1
|
Nikitas J, Subramanian K, Proudfoot J, Davicioni E, Ricaurte-Fajardo A, Armstrong WR, Czernin J, Osborne JR, Marciscano AE, Smith CP, Valle L, Steinberg ML, Boutros P, Rettig M, Reiter RE, Weiner A, Barbieri CE, Calais J, Nagar H, Kishan AU. Predictive Value of Genomic Classifier Scores and Transcriptomic Data for Prostate Cancer Distant Metastasis Risk: A Multicenter Retrospective Study. Int J Radiat Oncol Biol Phys 2023; 117:e423-e424. [PMID: 37785390 DOI: 10.1016/j.ijrobp.2023.06.1581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) has a greater specificity and sensitivity for detection of extraprostatic prostate cancer than conventional imaging. The Decipher genomic classifier is an established prognostic biomarker being evaluated for its ability to predict systemic treatment intensification. The relationship between Decipher scores and PSMA-based spread remains unknown, as do differences in transcriptomic patterns of PSMA PET-based spread in the de novo vs. recurrent setting. MATERIALS/METHODS We retrospectively identified patients who (a) had undergone staging with a PSMA PET prior to treatment or for evaluation of recurrence post-radical prostatectomy (RP) at two institutions and (b) had transcriptomic data available from the Genomics Resource for Intelligent Discovery (GRID) database from either biopsy or RP specimens. We classified the PSMA PET pattern of spread using molecular imaging (mi) staging as localized (miT+N0M0), node-positive (miN1M0), distant metastasis (miM1a-c), or negative/non-diagnostic. We used logistic regression to calculate the odds ratios (OR) with 95% confidence intervals (CI) for distant metastasis risk based on Decipher score both pre-treatment and post-RP. As an exploratory analysis, we compared each of the staging groups for differences in important transcriptomic signatures. Kruskal-Wallis and Pearson chi-squared tests were used for continuous and categorical variables, respectively. RESULTS A total of 315 patients were included in this analysis (n = 164 pre-treatment, n = 151 post-RP). Eighty PSMA PET scans were negative, while 147 were miT+N0M0, 45 were miN1M0, and 43 were miM1a-c. A higher Decipher score was associated with distant metastasis (miM1a-c) on PSMA PET both pre-treatment (OR 1.3 [95% CI: 1.0-1.7] per 0.1 increase in Decipher score, P = 0.05) and post-RP (OR 1.2 [1.0-1.4] per 0.1 increase in Decipher score, P = 0.04). There were higher TP53 mutation (P = 0.01) and cell cycle progression (P = 0.04) signature scores in miM1a-c patients compared to miN1M0 or miT+N0M0 patients. Basal subtype was more prevalent per PAM50 in miM1a-c or miN1M0 patients (36%) than miT+N0M0 patients (19%, P=0.01). Patients with de novo miN1M0 or miM1a disease (n = 19) had higher Decipher scores (0.85 vs 0.57, P = 0.10) and IFNa response (P = 0.08) than patients with recurrent miN1M0 or miM1a disease (n = 35). CONCLUSION Higher Decipher scores were associated with distant metastasis on PSMA PET in both the de novo and recurrent setting. Transcriptomic differences in pathways related to proliferation, p53 status, and PAM50 classification were seen when comparing localized, node-positive, and distant metastatic disease. Patients with de novo miN1M0 or miM1a disease may harbor more aggressive disease than those with miN1M0 or miM1a disease at recurrence.
Collapse
Affiliation(s)
- J Nikitas
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - K Subramanian
- Department of Nuclear Medicine, New York-Presbyterian/Weill Cornell Hospital, New York, NY
| | | | | | - A Ricaurte-Fajardo
- Department of Radiology, New York-Presbyterian/Weill Cornell Hospital, New York, NY
| | - W R Armstrong
- Ahmanson Translational Theranostics Division, UCLA Nuclear Medicine, Los Angeles, CA
| | - J Czernin
- Ahmanson Translational Theranostics Division, UCLA Nuclear Medicine, Los Angeles, CA
| | - J R Osborne
- Department of Radiology, New York-Presbyterian/Weill Cornell Medical Center, New York, NY
| | - A E Marciscano
- Department of Radiation Oncology, New York-Presbyterian Hospital / Weill Cornell Medical College, New York, NY
| | - C P Smith
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - L Valle
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - M L Steinberg
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - P Boutros
- Department of Urology, University of California, Los Angeles, Los Angeles, CA
| | - M Rettig
- Department of Urology, University of California, Los Angeles, Los Angeles, CA
| | - R E Reiter
- Department of Urology, University of California, Los Angeles, Los Angeles, CA
| | - A Weiner
- Department of Urology, University of California, Los Angeles, Los Angeles, CA
| | - C E Barbieri
- Department of Urology, New York-Presbyterian/Weill Cornell Medical Center, New York, NY
| | - J Calais
- Ahmanson Translational Theranostics Division, UCLA Nuclear Medicine, Los Angeles, CA
| | - H Nagar
- Department of Radiation Oncology, New York-Presbyterian/Weill Cornell Hospital, New York, NY
| | - A U Kishan
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| |
Collapse
|
2
|
Sierra I, Pyfrom S, Weiner A, Zhao G, Driscoll A, Yu X, Gregory BD, Vaughan AE, Anguera MC. Unusual X chromosome inactivation maintenance in female alveolar type 2 cells is correlated with increased numbers of X-linked escape genes and sex-biased gene expression. Stem Cell Reports 2023; 18:489-502. [PMID: 36638790 PMCID: PMC9968984 DOI: 10.1016/j.stemcr.2022.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 01/13/2023] Open
Abstract
Sex differences exist for many lung pathologies, including COVID-19 and pulmonary fibrosis, but the mechanistic basis for this remains unclear. Alveolar type 2 cells (AT2s), which play a key role in alveolar lung regeneration, express the X-linked Ace2 gene that has roles in lung repair and SARS-CoV-2 pathogenesis, suggesting that X chromosome inactivation (XCI) in AT2s might impact sex-biased lung pathology. Here we investigate XCI maintenance and sex-specific gene expression profiles using male and female AT2s. Remarkably, the inactive X chromosome (Xi) lacks robust canonical Xist RNA "clouds" and less enrichment of heterochromatic modifications in human and mouse AT2s. We demonstrate that about 68% of expressed X-linked genes in mouse AT2s, including Ace2, escape XCI. There are genome-wide expression differences between male and female AT2s, likely influencing both lung physiology and pathophysiologic responses. These studies support a renewed focus on AT2s as a potential contributor to sex-biased differences in lung disease.
