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Dason ES, Maxim M, Gesink D, Yee M, Chan C, Baxter NN, Shapiro H, Simpson AN. Medical Students' Perspectives on Family Planning and Impact on Specialty Choice. JAMA Surg 2024; 159:170-178. [PMID: 38090998 PMCID: PMC10719828 DOI: 10.1001/jamasurg.2023.6392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/31/2023] [Indexed: 12/17/2023]
Abstract
Importance Physicians are known to delay childbearing compared with nonphysicians and to experience higher rates of age-related pregnancy complications. Delay of childbearing is more pronounced in surgical specialties, and family planning and building goals may influence specialty choice. Objective To assess medical students' perspectives on the development of family planning goals and the timing of family building within a medical career to elucidate how these perceptions impact their choice of specialty. Design, Setting, and Participants This qualitative study included fourth-year medical students at the University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada, and was conducted between May and August 2021. Participants were purposively sampled to maximize diversity of gender and specialty choice. Interviews were conducted via videoconferencing software that were recorded, transcribed verbatim, and verified for accuracy. Thematic analysis was completed independently by 2 researchers and consensus on final themes was reached through discussion among study investigators. Data were analyzed between September and December 2021. Main Outcomes and Measures Participants were asked to share their perceptions of personal family planning goals, support currently in place, family planning education in medicine and factors contributing to their choice of specialty and program. Thematic analysis was completed. Results A total of 34 fourth-year medical students (median [range] age, 26 [24-33] years; 23 females [67.6%]) were interviewed. Four main themes were identified: (1) there is no ideal time to family build in a medical career, (2) family planning is a taboo topic, (3) surgical specialties offer less support for family building, and (4) residents who have children are perceived to place a burden on their colleagues. Medical students considered their family planning while deliberating among specialty choices and their experiences were highly influential in shaping their specialty selection. Conclusions and Relevance Results of this qualitative study suggest that medical students perceive that family building during training may have unfavorable implications for team dynamics and relationships with colleagues, and these perceptions may affect specialty choice and family planning goals. Integration of family planning discussions and support for family building into medical curricula is needed along with efforts to improve culture by supporting team dynamics and workload when students take parental leave.
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Affiliation(s)
- Ebernella Shirin Dason
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Madalina Maxim
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada
| | - Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Michelle Yee
- Department of Emergency Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Crystal Chan
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Nancy N. Baxter
- Li Ka Shing Knowledge Institute, St Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Heather Shapiro
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Andrea N. Simpson
- Li Ka Shing Knowledge Institute, St Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, St Michael’s Hospital/Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada
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Yee M, Surkis A, Lamb I, Contaxis N. The NYU Data Catalog: a modular, flexible infrastructure for data discovery. J Am Med Inform Assoc 2023; 30:1693-1700. [PMID: 37414539 PMCID: PMC10531119 DOI: 10.1093/jamia/ocad125] [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: 04/07/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023] Open
Abstract
OBJECTIVE Researchers at New York University (NYU) Grossman School of Medicine contacted the Health Sciences Library for help with locating large datasets for reuse. In response, the library developed and maintained the NYU Data Catalog, a public-facing data catalog that has supported not only faculty acquisition of data but also the dissemination of the products of their research in various ways. MATERIALS AND METHODS The current NYU Data Catalog is built upon the Symfony framework with a tailored metadata schema reflecting the scope of faculty research areas. The project team curates new resources, including datasets and supporting software code, and conducts quarterly and annual evaluations to assess user interactions with the NYU Data Catalog and opportunities for growth. RESULTS Since its launch in 2015, the NYU Data Catalog underwent a number of changes prompted by an increase in the disciplines represented by faculty contributors. The catalog has also utilized faculty feedback to enhance support of data reuse and researcher collaboration through alterations to its schema, layout, and visibility of records. DISCUSSION These findings demonstrate the flexibility of data catalogs as a platform for enabling the discovery of disparate sources of data. While not a repository, the NYU Data Catalog is well-positioned to support mandates for data sharing from study sponsors and publishers. CONCLUSION The NYU Data Catalog makes the most of the data that researchers share and can be harnessed as a modular and adaptable platform to promote data sharing as a cultural practice.
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Affiliation(s)
- Michelle Yee
- Health Sciences Library, New York University Grossman School of Medicine, New York, New York, USA
| | - Alisa Surkis
- Health Sciences Library, New York University Grossman School of Medicine, New York, New York, USA
| | - Ian Lamb
- Health Sciences Library, New York University Grossman School of Medicine, New York, New York, USA
| | - Nicole Contaxis
- Health Sciences Library, New York University Grossman School of Medicine, New York, New York, USA
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Wahezi SE, Patel A, Yerra S, Naeimi T, Sayed D, Oakes D, Ortiz N, Yee M, Yih C, Sitapara K, Schulz J, Kohan L, Rosenburg J, Schwechter E, Chan F, Gonzalez D, Baker C. Percutaneous Ultrasound-Guided Tenotomy of the Iliotibial Band for Trochanteric Pain Syndrome: A Longitudinal Observational Study With One-Year Durability Results. Pain Physician 2023; 26:393-401. [PMID: 37535779] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND Upper lateral hip pain is a common complaint in adults and is referred to as greater trochanteric pain syndrome (GTPS) and is more prevalent among older women. This is a debilitating condition that could result in lower physical activity and quality of life, and higher unemployment rate. GTPS is a clinical diagnosis, and many cases improve with conservative medical management (CMM). However, there is still a gap between patients not responding to CMM and those who are not good surgical candidates. Thus, percutaneous ultrasound tenotomy (PUT) may be a valuable treatment option to limit this gap. OBJECTIVES Demonstration of the one-year pain and functional outcomes, including sit to stand. SETTING Academic tertiary care medical center. METHODS Forty-eight consecutive patients with refractory trochanteric pain due to iliotibial band (ITB) tendinopathy. Fifty-six hips were treated; 8 patients underwent bilateral procedures. Electronic medical record review of consecutive patients who underwent ITB TENEX® was performed at Montefiore Medical Center from December 2019 to December 2021. Institutional guidelines recommended TENEX® for greater trochanteric pain refractory to conservative treatment and ultrasound (US) confirmed ITB tendinopathy (hypoechogenicity or thickened tendon > 6 mm). Pain level, as well as sit-to-stand, side-lying, and walking tolerance levels were evaluated at baseline preprocedure visit and one-year visit. Follow-up was performed by independent practitioners and corroborated by chart review. RESULTS Numeric Rating Scale (NRS-11) improved by 4 points across all patients. Seventy percent of patients endorsed pain relief at one-year visit. Median preprocedure NRS-11 was 9. The reported median NRS-11at one year was 5 (Wilcoxon signed rank NRS-11 demonstrated a Z score of -6.042 with P < 0.001). One-year analysis among all patients revealed 57%, 78%, and 66% improvement in side-lying, sit-to-stand, and walking tolerance levels, respectively. LIMITATIONS We believe that our results must be confirmed with a randomized control trial with a control arm and more patients included. CONCLUSIONS PUT of the ITB using the TENEX® tissue remodeling device could be a safe and effective treatment for ITB tendinopathy-associated GTPS.
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Affiliation(s)
- Sayed E Wahezi
- Department of Physical Medicine & Rehabilitation, Montefiore Medical Center, NY
| | | | - Sandeep Yerra
- Department of Pain Medicine, Montefiore Medical Center, NY
| | - Tahereh Naeimi
- Department of Pain Medicine, Montefiore Medical Center, NY
| | - Dawood Sayed
- Department of Pain Medicine, Kansas University Medical Center, KS
| | - Devin Oakes
- Department of Pain Medicine, Montefiore Medical Center, NY
| | - Nicole Ortiz
- Department of Physical Medicine & Rehabilitation, Montefiore Medical Center, NY
| | - Michelle Yee
- Department of Physical Medicine & Rehabilitation, Montefiore Medical Center, NY
| | - Christopher Yih
- Department of Physical Medicine & Rehabilitation, NYU Medical Center, NY
| | | | - Jacob Schulz
- Department of Orthopedic Surgery, Montefiore Medical Center, NY
| | - Lynn Kohan
- Department of Anesthesiology, University of Virginia, Charlottesville, VA
| | | | - Evan Schwechter
- Department of Orthopedic Surgery, Montefiore Medical Center, NY
| | - Ferdinand Chan
- Department of Orthopedic Surgery, Montefiore Medical Center, NY
| | - David Gonzalez
- Department of Orthopedic Surgery, Montefiore Medical Center, NY; Department of Sports Medicine, Montefiore Medical Center, NY
| | - Champ Baker
- Department of Orthopedic Surgery, Hughston Foundation, GA
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Smitherman EA, Chahine RA, Beukelman T, Lewandowski LB, Rahman AKMF, Wenderfer SE, Curtis JR, Hersh AO, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar‐Smiley F, Barillas‐Arias L, Basiaga M, Baszis K, Becker M, Bell‐Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang‐Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel‐Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie‐Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui‐Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein‐Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PM, McGuire S, McHale I, McMonagle A, McMullen‐Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O'Brien B, O'Brien T, Okeke O, Oliver M, Olson J, O'Neil K, Onel K, Orandi A, Orlando M, Osei‐Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan‐Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas‐Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth‐Wojcicki E, Rouster – Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert‐Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner‐Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care. Arthritis Care Res (Hoboken) 2023; 75:1553-1562. [PMID: 36775844 PMCID: PMC10500561 DOI: 10.1002/acr.25002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 11/23/2021] [Revised: 07/14/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis. METHODS We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded. RESULTS We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers. CONCLUSION In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.
