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Ullah MA, Garcillán B, Whitlock E, Figgett WA, Infantino S, Eslami M, Yang S, Rahman MA, Sheng YH, Weber N, Schneider P, Tam CS, Mackay F. An unappreciated cell survival-independent role for BAFF initiating chronic lymphocytic leukemia. Front Immunol 2024; 15:1345515. [PMID: 38469292 PMCID: PMC10927009 DOI: 10.3389/fimmu.2024.1345515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/25/2024] [Indexed: 03/13/2024] Open
Abstract
Background Chronic Lymphocytic Leukemia (CLL) is characterized by the expansion of CD19+ CD5+ B cells but its origin remains debated. Mutated CLL may originate from post-germinal center B cells and unmutated CLL from CD5+ mature B cell precursors. Irrespective of precursor types, events initiating CLL remain unknown. The cytokines BAFF and APRIL each play a significant role in CLL cell survival and accumulation, but their involvement in disease initiation remains unclear. Methods We generated novel CLL models lacking BAFF or APRIL. In vivo experiments were conducted to explore the impact of BAFF or APRIL loss on leukemia initiation, progression, and dissemination. Additionally, RNA-seq and quantitative real-time PCR were performed to unveil the transcriptomic signature influenced by BAFF in CLL. The direct role of BAFF in controlling the expression of tumor-promoting genes was further assessed in patient-derived primary CLL cells ex-vivo. Results Our findings demonstrate a crucial role for BAFF, but not APRIL, in the initiation and dissemination of CLL cells. In the absence of BAFF or its receptor BAFF-R, the TCL1 transgene only increases CLL cell numbers in the peritoneal cavity, without dissemination into the periphery. While BAFF binding to BAFF-R is dispensable for peritoneal CLL cell survival, it is necessary to activate a tumor-promoting gene program, potentially linked to CLL initiation and progression. This direct role of BAFF in controlling the expression of tumor-promoting genes was confirmed in patient-derived primary CLL cells ex-vivo. Conclusions Our study, involving both mouse and human CLL cells, suggests that BAFF might initiate CLL through mechanisms independent of cell survival. Combining current CLL therapies with BAFF inhibition could offer a dual benefit by reducing peripheral tumor burden and suppressing transformed CLL cell output.
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Affiliation(s)
- Md Ashik Ullah
- Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Cancer Program, Herston, QLD, Australia
| | - Beatriz Garcillán
- The Department of Microbiology and Immunology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Eden Whitlock
- Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Cancer Program, Herston, QLD, Australia
| | - William A. Figgett
- The Department of Microbiology and Immunology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
- Garvan Institute of Medical Research, Kinghorn Centre for Clinical Genomics, Darlinghurst, NSW, Australia
| | - Simona Infantino
- The Department of Microbiology and Immunology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Mahya Eslami
- Department of Immunobiology, University of Lausanne, Epalinges, Switzerland
- Department of Oncology and Children’s Research Centre, University Children’s Hospital Zürich, Zürich, Switzerland
| | - SiLing Yang
- Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Cancer Program, Herston, QLD, Australia
| | - M. Arifur Rahman
- Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Cancer Program, Herston, QLD, Australia
| | - Yong H. Sheng
- Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Cancer Program, Herston, QLD, Australia
| | - Nicholas Weber
- Cancer Care Services, Royal Brisbane and Women’s Hospital, Herston, QLD, Australia
| | - Pascal Schneider
- Department of Immunobiology, University of Lausanne, Epalinges, Switzerland
| | - Constantine S. Tam
- Department of Haematology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Haematology, Monash University, Melbourne, VIC, Australia
| | - Fabienne Mackay
- Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Cancer Program, Herston, QLD, Australia
- The Department of Microbiology and Immunology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
- The Department of Immunology and Pathology, Monash University, VIC, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
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Quah PS, Sutton V, Whitlock E, Figgett WA, Andrews DM, Fairfax KA, Mackay F. The effects of B-cell-activating factor on the population size, maturation and function of murine natural killer cells. Immunol Cell Biol 2022; 100:761-776. [PMID: 36106449 PMCID: PMC9828838 DOI: 10.1111/imcb.12585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 08/30/2022] [Accepted: 09/13/2022] [Indexed: 01/12/2023]
