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Hofmann SC, Andreska A, Burai E, Uribe J. Porous organizational boundaries and associated states: introducing member ness in international organizations. Eur J Int Relat 2023; 29:929-959. [PMID: 38026732 PMCID: PMC10663123 DOI: 10.1177/13540661231163988] [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] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
The current binary understanding of membership in international organizations (IOs), especially regional organizations (ROs), creates blind spots and biases in our understanding of who matters in IOs, as well as why and how they matter. Existing scholarship primarily looks at full member-states or non-state actors to capture who influences such organizations. Associated states are often portrayed as passive receivers of IO rules instead of active contributors. We address this blind spot and resulting analytical bias by exploring what types of association relationships exist and how they impact IOs. We propose a novel conceptualization of membership that we call memberness. On the level of IOs, memberness is based on the relative openness of organizational boundaries and stratified access via material and ideational contributions. On the level of states, memberness captures associated states' individual choices to contribute materially and/or ideationally to an IO. Memberness moves away from a purely rights-based understanding of membership (or who you are in an IO) to include a capacity-based understanding (or what you do in an IO). This shift in focus uncovers new channels of influence on IOs. Associated states' material and ideational contributions to IOs constitute three memberness types: payroller, sponsor, and advisor. We argue that these memberness types impact IOs' vitality, design, and performance in previously unrecognized ways. We illustrate these types with empirical examples from ROs across the globe and discuss the implications of memberness for IO research programs.
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Weinstein SP, Slanetz PJ, Lewin AA, Battaglia T, Chagpar AB, Dayaratna S, Dibble EH, Goel MS, Hayward JH, Kubicky CD, Le-Petross HT, Newell MS, Sanford MF, Scheel JR, Vincoff NS, Yao K, Moy L. ACR Appropriateness Criteria® Supplemental Breast Cancer Screening Based on Breast Density. J Am Coll Radiol 2021; 18:S456-S473. [PMID: 34794600 DOI: 10.1016/j.jacr.2021.09.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022]
Abstract
Mammography remains the only validated screening tool for breast cancer, however, there are limitations to mammography. One of the limitations of mammography is the variable sensitivity based on breast density. Supplemental screening may be considered based on the patient's risk level and breast density. For average-risk women with nondense breasts, the sensitivity of digital breast tomosynthesis (DBT) screening is high; additional supplemental screening is not warranted in this population. For average-risk women with dense breasts, given the decreased sensitivity of mammography/DBT, this population may benefit from additional supplemental screening with contrast-enhanced mammography, screening ultrasound (US), breast MRI, or abbreviated breast MRI. In intermediate-risk women, there is emerging evidence suggesting that women in this population may benefit from breast MRI or abbreviated breast MRI. In intermediate-risk women with dense breasts, given the decreased sensitivity of mammography/DBT, this population may benefit from additional supplemental screening with contrast-enhancedmammography or screening US. There is strong evidence supporting screening high-risk women with breast MRI regardless of breast density. Contrast-enhanced mammography, whole breast screening US, or abbreviated breast MRI may be also considered. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Susan P Weinstein
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Priscilla J Slanetz
- Panel Chair, Boston University School of Medicine, Boston, Massachusetts; and President, Massachusetts Radiological Society
| | - Alana A Lewin
- Panel Vice-Chair, New York University School of Medicine, New York, New York
| | - Tracy Battaglia
- Director, Womens Health Unit, Associate Director, Belkin Breast Health Center, Boston Medical Center and Boston University School of Medicine and Public Health, Boston, Massachusetts; and Chair, National Navigation Roundtable
| | - Anees B Chagpar
- Yale School of Medicine, New Haven, Connecticut; Society of Surgical Oncology
| | - Sandra Dayaratna
- Thomas Jefferson University Hospital, Robbinsville, New Jersey; American College of Obstetricians and Gynecologists
| | | | - Mita Sanghavi Goel
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois; American College of Physicians
| | | | | | - Huong T Le-Petross
- The University of Texas MD Anderson Cancer Center, Houston, Texas; and Breast Imaging Lead in Prevention, Breast Committee, DI Committee of the Alliance
| | - Mary S Newell
