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El Zein S, Mendoza MA, Wilson JW. Nontuberculous mycobacterial infections in patients with hematologic malignancies and recipients of hematopoietic stem cell transplantation. Transpl Infect Dis 2023; 25 Suppl 1:e14127. [PMID: 37594211 DOI: 10.1111/tid.14127] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/17/2023] [Accepted: 08/08/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND The incidence of mycobacterial infections in patients with hematologic malignancies and hematopoietic stem cell transplant (HSCT) recipients is increasing, contributing to significant mortality and morbidity. This review explores the epidemiology, risk factors, clinical presentation, diagnosis, and treatment of nontuberculous mycobacteria (NTM) in this population. METHODS A literature search was performed using PubMed with keywords and MeSH terms pertaining to the topics of nontuberculous mycobacteria, hematologic malignancies, hematopoietic stem cell transplant, cellular therapies, chimeric antigen therapies, epidemiology, diagnosis, and treatment. Additionally, we examined the reference lists of the included articles to identify other pertinent studies. RESULTS Diagnosing mycobacterial disease among patients with hematologic disease and treatment-associated immunosuppressive conditions is challenging due to the lack of distinctive clinical, radiographic, and laboratory markers, as well as the atypical manifestations compared to immunocompetent patients. Treatment involves using a combination of antibiotics for extended durations, coupled with strategies to achieve source control and reduce immunosuppression when feasible. This is complicated by the absence of clear data correlating in-vitro drug susceptibility and clinical outcome for many antimicrobials use to treat NTM, adverse drug-drug interactions, and the frequent challenges related to poor medication tolerability and toxicities. CONCLUSION The rising incidence and corresponding clinical challenges of mycobacterial infections in this unique patient population necessitate a heightened awareness and familiarity of NTM disease by clinicians to achieve timely diagnosis and favorable treatment outcomes.
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Affiliation(s)
- Said El Zein
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Maria A Mendoza
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - John W Wilson
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
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2
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Zeuli JD, Rivera CG, Wright JA, Kasten MJ, Mahmood M, Ragan AK, Rizza SA, Temesgen Z, Vergidis P, Wilson JW, Cummins NW. Pharmacogenomic panel testing provides insight and enhances medication management in people with HIV. AIDS 2023; 37:1525-1533. [PMID: 37199600 DOI: 10.1097/qad.0000000000003598] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Our study aimed to assess the impact of pharmacogenomic panel testing in people with HIV (PWH). DESIGN Prospective, observational intervention assessment. METHODS One hundred PWH were provided a comprehensive pharmacogenomic panel during routine care visits within the HIV specialty clinic of a large academic medical center. The panel determined the presence of specific genetic variants that could predict response or toxicity to commonly prescribed antiretroviral therapy (ART) and non-ART medications. An HIV specialty pharmacist reviewed the results with participants and the care team. The pharmacist (1) recommended clinically actionable interventions based on the participants' current drug therapy, (2) assessed for genetic explanations for prior medication failures, adverse effects, or intolerances, and (3) advised on potential future clinically actionable care interventions based on individual genetic phenotypes. RESULTS Ninety-six participants (median age 53 years, 74% white, 84% men, 89% viral load <50 copies/ml) completed panel testing, yielding 682 clinically relevant pharmacogenomic results (133 major, 549 mild-moderate). Ninety participants (89 on ART) completed follow-up visits with 65 (72%) receiving clinical recommendations based on current medication profiles. Of the 105 clinical recommendations, 70% advised additional monitoring for efficacy or toxicity, and 10% advised alteration of drug therapy. Panel results offered explanation for prior ART inefficacy in one participant and ART intolerance in 29%. Genetic explanation for non-ART toxicity was seen in 21% of participants, with genetic contributors to inefficacy of non-ART therapy identified in 39% of participants. CONCLUSION Preliminary data in a small cohort of PWH demonstrates benefit of routine pharmacogenomic panel testing.
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Affiliation(s)
- John D Zeuli
- Department of Pharmacy
- Section of Infectious Diseases
| | | | - Jessica A Wright
- Department of Pharmacy
- Center for Individualized Medicine, Mayo Clinic, Rochester, Minnesota, USA
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3
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El Zein S, Abu Saleh OM, Wengenack NL, Wilson JW. Clinical manifestations, treatment and outcomes of patients infected with Mycobacterium haemophilum with a focus on immune reconstitution inflammatory syndrome: a retrospective multi-site study. Infect Dis (Lond) 2023:1-13. [PMID: 37151046 DOI: 10.1080/23744235.2023.2208210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Mycobacterium haemophilum is a nontuberculous mycobacterium with fastidious in vitro growth requirements and an increasingly reported cause of extrapulmonary disease. Timely diagnosis and management of M. haemophilum infections and the immune reconstitution inflammatory syndromes (IRIS) observed in a subset of patients during treatment remain challenging. METHODS We conducted a retrospective chart review between January 1, 2010, and January 1, 2022 and identified 26 patients diagnosed with M. haemophilum infection at our institution. We describe their clinical presentation, diagnostic results, management, and outcomes. RESULTS The majority of patients in our cohort had upper and/or lower extremity skin involvement, were immunosuppressed, and had generally favourable treatment outcomes. All tested M. haemophilum isolates were susceptible in vitro to clarithromycin and trimethoprim-sulfamethoxazole. Moreover, high rates of susceptibility were noted for ciprofloxacin (95%), linezolid (90%), and rifampin (85%). IRIS was identified in 31% of cases and should be considered in patients who develop worsening skin lesions or systemic symptoms following the initiation of effective antimicrobial therapy. Visualisation of acid-fast bacilli on initial tissue stains, a positive mycobacterial blood culture, and rapid de-escalation of tumour necrosis factor-α inhibitors and/or corticosteroids were more frequently encountered among patients in our cohort who developed IRIS. CONCLUSION M. haemophilum infection should be considered among patients receiving immunomodulatory therapy who develop discoloured or nodular skin lesions involving the extremities, worsening focal arthritis, tenosynovitis, or isolated adenopathy. A heightened awareness of this pathogen's clinical and laboratory characteristics can lead to a timely diagnosis and favourable outcome.
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Affiliation(s)
- Said El Zein
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Omar M Abu Saleh
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nancy L Wengenack
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - John W Wilson
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Murad MH, Swift MD, Razonable RR, Tande AJ, Wilson JW, Kasten MJ, Sia IG, Matey JN, Vanichkachorn G, Caine NA, Shah V, O'Horo J, Destro Borgen MJ, Cowl CT, Berbari EF. Integrating Infectious Diseases and Preventive Medicine Specialties Into 1 Division: Experience of an Academic Medical Center. Mayo Clin Proc 2023; 98:224-228. [PMID: 36737113 PMCID: PMC9889966 DOI: 10.1016/j.mayocp.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/19/2022] [Accepted: 10/10/2022] [Indexed: 02/04/2023]
Affiliation(s)
- M Hassan Murad
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN.
| | - Melanie D Swift
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - Raymund R Razonable
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - Aaron J Tande
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - John W Wilson
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - Mary J Kasten
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - Irene G Sia
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | | | - Greg Vanichkachorn
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | | | - Vijay Shah
- Department of Medicine, Mayo Clinic, Rochester, MN
| | - Jack O'Horo
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | | | - Clayton T Cowl
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
| | - Elie F Berbari
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN
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5
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Wilson LM, Potter A, Maher C, Ellis MJ, Lane RL, Wilson JW, Keating DT, Jaberzadeh S, Button BM. Feasibility of the A-STEP for the assessment of exercise capacity in people with cystic fibrosis. Pediatr Pulmonol 2022; 57:2524-2532. [PMID: 35811327 PMCID: PMC9796135 DOI: 10.1002/ppul.26069] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To evaluate feasibility of the Alfred Step Test Exercise Protocol (A-STEP) for the assessment of exercise capacity in adults and children with cystic fibrosis (CF); in adults to test whether demographics and/or lung function correlated with exercise capacity. METHODS Adults and children with stable CF from two centres completed the A-STEP (a recently developed incremental maximal-effort step test). Feasibility was evaluated by: usefulness for exercise capacity assessment (measures of exercise capacity were: level reached, exercise-induced desaturation, and achievement of at least one maximal effort criteria); safety; operational factors; time to complete; floor and/or ceiling effects. We used multiple linear regression to test whether demographics and/or lung function correlated with exercise capacity. RESULTS A total of 49 participants: 38 adults (18 male), percent predicted (pp) forced expiration in one second (FEV1 ) 29-109, aged 22-48 years and 11 children (6 male), ppFEV1 68-107, aged 10-15 years were included. Levels reached (mean (SD) [range]) were 10.2 (2.4) [6-15] (adults), 10.1 (2.5) [7-14] (children); desaturation (change between baseline and peak-exercise SpO2 ): was 8.4 (3.8 [0-15]% (adults), 2.0 (2.0) [0-7]% (children). A total of 8 (21%) adults and no children desaturated <90% SpO2 . At least one criterion for maximal effort was reached by 33 (84%) adults and 10 (91%) children. There were no adverse events. The A-STEP was straightforward to use and carried out by one operator. A total of 26 (68.4%) adults and 7 (63.6%) children completed the test within the recommended 8-12 min. All participants completed a minimum of 6 levels, and completed the test before the final 16th level. In adults, ppFEV1 and ppFVC correlated with the level reached (r = 0.55; p = <0.001 and r = 0.66, p = <0.0001) and desaturation (r = 0.55, p = <0.001 and r = 0.45, p = <0.005). CONCLUSION In adults and children with stable CF, the A-STEP was feasible, safe, and operationally easy to use for the assessment of exercise capacity, without floor or ceiling effects. In adults, lung function correlated with exercise capacity.
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Affiliation(s)
- Lisa M Wilson
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia.,Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Angela Potter
- Department of Physiotherapy, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Carol Maher
- Department of Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, University of South Australia, Adelaide, Australia
| | - Matthew J Ellis
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Rebecca L Lane
- Department of Physiotherapy, Victoria University, Melbourne, Victoria, Australia
| | - John W Wilson
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.,Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Dominic T Keating
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.,Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Brenda M Button
- Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia.,Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.,Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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Comba IY, Chesdachai S, Tabaja H, Mahmood M, Deml S, Wengenack NL, Wilson JW. Cardiovascular device infections due to rapidly growing Mycobacteria: A review of cases at a tertiary care hospital. J Clin Tuberc Other Mycobact Dis 2022; 26:100296. [PMID: 35059507 PMCID: PMC8760459 DOI: 10.1016/j.jctube.2022.100296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Cardiovascular device infection due to rapidly growing mycobacteria (RGM) is rarely encountered in clinical practice. Due to the increasing number of indications and use of cardiovascular devices in an aging population, optimized management of these infections is of great importance. We report seven cases of RGM cardiovascular device infection. Three patients had left-ventricular assist device (LVAD) infections; two patients had cardiovascular implantable device (CIED) infections; and one had an aortic vascular stent infection. Specific cardiac valvular infection was not detected among any of the patients. All patients had a high number of comorbidities which limited some patients from receiving optimal combination antimicrobial therapy. The prognosis of cardiovascular device infections with RGM is guarded with only four patients still alive; however, the treatment approach for each patient varied considerably and often based on concurrent medical conditions, overall adjustments to goals of care, and specific patient preferences. Further analysis of cardiovascular device infections with RGM is warranted to establish a more systematic approach in successful management.
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Affiliation(s)
- Isin Yagmur Comba
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Corresponding author at: Division of Infectious Diseases, Department of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
| | - Supavit Chesdachai
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Hussam Tabaja
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Maryam Mahmood
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sharon Deml
- Division of Clinical Microbiology, Department of Laboratory Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nancy L. Wengenack
- Division of Clinical Microbiology, Department of Laboratory Medicine, Mayo Clinic, Rochester, MN, USA
| | - John W. Wilson
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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7
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Schneider-Futschik EK, Lobert VH, Wilson JW. Editorial: Functional Characterization and Pharmaceutical Targets in Common and Rare CFTR Dysfunctions. Front Physiol 2022; 12:830285. [PMID: 35140634 PMCID: PMC8819176 DOI: 10.3389/fphys.2021.830285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/16/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Elena K. Schneider-Futschik
- Cystic Fibrosis Pharmacology Laboratory, Department of Biochemistry & Pharmacology, Melbourne University, Melbourne, VIC, Australia
- *Correspondence: Elena K. Schneider-Futschik
| | - Viola H. Lobert
- Department of Nursing, Health and Laboratory Science, Østfold University College, Fredrikstad, Norway
- Department of Mechanical, Electronic and Chemical Engineering, OsloMet, Oslo, Norway
| | - John W. Wilson
- Department of Medicine, The Alfred Hospital, Monash University, Melbourne, VIC, Australia
- Cystic Fibrosis Service, The Alfred Hospital, Melbourne, VIC, Australia
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Wilson LM, Ellis MJ, Lane RL, Wilson JW, Keating DT, Jaberzadeh S, Button BM. Development of the A-STEP: A new incremental maximal exercise capacity step test in cystic fibrosis. Pediatr Pulmonol 2021; 56:3777-3784. [PMID: 34499432 DOI: 10.1002/ppul.25667] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Exercise testing is important in people with cystic fibrosis (pwCF). The aim was to develop an incremental maximal step test to assess exercise capacity across the range of pwCF, without floor or ceiling effects, within restrictions of space, and infection prevention. METHODS The step test was developed in adults with stable CF. Subjects assisted in selecting: step height, start rate, increments, stage and test duration parameters. Equipment to externally pace and time the test and measure exercise parameters were selected. Reasons for stopping, criteria for achieving a maximal test, and key outcome measures were determined. Documentation to record and standardize the test and instructions to set up the metronome and timer App were developed. Infection control practices were considered. RESULTS Eight subjects were recruited to develop the Alfred Step Test Exercise Protocol (A-STEP) on a 20 cm portable step. The A-STEP package included a pretest information sheet, clinical assessment and instructions, recording worksheet, and the metronome/timer instructions. The test started at 18 steps/min. Each level increased by two steps/min to a maximum of 48 steps (Level 16). Results were presented as mean (SD) [range] for: age 30.63 (5.89) [21-39] years; FEV1 58.13 (18.33) [32-89]%; levels: 10.31 (3.29) [6-15.5]. The A-STEP required space of 2 m2 and complied with current infection control guidelines. CONCLUSIONS The A-STEP is a new incremental maximal step test to assess exercise capacity in pwCF, without floor or ceiling effects. It addresses the issues of space restrictions and the need for strict infection prevention in the clinical setting.
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Affiliation(s)
- Lisa M Wilson
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia.,Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Matthew J Ellis
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Rebecca L Lane
- Department of Physiotherapy, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia.,Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - John W Wilson
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.,Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Dominic T Keating
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.,Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Brenda M Button
- Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia.,Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.,Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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9
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Yetmar ZA, Wilson JW, Beam E. Recurrent nocardiosis in solid organ transplant recipients: An evaluation of secondary prophylaxis. Transpl Infect Dis 2021; 23:e13753. [PMID: 34724316 DOI: 10.1111/tid.13753] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Immunocompromised individuals are at risk for Nocardia infection, with a recurrence rate of approximately 5%. Solid organ transplant (SOT) recipients often receive secondary prophylaxis due to their requirement of lifelong immunosuppression. However, data supporting this practice is sparse. We sought to evaluate Nocardia recurrence in SOT recipients, specifically evaluating secondary prophylaxis. METHODS We conducted a retrospective cohort study of SOT recipients diagnosed with nocardiosis from 2000 through 2020. We included adult SOT recipients who completed their course of Nocardia therapy and had at least 6 months of posttherapy follow-up. The primary outcome was Nocardia recurrence, which included relapse and reinfection. RESULTS One hundred two patients met inclusion criteria. Sixty-six (64.7%) were male and mean age was 58.6 ± 11.7 years. Most common SOT types were kidney (46.1%), heart (18.6%), kidney-pancreas (11.8%), and lung (10.8%). Most common sites of infection were lung (85.3%), skin (17.6%), and brain (14.7%). Secondary prophylaxis was utilized in 53 (52.0%) patients. Trimethoprim-sulfamethoxazole (TMP-SMX) single-strength daily was the most common prophylaxis agent and dose. Five patients (4.9%) experienced Nocardia recurrence, three of which were receiving secondary prophylaxis at time of recurrence. Two recurrences were with the same Nocardia species. Factors associated with recurrence were lung transplantation (p = .011), chronic lung disease (p = .032), and treatment ≤120 days (p = .006). Time from treatment completion to recurrence ranged from 107 to 875 days. CONCLUSIONS Nocardia recurrence in SOT recipients is an uncommon event. TMP-SMX secondary prophylaxis is incompletely protective and recurrence may be dependent upon other factors. Further study of secondary prophylaxis is warranted.