Collapse
Affiliation(s)
- Isabel Sierra
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sarah Pyfrom
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aaron Weiner
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gan Zhao
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amanda Driscoll
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Xiang Yu
- Joint International Research Laboratory of Metabolic & Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Brian D Gregory
- Department of Biology, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew E Vaughan
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA; Institute for Regenerative Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Penn Lung Biology Institute, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Montserrat C Anguera
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA; Institute for Regenerative Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| |
Collapse
|
3
|
Schaeffer E, Proudfoot J, Li E, Weiner A, Aguiar J, Hakansson A, Zhao X, Liu Y, Davicioni E, Ross A. 1377P Transcriptomic based indicators of potential therapeutic response to targeted therapy among 50,000 men with localized prostate cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
4
|
Weiner A, Alday A, Muriana A, Quevedo C, Rodríguez C. P06-11 Validation of zebrafish embryotoxicity test (ZET) as a qualified alternative assay for its regulatory use. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
5
|
Lam LKM, Murphy S, Kokkinaki D, Venosa A, Sherrill-Mix S, Casu C, Rivella S, Weiner A, Park J, Shin S, Vaughan AE, Hahn BH, Odom John AR, Meyer NJ, Hunter CA, Worthen GS, Mangalmurti NS. DNA binding to TLR9 expressed by red blood cells promotes innate immune activation and anemia. Sci Transl Med 2021; 13:eabj1008. [PMID: 34669439 DOI: 10.1126/scitranslmed.abj1008] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- L K Metthew Lam
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sophia Murphy
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Dimitra Kokkinaki
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Alessandro Venosa
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT 84112, USA
| | - Scott Sherrill-Mix
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Microbiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Carla Casu
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Stefano Rivella
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Aaron Weiner
- Department of Biomedical Sciences, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA 19104, USA
| | - Jeongho Park
- Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA 19104, USA
| | - Sunny Shin
- Department of Microbiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Andrew E Vaughan
- Department of Biomedical Sciences, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA 19104, USA
| | - Beatrice H Hahn
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Microbiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Audrey R Odom John
- Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Nuala J Meyer
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christopher A Hunter
- Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA 19104, USA.,Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - G Scott Worthen
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.,Division of Neonatalogy, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Nilam S Mangalmurti
- Division of Pulmonary, Allergy and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| |
Collapse
|
6
|
Javed S, Mustehsan M, Weiner A, Zhang L, Ayala R, Taub C. 4119Predictors of progression of preclinical left ventricular diastolic dysfunction to clinical heart failure in patients with malignancy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Preclinical diastolic dysfunction PDD is a well-known but poorly understood risk factor for clinical heart failure CHF. Preclinical diastolic dysfunction and predictors of progression of PDD to CHF in patients with malignancy has never been studied.
Purpose
The purpose of our study was to determine the incidence of CHF in cancer patients who have preexisting preclinical diastolic dysfunction, with a particular focus on identifying the risk factors contributing to progression of PDD to CHF.
Study design
We retrospectively sought all the patients who underwent echocardiography from 2003 to 2008 and were found to have preclinical diastolic dysfunction at our institution. PDD was defined as presence of grade I diastolic dysfunction, LVEF ≥50%, and free of clinical diagnosis of heart failure. Of these, only the patients who had a confirmed histopathological diagnosis of malignancy were included in the study. The end point was incidence of clinical heart failure, HFrEF and HFpEF. Multivariable adjusted Cox proportional hazards regression were performed to study the predictors of CHF.
Results
Out of 1086 patients with PDD and a histopathological diagnosis of malignancy, 208 patients were diagnosed with new onset CHF during the 10 years follow-up. Incidence of CHF, HFpEF and HFrEF was found to be 32.1 per 1,000 person-year, 13.9 per 1,000 person-year and 2.93 per 1,000 person-year respectively. Patients who developed clinical heart failure were found to have more hypertension, diabetes, myocardial infarction, peripheral vascular disease, pulmonary disease, renal disease, hematological malignancies and metastatic disease when compared to patients who did not develop heart failure. In multivariable adjusted Cox regression analysis, age at index date (HR 1.02, 95% CI 1.01–1.04, p=0.001), diabetes (HR 1.74, 95% CI 1.28–2.35, p<0.001), myocardial infarction (HR 2.19, 95% CI 1.49–3.20, p<0.001), lung disease (HR 1.53, 95% CI 1.14–2.06, p=0.004) and renal disease (HR 2.03, 95% CI 1.45–2.84, p<0.001) were independent predictors of CHF in patients with PDD and malignancy. Among chemotherapy agents, Vincristine, Ifosfamide, transtuzumab and Bortezomib were found to be associated with CHF.
Conclusion
This is the first study ever to report the incidence of CHF, HFrEF and HFpEF and identify a distinct set of predictors of heart failure in patients with PDD and malignancy. We estimated a much higher incidence of CHF (19%) in our study population, when compared to the general population with malignancy. Our study also depicted a significantly high incidence of HFpEF compared to HFrEF (8.3% vs 1.75%). Our study shows that patients with malignancy are at a significantly higher risk of developing heart failure if they have preexisting diastolic dysfunction. This emphasizes the importance of identifying patients with diastolic dysfunction and a more rigorous cardiovascular surveillance to prevent them from potential heart failure.
Acknowledgement/Funding
None
Collapse
Affiliation(s)
- S Javed
- Albert Einstein College of Medicine, Bronx, United States of America
| | - M Mustehsan
- Albert Einstein College of Medicine, Bronx, United States of America
| | - A Weiner
- Albert Einstein College of Medicine, Bronx, United States of America
| | - L Zhang
- Albert Einstein College of Medicine, Bronx, United States of America
| | - R Ayala
- Jacobi Medical Center, Bronx, United States of America
| | - C Taub
- Albert Einstein College of Medicine, Bronx, United States of America
| |
Collapse
|
7
|
Kertser A, Baruch K, Deczkowska A, Weiner A, Croese T, Kenigsbuch M, Cooper I, Tsoory M, Ben-Hamo S, Amit I, Schwartz M. Corticosteroid signaling at the brain-immune interface impedes coping with severe psychological stress. Sci Adv 2019; 5:eaav4111. [PMID: 31149632 PMCID: PMC6541460 DOI: 10.1126/sciadv.aav4111] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 04/22/2019] [Indexed: 05/22/2023]
Abstract
The immune system supports brain plasticity and homeostasis, yet it is prone to changes following psychological stress. Thus, it remains unclear whether and how stress-induced immune alterations contribute to the development of mental pathologies. Here, we show that following severe stress in mice, leukocyte trafficking through the choroid plexus (CP), a compartment that mediates physiological immune-brain communication, is impaired. Blocking glucocorticoid receptor signaling, either systemically or locally through its genetic knockdown at the CP, facilitated the recruitment of Gata3- and Foxp3-expressing T cells to the brain and attenuated post-traumatic behavioral deficits. These findings functionally link post-traumatic stress behavior with elevated stress-related corticosteroid signaling at the brain-immune interface and suggest a novel therapeutic target to attenuate the consequences of severe psychological stress.
