern Pacific) fauna of today. These extinction episodes have been interpreted by some authors as responses to climatic deterioration, especially climatic cooling associated with northern hemisphere glaciation.
Two new species-level compilations of gastropods suggest, however, that this traditional scenario may be oversimplified.
1) A new (but still preliminary) compilation of species from the Late Pliocene “Pinecrest Sand” of southern Florida contains 365 species. This compilation is based mainly on specimens > 5mm in size taken from bulk samples collected in quarries near Sarasota and held in the collections of the Florida Museum of Natural History; when smaller specimens are considered, and systematic analysis of larger forms from this and other localities is complete, it is likely that this number will increase significantly. The Pinecrest has been systematically neglected; although our count is preliminary, it represents the most complete and well-documented compilation available for this spectacular and highly diverse fauna.
This number for the Pinecrest compares with 479 species of gastropods in the overlying Late Pliocene-Early Pleistocene Caloosahatchee “Formation” (data of Campbell et al., 1975). 178 gastropod species are in common between the two units, yielding an extinction level of 51.2%. 301 (62.8%) of the Caloosahatchee gastropod species are not present in the Pinecrest.
Stanley (1986) listed 211 species of bivalves in the Pinecrest and 150 in the Calooshatchee, with 110 in common, giving an extinction level of 47.9%. 40 (26.7%) of the Caloosahatchee bivalve species are not present in the Pinecrest.
2) A new compilation of all described Recent shelled gastropods in the Western Atlantic (Cape Hatteras to Rio de Janeiro) contains 2800 species (2418 of which were described before 1972), compared to the 2360 species listed by Keen (1971) for the Recent Eastern Pacific. These two lists compare similar size and depth ranges, and indicate that the Western Atlantic gastropod fauna is not less species-rich than the Eastern Pacific gastropod fauna.
In addition, a growing body of evidence from other studies (ostracodes, foraminifera, isotopic analyses) indicates that the Late Pliocene was not a time of marked climatic cooling, at least not in the Western Atlantic. Still other studies (e.g., of the biogeography of turritelline gastropods, isotopic analyses on both sides of the Central American Isthmus, paleoceanographic modelling) suggest that the most significant environmental changes at this time may have been associated with changes in nutrient levels.
Taken together, these very preliminary results suggest a more complex history for the Western Atlantic mollusk fauna than previously envisioned. If the Plio-Pleistocene was a time of significant turnover but not significant diversity decline, and gastropods of the Recent Western Atlantic are not less diverse than their Eastern Pacific counterparts, then the patterns to be explained must be reexamined. Late Cenozoic extinction may have been significant in the Western Atlantic, but it may have been accompanied by high levels of diversification.
In any case, those faunal changes that did occur at this time may have been caused as much or more by changes in nutrient levels as in temperature.
Hospital-Sponsored Preferred Provider Organizations
- Daniel T. Roble, William A. Knowlton, Gary A. Rosenberg
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- Journal:
- Law, Medicine and Health Care / Volume 12 / Issue 5 / October 1984
- Published online by Cambridge University Press:
- 28 April 2021, pp. 204-209
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- October 1984
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The recent growth of new forms of health care delivery has been encouraged by the increase in competition in the health care industry. Several factors account for this increase in competition. First, there is an overabundance of physicians in many areas of the United States. In addition, many overbedded hospitals now compete for the same patients to fill their beds. Finally, health maintenance organizations and other alternative delivery systems, such as ambulatory surgical care centers, ‘surgicenters,” and birthing centers, are capturing more of the patient market and reducing hospital inpatient utilization.
Employers, insurers, and the government, as the third-party payers who most often pay for an individual's medical care, hope to take advantage of this new competitive environment and to moderate the increase in their health care expenditures.