1
|
Larson-Nath C, Wendt L, Rahhal R. Catheter salvage from central line-related bloodstream infections in pediatric intestinal failure. J Pediatr Gastroenterol Nutr 2024; 78:918-926. [PMID: 38451061 DOI: 10.1002/jpn3.12175] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/05/2024] [Accepted: 02/03/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Patients with intestinal failure require central venous access which puts them at risk for central line-associated bloodstream infections (CLABSI). Maintaining vascular patency is critical for this population to receive nutrition support. When CLABSIs occur line salvage can help maintain vascular access. The aim of this study is to assess factors associated with safe and successful central venous catheter salvage. METHODS Retrospective cohort study of patients with intestinal failure at two tertiary care institutions between 2012 and 2020. The study examined the rates of attempted salvage, factors associated with successful salvage, and complications associated with salvage attempts. RESULTS Over the study period, 76 patients with intestinal failure were include while central venous access was in place. There were a total of 94 CLABSIs. Salvage was more likely to be attempted when patients were under the direct care of an intestinal rehabilitation service (95% vs. 68%, p = 0.04). The overall successful salvage rate was 91.6% (n = 77). Gram-positive, Gram-negative, and polymicrobial infections had successful salvage rates of 97%, 92%, and 94% respectively. The successful salvage rate for fungal infections was 40%. There was no difference in 30-day complication rates for hospital readmission, intensive care unit admission, and death between patients who underwent salvage attempt and those who did not. CONCLUSIONS Central line salvage can be safely attempted for many infections in patients with intestinal failure, leading to vascular access preservation.
Collapse
Affiliation(s)
- Catherine Larson-Nath
- Pediatric Gastroenterology, Hepatology, and Nutrition University of Minnesota, Minneapolis, Minnesota, USA
| | - Linder Wendt
- Institute for Clinical and Translational Science University of Iowa, Iowa City, Iowa, USA
| | - Riad Rahhal
- Pediatric Gastroenterology, Hepatology, and Nutrition University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
2
|
Harshman L, Stalter E, Verhofste S, Dagle J, Steinbach E, Eyck PT, Wendt L, Segar J. Somatic growth outcomes in response to an individualized neonatal sodium supplementation protocol. Res Sq 2024:rs.3.rs-3911085. [PMID: 38405851 PMCID: PMC10889073 DOI: 10.21203/rs.3.rs-3911085/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Objective Evaluate the impact of a sodium (Na) supplementation protocol based upon urine Na concentration on growth parameters and morbidities. Study Design Retrospective cohort study of infants 260/7-336/7 weeks gestational age (GA) cared for before (2012-15, n = 225) and after (2016-20, n = 157) implementation of the protocol. Within- and between-group changes over time were assessed using repeated measures generalized linear models. Results For infants 260/7-296/7 weeks GA, utilization of the protocol was associated with increased mean body weight z-score at 8-weeks postnatal age, increased mean head circumference z-score at 16-weeks postnatal age, and decreased time on mechanical ventilation (all p < 0.02). No impact on growth was identified for infants 30-336/7 weeks GA. Incidences of hypertension, hypernatremia, bronchopulmonary dysplasia, and culture positive sepsis were unaffected by the protocol. Conclusion Protocolized Na supplementation results in improved growth and reduced time on invasive mechanical ventilation in extremely preterm infants without increasing incidence of morbidities.
Collapse
|
3
|
Abbott PW, Hardie JB, Walsh KP, Nessler AJ, Farley SJ, Freeman JH, Wemmie JA, Wendt L, Kim YC, Sowers LP, Parker KL. Knockdown of the Non-canonical Wnt Gene Prickle2 Leads to Cerebellar Purkinje Cell Abnormalities While Cerebellar-Mediated Behaviors Remain Intact. Cerebellum 2024:10.1007/s12311-023-01648-9. [PMID: 38165577 DOI: 10.1007/s12311-023-01648-9] [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] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 01/04/2024]
Abstract
Autism spectrum disorders (ASD) involve brain wide abnormalities that contribute to a constellation of symptoms including behavioral inflexibility, cognitive dysfunction, learning impairments, altered social interactions, and perceptive time difficulties. Although a single genetic variation does not cause ASD, genetic variations such as one involving a non-canonical Wnt signaling gene, Prickle2, has been found in individuals with ASD. Previous work looking into phenotypes of Prickle2 knock-out (Prickle2-/-) and heterozygous mice (Prickle2-/+) suggest patterns of behavior similar to individuals with ASD including altered social interaction and behavioral inflexibility. Growing evidence implicates the cerebellum in ASD. As Prickle2 is expressed in the cerebellum, this animal model presents a unique opportunity to investigate the cerebellar contribution to autism-like phenotypes. Here, we explore cerebellar structural and physiological abnormalities in animals with Prickle2 knockdown using immunohistochemistry, whole-cell patch clamp electrophysiology, and several cerebellar-associated motor and timing tasks, including interval timing and eyeblink conditioning. Histologically, Prickle2-/- mice have significantly more empty spaces or gaps between Purkinje cells in the posterior lobules and a decreased propensity for Purkinje cells to fire action potentials. These structural cerebellar abnormalities did not impair cerebellar-associated behaviors as eyeblink conditioning and interval timing remained intact. Therefore, although Prickle-/- mice show classic phenotypes of ASD, they do not recapitulate the involvement of the adult cerebellum and may not represent the pathophysiological heterogeneity of the disorder.
Collapse
Affiliation(s)
- Parker W Abbott
- Department of Psychiatry, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52242, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52245, USA
| | - Jason B Hardie
- Department of Psychiatry, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52242, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52245, USA
| | - Kyle P Walsh
- Department of Psychiatry, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52242, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52245, USA
| | - Aaron J Nessler
- Department of Biochemistry, The University of Iowa, Iowa City, IA, 52245, USA
| | | | - John H Freeman
- Department of Psychiatry, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52242, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52245, USA
| | - John A Wemmie
- Department of Psychiatry, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52242, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52245, USA
| | - Linder Wendt
- Department of Biostatistics, The University of Iowa, Iowa City, IA, 52245, USA
| | - Young-Cho Kim
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52245, USA
- Department of Neurology, The University of Iowa, Iowa City, IA, 52245, USA
| | - Levi P Sowers
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52245, USA
- Department of Pediatrics, The University of Iowa, Iowa City, IA, 52245, USA
| | - Krystal L Parker
- Department of Psychiatry, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52242, USA.
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, 52245, USA.
| |
Collapse
|
4
|
Sharathkumar A, Wendt L, Ortman C, Srinivasan R, Chute CG, Chrischilles E, Takemoto CM. COVID-19 outcomes in persons with hemophilia: results from a US-based national COVID-19 surveillance registry. J Thromb Haemost 2024; 22:61-75. [PMID: 37182697 PMCID: PMC10181864 DOI: 10.1016/j.jtha.2023.04.040] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/29/2023] [Accepted: 04/25/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Hypercoagulable state contributing to thrombotic complications worsens COVID-19 severity and outcomes, whereas anticoagulation improves outcomes by alleviating hypercoagulability. OBJECTIVES To examine whether hemophilia, an inherent hypocoagulable condition, offers protection against COVID-19 severity and reduces venous thromboembolism (VTE) risk in persons with hemophilia (PwH). METHODS A 1:3 propensity score-matched retrospective cohort study used national COVID-19 registry data (January 2020 through January 2022) to compare outcomes between 300 male PwH and 900 matched controls without hemophilia. RESULTS Analyses of PwH demonstrated that known risk factors (older age, heart failure, hypertension, cancer/malignancy, dementia, and renal and liver disease) contributed to severe COVID-19 and/or 30-day all-cause mortality. Non-central nervous system bleeding was an additional risk factor for poor outcomes in PwH. Odds of developing VTE with COVID-19 in PwH were associated with pre-COVID VTE diagnosis (odds ratio [OR], 51.9; 95% CI, 12.8-266; p < .001), anticoagulation therapy (OR, 12.7; 95% CI, 3.01-48.6; p < .001), and pulmonary disease (OR, 16.1; 95% CI, 10.4-25.4; p < .001). Thirty-day all-cause mortality (OR, 1.27; 95% CI, 0.75-2.11; p = .3) and VTE events (OR, 1.32; 95% CI, 0.64-2.73; p = .4) were not significantly different between the matched cohorts; however, hospitalizations (OR, 1.58; 95% CI, 1.20-2.10; p = .001) and non-central nervous system bleeding events (OR, 4.78; 95% CI, 2.98-7.48; p < .001) were increased in PwH. In multivariate analyses, hemophilia did not reduce adverse outcomes (OR, 1.32; 95% CI, 0.74-2.31; p = .2) or VTE (OR, 1.14; 95% CI, 0.44-2.67; p = .8) but increased bleeding risk (OR, 4.70; 95% CI, 2.98-7.48; p < .001). CONCLUSION After adjusting for patient characteristics/comorbidities, hemophilia increased bleeding risk with COVID-19 but did not protect against severe disease and VTE.
Collapse
Affiliation(s)
- Anjali Sharathkumar
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
| | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa, USA
| | - Chris Ortman
- Department of Bioinformatics, University of Iowa, Iowa City, Iowa, USA; Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Ragha Srinivasan
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | | | - Elizabeth Chrischilles
- Department of Bioinformatics, University of Iowa, Iowa City, Iowa, USA; Department of Epidemiology, School of Public Health, University of Iowa, Iowa, USA
| | - Clifford M Takemoto
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| |
Collapse
|
5
|
Deniz K, Poleksic M, Sharma A, Wendt L, Sainju R, Fattal D. Accuracy of patient-reported spell duration: A comparative study. Epilepsy Behav 2024; 150:109573. [PMID: 38070407 PMCID: PMC10843722 DOI: 10.1016/j.yebeh.2023.109573] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/22/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
Clinicians rely heavily on patient histories to make medical diagnoses, most of which are inherently subjective and prone to inaccuracies. The aim of this study is to compare the subjective versus objective duration of spells through a retrospective chart review of patients admitted to the epilepsy monitoring unit at our tertiary care medical center. One hundred patients were analyzed. Differences in the accuracy of subjective estimations versus objective duration were compared by age, sex, focal versus generalized, location (frontal versus non-frontal), and spell type (focal aware versus impaired awareness and epileptic versus non-epileptic). Our data show that patients are poor subjective estimators, with 73% of patients overestimating the duration of their spells. We did not find differences in estimated duration by age, sex, seizure location or spell type. A notable exception was patients with generalized convulsive seizures, who accurately reported spell duration to within 17 s. This is likely because these seizures are stereotypical, and patients/family time them. Moreover, patients with non-epileptic spells were worse estimators of their spell duration than those with epileptic spells. In addition, although the prefrontal lobe plays a role in time estimation, we did not find that patients with frontal lobe seizures were worse estimators than those with non-frontal seizures, but invasive monitoring can more precisely localize seizures within areas of the frontal lobe responsible for time estimation. Our data emphasize the importance of not relying solely on patient-reported time estimation in diagnosing and developing treatment plans and instead instructing patients to time their spells.
