1
|
Masucci L, Tian F, Tully S, Feng Z, McFarlane T, Chan KKW, Wong WWL. CAR T-cell Therapy for Diffuse Large B-cell Lymphoma in Canada: A Cost-Utility Analysis. Med Decis Making 2024; 44:296-306. [PMID: 38486447 PMCID: PMC10988988 DOI: 10.1177/0272989x241234070] [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: 06/13/2023] [Accepted: 01/28/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Chimeric antigen receptor (CAR) T-cell therapy is a novel cell therapy for treating non-Hodgkin lymphoma. The development of CAR T-cell therapy has transformed oncology treatment by offering a potential cure. However, due to the high cost of these therapies, and the large number of eligible patients, decision makers are faced with difficult funding decisions. Our objective was to assess the cost-effectiveness of tisagenlecleucel for adults with relapsed/refractory diffuse large B-cell lymphoma in Canada using updated survival data from the recent JULIET trial. METHODS We developed an individual-simulated discrete event simulation model to assess the costs and quality-adjusted life-years (QALY) of tisagenlecleucel compared with salvage chemotherapy. Survival estimates were obtained from a published clinical trial and retrospective analysis. If patients remained progression free for 5 y, they were assumed to be in long-term remission. Costing and utility data were obtained from reports and published sources. A Canadian health care payer perspective was used, and outcomes were modeled over a lifetime horizon. Costs and outcomes were discounted at 1.5% annually, with costs reported in 2021 Canadian dollars. A probabilistic analysis was used, and model parameters were varied in 1-way sensitivity analyses and scenario analyses. RESULTS After we incorporated the latest clinical evidence, tisagenlecleucel led to an additional cost of $503,417 and additional effectiveness of 2.48 QALYs, with an incremental cost-effectiveness ratio of $202,991 compared with salvage chemotherapy. At a willingness-to-pay threshold of $100,000/QALY, tisagenlecleucel had a 0% likelihood of being cost-effective. CONCLUSIONS At the current drug price, tisagenlecleucel was not found to be a cost-effective option. These results heavily depend on assumptions regarding long-term survival and the price of CAR T. Real-world evidence is needed to reduce uncertainty. HIGHLIGHTS For patients with diffuse large B-cell lymphoma who failed 2 or more lines of systemic therapy, CAR T was not found to be a cost-effective treatment option at a willingness-to-pay threshold of $100,000.These results heavily depend on the expected long-term survival. The uncertainty in the model may be improved using real-world evidence reported in the future.
Collapse
Affiliation(s)
- Lisa Masucci
- Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital, ON, Canada
| | - Feng Tian
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Stephen Tully
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Zeny Feng
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON, Canada
| | - Tom McFarlane
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Kelvin K. W. Chan
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Canadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada
| | - William W. L. Wong
- Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital, ON, Canada
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| |
Collapse
|
2
|
Howard AL, Lamb M. Compliance Trends in a 14-Week Ecological Momentary Assessment Study of Undergraduate Alcohol Drinkers. Assessment 2024; 31:277-290. [PMID: 36914966 PMCID: PMC10822069 DOI: 10.1177/10731911231159937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
High compliance is a priority for successful ecological momentary assessment (EMA) research, but meta-analyses of between-study differences show that reasons for missed prompts remain unclear. We examined compliance data from a 14-week, 182-survey EMA study of undergraduate alcohol use to test differences over time and across survey types between participants with better and worse compliance rates, and to evaluate the impact of incentives on ongoing participation. Participants were N = 196 students (65.8% female; Mage = 20.6). Overall compliance was 76.5%, declining gradually from 88.9% to 70% over 14 weeks. Declines were faster in participants with lower overall compliance, but we found no demographic, personality, mental health, or substance use differences between participants with better versus worse compliance rates. Compliance varied by survey type, and unannounced bonus incentives did not impact compliance rates. Participants completed fewer surveys the week after winning a gift card. We offer recommendations for designing future EMA studies.
Collapse
Affiliation(s)
| | - Megan Lamb
- Carleton University, Ottawa, Ontario, Canada
| |
Collapse
|
3
|
Fung A, Farmer J, Borkhoff CM. Young Infants Clinical Signs Study 8-sign Algorithm for Identification of Sick Infants Adapted for Routine Home Visits: A Systematic Review and Critical Appraisal of its Measurement Properties. Glob Pediatr Health 2024; 11:2333794X231219598. [PMID: 38283299 PMCID: PMC10812101 DOI: 10.1177/2333794x231219598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 10/12/2023] [Accepted: 11/23/2023] [Indexed: 01/30/2024] Open
Abstract
Objective. The 8-sign algorithm adapted from the Young Infants Clinical Signs Study (YICSS) is widely used to identify sick infants during home visits (YICSS-home algorithm). We aimed to critically appraise the development and evidence of measurement properties, including sensibility, reliability, and validity, of the YICSS-home algorithm. Methods. Relevant studies were identified through a systematic literature search. Results. The YICSS-home algorithm has good sensibility. The algorithm demonstrated at least moderate inter-rater reliability and sensitivity ranging from 69% to 80%. However, the algorithm was developed among sick infants brought for care to a health facility and not initially developed for use by community health workers (CHWs) during home visits. Some important risk factors were omitted at item generation. Inter-CHW reliability and construct validity have not been estimated. Conclusion. Future research should build on the strengths of the YICSS-home algorithm and address its limitations to develop a new algorithm with improved predictive accuracy.
Collapse
Affiliation(s)
- Alastair Fung
- Hospital for Sick Children, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | | | - Cornelia M. Borkhoff
- University of Toronto, Toronto, ON, Canada
- Hospital for Sick Children Research Institute, Toronto, ON, Canada
| |
Collapse
|
4
|
Folkins C, Gorman-Asal M, Brewster C, Foster R, Gulliver A, Thomson E, Singh P, Miah P, Magalhaes S, McDonald JT. Projected health and economic outcomes of extending public funding of pharmacy services to include administration of Pneu23 and Td/Tdap immunizations by pharmacy practitioners in New Brunswick. Can Pharm J (Ott) 2023; 156:215-224. [PMID: 37435502 PMCID: PMC10331360 DOI: 10.1177/17151635231176498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 07/13/2023]
Abstract
Background Although legislation permits New Brunswick pharmacy professionals to administer a wide range of immunizations, public funding for these services is currently limited to immunizations against influenza and COVID-19 and was recently extended to include pneumococcal immunization (Pneu23) in individuals aged 65 years or older. We used administrative data to project health and economic outcomes associated with the current Pneu23 program and with extension of public funding to include: 1) younger adults aged 19 years or older in the Pneu23 program, and 2) tetanus boosters (Td/Tdap). Methods Two model scenarios were compared: a Physician-Only model in which physicians remain the only practitioners to administer publicly funded Pneu23 and Td/Tdap, and a Blended model in which this service is also provided by pharmacy professionals. Immunization rates by practitioner type were projected based on physician billing data accessed via the New Brunswick Institute for Research, Data and Training in conjunction with trends observed with influenza immunization by pharmacists. These projections were used along with published data to estimate health and economic outcomes under each model. Results Public funding of Pneu23 (65+), Pneu23 (19+) and Td/Tdap (19+) administration by pharmacy professionals is projected to yield increased immunization rates and physician time savings compared with the Physician-Only model. Public funding of Pneu23 and Td/Tdap administration by pharmacy professionals in those aged ≥19 years would result in cost savings, owing primarily to productivity losses avoided in the working age population. Discussion Increased immunization rates, physician time savings and cost savings may be realized if public funding were extended to include administration of Pneu23 in younger adults and Td/Tdap, by pharmacy practitioners.
Collapse
Affiliation(s)
- Chris Folkins
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Madeleine Gorman-Asal
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Clark Brewster
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Rebecca Foster
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Adrienne Gulliver
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Emily Thomson
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Paramdeep Singh
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Pablo Miah
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
| | - Sandra Magalhaes
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick
| | - J. Ted McDonald
- New Brunswick Institute for Research, Data and Training, University of New Brunswick, Fredericton, New Brunswick
- Department of Political Science, University of New Brunswick, Fredericton, New Brunswick
| |
Collapse
|
5
|
Sang JM, Wong J, Ryan V, Cumming E, Wang L, Cui Z, Bacani N, Haag D, Lachowsky NJ, Cox J, Grace D, Otterstatter M, Morshed M, Edward J, Grennan T, Arkles J, Brownrigg B, Hogg RS, Moore DM. Examining the impacts of a syphilis awareness campaign among gay, bisexual, and other men who have sex with men (gbMSM) in British Columbia, Canada. Can J Public Health 2023; 114:295-307. [PMID: 36156198 PMCID: PMC10036687 DOI: 10.17269/s41997-022-00690-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/17/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Syphilis rates have increased in BC and disproportionately affect gay, bisexual, and other men who have sex with men (gbMSM). A social marketing campaign (Syphistory) ran from January to September 2017 with the primary goal of increasing syphilis knowledge and a secondary goal of increasing syphilis screening among gbMSM in BC. METHODS We used pre- and post-campaign surveys to assess changes in syphilis knowledge from a convenience sample of clients attending STI clinics using one-sided t-tests. We used online Piwik metrics to examine the campaign reach, and provincial testing data to examine trends in syphilis screening. We used data from the Engage Study to examine factors associated with campaign awareness and associations with syphilis testing. RESULTS Of the 2155 visitors to the Syphistory website with known geography, 79.4% were from BC. Moreover, STI clinic participants who saw the campaign demonstrated a greater knowledge of syphilis (9.7/12, 80.8%) than those who did not see the campaign (mean 8.9/12, 74%) (p < 0.001). Provincial syphilis testing rates were 8764 and 9749 in the 12 months before and after the campaign; however, we did not find an overall trend in testing before versus after the campaign (p = 0.147). Among Engage participants, 12.7% reported seeing the campaign and we found an association between campaign exposure and recent syphilis testing (aOR = 2.73; 95% CI = 1.51, 4.93). CONCLUSION gbMSM who saw the campaign were more likely to report being tested for syphilis in the previous 6 months. STI clinic attendees who reported seeing the campaign also had higher syphilis knowledge compared to those who did not.
Collapse
Affiliation(s)
- Jordan M Sang
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
| | - Jason Wong
- BC Centre for Disease Control, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | - Venessa Ryan
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Emma Cumming
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Lu Wang
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Zishan Cui
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Nicanor Bacani
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Devon Haag
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Nathan J Lachowsky
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- University of Victoria, Victoria, BC, Canada
| | - Joseph Cox
- McGill University, Montreal, QC, Canada
- Direction régionale de santé publique - Montréal, Montréal, QC, Canada
| | | | - Michael Otterstatter
- BC Centre for Disease Control, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | - Muhammad Morshed
- BC Centre for Disease Control, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | - Joshua Edward
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Troy Grennan
- BC Centre for Disease Control, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| | | | | | - Robert S Hogg
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Simon Fraser University, Burnaby, BC, Canada
| | - David M Moore
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
6
|
Zeng ZW, Linsdell P, Pomès R. Molecular dynamics study of Cl - permeation through cystic fibrosis transmembrane conductance regulator (CFTR). Cell Mol Life Sci 2023; 80:51. [PMID: 36694009 PMCID: PMC9873711 DOI: 10.1007/s00018-022-04621-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 01/25/2023]
Abstract
The recent elucidation of atomistic structures of Cl- channel CFTR provides opportunities for understanding the molecular basis of cystic fibrosis. Despite having been activated through phosphorylation and provided with ATP ligands, several near-atomistic cryo-EM structures of CFTR are in a closed state, as inferred from the lack of a continuous passage through a hydrophobic bottleneck region located in the extracellular portion of the pore. Here, we present repeated, microsecond-long molecular dynamics simulations of human CFTR solvated in a lipid bilayer and aqueous NaCl. At equilibrium, Cl- ions enter the channel through a lateral intracellular portal and bind to two distinct cationic sites inside the channel pore but do not traverse the narrow, de-wetted bottleneck. Simulations conducted in the presence of a strong hyperpolarizing electric field led to spontaneous Cl- translocation events through the bottleneck region of the channel, suggesting that the protein relaxed to a functionally open state. Conformational changes of small magnitude involving transmembrane helices 1 and 6 preceded ion permeation through diverging exit routes at the extracellular end of the pore. The pore bottleneck undergoes wetting prior to Cl- translocation, suggesting that it acts as a hydrophobic gate. Although permeating Cl- ions remain mostly hydrated, partial dehydration occurs at the binding sites and in the bottleneck. The observed Cl- pathway is largely consistent with the loci of mutations that alter channel conductance, anion binding, and ion selectivity, supporting the model of the open state of CFTR obtained in the present study.
Collapse
Affiliation(s)
- Zhi Wei Zeng
- Molecular Medicine, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Paul Linsdell
- Department of Physiology and Biophysics, Dalhousie University, PO Box 15000, Halifax, NS, B3H 1X5, Canada
| | - Régis Pomès
- Molecular Medicine, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
- Department of Biochemistry, University of Toronto, Toronto, ON, M5S 1A8, Canada.
| |
Collapse
|
7
|
Rosen JC, Sacher A, Tsao MS. Direct GDP-KRAS G12C inhibitors and mechanisms of resistance: the tip of the iceberg. Ther Adv Med Oncol 2023; 15:17588359231160141. [PMID: 36950276 PMCID: PMC10026147 DOI: 10.1177/17588359231160141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 02/06/2023] [Indexed: 03/18/2023] Open
Abstract
Kirsten rat sarcoma viral oncogene homolog mutations are observed in 25% of lung adenocarcinoma and 40% of these are G12C mutations. Historically, no approved targeted agents were available for patients with any KRAS mutation, and response rates to standard-of-care therapies were suboptimal. Newly developed inhibitors directed toward KRASG12C have been successful in clinical trials with overall response rates ranging between 32% and 46%, and two FDA approvals were granted in May 2021 and December 2022 as second-line or later monotherapies. However, rapid tumor resistance complicates their use as a monotherapy. With the rapid development of this novel class of inhibitors, it is important to discern the different types of tumor resistance that may arise and how each can differently contribute to tumor growth and survival. G12C inhibitor resistance is under investigation and combinations of therapies with G12C inhibitors have been proposed. Much of this insight is gleaned from preclinical investigations, as our knowledge of clinical resistance is in its infancy. In this review, we summarize the preclinical development of KRASG12C inhibitors, their clinical evaluations, different types of resistance mechanisms to these compounds, and ways of overcoming them. Finally, we underscore the importance of basic and translational investigations of these molecules in a landscape where their clinical evaluations garner the most attention, and we set the stage for what is to come.
Collapse
Affiliation(s)
- Joshua C. Rosen
- Princess Margaret Hospital Cancer Centre,
University Health Network, Toronto, ON, Canada
- Department of Laboratory Medicine and
Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto,
ON, Canada
| | - Adrian Sacher
- Princess Margaret Hospital Cancer Centre,
University Health Network, Toronto, ON, Canada
- Division of Medical Oncology, Department of
Medicine, Princess Margaret Cancer Centre, Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada
- Department of Immunology, Temerty Faculty of
Medicine, University of Toronto, Toronto, ON, Canada
| | | |
Collapse
|
8
|
Marcon AR, Wagner DN, Rachul C, Weiss MJ. Analyzing online public commentary responding to the announcement of deemed consent organ donation legislation in the Canadian province of Nova Scotia. PLoS One 2022; 17:e0278983. [PMID: 36520833 PMCID: PMC9754165 DOI: 10.1371/journal.pone.0278983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The Canadian province of Nova Scotia recently became the first jurisdiction in North America to pass deemed consent organ donation legislation. The announcement of this legislation generated substantial online discussion, which we analyzed to provide insights on public perception. METHODS We performed directed content analysis on 2663 user-generated comments appearing on two widely-shared Canadian Broadcasting Company (CBC) articles published online in April 2019. We determined levels of support and opposition in comments and described the specific rhetoric used for doing so. We also performed one-way ANOVA and Pearson chi-square tests to determine how the comments were being received and engaged by other users. RESULTS A range of commentary was present in both support and opposition to the changes in legislation. There were more negative than positive comments, and negative commentary generated more replies. Positive comments were received more positively by other users while negative comments were received more negatively. The total sum of negative comments was greatly influenced by a small number of very active participants. Negative commentary focused more on broad concepts and principles related to government, power, and individual rights rather than specific issues in the Nova Scotian context. Substantial issues of trust in the government and healthcare system were evident. CONCLUSIONS There were strong positive and negative sentiments expressed in the comments, but the total sum of negativity in the comments was significantly influenced by a small number of commentators. Analysis on the presumed consent concerns can be helpful to inform public outreach efforts.
