Journal ArticleContemporary Clinical Trials Communications · December 1, 2024
Background: eSource software that transfers patient electronic health record data into a clinical trial electronic case report form holds promise for increasing data quality while reducing data collection, monitoring and source document verification costs. ...
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Journal ArticleCirculation · November 5, 2024
AIM: The "2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery" provides recommendations to guide clinicians in the perioperative cardiovascular evaluation and management of adult patients ...
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Journal ArticleStud Health Technol Inform · August 22, 2024
While pilots and production use of software based on the Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) standard are increasing in clinical research, we lack consistent evaluative data on important outcomes, such as data accur ...
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Journal ArticleEur J Heart Fail · July 2024
AIM: The TRANSFORM-HF trial demonstrated no significant outcome differences between torsemide and furosemide following hospitalization for heart failure (HF), but may have been impacted by non-adherence to the randomized diuretic. The current study sought ...
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Journal ArticleJournal of Clinical and Translational Science · May 21, 2024
Introduction: The value of Source Data Verification (SDV) has been a common theme in the applied Clinical Translational Science literature. Yet, few published assessments of SDV quality exist even though they are needed to design risk-based and reduced mon ...
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Journal ArticleEur J Heart Fail · May 2024
AIM: Among patients discharged after hospitalization for heart failure (HF), a strategy of torsemide versus furosemide showed no difference in all-cause mortality or hospitalization. Clinicians have traditionally favoured torsemide in the setting of kidney ...
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Journal ArticleContemp Clin Trials Commun · April 2024
BACKGROUND: Registry-based trials have the potential to reduce randomized clinical trial (RCT) costs. However, observed cost differences also may be achieved through pragmatic trial designs. A systematic comparison of trial costs across different designs h ...
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Journal ArticleNEJM AI · April 2024
BACKGROUND: Machine learning (ML) may cost-effectively direct health care by identifying patients most likely to benefit from preventative interventions to avoid negative and expensive outcomes. System for High-Intensity Evaluation During Radiation Therapy ...
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Journal ArticleCirc Heart Fail · March 2024
BACKGROUND: The TRANSFORM-HF trial (Torsemide Comparison With Furosemide for Management of Heart Failure) found no significant difference in all-cause mortality or hospitalization among patients randomized to a strategy of torsemide versus furosemide follo ...
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Journal ArticleJAMA Cardiol · February 1, 2024
IMPORTANCE: Differences in clinical profiles, outcomes, and diuretic treatment effects may exist between patients with de novo heart failure (HF) and worsening chronic HF (WHF). OBJECTIVES: To compare clinical characteristics and treatment outcomes of tors ...
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ConferenceCirculation · November 7, 2023
Introduction:
TRANSFORM-HF trial showed no significant difference in mortality or hospitalization outcomes in patients randomized to torsemide (T) versus furosemide (F) following a heart failure (HF) ...
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ConferenceCirculation · November 7, 2023
Introduction:
In the TRANSFORM HF trial, among patients discharged after hospitalization for heart failure (HF), torsemide compared with furosemide did not result in a significant difference in all-ca ...
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Journal ArticleCirculation · July 11, 2023
BACKGROUND: Loop diuretics are a primary therapy for the symptomatic treatment of heart failure (HF), but whether torsemide improves patient symptoms and quality of life better than furosemide remains unknown. As prespecified secondary end points, the TRAN ...
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Journal ArticleContemporary clinical trials · May 2023
BackgroundeSource software is used to automatically copy a patient's electronic health record data into a clinical study's electronic case report form. However, there is little evidence to assist sponsors in identifying the best sites for multi-ce ...
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Journal ArticleJAMA · January 17, 2023
IMPORTANCE: Although furosemide is the most commonly used loop diuretic in patients with heart failure, some studies suggest a potential benefit for torsemide. OBJECTIVE: To determine whether torsemide results in decreased mortality compared with furosemid ...
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Journal ArticleAMIA Jt Summits Transl Sci Proc · 2023
The 21st Century Cures Act allows the US Food and Drug Administration to consider real world data (RWD) for new indications or post approval study requirements. However, there is limited guidance as to the relative quality of different RWD types. The ACE-R ...
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Journal ArticleHeart, Vessels and Transplantation · January 1, 2023
The International Research Interdisciplinary School (IRIS) program is a training for young researchers with a biomedical background who are interested in acquiring the methodological knowledge and experience in preparing a study protocol for a project. The ...
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Journal ArticleContemp Clin Trials · November 2022
BACKGROUND: Single Institutional Review Boards (sIRB) are not achieving the benefits envisioned by the National Institutes of Health. The recently published Health Level Seven (HL7®) Fast Healthcare Interoperability Resources (FHIR®) data exchange standard ...
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Journal ArticleJ Card Fail · October 2022
BACKGROUND: Death ascertainment can be challenging for pragmatic clinical trials that limit site follow-up activities to usual clinical care. METHODS AND RESULTS: We used blinded aggregate data from the ongoing ToRsemide comparison with furoSemide FOR Mana ...
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Journal ArticleTher Innov Regul Sci · November 2021
BACKGROUND: The 21st Century Cures Act allows the US Food and Drug Administration (FDA) to utilize real-world data (RWD) to create real-world evidence (RWE) for new indications or post approval study requirements. We compared central adjudication with two ...
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Journal ArticleStud Health Technol Inform · May 27, 2021
Direct extraction and use of electronic health record (EHR) data is a long-term and multifaceted endeavor that includes design, development, implementation and evaluation of methods and tools for semi-automating tasks in the research data collection proces ...
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Journal ArticleJACC Heart Fail · May 2021
Randomized clinical trials are the foundation of evidence-based medicine and central to practice guidelines and patient care decisions. Nonetheless, randomized trials in heart failure (HF) populations have become increasingly difficult to conduct and are f ...
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Journal ArticleJ Vasc Surg · September 2020
OBJECTIVE: Trials for endovascular aneurysm repair (EVAR) report lower perioperative mortality and morbidity, but also higher costs compared with open repair. However, few studies have examined the subsequent cost of follow-up evaluations and interventions ...
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Journal ArticleStud Health Technol Inform · June 16, 2020
Directly extracting data from site electronic health records for updating clinical trial databases (eSource) can reduce site data collection times and errors. We conducted a study to determine clinical trial characteristics that make eSource vs. traditiona ...
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Journal ArticleAMIA Annu Symp Proc · 2020
The direct use of EHR data in research, often referred to as 'eSource', has long-been a goal for researchers because of anticipated increases in data quality and reductions in site burden. eSource solutions should rely on data exchange standards for consis ...
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Journal ArticleJ Am Med Inform Assoc · October 1, 2019
OBJECTIVE: To assess measurement practice in clinical decision support evaluation studies. MATERIALS AND METHODS: We identified empirical studies evaluating clinical decision support systems published from 1998 to 2017. We reviewed titles, abstracts, and f ...