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Affiliation(s)
- Zachary A Yetmar
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - John W Wilson
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Elena Beam
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
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10
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Button BM, Wilson LM, Burge AT, Kimmel L, Finlayson F, Williams E, Talbot A, Tierney A, King S, Holland AE, Keating D, Kotsimbos T, Wilson JW. The AWESCORE, a patient-reported outcome measure: development, feasibility, reliability, validity and responsiveness for adults with cystic fibrosis. ERJ Open Res 2021; 7:00120-2021. [PMID: 34549047 PMCID: PMC8450462 DOI: 10.1183/23120541.00120-2021] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/06/2021] [Indexed: 11/05/2022] Open
Abstract
Background Quality of life has improved dramatically over the past two decades in people with cystic fibrosis (CF). Quantification has been enabled by patient-reported outcome measures (PROMs); however, many are lengthy and can be challenging to use in routine clinical practice. We propose a short-form PROM that correlates well with established quality-of-life measures. Methods We evaluated the utility of a 10-item score (AWESCORE) by measuring reliability, validity and responsiveness in adults with CF. The questions were developed by thematic analysis of survey questions to patients in a single adult CF centre. Each question was scored using a numerical rating scale 0 to 10. Total scores ranged from 0 to 100. Test-retest reliability was assessed over 24 h. To determine validity, comparisons were sought between stable subjects and those in pulmonary exacerbation, and between AWESCORE and Cystic Fibrosis Questionnaire - Revised (CFQ-R). Responsiveness to pulmonary exacerbation in individual subjects was evaluated. Results Five domains, each with two questions, were identified for respiratory, physical, nutritional, psychological and general health. A total of 246 consecutive adults attending the outpatient clinic completed the AWESCORE. Scores were higher during clinical stability compared to pulmonary exacerbation (mean± sd): 73±11 versus 48±11 (p<0.001). Each domain scored worse during an acute exacerbation (p<0.001). No differences in reliability were observed in scores on retesting using Bland-Altman comparison. The CFQ-R scores (mean±sd: 813±125) and AWESCORE (81±13) were moderately correlated (Pearson's r=0.649; p=0.002). Conclusions The AWESCORE is valid, reliable and responsive to altered health status in CF.
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Affiliation(s)
| | | | - Angela T Burge
- Monash University, School of Medicine, Prahran, Melbourne, Australia
| | - Lara Kimmel
- Alfred Health, Prahran, Melbourne, Australia
| | | | | | | | - Audrey Tierney
- School of Allied Health, University of Limerick, Limerick, Ireland
| | | | - Anne E Holland
- Monash University, School of Medicine, Prahran, Melbourne, Australia
| | | | - Tom Kotsimbos
- Monash University, School of Medicine, Prahran, Melbourne, Australia
| | - John W Wilson
- Monash University, School of Medicine, Prahran, Melbourne, Australia
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11
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Tan NY, Tarabochia AD, DeSimone DC, DeSimone CV, Wilson JW, Bagameri G, Bennett CE, Abu Saleh OM. Updated Experience of Mycobacterium chimaera Infection: Diagnosis and Management in a Tertiary Care Center. Open Forum Infect Dis 2021; 8:ofab348. [PMID: 34377729 PMCID: PMC8339283 DOI: 10.1093/ofid/ofab348] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/29/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Despite safety communications from the Food and Drug Administration (FDA) regarding the outbreak of Mycobacterium chimaera infections (MCIs) from contaminated heater-cooler devices, new cases continue to be identified. METHODS We retrospectively reviewed confirmed cases of MCI that were managed at Mayo Clinic sites (Arizona, Florida, and Minnesota) from 09/2015 to 01/2021. Clinical histories including prior cardiovascular surgery were recorded. Diagnostic workup including ophthalmologic examination, imaging, and laboratory testing was reviewed. Treatment and survival outcomes on follow-up were obtained. RESULTS Twelve patients with MCI were included. All patients had aortic valve or graft replacement. Five patients had their surgical procedures following the 10/15/2015 FDA safety communication. The mean time from surgery to symptom onset (range) was 32 (13-73) months. Ten of 11 patients who underwent ophthalmologic examination had chorioretinal abnormalities. Three patients who underwent microbial cell-free deoxyribonucleic acid sequencing tested positive for M. chimaera, which was subsequently confirmed with blood culture growth. Echocardiography and positron emission tomography/computed tomography (PET/CT) revealed evidence of prosthetic valve/graft infection in 7/12 (58.3%) and 6/10 (60.0%) of cases, respectively. Seven patients (58.3%) underwent redo cardiovascular surgery. Of these, 1 patient died 2 days postdischarge, 1 experienced spinal osteomyelitis relapse, and another had interval prosthetic valve fluorodeoxyglucose (FDG) uptake on PET/CT suspicious for recurrent infection. Among 4 patients on medical therapy only, 3 expired or transitioned to hospice during follow-up. CONCLUSIONS MCI continues to occur despite the FDA communications. Incorporation of ophthalmologic examination and use of advanced tools may improve MCI diagnosis. The mortality in these patients is high even with aggressive surgical/medical management.
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Affiliation(s)
- Nicholas Y Tan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Alex D Tarabochia
- Division of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniel C DeSimone
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | | | - John W Wilson
- Department of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Gabor Bagameri
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Courtney E Bennett
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Omar M Abu Saleh
- Department of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
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Escalante P, Wilson JW. New Diagnostics to Infer Risk in Tuberculosis: Is the Term "Latent Tuberculosis Infection" Obsolete? Am J Respir Crit Care Med 2021; 203:1460-1461. [PMID: 33596391 PMCID: PMC8483221 DOI: 10.1164/rccm.202101-0131ed] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Patricio Escalante
- Division of Pulmonary and Critical Care Medicine Mayo Clinic Rochester, Minnesota
| | - John W Wilson
- Division of Pulmonary and Critical Care Medicine Mayo Clinic Rochester, Minnesota
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13
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Bansal R, Vergidis P, Tosh P, Wilson JW, Hathcock M, Bennani NN, Paludo J, Villasboas JC, Wang Y, Ansell SM, Johnston PB, Freeman CM, Lin Y. Vaccine titers in lymphoma patients receiving chimeric antigen receptor T-cell therapy. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7555 Background: While CAR-T therapy is not myelo-ablative, patients with aggressive lymphoma treated with CD19 chimeric antigen receptor T cell therapy (CAR-T) are lymphodepleted and have prolonged B cell aplasia. The impact of CAR-T on immunologic protection from vaccine-preventable diseases (and thus the need to revaccinate) is not known. We report the vaccine titers of patients treated with axicabtagene ciloleucel (axi-cel) at Mayo Clinic. Methods: Retrospective chart review of adult lymphoma patients who received axi-cel from 9/2018 to 9/2020 for anti-viral and anti-bacterial titers prior to CAR-T infusion and at month 3 (MO3) post CAR-T. Results: Prior to CAR-T therapy, positive titer rate was highest for tetanus and lowest for Strep pneumoniae (Strep PNA) (Table). Similar trends were seen whether patients had stem cell transplant (ASCT) within 2 years of CAR-T (i.e. within immunization timeframe post ASCT) or not (Table). Compared to patients who had ASCT, those who did not had higher rate of positive titer for Strep PNA and lower rate for hepatitis B, Mumps, and VZV. The same trend for sero-positive rate were observed at MO3 post CAR-T. Patients with IgG<400 mg/dl received IVIG supplement for prophylaxis. Among the 23 patients who received IVIG, variable rate of conversion from negative to positive titers were seen for measles (1/2, 50%), mumps (2/3, 67%), rubella (2/3, 67%), varicella-zoster (VZV, 3/3, 100%), hepatitis A (6/6, 100%), hepatitis B (6/7, 86%) and Strep PNA (0/10, 0%). For patients who did not receive IVIG prophylaxis, there was one loss of seropositivity for Strep PNA (1/4, 25%). Conclusions: The presence of protective vaccine titers is variable for patients receiving CAR-T, regardless of recent ASCT. The loss of protective titers post CART was low. IVIG variably impacted vaccine titer status. Immunization remains important for patients with ASCT prior to CART, without completion of post ASCT immunization protocol. Further study is needed to inform the need for immunization and optimal timing post CART.[Table: see text]
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Affiliation(s)
| | | | | | | | | | | | - Jonas Paludo
- Mayo Clinic, Division of Hematology, Rochester, MN
| | | | - Yucai Wang
- Mayo Clinic, Division of Hematology, Rochester, MN
| | | | | | | | - Yi Lin
- Division of Hematology, Mayo Clinic, Rochester, MN
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King SJ, Keating D, Williams E, Paul E, Borg BM, Finlayson F, Button BM, Wilson JW, Kotsimbos T. Lumacaftor/ivacaftor-associated health stabilisation in adults with severe cystic fibrosis. ERJ Open Res 2021; 7:00203-2020. [PMID: 33569502 PMCID: PMC7861032 DOI: 10.1183/23120541.00203-2020] [Citation(s) in RCA: 6] [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: 04/21/2020] [Accepted: 10/27/2020] [Indexed: 11/05/2022] Open
Abstract
Introduction Lumacaftor/ivacaftor (LUM/IVA) has been shown to improve clinical outcomes in cystic fibrosis (CF) patients homozygous for Phe508del with forced expiratory volume in 1 s (FEV1) % pred >40%. We assessed the clinical utility of LUM/IVA in all eligible adult CF patients with FEV1 % pred <40% treated for at least 1 year under a single-centre managed access programme. Methods Following clinical optimisation, eligible patients (n=40) with FEV1 % pred <40% were commenced on LUM/IVA and monitored for tolerance and clinical outcomes, including health service utilisation, pulmonary function, weight and body composition. 24 patients reached 1 year of treatment by the time of evaluation. Six patients discontinued due to adverse events (five for increased airways reactivity) and three underwent lung transplantation. Results In comparison with the year prior to LUM/IVA commencement, significant reductions (median per year) were observed in the treatment year in the number of pulmonary exacerbations requiring hospitalisation (from 3 to 1.5; p=0.0002), hospitalisation days (from 27 to 17; p=0.0002) and intravenous antibiotic (IVAB) usage days (from 45 to 27; p=0.0007). Mean±sd change in FEV1 % pred was −2.10±1.18% per year in the year prior, with the decline reversed in the year following (+1.45±1.13% per year; p=0.035), although there was significant heterogeneity in individual responses. Mean±sd weight gain at 1 year was 2.5±4.1 kg (p=0.0007), comprising mainly fat mass (mean 2.2 kg). The proportion of patients severely underweight (body mass index <18.5 kg·m−2) decreased from 33% at baseline to 13% at 1 year (p=0.003). Conclusion This real-world evaluation study demonstrated benefits over several clinical domains (infective exacerbations requiring hospitalisation, IVABs, pulmonary function decline and nutritional parameters) in CF patients with severe lung disease. In adults with severe cystic fibrosis lung disease, 1 year of treatment with lumacaftor/ivacaftor was associated with reduced infective exacerbations, days of intravenous antibiotics and rate of pulmonary function decline, and improved nutritional statushttps://bit.ly/2I07suR
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Affiliation(s)
- Susannah J King
- Nutrition Dept, Alfred Hospital, Melbourne, Australia.,Cystic Fibrosis Service, Dept of Respiratory Medicine, Alfred Hospital, Melbourne, Australia.,Dept of Dietetics, Nutrition and Sport, LaTrobe University, Bundoora, Australia
| | - Dominic Keating
- Cystic Fibrosis Service, Dept of Respiratory Medicine, Alfred Hospital, Melbourne, Australia.,Dept of Medicine, Monash University, Melbourne, Australia
| | - Elyssa Williams
- Cystic Fibrosis Service, Dept of Respiratory Medicine, Alfred Hospital, Melbourne, Australia
| | - Eldho Paul
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Brigitte M Borg
- Physiology Service, Dept of Respiratory Medicine, Alfred Hospital, Melbourne, Australia
| | - Felicity Finlayson
- Cystic Fibrosis Service, Dept of Respiratory Medicine, Alfred Hospital, Melbourne, Australia
| | - Brenda M Button
- Cystic Fibrosis Service, Dept of Respiratory Medicine, Alfred Hospital, Melbourne, Australia.,Dept of Medicine, Monash University, Melbourne, Australia.,Physiotherapy Dept, Alfred Hospital, Melbourne, Australia
| | - John W Wilson
- Cystic Fibrosis Service, Dept of Respiratory Medicine, Alfred Hospital, Melbourne, Australia.,Dept of Medicine, Monash University, Melbourne, Australia
| | - Tom Kotsimbos
- Cystic Fibrosis Service, Dept of Respiratory Medicine, Alfred Hospital, Melbourne, Australia.,Dept of Medicine, Monash University, Melbourne, Australia
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15
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King SJ, Tierney AC, Edgeworth D, Keating D, Williams E, Kotsimbos T, Button BM, Wilson JW. Body composition and weight changes after ivacaftor treatment in adults with cystic fibrosis carrying the G551 D cystic fibrosis transmembrane conductance regulator mutation: A double-blind, placebo-controlled, randomized, crossover study with open-label extension. Nutrition 2021; 85:111124. [PMID: 33571868 DOI: 10.1016/j.nut.2020.111124] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 09/17/2020] [Revised: 11/15/2020] [Accepted: 12/09/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES In patients with cystic fibrosis (CF) who carry the G551D mutation, treatment with ivacaftor improves lung function and weight; however, short- and long-term impacts on body composition have not been well studied. METHODS Twenty adults with CF carrying the G551D mutation (mean ± standard deviation body mass index [BMI] 23.3 ± 4.3 kg/m2) were recruited for a single-center, double-blind, placebo-controlled, 28-d, crossover study of ivacaftor, followed by an open-label extension (OLE) for 5 mo. Eleven patients underwent measurements 2 y later. The study variables included weight, BMI, and body composition (including fat-free mass [FFM] and fat mass). RESULTS After 28 d of treatment with ivacaftor, weight increased by 1.1 ± 1.3 kg, BMI by 0.4 ± 0.5 kg/m2, and FFM by 1.1 ± 1.2 kg (all P < .005) with no change in fat mass. Differences between 28-d changes on ivacaftor and placebo were not statistically significant. In the following 5 mo of the OLE, there were significant increases in weight (1.2 ± 1.9 kg; P < .05) and fat mass (1.5 ± 1.9 kg; P < .01), but not in FFM. Between baseline and the end of the OLE, the total weight gain was 2.5 ± 2.4 kg (P < .005), comprised of 0.9 ± 1.5 kg FFM (P < .05) and 1.6 ± 1.8 kg fat mass (P < .005). For the 11 participants who were followed for a further 2 y, no further changes in mean weight, BMI, or body composition parameters between 6 mo and 2 y later were observed. CONCLUSIONS Small gains were seen in FFM in the first month of ivacaftor treatment. Weight, BMI, and fat-mass gains in the first 6 mo on ivacaftor plateaued by 2.5 y. The metabolic and clinical consequences of weight and fat-mass gains remain to be determined.
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Affiliation(s)
- Susannah J King
- Nutrition Department, Alfred Hospital, Melbourne, Victoria, Australia; Cystic Fibrosis Service, Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Department of Dietetics, Nutrition and Sport, LaTrobe University, Victoria, Australia.
| | - Audrey C Tierney
- Nutrition Department, Alfred Hospital, Melbourne, Victoria, Australia; Cystic Fibrosis Service, Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Department of Dietetics, Nutrition and Sport, LaTrobe University, Victoria, Australia; School of Allied Health, University of Limerick, Limerick, Ireland
| | - Deirdre Edgeworth
- Cystic Fibrosis Service, Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Department of Anesthesia and Intensive Care Medicine, St James' Hospital, Dublin, Ireland
| | - Dominic Keating
- Cystic Fibrosis Service, Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Elyssa Williams
- Cystic Fibrosis Service, Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
| | - Tom Kotsimbos
- Cystic Fibrosis Service, Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Brenda M Button
- Cystic Fibrosis Service, Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Melbourne, Victoria, Australia; Physiotherapy Department, Alfred Hospital, Melbourne, Victoria, Australia
| | - John W Wilson
- Cystic Fibrosis Service, Department of Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Department of Medicine, Monash University, Melbourne, Victoria, Australia
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Slaba TC, Wilson JW, Werneth CM, Whitman K. Updated deterministic radiation transport for future deep space missions. Life Sci Space Res (Amst) 2020; 27:6-18. [PMID: 34756231 DOI: 10.1016/j.lssr.2020.06.004] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/05/2020] [Accepted: 06/07/2020] [Indexed: 06/13/2023]
Abstract
NASA's deterministic transport code HZETRN, and its three-dimensional (3D) counterpart, 3DHZETRN, are being used to characterize the space radiation environment over a wide range of scenarios, including future planned missions to the moon or Mars. Combined with available spaceflight measurements, these tools provide the fundamental input for risk models used to quantify possible astronaut health decrements and satisfy agency limits in support of exploration initiatives. Further research is therefore needed to improve radiation transport and nuclear physics models while at the same time continuing to expand the available measurement database (ground-based and spaceflight) to validate such efforts. In this work, significant updates to the deterministic radiation transport models are presented. Charged muons and pions are fully coupled with the existing solutions developed for neutron and light ion (Z ≤ 2) transport. This update includes the 3D nature of pion production as well as the pion interactions, resulting in further production of energetic nucleons within shielding. Additional updates related to low energy proton recoils in hydrogenous materials and capture/decay processes associated with charged pions at rest are also described. Included in this work is the coupling of single and double-differential cross sections from Geant4 into HZETRN and 3DHZETRN. This enables a direct comparison of deterministic and Monte Carlo transport methodologies using the same nuclear databases for specific interactions. Comparisons between Geant4 and 3DHZETRN are shown and establish that the transport methodologies are in excellent agreement when the same cross sections are used. The deterministic codes are also compared to ISS data, and it is found that the updated 3D procedures are within measurement uncertainty (±5%) at cutoff rigidities below 1 GV, which approaches free space conditions.