Collapse
Affiliation(s)
- Kaancan Deniz
- University of Iowa Hospitals and Clinics, Department of Neurology, Iowa City, IA, 52242, USA
| | - Mia Poleksic
- University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Aditi Sharma
- University of Iowa Hospitals and Clinics, Department of Neurology, Iowa City, IA, 52242, USA; Imaging and Neuroscience Center, the University of Utah Hospital, 729 Arapeen Drive, Salt Lake City, UT 84108, USA(2)
| | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA 52242, USA
| | - Rup Sainju
- University of Iowa Hospitals and Clinics, Department of Neurology, Iowa City, IA, 52242, USA
| | - Deema Fattal
- University of Iowa Hospitals and Clinics, Department of Neurology and Otolaryngology, Iowa City, IA, 52242, USA; Iowa City Veterans Affairs Medical Center, Department of Neurology, Iowa City, IA, 52246, USA.
| |
Collapse
|
6
|
Bodmer BS, Breithaupt A, Heung M, Brunetti JE, Henkel C, Müller-Guhl J, Rodríguez E, Wendt L, Winter SL, Vallbracht M, Müller A, Römer S, Chlanda P, Muñoz-Fontela C, Hoenen T, Escudero-Pérez B. In vivo characterization of the novel ebolavirus Bombali virus suggests a low pathogenic potential for humans. Emerg Microbes Infect 2023; 12:2164216. [PMID: 36580440 PMCID: PMC9858441 DOI: 10.1080/22221751.2022.2164216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Ebolaviruses cause outbreaks of haemorrhagic fever in Central and West Africa. Some members of this genus such as Ebola virus (EBOV) are highly pathogenic, with case fatality rates of up to 90%, whereas others such as Reston virus (RESTV) are apathogenic for humans. Bombali virus (BOMV) is a novel ebolavirus for which complete genome sequences were recently found in free-tailed bats, although no infectious virus could be isolated. Its pathogenic potential for humans is unknown. To address this question, we first determined whether proteins encoded by the available BOMV sequence found in Chaerephon pumilus were functional in in vitro assays. The correction of an apparent sequencing error in the glycoprotein based on these data then allowed us to generate infectious BOMV using reverse genetics and characterize its infection of human cells. Furthermore, we used HLA-A2-transgenic, NOD-scid-IL-2γ receptor-knockout (NSG-A2) mice reconstituted with human haematopoiesis as a model to evaluate the pathogenicity of BOMV in vivo in a human-like immune environment. These data demonstrate that not only does BOMV show a slower growth rate than EBOV in vitro, but it also shows low pathogenicity in humanized mice, comparable to previous studies using RESTV. Taken together, these findings suggest a low pathogenic potential of BOMV for humans.
Collapse
Affiliation(s)
- B. S. Bodmer
- Institute for Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Greifswald – Insel Riems, Germany
| | - A. Breithaupt
- Department of Experimental Animal Facilities and Biorisk Management, Friedrich-Loeffler-Institut, Greifswald – Insel Riems, Germany
| | - M. Heung
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - J. E. Brunetti
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - C. Henkel
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - J. Müller-Guhl
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany,Leibniz Institute of Virology, Hamburg, Germany
| | - E. Rodríguez
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany,German Center for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel, Braunschweig, Germany
| | - L. Wendt
- Institute for Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Greifswald – Insel Riems, Germany
| | - S. L. Winter
- Schaller Research Groups, Department of Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany
| | - M. Vallbracht
- Schaller Research Groups, Department of Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany
| | - A. Müller
- Institute for Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Greifswald – Insel Riems, Germany
| | - S. Römer
- Institute for Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Greifswald – Insel Riems, Germany
| | - P. Chlanda
- Schaller Research Groups, Department of Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany
| | - C. Muñoz-Fontela
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany,German Center for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel, Braunschweig, Germany
| | - T. Hoenen
- Institute for Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Greifswald – Insel Riems, Germany, T. Hoenen Institute for Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut, Südufer 10, Greifswald – Insel Riems, 17493Germany
| | - B. Escudero-Pérez
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany,German Center for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel, Braunschweig, Germany
| |
Collapse
|
7
|
Cifra CL, Custer JW, Smith CM, Smith KA, Bagdure DN, Bloxham J, Goldhar E, Gorga SM, Hoppe EM, Miller CD, Pizzo M, Ramesh S, Riffe J, Robb K, Simone SL, Stoll HD, Tumulty JA, Wall SE, Wolfe KK, Wendt L, Eyck PT, Landrigan CP, Dawson JD, Reisinger HS, Singh H, Herwaldt LA. Prevalence and Characteristics of Diagnostic Error in Pediatric Critical Care: A Multicenter Study. Crit Care Med 2023; 51:1492-1501. [PMID: 37246919 PMCID: PMC10615661 DOI: 10.1097/ccm.0000000000005942] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Effective interventions to prevent diagnostic error among critically ill children should be informed by diagnostic error prevalence and etiologies. We aimed to determine the prevalence and characteristics of diagnostic errors and identify factors associated with error in patients admitted to the PICU. DESIGN Multicenter retrospective cohort study using structured medical record review by trained clinicians using the Revised Safer Dx instrument to identify diagnostic error (defined as missed opportunities in diagnosis). Cases with potential errors were further reviewed by four pediatric intensivists who made final consensus determinations of diagnostic error occurrence. Demographic, clinical, clinician, and encounter data were also collected. SETTING Four academic tertiary-referral PICUs. PATIENTS Eight hundred eighty-two randomly selected patients 0-18 years old who were nonelectively admitted to participating PICUs. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Of 882 patient admissions, 13 (1.5%) had a diagnostic error up to 7 days after PICU admission. Infections (46%) and respiratory conditions (23%) were the most common missed diagnoses. One diagnostic error caused harm with a prolonged hospital stay. Common missed diagnostic opportunities included failure to consider the diagnosis despite a suggestive history (69%) and failure to broaden diagnostic testing (69%). Unadjusted analysis identified more diagnostic errors in patients with atypical presentations (23.1% vs 3.6%, p = 0.011), neurologic chief complaints (46.2% vs 18.8%, p = 0.024), admitting intensivists greater than or equal to 45 years old (92.3% vs 65.1%, p = 0.042), admitting intensivists with more service weeks/year (mean 12.8 vs 10.9 wk, p = 0.031), and diagnostic uncertainty on admission (77% vs 25.1%, p < 0.001). Generalized linear mixed models determined that atypical presentation (odds ratio [OR] 4.58; 95% CI, 0.94-17.1) and diagnostic uncertainty on admission (OR 9.67; 95% CI, 2.86-44.0) were significantly associated with diagnostic error. CONCLUSIONS Among critically ill children, 1.5% had a diagnostic error up to 7 days after PICU admission. Diagnostic errors were associated with atypical presentations and diagnostic uncertainty on admission, suggesting possible targets for intervention.
Collapse
Affiliation(s)
- Christina L. Cifra
- Division of Critical Care, Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Division of Medical Critical Care, Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jason W. Custer
- Division of Critical Care, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Craig M. Smith
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kristen A. Smith
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Dayanand N. Bagdure
- Department of Pediatrics, Louisiana State University Health Shreveport School of Medicine, Shreveport, Louisiana
| | - Jodi Bloxham
- University of Iowa College of Nursing, Iowa City, Iowa
| | - Emily Goldhar
- Pediatric Intensive Care Unit, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Stephen M. Gorga
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
| | - Elizabeth M. Hoppe
- Pediatric Intensive Care Unit, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Christina D. Miller
- Department of Pediatrics, Section of Critical Care, University of Colorado School of Medicine, Aurora, Colorado
| | - Max Pizzo
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
- University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Sonali Ramesh
- Department of Pediatrics, BronxCare Health System, New York, New York
| | - Joseph Riffe
- Department of Pediatrics, Family First Health, York, Pennsylvania
| | - Katharine Robb
- Division of Critical Care, Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Shari L. Simone
- University of Maryland School of Nursing, Baltimore, Maryland
| | | | - Jamie Ann Tumulty
- Pediatric Intensive Care Unit, University of Maryland Children’s Hospital, Baltimore, Maryland
| | - Stephanie E. Wall
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
- University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Katie K. Wolfe
- Division of Critical Care Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Linder Wendt
- University of Iowa Institute for Clinical and Translational Science, Iowa City, Iowa
| | - Patrick Ten Eyck
- University of Iowa Institute for Clinical and Translational Science, Iowa City, Iowa
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa
| | - Christopher P. Landrigan
- Division of General Pediatrics, Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jeffrey D. Dawson
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa
| | - Heather Schacht Reisinger
- University of Iowa Institute for Clinical and Translational Science, Iowa City, Iowa
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Center for Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
| | - Hardeep Singh
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas
| | - Loreen A. Herwaldt
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| |
Collapse
|
8
|
Weiner H, Solomon JR, Thinnes R, Pinsky B, Ferreri C, Singleterry M, Bahamonde A, Awadh S, Tran J, Paradis AG, Vetter J, Brooks A, Lund S, Kuwaya D, Juhr D, Wendt L, Eyck PT, Traxel E, Kraft KH, Ellison JS, Storm DW. How Effective Was the 2014 AUA Cryptorchidism Guideline? A Multi-institutional Evaluation. Urol Pract 2023; 10:605-610. [PMID: 37498314 DOI: 10.1097/upj.0000000000000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION In 2014, the AUA published guidelines regarding the evaluation of cryptorchidism. This multi-institutional study aims to determine if these guidelines reduced the age of referral and the utilization of ultrasound in boys with cryptorchidism. We hypothesize that delayed referral continues, and utilization of ultrasound remains unchanged. METHODS A retrospective review of boys referred for the evaluation of cryptorchidism was performed at 4 academic institutions, collecting data for 1 year prior (2013) and 2 nonconsecutive years following guideline creation (2015 and 2019). Across these time frames, we compared median ages at evaluation and surgery, and rates of patient comorbidities, orchiopexy, and preevaluation ultrasound. RESULTS A total of 3,293 patients were included. The median age at initial pediatric urology evaluation in all cohorts was 39 months (IQR: 14-92 months). Following publication of the AUA Guidelines, there was no difference (P = .08) in the median age at first evaluation by a pediatric urologist between 2013 and 2015, and an increase (P = .03) between 2013 and 2019. Overall, 21.2% of patients received an ultrasound evaluation prior to referral, with no significant difference between 2013 and 2015 (P = .9) or 2019 (P = .5) cohorts. CONCLUSIONS Our data suggest that, despite publication of the AUA Guidelines on evaluation and treatment of cryptorchidism, there has been no reduction in the age of urological evaluation or the utilization of imaging in boys with undescended testis. Finding alternative avenues to disseminate these evidence-based recommendations to referring providers and exploring barriers to guideline adherence is necessary to improve care for patients with cryptorchidism.
