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Keywords = James Orr

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24 pages, 6873 KB  
Article
Characterisation of Naturally Occurring MERS-CoV Spike Mutations and Their Impact on Fusion and Neutralisation
by Rachael Dempsey, Hannah Goldswain, Joseph Newman, Nazia Thakur, Tracy MacGill, Todd Myers, Robert Orr, Dalan Bailey, James P. Stewart, Waleed Aljabr and Julian A. Hiscox
Viruses 2026, 18(3), 377; https://doi.org/10.3390/v18030377 - 18 Mar 2026
Viewed by 927
Abstract
In this study, the phenotypic consequences of naturally occurring single nucleotide polymorphisms (SNPs) in the Middle East respiratory syndrome coronavirus (MERS-CoV) Spike protein were investigated. The impact of Spike mutations on the syncytia formation and neutralisation of contemporary MERS-CoV strains is not currently [...] Read more.
In this study, the phenotypic consequences of naturally occurring single nucleotide polymorphisms (SNPs) in the Middle East respiratory syndrome coronavirus (MERS-CoV) Spike protein were investigated. The impact of Spike mutations on the syncytia formation and neutralisation of contemporary MERS-CoV strains is not currently well understood. Mutations were identified by aligning 584 MERS-CoV Spike sequences from either human clinical isolates collected between 2012 and 2024 or from a clinical isolate that had been passaged in human cells. Fifteen SNPs of interest occurring in the N-terminal domain (NTD), receptor binding domain (RBD) and adjacent to the S1/S2 cleavage site were selected for further characterisation based on their location in the Spike protein, frequency and identification in previous studies. A contemporary clade B, lineage 5 wildtype Spike sequence, obtained from a human MERS-CoV clinical isolate, was used as the backbone in this study. The mutations of interest were introduced to the wildtype backbone to generate Spike variants. Spike variants were characterised via cell–cell fusion assays, and a lentiviral pseudotyping system was used to investigate the impact of these Spike mutations on neutralisation. The I529T, E536K and L745F mutations were shown to increase fusion and syncytia formation. The L411F, T424I, L506F, L745F and T746K mutations were found to increase resistance to neutralisation by pooled patient sera. This study has identified novel naturally occurring Spike mutations that resulted in phenotypic differences in the syncytia formation and neutralisation of contemporary MERS-CoV strains. Continued investigation of the phenotypic consequences of MERS-CoV Spike mutations is essential for assessing the risk to public health, especially given the pandemic potential of this virus. Full article
(This article belongs to the Section Coronaviruses)
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23 pages, 4542 KB  
Article
Targeting NRF2 and FSP1 to Overcome Ferroptosis Resistance in TSC2-Deficient and Cancer Cells
by Tasmia Tahsin, Darius K. McPhail, Jesse D. Champion, Mohammad A. M. Alzahrani, Madeleine L. Hilditch, Alexandre Faris-Orr, Brian L. Calver, James G. Cronin, Juan C. Mareque-Rivas, Darren W. Sexton, Stephen Fôn Hughes, Robert Steven Conlan, David Mark Davies and Andrew R. Tee
Cancers 2025, 17(16), 2714; https://doi.org/10.3390/cancers17162714 - 21 Aug 2025
Cited by 9 | Viewed by 5539
Abstract
Background/Objectives: Ferroptosis is an iron-dependent form of regulated cell death driven by lipid peroxidation and holds promise as a therapeutic strategy against cancers with elevated iron metabolism. However, many tumors evade ferroptosis through the upregulation of specialized antioxidant defense mechanisms. Here, we [...] Read more.