Collapse
Affiliation(s)
- Alessandro R. Marcon
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, AB, Canada
| | - Darren N. Wagner
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, AB, Canada
| | - Christen Rachul
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MN, Canada
| | - Matthew J. Weiss
- FRCPC, Transplant Québec, Montréal, QC, Canada
- CHU de Québec, Université Laval Research Centre, Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Université Laval, Québec, QC, Canada
- Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada
| |
Collapse
|
9
|
Fedor BA, Kalisvaart AC, Ralhan S, Kung TF, MacLaren M, Colbourne F. Early, Intense Rehabilitation Fails to Improve Outcome After Intra-Striatal Hemorrhage in Rats. Neurorehabil Neural Repair 2022; 36:788-799. [PMID: 36384355 PMCID: PMC9720710 DOI: 10.1177/15459683221137342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The formation and degradation of an intracerebral hemorrhage causes protracted cell death, and an extended window for intervention. Experimental studies find that rehabilitation mitigates late cell death, with accelerated hematoma clearance as a potential mechanism. OBJECTIVE We assessed whether early, intense, enriched rehabilitation (ER, environmental enrichment and massed skills training) enhances functional benefit, reduces brain injury, and augments hematoma clearance. METHODS In experiment 1, rats (n = 56) were randomized to intervention in the light (-L) or dark phase (-D) of their housing cycle, then to 10 days of ER or control (CON) treatment after collagenase-induced striatal intracerebral hemorrhage (ICH). ER rats were treated from 5 to 14 days after ICH. Behavior and residual hematoma volume was assessed on day 14. In experiment 2, rats (n = 72) were randomized to ER-D10, ER-D20, or CON-D. ER rats completed 10 or 20 days of training in the dark. Rats were euthanized on day 60 for histology. In both experiments, behavioral assessment was completed pre-ICH, pre-ER (day 4 post-ICH), and post-ER (experiment 1: days 13-14; experiment 2: days 16-17 and 30-31). RESULTS Reaching intensity was high but similar between ER-D10 and ER-L10. Unlike previous work, rehabilitation did not alter skilled reaching or hematoma resolution. Varying ER duration also did not affect reaching success or lesion volume. CONCLUSIONS In contrast to others, and under these conditions, our findings show that striatal ICH was generally unresponsive to rehabilitation. This highlights the difficulty of replicating and extending published work, perhaps owing to small inter-study differences.
Collapse
Affiliation(s)
- Britt A. Fedor
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Anna C.J. Kalisvaart
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Shivani Ralhan
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Tiffany F.C. Kung
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Maxwell MacLaren
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Frederick Colbourne
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
10
|
Ilinca S, Rodrigues R, Fors S, Zólyomi E, Jull J, Rehnberg J, Vafaei A, Phillips S. Gender differences in access to community-based care: a longitudinal analysis of widowhood and living arrangements. Eur J Ageing 2022; 19:1339-1350. [PMID: 36692763 PMCID: PMC9326144 DOI: 10.1007/s10433-022-00717-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 01/26/2023] Open
Abstract
Persistent inequalities in access to community-based support limit opportunities for independent living for older people with care needs in Europe. Our study focuses on investigating how gender, widowhood and living arrangement associate with the probability of receiving home and community-based care, while accounting for the shorter-term associations of transitions into widowhood (bereavement) and living alone, as well as the longer-term associations of being widowed and living alone. We use comparative, longitudinal data from the Survey of Health, Ageing and Retirement in Europe (collected between 2004 and 2015 in 15 countries) specifying sex-disaggregated random-effects within-between models, which allow us to examine both cross-sectional and longitudinal associations among widowhood, living arrangements and community-based care use. We find widowhood and living alone are independently associated with care use for both older women and men, while bereavement is associated with higher probability of care use only for women. Socio-economic status was associated with care use for older women, but not for men in our sample. The gender-specific associations we identify have important implications for fairness in European long-term care systems. They can inform improved care targeting towards individuals with limited informal care resources (e.g. bereaved older men) and lower socio-economic status, who are particularly vulnerable to experiencing unmet care needs. Gender differences are attenuated in countries that support formal care provision, suggesting gender equity can be promoted by decoupling access to care from household and family circumstances. Supplementary Information The online version contains supplementary material available at 10.1007/s10433-022-00717-y.
Collapse
Affiliation(s)
- Stefania Ilinca
- European Centre for Social Welfare Policy and Research, Vienna, Austria.
| | - Ricardo Rodrigues
- ISEG Lisbon School of Economics and Management, University of Lisbon, Portugal, Lisbon
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Eszter Zólyomi
- European Centre for Social Welfare Policy and Research, Vienna, Austria
| | - Janet Jull
- European Centre for Social Welfare Policy and Research, Vienna, Austria
- School of Rehabilitation, Queen's University, Kingston, Canada
| | - Johan Rehnberg
- Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Afshin Vafaei
- Department of Family Medicine, Queen's University, Kingston, Canada
| | - Susan Phillips
- Department of Family Medicine, Queen's University, Kingston, Canada
| |
Collapse
|
11
|
Chiasson C, Moorman J, Romano E, Fang Z, Smith A. The brain at rest: Exploratory Neurophysiological Findings Among Men With Histories of Childhood Sexual Abuse. J Child Adolesc Trauma 2022; 15:1155-1164. [PMID: 36439659 PMCID: PMC9684391 DOI: 10.1007/s40653-022-00470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 06/16/2023]
Abstract
Purpose There is a lack of research on childhood sexual abuse (CSA) experienced by men, with even less research examining long term neurophysiological repercussions. This study explored the neurophysiology of the brain at rest to examine the influence of CSA on resting state functional connectivity (RSFC) into adulthood. Methods RSFC was examined with functional magnetic resonance imaging (fMRI) within the default mode, salience and limbic networks in men with CSA histories, with and without post-traumatic stress disorder (PTSD; CSA + PTSD n = 7, CSA-PTSD n = 9), and men without a CSA history nor PTSD (n = 13). Results CSA + PTSD participants had increased functional connectivity (FC) in the medial prefrontal cortex (mPFC) from the default mode network seed compared to participants with CSA-PTSD. Both CSA groups showed significantly less FC in the striatal-thalamic circuits of the salience network than the control group. Similarly, the robust FC between the bilateral amygdalae and the mPFC that was notable in control participants, was not exhibited in participants who experienced CSA with or without PTSD histories. Conclusions These findings demonstrate that intrinsic neurophysiological differences in limbic, salience and default mode network connectivity are apparent even during a resting state between the groups of participants. This is preliminary evidence of long-term neurophysiological effects of CSA in men with PTSD, and even in those without. Importantly, these findings can validate the lived experiences of males with CSA histories and guide researchers and clinicians to potential avenues to support their well-being.
Collapse
Affiliation(s)
- Carley Chiasson
- School of Psychology, University of Ottawa, Ottawa, ON Canada
| | - Jessie Moorman
- School of Psychology, University of Ottawa, Ottawa, ON Canada
| | - Elisa Romano
- School of Psychology, University of Ottawa, Ottawa, ON Canada
| | - Zhuo Fang
- School of Psychology, University of Ottawa, Ottawa, ON Canada
| | - Andra Smith
- School of Psychology, University of Ottawa, Ottawa, ON Canada
| |
Collapse
|
12
|
Matenchuk BA, Carson V, Riske LA, Carnio A, Davenport MH. TV time, physical activity, sedentary behaviour and cardiometabolic biomarkers in pregnancy-NHANES 2003-2006. Can J Public Health 2022; 113:726-735. [PMID: 35587307 PMCID: PMC9481763 DOI: 10.17269/s41997-022-00634-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 03/23/2022] [Indexed: 05/21/2023]
Abstract
OBJECTIVES This study examined the impacts of individual and combined associations between moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) (accelerometer-derived), as well as MVPA and television (TV) time (self-reported) on cardiometabolic biomarkers during pregnancy. METHODS Participants were 332 pregnant women from the 2003-2006 cycles of the National Health and Nutrition Examination Survey (NHANES). Multiple linear regression models were conducted to examine the relationships between individual and combinations of high/low MVPA, ST, and TV time with cardiometabolic biomarkers: body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL), and C-reactive protein (CRP). RESULTS Women with high MVPA (≥ 17 min/day) compared to those with low MVPA (< 17 min/day) had significantly lower BMI. Women with low ST (< 503 min/day) compared to those with high ST (≥ 503 min/day) had significantly lower SBP and DBP. Women with low TV (< 3 h/day) compared to those with high TV (≥ 3 h/day) had significantly lower BMI and log-transformed CRP. Women with a combination of low ST/high MVPA had lower SBP and DBP (ptrend < 0.03). Women with a combination of low TV/high MVPA had lower BMI and log-transformed CRP (ptrend < 0.00). CONCLUSION We need to consider both physical activity and sedentary time for improved cardiometabolic health during pregnancy.
Collapse
Affiliation(s)
- Brittany A Matenchuk
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Valerie Carson
- Behavioural Epidemiology Laboratory, Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Laurel A Riske
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Allison Carnio
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Margie H Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada.
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada.
- Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
13
|
Arino J, Milliken E. Effect of Movement on the Early Phase of an Epidemic. Bull Math Biol 2022; 84:128. [PMID: 36149585 PMCID: PMC9510491 DOI: 10.1007/s11538-022-01077-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/29/2022] [Indexed: 11/26/2022]
Abstract
The early phase of an epidemic is characterized by a small number of infected individuals, implying that stochastic effects drive the dynamics of the disease. Mathematically, we define the stochastic phase as the time during which the number of infected individuals remains small and positive. A continuous-time Markov chain model of a simple two-patch epidemic is presented. An algorithm for formalizing what is meant by small is presented, and the effect of movement on the duration of the early stochastic phase of an epidemic is studied.
Collapse
Affiliation(s)
- Julien Arino
- Department of Mathematics and Data Science Nexus, University of Manitoba, Winnipeg, MB Canada
| | - Evan Milliken
- Department of Mathematics, University of Louisville, Louisville, KY USA
| |
Collapse
|
14
|
Heid O, Khalid M, Smith H, Kim K, Smith S, Wekerle C, Bomberry T, Hill LD, General DA, Green TJ, Harris C, Jacobs B, Jacobs N, Kim K, Horse ML, Martin-Hill D, McQueen KCD, Miller TF, Noronha N, Smith S, Thomasen K, Wekerle C. Indigenous Youth and Resilience in Canada and the USA: a Scoping Review. ADV RES SCI 2022; 3:113-147. [PMID: 35733443 PMCID: PMC9206629 DOI: 10.1007/s42844-022-00060-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
Abstract
Relative to non-Indigenous youth, Indigenous youth have been under-represented when studying pathways to mental wellness. Yet, a broad range of adversity is acknowledged, from intergenerational and ongoing trauma arising from colonial policies. This scoping review explores resilience definitions, measures, key stressors, and what Indigenous youth identify as pathways to their wellness, based on quantitative and qualitative peer-reviewed literature in Canada and the Continental United States. Eight databases (EBSCO, PsycINFO, Science Direct, Social Science Citation Index, Web of Science, PsycARTICLES, and EMBASE) and hand searches of 7 relevant journals were conducted to ensure literature coverage. Two independent reviewers screened each article, with one Indigenous screener per article. The final scoping review analysis included 44 articles. In articles, no Indigenous term for resilience was found, but related concepts were identified (“walking a good path,” “good mind,” Grandfathers’ teachings on 7 values, decision-making for 7 generations into the future, etc.). Few Indigenous-specific measures of resilience exist, with studies relying on Western measures of psychological resilience. Qualitative approaches supporting youth-led resilience definitions yielded important insights. Youth stressors included the following: substance use, family instability, and loss of cultural identity. Youth resilience strategies included the following: having a future orientation, cultural pride, learning from the natural world, and interacting with community members (e.g., relationship with Elders, being in community and on the land). Indigenous traditional knowledge and cultural continuity serve as prominent pathways to Indigenous youth resilience. More research is needed to yield a holistic, youth-centered measure of resilience that includes traditional practices.
Collapse
Affiliation(s)
- Olivia Heid
- Health Sciences, Faculty of Health Science, McMaster University, Hamilton, Ontario Canada
| | - Marria Khalid
- Life Sciences, Faculty of Science, University of Waterloo, Waterloo, Ontario Canada
| | - Hailey Smith
- Social Work, School of Social Work, Dalhousie University, Halifax, Nova Scotia Canada
| | - Katherine Kim
- Pediatrics, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario Canada
| | - Savannah Smith
- Pediatrics, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario Canada
| | - Christine Wekerle
- Pediatrics, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Borgognone A, Noguera-Julian M, Oriol B, Noël-Romas L, Ruiz-Riol M, Guillén Y, Parera M, Casadellà M, Duran C, Puertas MC, Català-Moll F, De Leon M, Knodel S, Birse K, Manzardo C, Miró JM, Clotet B, Martinez-Picado J, Moltó J, Mothe B, Burgener A, Brander C, Paredes R. Gut microbiome signatures linked to HIV-1 reservoir size and viremia control. Microbiome 2022; 10:59. [PMID: 35410461 PMCID: PMC9004083 DOI: 10.1186/s40168-022-01247-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/16/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND The potential role of the gut microbiome as a predictor of immune-mediated HIV-1 control in the absence of antiretroviral therapy (ART) is still unknown. In the BCN02 clinical trial, which combined the MVA.HIVconsv immunogen with the latency-reversing agent romidepsin in early-ART treated HIV-1 infected individuals, 23% (3/13) of participants showed sustained low-levels of plasma viremia during 32 weeks of a monitored ART pause (MAP). Here, we present a multi-omics analysis to identify compositional and functional gut microbiome patterns associated with HIV-1 control in the BCN02 trial. RESULTS Viremic controllers during the MAP (controllers) exhibited higher Bacteroidales/Clostridiales ratio and lower microbial gene richness before vaccination and throughout the study intervention when compared to non-controllers. Longitudinal assessment indicated that the gut microbiome of controllers was enriched in pro-inflammatory bacteria and depleted in butyrate-producing bacteria and methanogenic archaea. Functional profiling also showed that metabolic pathways related to fatty acid and lipid biosynthesis were significantly increased in controllers. Fecal metaproteome analyses confirmed that baseline functional differences were mainly driven by Clostridiales. Participants with high baseline Bacteroidales/Clostridiales ratio had increased pre-existing immune activation-related transcripts. The Bacteroidales/Clostridiales ratio as well as host immune-activation signatures inversely correlated with HIV-1 reservoir size. CONCLUSIONS The present proof-of-concept study suggests the Bacteroidales/Clostridiales ratio as a novel gut microbiome signature associated with HIV-1 reservoir size and immune-mediated viral control after ART interruption. Video abstract.