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Journal ArticleStud Health Technol Inform · 2019
Death, as a biological phenomenon, is well understood and a commonly employed endpoint for clinical trials. However, death identification and adjudication may be difficult for pragmatic clinical trials (PCT) that rely upon electronic health record and pati ...
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Journal ArticleStud Health Technol Inform · 2019
Use of electronic health record (EHR) data in clinical trials has long been a goal for researchers. However, few demonstrations and fewer evaluative studies have been published. The variability in outcome choice and measurement hinders synthesis of the ext ...
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Journal ArticleStud Health Technol Inform · 2019
Clinical trials conducted for regulatory approval may include outcomes that are informative but not routinely collected in clinical practice. This situation can be problematic when pragmatic clinical trials (PCT) seek to use electronic health record (EHR) ...
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Journal ArticleStud Health Technol Inform · 2019
The availability of research and outcomes data is the primary limitation to evidence-based practice. Today, only a fraction of clinical decisions are based upon evidence derived from randomized control trials (RCTs), the gold-standard of knowledge discover ...
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Journal ArticleJ Empir Res Hum Res Ethics · October 2018
Digital informed consent may better inform individuals about health research and increase participation. In the United States and elsewhere, minorities and rural populations are underrepresented in health research and may benefit from well-designed electro ...
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Journal ArticleTher Innov Regul Sci · March 2018
BACKGROUND: While patient groups, regulators, and sponsors are increasingly considering engaging with patients in the design and conduct of clinical development programs, sponsors are often reluctant to go beyond pilot programs because of uncertainty in th ...
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Journal ArticleInt J Med Inform · July 2017
OBJECTIVE: This pilot study compared eSource-enabled versus traditional manual data transcription (non-eSource methods) for the collection of clinical registry information. The primary study objective was to compare the time spent completing registry forms ...
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Journal ArticleStud Health Technol Inform · 2017
Medicaid beneficiaries in 6 North Carolina counties were randomly assigned to 1 of 3 clinical decision support (CDS) care transition strategies: (1) usual care (Control), (2) CDS messaging to patients and their medical homes (Reports), or (3) CDS messaging ...
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Journal ArticleStud Health Technol Inform · 2017
The continued escalation of clinical trial costs is becoming a public health concern. During the past decade, medical research funding peaked and there is growing concern that there may be insufficient resources to test many promising medical products. Rec ...
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ConferenceStud Health Technol Inform · 2017
Systematic health IT evaluation studies are needed to ensure system quality and safety and to provide the basis for evidence-based health informatics. Well-trained health informatics specialists are required to guarantee that health IT evaluation studies a ...
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Journal ArticleJ Occup Environ Med · February 2016
OBJECTIVES: The aim of this study was to compare the impact of two worksite weight management (WM [education] and WM+ [education plus counseling]) programs, on health care utilization and costs. Secondarily, compare the intervention groups to an observatio ...
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Journal ArticleRespir Care · January 2016
BACKGROUND: An increasing number of centers are using active rehabilitation and ambulation for critically ill patients on extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation. This investigation assessed the economic impact at a s ...
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Journal ArticleChest · October 2015
BACKGROUND: The National Heart, Lung, and Blood Institute-sponsored IPF Clinical Research Network (IPFnet) studies enrolled subjects with idiopathic pulmonary fibrosis (IPF) to evaluate drug therapies in treatment trials. An adjudication committee (AC) pro ...
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Journal ArticleJ Cardiovasc Pharmacol · May 2015
Furosemide has historically been the primary loop diuretic in heart failure patients despite data suggesting potential advantages with torsemide. We used the Duke Echocardiography Lab Database to investigate patients admitted with heart failure to Duke Hos ...
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Journal ArticleAm Heart J · March 2015
The health and economic burden of heart failure is significant and continues to grow each year. Loop diuretics are an integral part of symptom management in heart failure. Furosemide is used disproportionately compared with other loop diuretics, and there ...
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Journal ArticleJ Occup Environ Med · February 2015
OBJECTIVE: To present the short-term follow-up findings of the Steps to Health study, a randomized trial to evaluate the effectiveness of two employee weight management programs offered within Duke University and the Health System. METHODS: A total of 550 ...
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Journal ArticleJ Am Heart Assoc · January 30, 2015
BACKGROUND: Clinical outcomes in patients with refractory angina (RA) are poorly characterized and variably described. Using the Duke Database for Cardiovascular Disease (DDCD), we explored characteristics that drive clinical endpoints in patients with cla ...
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Journal ArticleStud Health Technol Inform · 2015
Although health information technologies frequently serve as critical workflow components, we currently lack validated methods for identifying how heath informatics can support workflow redesign and for evaluating redesign results. In this study, we descri ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · September 2014
BACKGROUND: Many multicenter clinical trials use permuted-block randomization to create balanced treatment allocations within clinical centers. Unlike randomized trials, observational studies do not control treatment allocation, and statistical models are ...
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Journal ArticlePediatrics · August 2014
BACKGROUND: Besides vaccines and otitis media medicines, most products prescribed for children have not been studied in the pediatric population. To remedy this, Congress enacted legislation in 1997, known as pediatric exclusivity (PE), which provides 6 mo ...
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Journal ArticleAnesth Analg · May 2014
BACKGROUND: Enhanced recovery after surgery (ERAS) is a multimodal approach to perioperative care that combines a range of interventions to enable early mobilization and feeding after surgery. We investigated the feasibility, clinical effectiveness, and co ...
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Journal ArticleObesity (Silver Spring) · April 2014
OBJECTIVES: Evaluate the relationship between body mass index (BMI) and health claims costs over the last decade, assess the strength and nature of the relationship between BMI and costs, and identify comorbidities that may drive any increased costs. METHO ...
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Journal ArticleJ Clin Hypertens (Greenwich) · February 2014
Blood pressure exhibits circadian variability, and nighttime blood pressure is one of the best predictors of cardiovascular (CV) events. Adults with hypertension who lack a nighttime dipping pattern are at particularly high risk. Several studies have found ...
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Journal ArticleRespir Med · January 2014
BACKGROUND: Dyspnea is a hallmark symptom of idiopathic pulmonary fibrosis (IPF), and dyspnea induced physical activity limitation is a prominent driver of quality of life impairment among IPF patients. METHODS: We examined response data for the 21 physica ...
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Journal ArticleJ Vasc Surg · August 2013
BACKGROUND: The Positive Impact of EndoVascular Options for Treating Aneurysms Early (PIVOTAL) trial enrolled individuals with small (4.0- to 5.0-cm diameter) abdominal aortic aneurysms (AAA) and reported no difference in rupture or aneurysm-related death ...
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Journal ArticleRespir Res · July 13, 2013
BACKGROUND: Acute exacerbation of idiopathic pulmonary fibrosis has become an important outcome measure in clinical trials. This study aimed to explore the concept of suspected acute exacerbation as an outcome measure. METHODS: Three investigators retrospe ...