Collapse
Affiliation(s)
| | | | - Robert Thinnes
- University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | | | | | | | | | - Sami Awadh
- Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | | | | | | | | | - Daren Kuwaya
- University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Denise Juhr
- University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Linder Wendt
- University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | | | | | | | - Jonathan S Ellison
- Medical College of Wisconsin, Milwaukee, Wisconsin
- Children's Wisconsin, Milwaukee, Wisconsin
| | | |
Collapse
|
9
|
Tuttle A, Wendt L, Schultz K. Discovering novel barriers to eBook implementation. Clin Teach 2023; 20:e13632. [PMID: 37610077 DOI: 10.1111/tct.13632] [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: 05/29/2023] [Accepted: 07/27/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Medical errors when managing inpatient paediatric patients with diabetes mellitus can lead to significant morbidity and mortality, necessitating improvement in training of medical trainees. Previous educational interventions have focused on time and resource intensive methods, restricting their applicability to teaching in time-limited scenarios. We chose a blended learning approach to create and implement a novel eBook for use by trainees and then aimed to determine the efficacy and potential barriers to that implementation. APPROACH We grounded our work in complex adaptive systems theory and used the framework of complex adaptive blended learning system (CABLS) to shape both our implementation and evaluation. We utilised an embedded mixed methodology to quantitatively evaluate efficacy via knowledge acquisition and self-reported confidence and to qualitatively evaluate barriers via open-ended questions. EVALUATION Between 2022 and 2023, the study enrolled 72 learners and 12 educators. There was no statistically significant difference in change in knowledge acquisition and self-reported confidence between learners who did and did not have access to the eBook. Learners and educators identified several unique and novel barriers to eBook implementation, which were mapped to the CABLS framework. IMPLICATIONS Our results on the efficacy of implementation are inconclusive, possibly due to the small participant size and implying a need for multi-institutional evaluation. Our qualitative results demonstrated previously unknown barriers to eBook implementation. This knowledge can assist other medical specialties as they implement their own eBooks. We also hope to use these barriers to improve implementation in our next iteration: the outpatient setting.
Collapse
Affiliation(s)
- Alexander Tuttle
- Division of Pediatric Diabetes and Endocrinology, Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA
| | - Linder Wendt
- University of Iowa Institute for Clinical and Translational Science, Iowa City, Iowa, USA
| | - Katherine Schultz
- Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| |
Collapse
|
10
|
Ewald VAM, Trapp NT, Sarrett ME, Pace BD, Wendt L, Richards JG, Gala IK, Miller JN, Wessel JR, Magnotta VA, Wemmie JA, Boes AD, Parker KL. Supra-second interval timing in bipolar disorder: examining the role of disorder sub-type, mood, and medication status. Int J Bipolar Disord 2023; 11:32. [PMID: 37779127 PMCID: PMC10542629 DOI: 10.1186/s40345-023-00312-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Widely reported by bipolar disorder (BD) patients, cognitive symptoms, including deficits in executive function, memory, attention, and timing are under-studied. Work suggests that individuals with BD show impairments in interval timing tasks, including supra-second, sub-second, and implicit motor timing compared to the neuronormative population. However, how time perception differs within individuals with BD based on disorder sub-type (BDI vs II), depressed mood, or antipsychotic medication-use has not been thoroughly investigated. The present work administered a supra-second interval timing task concurrent with electroencephalography (EEG) to patients with BD and a neuronormative comparison group. As this task is known to elicit frontal theta oscillations, signal from the frontal (Fz) lead was analyzed at rest and during the task. RESULTS Results suggest that individuals with BD show impairments in supra-second interval timing and reduced frontal theta power during the task compared to neuronormative controls. However, within BD sub-groups, neither time perception nor frontal theta differed in accordance with BD sub-type, depressed mood, or antipsychotic medication use. CONCLUSIONS This work suggests that BD sub-type, depressed mood status or antipsychotic medication use does not alter timing profile or frontal theta activity. Together with previous work, these findings point to timing impairments in BD patients across a wide range of modalities and durations indicating that an altered ability to assess the passage of time may be a fundamental cognitive abnormality in BD.
Collapse
Affiliation(s)
| | - Nicholas T Trapp
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | | | - Benjamin D Pace
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
| | - Linder Wendt
- Institute for Clinical and Translational Science, The University of Iowa, Iowa City, IA, USA
| | - Jenny G Richards
- Department of Radiology, The University of Iowa, Iowa City, IA, USA
| | - Ilisa K Gala
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
| | | | - Jan R Wessel
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA, USA
- Department of Neurology, The University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Vincent A Magnotta
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
- Department of Radiology, The University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - John A Wemmie
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
- Department of Molecular Physiology and Biophysics, The University of Iowa, Iowa City, IA, USA
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Aaron D Boes
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
- Department of Pediatrics, The University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Krystal L Parker
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA.
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA.
| |
Collapse
|
11
|
O'Neal EE, Wendt L, Hamann C, Reyes M, Yang J, Peek-Asa C. Rates and predictors of teen driver crash culpability. J Safety Res 2023; 86:185-190. [PMID: 37718045 PMCID: PMC10505703 DOI: 10.1016/j.jsr.2023.05.009] [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] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 01/24/2023] [Accepted: 05/12/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Motor-vehicle crash risk is highest among teen drivers. Despite a wealth of research on the topic, there are still many contributors to these crashes that are not well understood. The current study sought to examine the contribution of graduated driver licensing (GDL) restrictions, sex, age, roadway circumstances, and citation history to teen drivers' crash culpability. METHOD Crash system data from the Iowa Department of Transportation were linked with traffic-related charges from the Iowa Court Information System. Crashes involving teens aged 14 to 17 years between 2016 and 2019 were analyzed (N = 19,847). Culpability was determined using the driver contributing circumstances from the crash report. Moving and non-moving traffic citations issued prior to the date of each crash were considered. A multivariable logistic regression model was constructed to examine predictors of crash culpability. RESULTS Teen drivers were determined to be culpable for more than two thirds of crashes (N = 13,604, 68.54%). Culpability was more prevalent among males, younger teens, in rural areas, in the presence of reported roadway contributing circumstances, during hours of restricted nighttime driving, and among teens with citation histories that included both moving and non-moving citations. Similarly, multivariable model results indicated that the likelihood of culpability was higher among males, in rural areas, and at each stage of GDL compared to teen drivers with unrestricted licenses. While drivers with a history of both moving and non-moving violations were more likely to be culpable, those with a history of only moving or only non-moving violations were less likely to be culpable compared to those with no violation history. CONCLUSION Sex, crash location, and GDL stage were associated with teen driver crash culpability. A singular prior moving or non-moving violation may play a protective role in teen crash culpability.
Collapse
Affiliation(s)
- Elizabeth E O'Neal
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States.
| | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, United States
| | - Cara Hamann
- College of Public Health, Department of Epidemiology, University of Iowa, Iowa City, IA, United States
| | - Michelle Reyes
- National Advanced Driving Simulator, University of Iowa, Iowa City, IA 52242, United States
| | - Jingzhen Yang
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - Corinne Peek-Asa
- University of California San Diego, San Diego, CA, United States
| |
Collapse
|
12
|
Fattal D, Platti N, Hester S, Wendt L. Vivid dreams are associated with a high percentage of REM sleep: a prospective study in veterans. J Clin Sleep Med 2023; 19:1661-1668. [PMID: 37128719 PMCID: PMC10476037 DOI: 10.5664/jcsm.10642] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/03/2023]
Abstract
STUDY OBJECTIVES Vivid dreams are dreams that feel real or are associated with dream enactment behavior. They are prevalent in veterans, especially in those with psychiatric disorders such as post-traumatic stress disorders. Such psychiatric disorders have known association with abnormalities in rapid eye movement (REM) sleep. Vivid dreams are also described in neurological conditions, such Lewy body dementias, which are also associated with REM sleep abnormality. Although vivid dreams occur in neuropsychiatric disorders that have REM sleep abnormalities, there are no studies that have directly investigated an association between vivid dreams and REM sleep. We sought to study vivid dreams and REM sleep in veterans. METHODS Veterans undergoing polysomnography at our hospital were invited to enroll. Participants completed a dream-related questionnaire the morning after their polysomnography. RESULTS We prospectively enrolled 505 veterans. After a night in the sleep laboratory, 196 of 504 (39%) reported experiencing a dream, and, of those, 117 of 190 (62%) described their dream as vivid. Discrepancies in patient totals are secondary to missing questionnaire data. Our novel finding is that participants with a high percentage of REM sleep (above 25%) were more than twice likely to report a vivid dream than participants with a lower percentage of REM sleep (P < .0001). Nonvivid dreams were not associated with a high percentage of REM sleep. CONCLUSIONS Vivid dreams are associated with a high percentage of REM sleep. Further research into the role of REM sleep abnormalities in vivid dreams may help to advance understanding of neuropsychiatric disorders. CITATION Fattal D, Platti N, Hester S, Wendt L. Vivid dreams are associated with a high percentage of REM sleep: a prospective study in veterans. J Clin Sleep Med. 2023;19(9):1661-1668.
Collapse
Affiliation(s)
- Deema Fattal
- Neurology Department, University of Iowa, Iowa City, Iowa
- Iowa City VA Medical Center, Iowa City, Iowa
| | - Nicole Platti
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | | | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa
| |
Collapse
|
13
|
Dunn H, Dukes K, Wendt L, Bunch J. Rapid Response Systems at a Long-Term Acute Care Hospital. Clin Nurs Res 2023; 32:1031-1040. [PMID: 36600589 DOI: 10.1177/10547738221144207] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Rapid Response Systems (RRS) improve patient outcomes at large medical centers. Little is known about how RRS are used in other medical settings. The purpose of this exploratory study was to describe RRS events at a long-term acute care hospital (LTACH). We conducted a retrospective review of 71 RRS event records at an urban 50-bed Midwestern LTACH. Measures included demographic data, triggering mechanisms, contextual factors, mechanism factors, and clinical outcomes. Of patients who experienced a RRS event, median age was 71 (62, 80) years; 52.1% were female; most (n = 49, 69%) were "full code." Most (n = 41, 58%) events occurred during the daytime. The most common trigger was "mental status changes/unresponsiveness." Registered nurses were the most frequent activator (n = 19, 26.8%) and responders (n = 63, 60.6%). Median duration of RRS events was 14 (6, 25) minutes. Most patients stabilized and their condition improved (n = 54, 76.1%). RRS can be expanded and modified to the LTACH population.
