1
|
Deflaux N, Selvaraj MS, Condon HR, Mayo K, Haidermota S, Basford MA, Lunt C, Philippakis AA, Roden DM, Denny JC, Musick A, Collins R, Allen N, Effingham M, Glazer D, Natarajan P, Bick AG. Demonstrating paths for unlocking the value of cloud genomics through cross cohort analysis. Nat Commun 2023; 14:5419. [PMID: 37669985 PMCID: PMC10480504 DOI: 10.1038/s41467-023-41185-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 08/24/2023] [Indexed: 09/07/2023] Open
Abstract
Recently, large scale genomic projects such as All of Us and the UK Biobank have introduced a new research paradigm where data are stored centrally in cloud-based Trusted Research Environments (TREs). To characterize the advantages and drawbacks of different TRE attributes in facilitating cross-cohort analysis, we conduct a Genome-Wide Association Study of standard lipid measures using two approaches: meta-analysis and pooled analysis. Comparison of full summary data from both approaches with an external study shows strong correlation of known loci with lipid levels (R2 ~ 83-97%). Importantly, 90 variants meet the significance threshold only in the meta-analysis and 64 variants are significant only in pooled analysis, with approximately 20% of variants in each of those groups being most prevalent in non-European, non-Asian ancestry individuals. These findings have important implications, as technical and policy choices lead to cross-cohort analyses generating similar, but not identical results, particularly for non-European ancestral populations.
Collapse
Affiliation(s)
| | - Margaret Sunitha Selvaraj
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Henry Robert Condon
- Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kelsey Mayo
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sara Haidermota
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA
| | - Melissa A Basford
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chris Lunt
- All of Us Research Program, National Institutes of Health, Bethesda, MD, USA
| | | | - Dan M Roden
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Joshua C Denny
- All of Us Research Program, National Institutes of Health, Bethesda, MD, USA
| | - Anjene Musick
- All of Us Research Program, National Institutes of Health, Bethesda, MD, USA
| | - Rory Collins
- Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK
- UK Biobank, Cheadle, Stockport, UK
| | - Naomi Allen
- Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK
- UK Biobank, Cheadle, Stockport, UK
| | | | | | - Pradeep Natarajan
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA
| | - Alexander G Bick
- Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| |
Collapse
|
2
|
Yeh HH, Peltz-Rauchman C, Johnson CC, Pawloski PA, Chesla D, Waring SC, Stevens AB, Epstein M, Joseph C, Miller-Matero LR, Gui H, Tang A, Boerwinkle E, Cicek M, Clark CR, Cohn E, Gebo K, Loperena R, Mayo K, Mockrin S, Ohno-Machado L, Schully S, Ramirez AH, Qian J, Ahmedani BK. Examining sociodemographic correlates of opioid use, misuse, and use disorders in the All of Us Research Program. PLoS One 2023; 18:e0290416. [PMID: 37594966 PMCID: PMC10437856 DOI: 10.1371/journal.pone.0290416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/07/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND The All of Us Research Program enrolls diverse US participants which provide a unique opportunity to better understand the problem of opioid use. This study aims to estimate the prevalence of opioid use and its association with sociodemographic characteristics from survey data and electronic health record (EHR). METHODS A total of 214,206 participants were included in this study who competed survey modules and shared EHR data. Adjusted logistic regressions were used to explore the associations between sociodemographic characteristics and opioid use. RESULTS The lifetime prevalence of street opioids was 4%, and the nonmedical use of prescription opioids was 9%. Men had higher odds of lifetime opioid use (aOR: 1.4 to 3.1) but reduced odds of current nonmedical use of prescription opioids (aOR: 0.6). Participants from other racial and ethnic groups were at reduced odds of lifetime use (aOR: 0.2 to 0.9) but increased odds of current use (aOR: 1.9 to 9.9) compared with non-Hispanic White participants. Foreign-born participants were at reduced risks of opioid use and diagnosed with opioid use disorders (OUD) compared with US-born participants (aOR: 0.36 to 0.67). Men, Younger, White, and US-born participants are more likely to have OUD. CONCLUSIONS All of Us research data can be used as an indicator of national trends for monitoring the prevalence of receiving prescription opioids, diagnosis of OUD, and non-medical use of opioids in the US. The program employs a longitudinal design for routinely collecting health-related data including EHR data, that will contribute to the literature by providing important clinical information related to opioids over time. Additionally, this data will enhance the estimates of the prevalence of OUD among diverse populations, including groups that are underrepresented in the national survey data.
Collapse
Affiliation(s)
- Hsueh-Han Yeh
- Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan, United States of America
| | - Cathryn Peltz-Rauchman
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, United States of America
| | - Christine C. Johnson
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, United States of America
| | - Pamala A. Pawloski
- HealthPartners Institute, Bloomington, Minnesota, United States of America
| | - David Chesla
- Office of Research and Education, Spectrum Health, Grand Rapids, Michigan, United States of America
| | - Stephen C. Waring
- Essentia Health, Essentia Institute of Rural Health, Duluth, Minnesota, United States of America
| | - Alan B. Stevens
- Center for Applied Health Research, Baylor Scott & White Health, Temple, Texas, United States of America
| | - Mara Epstein
- Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Christine Joseph
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, United States of America
| | - Lisa R. Miller-Matero
- Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan, United States of America
- Behavioral Health Services, Henry Ford Health, Detroit, Michigan, United States of America
| | - Hongsheng Gui
- Behavioral Health Services, Henry Ford Health, Detroit, Michigan, United States of America
| | - Amy Tang
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, United States of America
| | - Eric Boerwinkle
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Mine Cicek
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Cheryl R. Clark
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Elizabeth Cohn
- Hunter-Bellevue School of Nursing, Hunter College, City University of New York, New York, New York, United States of America
| | - Kelly Gebo
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Roxana Loperena
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Kelsey Mayo
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Stephen Mockrin
- All of Us Research Program, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Lucila Ohno-Machado
- Department of Biomedical Informatics, UCSD Health, La Jolla, California, United States of America
| | - Sheri Schully
- All of Us Research Program, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Andrea H. Ramirez
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Jun Qian
- Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Brian K. Ahmedani
- Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan, United States of America
- Behavioral Health Services, Henry Ford Health, Detroit, Michigan, United States of America
| |
Collapse
|
3
|
Randal FT, Lozano P, Qi S, Maene C, Shah S, Mo Y, Ratsimbazafy F, Boerwinkle E, Cicek M, Clark CR, Cohn E, Gebo K, Loperena R, Mayo K, Mockrin S, Ohno-Machado L, Schully S, Ramirez AH, Aschebrook-Kilfoy B, Ahsan H, Lam H, Kim KE. Achieving a Representative Sample of Asian Americans in Biomedical Research Through Community-Based Approaches: Comparing Demographic Data in the All of Us Research Program With the American Community Survey. J Transcult Nurs 2023; 34:59-67. [PMID: 36398985 DOI: 10.1177/10436596221130796] [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] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Underrepresented persons are often not included in biomedical research. It is unknown if the general Asian American population is being represented in All of Us. The purpose of this study was to compare the Asian demographic data in the All of Us cohort with the Asian nationally representative data from the American Community Survey. METHOD Demographic characteristics and health literacy of Asians in All of Us were examined. Findings were qualitatively compared with the Asian data in the 2019 American Community Survey 1-year estimate. RESULTS Compared with the national composition of Asians, less All of Us participants were born outside the United States (64% vs 79%), were younger, and had higher levels of education (76% vs 52%). Over 60% of All of Us participants reported high levels of health literacy. CONCLUSION This study had implications for the development of strategies that ensure diverse populations are represented in biomedical research.
Collapse
Affiliation(s)
| | | | - Siya Qi
- Asian Health Coalition, Chicago, IL, USA
| | | | | | - Yicklun Mo
- Asian Health Coalition, Chicago, IL, USA
| | | | - Eric Boerwinkle
- The University of Texas Health Science Center at Houston, USA
| | | | | | | | - Kelly Gebo
- Johns Hopkins University School of Medicine, Bethesda, MD, USA
| | | | - Kelsey Mayo
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Nagar SD, Pemu P, Qian J, Boerwinkle E, Cicek M, Clark CR, Cohn E, Gebo K, Loperena R, Mayo K, Mockrin S, Ohno-Machado L, Ramirez AH, Schully S, Able A, Green A, Zuchner S, Jordan IK, Meller R, Sanders LL, Mosby H, Olorundare EI, McCaslin A, Anderson C, Pearson A, Igwe KC, Silva K, Daugett G, McCray J, Prude M, Franklin C, Zuchner S, Carrasquillo O, Isasi R, McCauley JL, Melo JG, Riccio AK, Whitehead P, Guzman P, Gladfelter C, Velez R, Saporta M, Apagüeño B, Abreu L, Shenkman B, Hogan B, Handberg E, Hensley J, White S, Roth-Manning B, Mendoza T, Loiacono A, Weinbrenner D, Enani M, Nouina A, Zwick ME, Rosser TC, Quyyumi AA, Johnson TM, Martin GS, Alonso A, Thompson TAK, Deshpande N, Johnston HR, Ahmed H, Husbands L, Jordan IK, Meller R. Investigation of hypertension and type 2 diabetes as risk factors for dementia in the All of Us cohort. Sci Rep 2022; 12:19797. [PMID: 36396674 PMCID: PMC9672061 DOI: 10.1038/s41598-022-23353-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
The World Health Organization recently defined hypertension and type 2 diabetes (T2D) as modifiable comorbidities leading to dementia and Alzheimer's disease. In the United States (US), hypertension and T2D are health disparities, with higher prevalence seen for Black and Hispanic minority groups compared to the majority White population. We hypothesized that elevated prevalence of hypertension and T2D risk factors in Black and Hispanic groups may be associated with dementia disparities. We interrogated this hypothesis using a cross-sectional analysis of participant data from the All of Us (AoU) Research Program, a large observational cohort study of US residents. The specific objectives of our study were: (1) to compare the prevalence of dementia, hypertension, and T2D in the AoU cohort to previously reported prevalence values for the US population, (2) to investigate the association of hypertension, T2D, and race/ethnicity with dementia, and (3) to investigate whether race/ethnicity modify the association of hypertension and T2D with dementia. AoU participants were recruited from 2018 to 2019 as part of the initial project cohort (R2019Q4R3). Participants aged 40-80 with electronic health records and demographic data (age, sex, race, and ethnicity) were included for analysis, yielding a final cohort of 125,637 individuals. AoU participants show similar prevalence of hypertension (32.1%) and T2D (13.9%) compared to the US population (32.0% and 10.5%, respectively); however, the prevalence of dementia for AoU participants (0.44%) is an order of magnitude lower than seen for the US population (5%). AoU participants with dementia show a higher prevalence of hypertension (81.6% vs. 31.9%) and T2D (45.9% vs. 11.4%) compared to non-dementia participants. Dominance analysis of a multivariable logistic regression model with dementia as the outcome shows that hypertension, age, and T2D have the strongest associations with dementia. Hispanic was the only race/ethnicity group that showed a significant association with dementia, and the association of sex with dementia was non-significant. The association of T2D with dementia is likely explained by concurrent hypertension, since > 90% of participants with T2D also had hypertension. Black race and Hispanic ethnicity interact with hypertension, but not T2D, to increase the odds of dementia. This study underscores the utility of the AoU participant cohort to study disease prevalence and risk factors. We do notice a lower participation of aged minorities and participants with dementia, revealing an opportunity for targeted engagement. Our results indicate that targeting hypertension should be a priority for risk factor modifications to reduce dementia incidence.