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Journal ArticleContemp Clin Trials · July 2013
BACKGROUND: The workplace can be an important setting for addressing obesity. An increasing number of employers offer weight management programs. PURPOSE: Present the design, rationale and baseline characteristics of the Steps to Health study (STH), a rand ...
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Journal ArticleJ Med Syst · February 2013
To determine whether a clinical decision support system can favorably impact the delivery of emergency department and hospital services. Randomized clinical trial of three clinical decision support delivery modalities: email messages to care managers (emai ...
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Journal ArticleStud Health Technol Inform · 2013
Although evidence-based pharmacotherapies are a principal component of patient care, 30-50% of patients do not take their medications as prescribed. We conducted a randomized trial of two clinical decision support (CDS) interventions in 2219 patients: pati ...
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Journal ArticleJ Am Coll Cardiol · December 4, 2012
OBJECTIVES: The purpose of this study was to characterize long-term outcomes of percutaneous coronary intervention (PCI) in elderly diabetic patients in routine practice. BACKGROUND: Although drug-eluting stent (DES) implantation in diabetic patients is co ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · November 2012
BACKGROUND: Provider and public health interventions in the late 2006 sought to change the duration of clopidogrel use after drug-eluting stent (DES) implantation. We evaluated whether public health interventions were associated with changes in patient-rep ...
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Journal ArticleRespir Med · October 2012
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease that often causes disabling dyspnea. In IPF and other lung diseases, patient-reported outcomes (PROs)-questionnaires designed to gather information from the patient' ...
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Journal ArticleJ Am Coll Cardiol · February 14, 2012
OBJECTIVES: This study sought to assess percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) stenosis in routine U.S. clinical practice. BACKGROUND: Percutaneous coronary intervention for ULMCA stenosis is controversia ...
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Journal ArticleAm Heart J · January 2012
BACKGROUND: Therapies may reduce short-term rates of nonfatal myocardial infarction (MI) without a detectable effect on mortality. We sought to estimate the long-term clinical implications of nonfatal MI occurring within the first 3 and 6 months after init ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · January 2012
BACKGROUND: The National Cardiovascular Data Registry CathPCI Registry was recently linked with longitudinal Centers for Medicare & Medicaid (CMS) claims data. The degree to which this linked cohort is representative of the overall CathPCI Registry and CMS ...
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Journal ArticleStud Health Technol Inform · 2012
Governments are investing in health information technologies (HIT) to improve care quality and reduce medical costs. However, evidence of these benefits is limited. We conducted a randomized trial of three clinical decision support (CDS) interventions in 2 ...
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Journal ArticleJ Med Syst · December 2011
New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting forma ...
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Journal ArticleJ Am Coll Cardiol · October 25, 2011
OBJECTIVES: The purpose of this study was to determine the safety and efficacy of drug-eluting stents (DES) compared with bare-metal stents (BMS) in older patients with chronic kidney disease (CKD). BACKGROUND: DES may be associated with late death and myo ...
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Journal ArticleStud Health Technol Inform · 2011
BACKGROUND: Replication studies evaluate technologies in usual use settings. METHODS: We conducted a clinical trial to determine whether reductions in clinical and economic results observed in a previous study could be replicated in a larger setting. Subje ...
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Journal ArticleStud Health Technol Inform · 2011
BACKGROUND: New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. METHODS: We developed clinical research network economic models to evaluate three ...
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Journal ArticleStud Health Technol Inform · 2011
Governments and providers are investing in health information technologies with little evidence as to their ultimate value. We present a conceptual framework that can be used by hospitals, clinics, and health care systems to evaluate their health informati ...
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Journal ArticleAMIA Annu Symp Proc · November 13, 2010
Evidence-based pharmacotherapy is a central aspect of optimal patient care for many chronic conditions. However, medication non-adherence frequently inhibits the attainment of optimal pharmacotherapy regimens. In this study, we designed, developed, and imp ...
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Journal ArticleN Engl J Med · August 12, 2010
BACKGROUND: Sildenafil, a phosphodiesterase-5 inhibitor, may preferentially improve blood flow to well-ventilated regions of the lung in patients with advanced idiopathic pulmonary fibrosis, which could result in improvements in gas exchange. We tested the ...
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Journal ArticleJ Med Syst · June 2010
Thrombocytopenia is associated with increased patient risk. However, the costs of this complication are not well defined. This study assessed the impact of thrombocytopenia on in-hospital costs using results from CATCH, an observational study that examined ...
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Journal ArticleAm Heart J · March 2010
BACKGROUND: Relationships between long-term use and level of dual antiplatelet therapy and outcomes after drug-eluting stent implantation are not well established. METHODS: This is a retrospective cohort study of 9,256 patients receiving drug-eluting stent ...
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Journal ArticleJ Card Fail · December 2009
BACKGROUND: Anemia is associated with higher morbidity and mortality in patients with heart failure (HF), but its implications for heath care costs are not well described. METHODS AND RESULTS: We analyzed data on 1056 patients with symptomatic HF seen at D ...
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Journal ArticleJACC Cardiovasc Interv · December 2009
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OBJECTIVES: The aim of this study was to assess, after 2 years of follow-up, the safety, efficacy, and cost-effectiveness of a zotarolimus-eluting stent (ZES) compared with a paclitaxel-eluting stent (PES) in patients with native coronary lesions. BACKGROU ...
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Journal ArticleJACC Cardiovasc Interv · December 2009
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OBJECTIVES: This study was designed to evaluate long-term clinical and economic outcomes for subjects receiving Endeavor drug-eluting versus Driver bare-metal stents (both Medtronic CardioVascular, Santa Rosa, California). BACKGROUND: Early studies found t ...
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Journal ArticleJACC Cardiovasc Interv · December 2009
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OBJECTIVES: The aim of this study was to evaluate clinical and economic outcomes for subjects receiving zotarolimus-eluting (ZES) (n = 323) versus sirolimus-eluting stents (SES) (n = 113) in the ENDEAVOR III (Randomized Controlled Trial of the Medtronic En ...
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Journal ArticleJ Med Syst · August 2009
Chronic kidney disease (CKD) is associated with increased morbidity and mortality in coronary artery disease (CAD) patients. We compared the economic attractiveness of CAD revascularization procedures in patients with and without CKD. Our population includ ...
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Journal ArticleJ Am Coll Cardiol · May 5, 2009
OBJECTIVES: The aim of this study was to compare outcomes in older individuals receiving drug-eluting stents (DES) and bare-metal stents (BMS). BACKGROUND: Comparative effectiveness of DES relative to BMS remains unclear. METHODS: Outcomes were evaluated i ...
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Journal ArticleAm J Med · February 2009
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BACKGROUND: Residence in a lower-income area has been associated with higher mortality among patients receiving dialysis. We sought to determine whether these differences persist and whether the effect of income-area on mortality is different for African A ...