Collapse
Affiliation(s)
| | | | - Linder Wendt
- University of Iowa Institute for Clinical and Translational Science, USA
| | | |
Collapse
|
14
|
Sanchez S, Raghuram A, Wendt L, Hayakawa M, Chen CJ, Sheehan JP, Kim LJ, Abecassis IJ, Levitt MR, Meyer RM, Guniganti R, Kansagra AP, Lanzino G, Giordan E, Brinjikji W, Bulters DO, Durnford A, Fox WC, Smith J, Polifka AJ, Gross B, Amin-Hanjani S, Alaraj A, Kwasnicki A, Starke RM, Chen SH, van Dijk JMC, Potgieser ARE, Satomi J, Tada Y, Phelps R, Abla A, Winkler E, Du R, Lai PMR, Zipfel GJ, Derdeyn C, Samaniego EA. Natural history, angiographic presentation and outcomes of anterior cranial fossa dural arteriovenous fistulas. J Neurointerv Surg 2023; 15:903-908. [PMID: 35944975 DOI: 10.1136/jnis-2022-019160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/28/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Anterior cranial fossa dural arteriovenous fistulas (ACF-dAVFs) are aggressive vascular lesions. The pattern of venous drainage is the most important determinant of symptoms. Due to the absence of a venous sinus in the anterior cranial fossa, most ACF-dAVFs have some degree of drainage through small cortical veins. We describe the natural history, angiographic presentation and outcomes of the largest cohort of ACF-dAVFs. METHODS The CONDOR consortium includes data from 12 international centers. Patients included in the study were diagnosed with an arteriovenous fistula between 1990-2017. ACF-dAVFs were selected from a cohort of 1077 arteriovenous fistulas. The presentation, angioarchitecture and treatment outcomes of ACF-dAVF were extracted and analyzed. RESULTS 60 ACF-dAVFs were included in the analysis. Most ACF-dAVFs were symptomatic (38/60, 63%). The most common symptomatic presentation was intracranial hemorrhage (22/38, 57%). Most ACF-dAVFs drained through cortical veins (85%, 51/60), which in most instances drained into the superior sagittal sinus (63%, 32/51). The presence of cortical venous drainage predicted symptomatic presentation (OR 9.4, CI 1.98 to 69.1, p=0.01). Microsurgery was the most effective modality of treatment. 56% (19/34) of symptomatic patients who were treated had complete resolution of symptoms. Improvement of symptoms was not observed in untreated symptomatic ACF-dAVFs. CONCLUSION Most ACF-dAVFs have a symptomatic presentation. Drainage through cortical veins is a key angiographic feature of ACF-dAVFs that accounts for their malignant course. Microsurgery is the most effective treatment. Due to the high risk of bleeding, closure of ACF-dAVFs is indicated regardless of presentation.
Collapse
Affiliation(s)
- Sebastian Sanchez
- Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Ashrita Raghuram
- Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Linder Wendt
- Institute for Clinical and Translational Science, The University of Iowa, Iowa City, Iowa, USA
| | - Minako Hayakawa
- Department of Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Ching-Jen Chen
- Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jason P Sheehan
- Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Louis J Kim
- Department of Neurosurgery, University of Washington, Seattle, Washington, USA
| | | | - Michael R Levitt
- Department of Neurosurgery, University of Washington, Seattle, Washington, USA
| | - R Michael Meyer
- Department of Neurosurgery, University of Washington, Seattle, Washington, USA
| | - Ridhima Guniganti
- Department of Neurosurgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA
| | - Akash P Kansagra
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA
| | - Giuseppe Lanzino
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Enrico Giordan
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Diederik O Bulters
- Department of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, Southampton, UK
| | - Andrew Durnford
- Department of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, Southampton, UK
| | - W Christopher Fox
- Department of Neurosurgery, Mayo Clinic Jacksonville Campus, Jacksonville, Florida, USA
| | - Jessica Smith
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Adam J Polifka
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Bradley Gross
- Department of Neurosurgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, USA
| | - Sepideh Amin-Hanjani
- Department of Neurosurgery, University of Illinois Chicago, Chicago, Illinois, USA
| | - Ali Alaraj
- Department of Neurosurgery, University of Illinois Chicago, Chicago, Illinois, USA
| | - Amanda Kwasnicki
- Department of Neurosurgery, University of Illinois Chicago, Chicago, Illinois, USA
| | - Robert M Starke
- Department of Neurosurgery, University of Miami, Coral Gables, Florida, USA
| | - Stephanie H Chen
- Department of Neurosurgery, University of Miami, Coral Gables, Florida, USA
| | - J Marc C van Dijk
- Department of Neurosurgery, University of Groningen, Groningen, Groningen, Netherlands
| | - Adriaan R E Potgieser
- Department of Neurosurgery, University of Groningen, Groningen, Groningen, Netherlands
| | - Junichiro Satomi
- Department of Neurosurgery, Tokushima University Hospital, Tokushima, Tokushima, Japan
| | - Yoshiteru Tada
- Department of Neurosurgery, Tokushima University Hospital, Tokushima, Tokushima, Japan
| | - Ryan Phelps
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA
| | - Adib Abla
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA
| | - Ethan Winkler
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA
| | - Rose Du
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Pui Man Rosalind Lai
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Gregory J Zipfel
- Department of Neurosurgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA
| | - Colin Derdeyn
- Department of Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Edgar A Samaniego
- Departments of Neurology, Radiology and Neurosurgery, The University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
15
|
Raghuram A, Sanchez S, Wendt L, Cochran S, Ishii D, Osorno C, Bathla G, Koscik TR, Torner J, Hasan D, Samaniego EA. 3D aneurysm wall enhancement is associated with symptomatic presentation. J Neurointerv Surg 2023; 15:747-752. [PMID: 35853699 PMCID: PMC10173164 DOI: 10.1136/jnis-2022-019125] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/05/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Aneurysm wall enhancement (AWE) is a potential surrogate biomarker for aneurysm instability. Previous studies have assessed AWE using 2D multiplanar methods, most of which were conducted qualitatively. OBJECTIVE To use a new quantitative tool to analyze a large cohort of saccular aneurysms with 3D-AWE maps METHODS: Saccular aneurysms were imaged prospectively with 3T high resolution MRI. 3D-AWE maps of symptomatic (defined as ruptured or presentation with sentinel headache/cranial nerve neuropathy) and asymptomatic aneurysms were created by extending orthogonal probes from the aneurysm lumen into the wall. Three metrics were used to characterize enhancement: 3D circumferential AWE (3D-CAWE), aneurysm-specific contrast uptake (SAWE), and focal AWE (FAWE). Aneurysms with a circumferential AWE higher than the corpus callosum (3D-CAWE ≥1) were classified as 3D-CAWE+. Symptomatic presentation was analyzed with univariate and multivariate logistic models. Aneurysm size, size ratio, aspect ratio, irregular morphology, and PHASES and ELAPSS scores were compared with the new AWE metrics. Bleb and microhemorrhage analyses were also performed. RESULTS Ninety-three aneurysms were analyzed. 3D-CAWE, SAWE, and FAWE were associated with symptomatic status (OR=1.34, 1.25, and 1.08, respectively). A multivariate model including aneurysm size, 3D-CAWE+, age, female gender, and FAWE detected symptomatic status with 80% specificity and 90% sensitivity (area under the curve=0.914, =0.967). FAWE was also associated with irregular morphology and high-risk location (p=0.043 and p=0.001, respectively). In general, blebs enhanced 56% more than the aneurysm body. Areas of microhemorrhage co-localized with areas of increased SAWE (p=0.047). CONCLUSIONS 3D-AWE mapping provides a new set of metrics that could potentially improve the identification of symptomatic aneurysms.
Collapse
Affiliation(s)
- Ashrita Raghuram
- Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Sebastian Sanchez
- Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Linder Wendt
- Institute for Clinical and Translational Science, The University of Iowa, Iowa City, Iowa, USA
| | - Steven Cochran
- Department of Psychiatry, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Daizo Ishii
- Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Carlos Osorno
- Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Girish Bathla
- Department of Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Timothy R Koscik
- Department of Psychiatry, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - James Torner
- Institute for Clinical and Translational Science, The University of Iowa, Iowa City, Iowa, USA
- Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - David Hasan
- Department of Neurosurgery, Duke University, Durham, North Carolina, USA
| | - Edgar A Samaniego
- Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Department of Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| |
Collapse
|
16
|
Müller Ewald VA, Trapp NT, Sarrett ME, Pace BD, Wendt L, Richards JG, Gala IK, Miller JN, Wessel JR, Magnotta VA, Wemmie JA, Boes AD, Parker KL. Supra-second interval timing in bipolar disorder: examining the role of disorder sub-type, mood, and medication status. Res Sq 2023:rs.3.rs-3006203. [PMID: 37398216 PMCID: PMC10312933 DOI: 10.21203/rs.3.rs-3006203/v1] [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] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background : Widely reported by bipolar disorder (BD) patients, cognitive symptoms, including deficits in executive function, memory, attention, and timing are under-studied. Work suggests that individuals with BD show impairments in interval timing tasks, including supra-second, sub-second, and implicit motor timing compared to the neuronormative population. However, how time perception differs within individuals with BD based on BD sub-type (BDI vs II), mood, or antipsychotic medication-use has not been thoroughly investigated. The present work administered a supra-second interval timing task concurrent with electroencephalography (EEG) to patients with BD and a neuronormative comparison group. As this task is known to elicit frontal theta oscillations, signal from the frontal (Fz) lead was analyzed at rest and during the task. Results : Results suggest that individuals with BD show impairments in supra-second interval timing and reduced frontal theta power compared during the task to neuronormative controls. However, within BD sub-groups, neither time perception nor frontal theta differed in accordance with BD sub-type, mood, or antipsychotic medication use. Conclusions : his work suggests that BD sub-type, mood status or antipsychotic medication use does not alter timing profile or frontal theta activity. Together with previous work, these findings point to timing impairments in BD patients across a wide range of modalities and durations indicating that an altered ability to assess the passage of time may be a fundamental cognitive abnormality in BD.