Collapse
Affiliation(s)
- Alessandra Borgognone
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain.
| | - Marc Noguera-Julian
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
- CIBERINFEC, Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalonia, Spain
| | - Bruna Oriol
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
- Universitat Autonoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - Laura Noël-Romas
- Center for Global Health and Diseases, Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
- Department of Obstetrics & Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Marta Ruiz-Riol
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
- CIBERINFEC, Madrid, Spain
| | - Yolanda Guillén
- Institut Mar d'Investigacions mediques (IMIM), CIBERONC, Barcelona, Catalonia, Spain
| | - Mariona Parera
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
| | - Maria Casadellà
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
| | - Clara Duran
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
- Universitat Autonoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - Maria C Puertas
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
- CIBERINFEC, Madrid, Spain
| | - Francesc Català-Moll
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
| | - Marlon De Leon
- Center for Global Health and Diseases, Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
| | - Samantha Knodel
- Center for Global Health and Diseases, Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
- Department of Obstetrics & Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kenzie Birse
- Center for Global Health and Diseases, Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
- Department of Obstetrics & Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christian Manzardo
- Infectious Diseases Service, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Catalonia, Spain
| | - José M Miró
- CIBERINFEC, Madrid, Spain
- Infectious Diseases Service, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Catalonia, Spain
| | - Bonaventura Clotet
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
- CIBERINFEC, Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalonia, Spain
- Universitat Autonoma de Barcelona (UAB), Barcelona, Catalonia, Spain
- Fight AIDS Foundation, Infectious Diseases Department, Germans Trias i Pujol University Hospital, Barcelona, Catalonia, Spain
- Department of Infectious Diseases Service, Germans Trias i Pujol University Hospital, Barcelona, Catalonia, Spain
| | - Javier Martinez-Picado
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
- CIBERINFEC, Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalonia, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Catalonia, Spain
| | - José Moltó
- CIBERINFEC, Madrid, Spain
- Fight AIDS Foundation, Infectious Diseases Department, Germans Trias i Pujol University Hospital, Barcelona, Catalonia, Spain
- Department of Infectious Diseases Service, Germans Trias i Pujol University Hospital, Barcelona, Catalonia, Spain
| | - Beatriz Mothe
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
- CIBERINFEC, Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalonia, Spain
- Fight AIDS Foundation, Infectious Diseases Department, Germans Trias i Pujol University Hospital, Barcelona, Catalonia, Spain
- Department of Infectious Diseases Service, Germans Trias i Pujol University Hospital, Barcelona, Catalonia, Spain
| | - Adam Burgener
- Center for Global Health and Diseases, Department of Pathology, Case Western Reserve University, Cleveland, OH, USA
- Department of Obstetrics & Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Christian Brander
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain
- CIBERINFEC, Madrid, Spain
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalonia, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Catalonia, Spain
| | - Roger Paredes
- IrsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain.
- CIBERINFEC, Madrid, Spain.
- University of Vic-Central University of Catalonia (UVic-UCC), Vic, Catalonia, Spain.
- Universitat Autonoma de Barcelona (UAB), Barcelona, Catalonia, Spain.
- Center for Global Health and Diseases, Department of Pathology, Case Western Reserve University, Cleveland, OH, USA.
- Fight AIDS Foundation, Infectious Diseases Department, Germans Trias i Pujol University Hospital, Barcelona, Catalonia, Spain.
- Department of Infectious Diseases Service, Germans Trias i Pujol University Hospital, Barcelona, Catalonia, Spain.
| |
Collapse
|
16
|
Regenstreif L, Sadik M, Beaulieu E, Bodkin C, Kiefer L, Guenter D, Lee PWP, Kouyoumdjian FG. Buprenorphine/naloxone access for people with opioid use disorder in correctional facilities: taking steps to support knowledge translation. Health Justice 2022; 10:11. [PMID: 35235073 PMCID: PMC8889394 DOI: 10.1186/s40352-022-00174-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/20/2022] [Indexed: 06/14/2023]
Abstract
People with opioid use disorders are overrepresented in correctional facilities, and are at high risk of opioid overdose. Despite the fact that buprenorphine/naloxone is the first line treatment for people with opioid use disorder, there are often institutional, clinical, and logistical barriers to buprenorphine/naloxone initiation in correctional facilities. Guided by the knowledge-to-action framework, this knowledge translation project focused on synthesizing knowledge and developing a tool for buprenorphine/naloxone initiation that was tailored to correctional facilities, including jails. This information and tool can be used to support buprenorphine/naloxone access for people in correctional facilities, in parallel with other efforts to address barriers to treatment initiation in correctional facilities.
Collapse
Affiliation(s)
- Lori Regenstreif
- Department of Family Medicine, McMaster University, 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Marina Sadik
- Department of Family Medicine, McMaster University, 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Erin Beaulieu
- Department of Family Medicine, McMaster University, 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Claire Bodkin
- Department of Family Medicine, McMaster University, 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Lori Kiefer
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Ontario Ministry of the Solicitor General, Toronto, Ontario, Canada
| | - Dale Guenter
- Department of Family Medicine, McMaster University, 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Patsy W P Lee
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Fiona G Kouyoumdjian
- Department of Family Medicine, McMaster University, 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada.
| |
Collapse
|
17
|
Leatherdale A, Stukas S, Lei V, West HE, Campbell CJ, Hoiland RL, Cooper J, Wellington CL, Sekhon MS, Pryzdial ELG, Conway EM. Persistently elevated complement alternative pathway biomarkers in COVID-19 correlate with hypoxemia and predict in-hospital mortality. Med Microbiol Immunol 2022; 211:37-48. [PMID: 35034207 PMCID: PMC8761108 DOI: 10.1007/s00430-021-00725-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/29/2021] [Indexed: 01/05/2023]
Abstract
Mechanisms underlying the SARS-CoV-2-triggered hyperacute thrombo-inflammatory response that causes multi-organ damage in coronavirus disease 2019 (COVID-19) are poorly understood. Several lines of evidence implicate overactivation of complement. To delineate the involvement of complement in COVID-19, we prospectively studied 25 ICU-hospitalized patients for up to 21 days. Complement biomarkers in patient sera and healthy controls were quantified by enzyme-linked immunosorbent assays. Correlations with respiratory function and mortality were analyzed. Activation of complement via the classical/lectin pathways was variably increased. Strikingly, all patients had increased activation of the alternative pathway (AP) with elevated levels of activation fragments, Ba and Bb. This was associated with a reduction of the AP negative regulator, factor (F) H. Correspondingly, terminal pathway biomarkers of complement activation, C5a and sC5b-9, were significantly elevated in all COVID-19 patient sera. C5a and AP constituents Ba and Bb, were significantly associated with hypoxemia. Ba and FD at the time of ICU admission were strong independent predictors of mortality in the following 30 days. Levels of all complement activation markers were sustained throughout the patients’ ICU stays, contrasting with the varying serum levels of IL-6, C-reactive protein, and ferritin. Severely ill COVID-19 patients have increased and persistent activation of complement, mediated strongly via the AP. Complement activation biomarkers may be valuable measures of severity of lung disease and the risk of mortality. Large-scale studies will reveal the relevance of these findings to thrombo-inflammation in acute and post-acute COVID-19.
Collapse
Affiliation(s)
- Alexander Leatherdale
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Victor Lei
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Henry E West
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Ryan L Hoiland
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Vancouver, BC, Canada
| | - Jennifer Cooper
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Mypinder S Sekhon
- Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Edward L G Pryzdial
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Canadian Blood Services, Centre for Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Edward M Conway
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada.
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
18
|
Légaré C, Clément AA, Desgagné V, Thibeault K, White F, Guay SP, Arsenault BJ, Scott MS, Jacques PÉ, Perron P, Guérin R, Hivert MF, Bouchard L. Human plasma pregnancy-associated miRNAs and their temporal variation within the first trimester of pregnancy. Reprod Biol Endocrinol 2022; 20:14. [PMID: 35031065 PMCID: PMC8759232 DOI: 10.1186/s12958-021-00883-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/20/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND During pregnancy, maternal metabolism undergoes substantial changes to support the developing fetus. Such changes are finely regulated by different mechanisms carried out by effectors such as microRNAs (miRNAs). These small non-coding RNAs regulate numerous biological functions, mostly through post-transcriptional repression of gene expression. miRNAs are also secreted in circulation by numerous organs, such as the placenta. However, the complete plasmatic microtranscriptome of pregnant women has still not been fully described, although some miRNA clusters from the chromosome 14 (C14MC) and the chromosome 19 (C19MC and miR-371-3 cluster) have been proposed as being specific to pregnancy. Our aims were thus to describe the plasma microtranscriptome during the first trimester of pregnancy, by assessing the differences with non-pregnant women, and how it varies between the 4th and the 16th week of pregnancy. METHODS Plasmatic miRNAs from 436 pregnant (gestational week 4 to 16) and 15 non-pregnant women were quantified using Illumina HiSeq next-generation sequencing platform. Differentially abundant miRNAs were identified using DESeq2 package (FDR q-value ≤ 0.05) and their targeted biological pathways were assessed with DIANA-miRpath. RESULTS A total of 2101 miRNAs were detected, of which 191 were differentially abundant (fold change < 0.05 or > 2, FDR q-value ≤ 0.05) between pregnant and non-pregnant women. Of these, 100 miRNAs were less and 91 miRNAs were more abundant in pregnant women. Additionally, the abundance of 57 miRNAs varied according to gestational age at first trimester, of which 47 were positively and 10 were negatively associated with advancing gestational age. miRNAs from the C19MC were positively associated with both pregnancy and gestational age variation during the first trimester. Biological pathway analysis revealed that these 191 (pregnancy-specific) and 57 (gestational age markers) miRNAs targeted genes involved in fatty acid metabolism, ECM-receptor interaction and TGF-beta signaling pathways. CONCLUSION We have identified circulating miRNAs specific to pregnancy and/or that varied with gestational age in first trimester. These miRNAs target biological pathways involved in lipid metabolism as well as placenta and embryo development, suggesting a contribution to the maternal metabolic adaptation to pregnancy and fetal growth.
Collapse
Affiliation(s)
- Cécilia Légaré
- Department of Biochemistry and Functional Genomics, Faculty of Medicine and Health Sciences (FMHS), Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Andrée-Anne Clément
- Department of Biochemistry and Functional Genomics, Faculty of Medicine and Health Sciences (FMHS), Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Véronique Desgagné
- Department of Biochemistry and Functional Genomics, Faculty of Medicine and Health Sciences (FMHS), Université de Sherbrooke, Sherbrooke, QC, Canada
- Clinical Department of Laboratory Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Saguenay-Lac-St-Jean - Hôpital Universitaire de Chicoutimi, Pavillon des Augustines, 305 rue St-Vallier, Saguenay, QC, G7H 5H6, Canada
| | - Kathrine Thibeault
- Department of Biochemistry and Functional Genomics, Faculty of Medicine and Health Sciences (FMHS), Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédérique White
- Department of Biology, FMHS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Simon-Pierre Guay
- Department of Biochemistry and Functional Genomics, Faculty of Medicine and Health Sciences (FMHS), Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Specialized Medicine, Division of Medical Genetics, McGill University Health Centre, Montreal, QC, Canada
| | - Benoit J Arsenault
- Centre de Recherche de L'Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Québec, QC, Canada
- Department of Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Michelle S Scott
- Department of Biochemistry and Functional Genomics, Faculty of Medicine and Health Sciences (FMHS), Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Pierre-Étienne Jacques
- Department of Biology, FMHS, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke (CR-CHUS), Sherbrooke, QC, Canada
| | - Patrice Perron
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke (CR-CHUS), Sherbrooke, QC, Canada
- Department of Medicine, FMHS, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Renée Guérin
- Department of Biochemistry and Functional Genomics, Faculty of Medicine and Health Sciences (FMHS), Université de Sherbrooke, Sherbrooke, QC, Canada
- Clinical Department of Laboratory Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Saguenay-Lac-St-Jean - Hôpital Universitaire de Chicoutimi, Pavillon des Augustines, 305 rue St-Vallier, Saguenay, QC, G7H 5H6, Canada
| | - Marie-France Hivert
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, USA
| | - Luigi Bouchard
- Department of Biochemistry and Functional Genomics, Faculty of Medicine and Health Sciences (FMHS), Université de Sherbrooke, Sherbrooke, QC, Canada.
- Clinical Department of Laboratory Medicine, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Saguenay-Lac-St-Jean - Hôpital Universitaire de Chicoutimi, Pavillon des Augustines, 305 rue St-Vallier, Saguenay, QC, G7H 5H6, Canada.
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke (CR-CHUS), Sherbrooke, QC, Canada.
| |
Collapse
|
19
|
Shvartsman E, Richmond MEI, Schellenberg JJ, Lamont A, Perciani C, Russell JNH, Poliquin V, Burgener A, Jaoko W, Sandstrom P, MacDonald KS. Comparative analysis of DNA extraction and PCR product purification methods for cervicovaginal microbiome analysis using cpn60 microbial profiling. PLoS One 2022; 17:e0262355. [PMID: 35025956 PMCID: PMC8758110 DOI: 10.1371/journal.pone.0262355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022] Open
Abstract
Background The microbiota of the lower female genital tract plays an important role in women’s health. Microbial profiling using the chaperonin60 (cpn60) universal target (UT) improves resolution of vaginal species associated with negative health outcomes compared to the more commonly used 16S ribosomal DNA target. However, the choice of DNA extraction and PCR product purification methods may bias sequencing-based microbial studies and should be optimized for the sample type and molecular target used. In this study, we compared two commercial DNA extraction kits and two commercial PCR product purification kits for the microbial profiling of cervicovaginal samples using the cpn60 UT. Methods DNA from cervicovaginal secretions and vaginal lavage samples as well as mock community standards were extracted using either the specialized QIAamp DNA Microbiome Kit, or the standard DNeasy Blood & Tissue kit with enzymatic pre-treatment for enhanced lysis of gram-positive bacteria. Extracts were PCR amplified using well-established cpn60 primer sets and conditions. Products were then purified using a column-based method (QIAquick PCR Purification Kit) or a gel-based PCR clean-up method using the QIAEX II Gel Extraction Kit. Purified amplicons were sequenced with the MiSeq platform using standard procedures. The overall quality of each method was evaluated by measuring DNA yield, alpha diversity, and microbial composition. Results DNA extracted from cervicovaginal samples using the DNeasy Blood and Tissue kit, pre-treated with lysozyme and mutanolysin, resulted in increased DNA yield, bacterial diversity, and species representation compared to the QIAamp DNA Microbiome kit. The column-based PCR product purification approach also resulted in greater average DNA yield and wider species representation compared to a gel-based clean-up method. In conclusion, this study presents a fast, effective sample preparation method for high resolution cpn60 based microbial profiling of cervicovaginal samples.
Collapse
Affiliation(s)
- Elinor Shvartsman
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
- JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Meika E. I. Richmond
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
- JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - John J. Schellenberg
- JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Alana Lamont
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, United States of America
- Department of Obstetrics and Gynecology, University of Manitoba, Winnipeg, Canada
| | - Catia Perciani
- Department of Immunology, University of Toronto, Toronto, Canada
| | - Justen N. H. Russell
- JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Immunology, University of Toronto, Toronto, Canada
| | - Vanessa Poliquin
- Department of Obstetrics and Gynecology, University of Manitoba, Winnipeg, Canada
| | - Adam Burgener
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, United States of America
- Department of Obstetrics and Gynecology, University of Manitoba, Winnipeg, Canada
- Department of Medicine, Karolinska Institute, Solna, Sweden
| | - Walter Jaoko
- Kenyan AIDS Vaccine Initiative–Institute of Clinical Research (KAVI-ICR), University of Nairobi, Nairobi, Kenya
| | - Paul Sandstrom
- JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Kelly S. MacDonald
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
- JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
- Department of Immunology, University of Toronto, Toronto, Canada
- * E-mail:
| |
Collapse
|
20
|
Creese B, Ismail Z. Mild behavioral impairment: measurement and clinical correlates of a novel marker of preclinical Alzheimer's disease. Alzheimers Res Ther 2022; 14:2. [PMID: 34986891 PMCID: PMC8734161 DOI: 10.1186/s13195-021-00949-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 12/14/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Late-life onset neuropsychiatric symptoms are established risk factors for dementia. The mild behavioral impairment (MBI) diagnostic framework was designed to standardize assessment to determine dementia risk better. In this Mini Review, we summarize the emerging clinical and biomarker evidence, which suggests that for some, MBI is a marker of preclinical Alzheimer's disease. MAIN: MBI is generally more common in those with greater cognitive impairment. In community and clinical samples, frequency is around 10-15%. Mounting evidence in cognitively normal samples links MBI symptoms with known AD biomarkers for amyloid, tau, and neurodegeneration, as well as AD risk genes. Clinical studies have found detectable differences in cognition associated with MBI in cognitively unimpaired people. CONCLUSION The emerging evidence from biomarker and clinical studies suggests MBI can be an early manifestation of underlying neurodegenerative disease. Future research must now further validate MBI to improve identification of those at the very earliest stages of disease.