Collapse
Affiliation(s)
| | - Priscilla Pemu
- Morehouse School of Medicine, Atlanta, USA.,University of Miami, Coral Gables, USA
| | - Jun Qian
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,Vanderbilt University Medical Center, Nashville, USA
| | - Eric Boerwinkle
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,The University of Texas Health Science Center at Houston, Houston, USA
| | - Mine Cicek
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,Mayo Clinic, Rochester, USA
| | - Cheryl R Clark
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,Brigham and Women's Hospital, Boston, USA
| | - Elizabeth Cohn
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,Hunter College, New York, USA
| | - Kelly Gebo
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,Johns Hopkins University, Baltimore, USA
| | - Roxana Loperena
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,Vanderbilt University Medical Center, Nashville, USA
| | - Kelsey Mayo
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,Vanderbilt University Medical Center, Nashville, USA
| | - Stephen Mockrin
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,National Institutes of Health, Bethesda, USA
| | - Lucila Ohno-Machado
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,University of California, San Diego, USA
| | - Andrea H Ramirez
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,Vanderbilt University Medical Center, Nashville, USA
| | - Sheri Schully
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,Vanderbilt University Medical Center, Nashville, USA
| | - Ashley Able
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA.,Vanderbilt University Medical Center, Nashville, USA
| | - Ashley Green
- All of Us Demonstration Projects Subcommittee, National Institutes of Health, Bethesda, USA
| | - Stephan Zuchner
- Vanderbilt University Medical Center, Nashville, USA.,University of Miami, Coral Gables, USA
| | | | | | - Robert Meller
- Morehouse School of Medicine, Atlanta, USA. .,University of Miami, Coral Gables, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Aschebrook-Kilfoy B, Zakin P, Craver A, Shah S, Kibriya MG, Stepniak E, Ramirez A, Clark C, Cohn E, Ohno-Machado L, Cicek M, Boerwinkle E, Schully SD, Mockrin S, Gebo K, Mayo K, Ratsimbazafy F, Sanders A, Shah RC, Argos M, Ho J, Kim K, Daviglus M, Greenland P, Ahsan H. An Overview of Cancer in the First 315,000 All of Us Participants. PLoS One 2022; 17:e0272522. [PMID: 36048778 PMCID: PMC9436122 DOI: 10.1371/journal.pone.0272522] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/21/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The NIH All of Us Research Program will have the scale and scope to enable research for a wide range of diseases, including cancer. The program’s focus on diversity and inclusion promises a better understanding of the unequal burden of cancer. Preliminary cancer ascertainment in the All of Us cohort from two data sources (self-reported versus electronic health records (EHR)) is considered. Materials and methods This work was performed on data collected from the All of Us Research Program’s 315,297 enrolled participants to date using the Researcher Workbench, where approved researchers can access and analyze All of Us data on cancer and other diseases. Cancer case ascertainment was performed using data from EHR and self-reported surveys across key factors. Distribution of cancer types and concordance of data sources by cancer site and demographics is analyzed. Results and discussion Data collected from 315,297 participants resulted in 13,298 cancer cases detected in the survey (in 89,261 participants), 23,520 cancer cases detected in the EHR (in 203,813 participants), and 7,123 cancer cases detected across both sources (in 62,497 participants). Key differences in survey completion by race/ethnicity impacted the makeup of cohorts when compared to cancer in the EHR and national NCI SEER data. Conclusions This study provides key insight into cancer detection in the All of Us Research Program and points to the existing strengths and limitations of All of Us as a platform for cancer research now and in the future.
Collapse
Affiliation(s)
- Briseis Aschebrook-Kilfoy
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, United States of America
- Institute for Population and Precision Health, University of Chicago, Chicago, Illinois, United States of America
- Comprehensive Cancer Center, University of Chicago, Chicago, Illinois, United States of America
- * E-mail:
| | - Paul Zakin
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, United States of America
- Institute for Population and Precision Health, University of Chicago, Chicago, Illinois, United States of America
| | - Andrew Craver
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, United States of America
- Institute for Population and Precision Health, University of Chicago, Chicago, Illinois, United States of America
| | - Sameep Shah
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, United States of America
- Institute for Population and Precision Health, University of Chicago, Chicago, Illinois, United States of America
| | - Muhammad G. Kibriya
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, United States of America
- Institute for Population and Precision Health, University of Chicago, Chicago, Illinois, United States of America
| | - Elizabeth Stepniak
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, United States of America
- Institute for Population and Precision Health, University of Chicago, Chicago, Illinois, United States of America
| | - Andrea Ramirez
- Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Cheryl Clark
- Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Elizabeth Cohn
- Hunter College City University of New York, New York, New York, United States of America
| | - Lucila Ohno-Machado
- University of California San Diego Health, La Jolla, California, United States of America
| | - Mine Cicek
- Mayo Clinic, Rochester, Minnesota, United States of America
| | - Eric Boerwinkle
- The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Sheri D. Schully
- National Institutes of Health, Bethesda, Maryland, United States of America
| | - Stephen Mockrin
- National Institutes of Health, Leidos, Inc, Frederick, Maryland, United States of America
| | - Kelly Gebo
- Johns Hopkins University School of Medicine, Bethesda, Maryland, United States of America
| | - Kelsey Mayo
- National Institutes of Health, Bethesda, Maryland, United States of America
| | | | - Alan Sanders
- Northshore University Health System, Evanston, Illinois, United States of America
| | - Raj C. Shah
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Joyce Ho
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Karen Kim
- Comprehensive Cancer Center, University of Chicago, Chicago, Illinois, United States of America
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Martha Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, United States of America
- Institute for Population and Precision Health, University of Chicago, Chicago, Illinois, United States of America
- Comprehensive Cancer Center, University of Chicago, Chicago, Illinois, United States of America
| | | |
Collapse
|
6
|
Ramirez AH, Sulieman L, Schlueter DJ, Halvorson A, Qian J, Ratsimbazafy F, Loperena R, Mayo K, Basford M, Deflaux N, Muthuraman KN, Natarajan K, Kho A, Xu H, Wilkins C, Anton-Culver H, Boerwinkle E, Cicek M, Clark CR, Cohn E, Ohno-Machado L, Schully SD, Ahmedani BK, Argos M, Cronin RM, O’Donnell C, Fouad M, Goldstein DB, Greenland P, Hebbring SJ, Karlson EW, Khatri P, Korf B, Smoller JW, Sodeke S, Wilbanks J, Hentges J, Mockrin S, Lunt C, Devaney SA, Gebo K, Denny JC, Carroll RJ, Glazer D, Harris PA, Hripcsak G, Philippakis A, Roden DM, Ahmedani B, Cole Johnson CD, Ahsan H, Antoine-LaVigne D, Singleton G, Anton-Culver H, Topol E, Baca-Motes K, Steinhubl S, Wade J, Begale M, Jain P, Sutherland S, Lewis B, Korf B, Behringer M, Gharavi AG, Goldstein DB, Hripcsak G, Bier L, Boerwinkle E, Brilliant MH, Murali N, Hebbring SJ, Farrar-Edwards D, Burnside E, Drezner MK, Taylor A, Channamsetty V, Montalvo W, Sharma Y, Chinea C, Jenks N, Cicek M, Thibodeau S, Holmes BW, Schlueter E, Collier E, Winkler J, Corcoran J, D’Addezio N, Daviglus M, Winn R, Wilkins C, Roden D, Denny J, Doheny K, Nickerson D, Eichler E, Jarvik G, Funk G, Philippakis A, Rehm H, Lennon N, Kathiresan S, Gabriel S, Gibbs R, Gil Rico EM, Glazer D, Grand J, Greenland P, Harris P, Shenkman E, Hogan WR, Igho-Pemu P, Pollan C, Jorge M, Okun S, Karlson EW, Smoller J, Murphy SN, Ross ME, Kaushal R, Winford E, Wallace F, Khatri P, Kheterpal V, Ojo A, Moreno FA, Kron I, Peterson R, Menon U, Lattimore PW, Leviner N, Obedin-Maliver J, Lunn M, Malik-Gagnon L, Mangravite L, Marallo A, Marroquin O, Visweswaran S, Reis S, Marshall G, McGovern P, Mignucci D, Moore J, Munoz F, Talavera G, O'Connor GT, O'Donnell C, Ohno-Machado L, Orr G, Randal F, Theodorou AA, Reiman E, Roxas-Murray M, Stark L, Tepp R, Zhou A, Topper S, Trousdale R, Tsao P, Weidman L, Weiss ST, Wellis D, Whittle J, Wilson A, Zuchner S, Zwick ME. The All of Us Research Program: Data quality, utility, and diversity. Patterns 2022; 3:100570. [PMID: 36033590 PMCID: PMC9403360 DOI: 10.1016/j.patter.2022.100570] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 03/30/2022] [Accepted: 07/14/2022] [Indexed: 11/05/2022]
Abstract
The All of Us Research Program seeks to engage at least one million diverse participants to advance precision medicine and improve human health. We describe here the cloud-based Researcher Workbench that uses a data passport model to democratize access to analytical tools and participant information including survey, physical measurement, and electronic health record (EHR) data. We also present validation study findings for several common complex diseases to demonstrate use of this novel platform in 315,000 participants, 78% of whom are from groups historically underrepresented in biomedical research, including 49% self-reporting non-White races. Replication findings include medication usage pattern differences by race in depression and type 2 diabetes, validation of known cancer associations with smoking, and calculation of cardiovascular risk scores by reported race effects. The cloud-based Researcher Workbench represents an important advance in enabling secure access for a broad range of researchers to this large resource and analytical tools. The All of Us Research Program has released data for over 315,000 participants Demonstration projects support the utility and validity of the All of Us dataset The cloud-based Researcher Workbench provides secure, low-cost compute power
The engagement of participants in the research process and broad availability of data to diverse researchers are essential elements in building precision medicine equitably available for all. The NIH has established the ambitious All of Us Research Program to build one of the most diverse health databases in history with tools to support research to improve human health. Here, we present the initial launch of the Researcher Workbench with data types including surveys, physical measurements, and electronic health record data with validation studies to support researcher use of this novel platform. Broad access for researchers to data like these is a critical step in returning value to participants seeking to support the advancement of precision medicine and improved health for all.
