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Miko S, Poniatowski AR, Troeschel AN, Felton DJ, Banerji S, Bolduc MLF, Bronstein AC, Cavanaugh AM, Edge C, Gates AL, Jarvis M, Mintz NA, Parasram V, Rayman J, Smith AR, Wagner JC, Gerhardstein BG, Orr MF. Community health impacts after a jet fuel leak contaminated a drinking water system: Oahu, Hawaii, November 2021. J Water Health 2023; 21:956-971. [PMID: 37515565 PMCID: wh_2023_109 DOI: 10.2166/wh.2023.109] [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] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Abstract
BACKGROUND In 2021, a large petroleum leak contaminated a water source that supplied drinking water to military and civilians in Oahu, Hawaii. METHODS We conducted an Assessment of Chemical Exposures (ACE) survey and supplemented that information with complementary data sources: (1) poison center caller records; (2) emergency department visit data; and (3) a key informant questionnaire. RESULTS Among 2,289 survey participants, 86% reported ≥1 new or worsening symptom, 75% of which lasted ≥30 days, and 37% sought medical care. Most (n = 1,653, 72%) reported new mental health symptoms. Among equally observable symptoms across age groups, proportions of children ≤2 years experiencing vomiting, runny nose, skin rashes, and coughing (33, 46, 56, and 35%, respectively) were higher than other age groups. Poison center calls increased the first 2 weeks after the contamination, while emergency department visits increased in early December 2021. Key informant interviews revealed themes of lack of support, mental health symptoms, and long-term health impact concerns. DISCUSSION This event led to widespread exposure to petroleum products and negatively affected thousands of people. Follow-up health surveys or interventions should give special consideration to longer-term physical and mental health, especially children due to their unique sensitivity to environmental exposures.
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Affiliation(s)
- Shanna Miko
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA E-mail:
| | - Alex R Poniatowski
- National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Office of the Director, Atlanta, GA, USA
| | - Alyssa N Troeschel
- National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Office of the Director, Atlanta, GA, USA
| | | | | | - Michele L F Bolduc
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA
| | | | - Alyson M Cavanaugh
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA
| | - Charles Edge
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA
| | - Abigail L Gates
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA
| | | | | | - Vidisha Parasram
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA
| | - Jamie Rayman
- National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Office of the Director, Atlanta, GA, USA
| | - Amanda R Smith
- U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA
| | | | - Benjamin G Gerhardstein
- National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Office of the Director, Atlanta, GA, USA
| | - Maureen F Orr
- National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Office of the Director, Atlanta, GA, USA
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2
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Smith AR, DeVies J, Carey K, Sheppard M, Radhakrishnan L, Njai R, Ajani UA, Soetebier K, Hartnett K, Adjemian J. COVID-19 pandemic-associated changes in overall emergency department visits by age group, race, and ethnicity - United States, January 2019-April 2022. Am J Emerg Med 2023; 69:121-126. [PMID: 37087809 PMCID: PMC10104597 DOI: 10.1016/j.ajem.2023.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 03/07/2023] [Accepted: 04/03/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND ED data are an important source of surveillance data for monitoring many conditions of public health concern and are especially useful in describing trends related to new, or unusual public health events. The COVID-19 pandemic led to significant changes in emergency care seeking behavior. We described the trends in all-cause emergency department (ED) visit volumes by race, ethnicity, and age using ED data from the National Syndromic Surveillance Program (NSSP) during December 30, 2018-April 2, 2022. METHODS We described total and race, ethnicity, and age group-specific ED visit volumes during the COVID-19 pandemic by comparing quarterly visit volumes during the pandemic period to the relevant quarters in 2019. We quantified the variability of ED visits volumes by calculating the coefficient of variation in mean weekly ED visit volume for each quarter during Q1 2019-Q1 2022. RESULTS Overall ED visits dropped by 32% during Q2 2020, when the COVID-19 pandemic began, then rebounded to 2019 baseline by Q2 2021. ED visits for all race, ethnicity, and age groups similarly dropped in Q2 2020 and adults of all race and ethnicity groups rebounded to at or above pre-pandemic levels while children remained at or below the pre-pandemic baseline except during Q3 2021. There was larger variation in mean weekly ED visits compared to the respective quarter in 2019 for 6 of 9 quarters during Q1 2020-Q1 2022. CONCLUSIONS ED utilization fluctuated considerably during the COVID-19 pandemic. Overall ED visits returned to within 5% of 2019 baseline during Q2 2021, however, ED visits among children did not return to the 2019 baseline until Q3 2021, then again dropped below the 2019 baseline in Q4 2021. Trends in ED visit volumes were similar among race and ethnicity groups but differed by age group. Monitoring ED data stratified by race, ethnicity and age can help understand healthcare utilization trends and overall burden on the healthcare system as well as facilitate rapid identification and response to public health threats that may disproportionately affect certain populations.
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Affiliation(s)
- Amanda R Smith
- Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Center, Mailstop V25-3, Atlanta, GA 30345, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, 2400 Century Center, Mailstop V24-5, Atlanta, GA 30345, USA.
| | - Jourdan DeVies
- Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Center, Mailstop V25-3, Atlanta, GA 30345, USA; ICF International, 2635 Century Pkwy NE Suite 1000, Atlanta, GA 30345, USA.
| | - Kelly Carey
- Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Center, Mailstop V25-3, Atlanta, GA 30345, USA.
| | - Michael Sheppard
- Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Center, Mailstop V25-3, Atlanta, GA 30345, USA.
| | - Lakshmi Radhakrishnan
- Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Center, Mailstop V25-3, Atlanta, GA 30345, USA.
| | - Rashid Njai
- Office of Minority Health and Health Equity, Office of the Deputy Director for Public Health Service and Implementation, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop TW-3, Atlanta, GA 30341, USA.
| | - Umed A Ajani
- Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Center, Mailstop V25-3, Atlanta, GA 30345, USA.
| | - Karl Soetebier
- Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Center, Mailstop V25-3, Atlanta, GA 30345, USA.
| | - Kathleen Hartnett
- Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Center, Mailstop V25-3, Atlanta, GA 30345, USA.
| | - Jennifer Adjemian
- Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Center, Mailstop V25-3, Atlanta, GA 30345, USA.
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3
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Kambhampati AK, Burke RM, Dietz S, Sheppard M, Almendares O, Baker JM, Cates J, Stein Z, Johns D, Smith AR, Bull-Otterson L, Hofmeister MG, Cobb S, Dale SE, Soetebier KA, Potts CC, Adjemian J, Kite-Powell A, Hartnett KP, Kirking HL, Sugerman D, Parashar UD, Tate JE. Trends in Acute Hepatitis of Unspecified Etiology and Adenovirus Stool Testing Results in Children - United States, 2017-2022. MMWR Morb Mortal Wkly Rep 2022; 71:797-802. [PMID: 35709071 DOI: 10.15585/mmwr.mm7124e1] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
In November 2021, CDC was notified of a cluster of previously healthy children with hepatitis of unknown etiology evaluated at a single U.S. hospital (1). On April 21, 2022, following an investigation of this cluster and reports of similar cases in Europe (2,3), a health advisory* was issued requesting U.S. providers to report pediatric cases† of hepatitis of unknown etiology to public health authorities. In the United States and Europe, many of these patients have also received positive adenovirus test results (1,3). Typed specimens have indicated adenovirus type 41, which typically causes gastroenteritis (1,3). Although adenovirus hepatitis has been reported in immunocompromised persons, adenovirus is not a recognized cause of hepatitis in healthy children (4). Because neither acute hepatitis of unknown etiology nor adenovirus type 41 is reportable in the United States, it is unclear whether either has recently increased above historical levels. Data from four sources were analyzed to assess trends in hepatitis-associated emergency department (ED) visits and hospitalizations, liver transplants, and adenovirus stool testing results among children in the United States. Because of potential changes in health care-seeking behavior during 2020-2021, data from October 2021-March 2022 were compared with a pre-COVID-19 pandemic baseline. These data do not suggest an increase in pediatric hepatitis or adenovirus types 40/41 above baseline levels. Pediatric hepatitis is rare, and the relatively low weekly and monthly counts of associated outcomes limit the ability to interpret small changes in incidence. Ongoing assessment of trends, in addition to enhanced epidemiologic investigations, will help contextualize reported cases of acute hepatitis of unknown etiology in U.S. children.
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4
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Anderson KN, Radhakrishnan L, Lane RI, Sheppard M, DeVies J, Azondekon R, Smith AR, Bitsko RH, Hartnett KP, Lopes-Cardozo B, Leeb RT, van Santen KL, Carey K, Crossen S, Dias TP, Wotiz S, Adjemian J, Rodgers L, Njai R, Thomas C. Changes and Inequities in Adult Mental Health-Related Emergency Department Visits During the COVID-19 Pandemic in the US. JAMA Psychiatry 2022; 79:475-485. [PMID: 35293958 PMCID: PMC8928092 DOI: 10.1001/jamapsychiatry.2022.0164] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 12/24/2022]
Abstract
IMPORTANCE The COVID-19 pandemic has negatively affected adult mental health (MH), with racial and ethnic minoritized groups disproportionately affected. OBJECTIVE To examine changes in adult MH-related emergency department (ED) visits into the Delta variant pandemic period and identify changes and inequities in these visits before and during COVID-19 case surges. DESIGN, SETTING, AND PARTICIPANTS This epidemiologic cross-sectional study used National Syndromic Surveillance Program data from US adults aged 18 to 64 years from 1970 to 2352 ED facilities from January 1, 2019, to August 14, 2021. All MH-related ED visits and visits related to 10 disorders (ie, anxiety, depressive, bipolar, schizophrenia spectrum, trauma- and stressor-related, attention-deficit/hyperactivity, disruptive behavioral and impulse, obsessive-compulsive, eating, and tic disorders) were identified. EXPOSURES The following periods of MH-related ED visits were compared: (1) high Delta variant circulation (July 18-August 14, 2021) with a pre-Delta period (April 18-May 15, 2021), (2) after a COVID-19 case peak (February 14-March 13, 2021) with during a peak (December 27, 2020-January 23, 2021), and (3) the Delta period and the period after a COVID-19 case peak with the respective corresponding weeks during the prepandemic period. MAIN OUTCOMES AND MEASURES ED visits for 10 mental disorders and all MH-related visits. RESULTS This cross-sectional study included 107 761 319 ED visits among adults aged 18 to 64 years (59 870 475 [56%] women) from January 1, 2019, to August 14, 2021. There was stability in most MH-related ED visit counts between the Delta and pre-Delta periods (percentage change, -1.4% to -7.5%), except for eating disorders (-11.9%) and tic disorders (-19.8%) and after a COVID-19 case peak compared with during a peak (0.6%-7.4%). Most MH-related ED visit counts declined in the Delta period relative to the prepandemic period (-6.4% to -30.7%); there were fluctuations by disorder when comparing after a COVID-19 case peak with the corresponding prepandemic period (-15.4% to 11.3%). Accounting for ED visit volume, MH-related ED visits were a smaller proportion of visits in the Delta period compared with the pre-Delta period (visit ratio, 0.86; 95% CI, 0.85-0.86) and prepandemic period (visit ratio, 0.80; 95% CI, 0.79-0.80). After a COVID-19 case peak, MH-related ED visits were a larger proportion of ED visits compared with during a peak (visit ratio, 1.04; 95% CI, 1.03-1.04) and the corresponding prepandemic period (visit ratio, 1.11; 95% CI, 1.11-1.12). Of the 2 510 744 ED visits included in the race and ethnicity analysis, 24 592 (1%) were American Indian or Alaska Native persons, 33 697 (1%) were Asian persons, 494 198 (20%) were Black persons, 389 740 (16%) were Hispanic persons, 5000 (0.2%) were Native Hawaiian or Other Pacific Islander persons, and 1 172 683 (47%) were White persons. There was between- and within-group variation in ED visits by race and ethnicity and increases in selected disorders after COVID-19 peaks for adults aged 18 to 24 years. CONCLUSIONS AND RELEVANCE Results of this cross-sectional study suggest that EDs may have increases in MH-related visits after COVID-19 surges, specifically for young adults and individual racial and ethnic minoritized subpopulations. Public health practitioners should consider subpopulation-specific messaging and programmatic strategies that address differences in MH needs, particularly for those historically marginalized.
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Affiliation(s)
- Kayla N. Anderson
- National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lakshmi Radhakrishnan
- Center for Surveillance, Epidemiology, and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rashon I. Lane
- National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michael Sheppard
- Center for Surveillance, Epidemiology, and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jourdan DeVies
- Center for Surveillance, Epidemiology, and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Roseric Azondekon
- Center for Surveillance, Epidemiology, and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amanda R. Smith
- Center for Surveillance, Epidemiology, and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rebecca H. Bitsko
- National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen P. Hartnett
- Center for Surveillance, Epidemiology, and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Barbara Lopes-Cardozo
- Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rebecca T. Leeb
- National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Kelly Carey
- Center for Surveillance, Epidemiology, and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Jennifer Adjemian
- Center for Surveillance, Epidemiology, and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Loren Rodgers
- Center for Surveillance, Epidemiology, and Laboratory Services, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rashid Njai
- Office of Minority Health and Health Equity, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Craig Thomas
- National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia
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5
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Radhakrishnan L, Leeb RT, Bitsko RH, Carey K, Gates A, Holland KM, Hartnett KP, Kite-Powell A, DeVies J, Smith AR, van Santen KL, Crossen S, Sheppard M, Wotiz S, Lane RI, Njai R, Johnson AG, Winn A, Kirking HL, Rodgers L, Thomas CW, Soetebier K, Adjemian J, Anderson KN. Pediatric Emergency Department Visits Associated with Mental Health Conditions Before and During the COVID-19 Pandemic - United States, January 2019-January 2022. MMWR Morb Mortal Wkly Rep 2022; 71:319-324. [PMID: 35202358 DOI: 10.15585/mmwr.mm7108e2] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In 2021, a national emergency* for children's mental health was declared by several pediatric health organizations, and the U.S. Surgeon General released an advisory† on mental health among youths. These actions resulted from ongoing concerns about children's mental health in the United States, which was exacerbated by the COVID-19 pandemic (1,2). During March-October 2020, among all emergency department (ED) visits, the proportion of mental health-related visits increased by 24% among U.S. children aged 5-11 years and 31% among adolescents aged 12-17 years, compared with 2019 (2). CDC examined changes in U.S. pediatric ED visits for overall mental health conditions (MHCs) and ED visits associated with specific MHCs (depression; anxiety; disruptive behavioral and impulse-control disorders; attention-deficit/hyperactivity disorder; trauma and stressor-related disorders; bipolar disorders; eating disorders; tic disorders; and obsessive-compulsive disorders [OCD]) during 2019 through January 2022 among children and adolescents aged 0-17 years, overall and by sex and age. After declines in weekly visits associated with MHCs among those aged 0-17 years during 2020, weekly numbers of ED visits for MHCs overall and for specific MHCs varied by age and sex during 2021 and January 2022, when compared with corresponding weeks in 2019. Among adolescent females aged 12-17 years, weekly visits increased for two of nine MHCs during 2020 (eating disorders and tic disorders), for four of nine MHCs during 2021 (depression, eating disorders, tic disorders, and OCD), and for five of nine MHCs during January 2022 (anxiety, trauma and stressor-related disorders, eating disorders, tic disorders, and OCD), and overall MHC visits during January 2022, compared with 2019. Early identification and expanded evidence-based prevention and intervention strategies are critical to improving children's and adolescents' mental health (1-3), especially among adolescent females, who might have increased need.