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5
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Hahn T, Daymont C, Beukelman T, Groh B, Hays K, Bingham CA, Scalzi L, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J 2022; 20:107. [PMID: 36434731 PMCID: PMC9701017 DOI: 10.1186/s12969-022-00770-y] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months. METHODS We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed. RESULTS We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05). CONCLUSION While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.
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Affiliation(s)
- Timothy Hahn
- Department of Pediatrics, Penn State Children's Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA, 17033-0855, USA.
| | - Carrie Daymont
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Timothy Beukelman
- grid.265892.20000000106344187Department of Pediatrics, University of Alabama at Birmingham, CPPN G10, 1600 7th Ave South, Birmingham, AL 35233 USA
| | - Brandt Groh
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | | | - Catherine April Bingham
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Lisabeth Scalzi
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
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Yee M, Walther T, Frischknecht F, Douglas RG. Divergent Plasmodium actin residues are essential for filament localization, mosquito salivary gland invasion and malaria transmission. PLoS Pathog 2022; 18:e1010779. [PMID: 35998188 PMCID: PMC9439217 DOI: 10.1371/journal.ppat.1010779] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 09/02/2022] [Accepted: 07/29/2022] [Indexed: 11/18/2022] Open
Abstract
Actin is one of the most conserved and ubiquitous proteins in eukaryotes. Its sequence has been highly conserved for its monomers to self-assemble into filaments that mediate essential cell functions such as trafficking, cell shape and motility. The malaria-causing parasite, Plasmodium, expresses a highly sequence divergent actin that is critical for its rapid motility at different stages within its mammalian and mosquito hosts. Each of Plasmodium actin’s four subdomains have divergent regions compared to canonical vertebrate actins. We previously identified subdomains 2 and 3 as providing critical contributions for parasite actin function as these regions could not be replaced by subdomains of vertebrate actins. Here we probed the contributions of individual divergent amino acid residues in these subdomains on parasite motility and progression. Non-lethal changes in these subdomains did not affect parasite development in the mammalian host but strongly affected progression through the mosquito with striking differences in transmission to and through the insect. Live visualization of actin filaments showed that divergent amino acid residues in subdomains 2 and 4 enhanced localization associated with filaments, while those in subdomain 3 negatively affected actin filaments. This suggests that finely tuned actin dynamics are essential for efficient organ entry in the mosquito vector affecting malaria transmission. This work provides residue level insight on the fundamental requirements of actin in highly motile cells. Actin is one of the most abundant and conserved proteins known. Actin monomers can join together to form long filaments. The malaria-causing parasite is transmitted by mosquitoes and needs actin to move very rapidly. An actin from the parasite is different to other actins: its amino acid sequence has relatively high amounts of changes compared to animal species and the actin tends to form only short filaments. We previously identified two large parts of the protein that were critical for the parasite since these large parts could not be exchanged with the equivalent regions of other species. In this study, we focused in on these regions by making more discrete mutations. Most mutations of the actin sequence were tolerated by the parasite in the blood stages. However, these mutants has striking defects in progressing through mosquitoes, especially in invading its salivary glands. We used a new filament labeler to visualize how these mutations affect the actin filaments and found surprisingly different effects. Taken together, small changes to the sequence can have large consequences for the parasite, which ultimately affects its ability to transmit to a new host.
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Affiliation(s)
- Michelle Yee
- Integrative Parasitology, Center for Infectious Diseases, Heidelberg University Medical School, Heidelberg, Germany
| | - Tobias Walther
- Integrative Parasitology, Center for Infectious Diseases, Heidelberg University Medical School, Heidelberg, Germany
| | - Friedrich Frischknecht
- Integrative Parasitology, Center for Infectious Diseases, Heidelberg University Medical School, Heidelberg, Germany
- German Centre for Infection Research, DZIF, partner site Heidelberg, Heidelberg, Germany
- * E-mail: (FF); (RGD)
| | - Ross G. Douglas
- Integrative Parasitology, Center for Infectious Diseases, Heidelberg University Medical School, Heidelberg, Germany
- Biochemistry and Molecular Biology, Interdisciplinary Research Centre and Molecular Infection Biology, Biomedical Research Centre Seltersberg, Justus Liebig University Giessen, Giessen, Germany
- * E-mail: (FF); (RGD)
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Soulsby WD, Balmuri N, Cooley V, Gerber LM, Lawson E, Goodman S, Onel K, Mehta B, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis. Pediatr Rheumatol Online J 2022; 20:18. [PMID: 35255941 PMCID: PMC8903717 DOI: 10.1186/s12969-022-00676-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry. METHODS In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months. RESULTS One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability. CONCLUSION High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.
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Affiliation(s)
- William Daniel Soulsby
- University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA, 94158, USA.
| | - Nayimisha Balmuri
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Victoria Cooley
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Linda M. Gerber
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Erica Lawson
- grid.266102.10000 0001 2297 6811University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA 94158 USA
| | - Susan Goodman
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Karen Onel
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Bella Mehta
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
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Contaxis N, Clark J, Dellureficio A, Gonzales S, Mannheimer S, Oxley PR, Ratajeski MA, Surkis A, Yarnell AM, Yee M, Holmes K. Ten simple rules for improving research data discovery. PLoS Comput Biol 2022; 18:e1009768. [PMID: 35143479 PMCID: PMC8830647 DOI: 10.1371/journal.pcbi.1009768] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Nicole Contaxis
- NYU Health Sciences Library, NYU Langone Health, New York, New York, United States of America
- * E-mail:
| | - Jason Clark
- Montana State University Library, Montana State University, Bozeman, Montana, University States of America
| | - Anthony Dellureficio
- Medical library, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Sara Gonzales
- Galter Health Sciences Library and Learning Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Sara Mannheimer
- Montana State University Library, Montana State University, Bozeman, Montana, University States of America
| | - Peter R. Oxley
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill-Cornell Medicine, New York, New York, United States of America
| | - Melissa A. Ratajeski
- Health Sciences Library System, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Alisa Surkis
- NYU Health Sciences Library, NYU Langone Health, New York, New York, United States of America
| | - Amy M. Yarnell
- Health Sciences and Human Services Library, University of Maryland—Baltimore, Baltimore, Maryland, United States of America
| | - Michelle Yee
- NYU Health Sciences Library, NYU Langone Health, New York, New York, United States of America
| | - Kristi Holmes
- Galter Health Sciences Library and Learning Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
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9
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Gopal P, Sarathy JP, Yee M, Ragunathan P, Shin J, Bhushan S, Zhu J, Akopian T, Kandror O, Lim TK, Gengenbacher M, Lin Q, Rubin EJ, Grüber G, Dick T. Pyrazinamide triggers degradation of its target aspartate decarboxylase. Nat Commun 2020; 11:1661. [PMID: 32245967 PMCID: PMC7125159 DOI: 10.1038/s41467-020-15516-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 03/16/2020] [Indexed: 11/28/2022] Open
Abstract
Pyrazinamide is a sterilizing first-line tuberculosis drug. Genetic, metabolomic and biophysical analyses previously demonstrated that pyrazinoic acid, the bioactive form of the prodrug pyrazinamide (PZA), interrupts biosynthesis of coenzyme A in Mycobacterium tuberculosis by binding to aspartate decarboxylase PanD. While most drugs act by inhibiting protein function upon target binding, we find here that pyrazinoic acid is only a weak enzyme inhibitor. We show that binding of pyrazinoic acid to PanD triggers degradation of the protein by the caseinolytic protease ClpC1-ClpP. Thus, the old tuberculosis drug pyrazinamide exerts antibacterial activity by acting as a target degrader, a mechanism of action that has recently emerged as a successful strategy in drug discovery across disease indications. Our findings provide the basis for the rational discovery of next generation PZA. It has been shown that the bioactive component of pyrazinamide, pyrazinoic acid (POA), blocks coenzyme A biosynthesis in M. tuberculosis by binding to the aspartate decarboxylase PanD. Here the authors show that pyrazinamide triggers degradation of PanD by stimulating its degradation by the caseinolytic protease Clp.