Collapse
|
7
|
Clark CR, Chandler PD, Zhou G, Noel N, Achilike C, Mendez L, O'Connor GT, Smoller JW, Weiss ST, Murphy SN, Ommerborn MJ, Karnes JH, Klimentidis YC, Jordan CD, Hiatt RA, Ramirez AH, Loperena R, Mayo K, Cohn E, Ohno-Machado L, Boerwinkle E, Cicek M, Schully SD, Mockrin S, Gebo KA, Karlson EW. Geographic Variation in Obesity at the State Level in the All of Us Research Program. Prev Chronic Dis 2021; 18:E104. [PMID: 34941480 PMCID: PMC8718125 DOI: 10.5888/pcd18.210094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/10/2022] Open
Abstract
INTRODUCTION National obesity prevention strategies may benefit from precision health approaches involving diverse participants in population health studies. We used cohort data from the National Institutes of Health All of Us Research Program (All of Us) Researcher Workbench to estimate population-level obesity prevalence. METHODS To estimate state-level obesity prevalence we used data from physical measurements made during All of Us enrollment visits and data from participant electronic health records (EHRs) where available. Prevalence estimates were calculated and mapped by state for 2 categories of body mass index (BMI) (kg/m2): obesity (BMI >30) and severe obesity (BMI >35). We calculated and mapped prevalence by state, excluding states with fewer than 100 All of Us participants. RESULTS Data on height and weight were available for 244,504 All of Us participants from 33 states, and corresponding EHR data were available for 88,840 of these participants. The median and IQR of BMI taken from physical measurements data was 28.4 (24.4- 33.7) and 28.5 (24.5-33.6) from EHR data, where available. Overall obesity prevalence based on physical measurements data was 41.5% (95% CI, 41.3%-41.7%); prevalence of severe obesity was 20.7% (95% CI, 20.6-20.9), with large geographic variations observed across states. Prevalence estimates from states with greater numbers of All of Us participants were more similar to national population-based estimates than states with fewer participants. CONCLUSION All of Us participants had a high prevalence of obesity, with state-level geographic variation mirroring national trends. The diversity among All of Us participants may support future investigations on obesity prevention and treatment in diverse populations.
Collapse
Affiliation(s)
- Cheryl R Clark
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, 3rd Floor, Boston, MA 02120.
| | - Paulette D Chandler
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Guohai Zhou
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nyia Noel
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Confidence Achilike
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Lizette Mendez
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - George T O'Connor
- Pulmonary Center, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Jordan W Smoller
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Scott T Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Shawn N Murphy
- Research Information Science and Computing, Mass General Brigham, Boston, Massachusetts
| | - Mark J Ommerborn
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jason H Karnes
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, Arizona
| | - Yann C Klimentidis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | | | - Robert A Hiatt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Andrea H Ramirez
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- All of Us Research Program, National Institutes of Health, Bethesda, Maryland
| | - Roxana Loperena
- Medical Affairs, Inflammation and Autoimmunity, Incyte Corporation, Wilmington, Delaware
| | - Kelsey Mayo
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Elizabeth Cohn
- Hunter-Bellevue School of Nursing, Hunter College, City University of New York, New York, New York
| | - Lucila Ohno-Machado
- Department of Biomedical Informatics, University of California San Diego Health, La Jolla, California
| | - Eric Boerwinkle
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Mine Cicek
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Sheri D Schully
- All of Us Research Program, National Institutes of Health, Bethesda, Maryland
| | | | - Kelly A Gebo
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth W Karlson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
8
|
Giangreco NP, Lina S, Qian J, Kouame A, Subbian V, Boerwinkle E, Cicek M, Clark CR, Cohen E, Gebo KA, Loperena-Cortes R, Mayo K, Mockrin S, Ohno-Machado L, Schully SD, Tatonetti NP, Ramirez AH. Pediatric data from the All of Us research program: demonstration of pediatric obesity over time. JAMIA Open 2021; 4:ooab112. [PMID: 35155998 PMCID: PMC8827025 DOI: 10.1093/jamiaopen/ooab112] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/17/2021] [Accepted: 12/15/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe and demonstrate use of pediatric data collected by the All of Us Research Program. MATERIALS AND METHODS All of Us participant physical measurements and electronic health record (EHR) data were analyzed including investigation of trends in childhood obesity and correlation with adult body mass index (BMI). RESULTS We identified 19 729 participants with legacy pediatric EHR data including diagnoses, prescriptions, visits, procedures, and measurements gathered since 1980. We found an increase in pediatric obesity diagnosis over time that correlates with BMI measurements recorded in participants' adult EHRs and those physical measurements taken at enrollment in the research program. DISCUSSION We highlight the availability of retrospective pediatric EHR data for nearly 20 000 All of Us participants. These data are relevant to current issues such as the rise in pediatric obesity. CONCLUSION All of Us contains a rich resource of retrospective pediatric EHR data to accelerate pediatric research studies.
Collapse
Affiliation(s)
- Nicholas P Giangreco
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
- Department of Systems Biology, Columbia University, New York, New York, USA
| | - Sulieman Lina
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jun Qian
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Aymone Kouame
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Vignesh Subbian
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona, USA
- Department of Systems & Industrial Engineering, The University of Arizona, Tucson, Arizona, USA
| | - Eric Boerwinkle
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Mine Cicek
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Cheryl R Clark
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Elizabeth Cohen
- Hunter-Bellevue School of Nursing, Hunter College City University of New York, New York, New York, USA
| | - Kelly A Gebo
- Bloomberg School of Public Health, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Roxana Loperena-Cortes
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kelsey Mayo
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Stephen Mockrin
- All of Us Research Program, National Institutes of Health, Bethesda, Maryland, USA
- Leidos, Inc, Frederick, Maryland, USA
| | - Lucila Ohno-Machado
- Department of Biomedical Informatics, UCSD Health, La Jolla, California, USA
| | - Sheri D Schully
- All of Us Research Program, National Institutes of Health, Bethesda, Maryland, USA
| | - Nicholas P Tatonetti
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
- Department of Systems Biology, Columbia University, New York, New York, USA
| | - Andrea H Ramirez
- All of Us Research Program, National Institutes of Health, Bethesda, Maryland, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
9
|
Baxter SL, Saseendrakumar BR, Paul P, Kim J, Bonomi L, Kuo TT, Loperena R, Ratsimbazafy F, Boerwinkle E, Cicek M, Clark CR, Cohn E, Gebo K, Mayo K, Mockrin S, Schully SD, Ramirez A, Ohno-Machado L. Predictive Analytics for Glaucoma Using Data From the All of Us Research Program. Am J Ophthalmol 2021; 227:74-86. [PMID: 33497675 PMCID: PMC8184631 DOI: 10.1016/j.ajo.2021.01.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/02/2021] [Accepted: 01/06/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE To (1) use All of Us (AoU) data to validate a previously published single-center model predicting the need for surgery among individuals with glaucoma, (2) train new models using AoU data, and (3) share insights regarding this novel data source for ophthalmic research. DESIGN Development and evaluation of machine learning models. METHODS Electronic health record data were extracted from AoU for 1,231 adults diagnosed with primary open-angle glaucoma. The single-center model was applied to AoU data for external validation. AoU data were then used to train new models for predicting the need for glaucoma surgery using multivariable logistic regression, artificial neural networks, and random forests. Five-fold cross-validation was performed. Model performance was evaluated based on area under the receiver operating characteristic curve (AUC), accuracy, precision, and recall. RESULTS The mean (standard deviation) age of the AoU cohort was 69.1 (10.5) years, with 57.3% women and 33.5% black, significantly exceeding representation in the single-center cohort (P = .04 and P < .001, respectively). Of 1,231 participants, 286 (23.2%) needed glaucoma surgery. When applying the single-center model to AoU data, accuracy was 0.69 and AUC was only 0.49. Using AoU data to train new models resulted in superior performance: AUCs ranged from 0.80 (logistic regression) to 0.99 (random forests). CONCLUSIONS Models trained with national AoU data achieved superior performance compared with using single-center data. Although AoU does not currently include ophthalmic imaging, it offers several strengths over similar big-data sources such as claims data. AoU is a promising new data source for ophthalmic research.
Collapse
Affiliation(s)
- Sally L Baxter
- From the Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, (S.L.B., B.R.S.), La Jolla, California; UCSD Health Department of Biomedical Informatics, University of California San Diego, (S.L.B., B.R.S., P.P., J.K., L.B., T.-T.K., L.O.-M.), La Jolla, California.
| | - Bharanidharan Radha Saseendrakumar
- From the Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, (S.L.B., B.R.S.), La Jolla, California; UCSD Health Department of Biomedical Informatics, University of California San Diego, (S.L.B., B.R.S., P.P., J.K., L.B., T.-T.K., L.O.-M.), La Jolla, California
| | - Paulina Paul
- UCSD Health Department of Biomedical Informatics, University of California San Diego, (S.L.B., B.R.S., P.P., J.K., L.B., T.-T.K., L.O.-M.), La Jolla, California
| | - Jihoon Kim
- UCSD Health Department of Biomedical Informatics, University of California San Diego, (S.L.B., B.R.S., P.P., J.K., L.B., T.-T.K., L.O.-M.), La Jolla, California
| | - Luca Bonomi
- UCSD Health Department of Biomedical Informatics, University of California San Diego, (S.L.B., B.R.S., P.P., J.K., L.B., T.-T.K., L.O.-M.), La Jolla, California
| | - Tsung-Ting Kuo
- UCSD Health Department of Biomedical Informatics, University of California San Diego, (S.L.B., B.R.S., P.P., J.K., L.B., T.-T.K., L.O.-M.), La Jolla, California
| | - Roxana Loperena
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee (R.L., F.R.)
| | - Francis Ratsimbazafy
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee (R.L., F.R.)
| | - Eric Boerwinkle
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas (E.B.)
| | - Mine Cicek
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota (M.C.)
| | - Cheryl R Clark
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts (C.R.C.)
| | - Elizabeth Cohn
- Hunter-Bellevue School of Nursing, Hunter College City University of New York, New York, New York (E.C.)
| | - Kelly Gebo
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, Maryland
| | - Kelsey Mayo
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee (R.L., F.R.)
| | - Stephen Mockrin
- Life Sciences Division, Leidos, Inc, Frederick, (S.M.), Maryland
| | - Sheri D Schully
- All of Us Research Program, National Institutes of Health, Bethesda (K.M., S.S.), Bethesda, Maryland
| | - Andrea Ramirez
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee (A.R.)