Collapse
Affiliation(s)
- Victόria A. Müller Ewald
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
- Iowa Neuroscience institute, The University of Iowa, Iowa City, Iowa, United States of America
| | - Nicholas T. Trapp
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
- Iowa Neuroscience institute, The University of Iowa, Iowa City, Iowa, United States of America
| | - McCall E. Sarrett
- Department of Psychological and Brain sciences, Villanova University, Villanova, Pennsylvania, United States of America
| | - Benjamin D. Pace
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
| | - Linder Wendt
- Institute for Clinical and Translational Science, The University of Iowa, Iowa City, Iowa, United States of America
| | - Jenny G. Richards
- Department of Radiology, The University of Iowa, Iowa City, Iowa, United States of America
| | - Ilisa K. Gala
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
| | - Jacob N. Miller
- St. Luke’s Hospital, Cedar Rapids, Iowa, United States of America
| | - Jan R. Wessel
- Department of Psychological & Brain sciences, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Neurology, The University of Iowa, Iowa City, Iowa, United States of America
- Iowa Neuroscience institute, The University of Iowa, Iowa City, Iowa, United States of America
| | - Vincent A. Magnotta
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Radiology, The University of Iowa, Iowa City, Iowa, United States of America
- Iowa Neuroscience institute, The University of Iowa, Iowa City, Iowa, United States of America
| | - John A. Wemmie
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Molecular Physiology and Biophysics, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Neurosurgery, The University of Iowa, Iowa City, Iowa, United States of America
- Iowa Neuroscience institute, The University of Iowa, Iowa City, Iowa, United States of America
| | - Aaron D. Boes
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
- Department of Pediatrics, The University of Iowa, Iowa City, Iowa, United States of America
- Iowa Neuroscience institute, The University of Iowa, Iowa City, Iowa, United States of America
| | - Krystal L. Parker
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa, United States of America
- Iowa Neuroscience institute, The University of Iowa, Iowa City, Iowa, United States of America
| |
Collapse
|
17
|
Hamann CJ, Jansson S, Wendt L, Cavanaugh JE, Peek-Asa C. Informing traffic enforcement leniency and discretion: Crash culpability and the effectiveness of written warnings versus citations. Accid Anal Prev 2023; 189:107121. [PMID: 37253280 DOI: 10.1016/j.aap.2023.107121] [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] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/04/2023] [Accepted: 05/16/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Deterrence of risky driving behavior is important for the prevention of crashes and injuries. Traffic law enforcement is a key strategy used to decrease risky driving, but there is little evidence on the deterrent effect of issuing warnings versus citations to drivers regarding the prevention of future crashes. The purpose of this study was to 1) investigate the difference between citations and written warnings in their association with future crash culpability and 2) investigate whether drivers who were issued written warnings or citations have different associations with future crash culpability likelihood than those without prior citations or written warnings. METHODS Data for this study included Iowa Department of Transportation crash data for 2016 to 2019 linked to data from the Iowa Court Case Management System. A quasi-induced exposure method was used based on driver pairs involved in the same collision in which one driver was deemed culpable and one was non-culpable. Conditional logistic regression models were constructed to examine predictors of crash culpability. The main independent variable was traffic citation and warnings history categorized into moving warning, non-moving warning, moving citation, non-moving citation, or no citation or warning in the 30 days prior to the crash. RESULTS The study sample included a total of 152,986 drivers. Among drivers with moving violations, previously cited drivers were more likely to be crash culpable than previously warned drivers (OR = 1.64, 95% CI = 1.29-2.08). Drivers with prior non-moving citations were less likely to be the culpable party in a crash than a driver who had no recent warnings or citations (OR = 0.72, 95% CI = 0.58-0.89). Drivers with prior warnings (moving or non-moving) did not appreciably differ in crash culpability relative to drivers who had not received any citations or warnings in the previous 30 days. CONCLUSIONS Drivers with prior moving citations were more likely to be culpable in a future crash than drivers with prior moving warnings, which may relate to overall driving riskiness as opposed to effectiveness of citations in deterring risky driving behaviors. Results from this study also suggest that officer discretion was being appropriately applied by citing the riskiest drivers, while giving lower risk drivers warnings. Results from this study may be useful to support strengthening of state driver improvement programming.
Collapse
Affiliation(s)
- Cara J Hamann
- Department of Epidemiology, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242, USA.
| | - Stephanie Jansson
- Department of Biostatistics, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242, USA
| | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Joseph E Cavanaugh
- Department of Biostatistics, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242, USA
| | - Corinne Peek-Asa
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, 145 N. Riverside Drive, Iowa City, IA 52242, USA
| |
Collapse
|
18
|
De Rosa P, Takacs EB, Wendt L, Tracy CR. Effect of Holistic Review, Interview Blinding, and Structured Questions in Resident Selection: Can we Predict Who Will Do Well in a Residency Interview? Urology 2023; 173:41-47. [PMID: 36603653 DOI: 10.1016/j.urology.2022.11.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/06/2022] [Accepted: 11/15/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To examine the Urology residency application process, particularly the interview. Historically, the residency interview has been vulnerable to bias and not determined to be a predictor of future residency performance. Our goal is to determine the relationship between pre-interview metrics and post-interview ranking using best practices for Urology resident selection including holistic review, blinded interviews, and structured behaviorally anchored questions. METHODS Applications were assessed on cognitive (Alpha Omega Alpha, class rank, junior year clinical clerkship grades) and non-cognitive attributes (letters of recommendation [LOR], personal statement [PS], demographics, research, personal characteristics) by reviewers blinded to USMLE scores and photograph. Interviewers were blinded to the application other than PS and LORs. Interviews consisted of a structured behaviorally anchored question (SBI) and an unstructured interview (UI). Odds ratios were determined comparing pre-interview and interview impressions. RESULTS Fifty-one applicants were included in the analysis. USMLE step 1 score (average 245) was associated with Alpha Omega Alpha, class rank, junior year clinical clerkship, and PS. The UI score was associated with the LOR (P = .04) whereas SBI scores were not (P = .5). Faculty rank was associated with SBI, UI, and overall interview (OI) scores (P < .001). Faculty rank was also associated with LOR. Resident impression of interviewees were associated with faculty interview scores (P = .001) and faculty rank (P < .001). CONCLUSION Traditional interviews may be biased toward application materials and may be balanced with behavioral questions. While Step 1 score does not offer additional information over other PI metrics, blinded interviews may offer discriminant validity over a PI rubric.
Collapse
Affiliation(s)
- Paige De Rosa
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, Iowa
| | - Elizabeth B Takacs
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, Iowa
| | - Linder Wendt
- Department of Statistics, University of Iowa, Iowa City, Iowa
| | - Chad R Tracy
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, Iowa.
| |
Collapse
|
19
|
Griffin BR, Wendt L, Vaughan-Sarrazin M, Hounkponou H, Reisinger HS, Goldstein SL, Jalal D, Misurac J. Nephrotoxin Exposure and Acute Kidney Injury in Adults. Clin J Am Soc Nephrol 2023; 18:163-172. [PMID: 36754005 PMCID: PMC10103278 DOI: 10.2215/cjn.0000000000000044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/30/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Rates of nephrotoxic AKI are not well described in adults due to lack of a clear definition, debate over which drugs should be considered nephrotoxins, and illness-related confounding. Nephrotoxic Injury Negated by Just-in Time Action (NINJA), a program that reduces rates of nephrotoxic AKI in pediatric populations, may be able to address these concerns, but whether NINJA can be effectively applied to adults remains unclear. METHODS In this retrospective cohort study conducted at the University of Iowa Hospital, we included adult patients admitted to a general hospital floor for ≥48 hours during 2019. The NINJA algorithm screened charts for high nephrotoxin exposure and AKI. After propensity score matching, Cox proportional hazard modeling was used to evaluate the relationship between nephrotoxic exposure and all-stage AKI, stage 2-3 AKI, or death. Additional analyses evaluated the most frequent nephrotoxins used in this population. RESULTS Of 11,311 patients, 1527 (16%) had ≥1 day of high nephrotoxin exposure. Patients with nephrotoxic exposures subsequently developed AKI in 29% of cases, and 22% of all inpatient AKI events met nephrotoxic AKI criteria. Common nephrotoxins were vancomycin, iodinated contrast dye, piperacillin-tazobactam, acyclovir, and lisinopril. After propensity score matching, Cox proportional hazard models for high nephrotoxin exposure were significantly associated with all AKI (hazard ratio [HR] 1.43, 1.19-1.72, P<0.001), stage 2-3 AKI (HR 1.78, 1.18-2.67, P=0.006), and mortality (HR 2.12, 1.09-4.11, P=0.03). CONCLUSIONS Nephrotoxin exposure in adults is common and is significantly associated with AKI development, including stage 2-3 AKI.
Collapse
Affiliation(s)
- Benjamin R Griffin
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans' Affairs Health Care System, Iowa City, Iowa
| | - Linder Wendt
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Mary Vaughan-Sarrazin
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans' Affairs Health Care System, Iowa City, Iowa
| | - Hermann Hounkponou
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Heather S Reisinger
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans' Affairs Health Care System, Iowa City, Iowa
| | - Stuart L Goldstein
- Division of Nephrology and Hypertension, Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Diana Jalal
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City Veterans' Affairs Health Care System, Iowa City, Iowa
| | - Jason Misurac
- Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa
| |
Collapse
|
20
|
Chapman JM, Wendt L, Knudson CM. Comparison of platelet antibody screen, crossmatching and HLA antibody testing in patients refractory to platelet transfusions. Transfus Apher Sci 2022:103622. [PMID: 36535829 DOI: 10.1016/j.transci.2022.103622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/29/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
Patients undergoing recurrent platelet transfusions can become refractory to these transfusions. Platelet antibody screens (Immucor), platelet crossmatching assays (Immucor), and HLA antibody testing are commonly used to test these patients. The relative effectiveness of these tests has not been determined. A higher incidence of strongly positive screen results that did not predict crossmatch results was anecdotally noted. Therefore, the results of the platelet antibody screens and crossmatches were systematically compiled over a 12-year period from 2010 to 2021. Of note, the Immucor Capture-P Ready Screen (platelet antibody) had a recall in March 2013 after which the performance of the test appears to have changed. The positivity rate of the platelet antibody screen increased over the course of the study, and this was statistically significant when analyzing year as a continuous variable and when grouping years by four-year periods (2010-13,2014-17,2018-21). In contrast, platelet crossmatch reactivity decreased slightly throughout this period. During the 2018-21 period, HLA antibody testing was commonly performed and correlated well with the crossmatch testing but not with the screen. These results suggest that the drastic increase in positivity we observed in the platelet antibody screen over this period is due to increased analytic sensitivity (with possible reduced specificity) of the screen and not a change in our patient population. Based on these results, the platelet antibody screen has little clinical utility and directly performing platelet crossmatching or HLA antibody testing is recommended for patients suspected to be refractory to platelet transfusions due to alloimmune-mediated factors.