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Affiliation(s)
- Pooja Gopal
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,MSD Translational Medicine Research Centre, Merck Research Laboratories, Singapore, Singapore
| | - Jickky Palmae Sarathy
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michelle Yee
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Priya Ragunathan
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Joon Shin
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Shashi Bhushan
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Junhao Zhu
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Tatos Akopian
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Olga Kandror
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Teck Kwang Lim
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Martin Gengenbacher
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA.,Department of Medical Sciences, Hackensack Meridian Medical School at Seton Hall University, Nutley, NJ, USA
| | - Qingsong Lin
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Eric J Rubin
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Gerhard Grüber
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Thomas Dick
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. .,Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA. .,Department of Medical Sciences, Hackensack Meridian Medical School at Seton Hall University, Nutley, NJ, USA.
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10
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Sandhu S, Karagic M, Roizen G, Yee M, Jerschow E. M004 METHIMAZOLE INDUCED V.S. IDIOPATHIC LUPUS IN A PEDIATRIC PATIENT. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.082] [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: 10/25/2022]
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11
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Safi H, Gopal P, Lingaraju S, Ma S, Levine C, Dartois V, Yee M, Li L, Blanc L, Ho Liang HP, Husain S, Hoque M, Soteropoulos P, Rustad T, Sherman DR, Dick T, Alland D. Phase variation in Mycobacterium tuberculosis glpK produces transiently heritable drug tolerance. Proc Natl Acad Sci U S A 2019; 116:19665-19674. [PMID: 31488707 PMCID: PMC6765255 DOI: 10.1073/pnas.1907631116] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [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: 11/18/2022] Open
Abstract
The length and complexity of tuberculosis (TB) therapy, as well as the propensity of Mycobacterium tuberculosis to develop drug resistance, are major barriers to global TB control efforts. M. tuberculosis is known to have the ability to enter into a drug-tolerant state, which may explain many of these impediments to TB treatment. We have identified a mechanism of genetically encoded but rapidly reversible drug tolerance in M. tuberculosis caused by transient frameshift mutations in a homopolymeric tract (HT) of 7 cytosines (7C) in the glpK gene. Inactivating frameshift mutations associated with the 7C HT in glpK produce small colonies that exhibit heritable multidrug increases in minimal inhibitory concentrations and decreases in drug-dependent killing; however, reversion back to a fully drug-susceptible large-colony phenotype occurs rapidly through the introduction of additional insertions or deletions in the same glpK HT region. These reversible frameshift mutations in the 7C HT of M. tuberculosis glpK occur in clinical isolates, accumulate in M. tuberculosis-infected mice with further accumulation during drug treatment, and exhibit a reversible transcriptional profile including induction of dosR and sigH and repression of kstR regulons, similar to that observed in other in vitro models of M. tuberculosis tolerance. These results suggest that GlpK phase variation may contribute to drug tolerance, treatment failure, and relapse in human TB. Drugs effective against phase-variant M. tuberculosis may hasten TB treatment and improve cure rates.
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Affiliation(s)
- Hassan Safi
- Center for Emerging Pathogens, New Jersey Medical School, Rutgers University, Newark, NJ 07103;
- Department of Medicine, New Jersey Medical School, Rutgers University, Newark, NJ 07103
| | - Pooja Gopal
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 117597 Singapore, Republic of Singapore
| | - Subramanya Lingaraju
- Center for Emerging Pathogens, New Jersey Medical School, Rutgers University, Newark, NJ 07103
- Department of Medicine, New Jersey Medical School, Rutgers University, Newark, NJ 07103
| | - Shuyi Ma
- Center for Infectious Disease, Seattle Children's Hospital, Seattle, WA 98105
| | - Carly Levine
- Center for Emerging Pathogens, New Jersey Medical School, Rutgers University, Newark, NJ 07103
- Department of Medicine, New Jersey Medical School, Rutgers University, Newark, NJ 07103
| | - Veronique Dartois
- The Public Health Research Institute, New Jersey Medical School, Rutgers University, Newark, NJ 07103
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110
| | - Michelle Yee
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 117597 Singapore, Republic of Singapore
| | - Liping Li
- The Public Health Research Institute, New Jersey Medical School, Rutgers University, Newark, NJ 07103
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110
| | - Landry Blanc
- The Public Health Research Institute, New Jersey Medical School, Rutgers University, Newark, NJ 07103
| | - Hsin-Pin Ho Liang
- The Public Health Research Institute, New Jersey Medical School, Rutgers University, Newark, NJ 07103
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110
| | - Seema Husain
- Genomics Center, New Jersey Medical School, Rutgers University, Newark, NJ 07103
| | - Mainul Hoque
- Genomics Center, New Jersey Medical School, Rutgers University, Newark, NJ 07103
| | | | - Tige Rustad
- Center for Infectious Disease, Seattle Children's Hospital, Seattle, WA 98105
| | - David R Sherman
- Center for Infectious Disease, Seattle Children's Hospital, Seattle, WA 98105
| | - Thomas Dick
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110
| | - David Alland
- Center for Emerging Pathogens, New Jersey Medical School, Rutgers University, Newark, NJ 07103;
- Department of Medicine, New Jersey Medical School, Rutgers University, Newark, NJ 07103
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12
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Kalayci A, Gibson CM, Chi G, Yee M, Korjian S, Datta S, Nafee T, Gurin M, Haroian N, Hull RD, Hernandez AF, Cohen AT, Harrington RA, Goldhaber SZ. P251Asymptomatic deep vein thrombosis in acutely ill medical patients: insights from the APEX trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p251] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Kalayci
- Harvard Medical School, Cardiology, Boston, United States of America
| | - C M Gibson
- Harvard Medical School, Cardiology, Boston, United States of America
| | - G Chi
- Harvard Medical School, Cardiology, Boston, United States of America
| | - M Yee
- Harvard Medical School, Cardiology, Boston, United States of America
| | - S Korjian
- Harvard Medical School, Cardiology, Boston, United States of America
| | - S Datta
- Harvard Medical School, Cardiology, Boston, United States of America
| | - T Nafee
- Harvard Medical School, Cardiology, Boston, United States of America
| | - M Gurin
- Harvard Medical School, Cardiology, Boston, United States of America
| | - N Haroian
- Harvard Medical School, Cardiology, Boston, United States of America
| | - R D Hull
- University of Calgary, Cardiology, Calgary, Canada
| | - A F Hernandez
- Duke University Medical Center, Cardiology, Durham, United States of America
| | - A T Cohen
- St Thomas' Hospital, Haematology, London, United Kingdom
| | - R A Harrington
- Stanford University Medical Center, Cardiology, Stanford, United States of America
| | - S Z Goldhaber
- Brigham and Women's Hospital, Cardiology, Boston, United States of America
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13
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Crew KD, Anderson G, Hershman DL, Terry MB, Tehranifar P, Lew DL, Yee M, Brown EA, Kairouz SS, Minasian LM, Ford L, Neuhouser ML, Arun BK, Brown PH. Abstract P5-15-02: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-15-02] [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: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- KD Crew
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - G Anderson
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - DL Hershman
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - MB Terry
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - P Tehranifar
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - DL Lew
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - M Yee
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - EA Brown
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - SS Kairouz
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - LM Minasian
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - L Ford
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - ML Neuhouser
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - BK Arun
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
| | - PH Brown
- Columbia University Medical Center, New York, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; SWOG Statistics and Data Management Center, Seattle, WA; Beaumont NCORP, William Beaumont Hospital, Troy, MI; Heartland NCORP, Cancer Care Specialists of Central Illinois, Decatur, IL; National Cancer Institute, Bethesda, MD; MD Anderson Cancer Center, Houston, TX
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14
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Price E, Al-Sajee D, Krisna SS, Howie KJ, Munoz C, Yee M, Patel M, O'Byrne PM, Lima H, Sehmi R, Gauvreau GM. Elevated Eosinophil Lineage-Committed Progenitors In Skin Lesions Of Patients With Moderate-To-Severe Atopic Dermatitis. J Allergy Clin Immunol 2018. [DOI: 10.1016/j.jaci.2017.12.295] [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: 10/18/2022]
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15
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Oliveria JP, El-Gammal AI, Yee M, Obminski CD, Scime TX, Watson RM, Howie K, O'Byrne PM, Sehmi R, Gauvreau GM. Changes in regulatory B-cell levels in bone marrow, blood, and sputum of patients with asthma following inhaled allergen challenge. J Allergy Clin Immunol 2017; 141:1495-1498.e9. [PMID: 29221714 DOI: 10.1016/j.jaci.2017.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/24/2017] [Accepted: 11/01/2017] [Indexed: 01/03/2023]
Affiliation(s)
- John-Paul Oliveria
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Amani I El-Gammal
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Michelle Yee
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Caitlin D Obminski
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Tara X Scime
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Richard M Watson
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Karen Howie
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Paul M O'Byrne
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Roma Sehmi
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada
| | - Gail M Gauvreau
- Department of Medicine, Division of Respirology, McMaster University, Hamilton, Ontario, Canada.