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Radhakrishnan L, Carey K, Hartnett KP, Kite-Powell A, Zwald M, Anderson KN, Leeb RT, Holland KM, Gates A, DeVies J, Smith AR, van Santen KL, Crossen S, Sheppard M, Wotiz S, Johnson AG, Winn A, Kirking HL, Lane RI, Njai R, Rodgers L, Thomas CW, Soetebier K, Adjemian J. Pediatric Emergency Department Visits Before and During the COVID-19 Pandemic - United States, January 2019-January 2022. MMWR Morb Mortal Wkly Rep 2022; 71:313-318. [PMID: 35202351 DOI: 10.15585/mmwr.mm7108e1] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Emergency departments (EDs) in the United States remain a frontline resource for pediatric health care emergencies during the COVID-19 pandemic; however, patterns of health-seeking behavior have changed during the pandemic (1,2). CDC examined changes in U.S. ED visit trends to assess the continued impact of the pandemic on visits among children and adolescents aged 0-17 years (pediatric ED visits). Compared with 2019, pediatric ED visits declined by 51% during 2020, 22% during 2021, and 23% during January 2022. Although visits for non-COVID-19 respiratory illnesses mostly declined, the proportion of visits for some respiratory conditions increased during January 2022 compared with 2019. Weekly number and proportion of ED visits increased for certain types of injuries (e.g., drug poisonings, self-harm, and firearm injuries) and some chronic diseases, with variation by pandemic year and age group. Visits related to behavioral concerns increased across pandemic years, particularly among older children and adolescents. Health care providers and families should remain vigilant for potential indirect impacts of the COVID-19 pandemic, including health conditions resulting from delayed care, and increasing emotional distress and behavioral health concerns among children and adolescents.
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7
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Kracalik I, Ham DC, McAllister G, Smith AR, Vowles M, Kauber K, Zambrano M, Rodriguez G, Garner K, Chorbi K, Cassidy PM, McBee S, Stoney RJ, Moser K, Villarino ME, Zazueta OE, Bhatnagar A, Sula E, Stanton RA, Brown AC, Halpin AL, Epstein L, Walters MS. Extensively Drug-Resistant Carbapenemase-Producing Pseudomonas aeruginosa and Medical Tourism from the United States to Mexico, 2018-2019. Emerg Infect Dis 2022; 28:51-61. [PMID: 34932447 PMCID: PMC8714193 DOI: 10.3201/eid2801.211880] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Carbapenem-resistant Pseudomonas aeruginosa (CRPA) producing the Verona integron‒encoded metallo-β-lactamase (VIM) are highly antimicrobial drug-resistant pathogens that are uncommon in the United States. We investigated the source of VIM-CRPA among US medical tourists who underwent bariatric surgery in Tijuana, Mexico. Cases were defined as isolation of VIM-CRPA or CRPA from a patient who had an elective invasive medical procedure in Mexico during January 2018‒December 2019 and within 45 days before specimen collection. Whole-genome sequencing of isolates was performed. Thirty-eight case-patients were identified in 18 states; 31 were operated on by surgeon 1, most frequently at facility A (27/31 patients). Whole-genome sequencing identified isolates linked to surgeon 1 were closely related and distinct from isolates linked to other surgeons in Tijuana. Facility A closed in March 2019. US patients and providers should acknowledge the risk for colonization or infection after medical tourism with highly drug-resistant pathogens uncommon in the United States.
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Affiliation(s)
| | | | - Gillian McAllister
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Amanda R. Smith
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Maureen Vowles
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Kelly Kauber
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Melba Zambrano
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Gretchen Rodriguez
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Kelley Garner
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Kaitlyn Chorbi
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - P. Maureen Cassidy
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Shannon McBee
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Rhett J. Stoney
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Kathleen Moser
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Margarita E. Villarino
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Oscar E. Zazueta
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Amelia Bhatnagar
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Erisa Sula
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Richard A. Stanton
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Allison C. Brown
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Alison L. Halpin
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Lauren Epstein
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - Maroya Spalding Walters
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
| | - for the Verona Integron-Encoded Metallo-β-Lactamase–Producing Carbapenem-Resistant Pseudomonas aeruginosa Medical Tourism Investigation Team2
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Kracalik, D. Cal Ham, G. McAllister, R.J. Stoney, K. Moser, M.E. Villarino, A. Bhatnagar, E. Sula, R.A. Stanton, A.C. Brown, A.L. Halpin, L. Epstein, M. Spalding Walters)
- Utah Department of Health, Salt Lake City, Utah, USA (A.R. Smith, M. Vowles); Washington State Department of Health, Olympia, Washington, USA (K. Kauber)
- Texas Department of State Health Services, Austin, Texas, USA (M. Zambrano, G. Rodriguez)
- Arkansas Department of Health, Little Rock, Arkansas, USA (K. Garner)
- Arizona Department of Health Services, Phoenix, Arizona, USA (K. Chorbi)
- Oregon Health Authority, Portland, Oregon, USA (P.M. Cassidy)
- West Virginia Department of Health and Human Resources, Charleston, West Virginia, USA (S. McBee)
- Secretaría de Salud de Baja California, Mexicali, Mexico (O.E. Zazueta)
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8
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Pritchard CE, Williams AP, Davies P, Jones D, Smith AR. Spatial behaviour of sheep during the neonatal period: Preliminary study on the influence of shelter. Animal 2021; 15:100252. [PMID: 34090091 DOI: 10.1016/j.animal.2021.100252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Effective shelter has been demonstrated to reduce neonatal lamb mortality rates during periods of inclement weather. Periods of high wind speed and rainfall have been shown to influence shelter usage; however, it is not yet known how ewe factors such as breed, age and body condition score influence shelter-seeking behaviour. This study, conducted on a working upland farm in the UK, examined impact of artificial shelter on the biological and climatic factors that influence peri-parturient ewe behaviour. Pregnant ewes (n = 147) were randomly allocated between two adjacent fields which were selected for their similarity in size, topography, pasture management, orientation to the prevailing wind and available natural shelter. In one field, three additional artificial shelters were installed to increase the available shelter for ewes, this field was designated the Test field; no additional artificial shelter was provided in the second field which was used as the Control field. Individual ewes were observed every 2 h between 0800 and 1600 for 14 continuous days to monitor their location relative to shelter. Ewe breed (Aberfield and Highlander), age (2-8 years) and body condition score were considered as explanatory variables to explain flock and individual variance in shelter-seeking behaviour and the prevalence of issues which required the intervention of the shepherd, termed 'shepherding problems'. Any ewe observed with dystocia, a dead or poor vigour lamb or who exhibited mismothering behaviour was recorded as a shepherding problem. The prevalence of these shepherding problems which necessitate human intervention represents arguably the most critical limiting factor for the successful management of commercial sheep flocks in outdoor lambing systems. Overall, ewes in the Test field with access to additional artificial shelter experienced fewer shepherding problems than those in the Control field (P < 0.05). A significant breed effect was also observed, with Highlander ewes more likely to seek shelter than Aberfield ewes (P < 0.001), and experiencing significantly fewer shepherding interventions (P < 0.05). These findings demonstrate the substantial and significant benefits to animal welfare and productivity that can be achieved through the provision of shelter in commercial, upland, outdoor lambing systems in the UK.
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Affiliation(s)
- C E Pritchard
- School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2DG, UK
| | - A P Williams
- School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2DG, UK.
| | - P Davies
- Department of Livestock & One Health, Institute of Infection, University of Liverpool, Neston, CH64 7TE, UK
| | - D Jones
- Innovis Ltd., Capel Dewi, Aberystwyth SY23 3HU, UK
| | - A R Smith
- School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2DG, UK
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9
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Smith AR, Vowles M, Horth RZ, Smith L, Rider L, Wagner JM, Sangster A, Young EL, Schuckel H, Stewart J, Gruninger RJ, Rossi A, Oakeson KF, Nakashima AK. Infection control response to an outbreak of OXA-23 carbapenemase-producing carbapenem-resistant Acinetobacter baumannii in a skilled nursing facility in Utah. Am J Infect Control 2021; 49:792-799. [PMID: 33217512 DOI: 10.1016/j.ajic.2020.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Antibiotic-resistant Acinetobacter species are a growing public health threat, yet are not nationally notifiable, and most states do not mandate reporting. Additionally, there are no standardized methods to detect Acinetobacter species colonization. METHODS An outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) was identified at a Utah ventilator unit in a skilled nursing facility. An investigation was conducted to identify transmission modes in order to control spread of CRAB. Culture-based methods were used to identify patient colonization and environmental contamination in the facility. RESULTS Of the 47 patients screened, OXA-23-producing CRAB were detected in 10 patients (21%), with 7 patients (15%) having been transferred from out-of-state facilities. Of patients who screened positive, 60% did not exhibit any signs or symptoms of active infection by chart review. A total of 38 environmental samples were collected and CRAB was recovered from 37% of those samples. Whole genome sequencing analyses of patient and environmental isolates suggested repeated CRAB introduction into the facility and highlighted the role of shared equipment in transmission. CONCLUSIONS The investigation demonstrated this ventilated skilled nursing facility was an important reservoir for CRAB in the community and highlights the need for improved surveillance, strengthened infection control and inter-facility communication within and across states.
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Smith AR, DeVies J, Caruso E, Radhakrishnan L, Sheppard M, Stein Z, Calanan RM, Hartnett KP, Kite-Powell A, Rodgers L, Adjemian J. Emergency Department Visits for COVID-19 by Race and Ethnicity - 13 States, October-December 2020. MMWR Morb Mortal Wkly Rep 2021; 70:566-569. [PMID: 33857062 PMCID: PMC8345000 DOI: 10.15585/mmwr.mm7015e3] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Hershow RB, Wu K, Lewis NM, Milne AT, Currie D, Smith AR, Lloyd S, Orleans B, Young EL, Freeman B, Schwartz N, Bryant B, Espinosa C, Nakazawa Y, Garza E, Almendares O, Abara WE, Ehlman DC, Waters K, Hill M, Risk I, Oakeson K, Tate JE, Kirking HL, Dunn A, Vallabhaneni S, Hersh AL, Chu VT. Low SARS-CoV-2 Transmission in Elementary Schools - Salt Lake County, Utah, December 3, 2020-January 31, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:442-448. [PMID: 33764967 PMCID: PMC7993560 DOI: 10.15585/mmwr.mm7012e3] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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12
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Salvatore PP, Sula E, Coyle JP, Caruso E, Smith AR, Levine RS, Baack BN, Mir R, Lockhart ER, Tiwari TSP, Dee DL, Boehmer TK, Jackson BR, Bhattarai A. Recent Increase in COVID-19 Cases Reported Among Adults Aged 18-22 Years - United States, May 31-September 5, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1419-1424. [PMID: 33006586 PMCID: PMC7537557 DOI: 10.15585/mmwr.mm6939e4] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Nishimura Y, Francis JN, Donau OK, Jesteadt E, Sadjadpour R, Smith AR, Seaman MS, Welch BD, Martin MA, Kay MS. Prevention and treatment of SHIVAD8 infection in rhesus macaques by a potent d-peptide HIV entry inhibitor. Proc Natl Acad Sci U S A 2020; 117:22436-22442. [PMID: 32820072 PMCID: PMC7486783 DOI: 10.1073/pnas.2009700117] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Indexed: 11/18/2022] Open
Abstract
Cholesterol-PIE12-trimer (CPT31) is a potent d-peptide HIV entry inhibitor that targets the highly conserved gp41 N-peptide pocket region. CPT31 exhibited strong inhibitory breadth against diverse panels of primary virus isolates. In a simian-HIV chimeric virus AD8 (SHIVAD8) macaque model, CPT31 prevented infection from a single high-dose rectal challenge. In chronically infected animals, CPT31 monotherapy rapidly reduced viral load by ∼2 logs before rebound occurred due to the emergence of drug resistance. In chronically infected animals with viremia initially controlled by combination antiretroviral therapy (cART), CPT31 monotherapy prevented viral rebound after discontinuation of cART. These data establish CPT31 as a promising candidate for HIV prevention and treatment.
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Affiliation(s)
- Yoshiaki Nishimura
- Laboratory of Molecular Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892
| | - J Nicholas Francis
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112
- Navigen, Inc., Salt Lake City, UT 84108
| | - Olivia K Donau
- Laboratory of Molecular Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892
| | - Eric Jesteadt
- Laboratory of Molecular Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892
| | - Reza Sadjadpour
- Laboratory of Molecular Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892
| | - Amanda R Smith
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112
| | - Michael S Seaman
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA 02215
| | | | - Malcolm A Martin
- Laboratory of Molecular Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892;
| | - Michael S Kay
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112;
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14
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Smith AR, Nelson EE, Kircanski K, Rappaport BI, Do QB, Leibenluft E, Pine DS, Jarcho JM. Social anxiety and age are associated with neural response to social evaluation during adolescence. Dev Cogn Neurosci 2020; 42:100768. [PMID: 32077442 PMCID: PMC7030986 DOI: 10.1016/j.dcn.2020.100768] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 05/31/2019] [Revised: 01/14/2020] [Accepted: 01/31/2020] [Indexed: 11/15/2022] Open
Abstract
Adolescence is a sensitive period for the development of adaptive social behaviors and social anxiety, possibly due to aspects of brain development. However, research is needed to examine interactions among age, social anxiety, and social dynamics previously shown to influence neural responding. The current functional magnetic resonance imaging (fMRI) study examines brain function in 8-18 year-olds with varying levels of social anxiety. Interactions are examined among age, social anxiety, and two key task factors: valence and predictability of social interactions. Results demonstrate age, social anxiety severity, and each of the two key task-based factors interact to predict neural response in the caudate, middle and superior temporal gyri. In particular, among adolescents less-than 13 years of age, higher social anxiety predicted greater responding to unpredictable negative evaluations. However, in this same age group, the opposite pattern emerged during receipt of unpredictable positive evaluations, with less neural response in more anxious youth. Adolescents aged 13 and older overall showed less robust effects. We discuss these findings in terms of age- and anxiety-related differences in socioemotional processing.