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Affiliation(s)
- T C Slaba
- NASA Langley Research Center, Hampton, VA, USA.
| | - J W Wilson
- Old Dominion University Research Foundation, Norfolk, VA, USA
| | - C M Werneth
- NASA Langley Research Center, Hampton, VA, USA
| | - K Whitman
- University of Houston, Houston, TX, USA
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17
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Affiliation(s)
- Kenny T Quang
- Department of Surgery, Division of Acute Care Surgery and Burns, University of South Alabama, Mobile, AL, USA
| | - Justin L Hunter
- Department of Surgery, Division of Acute Care Surgery and Burns, University of South Alabama, Mobile, AL, USA
| | - John W Wilson
- Department of Surgery, Division of Acute Care Surgery and Burns, University of South Alabama, Mobile, AL, USA
| | - Jon D Simmons
- Department of Surgery, Division of Acute Care Surgery and Burns, University of South Alabama, Mobile, AL, USA
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18
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Razonable RR, Carmona EM, Vergidis P, Wilson JW, Marshall WF. Clinical Guidance and the Delivery of Care for Patients With Coronavirus Disease 2019. Mayo Clin Proc 2020; 95:S23-S25. [PMID: 32829906 PMCID: PMC7309821 DOI: 10.1016/j.mayocp.2020.05.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/29/2020] [Indexed: 11/21/2022]
Affiliation(s)
| | - Eva M Carmona
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | | | - John W Wilson
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN
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19
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Fernando R, McDowell AC, Bhavaraju R, Fraimow H, Wilson JW, Armitige L, Haley C, Goswami ND. A model for bringing TB expertise to HIV providers: Medical consultations to the CDC-funded Regional Tuberculosis Training and Medical Consultation Centers, 2013-2017. PLoS One 2020; 15:e0236933. [PMID: 32866154 PMCID: PMC7458296 DOI: 10.1371/journal.pone.0236933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 07/16/2020] [Indexed: 11/19/2022] Open
Abstract
Background Persons living with human immunodeficiency virus (HIV) are at a greater risk of developing tuberculosis (TB) compared to people without HIV and of developing complications due to the complexity of TB/HIV coinfection management. Methods During 2013–2017, the Centers for Disease Control and Prevention (CDC) funded 5 TB Regional Training and Medical Consultation Centers (RTMCCs) (now known as TB Centers of Excellence or COEs) to provide medical consultation to providers for TB disease and latent TB infection (LTBI), with data entered into a Medical Consultation Database (MCD). Descriptive analyses of TB/HIV-related consultations were conducted using SAS® software, version [9.4] to determine the distribution of year of consultation, medical setting and provider type, frequency of consultations regarding a pediatric (<18 years) patient, and to categorize key concepts and themes arising within consultation queries and medical consultant responses. Results Of 14,586 consultations captured by the MCD in 2013–2017, 544 (4%) were categorized as TB/HIV-related, with 100 (18%) received in 2013, 129 (24%) in 2014, 104 (19%) in 2015, 117 (22%) in 2016, and 94 (17%) in 2017. Most TB/HIV consultations came from nurses (54%) or physicians (43%) and from local (65%) or state health departments (10%). Only 17 (3%) of HIV-related consultations involved pediatric cases. Off the 544 TB/HIV consultations, 347 (64%) concerned the appropriate treatment regimen for TB/HIV or LTBI/HIV for a patient on or not on antiretroviral therapy (ART). Conclusions The data support a clear and ongoing gap in areas of specialized HIV knowledge by TB experts that could be supplemented with proactive educational outreach. The specific categories of TB/HIV inquiries captured by this analysis are strategically informing future targeted training and educational activities planned by the CDC TB Centers of Excellence, as well as guiding HIV educational efforts at regional and national TB meetings.
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Affiliation(s)
- Robyn Fernando
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Ashley C. McDowell
- Emory University School of Medicine, Atlanta, Georgia, United States of America
- * E-mail:
| | - Rajita Bhavaraju
- Global TB Institute at Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
| | - Henry Fraimow
- Global TB Institute at Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
| | - John W. Wilson
- Mayo Clinic Center for Tuberculosis, Rochester, Minnesota, United States of America
| | - Lisa Armitige
- Heartland National TB Center, San Antonio, Texas, United States of America
| | - Connie Haley
- University of Florida, Gainesville, Florida, United States of America
| | - Neela D. Goswami
- Division of Tuberculosis Elimination, NCHHSTP, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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20
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Wilson JW, Werneth CM, Slaba TC, Badavi FF, Reddell BD, Bahadori AA. Effects of the Serber first step in 3DHZETRN-v2.1. Life Sci Space Res (Amst) 2020; 26:10-27. [PMID: 32718675 DOI: 10.1016/j.lssr.2020.03.004] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 06/11/2023]
Abstract
3DHZETRN-v2 includes a detailed three dimensional (3D) treatment of neutron/light-ion transport based on a quasi-elastic/multiple production assumption allowing improved agreement of the neutron/light-ion fluence compared with results of three Monte Carlo (MC) codes in the sense that the variance with respect to the individual MC results is less than the variance among the MC code results. The current numerical methods are no longer the main limitation to HZETRN code development and further changes in the nuclear model are required. In a prior study, an improved quasi-elastic spectrum based on a solution of the transport approximation to nuclear media effects showed promise, but the remaining multiple-production spectrum was based on a database derived from the Ranft model that used Bertini multiplicities. In the present paper, we will implement a more complete Serber first step into the 3DHZETRN-v2 code, but we retain the Bertini-Ranft branching ratios and evaporation multiplicities. It is shown that the new Serber model in the 3HZETRN-v2 code reduces the variance with individual MC codes, which are largely due to nuclear cross section model differences. The code will be available through the software system, OLTARIS, for shield design and validation and provides a basis for personal computer software capable of space shield analysis and optimization.
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Affiliation(s)
- J W Wilson
- Old Dominion University, Norfolk, VA, United States
| | - C M Werneth
- NASA Langley Research Center, Hampton, VA, United States.
| | - T C Slaba
- NASA Langley Research Center, Hampton, VA, United States
| | - F F Badavi
- Old Dominion University, Norfolk, VA, United States
| | - B D Reddell
- Johnson Space Center, Houston, TX, United States
| | - A A Bahadori
- Kansas State University, Manhatton, KS, United States
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21
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Noonan MJ, Fleming CH, Tucker MA, Kays R, Harrison A, Crofoot MC, Abrahms B, Alberts SC, Ali AH, Altmann J, Antunes PC, Attias N, Belant JL, Beyer DE, Bidner LR, Blaum N, Boone RB, Caillaud D, de Paula RC, de la Torre JA, Dekker J, DePerno CS, Farhadinia M, Fennessy J, Fichtel C, Fischer C, Ford A, Goheen JR, Havmøller RW, Hirsch BT, Hurtado C, Isbell LA, Janssen R, Jeltsch F, Kaczensky P, Kaneko Y, Kappeler P, Katna A, Kauffman M, Koch F, Kulkarni A, LaPoint S, Leimgruber P, Macdonald DW, Markham AC, McMahon L, Mertes K, Moorman CE, Morato RG, Moßbrucker AM, Mourão G, O'Connor D, Oliveira‐Santos LGR, Pastorini J, Patterson BD, Rachlow J, Ranglack DH, Reid N, Scantlebury DM, Scott DM, Selva N, Sergiel A, Songer M, Songsasen N, Stabach JA, Stacy‐Dawes J, Swingen MB, Thompson JJ, Ullmann W, Vanak AT, Thaker M, Wilson JW, Yamazaki K, Yarnell RW, Zieba F, Zwijacz‐Kozica T, Fagan WF, Mueller T, Calabrese JM. Effects of body size on estimation of mammalian area requirements. Conserv Biol 2020; 34:1017-1028. [PMID: 32362060 PMCID: PMC7496598 DOI: 10.1111/cobi.13495] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/27/2019] [Accepted: 12/24/2019] [Indexed: 06/08/2023]
Abstract
Accurately quantifying species' area requirements is a prerequisite for effective area-based conservation. This typically involves collecting tracking data on species of interest and then conducting home-range analyses. Problematically, autocorrelation in tracking data can result in space needs being severely underestimated. Based on the previous work, we hypothesized the magnitude of underestimation varies with body mass, a relationship that could have serious conservation implications. To evaluate this hypothesis for terrestrial mammals, we estimated home-range areas with global positioning system (GPS) locations from 757 individuals across 61 globally distributed mammalian species with body masses ranging from 0.4 to 4000 kg. We then applied block cross-validation to quantify bias in empirical home-range estimates. Area requirements of mammals <10 kg were underestimated by a mean approximately15%, and species weighing approximately100 kg were underestimated by approximately50% on average. Thus, we found area estimation was subject to autocorrelation-induced bias that was worse for large species. Combined with the fact that extinction risk increases as body mass increases, the allometric scaling of bias we observed suggests the most threatened species are also likely to be those with the least accurate home-range estimates. As a correction, we tested whether data thinning or autocorrelation-informed home-range estimation minimized the scaling effect of autocorrelation on area estimates. Data thinning required an approximately93% data loss to achieve statistical independence with 95% confidence and was, therefore, not a viable solution. In contrast, autocorrelation-informed home-range estimation resulted in consistently accurate estimates irrespective of mass. When relating body mass to home range size, we detected that correcting for autocorrelation resulted in a scaling exponent significantly >1, meaning the scaling of the relationship changed substantially at the upper end of the mass spectrum.
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Affiliation(s)
- Michael J. Noonan
- Smithsonian Conservation Biology InstituteNational Zoological Park1500 Remount RoadFront RoyalVA22630U.S.A.
- Department of BiologyUniversity of MarylandCollege ParkMD20742U.S.A.
| | - Christen H. Fleming
- Smithsonian Conservation Biology InstituteNational Zoological Park1500 Remount RoadFront RoyalVA22630U.S.A.
- Department of BiologyUniversity of MarylandCollege ParkMD20742U.S.A.
| | - Marlee A. Tucker
- Senckenberg Biodiversity and Climate Research CentreSenckenberg Gesellschaft für NaturforschungSenckenberganlage 25Frankfurt (Main)60325Germany
- Department of Biological SciencesGoethe UniversityMax‐von‐Laue‐Straße 9Frankfurt (Main)60438Germany
- Department of Environmental ScienceInstitute for Wetland and Water ResearchRadboud UniversityP.O. Box 9010NijmegenGLNL‐6500The Netherlands
| | - Roland Kays
- North Carolina Museum of Natural SciencesBiodiversity LabRaleighNC27601U.S.A.
- Fisheries, Wildlife, and Conservation Biology Program, College of Natural Resources Campus Box 8001North Carolina State UniversityRaleighNC27695U.S.A.
| | - Autumn‐Lynn Harrison
- Migratory Bird CenterSmithsonian Conservation Biology InstituteWashingtonD.C.20013U.S.A.
| | - Margaret C. Crofoot
- Department of AnthropologyUniversity of California, DavisDavisCA95616U.S.A.
- Smithsonian Tropical Research InstituteBalboa Ancon0843‐03092Republic of Panama
| | - Briana Abrahms
- Environmental Research DivisionNOAA Southwest Fisheries Science CenterMontereyCA93940U.S.A.
| | - Susan C. Alberts
- Departments of Biology and Evolutionary AnthropologyDuke UniversityDurhamNC27708U.S.A.
| | | | - Jeanne Altmann
- Department of Ecology and EvolutionPrinceton University106A Guyot HallPrincetonNJ08544U.S.A.
| | - Pamela Castro Antunes
- Department of EcologyFederal University of Mato Grosso do SulCampo GrandeMS79070–900Brazil
| | - Nina Attias
- Programa de Pós‐Graduaçao em Biologia Animal, Universidade Federal do Mato Grosso do SulCidade UniversitáriaAv. Costa e SilvaCampo GrandeMato Grosso do Sul79070‐900Brazil
| | - Jerrold L. Belant
- Camp Fire Program in Wildlife Conservation, State University of New YorkCollege of Environmental Science and ForestrySyracuseNY13210U.S.A.
| | - Dean E. Beyer
- Michigan Department of Natural Resources1990 U.S. 41 SouthMarquetteMI49855U.S.A.
| | - Laura R. Bidner
- Department of AnthropologyUniversity of California, DavisDavisCA95616U.S.A.
- Mpala Research CentreNanyuki555–104000Kenya
| | - Niels Blaum
- University of Potsdam, Plant Ecology and Nature ConservationAm Mühlenberg 3Potsdam14476Germany
| | - Randall B. Boone
- Natural Resource Ecology LaboratoryColorado State UniversityFort CollinsCO80523U.S.A.
- Department of Ecosystem Science and SustainabilityColorado State UniversityFort CollinsCO80523U.S.A.
| | - Damien Caillaud
- Department of AnthropologyUniversity of California, DavisDavisCA95616U.S.A.
| | - Rogerio Cunha de Paula
- National Research Center for Carnivores ConservationChico Mendes Institute for the Conservation of BiodiversityEstrada Municipal Hisaichi Takebayashi 8600AtibaiaSP12952‐011Brazil
| | - J. Antonio de la Torre
- Instituto de Ecología, Universidad Nacional Autónoma de Mexico and CONACyTCiudad UniversitariaMexicoD.F.04318Mexico
| | - Jasja Dekker
- Jasja Dekker DierecologieEnkhuizenstraat 26ArnhemWZ6843The Netherlands
| | - Christopher S. DePerno
- Fisheries, Wildlife, and Conservation Biology Program, College of Natural Resources Campus Box 8001North Carolina State UniversityRaleighNC27695U.S.A.
| | - Mohammad Farhadinia
- Wildlife Conservation Research Unit, Department of ZoologyUniversity of OxfordTubney House, OxfordshireOxfordOX13 5QLU.K.
- Future4Leopards FoundationTehranIran
| | | | - Claudia Fichtel
- German Primate CenterBehavioral Ecology & Sociobiology UnitKellnerweg 4Göttingen37077Germany
| | - Christina Fischer
- Restoration Ecology, Department of Ecology and Ecosystem ManagementTechnische Universität MünchenEmil‐Ramann‐Straße 6Freising85354Germany
| | - Adam Ford
- The Irving K. Barber School of Arts and Sciences, Unit 2: BiologyThe University of British ColumbiaOkanagan Campus, SCI 109, 1177 Research RoadKelownaBCV1V 1V7Canada
| | - Jacob R. Goheen
- Department of Zoology and PhysiologyUniversity of WyomingLaramieWY82071U.S.A.
| | | | - Ben T. Hirsch
- Zoology and Ecology, College of Science and EngineeringJames Cook UniversityTownsvilleQLD4811Australia
| | - Cindy Hurtado
- Museo de Historia NaturalUniversidad Nacional Mayor de San MarcosLima15072Peru
- Department of Forest Resources ManagementThe University of British ColumbiaVancouverBCV6T 1Z4Canada
| | - Lynne A. Isbell
- Department of AnthropologyUniversity of California, DavisDavisCA95616U.S.A.
- Mpala Research CentreNanyuki555–104000Kenya
| | - René Janssen
- Bionet NatuuronderzoekValderstraat 39Stein6171ELThe Netherlands
| | - Florian Jeltsch
- University of Potsdam, Plant Ecology and Nature ConservationAm Mühlenberg 3Potsdam14476Germany
| | - Petra Kaczensky
- Norwegian Institute for Nature Research — NINASluppenTrondheimNO‐7485Norway
- Research Institute of Wildlife Ecology, University of Veterinary MedicineSavoyenstraße 1ViennaA‐1160Austria
| | - Yayoi Kaneko
- Tokyo University of Agriculture and TechnologyTokyo183–8509Japan
| | - Peter Kappeler
- German Primate CenterBehavioral Ecology & Sociobiology UnitKellnerweg 4Göttingen37077Germany
| | - Anjan Katna
- Ashoka Trust for Research in Ecology and the Environment (ATREE)BangaloreKarnataka560064India
- Manipal Academy of Higher EducationManipalKarnataka576104India
| | - Matthew Kauffman
- U.S. Geological Survey, Wyoming Cooperative Fish and Wildlife Research Unit, Department of Zoology and PhysiologyUniversity of WyomingLaramieWY82071U.S.A.
| | - Flavia Koch
- German Primate CenterBehavioral Ecology & Sociobiology UnitKellnerweg 4Göttingen37077Germany
| | - Abhijeet Kulkarni
- Ashoka Trust for Research in Ecology and the Environment (ATREE)BangaloreKarnataka560064India
| | - Scott LaPoint
- Max Planck Institute for OrnithologyVogelwarte RadolfzellAm Obstberg 1RadolfzellD‐78315Germany
- Black Rock Forest65 Reservoir RoadCornwallNY12518U.S.A.
| | - Peter Leimgruber
- Smithsonian Conservation Biology InstituteNational Zoological Park1500 Remount RoadFront RoyalVA22630U.S.A.
| | - David W. Macdonald
- Wildlife Conservation Research Unit, Department of ZoologyUniversity of OxfordTubney House, OxfordshireOxfordOX13 5QLU.K.
| | | | - Laura McMahon
- Office of Applied ScienceDepartment of Natural ResourcesRhinelanderWI54501U.S.A.
| | - Katherine Mertes
- Smithsonian Conservation Biology InstituteNational Zoological Park1500 Remount RoadFront RoyalVA22630U.S.A.
| | - Christopher E. Moorman
- Fisheries, Wildlife, and Conservation Biology Program, College of Natural Resources Campus Box 8001North Carolina State UniversityRaleighNC27695U.S.A.
| | - Ronaldo G. Morato
- National Research Center for Carnivores ConservationChico Mendes Institute for the Conservation of BiodiversityEstrada Municipal Hisaichi Takebayashi 8600AtibaiaSP12952‐011Brazil
- Institute for the Conservation of Neotropical Carnivores – Pró‐CarnívorosAtibaiaSao Paulo12945‐010Brazil
| | | | - Guilherme Mourão
- Embrapa PantanalRua 21 de setembro 1880Corumb´aMS79320–900Brazil
| | - David O'Connor
- Department of Biological SciencesGoethe UniversityMax‐von‐Laue‐Straße 9Frankfurt (Main)60438Germany
- San Diego Zoo Institute of Conservation Research15600 San Pasqual Valley RoadEscondidoCA92027U.S.A.