Collapse
Affiliation(s)
- Byron Creese
- Medical School, College of Medicine and Health, University of Exeter, Exeter, UK.
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, Community Health Sciences, and Pathology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
21
|
Theron L, Rothmann S, Makhnach A, Ungar M. Adolescent Mental Health Resilience and Combinations of Caregiver Monitoring and Warmth: A Person-centred Perspective. J Child Fam Stud 2022; 31:2860-2870. [PMID: 36254162 PMCID: PMC9560922 DOI: 10.1007/s10826-022-02287-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 05/22/2023]
Abstract
Caregiver monitoring and warmth have protective mental health effects for adolescents, including vulnerable adolescents. However, combinations of the aforesaid parenting behaviours and their relationship with adolescent mental health are underexplored, especially among younger and older South African (SA) adolescents challenged by structural disadvantage. Hence, the purpose of this study was to investigate unique profiles of caregiver monitoring and warmth and their associations with depression and conduct problems as reported by younger and older adolescents from disadvantaged SA communities. Latent profile and linear regression analyses were used to examine cross-sectional survey data generated by 891 adolescents from two disadvantaged SA communities (62.2% aged 13-17 [average age: 16.13]; 37.5% aged 18-24 [average age: 20.62]). Two profiles emerged. The first, i.e. substantial caregiver warmth and some monitoring, was associated with younger and older adolescent reports of statistically significantly fewer symptoms of depression and conduct problems. The second, i.e. caregiver monitoring without much warmth, was associated with significantly more symptoms of depression or conduct problems among younger and older adolescents. Traditional gender effects (i.e. higher depression symptoms among girls; higher conduct problem symptoms among boys) were amplified when caregiver monitoring was combined with low warmth. In short, protecting the mental health of younger and older adolescents from disadvantaged communities requires higher levels of caregiver warmth combined with moderate levels of caregiver supervision. Because stressors associated with disadvantaged communities jeopardise warm parenting, supporting caregiver resilience to those stressors is integral to supporting adolescent mental health.
Collapse
Affiliation(s)
- Linda Theron
- Department of Educational Psychology, University of Pretoria, Pretoria, South Africa
| | | | - Alexander Makhnach
- Institute of Psychology of the Russian Academy of Sciences, Moscow, Russia
| | - Michael Ungar
- Resilience Research Centre, Dalhousie University, Halifax, NS Canada
| |
Collapse
|
22
|
Smith TL, Oubaha M, Cagnone G, Boscher C, Kim JS, El Bakkouri Y, Zhang Y, Chidiac R, Corriveau J, Delisle C, Andelfinger GU, Sapieha P, Joyal JS, Gratton JP. eNOS controls angiogenic sprouting and retinal neovascularization through the regulation of endothelial cell polarity. Cell Mol Life Sci 2021; 79:37. [PMID: 34971428 PMCID: PMC8739159 DOI: 10.1007/s00018-021-04042-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/27/2021] [Accepted: 11/13/2021] [Indexed: 11/29/2022]
Abstract
The roles of nitric oxide (NO) and endothelial NO synthase (eNOS) in the regulation of angiogenesis are well documented. However, the involvement of eNOS in the sprouting of endothelial tip-cells at the vascular front during sprouting angiogenesis remains poorly defined. In this study, we show that downregulation of eNOS markedly inhibits VEGF-stimulated migration of endothelial cells but increases their polarization, as evidenced by the reorientation of the Golgi in migrating monolayers and by the fewer filopodia on tip cells at ends of sprouts in endothelial cell spheroids. The effect of eNOS inhibition on EC polarization was prevented in Par3-depleted cells. Importantly, downregulation of eNOS increased the expression of polarity genes, such as PARD3B, PARD6A, PARD6B, PKCΖ, TJP3, and CRB1 in endothelial cells. In retinas of eNOS knockout mice, vascular development is retarded with decreased vessel density and vascular branching. Furthermore, tip cells at the extremities of the vascular front have a marked reduction in the number of filopodia per cell and are more oriented. In a model of oxygen-induced retinopathy (OIR), eNOS deficient mice are protected during the initial vaso-obliterative phase, have reduced pathological neovascularization, and retinal endothelial tip cells have fewer filopodia. Single-cell RNA sequencing of endothelial cells from OIR retinas revealed enrichment of genes related to cell polarity in the endothelial tip-cell subtype of eNOS deficient mice. These results indicate that inhibition of eNOS alters the polarity program of endothelial cells, which increases cell polarization, regulates sprouting angiogenesis and normalizes pathological neovascularization during retinopathy.
Collapse
Affiliation(s)
- Tracy L Smith
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Malika Oubaha
- Département des Sciences Biologiques, Université du Québec à Montréal (UQAM), Montreal, QC, Canada.
| | - Gael Cagnone
- Department of Pediatrics and Centre Hospitalier Universitaire Ste-Justine, Université de Montréal, Montreal, QC, Canada
| | - Cécile Boscher
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Jin Sung Kim
- Department of Pediatrics and Centre Hospitalier Universitaire Ste-Justine, Université de Montréal, Montreal, QC, Canada
| | - Yassine El Bakkouri
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Ying Zhang
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, China
| | - Rony Chidiac
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Donnelly Centre, University of Toronto, Toronto, Canada
| | - Jeanne Corriveau
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Chantal Delisle
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Gregor U Andelfinger
- Department of Pediatrics and Centre Hospitalier Universitaire Ste-Justine, Université de Montréal, Montreal, QC, Canada
| | - Przemyslaw Sapieha
- Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Université de Montréal, Montreal, QC, Canada
| | - Jean-Sébastien Joyal
- Department of Pediatrics and Centre Hospitalier Universitaire Ste-Justine, Université de Montréal, Montreal, QC, Canada
| | - Jean-Philippe Gratton
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
| |
Collapse
|
23
|
Konwar C, Asiimwe R, Inkster AM, Merrill SM, Negri GL, Aristizabal MJ, Rider CF, MacIsaac JL, Carlsten C, Kobor MS. Risk-focused differences in molecular processes implicated in SARS-CoV-2 infection: corollaries in DNA methylation and gene expression. Epigenetics Chromatin 2021; 14:54. [PMID: 34895312 PMCID: PMC8665859 DOI: 10.1186/s13072-021-00428-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/26/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Understanding the molecular basis of susceptibility factors to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a global health imperative. It is well-established that males are more likely to acquire SARS-CoV-2 infection and exhibit more severe outcomes. Similarly, exposure to air pollutants and pre-existing respiratory chronic conditions, such as asthma and chronic obstructive respiratory disease (COPD) confer an increased risk to coronavirus disease 2019 (COVID-19). METHODS We investigated molecular patterns associated with risk factors in 398 candidate genes relevant to COVID-19 biology. To accomplish this, we downloaded DNA methylation and gene expression data sets from publicly available repositories (GEO and GTEx Portal) and utilized data from an empirical controlled human exposure study conducted by our team. RESULTS First, we observed sex-biased DNA methylation patterns in autosomal immune genes, such as NLRP2, TLE1, GPX1, and ARRB2 (FDR < 0.05, magnitude of DNA methylation difference Δβ > 0.05). Second, our analysis on the X-linked genes identified sex associated DNA methylation profiles in genes, such as ACE2, CA5B, and HS6ST2 (FDR < 0.05, Δβ > 0.05). These associations were observed across multiple respiratory tissues (lung, nasal epithelia, airway epithelia, and bronchoalveolar lavage) and in whole blood. Some of these genes, such as NLRP2 and CA5B, also exhibited sex-biased gene expression patterns. In addition, we found differential DNA methylation patterns by COVID-19 status for genes, such as NLRP2 and ACE2 in an exploratory analysis of an empirical data set reporting on human COVID-9 infections. Third, we identified modest DNA methylation changes in CpGs associated with PRIM2 and TATDN1 (FDR < 0.1, Δβ > 0.05) in response to particle-depleted diesel exhaust in bronchoalveolar lavage. Finally, we captured a DNA methylation signature associated with COPD diagnosis in a gene involved in nicotine dependence (COMT) (FDR < 0.1, Δβ > 0.05). CONCLUSION Our findings on sex differences might be of clinical relevance given that they revealed molecular associations of sex-biased differences in COVID-19. Specifically, our results hinted at a potentially exaggerated immune response in males linked to autosomal genes, such as NLRP2. In contrast, our findings at X-linked loci such as ACE2 suggested a potentially distinct DNA methylation pattern in females that may interact with its mRNA expression and inactivation status. We also found tissue-specific DNA methylation differences in response to particulate exposure potentially capturing a nitrogen dioxide (NO2) effect-a contributor to COVID-19 susceptibility. While we identified a molecular signature associated with COPD, all COPD-affected individuals were smokers, which may either reflect an association with the disease, smoking, or may highlight a compounded effect of these two risk factors in COVID-19. Overall, our findings point towards a molecular basis of variation in susceptibility factors that may partly explain disparities in the risk for SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Chaini Konwar
- BC Children's Hospital Research Institute (BCCHR), 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- Centre for Molecular Medicine and Therapeutics, Vancouver, BC, V6H 0B3, Canada
| | - Rebecca Asiimwe
- BC Children's Hospital Research Institute (BCCHR), 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- Centre for Molecular Medicine and Therapeutics, Vancouver, BC, V6H 0B3, Canada
| | - Amy M Inkster
- BC Children's Hospital Research Institute (BCCHR), 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- The Department of Medical Genetics, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Sarah M Merrill
- BC Children's Hospital Research Institute (BCCHR), 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- Centre for Molecular Medicine and Therapeutics, Vancouver, BC, V6H 0B3, Canada
| | - Gian L Negri
- Canada's Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC, V5Z 1L3, Canada
| | - Maria J Aristizabal
- BC Children's Hospital Research Institute (BCCHR), 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- Centre for Molecular Medicine and Therapeutics, Vancouver, BC, V6H 0B3, Canada
- The Department of Ecology and Evolutionary Biology, University of Toronto, Toronto, ON, M5S 3B2, Canada
- Department of Biology, Queen' University, Kingston, ON, K7L 3N6, Canada
- Program in Child and Brain Development, CIFAR, MaRS Centre, 661 University Ave, Toronto, ON, M5G 1M1, Canada
| | - Christopher F Rider
- The Department of Respiratory Medicine, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada
| | - Julie L MacIsaac
- BC Children's Hospital Research Institute (BCCHR), 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada
- Centre for Molecular Medicine and Therapeutics, Vancouver, BC, V6H 0B3, Canada
| | - Christopher Carlsten
- The Department of Respiratory Medicine, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada
| | - Michael S Kobor
- BC Children's Hospital Research Institute (BCCHR), 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
- Centre for Molecular Medicine and Therapeutics, Vancouver, BC, V6H 0B3, Canada.
- Program in Child and Brain Development, CIFAR, MaRS Centre, 661 University Ave, Toronto, ON, M5G 1M1, Canada.
- The Department of Medical Genetics, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
| |
Collapse
|
24
|
Nordlund J, Henry RS, Kwakkenbos L, Carrier ME, Levis B, Nielson WR, Bartlett SJ, Dyas L, Tao L, Fedoruk C, Nielsen K, Hudson M, Pope J, Frech T, Gholizadeh S, Johnson SR, Piotrowski P, Jewett LR, Gordon J, Chung L, Bilsker D, Levis AW, Turner KA, Cumin J, Welling J, Fortuné C, Leite C, Gottesman K, Sauve M, Rodríguez-Reyna TS, Larche M, van Breda W, Suarez-Almazor ME, Wurz A, Culos-Reed N, Malcarne VL, Mayes MD, Boutron I, Mouthon L, Benedetti A, Thombs BD. The Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program: protocol for a two-arm parallel partially nested randomized controlled feasibility trial with progression to full-scale trial. Trials 2021; 22:856. [PMID: 34838105 PMCID: PMC8626736 DOI: 10.1186/s13063-021-05827-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Systemic sclerosis (scleroderma; SSc) is a rare autoimmune connective tissue disease. We completed an initial feasibility trial of an online self-administered version of the Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program using the cohort multiple randomized controlled trial (RCT) design. Due to low intervention offer uptake, we will conduct a new feasibility trial with progression to full-scale trial, using a two-arm parallel, partially nested RCT design. The SPIN-SELF Program has also been revised to include facilitator-led videoconference group sessions in addition to online material. We will test the group-based intervention delivery format, then evaluate the effect of the SPIN-SELF Program on disease management self-efficacy (primary) and patient activation, social appearance anxiety, and functional health outcomes (secondary). METHODS This study is a feasibility trial with progression to full-scale RCT, pending meeting pre-defined criteria, of the SPIN-SELF Program. Participants will be recruited from the ongoing SPIN Cohort ( http://www.spinsclero.com/en/cohort ) and via social media and partner patient organizations. Eligible participants must have SSc and low to moderate disease management self-efficacy (Self-Efficacy for Managing Chronic Disease (SEMCD) Scale score ≤ 7.0). Participants will be randomized (1:1 allocation) to the group-based SPIN-SELF Program or usual care for 3 months. The primary outcome in the full-scale trial will be disease management self-efficacy based on SEMCD Scale scores at 3 months post-randomization. Secondary outcomes include SEMCD scores 6 months post-randomization plus patient activation, social appearance anxiety, and functional health outcomes at 3 and 6 months post-randomization. We will include 40 participants to assess feasibility. At the end of the feasibility portion, stoppage criteria will be used to determine if the trial procedures or SPIN-SELF Program need important modifications, thereby requiring a re-set for the full-scale trial. Otherwise, the full-scale RCT will proceed, and outcome data from the feasibility portion will be utilized in the full-scale trial. In the full-scale RCT, 524 participants will be recruited. DISCUSSION The SPIN-SELF Program may improve disease management self-efficacy, patient activation, social appearance anxiety, and functional health outcomes in people with SSc. SPIN works with partner patient organizations around the world to disseminate its programs free-of-charge. TRIAL REGISTRATION ClinicalTrials.gov NCT04246528 . Registered on 27 January 2020.