Abstract
The role of B-cell-activating factor (BAFF) in B-lymphocyte biology has been comprehensively studied, but its contributions to innate immunity remain unclear. Natural killer (NK) cells form the first line of defense against viruses and tumors, and have been shown to be defective in patients with systemic lupus erythematosus (SLE). The link between BAFF and NK cells in the development and progression of SLE remains unstudied. By assessing NK cell numbers in wild-type (WT), BAFF-/- (BAFF deficient), BAFF-R-/- (BAFF receptor deficient), TACI-/- (transmembrane activator and calcium modulator and cyclophilin ligand interactor deficient), BCMA-/- (B-cell maturation antigen deficient) and BAFF transgenic (Tg) mice, we observed that BAFF signaling through BAFF-R was essential for sustaining NK cell numbers in the spleen. However, according to the cell surface expression of CD27 and CD11b on NK cells, we found that BAFF was dispensable for NK cell maturation. Ex vivo and in vivo models showed that NK cells from BAFF-/- and BAFF Tg mice produced interferon-γ and killed tumor cells at a level similar to that in WT mice. Finally, we established that NK cells do not express receptors that interact with BAFF in the steady state or in the BAFF Tg mouse model of SLE. Our findings demonstrate that BAFF has an indirect effect on NK cell homeostasis and no effect on NK cell function.
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Affiliation(s)
- Pin Shie Quah
- Department of Immunology and PathologyCentral Clinical School, Monash UniversityMelbourneVICAustralia,Department of Microbiology and ImmunologyThe University of Melbourne, Peter Doherty Institute for Infection and ImmunityMelbourneVICAustralia
| | - Vivien Sutton
- Rosie Lew Cancer Immunology ProgramPeter MacCallum Cancer CentreMelbourneVICAustralia,Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVICAustralia
| | - Eden Whitlock
- Department of Microbiology and ImmunologyThe University of Melbourne, Peter Doherty Institute for Infection and ImmunityMelbourneVICAustralia,QIMR Berghofer Medical Research InstituteHerstonQLDAustralia
| | - William A Figgett
- Department of Immunology and PathologyCentral Clinical School, Monash UniversityMelbourneVICAustralia,Department of Microbiology and ImmunologyThe University of Melbourne, Peter Doherty Institute for Infection and ImmunityMelbourneVICAustralia,Garvan Institute of Medical ResearchDarlinghurstNSWAustralia
| | - Daniel M Andrews
- Department of Immunology and PathologyCentral Clinical School, Monash UniversityMelbourneVICAustralia,Bioproperties, RingwoodMelbourneVICAustralia
| | - Kirsten A Fairfax
- Blood Cells and Blood Cancer DivisionThe Walter and Eliza Hall Institute of Medical ResearchParkvilleVICAustralia,Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTASAustralia,School of Medicine, College of Health and MedicineUniversity of TasmaniaHobartTASAustralia
| | - Fabienne Mackay
- Department of Immunology and PathologyCentral Clinical School, Monash UniversityMelbourneVICAustralia,Department of Microbiology and ImmunologyThe University of Melbourne, Peter Doherty Institute for Infection and ImmunityMelbourneVICAustralia,QIMR Berghofer Medical Research InstituteHerstonQLDAustralia,Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia
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Liau NPD, Laktyushin A, Lucet IS, Murphy JM, Yao S, Whitlock E, Callaghan K, Nicola NA, Kershaw NJ, Babon JJ. The molecular basis of JAK/STAT inhibition by SOCS1. Nat Commun 2018. [PMID: 29674694 DOI: 10.1038/s41467‐018‐04013‐1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The SOCS family of proteins are negative-feedback inhibitors of signalling induced by cytokines that act via the JAK/STAT pathway. SOCS proteins can act as ubiquitin ligases by recruiting Cullin5 to ubiquitinate signalling components; however, SOCS1, the most potent member of the family, can also inhibit JAK directly. Here we determine the structural basis of both these modes of inhibition. Due to alterations within the SOCS box domain, SOCS1 has a compromised ability to recruit Cullin5; however, it is a direct, potent and selective inhibitor of JAK catalytic activity. The kinase inhibitory region of SOCS1 targets the substrate binding groove of JAK with high specificity and thereby blocks any subsequent phosphorylation. SOCS1 is a potent inhibitor of the interferon gamma (IFNγ) pathway, however, it does not bind the IFNγ receptor, making its mode-of-action distinct from SOCS3. These findings reveal the mechanism used by SOCS1 to inhibit signalling by inflammatory cytokines.