- Emory University Hospital, Atlanta, Georgia; Governor, ABR; and Board Member, SBI
| | | | - John R Scheel
- Fellowship Director, University of Washington, Seattle, Washington
| | - Nina S Vincoff
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York
| | - Katherine Yao
- NorthShore University HealthSystem, Evanston, Illinois; Vice Chair, National Accreditation Program for Breast Centers; and American College of Surgeons
| | - Linda Moy
- Specialty Chair, NYU Clinical Cancer Center, New York, New York; Chair, ACR NMD Registry; Senior Deputy Editor, Radiology; and Advisory Board, iCAD and Lunit
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Affiliation(s)
| | - Adam Friedmann
- Harley Street Dermatology Clinic, London, United Kingdom
| | - Brett King
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
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Janssen NAH, Yang A, Strak M, Steenhof M, Hellack B, Gerlofs-Nijland ME, Kuhlbusch T, Kelly F, Harrison R, Brunekreef B, Hoek G, Cassee F. Oxidative potential of particulate matter collected at sites with different source characteristics. Sci Total Environ 2014; 472:572-81. [PMID: 24317165 DOI: 10.1016/j.scitotenv.2013.11.099] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 11/15/2013] [Accepted: 11/19/2013] [Indexed: 04/14/2023]
Abstract
BACKGROUND The oxidative potential (OP) of particulate matter (PM) has been proposed as a more health relevant metric than PM mass. Different assays exist for measuring OP and little is known about how the different assays compare. AIM To assess the OP of PM collected at different site types and to evaluate differences between locations, size fractions and correlation with PM mass and PM composition for different measurement methods for OP. METHODS PM2.5 and PM10 was sampled at 5 sites: an underground station, a farm, 2 traffic sites and an urban background site. Three a-cellular assays; dithiothreitol (OP(DTT)), electron spin resonance (OP(ESR)) and ascorbate depletion (OP(AA)) were used to characterize the OP of PM. RESULTS The highest OP was observed at the underground, where OP of PM10 was 30 (OP(DTT)) to >600 (OP(ESR)) times higher compared to the urban background when expressed as OP/m(3) and 2-40 times when expressed as OP/μg. For the outdoor sites, samples from the farm showed significantly lower OP(ESR) and OP(AA), whereas samples from the continuous traffic site showed the highest OP for all assays. Contrasts in OP between sites were generally larger than for PM mass and were lower for OP(DTT) compared to OP(ESR) and OP(AA). Furthermore, OP(DTT)/μg was significantly higher in PM2.5 compared to PM10, whereas the reverse was the case for OP(ESR). OP(ESR) and OP(AA) were highly correlated with traffic-related PM components (i.e. EC, Fe, Cu, PAHs), whereas OP(DTT) showed the highest correlation with PM mass and OC. CONCLUSIONS Contrasts in OP between sites, differences in size fractions and correlation with PM composition depended on the specific OP assay used, with OP(ESR) and OP(AA) showing the most similar results. This suggests that either OP(ESR) or OP(AA) and OP(DTT) can complement each other in providing information regarding the oxidative properties of PM, which can subsequently be used to study its health effects.
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Affiliation(s)
- Nicole A H Janssen
- Department for Environmental Health, National Institute for Public Health and the Environment (RIVM), P.O. Box, 2720 BA, Bilthoven, The Netherlands.
| | - Aileen Yang
- Department for Environmental Health, National Institute for Public Health and the Environment (RIVM), P.O. Box, 2720 BA, Bilthoven, The Netherlands; Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands.
| | - Maciej Strak
- Department for Environmental Health, National Institute for Public Health and the Environment (RIVM), P.O. Box, 2720 BA, Bilthoven, The Netherlands; Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands.
| | - Maaike Steenhof
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands.
| | - Bryan Hellack
- Air Quality & Sustainable Nanotechnology, Institute of Energy and Environmental Technology (IUTA), Bliersheimer Straße 60, 47229 Duisburg, Germany.
| | - Miriam E Gerlofs-Nijland
- Department for Environmental Health, National Institute for Public Health and the Environment (RIVM), P.O. Box, 2720 BA, Bilthoven, The Netherlands.
| | - Thomas Kuhlbusch
- Air Quality & Sustainable Nanotechnology, Institute of Energy and Environmental Technology (IUTA), Bliersheimer Straße 60, 47229 Duisburg, Germany.
| | - Frank Kelly
- MRC-PHE Centre for Environment and Health, School of Biomedical Sciences, King's College London, 150 Stamford Street, London SE1 9NH, United Kingdom.
| | - Roy Harrison
- Division of Environmental Health & Risk Management, School of Geography, Earth & Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom; Department of Environmental Sciences, Center of Excellence in Environmental Studies, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia.