- National Geographic Partners1145 17th Street NWWashingtonD.C.20036U.S.A.
| | | | - Jennifer Pastorini
- Centre for Conservation and Research26/7 C2 Road, KodigahawewaJulpallamaTissamaharama82600Sri Lanka
- Anthropologisches InstitutUniversität ZürichWinterthurerstrasse 190Zurich8057Switzerland
| | - Bruce D. Patterson
- Integrative Research CenterField Museum of Natural HistoryChicagoIL60605U.S.A.
| | - Janet Rachlow
- Department of Fish and Wildlife SciencesUniversity of Idaho875 Perimeter Drive MS 1136MoscowID83844‐1136U.S.A.
| | - Dustin H. Ranglack
- Department of BiologyUniversity of Nebraska at KearneyKearneyNE68849U.S.A.
| | - Neil Reid
- Institute for Global Food Security (IGFS), School of Biological SciencesQueen's University BelfastBelfastBT9 5DLU.K.
| | - David M. Scantlebury
- School of Biological SciencesQueen's University Belfast19 Chlorine GardensBelfastNorthern IrelandBT9 5DLU.K.
| | - Dawn M. Scott
- School of Life SciencesKeele UniversityKeeleStaffordshireST5 5BGU.K.
| | - Nuria Selva
- Institute of Nature ConservationPolish Academy of SciencesMickiewicza 33Krakow31–120Poland
| | - Agnieszka Sergiel
- Institute of Nature ConservationPolish Academy of SciencesMickiewicza 33Krakow31–120Poland
| | - Melissa Songer
- Smithsonian Conservation Biology InstituteNational Zoological Park1500 Remount RoadFront RoyalVA22630U.S.A.
| | - Nucharin Songsasen
- Smithsonian Conservation Biology InstituteNational Zoological Park1500 Remount RoadFront RoyalVA22630U.S.A.
| | - Jared A. Stabach
- Smithsonian Conservation Biology InstituteNational Zoological Park1500 Remount RoadFront RoyalVA22630U.S.A.
| | - Jenna Stacy‐Dawes
- San Diego Zoo Institute of Conservation Research15600 San Pasqual Valley RoadEscondidoCA92027U.S.A.
| | - Morgan B. Swingen
- Fisheries, Wildlife, and Conservation Biology Program, College of Natural Resources Campus Box 8001North Carolina State UniversityRaleighNC27695U.S.A.
- 1854 Treaty Authority4428 Haines RoadDuluthMN55811U.S.A.
| | - Jeffrey J. Thompson
- Asociación Guyra Paraguay – CONACYTParque Ecológico Asunción VerdeAsuncion1101Paraguay
- Instituto SaiteCoronel Felix Cabrera 166Asuncion1101Paraguay
| | - Wiebke Ullmann
- University of Potsdam, Plant Ecology and Nature ConservationAm Mühlenberg 3Potsdam14476Germany
| | - Abi Tamim Vanak
- Ashoka Trust for Research in Ecology and the Environment (ATREE)BangaloreKarnataka560064India
- Wellcome Trust/DBT India AllianceHyderabad500034India
- School of Life SciencesUniversity of KwaZulu‐NatalWestvilleDurban4041South Africa
| | - Maria Thaker
- Centre for Ecological SciencesIndian Institute of ScienceBangalore560012India
| | - John W. Wilson
- Department of Zoology & EntomologyUniversity of PretoriaPretoria0002South Africa
| | - Koji Yamazaki
- Ibaraki Nature MuseumZoological Laboratory700 OsakiBando‐cityIbaraki306–0622Japan
- Forest Ecology LaboratoryDepartment of Forest ScienceTokyo University of Agriculture1‐1‐1 SakuragaokaSetagaya‐KuTokyo156–8502Japan
| | - Richard W. Yarnell
- School of Animal, Rural and Environmental SciencesNottingham Trent UniversityBrackenhurst CampusSouthwellNG25 0QFU.K.
| | - Filip Zieba
- Tatra National ParkKúznice 1Zakopane34–500Poland
| | | | - William F. Fagan
- Department of BiologyUniversity of MarylandCollege ParkMD20742U.S.A.
| | - Thomas Mueller
- Senckenberg Biodiversity and Climate Research CentreSenckenberg Gesellschaft für NaturforschungSenckenberganlage 25Frankfurt (Main)60325Germany
- Department of Biological SciencesGoethe UniversityMax‐von‐Laue‐Straße 9Frankfurt (Main)60438Germany
| | - Justin M. Calabrese
- Smithsonian Conservation Biology InstituteNational Zoological Park1500 Remount RoadFront RoyalVA22630U.S.A.
- Department of BiologyUniversity of MarylandCollege ParkMD20742U.S.A.
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Zhai HX, Cowieson AJ, Lehmann M, Wilson JW. Research Note: Delay in sampling influences the profile of phytate in gizzard digesta and ileal digestibility of phosphorus in broilers. Poult Sci 2020; 99:5065-5069. [PMID: 32988543 PMCID: PMC7598329 DOI: 10.1016/j.psj.2020.06.049] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/30/2020] [Accepted: 06/13/2020] [Indexed: 11/19/2022] Open
Abstract
The objective of this study was to investigate the effect of different durations of time delay when sampling digesta from the gizzard and ileum of broilers on the degradation of myo-inositol hexakisphosphate (InsP6) and digestibility of phosphorus (P). There was 1 experimental diet with a supplemental phytase activity of 1,212 phytase units/kg feed, which was provided to birds from day 13 to 18 after hatching. The diet was formulated to provide 6.6 g/kg Ca and 1.9 g/kg nonphytate P and fed to 24 cages of 6 birds. The 24 cages of birds were further randomly divided into 6 subgroups of 4 cages from which the digesta samples in the gizzard and ileum were collected at 0, 5, 10, or 20 min postmortem. The results showed that the concentration of InsP6 decreased linearly (P = 0.002), InsP5 decreased quadratically (P = 0.038), and the summation of concentrations of P in InsP6-4 decreased linearly (P = 0.028) in the gizzard digesta with the increasing delay of sampling. In the ileum, the digestibility of phytate P tended to decrease linearly (P = 0.087), and the digestibility of total P decreased linearly (P = 0.026) with prolonged delay. In conclusion, delay in sampling could alter the measured profile of InsP esters in gizzard digesta probably because of a continued effect of supplemental phytase, while the ileal digestibility of total P could diminish. Therefore, standard sampling procedures should be implemented to minimize variance.
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Affiliation(s)
- H X Zhai
- DSM (China) Animal Nutrition Research Center Co., Ltd, Bazhou, P. R. China.
| | - A J Cowieson
- DSM Nutritional Products Ltd, Kaiseraugst, Switzerland
| | - M Lehmann
- DSM Nutritional Products Ltd, Kaiseraugst, Switzerland
| | - J W Wilson
- DSM Nutritional Products Ltd, Kaiseraugst, Switzerland
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23
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Stewart JD, Shakya KM, Bilinski T, Wilson JW, Ravi S, Choi CS. Variation of near surface atmosphere microbial communities at an urban and a suburban site in Philadelphia, PA, USA. Sci Total Environ 2020; 724:138353. [PMID: 32408469 DOI: 10.1016/j.scitotenv.2020.138353] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 02/02/2020] [Revised: 03/28/2020] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
Microorganisms are abundant in the near surface atmosphere and make up a significant fraction of organic aerosols with implications on both human health and ecosystem services. Despite their importance, studies investigating biogeographical patterns of the atmospheric microbiome between urban and suburban areas are limited. Urban and suburban locations (including their microbial communities) vary considerably depending on climate, topography, industrial activities, demographics and other socio-economic factors. Hence, we need more location-specific data to make informed decision affecting air quality, human health, and the implication of a changing climate and policy decisions. The objective of this study was to describe how the atmospheric microbiome varies in composition and function between urban and suburban sites. We used high-throughput sequencing to analyze microbial communities collected at different times from PM2.5 samples collected by active sampling method (using a pump and an impactor) and dust settling of TSP collected by passive sampling method (no pump and no impactor) from an urban and suburban site. We found diverse communities unique in composition at both sites with equivalent functional potential. Taxonomic composition varied significantly with Proteobacteria, Firmicutes, Actinobacteria, Bacteroidetes, and Other phyla in greater relative abundance at the urban site. In contrast, Cyanobacteria, Tenericutes, Fusobacteria, and Deinococcus, were enriched at the suburban site. Community diversity also demonstrated a high degree of temporal variation within site. We identified over one-third of the communities as potentially pathogenic taxa (urban: 47.52% ± 14.40%, suburban: 34.53% ± 14.60%) and determined the majority of organisms come from animal-associated host or are environmental non-specific. Potentially pathogenic taxa and source environments were similar between active- and passive- sampling method results. Our research is novel it adds to the underrepresented set of studies on atmospheric microbial structure and function across land types and is the first to compare suburban and urban atmospheric communities.
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Affiliation(s)
- J D Stewart
- Department of Geography & the Environment, Villanova University, PA, USA
| | - K M Shakya
- Department of Geography & the Environment, Villanova University, PA, USA.
| | - T Bilinski
- Department of Ecology and Evolutionary Biology, University of Colorado, Boulder, CO, USA
| | - J W Wilson
- Department of Biology, Villanova University, PA, USA
| | - S Ravi
- Department of Earth & Environmental Science, Temple University, PA, USA
| | - Chong Seok Choi
- Department of Earth & Environmental Science, Temple University, PA, USA
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Razonable RR, Pennington KM, Meehan AM, Wilson JW, Froemming AT, Bennett CE, Marshall AL, Virk A, Carmona EM. A Collaborative Multidisciplinary Approach to the Management of Coronavirus Disease 2019 in the Hospital Setting. Mayo Clin Proc 2020; 95:1467-1481. [PMID: 32622450 PMCID: PMC7260518 DOI: 10.1016/j.mayocp.2020.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/09/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023]
Abstract
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which presents an unprecedented challenge to medical providers worldwide. Although most SARS-CoV-2-infected individuals manifest with a self-limited mild disease that resolves with supportive care in the outpatient setting, patients with moderate to severe COVID-19 will require a multidisciplinary collaborative management approach for optimal care in the hospital setting. Laboratory and radiologic studies provide critical information on disease severity, management options, and overall prognosis. Medical management is mostly supportive with antipyretics, hydration, oxygen supplementation, and other measures as dictated by clinical need. Among its medical complications is a characteristic proinflammatory cytokine storm often associated with end-organ dysfunction, including respiratory failure, liver and renal insufficiency, cardiac injury, and coagulopathy. Specific recommendations for the management of these medical complications are discussed. Despite the issuance of emergency use authorization for remdesivir, there are still no proven effective antiviral and immunomodulatory therapies, and their use in COVID-19 management should be guided by clinical trial protocols or treatment registries. The medical care of patients with COVID-19 extends beyond their hospitalization. Postdischarge follow-up and monitoring should be performed, preferably using telemedicine, until the patients have fully recovered from their illness and are released from home quarantine protocols.
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Key Words
- agp, aerosol-generating procedure
- aki, acute kidney injury
- alt, alanine aminotransferase
- ards, acute respiratory distress syndrome
- ast, aspartate aminotransferase
- cbc, complete blood cell
- cdc, centers for disease control and prevention
- covid-19, coronavirus disease 2019
- crp, c-reactive protein
- ct, computed tomography
- ecg, electrocardiogram
- esr, erythrocyte sedimentation rate
- fda, food and drug administration
- ggo, ground-glass opacity
- hrct, high-resolution computed tomography
- icu, intensive care unit
- il, interleukin
- ldh, lactate dehydrogenase
- lft, liver function test
- pcr, polymerase chain reaction
- rsv, respiratory syncytial virus
- sars-cov-2, severe acute respiratory syndrome coronavirus 2
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Affiliation(s)
| | - Kelly M Pennington
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Anne M Meehan
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN
| | - John W Wilson
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN
| | | | | | | | - Abinash Virk
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN
| | - Eva M Carmona
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
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Rotter J, Graffeo CS, Perry A, Gilder HE, Wilson JW, Link MJ. Polymicrobial Intracerebral Abscess Growing Mycobacterium avium Complex and Achromobacter xylosoxidans: Case Report and Literature Review. World Neurosurg 2020; 141:441-447.e1. [PMID: 32525087 DOI: 10.1016/j.wneu.2020.05.283] [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: 04/30/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Mycobacterium avium complex (MAC) and Achromobacter xylosoxidans (AX) are uncommon sources of neurosurgical infections, particularly in immunocompetent hosts. We report the first published case of intracranial AX abscess and polymicrobial AX-MAC abscess, as well as the fourth MAC abscess in a non-immunocompromised patient. METHODS This case report was conducted via retrospective chart review. A literature review was completed in compliance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. RESULTS Ten years following mucocele resection, a 60-year-old man presented with sinus congestion and headache. Head imaging revealed a left frontal lesion abutting the cribriform plate and ethmoid roof. The patient had a left frontal craniotomy for abscess drainage. Intraoperative cultures demonstrated polymicrobial growth of AX and MAC, managed with antimicrobial therapy and staged skull base reconstruction. Three cases of MAC abscess and 16 cases of AX ventriculitis or meningitis have been reported in immunocompetent patients. All MAC cerebral abscesses occurred in adults, one of whom succumbed to the infection. Of the 9 AX meningitis cases, 4 occurred in neonates and 2 in pediatric patients. Six of the 7 AX ventriculitis cases occurred after neurosurgical operations at the same hospital from contaminated chlorhexidine basins. Except for the neonates, AX ventriculitis or meningitis patients had undergone neurosurgery or had a history of cranial trauma. There were no reports of polymicrobial AX-MAC intracranial abscess. CONCLUSIONS AX and MAC are rare causes of intracranial infection. Patients with these pathogens identified in the central nervous system require a multidisciplinary approach for successful management.
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Affiliation(s)
- Juliana Rotter
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Avital Perry
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Hannah E Gilder
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - John W Wilson
- Division of Infectious Disease, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael J Link
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
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Castillo Almeida N, Gurram P, Hwang SR, Benanni NN, Barreto J, Tosh P, Wilson JW. Prevalence and outcomes of pneumocystis pneumonia in patients with T-cell lymphoma. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e20057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20057 Background: T-cell lymphomas (TCL) are a heterogeneous group of rare, but aggressive non-Hodgkin lymphomas. CD4+ and CD8+ T-cell function plays a vital role in the immunologic response to P.jirovecii infection. Our study aims to define the prevalence of Pneumocystis jirovecii pneumonia (PJP) in HIV-uninfected TCL patients. Methods: All patients at Mayo Clinic, Rochester MN diagnosed with TCL and a positive Pneumocystis PCR assay from either bronchoalveolar lavage (BAL) fluid or other respiratory specimens were identified from March 2005 until November 2019. Patients with TCL and a diagnosis of PJP made outside of our medical center were identified through Advanced Cohort Explorer, a query building tool. Results: A total of 922 patients with TCL were identified, and only 14 cases (1.5%) had confirmed PJP. In confirmed PJP cases, the median age of TCL diagnosis was 62 years (IQR 51-70 years), 79% were male, and the median number of chemotherapy lines was 1.5 (IQR of 1-3). Half of the cases (6/12) received CHOP as first-line of therapy, followed by CHOEP (25%, 3/12). The median time to PJP diagnosis relative to chemotherapy was 18 days (IQR 14-27 days). Peripheral TCL, not otherwise specified was the most common TCL, followed by angioimmunoblastic TCL, and CD30+ T-cell lymphoproliferative disorders (64%, 29% and 7%, respectively). The primary specimen type sampled for PJP diagnosis was BAL fluid (n = 9, 64%), followed by sputum (n = 3, 22%), induced sputum (n = 1, 7%), and transbronchial lung biopsy (n = 1, 7%). Three patients had a prior autologous stem cell transplant (ASCT), and all three cases had relapsed TCL one year after ASCT. 77% of cases received oral prednisone equivalents (median dose of 25 mg, IQR 20-40 mg) 30 days prior to PJP diagnosis. Two patients developed PJP despite anti- Pneumocystis prophylaxis with aerosolized pentamidine. At the time of PJP diagnosis, most patients had lymphopenia (88%, 8/9), and CD4+ T-cells measurement was obtained only in one patient (CD4+ of 100 cells/mL). 71% of the cases were treated with trimethoprim/sulfamethoxazole (TMP/SMX). After the initial PJP episode, 36% of the cases were transitioned to TMP/SMX for secondary prophylaxis. All cause 30-day and 90-day mortality was 7% and 29%, respectively. Mortality attributed to PJP was 7% (n = 1). Conclusions: In our TCL cohort, the occurrence of PJP was low. Primary prophylaxis should be individualized in this population.