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Affiliation(s)
- Nicholas P D Liau
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Artem Laktyushin
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Isabelle S Lucet
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - James M Murphy
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Shenggen Yao
- The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Eden Whitlock
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Kimberley Callaghan
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Nicos A Nicola
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Nadia J Kershaw
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia. .,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia.
| | - Jeffrey J Babon
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia. .,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia.
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4
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Liau NPD, Laktyushin A, Lucet IS, Murphy JM, Yao S, Whitlock E, Callaghan K, Nicola NA, Kershaw NJ, Babon JJ. The molecular basis of JAK/STAT inhibition by SOCS1. Nat Commun 2018; 9:1558. [PMID: 29674694 PMCID: PMC5908791 DOI: 10.1038/s41467-018-04013-1] [Citation(s) in RCA: 240] [Impact Index Per Article: 40.0] [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: 02/05/2018] [Accepted: 03/27/2018] [Indexed: 12/22/2022] Open
Abstract
The SOCS family of proteins are negative-feedback inhibitors of signalling induced by cytokines that act via the JAK/STAT pathway. SOCS proteins can act as ubiquitin ligases by recruiting Cullin5 to ubiquitinate signalling components; however, SOCS1, the most potent member of the family, can also inhibit JAK directly. Here we determine the structural basis of both these modes of inhibition. Due to alterations within the SOCS box domain, SOCS1 has a compromised ability to recruit Cullin5; however, it is a direct, potent and selective inhibitor of JAK catalytic activity. The kinase inhibitory region of SOCS1 targets the substrate binding groove of JAK with high specificity and thereby blocks any subsequent phosphorylation. SOCS1 is a potent inhibitor of the interferon gamma (IFNγ) pathway, however, it does not bind the IFNγ receptor, making its mode-of-action distinct from SOCS3. These findings reveal the mechanism used by SOCS1 to inhibit signalling by inflammatory cytokines. Cytokines are key molecules in controlling haematopoiesis that signal via the JAK/STAT pathway. Here the authors present the structures of SOCS1 bound to its JAK1 target as well as in complex with elonginB and elonginC, providing a molecular explanation for the potent JAK- inhibitory activity of SOCS1.
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Affiliation(s)
- Nicholas P D Liau
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Artem Laktyushin
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Isabelle S Lucet
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - James M Murphy
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Shenggen Yao
- The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Eden Whitlock
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Kimberley Callaghan
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Nicos A Nicola
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia.,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia
| | - Nadia J Kershaw
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia. .,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia.
| | - Jeffrey J Babon
- Walter and Eliza Hall Institute, 1G Royal Parade, Parkville, VIC, 3052, Australia. .,The University of Melbourne, Royal Parade, Parkville, VIC, 3050, Australia.