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Affiliation(s)
- A R Smith
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD United States.
| | - E E Nelson
- Center for Biobehavioral Health, Research Institute at Nationwide Children's Hospital, Department of Pediatrics, College of Medicine, Ohio State University, Columbus, OH United States
| | - K Kircanski
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD United States
| | - B I Rappaport
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri United States
| | - Q B Do
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania United States
| | - E Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD United States
| | - D S Pine
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD United States
| | - J M Jarcho
- Department of Psychology, Temple University, Philadelphia, Pennsylvania United States
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15
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Smith AR, Weinstock MT, Siglin AE, Whitby FG, Francis JN, Hill CP, Eckert DM, Root MJ, Kay MS. Characterization of resistance to a potent D-peptide HIV entry inhibitor. Retrovirology 2019; 16:28. [PMID: 31640718 PMCID: PMC6805555 DOI: 10.1186/s12977-019-0489-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/03/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND PIE12-trimer is a highly potent D-peptide HIV-1 entry inhibitor that broadly targets group M isolates. It specifically binds the three identical conserved hydrophobic pockets at the base of the gp41 N-trimer with sub-femtomolar affinity. This extremely high affinity for the transiently exposed gp41 trimer provides a reserve of binding energy (resistance capacitor) to prevent the viral resistance pathway of stepwise accumulation of modest affinity-disrupting mutations. Such modest mutations would not affect PIE12-trimer potency and therefore not confer a selective advantage. Viral passaging in the presence of escalating PIE12-trimer concentrations ultimately selected for PIE12-trimer resistant populations, but required an extremely extended timeframe (> 1 year) in comparison to other entry inhibitors. Eventually, HIV developed resistance to PIE12-trimer by mutating Q577 in the gp41 pocket. RESULTS Using deep sequence analysis, we identified three mutations at Q577 (R, N and K) in our two PIE12-trimer resistant pools. Each point mutant is capable of conferring the majority of PIE12-trimer resistance seen in the polyclonal pools. Surface plasmon resonance studies demonstrated substantial affinity loss between PIE12-trimer and the Q577R-mutated gp41 pocket. A high-resolution X-ray crystal structure of PIE12 bound to the Q577R pocket revealed the loss of two hydrogen bonds, the repositioning of neighboring residues, and a small decrease in buried surface area. The Q577 mutations in an NL4-3 backbone decreased viral growth rates. Fitness was ultimately rescued in resistant viral pools by a suite of compensatory mutations in gp120 and gp41, of which we identified seven candidates from our sequencing data. CONCLUSIONS These data show that PIE12-trimer exhibits a high barrier to resistance, as extended passaging was required to develop resistant virus with normal growth rates. The primary resistance mutation, Q577R/N/K, found in the conserved gp41 pocket, substantially decreases inhibitor affinity but also damages viral fitness, and candidate compensatory mutations in gp160 have been identified.
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Affiliation(s)
- Amanda R. Smith
- 0000 0001 2193 0096grid.223827.eDepartment of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112 USA
| | - Matthew T. Weinstock
- 0000 0001 2193 0096grid.223827.eDepartment of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112 USA
| | - Amanda E. Siglin
- 0000 0001 2166 5843grid.265008.9Department of Biochemistry and Molecular Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107 USA
| | - Frank G. Whitby
- 0000 0001 2193 0096grid.223827.eDepartment of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112 USA
| | - J. Nicholas Francis
- 0000 0001 2193 0096grid.223827.eDepartment of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112 USA
| | - Christopher P. Hill
- 0000 0001 2193 0096grid.223827.eDepartment of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112 USA
| | - Debra M. Eckert
- 0000 0001 2193 0096grid.223827.eDepartment of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112 USA
| | - Michael J. Root
- 0000 0001 2166 5843grid.265008.9Department of Biochemistry and Molecular Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107 USA
| | - Michael S. Kay
- 0000 0001 2193 0096grid.223827.eDepartment of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT 84112 USA
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16
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Jones SA, Jones JM, Leung V, Nakashima AK, Oakeson KF, Smith AR, Hunter R, Kim JJ, Cumming M, McHale E, Young PP, Fridey JL, Kelley WE, Stramer SL, Wagner SJ, West FB, Herron R, Snyder E, Hendrickson JE, Peaper DR, Gundlapalli AV, Langelier C, Miller S, Nambiar A, Moayeri M, Kamm J, Moulton-Meissner H, Annambhotla P, Gable P, McAllister GA, Breaker E, Sula E, Halpin AL, Basavaraju SV. Sepsis Attributed to Bacterial Contamination of Platelets Associated with a Potential Common Source - Multiple States, 2018. MMWR Morb Mortal Wkly Rep 2019; 68:519-523. [PMID: 31194723 PMCID: PMC6613552 DOI: 10.15585/mmwr.mm6823a2] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
During May-October 2018, four patients from three states experienced sepsis after transfusion of apheresis platelets contaminated with Acinetobacter calcoaceticus-baumannii complex (ACBC) and Staphylococcus saprophyticus; one patient died. ACBC isolates from patients' blood, transfused platelet residuals, and two environmental samples were closely related by whole genome sequencing. S. saprophyticus isolates from two patients' blood, three transfused platelet residuals, and one hospital environmental sample formed two whole genome sequencing clusters. This whole genome sequencing analysis indicated a potential common source of bacterial contamination; investigation into the contamination source continues. All platelet donations were collected using apheresis cell separator machines and collection sets from the same manufacturer; two of three collection sets were from the same lot. One implicated platelet unit had been treated with pathogen-inactivation technology, and two had tested negative with a rapid bacterial detection device after negative primary culture. Because platelets are usually stored at room temperature, bacteria in contaminated platelet units can proliferate to clinically relevant levels by the time of transfusion. Clinicians should monitor for sepsis after platelet transfusions even after implementation of bacterial contamination mitigation strategies. Recognizing adverse transfusion reactions and reporting to the platelet supplier and hemovigilance systems is crucial for public health practitioners to detect and prevent sepsis associated with contaminated platelets.
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17
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Kracalik I, Ham C, Smith AR, Vowles M, Kauber K, Zambrano M, Rodriguez G, Garner K, Chorbi K, Cassidy PM, McBee S, Stoney R, Brown AC, Moser K, Villarino ME, Walters MS. Notes from the Field: Verona Integron-Encoded Metallo-β-Lactamase-Producing Carbapenem-Resistant Pseudomonas aeruginosa Infections in U.S. Residents Associated with Invasive Medical Procedures in Mexico, 2015-2018. MMWR Morb Mortal Wkly Rep 2019; 68:463-464. [PMID: 31120867 PMCID: PMC6532950 DOI: 10.15585/mmwr.mm6820a4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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18
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Hanson NJ, Carriveau DM, Morgan HE, Smith AR, Michael TJ, Miller MG. Deception of Ambient Temperature Does Not Elicit Performance Benefits During a 5 km Run in Hot, Humid Conditions. J Strength Cond Res 2018; 32:2250-2257. [PMID: 30044341 DOI: 10.1519/jsc.0000000000001933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hanson, NJ, Carriveau, DM, Morgan, HE, Smith, AR, Michael, TJ, and Miller, MG. Deception of ambient temperature does not elicit performance benefits during a 5 km run in hot, humid conditions. J Strength Cond Res 32(8): 2250-2257, 2018-The purpose of this study was to investigate the effect of deception of ambient temperature on 5 km performance in recreational runners. Eleven participants (6 men, 5 women) each performed three 5 km runs in a random order consisting of a control trial (CON) in temperate conditions (21° C, 43% RH), a hot humid trial (HOT; 31° C, 65% RH) and a deception trial (DEC; 31° C, 65% RH), where participants were told it was 5° C lower than it actually was. Overall completion time was recorded at the end of trials; thermal sensation (TS), rating of perceived exertion (RPE), and core temperature (TC) were recorded each kilometer. Participants completed the 5 km run faster in the CON condition (23:18 ± 2:05; mean ± SD) compared with DEC (p = 0.005) and HOT (p = 0.014). There was no difference in completion time (p = 0.554) between DEC (25:11 ± 2:41) and HOT (24:25 ± 2:47). Similarly, TS was lower in the CON condition (5.7 ± 0.2) compared with DEC and HOT (p < 0.001 and p = 0.016, respectively) and no differences were seen between the DEC (6.4 ± 0.2) and HOT (6.5 ± 0.2) conditions. No differences in RPE (p = 0.115) or rise in TC (p = 0.289) were seen between the 3 conditions. Deception of the environmental conditions did not positively affect 5 km running performance, and no differences were seen in physiological or psychological variables.
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Affiliation(s)
- Nicholas J Hanson
- Department of Human Performance and Health Education, Western Michigan University, Kalamazoo, Michigan
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19
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Chadwick ML, Lane A, Thomas D, Smith AR, White AR, Davidson D, Feng Y, Boscolo E, Zheng Y, Adams DM, Gupta A, Veillette A, Chow LML. Combined mTOR and MEK inhibition is an effective therapy in a novel mouse model for angiosarcoma. Oncotarget 2018; 9:24750-24765. [PMID: 29872503 PMCID: PMC5973867 DOI: 10.18632/oncotarget.25345] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/21/2018] [Indexed: 02/03/2023] Open
Abstract
Angiosarcoma is an aggressive malignancy of vascular origin that occurs de novo or in the context of previous cancer therapy. Despite multi-modal aggressive treatment including surgical resection, chemotherapy, and radiation, five-year overall survival remains poor at 35%. Due to its rarity, little is known about its molecular pathology and clinical trials have been extremely difficult to conduct. Development of animal models for rare diseases like angiosarcoma is critical to improve our understanding of tumorigenesis and to test novel treatment regimens. A genetically engineered mouse model for angiosarcoma was generated by conditional deletion of Trp53, Pten, and Ptpn12 in endothelial cells. Tumors arising from these mice recapitulate the histology and molecular pathology of the human disease including hyperactivation of the PI3K/mTOR and MAPK signaling pathways. Treatment of tumor-bearing mice with mTOR or MEK inhibitors effectively inactivated signaling and resulted in reduced proliferation and elevated apoptosis leading to tumor regression. The effect of treatment on tumor growth was transient and proliferation was restored after a period of dormancy. However, combined inhibition of mTOR and MEK resulted in profound tumor regression which was sustained for the duration of treatment. These results suggest that angiosarcoma may be effectively treated by this drug combination.
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Affiliation(s)
- Michelle L Chadwick
- Department of Cancer and Cell Biology, University of Cincinnati, Cincinnati, OH, USA.,Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Adam Lane
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dana Thomas
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Amanda R Smith
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Angela R White
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Yuxin Feng
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Elisa Boscolo
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Yi Zheng
- Department of Cancer and Cell Biology, University of Cincinnati, Cincinnati, OH, USA.,Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Denise M Adams
- Vascular Anomalies Center, Boston Children's Hospital, Boston, MA, USA
| | - Anita Gupta
- Department of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - André Veillette
- Institut de Recherches Cliniques de Montréal, Montréal, Canada
| | - Lionel M L Chow
- Department of Cancer and Cell Biology, University of Cincinnati, Cincinnati, OH, USA.,Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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20
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Alduino C, Alessandria F, Alfonso K, Andreotti E, Arnaboldi C, Avignone FT, Azzolini O, Balata M, Bandac I, Banks TI, Bari G, Barucci M, Beeman JW, Bellini F, Benato G, Bersani A, Biare D, Biassoni M, Bragazzi F, Branca A, Brofferio C, Bryant A, Buccheri A, Bucci C, Bulfon C, Camacho A, Caminata A, Canonica L, Cao XG, Capelli S, Capodiferro M, Cappelli L, Cardani L, Cariello M, Carniti P, Carrettoni M, Casali N, Cassina L, Cereseto R, Ceruti G, Chiarini A, Chiesa D, Chott N, Clemenza M, Conventi D, Copello S, Cosmelli C, Cremonesi O, Crescentini C, Creswick RJ, Cushman JS, D'Addabbo A, D'Aguanno D, Dafinei I, Datskov V, Davis CJ, Del Corso F, Dell'Oro S, Deninno MM, Di Domizio S, Di Vacri ML, Di Paolo L, Drobizhev A, Ejzak L, Faccini R, Fang DQ, Faverzani M, Ferri E, Ferroni F, Fiorini E, Franceschi MA, Freedman SJ, Fujikawa BK, Gaigher R, Giachero A, Gironi L, Giuliani A, Gladstone L, Goett J, Gorla P, Gotti C, Guandalini C, Guerzoni M, Gutierrez TD, Haller EE, Han K, Hansen EV, Heeger KM, Hennings-Yeomans R, Hickerson KP, Huang HZ, Iannone M, Ioannucci L, Kadel R, Keppel G, Kogler L, Kolomensky YG, Leder A, Ligi C, Lim KE, Liu X, Ma YG, Maiano C, Maino M, Marini L, Martinez M, Martinez Amaya C, Maruyama RH, Mei Y, Moggi N, Morganti S, Mosteiro PJ, Nagorny SS, Napolitano T, Nastasi M, Nisi S, Nones C, Norman EB, Novati V, Nucciotti A, Nutini I, O'Donnell T, Olcese M, Olivieri E, Orio F, Orlandi D, Ouellet JL, Pagliarone CE, Pallavicini M, Palmieri V, Pattavina L, Pavan M, Pedretti M, Pedrotta R, Pelosi A, Pessina G, Pettinacci V, Piperno G, Pira C, Pirro S, Pozzi S, Previtali E, Reindl F, Rimondi F, Risegari L, Rosenfeld C, Rossi C, Rusconi C, Sakai M, Sala E, Salvioni C, Sangiorgio S, Santone D, Schaeffer D, Schmidt B, Schmidt J, Scielzo ND, Singh V, Sisti M, Smith AR, Stivanello F, Taffarello L, Tatananni L, Tenconi M, Terranova F, Tessaro M, Tomei C, Ventura G, Vignati M, Wagaarachchi SL, Wallig J, Wang BS, Wang HW, Welliver B, Wilson J, Wilson K, Winslow LA, Wise T, Zanotti L, Zarra C, Zhang GQ, Zhu BX, Zimmermann S, Zucchelli S. First Results from CUORE: A Search for Lepton Number Violation via 0νββ Decay of ^{130}Te. Phys Rev Lett 2018; 120:132501. [PMID: 29694201 DOI: 10.1103/physrevlett.120.132501] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Indexed: 06/08/2023]
Abstract
The CUORE experiment, a ton-scale cryogenic bolometer array, recently began operation at the Laboratori Nazionali del Gran Sasso in Italy. The array represents a significant advancement in this technology, and in this work we apply it for the first time to a high-sensitivity search for a lepton-number-violating process: ^{130}Te neutrinoless double-beta decay. Examining a total TeO_{2} exposure of 86.3 kg yr, characterized by an effective energy resolution of (7.7±0.5) keV FWHM and a background in the region of interest of (0.014±0.002) counts/(keV kg yr), we find no evidence for neutrinoless double-beta decay. Including systematic uncertainties, we place a lower limit on the decay half-life of T_{1/2}^{0ν}(^{130}Te)>1.3×10^{25} yr (90% C.L.); the median statistical sensitivity of this search is 7.0×10^{24} yr. Combining this result with those of two earlier experiments, Cuoricino and CUORE-0, we find T_{1/2}^{0ν}(^{130}Te)>1.5×10^{25} yr (90% C.L.), which is the most stringent limit to date on this decay. Interpreting this result as a limit on the effective Majorana neutrino mass, we find m_{ββ}<(110-520) meV, where the range reflects the nuclear matrix element estimates employed.