Collapse
Affiliation(s)
- A. Kertser
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - K. Baruch
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - A. Deczkowska
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - A. Weiner
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - T. Croese
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - M. Kenigsbuch
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - I. Cooper
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel
| | - M. Tsoory
- Department of Veterinary Resources, Weizmann Institute of Science, Rehovot, Israel
| | - S. Ben-Hamo
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - I. Amit
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - M. Schwartz
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- Corresponding author.
| |
Collapse
|
8
|
Abstract
Envenomation by spiders or scorpions is a public health problem in many parts of the world and is not isolated to the tropics and subtropics. Spiders and scorpions can be unintentionally transported globally, and keeping them as pets is becoming more popular, so envenomation can occur anywhere. Emergency nurses should be prepared to assess and treat patients who present with a bite or sting. This article gives an overview of the signs, symptoms and treatment of envenomation by species of arachnids that are clinically significant to humans.
Collapse
Affiliation(s)
- Stephen McGhee
- University of South Florida College of Nursing, Tampa, Florida, US
| | | | - Alan Finnegan
- Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust
| | | | - John M Clochesy
- University of South Florida College of Nursing, Tampa, Florida, US
| | - Brian Graves
- University of South Florida College of Nursing, Tampa, Florida, US
| |
Collapse
|
9
|
Houghton M, Selby M, Weiner A, Choo QL. Hepatitis C virus: structure, protein products and processing of the polyprotein precursor. Curr Stud Hematol Blood Transfus 2015:1-11. [PMID: 7956324 DOI: 10.1159/000423264] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
10
|
Goldin D, Emerson S, Goike J, Weiner A, Schultz C, Vartanian S, Savin M, Kirsch M. Indirect predictors of peak skin dose during high risk interventional procedures: A data driven approach to find a better method than total fluoroscopy time. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
11
|
Yorkin M, McKinley J, Yablonsky C, Weiner A, Byrd-Bredbenner C. Hungry Planet: Nutrient Density of Household Food Supplies in 24 Nations. J Acad Nutr Diet 2012. [DOI: 10.1016/j.jand.2012.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
12
|
Kapishnikov S, Weiner A, Als-Nielsen J, Elbaum M, Leiserowitz L. Oriented nucleation of hemozoin at the food vacuole membrane in Plasmodium falciparum. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311092968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
13
|
Wang S, Xiao S, Weiner A. Broadband, high spectral resolution 2-D wavelength-parallel polarimeter for Dense WDM systems. Opt Express 2005; 13:9374-9380. [PMID: 19503138 DOI: 10.1364/opex.13.009374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A broadband wavelength-parallel polarimeter has been designed or polarization measurements of multiple Dense WDM channels in parallel, which is based on a 2-D spectral disperser via a diffraction grating and a virtually-imaged phased-array (VIPA). At a hyperfine 2.8 GHz sub-channel spacing, we have demonstrated spectral polarization measurements of ~1500 sub-channels (~32 nm spectral range), with a potential total measurement time of less than 5 ms.
Collapse
|
14
|
Mínguez-Vega G, McKinney J, Weiner A. A programmable Fresnel transform pulse shaper. Opt Express 2005; 13:8056-8068. [PMID: 19498836 DOI: 10.1364/opex.13.008056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We demonstrate the first reprogrammable Fresnel transform pulse shaper based on a modified direct space-to-time pulse shaping apparatus. In our approach, the pulse shaping lens and mask are implemented by a dual-layer liquid crystal spatial light modulator. The input mask subsequently undergoes a free-space Fresnel transform which causes quadratic dispersion of the output temporal waveform. When used as a spectrometer, we demonstrate that the passband function of the apparatus (determined by the Fourier transform of the input spatial mask) may be chosen to exhibit a user-defined scale. Here we present the theory of operation, as well as experimental verification in both the time- and frequency-domains.
Collapse
|
15
|
|
16
|
McKinney J, Weiner A. Engineering of the passband function of a generalized spectrometer. Opt Express 2004; 12:5022-5036. [PMID: 19484058 DOI: 10.1364/opex.12.005022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
To our knowledge, we demonstrate a new scheme for passband engineering of a grating spectrometer. Through spatial masking of the input beam and translation of the optical components we present shaping, shifting, and scaling of the passband in optical frequency. Specifically, we demonstrate the relationship between the applied spatial masking function and the spectrometer passband may be tuned from an exact Fourier transform to a direct scaling through longitudinal displacement of the spectrometer lens and sampling slit and that this operation is independent of the choice of spectrometer center frequency.
Collapse
|
17
|
Nelson R, Leaird D, Weiner A. Programmable polarization-independent spectral phase compensation and pulse shaping. Opt Express 2003; 11:1763-1769. [PMID: 19466057 DOI: 10.1364/oe.11.001763] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We report the first use of a double-layer liquid crystal modulator array for spectral phase pulse shaping that operates independent of polarization. Such insensitivity to polarization is crucial for fiber applications, e.g., dispersion compensation.
Collapse
|
18
|
Orengo-Nania S, Landry T, Von Tress M, Silver LH, Weiner A, Davis AA. Evaluation of travoprost as adjunctive therapy in patients with uncontrolled intraocular pressure while using timolol 0.5%. Am J Ophthalmol 2001; 132:860-8. [PMID: 11730649 DOI: 10.1016/s0002-9394(01)01257-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the intraocular pressure-lowering efficacy and safety of travoprost 0.0015% and 0.004%, dosed daily in the evening compared with vehicle, in patients with open-angle glaucoma or ocular hypertension, whose intraocular pressure was not adequately controlled on timolol 0.5% twice daily (twice daily). METHODS Subjects who qualified at screening began a run-in period dosing timolol twice daily for 3 weeks. If the subjects had an intraocular pressure of 24 to 36 mm Hg at 8 AM and 21 to 36 mm Hg at 10 AM and 4 pm in at least one eye on timolol, they were randomized to one of two concentrations of travoprost (0.0015% or 0.004%) or vehicle solution every day and were followed for 6 months. Four hundred twenty-six subjects were randomized. The mean intraocular pressure at 8 AM, 10 AM, and 4 PM in the patient's eye with the higher intraocular pressure was used for the analysis. RESULTS Mean baseline values (25 mm Hg) for subjects at eligibility (while maintained on timolol) were not significantly different (P <.0001) among the treatment groups. The intraocular pressure was lowered an additional -5.7 to -7.2 mm Hg and -5.1 to -6.7 mm Hg in the travoprost 0.004% and 0.0015% concentrations, respectively. These changes were significantly (P < or =.0001) different from the vehicle group (-1.3 to -2.8 mm Hg). The intraocular pressure range on treatment at all visit times over the 6-month treatment period ranged from 17.9 to 19.2 mm Hg for travoprost 0.004% and 18.3 to 20.1 mm Hg for travoprost 0.0015% compared with 22.4 to 24.1 mm Hg for vehicle. Average hyperemia scores ranged from trace to mild (mean 0.5 on a scale of 0 = none/trace; 1= mild; 2 = moderate; 3 = severe) for all treatment groups. No iris pigmentation changes were observed in any patient during this study. There were no clinically or statistically significant changes from baseline in visual acuity, ocular cells and flare, fundus parameter, cup-to-disk ratio and visual field between the treatment groups. There were no serious adverse events reported for any treatment group. CONCLUSIONS Travoprost produced clinically relevant and statistically significant additional intraocular pressure reductions from baseline when used adjunctively with timolol in subjects with open-angle glaucoma or ocular hypertension.