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Journal ArticleStud Health Technol Inform · 2009
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Lower income individuals in the US frequently experience difficulties in obtaining access to needed health care services. We describe a randomized clinical trial that seeks to improve the quality of, and access to healthcare services for medically underser ...
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Journal Article · December 1, 2008
This chapter describes a framework for conducting economic analyses of health information technologies (HIT). It explains the basic principles of healthcare economic analyses and the relationships between the costs and effectiveness of a health interventio ...
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Journal ArticleKidney Int · December 2008
Although the results of Pizzi et al. point to the potential economic attractiveness of a ferric gluconate treatment strategy, they may not be sufficient to change public policy and reimbursement practices. What is required is a large, simple trial that wil ...
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Journal ArticleHealth Policy · December 2008
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OBJECTIVES: We sought to determine whether dialysis patient mortality rates are associated with differences in dialysis facility size, and whether this relationship differs among higher risk diabetic and lower-risk non-diabetic patients. METHODS: Using 186 ...
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Journal ArticleAMIA Annu Symp Proc · November 6, 2008
Data collection from patients for use in clinical decision making is foundational for medical practice. Increasingly, kiosks are being used to facilitate direct data collection from patients. However, kiosk-collected data are generally not integrated into ...
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Journal ArticleAm Heart J · October 2008
BACKGROUND: Congress has authorized the United States Food and Drug Administration (FDA) to provide industry sponsors with a 6-month extension of drug marketing rights under the Pediatric Exclusivity Provision if FDA-requested pediatric drug trials are con ...
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Journal ArticleArch Intern Med · August 11, 2008
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BACKGROUND: Clinical trials of drug-eluting stents (DES) vs bare metal stents (BMS) report a reduced need for target lesion revascularization with no difference in death or myocardial infarction. However, these trials selectively enrolled patients with low ...
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Journal ArticleCurr Cardiol Rep · July 2008
Stents that elute antiproliferative drugs prevent restenosis after percutaneous coronary artery revascularization, reducing the need for repeat procedures. Randomized trials in low-risk patients supported initial regulatory approval for drug-eluting stents ...
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Journal ArticleJ Med Syst · April 2008
Drug-eluting stents (DES) reduce subsequent revascularization procedures. Although randomized trials have compared DES to brachytherapy and balloon angioplasty (PTCA) for in-stent restenosis, few long-term comparisons have been made to bare metal stents (B ...
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Journal ArticleAm Heart J · February 2008
BACKGROUND: Bleeding and blood transfusion are associated with increased morbidity and mortality among patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, the economic consequences of these complications are not well define ...
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Journal ArticleArch Intern Med · January 14, 2008
BACKGROUND: Despite widespread heparin use in clinical practice, the associated development of thrombocytopenia is an underrecognized and undertreated complication. METHODS: We analyzed data from consecutive hospitalized patients treated with heparin (unfr ...
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Journal ArticleClin Trials · 2008
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BACKGROUND: Over the past decade, annual funding for biomedical research has more than doubled while new molecular entity approvals have declined by one third. OBJECTIVE: To assess the value of practices commonly employed in the conduct of large-scale clin ...
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Journal ArticleAMIA Annu Symp Proc · October 11, 2007
Non-adherence to evidence-based pharmacotherapy is associated with increased morbidity and mortality. Claims data can be used to detect and intervene on such non-adherence, but existing claims-based approaches for measuring adherence to pharmacotherapy gui ...
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Journal ArticleAMIA Annu Symp Proc · October 11, 2007
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Health information technology evaluators need to distinguish between intervention efficacy as assessed in the ideal circumstances of clinical trials and intervention effectiveness as assessed in the real world circumstances of actual practice. Because curr ...
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Journal ArticleAMIA Annu Symp Proc · October 11, 2007
The clinic-based healthcare model does not deliver high quality, cost-effective care to populations of patients. Despite public perception that aggressive investment in information technology will lead to improvements in the safety and quality of healthcar ...
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Journal ArticleAMIA Annu Symp Proc · October 11, 2007
Health information technology evaluators need to distinguish between intervention efficacy as assessed in the ideal circumstances of clinical trials and intervention effectiveness as assessed in the real world circumstances of actual practice. We have deve ...
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Journal ArticleMed Care · October 2007
Inverse probability-weighted estimation is a powerful tool for use with observational data. In this article, we describe how this propensity score-based method can be used to compare the effectiveness of 2 or more treatments. First, we discuss the inherent ...
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Journal ArticleJ Urol · May 2007
PURPOSE: Percutaneous nephrolithotomy is a commonly used procedure for treatment of large or complex renal calculi. In some instances postoperative residual stone fragments are an unavoidable result. Yet to our knowledge no study has examined the impact of ...
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Journal ArticleJAMA · February 7, 2007
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CONTEXT: In 1997, Congress authorized the US Food and Drug Administration (FDA) to grant 6-month extensions of marketing rights through the Pediatric Exclusivity Program if industry sponsors complete FDA-requested pediatric trials. The program has been pra ...
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Journal ArticleJAMA · January 10, 2007
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CONTEXT: Recent studies of drug-eluting intracoronary stents suggest that current antiplatelet regimens may not be sufficient to prevent late stent thrombosis. OBJECTIVE: To assess the association between clopidogrel use and long-term clinical outcomes of ...
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Journal ArticleEvidence-Based Communication Assessment and Intervention · January 1, 2007
Systematic reviews in the health and social sciences are increasingly recognized as a valuable scientific tool to support decision making by clinicians, managers, administrators, and policy makers. Numerous organizations have arisen to fulfill growing dema ...
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Journal ArticleBMC Med Res Methodol · November 15, 2006
BACKGROUND: Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Revi ...
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Journal ArticleJ Card Fail · June 2006
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BACKGROUND: The Digitalis Investigation Group (DIG) clinical train randomized 6800 congestive heart failure patients (ejection fraction > or =45%) to a daily regimen of either digoxin or placebo. At 37 months average follow-up, patients in both groups had ...
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Journal ArticleJ Electrocardiol · April 2006
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BACKGROUND AND PURPOSE: Health economic analyses seek to assess the relative value (cost vs health benefit trade-offs) of medical technologies. However, these methods have been underused in studies of the electrocardiogram (ECG). METHODS: We develop a fram ...
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Journal ArticleJ Electrocardiol · January 2006
PURPOSE: To determine whether a short-term, problem-based educational intervention leads to increased research activity among health care practitioners. SUBJECTS AND METHODS: Participant's success was evaluated as a composite of 2 outcomes. These were (1) ...
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Journal ArticleAMIA Annu Symp Proc · 2006
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Medical information systems are being recognized for their ability to improve patient outcomes. While standards for the economic evaluation of medical technologies were instituted in the mid-1990s, little is known about their application in medical informa ...