| | - Lucila Ohno-Machado
- UCSD Health Department of Biomedical Informatics, University of California San Diego, (S.L.B., B.R.S., P.P., J.K., L.B., T.-T.K., L.O.-M.), La Jolla, California; Division of Health Services Research and Development, Veterans Affairs San Diego Healthcare System, La Jolla, California (L.O.-M.), USA
| |
Collapse
|
10
|
Chandler PD, Clark CR, Zhou G, Noel NL, Achilike C, Mendez L, Ramirez AH, Loperena-Cortes R, Mayo K, Cohn E, Ohno-Machado L, Boerwinkle E, Cicek M, Qian J, Schully S, Ratsimbazafy F, Mockrin S, Gebo K, Dedier JJ, Murphy SN, Smoller JW, Karlson EW. Hypertension prevalence in the All of Us Research Program among groups traditionally underrepresented in medical research. Sci Rep 2021; 11:12849. [PMID: 34158555 PMCID: PMC8219813 DOI: 10.1038/s41598-021-92143-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 06/04/2021] [Indexed: 11/18/2022] Open
Abstract
The All of Us Research Program was designed to enable broad-based precision medicine research in a cohort of unprecedented scale and diversity. Hypertension (HTN) is a major public health concern. The validity of HTN data and definition of hypertension cases in the All of Us (AoU) Research Program for use in rule-based algorithms is unknown. In this cross-sectional, population-based study, we compare HTN prevalence in the AoU Research Program to HTN prevalence in the 2015-2016 National Health and Nutrition Examination Survey (NHANES). We used AoU baseline data from patient (age ≥ 18) measurements (PM), surveys, and electronic health record (EHR) blood pressure measurements. We retrospectively examined the prevalence of HTN in the EHR cohort using Systemized Nomenclature of Medicine (SNOMED) codes and blood pressure medications recorded in the EHR. We defined HTN as the participant having at least 2 HTN diagnosis/billing codes on separate dates in the EHR data AND at least one HTN medication. We calculated an age-standardized HTN prevalence according to the age distribution of the U.S. Census, using 3 groups (18-39, 40-59, and ≥ 60). Among the 185,770 participants enrolled in the AoU Cohort (mean age at enrollment = 51.2 years) available in a Researcher Workbench as of October 2019, EHR data was available for at least one SNOMED code from 112,805 participants, medications for 104,230 participants, and 103,490 participants had both medication and SNOMED data. The total number of persons with SNOMED codes on at least two distinct dates and at least one antihypertensive medication was 33,310 for a crude prevalence of HTN of 32.2%. AoU age-adjusted HTN prevalence was 27.9% using 3 groups compared to 29.6% in NHANES. The AoU cohort is a growing source of diverse longitudinal data to study hypertension nationwide and develop precision rule-based algorithms for use in hypertension treatment and prevention research. The prevalence of hypertension in this cohort is similar to that in prior population-based surveys.
Collapse
Affiliation(s)
- Paulette D Chandler
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
| | - Cheryl R Clark
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Guohai Zhou
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Nyia L Noel
- Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Confidence Achilike
- Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Lizette Mendez
- Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | | | | | - Kelsey Mayo
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Eric Boerwinkle
- University of Texas Health Science Center School of Public Health, Houston, TX, USA
| | | | - Jun Qian
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | - Kelly Gebo
- Johns Hopkins University, Baltimore, MD, USA
| | - Julien J Dedier
- Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Shawn N Murphy
- Research Information Science and Computing, Mass General Brigham, Boston, MA, USA
| | - Jordan W Smoller
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Elizabeth W Karlson
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| |
Collapse
|
11
|
Cronin RM, Halvorson AE, Springer C, Feng X, Sulieman L, Loperena-Cortes R, Mayo K, Carroll RJ, Chen Q, Ahmedani BK, Karnes J, Korf B, O’Donnell CJ, Qian J, Ramirez AH. Comparison of family health history in surveys vs electronic health record data mapped to the observational medical outcomes partnership data model in the All of Us Research Program. J Am Med Inform Assoc 2021; 28:695-703. [PMID: 33404595 PMCID: PMC7973437 DOI: 10.1093/jamia/ocaa315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/10/2021] [Revised: 10/15/2020] [Accepted: 11/14/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Family health history is important to clinical care and precision medicine. Prior studies show gaps in data collected from patient surveys and electronic health records (EHRs). The All of Us Research Program collects family history from participants via surveys and EHRs. This Demonstration Project aims to evaluate availability of family health history information within the publicly available data from All of Us and to characterize the data from both sources. MATERIALS AND METHODS Surveys were completed by participants on an electronic portal. EHR data was mapped to the Observational Medical Outcomes Partnership data model. We used descriptive statistics to perform exploratory analysis of the data, including evaluating a list of medically actionable genetic disorders. We performed a subanalysis on participants who had both survey and EHR data. RESULTS There were 54 872 participants with family history data. Of those, 26% had EHR data only, 63% had survey only, and 10.5% had data from both sources. There were 35 217 participants with reported family history of a medically actionable genetic disorder (9% from EHR only, 89% from surveys, and 2% from both). In the subanalysis, we found inconsistencies between the surveys and EHRs. More details came from surveys. When both mentioned a similar disease, the source of truth was unclear. CONCLUSIONS Compiling data from both surveys and EHR can provide a more comprehensive source for family health history, but informatics challenges and opportunities exist. Access to more complete understanding of a person's family health history may provide opportunities for precision medicine.
Collapse
Affiliation(s)
- Robert M Cronin
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Alese E Halvorson
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Cassie Springer
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Xiaoke Feng
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lina Sulieman
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Roxana Loperena-Cortes
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kelsey Mayo
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Robert J Carroll
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Qingxia Chen
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Brian K Ahmedani
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Jason Karnes
- Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tuscon, Arizona, USA
| | - Bruce Korf
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christopher J O’Donnell
- Department of Medicine, Veterans Administration Boston Healthcare System, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jun Qian
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Andrea H Ramirez
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
12
|
Johnson GC, Karajah MT, Mayo K, Armenta TC, Blumstein DT. The bigger they are the better they taste: size predicts predation risk and anti-predator behavior in giant clams. J Zool (1987) 2016. [DOI: 10.1111/jzo.12401] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G. C. Johnson
- Department of Ecology and Evolutionary Biology; University of California Los Angeles; Los Angeles CA USA
| | - M. T. Karajah
- Department of Ecology and Evolutionary Biology; University of California Los Angeles; Los Angeles CA USA
| | - K. Mayo
- Department of Ecology and Evolutionary Biology; University of California Los Angeles; Los Angeles CA USA
| | - T. C. Armenta
- Department of Ecology and Evolutionary Biology; University of California Los Angeles; Los Angeles CA USA
| | - D. T. Blumstein
- Department of Ecology and Evolutionary Biology; University of California Los Angeles; Los Angeles CA USA
| |
Collapse
|
13
|
Kauwe JSK, Bertelsen S, Mayo K, Cruchaga C, Abraham R, Hollingworth P, Harold D, Owen MJ, Williams J, Lovestone S, Morris JC, Goate AM. Suggestive synergy between genetic variants in TF and HFE as risk factors for Alzheimer's disease. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:955-9. [PMID: 20029940 PMCID: PMC2877151 DOI: 10.1002/ajmg.b.31053] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [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: 11/10/2022]
Abstract
Alzheimer's disease (AD) is a complex disease that is likely influenced by many genetic and environmental factors. Citing evidence that iron may play a role in AD pathology, Robson et al. [Robson et al. (2004); J Med Genet 41:261-265] reported that epistatic interaction between rs1049296 (P589S) in the transferrin gene (TF) and rs1800562 (C282Y) in the hemochromatosis gene (HFE) results in significant association with risk for AD. In this study we attempted to replicate their findings in a total of 1,166 cases and 1,404 controls from three European and European American populations. Allele and genotype frequencies were consistent across the three populations. Using synergy factor analysis (SFA) and Logistic Regression analysis we tested each population and the combined sample for interactions between these two SNPs and risk for AD. We observed significant association between bi-carriers of the minor alleles of rs1049296 and rs1800562 in the combined sample using SFA (P = 0.0016, synergy factor = 2.71) and adjusted SFA adjusting for age and presence of the APOE epsilon 4 allele (P = 0.002, OR = 2.4). These results validate those of the previous report and support the hypothesis that iron transport and regulation play a role in AD pathology.
Collapse
Affiliation(s)
- JSK Kauwe
- Departments of Psychiatry & Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - S Bertelsen
- Departments of Psychiatry & Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - K Mayo
- Departments of Psychiatry & Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - C Cruchaga
- Departments of Psychiatry & Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - R Abraham
- MRC Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, Cardiff CF14 4XN, UK
| | - P Hollingworth
- MRC Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, Cardiff CF14 4XN, UK
| | - D Harold
- MRC Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, Cardiff CF14 4XN, UK
| | - MJ Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, Cardiff CF14 4XN, UK
| | - J Williams
- MRC Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, Cardiff CF14 4XN, UK
| | - S Lovestone
- Department of Neuroscience, Institute of Psychiatry, Kings College, London, UK
| | - JC Morris
- Departments of Psychiatry & Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - AM Goate
- Departments of Psychiatry & Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | | |
Collapse
|
14
|
Marchetti C, Hamdane M, Mitchell V, Mayo K, Devisme L, Rigot JM, Beauvillain JC, Hermand E, Defossez A. Immunolocalization of inhibin and activin alpha and betaB subunits and expression of corresponding messenger RNAs in the human adult testis. Biol Reprod 2003; 68:230-5. [PMID: 12493718 DOI: 10.1095/biolreprod.102.004424] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Inhibin B is a testicular peptide hormone that regulates FSH secretion in a negative feedback loop. Inhibin B is a dimer of an alpha and a beta(B) subunit. In adult testes, the cellular site of production is still controversial, and it was hypothesized that germ cells contribute to inhibin B production. To determine which cell types in the testes may produce inhibin B, the immunohistochemical localization of the two subunits of inhibin B were examined in adult testicular biopsies with normal spermatogenesis, spermatogenic arrest, or Sertoli cell only (SCO) tubules. Moreover, using in situ hybridization with mRNA probes, the mRNA expression patterns of inhibin alpha and inhibin/activin beta(B) subunits have been investigated. In all testes, Sertoli cells and Leydig cells showed positive immunostaining for inhibin alpha subunit and expressed inhibin alpha subunit mRNA. Using inhibin beta(B) subunit immunoserum on testes with normal spermatogenesis and with spermatogenic arrest, intense labeling was located in germ cells from pachytene spermatocytes to round spermatids but not in Sertoli cells. Inhibin beta(B) subunit mRNA expression was intense in germ cells from spermatogonia to round spermatids and in Sertoli cells in these testes. In testes with SCO, high inhibin beta(B) subunit mRNA labeling density was observed in both Sertoli cells and Leydig cells, whereas beta(B) subunit immunostaining was negative for Sertoli cells and faintly positive for Leydig cells. These results agree with the recent opinion that inhibin B in adult men is possibly a joint product of Sertoli cells and germ cells.