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Affiliation(s)
- C Alduino
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | | | - K Alfonso
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - E Andreotti
- Dipartimento di Fisica e Matematica, Università dell'Insubria, Como I-22100, Italy
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - C Arnaboldi
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - F T Avignone
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - O Azzolini
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - M Balata
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - I Bandac
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - T I Banks
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - G Bari
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - M Barucci
- Dipartimento di Fisica, Università di Firenze, Firenze I-50125, Italy
- INFN - Sezione di Firenze, Firenze I-50125, Italy
| | - J W Beeman
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - F Bellini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - G Benato
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - A Bersani
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - D Biare
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - M Biassoni
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - F Bragazzi
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - A Branca
- INFN - Sezione di Padova, Padova I-35131, Italy
| | - C Brofferio
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Bryant
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Buccheri
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - C Bucci
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - C Bulfon
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - A Camacho
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - A Caminata
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - L Canonica
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - X G Cao
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - S Capelli
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | | | - L Cappelli
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L Cardani
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - M Cariello
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - P Carniti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Carrettoni
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - N Casali
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - L Cassina
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - R Cereseto
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - G Ceruti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - A Chiarini
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - D Chiesa
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - N Chott
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - M Clemenza
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - D Conventi
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - S Copello
- INFN - Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - C Cosmelli
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - O Cremonesi
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | | | - R J Creswick
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - J S Cushman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A D'Addabbo
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - D D'Aguanno
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Ingegneria Civile e Meccanica, Università degli Studi di Cassino e del Lazio Meridionale, Cassino I-03043, Italy
| | - I Dafinei
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - V Datskov
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - C J Davis
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - F Del Corso
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - S Dell'Oro
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
- INFN - Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - M M Deninno
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - S Di Domizio
- INFN - Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - M L Di Vacri
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Scienze Fisiche e Chimiche, Università dell'Aquila, L'Aquila I-67100, Italy
| | - L Di Paolo
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Drobizhev
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L Ejzak
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - R Faccini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - D Q Fang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - M Faverzani
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - E Ferri
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - F Ferroni
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - E Fiorini
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M A Franceschi
- INFN - Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - S J Freedman
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B K Fujikawa
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - R Gaigher
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - A Giachero
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - L Gironi
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Giuliani
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Universit Paris-Saclay, 91405 Orsay, France
| | - L Gladstone
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J Goett
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - P Gorla
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - C Gotti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Guandalini
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - M Guerzoni
- INFN - Sezione di Bologna, Bologna I-40127, Italy
| | - T D Gutierrez
- Physics Department, California Polytechnic State University, San Luis Obispo, California 93407, USA
| | - E E Haller
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
| | - K Han
- INPAC and School of Physics and Astronomy, Shanghai Jiao Tong University; Shanghai Laboratory for Particle Physics and Cosmology, Shanghai 200240, China
| | - E V Hansen
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - K M Heeger
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R Hennings-Yeomans
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - K P Hickerson
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - H Z Huang
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - M Iannone
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - L Ioannucci
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - R Kadel
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - G Keppel
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - L Kogler
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - Yu G Kolomensky
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Leder
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - C Ligi
- INFN - Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - K E Lim
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - X Liu
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - Y G Ma
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - C Maiano
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Maino
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - L Marini
- INFN - Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - M Martinez
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
- Laboratorio de Fisica Nuclear y Astroparticulas, Universidad de Zaragoza, Zaragoza 50009, Spain
| | - C Martinez Amaya
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - R H Maruyama
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Mei
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - N Moggi
- INFN - Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum - Università di Bologna, Bologna I-40127, Italy
| | - S Morganti
- INFN - Sezione di Roma, Roma I-00185, Italy
| | | | - S S Nagorny
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- INFN - Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - T Napolitano
- INFN - Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - M Nastasi
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - S Nisi
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - C Nones
- Service de Physique des Particules, CEA / Saclay, 91191 Gif-sur-Yvette, France
| | - E B Norman
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - V Novati
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Universit Paris-Saclay, 91405 Orsay, France
| | - A Nucciotti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - I Nutini
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- INFN - Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - T O'Donnell
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - M Olcese
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - E Olivieri
- Dipartimento di Fisica, Università di Firenze, Firenze I-50125, Italy
- INFN - Sezione di Firenze, Firenze I-50125, Italy
| | - F Orio
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - D Orlandi
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - J L Ouellet
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - C E Pagliarone
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Ingegneria Civile e Meccanica, Università degli Studi di Cassino e del Lazio Meridionale, Cassino I-03043, Italy
| | - M Pallavicini
- INFN - Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - V Palmieri
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - L Pattavina
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Pavan
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Pedretti
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Pedrotta
- INFN - Sezione di Padova, Padova I-35131, Italy
| | - A Pelosi
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - G Pessina
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | | | - G Piperno
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - C Pira
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - S Pirro
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - S Pozzi
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - E Previtali
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - F Reindl
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - F Rimondi
- INFN - Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum - Università di Bologna, Bologna I-40127, Italy
| | - L Risegari
- Dipartimento di Fisica, Università di Firenze, Firenze I-50125, Italy
- INFN - Sezione di Firenze, Firenze I-50125, Italy
| | - C Rosenfeld
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - C Rossi
- INFN - Sezione di Genova, Genova I-16146, Italy
| | - C Rusconi
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Sakai
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - E Sala
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Salvioni
- Dipartimento di Fisica e Matematica, Università dell'Insubria, Como I-22100, Italy
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
| | - S Sangiorgio
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D Santone
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Scienze Fisiche e Chimiche, Università dell'Aquila, L'Aquila I-67100, Italy
| | - D Schaeffer
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - B Schmidt
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Schmidt
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - N D Scielzo
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - V Singh
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - M Sisti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A R Smith
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - F Stivanello
- INFN - Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | | | - L Tatananni
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Tenconi
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Universit Paris-Saclay, 91405 Orsay, France
| | - F Terranova
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Tessaro
- INFN - Sezione di Padova, Padova I-35131, Italy
| | - C Tomei
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - G Ventura
- Dipartimento di Fisica, Università di Firenze, Firenze I-50125, Italy
- INFN - Sezione di Firenze, Firenze I-50125, Italy
| | - M Vignati
- INFN - Sezione di Roma, Roma I-00185, Italy
| | - S L Wagaarachchi
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Wallig
- Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B S Wang
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - H W Wang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - B Welliver
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - K Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - L A Winslow
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - T Wise
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - L Zanotti
- INFN - Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Zarra
- INFN - Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - G Q Zhang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - B X Zhu
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - S Zimmermann
- Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Zucchelli
- INFN - Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum - Università di Bologna, Bologna I-40127, Italy
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Steed TC, Treiber JM, Patel K, Ramakrishnan V, Merk A, Smith AR, Carter BS, Dale AM, Chow LML, Chen CC. Differential localization of glioblastoma subtype: implications on glioblastoma pathogenesis. Oncotarget 2018; 7:24899-907. [PMID: 27056901 PMCID: PMC5041878 DOI: 10.18632/oncotarget.8551] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 03/26/2016] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The subventricular zone (SVZ) has been implicated in the pathogenesis of glioblastoma. Whether molecular subtypes of glioblastoma arise from unique niches of the brain relative to the SVZ remains largely unknown. Here, we tested whether these subtypes of glioblastoma occupy distinct regions of the cerebrum and examined glioblastoma localization in relation to the SVZ. METHODS Pre-operative MR images from 217 glioblastoma patients from The Cancer Imaging Archive were segmented automatically into contrast enhancing (CE) tumor volumes using Iterative Probabilistic Voxel Labeling (IPVL). Probabilistic maps of tumor location were generated for each subtype and distances were calculated from the centroid of CE tumor volumes to the SVZ. Glioblastomas that arose in a Genetically Modified Murine Model (GEMM) model were also analyzed with regard to SVZ distance and molecular subtype. RESULTS Classical and mesenchymal glioblastomas were more diffusely distributed and located farther from the SVZ. In contrast, proneural and neural glioblastomas were more likely to be located in closer proximity to the SVZ. Moreover, in a GFAP-CreER; PtenloxP/loxP; Trp53loxP/loxP; Rb1loxP/loxP; Rbl1-/- GEMM model of glioblastoma where tumor can spontaneously arise in different regions of the cerebrum, tumors that arose near the SVZ were more likely to be of proneural subtype (p < 0.0001). CONCLUSIONS Glioblastoma subtypes occupy different regions of the brain and vary in proximity to the SVZ. These findings harbor implications pertaining to the pathogenesis of glioblastoma subtypes.
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Affiliation(s)
- Tyler C Steed
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Jeffrey M Treiber
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Kunal Patel
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA.,Weill-Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA
| | - Valya Ramakrishnan
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Alexander Merk
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Amanda R Smith
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Bob S Carter
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Anders M Dale
- Multimodal Imaging Laboratory, University of California San Diego, La Jolla, CA, USA.,Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Lionel M L Chow
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Clark C Chen
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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22
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Malogolowkin MH, Hemmer MT, Le-Rademacher J, Hale GA, Mehta PA, Smith AR, Kitko C, Abraham A, Abdel-Azim H, Dandoy C, Angel Diaz M, Gale RP, Guilcher G, Hayashi R, Jodele S, Kasow KA, MacMillian ML, Thakar M, Wirk BM, Woolfrey A, Thiel EL. Outcomes following autologous hematopoietic stem cell transplant for patients with relapsed Wilms' tumor: a CIBMTR retrospective analysis. Bone Marrow Transplant 2017; 52:1549-1555. [PMID: 28869618 PMCID: PMC5665725 DOI: 10.1038/bmt.2017.178] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 04/18/2017] [Accepted: 06/14/2017] [Indexed: 12/04/2022]
Abstract
Despite the dramatic improvement in the overall survival for patients diagnosed with Wilms’ tumor (WT), the outcomes for those that experience relapse have remained disappointing. We describe the outcomes of 253 patients with relapsed WT who received high-dose chemotherapy (HDT) followed by autologous hematopoietic stem cell transplant (HCT) between 1990 and 2013, and reported to the Center for International Blood and Marrow Transplantation Research (CIBMTR). The 5-year estimates for event free survival (EFS) and overall survival (OS) were 36% (95% CI; 29 – 43%) and 45% (95% CI; 38 – 51%) respectively. Relapse of primary disease was the cause of death in 81% of the population. EFS, OS, relapse and transplant-related mortality (TRM) showed no significant differences when broken down by disease status at transplant, time from diagnosis to transplant, year of transplant or conditioning regimen. Our data suggest that HDT followed by autologous HCT for relapsed WT is well tolerated and outcomes are similar to those reported in the literature. Since attempts to conduct a randomized trial comparing maintenance chemotherapy with consolidation versus high-dose chemotherapy followed by stem cell transplant have failed, one should balance the potential benefits with the yet unknown long-term risks. Since disease recurrence continues to be the most common cause of death, future research should focus on the development of consolidation therapies for those patients achieving complete response to therapy.