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16
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Gopal P, Nartey W, Ragunathan P, Sarathy J, Kaya F, Yee M, Setzer C, Manimekalai MSS, Dartois V, Grüber G, Dick T. Pyrazinoic Acid Inhibits Mycobacterial Coenzyme A Biosynthesis by Binding to Aspartate Decarboxylase PanD. ACS Infect Dis 2017; 3:807-819. [PMID: 28991455 DOI: 10.1021/acsinfecdis.7b00079] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Previously, we showed that a major in vitro and in vivo mechanism of resistance to pyrazinoic acid (POA), the bioactive component of the critical tuberculosis (TB) prodrug pyrazinamide (PZA), involves missense mutations in the aspartate decarboxylase PanD, an enzyme required for coenzyme A biosynthesis. What is the mechanism of action of POA? Upon demonstrating that treatment of M. bovis BCG with POA resulted in a depletion of intracellular coenzyme A and confirming that this POA-mediated depletion is prevented by either missense mutations in PanD or exogenous supplementation of pantothenate, we hypothesized that POA binds to PanD and that this binding blocks the biosynthetic pathway. Here, we confirm both hypotheses. First, metabolomic analyses showed that POA treatment resulted in a reduction of the concentrations of all coenzyme A precursors downstream of the PanD-mediated catalytic step. Second, using isothermal titration calorimetry, we established that POA, but not its prodrug PZA, binds to PanD. Binding was abolished for mutant PanD proteins. Taken together, these findings support a mechanism of action of POA in which the bioactive component of PZA inhibits coenzyme A biosynthesis via binding to aspartate decarboxylase PanD. Together with previous works, these results establish PanD as a genetically, metabolically, and biophysically validated target of PZA.
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Affiliation(s)
- Pooja Gopal
- Department of Microbiology
and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2, Singapore 117545
| | - Wilson Nartey
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 639798
| | - Priya Ragunathan
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 639798
| | - Jansy Sarathy
- Public
Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, 225 Warren Street, Newark, New Jersey 07103, United States
| | - Firat Kaya
- Public
Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, 225 Warren Street, Newark, New Jersey 07103, United States
| | - Michelle Yee
- Department of Microbiology
and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2, Singapore 117545
| | - Claudia Setzer
- Department of Microbiology
and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2, Singapore 117545
| | | | - Véronique Dartois
- Public
Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, 225 Warren Street, Newark, New Jersey 07103, United States
| | - Gerhard Grüber
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 639798
| | - Thomas Dick
- Department of Microbiology
and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2, Singapore 117545
- Public
Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, 225 Warren Street, Newark, New Jersey 07103, United States
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17
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Gopal P, Tasneen R, Yee M, Lanoix JP, Sarathy J, Rasic G, Li L, Dartois V, Nuermberger E, Dick T. In Vivo-Selected Pyrazinoic Acid-Resistant Mycobacterium tuberculosis Strains Harbor Missense Mutations in the Aspartate Decarboxylase PanD and the Unfoldase ClpC1. ACS Infect Dis 2017; 3:492-501. [PMID: 28271875 PMCID: PMC5514395 DOI: 10.1021/acsinfecdis.7b00017] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 01/02/2023]
Abstract
Through mutant selection on agar containing pyrazinoic acid (POA), the bioactive form of the prodrug pyrazinamide (PZA), we recently showed that missense mutations in the aspartate decarboxylase PanD and the unfoldase ClpC1, and loss-of-function mutation of polyketide synthases Mas and PpsA-E involved in phthiocerol dimycocerosate synthesis, cause resistance to POA and PZA in Mycobacterium tuberculosis. Here we first asked whether these in vitro-selected POA/PZA-resistant mutants are attenuated in vivo, to potentially explain the lack of evidence of these mutations among PZA-resistant clinical isolates. Infection of mice with panD, clpC1, and mas/ppsA-E mutants showed that whereas growth of clpC1 and mas/ppsA-E mutants was attenuated, the panD mutant grew as well as the wild-type. To determine whether these resistance mechanisms can emerge within the host, mice infected with wild-type M. tuberculosis were treated with POA, and POA-resistant colonies were confirmed for PZA and POA resistance. Genome sequencing revealed that 82 and 18% of the strains contained missense mutations in panD and clpC1, respectively. Consistent with their lower fitness and POA resistance level, independent mas/ppsA-E mutants were not found. In conclusion, we show that the POA/PZA resistance mechanisms due to panD and clpC1 missense mutations are recapitulated in vivo. Whereas the representative clpC1 mutant was attenuated for growth in the mouse infection model, providing a possible explanation for their absence among clinical isolates, the growth kinetics of the representative panD mutant was unaffected. Why POA/PZA resistance-conferring panD mutations are observed in POA-treated mice but not yet among clinical strains isolated from PZA-treated patients remains to be determined.
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Affiliation(s)
- Pooja Gopal
- Department of Microbiology
and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
| | - Rokeya Tasneen
- Center for Tuberculosis
Research, Johns Hopkins University, Baltimore, Maryland, United States
| | - Michelle Yee
- Department of Microbiology
and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
| | - Jean-Philippe Lanoix
- Department of Infectious Diseases, University Hospital of Amiens-Picardie, Amiens, France
| | - Jansy Sarathy
- Public
Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey, United States
| | - George Rasic
- Public
Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey, United States
| | - Liping Li
- Public
Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey, United States
| | - Véronique Dartois
- Public
Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey, United States
| | - Eric Nuermberger
- Center for Tuberculosis
Research, Johns Hopkins University, Baltimore, Maryland, United States
| | - Thomas Dick
- Department of Microbiology
and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
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Rumbach AF, Cremer R, Chatwood A, Fink S, Haider S, Yee M. The Challenges of Dysphagia Management and Rehabilitation in Two Complex Cases Post Chemical Ingestion Injury. Am J Speech Lang Pathol 2016; 25:470-480. [PMID: 27626140 DOI: 10.1044/2016_ajslp-15-0043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 03/03/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Dysphagia is common sequelae of chemical ingestion injury, resulting from damage to critical swallowing structures. From a speech-language pathology perspective, this study outlines the physiological deficits in 2 individuals with severe injury (1 woman, acid; 1 man, alkali) and the pattern of dysphagia rehabilitation and recovery. METHOD A retrospective chart review of clinical and instrumental assessments was conducted to examine swallow characteristics and speech-language pathology management (compensatory and rehabilitation strategies) at multiple time points. RESULTS Chemical ingestion injury resulted in severe pharyngeal dysphagia for both participants, warranting speech-language pathology management. Dysphagia was characterized by poor base of tongue mobility and reduced laryngeal excursion. Decreased airway patency and protection, secondary to mucosal sloughing, widespread edema, and structural deficits necessitated tracheostomy. Recovery was complicated by physical alterations of pharyngeal and laryngeal structures (e.g., interarytenoid adhesions) and esophageal strictures. Participant 1 was discharged (Day 135) consuming a texture-modified diet; Participant 2 remained nil by mouth (Day 329). CONCLUSIONS Dysphagia recovery subsequent to chemical ingestion is protracted and complex. Clinical outcomes may be improved through individualized and intensive rehabilitation by speech-language pathologists.