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands.
| | - Flemming Cassee
- Department for Environmental Health, National Institute for Public Health and the Environment (RIVM), P.O. Box, 2720 BA, Bilthoven, The Netherlands; Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD Utrecht, The Netherlands.
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Carrieri MP, Lions C, Sogni P, Winnock M, Roux P, Mora M, Bonnard P, Salmon D, Dabis F, Spire B. Association between elevated coffee consumption and daily chocolate intake with normal liver enzymes in HIV-HCV infected individuals: results from the ANRS CO13 HEPAVIH cohort study. J Hepatol 2014; 60:46-53. [PMID: 23978720 DOI: 10.1016/j.jhep.2013.08.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 08/06/2013] [Accepted: 08/16/2013] [Indexed: 01/16/2023]
Abstract
BACKGROUND & AIMS We used longitudinal data from the ANRS CO13 HEPAVIH cohort study of HIV-HCV co-infected individuals to investigate whether polyphenol rich food intake through coffee and/or daily chocolate consumption could play a role in reducing liver enzymes levels. METHODS Longitudinal data collection included self-administered questionnaires and medical data (aspartate aminotransferase (AST) and alanine aminotransferase (ALT) liver enzymes). Two analyses were performed to assess the association between coffee (≥3 cups a day) and daily chocolate intake and abnormal values of AST and ALT (AST or ALT >2.5 × upper normal limit (UNL)) (N=990) over time, after adjustment for known correlates. Logistic regression models based on generalized estimating equations were used to take into account the correlations between repeated measures and estimate adjusted odds ratio. RESULTS After adjustment, patients reporting elevated coffee consumption and daily chocolate intake were less likely to present abnormal ALT (OR=0.65; p=0.04 and OR=0.57; p=0.04, for coffee and chocolate respectively), while only patients reporting elevated coffee consumption were less likely to have abnormal AST values (p=0.05). Nevertheless, the combined indicator of coffee and chocolate intake was most significantly associated with approximately 40% reduced risk of abnormal liver enzymes (p=0.003 for AST; p=0.002 for ALT). CONCLUSIONS Elevated coffee consumption and daily chocolate intake appear to be associated with reduced levels of liver enzymes in HIV-HCV co-infected patients. Further experimental and observational research is needed to better understand the role that polyphenol intake or supplementation can play on liver disease and liver injury.
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Affiliation(s)
- M Patrizia Carrieri
- INSERM, U912 (SESSTIM), Marseille, France; Aix Marseille Univ, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France.
| | - Caroline Lions
- INSERM, U912 (SESSTIM), Marseille, France; Aix Marseille Univ, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
| | - Philippe Sogni
- Institut Cochin, Université Paris-Descartes, INSERM U567-CNRS (UMR 8104), Paris, France; APHP, Hôpital Cochin, Service d'Hépatologie, Paris, France
| | - Maria Winnock
- INSERM, U897 and ISPED, Université Victor Segalen, Bordeaux, France
| | - Perrine Roux
- INSERM, U912 (SESSTIM), Marseille, France; Aix Marseille Univ, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
| | - Marion Mora
- INSERM, U912 (SESSTIM), Marseille, France; Aix Marseille Univ, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
| | - Philippe Bonnard
- Maladies Infectieuses, Hôpital Tenon, UPMC Univ Paris 06, UPMC Paris Liver Center, Paris, France
| | - Dominique Salmon
- Service des Maladies Infectieuses et Tropicales, Hôpital Cochin, AP-HP, Paris, France; Université Paris Descartes, Paris, France
| | - François Dabis
- INSERM, U897 and ISPED, Université Victor Segalen, Bordeaux, France
| | - Bruno Spire
- INSERM, U912 (SESSTIM), Marseille, France; Aix Marseille Univ, IRD, UMR-S912, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
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Lee W, Hu K, Tonelli M, Bahrami A, Neuhardt E, Glass KC, Markley JL. Fast automated protein NMR data collection and assignment by ADAPT-NMR on Bruker spectrometers. J Magn Reson 2013; 236:83-8. [PMID: 24091140 PMCID: PMC3858185 DOI: 10.1016/j.jmr.2013.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 07/09/2013] [Revised: 08/14/2013] [Accepted: 08/16/2013] [Indexed: 05/05/2023]
Abstract