Collapse
|
15
|
Aguejouf O, Mayo K, Monteiro L, Doutremepuich F, Doutremepuich C, Megraud F. Increase of arterial thrombosis parameters in chronic Helicobacter pylori infection in mice. Thromb Res 2002; 108:245-8. [PMID: 12617988 DOI: 10.1016/s0049-3848(03)00006-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An animal model was developed to study arterial thrombosis and determine if animals infected with Helicobacter pylori behave differently after induction of direct damage to blood vessels. Twenty-one C56/BL6 mice inoculated with the "Sydney strain" of H. pylori and 19 uninfected animals were kept for 1 year before testing. Vascular lesions were induced to mesenteric arterioles (15-25 microm diameter) by Argon laser. The dynamic course of thrombus formation was continuously monitored by a video camera for 10 min. Three parameters were assessed: (1) the number of laser pulses required to induce thrombus formation, (2) the number of platelet emboli removed by the blood flow and, (3) the duration of embolization. Additionally, blood was tested for platelet aggregation, fibrinogen, and cell count. Of the parameters measured, statistical differences between infected and uninfected mice concerned the number of emboli formed (6.00+/-2.18 infected vs. 3.89+/-1.37 non-infected, p=.0006) and the duration of embolization (2.41+/-0.73 min infected vs. 1.47+/-0.61 min non-infected p>.0001). A significant difference was also found in the fibrinogen levels between infected and uninfected mice. Chronic infection of mice with H. pylori leads to increased platelet embolization after damage to arterioles. These results are in favor of the possible involvement of H. pylori infection in the acute phase of coronary heart disease (CHD).
Collapse
Affiliation(s)
- O Aguejouf
- Laboratoire d'Hématologie, Faculté de Pharmacie, Université Bordeaux II, France
| | | | | | | | | | | |
Collapse
|
16
|
Abstract
We have used a method for the two-dimensional crystallization of retroviral structural proteins to obtain a three-dimensional structure of negatively stained, membrane-bound, histidine-tagged Moloney murine leukemia virus (M-MuLV) capsid protein (his-MoCA) arrays. Tilted and untilted micrographs from crystals formed by purified his-MoCA proteins incubated beneath lipid monolayers containing nickel-chelating lipids were used in 3D reconstructions. The 2D crystals had unit cell dimensions of a=72.6 A, b=72.5 A and gamma=119.5 degrees, but appeared to have no intrinsic symmetry (p1) in 3D, in contrast to the trigonal or hexagonal appearance of their 2D projections. Membrane-bound his-MoCA proteins showed a strand-like organization, apparently with dimer building blocks. Membrane-proximal regions, or putative N-terminal domains (NTDs), dimerized with different partners than the membrane-distal putative C-terminal domains (CTDs). Evidence also suggests that CTDs can adopt alternate orientations relative to their NTDs, forming interstrand connections. Our results are consistent with helical-spiral models for retrovirus particle assembly, but are not easily reconcilable with icosahedral models.
Collapse
Affiliation(s)
- J McDermott
- Vollum Institute and Department of Microbiology, Oregon Health Sciences University, Portland, OR 97201-3098, USA
| | | | | |
Collapse
|
17
|
Ashorn M, Cantet F, Mayo K, Megraud F. Cytoskeletal rearrangements induced by Helicobacter pylori strains in epithelial cell culture: possible role of the cytotoxin. Dig Dis Sci 2000; 45:1774-80. [PMID: 11052319 DOI: 10.1023/a:1005578110764] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The relationship between Helicobacter pylori adherence, cytotoxin production, and modification of the cytoskeletal structure was investigated by studying the effects of 12 H. pylori strains cocultured with Hep-2 epithelial cells. Bacterial strains were isolated from patients with peptic ulcer disease or nonulcer dyspepsia. Presence of the cag pathogenicity island and vacA subtypes of the strains were determined as was the production of vacuolating cytotoxin. We found that cytoskeletal rearrangements, as observed by confocal microscopy after double staining of the bacteria and the cell actin with Texas red and fluorescein-conjugated phalloidin, respectively, occurred essentially when the strains were cytotoxin producers and that the supernatants alone could also lead to these modifications.
Collapse
Affiliation(s)
- M Ashorn
- Laboratoire de Bactériologie, Université Victor Ségalen Bordeaux II, France
| | | | | | | |
Collapse
|
18
|
Matysiak-Budnik T, de Mascarel A, Abely M, Mayo K, Heyman M, Mégraud F. Positive effect of rebamipide on gastric permeability in mice after eradication of Helicobacter felis. Scand J Gastroenterol 2000; 35:470-5. [PMID: 10868448 DOI: 10.1080/003655200750023714] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Despite Helicobacter pylori eradication, gastric inflammation persists for months or years. Preliminary results have indicated that an increase in gastric permeability could be one reason. Our aim was to evaluate the effect of a mucosal protective drug, rebamipide, on gastric permeability in a model of H. felis-infected mice. METHODS Thirty-three C57/BL6 mice were inoculated with H. felis, and seven controls were kept non-inoculated. After 2 months 20 infected mice were treated with omeprazole, amoxicillin, and clarithromycin for 1 week and then for 4 weeks with either rebamipide (n = 9) or placebo (n = 11). The 13 remaining mice were kept untreated. After cessation of treatment, a fragment of antrum obtained from each mouse was mounted in a small Ussing chamber to study the electric resistance of the tissue (R) and antral permeability. RESULTS No modification of the paracellular permeability (R, JNa, JMan) was observed in either group. However, the transcellular permeability to horseradish peroxidase (HRP) was significantly increased in H. felis-infected non-treated mice (1131 +/- 463, 948 +/- 339, and 182 +/- 312 ng/h x cm2) as compared with non-infected controls (469 +/- 262, 458 +/- 261, and 10 +/- 6 ng/ h x cm2, for J3H-HRP, JD, and JHRPi, respectively) (P < 0.003). Eradication of the bacteria by antibiotics without subsequent treatment with rebamipide led to a non-significant decrease in the HRP fluxes. However, when rebamipide was used after the antibiotic treatment, a significant (P < 0.01) decrease in HRP fluxes as compared with non-treated mice was observed. CONCLUSIONS These results confirm that gastric permeability to macromolecules remains increased despite H. felis eradication and show that rebamipide can facilitate the normalization of gastric permeability to macromolecules after bacterial eradication.
Collapse
Affiliation(s)
- T Matysiak-Budnik
- INSERM E9925, Faculty of Medicine Necker-Sick Children, Paris, France
| | | | | | | | | | | |
Collapse
|
19
|
Mâsse LC, Ainsworth BE, Tortolero S, Levin S, Fulton JE, Henderson KA, Mayo K. Measuring physical activity in midlife, older, and minority women: issues from an expert panel. J Womens Health (Larchmt) 1998; 7:57-67. [PMID: 9511133 DOI: 10.1089/jwh.1998.7.57] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.6] [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: 02/06/2023] Open
Abstract
This article summarizes the findings of an exploratory meeting of 53 experts brought together under the aegis of the Women's Health Initiative to identify important issues related to measuring physical activity in minority women, women in midlife (aged 40-75), and older women (aged > 75). The findings address five areas, three dealing with measurement and two concerning the design of surveys: (1) population characteristics to consider when measuring the physical activity of women and minority populations, (2) activity dimensions relevant to physical activity surveys, (3) measuring moderate and intermittent activities, (4) designing and administering physical activity surveys for older and minority women, and (5) establishing the reliability and validity of such physical activity surveys. Although the focus of the expert panel meeting was on identifying issues related to the measurement of physical activity in women, many issues summarized here can be generalized to children and men. The panel's findings concerning measuring physical activity are timely, as they directly bear on the challenges associated with the physical activity guidelines jointly issued by the Centers for Disease Control and Prevention and the American College of Sports Medicine and the recommendations made in the Surgeon General's 1996 report, Physical Activity and Health.
Collapse
Affiliation(s)
- L C Mâsse
- School of Public Health, University of Texas-Houston, USA
| | | | | | | | | | | | | |
Collapse
|
20
|
Mayo K, Pretolani S, Gasbarrini G, Ghironzi G, Megraud F. Heterogeneity of immunoglobulin G response to Helicobacter pylori measured by the unweighted pair group method with averages. Clin Diagn Lab Immunol 1998; 5:70-3. [PMID: 9455883 PMCID: PMC121394 DOI: 10.1128/cdli.5.1.70-73.1998] [Citation(s) in RCA: 9] [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] [Indexed: 02/06/2023]
Abstract
The heterogeneity of the immune response to Helicobacter pylori has always been noticed but has never been evaluated by obtaining a quantitative measure. For this purpose, sera were tested by enzyme-linked immunosorbent assay, and 207 positive serum specimens were subsequently tested by immunoblotting. The presence or absence of six specific bands was noted. The homology of the different profiles of bands was measured by calculating the Dice coefficient, and a dendrogram was constructed. Thirty-four profiles were found, with each profile containing from 1 to 43 serum specimens. At a level of 72% similarity, 115 of the serum specimens studied fell into eight profiles. At a level of 48% similarity, 186 of the serum specimens studied fell into 22 profiles. The difference in immunoblot profiles was probably linked to the host immune response, but infection with strains carrying different antigens cannot be ruled out.
Collapse
Affiliation(s)
- K Mayo
- Laboratoire de Bactériologie-Enfants, Hôpital Pellegrin, Bordeaux, France
| | | | | | | | | |
Collapse
|
21
|
Heikkinen M, Mayo K, Mégraud F, Vornanen M, Marin S, Pikkarainen P, Julkunen R. Association of CagA-positive and CagA-negative Helicobacter pylori strains with patients' symptoms and gastritis in primary care patients with functional upper abdominal complaints. Scand J Gastroenterol 1998; 33:31-8. [PMID: 9489905 DOI: 10.1080/00365529850166176] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND CagA-positive Helicobacter pylori strains have been reported to be associated with peptic ulcer or malignancy more often than cagA-negative strains. Less is known about the relation of H. pylori serology (CagA-negative or CagA-positive) to histologic changes in the stomach of patients with functional upper abdominal complaints. The association of H. pylori status with patient symptoms or with different subgroups of non-organic dyspepsia is also obscure. In the present study patients' symptoms and their relation to H. pylori serology (H. pylori-negative, H. pylori-positive but CagA-negative, and H. pylori-positive and CagA-positive) were evaluated in general practice patients who had functional upper abdominal complaints. The association of H. pylori serology with different symptom-based subgroups of functional upper abdominal complaints was also assessed. The severity and activity of inflammation and the presence of atrophy and intestinal metaplasia in the antrum and body were evaluated and compared with H. pylori status. METHODS Four hundred consecutive unselected dyspeptic patients in primary care were investigated by means of gastroscopy, upper abdominal ultrasound, laboratory screening including H. pylori and CagA serology, and other examinations if needed. Of these patients 193 with functional upper abdominal complaints were enrolled in this study. RESULTS Of the study patients 87 (45%) were H. pylori-negative, 70 (36%) were H. pylori- and CagA-positive, and 36 (19%) were H. pylori-positive but CagA-negative. There were no differences in the occurrence of any dyspeptic symptoms between H. pylori-related subgroups. Nor was there an association between H. pylori status and symptom-based subgroups in our study patients. Inflammation of the stomach was related to H. pylori infection, but CagA-seropositive patients did not have moderate or severe inflammation more often than CagA-seronegative ones. CagA-seropositive patients with functional upper abdominal complaints did not have atrophic changes or intestinal metaplasia in the stomach more often than those who were CagA-negative. CONCLUSIONS H. pylori or more specific CagA serology is not associated with any specific symptom profile of dyspepsia or with any symptom-based subgroups in patients with functional upper abdominal complaints in primary care. The study patients with CagA seropositivity did not have more severe histologic changes in the stomach than the patients who were H. pylori-seropositive but CagA-seronegative.