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Affiliation(s)
| | | | - Steven R Hwang
- Department of Internal Medicine, Mayo Clinic, Rochester, MN
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Babatunde OO, Cowieson AJ, Wilson JW, Adeola O. The impact of age and feeding length on phytase efficacy during the starter phase of broiler chickens. Poult Sci 2020; 98:6742-6750. [PMID: 31287893 PMCID: PMC8913947 DOI: 10.3382/ps/pez390] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 01/30/2019] [Accepted: 06/12/2019] [Indexed: 11/20/2022] Open
Abstract
Phytase is of importance to the poultry industry because of its ability to hydrolyze phytate and release phosphorus (P) for use by poultry. However, the effect of age on phytase efficacy is not fully understood. A total of 864 day-old broiler chicks were used to investigate the effect of age and feeding length on phytase efficacy using growth performance, mineral utilization, and tibia ash as response criteria of evaluation. The experiment was arranged as a 3 × 2 × 2 factorial in a randomized complete block design with 3 diets including; a positive control (PC; 0.4% non-phytate P (nPP)), a negative control (NC; 0.2% nPP) and a NC diet supplemented with phytase at 2,000 FYT/kg; 2 ages (i.e., days 14 and 22); and 2 feeding lengths (i.e., 2 and 5 D) with 8 replicates each. Birds fed the NC had decreased (P < 0.01) body weight gain and feed efficiency compared with birds fed the PC regardless of age or feeding length. Similarly, birds fed the phytase-supplemented diet had improved (P < 0.01) performance as compared to birds fed the NC regardless of age. There were no significant differences in P utilization between birds fed for 2 to 14 D or 22 D and birds fed for 5 D to both ages. However, phytase was more efficacious at day 14 than day 22 when mineral utilization was considered because the super dose of phytase elicited greater response in birds fed the phytase supplemented diet for 2 D until day 14. In contrast, percentage tibia ash improved (P < 0.01) in birds fed phytase supplemented diet for 5 D at both ages as compared with birds fed for 2 D. In conclusion, testing phytase products, even at high doses, for 2 D during the second week in the life cycle of broiler chicks, can be recommended from the results of this study.
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Affiliation(s)
- O O Babatunde
- Department of Animal Sciences, Purdue University, West Lafayette, IN 47907
| | - A J Cowieson
- DSM Nutritional Products, Wurmisweg 576, Kaiseraugst 4303, Switzerland
| | - J W Wilson
- DSM Nutritional Products, Wurmisweg 576, Kaiseraugst 4303, Switzerland
| | - O Adeola
- Department of Animal Sciences, Purdue University, West Lafayette, IN 47907
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Gobaud AN, Haley CA, Wilson JW, Bhavaraju R, Lardizabal A, Seaworth BJ, Goswami ND. Multidrug-resistant tuberculosis care in the United States. Int J Tuberc Lung Dis 2020; 24:409-413. [PMID: 32317065 DOI: 10.5588/ijtld.19.0515] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: To examine the utilization of the Tuberculosis (TB) Centers of Excellence (COE) medical consultation service and evaluate how these services were being employed for patients in relation to multidrug-resistant TB (MDR-TB).METHODS: Medical consults are documented in a secure database. The database was queried for MDR-TB consultations over the period 1 January 2013-31 December 2017. All were analyzed to assess provider type, center, setting, year of call, and type of patient (pediatric vs. adult). A subgroup was randomly selected for thematic analysis.RESULTS: The centers received 1560 MDR-TB consultation requests over this period. Providers requesting consults were primarily physicians (55%). The majority of requests were from public health departments (64%) and for adult patients (80%). Four major topic areas emerged: 1) initial management of MDR-TB, 2) MDR-TB longitudinal treatment and complications, 3) management of persons exposed to MDR-TB, and 4) MDR-TB treatment completion.CONCLUSIONS: Analysis of these consultations provides insight into the type of expert advice about MDR-TB that was provided. These findings highlight topics where increased medical training and education may help to improve MDR-TB-related practices.
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Affiliation(s)
- A N Gobaud
- Rollins School of Public Health, Emory University, Atlanta, GA
| | - C A Haley
- Southeastern National TB Center at University of Gainesville, Gainesville, FL
| | - J W Wilson
- Mayo Clinic Center for Tuberculosis, Rochester, MN
| | - R Bhavaraju
- Global TB Institute at Rutgers, The State University of New Jersey, Newark, NJ
| | - A Lardizabal
- Global TB Institute at Rutgers, The State University of New Jersey, Newark, NJ
| | - B J Seaworth
- Heartland National Tuberculosis Center and University of Texas Health Science Center, Tyler, TX
| | - N D Goswami
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Nahid P, Mase SR, Migliori GB, Sotgiu G, Bothamley GH, Brozek JL, Cattamanchi A, Cegielski JP, Chen L, Daley CL, Dalton TL, Duarte R, Fregonese F, Horsburgh CR, Ahmad Khan F, Kheir F, Lan Z, Lardizabal A, Lauzardo M, Mangan JM, Marks SM, McKenna L, Menzies D, Mitnick CD, Nilsen DM, Parvez F, Peloquin CA, Raftery A, Schaaf HS, Shah NS, Starke JR, Wilson JW, Wortham JM, Chorba T, Seaworth B. Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline. Am J Respir Crit Care Med 2020; 200:e93-e142. [PMID: 31729908 PMCID: PMC6857485 DOI: 10.1164/rccm.201909-1874st] [Citation(s) in RCA: 230] [Impact Index Per Article: 57.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: The American Thoracic Society, U.S. Centers for Disease Control and Prevention, European Respiratory Society, and Infectious Diseases Society of America jointly sponsored this new practice guideline on the treatment of drug-resistant tuberculosis (DR-TB). The document includes recommendations on the treatment of multidrug-resistant TB (MDR-TB) as well as isoniazid-resistant but rifampin-susceptible TB.Methods: Published systematic reviews, meta-analyses, and a new individual patient data meta-analysis from 12,030 patients, in 50 studies, across 25 countries with confirmed pulmonary rifampin-resistant TB were used for this guideline. Meta-analytic approaches included propensity score matching to reduce confounding. Each recommendation was discussed by an expert committee, screened for conflicts of interest, according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.Results: Twenty-one Population, Intervention, Comparator, and Outcomes questions were addressed, generating 25 GRADE-based recommendations. Certainty in the evidence was judged to be very low, because the data came from observational studies with significant loss to follow-up and imbalance in background regimens between comparator groups. Good practices in the management of MDR-TB are described. On the basis of the evidence review, a clinical strategy tool for building a treatment regimen for MDR-TB is also provided.Conclusions: New recommendations are made for the choice and number of drugs in a regimen, the duration of intensive and continuation phases, and the role of injectable drugs for MDR-TB. On the basis of these recommendations, an effective all-oral regimen for MDR-TB can be assembled. Recommendations are also provided on the role of surgery in treatment of MDR-TB and for treatment of contacts exposed to MDR-TB and treatment of isoniazid-resistant TB.
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Asp AJ, Webber CM, Nicolai EN, Martínez-Gálvez G, Marks VS, Ben-Abraham EI, Wilson JW, Lujan JL. A Low-Cost Humidity Control System to Protect Microscopes in a Tropical Climate. Ann Glob Health 2020; 86:16. [PMID: 32090023 PMCID: PMC7019200 DOI: 10.5334/aogh.2585] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction A clean and functional microscope is necessary for accurate diagnosis of infectious diseases. In tropical climates, high humidity levels and improper storage conditions allow for the accumulation of debris and fungus on the optical components of diagnostic equipment, such as microscopes. Objective Our objective was to develop and implement a low-cost, sustainable, easy to manage, low-maintenance, passive humidity control chamber to both reduce debris accumulation and microbial growth onto the optical components of microscopes. Methods Constructed from easily-sourced and locally available materials, the cost of each humidity control chamber is approximately $2.35 USD. Relative humidity levels were recorded every 30 minutes over a period of 10 weeks from two chambers deployed at the Belize Vector and Ecology Center and the University of Belize. Results The humidity control chamber deployed at the University of Belize maintained internal relative humidity at an average of 35.3% (SD = 4.2%) over 10 weeks, while the average external relative humidity was 86.4% (SD = 12.4%). The humidity control chamber deployed at the Belize Vector and Ecology Center effectively maintained internal relative humidity to an average of 54.5% (SD = 9.4%) over 10 weeks, while the average external relative humidity was 86.9% (SD = 12.9%). Conclusions Control of relative humidity is paramount for the sustainability of medical equipment in tropical climates. The humidity control chambers reduced relative humidity to levels that were not conducive for fungal growth while reducing microscope contamination from external sources. This will likely extend the service life of the microscopes while taking advantage of low-cost, locally sourced components.
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Affiliation(s)
- Anders J. Asp
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota, US
| | - Christina M. Webber
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota, US
| | - Evan N. Nicolai
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota, US
| | | | - Victoria S. Marks
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota, US
| | - Ephraim I. Ben-Abraham
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, Minnesota, US
| | - John W. Wilson
- Department of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, US
| | - J. Luis Lujan
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, US
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, US
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Wilson JW, Nilsen DM, Marks SM. Multidrug-Resistant Tuberculosis in Patients with Human Immunodeficiency Virus. Management Considerations within High-resourced Settings. Ann Am Thorac Soc 2020; 17:16-23. [PMID: 31365831 PMCID: PMC6938532 DOI: 10.1513/annalsats.201902-185cme] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 02/27/2019] [Accepted: 07/30/2019] [Indexed: 12/15/2022] Open
Abstract
The management of multidrug-resistant tuberculosis (MDR TB) is notably complex among patients with human immunodeficiency virus (HIV). TB treatment recommendations typically include very little information specific to HIV and MDR TB, which often is derived from clinical trials conducted in low-resource settings. Mortality rates among patients with HIV and MDR TB remain high. We reviewed the published literature and recommendations to synthesize possible patient management approaches demonstrated to improve treatment outcomes in high-resourced countries for patients with MDR TB and HIV. Approaches to diagnostic testing, impact and timing of antiretroviral therapy on mortality, anti-MDR TB and antiretroviral drug interactions, and the potential role for short-course MDR TB therapy are examined. The combination of antiretroviral therapy with expanded TB drug therapy, along with the management of immune reconstitution inflammatory syndrome, other potential HIV-associated opportunistic diseases, and drug toxicities, necessitate an integrated multidisciplinary patient care approach using public health case management and provider expertise in drug-resistant TB and HIV management.
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Affiliation(s)
- John W. Wilson
- Division of Infectious Diseases, Mayo Clinic, 200 First Street, SW, Rochester MN 55905, Tel (507) 255-0596, Fax (507255-7767
| | - Diana M. Nilsen
- Bureau of TB Control, New York City Department of Health & Mental Hygiene, Gotham Center, CN#72B, 42-09 28th Street, Queens, NY 11101-4132
| | - Suzanne M. Marks
- Data Management, Statistics, and Evaluation Branch, Division of Tuberculosis Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Mailstop MS12-4, 1600 Clifton Road, NE, Atlanta, GA 30333
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Zhao Y, Seelhammer TG, Barreto EF, Wilson JW. Altered Pharmacokinetics and Dosing of Liposomal Amphotericin B and Isavuconazole during Extracorporeal Membrane Oxygenation. Pharmacotherapy 2019; 40:89-95. [PMID: 31742741 DOI: 10.1002/phar.2348] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Drug pharmacokinetics may be significantly altered in patients receiving extracorporeal membrane oxygenation (ECMO). Ensuring the optimized effective dosing of antimicrobials on ECMO remains a challenge. To date, limited data are available regarding the optimal use of amphotericin and triazoles during ECMO. We report a case of altered pharmacokinetics, insufficient liposomal amphotericin B and isavuconazole levels, and the need for escalated doses during ECMO in a patient with severe acute respiratory distress syndrome secondary to pulmonary blastomycosis. A 2-fold increase in the standard total daily dose of both drugs was necessary to overcome low serum concentrations thought to be secondary to drug loss from ECMO circuit sequestration. These findings have important implications for optimizing antimicrobial therapy in patients receiving ECMO to maximize therapeutic efficacy. The use of therapeutic drug monitoring for patients receiving antimicrobial therapy with concurrent ECMO may facilitate appropriate drug dosing to achieve adequate serum concentrations and optimize favorable patient outcomes. Further studies exploring antimicrobial pharmacokinetics during ECMO are needed to inform dosing recommendations in critically ill patients.
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Affiliation(s)
- Yanjun Zhao
- Department of Pharmacy, Mayo Clinic, Rochester, Minnesota
| | - Troy G Seelhammer
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Erin F Barreto
- Department of Pharmacy, Mayo Clinic, Rochester, Minnesota.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
| | - John W Wilson
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota
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Allen-Graham J, Mitchell L, Heriot N, Armani R, Langton D, Levinson M, Young A, Smith JA, Kotsimbos T, Wilson JW. Electronic health records and online medical records: an asset or a liability under current conditions? AUST HEALTH REV 2019; 42:59-65. [PMID: 28104042 DOI: 10.1071/ah16095] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 11/13/2016] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information. Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital's current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary. Results Of all medical records audited, 82% contained medical and surgical history, allergy information and patient demographics. All audited discharge summaries lacked at least one of the following: demographics, medication allergies, medical and surgical history, medications and adverse drug event information. Only 49% of records audited showed evidence the discharge summary was sent outside the institution. Conclusions The quality of medical data captured and information management is variable across hospitals. It is recommended that medical history documentation guidelines and standardised discharge summaries be implemented in Australian healthcare services. What is known about this topic? Australia has a complex health system, the government has approved funding to develop a universal online electronic medical record system and is currently trialling this in an opt-out style in the Napean Blue Mountains (NSW) and in Northern Queensland. The system was originally named the personally controlled electronic health record but has since been changed to MyHealth Record (2016). In Victoria, there exists a wide range of electronic health records used to varying degrees, with some hospitals still relying on paper-based records and many using scanned medical records. This causes inefficiencies in the recall of patient information and can potentially lead to incidences of adverse drug events. What does this paper add? This paper supports the concept of a shared medical record system using 200 audited patient records across five Victorian metropolitan hospitals, comparing the current information systems in place for healthcare practitioners to retrieve data. This research identifies the degree of concordance between these sources of information and in doing so, areas for improvement. What are the implications for practitioners? Implications of this research are the improvements in the quality, storage and accessibility of medical data in Australian healthcare systems. This is a relevant issue in the current Australian environment where no guidelines exist across the board in medical history documentation or in the distribution of discharge summaries to other healthcare providers (general practitioners, etc).