Collapse
Affiliation(s)
- S Orengo-Nania
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin, NC-205, Houston, TX 77030, USA.
| | | | | | | | | | | |
Collapse
|
19
|
Netland PA, Landry T, Sullivan EK, Andrew R, Silver L, Weiner A, Mallick S, Dickerson J, Bergamini MV, Robertson SM, Davis AA. Travoprost compared with latanoprost and timolol in patients with open-angle glaucoma or ocular hypertension. Am J Ophthalmol 2001; 132:472-84. [PMID: 11589866 DOI: 10.1016/s0002-9394(01)01177-1] [Citation(s) in RCA: 325] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study evaluated the safety and intraocular pressure-lowering efficacy of two concentrations of travoprost (0.0015% and 0.004%) compared with latanoprost 0.005% and timolol 0.5% in patients with open-angle glaucoma or ocular hypertension. METHODS Eight hundred one patients with open-angle glaucoma or ocular hypertension were randomly assigned to travoprost 0.0015%, travoprost 0.004%, latanoprost 0.005%, or timolol 0.5%. The efficacy and safety of travoprost (0.0015% and 0.004%) daily was compared with latanoprost daily and timolol twice daily for a period of 12 months. RESULTS Travoprost was equal or superior to latanoprost and superior to timolol with mean intraocular pressure over visits and time of day ranging from 17.9 to 19.1 mm Hg (travoprost 0.0015%), 17.7 to 19.1 mm Hg (travoprost 0.004%), 18.5 to 19.2 mm Hg (latanoprost), and 19.4 to 20.3 mm Hg (timolol). For all visits pooled, the mean intraocular pressure at 4 PM for travoprost was 0.7 mm Hg (0.0015%, P =.0502) and 0.8 mm Hg (0.004%, P =.0191) lower than for latanoprost. Travoprost 0.004% was more effective than latanoprost and timolol in reducing intraocular pressure in black patients by up to 2.4 mm Hg (versus latanoprost) and 4.6 mm Hg (versus timolol). Based on a criterion of 30% or greater intraocular pressure reduction from diurnal baseline or intraocular pressure 17 mm Hg or less, travoprost 0.0015% and 0.004% had an overall response to treatment of 49.3% and 54.7%, respectively, compared with 49.6% for latanoprost and 39.0% for timolol. Iris pigmentation change was observed in 10 of 201 of patients (5.0%) receiving travoprost 0.0015%, six of 196 of patients (3.1%) receiving travoprost 0.004%, 10 of 194 of patients (5.2%) receiving latanoprost, and none of the patients receiving timolol (0 of 196). The average ocular hyperemia score was less than 1 on a scale of 0 to 3, indicating that on average patients experienced between none/trace and mild for all treatment groups. There were no serious, unexpected, related adverse events reported for any therapy. CONCLUSIONS Travoprost (0.0015% and 0.004%), a highly selective, potent prostaglandin F (FP) receptor agonist, is equal or superior to latanoprost and superior to timolol in lowering intraocular pressure in patients with open-angle glaucoma or ocular hypertension. In addition, travoprost 0.004% is significantly better than either latanoprost or timolol in lowering intraocular pressure in black patients. Travoprost is safe and generally well tolerated in the studied patient population.
Collapse
Affiliation(s)
- P A Netland
- Department of Ophthalmology, University of Tennessee Health Science Center, 956 Court Ave., Memphis, TN 38163, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Kane RL, Weiner A, Homyak P, Bershadsky B. The Minnesota Senior Health Options program: an early effort at integrating care for the dually eligible. J Gerontol A Biol Sci Med Sci 2001; 56:M559-66. [PMID: 11524448 DOI: 10.1093/gerona/56.9.m559] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Duplication of funding and resultant inefficiencies have prompted active consideration of pooling the funding for persons covered by both Medicare and Medicaid into a single managed care program. This study reports the initial results of the first such program. METHODS A sample of enrollees in Minnesota Senior Health Options (MSHO) and two sets of controls (within the same catchment area and outside it) as well as their families were interviewed to assess their functional status and satisfaction with their medical care. Respondents included those living in the community and those living in nursing homes. RESULTS The MSHO and control samples were generally alike in terms of demographics and illness patterns. The differences that were found reflected those attributable to geographic location more than program. The groups were also similar with regard to functional status. There were few satisfaction differences among the community-dwelling samples, but the MSHO nursing residents and especially their families expressed more satisfaction with several aspects of care. CONCLUSIONS Whereas no causal conclusions about outcomes can be drawn from a cross-sectional sample, there is no indication that managed care for the dually eligible population has profound impacts on care. However, the system of care provided to nursing home residents is appreciated over traditional care.
Collapse
Affiliation(s)
- R L Kane
- University of Minnesota School of Public Health, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
| | | | | | | |
Collapse
|
21
|
Obert JL, McCann MJ, Marinelli-Casey P, Weiner A, Minsky S, Brethen P, Rawson R. The matrix model of outpatient stimulant abuse treatment: history and description. J Psychoactive Drugs 2000; 32:157-64. [PMID: 10908003 DOI: 10.1080/02791072.2000.10400224] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The Matrix model was originally developed in response to the cocaine epidemic of the 1980s. The program consists of relapse prevention groups, education groups, social support groups, individual counseling, and urine and breath testing delivered in a structured manner over a 16-week period. The treatment is a directive, nonconfrontational approach which focuses on current issues and behavior change. Several evaluations of the model have supported its usefulness and efficacy with methamphetamine (MA) users. Methamphetamine users appear to respond to treatment similarly to cocaine users and many continue to show improvements at follow-up.
Collapse
Affiliation(s)
- J L Obert
- Matrix Institute on Addictions, Los Angeles, California 90025, USA
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
Computers have brought social, cultural, and economic benefits. They also are challenging social workers to preserve a basic tenet of the profession--confidentiality. Electronic record systems and rapid changes in communication over the Internet are outpacing the profession's ability to ensure privacy. This article discusses ideas of information protection and makes recommendations to minimize violations of privacy.