Collapse
Affiliation(s)
- M Heikkinen
- Dept. of Medicine, Kuopio University Hospital, Finland
| | | | | | | | | | | | | |
Collapse
|
22
|
Heikkinen M, Janatuinen E, Mayo K, Mégraud F, Julkunen R, Pikkarainen P. Usefulness of anti-Helicobacter pylori and anti-CagA antibodies in the selection of patients for gastroscopy. Am J Gastroenterol 1997; 92:2225-9. [PMID: 9399758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Screening of dyspeptic patients with serological tests for Helicobacter pylori before open-access gastroscopy has been suggested to be worthwhile. CagA-positive H. pylori strains may be associated with major pathology more often than CagA-negative strains. The usefulness of anti-H. pylori and anti-CagA antibodies in screening for gastroscopy was evaluated in unselected dyspeptic patients. METHODS Four hundred consecutive, unselected dyspeptic patients (mean age, 56.8 yr) in primary care were investigated with gastroscopy, ultrasonography of the upper abdomen, laboratory tests (including serological tests for H. pylori and CagA), and other examinations if needed. The patients were followed for 1 yr. RESULTS Results of serological tests were positive for H. pylori in 56.2% of patients, of whom 64.4% also had results positive for CagA. Use of H. pylori and CagA serology-based screening combined with a history of nonsteroidal anti-inflammatory drug use would have detected only 80 and 70% of the major pathologies (peptic ulcer, moderate or severe esophagitis, celiac disease, or malignancy), respectively, in these patients. Gastroscopy would have been avoided in 30 and 41%, respectively, if only patients who had positive results on serological tests or who were nonsteroidal anti-inflammatory drug users would have been referred. In patients younger than 45 yr of age (n = 87), 60-74% of gastroscopies would have been avoided, but 50-60% of major pathologies would have been missed, by using the screening strategy studied. One of the nine malignancies (all in patients >45 yr of age) was H. pylori-negative, and two were CagA-negative. CONCLUSIONS Anti-CagA antibodies do not offer advantages compared with anti-H. pylori antibodies in screening patients for gastroscopy. A remarkable share of major pathologies are missed by both of these screening methods. Therefore, the results of these screening tests are not recommended as selective criteria for gastroscopy.
Collapse
Affiliation(s)
- M Heikkinen
- Department of Medicine, Kuopio University Hospital, Finland
| | | | | | | | | | | |
Collapse
|
23
|
Abstract
PURPOSE To address the lack of information in nursing for delivering culturally appropriate care and provide a framework for nurses to incorporate diverse beliefs and health needs into research and practice. People interpret and react to health and illness events within a cultural system. However, the nursing literature contains little about how to elicit cultural beliefs. ORGANIZING FRAMEWORK Use of Kleinman's (1980) concept of explanatory models (EMs) is explored first, by describing the concept as it was developed by Kleinman, and second, by illustrating how it was used in three research studies conducted between 1990 and 1994. METHOD Individual in-depth interviews were conducted with community-based convenience samples. Data were analyzed using content analysis. Explanatory models were explored with health people following illness, and with people having a condition with potential health risks, to illustrate their usefulness in nursing research and practice. CONCLUSIONS The findings provide a beginning understanding of the complex linkages between beliefs and actions and demonstrate the versatility and usefulness of EMs for nursing research and practice. Assessing models offers one means for researchers and clinicians to explore health beliefs and the linkages between beliefs and behaviors.
Collapse
Affiliation(s)
- J C McSweeney
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock 72205, USA
| | | | | |
Collapse
|
24
|
Timms J, Abercrombie B, Saccogna J, Natvig D, Douglas MS, Mayo K, Walton C. Enhancing student learning and employee health through university-community partnerships. S C Nurse (1994) 1997; 4:20-23. [PMID: 9391426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
|
25
|
Abstract
OBJECTIVE To determine if the ammonia produced by Helicobacter pylori affects the phagocytic ability of human polymorphonuclear leucocytes as measured by the oxidative burst. METHODS Interactions between opsonized urease-positive and -negative strains of H. pylori with polymorphonuclear leucocytes were studied in two series of experiments. In the first series of experiments, concentrations from 0 to 50 mM of NH4Cl were added to polymorphonuclear leucocytes. In the second series of experiments, bacteria were pre-incubated for 1 h with urea (0 to 50 mM) before addition of phagocytes. Luminol-dependent chemiluminescence was measured every 5 min over a 50-min period. The pH was verified in each treatment. RESULTS Inhibition of chemiluminescence, increasing with concentration, was noted in all treatments when NH4Cl was added. When urea was added to urease-positive strains, chemiluminescence was significantly reduced when compared to the urease-negative strain and the zymosan control. This effect could not be attributed to a change in pH in the experiments using NH4Cl or urea at a concentration of 5 mM and 10 mM. CONCLUSION Ammonia generated by H. pylori may contribute to the decreased activity of polymorphonuclear leucocytes in vivo.
Collapse
Affiliation(s)
- K Mayo
- Laboratoire de Bactériologie-Enfants, Hopital Pellegrin, Bordeaux, France
| | | | | | | |
Collapse
|
26
|
Abstract
An urban shelter in Charleston, South Carolina developed and began a tuberculosis (TB) prevention and control plan that addressed the priorities recommended by the Centers for Disease Control and Prevention. After an increase in TB in the shelter in 1992, the local health department, the homeless clinic nurse practitioners, and Medical University of South Carolina College of Nursing faculty and students collaborated with the shelter staff to provide initial mass screenings for contact investigation. They also developed and implemented new policies and procedures for an ongoing TB prevention and control program. The new policies required that guests obtain screening for TB within 7 days of arrival at the shelter and every 6 months thereafter. Also, a public health nurse began providing directly observed therapy twice weekly at the shelter. Of the initial 22 persons who started TB preventive therapy in 1993, 17 (77%) completed therapy. The clinic nurse practitioners, nursing students, and public health nurses had important and defined roles in the mass-screening process, case identification and treatment, policy development and implementation, health education, and establishing methods of communication between the shelter, clinic, and health department. An ongoing health care community collaborative effort may successfully reduce tuberculosis disease in a homeless shelter population.
Collapse
Affiliation(s)
- K Mayo
- Medical University of South Carolina, College of Nursing, Charleston, SC 29425-2402, USA
| | | | | | | |
Collapse
|
27
|
Abstract
Nurses will be key participants in health care reform as health care shifts from a hospital-based disease orientation to a community-centered health promotion focus. Nursing in communities, the environmental context of clients' everyday lives, requires attention to social, economic, and political circumstances that influence health status and access to health care. Therefore, nursing educators have the responsibility to prepare future nurses for community-based practice by instilling moral and professional practice obligations, cultural sensitivity, and other facets of social responsibility. In this article, social responsibility and journaling, a teaching/learning strategy suggested by the new paradigm approach of the curriculum revolution, are explored. A qualitative research study of more than 100 nursing student journal entries illustrates the concept of social responsibility and how it developed in a group of baccalaureate nursing students during a clinical practicum in a large urban homeless shelter.
Collapse
|
28
|
Gasbarrini G, Pretolani S, Bonvicini F, Gatto MR, Tonelli E, Mégraud F, Mayo K, Ghironzi G, Giulianelli G, Grassi M. A population based study of Helicobacter pylori infection in a European country: the San Marino Study. Relations with gastrointestinal diseases. Gut 1995; 36:838-44. [PMID: 7615270 PMCID: PMC1382619 DOI: 10.1136/gut.36.6.838] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Helicobacter pylori is present worldwide but few large population studies exist on the epidemiology of the infection. A random cross sectional study was performed of H pylori infection in the adult population of San Marino, a European country with high gastric cancer rate, to assess its prevalence and to evaluate its relations with gastrointestinal disease. In 2237 subjects (77% of the initial sample) H pylori IgG antibodies were detected with enzyme linked immunosorbent assay (ELISA) and immunoblotting. A questionnaire including questions about occupation, place of birth, and smoking was given to all subjects. Dyspepsia, peptic ulcer, and gastric cancer in the subjects, relatives, and partners as well as use of drug, dental treatment/prostheses, and gastrointestinal endoscopies, were evaluated by multivariate analysis. H pylori prevalence was of 51%, increased with age from 23% (20-29 years) to 68% (> or = 70 years), and was higher among manual workers. H pylori was independently associated with ulcer (OR = 1.63, 95% confidence intervals (CI) = 1.16 to 2.27), H2 antagonists (OR = 1.94, 95% CI = 1.21 to 3.10), and benzodiazepines (OR = 1.57, 95% CI = 1.02 to 2.42), dental prostheses (OR = 1.25, 95% CI = 1.05 to 1.49), gastroscopy in the past five years (OR = 1.50, 95% CI = 1.05 to 2.14), peptic ulcer in siblings (OR = 1.52, 95% CI = 1.09 to 2.12), gastric cancer in father (OR = 1.61, 95% CI = 1.02 to 2.52). The association of seropositivity with history of ulcer, gastric cancer in family, gastroscopy, and H2 antagonists suggests that H pylori is an epidemiological key factor in the pathogenesis of gastroduodenal diseases in this area.
Collapse
Affiliation(s)
- G Gasbarrini
- Istituto di Igiene, University of Bologna, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Abstract
The purpose of this naturalistic study was to compare values held by 36 white and 31 black women related to body size, and to identify factors that influence these values and linkages between body size values and weight management activities. Black women of lower SES were significantly different from black women of higher SES and white women, regardless of SES, in that they were heavier, viewed themselves as heavier, and perceived attractive body size as heavier. Black lower status women had to become a great deal heavier than the other groups before they defined themselves as overweight. We suggest that black lower social status women have a wider range of "normal" and attractive body size and that this wider range is developed from comparisons of other women in their social milieu and influences the initiation of weight loss activities.
Collapse
Affiliation(s)
- J D Allan
- School of Nursing, University of Texas at Austin 78701-1499
| | | | | |
Collapse
|
30
|
Abstract
A total of 631 serum samples collected in 1969, 1979, and 1989 from adults and children were screened for Helicobacter pylori by Western blot analysis. Results showed that H. pylori seroprevalence has become less frequent over the 20-year period. By studying seropositivity by year of birth, the magnitude of a cohort effect of H. pylori seropositivity was estimated. The odds of being seropositive decreased by 26% per decade, P = .008 (95% confidence interval, 8%-41%). Estimates of seroprevalence adjusted for both age-specific variation and the cohort effect suggest that most seropositivity in adults occurs by the age of 15 years. The implication of these findings is that H. pylori infection is becoming less frequent and is predominantly acquired in childhood.