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Journal ArticleAMIA Annu Symp Proc · 2006
Standards for the economic evaluation of medical technologies were instituted in the mid-1990s, yet little is known about their application in medical information technology studies. In a review of evaluation studies published between 1982 and 2002, we fou ...
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Journal ArticleJ Urol · December 2005
PURPOSE: Robot assisted prostatectomy (RAP) is more costly than traditional radical retropubic prostatectomy (RRP) under the cost structures at certain hospitals. However, this finding may not be the case in all care settings. We investigated the sensitivi ...
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Journal ArticleAm J Med · September 2005
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PURPOSE: Obesity is a coronary disease risk factor, but its independent effect on clinical outcomes following acute coronary syndromes has not been quantified. We evaluated the relationship between elevated body mass index (BMI) and 30-day, 90-day, and 1-y ...
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Journal ArticleExpert Opin Pharmacother · June 2005
Percutaneous coronary intervention is an increasingly common treatment for many people with coronary disease. Randomised trials using antiproliferative, drug-eluting stents (DES) have shown important reductions in the need for repeat procedures after initi ...
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Journal ArticleAnn Intern Med · April 19, 2005
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BACKGROUND: The Multicenter Automatic Defibrillator Implantation Trial (MADIT)-II demonstrated that implantable cardioverter defibrillators (ICDs) save lives when used in patients with a history of myocardial infarction (MI) and an ejection fraction of 0.3 ...
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Journal ArticleAm Heart J · April 2005
BACKGROUND: The ASSENT-3 study examined the safety and efficacy of 3 alternative regimens for ST-elevation acute myocardial infarction: full-dose tenecteplase (TNK-tPA) plus enoxaparin; half-dose TNK-tPA plus unfractionated heparin plus abciximab; and full ...
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Journal ArticleJ Med Syst · April 2005
Hospitals and payers use economic profiling to evaluate physician and surgeon performance. However, there is significant variation in the data sources and analytic methods that are used. We used information from a hospital's cardiac surgery and cost accoun ...
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Journal ArticleAm Heart J · March 2005
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BACKGROUND: The pharmaceutical industry spends approximately 26.4 billion dollars annually for research and development (4.1 billion dollars in cardiovascular products). We compared pharmaceutical companies' planned resource use and costs in Phase III card ...
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Journal ArticleAMIA Annu Symp Proc · 2005
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Health information professionals recognize the need to demonstrate that the benefits of health information technological (HIT) interventions outweigh their costs. However, such cost-benefit analyses are rarely conducted for HIT interventions, due in part t ...
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Journal ArticleAMIA Annu Symp Proc · 2005
This study describes a framework for conducting economic analyses for health information technology (HIT) interventions, in the context of three interventions that are currently being implemented in a community-based health network caring for 17,779 Medica ...
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Journal ArticleAm Heart J · March 2004
BACKGROUND: Drug-eluting intracoronary stents decrease restenosis and later revascularization. The US Department of Health and Human Services (HHS), recognizing the financial and clinical impact of this technology, recently proposed accelerated reimburseme ...
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Chapter · January 1, 2004
INTRODUCTION Three 20th century trends have converged to create today’s technology-driven health care system [1]. First, increasing life expectancy (49.2 years in 1900 vs. 77.2 years in 2001 for the United States) means that people live long enough to deve ...
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Journal ArticleFam Med · 2004
OBJECTIVE: This study's objective was to introduce research concepts and skills in family medicine residency through a problem-based course. METHODS: Eight third-year residents per year in 3 academic years participated. Groups of two-three were presented w ...
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Journal ArticleJournal of biomolecular techniques : JBT · December 2003
Fully characterizing the interactions involving biomolecules requires information on the assembly state, affinity, kinetics, and thermodynamics associated with complex formation. The analytical technologies often used to measure biomolecular interactions i ...
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Journal ArticleJournal of bacteriology · July 2003
The bacterial protein encoded by the gene ychF is 1 of 11 universally conserved GTPases and the only one whose function is unknown. The crystal structure determination of YchF was sought to help with the functional assignment of the protein. The YchF prote ...
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Journal ArticleBiochemistry · May 2003
PhzD from Pseudomonas aeruginosa is an isochorismatase involved in phenazine biosynthesis. Phenazines are antimicrobial compounds that provide Pseudomonas with a competitive advantage in certain environments and may be partly responsible for the persistenc ...
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Journal ArticleThe Journal of biological chemistry · April 2003
D-Tyr-tRNA(Tyr) deacylase is an editing enzyme that removes d-tyrosine and other d-amino acids from charged tRNAs, thereby preventing incorrect incorporation of d-amino acids into proteins. A model for the catalytic mechanism of this enzyme is proposed bas ...
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Journal ArticleProteins · April 2003
The crystal structures of YibK from Haemophilus influenzae (HI0766) have been determined with and without bound cofactor product S-adenosylhomocysteine (AdoHcy) at 1.7 and 2.0 A resolution, respectively. The molecule adopts an alpha/beta fold, with a topol ...
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Journal ArticleJournal of structural biology · March 2003
Small-angle neutron scattering and contrast variation were used to study the solution structure of GroEL and GroEL/GroES chaperonins complexed with a nonnative variant of the polypeptide substrate, subtilisin (PJ9). The subtilisin was 86% deuterated (dPJ9) ...
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Journal ArticleBiochemistry · January 2003
HI0719 belongs to a large family of highly conserved proteins with no definitive molecular function and is found in organisms ranging from bacteria to humans. We describe the NMR structure of HI0719, the first solution structure for a member of this family ...
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Journal ArticleN C Med J · 2003
OBJECTIVE: Lipid clinic models that combine diet and drug therapy have shown significantly better hyperlipidemia management than usual care. The objective is to demonstrate that such a model can be established and utilized in a primary care practice, repli ...
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Journal ArticleCurrent drug targets. Infectious disorders · December 2002
The three-dimensional structures of Haemophilus influenzae proteins whose biological functions are unknown are being determined as part of a structural genomics project to ask whether structural information can assist in assigning the functions of proteins ...
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Journal ArticleProteins · August 2002
A hypothetical protein encoded by the gene YjeE of Haemophilus influenzae was selected as part of a structural genomics project for X-ray analysis to assist with the functional assignment. The protein is considered essential to bacteria because the gene is ...
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Journal ArticleJ Med Syst · August 2002
Assessing the effectiveness of newer treatments for rare diseases can be challenging because of the small number of patients treated at individual centers. We enrolled patients undergoing percutaneous transluminal septal myocardial ablation (PTSMA) for hyp ...
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Journal ArticleAm Heart J · June 2002
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BACKGROUND: The Inhibition of Metallo Protease by BMS-186716 in a Randomized Exercise and Symptoms Study in Subjects With Heart Failure (IMPRESS) clinical trial randomized patients with congestive heart failure to a daily regimen of either omapatrilat or l ...