Collapse
Affiliation(s)
- S R Gelman
- Wurzweiler School of Social Work, Yeshiva University, New York City 10033, USA
| | | | | |
Collapse
|
23
|
Robertson B, Myers G, Howard C, Brettin T, Bukh J, Gaschen B, Gojobori T, Maertens G, Mizokami M, Nainan O, Netesov S, Nishioka K, Shin i T, Simmonds P, Smith D, Stuyver L, Weiner A. Classification, nomenclature, and database development for hepatitis C virus (HCV) and related viruses: proposals for standardization. International Committee on Virus Taxonomy. Arch Virol 1999; 143:2493-503. [PMID: 9930205 DOI: 10.1007/s007050050479] [Citation(s) in RCA: 323] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
24
|
Weiner A. Nature, nurture, and memory in a Socialist utopia: delineating the Soviet socio-ethnic body in the age of Socialism. Am Hist Rev 1999; 104:1114-1155. [PMID: 19291898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
|
25
|
Abstract
OBJECTIVE To determine whether foveal function distal to the ganglion cell layer is an independent predictor of central visual field function in glaucoma. SETTING University affiliated hospital and private practice. PARTICIPANTS Twenty-seven eyes (27 patients) with normal-pressure glaucoma, 10 eyes (10 patients) with primary open-angle glaucoma, and 47 eyes of 47 matched normal volunteers. INTERVENTION AND MAIN OUTCOME MEASURES Foveal cone electroretinogram (ERG) amplitude, relative optic cup to disc area and their relations to Humphrey full-threshold 30-2 visual field central 4-point mean total deviation (C4MTD) and pattern deviation (C4MPD). RESULTS Foveal cone ERG amplitude was subnormal in 14 (37.8%) of the 37 glaucomatous eyes and lower in the glaucoma group compared with normal eyes (P<.01). The C4MTD and C4MPD were lower in glaucomatous eyes with subnormal amplitudes compared with those with normal amplitudes (P<.01 and P<.05, respectively). Amplitude was directly correlated with C4MTD (P<.01) and C4MPD (P<.01). Relative optic cup to disc area was inversely correlated with C4MTD (P<.001) and C4MPD (P<.001). Partial correlation analysis revealed that amplitude and relative optic cup to disc area were independent predictors of C4MTD and C4MPD. CONCLUSION Foveal function distal to the ganglion cell layer and optic disc cupping independently predict central visual field function in glaucoma.
Collapse
Affiliation(s)
- A Weiner
- Division of Ophthalmology, St Luke's Medical Center, Cleveland, Ohio 44104, USA.
| | | | | | | | | | | |
Collapse
|
26
|
Weiner A, Schmidt ME, Patel S, Gussler CH, Remler BF, Kaufman SR, Kohn HD, Weidenthal DT. Foveal outer retinal function in eyes with unexplained visual symptoms or acuity loss. Arch Ophthalmol 1998; 116:1161-8. [PMID: 9747673 DOI: 10.1001/archopht.116.9.1161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine whether foveal outer retinal dysfunction is common in eyes with unexplained visual symptoms or acuity loss. DESIGN Prospective study. PARTICIPANTS Seventy-three eyes of 44 consecutive patients with unexplained visual symptoms or acuity loss, 39 eyes of 39 control subjects, and 12 eyes of 7 patients with known maculopathy. INTERVENTION Foveal cone electroretinography (ERG) and letter recognition perimetry. MAIN OUTCOME MEASURES Foveal cone ERG data. RESULTS Abnormal foveal cone ERG data were recorded in 35 (48%) of 73 eyes (23 [52%] of 44 patients). Among these 35 eyes, amplitude was lower than in normal controls (P<.001) and was correlated with visual acuity and the number of letter recognition perimetry errors (P<.05 for both). The latter was higher in eyes with abnormal retinal responses than in symptomatic eyes with normal responses (P<.01). However, initial symptoms, visual acuity, and macular appearance did not differentiate between these 2 groups. Foveal cone ERG test vs retest data showed consistent results. CONCLUSION Foveal outer retinal dysfunction is a common underlying mechanism of previously unexplained visual symptoms or acuity loss. Foveal cone ERG testing should be considered early in the evaluation of eyes with this presentation.
Collapse
Affiliation(s)
- A Weiner
- Division of Ophthalmology, Saint Luke's Medical Center, Cleveland, Ohio 44104, USA.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Bayer M, Orlando J, McCorraick M, Weiner A, Deckel A. Persistent neurological sequelae following chronic exposure to carbon monoxide. Toxicol Lett 1998. [DOI: 10.1016/s0378-4274(98)80311-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
28
|
Sandberg MA, Weiner A, Miller S, Gaudio AR. High-risk characteristics of fellow eyes of patients with unilateral neovascular age-related macular degeneration. Ophthalmology 1998; 105:441-7. [PMID: 9499774 DOI: 10.1016/s0161-6420(98)93025-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE This study aimed to determine whether clinical tests of ocular function and macular appearance independently can help to predict which patients with unilateral neovascular age-related macular degeneration (AMD) will have a choroidal neovascular membrane (CNVM) develop in their fellow eye. DESIGN The study design was a prospective cohort study. PARTICIPANTS One hundred twenty-seven patients with unilateral neovascular AMD observed for up to 4.5 years participated. INTERVENTION Functional measurements included visual acuity, macular visual field, glare recovery time, and foveal electroretinogram amplitude and implicit time. MAIN OUTCOME MEASURE The age-adjusted proportion of patients having a CNVM develop over follow-up assessed by the Cox proportional hazards model with stepwise selection was measured. RESULTS On average, 8.8% of patients had a CNVM develop each year. Independent risk factors for the fellow eye were its glare recovery time in minutes (relative risk = 1.30, confidence interval = 1.10-1.54, P = 0.003) and its extent of visible macular abnormalities on a four-point scale (relative risk = 1.62, confidence interval = 1.06-2.59, P = 0.03). Of the fellow eyes that converted, the interval to have a CNVM develop was inversely related to the foveal electroretinogram implicit time. CONCLUSIONS A slower recovery from glare and more extensive funduscopic changes appear to be independent risk factors for the development of a CNVM in the fellow eyes of patients with unilateral neovascular AMD. A slower foveal electroretinogram implicit time may be a sign of early stage CNVM development, perhaps because of outer retinal ischemia. These results have clinical management implications, particularly for those patients at high risk of having a potentially treatable form of AMD develop.