Background/Objectives: Ferroptosis is an iron-dependent form of regulated cell death driven by lipid peroxidation and holds promise as a therapeutic strategy against cancers with elevated iron metabolism. However, many tumors evade ferroptosis through the upregulation of specialized antioxidant defense mechanisms. Here, we investigated ferroptosis susceptibility and resistance mechanisms in TSC models and in ovarian and breast cancer cell lines, aiming to identify potential therapeutic targets. Methods: Ferroptosis sensitivity was assessed using RSL3 and erastin. We explored the contribution of ferroptosis defense pathways using inhibitors of NRF2 (ML385) and FSP1 (iFSP1). RNA sequencing was performed to evaluate the expression of ferroptosis resistance genes and to explore NRF2-regulated transcriptional programs. Results: TSC2-deficient cells were resistant to RSL3- and erastin-induced ferroptosis. This resistance correlated with upregulation of ferroptosis defense genes, including NRF2 and its downstream targets. Pharmacological inhibition of NRF2 resensitized TSC2-deficient cells to ferroptosis, confirming a protective role for NRF2. However, FSP1 inhibition did not restore ferroptosis sensitivity in TSC2-deficient angiomyolipoma cells. In contrast, FSP1 knockdown significantly enhanced ferroptosis sensitivity in ovarian (PEO1, PEO4, OVCAR3) and breast (MDA-MB-436) cancer cells. Notably, in MDA-MB-436 cells, FSP1 knockdown was more effective than NRF2 inhibition to enhance ferroptosis sensitivity. FSP1 expression was not regulated by NRF2, suggesting that NRF2-targeted therapies alone may be insufficient to overcome ferroptosis resistance in certain cancer contexts. Conclusions: TSC2-deficient cells resist ferroptosis via an adaptive antioxidant response that protects against elevated iron-mediated lipid peroxidation. Our findings identify NRF2 and FSP1 as key, but mechanistically distinct, regulators of ferroptosis resistance. The differential efficacy of targeting these pathways across cancer types highlights the potential need for patient stratification. Dual targeting of NRF2 and FSP1 may offer an effective therapeutic strategy for iron-dependent, ferroptosis-resistant cancers. Full article
(This article belongs to the Section Molecular Cancer Biology)
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10 pages, 1211 KB  
Article
Impact of COVID-19 on 1-Year Survival Outcomes in Hepatocellular Carcinoma: A Multicenter Cohort Study
by Shuell De Souza, Jeffrey Kahol de Jong, Ylenia Perone, Shishir Shetty, Maria Qurashi, Mathew Vithayathil, Tahir Shah, Paul Ross, Laura Temperley, Vincent S. Yip, Abhirup Banerjee, Dominik Bettinger, Lukas Sturm, Helen L. Reeves, Daniel Geh, James Orr, Benjamin Allen, Robert P. Jones and Rohini Sharma
Cancers 2023, 15(13), 3378; https://doi.org/10.3390/cancers15133378 - 27 Jun 2023
Cited by 5 | Viewed by 2587
Abstract
Introduction: The COVID-19 pandemic has caused severe disruption of healthcare services worldwide and interrupted patients’ access to essential services. During the first lockdown, many healthcare services were shut to all but emergencies. In this study, we aimed to determine the immediate and long-term [...] Read more.
Introduction: The COVID-19 pandemic has caused severe disruption of healthcare services worldwide and interrupted patients’ access to essential services. During the first lockdown, many healthcare services were shut to all but emergencies. In this study, we aimed to determine the immediate and long-term indirect impact of COVID-19 health services utilisation on hepatocellular cancer (HCC) outcomes. Methods: A prospective cohort study was conducted from 1 March 2020 until 30 June 2020, correlating to the first wave of the COVID-19 pandemic. Patients were enrolled from tertiary hospitals in the UK and Germany with dedicated HCC management services. All patients with current or past HCC who were discussed at a multidisciplinary meeting (MDM) were identified. Any delay to treatment (DTT) and the effect on survival at one year were reported. Results: The median time to receipt of therapy following MDM discussion was 49 days. Patients with Barcelona Clinic Liver Cancer (BCLC) stages-A/B disease were more likely to experience DTT. Significant delays across all treatments for HCC were observed, but delay was most marked for those undergoing curative therapies. Even though severe delays were observed in curative HCC treatments, this did not translate into reduced survival in patients. Conclusion: Interruption of routine healthcare services because of the COVID-19 pandemic caused severe delays in HCC treatment. However, DTT did not translate to reduced survival. Longer follow is important given the delay in therapy in those receiving curative therapy. Full article
(This article belongs to the Special Issue Human Hepatocellular Carcinoma (HCC) 2.0)
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9 pages, 860 KB  
Communication
In Vitro Activity of Novel Topoisomerase Inhibitors against Francisella tularensis and Burkholderia pseudomallei
by Adam O. Whelan, Ian Cooper, Nicola Ooi, David Orr, Kevin Blades, James Kirkham, Amanda Lyons, Kay B. Barnes, Mark I. Richards, Anne-Marie Salisbury, Mark Craighead and Sarah V. Harding
Antibiotics 2023, 12(6), 983; https://doi.org/10.3390/antibiotics12060983 - 30 May 2023
Cited by 2 | Viewed by 2509
Abstract
Antimicrobial resistance is a global issue, and the investigation of alternative therapies that are not traditional antibiotics are warranted. Novel bacterial type II topoisomerase inhibitors (NBTIs) have recently emerged as a novel class of antibiotics with reduced potential for cross-resistance to fluoroquinolones due [...] Read more.