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5
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Lang MJ, Brennan MS, O'Reilly LA, Ottina E, Czabotar PE, Whitlock E, Fairlie WD, Tai L, Strasser A, Herold MJ. Characterisation of a novel A1-specific monoclonal antibody. Cell Death Dis 2014; 5:e1553. [PMID: 25476901 PMCID: PMC4649835 DOI: 10.1038/cddis.2014.519] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M J Lang
- 1] Molecular Genetics of Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia [2] Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - M S Brennan
- 1] Molecular Genetics of Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia [2] Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - L A O'Reilly
- 1] Molecular Genetics of Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia [2] Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - E Ottina
- Division of Developmental Immunology, Biocenter, Innsbruck Medical University, Innsbruck, Austria
| | - P E Czabotar
- 1] Molecular Genetics of Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia [2] Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - E Whitlock
- 1] Molecular Genetics of Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia [2] Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - W D Fairlie
- 1] Molecular Genetics of Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia [2] Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - L Tai
- 1] Molecular Genetics of Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia [2] Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - A Strasser
- 1] Molecular Genetics of Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia [2] Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - M J Herold
- 1] Molecular Genetics of Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia [2] Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
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6
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Valanis BG, Bowen DJ, Bassford T, Whitlock E, Charney P, Carter RA. Sexual orientation and health: comparisons in the women's health initiative sample. Arch Fam Med 2000; 9:843-53. [PMID: 11031391 DOI: 10.1001/archfami.9.9.843] [Citation(s) in RCA: 248] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Little is known about older lesbian and bisexual women. Existing research rarely compares characteristics of these women with comparable heterosexual women. OBJECTIVE To compare heterosexual and nonheterosexual women 50 to 79 years on specific demographic characteristics, psychosocial risk factors, screening practices, and other health-related behaviors associated with increased risk for developing particular diseases or disease outcomes. DESIGN Analysis of data from 93,311 participants in the Women's Health Initiative (WHI) study of health in postmenopausal women, comparing characteristics of 5 groups: heterosexuals, bisexuals, lifetime lesbians, adult lesbians, and those who never had sex as an adult. SETTING Subjects were recruited at 40 WHI study centers nationwide representing a range of geographic and ethnic diversity. PARTICIPANTS Postmenopausal women aged 50 to 79 years who met WHI eligibility criteria, signed an informed consent to participate in the WHI clinical trial(s) or observational study, and responded to the baseline questions on sexual orientation. MAIN OUTCOME MEASURES Demographic characteristics, psychosocial risk factors, recency of screening tests, and other health-related behaviors as assessed on the WHI baseline questionnaire. RESULTS Although of higher socioeconomic status than the heterosexuals, the lesbian and bisexual women more often used alcohol and cigarettes, exhibited other risk factors for reproductive cancers and cardiovascular disease, and scored lower on measures of mental health and social support. Notable is the 35% of lesbians and 81% of bisexual women who have been pregnant. Women reporting that they never had sex as an adult had lower rates of Papanicolaou screening and hormone replacement therapy use than other groups. CONCLUSIONS This sample of older lesbian and bisexual women from WHI shows many of the same health behaviors, demographic, and psychosocial risk factors reported in the literature for their younger counterparts, despite their higher socioeconomic status and access to health care. The lower rates of recommended screening services and higher prevalence of obesity, smoking, alcohol use, and lower intake of fruit and vegetables among these women compared with heterosexual women indicate unmet needs that require effective interactions between care providers and nonheterosexual women.
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Affiliation(s)
- B G Valanis
- Kaiser Permanente Center for Health Research, 3800 N Interstate Ave, Portland, OR 97227, USA.
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7
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Affiliation(s)
- J F Hollis
- Center for Health Research, Kaiser Permanente, 3800 N Interstate Avenue, Portland, OR 97227-1110, USA.
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Vogt TM, Hollis JF, Lichtenstein E, Stevens VJ, Glasgow R, Whitlock E. The medical care system and prevention: the need for a new paradigm. HMO Pract 1998; 12:5-13. [PMID: 10178378] [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: 02/11/2023]
Abstract
The American medical care system falls to provide effective prevention services even though some prevention services are among the most cost-effective medical procedures available. Many prevention services are routinely delivered in inefficient or ineffective ways, and new technologies may be widely and aggressively implemented despite serious doubts about their efficacy and cost-effectiveness. The barriers to effective prevention services result from conceptual limitations in our model of medical care systems, particularly the lack of a population-based perspective. A change in paradigm is needed before reforms in our health care system can improve health without bankrupting the nation.