Collapse
Affiliation(s)
- Julia Nordlund
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Richard S. Henry
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
- Department of Psychiatry, McGill University, Montreal, Quebec Canada
| | - Linda Kwakkenbos
- Department of Clinical Psychology, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marie-Eve Carrier
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Brooke Levis
- Centre for Prognosis Research, School of Medicine, Keele University, Keele, Staffordshire UK
| | | | - Susan J. Bartlett
- Department of Medicine, McGill University, Montreal, Quebec Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec Canada
| | - Laura Dyas
- Scleroderma Foundation, Michigan Chapter, Southfield, MI USA
| | - Lydia Tao
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Claire Fedoruk
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Karen Nielsen
- Scleroderma Society of Ontario, Hamilton, Ontario Canada
| | - Marie Hudson
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
- Department of Medicine, McGill University, Montreal, Quebec Canada
| | - Janet Pope
- Department of Medicine, University of Western Ontario, London, Ontario Canada
| | - Tracy Frech
- Department of Internal Medicine, University of Utah, Salt Lake City, UT USA
| | - Shadi Gholizadeh
- California School of Professional Psychology/Alliant, Los Angeles, CA USA
| | - Sindhu R. Johnson
- Toronto Scleroderma Program, Mount Sinai Hospital & Toronto Western Hospital, Toronto, Ontario Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario Canada
| | | | - Lisa R. Jewett
- Department of Psychology, Jewish General Hospital, Montreal, Quebec Canada
| | - Jessica Gordon
- Department of Medicine, Hospital for Special Surgery, New York City, NY USA
| | - Lorinda Chung
- Department of Medicine, Stanford University, Palo Alto, CA USA
- Department of Medicine, Palo Alto VA Health Care System, Palo Alto, CA USA
| | - Dan Bilsker
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia Canada
| | - Alexander W. Levis
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA USA
| | - Kimberly A. Turner
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Julie Cumin
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
| | - Joep Welling
- NVLE Dutch patient organization for systemic autoimmune diseases, Utrecht, The Netherlands
| | | | | | | | - Maureen Sauve
- Scleroderma Society of Ontario, Hamilton, Ontario Canada
- Scleroderma Canada, Hamilton, Ontario Canada
| | | | - Maggie Larche
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario Canada
| | - Ward van Breda
- Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands
| | - Maria E. Suarez-Almazor
- Department of General Internal Medicine, University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, British Columbia Canada
| | - Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta Canada
- Department of Oncology, Cumming School of Medicine, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta Canada
| | - Vanessa L. Malcarne
- Department of Psychology, San Diego State University, San Diego, CA USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California San Diego, San Diego, CA USA
| | - Maureen D. Mayes
- Department of Internal Medicine, University of Texas McGovern School of Medicine, Houston, TX USA
| | - Isabelle Boutron
- Université de Paris, Centre of Research Epidemiology and Statistics (CRESS), Inserm, INRA, Paris, France
- Centre d’Épidémiologie Clinique, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Hôtel Dieu, Paris, France
| | - Luc Mouthon
- Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d’Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- APHP-CUP, Hôpital Cochin, Université de Paris, F-75014 Paris, France
| | - Andrea Benedetti
- Department of Medicine, McGill University, Montreal, Quebec Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec Canada
| | - Brett D. Thombs
- Lady Davis Institute of the Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montreal, Quebec, H3T 1E2 Canada
- Department of Psychiatry, McGill University, Montreal, Quebec Canada
- Department of Medicine, McGill University, Montreal, Quebec Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec Canada
- Department of Psychology, McGill University, Montreal, Quebec Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec Canada
| |
Collapse
|
25
|
Ntunzwenimana JC, Boucher G, Paquette J, Gosselin H, Alikashani A, Morin N, Beauchamp C, Thauvette L, Rivard MÈ, Dupuis F, Deschênes S, Foisy S, Latour F, Lavallée G, Daly MJ, Xavier RJ, Charron G, Goyette P, Rioux JD. Functional screen of inflammatory bowel disease genes reveals key epithelial functions. Genome Med 2021; 13:181. [PMID: 34758847 PMCID: PMC8582123 DOI: 10.1186/s13073-021-00996-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/21/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Genetic studies have been tremendously successful in identifying genomic regions associated with a wide variety of phenotypes, although the success of these studies in identifying causal genes, their variants, and their functional impacts has been more limited. METHODS We identified 145 genes from IBD-associated genomic loci having endogenous expression within the intestinal epithelial cell compartment. We evaluated the impact of lentiviral transfer of the open reading frame (ORF) of these IBD genes into the HT-29 intestinal epithelial cell line via transcriptomic analyses. By comparing the genes in which expression was modulated by each ORF, as well as the functions enriched within these gene lists, we identified ORFs with shared impacts and their putative disease-relevant biological functions. RESULTS Analysis of the transcriptomic data for cell lines expressing the ORFs for known causal genes such as HNF4a, IFIH1, and SMAD3 identified functions consistent with what is already known for these genes. These analyses also identified two major clusters of genes: Cluster 1 contained the known IBD causal genes IFIH1, SBNO2, NFKB1, and NOD2, as well as genes from other IBD loci (ZFP36L1, IRF1, GIGYF1, OTUD3, AIRE and PITX1), whereas Cluster 2 contained the known causal gene KSR1 and implicated DUSP16 from another IBD locus. Our analyses highlight how multiple IBD gene candidates can impact on epithelial structure and function, including the protection of the mucosa from intestinal microbiota, and demonstrate that DUSP16 acts a regulator of MAPK activity and contributes to mucosal defense, in part via its regulation of the polymeric immunoglobulin receptor, involved in the protection of the intestinal mucosa from enteric microbiota. CONCLUSIONS This functional screen, based on expressing IBD genes within an appropriate cellular context, in this instance intestinal epithelial cells, resulted in changes to the cell's transcriptome that are relevant to their endogenous biological function(s). This not only helped in identifying likely causal genes within genetic loci but also provided insight into their biological functions. Furthermore, this work has highlighted the central role of intestinal epithelial cells in IBD pathophysiology, providing a scientific rationale for a drug development strategy that targets epithelial functions in addition to the current therapies targeting immune functions.
Collapse
Affiliation(s)
- Jessy Carol Ntunzwenimana
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
- Université de Montréal, Montreal, Quebec, Canada
| | - Gabrielle Boucher
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Jean Paquette
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Hugues Gosselin
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Azadeh Alikashani
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Nicolas Morin
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Claudine Beauchamp
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Louise Thauvette
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Marie-Ève Rivard
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Frédérique Dupuis
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Sonia Deschênes
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Sylvain Foisy
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Frédéric Latour
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Geneviève Lavallée
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Mark J Daly
- Massachusetts General Hospital, Boston, MA, USA
- The Broad Institute, Cambridge, MA, USA
| | - Ramnik J Xavier
- Massachusetts General Hospital, Boston, MA, USA
- The Broad Institute, Cambridge, MA, USA
| | - Guy Charron
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - Philippe Goyette
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada
| | - John D Rioux
- Montreal Heart Institute Research Centre, 5000 rue Bélanger, S-6201, Montreal, Quebec, Canada.
- Université de Montréal, Montreal, Quebec, Canada.
| |
Collapse
|
26
|
Patterson PB, Mumtaz Z, Chirwa E, Mambulasa J, Kachale F, Nyagero J. Culture's Place in Quality of Care in a Resource-Constrained Health System: Comparison Between Three Malawi Districts. Qual Health Res 2021; 31:2528-2541. [PMID: 34581657 PMCID: PMC9207986 DOI: 10.1177/10497323211037636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Public health scholars describe "culture of quality" in terms of desired values, attitudes, and practices, but this literature rarely includes explicitly stated theories of culture formation. In this article, we apply Fredrik Barth's transactional model to demonstrate how taking a theory-centered approach can help to identify what would be necessary to foster "cultures of quality" outlined in the public health literature. We draw on data from a study of the Republic of Malawi's Performance and Quality Improvement for Reproductive Health initiative. These data were generated in 2017-2018 through a 6-month organizational ethnography in three facilities selected to represent a range of districts with differing social and economic contexts. Our analysis revealed facility-level organizational cultures in which staff valued providing care, but responded to structural constraints by normalizing divergence from quality-of-care protocols. These findings indicate that sustaining a quality-oriented organizational culture requires addressing underlying conditions that generate routine experiences and practices.
Collapse
Affiliation(s)
| | - Zubia Mumtaz
- University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | | |
Collapse
|
27
|
Cau A, Cheng MP, Lee T, Levin A, Lee TC, Vinh DC, Lamontagne F, Singer J, Walley KR, Murthy S, Patrick D, Rewa O, Winston B, Marshall J, Boyd J, Russell JA. Acute Kidney Injury and Renal Replacement Therapy in COVID-19 Versus Other Respiratory Viruses: A Systematic Review and Meta-Analysis. Can J Kidney Health Dis 2021; 8:20543581211052185. [PMID: 34733538 PMCID: PMC8558598 DOI: 10.1177/20543581211052185] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 09/04/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is a potentially fatal complication of Coronavirus Disease-2019 (COVID-19). Binding of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, to its viral receptor, angiotensin converting enzyme 2 (ACE2), results in viral entry and may cause AKI. OBJECTIVES We performed a systematic review and meta-analysis of the frequencies of AKI and renal replacement therapy (RRT) in critically ill COVID-19 patients and compared those frequencies with patients who were infected by respiratory viruses that bind or downregulate ACE2 (ACE2-associated viruses) and viruses that do not bind nor downregulate ACE2 (non-ACE2-associated viruses). DESIGN Systematic review and meta-analysis. SETTING Observational studies on COVID-19 and other respiratory viral infections reporting AKI and RRT were included. The exclusion criteria were non-English articles, non-peer-reviewed articles, review articles, studies that included patients under the age of 18, studies including fewer than 10 patients, and studies not reporting AKI and RRT rates. PATIENTS Adult COVID-19, Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and influenza patients. MEASUREMENTS We extracted the following data from the included studies: author, year, study location, age, sex, race, diabetes mellitus, hypertension, chronic kidney disease, shock, vasopressor use, mortality, intensive care unit (ICU) admission, ICU mortality, AKI, and RRT. METHODS We systematically searched PubMed and EMBASE for articles reporting AKI or RRT. AKI was defined by authors of included studies. Critical illness was defined by ICU admission. We performed a random effects meta-analysis to calculate pooled estimates for the AKI and RRT rate within each virus group using a random intercept logistic regression model. RESULTS Of 23 655 hospitalized, critically ill COVID-19 patients, AKI frequencies were not significantly different between COVID-19 patients (51%, 95% confidence interval [CI]: 44%-57%) and critically ill patients infected with ACE2-associated (56%, 95% CI: 37%-74%, P = .610) or non-ACE2-associated viruses (63%, 95% CI: 43%-79%, P = .255). Pooled RRT rates were also not significantly different between critically ill, hospitalized patients with COVID-19 (20%, 95% CI: 16%-24%) and ACE2-associated viruses (18%, 95% CI: 8%-33%, P = .747). RRT rates for both COVID-19 and ACE2-associated viruses were significantly different (P < .001 for both) from non-ACE2-associated viruses (49%, 95% CI: 44%-54%). After adjusting for shock or vasopressor use, AKI and RRT rates were not significantly different between groups. LIMITATIONS Limitations of this study include the heterogeneity of definitions of AKI that were used across different virus studies. We could not match severity of infection or do propensity matching across studies. Most of the included studies were conducted in retrospective fashion. Last, we did not include non-English publications. CONCLUSIONS Our findings suggest that viral ACE2 association does not significantly alter the rates of AKI and RRT among critically ill patients admitted to the ICU. However, the rate of RRT is lower in patients with COVID-19 or ACE2-associated viruses when compared with patients infected with non-ACE2-binding viruses, which might partly be due to the lower frequencies of shock and use of vasopressors in these two virus groups. Prospective studies are necessary to demonstrate whether modulation of the ACE2 axis with Renin-Angiotensin System inhibitors impacts the rates of AKI and whether they are beneficial or harmful in COVID-19 patients.
Collapse
Affiliation(s)
- A. Cau
- The University of British Columbia, Vancouver, BC, Canada
| | - M. P. Cheng
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Terry Lee
- Centre for Health Evaluation & Outcomes Science, The University of British Columbia, Vancouver, BC, Canada
| | - A. Levin
- Division of Nephrology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - T. C. Lee
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - D. C. Vinh
- Department of Medicine, McGill University, Montreal, QC, Canada
| | | | - J. Singer
- Centre for Health Evaluation & Outcomes Science, The University of British Columbia, Vancouver, BC, Canada
| | - K. R. Walley
- Centre for Heart Lung Innovation, St. Paul’s Hospital and The University of British Columbia, Vancouver, BC, Canada
| | - S. Murthy
- BC Children’s Hospital, The University of British Columbia, Vancouver, BC, Canada
| | - D. Patrick
- British Columbia Centre for Disease Control and The University of British Columbia, Vancouver, BC, Canada
| | - O. Rewa
- University of Alberta, Edmonton, AB, Canada
| | - B. Winston
- University of Calgary, Calgary, AB, Canada
| | - J. Marshall
- St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada
| | - J. Boyd
- Centre for Heart Lung Innovation, St. Paul’s Hospital and The University of British Columbia, Vancouver, BC, Canada
| | - JA Russell
- Centre for Heart Lung Innovation, St. Paul’s Hospital and The University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
28
|
Law MP, Berry A, Clarke N, Hay G, Muhl C, Pilato K, Hunter D, Larson A. Using the QI Maturity Tool - Modified Ontario Version to assess the state of QI maturity in Ontario's public health units. Arch Public Health 2021; 79:181. [PMID: 34670629 PMCID: PMC8527771 DOI: 10.1186/s13690-021-00703-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/06/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Implementation of quality improvement (QI) practices varies considerably among public health units (PHUs) in Ontario. With the emphasis on continuous quality improvement (CQI) in the revised Ontario Public Health Standards (OPHS), there is a need to understand the level of QI maturity in Ontario's PHUs. The objective of this research was to establish a baseline understanding of QI maturity in Ontario's PHUs. METHODS The QI Maturity Tool - Modified Ontario Version was used to assess the state of QI maturity in 34 PHUs across Ontario. QI maturity was assessed through 23 questions across three dimensions: QI Organizational Culture; QI Capacity and Competency; and QI Perceived Value. QI maturity scores were classified into five stages: Beginning; Emerging; Progressing; Achieving; and Excelling. QI maturity scores were calculated for each of the 34 participating PHUs to determine their stage of QI maturity. Each PHU's score was then used to determine the provincial average for QI maturity. Participants were also asked to answer three questions related to core CQI organizational structures. RESULTS Across the 34 PHUs, 3503 staff participated in the survey. A review of individual PHU scores indicates that Ontario's PHUs are at varying stages of QI maturity. The average QI maturity score of 4.94 for the 34 participating PHUs places the provincial average in the "Emerging" stage of QI maturity. By QI dimensions, the participating PHUs scored in the "Emerging" stage for QI Organizational Culture (5.09), the "Beginning" stage for QI Competency and Capacity (4.58), and the "Achieving" stage for QI Perceived Value (6.00). CONCLUSION There is an urgent need for Ontario's PHUs to progress to higher stages of QI maturity. Participants place a high value on QI, but collectively are at less "mature" stages of QI in relation to QI organizational culture and the competency and capacity to engage in QI activities. PHUs should leverage the value that staff place on QI to foster the development of a culture of QI and provide staff with relevant knowledge and skills to engage in QI activities.
Collapse
Affiliation(s)
- Madelyn P Law
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Alex Berry
- Northwestern Health Unit, Kenora, Ontario, Canada
| | - Nicole Clarke
- Niagara Region Public Health, Thorold, Ontario, Canada
| | - Graham Hay
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Caitlin Muhl
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.
| | - Kelly Pilato
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Danielle Hunter
- North Bay Parry Sound District Health Unit, North Bay, Ontario, Canada
| | - Anna Larson
- Halton Region Health Department, Oakville, Ontario, Canada
| |
Collapse
|
29
|
Giguère K, Vaziri M, Olivier C, Charest L, Szabo J, Thomas R, Maheu-Giroux M. Characteristics of new HIV diagnoses over 1995-2019: A clinic-based study in Montréal, Canada. PLoS One 2021; 16:e0258383. [PMID: 34618875 PMCID: PMC8496787 DOI: 10.1371/journal.pone.0258383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/26/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Characterization of populations at risk of acquiring HIV is required to inform the public health response to HIV. To identify potential changing needs in HIV prevention and care cascade, we aim to describe how the demographic profiles and exposure categories of newly diagnosed HIV positive individuals attending a large sexual health clinic in Montréal (Canada) evolved since the beginning of the antiretroviral therapy era in the mid-1990s. METHODS Using diagnosis data from participants of the Clinique médicale l'Actuel cohort of HIV-positive patients, we examined the distribution of exposure categories (sexual orientation, sexual behaviours, injection drug use, being born in an HIV-endemic country) by gender and year of diagnosis. Time trends in mean age and in the proportion of patients with late (CD4 <350 cells/μL) or advanced stage (CD4 <200 cells/μL) of HIV infection at diagnosis were assessed through meta-regressions. RESULTS A total of 2,612 patients diagnosed with HIV between January 1st, 1995 and December 31st, 2019 were included. Overall, mean age was 35 years (standard deviation: 10 years) and remained stable over time. The proportion of patients with advanced stage of HIV infection decreased from 16% in 1995 to 4% in 2019. Although men who have sex with men (MSM) consistently accounted for the highest proportion of new diagnoses (77%, 2,022/2,612 overall), their proportion decreased since 2013. There was also a concomitant decrease in the proportion of people who inject drugs, with none of the newly diagnosed participants reporting injection drug use since 2017, and an important increase in the proportion of patients born in an HIV-endemic country (24%, 7/29 in 2019), especially among women. Compared to patients from non-endemic countries, those from HIV-endemic countries were characterized by higher proportions of heterosexuals (88% vs 17%) and of women (52% vs 7%), and were twice likely to get diagnosed at an advanced stage of HIV infection (32% vs 15%). CONCLUSIONS In absolute numbers, MSM continue to account for the largest exposure category. However, patients from HIV-endemic countries, who tend to be diagnosed at later stages of HIV infection, constitute an increasing proportion of newly diagnosed individuals. These persons could face distinct barriers to rapid diagnosis. Tailoring HIV testing strategies and other prevention interventions to the specific unmet prevention needs of these individuals is warranted.