Antimicrobial resistance is a global issue, and the investigation of alternative therapies that are not traditional antibiotics are warranted. Novel bacterial type II topoisomerase inhibitors (NBTIs) have recently emerged as a novel class of antibiotics with reduced potential for cross-resistance to fluoroquinolones due to their novel mechanism of action. This study investigated the in vitro activity of a series of cyclohexyl–oxazolidinone bacterial topoisomerase inhibitors against type strains of Francisella tularensis and Burkholderia pseudomallei. Broth microdilution, time-kill, and cell infection assays were performed to determine activity against these biothreat pathogens. Two candidates were identified that demonstrated in vitro activity in multiple assays that in some instances was equivalent to ciprofloxacin and doxycycline. These data warrant the further evaluation of these novel NBTIs and future iterations in vitro and in vivo. Full article
(This article belongs to the Section Novel Antimicrobial Agents)
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37 pages, 8227 KB  
Review
Multi-Agent Deep Reinforcement Learning for Multi-Robot Applications: A Survey
by James Orr and Ayan Dutta
Sensors 2023, 23(7), 3625; https://doi.org/10.3390/s23073625 - 30 Mar 2023
Cited by 183 | Viewed by 38693
Abstract
Deep reinforcement learning has produced many success stories in recent years. Some example fields in which these successes have taken place include mathematics, games, health care, and robotics. In this paper, we are especially interested in multi-agent deep reinforcement learning, where multiple agents [...] Read more.
Deep reinforcement learning has produced many success stories in recent years. Some example fields in which these successes have taken place include mathematics, games, health care, and robotics. In this paper, we are especially interested in multi-agent deep reinforcement learning, where multiple agents present in the environment not only learn from their own experiences but also from each other and its applications in multi-robot systems. In many real-world scenarios, one robot might not be enough to complete the given task on its own, and, therefore, we might need to deploy multiple robots who work together towards a common global objective of finishing the task. Although multi-agent deep reinforcement learning and its applications in multi-robot systems are of tremendous significance from theoretical and applied standpoints, the latest survey in this domain dates to 2004 albeit for traditional learning applications as deep reinforcement learning was not invented. We classify the reviewed papers in our survey primarily based on their multi-robot applications. Our survey also discusses a few challenges that the current research in this domain faces and provides a potential list of future applications involving multi-robot systems that can benefit from advances in multi-agent deep reinforcement learning. Full article
(This article belongs to the Special Issue Mobile Robots: Navigation, Control and Sensing)
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16 pages, 891 KB  
Review
The Use of Host Biomarkers for the Management of Invasive Fungal Disease
by James S. Griffiths, Selinda J. Orr, Charles Oliver Morton, Juergen Loeffler and P. Lewis White
J. Fungi 2022, 8(12), 1307; https://doi.org/10.3390/jof8121307 - 16 Dec 2022
Cited by 11 | Viewed by 4648
Abstract
Invasive fungal disease (IFD) causes severe morbidity and mortality, and the number of IFD cases is increasing. Exposure to opportunistic fungal pathogens is inevitable, but not all patients with underlying diseases increasing susceptibility to IFD, develop it. IFD diagnosis currently uses fungal biomarkers [...] Read more.