Collapse
Affiliation(s)
- James M Chapman
- DeGowin Blood Center, Department of Pathology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Linder Wendt
- Biostatistician with the Institute for Clinical and Translation Research, University of Iowa, Iowa City, IA, USA
| | - C Michael Knudson
- DeGowin Blood Center, Department of Pathology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.
| |
Collapse
|
21
|
Fattal D, Hester S, Wendt L. Body weight and obstructive sleep apnea: a mathematical relationship between body mass index and apnea-hypopnea index in veterans. J Clin Sleep Med 2022; 18:2723-2729. [PMID: 35929587 PMCID: PMC9713905 DOI: 10.5664/jcsm.10190] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 12/14/2022]
Abstract
STUDY OBJECTIVES A high body mass index (BMI) is a risk factor for obstructive sleep apnea. However, to our knowledge there is no reported equation that quantifies the relationship between weight, as measured by BMI, and apnea severity, as assessed by the apnea-hypopnea index (AHI). Our objective was to find a mathematical relationship between BMI and AHI. METHODS We prospectively recruited 434 veterans from our polysomnography laboratory. Veterans already undergoing a sleep study were approached, and those who consented were enrolled. The veterans who enrolled in our study also participated in their scheduled sleep study. This study was approved by our institutional review board. RESULTS We found a simple mathematical relationship between BMI and AHI: for every 1-point drop in BMI (corresponding to 5-8 pounds, depending on a person's height), AHI decreases by 6.2%. And limiting BMI to 25-40 kg/m2 (which includes about 80% of the BMIs), then AHI drops by 7.1%. Simply put as a rule of thumb: For every 7-pounds drop in weight, expect a 7% drop in AHI. CONCLUSIONS To our knowledge, this is the first simple mathematical equation that associates the severity of weight with the severity of apnea in veterans. This equation can be a practical rule of thumb that can be implemented in clinics to predict the amount of weight a patient needs to lose to decrease their apnea, which might help motivate patients to lose weight. CITATION Fattal D, Hester S, Wendt L. Body weight and obstructive sleep apnea: a mathematical relationship between body mass index and apnea-hypopnea index in veterans. J Clin Sleep Med. 2022;18(12):2723-2729.
Collapse
Affiliation(s)
- Deema Fattal
- Neurology Department, University of Iowa, Iowa City, Iowa
- Iowa City VA Medical Center, Iowa City, Iowa
| | | | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa
| |
Collapse
|
22
|
Rossi S, Wendt L, Ballas Z, Knudson CM. In response to Joubeh and Singh: Allergic reactions to platelets; to B or not to B? Transfusion 2022; 62:2655-2656. [PMID: 36478384 DOI: 10.1111/trf.17161] [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] [Received: 08/16/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Siera Rossi
- Department of Pathology, University of Iowa, Iowa City, Iowa, USA
| | | | - Zuhair Ballas
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA
| | | |
Collapse
|
23
|
Hamann CJ, Wendt L, Davis J, Peek-Asa C, Jansson S, Cavanaugh JE. Should we throw the book at 'em? Charge combinations and conviction rates among alcohol-influenced drivers involved in motorcycle crashes. J Safety Res 2022; 83:294-301. [PMID: 36481020 DOI: 10.1016/j.jsr.2022.09.003] [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] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/06/2022] [Accepted: 09/06/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Motorcycle fatality rates are increasing, and impaired driving is a major contributing factor. Impaired driving laws are a main component of state efforts to reduce drunk driving, but motorcycle crash charge and conviction outcomes have yet to be studied. The purpose of this study was to evaluate driver charge and conviction outcomes following alcohol-related motorcycle crashes. METHODS Data for this study were drawn from Iowa crash, charge, and conviction data from 2011 to 2018. The study sample included 480 alcohol-influenced drivers (428 motorcyclists and 52 other vehicle drivers) involved in motorcycle crashes. Driver crash-related charges were categorized by type: Alcohol, Moving Violations, and Administrative/Miscellaneous. Factors associated with convictions were determined and estimated with multivariable logistic regression models. The main factor of interest was charge combination. RESULTS Over three-quarters (78.5%) of the 480 alcohol-influenced drivers in crashes received any charge type and 68.1% received an alcohol-related charge. Among drivers with any charge, 88.6% were convicted, and among drivers with alcohol charges, 87.2% were convicted on an alcohol charge. After adjusting for BAC, drivers with a combination of Alcohol, Administrative, and Moving Violation charges had more than three times the odds of conviction of any charge compared to drivers with alcohol only charges (OR = 3.21, 95% CI = 1.00-10.26). However, charge combinations had little impact on alcohol-related convictions. CONCLUSIONS Convictions were more likely when the impaired driver was charged with multiple types of offenses than with a single offense. An increased variety of charges was not associated with greater rates of conviction on alcohol-specific charges, which had high conviction rates overall. PRACTICAL APPLICATIONS Law enforcement officers should be informed that lesser infractions impact driver conviction outcomes in alcohol-related crashes and procedures for issuing charges should be evaluated to assure equitable enforcement and to hold drivers accountable for unsafe driving behaviors.
Collapse
Affiliation(s)
- Cara J Hamann
- Injury Prevention Research Center, University of Iowa, 145 N Riverside Dr, Iowa City, IA 52242, United States; Department of Epidemiology, University of Iowa College of Public Health, 145 N Riverside Dr., Iowa City, IA 52242, United States.
| | - Linder Wendt
- Injury Prevention Research Center, University of Iowa, 145 N Riverside Dr, Iowa City, IA 52242, United States; Institute for Clinical and Translational Science, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242, United States(1)
| | - Jonathan Davis
- Injury Prevention Research Center, University of Iowa, 145 N Riverside Dr, Iowa City, IA 52242, United States; Department of Occupational and Environmental Health, University of Iowa College of Public Health, 145 N Riverside Dr., Iowa City, IA 52242, United States
| | - Corinne Peek-Asa
- Injury Prevention Research Center, University of Iowa, 145 N Riverside Dr, Iowa City, IA 52242, United States; Department of Epidemiology, University of California, San Diego, School of Public Health, 3100 Gilman Dr, La Jolla, CA 92093, United States(1)
| | - Stephanie Jansson
- Injury Prevention Research Center, University of Iowa, 145 N Riverside Dr, Iowa City, IA 52242, United States; Department of Biostatistics, University of Iowa College of Public Health, 145 N Riverside Dr., Iowa City, IA 52242, United States
| | - Joseph E Cavanaugh
- Injury Prevention Research Center, University of Iowa, 145 N Riverside Dr, Iowa City, IA 52242, United States; Department of Biostatistics, University of Iowa College of Public Health, 145 N Riverside Dr., Iowa City, IA 52242, United States
| |
Collapse
|
24
|
Sanchez S, Raghuram A, Fakih R, Wendt L, Bathla G, Hickerson M, Ortega-Gutierrez S, Leira E, Samaniego EA. 3D Enhancement Color Maps in the Characterization of Intracranial Atherosclerotic Plaques. AJNR Am J Neuroradiol 2022; 43:1252-1258. [PMID: 35953278 PMCID: PMC9451620 DOI: 10.3174/ajnr.a7605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/24/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE High-resolution MR imaging allows the identification of culprit symptomatic plaques after the administration of gadolinium. Current high-resolution MR imaging methods are limited by 2D multiplanar views and manual sampling of ROIs. We analyzed a new 3D method to objectively quantify gadolinium plaque enhancement. MATERIALS AND METHODS Patients with stroke due to intracranial atherosclerotic disease underwent 7T high-resolution MR imaging. 3D segmentations of the plaque and its parent vessel were generated. Signal intensity probes were automatically extended from the lumen into the plaque and the vessel wall to generate 3D enhancement color maps. Plaque gadolinium (Gd) uptake was quantified from 3D color maps as gadolinium uptake = (µPlaque T1 + Gd -µPlaque T1/SDPlaque T1). Additional metrics of enhancement such as enhancement ratio, variance, and plaque-versus-parent vessel enhancement were also calculated. Conventional 2D measures of enhancement were collected for comparison. RESULTS Thirty-six culprit and 44 nonculprit plaques from 36 patients were analyzed. Culprit plaques had higher gadolinium uptake than nonculprit plaques (P < .001). Gadolinium uptake was the most accurate metric for identifying culprit plaques (OR, 3.9; 95% CI 2.1-8.3). Gadolinium uptake was more sensitive (86% versus 70%) and specific (71% versus 68%) in identifying culprit plaques than conventional 2D measurements. A multivariate model, including gadolinium uptake and plaque burden, identified culprit plaques with an 83% sensitivity and 86% specificity. CONCLUSIONS The new 3D color map method of plaque-enhancement analysis is more accurate for identifying culprit plaques than conventional 2D methods. This new method generates a new set of metrics that could potentially be used to assess disease progression.
Collapse
Affiliation(s)
- S Sanchez
- From the Department of Neurology (S.S., A.R., R.F., M.H., S.O.-G., E.L., E.A.S.)
| | - A Raghuram
- From the Department of Neurology (S.S., A.R., R.F., M.H., S.O.-G., E.L., E.A.S.)
| | - R Fakih
- From the Department of Neurology (S.S., A.R., R.F., M.H., S.O.-G., E.L., E.A.S.)
| | - L Wendt
- Institute for Clinical and Translational Science (L.W.), University of Iowa, Iowa City, Iowa
| | - G Bathla
- Radiology (G.B., S.O.-G., E.A.S.)
| | - M Hickerson
- From the Department of Neurology (S.S., A.R., R.F., M.H., S.O.-G., E.L., E.A.S.)
| | - S Ortega-Gutierrez
- From the Department of Neurology (S.S., A.R., R.F., M.H., S.O.-G., E.L., E.A.S.)
- Radiology (G.B., S.O.-G., E.A.S.)
- Neurosurgery (S.O.-G., E.A.S.), University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - E Leira
- From the Department of Neurology (S.S., A.R., R.F., M.H., S.O.-G., E.L., E.A.S.)
| | - E A Samaniego
- From the Department of Neurology (S.S., A.R., R.F., M.H., S.O.-G., E.L., E.A.S.)
- Radiology (G.B., S.O.-G., E.A.S.)