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Affiliation(s)
| | - Rebecca Cremer
- Royal Brisbane and Women's Hospital, Metro North Hospital Health Service, Queensland Health, Brisbane, Australia
| | | | - Sari Fink
- The University of Queensland, Australia
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Davies A, Gebremedhin S, Yee M, Padilla RJ, Duzgunes N, Konopka K, Dorocka-Bobkowska B. Cationic porphyrin-mediated photodynamic inactivation of Candida biofilms and the effect of miconazole. J Physiol Pharmacol 2016; 67:777-783. [PMID: 28011958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 10/31/2016] [Indexed: 06/06/2023]
Abstract
The formation of biofilms by Candida and the increasing resistance of Candida species to antifungals contribute to the high recurrence rates of denture stomatitis. This increase has stimulated an interest in antimicrobial photodynamic therapy (aPDT) as an alternative treatment. We examined the photoactivity of the porphyrin-based photosensitizer, TMP-1363, against biofilms of C. albicans, C. glabrata, C. tropicalis and C. parapsilosis, and the effect of the combined use of miconazole and aPDT. Biofilms of three American Type Culture Collection (ATCC) strains and four clinical isolates developed on poly(methyl methacrylate) (PMMA) disks, were incubated with miconazole, followed by treatment with TMP-1363 for 30 min at 37°C. The plates were exposed to broadband visible light at a distance of 10 cm to the plate, for 30 min (irradiance at the surface of the plate: 32.5 mW/cm2). The metabolic activity of the biofilms was measured by the XTT assay. ATCC strains and C. glabrata 7531/06 were not sensitive to TMP-aPDT, whereas the metabolic activities of the remaining three clinical isolates were reduced to 64.2 ± 5.5% of controls. Miconazole at 25 μg/ml decreased the viability of all strains except the ATTCC strain C. albicans MYA274; however its combination with aPDT was effective against this strain, suggesting a synergistic interaction. Effects of miconazole and aPDT on C. albicans MYA 2732, C. albicans 6122/06 were additive. With C. tropicalis and C. parapsilosis, the combined treatment had a higher, but not entirely additive, cytotoxic effect. The combined use of miconazole and TMP-aPDT is advantageous in the treatment of biofilms of a number of Candida species and strains, but not all. The molecular basis of this differential response is not known.
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Affiliation(s)
- A Davies
- Department of Biomedical Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
- Department of Diagnostic Sciences, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S Gebremedhin
- Department of Biomedical Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - M Yee
- Department of Biomedical Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - R J Padilla
- Department of Diagnostic Sciences, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - N Duzgunes
- Department of Biomedical Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - K Konopka
- Department of Biomedical Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - B Dorocka-Bobkowska
- Department of Oral Pathology, University of Medical Sciences, Poznan, Poland.
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Gopal P, Yee M, Sarathy J, Low JL, Sarathy JP, Kaya F, Dartois V, Gengenbacher M, Dick T. Pyrazinamide Resistance Is Caused by Two Distinct Mechanisms: Prevention of Coenzyme A Depletion and Loss of Virulence Factor Synthesis. ACS Infect Dis 2016; 2:616-626. [PMID: 27759369 DOI: 10.1021/acsinfecdis.6b00070] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pyrazinamide (PZA) is a critical component of first- and second-line treatments of tuberculosis (TB), yet its mechanism of action largely remains an enigma. We carried out a genetic screen to isolate Mycobacterium bovis BCG mutants resistant to pyrazinoic acid (POA), the bioactive derivative of PZA, followed by whole genome sequencing of 26 POA resistant strains. Rather than finding mutations in the proposed candidate targets fatty acid synthase I and ribosomal protein S1, we found resistance conferring mutations in two pathways: missense mutations in aspartate decarboxylase panD, involved in the synthesis of the essential acyl carrier coenzyme A (CoA), and frameshift mutations in the vitro nonessential polyketide synthase genes mas and ppsA-E, involved in the synthesis of the virulence factor phthiocerol dimycocerosate (PDIM). Probing for cross resistance to two structural analogs of POA, nicotinic acid and benzoic acid, showed that the analogs share the PDIM- but not the CoA-related mechanism of action with POA. We demonstrated that POA depletes CoA in wild-type bacteria, which is prevented by mutations in panD. Sequencing 10 POA-resistant Mycobacterium tuberculosis H37Rv isolates confirmed the presence of at least 2 distinct mechanisms of resistance to the drug. The emergence of resistance through the loss of a virulence factor in vitro may explain the lack of clear molecular patterns in PZA-resistant clinical isolates, other than mutations in the prodrug-converting enzyme. The apparent interference of POA with virulence pathways may contribute to the drug's excellent in vivo efficacy compared to its modest in vitro potency.
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Affiliation(s)
- Pooja Gopal
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Michelle Yee
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Jickky Sarathy
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Jian Liang Low
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Jansy P. Sarathy
- Public Health Research Institute, Rutgers—New Jersey Medical School, Newark, New Jersey 07103, United States
| | - Firat Kaya
- Public Health Research Institute, Rutgers—New Jersey Medical School, Newark, New Jersey 07103, United States
| | - Véronique Dartois
- Public Health Research Institute, Rutgers—New Jersey Medical School, Newark, New Jersey 07103, United States
| | - Martin Gengenbacher
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Thomas Dick
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
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Savitz DA, Bobb JF, Carr JL, Clougherty JE, Dominici F, Elston B, Ito K, Ross Z, Yee M, Matte TD. Ambient fine particulate matter, nitrogen dioxide, and term birth weight in New York, New York. Am J Epidemiol 2014; 179:457-66. [PMID: 24218031 DOI: 10.1093/aje/kwt268] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Building on a unique exposure assessment project in New York, New York, we examined the relationship of particulate matter with aerodynamic diameter less than 2.5 μm and nitrogen dioxide with birth weight, restricting the population to term births to nonsmokers, along with other restrictions, to isolate the potential impact of air pollution on growth. We included 252,967 births in 2008-2010 identified in vital records, and we assigned exposure at the residential location by using validated models that accounted for spatial and temporal factors. Estimates of association were adjusted for individual and contextual sociodemographic characteristics and season, using linear mixed models to quantify the predicted change in birth weight in grams related to increasing pollution levels. Adjusted estimates for particulate matter with aerodynamic diameter less than 2.5 μm indicated that for each 10-µg/m(3) increase in exposure, birth weights declined by 18.4, 10.5, 29.7, and 48.4 g for exposures in the first, second, and third trimesters and for the total pregnancy, respectively. Adjusted estimates for nitrogen dioxide indicated that for each 10-ppb increase in exposure, birth weights declined by 14.2, 15.9, 18.0, and 18.0 g for exposures in the first, second, and third trimesters and for the total pregnancy, respectively. These results strongly support the association of urban air pollution exposure with reduced fetal growth.
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Ross Z, Ito K, Johnson S, Yee M, Pezeshki G, Clougherty JE, Savitz D, Matte T. Spatial and temporal estimation of air pollutants in New York City: exposure assignment for use in a birth outcomes study. Environ Health 2013; 12:51. [PMID: 23802774 PMCID: PMC3704849 DOI: 10.1186/1476-069x-12-51] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [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: 04/10/2013] [Accepted: 06/19/2013] [Indexed: 05/20/2023]
Abstract
BACKGROUND Recent epidemiological studies have examined the associations between air pollution and birth outcomes. Regulatory air quality monitors often used in these studies, however, were spatially sparse and unable to capture relevant within-city variation in exposure during pregnancy. METHODS This study developed two-week average exposure estimates for fine particles (PM2.5) and nitrogen dioxide (NO2) during pregnancy for 274,996 New York City births in 2008-2010. The two-week average exposures were constructed by first developing land use regression (LUR) models of spatial variation in annual average PM2.5 and NO2 data from 150 locations in the New York City Community Air Survey and emissions source data near monitors. The annual average concentrations from the spatial models were adjusted to account for city-wide temporal trends using time series derived from regulatory monitors. Models were developed using Year 1 data and validated using Year 2 data. Two-week average exposures were then estimated for three buffers of maternal address and were averaged into the last six weeks, the trimesters, and the entire period of gestation. We characterized temporal variation of exposure estimates, correlation between PM2.5 and NO2, and correlation of exposures across trimesters. RESULTS The LUR models of average annual concentrations explained a substantial amount of the spatial variation (R2 = 0.79 for PM2.5 and 0.80 for NO2). In the validation, predictions of Year 2 two-week average concentrations showed strong agreement with measured concentrations (R2 = 0.83 for PM2.5 and 0.79 for NO2). PM2.5 exhibited greater temporal variation than NO2. The relative contribution of temporal vs. spatial variation in the estimated exposures varied by time window. The differing seasonal cycle of these pollutants (bi-annual for PM2.5 and annual for NO2) resulted in different patterns of correlations in the estimated exposures across trimesters. The three levels of spatial buffer did not make a substantive difference in estimated exposures. CONCLUSIONS The combination of spatially resolved monitoring data, LUR models and temporal adjustment using regulatory monitoring data yielded exposure estimates for PM2.5 and NO2 that performed well in validation tests. The interaction between seasonality of air pollution and exposure intervals during pregnancy needs to be considered in future studies.
