Try a new search

Format these results:

Searched for:

person:mccles03

in-biosketch:true

Total Results:

20


Pretreatment stabilization increases completion of trauma-focused evidence-based psychotherapies

Staudenmeyer, Anna H; Maxwell, Susan; Mohlenhoff, Brian; Yasser, Julia; Schmitz, Martha; Metzler, Thomas; Maguen, Shira; Neylan, Thomas; Wolfe, William
OBJECTIVE:Veterans with posttraumatic stress disorder (PTSD) initiate and complete cognitive processing therapy (CPT) and prolonged exposure (PE) at low rates within Veterans Health Administration (VHA) despite substantial dissemination and training. This study investigated how trauma-informed, skills-based treatment ("stabilization") administered before CPT and PE was related to initiation and completion of trauma-focused evidence-based psychotherapies (TF-EBPs). METHOD/METHODS:= 341). Before initiation of TF-EBP, veterans received either no stabilization or received individual and/or group stabilization. RESULTS:= .090). CONCLUSIONS:Findings suggest that individual stabilization may improve delivery of TF-EBPs in VHA settings by increasing TF-EBP completion without reducing initiation, while pretreatment with group-only stabilization may reduce initiation of TF-EBPs. Results inform how models of care can improve TF-EBP retention and completion among veterans with PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
PMID: 35511541
ISSN: 1942-969x
CID: 5232802

Congenital myasthenic syndrome due to mutations in MUSK suggests that the level of MuSK phosphorylation is crucial for governing synaptic structure

Rodríguez Cruz, Pedro M; Cossins, Judith; Cheung, Jonathan; Maxwell, Susan; Jayawant, Sandeep; Herbst, Ruth; Waithe, Dominic; Kornev, Alexandr P; Palace, Jacqueline; Beeson, David
MUSK encodes the muscle-specific receptor tyrosine kinase (MuSK), a key component of the agrin-LRP4-MuSK-DOK7 signaling pathway, which is essential for the formation and maintenance of highly specialized synapses between motor neurons and muscle fibers. We report a patient with severe early-onset congenital myasthenic syndrome and two novel missense mutations in MUSK (p.C317R and p.A617V). Functional studies show that MUSK p.C317R, located at the frizzled-like cysteine-rich domain of MuSK, disrupts an integral part of MuSK architecture resulting in ablated MuSK phosphorylation and acetylcholine receptor (AChR) cluster formation. MUSK p.A617V, located at the kinase domain of MuSK, enhances MuSK phosphorylation resulting in anomalous AChR cluster formation. The identification and evidence for pathogenicity of MUSK mutations supported the initiation of treatment with β2-adrenergic agonists with a dramatic improvement of muscle strength in the patient. This work suggests uncharacterized mechanisms in which control of the precise level of MuSK phosphorylation is crucial in governing synaptic structure.
PMID: 31765060
ISSN: 1098-1004
CID: 4237572

IMPROVING RESIDENT EDUCATION AND MASTERY IN REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY FOR THE GENERALIST OB/GYN: A SURVEY-BASED [Meeting Abstract]

Gilmore, Emma V.; Blakemore, Jennifer K.; Maxwell, Susan; Devore, Shannon
ISI:000579355300240
ISSN: 0015-0282
CID: 4685202

Should every embryo undergo preimplantation genetic testing for aneuploidy? A review of the modern approach to in vitro fertilization

Maxwell, Susan M; Grifo, James A
Aneuploid conceptions constitute the majority of pregnancy failures in women of advanced maternal age. The best way to combat age-related decline in fertility is through preimplantation genetic testing for aneuploidy (PGT-A). PGT-A allows for better embryo selection, which improves implantation rates with single embryo transfer and reduces miscarriage rates. Single embryo transfers decrease multiple gestations and adverse pregnancy outcomes such as preterm or low birth weight infants. Advancements in extended embryo culture, blastocyst biopsy techniques, and 24-chromosome aneuploidy screening platforms have made PGT-A safe and accessible for all patients who undergo in vitro fertilization. Improved genomic coverage of new sequencing platforms, such as next-generation sequencing, has increased the identification and diagnosis of mosaicism and partial aneuploidies in preimplantation embryos. Mosaic embryos have decreased viability compared to euploid embryos when transferred, but some mosaic embryos result in normal live births. Whole genome amplification artifacts may contribute to a misdiagnosis of mosaicism, or some mosaic embryos may self-correct to euploid after implantation. For this reason, patients without euploid embryos should be given the option of transferring mosaic embryos after genetic counseling. Further research is needed to characterize which mosaic embryos may be viable.
PMID: 30146380
ISSN: 1532-1932
CID: 3255702

Next generation sequencing for preimplantation genetic screening improves pregnancy outcomes compared with array comparative genomic hybridization in single thawed euploid embryo transfer cycles