Collapse
Affiliation(s)
- M A Sandberg
- Berman-Gund Laboratory for the Study of Retinal Degenerations, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston 02114, USA
| | | | | | | |
Collapse
|
29
|
Affiliation(s)
- M Belfort
- Wadsworth Center, New York State Department of Health and School of Public Health, State University of New York at Albany, 12201-2002, USA
| | | |
Collapse
|
30
|
Weiner A, Christopoulos VA, Gussler CH, Adams DH, Kaufman SR, Kohn HD, Weidenthal DT. Foveal cone function in nonproliferative diabetic retinopathy and macular edema. Invest Ophthalmol Vis Sci 1997; 38:1443-9. [PMID: 9191608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To study results of foveal cone electroretinography (ERG) in patients with nonproliferative diabetic retinopathy (NPDR), with and without clinically significant macular edema (CSME). METHODS Electroretinograms of foveal cones were elicited, with a dual-beam stimulator-ophthalmoscope, from 18 consecutive patients with bilateral NPDR and unilateral CSME. RESULTS Analysis of resulting data revealed that mean amplitude was significantly lower in eyes with CSME and in eyes without CSME., compared with that in normal eyes. Mean implicit time was significantly longer in eyes with CSME compared with that in normal eyes, but in eyes of diabetic patients without CSME., mean implicit time was the same as that in normal eyes. Amplitudes were directly correlated and implicit times were inversely correlated with best-corrected Snellen visual acuity in eyes with and without CSME. Eyes with CSME had significantly lower amplitudes and longer implicit times than their fellow eyes without CSME. In addition, eyes with NPDR, with or without CSME, did not exhibit the normal rise in amplitude with increasing duration of light exposure. CONCLUSIONS Electroretinographic findings showed abnormalities in foveal cone responses in eyes with NPDR, particularly in the presence of CSME. These results may support a functional role for outer retinal dysfunction in patients with diabetic retinopathy and loss of central vision.
Collapse
Affiliation(s)
- A Weiner
- Division of Ophthalmology, St. Luke's Medical Center, Cleveland, Ohio 44104, USA
| | | | | | | | | | | | | |
Collapse
|
31
|
Wallace JI, Porter J, Weiner A, Steinberg A. Oral sex, crack smoking, and HIV infection among female sex workers who do not inject drugs. Am J Public Health 1997; 87:470. [PMID: 9096561 PMCID: PMC1381031 DOI: 10.2105/ajph.87.3.470] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
32
|
Szajnberg NM, Weiner A. The child's conception of psychiatric cure. Child Psychiatry Hum Dev 1996; 26:247-54. [PMID: 8935314 DOI: 10.1007/bf02353241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Twenty-two sequentially hospitalized children on a preadolescent psychiatric unit were videotaped with a semi-structured Piagetian-type interview that focused on assessing their understanding of why they were in the hospital, how they conceptualized their problems and how they thought they would get better or cured. We found six categories of "cure": 1) there was no cure for their problems; 2) cure meant reversal of some behaviors; 3) cure involved some internal change; 4) cure was equivalent to being discharged; 5) cure meant changing other people; and 6) idiosyncratic answers. Our findings suggest that it is useful to clarify a child's understanding of treatment and cure in order to target more understandable and effective treatment.
Collapse
Affiliation(s)
- N M Szajnberg
- Langley Porter Psychiatric Institute, UCSF 94143, USA
| | | |
Collapse
|
33
|
Abstract
The social dynamics of prostitution render prostitutes unable at times to meet basic human needs, vulnerable to violence, and at risk for sexually transmitted disease. Since April 1989 a mobile van from a private foundation has been contacting prostitutes throughout the five boroughs of New York City to provide HIV testing and counseling and to distribute condoms, bleach kits for cleaning needles, and HIV prevention information. Data collected from 1,963 female prostitutes are discussed in this article. Information is provided on demographics, family and living arrangements, sex and drug practices, HIV status and risk reduction practices, and health history. Methods are discussed for social workers to develop creative ways to provide outreach and develop relationships with a vulnerable population that invests much effort in remaining concealed.
Collapse
Affiliation(s)
- A Weiner
- Wurzweiler School of Social Work, Yeshiva University, New York, NY 10033, USA
| |
Collapse
|
34
|
Weiner A, Erickson AL, Kansopon J, Crawford K, Muchmore E, Hughes AL, Houghton M, Walker CM. Persistent hepatitis C virus infection in a chimpanzee is associated with emergence of a cytotoxic T lymphocyte escape variant. Proc Natl Acad Sci U S A 1995; 92:2755-9. [PMID: 7708719 PMCID: PMC42297 DOI: 10.1073/pnas.92.7.2755] [Citation(s) in RCA: 256] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Hepatitis C virus (HCV) establishes a persistent infection in humans and chimpanzees despite the presence of virus-specific, class I major histocompatibility complex-restricted CD8+ cytotoxic T lymphocytes (CTLs) in the liver. The data presented here demonstrate that CTLs directed against a conserved epitope in the HCV nonstructural 3 protein persist in the liver of a chronically infected chimpanzee for at least 2 years after infection. However, these CTLs did not recognize the HCV quasi-species present in the plasma of this animal at week 16 postinfection or at later time points. Escape from the CTL response was facilitated by an aspartic acid to glutamic acid (D-->E) substitution at amino acid position 1449 in all HCV genomes that were sequenced. The results of this study strongly support the concept that CTL responses can select for variant viruses with an enhanced ability to persist in a host and have important implications for the design of vaccines against HCV.
Collapse
Affiliation(s)
- A Weiner
- Chiron Corporation, Emeryville, CA 94608, USA
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Weiner A, Kuppermintz H, Guttmann D. Video home training (the Orion project): a short-term preventive and treatment intervention for families with young children. Fam Process 1994; 33:441-453. [PMID: 7698307 DOI: 10.1111/j.1545-5300.1994.00441.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Developed in Holland and based on short-term, home-centered, filmed video feedback of family interactions, an experimental Orion project was conducted in Israel to determine whether it could be provided through local welfare departments as a routine treatment alternative. This article summarizes an evaluation of 52 families (with problems in parent-child interaction) and 64 control families that participated in the Orion Video Home-Training Project. Only the Orion families showed significant gains in all the eight areas of positive parent-child communication that are the focus of the program, which is based on reinforcing potential family strengths. These gains were generally sustained 6 months after program completion. There were several background variables, such as family status, income, health, education, and employment, that influenced the extent of family gains.
Collapse
Affiliation(s)
- A Weiner
- Orion Project, School of Social Work, Haifa University, Mt. Carmel, Israel
| | | | | |
Collapse
|
36
|
Sandberg MA, Gaudio AR, Miller S, Weiner A. Iris pigmentation and extent of disease in patients with neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci 1994; 35:2734-40. [PMID: 7514581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To determine whether the extent of disease in age-related macular degeneration (AMD) varies with iris pigmentation. METHODS The authors assessed visual function and macular appearance in the fellow eye or both eyes of 132 white patients with unilateral neovascular AMD. All patients had a visual acuity of 20/60 or better in the fellow eye. Eighty-nine of the patients were coded as having light irides (blue, green, or hazel) and 43 were coded as having dark irides (brown); the two groups of patients had comparable mean ages. RESULTS By the Mann-Whitney test for differences in mean rank, fellow eyes with light irides showed a marginally worse visual acuity (P = .156) but significantly more visual field impairment by letter recognition perimetry (P = .011) and the macular threshold test of the Humphrey Field Analyzer (P = .043), and more retinal pigment epithelial atrophy (P = .017) and focal areas of hyperpigmentation (P = .002) than fellow eyes with dark irides. For eyes with a choroidal neovascular membrane (CNVM), those with light irides had significantly lower visual acuities (P = .006) and larger scars (P = .006) than eyes with dark irides. In addition, extent of disease in the eye with a CNVM was positively correlated with extent of disease in the fellow eye for most comparisons. CONCLUSIONS These observations suggest that light iris pigmentation is associated with more extensive retinal disease in patients with unilateral neovascular AMD. Furthermore, in such patients, those with worse disease in the eye with a CNVM may tend to have more extensive atrophic disease in the fellow eye.