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Affiliation(s)
- Zev Ross
- ZevRoss Spatial Analysis, 120 N. Aurora St Suite 3A, Ithaca, NY, 14850, USA
| | - Kazuhiko Ito
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Sarah Johnson
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Michelle Yee
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Grant Pezeshki
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Jane E Clougherty
- Graduate School of Public Health, Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - David Savitz
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Thomas Matte
- New York City Department of Health and Mental Hygiene, New York, NY, USA
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Wong KT, Grove JS, Grandinetti A, Curb JD, Yee M, Blanchette P, Ross GW, Rodriguez BI. Association of fibrinogen with Parkinson disease in elderly Japanese-American men: a prospective study. Neuroepidemiology 2009; 34:50-4. [PMID: 19940513 DOI: 10.1159/000260070] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Accepted: 07/24/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The purpose of this prospective study was to examine whether fibrinogen level is associated with Parkinson disease (PD) for both prevalent and incident cases. METHODS The Honolulu Asia-Aging Study is a longitudinal study of Japanese-American men based on the Honolulu Heart Study birth cohort. The original cohort consisted of 8,006 participants with selective service records who were living on the island of Oahu, Hawaii, in 1965. For this analysis, baseline was defined as the 1991-1993 examination (n = 3,845) when men were aged 71-93 years old. Multivariate logistic regression and Cox proportional hazards models were used, adjusting for potential confounders. RESULTS We identified 61 prevalent cases and 61 incident cases of PD during the follow-up. High fibrinogen level (presence in the top quintile) was associated with higher frequency of PD for both prevalent (OR = 2.07, 95% CI = 1.10-3.88, p = 0.024) and incident cases (HR = 3.05, 95% CI = 1.34-6.97, p = 0.008) among men aged 76-93 years, after adjusting for age, smoking, and low-density lipoprotein cholesterol. CONCLUSIONS These results suggest high fibrinogen level is associated with increased risk of PD among men over 75 years.
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Affiliation(s)
- K T Wong
- Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
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Affiliation(s)
- M Yee
- AmeriPath New York Gastrointestinal Diagnostics, 1 Greenwich Place, Shelton, CT 06484, USA
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Boyd C, Abraham S, Taylor A, Cousins E, Hughan M, Yee M. Medical students' opinions of chaperone use during gynecological and anorectal examinations. J Psychosom Obstet Gynaecol 2002; 23:11-5. [PMID: 12061032 DOI: 10.3109/01674820209093410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The opinions of medical students on chaperone use during physical examinations of the male and female was studied. The students (157) had conducted their first gynecological or first anorectal and prostate examination. Fifty-one percent of students were female, 56% younger than 25 years of age, and 77% males and 73% females had experienced sexual intercourse. Data on the use of a chaperone during vaginal, anorectal, breast and musculoskeletal examinations when conducted by doctors and by students was collected by anonymous questionnaires. Most students feel a chaperone is necessary when students-in-training conduct vaginal (94%), anorectal (94%) or breast (89%) examinations. Fewer students feel a chaperone is necessary when doctors rather than students conduct vaginal (41%), anorectal (22%) and breast (25%) examinations. Students were significantly more likely to feel a chaperone was necessary when a doctor of the opposite sex conducts vaginal (58%) and anorectal (34%) examinations, compared to a doctor of the same sex. Students who were male, 25 years or older or had not experienced sexual intercourse were significantly more likely to favour doctors using chaperones. The differences in responses of students of differing age, gender and sexual experience should be considered and discussed when students are learning invasive physical examinations.
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Affiliation(s)
- C Boyd
- Department of Obstetrics and Gynaecology, University of Sydney, NSW 2000, Australia
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Pangi C, Shwe T, Win DL, Saw WW, Gyi KK, Yee M, Myint YY, Htay TT. A comparative study of intervention methods (full, partial and non-integration) on late case detection and treatment irregularity in Yangon, Myanmar. Indian J Lepr 2000; 70 Suppl:97S-105S. [PMID: 10992872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The high percentage (20%) of new cases with grade 2 disabilities, and a low treatment regularity of 47% indicated problems in case detection and case holding in Urban Yangon. The fact that Urban Health Centers (UHCs) were not involved in leprosy control programme might have had an adverse influence. To compare the effectiveness of two methods of integration (full and partial) of urban leprosy services in terms of early case detection and regularity of treatment this study was conducted, in an urban area. Two townships with similar leprosy prevalence, staff infrastructure, socio-economic status, transport, communication and working capacity of the Township Medical Officers (TMOs) were chosen for this intervention study: UHC-A(Thingangyun) for full integration and UHC-B(Tamwe) for partial integration and the remaining 14 townships as non-integrated areas served by the Central Special Skin Clinic (CSSC). This study has shown that it was possible to fully integrate Leprosy Control Programme (LCP) into the Urban Health Centres [Basic Health Services (BHS)] in Urban Yangon. Case detection could be improved by active case finding such as contact examination and school examination conducted by the personnel of UHCs. Treatment regularity was found to be directly proportional to prompt defaulter retrieval action and the motivational level of the TMO and peripheral BHS workers. There were more complaints from patients (8.1%) treated at UHC-A when compared to CSSC (6.7%). Among defaulters there were more adults than children, more males than females and more PB than MB patients.
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Affiliation(s)
- C Pangi
- Central Special Skin Clinic, Yangon General Hospital, Myanmar
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28
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Moinpour C, Savage M, Troxel A, Lovato L, Eisenberger M, Veith R, Higgins B, Skeel R, Yee M, Blumenstein B, Crawford E, Meyskens F. Quality of Life in Advanced Prostate Cancer: Results of a Randomized Therapeutic Trial. J Urol 1999. [DOI: 10.1016/s0022-5347(01)61702-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- C.M. Moinpour
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - M.J. Savage
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - A. Troxel
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - L.C. Lovato
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - M. Eisenberger
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - R.W. Veith
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - B. Higgins
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - R. Skeel
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - M. Yee
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - B.A. Blumenstein
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - E.D. Crawford
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
| | - F.L. Meyskens
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington, Mercy Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, Columbia Presbyterian Cancer Center, New York, New York, Stanley S. Scott Cancer Center, Louisiana State University Medical Center-New Orleans, New Orleans, Louisiana, Brooke Army Medical Center/Wilford Hall Medical Center, San Antonio, Texas, Medical College of Ohio, Toledo, Ohio, University of Colorado,
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Moinpour CM, Savage MJ, Troxel A, Lovato LC, Eisenberger M, Veith RW, Higgins B, Skeel R, Yee M, Blumenstein BA, Crawford ED, Meyskens FL. Quality of life in advanced prostate cancer: results of a randomized therapeutic trial. J Natl Cancer Inst 1998; 90:1537-44. [PMID: 9790546 DOI: 10.1093/jnci/90.20.1537] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.0] [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] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND For patients with metastatic prostate cancer, treatment is primarily palliative, relying mainly on the suppression of systemic androgen hormone levels. To help document the achievement of palliation and to characterize positive and negative effects of treatment, we evaluated quality-of-life (QOL) parameters in patients with metastatic prostate cancer who were randomly assigned to two methods of androgen deprivation. METHODS Patients (n = 739) with stage M1 (bone or soft tissue metastasis) prostate cancer were enrolled in a QOL protocol that was a companion to Southwest Oncology Group INT-0105, a randomized double-blind trial comparing treatment with bilateral orchiectomy (surgical castration) plus either flutamide or placebo. Patients completed a comprehensive battery of QOL questionnaires at random assignment to treatment and at 1, 3, and 6 months later. Data were collected on three treatment-specific symptoms (diarrhea, gas pain, and body image), on physical functioning, and on emotional functioning. All P values are two-sided. RESULTS Questionnaire return rates for this study never dropped below 80%; only 2% of the patients did not submit baseline QOL assessments. Cross-sectional analyses (corrected for multiple testing) identified statistically significant differences that favored orchiectomy plus placebo for two of the five primary QOL parameters as follows: patients receiving flutamide reported more diarrhea at 3 months (P = .001) and worse emotional functioning at 3 and 6 months (both P<.003). Longitudinal analyses replicated these findings. Other analyzed QOL parameters favored the group receiving placebo but were not statistically significant after adjustment for multiple testing. CONCLUSIONS We found a consistent pattern of better QOL outcomes at each follow-up assessment during the first 6 months of treatment for orchiectomized patients with metastatic prostate cancer who received placebo versus flutamide. Improvement over time was evident in both treatment groups but more so for patients receiving placebo.