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Journal ArticleBiophys Chem · April 10, 2002
Microcalorimetry and high-performance liquid chromatography (HPLC) have been used to conduct a thermodynamic investigation of reactions catalyzed by PABA synthase, the enzyme located at the first step in the shikimic acid metabolic pathway leading from cho ...
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Journal ArticleProteins · March 2002
The crystal structure of the YrbI protein from Haemophilus influenzae (HI1679) was determined at a 1.67-A resolution. The function of the protein had not been assigned previously, and it is annotated as hypothetical in sequence databases. The protein exhib ...
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Journal ArticleBiochemistry · February 2002
Aminodeoxychorismate synthase is part of a heterodimeric complex that catalyzes the two-step biosynthesis of 4-amino-4-deoxychorismate, a precursor of p-aminobenzoate and folate in microorganisms. In the first step, a glutamine amidotransferase encoded by ...
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Journal ArticleObes Res · February 2002
OBJECTIVE: Obesity is an important risk factor for coronary artery disease (CAD); however, its effect on acute coronary syndrome (ACS) patients' long-term clinical and economic outcomes has not been quantified. We assessed the impact of increasing body mas ...
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Journal ArticleAm J Cardiol · January 15, 2002
This study examined the effects of exercise and stress management training on clinical outcomes and medical expenditures over a 5-year follow-up period in 94 male patients with established coronary artery disease (CAD) and evidence of ambulatory or mental ...
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Journal ArticleBiochemistry · December 2001
The 39 kDa receptor-associated protein (RAP) is a three-domain escort protein in the secretory pathway for several members of the low-density lipoprotein receptor (LDLR) family of endocytic receptors, including the LDLR-related protein (LRP). The minimal f ...
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Journal ArticleProteins · December 2001
The crystal structure of YecO from Haemophilus influenzae (HI0319), a protein annotated in the sequence databases as hypothetical, and that has not been assigned a function, has been determined at 2.2-A resolution. The structure reveals a fold typical of S ...
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Journal ArticleJournal of structural biology · November 2001
Dephospho-coenzyme A kinase catalyzes the final step in CoA biosynthesis, the phosphorylation of the 3'-hydroxyl group of ribose using ATP as a phosphate donor. The protein from Haemophilus influenzae was cloned and expressed, and its crystal structure was ...
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Journal ArticleAm Heart J · November 2001
BACKGROUND: The segment of patients with advanced coronary artery disease, or disease that is not amenable to conventional revascularization therapies, continues to grow. Because the natural history of these patients is less defined, the appropriate end po ...
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Journal ArticleAdolescent medicine (Philadelphia, Pa.) · October 2001
More than half of the world's population of 6 billion people is under age 25 years. Of the estimated 1.2 billion adolescents worldwide (1 in every 5 people is an adolescent), about 85% live in developing countries and the remainder in the industrialised wo ...
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Journal ArticleBiochemistry · September 2001
A novel bacterial ribosome binding protein, protein Y (also known as YfiA), was recently shown to reside at the 30S/50S subunit interface and to stabilize the ribosomal 70S complex against dissociation at low magnesium ion concentrations. We report here th ...
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Journal ArticleMed Care · August 2001
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BACKGROUND: The acute phase of coronary artery disease (CAD) is dramatic and receives much attention because of its high mortality and associated treatment cost. However, the acute phase typically resolves within 30 days whereas CAD is a chronic disease, w ...
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Journal ArticleBiochemistry · May 2001
We have purified the mouse prohormone convertase 1 (PC1) pro-domain expressed in Escherichia coli cells and demonstrated, using a number of biophysical methods, that this domain is an independent folding unit with a T(m) of 39 degrees C at a protein concen ...
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Journal ArticleJ Electrocardiol · 2001
A method has been developed for establishing a "University Without Walls" for the purpose of studying the relationship between electrocardiographic estimation and magnetic resonance imaging measurements of myocardial infarct size. The research team include ...
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Journal ArticleJornal de pediatria. · November 2000
OBJECTIVE: To emphasize the importance of nutrition for healthy growth and development during adolescence. METHODS: 1 - National and international bibliographic review of the main anthropometric data to be used during puberty. 2 - Description of practical ...
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Journal ArticleProteins · July 2000
Structural genomics of proteins of unknown function most straightforwardly assists with assignment of biochemical activity when the new structure resembles that of proteins whose functions are known. When a new fold is revealed, the universe of known folds ...
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Journal ArticleN Engl J Med · March 16, 2000
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BACKGROUND: Reducing the length of hospitalizations can reduce short-term costs, but there are few data on the long-term clinical and economic consequences of early discharge. METHODS: Using data from the Global Utilization of Streptokinase and Tissue Plas ...
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Journal ArticlePharmacoeconomics · March 2000
OBJECTIVE: To evaluate the relationship between how much a new cardiovascular therapy improves clinical outcomes over current therapies and how much more it can cost while still remaining 'economically attractive'. DESIGN: We developed a decision model to ...
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Journal ArticleCurrent opinion in biotechnology · February 2000
Many of the gene products of completely sequenced organisms are 'hypothetical' - they cannot be related to any previously characterized proteins - and so are of completely unknown function. Structural studies provide one means of obtaining functional infor ...
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Journal ArticleAnn Emerg Med · January 2000
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STUDY OBJECTIVE: Conventional emergency department testing strategies for patients with chest pain often do not provide unequivocal diagnosis of acute coronary syndromes. This study was conducted to determine whether the routine use of single photon emissi ...
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Journal ArticleJ Electrocardiol · 2000
The use of reperfusion therapy in patients with ST elevation acute coronary syndromes had been established. However, reperfusion therapy is usually considered contra-indicated in those with ST depression, despite the knowledge that regional posterior infar ...
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Journal ArticleHealth Care Manag Sci · December 1999
We introduce a technique for patient mix-adjusting x charts and compared differences between unadjusted and patient mix-adjusted results. Our data came from coronary artery bypass graft (CABG) surgery patients at Baptist Medical Center, Oklahoma City, Okla ...
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Journal ArticleBiochemistry · October 1999
The repressor of biotin biosynthesis binds to the biotin operator sequence to repress transcription initiation at the biotin biosynthetic operon. Site-specific binding of BirA to the biotin operator is allosterically regulated by binding of the small molec ...
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Journal ArticleBiochemistry · October 1998
The biochemical and structural properties of bovine retinal nucleoside diphosphate kinase were investigated. The enzyme showed two polypeptides of approximately 17.5 and 18.5 kDa on SDS-PAGE, while isoelectric focusing revealed seven to eight proteins with ...
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Journal ArticleThe Journal of biological chemistry · September 1998
Shifts in the sigmoidal kinetics of allosteric threonine deaminase promoted by isoleucine and valine binding control branched chain amino acid biosynthesis in Escherichia coli. A highly conserved alpha-helix in the C-terminal regulatory domain of the tetra ...