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Affiliation(s)
- T M Vogt
- Cancer Research Center of Hawaii, Honolulu, USA
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9
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Goldberg BW, Whitlock E, Greenlick M. Firearm ownership and health care workers. Public Health Rep 1996; 111:256-9. [PMID: 8643818 PMCID: PMC1381769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Health professionals have increasingly become aware of the public health hazards caused by firearms. This study was designed to determine the firearm ownership and storage practices of a group of health care workers. METHODS All 6436 nonphysician employees of a large health maintenance organization were surveyed as part of an ongoing effort to enhance the organization's effectiveness. Two questions regarding firearm ownership and storage practices were included in the 85-question survey instrument. A total of 4999 surveys were returned, for a response rate of 78%. RESULTS Forty-two percent of the health workers surveyed reported keeping a firearm in their home, and 35% of firearm owners stored that firearm loaded. Men were more likely than women to report having a firearm in the home. Firearm ownership and storage of a loaded firearm decreased with higher levels of education in both sexes. A measure of increased alcohol consumption was related to higher rates of firearm ownership and storage of loaded firearms in men. CONCLUSIONS A substantial number of health care workers had firearms in their homes and did not store them safely. Counseling regarding the risks associated with easy access to firearms should be considered for inclusion in employee health programs as well as in employee assistance and alcohol treatment programs.
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Affiliation(s)
- B W Goldberg
- Department of Public Health and Preventive Medicine, Oregon Health Sciences, University School of Medicine, Portland 97201, USA.
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Whitlock E, Whitmore J. Report from AMRA manpower survey. Part III: Non-management positions. J Am Med Rec Assoc 1987; 58:26-32. [PMID: 10282202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
This is the third in a series of three articles reporting results of the 1986 AMRA Manpower Survey. The purpose of this article is to provide information on the following non-management positions: coding, transcription, record deficiency analysis, release of information, record retrieval/filing, and general clerical. The first article described the survey and provided information on directors of medical record departments. The second article addressed other management positions in the medical record department.
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Mulé SJ, Whitlock E, Jukofsky D. Radioimmunoassay of drugs subject to abuse: critical evaluation of urinary morphine-barbiturate, morphine, barbiturate, and amphetamine assays. Clin Chem 1975; 21:81-6. [PMID: 1116282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Radioimmunoassays for morphine-barbiturate (MOR-BARB), morphine, barbiturate, and amphetamine were evaluated by a direct comparison with differential elution extraction thin-layer chromatography, the "enzyme multiplied immunoassay technique," and XAD-2 resin extraction thin-layer chromatography for the detection in urine of drugs subject to abuse. Statistically significant (Psmaller than 0.01) concentrations for detection were: 50-100 mug/liter for MOR-BARB; 5 Mug/liter for morphine, 10 mug/liter for barbiturate, and 100 mug/liter for amphetamine. Unconfirmed and unaccounted-for radioimmunoassay positives (false) were: 0% for morphine in the radioimmunoassay for MOR-BARB and that for morphine alone; 2.8% for barbiturates in the MOR-BARB assay and that for barbiturates alone; 0-6% when a combination of these drugs was present in the MOR-BARB, morphine, or barbiturate assay; and 2.4% in the amphetamine radioimmunoassay. Less than 1% of all radioimmunoassay-negative samples were unconfirmed (false). Cross-reactivity was observed with drugs of a similar chemical structure in each of the radioimmunoassays tested. All the radio-immunoassays were easy to use, highly sensitive, and extremely reliable for detecting drug use or abuse.
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12
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Mule SJ, Whitlock E. Effect of morphine on esterified fatty acids in plasma and brain of the nontolerant, tolerant and abstinent rat. Biochem Pharmacol 1972; 21:2153-5. [PMID: 4645887 DOI: 10.1016/0006-2952(72)90172-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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