Collapse
Affiliation(s)
- Katia Giguère
- Centre de Recherche du CHUM, Université de Montréal, Montréal, QC, Canada
| | | | | | | | - Jason Szabo
- Clinique médicale l’Actuel, Montréal, QC, Canada
| | | | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
| |
Collapse
|
30
|
Abstract
The phenomenon of dreaming about the laboratory when participating in a sleep study is common. The content of such dreams draws upon episodic memory fragments of the participant's lab experience, generally, experimenters, electrodes, the lab setting, and experimental tasks. However, as common as such dreams are, they have rarely been given a thorough quantitative or qualitative treatment. Here we assessed 528 dreams (N = 343 participants) collected in a Montreal sleep lab to 1) evaluate state and trait factors related to such dreams, and 2) investigate the phenomenology of lab incorporations using a new scoring system. Lab incorporations occurred in over a third (35.8%) of all dreams and were especially likely to occur in REM sleep (44.2%) or from morning naps (48.4%). They tended to be related to higher depression scores, but not to sex, nightmare-proneness or anxiety. Common themes associated with lab incorporation were: Meta-dreaming, including lucid dreams and false awakenings (40.7%), Sensory incorporations (27%), Wayfinding to, from or within the lab (24.3%), Sleep as performance (19.6%), Friends/Family in the lab (15.9%) and Being an object of observation (12.2%). Finally, 31.7% of the lab incorporation dreams included relative projections into a near future (e.g., the experiment having been completed), but very few projections into the past (2.6%). Results clarify sleep stage and sleep timing factors associated with dreamed lab incorporations. Phenomenological findings further reveal both the typical and unique ways in which lab memory elements are incorporated de novo into dreaming. Identified themes point to frequent social and skillful dream scenarios that entail monitoring of one's current state (in the lab) and projection of the self into dream environments elaborated around local space and time. The findings have implications for understanding fundamental dream formation mechanisms but also for appreciating both the advantages and methodological pitfalls of conducting laboratory-based dream collection.
Collapse
Affiliation(s)
- Claudia Picard-Deland
- Dream & Nightmare Laboratory, Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
- Department of Neuroscience, Université de Montréal, Montréal, Québec, Canada
| | - Tore Nielsen
- Dream & Nightmare Laboratory, Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM – Hôpital du Sacré-Coeur de Montréal, Montréal, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
- * E-mail:
| | - Michelle Carr
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, United States of America
| |
Collapse
|
31
|
Carson V, Predy M, Hunter S, Storey K, Farmer AP, McIsaac JL, Flynn J. An Environmental Scan of Existing Canadian Childcare Resources Targeting Improvements in Health Behaviours. Early Child Educ J 2021; 50:1417-1428. [PMID: 36339969 PMCID: PMC9622543 DOI: 10.1007/s10643-021-01266-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 06/16/2023]
Abstract
UNLABELLED The objective was to conduct an environmental scan of existing Canadian childcare resources targeting nutrition, physical activity, sedentary behaviour, and/or sleep. A comprehensive search plan was conducted that involved four search strategies: (1) grey literature databases, (2) customized Google search engines, (3) targeted websites, and (4) consultation with content experts. A resource (i.e., information, materials) must have been created by government or an organization/agency within Canada, available in English, intended for childcare educators or directors working with children ≤ 5 years of age, and focused on targeting improvements in nutrition, physical activity, sedentary behaviour, and/or sleep. The quality of each included resource was assessed using a modified version of the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist. A total of 192 eligible resources were included. Most resources targeted only nutrition (n = 101) or physical activity (n = 60), and few resources targeted only sedentary behaviour (n = 2) or sleep (n = 1). The remaining 28 resources targeted more than one health behaviour. The 4 most common topics of resources were menu/meal planning (n = 55), healthy nutrition practices/environment (n = 37), physical activities/games (n = 33), and nutrition/food literacy (n = 20). Only 52 included resources cited evidence. One-third of the included resources (n = 64) were rated as high quality, including 55 that received a point for the significance criterion. Therefore, numerous high quality Canadian childcare resources exist for nutrition and physical activity. Future resource development is needed for sedentary behaviour and sleep. Findings can assist future intervention work and the database of resources can be utilized by relevant stakeholders to support other childcare initiatives. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10643-021-01266-2.
Collapse
Affiliation(s)
- Valerie Carson
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB Canada
| | - Madison Predy
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB Canada
| | - Stephen Hunter
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB Canada
| | - Kate Storey
- School of Public Health, University of Alberta, Edmonton, AB Canada
| | - Anna P. Farmer
- Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB Canada
| | - Jessie-Lee McIsaac
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS Canada
| | | |
Collapse
|
32
|
Laucyte-Cibulskiene A, Ward LJ, Ebert T, Tosti G, Tucci C, Hernandez L, Kautzky-Willer A, Herrero MT, Norris CM, Pilote L, Söderberg M, Brismar TB, Ripsweden J, Stenvinkel P, Raparelli V, Kublickiene K. Role of GDF-15, YKL-40 and MMP 9 in patients with end-stage kidney disease: focus on sex-specific associations with vascular outcomes and all-cause mortality. Biol Sex Differ 2021; 12:50. [PMID: 34526107 PMCID: PMC8444580 DOI: 10.1186/s13293-021-00393-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/29/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sex differences are underappreciated in the current understanding of cardiovascular disease (CVD) in association with chronic kidney disease (CKD). A hallmark of CKD is vascular aging that is characterised, amongst others, by; systemic inflammation, microbiota disbalance, oxidative stress, and vascular calcification-features linked to atherosclerosis/arteriosclerosis development. Thus, it is the necessary to introduce novel biomarkers related to athero-/arteriosclerotic damage for better assessment of vascular ageing in patients CKD. However, little is known about the relationship between uraemia and novel CVD biomarkers, such as growth differentiation factor-15 (GDF-15), cartilage glycoprotein-39 (YKL-40) and matrix metalloproteinase-9 (MMP-9). Therefore, we hypothesise that there are sex-specific relationships between GDF-15, YKL-40, MMP-9 levels in end-stage kidney disease (ESKD) patients in relation to gut microbiota, vascular calcification, inflammation, comorbidities, and all-cause mortality. METHODS ESKD patients, males (n = 151) and females (n = 79), not receiving renal replacement therapy were selected from two ongoing prospective ESKD cohorts. GDF-15, YKL-40 and MMP9 were analysed using enzyme-linked immunosorbent assay kits. Biomarker levels were analysed in the context of gut microbiota-derived trimethylamine N-oxide (TMAO), vascular calcification, inflammatory response, oxidative stress, comorbidities, and all-cause mortality. RESULTS Increased GDF-15 correlated with higher TMAO in females only, and with higher coronary artery calcification and IL-6. In females, diabetes was associated with elevated GDF-15 and MMP-9, whilst males with diabetes only had elevated GDF-15. No associations were found between biomarkers and CVD comorbidity. Deceased males and females had higher GDF-15 concentrations (p = 0.01 and p < 0.001, respectively), meanwhile only YKL-40 was increased in deceased males (p = 0.02). CONCLUSIONS In conclusion, in males GDF-15 and YKL-40 were related to vascular calcification, inflammation, and oxidative stress, whilst in females GDF-15 was related to TMAO. Increased levels of YKL-40 and GDF-15 in males, and only GDF-15 in females, were associated with all-cause mortality. Our findings suggest that sex-specific associations of novel CVD biomarkers have a potential to affect development of cardiovascular complications in patients with ESKD.
Collapse
Affiliation(s)
- Agne Laucyte-Cibulskiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Nephrology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Liam J Ward
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Ebert
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Giulia Tosti
- Institute of Internal Medicine, Catholic University of Rome, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Claudia Tucci
- Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Leah Hernandez
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Maria-Trinidad Herrero
- Clinical and Experimental Neuroscience, Institutes for Aging Research and Bio-Health Research of Murcia, School of Medicine, University of Murcia, Murcia, Spain
| | - Colleen M Norris
- University of Alberta, Faculty of Nursing, Edmonton, AB, Canada
- Cardiovascular and Stroke Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada
| | - Louise Pilote
- Division of Clinical Epidemiology, Research Institute of McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Magnus Söderberg
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Göteborg, Sweden
| | - Torkel B Brismar
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Jonaz Ripsweden
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Valeria Raparelli
- University of Alberta, Faculty of Nursing, Edmonton, AB, Canada
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Karolina Kublickiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
- Division of Renal Medicine, Department for Clinical Science, Intervention & Technology, Karolinska University Hospital-Flemingsberg Campus, 14186, Stockholm, Sweden.
| |
Collapse
|
33
|
Jones W, Kaoser R, Fischer B. Patterns, trends and determinants of medical opioid utilization in Canada 2005-2020: characterizing an era of intensive rise and fall. Subst Abuse Treat Prev Policy 2021; 16:65. [PMID: 34521418 PMCID: PMC8438558 DOI: 10.1186/s13011-021-00396-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Into the 21st century, the conflation of high rates of chronic pain, systemic gaps in treatment availability and access, and the arrival of potent new opioid medications (e.g., slow-release oxycodone) facilitated strong increases in medical opioid dispensing in Canada. These persisted until post-2010 alongside rising opioid-related adverse (e.g., morbidity/mortality) outcomes. We examine patterns, trends and determinants of opioid dispensing in Canada, and specifically its 10 provinces, for the years 2005-2020. METHODS Raw data on prescription opioid dispensing were obtained from a large national community-based pharmacy database (IQVIA/Compuscript), converted into Defined-Daily-Doses/1,000 population/day for 'strong' and 'weak' opioid categories per standard methods. Dispensing by opioid category and formulations by province/year was assessed descriptively; regression analysis was applied to examine possible segmentation of over-time strong opioid dispensing. RESULTS All provinces reported starkly increasing strong opioid dispensing peaking 2011-2016, and subsequent marked declines. About half reported lower strong opioid dispensing in 2020 compared to 2005, with continuous inter-provincial differences of > 100 %; weak opioids also declined post-2011/12. Segmented regression suggests breakpoints for strong opioids in 2011/12 and 2015/16, coinciding with main interventions (e.g., selective opioid delisting, new prescribing guidelines) towards more restrictive opioid utilization control. CONCLUSIONS We characterized an era of marked rise and fall, while featuring stark inter-provincial heterogeneity in opioid dispensing in Canada. While little evidence for improvements in pain care outcomes exists, the starkly inverting opioid utilization have been associated with extensive population-level harms (e.g., misuse, morbidity, mortality) over-time. This national case study raises fundamental questions for opioid-related health policy and practice.
Collapse
Affiliation(s)
- Wayne Jones
- Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Suite 2400, 515 W. Hastings Street, British Columbia, Vancouver, Canada
| | - Ridhwana Kaoser
- Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Suite 2400, 515 W. Hastings Street, British Columbia, Vancouver, Canada
| | - Benedikt Fischer
- Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Suite 2400, 515 W. Hastings Street, British Columbia, Vancouver, Canada.
- Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Auckland, 1023, Grafton, New Zealand.
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, Canada.
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), R. Sena Madureira, 1500 - Vila Clementino, São Paulo, Brazil.
| |
Collapse
|
34
|
Chadha A, Moreau F, Wang S, Dufour A, Chadee K. Entamoeba histolytica activation of caspase-1 degrades cullin that attenuates NF-κB dependent signaling from macrophages. PLoS Pathog 2021; 17:e1009936. [PMID: 34499701 PMCID: PMC8454965 DOI: 10.1371/journal.ppat.1009936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 09/21/2021] [Accepted: 09/01/2021] [Indexed: 12/18/2022] Open
Abstract
While Entamoeba histolytica (Eh)-induced pro-inflammatory responses are critical in disease pathogenesis, the downstream signaling pathways that subsequently dampens inflammation and the immune response remains unclear. Eh in contact with macrophages suppresses NF-κB signaling while favoring NLRP3-dependent pro-inflammatory cytokine production by an unknown mechanism. Cullin-1 and cullin-5 (cullin-1/5) assembled into a multi-subunit RING E3 ubiquitin ligase complex are substrates for neddylation that regulates the ubiquitination pathway important in NF-κB activity and pro-inflammatory cytokine production. In this study, we showed that upon live Eh contact with human macrophages, cullin-1/4A/4B/5 but not cullin-2/3, were degraded within 10 minutes. Similar degradation of cullin-1/5 were observed from colonic epithelial cells and proximal colonic loops tissues of mice inoculated with live Eh. Degradation of cullin-1/5 was dependent on Eh-induced activation of caspase-1 via the NLRP3 inflammasome. Unlike cullin-4B, the degradation of cullin-4A was partially dependent on caspase-1 and was inhibited with a pan caspase inhibitor. Cullin-1/5 degradation was dependent on Eh cysteine proteinases EhCP-A1 and EhCP-A4, but not EhCP-A5, based on pharmacological inhibition of the cysteine proteinases and EhCP-A5 deficient parasites. siRNA silencing of cullin-1/5 decreased the phosphorylation of pIκ-Bα in response to Eh and LPS stimulation and downregulated NF-κB-dependent TNF-α mRNA expression and TNF-α and MCP-1 pro-inflammatory cytokine production. These results unravel a unique outside-in strategy employed by Eh to attenuate NF-κB-dependent pro-inflammatory responses via NLRP3 activation of caspase-1 that degraded cullin-1/5 from macrophages. The protozoan parasite Entamoeba histolytica (Eh) is the etiologic agent for the disease amebiasis. It is a potent pathogen that deploys an arsenal of virulence factors to trigger and subvert host immune defenses. One of the hallmark features of the disease is amebic colitis and in extreme cases, it can lead to abscesses of the liver and brain. For unknown reasons, the parasite breaches colonic mucosal barriers and invade underlying tissues. The host immune system plays a decisive role in determining the outcome of the disease. At the molecular level, the interaction of Eh with macrophage is a turning point in shaping pro-inflammatory responses. Understanding host-pathogen intricacies at the molecular level is key in determining the complexity of the disease. In the context of amebiasis, the underlying molecular events that occur at the Eh-macrophage intercellular junction are partly unravelled. Here we sought to interrogate the mechanisms by which NF-κB signaling is aborted following Eh-macrophage contact and found two regulatory scaffold proteins, cullin-1 and -5 (cullin-1/5) of the multiple E3 ligase complex, are degraded leading to dampening of NF-κB signaling. During Eh-macrophage contact, cullin-1/4A/4B/5 were rapidly degraded whereas cullin-2/3 were not. The degradation of cullin-1/5 was highly dependent on Eh-induced caspase-1 activation via the NLRP3 inflammasome. In contrast, the degradation of cullin-4A but not cullin-4B, was partially dependent on caspase-1 and was inhibited with a cell-permeable pan caspase inhibitor. Intriguingly, we found that Eh virulence factor EhCP-A1 and EhCP-A4, but not EhCP-A5, played an important role in mediating the degradation of these proteins. Silencing cullin-1/5 decreased the phosphorylation of Iκ-Bα in response to Eh and LPS stimulation that markedly downregulated NF-κB-dependent TNF-α mRNA expression and TNF-α and MCP-1 pro-inflammatory cytokine production. This study unravelled a novel role for Eh-induced NLRP3 inflammasome activation of caspase-1 that intersected with the NF-κB pathway leading to the degradation of the novel substrates cullin-1/5 that regulates NF-κB-dependent pro-inflammatory cytokine production.