Collapse
Affiliation(s)
- N Banatvala
- Department of Epidemiology and Medical Statistics, London Hospital Medical College, United Kingdom
| | | | | | | | | | | |
Collapse
|
31
|
Abstract
The cytotoxic T-lymphocyte (CTL) response to measles virus (MV) was studied in blood samples from 13 acute- and early convalescent-phase patients with measles infection despite previous vaccination with the live-MV vaccine. MV CTL responses were also measured in six healthy peer controls who had live-MV vaccination during childhood and in five healthy adults who had a remote history of natural measles. All patients recovered from illness without complication. Acute MV infection was diagnosed on the basis of the Centers for Disease Control criteria and by measuring MV-specific immunoglobulin G (IgG) and IgM antibodies. Elevated IgG titers occurred in 80% of the patients at 1 to 2 weeks and in 100% at 4 weeks postinfection. IgM antibodies were detectable in all patient tested and were elevated in 60% of the patients at 1 to 2 weeks postinfection. The MV-specific CTL response was enhanced in 10 of the 13 patients tested, with a mean maximal lysis of 48.5% +/- 13.3%, compared with that of healthy peer controls who had had live-MV vaccinations during childhood (mean lysis, 14.6% +/- 12.9%; n = 6) and healthy adults with a remote history of natural measles (mean, 30.8% +/- 12.2%; n = 5). Three patients had low MV CTL levels at two time points following measles, with a mean lysis of 12% +/- 1.7%. It is concluded that while there is no evidence for a deficiency in the generation of cellular immunity to MV in the majority of patients with MV vaccine failure, a small number of individuals may fail to develop an enhanced T-cell response following infection.
Collapse
Affiliation(s)
- V H Wu
- Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland 20892
| | | | | | | | | | | |
Collapse
|
32
|
Mayo K. Homelessness in the south--excerpts from student journals. Imprint 1992; 39:64-7. [PMID: 1295831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
33
|
Fixa B, Komárková O, Krejsek K, Bures J, Nozicka Z, Giorcelli W, Rodi M, Camisasca G, Martinotti RG, Mendall MA, Goggin PM, Molineaux N, Levy J, Toosy T, Strachan D, Northfield TC, Vorobjova T, Vassiljev V, Kisand K, Wadström T, Uibo R, Zotz RB, Xu SG, Recklinghausen GV, Meusers P, Goebell H, Rhee KH, Youn HS, Paik SK, Lee WK, Cho MJ, Park CK, Li Y, Hu P, Du G, Wong Z, Hazell SL, Mitchell HM, Korwin JDD, Remot P, Hartemann P, Catelle A, Conroy MC, Schmitt J, Stolte M, Wellens E, Bethke B, Ritter M, Eidt H, Zanten SVV, Best L, Bezanson G, Marrie T, Poniewierka E, Gosciniak G, Matysiak-Budnik T, Quatrini M, Boni F, Baldassarri AR, Vecchi AD, Castelnovo C, Viganò E, Tenconi L, Bianchi PA, Carlucci A, Ferrini G, Bianco I, Larcinese G, Sciascio AD, Fly GF, Hauge T, Persson J, Coelho LGV, Teixeira MM, Passos MCF, Givisiez CB, Santos CMFR, Rodrigues CJS, Chausson Y, Castro LP, Hyvärinen H, Seppälä K, Kivilaakso E, Kosunen T, Gormse M, Pilotto A, Vianello F, Tornaboni D, Dotto P, Battaglia G, Binda F, Mario FD, Donisi PM, Pasini M, Benve-nuti ME, Stracca-Pansa V, Pasquino M, Jablonowski H, Szelényi H, Hengels KJ, Strohmeyer G, Banatvala N, Mayo K, Megraud F, Jennings R, Deeks JJ, Feldman RA, Bulighin G, Ederie A, Pilati S, Franzin G, Zamboni G, Maran M, Musola R, Tobin A, Hackman RC, McDonald GB, Fatela N, Cristino JM, Monteiro L, Ramalho F, Saragoça A, Salgado MJ, Moura MCD, Pretolani S, Gasbarrini G, Bonvicini F, Baraldini M, Tonelli E, Gatto MRA, Ghironzi GC, égraud FM, Bouchard S, Lubcvzumiska-Kowalska W, Knapik Z, Meenan J, Goggins M, Shahi C, Keeling PWN, Keane C, Weir DG, Vaira D, Miglioli M, Mulè P, Holten J, Menegati M, Biasco G, Vergura M, Nannetti A, Barbara L, Boschini A, Begnini M, Menegatti M, Ghira C, D’Errico A, Evans DG, Asnicar MA, Evans DJ, Graham DY, Lee CH, Coschieri M, Fosse T, Paul MCS, Michiels JR, Delmont JP, Péroux JL, Pradier C, Rampai P, Pazzi P, Merighi A, Gamberini S, Scarliarini R, Bicochi R, Libanore M, Bisi G, Gulllini S. Epidemiology. Ir J Med Sci 1992. [DOI: 10.1007/bf02942891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
34
|
Engel JD, Beug H, LaVail JH, Zenke MW, Mayo K, Leonard MW, Foley KP, Yang Z, Kornhauser JM, Ko LJ. cis and trans regulation of tissue-specific transcription. J Cell Sci Suppl 1992; 16:21-31. [PMID: 1297649 DOI: 10.1242/jcs.1992.supplement_16.4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Analysis of both the cis-regulatory sequences which control globin gene switching as well as the trans-acting factors which bind to these sequences to elicit a differential, developmentally regulated response has lent insight into the general mechanisms responsible for tissue-specific gene regulation. We show here that the chicken adult beta-globin gene promoter sequences are intimately involved in competitive interaction with the beta/epsilon-globin enhancer to regulate differentially epsilon- versus beta-globin gene transcription. Secondly, we show that the family of GATA transcription factors directs gene regulation in a variety of discrete cell types, and describe potential cellular target genes for each member of the GATA factor family, as well as potential mechanisms whereby multiple GATA factors expressed in a single cell might be used to elicit differential transcriptional activities.
Collapse
Affiliation(s)
- J D Engel
- Department of Biochemistry, Molecular Biology and Cell Biology, Northwestern University, Evanston, IL 60208-3500
| | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Mayo K. Kitt Mayo. Interview by Marcy White. Imprint 1991; 38:37-8. [PMID: 1748453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
36
|
Rexroad CE, Mayo K, Bolt DJ, Elsasser TH, Miller KF, Behringer RR, Palmiter RD, Brinster RL. Transferrin- and albumin-directed expression of growth-related peptides in transgenic sheep. J Anim Sci 1991; 69:2995-3004. [PMID: 1715850 DOI: 10.2527/1991.6972995x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Chimeric genes containing either the mouse transferrin (Trf) enhancer/promoter fused to the structural sequences encoding bovine growth hormone (GH) or the mouse albumin (Alb) enhancer/promoter fused to the gene for human growth hormone-releasing factor (GRF) were microinjected into sheep zygotes. A low percentage of resulting transgenic sheep chronically expressed the respective genes, resulting in elevated plasma concentrations of circulating GH or GRF, respectively. Growth hormone-releasing factor expression induced elevated plasma levels of endogenous GH production. In addition, elevated levels of circulating insulin-like growth factor-I were observed in the bovine GH-expressing Trf transgenic sheep. Growth of these founder transgenic sheep relative to controls were not enhanced. In part, this may be due to the development of the diabetic condition exhibited by both transgenic groups. These results demonstrate that the mouse Trf and Alb enhancer/promoters are active in sheep and suggest that alternate strategies for expressing growth-related genes may be required to modulate growth in sheep.
Collapse
Affiliation(s)
- C E Rexroad
- Reprod. Lab., Livest. and Poult. Sci. Inst., U.S. Department of Agriculture, Beltsville, MD 20705
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Aida T, Urata S, Oquro T, AKIMOTO Y, OBINATA A, ODA Y, ENDO H, KASAI KI, HIRANO H, AOKI T, OINUMA T, KAWANO J, SUGANUMA T, Arai R, Kojima Y, Maeda T, Arakawa M, Mizoguchi A, Fujimoto E, Miki A, Ide C, ARAKI N, TAKASHIMA Y, OGAWA K, ARAKI T, Chang C, Ogawa Y, Kuwahara H, Yagi T, CHIDA K, CHIKAMORI K, ARAKI T, CUI YX, KIGUCHI K, NOZAWA S, IWAMORI M, NAGAI Y, KAWAKAMI H, HIRANO H, DAIMON T, KAWAI K, UCHIDA K, DATE F, SASANO H, NAGURA H, DOBASHI K, MUNIM A, ASAYAMA K, SUZUKI K, KATO K, KAWAOI A, ENDO H, YAMADA G, NISHIMOTO H, TSUJI T, NAKANE PK, FUJII T, KOMORI K, SAKAI M, YAMADA K, KARASAWA N, NAGATSU I, FUJIMOTO T, NAKADE S, MIKOSHIBA K, OGAWA K, FUKUDA K, FUKAMI M, FUKUI M, KIMURA K, QIAO Y, MURATA J, ASANO G, HANAI T, USUDA N, MORITA T, KONG Y, NAGATA T, HARADA T, HASHIMOTO K, TORII I, MORIKAWA S, HAREYAMA M, FUJIMOTO K, HONDA Y, HIRAKAWA M, KAWATA M, HIROSE Y, WATANABE M, SHIMADA M, IHIDA K, TSUYAMA S, NASHIO N, MURATA F, KATSUYAMA T, OHTA H, IMAMOTO K, KARASAWA N, NAGATU I, Inada K, Utunomiya H, Sato K, Osamura R, Katakami H, Mayo K, ISHIBASHI T, KANAZAWA K, SAITO T, ITO N, KAWAHARA S, HIRANO Y, HIROTA T, ITOH A, ITOH K, TAKESHITA T, ITOH M, Itoh J, Inada K, Osamura R, Watanabe K, Itoh Y, Komatsu N, Watanabe K, Angeletti H, ITO-SAITO A, SAITO N, MATSUMURA T, TANAKA C, IWAMOTO M, WATANABE J, ASADA-KUBOTA M, KANAMURA S. GENERAL SESSION. Acta Histochem Cytochem 1991. [DOI: 10.1267/ahc.24.508] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Takeo Aida
- Dept. of Pathology and Central Institute for EM Res. Nippon Medical School
| | - Shinichi Urata
- Dept. of Pathology and Central Institute for EM Res. Nippon Medical School
| | - Tatsuo Oquro
- Dept. of Pathology and Central Institute for EM Res. Nippon Medical School
| | | | | | - Yuko ODA
- Biol Chem, Fac Pharm Sci, Teikyo Univ
| | | | | | | | - Toshihiro AOKI
- First Department of Internal Medicine, Miyazaki Medical College
- Department of Anatomy, Miyazaki Medical College
| | | | | | | | - Ryohachi Arai
- Department of Anatomy, Shiga University of Medical Science
| | - Yasuji Kojima
- Department of Anatomy, Shiga University of Medical Science
| | | | - M. Arakawa
- Department of Anatomy, Kobe University School of Medicine
| | - A. Mizoguchi
- Department of Anatomy, Kobe University School of Medicine
| | - E. Fujimoto
- Department of Anatomy, Kobe University School of Medicine
| | - A. Miki
- Department of Anatomy, Kobe University School of Medicine
| | - C. Ide
- Department of Anatomy, Kobe University School of Medicine
| | - Nobukazu ARAKI
- Department of Anatomy, Ehime University School of Medicine
| | | | - Kazuo OGAWA
- Department of Anatomy, Faculty of Medicine, Kyoto University
| | - Tsutomu ARAKI