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Affiliation(s)
- M H Malogolowkin
- Davis Cancer Center, University of California, Sacramento, CA, USA
| | - M T Hemmer
- CIBMTR (Center for International Blood and Marrow Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - J Le-Rademacher
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - G A Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St Petersburg, FL, USA
| | - P A Mehta
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - A R Smith
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - C Kitko
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - A Abraham
- Division of Blood and Marrow Transplantation, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC, USA
| | - H Abdel-Azim
- Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - C Dandoy
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - M Angel Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - R P Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK
| | - G Guilcher
- Section of Paediatric Oncology and Blood and Marrow Transplant, Alberta Children's Hospital, Calgary, AB, Canada
| | - R Hayashi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, MO, USA
| | - S Jodele
- Cincinnatti Children's Hospital, Cincinnati, OH, USA
| | - K A Kasow
- Division of Hematology-Oncology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M L MacMillian
- University of Minnesota Blood and Marrow Transplant Program, Minneapolis, MN, USA
| | - M Thakar
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - B M Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - A Woolfrey
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - E L Thiel
- Medical College of Wisconsin, Milwaukee, WI, USA
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23
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White AR, Kumar SS, Smith AR, Ramkissoon A, Oatman N, Dasgupta B, Breese EH, Stevenson C, Fuller C, Fouladi M, DeWire MD, Drissi R, Chow LM. TMOD-10. INTRACRANIAL PATIENT-DERIVED XENOGRAFT FROM A PEDIATRIC GLIOBLASTOMA RETAINS MOLECULAR CHARACTERISTICS AND GROWTH PATHWAYS. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox083.209] [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: 11/14/2022] Open
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24
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Butt Z, Dew MA, Liu Q, Simpson MA, Smith AR, Zee J, Gillespie BW, Abbey SE, Ladner DP, Weinrieb R, Fisher RA, Hafliger S, Terrault N, Burton J, Sherker AH, DiMartini A. Psychological Outcomes of Living Liver Donors From a Multicenter Prospective Study: Results From the Adult-to-Adult Living Donor Liver Transplantation Cohort Study2 (A2ALL-2). Am J Transplant 2017; 17:1267-1277. [PMID: 27865040 PMCID: PMC5612366 DOI: 10.1111/ajt.14134] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/21/2016] [Accepted: 11/08/2016] [Indexed: 01/25/2023]
Abstract
Although single-center and cross-sectional studies have suggested a modest impact of liver donation on donor psychological well-being, few studies have assessed these outcomes prospectively among a large cohort. We conducted one of the largest, prospective, multicenter studies of psychological outcomes in living liver donors within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study2 (A2ALL-2) consortium. In total, 271 (91%) of 297 eligible donors were interviewed at least once before donation and at 3, 6, 12, and 24 mo after donation using validated measures. We found that living liver donors reported low rates of major depressive (0-3%), alcohol abuse (2-5%), and anxiety syndromes (2-3%) at any given assessment in their first 2 years after donation. Between 4.7% and 9.6% of donors reported impaired mental well-being at various time points. We identified significant predictors for donors' perceptions of being better people and experiencing psychological growth following donation, including age, sex, relationship to recipient, ambivalence and motivation regarding donation, and feeling that donation would make life more worthwhile. Our results highlight the need for close psychosocial monitoring for those donors whose recipients died (n=27); some of those donors experienced guilt and concerns about responsibility. Careful screening and targeted, data-driven follow-up hold promise for optimizing psychological outcomes following this procedure for potentially vulnerable donors.
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Affiliation(s)
- Z Butt
- Departments of Medical Social Sciences, Surgery, & Psychiatry and Behavioral Sciences Northwestern University, Chicago IL
| | - MA Dew
- Departments of Psychiatry, Surgery, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh PA
| | - Q Liu
- Arbor Research Collaborative for Health, Ann Arbor, MI
| | - MA Simpson
- Department of Transplantation, Lahey Hospital and Medical Center, Burlington, MA
| | - AR Smith
- Arbor Research Collaborative for Health, Ann Arbor, MI,Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - J Zee
- Arbor Research Collaborative for Health, Ann Arbor, MI
| | - BW Gillespie
- Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - SE Abbey
- Department of Psychiatry and Transplantation, University Health Network, University of Toronto, Toronto, Ontario, CA
| | - DP Ladner
- Departments of Medical Social Sciences, Surgery, & Psychiatry and Behavioral Sciences Northwestern University, Chicago IL
| | - R Weinrieb
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - RA Fisher
- Professor of Surgery, Harvard Medical School Chief, Division of Transplantation, The Transplant Institute Beth Israel Deaconess Medical Center, Harvard University, Boston, MA
| | - S Hafliger
- Department of Psychiatry, Columbia University, New York, NY
| | - N Terrault
- Departments of Medicine and Surgery, University of California at San Francisco, San Francisco, CA
| | - J Burton
- Department of Medicine, University of Colorado, Denver, Aurora, CO
| | - AH Sherker
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - A DiMartini
- Departments of Psychiatry, Surgery, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh PA
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25
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DiMartini A, Dew MA, Liu Q, Simpson MA, Ladner DP, Smith AR, Zee J, Abbey S, Gillespie BW, Weinrieb R, Mandell MS, Fisher RA, Emond JC, Freise CE, Sherker AH, Butt Z. Social and Financial Outcomes of Living Liver Donation: A Prospective Investigation Within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study 2 (A2ALL-2). Am J Transplant 2017; 17:1081-1096. [PMID: 27647626 PMCID: PMC5359081 DOI: 10.1111/ajt.14055] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/04/2016] [Accepted: 09/07/2016] [Indexed: 01/25/2023]
Abstract
Because results from single-center (mostly kidney) donor studies demonstrate interpersonal relationship and financial strains for some donors, we conducted a liver donor study involving nine centers within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study 2 (A2ALL-2) consortium. Among other initiatives, A2ALL-2 examined the nature of these outcomes following donation. Using validated measures, donors were prospectively surveyed before donation and at 3, 6, 12, and 24 mo after donation. Repeated-measures regression models were used to examine social relationship and financial outcomes over time and to identify relevant predictors. Of 297 eligible donors, 271 (91%) consented and were interviewed at least once. Relationship changes were positive overall across postdonation time points, with nearly one-third reporting improved donor family and spousal or partner relationships and >50% reporting improved recipient relationships. The majority of donors, however, reported cumulative out-of-pocket medical and nonmedical expenses, which were judged burdensome by 44% of donors. Lower income predicted burdensome donation costs. Those who anticipated financial concerns and who held nonprofessional positions before donation were more likely to experience adverse financial outcomes. These data support the need for initiatives to reduce financial burden.
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Affiliation(s)
- A DiMartini
- Department of Psychiatry, University of Pittsburgh, Pittsburgh PA, USA,Department of Surgery, University of Pittsburgh, Pittsburgh PA, USA
| | - MA Dew
- Department of Psychiatry, University of Pittsburgh, Pittsburgh PA, USA,Department of Psychology, University of Pittsburgh, Pittsburgh PA, USA,Department of Epidemiology, University of Pittsburgh, Pittsburgh PA, USA,Department of Biostatistics, University of Pittsburgh, Pittsburgh PA, USA
| | - Q Liu
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - MA Simpson
- Lahey Hospital and Medical Center Clinical Research and Education, Burlington, MA, USA,Department of Transplantation, Burlington, MA, USA
| | - DP Ladner
- Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Chicago, IL, USA,Comprehensive Transplant Center, Northwestern University, Chicago, IL, USA
| | - AR Smith
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA,Departments of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - J Zee
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - S Abbey
- Department of Psychiatry, University of Toronto and University Health Network, Toronto ON, CA
| | - BW Gillespie
- Departments of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - R Weinrieb
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - MS Mandell
- Department of Anesthesiology, University of Colorado, Denver CO, USA
| | - RA Fisher
- Department of Transplant Surgery, Virginia Commonwealth University, Richmond, VA, USA (current affiliation, Beth Israel Deaconess Department of Surgery, Harvard University)
| | - JC Emond
- Department of Surgery, Columbia University Medical Center, New York, New York, USA
| | - CE Freise
- Department of Surgery, University of California at San Francisco, San Francisco, CA, USA
| | - AH Sherker
- Liver Diseases Research Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Z Butt
- Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Chicago, IL, USA,Comprehensive Transplant Center, Northwestern University, Chicago, IL, USA,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago IL, USA,Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago IL, USA
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26
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Phelan R, Mann E, Napurski C, DeFor TE, Petryk A, Miller WP, Wagner JE, Verneris MR, Smith AR. Ovarian function after hematopoietic cell transplantation: a descriptive study following the use of GnRH agonists for myeloablative conditioning and observation only for reduced-intensity conditioning. Bone Marrow Transplant 2016; 51:1369-1375. [PMID: 27272448 DOI: 10.1038/bmt.2016.150] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/21/2016] [Accepted: 04/22/2016] [Indexed: 12/11/2022]
Abstract
Gonadal failure is a health and quality-of-life concern in hematopoietic cell transplant (HCT) survivors. While ovarian dysfunction is nearly universal following myeloablative (MA) conditioning, the risk is unclear after reduced-intensity conditioning (RIC). Gonadotropin-releasing hormone agonists decrease ovarian failure rates following conventional chemotherapy, but little is known about its effectiveness with HCT. We investigated the impact of leuprolide on ovarian function after MA conditioning and monitored ovarian function after RIC in this descriptive pilot study. Post-menarchal females <50 years undergoing HCT with adequate baseline ovarian function (follicle-stimulating hormone (FSH) level <40 mIU/mL and normal menstruation) were eligible. Prior to MA conditioning, leuprolide was administered. Those undergoing RIC were observed. FSH was measured at various time points. Seventeen women aged 12-45 years were evaluated (7 in the intervention group and 10 in the observation group). Compared to the historical high rate of ovarian failure after MA conditioning, 3 of 7 evaluable Lupron recipients had ovarian failure at a median of 703 days post transplant. Ovarian failure occurred in 1 of 10 recipients of RIC at a median follow-up of 901 days. In conclusion, leuprolide may protect ovarian function after MA conditioning. Additionally, RIC with cyclophosphamide, fludarabine and low-dose TBI has a low risk of ovarian failure.
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Affiliation(s)
- R Phelan
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - E Mann
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - C Napurski
- Cancer Survivorship Program, University of Minnesota, Minneapolis, MN, USA
| | - T E DeFor
- BMT Research Program, University of Minnesota, Minneapolis, MN, USA
| | - A Petryk
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - W P Miller
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - J E Wagner
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - M R Verneris
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - A R Smith
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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27
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Samstein B, Smith AR, Freise CE, Zimmerman M, Baker T, Othloff KM, Fisher RA, Merion RM. Complications and Their Resolution in Recipients of Deceased and Living Donor Liver Transplants: Findings From the A2ALL Cohort Study. Am J Transplant 2016; 16:594-602. [PMID: 26461803 PMCID: PMC4733444 DOI: 10.1111/ajt.13479] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 06/19/2015] [Accepted: 07/19/2015] [Indexed: 01/25/2023]
Abstract
The purpose of this study was to explore long-term complications in recipients of deceased donor liver transplant (DDLT) and living donor liver transplant (LDLT) in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). We analyzed 471 DDLTs and 565 LDLTs from 1998 to 2010 that were followed up to 10 years for 36 categories of complications. Probabilities of complications and their resolutions were estimated using the Kaplan-Meier method, and predictors were tested in Cox proportional hazards models. Median follow-up for DDLT and LDLT was 4.19 and 4.80 years, respectively. DDLT recipients were more likely to have hepatocellular carcinoma and higher disease severity, including Model for End-Stage Liver Disease score. Complications occurring with higher probability in LDLT included biliary-related complications and hepatic artery thrombosis. In DDLT, ascites, intra-abdominal bleeding, cardiac complications and pulmonary edema were significantly more probable. Development of chronic kidney disease stage 4 or 5 was less likely in LDLT recipients (hazard ratio [HR] 0.41, p = 0.02). DDLT and LDLT had similar risk of grade 4 complications (HR 0.89, p = 0.60), adjusted for other risk factors. Once a complication occurred, the time to resolution did not differ between LDLT and DDLT. Future efforts should be directed toward reducing the occurrence of complications after liver transplantation.
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Affiliation(s)
- B Samstein
- Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY
| | - AR Smith
- Department of Biostatistics, University of Michigan, Ann Arbor, MI,Arbor Research Collaborative for Health, Ann Arbor, MI
| | - CE Freise
- Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - M Zimmerman
- Division of Transplant Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - T Baker
- Department of Surgery, Northwestern University, Chicago, IL
| | - KM Othloff
- Department of Surgery, University of Pennsylvania, Philadelphia, PA
| | - RA Fisher
- Division of Transplantation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - RM Merion
- Arbor Research Collaborative for Health, Ann Arbor, MI,Department of Surgery, University of Michigan, Ann Arbor, MI
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28
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Alfonso K, Artusa DR, Avignone FT, Azzolini O, Balata M, Banks TI, Bari G, Beeman JW, Bellini F, Bersani A, Biassoni M, Brofferio C, Bucci C, Caminata A, Canonica L, Cao XG, Capelli S, Cappelli L, Carbone L, Cardani L, Casali N, Cassina L, Chiesa D, Chott N, Clemenza M, Copello S, Cosmelli C, Cremonesi O, Creswick RJ, Cushman JS, Dafinei I, Dally A, Dell'Oro S, Deninno MM, Di Domizio S, Di Vacri ML, Drobizhev A, Ejzak L, Fang DQ, Faverzani M, Fernandes G, Ferri E, Ferroni F, Fiorini E, Freedman SJ, Fujikawa BK, Giachero A, Gironi L, Giuliani A, Gorla P, Gotti C, Gutierrez TD, Haller EE, Han K, Hansen E, Heeger KM, Hennings-Yeomans R, Hickerson KP, Huang HZ, Kadel R, Keppel G, Kolomensky YG, Lim KE, Liu X, Ma YG, Maino M, Martinez M, Maruyama RH, Mei Y, Moggi N, Morganti S, Nisi S, Nones C, Norman EB, Nucciotti A, O'Donnell T, Orio F, Orlandi D, Ouellet JL, Pagliarone CE, Pallavicini M, Palmieri V, Pattavina L, Pavan M, Pedretti M, Pessina G, Pettinacci V, Piperno G, Pirro S, Pozzi S, Previtali E, Rosenfeld C, Rusconi C, Sala E, Sangiorgio S, Santone D, Scielzo ND, Sisti M, Smith AR, Taffarello L, Tenconi M, Terranova F, Tomei C, Trentalange S, Ventura G, Vignati M, Wagaarachchi SL, Wang BS, Wang HW, Wielgus L, Wilson J, Winslow LA, Wise T, Zanotti L, Zarra C, Zhang GQ, Zhu BX, Zucchelli S. Search for Neutrinoless Double-Beta Decay of (130)Te with CUORE-0. Phys Rev Lett 2015; 115:102502. [PMID: 26382673 DOI: 10.1103/physrevlett.115.102502] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Indexed: 06/05/2023]
Abstract
We report the results of a search for neutrinoless double-beta decay in a 9.8 kg yr exposure of (130)Te using a bolometric detector array, CUORE-0. The characteristic detector energy resolution and background level in the region of interest are 5.1±0.3 keV FWHM and 0.058±0.004(stat)±0.002(syst)counts/(keV kg yr), respectively. The median 90% C.L. lower-limit half-life sensitivity of the experiment is 2.9×10(24) yr and surpasses the sensitivity of previous searches. We find no evidence for neutrinoless double-beta decay of (130)Te and place a Bayesian lower bound on the decay half-life, T(1/2)(0ν)>2.7×10(24) yr at 90% C.L. Combining CUORE-0 data with the 19.75 kg yr exposure of (130)Te from the Cuoricino experiment we obtain T(1/2)(0ν)>4.0×10(24) yr at 90% C.L. (Bayesian), the most stringent limit to date on this half-life. Using a range of nuclear matrix element estimates we interpret this as a limit on the effective Majorana neutrino mass, m(ββ)<270-760 meV.