Collapse
Affiliation(s)
- M A Sandberg
- Berman-Gund Laboratory for the Study of Retinal Degenerations, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston 02114
| | | | | | | |
Collapse
|
37
|
Choo QL, Kuo G, Ralston R, Weiner A, Chien D, Van Nest G, Han J, Berger K, Thudium K, Kuo C. Vaccination of chimpanzees against infection by the hepatitis C virus. Proc Natl Acad Sci U S A 1994; 91:1294-8. [PMID: 7509068 PMCID: PMC43144 DOI: 10.1073/pnas.91.4.1294] [Citation(s) in RCA: 421] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
A high incidence of community-acquired hepatitis C virus infection that can lead to the progressive development of chronic active hepatitis, liver cirrhosis, and primary hepatocellular carcinoma occurs throughout the world. A vaccine to control the spread of this agent that represents a major cause of chronic liver disease is therefore needed. Seven chimpanzees (Pan troglodytes) have been immunized with both putative envelope glycoproteins [E1 (gp33) and E2 (gp72)] that were copurified from HeLa cells infected with a recombinant vaccinia virus expression vector. Despite the induction of a weak humoral immune response to these viral glycoproteins in experimentally infected chimpanzees, a strong humoral immune response was obtained in all vaccines. The five highest responders showed complete protection against an i.v. challenge with homologous hepatitis C virus 1. The remaining two vaccines became infected, but both infection and disease may have been ameliorated in comparison with four similarly challenged control chimpanzees, all of which developed acute hepatitis and chronic infections. These results provide considerable encouragement for the eventual control of hepatitis C virus infection by vaccination.
Collapse
Affiliation(s)
- Q L Choo
- Chiron Corporation, Emeryville, CA 94608
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Choo QL, Kuo G, Weiner A, Wang KS, Overby L, Bradley D, Houghton M. Identification of the major, parenteral non-A, non-B hepatitis agent (hepatitis C virus) using a recombinant cDNA approach. Semin Liver Dis 1992; 12:279-88. [PMID: 1332193 DOI: 10.1055/s-2007-1007399] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Q L Choo
- Chiron Corporation, Emeryville, CA 94608
| | | | | | | | | | | | | |
Collapse
|
39
|
Martell M, Esteban JI, Quer J, Genescà J, Weiner A, Esteban R, Guardia J, Gómez J. Hepatitis C virus (HCV) circulates as a population of different but closely related genomes: quasispecies nature of HCV genome distribution. J Virol 1992; 66:3225-9. [PMID: 1313927 PMCID: PMC241092 DOI: 10.1128/jvi.66.5.3225-3229.1992] [Citation(s) in RCA: 655] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Sequencing of multiple recombinant clones generated from polymerase chain reaction-amplified products demonstrated that the degree of heterogeneity of two well-conserved regions of the hepatitis C virus (HCV) genome within individual plasma samples from a single patient was consistent with a quasispecies structure of HCV genomic RNA. About half of circulating RNA molecules were identical, while the remaining consisted of a spectrum of mutants differing from each other in one to four nucleotides. Mutant sequence diversity ranged from silent mutations to appearance of in-frame stop codons and included both conservative and nonconservative amino acid substitutions. From the relative proportion of essentially defective sequences, we estimated that most circulating particles should contain defective genomes. These observations might have important implications in the physiopathology of HCV infection and underline the need for a population-based approach when one is analyzing HCV genomes.
Collapse
Affiliation(s)
- M Martell
- Department of Medicine, Hospital General Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
We analyzed ocular findings from two patients (aged 49 and 60 years) with hydroxychloroquine (Plaquenil, Winthrop Pharmaceuticals, Division of Sterling Drug, Inc., New York, New York) retinopathy. Both patients were treated for systemic lupus erythematosus; one patient was treated with 400 to 800 mg of hydroxychloroquine per day (6.1 to 12.2 mg/kg of body weight/day) over a ten-year period. Cumulative doses were 1,788 and 2,920 g, respectively. Neither patient had ever been treated with chloroquine. One patient complained of glare and difficulty in adjusting to changes in illumination, whereas the other was asymptomatic. Both had bilateral visual acuities of 20/25, pericentral scotomata, and increased final dark-adapted rod thresholds in the two retinal areas that were tested. Fullfield electroretinograms were reduced and delayed, and focal cone electroretinography showed abnormal foveal responses as well. Ophthalmoscopy and fluorescein angiography showed a bull's-eye maculopathy in both eyes of one patient and perifoveal depigmentation in both eyes of the other patient. Retinal function remained stable at follow-up examinations 18 to 24 months after the cessation of hydroxychloroquine treatment. These two cases demonstrate that peripheral retinopathy, as well as maculopathy, can develop in patients who are treated with hydroxychloroquine for systemic lupus erythematosus, and that retinal function may remain stable after discontinuation of hydroxychloroquine treatment.
Collapse
Affiliation(s)
- A Weiner
- Berman-Gund Laboratory, Massachusetts Eye and Ear Infirmary, Boston 02114
| | | | | | | | | |
Collapse
|
41
|
Weiner A, Sandberg MA. Normal change in the foveal cone ERG with increasing duration of light exposure. Invest Ophthalmol Vis Sci 1991; 32:2842-5. [PMID: 1894482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Foveal cone electroretinograms (ERG) were elicited with a stimulator-ophthalmoscope from 24 normal subjects with a 4 degrees stimulus flickering at 42 Hz and centered within a 12 degrees steady surround. The stimulus and surround were presented at retinal illuminances of 4.8 log td and 5.5 log td, respectively, to facilitate visualization of the fundus. Several consecutive averaged responses were evaluated to determine whether increasing duration of light exposure causes an increase in amplitude, as previously found for the full-field cone ERG. On average, amplitude increased by 27% over time, and the linear regression of amplitude on recording number accounted, on average, for 42% of the amplitude variability between consecutive responses. Two subjects had amplitudes that were initially subnormal, based on previously published norms, but that value increased to within the normal range in subsequent recordings. These findings show that a significant change in the cone ERG occurs in the fovea with increasing duration of light exposure at these retinal illuminances, and suggest that, when the stimulator-ophthalmoscope is used, consecutive foveal cone ERGs should be obtained from patients with suspected macular disease to avoid a false diagnosis of retinal malfunction.