- Neurosurgery (S.O.-G., E.A.S.), University of Iowa Hospitals and Clinics, Iowa City, Iowa
| |
Collapse
|
25
|
Kenne KA, Wendt L, Brooks Jackson J. Prevalence of pelvic floor disorders in adult women being seen in a primary care setting and associated risk factors. Sci Rep 2022; 12:9878. [PMID: 35701486 PMCID: PMC9198100 DOI: 10.1038/s41598-022-13501-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/25/2022] [Indexed: 11/09/2022] Open
Abstract
Determine the prevalence of pelvic floor disorders (PFD) stratified by age, race, body mass index (BMI), and parity in adult women attending family medicine and general internal medicine clinics at an academic health system. The medical records of 25,425 adult women attending primary care clinics were queried using International Classification of Diseases-10th Revision codes (ICD-10 codes) for PFD [urinary incontinence (UI), pelvic organ prolapse (POP), and bowel dysfunction (anal incontinence (AI) and difficult defecation)]. Prevalence and odds ratios were calculated using univariate and multivariate analysis for age, race, BMI, and parity when available. Multivariate logistic regression models were used to assess the impact of age, race, BMI, and parity on the likelihood of being diagnosed with a PFD. A separate model was constructed for each of the three PFD categories (UI, POP, and bowel dysfunction) as well as a model assessing the likelihood of occurrence for any type of PFD. The percentage of women with at least one PFD was 32.0% with bowel dysfunction the most common (24.6%), followed by UI (11.1%) and POP (4.4%). 5.5% had exactly two PFD and 1.1% had all 3 categories of PFD. Older age and higher BMI were strongly and significantly associated with each of the three PFD categories, except for BMI and prolapse. Relative to White patients, Asian patients were at significantly lower risk for each category of PFD, while Black patients were at significantly lower risk for UI and POP, but at significantly greater risk for bowel dysfunction and the presence of any PFD. Higher parity was also significantly associated with pelvic organ prolapse. Using multivariate analyses, age, race, and BMI were all independently associated with PFD. PFD are highly prevalent in the primary care setting and should be screened for, especially in older and obese women. BMI may represent a modifiable risk factor.
Collapse
Affiliation(s)
- Kimberly A Kenne
- Institute for Clinical and Translational Science, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 31674 PFP, Iowa City, IA, 42240, USA.
| | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 31674 PFP, Iowa City, IA, 42240, USA
| | - J Brooks Jackson
- Institute for Clinical and Translational Science, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 31674 PFP, Iowa City, IA, 42240, USA
| |
Collapse
|
26
|
Weber MA, Conlon MM, Stutt HR, Wendt L, Ten Eyck P, Narayanan NS. Quantifying the inverted U: A meta-analysis of prefrontal dopamine, D1 receptors, and working memory. Behav Neurosci 2022; 136:207-218. [PMID: 35389678 DOI: 10.1037/bne0000512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dopamine in the prefrontal cortex can be disrupted in human disorders that affect cognitive function such as Parkinson's disease (PD), attention-deficit hyperactivity disorder (ADHD), and schizophrenia. Dopamine has a powerful effect on prefrontal circuits via the D1-type dopamine receptor (D1DR). It has been proposed that prefrontal dopamine has "inverted U-shaped" dynamics, with optimal dopamine and D1DR signaling required for peak cognitive function. However, the quantitative relationship between prefrontal dopamine and cognitive function is not clear. Here, we conducted a meta-analysis of published manipulations of prefrontal dopamine and the effects on working memory, a high-level executive function in humans, primates, and rodents that involves maintaining and manipulating information over seconds to minutes. We reviewed 646 articles and found that 75 studies met criteria for inclusion. Our quantification of effect sizes for dopamine, D1DRs, and behavior revealed a negative quadratic slope. This is consistent with the proposed inverted U-shape of prefrontal dopamine and D1DRs and working memory performance, explaining 10% of the variance. Of note, the inverted quadratic fit was much stronger for prefrontal D1DRs alone, explaining 26% of the variance, compared to prefrontal dopamine alone, explaining 10% of the variance. Taken together, these data, derived from a variety of manipulations and systems, demonstrate that optimal prefrontal dopamine signaling is linked with higher cognitive function. Our results provide insight into the fundamental dynamics of prefrontal dopamine, which could be useful for pharmacological interventions targeting prefrontal dopaminergic circuits, and into the pathophysiology of human brain disease. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | | | - Linder Wendt
- Institute for Clinical and Translational Science
| | | | | |
Collapse
|
27
|
Schmitz A, Wood KE, Badheka A, Burghardt E, Wendt L, Sharathkumar A, Koestner B. NT-proBNP Levels Following IVIG Treatment for Multisystem Inflammatory Syndrome in Children. Hosp Pediatr 2022; 12:e261-e265. [PMID: 35388427 DOI: 10.1542/hpeds.2022-006534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND N-terminal of pro-brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) levels are often elevated in Multisystem Inflammatory Syndrome in Children (MIS-C) secondary to inflammation, myocardial dysfunction, or increased wall tension. Intravenous Immunoglobulin (IVIG), accepted treatment for MIS-C, may transiently increase myocardial tension and contribute to an increase in NT-proBNP. OBJECTIVE We sought to study the association between pre- and post-IVIG levels of NT-proBNP and CRP and their clinical significance. METHODS This single center retrospective cohort study included consecutive children, ages ≤ 21 years, with diagnosis of MIS-C who received IVIG from April 2020 through October 2021. Data collection included clinical characteristics, laboratory tests, management, and outcomes. Study cohort consisted of patients who received IVIG and had NT-proBNP levels available pre- and post-IVIG. RESULTS Among 35 patients with MIS-C, 30 met inclusion criteria. Twenty-four, 80%, showed elevation in NT-proBNP post-IVIG. The median NT-proBNP level pre-IVIG was 1,921 pg/mL (IQR 548, 3,956), significantly lower than the post-IVIG median of 3,756 pg/mL (IQR 1,342, 7,634)) (p=0.0010). The median pre-IVIG CRP level was significantly higher than the post-IVIG level (12 mg/dL vs 8 mg/dL, p= 0.0006). All but one recovered prior to discharge, and none had signs of worsening cardiac function post-IVIG. In those who recovered, NT-proBNP had normalized by discharge or 1-week follow-up. CONCLUSIONS Our study shows that NT-proBNP levels often transiently increase immediately after IVIG therapy without signs of worsening myocardial function. These values should be interpreted in the context of CRP levels and clinical recovery.
Collapse
Affiliation(s)
- Anna Schmitz
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA.,Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Kelly E Wood
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA.,Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Aditya Badheka
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA.,Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Elliot Burghardt
- Carver College of Medicine, University of Iowa, Iowa City, IA.,Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA
| | - Linder Wendt
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA
| | - Anjali Sharathkumar
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA.,Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Bryan Koestner
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA.,Carver College of Medicine, University of Iowa, Iowa City, IA
| |
Collapse
|
28
|
Wittstein K, Cordsmeier A, Lambert C, Wendt L, Sir EB, Weber J, Wurzler N, Petrini LE, Stadler M. Identification of Rosellinia species as producers of cyclodepsipeptide PF1022 A and resurrection of the genus Dematophora as inferred from polythetic taxonomy. Stud Mycol 2020; 96:1-16. [PMID: 32165986 PMCID: PMC7056724 DOI: 10.1016/j.simyco.2020.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Rosellinia (Xylariaceae) is a large, cosmopolitan genus comprising over 130 species that have been defined based mainly on the morphology of their sexual morphs. The genus comprises both lignicolous and saprotrophic species that are frequently isolated as endophytes from healthy host plants, and important plant pathogens. In order to evaluate the utility of molecular phylogeny and secondary metabolite profiling to achieve a better basis for their classification, a set of strains was selected for a multi-locus phylogeny inferred from a combination of the sequences of the internal transcribed spacer region (ITS), the large subunit (LSU) of the nuclear rDNA, beta-tubulin (TUB2) and the second largest subunit of the RNA polymerase II (RPB2). Concurrently, various strains were surveyed for production of secondary metabolites. Metabolite profiling relied on methods with high performance liquid chromatography with diode array and mass spectrometric detection (HPLC-DAD/MS) as well as preparative isolation of the major components after re-fermentation followed by structure elucidation using nuclear magnetic resonance (NMR) spectroscopy and high resolution mass spectrometry (HR-MS). Two new and nine known isopimarane diterpenoids were identified during our mycochemical studies of two selected Dematophora strains and the metabolites were tested for biological activity. In addition, the nematicidal cyclodepsipeptide PF1022 A was purified and identified from a culture of Rosellinia corticium, which is the first time that this endophyte-derived drug precursor has been identified unambiguously from an ascospore-derived isolate of a Rosellinia species. While the results of this first HPLC profiling were largely inconclusive regarding the utility of secondary metabolites as genus-specific chemotaxonomic markers, the phylogeny clearly showed that species featuring a dematophora-like asexual morph were included in a well-defined clade, for which the genus Dematophora is resurrected. Dematophora now comprises all previously known important plant pathogens in the genus such as D. arcuata, D. bunodes, D. necatrix and D. pepo, while Rosellinia s. str. comprises those species that are known to have a geniculosporium-like or nodulisporium-like asexual morph, or where the asexual morph remains unknown. The extensive morphological studies of L.E. Petrini served as a basis to transfer several further species from Rosellinia to Dematophora, based on the morphology of their asexual morphs. However, most species of Rosellinia and allies still need to be recollected in fresh state, cultured, and studied for their morphology and their phylogenetic affinities before the infrageneric relationships can be clarified.