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Affiliation(s)
- K Alfonso
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - D R Artusa
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
| | - F T Avignone
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - O Azzolini
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - M Balata
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
| | - T I Banks
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - G Bari
- INFN-Sezione di Bologna, Bologna I-40127, Italy
| | - J W Beeman
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - F Bellini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - A Bersani
- INFN-Sezione di Genova, Genova I-16146, Italy
| | - M Biassoni
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - C Brofferio
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - C Bucci
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
| | - A Caminata
- INFN-Sezione di Genova, Genova I-16146, Italy
| | - L Canonica
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
| | - X G Cao
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - S Capelli
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - L Cappelli
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
- Dipartimento di Ingegneria Civile e Meccanica, Università degli Studi di Cassino e del Lazio Meridionale, Cassino I-03043, Italy
| | - L Carbone
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - L Cardani
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - N Casali
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - L Cassina
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - D Chiesa
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - N Chott
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - M Clemenza
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - S Copello
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - C Cosmelli
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - O Cremonesi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - R J Creswick
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - J S Cushman
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - I Dafinei
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - A Dally
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - S Dell'Oro
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
- INFN-Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - M M Deninno
- INFN-Sezione di Bologna, Bologna I-40127, Italy
| | - S Di Domizio
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - M L Di Vacri
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
- Dipartimento di Scienze Fisiche e Chimiche, Università dell'Aquila, L'Aquila I-67100, Italy
| | - A Drobizhev
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L Ejzak
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - D Q Fang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - M Faverzani
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - G Fernandes
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - E Ferri
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - F Ferroni
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - E Fiorini
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - S J Freedman
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B K Fujikawa
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Giachero
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - L Gironi
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - A Giuliani
- Centre de Sciences Nucléaires et de Sciences de la Matière (CSNSM), 91405 Orsay Campus, Orsay, France
| | - P Gorla
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
| | - C Gotti
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - T D Gutierrez
- Physics Department, California Polytechnic State University, San Luis Obispo, California 93407, USA
| | - E E Haller
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
| | - K Han
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - E Hansen
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - K M Heeger
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R Hennings-Yeomans
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - K P Hickerson
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - H Z Huang
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - R Kadel
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - G Keppel
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - Yu G Kolomensky
- Department of Physics, University of California, Berkeley, California 94720, USA
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - K E Lim
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - X Liu
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - Y G Ma
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - M Maino
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - M Martinez
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- Laboratorio de Fisica Nuclear y Astroparticulas, Universidad de Zaragoza, Zaragoza 50009, Spain
| | - R H Maruyama
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Mei
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - N Moggi
- INFN-Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Scienze per la Qualità della Vita, Alma Mater Studiorum-Università di Bologna, Bologna I-47921, Italy
| | - S Morganti
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - S Nisi
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
| | - C Nones
- CEA, Centre de Saclay, Irfu/SPP, F-91191 Gif-sur-Yvette, France
| | - E B Norman
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - A Nucciotti
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - T O'Donnell
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - F Orio
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - D Orlandi
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
| | - J L Ouellet
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - C E Pagliarone
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
- Dipartimento di Ingegneria Civile e Meccanica, Università degli Studi di Cassino e del Lazio Meridionale, Cassino I-03043, Italy
| | - M Pallavicini
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - V Palmieri
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - L Pattavina
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
| | - M Pavan
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - M Pedretti
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G Pessina
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | | | - G Piperno
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - S Pirro
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
| | - S Pozzi
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - E Previtali
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - C Rosenfeld
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - C Rusconi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - E Sala
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - S Sangiorgio
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D Santone
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
- Dipartimento di Scienze Fisiche e Chimiche, Università dell'Aquila, L'Aquila I-67100, Italy
| | - N D Scielzo
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M Sisti
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - A R Smith
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | | | - M Tenconi
- Centre de Sciences Nucléaires et de Sciences de la Matière (CSNSM), 91405 Orsay Campus, Orsay, France
| | - F Terranova
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - C Tomei
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - S Trentalange
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - G Ventura
- Dipartimento di Fisica, Università di Firenze, Firenze I-50125, Italy
- INFN-Sezione di Firenze, Firenze I-50125, Italy
| | - M Vignati
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - S L Wagaarachchi
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B S Wang
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - H W Wang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - L Wielgus
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - J Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - L A Winslow
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - T Wise
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
- Department of Physics, University of Wisconsin, Madison, Wisconsin 53706, USA
| | - L Zanotti
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - C Zarra
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67010, Italy
| | - G Q Zhang
- Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - B X Zhu
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - S Zucchelli
- INFN-Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum-Università di Bologna, Bologna I-40127, Italy
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Smith AR, Garris PA, Casto JM. Real-time monitoring of electrically evoked catecholamine signals in the songbird striatum using in vivo fast-scan cyclic voltammetry. J Chem Neuroanat 2015; 66-67:28-39. [PMID: 25900708 DOI: 10.1016/j.jchemneu.2015.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/04/2015] [Accepted: 04/04/2015] [Indexed: 01/06/2023]
Abstract
Fast-scan cyclic voltammetry is a powerful technique for monitoring rapid changes in extracellular neurotransmitter levels in the brain. In vivo fast-scan cyclic voltammetry has been used extensively in mammalian models to characterize dopamine signals in both anesthetized and awake preparations, but has yet to be applied to a non-mammalian vertebrate. The goal of this study was to establish in vivo fast-scan cyclic voltammetry in a songbird, the European starling, to facilitate real-time measurements of extracellular catecholamine levels in the avian striatum. In urethane-anesthetized starlings, changes in catecholamine levels were evoked by electrical stimulation of the ventral tegmental area and measured at carbon-fiber microelectrodes positioned in the medial and lateral striata. Catecholamines were elicited by different stimulations, including trains related to phasic dopamine signaling in the rat, and were analyzed to quantify presynaptic mechanisms governing exocytotic release and neuronal uptake. Evoked extracellular catecholamine dynamics, maximal amplitude of the evoked catecholamine signal, and parameters for catecholamine release and uptake did not differ between striatal regions and were similar to those determined for dopamine in the rat dorsomedial striatum under similar conditions. Chemical identification of measured catecholamine by its voltammogram was consistent with the presence of both dopamine and norepinephrine in striatal tissue content. However, the high ratio of dopamine to norepinephrine in tissue content and the greater sensitivity of the carbon-fiber microelectrode to dopamine compared to norepinephrine favored the measurement of dopamine. Thus, converging evidence suggests that dopamine was the predominate analyte of the electrically evoked catecholamine signal measured in the striatum by fast-scan cyclic voltammetry. Overall, comparisons between the characteristics of these evoked signals suggested a similar presynaptic regulation of dopamine in the starling and rat striatum. Fast-scan cyclic voltammetry thus has the potential to be an invaluable tool for investigating the neural underpinnings of behavior in birds.
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Affiliation(s)
- Amanda R Smith
- School of Biological Sciences, Illinois State University, Campus Box 4120, Normal, IL 61790-4120, USA.
| | - Paul A Garris
- School of Biological Sciences, Illinois State University, Campus Box 4120, Normal, IL 61790-4120, USA
| | - Joseph M Casto
- School of Biological Sciences, Illinois State University, Campus Box 4120, Normal, IL 61790-4120, USA
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Corbett JP, Pandya SG, Mandru AO, Pak J, Kordesch ME, Smith AR. Note: advancement in tip etching for preparation of tunable size scanning tunneling microscopy tips. Rev Sci Instrum 2015; 86:026104. [PMID: 25725897 DOI: 10.1063/1.4907706] [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] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/26/2015] [Indexed: 06/04/2023]
Abstract
The two aspects of a scanning tunneling microscopy tip, the macroscopic profile and the nanoscale apex, can be tailored by controlling the tension during electrochemical etching and the solution-electrode contact area via acetone vapor. The apex diameter is shown to be proportional to the square root of the tension, and is demonstrated over apex diameters of 150-500 nm. The apex was found to be created in four distinct shapes where a secondary etching can reshape the tip into a single geometry. Improvement in tip height and stability of the profile are demonstrated versus a non-acetone fabrication control.
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Affiliation(s)
- J P Corbett
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute, Ohio University, Athens, Ohio 45701, USA
| | - S G Pandya
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute, Ohio University, Athens, Ohio 45701, USA
| | - A-O Mandru
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute, Ohio University, Athens, Ohio 45701, USA
| | - J Pak
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute, Ohio University, Athens, Ohio 45701, USA
| | - M E Kordesch
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute, Ohio University, Athens, Ohio 45701, USA
| | - A R Smith
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute, Ohio University, Athens, Ohio 45701, USA
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Smith AR, Ellison AL, Robinson AL, Drake M, McDowell SA, Mitchell JK, Gerard PD, Heckler RA, McKillip JL. Enumeration of sublethally injured Escherichia coli O157:H7 ATCC 43895 and Escherichia coli strain B-41560 using selective agar overlays versus commercial methods. J Food Prot 2013; 76:674-9. [PMID: 23575132 DOI: 10.4315/0362-028x.jfp-12-363] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Quality control procedures during food processing may involve direct inoculation of food samples onto appropriate selective media for subsequent enumeration. However, sublethally injured bacteria often fail to grow, enabling them to evade detection and intervention measures and ultimately threaten the health of consumers. This study compares traditional selective and nonselective agar-based overlays versus two commercial systems (Petrifilm and Easygel) for recovery of injured E. coli B-41560 and O157:H7 strains. Bacteria were propagated in tryptic soy broth (TSB), ground beef slurry, and infant milk formula to a density of 10(6) to 10(8) CFU/ml and then were stressed for 6 min either in lactic acid (pH 4.5) or heat shocked for 3 min at 60°C. Samples were pour plated in basal layers of either tryptic soy agar (TSA), sorbitol MacConkey agar (SMAC), or violet red bile agar (VRB) and were resuscitated for 4 h prior to addition of agar overlays. Other stressed bacteria were plated directly onto Petrifilm and Easygel. Results indicate that selective and nonselective agar overlays recovered significantly higher numbers (greater than 1 log) of acid- and heat-injured E. coli O157:H7 from TSB, ground beef, and infant milk formula compared with direct plating onto selective media, Petrifilm, or Easygel, while no significant differences among these media combinations were observed for stressed E. coli B-41560. Nonstressed bacteria from TSB and ground beef were also recovered at densities significantly higher in nonselective TSA-TSA and in VRB-VRB and SMAC-SMAC compared with Petrifilm and Easygel. These data underscore the need to implement food safety measures that address sublethally injured pathogens such as E. coli O157:H7 in order to avoid underestimation of true densities for target pathogens.
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Affiliation(s)
- Amanda R Smith
- Department of Biology, Ball State University, Muncie, Indiana 47306, USA
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Smith AR, Ma K, Soares D, Carleton KL. Relative LWS cone opsin expression determines optomotor thresholds in Malawi cichlid fish. Genes Brain Behav 2011; 11:185-92. [PMID: 21992615 DOI: 10.1111/j.1601-183x.2011.00739.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Associating quantitative genetic traits with quantitative behaviors is a relatively unexplored region of sensory neurobiology. The visual system is an ideal place to test models associating these levels of sensory perception. In this study, we reared cichlid fish from Lake Malawi in different ambient light environments. We then tested the visual sensitivities of these fish using the optomotor response (OMR) behavioral paradigm and measured the relative expression of cone opsin genes. We found that the light environment experienced by fish during development can alter gene expression, particularly as it applies to the long wavelength-sensitive (LWS) opsin gene. Also, fish from different rearing conditions exhibited different behavioral sensitivities. We combined these data with predictions of opsin pigment absorption by the different OMR stimuli to determine which cone types are most likely to influence the OMR behavior. While we hypothesized that this behavior would be controlled by a random-wiring model reflecting the expression of both medium wavelength-sensitive (MWS) and LWS opsins, our models suggest that only the LWS pigment is required to predict behavior. Furthermore, analyses show that LWS expression variation accounts for ~20% of the observed behavioral variance. This work confirms that sensory gene expression influences behavior in a predictable fashion. It also suggests that the neural wiring of basal visual pathways in cichlid fish may differ from that observed in mammals and zebrafish, but is similar to that described in goldfish. This finding has important implications for the evolution of the magnocellular neural pathway in teleosts.
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Affiliation(s)
- A R Smith
- Department of Biology, University of Maryland, College Park, MD 20742, USA.
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Lai CJ, Smith AR, Stebbins MR, Cutler TW, Lipton HL. Promoting interprofessional collaboration: pharmacy students teaching current and future prescribers about Medicare Part D. J Manag Care Pharm 2011; 17:439-48. [PMID: 21787029 PMCID: PMC10437694 DOI: 10.18553/jmcp.2011.17.6.439] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Nearly all health professional students and prescribers, regardless of specialty, will care for older adults who are enrolled in or eligible for the Medicare Part D prescription drug benefit. Given the growing numbers of older adults, the increased burden of chronic disease, and the escalating costs of health care, health professional students and prescribers across disciplines should learn strategies to promote cost-effective prescribing and collaborate with pharmacists who are experts in medication use and costs. OBJECTIVE To describe and evaluate the impact of a statewide peer education program in which selected students at 7 California schools of pharmacy delivered a clinically relevant lecture on Part D to a multidisciplinary audience of health professional students and prescribers. METHODS Trained pharmacy students delivered a case-based lecture on Medicare Part D to other health professional students and prescribers throughout the state of California. An 11-item survey designed to evaluate (a) self-assessed Part D knowledge, (b) opinion of pharmacists' roles on the health care team, (c) intent to collaborate with pharmacists, and (d) awareness of cost-savings strategies to reduce patients' out-of-pocket drug costs was administered before and after the lecture. Pre-lecture versus post-lecture results were tested for statistical significance using the Wilcoxon signed-rank test with Bonferroni adjustment of alpha to 0.004 because of multiple comparisons. RESULTS From October 2008 through May 2010, trained students from 7 pharmacy schools gave 58 presentations to a total of 1,490 current or future prescribers, including 304 nurse practitioner students and 279 resident physicians. At baseline pre-lecture, self-rated knowledge of Medicare Part D was generally poor; only 4.9% of respondents strongly agreed that "I understand the Medicare Part D benefit," and 6.6% strongly agreed that they could "identify key Medicare Part D resources to help my patients." Nine of 11 survey items showed statistically significant improvement (P less than 0.001), including all 4 items in the Part D knowledge domain and all 5 items in the intent-to-collaborate domain (e.g., "I consult with pharmacists and/or pharmacy students about drug costs"). Outcomes were similar across the 7 schools. CONCLUSION At pre-lecture baseline, self-reported deficits in knowledge about Part D policy and drug cost-savings resources and strategies existed among medical, nursing and physician assistant students, resident physicians, and other health professionals. A pharmacy student-led peer education lecture can be used to bridge this gap, resulting in timely dissemination of geriatrics health policy information and increased awareness of pharmacists' roles and expertise in pharmaceutical health policy and patient care.