Collapse
Affiliation(s)
- Attinder Chadha
- Departments of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - France Moreau
- Departments of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Shanshan Wang
- Departments of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Antoine Dufour
- Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
- Biochemistry and Molecular Biology, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Kris Chadee
- Departments of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
| |
Collapse
|
35
|
Cloutier G, Destrempes F, Yu F, Tang A. Quantitative ultrasound imaging of soft biological tissues: a primer for radiologists and medical physicists. Insights Imaging 2021; 12:127. [PMID: 34499249 PMCID: PMC8429541 DOI: 10.1186/s13244-021-01071-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/07/2021] [Indexed: 12/26/2022] Open
Abstract
Quantitative ultrasound (QUS) aims at quantifying interactions between ultrasound and biological tissues. QUS techniques extract fundamental physical properties of tissues based on interactions between ultrasound waves and tissue microstructure. These techniques provide quantitative information on sub-resolution properties that are not visible on grayscale (B-mode) imaging. Quantitative data may be represented either as a global measurement or as parametric maps overlaid on B-mode images. Recently, major ultrasound manufacturers have released speed of sound, attenuation, and backscatter packages for tissue characterization and imaging. Established and emerging clinical applications are currently limited and include liver fibrosis staging, liver steatosis grading, and breast cancer characterization. On the other hand, most biological tissues have been studied using experimental QUS methods, and quantitative datasets are available in the literature. This educational review addresses the general topic of biological soft tissue characterization using QUS, with a focus on disseminating technical concepts for clinicians and specialized QUS materials for medical physicists. Advanced but simplified technical descriptions are also provided in separate subsections identified as such. To understand QUS methods, this article reviews types of ultrasound waves, basic concepts of ultrasound wave propagation, ultrasound image formation, point spread function, constructive and destructive wave interferences, radiofrequency data processing, and a summary of different imaging modes. For each major QUS technique, topics include: concept, illustrations, clinical examples, pitfalls, and future directions.
Collapse
Affiliation(s)
- Guy Cloutier
- Laboratory of Biorheology and Medical Ultrasonics, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis, Montréal, Québec, H2X 0A9, Canada.
- Department of Radiology, Radio-oncology, and Nuclear Medicine, Université de Montréal, Montréal, Québec, Canada.
- Institute of Biomedical Engineering, Université de Montréal, Montréal, Québec, Canada.
| | - François Destrempes
- Laboratory of Biorheology and Medical Ultrasonics, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis, Montréal, Québec, H2X 0A9, Canada
| | - François Yu
- Department of Radiology, Radio-oncology, and Nuclear Medicine, Université de Montréal, Montréal, Québec, Canada
- Institute of Biomedical Engineering, Université de Montréal, Montréal, Québec, Canada
- Microbubble Theranostics Laboratory, CRCHUM, Montréal, Québec, Canada
| | - An Tang
- Department of Radiology, Radio-oncology, and Nuclear Medicine, Université de Montréal, Montréal, Québec, Canada
- Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
- Laboratory of Medical Image Analysis, Montréal, CRCHUM, Canada
| |
Collapse
|
36
|
Ghomashchi S, Whyne CM, Chinnery T, Habach F, Akens MK. Impact of radiofrequency ablation (RFA) on bone quality in a murine model of bone metastases. PLoS One 2021; 16:e0256076. [PMID: 34495961 PMCID: PMC8425524 DOI: 10.1371/journal.pone.0256076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/30/2021] [Indexed: 01/22/2023] Open
Abstract
Thermal therapies such as radiofrequency ablation (RFA) are gaining widespread clinical adoption in the local treatment of skeletal metastases. RFA has been shown to successfully destroy tumor cells, yet the impact of RFA on the quality of the surrounding bone has not been well characterized. RFA treatment was performed on femora of rats with bone metastases (osteolytic and osteoblastic) and healthy age matched rats. Histopathology, second harmonic generation imaging and backscatter electron imaging were used to characterize changes in the structure, organic and mineral components of the bone after RFA. RFA treatment was shown to be effective in targeting tumor cells and promoting subsequent new bone formation without impacting the surrounding bone negatively. Mineralization profiles of metastatic models were significantly improved post-RFA treatment with respect to mineral content and homogeneity, suggesting a positive impact of RFA treatment on the quality of cancer involved bone. Evaluating the impact of RFA on bone quality is important in directing the growth of this minimally invasive therapeutic approach with respect to fracture risk assessment, patient selection, and multimodal treatment planning.
Collapse
Affiliation(s)
- Soroush Ghomashchi
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Cari M. Whyne
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Tricia Chinnery
- Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Fayez Habach
- Department of Physics, University of Toronto, Ontario, Canada
| | - Margarete K. Akens
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Techna Institute, University Health Network, Toronto, Ontario, Canada
| |
Collapse
|
37
|
Weckman AM, Conroy AL, Madanitsa M, Gnaneswaran B, McDonald CR, Kalilani-Phiri L, Chandna J, Ali D, Mwapasa V, Khairallah C, Thwai KL, Meshnick SR, Taylor SM, ter Kuile FO, Kain KC, Gladstone M. Neurocognitive outcomes in Malawian children exposed to malaria during pregnancy: An observational birth cohort study. PLoS Med 2021; 18:e1003701. [PMID: 34582452 PMCID: PMC8478258 DOI: 10.1371/journal.pmed.1003701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/17/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Annually 125 million pregnancies are at risk of malaria infection. However, the impact of exposure to malaria in pregnancy on neurodevelopment in children is not well understood. We hypothesized that malaria in pregnancy and associated maternal immune activation result in neurodevelopmental delay in exposed offspring. METHODS AND FINDINGS Between April 2014 and April 2015, we followed 421 Malawian mother-baby dyads (median [IQR] maternal age: 21 [19, 28] years) who were previously enrolled (median [IQR] gestational age at enrollment: 19.7 [17.9, 22.1] weeks) in a randomized controlled malaria prevention trial with 5 or 6 scheduled assessments of antenatal malaria infection by PCR. Children were evaluated at 12, 18, and/or 24 months of age with cognitive tests previously validated in Malawi: the Malawi Developmental Assessment Tool (MDAT) and the MacArthur-Bates Communicative Development Inventories (MCAB-CDI). We assessed the impact of antenatal malaria (n [%] positive: 240 [57.3]), placental malaria (n [%] positive: 112 [29.6]), and maternal immune activation on neurocognitive development in children. Linear mixed-effects analysis showed that children exposed to antenatal malaria between 33 and 37 weeks gestation had delayed language development across the 2-year follow-up, as measured by MCAB-CDI (adjusted beta estimate [95% CI], -7.53 [-13.04, -2.02], p = 0.008). Maternal immune activation, characterized by increased maternal sTNFRII concentration, between 33 and 37 weeks was associated with lower MCAB-CDI language score (adjusted beta estimate [95% CI], -8.57 [-13.09, -4.06], p < 0.001). Main limitations of this study include a relatively short length of follow-up and a potential for residual confounding that is characteristic of observational studies. CONCLUSIONS This mother-baby cohort presents evidence of a relationship between malaria in pregnancy and neurodevelopmental delay in offspring. Malaria in pregnancy may be a modifiable risk factor for neurodevelopmental injury independent of birth weight or prematurity. Successful interventions to prevent malaria during pregnancy may reduce the risk of neurocognitive delay in children.
Collapse
Affiliation(s)
- Andrea M. Weckman
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- SAR Laboratories, Sandra Rotman Centre for Global Health, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Andrea L. Conroy
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Mwayiwawo Madanitsa
- College of Medicine, University of Malawi, Blantyre, Malawi
- Academy of Medical Sciences, Malawi University of Science and Technology, Thyolo, Malawi
| | - Bruno Gnaneswaran
- Women and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Chloe R. McDonald
- Grand Challenges Canada, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | | | - Jaya Chandna
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Doreen Ali
- Department of Preventive Health Services, Ministry of Health, Lilongwe, Malawi
| | - Victor Mwapasa
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Carole Khairallah
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kyaw Lay Thwai
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Steven R. Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Steve M. Taylor
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Division of Infectious Diseases, Duke University, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Feiko O. ter Kuile
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kevin C. Kain
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- SAR Laboratories, Sandra Rotman Centre for Global Health, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
- Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Melissa Gladstone
- Women and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- * E-mail:
| |
Collapse
|
38
|
van der Veldt S, Etter G, Mosser CA, Manseau F, Williams S. Conjunctive spatial and self-motion codes are topographically organized in the GABAergic cells of the lateral septum. PLoS Biol 2021; 19:e3001383. [PMID: 34460812 PMCID: PMC8432898 DOI: 10.1371/journal.pbio.3001383] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 09/10/2021] [Accepted: 08/02/2021] [Indexed: 12/22/2022] Open
Abstract
The hippocampal spatial code’s relevance for downstream neuronal populations—particularly its major subcortical output the lateral septum (LS)—is still poorly understood. Here, using calcium imaging combined with unbiased analytical methods, we functionally characterized and compared the spatial tuning of LS GABAergic cells to those of dorsal CA3 and CA1 cells. We identified a significant number of LS cells that are modulated by place, speed, acceleration, and direction, as well as conjunctions of these properties, directly comparable to hippocampal CA1 and CA3 spatially modulated cells. Interestingly, Bayesian decoding of position based on LS spatial cells reflected the animal’s location as accurately as decoding using the activity of hippocampal pyramidal cells. A portion of LS cells showed stable spatial codes over the course of multiple days, potentially reflecting long-term episodic memory. The distributions of cells exhibiting these properties formed gradients along the anterior–posterior and dorsal–ventral axes of the LS, directly reflecting the topographical organization of hippocampal inputs to the LS. Finally, we show using transsynaptic tracing that LS neurons receiving CA3 and CA1 excitatory input send projections to the hypothalamus and medial septum, regions that are not targeted directly by principal cells of the dorsal hippocampus. Together, our findings demonstrate that the LS accurately and robustly represents spatial, directional as well as self-motion information and is uniquely positioned to relay this information from the hippocampus to its downstream regions, thus occupying a key position within a distributed spatial memory network. Calcium imaging of neurons in freely behaving mice reveals how the lateral septum, the main output of the hippocampal place cells, effectively represents information about not only location, but also head direction and self-movement, and may be pivotal in sending this information to downstream brain regions.
Collapse
Affiliation(s)
| | - Guillaume Etter
- McGill University & Douglas Mental Health University Institute, Montreal, Canada
| | - Coralie-Anne Mosser
- McGill University & Douglas Mental Health University Institute, Montreal, Canada
| | - Frédéric Manseau
- McGill University & Douglas Mental Health University Institute, Montreal, Canada
| | - Sylvain Williams
- McGill University & Douglas Mental Health University Institute, Montreal, Canada
- * E-mail:
| |
Collapse
|
39
|
Muradov JH, Finnen RL, Gulak MA, Hay TJM, Banfield BW. pUL21 regulation of pUs3 kinase activity influences the nature of nuclear envelope deformation by the HSV-2 nuclear egress complex. PLoS Pathog 2021; 17:e1009679. [PMID: 34424922 PMCID: PMC8412291 DOI: 10.1371/journal.ppat.1009679] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/02/2021] [Accepted: 08/11/2021] [Indexed: 11/19/2022] Open
Abstract
It is well established that the herpesvirus nuclear egress complex (NEC) has an intrinsic ability to deform membranes. During viral infection, the membrane-deformation activity of the NEC must be precisely regulated to ensure efficient nuclear egress of capsids. One viral protein known to regulate herpes simplex virus type 2 (HSV-2) NEC activity is the tegument protein pUL21. Cells infected with an HSV-2 mutant lacking pUL21 (ΔUL21) produced a slower migrating species of the viral serine/threonine kinase pUs3 that was shown to be a hyperphosphorylated form of the enzyme. Investigation of the pUs3 substrate profile in ΔUL21-infected cells revealed a prominent band with a molecular weight consistent with that of the NEC components pUL31 and pUL34. Phosphatase sensitivity and retarded mobility in phos-tag SDS-PAGE confirmed that both pUL31 and pUL34 were hyperphosphorylated by pUs3 in the absence of pUL21. To gain insight into the consequences of increased phosphorylation of NEC components, the architecture of the nuclear envelope in cells producing the HSV-2 NEC in the presence or absence of pUs3 was examined. In cells with robust NEC production, invaginations of the inner nuclear membrane were observed that contained budded vesicles of uniform size. By contrast, nuclear envelope deformations protruding outwards from the nucleus, were observed when pUs3 was included in transfections with the HSV-2 NEC. Finally, when pUL21 was included in transfections with the HSV-2 NEC and pUs3, decreased phosphorylation of NEC components was observed in comparison to transfections lacking pUL21. These results demonstrate that pUL21 influences the phosphorylation status of pUs3 and the HSV-2 NEC and that this has consequences for the architecture of the nuclear envelope. During all herpesvirus infections, the nuclear envelope undergoes deformation in order to enable viral capsids assembled within the nucleus of the infected cell to gain access to the cytoplasm for further maturation and spread to neighbouring cells. These nuclear envelope deformations are orchestrated by the viral nuclear egress complex (NEC), which, in HSV, is composed of two viral proteins, pUL31 and pUL34. How the membrane-deformation activity of the NEC is controlled during infection is incompletely understood. The studies in this communication reveal that the phosphorylation status of pUL31 and pUL34 can determine the nature of nuclear envelope deformations and that the viral protein pUL21 can modulate the phosphorylation status of both NEC components. These findings provide an explanation for why HSV-2 strains lacking pUL21 are defective in nuclear egress. A thorough understanding of how NEC activity is controlled during infection may yield strategies to disrupt this fundamental step in the herpesvirus lifecycle, providing the basis for novel antiviral strategies.
Collapse
Affiliation(s)
- Jamil H. Muradov
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Canada
| | - Renée L. Finnen
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Canada
| | - Michael A. Gulak
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Canada
| | - Thomas J. M. Hay
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Canada
| | - Bruce W. Banfield
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Canada
- * E-mail:
| |
Collapse
|
40
|
Courchesne V, Bedford R, Pickles A, Duku E, Kerns C, Mirenda P, Bennett T, Georgiades S, Smith IM, Ungar WJ, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Szatmari P, Elsabbagh M. Non-verbal IQ and change in restricted and repetitive behavior throughout childhood in autism: a longitudinal study using the Autism Diagnostic Interview-Revised. Mol Autism 2021; 12:57. [PMID: 34391468 PMCID: PMC8364071 DOI: 10.1186/s13229-021-00461-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Restricted and repetitive behavior (RRB) is one of the characteristic features of Autism Spectrum Disorder. This domain of symptoms includes a broad range of behaviors. There is a need to study each behavior individually to better understand the role of each in the development of autistic children. Moreover, there are currently no longitudinal studies investigating change in these behaviors over development. METHODS The goal of the present study was to explore the association between age and non-verbal IQ (NVIQ) on 15 RRB symptoms included in the Autism Diagnostic Interview-Revised (ADI-R) over time. A total of 205 children with ASD were assessed using the ADI-R at time of diagnosis, at age 6 years, and at age 11 years, and with the Wechsler Intelligence Scales for Children-Fourth Edition (WISC-IV) at age 8 years. RESULTS The proportion of children showing each RRB tended to diminish with increasing age, except for sensitivity to noise and circumscribed interests, where the proportion increased over time. Although there was no significant main effect of NVIQ, there was a significant interaction between age and NVIQ. This was mainly driven by Difficulties with change in routine, for which higher NVIQ was associated with the behavior remaining relatively stable with age, while lower NVIQ was associated with the behavior becoming more prevalent with age. LIMITATIONS The study focused on the presence/absence of each RRB but did not account for potential changes in frequency or severity of the behaviors over development. Furthermore, some limitations are inherent to the measures used. The ADI-R relies on parent report and hence has some level of subjectivity, while the Wechsler intelligence scales can underestimate the intellectual abilities of some autistic children. CONCLUSIONS These results confirm that specific RRB are differentially linked to age and NVIQ. Studying RRB individually is a promising approach to better understanding how RRB change over the development of autistic children and are linked to other developmental domains.