Invasive fungal disease (IFD) causes severe morbidity and mortality, and the number of IFD cases is increasing. Exposure to opportunistic fungal pathogens is inevitable, but not all patients with underlying diseases increasing susceptibility to IFD, develop it. IFD diagnosis currently uses fungal biomarkers and clinical risk/presentation to stratify high-risk patients and classifies them into possible, probable, and proven IFD. However, the fungal species responsible for IFD are highly diverse and present numerous diagnostic challenges, which culminates in the empirical anti-fungal treatment of patients at risk of IFD. Recent studies have focussed on host-derived biomarkers that may mediate IFD risk and can be used to predict, and even identify IFD. The identification of novel host genetic variants, host gene expression changes, and host protein expression (cytokines and chemokines) associated with increased risk of IFD has enhanced our understanding of why only some patients at risk of IFD actually develop disease. Furthermore, these host biomarkers when incorporated into predictive models alongside conventional diagnostic techniques enhance predictive and diagnostic results. Once validated in larger studies, host biomarkers associated with IFD may optimize the clinical management of populations at risk of IFD. This review will summarise the latest developments in the identification of host biomarkers for IFD, their use in predictive modelling and their potential application/usefulness for informing clinical decisions. Full article
(This article belongs to the Special Issue Novel Technologies for Diagnosis of Fungal Infection)
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14 pages, 1844 KB  
Article
Near Infrared Emitting Semiconductor Polymer Dots for Bioimaging and Sensing
by Connor Riahin, Kushani Mendis, Brandon Busick, Marcin Ptaszek, Mengran Yang, Gary Stacey, Amar Parvate, James E. Evans, Jeremiah Traeger, Dehong Hu, Galya Orr and Zeev Rosenzweig
Sensors 2022, 22(19), 7218; https://doi.org/10.3390/s22197218 - 23 Sep 2022
Cited by 6 | Viewed by 4590
Abstract
Semiconducting polymer dots (Pdots) are rapidly becoming one of the most studied nanoparticles in fluorescence bioimaging and sensing. Their small size, high brightness, and resistance to photobleaching make them one of the most attractive fluorophores for fluorescence imaging and sensing applications. This paper [...] Read more.
Semiconducting polymer dots (Pdots) are rapidly becoming one of the most studied nanoparticles in fluorescence bioimaging and sensing. Their small size, high brightness, and resistance to photobleaching make them one of the most attractive fluorophores for fluorescence imaging and sensing applications. This paper highlights our recent advances in fluorescence bioimaging and sensing with nanoscale luminescent Pdots, specifically the use of organic dyes as dopant molecules to modify the optical properties of Pdots to enable deep red and near infrared fluorescence bioimaging applications and to impart sensitivity of dye doped Pdots towards selected analytes. Building on our earlier work, we report the formation of secondary antibody-conjugated Pdots and provide Cryo-TEM evidence for their formation. We demonstrate the selective targeting of the antibody-conjugated Pdots to FLAG-tagged FLS2 membrane receptors in genetically engineered plant leaf cells. We also report the formation of a new class of luminescent Pdots with emission wavelengths of around 1000 nm. Finally, we demonstrate the formation and utility of oxygen sensing Pdots in aqueous media. Full article
(This article belongs to the Special Issue Optical Sensing for Chemical Application)
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18 pages, 3325 KB  
Article
TMEM176B Regulates AKT/mTOR Signaling and Tumor Growth in Triple-Negative Breast Cancer
by Chifei Kang, Ran Rostoker, Sarit Ben-Shumel, Rola Rashed, James Andrew Duty, Deniz Demircioglu, Irini M. Antoniou, Lika Isakov, Zila Shen-Orr, Jose Javier Bravo-Cordero, Nathan Kase, Math P. Cuajungco, Thomas M. Moran, Derek LeRoith and Emily Jane Gallagher
Cells 2021, 10(12), 3430; https://doi.org/10.3390/cells10123430 - 6 Dec 2021
Cited by 16 | Viewed by 7530
Abstract
TMEM176B is a member of the membrane spanning 4-domains (MS4) family of transmembrane proteins, and a putative ion channel that is expressed in immune cells and certain cancers. We aimed to understand the role of TMEM176B in cancer cell signaling, gene expression, cell [...] Read more.
TMEM176B is a member of the membrane spanning 4-domains (MS4) family of transmembrane proteins, and a putative ion channel that is expressed in immune cells and certain cancers. We aimed to understand the role of TMEM176B in cancer cell signaling, gene expression, cell proliferation, and migration in vitro, as well as tumor growth in vivo. We generated breast cancer cell lines with overexpressed and silenced TMEM176B, and a therapeutic antibody targeting TMEM176B. Proliferation and migration assays were performed in vitro, and tumor growth was evaluated in vivo. We performed gene expression and Western blot analyses to identify the most differentially regulated genes and signaling pathways in cells with TMEM176B overexpression and silencing. Silencing TMEM176B or inhibiting it with a therapeutic antibody impaired cell proliferation, while overexpression increased proliferation in vitro. Syngeneic and xenograft tumor studies revealed the attenuated growth of tumors with TMEM176B gene silencing compared with controls. We found that the AKT/mTOR signaling pathway was activated or repressed in cells overexpressing or silenced for TMEM176B, respectively. Overall, our results suggest that TMEM176B expression in breast cancer cells regulates key signaling pathways and genes that contribute to cancer cell growth and progression, and is a potential target for therapeutic antibodies. Full article
(This article belongs to the Section Intracellular and Plasma Membranes)
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15 pages, 258 KB  
Article
Advancing the Evangelical Mind: Melvin Grove Kyle, J. Gresham Machen, and the League of Evangelical Students
by Jeffrey S. McDonald
Religions 2021, 12(7), 498; https://doi.org/10.3390/rel12070498 - 4 Jul 2021
Cited by 1 | Viewed by 6600
Abstract
This article seeks to analyze Melvin Grove Kyle and the growth of the League of Evangelical Students (LES) founded by J. Gresham Machen and Princeton Seminary students in 1925. Both Kyle and Machen were scholarly leaders in the LES and served on the [...] Read more.