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Affiliation(s)
- Cindy J. Lai
- UCSF School of Medicine, 505 Parnassus Ave., M1078, San Francisco, CA 94143, USA,
| | - Amanda R. Smith
- UCSF School of Medicine, 505 Parnassus Ave., M1078, San Francisco, CA 94143, USA,
| | - Marilyn R. Stebbins
- UCSF School of Medicine, 505 Parnassus Ave., M1078, San Francisco, CA 94143, USA,
| | - Timothy W. Cutler
- UCSF School of Medicine, 505 Parnassus Ave., M1078, San Francisco, CA 94143, USA,
| | - Helene L. Lipton
- UCSF School of Medicine, 505 Parnassus Ave., M1078, San Francisco, CA 94143, USA,
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Sieren JC, Smith AR, Thiesse J, Namati E, Hoffman EA, Kline JN, McLennan G. Exploration of the volumetric composition of human lung cancer nodules in correlated histopathology and computed tomography. Lung Cancer 2011; 74:61-8. [PMID: 21371772 DOI: 10.1016/j.lungcan.2011.01.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 01/18/2011] [Accepted: 01/30/2011] [Indexed: 10/18/2022]
Abstract
Gaining a complete and comprehensive understanding of lung cancer nodule histological compositions and how these tissues are represented in radiological data is important not only for expanding the current knowledge base of cancer growth and development but also has potential implications for classification standards, radiological diagnosis methods and for the evaluation of treatment response. In this study we generate large scale histological segmentations of the cancerous and non-cancerous tissues within resected lung nodules. We have implemented a processing pipeline which allows for the direct correlation between histological data and spatially corresponding computed tomography data. Utilizing these correlated datasets we evaluated the statistical separation between Hounsfield Unit (HU) histogram values for each tissue type. The findings of this study revealed that lung cancer nodules contain a complex intermixing of cellular tissue types and that trends exist in the relationship between these tissue types. It was found that the mean Hounsfield Unit values for isolated lung cancer nodules imaged with computed tomography, had statistically significantly different values for non-solid bronchoalveolar carcinoma, solid cancerous tumor, blood, and inactive fibrotic stromal tissue.
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Affiliation(s)
- J C Sieren
- Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA.
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Armato SG, McLennan G, Bidaut L, McNitt-Gray MF, Meyer CR, Reeves AP, Zhao B, Aberle DR, Henschke CI, Hoffman EA, Kazerooni EA, MacMahon H, Van Beeke EJR, Yankelevitz D, Biancardi AM, Bland PH, Brown MS, Engelmann RM, Laderach GE, Max D, Pais RC, Qing DPY, Roberts RY, Smith AR, Starkey A, Batrah P, Caligiuri P, Farooqi A, Gladish GW, Jude CM, Munden RF, Petkovska I, Quint LE, Schwartz LH, Sundaram B, Dodd LE, Fenimore C, Gur D, Petrick N, Freymann J, Kirby J, Hughes B, Casteele AV, Gupte S, Sallamm M, Heath MD, Kuhn MH, Dharaiya E, Burns R, Fryd DS, Salganicoff M, Anand V, Shreter U, Vastagh S, Croft BY. The Lung Image Database Consortium (LIDC) and Image Database Resource Initiative (IDRI): a completed reference database of lung nodules on CT scans. Med Phys 2011; 38:915-31. [PMID: 21452728 PMCID: PMC3041807 DOI: 10.1118/1.3528204] [Citation(s) in RCA: 826] [Impact Index Per Article: 63.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 11/16/2010] [Accepted: 11/20/2010] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The development of computer-aided diagnostic (CAD) methods for lung nodule detection, classification, and quantitative assessment can be facilitated through a well-characterized repository of computed tomography (CT) scans. The Lung Image Database Consortium (LIDC) and Image Database Resource Initiative (IDRI) completed such a database, establishing a publicly available reference for the medical imaging research community. Initiated by the National Cancer Institute (NCI), further advanced by the Foundation for the National Institutes of Health (FNIH), and accompanied by the Food and Drug Administration (FDA) through active participation, this public-private partnership demonstrates the success of a consortium founded on a consensus-based process. METHODS Seven academic centers and eight medical imaging companies collaborated to identify, address, and resolve challenging organizational, technical, and clinical issues to provide a solid foundation for a robust database. The LIDC/IDRI Database contains 1018 cases, each of which includes images from a clinical thoracic CT scan and an associated XML file that records the results of a two-phase image annotation process performed by four experienced thoracic radiologists. In the initial blinded-read phase, each radiologist independently reviewed each CT scan and marked lesions belonging to one of three categories ("nodule > or =3 mm," "nodule <3 mm," and "non-nodule > or =3 mm"). In the subsequent unblinded-read phase, each radiologist independently reviewed their own marks along with the anonymized marks of the three other radiologists to render a final opinion. The goal of this process was to identify as completely as possible all lung nodules in each CT scan without requiring forced consensus. RESULTS The Database contains 7371 lesions marked "nodule" by at least one radiologist. 2669 of these lesions were marked "nodule > or =3 mm" by at least one radiologist, of which 928 (34.7%) received such marks from all four radiologists. These 2669 lesions include nodule outlines and subjective nodule characteristic ratings. CONCLUSIONS The LIDC/IDRI Database is expected to provide an essential medical imaging research resource to spur CAD development, validation, and dissemination in clinical practice.
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Thiesse J, Namati E, Sieren JC, Smith AR, Reinhardt JM, Hoffman EA, McLennan G. Lung structure phenotype variation in inbred mouse strains revealed through in vivo micro-CT imaging. J Appl Physiol (1985) 2010; 109:1960-8. [PMID: 20671036 PMCID: PMC3006419 DOI: 10.1152/japplphysiol.01322.2009] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 07/26/2010] [Indexed: 11/22/2022] Open
Abstract
Within pulmonary research, the development of mouse models has provided insight into disease development, progression, and treatment. Structural phenotypes of the lung in healthy inbred mouse strains are necessary for comparison to disease models. To date, progress in the assessment of lung function in these small animals using whole lung function tests has been made. However, assessment of in vivo lung structure of inbred mouse strains has yet to be well defined. Therefore, the link between the structure and function phenotypes is still unclear. With advancements in small animal imaging it is now possible to investigate lung structures such as the central and peripheral airways, whole lung, and lobar volumes of mice in vivo, through the use of micro-CT imaging. In this study, we performed in vivo micro-CT imaging of the C57BL/6, A/J, and BALB/c mouse strains using the intermittent iso-pressure breath hold (IIBH) technique. The resulting high-resolution images were used to extract lung structure phenotypes. The three-dimensional lobar structures and airways were defined and a meaningful mouse airway nomenclature was developed. In addition, using these techniques we have uncovered significant differences in the airway structures between inbred mouse strains in vivo.
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Affiliation(s)
- Jacqueline Thiesse
- Department of Internal Medicine, The University of Iowa, Iowa City, IA 52242, USA
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Beck JC, Cao Q, Trotz B, Smith AR, Weigel BJ, Verneris MR, Burke MJ. Allogeneic hematopoietic cell transplantation outcomes for children with B-precursor acute lymphoblastic leukemia and early or late BM relapse. Bone Marrow Transplant 2010; 46:950-5. [PMID: 20856210 DOI: 10.1038/bmt.2010.217] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Large registry studies have shown superior disease-free survival (DFS) with matched sibling donor (MSD) allogeneic hematopoietic cell transplantation (allo-HCT) over chemotherapy alone for patients with B-precursor acute lymphoblastic leukemia (ALL) and a late BM relapse. As most of these patients will not have an MSD, the decision to pursue an unrelated allo-HCT in second remission (CR2) or await a future relapse and perform HCT in third remission (CR3) continues to be debated. Between 1990 and 2006, 41 children with relapsed B-precursor ALL received a myeloablative allo-HCT at the University of Minnesota. Graft sources consisted of matched related donor (n=11), matched unrelated donor (n=9), and unrelated umbilical cord blood (n=21). Before allo-HCT, 15 patients had an early relapse (<36 months from diagnosis) and 26 had an initial late relapse (36 months from diagnosis). In all, 30 patients (73%) were in CR2 and 11 were in CR3 (27%) at time of allo-HCT. Five year OS/DFS were similar for patients with an early or late marrow relapse, but there was inferior DFS among late-relapse patients transplanted in CR3 compared with CR2 (30% vs 75%, P=0.04). These results suggest that allo-HCT should be pursued in children after a first marrow relapse, rather than waiting for subsequent recurrence.
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Affiliation(s)
- J C Beck
- Division of Pediatric Hematology/Oncology/Bone and Marrow Transplantation, University of Minnesota, Minneapolis, MN 55455 USA
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Lipton HL, Lai CJ, Cutler TW, Smith AR, Stebbins MR. Peer-to-peer interprofessional health policy education for Medicare part D. Am J Pharm Educ 2010; 74:102. [PMID: 21045944 PMCID: PMC2933011 DOI: 10.5688/aj7406102] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 01/27/2009] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To determine whether a peer-to-peer education program was an expedient and effective approach to improve knowledge and promote interprofessional communication and collaboration. DESIGN Trained pharmacy students taught nursing students, medical students, and medical residents about the Medicare Part D prescription drug benefit (Part D), in 1- to 2-hour lectures. ASSESSMENT Learners completed a survey instrument to assess the effectiveness of the presentation and their attitudes toward the peer-to-peer instructional format. Learners strongly or somewhat agreed that the peer-to-peer format was effective in providing Part D education (99%) and promoted interprofessional collaboration (100%). Qualitative data highlighted the program's clinical relevance, value in promoting interprofessional collaboration, and influence on changing views about the roles and contributions of pharmacists. CONCLUSION The Part D peer educator program is an innovative way to disseminate contemporary health policy information rapidly, while fostering interprofessional collaboration.
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Affiliation(s)
- Helene L Lipton
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA 94118, USA.
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Meyerholz DK, Stoltz DA, Namati E, Ramachandran S, Pezzulo AA, Smith AR, Rector MV, Suter MJ, Kao S, McLennan G, Tearney GJ, Zabner J, McCray PB, Welsh MJ. Loss of cystic fibrosis transmembrane conductance regulator function produces abnormalities in tracheal development in neonatal pigs and young children. Am J Respir Crit Care Med 2010; 182:1251-61. [PMID: 20622026 DOI: 10.1164/rccm.201004-0643oc] [Citation(s) in RCA: 147] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
RATIONALE Although airway abnormalities are common in patients with cystic fibrosis (CF), it is unknown whether they are all secondary to postnatal infection and inflammation, which characterize the disease. OBJECTIVES To learn whether loss of the cystic fibrosis transmembrane conductance regulator (CFTR) might affect major airways early in life, before the onset of inflammation and infection. METHODS We studied newborn CFTR⁻(/)⁻ pig trachea, using computed tomography (CT) scans, pathology, and morphometry. We retrospectively analyzed trachea CT scans in young children with CF and also previously published data of infants with CF. MEASUREMENTS AND MAIN RESULTS We discovered three abnormalities in the porcine CF trachea. First, the trachea and mainstem bronchi had a uniformly small caliber and cross-sections of trachea were less circular than in controls. Second, trachealis smooth muscle had an altered bundle orientation and increased transcripts in a smooth muscle gene set. Third, submucosal gland units occurred with similar frequency in the mucosa of CF and control airways, but CF submucosal glands were hypoplastic and had global reductions in tissue-specific transcripts. To learn whether any of these changes occurred in young patients with CF, we examined CT scans from children 2 years of age and younger, and found that CF tracheas were less circular in cross-section, but lacked differences in lumen area. However, analysis of previously published morphometric data showed reduced tracheal lumen area in neonates with CF. CONCLUSIONS Our findings in newborn CF pigs and young patients with CF suggest that airway changes begin during fetal life and may contribute to CF pathogenesis and clinical disease during postnatal life.
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Abstract
A mixed population, enriched and established in a defined medium, from a sewage sludge inoculum was capable of complete mineralization of 4-chlorobenzoate. An organism, identified as Arthrobacter sp., was isolated from the consortium and shown to be capable of utilizing 4-chlorobenzoate as the sole carbon and energy source in pure culture. This organism (strain TM-1), dehalogenated 4-chlorobenzoate as the initial step in the degradative pathway. The product, 4-hydroxybenzoate, was further metabolized via protocatechuate. The ability of strain TM-1 to degrade 4-chlorobenzoate in liquid medium at 25 degrees C was improved by the use of continuous culture and repeated sequential subculturing. Other chlorinated benzoates and the parent compound benzoate did not support growth of strain TM-1. An active cell extract was prepared and shown to dehalogenate 4-chloro-, 4-fluoro-, and 4-bromobenzoate. Dehalogenase activity had an optimum pH of 6.8 and an optimum temperature of 20 degrees C and was inhibited by dissolved oxygen and stimulated by manganese (Mn). Strain improvement resulted in an increase in the specific activity of the cell extract from 0.09 to 0.85 nmol of 4-hydroxybenzoate per min per mg of protein and a decrease in the doubling time of the organism from 50 to 1.6 h.
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Affiliation(s)
- T S Marks
- Microbial Technology Laboratory, PHLS Centre for Applied Microbiology and Research, Porton Down, Wiltshire SP4 OJG, and School of Biological Sciences and Environmental Health, Thames Polytechnic, London SE18 6PF, United Kingdom
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Abstract
1. A cell-free system from Pseudomonas fluorescens catalysed the oxidative demethylation and subsequent ring-cleavage of vanillate, with uptake of 2.5 moles of oxygen/mole of substrate. 2. Demethylation involved absorption of 0.5 mole of oxygen/mole, and required reduced glutathione (GSH) and nucleotide (probably NADPH) as cofactors, with further possible requirements, the natures of which are discussed. 3. Incomplete evidence suggested that the aromatic ring was opened via protocatechuate and the appropriate oxygenase, with absorption of 1 mole of oxygen/mole of substrate, eventually yielding beta-oxoadipate. 4. The methyl group was removed sequentially as formaldehyde, formate and carbon dioxide, the steps catalysed respectively by formaldehyde dehydrogenase, which required GSH and NAD(+), and formate dehydrogenase. Each enzyme was cytochrome-linked and accounted for absorption of 0.5mole of oxygen/mole of substrate. 5. All enzymes except formate dehydrogenase, which was a cell-wall enzyme, resided in the soluble fraction of the extract. The demethylase could not be resolved because of unknown cofactor requirements.