Collapse
Affiliation(s)
- V Courchesne
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
| | - R Bedford
- King's College London, London, UK
- University of Bath, Bath, UK
| | | | - E Duku
- McMaster University, Hamilton, Canada
| | - C Kerns
- University of British Columbia, Vancouver, Canada
| | - P Mirenda
- University of British Columbia, Vancouver, Canada
| | - T Bennett
- McMaster University, Hamilton, Canada
| | | | - I M Smith
- Dalhousie University, IWK Health Centre, Halifax, Canada
| | - W J Ungar
- Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | | | | | | | - P Szatmari
- Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - M Elsabbagh
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| |
Collapse
|
41
|
Fernandez Cruz AL, Chen CM, Sanford R, Collins DL, Brouillette MJ, Mayo NE, Fellows LK. Multimodal neuroimaging markers of variation in cognitive ability in older HIV+ men. PLoS One 2021; 16:e0243670. [PMID: 34314416 PMCID: PMC8315526 DOI: 10.1371/journal.pone.0243670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 07/12/2021] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE This study used converging methods to examine the neural substrates of cognitive ability in middle-aged and older men with well-controlled HIV infection. METHODS Seventy-six HIV+ men on antiretroviral treatment completed an auditory oddball task and an inhibitory control (Simon) task while time-locked high-density EEG was acquired; 66 had usable EEG data from one or both tasks; structural MRI was available for 43. We investigated relationships between task-evoked EEG responses, cognitive ability and immunocompromise. We also explored the structural correlates of these EEG markers in the sub-sample with complete EEG and MRI data (N = 27). RESULTS EEG activity was associated with cognitive ability at later (P300) but not earlier stages of both tasks. Only the oddball task P300 was reliably associated with HIV severity (nadir CD4). Source localization confirmed that the tasks engaged partially distinct circuits. Thalamus volume correlated with oddball task P300 amplitude, while globus pallidus volume was related to the P300 in both tasks. INTERPRETATION This is the first study to use task-evoked EEG to identify neural correlates of individual differences in cognition in men living with well-controlled HIV infection, and to explore the structural basis of the EEG markers. We found that EEG responses evoked by the oddball task are more reliably related to cognitive performance than those evoked by the Simon task. We also provide preliminary evidence for a subcortical contribution to the effects of HIV infection severity on P300 amplitudes. These results suggest brain mechanisms and candidate biomarkers for individual differences in cognition in HIV.
Collapse
Affiliation(s)
- Ana Lucia Fernandez Cruz
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Chien-Ming Chen
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Ryan Sanford
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - D. Louis Collins
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Nancy E. Mayo
- School of Physical and Occupational Therapy, Division of Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Lesley K. Fellows
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
42
|
Schwartz KD, Exner-Cortens D, McMorris CA, Makarenko E, Arnold P, Van Bavel M, Williams S, Canfield R. COVID-19 and Student Well-Being: Stress and Mental Health during Return-to-School. Can J Sch Psychol 2021; 36:166-185. [PMID: 34040284 PMCID: PMC8114331 DOI: 10.1177/08295735211001653] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Students have been multiply impacted by the COVID-19 pandemic: threats to their own and their family's health, the closure of schools, and pivoting to online learning in March 2020, a long summer of physical distancing, and then the challenge of returning to school in fall 2020. As damaging as the physical health effects of a global pandemic are, much has been speculated about the "second wave" of mental health crises, particularly for school-aged children and adolescents. Yet, few studies have asked students about their experiences during the pandemic. The present study engaged with over two thousand (N = 2,310; 1,288 female; M age = 14.5) 12- to 18-year-old Alberta students during their first few weeks of return-to-school in fall 2020. Students completed an online survey that asked about their perceptions of COVID-19, their fall return-to-school experiences (84.9% returned in-person), their self-reported pandemic-related stress, and their behavior, affect, and cognitive functioning in the first few weeks of September. The majority of students (84.9%) returned to school in person. Students reported moderate and equal concern for their health, family confinement, and maintaining social contact. Student stress levels were also above critical thresholds for 25% of the sample, and females and older adolescents (age 15-18 years) generally reported higher stress indicators as compared to males and younger (age 12-14 years) adolescents. Multivariate analysis showed that stress indicators were positively and significantly correlated with self-reported behavioral concerns (i.e., conduct problems, negative affect, and cognitive/inattention), and that stress arousal (e.g., sleep problems, hypervigilance) accounted for significant variance in behavioral concerns. Results are discussed in the context of how schools can provide both universal responses to students during COVID-19 knowing that most students are coping well, while some may require more targeted strategies to address stress arousal and heightened negative affect.
Collapse
|
43
|
Aiyegbusi OL, Nair D, Peipert JD, Schick-Makaroff K, Mucsi I. A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases. Ther Adv Chronic Dis 2021; 12:20406223211015958. [PMID: 34104376 PMCID: PMC8150668 DOI: 10.1177/20406223211015958] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/20/2021] [Indexed: 12/14/2022] Open
Abstract
An application of telemedicine of growing interest and relevance is the use of personal computers and mobile devices to collect patient-reported outcomes (PROs). PROs are self-reports of patients' health status without interpretation by anyone else. The tools developed to assess PROs are known as patient-reported outcomes measures (PROMs). The technological innovations that have led to an increased ownership of electronic devices have also facilitated the development of electronic PROMs (ePROMs). ePROMs are a conduit for telemedicine in the care of patients with chronic diseases. Various studies have demonstrated that the use of ePROMs in routine clinical practice is both acceptable and feasible with patients increasingly expressing a preference for an electronic mode of administration. There is increasing evidence that the use of electronic patient-reported outcome (ePROMs) could have significant impacts on outcomes valued by patients, healthcare providers and researchers. Whilst the development and implementation of these systems may be initially costly and resource-intensive, patient preferences and existing evidence to support their implementation suggests the need for continued research prioritisation in this area. This narrative review summarises and discusses evidence of the impact of ePROMs on clinical parameters and outcomes relevant to chronic diseases. We also explore recently published literature regarding issues that may influence the robust implementation of ePROMs for routine clinical practice.
Collapse
Affiliation(s)
- Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK National Institute for Health Research (NIHR) Applied Research Centre, West Midlands, UK
| | - Devika Nair
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA Vanderbilt O’Brien Center for Kidney Disease, Nashville, TN, USA
| | - John Devin Peipert
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Istvan Mucsi
- Multiorgan Transplant Program, University Health Network and Division of Nephrology, Department of Medicine, University of Toronto, ON, Canada
| |
Collapse
|
44
|
Affiliation(s)
- Donna E Stewart
- University Professor, Department of Psychiatry, 7938University of Toronto, Toronto, Ontario, Canada; Head of Research and Academic Development, Centre for Mental Health, Senior Scientist, University Health Network, Toronto, Ontario, Canada; Ethics and Review Committee, World Psychiatric Association, Geneva, Switzerland
| | - Harriet MacMillan
- Distinguished University Professor, Departments of Psychiatry and Behavioural Neurosciences, and Pediatrics, and Chedoke Health Chair in Child Psychiatry, Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Melissa Kimber
- Assistant Professor, Department of Psychiatry and Behavioural Neurosciences and Core Member of the Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
45
|
Kalatharan V, Welk B, Nash DM, McArthur E, Slater J, Sarma S, Pei Y, Garg AX. Complications in Patients With Autosomal Dominant Polycystic Kidney Disease Undergoing Ureteroscopy: A Cohort Study. Can J Kidney Health Dis 2020; 7:2054358120972830. [PMID: 33282326 PMCID: PMC7691941 DOI: 10.1177/2054358120972830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/30/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Ureteroscopy is a minimally invasive treatment option for upper tract stones. The distorted kidney anatomy in patients with autosomal dominant polycystic kidney disease (ADPKD) may place them at higher risk for ureteroscopic complications. OBJECTIVE To compare the 30-day risk of ureteroscopic complications between patients with and without ADPKD. DESIGN Retrospective cohort study. SETTING Ontario, Canada. PATIENTS Seventy three patients with ADPKD and 81 445 patients without ADPKD who underwent ureteroscopy for upper urinary tract stones between April 1, 2002, and March 1, 2018. MEASUREMENTS A 30-day risk of (1) hospital presentation with ureteroscopic complications (which was a composite outcome of either emergency department visit or hospital admission with acute kidney injury, urinary tract infection, or sepsis); (2) all-cause hospital presentation; (3) all-cause hospital admission; and (4) all-cause emergency department visit. METHODS We regressed outcomes on demographic variables, health care use in the prior 1-year, various procedures and comorbidities related to the outcome in the prior 5 years, and prescribed medications filled in the past 120 days using modified Poisson regression to compare the risk ratio (RR) of each outcome between patients with and without ADPKD. RESULTS The median (interquartile, IQR) age was 44 (38-60 years) in the ADPKD group and 53 (42-64) in the control group. About 40% were women in both groups. The risk of ureteroscopic complications was not significantly different in patients with versus without ADPKD (8.2% vs 4.3%; adjusted RR = 1.5, 95% confidence interval [CI] = 0.7-3.2). Patients with versus without ADPKD were more likely to present to hospital after their procedure (35.6% vs. 20.0%; adjusted RR = 1.6, 95% CI = 1.2-2.2), which included a statistically significant increase in the risk of presenting to the emergency department (32.9% vs. 19.0%; adjusted RR = 1.6, 95% CI = 1.1-2.2) but not hospital admissions (10.9% vs. 5.0%; adjusted RR = 1.8, 95% CI = 0.9-3.4). LIMITATIONS The low numbers of events led to imprecision around the estimates. CONCLUSION Patients with ADPKD have a higher risk of return to the hospital within 30 days of ureteroscopy for stone disease. TRIAL REGISTRATION We did not register this study.
Collapse
Affiliation(s)
- Vinusha Kalatharan
- Department of Epidemiology and
Biostatistics, Western University, London, ON, Canada
- ICES, ON, Canada
| | - Blayne Welk
- Department of Epidemiology and
Biostatistics, Western University, London, ON, Canada
- ICES, ON, Canada
- Department of Surgery, Western
University, London, ON, Canada
| | | | | | | | - Sisira Sarma
- Department of Epidemiology and
Biostatistics, Western University, London, ON, Canada
- ICES, ON, Canada
| | - York Pei
- University Health Network, University of
Toronto, ON, Canada
| | - Amit X. Garg
- Department of Epidemiology and
Biostatistics, Western University, London, ON, Canada
- ICES, ON, Canada
- Division of Nephrology, Department of
Medicine, Western University, London, ON, Canada
| |
Collapse
|
46
|
Senécal JL, Hoa S, Yang R, Koenig M. Pathogenic roles of autoantibodies in systemic sclerosis: Current understandings in pathogenesis. J Scleroderma Relat Disord 2020; 5:103-129. [PMID: 35382028 PMCID: PMC8922609 DOI: 10.1177/2397198319870667] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/29/2019] [Indexed: 09/12/2023]
Abstract
The potential pathogenic role for autoantibodies in systemic sclerosis has captivated researchers for the past 40 years. This review answers the question whether there is yet sufficient knowledge to conclude that certain serum autoantibodies associated with systemic sclerosis contribute to its pathogenesis. Definitions for pathogenic, pathogenetic and functional autoantibodies are formulated, and the need to differentiate these autoantibodies from natural autoantibodies is emphasized. In addition, seven criteria for the identification of pathogenic autoantibodies are proposed. Experimental evidence is reviewed relevant to the classic systemic sclerosis antinuclear autoantibodies, anti-topoisomerase I and anticentromere, and to functional autoantibodies to endothelin 1 type A receptor, angiotensin II type 1 receptor, muscarinic receptor 3, platelet-derived growth factor receptor, chemokine receptors CXCR3 and CXCR4, estrogen receptor α, and CD22. Pathogenic evidence is also reviewed for anti-matrix metalloproteinases 1 and 3, anti-fibrillin 1, anti-IFI16, anti-eIF2B, anti-ICAM-1, and anti-RuvBL1/RuvBL2 autoantibodies. For each autoantibody, objective evidence for a pathogenic role is scored qualitatively according to the seven pathogenicity criteria. It is concluded that anti-topoisomerase I is the single autoantibody specificity with the most evidence in favor of a pathogenic role in systemic sclerosis, followed by anticentromere. However, these autoantibodies have not been demonstrated yet to fulfill completely the seven proposed criteria for pathogenicity. Their contributory roles to the pathogenesis of systemic sclerosis remain possible but not yet conclusively demonstrated. With respect to functional autoantibodies and other autoantibodies, only a few criteria for pathogenicity are fulfilled. Their common presence in healthy and disease controls suggests that major subsets of these immunoglobulins are natural autoantibodies. While some of these autoantibodies may be pathogenetic in systemic sclerosis, establishing that they are truly pathogenic is a work in progress. Experimental data are difficult to interpret because high serum autoantibody levels may be due to polyclonal B-cell activation. Other limitations in experimental design are the use of total serum immunoglobulin G rather than affinity-purified autoantibodies, the confounding effect of other systemic sclerosis autoantibodies present in total immunoglobulin G and the lack of longitudinal studies to determine if autoantibody titers fluctuate with systemic sclerosis activity and severity. These intriguing new specificities expand the spectrum of autoantibodies observed in systemic sclerosis. Continuing elucidation of their potential mechanistic roles raises hope of a better understanding of systemic sclerosis pathogenesis leading to improved therapies.
Collapse
Affiliation(s)
- Jean-Luc Senécal
- Scleroderma Research Chair, Université de Montréal, Montreal, QC, Canada
- Division of Rheumatology, Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Autoimmunity Research Laboratory, Research Centre of the Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Sabrina Hoa
- Division of Rheumatology, Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Autoimmunity Research Laboratory, Research Centre of the Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Roger Yang
- Division of Rheumatology, Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Martial Koenig
- Autoimmunity Research Laboratory, Research Centre of the Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
- Division of Internal Medicine, Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
| |
Collapse
|
47
|
Jansen L, Maina G, Horsburgh B, Kumaran M, Mcharo K, Laliberte G, Kappel J, Bullin CA. Co-Developed Indigenous Educational Materials for Chronic Kidney Disease: A Scoping Review. Can J Kidney Health Dis 2020; 7:2054358120916394. [PMID: 32426147 PMCID: PMC7218329 DOI: 10.1177/2054358120916394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 02/14/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Canadian Indigenous populations experience significantly more chronic kidney disease (CKD) than the general population. Indigenous people who live in rural and remote areas may also have difficulty accessing both information and care for their CKD. Informed decision making about treatment options for advancing kidney disease may be delayed, which can result in poor health outcomes and decreased quality of life. Moreover, Indigenous people may experience marginalization within Western health care systems. OBJECTIVE The objective of this scoping review is to identify culturally appropriate and co-developed Indigenous educational tools that will ultimately support CKD learning and end-stage kidney treatment decision making. DESIGN Scoping Review. SETTING Databases included Embase, CINAHL, Medline (OVID), ERIC, and the Canadian Agency for Drugs and Technology Gray Matters. STUDY PARTICIPANTS Community-based Indigenous patients, families, health care workers, and community members. METHODS We systematically reviewed the literature to explore the availability of co-developed Indigenous educational tools and material for CKD treatment options. Titles, abstracts, and full texts were reviewed independently by 2 reviewers with disagreements resolved through a third. All aspects of this project, including searching the databases were done in consultation with an Indigenous Elder. RESULTS Only one retrieved article identified a comprehensive CKD tool co-developed by researchers, health care providers, and an Indigenous community. Three themes emerged from the scoping review that may inform characteristics of co-developed tools: cultural appropriateness; appraisal of utility and effectiveness and; content informed by co-development of traditional and Western chronic disease knowledge. LIMITATIONS Consistent with scoping review methodology, the methodological quality of included studies was not assessed. In addition, it was difficult to synthesize the findings from the research and gray literature. CONCLUSION Little is known about the co-development of Indigenous educational tools for CKD. Further in-depth understanding is required about how to best engage with Indigenous communities, specifically to co-develop contextualized CKD tools that are acceptable to Indigenous people.Trial registration: Not applicable as this review described secondary data.
Collapse
Affiliation(s)
- Lynn Jansen
- College of Nursing, University of Saskatchewan, Prince Albert, Canada
| | - Geoffrey Maina
- College of Nursing, University of Saskatchewan, Prince Albert, Canada
| | - Beth Horsburgh
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Maha Kumaran
- Education Library, University of Saskatchewan, Saskatoon, Canada
| | - Kasha Mcharo
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | | | - Joanne Kappel
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Carol Ann Bullin
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| |
Collapse
|