ADAPT-NMR (Assignment-directed Data collection Algorithm utilizing a Probabilistic Toolkit in NMR) supports automated NMR data collection and backbone and side chain assignment for [U-(13)C, U-(15)N]-labeled proteins. Given the sequence of the protein and data for the orthogonal 2D (1)H-(15)N and (1)H-(13)C planes, the algorithm automatically directs the collection of tilted plane data from a variety of triple-resonance experiments so as to follow an efficient pathway toward the probabilistic assignment of (1)H, (13)C, and (15)N signals to specific atoms in the covalent structure of the protein. Data collection and assignment calculations continue until the addition of new data no longer improves the assignment score. ADAPT-NMR was first implemented on Varian (Agilent) spectrometers [A. Bahrami, M. Tonelli, S.C. Sahu, K.K. Singarapu, H.R. Eghbalnia, J.L. Markley, PLoS One 7 (2012) e33173]. Because of broader interest in the approach, we present here a version of ADAPT-NMR for Bruker spectrometers. We have developed two AU console programs (ADAPT_ORTHO_run and ADAPT_NMR_run) that run under TOPSPIN Versions 3.0 and higher. To illustrate the performance of the algorithm on a Bruker spectrometer, we tested one protein, chlorella ubiquitin (76 amino acid residues), that had been used with the Varian version: the Bruker and Varian versions achieved the same level of assignment completeness (98% in 20 h). As a more rigorous evaluation of the Bruker version, we tested a larger protein, BRPF1 bromodomain (114 amino acid residues), which yielded an automated assignment completeness of 86% in 55 h. Both experiments were carried out on a 500 MHz Bruker AVANCE III spectrometer equipped with a z-gradient 5 mm TCI probe. ADAPT-NMR is available at http://pine.nmrfam.wisc.edu/ADAPT-NMR in the form of pulse programs, the two AU programs, and instructions for installation and use.
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Affiliation(s)
- Woonghee Lee
- National Magnetic Resonance Facility at Madison
- Biochemistry Department, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
- To whom correspondence should be addressed: , Telephone: +1-608-263-1722. , Telephone: +1-608-263-9349, Fax: +1-608-262-3759
| | - Kaifeng Hu
- National Magnetic Resonance Facility at Madison
| | | | | | - Elizabeth Neuhardt
- Department of Pharmaceutical Sciences, Albany College of Pharmacy and Health Sciences, Colchester, VT 05446, USA
| | - Karen C. Glass
- Department of Pharmaceutical Sciences, Albany College of Pharmacy and Health Sciences, Colchester, VT 05446, USA
| | - John L. Markley
- National Magnetic Resonance Facility at Madison
- Biochemistry Department, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
- To whom correspondence should be addressed: , Telephone: +1-608-263-1722. , Telephone: +1-608-263-9349, Fax: +1-608-262-3759
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Chhabra R, O'Keefe JH, Patil H, O'Keefe E, Thompson RC, Ansari S, Kennedy KF, Lee LW, Helzberg JH. Association of coronary artery calcification with hepatic steatosis in asymptomatic individuals. Mayo Clin Proc 2013; 88:1259-65. [PMID: 24138963 DOI: 10.1016/j.mayocp.2013.06.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 06/17/2013] [Accepted: 06/21/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To determine the association of coronary artery calcification with hepatic steatosis in asymptomatic volunteers. PATIENTS AND METHODS The study group comprised 400 asymptomatic volunteers, enrolled from April 1, 2011, to September 30, 2012, without known coronary artery disease who were self-referred for screening noncontrast computed tomography to determine coronary calcium score (CCS). Computed tomographic images were used to determine the presence of hepatic steatosis. An a priori model was created to predict a CCS of 100 Agatston units (AU) or higher on the basis of Framingham risk factors, diabetes mellitus, and metabolic syndrome. Hepatic steatosis was then added to this model. Computation of the odds ratio (OR) for hepatic steatosis predicting a CCS of 100 AU or higher was performed. Finally, the OR for a CCS of 100 AU or higher being associated with hepatic steatosis was calculated. RESULTS When hepatic steatosis was added to traditional coronary risk factors, it was independently associated with a CCS of 100 AU or higher (OR, 2.85). This was greater than the OR of Framingham factors, diabetes mellitus, or metabolic syndrome. A CCS of 100 AU or higher was independently associated with an increased risk for hepatic steatosis (OR, 2.4). This OR was higher than traditional hepatic steatosis risk factors or metabolic syndrome. CONCLUSION Hepatic steatosis is a strong independent predictor of a CCS of 100 AU or higher in asymptomatic patients. It is associated with an increased risk of coronary artery disease beyond that expected from traditional coronary risk factors and/or metabolic syndrome. Additional studies are needed to clarify the role of hepatic steatosis as a possible independent risk factor for the development of coronary artery disease.