Collapse
Key Words
- Dematophora
- Dematophora acutispora (Theiss.) C. Lambert, K. Wittstein & M. Stadler
- Dematophora arcuata (Petch) C. Lambert, K. Wittstein & M. Stadler
- Dematophora asperata (Massee ex Wakef.) Lambert, K. Wittstein & M. Stadler
- Dematophora beccariana (Ces.) C. Lambert, K. Wittstein & M, Stadler
- Dematophora boedijnii (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Dematophora bothrina (Berk. & Broome) C. Lambert, K. Wittstein & M. Stadler
- Dematophora bunodes (Berk. & Broome) C. Lambert, K. Wittstein & M. Stadler
- Dematophora buxi (Fabre) C. Lambert, K. Wittstein & M. Stadler
- Dematophora compacta (Takemoto) C. Lambert, K. Wittstein & M. Stadler
- Dematophora francisiae (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Dematophora freycinetiae (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Dematophora gigantea (Ellis & Everh.) C. Lambert, K. Wittstein & M. Stadler
- Dematophora grantii (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Dematophora hsiehiae (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Dematophora hughesii (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Dematophora javaensis (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Dematophora macdonaldii (Bres.) C. Lambert, K. Wittstein & M. Stadler
- Dematophora obregonii (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Dematophora obtusiostiolata (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Dematophora paraguayensis (Starbäck) C. Lambert, K. Wittstein & M. Stadler
- Dematophora pepo (Pat.) C. Lambert, K. Wittstein & M. Stadler
- Dematophora puiggarii (Pat.) C. Lambert, K. Wittstein & M. Stadler
- Dematophora pyramidalis (Lar.N. Vassiljeva) C. Lambert, K. Wittstein & M. Stadler
- Dematophora samuelsii (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Dematophora siggersii (L.E. Petrini) C. Lambert, K. Wittstein & M. Stadler
- Genus resurrection
- Isopimarane diterpenoids
- PF1022A
- Polythetic taxonomy
- Rosellinia
- Xylariaceae
Collapse
Affiliation(s)
- K Wittstein
- Helmholtz-Zentrum für Infektionsforschung GmbH, Department Microbial Drugs, Inhoffenstrasse 7, Braunschweig, 38124, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover-Braunschweig, Braunschweig, 38124, Germany
| | - A Cordsmeier
- Helmholtz-Zentrum für Infektionsforschung GmbH, Department Microbial Drugs, Inhoffenstrasse 7, Braunschweig, 38124, Germany.,University Hospital Erlangen, Institute of Microbiology - Clinical Microbiology, Immunology and Hygiene, Wasserturmstraße 3/5, Erlangen, 91054, Germany
| | - C Lambert
- Helmholtz-Zentrum für Infektionsforschung GmbH, Department Microbial Drugs, Inhoffenstrasse 7, Braunschweig, 38124, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover-Braunschweig, Braunschweig, 38124, Germany
| | - L Wendt
- Helmholtz-Zentrum für Infektionsforschung GmbH, Department Microbial Drugs, Inhoffenstrasse 7, Braunschweig, 38124, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover-Braunschweig, Braunschweig, 38124, Germany
| | - E B Sir
- Instituto de Bioprospección y Fisiología Vegetal-INBIOFIV (CONICET-UNT), San Lorenzo 1469, San Miguel de Tucumán, Tucumán, 4000, Argentina
| | - J Weber
- Helmholtz-Zentrum für Infektionsforschung GmbH, Department Microbial Drugs, Inhoffenstrasse 7, Braunschweig, 38124, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover-Braunschweig, Braunschweig, 38124, Germany
| | - N Wurzler
- Helmholtz-Zentrum für Infektionsforschung GmbH, Department Microbial Drugs, Inhoffenstrasse 7, Braunschweig, 38124, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover-Braunschweig, Braunschweig, 38124, Germany
| | - L E Petrini
- Via al Perato 15c, Breganzona, CH-6932, Switzerland
| | - M Stadler
- Helmholtz-Zentrum für Infektionsforschung GmbH, Department Microbial Drugs, Inhoffenstrasse 7, Braunschweig, 38124, Germany.,German Centre for Infection Research (DZIF), Partner site Hannover-Braunschweig, Braunschweig, 38124, Germany
| |
Collapse
|
29
|
See Hoe LE, Foster SR, Wendt L, Patel HH, Headrick JP, Peart JN. Regulation of the β-Adrenergic Receptor Signaling Pathway in Sustained Ligand-Activated Preconditioning. J Pharmacol Exp Ther 2019; 369:37-46. [DOI: 10.1124/jpet.118.251660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 01/10/2019] [Indexed: 12/12/2022] Open
|
30
|
Brückner I, Kirchner K, Müller Y, Schiwy S, Klaer K, Dolny R, Wendt L, Könemann S, Pinnekamp J, Hollert H, Rosenbaum MA. Status quo report on wastewater treatment plant, receiving water's biocoenosis and quality as basis for evaluation of large-scale ozonation process. Water Sci Technol 2018; 77:337-345. [PMID: 29377818 DOI: 10.2166/wst.2017.548] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The project DemO3AC (demonstration of large-scale wastewater ozonation at the Aachen-Soers wastewater treatment plant, Germany) of the Eifel-Rur Waterboard contains the construction of a large-scale ozonation plant for advanced treatment of the entire 25 million m³/yr of wastewater passing through its largest wastewater treatment plant (WWTP). In dry periods, up to 70% of the receiving water consists of treated wastewater. Thus, it is expected that effects of ozonation on downstream water biocoenosis will become observable. Extensive monitoring of receiving water and the WWTP shows a severe pollution with micropollutants (already prior to WWTP inlet). (Eco-)Toxicological investigations showed increased toxicity at the inlet of the WWTP for all assays. However, endocrine-disrupting potential was also present at other sampling points at the WWTP and in the river and could not be eliminated sufficiently by the WWTP. Total cell counts at the WWTP are slightly below average. Investigations of antibiotic resistances show no increase after the WWTP outlet in the river. However, cells carrying antibiotic-resistant genes seem to be more stress resistant in general. Comparing investigations after implementation of ozonation should lead to an approximation of the correlation between micropollutants and water quality/biocoenosis and the effects that ozonation has on this matter.
Collapse
Affiliation(s)
- I Brückner
- Waterboard Eifel-Rur, Eisenbahnstr. 5, Dueren 52353, Germany E-mail:
| | - K Kirchner
- Institute of Applied Microbiology, RWTH Aachen University, Worringerweg 1, Aachen 52074, Germany
| | - Y Müller
- Institute for Environmental Research, RWTH Aachen University, Worringerweg 1, Aachen 52074, Germany
| | - S Schiwy
- Institute for Environmental Research, RWTH Aachen University, Worringerweg 1, Aachen 52074, Germany
| | - K Klaer
- Institute of Environmental Engineering, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, Aachen 52074, Germany
| | - R Dolny
- Institute of Environmental Engineering, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, Aachen 52074, Germany
| | - L Wendt
- Institute of Applied Microbiology, RWTH Aachen University, Worringerweg 1, Aachen 52074, Germany
| | - S Könemann
- Institute for Environmental Research, RWTH Aachen University, Worringerweg 1, Aachen 52074, Germany
| | - J Pinnekamp
- Institute of Environmental Engineering, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, Aachen 52074, Germany
| | - H Hollert
- Institute for Environmental Research, RWTH Aachen University, Worringerweg 1, Aachen 52074, Germany
| | - M A Rosenbaum
- Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll-Institute, Adolf-Reichwein-Str. 23, Jena 07745, Germany
| |
Collapse
|
31
|
Albring A, Wendt L, Benson S, Nissen S, Yavuz Z, Engler H, Witzke O, Schedlowski M. Preserving Learned Immunosuppressive Placebo Response: Perspectives for Clinical Application. Clin Pharmacol Ther 2014; 96:247-55. [DOI: 10.1038/clpt.2014.75] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 03/27/2014] [Indexed: 12/13/2022]
|
32
|
Abstract
The kinetics and the temperature dependence of potassium loss from Escherichia coli cells treated with colicin K have been examined. At 37 C, after a single lethal hit, essentially all of the intracellular potassium is lost within the first few minutes of treatment. The initial rate of loss is linearly related to colicin concentration up to a multiplicity of 30. As the temperature is decreased over the range from 37 to 1 C, an increasing delay is seen in the initiation of potassium loss after colicin adsorption. This delay can be overcome by increasing colicin multiplicity and probably reflects an alteration of the cell membrane at these temperatures. A comparison of this effect with an apparently related effect of temperature on the action of irehdiamine A indicates that the delay may represent the inhibition of a transmission process occurring in the membrane.
Collapse
Affiliation(s)
- L Wendt
- Department of Biology, Washington University, St. Louis, Missouri 63130
| |
Collapse
|
33
|
Schäfer-Graf U, Wendt L, Gaber B, Kilavuz Ö, Abou-Dakn M, Vetter K. Lässt sich die Anzahl wiederholter Ultraschalluntersuchungen bei GDM limitieren ohne eine fetale Makrosomie übersehen? DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1221914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
34
|
Schäfer-Graf U, Wendt L, Gaber B, Kilavuz O, Abou-Dakn M, Vetter K. Lässt sich die Anzahl wiederholter Ultraschalluntersuchungen bei GDM limitieren ohne eine fetale Makrosomie zu übersehen? Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
35
|
Meler J, Wendt L. Pharmaceutical interaction of lidocaine hydrochloride and sodium carboxymethylcellulose in "hydrocortisonum" suspension. Pharmazie 1990; 45:692-3. [PMID: 2284319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- J Meler
- Department of Applied Pharmacy, Medical Academy, Wroclaw, Poland
| | | |
Collapse
|
36
|
Meler J, Wendt L, Krutul H. Conservation of two-phase system stabilized with linseed mucilage. Pharmazie 1987; 42:700-1. [PMID: 3438327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- J Meler
- Department of Applied Pharmacy, Medical Academy, Wrocław, Poland
| | | | | |
Collapse
|
37
|
Varimo P, Similä S, Wendt L, Kolvisto M. Frequency of breast-feeding and hyperbilirubinemia. Clin Pediatr (Phila) 1986; 25:112. [PMID: 3943257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
38
|
Pluta J, Figura B, Lorenz K, Wendt L. Investigations of content of heavy metals in chosen dosage forms of drugs of vegetal origin. Pharmazie 1984; 39:63. [PMID: 6718471] [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: 01/21/2023]
|
39
|
Wendt L, Similä S, Kouvalainen K. [Nonketone hyperglycinemia]. Pediatriia 1981:36-9. [PMID: 7279501] [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: 01/24/2023]
|
40
|
Wendt L, Wendt T, Wendt A. Protein transport and protein storage in etiology and pathogenesis of arteriosclerosis. Z Ernahrungswiss 1981; 20:1-43. [PMID: 6454307 DOI: 10.1007/bf02027956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
41
|
Abstract
Colicin E1 blocks proline accumulation by membrane vesicles prepared from wild-type sensitive Escherichia coli. Two classes of mutant cells are unaffected by colicin. Vesicles from colicin-resistant strains are sensitive to colicin E1, whereas vesicles from colicin-tolerant strains are unaffected by colicin El. These results suggest that the colicin E1 receptor is on the cell membrane and that colicin-tolerant strains have altered membranes while colicin-resistant strains have altered cell walls.
Collapse
|
42
|
Abstract
The addition of phenethyl alcohol (PEA) to cultures of male strains of Escherichia coli rapidly prevents the adsorption of the male-specific bacteriophages f1 and f2 to the donor cells. The adsorption of f2 to F pili in cell-free preparations is unaffected by PEA. In a mating system, PEA alters the kinetics of gene transfer in minimal medium but not in broth. Sodium cyanide, azide, and iodoacetate also apparently inhibit f2 adsorption to cells but not to detached F pili. The phage adsorption inhibitory action of PEA is completely reversible in the presence of 100 mug of chloramphenicol per ml.
Collapse
|
43
|
Abstract
Phenethyl alcohol (PEA) caused Escherichia coli to take up greatly increased amounts of acriflavine, a compound to which healthy growing cells are impermeable. PEA also caused an increased rate of efflux (leakage) of cellular potassium under conditions which do not greatly alter the influx of potassium via the energy-dependent potassium pump. We therefore propose that the primary effect of PEA is a limited breakdown of the cell membrane. The inhibition of deoxyribonucleic acid synthesis and other cellular functions would then be secondary consequences of the alteration in the membrane structure.
Collapse
|
44
|
|