This article seeks to analyze Melvin Grove Kyle and the growth of the League of Evangelical Students (LES) founded by J. Gresham Machen and Princeton Seminary students in 1925. Both Kyle and Machen were scholarly leaders in the LES and served on the organization’s board together. This paper will establish the importance of Melvin Grove Kyle as a leading evangelical scholar and biblical archaeologist. It will also explain the origins and growth of the LES and how various Presbyterians influenced the organization and sought to advance a broader evangelical Protestant intellectual life in the difficult period of the 1920s and 1930s. Machen’s role will be highlighted, and the thinking of various evangelical scholars associated with the LES will be analyzed. This study is important because it helps us grasp how evangelical Protestantism rehabilitated and advanced itself intellectually in a period when the movement faced educational marginalization in the wider culture. Full article
(This article belongs to the Special Issue Evangelicalism: New Directions in Scholarship)
26 pages, 599 KB  
Article
Exposure of Mediterranean Countries to Ocean Acidification
by Nathalie Hilmi, Denis Allemand, Mine Cinar, Sarah Cooley, Jason M Hall-Spencer, Gunnar Haraldsson, Caroline Hattam, Ross A. Jeffree, James C. Orr, Katrin Rehdanz, Stéphanie Reynaud, Alain Safa and Sam Dupont
Water 2014, 6(6), 1719-1744; https://doi.org/10.3390/w6061719 - 16 Jun 2014
Cited by 23 | Viewed by 16546
Abstract
This study examines the potential effects of ocean acidification on countries and fisheries of the Mediterranean Sea. The implications for seafood security and supply are evaluated by examining the sensitivity of the Mediterranean to ocean acidification at chemical, biological, and macro-economic levels. The [...] Read more.
This study examines the potential effects of ocean acidification on countries and fisheries of the Mediterranean Sea. The implications for seafood security and supply are evaluated by examining the sensitivity of the Mediterranean to ocean acidification at chemical, biological, and macro-economic levels. The limited information available on impacts of ocean acidification on harvested (industrial, recreational, and artisanal fishing) and cultured species (aquaculture) prevents any biological impact assessment. However, it appears that non-developed nations around the Mediterranean, particularly those for which fisheries are increasing, yet rely heavily on artisanal fleets, are most greatly exposed to socioeconomic consequences from ocean acidification. Full article
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16 pages, 921 KB  
Article
Hepatic Oxidative Stress in Fructose-Induced Fatty Liver Is Not Caused by Sulfur Amino Acid Insufficiency
by Sachin S. Kunde, James R. Roede, Miriam B. Vos, Michael L. Orr, Young-Mi Go, Youngja Park, Thomas R. Ziegler and Dean P. Jones
Nutrients 2011, 3(11), 987-1002; https://doi.org/10.3390/nu3110987 - 18 Nov 2011
Cited by 18 | Viewed by 10785
Abstract
Fructose-sweetened liquid consumption is associated with fatty liver and oxidative stress. In rodent models of fructose-mediated fatty liver, protein consumption is decreased. Additionally, decreased sulfur amino acid intake is known to cause oxidative stress. Studies were designed to test whether oxidative stress in [...] Read more.