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Affiliation(s)
- C M Moinpour
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA
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Kim YR, Yee M, Metha S, Chupp V, Kendall R, Scott CS. Simultaneous differentiation and quantitation of erythroblasts and white blood cells on a high throughput clinical haematology analyser. Clin Lab Haematol 1998; 20:21-9. [PMID: 9681207 DOI: 10.1046/j.1365-2257.1998.00092.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
After the neonatal period, the presence of nucleated red blood cells (NRBC) in peripheral blood is indicative of pathology. Despite the clinical utility of such measurements, automated NRBC counting has hitherto not been available on routine automated blood cell counting analysers. To address this, an automated method for the analysis of NRBC was developed and incorporated into the Abbott Cell Dyn 4000 (CD4000) haematology analyser. The system white blood cell (WBC) reagent was specifically formulated to preserve concomitantly white blood cell (WBC) morphology, rapidly lyse red blood cell and NRBC membranes, and subsequently stain NRBC nuclei with a nucleotide specific fluorochrome dye (Kim et al. 1996a). The fluorochrome itself does not permeabilize the membrane of intact viable white blood cells. The sample is processed by flow cytometry and the signals generated from an argon-ion laser light source are analysed. Axial light loss (AxLL), intermediate angle light scatter (IAS) and red fluorescence (FL3) are used to discriminate between particles of various types. By using these discriminators in a three-dimensional approach, NRBC from a discrete cluster which can easily be separated from leucocytes and enumerated as a distinct cell population during the optical WBC differential analysis. Consequently, accurate absolute WBC counts and differentials can be obtained even in the presence of NRBC. Background 'noise' (both fluorescent and non-fluorescent) from platelets. Howell-Jolly bodies, basophilic stippling, RNA from lysed reticulocytes, and DNA from leucocyte and megakaryocytic fragments are essentially eliminated (Kim et al. 1996b). While the membranes of intact and viable leucocytes remain impermeable to the passage of the fluorochrome stain, leucocytes with damaged membranes are permeable to the dye and generate FL3+ signals. Such cells, which are commonly seen as a consequence of sample ageing as well as in some distinctive pathologies, are identified by the algorithm (using their AxLL signal size) and are labelled as non-viable. Moreover, because non-viable leucocytes are retained in the WBC count and differential analyses, the CD4000 is further able to provide both numerical and graphical data regarding the relative frequency of viable and non-viable components. This additional information can serve as valuable 'decision-drivers' in the laboratory data review process.
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Affiliation(s)
- Y R Kim
- Abbott Diagnostics, Santa Clara, California, USA
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Abstract
One hundred and one new dinucleotide repeat polymorphisms specific for the canine genome have been identified and characterized. Screening of both primary libraries and marker-selected libraries enriched for simple sequence repeats led to the isolation of large numbers of genomic clones that contained (CA)n repeats. Over 200 of these clones were sequenced, and PCR primers that bracket the repeat were developed for those that contained ten or more continuous (CA)n units. This effort led to the production of 101 polymorphic markers, which were assigned to one of four categories depending on their degree of polymorphism. Fifty-four markers were found to be highly or very highly polymorphic as they had four or more alleles when tested on a panel of unrelated dogs. This group of markers will be useful for following inheritance of traits in crosses between dogs.
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Affiliation(s)
- E A Ostrander
- Transplantation Biology Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98104, USA
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32
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Casasent D, Yee M. Multitarget-tracking optical processing system. Appl Opt 1994; 33:6860-6872. [PMID: 20941233 DOI: 10.1364/ao.33.006860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We consider multitarget tracking, estimating the state vector (two-dimensional position and velocity) of each target from physical measurements. We consider a full system for this and the role for analog optical processing within its subsystems. We emphasize the neural network data-association subsystem (which associates measurements in the present input frame with estimates from previous frames of data). Our new optimization neural net results concern associations between measurements and estimates and show that use of a simple fixed-coefficient estimation filter is sufficient. For completeness in our full system approach we briefly describe our optical detection subsystem and its use to reduce frame-to-frame jitter in the measurements. We also briefly note our Hough-transform optical subsystem and discuss its use in detecting and correcting data dropout errors and errors in the data-association and estimator systems. We conclude that analog optical processing has significant use in a full multitarget tracking system.
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33
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Nicholas JJ, Yee M, Latash ML. Decreased perception threshold to electrocutaneous stimulation in a patient with fibromyalgia. J Rheumatol 1994; 21:1580-1. [PMID: 7983672] [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] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Abstract
A sample of 128 boys and girls in four age groups (three, five, seven, nine years) undertook tasks designed to assess their ability to categorize by gender, gender constancy, evaluations of gender groups, and gender discrimination in the allocation of prizes in a task performance setting. Results indicated that all children could categorize accurately by gender although nine-year-olds tended to adopt more complex criteria. Gender constancy increased with age, although not monotonically--seven-year-olds displayed less constancy than five-year-olds. Gender differentiation in attitudes was very marked from five years upwards, and even earlier in girls (both groups viewed their own gender more favourably). This greater own gender favouritism among girls was even clearer in the discrimination task: girls awarded girls' groups more desirable toys even when they had ostensibly performed less well than the boys' group. The boys attended more to performance information. Girls also made more negative comments about boys than vice versa.
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Affiliation(s)
- M Yee
- School of Psychology, University of Wales, Cardiff
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35
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Tincknell TG, Potempa K, Lopez M, Braun LT, Szidon JP, Fogg L, Yee M. 272 AEROBIC TRAINING EFFECTS IN HEMIPARETIC STROKE PATIENTS. Med Sci Sports Exerc 1994. [DOI: 10.1249/00005768-199405001-00273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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36
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Kuypers FA, Lubin BH, Yee M, Agre P, Devaux PF, Geldwerth D. The distribution of erythrocyte phospholipids in hereditary spherocytosis demonstrates a minimal role for erythrocyte spectrin on phospholipid diffusion and asymmetry. Blood 1993; 81:1051-7. [PMID: 8427987] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
In the human erythrocyte membrane phosphatidylcholine and sphingomyelin reside mainly in the outer leaflet, whereas the aminophospholipids, phosphatidylethanolamine and phosphatidylserine, are mainly found in the inner leaflet. Maintenance of phospholipid asymmetry has been assumed to involve interactions between the aminophospholipids and the membrane skeleton, in particular spectrin. To investigate whether spectrin contributes to maintaining the phospholipid transbilayer distribution and kinetics of redistribution, we studied erythrocytes from hereditary spherocytosis patients whose spectrin levels ranged from 34% to 82% of normal. The phospholipid composition and the accessibility of membrane phospholipids to hydrolysis by phospholipases were in the normal range. Spin-labeled phosphatidylserine and phosphatidylethanolamine analogues that had been introduced into the outer leaflet were rapidly transported at 37 degrees C to the inner leaflet, whereas the redistribution of spin-labeled phosphatidylcholine was slower. The kinetics of transbilayer movement of these spin-labeled phospholipid in all samples was in the normal range and was not affected by the level of spectrin. Although these erythrocyte membranes contained as little as 34% of the normal level of spectrin and were characterized by several physical abnormalities, the composition, distribution, and transbilayer kinetics of the phospholipids were found to be normal. We therefore conclude that spectrin plays, at best, only a minor role in maintaining the distribution of erythrocyte membrane phospholipid.
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Affiliation(s)
- F A Kuypers
- Children's Hospital Oakland Research Institute, CA 94609
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37
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Yee M, Casasent D. Multitarget data association using an optical neural network. Appl Opt 1992; 31:613-624. [PMID: 20720656 DOI: 10.1364/ao.31.000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A neural network solution to the data association problem in multitarget tracking is presented. It uses position and velocity measurements of the targets over two consecutive time frames. A quadratic neural energy function, which is suitable for an optical processing implementation, results. Simulation resultsusing realistic target trajectories with target measurement noise including platform movement or jitter are presented. The results show that the network performs well when track data are corrupted by significant noise. Several possible optical neural network architectures to implement this algorithm are discussed, including a new all-optical matrix-vector multiplication approach. The matrix structure is employed to allow binary-ternary spatial light modulators to be used.
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Brecher G, Neben S, Yee M, Bullis J, Cronkite EP. Pluripotent stem cells with normal or reduced self renewal survive lethal irradiation. Exp Hematol 1988; 16:627-30. [PMID: 2899030] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Transfusion with 10,000 or 20,000 marrow cells resulted in 30+ days survival of 15%-50% of mice exposed to an Ld90 or LD100 or radiation. The use of congenic mice with alloenzyme markers permitted the identification of host and donor cells in the peripheral blood of transfused animals. Donor cells were present initially in all hosts. Between 55% and 92% of the animals became 100% host type by 12-24 weeks after transfusion in three separate experiments. To explore whether the temporary repopulation by donor cells was due to short-lived stem cells, the marrows of several primary hosts were transfused into secondary, lethally irradiated hosts. Some of the retransplanted primary donor and host cells persisted only temporarily. It is suggested that some of the donor stem cells in both the primary and secondary hosts had an intrinsically shortened life span.