- Department of Mechanical Engineering, Faculty of Engineering, University of Tokushima
| | - C.K. Chang
- Dept. of Oral Pathology, Osaka Univ. Dental School
| | - Y. Ogawa
- Dept. of Oral Pathology, Osaka Univ. Dental School
| | - H. Kuwahara
- Dept. of Pathology, Osaka City Univ. Medical School
| | - T. Yagi
- Dept. of Oral Pathology, Osaka Univ. Dental School
| | - Kohsuke CHIDA
- Department of Pathology, Kitasato University of Hygienic Sciences
| | | | - Tsutomu ARAKI
- Department of Mechanical Engineering, University of Tokushima
| | | | | | | | | | | | | | | | - T. DAIMON
- Department of Anatomy, School of Medicine Teikyo University
| | - K. KAWAI
- Department of Anatomy, School of Medicine Teikyo University
| | - K. UCHIDA
- Department of Anatomy, School of Medicine Teikyo University
| | | | | | | | | | - Afreen MUNIM
- Dept of Pediatrics & Pathology, Yamanashi Medical College
| | | | - Koichi SUZUKI
- Dept of Pediatrics & Pathology, Yamanashi Medical College
| | - Kiyohiko KATO
- Dept of Pediatrics & Pathology, Yamanashi Medical College
| | - Akira KAWAOI
- Dept of Pediatrics & Pathology, Yamanashi Medical College
| | - Hisashi ENDO
- The First Department of Internal Medicine, Okayama University Medical School
| | - Gotaro YAMADA
- The First Department of Internal Medicine, Okayama University Medical School
| | - Hiroshi NISHIMOTO
- The First Department of Internal Medicine, Okayama University Medical School
| | - Takao TSUJI
- The First Department of Internal Medicine, Okayama University Medical School
| | - Paul K. NAKANE
- The Third Department of Anatomy, Nagasaki University School of Medicine
| | - Tetsuya FUJII
- Department of Anatomy, School of Medicine, Fujita Health University
| | - Kaoru KOMORI
- Department of Anatomy, School of Medicine, Fujita Health University
| | - Masao SAKAI
- Department of Anatomy, School of Medicine, Fujita Health University
| | - Keiki YAMADA
- Department of Anatomy, School of Medicine, Fujita Health University
| | | | - Ikuko NAGATSU
- Department of Anatomy, School of Medicine, Fujita Health University
| | | | | | | | | | | | | | | | | | - Yan QIAO
- Department of Pathology, Nippon Medical School
| | | | - Goro ASANO
- Department of Pathology, Nippon Medical School
| | - Toru HANAI
- Department of Anatomy and Cell Biology. Shinshu University School of Medicine
| | - Nobuteru USUDA
- Department of Anatomy and Cell Biology. Shinshu University School of Medicine
| | - Takashi MORITA
- Department of Anatomy and Cell Biology. Shinshu University School of Medicine
| | - Yonuli KONG
- Department of Anatomy and Cell Biology. Shinshu University School of Medicine
| | - Tetsuji NAGATA
- Department of Anatomy and Cell Biology. Shinshu University School of Medicine
| | | | | | | | | | - Masashi HAREYAMA
- Dept. Anat, Fac. Med. Kyoto Univ
- Dept. Ophthalmol. Fac. Med. Kyoto Univ
| | | | | | - Makoto HIRAKAWA
- Department of Anatomy, Kyoto Prefectural University of Medicine
| | | | | | | | | | - K. IHIDA
- Dept. Anat. Fac. Med. Kagoshima Univ
| | | | - N. NASHIO
- Dept. Anat. Fac. Med. Kagoshima Univ
| | - F. MURATA
- Dept. Anat. Fac. Med. Kagoshima Univ
| | | | - H. OHTA
- Dept. Med. Lab. Fac. Med. Shinshu Univ
| | - Kikuko IMAMOTO
- Dept. of Anatomy, Shiga Univ. Med. Sci., Otsu & Dept. of Anatomy, Fujita-gakuen Health Univ
| | - Nobuyuki KARASAWA
- Dept. of Anatomy, Shiga Univ. Med. Sci., Otsu & Dept. of Anatomy, Fujita-gakuen Health Univ
| | - Ikuko NAGATU
- Dept. of Anatomy, Shiga Univ. Med. Sci., Otsu & Dept. of Anatomy, Fujita-gakuen Health Univ
| | - K. Inada
- Department of Pathology Tokai University School of Medicine
| | - H. Utunomiya
- Department of Pathology Tokai University School of Medicine
| | - K. Sato
- Department of Pathology Tokai University School of Medicine
| | - R.Y. Osamura
- Department of Pathology Tokai University School of Medicine
| | - H. Katakami
- Department of Pathology Tokai University School of Medicine
| | - K. Mayo
- Department of Pathology Tokai University School of Medicine
| | | | | | | | - Nobuaki ITO
- Department of Legal Medicine, Nara Medical University
| | | | | | | | - Atsuko ITOH
- Dept. of Legal Medicine, Toho Univ. Sch. of Med
| | - Kinji ITOH
- Dept. of Pathology, Toho Univ. Sch. of Med
| | | | | | - J. Itoh
- Cell Biol. Res. Lab., Dept. of Pathol. Tokai Univ. Sch. of Med
| | - K. Inada
- Cell Biol. Res. Lab., Dept. of Pathol. Tokai Univ. Sch. of Med
| | - R.Y. Osamura
- Cell Biol. Res. Lab., Dept. of Pathol. Tokai Univ. Sch. of Med
| | - K. Watanabe
- Cell Biol. Res. Lab., Dept. of Pathol. Tokai Univ. Sch. of Med
| | - Y. Itoh
- Department of Pathology Tokai University School of Medicine
| | - N. Komatsu
- Department of Pathology Tokai University School of Medicine
| | - K. Watanabe
- Department of Pathology Tokai University School of Medicine
| | - H. Angeletti
- Department of Pathology Tokai University School of Medicine
| | - Atsuko ITO-SAITO
- Departments of Medical Zoology, Kobe University School of Medicine
| | - Naoaki SAITO
- Departments of Pharmacology, Kobe University School of Medicine
| | - Takeo MATSUMURA
- Departments of Medical Zoology, Kobe University School of Medicine
| | - Chikako TANAKA
- Departments of Pharmacology, Kobe University School of Medicine
| | - Masunobu IWAMOTO
- Departments of Anatomy and Orthopedics, Kansai Medical University
| | - Jun WATANABE
- Departments of Anatomy and Orthopedics, Kansai Medical University
| | | | | |
Collapse
|
38
|
Oettinger W, Mayo K, Stager MA, Fischer N, Engst U, Hansen ST. [Thromboxane A2 and granulocyte elastase after severe trauma--relationship to complications and survival rates]. Wien Klin Wochenschr 1989; 101:805-13. [PMID: 2609665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Of 64 polytraumatized patients with a mean injury severity score of 33.1, 42 showed marked systemic release of thromboxane B2 and granulocyte elastase during the initial 18 hours after trauma, reaching peak arterial levels of greater than 1,000 pg/ml and ng/ml, respectively. If those patients ("responders": plasma TXB2 greater than 250 pg/ml) were compared with the remaining 22 ("non-responders": TXB2 less than 250 pg/ml) the following became obvious: "Late" mortality (greater than 3 d) was 31% in responders, which is significantly higher than in non-responders (9%). No correlation was observed between "early" mortality (less than 3 d) and mediator release. There was no difference in the incidence of the adult respiratory distress syndrome (ARDS) (38% versus 32%) or the late sepsis syndrome (17% versus 18%) between responders and non-responders. Morbidity, however, differed markedly in that ARDS in responders was associated with significantly higher elastase levels, a higher mortality and 10 times higher incidence of sepsis as compared to responders without ARDS. ARDS in non-responders, by contrast, did not change elastase maxima or the mortality rate as compared to non-responders without ARDS. It is concluded that TXB2 is not a predictor of posttraumatic ARDS, but is related to a complicated course, in particular to sepsis and mortality. Elastase with high probability predicts ARDS and/or the late sepsis syndrome. Simultaneous determination of TXB2 further enhances the predictive value of elastase.
Collapse
Affiliation(s)
- W Oettinger
- Abteilung für Allgemeine Chirurgie, Universität Ulm
| | | | | | | | | | | |
Collapse
|
39
|
Abstract
This case report describes an unusual recurrence of a cemento-ossifying fibroma and illustrates the diagnostic difficulties that may be encountered when treating fibro-osseous lesions.
Collapse
Affiliation(s)
- K Mayo
- Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor 48109-1078
| | | |
Collapse
|
40
|
Mayo K. Dextrose containing intravenous fluids impairs outcome and increases death after eight minutes of cardiac arrest and resuscitation in dogs. J Oral Maxillofac Surg 1987. [DOI: 10.1016/0278-2391(87)90026-7] [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: 11/28/2022]
|
41
|
Rogol AD, Blizzard RM, Foley TP, Furlanetto R, Selden R, Mayo K, Thorner MO. Growth hormone releasing hormone and growth hormone: genetic studies in familial growth hormone deficiency. Pediatr Res 1985; 19:489-92. [PMID: 3923425 DOI: 10.1203/00006450-198505000-00016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Four families with growth hormone (GH) deficiency, either isolated or with other pituitary hormonal deficits are described. Members of each underwent pharmacological testing for GH secretion and infusions of GH releasing hormone (GHRH) to determine the locus of the defect in GH secretion. In addition, we have extracted DNA from white blood cells to characterize the GHRH and GH genes. All members tested had the normal complement of GH and GHRH genes. Four generations of one family with isolated GH deficiency, autosomal dominant were studied. The younger members showed minimal GH responsiveness to a single infusion of GHRH. However, the older members did not respond even after 30 doses of GHRH given intravenously every 3 h. Two members of a family with the autosomal recessive type of isolated GH deficiency had large GH increases after GHRH infusion. Thus in these families the GH secretory defect lies within the hypothalamus. Members of two families with pituitary deficiency (GH and other tropic hormones) of the autosomal recessive type had variable responses to GHRH and varying amounts of pituitary tissue seen on high resolution CT scans. Although it is not possible to delineate the precise location of the secretory defects in these latter two families, a hypothalamic defect is probable based on the responses to multiple trophic stimuli. Heterogeneity of structure and function exists within and between families with isolated GH deficiency and within and among families with pituitary deficiency. It is from the study of such families in which all members presumably have the same underlying defect that one can more readily decide on a pathogenetic mechanism.
Collapse
|