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Affiliation(s)
- Judith Allen-Graham
- Monash University, Wellington Road and Blackburn Road, Clayton, Vic. 3800, Australia. ;
| | - Lauren Mitchell
- The Alfred Hospital, 55 Commercial Road, Melbourne, Vic. 3004, Australia.
| | - Natalie Heriot
- Monash University, Wellington Road and Blackburn Road, Clayton, Vic. 3800, Australia. ;
| | - Roksana Armani
- Monash University, Wellington Road and Blackburn Road, Clayton, Vic. 3800, Australia. ;
| | - David Langton
- Monash University, Wellington Road and Blackburn Road, Clayton, Vic. 3800, Australia. ;
| | - Michele Levinson
- Monash University, Wellington Road and Blackburn Road, Clayton, Vic. 3800, Australia. ;
| | - Alan Young
- Monash University, Wellington Road and Blackburn Road, Clayton, Vic. 3800, Australia. ;
| | - Julian A Smith
- Monash University, Wellington Road and Blackburn Road, Clayton, Vic. 3800, Australia. ;
| | - Tom Kotsimbos
- Monash University, Wellington Road and Blackburn Road, Clayton, Vic. 3800, Australia. ;
| | - John W Wilson
- Monash University, Wellington Road and Blackburn Road, Clayton, Vic. 3800, Australia. ;
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Norbury JW, Slaba TC, Aghara S, Badavi FF, Blattnig SR, Clowdsley MS, Heilbronn LH, Lee K, Maung KM, Mertens CJ, Miller J, Norman RB, Sandridge CA, Singleterry R, Sobolevsky N, Spangler JL, Townsend LW, Werneth CM, Whitman K, Wilson JW, Xu SX, Zeitlin C. Advances in space radiation physics and transport at NASA. Life Sci Space Res (Amst) 2019; 22:98-124. [PMID: 31421854 DOI: 10.1016/j.lssr.2019.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 04/27/2019] [Revised: 06/20/2019] [Accepted: 07/03/2019] [Indexed: 06/10/2023]
Abstract
The space radiation environment is a complex mixture of particle types and energies originating from sources inside and outside of the galaxy. These environments may be modified by the heliospheric and geomagnetic conditions as well as planetary bodies and vehicle or habitat mass shielding. In low Earth orbit (LEO), the geomagnetic field deflects a portion of the galactic cosmic rays (GCR) and all but the most intense solar particle events (SPE). There are also dynamic belts of trapped electrons and protons with low to medium energy and intense particle count rates. In deep space, the GCR exposure is more severe than in LEO and varies inversely with solar activity. Unpredictable solar storms also present an acute risk to astronauts if adequate shielding is not provided. Near planetary surfaces such as the Earth, moon or Mars, secondary particles are produced when the ambient deep space radiation environment interacts with these surfaces and/or atmospheres. These secondary particles further complicate the local radiation environment and modify the associated health risks. Characterizing the radiation fields in this vast array of scenarios and environments is a challenging task and is currently accomplished with a combination of computational models and dosimetry. The computational tools include models for the ambient space radiation environment, mass shielding geometry, and atomic and nuclear interaction parameters. These models are then coupled to a radiation transport code to describe the radiation field at the location of interest within a vehicle or habitat. Many new advances in these models have been made in the last decade, and the present review article focuses on the progress and contributions made by workers and collaborators at NASA Langley Research Center in the same time frame. Although great progress has been made, and models continue to improve, significant gaps remain and are discussed in the context of planned future missions. Of particular interest is the juxtaposition of various review committee findings regarding the accuracy and gaps of combined space radiation environment, physics, and transport models with the progress achieved over the past decade. While current models are now fully capable of characterizing radiation environments in the broad range of forecasted mission scenarios, it should be remembered that uncertainties still remain and need to be addressed.
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Affiliation(s)
- John W Norbury
- NASA Langley Research Center, Hampton, Virginia 23681, USA.
| | - Tony C Slaba
- NASA Langley Research Center, Hampton, Virginia 23681, USA
| | - Sukesh Aghara
- University of Massachusetts, Lowell, Massachusetts 01854, USA
| | | | | | | | | | - Kerry Lee
- NASA Johnson Space Center, Houston, Texas 77058, USA
| | - Khin M Maung
- University of Southern Mississippi, Hattiesburg, Mississippi 39406, USA
| | | | - Jack Miller
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - Ryan B Norman
- NASA Langley Research Center, Hampton, Virginia 23681, USA
| | | | | | - Nikolai Sobolevsky
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - Jan L Spangler
- Science and Technology Corporation, Hampton, Virginia 23666, USA
| | | | | | | | - John W Wilson
- Old Dominion University, Norfolk, Virginia 23529, USA
| | | | - Cary Zeitlin
- Leidos Innovations Corporation, Houston, Texas 77058, USA
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Shulha JA, Escalante P, Wilson JW. Pharmacotherapy Approaches in Nontuberculous Mycobacteria Infections. Mayo Clin Proc 2019; 94:1567-1581. [PMID: 31160063 DOI: 10.1016/j.mayocp.2018.12.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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] [Received: 09/06/2018] [Revised: 11/16/2018] [Accepted: 12/14/2018] [Indexed: 01/29/2023]
Abstract
Nontuberculous mycobacteria (NTM) comprise a heterogeneous group of organisms, with only a small subset known to cause disease in humans. Although NTM infection is not a reportable disease, both the increasing clinical recognition and recent advancements in laboratory diagnostic capabilities of NTM infections in immunocompromised and immunocompetent patients are rapidly evolving. We reviewed antimicrobial agents used to treat the most frequently encountered NTM infections and examined optimized drug dosing strategies, toxicity profiles, drug-drug interactions, and the role of therapeutic drug monitoring. Antimicrobial susceptibility testing and patient monitoring on therapy were also examined. We used PubMed to review the published literature on the management of select NTM pathogens, the common syndromes encountered since 2000, and select pharmacokinetic principles of select antimicrobial agents used since 1990. We included select clinical trials, systematic reviews, published guidelines, and observational studies when applicable. The prolonged duration and the necessity for combination therapy for most forms of NTM disease can be problematic for many patients. A multidisciplinary care team that includes pharmacy engagement may help increase rates of optimal patient tolerability and successful treatment completion.
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Affiliation(s)
| | - Patricio Escalante
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN
| | - John W Wilson
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN
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O'Horo JC, Marcelin JR, Abu Saleh OM, Barwise AK, Odean PM, Rivera CG, Tande AJ, Wilson JW, Osmon DR, Tosh PK. Standardizing Febrile Neutropenia Management: Antimicrobial Stewardship in the Hematologic Malignancy Population. J Oncol Pract 2019; 15:e843-e848. [PMID: 31322989 DOI: 10.1200/jop.18.00775] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Patients with febrile neutropenia (FN) often are subject to antibiotic and diagnostic test overuse. We sought to improve appropriate use of antimicrobials and diagnostic tests for patients with FN. We used a blended quality approach with Lean Six Sigma tools and iterative improvement of a clinical decision aid to guide providers through empirical antimicrobial selection and diagnostic evaluation of patients with FN during a yearlong period. We evaluated the incidence of nonadherence to best practice before, during, and after rollout of a clinical decision aid in conjunction with an educational initiative. At baseline, 71% of patients with FN had at least one critical deviation from best practice. During the project, the percentage decreased to 27.3%; 4 months after the project was completed, the percentage was 33.3% (P = .04). A clinical decision aid can improve adherence to best practices for the empirical management of FN.
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Affiliation(s)
- John C O'Horo
- Mayo Clinic, Rochester, MN.,Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC) Group, Mayo Clinic, Rochester, MN
| | | | | | - Amelia K Barwise
- Mayo Clinic, Rochester, MN.,Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC) Group, Mayo Clinic, Rochester, MN
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Babatunde OO, Cowieson AJ, Wilson JW, Adeola O. Influence of age and duration of feeding low-phosphorus diet on phytase efficacy in broiler chickens during the starter phase. Poult Sci 2019; 98:2588-2597. [PMID: 30753622 DOI: 10.3382/ps/pez014] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 06/23/2018] [Accepted: 01/29/2019] [Indexed: 11/20/2022] Open
Abstract
A total of 1,408 male broiler chickens were used to evaluate the impact of age and duration of feeding low-phosphorus (P) diet on the efficacy of phytase using growth performance, nutrient utilization, tibia ash, and plasma indices. Diets were formulated with 2 non-phytate P (nPP) concentrations (i.e., 0.20 and 0.40%) and 2 phytase concentrations (i.e., 1,000 and 2,000 FTU/kg) added to the 0.20% nPP diet. Four dietary treatments with 8 replicate cages each were fed to broiler chicks at different ages and for different duration. Specifically, these were days 6 to 8 (12 birds per replicate), 12 to 14, 9 to 14, 20 to 22, or 6 to 22 (8 birds per replicate). Parameters were measured on the last day of each period. Duration of feeding effect was examined by comparing responses of birds fed for 2 or 5 D at day 14 and for 2 or 16 D at day 22; age effect was determined by comparing responses of birds fed for 2 D at age 8, 14 and 22 D post-hatching. Body weight gain and gain-to-feed ratio were increased (P < 0.01) in birds fed diets supplemented with phytase; however, an increase in duration of feeding improved (P < 0.01) feed efficiency with birds fed for 16 D performing better than birds fed for 2 D at day 22. In addition, phytase supplementation improved (P < 0.01) apparent P and calcium digestibility and retention, but the age effect on phytase efficacy was more apparent at day 14 and the duration of feeding effect was evident in birds fed for 2 D due to the increased levels of mineral utilization at that age/duration of feeding as compared with the other groups. The results of this study show that phytase efficacy was at optimum in birds fed low-P diet for 2 D at day 14. This period can be recommended for further bioefficacy studies of phytase.
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Affiliation(s)
- O O Babatunde
- Department of Animal Sciences, Purdue University, West Lafayette, IN 47907
| | - A J Cowieson
- DSM Nutritional Products, Wurmisweg 576, Kaiseraugst 4303, Switzerland
| | - J W Wilson
- DSM Nutritional Products, Wurmisweg 576, Kaiseraugst 4303, Switzerland
| | - O Adeola
- Department of Animal Sciences, Purdue University, West Lafayette, IN 47907
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Abstract
Introduction: Mycobacterium scrofulaceum infection has been identified in cases of paediatric cervical lymphadenitis but is less well defined in adults. To further characterize manifestations of M. scrofulaceum disease and treatment approaches, we reviewed our medical centre's experience and other published reports. Methods: We performed a retrospective chart review of patients at our medical centre with a positive M. scrofulaceum culture over a 15-year period. We compare our findings with those published in the literature to identify commonalities in disease presentations and treatment outcomes. Results: We identified 17 patients in our centre with positive M. scrofulaceum cultures, 10 of whom were diagnosed with clinical infection. The types of disease encountered included pulmonary and pleural infection (4), bone and joint infections with a foreign body (2), skin and soft tissue infection (2), brain abscess (1) and paediatric cervical adenitis (1). Structural lung disease was a common finding in cases of pulmonary infection. All adult patients except those with bone and joint infections had some type of immunomodulatory condition and/or structural lung disease. In seven patients, M. scrofulaceum was isolated in urinary or respiratory cultures without signs of clinical disease. Conclusion: M. scrofulaceum is a rare cause of non-tuberculosis mycobacterial infection in humans but can infect any tissue. Adults with pulmonary disease often have underlying structural lung disease, and those with extrapulmonary disease commonly have immunosuppressive conditions or foreign body-associated infections. Treatment outcomes are generally favourable; however, in patients with pulmonary M. scrofulaceum disease prognosis is more guarded.
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Affiliation(s)
- John W Wilson
- a Division of Infectious Diseases , Mayo Clinic , Rochester , MN , USA
| | - Anil C Jagtiani
- b Division of Infectious Diseases , Kaiser Permanente, Fontana Medical Center , Fontana , CA , USA
| | - Nancy L Wengenack
- c Division of Clinical Microbiology , Mayo Clinic , Rochester , MN , USA
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Losonczy LI, Williams S, Papali A, Costantino CA, Colas LN, Patel BM, Zimmer DF, Olwine SR, Davidson Z, Wilson JW, McCurdy MT, Augustin ME, Nielsen ND. Haiti Acute and Emergency Care Conference: descriptive analysis of an acute care continuing medical education program. Journal of Global Health Reports 2019. [DOI: 10.29392/joghr.3.e2019012] [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: 11/08/2022] Open
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Abstract
BACKGROUND Valvular involvement as a manifestation of Lyme carditis is rare. The first case describing a possible association between Lyme disease and cardiac valvular disease in the United States was published in 1993. Since that time there have been 2 cases of Lyme endocarditis confirmed by Borrelia-positive 16S ribosomal RNA polymerase chain reaction and sequencing from valvular tissue and reported from Europe. Here we describe a case of Lyme endocarditis that, to our knowledge, is the first reported case confirmed by molecular diagnostics in the United States. METHODS We present the case of a 68-year-old man with progressive dyspnea who had mitral valve perforation with severe mitral valve insufficiency seen on transesophageal echocardiogram. RESULTS Subsequently resected valve tissue had signs of acute inflammation without organisms seen. Although blood and valve tissue cultures were negative, 16S ribosomal RNA polymerase chain reaction and sequencing demonstrated Borrelia burgdorferi. CONCLUSION Lyme endocarditis can be a challenging diagnosis to confirm, given the rarity of cases and the need for molecular tools of resected valve tissue. It should be included among diagnostic possibilities in patients with culture-negative endocarditis who have exposure to ticks in endemic and emerging areas of Lyme disease.
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Affiliation(s)
- Ana C Paim
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minn.
| | - Larry M Baddour
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minn
| | - Bobbi S Pritt
- Division of Clinical Microbiology, Mayo Clinic, Rochester, Minn
| | | | - John W Wilson
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minn
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Pallin M, Keating D, Kaye DM, Kotsimbos T, Wilson JW. Subclinical Left Ventricular Dysfunction is Influenced by Genotype Severity in Patients with Cystic Fibrosis. Clin Med Insights Circ Respir Pulm Med 2018; 12:1179548418794154. [PMID: 30147387 PMCID: PMC6102756 DOI: 10.1177/1179548418794154] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 07/20/2018] [Indexed: 01/05/2023]
Abstract
Background and objective: Over 2000 genotypes in the cystic fibrosis (CF) gene have been described.
These genotypic differences result in variable clinical manifestations of
CF, with severity of disease dependent on CF transmembrane conductance
(CFTR) protein function. CFTR is widely distributed in nucleated cells,
including cardiac myocytes, but the effect of genotype on cardiac function
is not known. Methods: This retrospective review of echocardiographic data is from a single adult CF
centre between 2000 and 2015. Patients were cohorted based on the functional
classification of genotype. ‘Severe’ patients had both CF genes from
functional classification groups 1-3; ‘mild’ patients had one or no gene
from these groups, or in the event of the second gene being unknown were
pancreatic sufficient. Results: Genotype and echocardiography were recorded during the inclusion period in
100 patients, 79 of whom were classified as having severe genotypes.
Although the severe group were younger they had a lower fractional
shortening (33.66 ± 6.6 vs
36.9 ± 6.3, P < .05), left
atrial area (14.9 ± 3.6 versus 18.0 ± 4.2 cm2;
P < .01) and volume (39.9 ± 18.7 versus 51.0 ± 18.7 mL;
P < .05) and showed a trend to lower left
ventricular ejection fraction. Conclusions: This study is the first to show that in CF, severity of genotype (functional
classification) is associated with cardiac impairment. Patients with severe
CF genotype and cardiac dysfunction should be identified to evaluate cardiac
response to gene-modifying treatments prior to consideration for lung
transplantation.
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Affiliation(s)
- Michael Pallin
- Cystic Fibrosis Service, Alfred Health and Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Dominic Keating
- Cystic Fibrosis Service, Alfred Health and Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - David M Kaye
- Cardiovascular Medicine, Alfred Health and Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Tom Kotsimbos
- Cystic Fibrosis Service, Alfred Health and Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - John W Wilson
- Cystic Fibrosis Service, Alfred Health and Central Clinical School, Monash University, Melbourne, VIC, Australia
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42
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McCarter SJ, Vijayvargiya P, Sidana S, Nault AM, Lane CE, Lehman JS, Wilson JW, Parikh SA, Nowakowski GS, Al-Kali A. A case of ibrutinib-associated aspergillosis presenting with central nervous system, myocardial, pulmonary, intramuscular, and subcutaneous abscesses. Leuk Lymphoma 2018; 60:559-561. [PMID: 30070153 DOI: 10.1080/10428194.2018.1494271] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Stuart J McCarter
- a Department of Internal Medicine , Mayo Clinic , Rochester , MN , USA
| | | | - Surbhi Sidana
- c Division of Hematology , Mayo Clinic , Rochester , MN , USA
| | - Ashley M Nault
- d Department of Dermatology , Mayo Clinic , Rochester , MN , USA
| | - Colleen E Lane
- e Division of Cardiology , Mayo Clinic , Rochester , MN , USA
| | - Julia S Lehman
- d Department of Dermatology , Mayo Clinic , Rochester , MN , USA
| | - John W Wilson
- b Division of Infectious Disease , Mayo Clinic , Rochester , MN , USA
| | - Sameer A Parikh
- c Division of Hematology , Mayo Clinic , Rochester , MN , USA
| | | | - Aref Al-Kali
- c Division of Hematology , Mayo Clinic , Rochester , MN , USA
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43
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Tucker MA, Böhning-Gaese K, Fagan WF, Fryxell JM, Van Moorter B, Alberts SC, Ali AH, Allen AM, Attias N, Avgar T, Bartlam-Brooks H, Bayarbaatar B, Belant JL, Bertassoni A, Beyer D, Bidner L, van Beest FM, Blake S, Blaum N, Bracis C, Brown D, de Bruyn PJN, Cagnacci F, Calabrese JM, Camilo-Alves C, Chamaillé-Jammes S, Chiaradia A, Davidson SC, Dennis T, DeStefano S, Diefenbach D, Douglas-Hamilton I, Fennessy J, Fichtel C, Fiedler W, Fischer C, Fischhoff I, Fleming CH, Ford AT, Fritz SA, Gehr B, Goheen JR, Gurarie E, Hebblewhite M, Heurich M, Hewison AJM, Hof C, Hurme E, Isbell LA, Janssen R, Jeltsch F, Kaczensky P, Kane A, Kappeler PM, Kauffman M, Kays R, Kimuyu D, Koch F, Kranstauber B, LaPoint S, Leimgruber P, Linnell JDC, López-López P, Markham AC, Mattisson J, Medici EP, Mellone U, Merrill E, de Miranda Mourão G, Morato RG, Morellet N, Morrison TA, Díaz-Muñoz SL, Mysterud A, Nandintsetseg D, Nathan R, Niamir A, Odden J, O'Hara RB, Oliveira-Santos LGR, Olson KA, Patterson BD, Cunha de Paula R, Pedrotti L, Reineking B, Rimmler M, Rogers TL, Rolandsen CM, Rosenberry CS, Rubenstein DI, Safi K, Saïd S, Sapir N, Sawyer H, Schmidt NM, Selva N, Sergiel A, Shiilegdamba E, Silva JP, Singh N, Solberg EJ, Spiegel O, Strand O, Sundaresan S, Ullmann W, Voigt U, Wall J, Wattles D, Wikelski M, Wilmers CC, Wilson JW, Wittemyer G, Zięba F, Zwijacz-Kozica T, Mueller T. Moving in the Anthropocene: Global reductions in terrestrial mammalian movements. Science 2018; 359:466-469. [PMID: 29371471 DOI: 10.1126/science.aam9712] [Citation(s) in RCA: 481] [Impact Index Per Article: 80.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 12/11/2017] [Indexed: 11/02/2022]
Abstract
Animal movement is fundamental for ecosystem functioning and species survival, yet the effects of the anthropogenic footprint on animal movements have not been estimated across species. Using a unique GPS-tracking database of 803 individuals across 57 species, we found that movements of mammals in areas with a comparatively high human footprint were on average one-half to one-third the extent of their movements in areas with a low human footprint. We attribute this reduction to behavioral changes of individual animals and to the exclusion of species with long-range movements from areas with higher human impact. Global loss of vagility alters a key ecological trait of animals that affects not only population persistence but also ecosystem processes such as predator-prey interactions, nutrient cycling, and disease transmission.