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Journal ArticleActa crystallographica. Section D, Biological crystallography · May 1998
The biosynthetic threonine deaminase from Escherichia coli, an allosteric tetramer with key regulatory functions, has been crystallized in several crystal forms. Two distinct forms, both belonging to either space group P3121 or P3221, with different sized ...
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Journal ArticleStructure · April 1998
BACKGROUND: Feedback inhibition of biosynthetic threonine deaminase (TD) from Escherichia coli provided one of the earliest examples of protein-based metabolic regulation. Isoleucine, the pathway end-product, and valine, the product of a parallel pathway, ...
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Journal ArticleProc AMIA Symp · 1998
Acute coronary syndromes have remained the focus of many clinical economic studies due to the increasing prevalence of the disease and the tightening of cost controls. An accurate descriptive cost model for this population would be a valuable tool for clin ...
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Journal ArticleAm J Cardiol · December 15, 1997
This study assessed the cost effectiveness of inpatient antiarrhythmic therapy initiation for supraventricular tachycardias using a metaanalysis of proarrhythmic risk and a decision analysis that compared inpatient to outpatient therapy initiation. A MEDLI ...
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Journal ArticleAm J Manag Care · December 1997
The preoperative identification that patients are at high risk for adverse postoperative outcomes is the first step toward preventing costly in-hospital complications. The economic implications of noninvasive screening strategies in the care of patients un ...
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Journal ArticleProtein expression and purification · October 1997
An Escherichia coli expression vector pRE (P. Reddy, A. Peterkofsky, and K. McKenney, 1989, Nucleic Acids Res. 17, 10473-10488), originally developed for the cloning and expression of lethal genes, was used for cloning and hyperexpression of GroEL and GroE ...
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Journal ArticleBiochemistry · August 1997
In complex with subtilisin BPN', the 77 amino acid prodomain folds into a stable compact structure comprising a four-stranded antiparallel beta-sheet and two three-turn alpha-helices. When isolated from subtilisin, the prodomain is 97% unfolded even under ...
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Journal ArticleProc AMIA Annu Fall Symp · 1997
Newer pharmacologic agents have demonstrated significant clinical and economic benefit in high-risk percutaneous transluminal coronary angioplasty (PTCA) patients. However, the higher costs of these agents may prohibit their use in lower-risk coronary arte ...
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Journal ArticleJournal of the American Medical Informatics Association · January 1, 1997
Newer pharmacologic agents have demonstrated significant clinical and economic benefit in high-risk percutaneous transluminal coronary angioplasty (PTCA) patients. However, the higher costs of these agents may prohibit their use in lower-risk coronary arte ...
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Journal ArticleThe Journal of biological chemistry · November 1996
R67 dihydrofolate reductase (DHFR) provides resistance to the antibacterial drug trimethoprim. This R-plasmid-encoded enzyme does not share any homology with chromosomal DHFR. A recent crystal structure of active, homotetrameric R67 DHFR (Narayana, N., Mat ...
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Journal ArticleBiochemistry · July 1996
The crystal structures of the complexes between the anti-hen egg white lysozyme (HEL) antibody D1.3 and HEL and between D1.3 and the anti-D1.3 antibody E5.2 have shown that D1.3 contacts these two proteins through essentially the same set of combining site ...
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Journal ArticleProceedings of the National Academy of Sciences of the United States of America · March 1996
The Escherichia coli chaperonins GroEL and GroES facilitate the refolding of polypeptide chains in an ATP hydrolysis-dependent reaction. The elementary steps in the binding and release of polypeptide substrates to GroEL were investigated in surface plasmon ...
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Journal ArticleJournal of molecular recognition : JMR · 1996
The reactions of lysozyme with the specific monoclonal antibody D1.3, its Fv fragment and a mutant of the Fv, were studied under conditions of reduced water activity through the addition of the cosolutes glycerol, ethanol, dioxane and methanol. Titration c ...
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Journal ArticleJ Nucl Cardiol · 1996
This review presents a brief overview of existing diagnostic and prognostic methodologies to be used for the evaluation of patients undergoing noninvasive testing. In part I of this review, we will present methods for use of logistic and Cox regression ana ...
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Journal ArticleProc AMIA Annu Fall Symp · 1996
Accurately risk-stratifying patients is a key component of health care outcomes assessment. And, many health care organizations increasingly are relying upon automated means for assistance in making patient risk-stratification decisions. Unfortunately, the ...
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Journal ArticleAnnals of Operations Research · January 1, 1996
The recent Joint Commission on Accreditation of Healthcare Organization (JCAHO) requirement that hospital accreditation be based upon a Total Quality Management (TQM) approach has focused the attention of health care administrations on the use of technique ...
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Journal ArticleThe Journal of experimental medicine · December 1995
The three-dimensional structure of an unglycosylated T cell antigen receptor (TCR) beta chain has recently been determined to 1.7 A resolution. To investigate whether this soluble beta chain (murine V beta 8.2J beta 2.1C beta 1) retains superantigen (SAG)- ...
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Journal ArticleThe Journal of biological chemistry · September 1995
The heat shock protein GroEL from Escherichia coli is a tetradecameric oligomer that facilitates the refolding of nonnative polypeptides in an ATP-hydrolysis dependent reaction. A mutant in GroEL was prepared in which lysine 3 was substituted with glutamat ...
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Journal ArticleBiochemistry · August 1995
In an effort to clarify the role of GroES in chaperonin-facilitated protein folding, a plasmid-encoding expression system for GroES incorporating a histidine-tagged, thrombin-cleavable, N-terminal sequence was constructed. This approach facilitated the rap ...
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Journal ArticleBiochemistry · July 1995
The linkage between substrate and regulatory effector binding to separate sites on allosteric enzymes results in shifts in their sigmoidal kinetics to regulate metabolism. Control of branched chain amino acid biosynthesis in Escherichia coli occurs in part ...
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Journal ArticlePharmaceutica acta Helvetiae · March 1995
Antibodies possess a highly complementary combining site structure to that of their specific antigens. In many instances their reactions are driven by enthalpic factors including, at least in the case of the reaction of monoclonal antibody D1.3 with lysozy ...
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Journal ArticleArchives of biochemistry and biophysics · January 1995
The sigmoidal steady-state kinetics of biosynthetic threonine deaminase from Escherichia coli is allosterically controlled by isoleucine and valine, the end-products of branched-chain amino acid biosynthesis. A basis for the regulation of threonine deamina ...
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Journal ArticleThe Journal of biological chemistry · January 1995
The molecular chaperone GroEl from Escherichia coli is a member of the highly conserved Hsp60 family of proteins that facilitates protein folding. A central question regarding the mechanism of GroEL-assisted refolding of proteins concerns its broad substra ...
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Journal ArticleProc Annu Symp Comput Appl Med Care · 1995
This paper describes a healthcare cost accounting system which is under development at Duke University Medical Center. Our approach differs from current practice in that this system will dynamically adjust its resource usage estimates to compensate for var ...