Collapse
Affiliation(s)
- A Weiner
- Berman-Gund Laboratory for the Study of Retinal Degenerations, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston 02114
| | | |
Collapse
|
42
|
Abstract
We determined the relative frequencies of the different types of chronic uveitis, and the possible associated conditions, among 400 consecutive patients with chronic uveitis examined during the years 1982 through 1988. Of the 400 patients, 183 (45.75%) had anterior uveitis, 98 (24.5%) ahd panuveitis, 61 (15.3%) had intermediate uveitis, and 58 (14.5%) had isolated posterior uveitis. Only four of the 98 patients with panuveitis (4.1%) were considered idiopathic after a comprehensive examination, whereas 94 of the 183 patients with anterior uveitis (51.4%) were similarly classified. We found an associated condition in 242 of the 400 patients of the study group (60.5%). Of these 242 patients, 61 had Behçet's disease, which constituted the most frequently encountered associated condition in this study. Of the 61 patients with Behçet's disease, 58 had panuveitis and constituted 59.2% of the panuveitis group. Of the 61 patients with intermediate uveitis, 17 (27.9%) had a concurrent disease. An associated condition was found in 95% and 96.2% of patients with unilateral and bilateral panuveitis, respectively, but in none of the patients with unilateral intermediate uveitis. Environmental, cultural, or genetic factors may be accountable for the differences discovered between our findings and those of previously published studies from the United States and England with respect to relative frequencies of some of the associated diseases in patients with chronic uveitis.
Collapse
Affiliation(s)
- A Weiner
- Department of Ophthalmology, Hadassah Medical Center, Hebrew University Medical School, Jerusalem, Israel
| | | |
Collapse
|
43
|
Houghton M, Weiner A, Han J, Kuo G, Choo QL. Molecular biology of the hepatitis C viruses: implications for diagnosis, development and control of viral disease. Hepatology 1991. [PMID: 1650328 DOI: 10.1002/hep.1840140227] [Citation(s) in RCA: 531] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- M Houghton
- Chiron Corporation, Emeryville, California 94608
| | | | | | | | | |
Collapse
|
44
|
Abstract
The anti-C100-enzyme-linked immunosorbent assay, the new four-antigen antibody recombinant immunoblot assay, and detection of viral RNA sequences by copy DNA-polymerase chain reaction were used to establish the course of hepatitis C virus (HCV) infection in recipients of HCV-infected blood products. Different patterns of infection were observed: (1) persistent HCV infection with and without chronic hepatitis, and with acute resolved hepatitis; and (2) acute resolved hepatitis with clearance of HCV. In order to determine whether different infection- and anti-HCV recognition patterns are correlated to differences in viral nucleotide sequences, we compared sequences in the NS3 region between isolates from recipient(s) and their infective donors. Based on these comparisons we conclude that in The Netherlands two types of molecular variants circulate; one resembling the Japanese prototype isolate JH1, and the other the HCV-1 isolate from the U.S.A. The difference in sequence homology between the two types is approximately 24%. Comparison of sequences of donors and involved recipients determined in isolates prepared from blood samples four years after transfusion revealed that viral RNA sequences are strongly conserved (greater than 96.8%) in the NS3 region. These data indicate that the observed differences in anti-HCV immune response patterns between recipients are more a reflection of their immune reactivity than of divergence of viral strains.
Collapse
Affiliation(s)
- H T Cuypers
- Central Laboratory, The Netherlands Red Cross Blood Transfusion Service, Amsterdam
| | | | | | | | | | | | | |
Collapse
|
45
|
Abstract
This study is a comprehensive, longitudinal assessment of the characteristics of special care patients. Demented patients in special care units (SCUs) within four nursing homes were compared with their demented counterparts in the same facilities who were not placed in SCUs. Results of this preliminary study suggest that the two groups differ in level of cognitive impairment, in behavior, and in functional and physical status. No deleterious or beneficial effects were associated with SCU residence during a 6-month period.
Collapse
Affiliation(s)
- D Holmes
- Hebrew Home for the Aged, Riverdale, NY 10471
| | | | | | | | | | | |
Collapse
|
46
|
Pfeffer CR, Stokes P, Weiner A, Shindledecker R, Faughnan L, Mintz M, Stoll PM, Heiligenstein E. Psychopathology and plasma cortisol responses to dexamethasone in prepubertal psychiatric inpatients. Biol Psychiatry 1989; 26:677-89. [PMID: 2804189 DOI: 10.1016/0006-3223(89)90102-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This study of 51 prepubertal psychiatric inpatients evaluates plasma cortisol measurements at 8 AM, 4 PM, and 11 PM before and after dexamethasone was administered in counterbalanced order at doses of 0.5 mg and 1.0 mg. Approximately 76.5% of the children had an affective disorder. Major depressive disorder was associated with higher plasma cortisol levels than other disorders. Pre- and postdexamethasone plasma cortisol levels using 0.5 mg dexamethasone exhibited a circadian variation. The optimal criterion for cortisol nonsuppression was 5 micrograms/dl measured at 8 AM after administration of 0.5 mg dexamethasone.
Collapse
Affiliation(s)
- C R Pfeffer
- Department of Psychiatry, Cornell University Medical College, New York, NY
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Fatis M, Weiner A, Hawkins J, Van Dorsten B. Following up on a commercial weight loss program: do the pounds stay off after your picture has been in the newspaper? J Am Diet Assoc 1989; 89:547-8. [PMID: 2703635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M Fatis
- Department of Psychology, Mankato State University, Minnesota 56001
| | | | | | | |
Collapse
|
48
|
Abstract
Conscious understanding of their psychiatric hospitalization and illness was examined in 22 preadolescent children. Semistructured interviews evaluated their understanding of why they were hospitalized and its relationship to their problems. Their concepts of hospitalization fell into five categories: moralistic/punitive, adultomorphic, medical/physical, doesn't know, and due to misunderstanding. Most children described personal problems, yet believed that these were unrelated to and did not justify hospitalization.
Collapse
|
49
|
|
50
|
Pe'er J, Weiner A, Vidaurri L. Clinicopathologic report of spontaneous expulsive hemorrhage. Ann Ophthalmol 1987; 19:139-41. [PMID: 3619263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A 78-year-old woman who was known to suffer from bilateral absolute glaucoma underwent enucleation of her left eye because of corneal perforation with spontaneous bleeding. The clinical and pathologic findings were compatible with spontaneous expulsive hemorrhage. A possible cause of the hemorrhage in this case was inflamed necrotic choroidal vascular walls that bled after corneal perforation with decompression in the glaucomatous eye.
Collapse
|