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Affiliation(s)
- Marlee A Tucker
- Senckenberg Biodiversity and Climate Research Centre, Senckenberg Gesellschaft für Naturforschung, 60325 Frankfurt (Main), Germany. .,Department of Biological Sciences, Goethe University, 60438 Frankfurt (Main), Germany
| | - Katrin Böhning-Gaese
- Senckenberg Biodiversity and Climate Research Centre, Senckenberg Gesellschaft für Naturforschung, 60325 Frankfurt (Main), Germany.,Department of Biological Sciences, Goethe University, 60438 Frankfurt (Main), Germany
| | - William F Fagan
- Department of Biology, University of Maryland, College Park, MD 20742, USA.,SESYNC, University of Maryland, Annapolis, MD 21401, USA
| | - John M Fryxell
- Department of Integrative Biology, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - Bram Van Moorter
- Norwegian Institute for Nature Research, P.O. Box 5685 Torgard, NO-7485 Trondheim, Norway
| | - Susan C Alberts
- Departments of Biology and Evolutionary Anthropology, Duke University, Durham, NC 27708, USA
| | | | - Andrew M Allen
- Department of Wildlife, Fish and Environmental Studies, Swedish University of Agricultural Sciences, Umeå 90183, Sweden.,Institute for Water and Wetland Research, Department of Animal Ecology and Physiology, Radboud University, 6500GL Nijmegen, Netherlands
| | - Nina Attias
- Ecology and Conservation Graduate Program, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Tal Avgar
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Hattie Bartlam-Brooks
- Structure and Motion Laboratory, Royal Veterinary College, University of London, London NW1 0TU, UK
| | | | - Jerrold L Belant
- Carnivore Ecology Laboratory, Forest and Wildlife Research Center, Mississippi State University, Box 9690, Mississippi State, MS, USA
| | - Alessandra Bertassoni
- Animal Biology Postgraduate Program, São Paulo State University, São José do Rio Preto, SP 15054-000, Brazil
| | - Dean Beyer
- Michigan Department of Natural Resources, 1990 U.S. 41 South, Marquette, MI 49855, USA
| | - Laura Bidner
- Department of Anthropology, University of California, Davis, CA 95616, USA
| | | | - Stephen Blake
- Max Planck Institute for Ornithology, Vogelwarte Radolfzell, D-78315 Radolfzell, Germany.,Wildlife Conservation Society, Bronx, NY 10460, USA
| | - Niels Blaum
- University of Potsdam, Plant Ecology and Nature Conservation, 14476 Potsdam, Germany
| | - Chloe Bracis
- Senckenberg Biodiversity and Climate Research Centre, Senckenberg Gesellschaft für Naturforschung, 60325 Frankfurt (Main), Germany.,Department of Biological Sciences, Goethe University, 60438 Frankfurt (Main), Germany
| | - Danielle Brown
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN 37132, USA
| | - P J Nico de Bruyn
- Mammal Research Institute, Department of Zoology and Entomology, University of Pretoria, Hatfield 0028, Gauteng, South Africa
| | - Francesca Cagnacci
- Department of Biodiversity and Molecular Ecology, Research and Innovation Centre, Fondazione Edmund Mach, 38010 San Michele all'Adige (TN), Italy.,Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
| | - Justin M Calabrese
- Department of Biology, University of Maryland, College Park, MD 20742, USA.,Smithsonian Conservation Biology Institute, National Zoological Park, Front Royal, VA, USA
| | - Constança Camilo-Alves
- Departamento de Fitotecnia, Universidade de Évora, Pólo da Mitra, 7002-554 Évora, Portugal.,ICAAM-Institute of Mediterranean Agricultural and Environmental Sciences, University of Évora, Évora, Portugal
| | - Simon Chamaillé-Jammes
- Centre d'Ecologie Fonctionnelle et Evolutive UMR 5175, CNRS-Université de Montpellier-Université Paul-Valéry Montpellier-EPHE, 34293 Montpellier Cedex 5, France
| | - Andre Chiaradia
- Phillip Island Nature Parks, Victoria, Australia.,School of Biological Sciences, Monash University, Melbourne, Australia
| | - Sarah C Davidson
- Department of Civil, Environmental and Geodetic Engineering, Ohio State University, Columbus, OH 43210, USA.,Max Planck Institute for Ornithology, Vogelwarte Radolfzell, D-78315 Radolfzell, Germany
| | - Todd Dennis
- Department of Biology, Fiji National University, P.O. Box 5529, Natabua, Lautoka, Fiji Islands
| | - Stephen DeStefano
- U.S. Geological Survey, Massachusetts Cooperative Fish and Wildlife Research Unit, University of Massachusetts, Amherst, MA 01003, USA
| | - Duane Diefenbach
- U.S. Geological Survey, Pennsylvania Cooperative Fish and Wildlife Research Unit, Pennsylvania State University, University Park, PA 16802, USA
| | - Iain Douglas-Hamilton
- Save the Elephants, P.O. Box 54667, Nairobi 00200, Kenya.,Department of Zoology, University of Oxford, Oxford OX1 3PS, UK
| | - Julian Fennessy
- Giraffe Conservation Foundation, P.O. Box 86099, Eros, Namibia
| | - Claudia Fichtel
- German Primate Center, Behavioral Ecology and Sociobiology Unit, 37077 Göttingen, Germany
| | - Wolfgang Fiedler
- Max Planck Institute for Ornithology, Vogelwarte Radolfzell, D-78315 Radolfzell, Germany
| | - Christina Fischer
- Restoration Ecology, Department of Ecology and Ecosystem Management, Technische Universität München, 85354 Freising, Germany
| | - Ilya Fischhoff
- Cary Institute of Ecosystem Studies, Millbrook, NY 12545, USA
| | - Christen H Fleming
- Department of Biology, University of Maryland, College Park, MD 20742, USA.,Smithsonian Conservation Biology Institute, National Zoological Park, Front Royal, VA, USA
| | - Adam T Ford
- Irving K. Barber School of Arts and Sciences, Unit 2: Biology, University of British Columbia, Okanagan Campus, Kelowna, BC V1V 1V7, Canada
| | - Susanne A Fritz
- Senckenberg Biodiversity and Climate Research Centre, Senckenberg Gesellschaft für Naturforschung, 60325 Frankfurt (Main), Germany.,Department of Biological Sciences, Goethe University, 60438 Frankfurt (Main), Germany
| | - Benedikt Gehr
- Department of Evolutionary Biology and Environmental Studies, University of Zurich, 8057 Zurich, Switzerland
| | - Jacob R Goheen
- Department of Zoology and Physiology, University of Wyoming, Laramie, WY 82071, USA
| | - Eliezer Gurarie
- Department of Biology, University of Maryland, College Park, MD 20742, USA.,School of Environmental and Forest Sciences, University of Washington, Seattle, WA 98195, USA
| | - Mark Hebblewhite
- Wildlife Biology Program, Department of Ecosystem and Conservation Sciences, College of Forestry and Conservation, University of Montana, Missoula, MT 59812, USA
| | - Marco Heurich
- Bavarian Forest National Park, Department of Conservation and Research, 94481 Grafenau, Germany.,Chair of Wildlife Ecology and Management, Albert Ludwigs University of Freiburg, 79106 Freiburg, Germany
| | | | - Christian Hof
- Senckenberg Biodiversity and Climate Research Centre, Senckenberg Gesellschaft für Naturforschung, 60325 Frankfurt (Main), Germany
| | - Edward Hurme
- Department of Biology, University of Maryland, College Park, MD 20742, USA
| | - Lynne A Isbell
- Department of Anthropology, University of California, Davis, CA 95616, USA.,Animal Behavior Graduate Group, University of California, Davis, CA 95616, USA
| | - René Janssen
- Bionet Natuuronderzoek, 6171EL Stein, Netherlands
| | - Florian Jeltsch
- University of Potsdam, Plant Ecology and Nature Conservation, 14476 Potsdam, Germany
| | - Petra Kaczensky
- Norwegian Institute for Nature Research, P.O. Box 5685 Torgard, NO-7485 Trondheim, Norway.,Research Institute of Wildlife Ecology, University of Veterinary Medicine Vienna, A-1160 Vienna, Austria
| | - Adam Kane
- School of Biological, Earth and Environmental Sciences, University College Cork, Cork, Ireland
| | - Peter M Kappeler
- German Primate Center, Behavioral Ecology and Sociobiology Unit, 37077 Göttingen, Germany
| | - Matthew Kauffman
- U.S. Geological Survey, Wyoming Cooperative Fish and Wildlife Research Unit, Department of Zoology and Physiology, University of Wyoming, Laramie, WY, USA
| | - Roland Kays
- North Carolina Museum of Natural Sciences, Raleigh, NC 27601, USA.,Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA
| | - Duncan Kimuyu
- Department of Natural Resource Management, Karatina University, P.O. Box 1957-10101, Karatina, Kenya
| | - Flavia Koch
- German Primate Center, Behavioral Ecology and Sociobiology Unit, 37077 Göttingen, Germany.,Department of Psychology, University of Lethbridge, Lethbridge, Alberta T1K 3M4, Canada
| | - Bart Kranstauber
- Department of Evolutionary Biology and Environmental Studies, University of Zurich, 8057 Zurich, Switzerland
| | - Scott LaPoint
- Max Planck Institute for Ornithology, Vogelwarte Radolfzell, D-78315 Radolfzell, Germany.,Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY 10964, USA
| | - Peter Leimgruber
- Smithsonian Conservation Biology Institute, National Zoological Park, Front Royal, VA, USA
| | - John D C Linnell
- Norwegian Institute for Nature Research, P.O. Box 5685 Torgard, NO-7485 Trondheim, Norway
| | - Pascual López-López
- Cavanilles Institute of Biodiversity and Evolutionary Biology, Terrestrial Vertebrates Group, University of Valencia, E-46980 Paterna, Valencia, Spain
| | - A Catherine Markham
- Department of Anthropology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Jenny Mattisson
- Norwegian Institute for Nature Research, P.O. Box 5685 Torgard, NO-7485 Trondheim, Norway
| | - Emilia Patricia Medici
- International Union for Conservation of Nature (IUCN) Species Survival Commission (SSC) Tapir Specialist Group (TSG), Rua Licuala, 622, Damha 1, Campo Grande, CEP: 79046-150, Mato Grosso do Sul, Brazil.,IPÊ (Instituto de Pesquisas Ecológicas; Institute for Ecological Research), Caixa Postal 47, Nazaré Paulista, CEP: 12960-000, São Paulo, Brazil
| | - Ugo Mellone
- Vertebrates Zoology Research Group, Departamento de Ciencias Ambientales y Recursos Naturales, University of Alicante, Alicante, Spain
| | - Evelyn Merrill
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | | | - Ronaldo G Morato
- National Research Center for Carnivores Conservation, Chico Mendes Institute for the Conservation of Biodiversity, Atibaia-SP 12952-011, Brazil
| | | | - Thomas A Morrison
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Samuel L Díaz-Muñoz
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY 10003, USA.,Department of Microbiology and Molecular Genetics, University of California, Davis, CA 95616, USA
| | - Atle Mysterud
- Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, University of Oslo, Blindern, NO-0316 Oslo, Norway
| | - Dejid Nandintsetseg
- Senckenberg Biodiversity and Climate Research Centre, Senckenberg Gesellschaft für Naturforschung, 60325 Frankfurt (Main), Germany.,Department of Biological Sciences, Goethe University, 60438 Frankfurt (Main), Germany
| | - Ran Nathan
- Movement Ecology Laboratory, Department of Ecology, Evolution and Behavior, Alexander Silberman Institute of Life Sciences, Hebrew University of Jerusalem, Jerusalem 91904, Israel
| | - Aidin Niamir
- Senckenberg Biodiversity and Climate Research Centre, Senckenberg Gesellschaft für Naturforschung, 60325 Frankfurt (Main), Germany
| | - John Odden
- Norwegian Institute for Nature Research, NO-0349 Oslo, Norway
| | - Robert B O'Hara
- Senckenberg Biodiversity and Climate Research Centre, Senckenberg Gesellschaft für Naturforschung, 60325 Frankfurt (Main), Germany.,Department of Mathematical Sciences and Centre for Biodiversity Dynamics, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | | | - Kirk A Olson
- Wildlife Conservation Society, Mongolia Program, Ulaanbaatar, Mongolia
| | - Bruce D Patterson
- Integrative Research Center, Field Museum of Natural History, Chicago, IL 60605, USA
| | - Rogerio Cunha de Paula
- National Research Center for Carnivores Conservation, Chico Mendes Institute for the Conservation of Biodiversity, Atibaia-SP 12952-011, Brazil
| | - Luca Pedrotti
- Consorzio Parco Nazionale dello Stelvio, Bormio (Sondrio), Italy
| | - Björn Reineking
- Univ. Grenoble Alpes, Irstea, UR LESSEM, BP 76, 38402 St-Martin-d'Hères, France.,University of Bayreuth, BayCEER, 95447 Bayreuth, Germany
| | | | - Tracey L Rogers
- Evolution and Ecology Research Centre and School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Christer Moe Rolandsen
- Norwegian Institute for Nature Research, P.O. Box 5685 Torgard, NO-7485 Trondheim, Norway
| | | | - Daniel I Rubenstein
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA
| | - Kamran Safi
- Max Planck Institute for Ornithology, Vogelwarte Radolfzell, D-78315 Radolfzell, Germany.,Department of Biology, University of Konstanz, 78467 Konstanz, Germany
| | - Sonia Saïd
- Directorate of Studies and Expertise (DRE), Office National de la Chasse et de la Faune Sauvage, Montfort, 01330 Birieux, France
| | - Nir Sapir
- Department of Evolutionary and Environmental Biology, University of Haifa, 3498838 Haifa, Israel
| | - Hall Sawyer
- Western Ecosystems Technology Inc., Laramie, WY 82070, USA
| | - Niels Martin Schmidt
- Department of Bioscience, Aarhus University, 4000 Roskilde, Denmark.,Arctic Research Centre, Aarhus University, 8000 Aarhus C, Denmark
| | - Nuria Selva
- Institute of Nature Conservation Polish Academy of Sciences, 31-120 Krakow, Poland
| | - Agnieszka Sergiel
- Institute of Nature Conservation Polish Academy of Sciences, 31-120 Krakow, Poland
| | | | - João Paulo Silva
- REN Biodiversity Chair, CIBIO/InBIO Associate Laboratory, Universidade do Porto, Campus Agrário de Vairão, 4485-661 Vairão, Portugal.,Centre for Applied Ecology "Prof. Baeta Neves"/InBIO Associate Laboratory, Instituto Superior de Agronomia, Universidade de Lisboa, Tapada da Ajuda, 1349-017 Lisbon, Portugal.,Centre for Ecology, Evolution and Environmental Changes, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, 1749-016 Lisbon, Portugal
| | - Navinder Singh
- Department of Wildlife, Fish and Environmental Studies, Swedish University of Agricultural Sciences, Umeå 90183, Sweden
| | - Erling J Solberg
- Norwegian Institute for Nature Research, P.O. Box 5685 Torgard, NO-7485 Trondheim, Norway
| | - Orr Spiegel
- Department of Environmental Science and Policy, University of California, Davis, CA, USA
| | - Olav Strand
- Norwegian Institute for Nature Research, P.O. Box 5685 Torgard, NO-7485 Trondheim, Norway
| | | | - Wiebke Ullmann
- University of Potsdam, Plant Ecology and Nature Conservation, 14476 Potsdam, Germany
| | - Ulrich Voigt
- Institute for Terrestrial and Aquatic Wildlife Research, University of Veterinary Medicine Hannover-Foundation, 30173 Hannover, Germany
| | - Jake Wall
- Save the Elephants, P.O. Box 54667, Nairobi 00200, Kenya
| | - David Wattles
- U.S. Geological Survey, Massachusetts Cooperative Fish and Wildlife Research Unit, University of Massachusetts, Amherst, MA 01003, USA
| | - Martin Wikelski
- Max Planck Institute for Ornithology, Vogelwarte Radolfzell, D-78315 Radolfzell, Germany.,Department of Biology, University of Konstanz, 78467 Konstanz, Germany
| | - Christopher C Wilmers
- Center for Integrated Spatial Research, Environmental Studies Department, University of California, Santa Cruz, CA 95060, USA
| | - John W Wilson
- Department of Zoology and Entomology, University of Pretoria, Hatfield 0028, South Africa
| | - George Wittemyer
- Save the Elephants, P.O. Box 54667, Nairobi 00200, Kenya.,Department of Fish, Wildlife and Conservation Biology, Colorado State University, Fort Collins, CO 80523, USA
| | - Filip Zięba
- Tatra National Park, 34-500 Zakopane, Poland
| | | | - Thomas Mueller
- Senckenberg Biodiversity and Climate Research Centre, Senckenberg Gesellschaft für Naturforschung, 60325 Frankfurt (Main), Germany. .,Department of Biological Sciences, Goethe University, 60438 Frankfurt (Main), Germany.,Smithsonian Conservation Biology Institute, National Zoological Park, Front Royal, VA, USA
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Cox NS, Alison JA, Button BM, Wilson JW, Morton JM, Holland AE. Accumulating physical activity in at least 10-minute bouts predicts better lung function after 3-years in adults with cystic fibrosis. ERJ Open Res 2018; 4:00095-2017. [PMID: 29637075 PMCID: PMC5890021 DOI: 10.1183/23120541.00095-2017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 01/26/2018] [Indexed: 11/22/2022] Open
Abstract
In people with cystic fibrosis (CF) reduced fitness and lower levels of physical activity have been associated with poorer prognosis [1] and greater decline in lung function [2]. Despite the health benefits of being physically active [3], in people with CF adherence to exercise programmes is often poor [4], and prescribed exercise training programmes have seldom translated into increased daily physical activity [5]. Achieving physical activity guidelines by undertaking multiple bouts of moderate-vigorous physical activity ≥10 min duration, but not shorter periods of activity, was independently associated with less decline in FEV1over 3 years among adults with CFhttp://ow.ly/yk6930ivCV8
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Affiliation(s)
- Narelle S Cox
- Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia
| | - Jennifer A Alison
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia.,Dept of Physiotherapy, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Brenda M Button
- Dept of Physiotherapy, Alfred Hospital, Melbourne, Australia.,Dept of Medicine, Alfred Campus, Monash University, Melbourne, Australia.,Dept of Respiratory Medicine, Alfred Hospital, Melbourne, Australia
| | - John W Wilson
- Dept of Medicine, Alfred Campus, Monash University, Melbourne, Australia.,Dept of Respiratory Medicine, Alfred Hospital, Melbourne, Australia
| | - Judith M Morton
- Dept of Respiratory Medicine, Monash Health, Clayton, Australia.,Dept of Medicine, Monash Campus, Monash University, Clayton, Australia
| | - Anne E Holland
- Discipline of Physiotherapy, La Trobe University, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia.,Dept of Physiotherapy, Alfred Hospital, Melbourne, Australia
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45
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Kassem AM, Ganguli M, Yaffe K, Hanlon JT, Lopez OL, Wilson JW, Ensrud K, Cauley JA. Anxiety symptoms and risk of dementia and mild cognitive impairment in the oldest old women. Aging Ment Health 2018; 22:474-482. [PMID: 28071922 PMCID: PMC5894510 DOI: 10.1080/13607863.2016.1274370] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Research is limited and findings conflict regarding anxiety as a predictor of future cognitive decline in the oldest old persons. We examined the relationship between levels of and changes in anxiety symptoms, and subsequent dementia and mild cognitive impairment (MCI) in the oldest old women. METHOD We conducted secondary analyses of data collected from 1425 community-dwelling women (mean age = 82.8, SD ±3.1 years) followed on average for five years. The Goldberg Anxiety Scale was used to assess anxiety symptoms at baseline, and an expert clinical panel adjudicated dementia and MCI at follow-up. Participants with probable cognitive impairment at baseline were excluded. RESULTS At baseline, 190 (13%) women had moderate/severe anxiety symptoms and 403 (28%) had mild anxiety symptoms. Compared with those with no anxiety symptoms at baseline, women with mild anxiety symptoms were more likely to develop dementia at follow-up (multivariable-adjusted odds ratio = 1.66, 95% confidence interval 1.12-2.45). No significant association was observed between anxiety symptoms and MCI. CONCLUSION In the oldest old women, our findings suggest that mild anxiety symptoms may predict future risk of dementia, but not MCI. Future studies should explore potential biological mechanisms underlying associations of anxiety with cognitive impairment.