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Journal ArticleThe Journal of biological chemistry · November 1994
The sigmoidal kinetics of alpha-ketobutyrate production catalyzed by threonine deaminase are shifted in the presence of the feedback inhibitor isoleucine and the activator valine to control carbon flow through branched-chain amino acid biosynthesis in Esch ...
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Journal ArticleThe Journal of biological chemistry · November 1994
Control of the regulatory enzyme threonine deaminase from Escherichia coli is achieved by isoleucine inhibition and valine activation. The mechanism by which these heterotropic effectors regulate the enzyme was investigated by measuring the binding of isol ...
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Journal ArticleJournal of bacteriology · May 1994
Aromatic amine dehydrogenase (AADH) catalyzes the oxidative deamination of aromatic amines including tyramine and dopamine. AADH is structurally similar to methylamine dehydrogenase (MADH) and possesses the same tryptophan tryptophylquinone (TTQ) prostheti ...
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Journal ArticleBiochemistry · April 1994
R67 dihydrofolate reductase (DHFR) is an R-plasmid encoded enzyme that confers resistance to the antibacterial drug trimethoprim. This enzyme is not homologous in sequence or structure to chromosomal DHFRs. Equilibrium folding of tetrameric R67 DHFR was st ...
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Journal ArticleJournal of molecular recognition : JMR · March 1994
The reaction between the mouse (BALB/c) anti-idiotopic monoclonal antibodies E225 and E5.2 and idiotopes on the (BALB/c) anti-lysozyme monoclonal antibody D1.3 has been characterized by titration calorimetry, by equilibrium sedimentation and by the determi ...
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Journal ArticleJ Am Med Inform Assoc · 1994
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OBJECTIVES: To examine the influences of situational and model factors on the accuracy of Bayesian learning systems. DESIGN: This study examines the impacts of variations in two situational factors, training sample size and number of attributes, and in two ...
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Journal ArticleMed Decis Making · 1994
This paper suggests a new approach for lowering follow-up costs, improving the delivery of health care, and monitoring treatment outcomes. An automated telephone follow-up system that calls, identifies, and interviews clients is an alternative method for m ...
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Journal ArticleJournal of bacteriology · October 1993
High-level expression of the regulatory enzyme threonine deaminase in Escherichia coli strains grown on minimal medium that are deficient in the activities of enzymes needed for branched-chain amino acid biosynthesis result in growth inhibition, possibly b ...
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Journal ArticleAnnals of internal medicine · May 1993
Common variable immunodeficiency (CVI) is a heterogenous immunodeficiency syndrome characterized by hypogammaglobulinemia, recurrent bacterial infections, and various immunologic abnormalities. In addition to recurrent infections, patients with this syndro ...
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Journal ArticleBiochemistry · February 1993
R67 dihydrofolate reductase (DHFR) is an R-plasmid encoded protein that confers clinical resistance to the antibacterial drug trimethoprim. To determine whether an acidic titration in kinetic pH profiles is related to titration of histidines 62, 162, 262, ...
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Journal ArticlePediatric research · January 1993
Common variable immunodeficiency (CVI) is a heterogeneous condition marked by a number of different immunologic defects. One group of patients, perhaps 60% of the CVI group as a whole, is characterized by T cells that produce reduced amounts of IL-2 (mRNA ...
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Journal ArticleJournal of paediatrics and child health · 1993
Street youth are children and adolescents who express, through their bodies and lives, misery and social abandonment. Paradoxically, they are also the embodiment of resistance and survival strategies in a very unfavourable environment. The current deterior ...
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Journal ArticleProc Annu Symp Comput Appl Med Care · 1993
This paper examines the influences of situational and model factors upon the accuracy of Bayesian learning systems. In particular, it is concerned with the impact of variations in training sample size, number of attributes, choice of Bayesian model, and cr ...
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Journal ArticleThe Journal of biological chemistry · November 1992
A comprehensive set of hybrid molecules of aspartate transcarbamylase (ATCase) from Escherichia coli has been constructed of wild-type and mutationally altered catalytic chains. The mutant enzymes that were virtually devoid of activity contained a replacem ...
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Journal ArticleThe Journal of biological chemistry · March 1991
Feedback inhibition of the regulatory enzyme threonine deaminase by isoleucine provides an important level of enzymic control over branched chain amino acid biosynthesis in Escherichia coli. Cloning ilvA, the structural gene for threonine deaminase, under ...
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Journal ArticleBiochemistry · April 1990
The sigmoidal dependence of activity on substrate concentration exhibited by the regulatory enzyme aspartate transcarbamoylase (ATCase) of Escherichia coli is generally attributed to a ligand-promoted change in the quaternary structure of the enzyme. Altho ...
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Journal ArticleThe Journal of biological chemistry · January 1990
In Saccharomyces cerevisiae, ornithine transcarbamoylase and arginase form a regulatory multienzyme complex (Hensley, P. (1988) Curr. Top. Cell. Regul. 29, 35-75). In this complex, arginase acts as a negative allosteric effector for ornithine transcarbamoy ...
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Journal ArticleProceedings of the National Academy of Sciences of the United States of America · May 1989
Changes in subunit interaction energies linked to the allosteric transition of the regulatory enzyme aspartate transcarbamoylase (ATCase; EC 2.1.3.2) from Escherichia coli are localized in part at interfaces between the six catalytic (c) and six regulatory ...
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Journal ArticleThe Journal of biological chemistry · September 1986
Association of arginase and ornithine transcarbamoylase (OTCase) has been proposed to play an essential role in the regulation of arginine metabolism in Saccharomyces cerevisiae (Wiame, J.-M. (1971) Curr. Top. Cell. Reg. 4, 1-39). In this report multienzym ...
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Journal ArticleThe Journal of biological chemistry · September 1986
Electron microscopic studies employing negative staining, rotary shadowing, and unidirectional shadowing have revealed the subunit architecture of ornithine transcarbamoylase and arginase from Saccharomyces cerevisiae. These techniques have confirmed the q ...
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Journal ArticleThe Journal of biological chemistry · May 1986
It has been proposed that regulatory multienzyme complex formation between yeast ornithine transcarbamoylase (OTCase) and arginase is triggered by a conformational change promoted by the binding of ornithine to a regulatory site in OTCase (Wiame, J.-M. (19 ...
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Journal ArticleThe Journal of biological chemistry · April 1984
Ornithine transcarbamoylase (OTCase) has been purified in 100-mg quantities from a plasmid-containing, enzyme-overproducing strain of Saccharomyces cerevisiae. The specific activity of the homogeneous enzyme is 2.5-fold above that previously reported. The ...
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Journal ArticlePediatrics · October 1978
A group of 168 short but otherwise normal children (group A) and 25 children deficient in growth hormone (GH) (group B) wwere studied with an exercise stimulation test to determine the expected error of this method. In group A, 125 (74.4%) had maximum GH r ...
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