Friedenthal, Jenna; Maxwell, Susan M; Munné, Santiago; Kramer, Yael; McCulloh, David H; McCaffrey, Caroline; Grifo, James A
OBJECTIVE:To evaluate whether the use of next generation sequencing (NGS) for preimplantation genetic screening (PGS) in single thawed euploid embryo transfer (STEET) cycles improves pregnancy outcomes compared with array comparative genomic hybridization (aCGH). DESIGN/METHODS:Retrospective cohort study. SETTING/METHODS:Single university-based fertility center. PATIENT(S)/METHODS:A total of 916 STEET cycles from January 2014 to December 2016 were identified. Cases included 548 STEET cycles using NGS for PGS and controls included 368 STEET cycles using aCGH for PGS. INTERVENTION(S)/METHODS:Patients having a STEET after undergoing IVF and PGS with either NGS or aCGH. MAIN OUTCOME MEASURE(S)/METHODS:Primary outcomes were implantation rate, ongoing pregnancy/live birth rate (OP/LBR), biochemical pregnancy rate (PR), and spontaneous abortion (SAB) rate. RESULT(S)/RESULTS:The implantation rate was significantly higher in the NGS group compared with the aCGH group (71.6% vs. 64.6%). The OP/LBR was also significantly higher in the NGS group (62% vs. 54.4%), and there were significantly more biochemical pregnancies in the aCGH group compared with the NGS group (15.1% vs. 8.7%). After adjustment for confounding variables with a multiple logistic regression analysis, OP/LBR remained significantly higher in the NGS group. The SAB rate was not significantly different in the NGS group compared with the aCGH group (12.4% vs. 12.7%). CONCLUSION(S)/CONCLUSIONS:Preimplantation genetic screening using NGS significantly improves pregnancy outcomes versus PGS using aCGH in STEET cycles. Next-generation sequencing has the ability to identify and screen for embryos with reduced viability such as mosaic embryos and those with partial aneuploidies or triploidy. Pregnancy outcomes with NGS may be improved due to the exclusion of these abnormal embryos.
PMID: 29605407
ISSN: 1556-5653
CID: 3025962

THE PROGESTIN-CONTAINING INTRAUTERINE DEVICE (IUD) DURING OVARIAN STIMULATION AND OOCYTE RETRIEVAL: SHOULD IT STAYOR SHOULD IT GO? [Meeting Abstract]

Friedenthal, J; Maxwell, SM; Willson, S; McCulloh, DH; Grifo, J; Goldman, KN
ISI:000409446000025
ISSN: 1556-5653
CID: 2713832

DETERMINING THE ODDS OF PREGNANCY IN BRCA POSITIVE WOMEN UNDERGOING COMBINED PREIMPLANTATION GENETIC DIAGNOSIS (PGD) AND SCREENING. [Meeting Abstract]

Sachdev, NM; Maxwell, SM; Jordan, A; Prates, R; Konstantinidis, M; Licciardi, F
ISI:000409446002011
ISSN: 1556-5653
CID: 2713672

PREGNANCY OUTCOMES FOLLOWING TRANSFER OF EMBRYOS DIAGNOSED AS CHROMOSOMALLY MOSAIC BY NEXT-GENERATION SEQUENCING (NGS). [Meeting Abstract]

Besser, A; Maxwell, SM; Friedenthal, J; Munne, S; McCaffrey, C; Grifo, J
ISI:000409446002026
ISSN: 1556-5653
CID: 2713662

CLINICAL ERROR RATES OF NEXT GENERATION SEQUENCING (NGS) COMPARED TO ARRAY COMPARATIVE GENOMIC HYBRIDIZATION (ACGH) INEUPLOID BLASTOCYSTS. [Meeting Abstract]

Friedenthal, J; Maxwell, SM; Tiegs, AW; Besser, A; McCaffrey, C; Munne, S; Noyes, N; Grifo, J
ISI:000409446002092
ISSN: 1556-5653
CID: 2713612

Clinical implementation of next-generation sequencing (NGS) for preimplantation genetic screening (PGS) improves pregnancy outcomes [Meeting Abstract]

Friedenthal, J; Maxwell, S; Munne, S; Kramer, Y; McCaffrey, C; Grifo, J
Study question: Does NGS for PGS improve pregnancy outcomes as compared to array comparative genomic hybridization (aCGH)? Summary answer: NGS improves implantation and ongoing pregnancy rates/live birth rates compared to aCGH among patients undergoing in vitro fertilization (IVF) with PGS. What is known already: Array CGH is widely used for IVF with PGS. NGS, a new platform for PGS, may be able to detect more cases of mosaicism and triploidy (69XXY) than aCGH. Genetic abnormalities detected by NGS are significantly higher among pregnancies resulting in miscarriage than live birth. Study design, size, duration: This was a retrospective study of 1015 patients undergoing IVF with PGS followed by single thawed euploid embryo transfer (STEET) from 1/2014 to 12/2016 at a single university medical center. Participants/materials, setting, methods: All IVF cycles with PGS and STEET were included. Oocyte thaws for biopsy, double embryo transfers (ET), mosaic ET, or cycles with incomplete outcome data were excluded. Primary outcomes: implantation rate (IR), spontaneous abortion rate (SABR), and ongoing pregnancy rate/live birth rate (OPR/LBR). Demographic data included age, gravidity, parity, number of prior IVF cycles, ovarian reserve testing, and infertility diagnosis. Student's t-test and Fisher's exact test were used for statistical analysis with P < 0.05 considered significant. Main results and the role of chance: 424 patients underwent PGS with aCGH, and 591 patients underwent PGS with NGS. 18 patients were excluded from the NGS group for incomplete outcome data (11) or mosaic ET (7). There was no difference in baseline demographics between groups. The mean age of patients was 35.7 years. IR was significantly higher in the NGS group compared to the aCGH group (71.7% vs. 65.1%, p = 0.027). The OPR/LBR was also significantly higher in the NGS group (62.3% vs. 55.0%, p = 0.023). The SABR was decreased in the NGS group compared to the aCGH group, but this was not statistically significant (11.9% vs. 12.7%., p = 0.813). Limitations, reasons for caution: This study was limited by its retrospective design. Prospective data on the outcomes of mosaic embryo transfers is needed to determine their true implantation potential. Wider implications of the findings: PGS using NGS significantly improves pregnancy outcomes over PGS using aCGH. Mosaic embryos may have reduced implantation potential. Therefore, the exclusion of mosaic embryos with NGS may explain these results
EMBASE:617483832
ISSN: 1460-2350
CID: 2665512