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Affiliation(s)
- Rajiv Chhabra
- Department of Gastroenterology and Hepatology, Saint Luke's Hospital of Kansas City, Kansas City, MO; Liver Disease Management Center and Division of Gastroenterology, Department of Medicine, Saint Luke's Hospital, Kansas City, MO; School of Medicine, Department of Medicine, University of Missouri-Kansas City, Kansas City, MO
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Yamamura A, Miura K, Karasawa H, Morishita K, Abe K, Mizuguchi Y, Saiki Y, Fukushige S, Kaneko N, Sase T, Nagase H, Sunamura M, Motoi F, Egawa S, Shibata C, Unno M, Sasaki I, Horii A. Suppressed expression of NDRG2 correlates with poor prognosis in pancreatic cancer. Biochem Biophys Res Commun 2013; 441:102-7. [PMID: 24134849 DOI: 10.1016/j.bbrc.2013.10.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 10/05/2013] [Indexed: 12/20/2022]
Abstract
Pancreatic cancer is a highly lethal disease with a poor prognosis; the molecular mechanisms of the development of this disease have not yet been fully elucidated. N-myc downstream regulated gene 2 (NDRG2), one of the candidate tumor suppressor genes, is frequently downregulated in pancreatic cancer, but there has been little information regarding its expression in surgically resected pancreatic cancer specimens. We investigated an association between NDRG2 expression and prognosis in 69 primary resected pancreatic cancer specimens by immunohistochemistry and observed a significant association between poor prognosis and NDRG2-negative staining (P=0.038). Treatment with trichostatin A, a histone deacetylase inhibitor, predominantly up-regulated NDRG2 expression in the NDRG2 low-expressing cell lines (PANC-1, PCI-35, PK-45P, and AsPC-1). In contrast, no increased NDRG2 expression was observed after treatment with 5-aza-2' deoxycytidine, a DNA demethylating agent, and no hypermethylation was detected in either pancreatic cancer cell lines or surgically resected specimens by methylation specific PCR. Our present results suggest that (1) NDRG2 is functioning as one of the candidate tumor-suppressor genes in pancreatic carcinogenesis, (2) epigenetic mechanisms such as histone modifications play an essential role in NDRG2 silencing, and (3) the expression of NDRG2 is an independent prognostic factor in pancreatic cancer.
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Affiliation(s)
- Akihiro Yamamura
- Department of Surgery, Tohoku University, Graduate School of Medicine, Sendai, Japan; Department of Pathology, Tohoku University, Graduate School of Medicine, Sendai, Japan
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Clavel MA, Messika-Zeitoun D, Pibarot P, Aggarwal SR, Malouf J, Araoz PA, Michelena HI, Cueff C, Larose E, Capoulade R, Vahanian A, Enriquez-Sarano M. The complex nature of discordant severe calcified aortic valve disease grading: new insights from combined Doppler echocardiographic and computed tomographic study. J Am Coll Cardiol 2013; 62:2329-38. [PMID: 24076528 DOI: 10.1016/j.jacc.2013.08.1621] [Citation(s) in RCA: 369] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 07/17/2013] [Accepted: 08/17/2013] [Indexed: 12/23/2022]
Abstract
OBJECTIVES With concomitant Doppler echocardiography and multidetector computed tomography (MDCT) measuring aortic valve calcification (AVC) load, this study aimed at defining: 1) independent physiologic/structural determinants of aortic valve area (AVA)/mean gradient (MG) relationship; 2) AVC thresholds best associated with severe aortic stenosis (AS); and 3) whether, in AS with discordant MG, severe calcified aortic valve disease is generally detected. BACKGROUND Aortic stenosis with discordant markers of severity, AVA in severe range but low MG, is a conundrum, unresolved by outcome studies. METHODS Patients (n = 646) with normal left ventricular ejection fraction AS underwent Doppler echocardiography and AVC measurement by MDCT. On the basis of AVA-indexed-to-body surface area (AVAi) and MG, patients were categorized as concordant severity grading (CG) with moderate AS (AVAi >0.6 cm²/m², MG <40 mm Hg), severe AS (AVAi ≤0.6 cm²/m², MG ≥ 40 mm Hg), discordant-severity-grading (DG) with low-MG (AVAi ≤0.6 cm(2)/m(2), MG <40 mm Hg), or high-MG (AVAi >0.6 cm(2)/m(2), MG ≥40 mm Hg). RESULTS The MG (discordant in 29%) was strongly determined by AVA and flow but also independently and strongly influenced by AVC-load (p < 0.0001) and systemic arterial compliance (p < 0.0001). The AVC-load (median [interquartile range]) was similar within patients with DG (low-MG: 1,619 [965 to 2,528] arbitrary units [AU]; high-MG: 1,736 [1,209 to 2,894] AU; p = 0.49), higher than