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Affiliation(s)
- Ahmed M. Kassem
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, United States
| | - Mary Ganguli
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, United States,Departments of Psychiatry and Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, United States
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology and Epidemiology, University of California, San Francisco, CA 94143, United States
| | - Joseph T. Hanlon
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, United States,Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, United States
| | - Oscar L. Lopez
- Departments of Psychiatry and Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, United States
| | - John W. Wilson
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, United States
| | - Kristine Ensrud
- Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55417, United States
| | - Jane A. Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, United States
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46
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Abstract
Increasing numbers of international patients are receiving care at US medical centers, entailing various challenges and benefits to all involved. Despite the potential challenges, the collective experiences can transform healthcare providers and their institutions into better physicians, better medical centers, and overall better members of a global society with increased awareness of the global human experience.
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Affiliation(s)
- Kelly A Cawcutt
- Assistant Professor, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA. E-mail:
| | - John W Wilson
- Associate Professor, Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
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47
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Schneider EK, McQuade RM, Carbone VC, Reyes-Ortega F, Wilson JW, Button B, Saito A, Poole DP, Hoyer D, Li J, Velkov T. The potentially beneficial central nervous system activity profile of ivacaftor and its metabolites. ERJ Open Res 2018; 4:00127-2017. [PMID: 29560360 PMCID: PMC5850045 DOI: 10.1183/23120541.00127-2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/29/2018] [Indexed: 12/26/2022] Open
Abstract
Ivacaftor-lumacaftor and ivacaftor are two new breakthrough cystic fibrosis transmembrane conductance modulators. The interactions of ivacaftor and its two metabolites hydroxymethylivacaftor (iva-M1) and ivacaftorcarboxylate (iva-M6) with neurotransmitter receptors were investigated in radioligand binding assays. Ivacaftor displayed significant affinity to the 5-hydroxytryptamine (5-HT; serotonin) 5-HT2C receptor (pKi=6.06±0.03), β3-adrenergic receptor (pKi=5.71±0.07), δ-opioid receptor (pKi=5.59±0.06) and the dopamine transporter (pKi=5.50±0.20); iva-M1 displayed significant affinity to the 5-HT2C receptor (pKi=5.81±0.04) and the muscarinic M3 receptor (pKi=5.70±0.10); iva-M6 displayed significant affinity to the 5-HT2A receptor (pKi=7.33±0.05). The in vivo central nervous system activity of ivacaftor (40 mg·kg-1 intraperitoneally for 21 days) was assessed in a chronic mouse model of depression. In the forced swim test, the ivacaftor-treated group displayed decreased immobility (52.8±7.6 s), similarly to fluoxetine (33.8±11.0 s), and increased climbing/swimming activity (181.5±9.2 s). In the open field test, ivacaftor produced higher locomotor activity than the fluoxetine group, measured both as mean number of paw touches (ivacaftor 81.1±9.6 versus fluoxetine 57.9±9.5) and total distance travelled (ivacaftor 120.6±16.8 cm versus fluoxetine 84.5±16.0 cm) in 600 s. Treatment of 23 cystic fibrosis patients with ivacaftor-lumacaftor resulted in significant improvements in quality of life (including anxiety) in all five domains of the AweScoreCF questionnaire (p=0.092-0.096). Our findings suggest ivacaftor displays potential clinical anxiolytic and stimulating properties, and may have beneficial effects on mood.
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Affiliation(s)
- Elena K. Schneider
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
- Dept of Pharmacology and Therapeutics, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Rachel M. McQuade
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
| | | | - Felisa Reyes-Ortega
- Dept of Applied Physics, Sciences Faculty, University of Granada, Granada, Spain
| | - John W. Wilson
- Dept of Medicine, Monash University, The Alfred Hospital, Melbourne, Australia
- Cystic Fibrosis Service, The Alfred Hospital, Melbourne, Australia
| | - Brenda Button
- Dept of Medicine, Monash University, The Alfred Hospital, Melbourne, Australia
- Cystic Fibrosis Service, The Alfred Hospital, Melbourne, Australia
| | - Ayame Saito
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Daniel P. Poole
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Daniel Hoyer
- Dept of Pharmacology and Therapeutics, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
- Dept of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - Jian Li
- Monash Biomedicine Discovery Institute, Dept of Microbiology, Monash University, Clayton, Australia
- These two authors contributed equally to this work
| | - Tony Velkov
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Australia
- Dept of Pharmacology and Therapeutics, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
- These two authors contributed equally to this work
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48
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Shah A, O'Horo JC, Wilson JW, Granger D, Theel ES. An Unusual Cluster of Neuroinvasive Lyme Disease Cases Presenting With Bannwarth Syndrome in the Midwest United States. Open Forum Infect Dis 2017; 5:ofx276. [PMID: 29383323 PMCID: PMC5777478 DOI: 10.1093/ofid/ofx276] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Bannwarth syndrome (BWS), an infrequent manifestation of neuroinvasive Lyme disease (LD) characterized by radiculopathy, neuropathy, and lymphocytic pleocytosis, is more commonly documented in Europe than North America. Here, we describe a cluster of 5 neuroinvasive LD cases with BWS in the upper Midwest United States between July and August 2017.
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Affiliation(s)
- Aditya Shah
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota
| | - John C O'Horo
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota.,Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - John W Wilson
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota
| | - Dane Granger
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Elitza S Theel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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49
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Mahmood M, Ajmal S, Abu Saleh OM, Bryson A, Marcelin JR, Wilson JW. Mycobacterium genavense infections in non-HIV immunocompromised hosts: a systematic review. Infect Dis (Lond) 2017; 50:329-339. [PMID: 29157060 DOI: 10.1080/23744235.2017.1404630] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Mycobacterium genavense is a non-tuberculous mycobacterium which can rarely cause disease in non-HIV immunocompromised hosts. We describe our experience with this unusual infection and perform a systematic review of the literature to describe the features of M. genavense infection in non-HIV immunocompromised hosts. METHODS All cases of Mycobacterium genavense infection in non-HIV patients at our institution were reviewed. In addition, we conducted a systematic review of the literature to identify previously published cases of M. genavense infections in non-HIV hosts. FINDINGS Two cases of M. genavense were identified at our center; a 51-year-old renal transplant recipient with a prosthetic knee joint infection and a 66-year-old woman with idiopathic CD4 lymphocytopenia with gastrointestinal tract disease. The systematic review identified 44 cases of M. genavense infection in non-HIV hosts. The most common underlying conditions were solid organ transplantation (40%), sarcoidosis (14%) and hematopoietic stem cell transplantation (7%). Disease most commonly involved the gastrointestinal tract, spleen, liver or bone marrow. Diagnosis was challenging with PCR required for identification in nearly all cases. Over one-third of patients died, which may reflect the combination of infection and underlying comorbidities. Overall cure was achieved in 61% with a mean duration of antimycobacterial therapy of 15.5 months (range 10-24). CONCLUSION M. genavense infection is a rare mycobacterial infection in non-HIV immunocompromised hosts. It should be suspected in immunocompromised patients presenting with disseminated mycobacterial infection, acid fast bacilli on smear or histopathologic examination, with poor or no growth in mycobacterial cultures.
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Affiliation(s)
- Maryam Mahmood
- a Division of Infectious Disease, Department of Medicine , Mayo Clinic , Rochester , MN , USA
| | - Saira Ajmal
- a Division of Infectious Disease, Department of Medicine , Mayo Clinic , Rochester , MN , USA
| | - Omar M Abu Saleh
- a Division of Infectious Disease, Department of Medicine , Mayo Clinic , Rochester , MN , USA
| | - Alexandra Bryson
- b Department of Laboratory Medicine and Pathology , Mayo Clinic , Rochester , MN , USA
| | - Jasmine R Marcelin
- c Divison of Infectious Disease, Department of Medicine , University of Nebraska Medical Center , Omaha , NE , USA
| | - John W Wilson
- a Division of Infectious Disease, Department of Medicine , Mayo Clinic , Rochester , MN , USA
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50
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Laso Bayas JC, Lesiv M, Waldner F, Schucknecht A, Duerauer M, See L, Fritz S, Fraisl D, Moorthy I, McCallum I, Perger C, Danylo O, Defourny P, Gallego J, Gilliams S, Akhtar IUH, Baishya SJ, Baruah M, Bungnamei K, Campos A, Changkakati T, Cipriani A, Das K, Das K, Das I, Davis KF, Hazarika P, Johnson BA, Malek Z, Molinari ME, Panging K, Pawe CK, Pérez-Hoyos A, Sahariah PK, Sahariah D, Saikia A, Saikia M, Schlesinger P, Seidacaru E, Singha K, Wilson JW. A global reference database of crowdsourced cropland data collected using the Geo-Wiki platform. Sci Data 2017; 4:170136. [PMID: 28949323 PMCID: PMC5613736 DOI: 10.1038/sdata.2017.136] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 04/18/2017] [Accepted: 08/02/2017] [Indexed: 11/09/2022] Open
Abstract
A global reference data set on cropland was collected through a crowdsourcing campaign using the Geo-Wiki crowdsourcing tool. The campaign lasted three weeks, with over 80 participants from around the world reviewing almost 36,000 sample units, focussing on cropland identification. For quality assessment purposes, two additional data sets are provided. The first is a control set of 1,793 sample locations validated by students trained in satellite image interpretation. This data set was used to assess the quality of the crowd as the campaign progressed. The second data set contains 60 expert validations for additional evaluation of the quality of the contributions. All data sets are split into two parts: the first part shows all areas classified as cropland and the second part shows cropland average per location and user. After further processing, the data presented here might be suitable to validate and compare medium and high resolution cropland maps generated using remote sensing. These could also be used to train classification algorithms for developing new maps of land cover and cropland extent.
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Affiliation(s)
| | - Myroslava Lesiv
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - François Waldner
- Université catholique de Louvain (UCL)-Earth and Life Institute, Louvain-la-Neuve, Belgium
| | - Anne Schucknecht
- European Commission-Joint Research Centre (JRC), Ispra, Italy.,Karlsruhe Institute of Technology (KIT), Department of Atmospheric Environmental Research, Garmisch-Partenkirchen 82467, Germany
| | - Martina Duerauer
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Linda See
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Steffen Fritz
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Dilek Fraisl
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Inian Moorthy
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Ian McCallum
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Christoph Perger
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Olha Danylo
- International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria
| | - Pierre Defourny
- Université catholique de Louvain (UCL)-Earth and Life Institute, Louvain-la-Neuve, Belgium
| | - Javier Gallego
- European Commission-Joint Research Centre (JRC), Ispra, Italy
| | - Sven Gilliams
- Vlaamse Instelling voor Technologisch Onderzoek (VITO), Mol, Belgium
| | - Ibrar Ul Hassan Akhtar
- COMSATS Institute of Information Technology, Islamabad, Pakistan.,Pakistan Space and Upper Atmosphere Research Commission (SUPARCO), Islamabad, Pakistan
| | | | | | | | - Alfredo Campos
- Taguay, Córdoba, Argentina.,Instituto de Clima y Agua, Instituto Nacional de Tecnología Agropecuaria (INTA), Buenos Aires, Argentina
| | | | - Anna Cipriani
- Dipartimento di Scienze Chimiche e Geologiche, University of Modena and Reggio Emilia, Modena, Italy.,Lamont-Doherty Earth Observatory of Columbia University, Palisades, New York, USA
| | | | | | | | - Kyle Frankel Davis
- The Earth Institute, Columbia University, New York, USA.,The Nature Conservancy, New York, USA
| | | | - Brian Alan Johnson
- Institute for Global Environmental Strategies, Kamiyamaguchi, Hayama, Japan
| | - Ziga Malek
- Vrije Universiteit, Amsterdam, Netherlands
| | | | | | | | - Ana Pérez-Hoyos
- European Commission-Joint Research Centre (JRC), Ispra, Italy
| | | | | | | | - Meghna Saikia
- Don Bosco College of Engineering and Technology, Guwahati, India
| | - Peter Schlesinger
- The Tropical Agriculture Research and Higher Education Center (CATIE), Turrialba, Costa Rica.,University of Idaho, Moscow, USA
| | | | | | - John W Wilson
- Department of Zoology and Entomology, University of Pretoria, Pretoria, South Africa
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