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Affiliation(s)
- G Brecher
- Lawrence Berkeley Laboratory, University of California, Berkeley 94708
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Juneau M, Rogers F, De Santos V, Yee M, Evans A, Bohn A, Haskell WL, Taylor CB, DeBusk RF. Effectiveness of self-monitored, home-based, moderate-intensity exercise training in middle-aged men and women. Am J Cardiol 1987; 60:66-70. [PMID: 3604945 DOI: 10.1016/0002-9149(87)90986-6] [Citation(s) in RCA: 80] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The effects of 6 months of self-monitored, home-based exercise training on maximal oxygen uptake (VO2 max), body composition and plasma lipid levels of healthy, sedentary, middle-aged persons were evaluated in 60 men, aged 49 +/- 6 years, and 60 women, aged 47 +/- 5 years. Moderate-intensity training was performed 5 times per week in sessions of 47 +/- 7 minutes and 54 +/- 8 minutes for men and women, respectively. The individually prescribed range of heart rate corresponded to 65 to 77% of the peak value during symptom-limited treadmill testing (mean of 72% for men and 69% for women). Caloric expenditure per training session was approximately 345 kcal for men and 235 kcal for women. VO2 max increased 15% in men and 9% in women (both p less than 0.01). The greater increase in VO2 max in men than in women primarily reflected greater adherence to training in men (greater than or equal to 90% vs greater than or equal to 75%). The increase in VO2 max in women who showed very high adherence was comparable to that of men. Body weight decreased, by 1.5 +/- 10 kg, in men (p less than 0.05) but not in women undergoing training. No significant training-induced changes in plasma lipid levels were noted in either men or women. Baseline orientation and follow-up telephone calls required less than 1 hour of staff time per participant. Self-monitored, moderate-intensity, home-based exercise training significantly increases functional capacity in healthy, middle-aged men and women. Such training provides an alternative to group-based exercise training.
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Schwartz RS, Olson JA, Raventos-Suarez C, Yee M, Heath RH, Lubin B, Nagel RL. Altered plasma membrane phospholipid organization in Plasmodium falciparum-infected human erythrocytes. Blood 1987; 69:401-7. [PMID: 3542079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The intraerythrocytic development of the malaria parasite is accompanied by distinct morphological and biochemical changes in the host cell membrane, yet little is known about development-related alterations in the transbilayer organization of membrane phospholipids in parasitized cells. This question was examined in human red cells infected with Plasmodium falciparum. Normal red cells were infected with strain FCR3 or with clonal derivatives that either produce (K+) or do not produce (K-) knobby protuberances on the infected red cells. Parasitized cells were harvested at various stages of parasite development, and the bilayer orientation of red cell membrane phospholipids was determined chemically using 2,4,6-trinitrobenzene sulphonic acid (TNBS) or enzymatically using bee venom phospholipase A2 (PLA2) and sphingomyelinase C (SMC). We found that parasite development was accompanied by distinct alterations in the red cell membrane transbilayer distribution of phosphatidylcholine (PC), phosphatidylethanolamine (PE), and phosphatidylserine (PS). Increases in the exoplasmic membrane leaflet exposure of PE and PS were larger in the late-stage parasitized cells than in the early-stage parasitized cells. Similar results were obtained for PE membrane distribution using either chemical (TNBS) or enzymatic (PLA2 plus SMC) methods, although changes in PS distribution were observed only with TNBS. Uninfected cohort cells derived from mixed populations of infected and uninfected cells exhibited normal patterns of membrane phospholipid organization. The observed alterations in P falciparum-infected red cell membrane phospholipid distribution, which is independent of the presence or absence of knobby protuberances, might be associated with the drastic changes in cell membrane permeability and susceptibility to early hemolysis observed in the late stages of parasite development.
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Abstract
Treatment of purified preparations of Na,K-ATPase by phospholipase A2 has led to the formation of two-dimensional crystals of the protein. Control tests with another phospholipase and two detergents have shown that crystallization occurs as the result of hydrolysis and/or solubilization of the phospholipids in the enzyme vesicles. Experimentation with various buffer systems has indicated that reduction in the amount of phospholipids alone is sufficient for inducing the formation of crystalline sheets. Inclusion of crystal inducing ions in the buffer facilitates the crystallization process, resulting in more extensive arrays. The new crystalline sheets are exclusively dimeric with average unit cell dimensions: a = 15.8 +/- 0.4 nm, b = 4.9 +/- 0.2 nm, and gamma = 64 +/- 3 degrees. Examination of the micrographs shows that the initial intermolecular interaction leading to the formation of sheets is between the alpha subunits. Results from this study suggest that removal and/or modification of phospholipids by phospholipases could prove successful in crystallizing those membrane proteins in which excess lipid is the main barrier to the formation of two-dimensional arrays.
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Schrier SL, Chiu DT, Yee M, Sizer K, Lubin B. Alteration of membrane phospholipid bilayer organization in human erythrocytes during drug-induced endocytosis. J Clin Invest 1983; 72:1698-705. [PMID: 6630521 PMCID: PMC370458 DOI: 10.1172/jci111129] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Our plan was to evaluate the potentially important role of phospholipids in erythrocyte shape alterations by determining if their orientation was altered during endocytosis. Stomatocytosis and endocytosis were induced in normal intact human erythrocytes by incubation with three agents: primaquine, vinblastine, and chlorpromazine, each of which has its own requirements and time course for producing endocytosis. The organization of the phospholipid bilayer was assessed by measuring the extent of degradation of phophatidylcholine (PC), phophatidylethanolamine (PE), phosphatidylserine (PS), and sphingomyelin (SM) produced by exposure of erythrocytes to a nonpenetrating protease-free phospholipase A2 alone or in combination with a purified sphingomyelinase as well. The induction of stomatocytosis did not change this orientation. However, correlating with the onset of endocytosis but not its extent, there was an increase in PE degradation, which could be detected regularly only by use of phospholipase A2 alone. Use of the combination of phospholipase A2 and sphingomyelinase showed that the extent and course of endocytosis was paralleled by an apparent movement of PC and SM from the outer to the inner half of the lipid bilayer. Since no further PE was hydrolyzed and because no PS was ever degraded, this inward movement of PC and SM did not represent the establishment of complete symmetry in the membrane. By adjusting the experimental design it was possible to implicate the endocytic process, and not insertion of drug in the membrane, as the cause of the alterations in phospholipid organization seen. Our findings indicate that the phospholipid orientation is very closely involved in the endocytosis process and that specific states of phospholipid asymmetry may be related to identifiable membrane events.
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Foster CS, Yee M. Corneoscleral manifestations of Graves' disease, the acquired connective tissue disorders, and systemic vasculitis. Int Ophthalmol Clin 1983; 23:131-57. [PMID: 6131047 DOI: 10.1097/00004397-198302310-00012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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45
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Abstract
In summary, we propose the following scheme (Figure 5) to describe the role of peroxidation in the pathophysiology of SCA. Sickle erythrocytes are more susceptible to peroxidation than are normal erythrocytes. This increased susceptibility to peroxidation is, in part, due to decreased blood vitamin E levels and abnormal membrane phospholipid organization induced by sickling. The peroxidative damage of sickle erythrocytes may accelerate or contribute to loss of cell deformability and to chronic hemolysis. Peroxidative damage can produce abnormal cellular properties, such as potassium leak and reduced filterability, and contribute to formation of ISCs. Increased red cell rigidity can initiate episodes of capillary obstruction, leading to vasoocclusive painful crises and to tissue infarction. Liver dysfunction as well as increased production of bilirubin secondary to hemolysis could result in bile sludging and decreased secretion of bile salts into the intestinal lumen. Reduced bile salt secretion leads to partial fat and vitamin E malabsorption. Vitamin E deficiency enhances red cell susceptibility to peroxidation and promotes a vicious cycle in SCA. Although we have not studied factors that might initiate peroxidative damage, sickle hemoglobin and excess body iron should be considered as potential sources. Our studies suggest that vitamin E supplementation to sickle-cell patients could be of clinical benefit.
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46
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McNamara JJ, Lacro RV, Yee M, Smith GT. Hemorrhagic infarction and coronary reperfusion. J Thorac Cardiovasc Surg 1981; 81:498-501. [PMID: 7206756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Coronary ligation experiments were performed on 23 primates. Some of the experiments were followed by reperfusion after periods of occlusion of from 1 to 6 hours. Hemorrhage into the infarct was noted in all animals and was greatest following reperfusion after 4 hours of occlusion or longer. Hemorrhage increases the measured infarct size to the point that it is actually larger than that seen with ligation alone. However, this increase is accounted for by the larger amount of intramyocardial hemorrhage. Hemorrhage is greatest in the center of the infarct and decreases at the margins. It appears that hemorrhage occurs into necrotic muscle and does not occur significantly at the margins of the infarct where damage to otherwise viable myocardium might result.
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47
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Yee M. 'Hospital of stars' seeks to discard Hollywood image. Health Care Week 1978; 2:12. [PMID: 10308255] [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: 02/12/2023]
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48
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Yee M, Bresnick E. Effect of administration of 3-methylcholanthrene on the salt-extractable chromatin proteins of rat liver. Mol Pharmacol 1971; 7:191-8. [PMID: 5125854] [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] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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