Fructose-sweetened liquid consumption is associated with fatty liver and oxidative stress. In rodent models of fructose-mediated fatty liver, protein consumption is decreased. Additionally, decreased sulfur amino acid intake is known to cause oxidative stress. Studies were designed to test whether oxidative stress in fructose-sweetened liquid-induced fatty liver is caused by decreased ad libitum solid food intake with associated inadequate sulfur amino acid intake. C57BL6 mice were grouped as: control (ad libitum water), fructose (ad libitum 30% fructose-sweetened liquid), glucose (ad libitum 30% glucose-sweetened water) and pair-fed (ad libitum water and sulfur amino acid intake same as the fructose group). Hepatic and plasma thiol-disulfide antioxidant status were analyzed after five weeks. Fructose- and glucose-fed mice developed fatty liver. The mitochondrial antioxidant protein, thioredoxin-2, displayed decreased abundance in the liver of fructose and glucose-fed mice compared to controls. Glutathione/glutathione disulfide redox potential (EhGSSG) and abundance of the cytoplasmic antioxidant protein, peroxiredoxin-2, were similar among groups. We conclude that both fructose and glucose-sweetened liquid consumption results in fatty liver and upregulated thioredoxin-2 expression, consistent with mitochondrial oxidative stress; however, inadequate sulfur amino acid intake was not the cause of this oxidative stress. Full article
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10 pages, 176 KB  
Article
The Effects of 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) on the Mortality and Growth of Two Amphibian Species (Xenopus laevis and Pseudacris triseriata)
by Alex Collier, Lowell Orr, Julie Morris and James Blank
Int. J. Environ. Res. Public Health 2008, 5(5), 368-377; https://doi.org/10.3390/ijerph5050368 - 31 Dec 2008
Cited by 10 | Viewed by 9395
Abstract
We observed a slight drop in the growth of Xenopus laevis and Pseudacris triseriata larvae following acute exposure (24-48 h) during egg development to three concentrations of TCDD (0.3, 3.0, 30.0 μg/l). Our exposure protocol was modeled on a previous investigation that was [...] Read more.
We observed a slight drop in the growth of Xenopus laevis and Pseudacris triseriata larvae following acute exposure (24-48 h) during egg development to three concentrations of TCDD (0.3, 3.0, 30.0 μg/l). Our exposure protocol was modeled on a previous investigation that was designed to mimic the effects of maternal deposition of TCDD. The doses selected were consistent with known rates of maternal transfer between mother and egg using actual adult body burdens from contaminated habitats. Egg and embryonic mortality immediately following exposure increased only among 48 h X. laevis treatments. Control P. triseriata and X. laevis completed metamorphosis more quickly than TCDDtreated animals. The snout-vent length of recently transformed P. triseriata did not differ between treatments although controls were heavier than high-dosed animals. Likewise, the snout-vent length and weight of transformed X. laevis did not differ between control and TCDD treatments. These findings provide additional evidence that amphibians, including P. triseriata and X. laevis are relatively insensitive to acute exposure to TCDD during egg and embryonic development. Although the concentrations selected for this study were relatively high, they were not inconsistent with our current understanding of bioaccumulation via maternal transfer. Full article
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15 pages, 21881 KB  
Case Report
A Pattern of Medication-Induced Persistent Bulbar and Cervical Dystonia
by James F. Bosma, Virginia C. Geoffrey, Bradley T. Thatch, James M. Weiffenbach, James F. Kavanaugh and William Orr
Int. J. Orofac. Myol. Myofunct. Ther. 1982, 8(1), 5-19; https://doi.org/10.52010/ijom.1982.8.1.3 - 1 Mar 1982
Cited by 6 | Viewed by 264
Abstract
A longitudinal, analytical, and treatment oriented case study is presented describing the effects of a medication-induced impairment of neurological function. The subject is an elderly, Caucasian, female whose presenting symptoms included spasmodic eyelid movement; lack of muscle tone and control for specific muscles [...] Read more.
A longitudinal, analytical, and treatment oriented case study is presented describing the effects of a medication-induced impairment of neurological function. The subject is an elderly, Caucasian, female whose presenting symptoms included spasmodic eyelid movement; lack of muscle tone and control for specific muscles of the head and neck region; generalized hyperactivity; plus distortion of speech and deglutition. Clinical investigation determined that the subject’s timed release antihistamine medication was the primary etiological factor in the presenting symptoms. Discontinuation of the medication resulted in a decrease, but not complete remission, of the symptoms. Clinical evaluation of the residual speech impairment included intensive therapy which was only minimally successful in reducing propositional speech distortion. The patient's neuropathy was inferred to be suprabulbar in site as a result of the speech analysis which is described as a reliable diagnostic aid in evaluation of severity of this type of neurological pathology. During the eight years of observation of this subject, documentation of the impairment was made by means of various media. Some of the results of this documentation accompany the study. Full article
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