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Affiliation(s)
- N J Cartwright
- Department of Virology and Bacteriology, University of Birmingham
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Sieren JC, Weydert J, Bell A, De Young B, Smith AR, Thiesse J, Namati E, McLennan G. An automated segmentation approach for highlighting the histological complexity of human lung cancer. Ann Biomed Eng 2010; 38:3581-91. [PMID: 20571856 DOI: 10.1007/s10439-010-0103-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [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] [Received: 04/20/2010] [Accepted: 06/11/2010] [Indexed: 11/25/2022]
Abstract
Lung cancer nodules, particularly adenocarcinoma, contain a complex intermixing of cellular tissue types: incorporating cancer cells, fibroblastic stromal tissue, and inactive fibrosis. Quantitative proportions and distributions of the various tissue types may be insightful for understanding lung cancer growth, classification, and prognostic factors. However, current methods of histological assessment are qualitative and provide limited opportunity to systematically evaluate the relevance of lung nodule cellular heterogeneity. In this study we present both a manual and an automatic method for segmentation of tissue types in histological sections of resected human lung cancer nodules. A specialized staining approach incorporating immunohistochemistry with a modified Masson's Trichrome counterstain was employed to maximize color contrast in the tissue samples for automated segmentation. The developed, clustering-based, fully automated segmentation approach segments complete lung nodule cross-sectional histology slides in less than 1 min, compared to manual segmentation which requires multiple hours to complete. We found the accuracy of the automated approach to be comparable to that of the manual segmentation with the added advantages of improved time efficiency, removal of susceptibility to human error, and 100% repeatability.
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Affiliation(s)
- J C Sieren
- Department of Internal Medicine, University of Iowa, Iowa City, USA.
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Patel RA, Lipton HL, Cutler TW, Smith AR, Tsunoda SM, Stebbins MR. Cost minimization of medicare part D prescription drug plan expenditures. Am J Manag Care 2009; 15:545-553. [PMID: 19670958] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To minimize out-of-pocket prescription drug plan (PDP) expenditures by Medicare beneficiaries. STUDY DESIGN Cost-minimization analysis. METHODS Trained student pharmacists from 6 California pharmacy schools provided expert guidance on Medicare Part D PDPs to beneficiaries through interventions at statewide outreach events. Demographic and insurance information for 2008 was collected via survey. Cost information for the beneficiary's current PDP for 2008 and for the least expensive PDP for 2008 was obtained using the Medicare Plan Finder tool (http://www.medicare.gov). RESULTS Data were collected from 250 beneficiaries at 22 outreach events. For the cost-minimization analysis, data were excluded from 72 beneficiaries who were not enrolled in a stand-alone PDP before the intervention and from another 23 beneficiaries for whom information regarding their current PDP or prescription drug profile was incomplete. Of the remaining 155 study participants, 39.4% were male, the mean (SD) age was 74.6 (8.7) years, and they were taking a mean (SD) of 5.3 (3.5) prescription drugs each month. In addition, 68 beneficiaries (43.9%) had limited or no English proficiency, and 85 beneficiaries (54.8%) were enrolled in both Medicare and Medicaid. In total, 89.7% of beneficiaries could have realized cost savings by switching to a different PDP. The median annual potential cost savings was $98 per beneficiary but this varied as a function of subsidy level. CONCLUSION Targeted community outreach services to Medicare Part D beneficiaries can help optimize patient selection of a PDP, thereby resulting in lower out-of-pocket expenditures.
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Affiliation(s)
- Rajul A Patel
- Department of Pharmacy Practice, University of the Pacific, Stockton, CA 95211, USA.
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Stebbins MR, Cutler TW, Corelli RL, Smith AR, Lipton HL. Medicare part D community outreach train-the-trainer program for pharmacy faculty. Am J Pharm Educ 2009; 73:53. [PMID: 19564996 PMCID: PMC2703286 DOI: 10.5688/aj730353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Accepted: 06/12/2008] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To assess the train-the-trainer component of an initiative (Partners in D) to train pharmacy students to facilitate patient enrollment in the best Medicare Part D prescription drug plan (Part D). METHODS Faculty members from 6 California colleges or schools of pharmacy were taught how to train pharmacy students about Medicare Part D and how to conduct outreach events targeting underserved patient populations. A preintervention and postintervention survey instrument was administered to determine participants' (1) knowledge of the Part D program; (2) skill using the Medicare Prescription Drug Plan Finder tool; and (3) confidence in their ability to train pharmacy students. Implementation of the Partners in D curriculum in faculty members' colleges or schools of pharmacy was also determined. RESULTS Participants' knowledge of Part D, mastery of the Plan Finder, and confidence in teaching the material to pharmacy students all significantly improved. Within 8 weeks following the program, 5 of 6 colleges or schools of pharmacy adopted Partners in D coursework and initiated teaching the Partners-in-D curriculum. Four months afterwards, 21 outreach events reaching 186 Medicare beneficiaries had been completed. CONCLUSIONS The train-the-trainer component of the Partners in D program is practical and effective, and merits serious consideration as a national model for educating patients about Medicare Part D.
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Affiliation(s)
- Marilyn R Stebbins
- School of Pharmacy, University of California-San Francisco, 521 Parnassus, San Francisco, CA 94143, USA.
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Cutler TW, Stebbins MR, Lai E, Smith AR, Lipton HL. Problem-based learning using the online Medicare Part D Plan Finder tool. Am J Pharm Educ 2008; 72:47. [PMID: 18698399 PMCID: PMC2508730 DOI: 10.5688/aj720347] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Accepted: 12/21/2007] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To implement didactic and problem-based learning curricular innovations aimed at increasing students' knowledge of Medicare Part D, improving their ability to apply the online Medicare Prescription Drug Plan Finder tool to a patient case, and improving their attitudes toward patient advocacy for Medicare beneficiaries. METHODS A survey instrument and a case-based online Medicare Prescription Drug Plan Finder tool exercise were administered to a single group (n = 120) of second-year pharmacy graduate students prior to and following completion of a course on health policy. Three domains (knowledge, skill mastery and attitudes) were measured before and after two 90-minute lectures on Medicare Part D. RESULTS The online Medicare Prescription Drug Plan Finder exercise and Medicare Part D didactic lectures had positive effects on students' knowledge of Part D, attitudes toward patient advocacy, and ability to accurately use the Medicare Prescription Drug Plan Finder tool. CONCLUSIONS The success of these didactic and problem-based curricular innovations in improving pharmacy students' knowledge, skills, and attitudes regarding Part D warrants further evaluation to determine their portability to clinical settings and other pharmacy schools.
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Affiliation(s)
- Timothy W Cutler
- School of Pharmacy, University of California-San Francisco, C-152 Box 0622, 521 Parnassus Avenue, San Francisco, CA 94143-0622, USA.
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Jones GT, Beezer AE, Cosgrove RF, Smith AR. Rapid microbiological pH assay for the determination of cephradine in pharmaceutical formulations and biological fluids. J Pharm Biomed Anal 2008; 3:367-70. [PMID: 16867673 DOI: 10.1016/0731-7085(85)80045-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/1985] [Indexed: 11/19/2022]
Affiliation(s)
- G T Jones
- Squibb Institute for Medical Research, Reeds Lane, Moreton, Wirral, Merseyside, L46 1QW, UK
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Firestone RB, West A, Kennett JP, Becker L, Bunch TE, Revay ZS, Schultz PH, Belgya T, Kennett DJ, Erlandson JM, Dickenson OJ, Goodyear AC, Harris RS, Howard GA, Kloosterman JB, Lechler P, Mayewski PA, Montgomery J, Poreda R, Darrah T, Hee SSQ, Smith AR, Stich A, Topping W, Wittke JH, Wolbach WS. Evidence for an extraterrestrial impact 12,900 years ago that contributed to the megafaunal extinctions and the Younger Dryas cooling. Proc Natl Acad Sci U S A 2007; 104:16016-21. [PMID: 17901202 PMCID: PMC1994902 DOI: 10.1073/pnas.0706977104] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [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: 11/18/2022] Open
Abstract
A carbon-rich black layer, dating to approximately 12.9 ka, has been previously identified at approximately 50 Clovis-age sites across North America and appears contemporaneous with the abrupt onset of Younger Dryas (YD) cooling. The in situ bones of extinct Pleistocene megafauna, along with Clovis tool assemblages, occur below this black layer but not within or above it. Causes for the extinctions, YD cooling, and termination of Clovis culture have long been controversial. In this paper, we provide evidence for an extraterrestrial (ET) impact event at approximately equal 12.9 ka, which we hypothesize caused abrupt environmental changes that contributed to YD cooling, major ecological reorganization, broad-scale extinctions, and rapid human behavioral shifts at the end of the Clovis Period. Clovis-age sites in North American are overlain by a thin, discrete layer with varying peak abundances of (i) magnetic grains with iridium, (ii) magnetic microspherules, (iii) charcoal, (iv) soot, (v) carbon spherules, (vi) glass-like carbon containing nanodiamonds, and (vii) fullerenes with ET helium, all of which are evidence for an ET impact and associated biomass burning at approximately 12.9 ka. This layer also extends throughout at least 15 Carolina Bays, which are unique, elliptical depressions, oriented to the northwest across the Atlantic Coastal Plain. We propose that one or more large, low-density ET objects exploded over northern North America, partially destabilizing the Laurentide Ice Sheet and triggering YD cooling. The shock wave, thermal pulse, and event-related environmental effects (e.g., extensive biomass burning and food limitations) contributed to end-Pleistocene megafaunal extinctions and adaptive shifts among PaleoAmericans in North America.
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Affiliation(s)
- R B Firestone
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA.
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Abstract
The United States health care system currently faces many challenges, including rising costs and variable quality. Health care purchasers and payers are demanding increased transparency and accountability for their health care dollars. Pay-for-performance (P4P) initiatives, which seek to link provider reimbursement to measures of quality and efficiency, have been introduced by both private and government payers. Despite their appeal over current provider reimbursement systems, which reward volume and intensity of services rather than quality and efficiency, P4P programs face numerous challenges in their implementation, including difficulty defining and measuring quality, high costs associated with collecting and analyzing performance data, problems with risk adjustment, lack of additional funding to reward quality, unintended consequences of provider gaming and patient deselection, and impact on low-tier, low-quality providers. Future efforts should involve collaboration among providers, payers, and policy makers to ensure that P4P programs are implemented safely and effectively.
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Affiliation(s)
- Kevin J Bozic
- Department of Orthopaedic Surgery and Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California 94143-0728, USA
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Bozic KJ, Smith AR, Hariri S, Adeoye S, Gourville J, Maloney WJ, Parsley B, Rubash HE. The 2007 ABJS Marshall Urist Award: The impact of direct-to-consumer advertising in orthopaedics. Clin Orthop Relat Res 2007; 458:202-19. [PMID: 17353799 DOI: 10.1097/blo.0b013e31804fdd02] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [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: 01/31/2023]
Abstract
Direct-to-consumer advertising (DTCA) has become an influential factor in healthcare delivery in the United States. We evaluated the influence of DTCA on surgeon and patient opinions and behavior in orthopaedics by surveying orthopaedic surgeons who perform hip and knee arthroplasties and patients who were scheduled to have hip or knee arthro-plasty. Respondents were asked for their opinions of and experiences with DTCA, including the influence of DTCA on surgeon and patient decision making. Greater than 98% of surgeon respondents had experience with patients who were exposed to DTCA. The majority of surgeon respondents reported DTCA had an overall negative impact on their practice and their interaction with patients (74%), and their patients often were confused or misinformed about the appropriate treatment for their condition based on an advertisement (77%). Fifty-two percent of patient respondents recalled seeing or hearing advertisements related to hip or knee arthroplasty. These patients were more likely to request a specific type of surgery or brand of implant from their surgeon and to see more than one surgeon before deciding to have surgery. Direct-to-consumer advertising seems to play a substantial role in surgeon and patient decision making in orthopaedics. Future efforts should be aimed at improving the quality and accuracy of information contained in consumer-directed advertisements related to orthopaedic implants and procedures.
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Affiliation(s)
- Kevin J Bozic
- Department of Orthopaedic Surgery, University of California San Francisco, CA 94143-0728, USA.
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Arnaboldi C, Artusa DR, Avignone FT, Balata M, Bandac I, Barucci M, Beeman JW, Brofferio C, Bucci C, Capelli S, Carbone L, Cebrian S, Cremonesi O, Creswick RJ, de Waard A, Farach HA, Fiorini E, Frossati G, Guardincerri E, Giuliani A, Gorla P, Haller EE, McDonald RJ, Morales A, Norman EB, Nucciotti A, Olivieri E, Pallavicini M, Palmieri E, Pasca E, Pavan M, Pedretti M, Pessina G, Pirro S, Previtali E, Risegari L, Rosenfeld C, Sangiorgio S, Sisti M, Smith AR, Torres L, Ventura G. New limit on the neutrinoless betabeta decay of 130Te. Phys Rev Lett 2005; 95:142501. [PMID: 16241648 DOI: 10.1103/physrevlett.95.142501] [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] [Subscribe] [Scholar Register] [Received: 01/18/2005] [Indexed: 05/05/2023]
Abstract
We report the present results of CUORICINO, a search for neutrinoless double-beta (0nu betabeta) decay of 130Te. The detector is an array of 62 TeO2 bolometers with a total active mass of 40.7 kg. The array is cooled by a dilution refrigerator shielded from environmental radioactivity and energetic neutrons, operated at approximately 8 mK in the Gran Sasso Underground Laboratory. No evidence for (0nu betabeta) decay was found and a new lower limit, T(1/2)(0nu) > or = 1.8 x 10(24) yr (90% C.L.) is set, corresponding to [m(nu)] < or = 0.2 to 1.1 eV, depending on the theoretical nuclear matrix elements used in the analysis.
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Affiliation(s)
- C Arnaboldi
- Dipartimento di Fisica dell'Università di Milano-Bicocca e Sezione di Milano dell'INFN, Milan I-20126, Italy
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