CG-moderate-AS (861 [427 to 1,519] AU; p < 0.0001) but lower than CG-severe-AS (2,931 [1,924 to 4,292] AU; p < 0.0001). The AVC-load thresholds separating severe/moderate AS were defined in CG-AS with normal flow (stroke-volume-index >35 ml/m(2)). The AVC-load, absolute or indexed, identified severe AS accurately (area under the curve ≥0.89, sensitivity ≥86%, specificity ≥79%) in men and women. Upon application of these criteria to DG-low MG, at least one-half of the patients were identified as severe calcified aortic valve disease, irrespective of flow. CONCLUSIONS Among patients with AS, MG is often discordant from AVA and is determined by multiple factors, valvular (AVC) and non-valvular (arterial compliance) independently of flow. The AVC-load by MDCT, strongly associated with AS severity, allows diagnosis of severe calcified aortic valve disease. At least one-half of the patients with discordant low gradient present with heavy AVC-load reflective of severe calcified aortic valve disease, emphasizing the clinical yield of AVC quantification by MDCT to diagnose and manage these complex patients.
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Affiliation(s)
| | - David Messika-Zeitoun
- Cardiology Department, AP-HP, Bichat Hospital, Paris, France; INSERM U698 and University Paris 7-Diderot, Paris, France
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Québec, Canada
| | | | - Joseph Malouf
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | - Phillip A Araoz
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
| | | | - Caroline Cueff
- Cardiology Department, AP-HP, Bichat Hospital, Paris, France
| | - Eric Larose
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Québec, Canada
| | - Romain Capoulade
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Québec, Canada
| | - Alec Vahanian
- Cardiology Department, AP-HP, Bichat Hospital, Paris, France; INSERM U698 and University Paris 7-Diderot, Paris, France
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Palma A, Gianchecchi E, Palombi M, Luciano R, Di Carlo P, Crinò A, Cappa M, Fierabracci A. Analysis of the autoimmune regulator gene in patients with autoimmune non-APECED polyendocrinopathies. Genomics 2013; 102:163-8. [PMID: 23643663 DOI: 10.1016/j.ygeno.2013.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 04/19/2013] [Accepted: 04/22/2013] [Indexed: 12/28/2022]
Abstract
The pathogenesis of autoimmunity was derived from a complex interaction of genetic and environmental factors. Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy is a rare autosomal recessive disease caused by mutations in the autoimmune regulator (AIRE) gene. AIRE gene variants and, in particular, heterozygous loss-of-function mutations were also discovered in organ-specific autoimmune disorders, possibly contributing to their etiopathogenesis. It was suggested that even predisposition to develop certain autoimmune conditions may be derived from AIRE gene polymorphisms including S278R and intronic IVS9+6 G>A. In this study we unravel the hypothesis on whether AIRE gene variants may predispose individuals to associated autoimmune conditions in 41 Italian patients affected by non-APECED autoimmune polyendocrinopathies. We could not detect any heterozygous mutations of the AIRE gene. Although a trend of association was observed, heterozygous polymorphisms S278R and IVS9+6 G>A were detected in patients without statistically significant prevalence than in controls. Their putative contribution to autoimmune polyendocrinopathies and their predictive value in clinical strategies of disease development could be unravelled by analysing a larger sample of diseased patients and healthy individuals.
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Affiliation(s)
- Alessia Palma
- Research Laboratories, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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Kalkan G, Yigit S, Karakuş N, Ateş O, Bozkurt N, Ozdemir A, Pancar GŞ. Methylenetetrahydrofolate reductase C677T mutation in patients with alopecia areata in Turkish population. Gene 2013; 530:109-12. [PMID: 23954881 DOI: 10.1016/j.gene.2013.08.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 08/01/2013] [Accepted: 08/03/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Methylene-tetrahydrofolate reductase (MTHFR) is a key enzyme regulating folate metabolism and it is thought to influence DNA methylation and nucleic acid synthesis. Mutations in the MTHFR gene have been associated with several autoimmune disorders in previous studies. Alopecia areata (AA) is considered to be a tissue-specific autoimmune disease as the hair follicle has been targeted and antibodies to their own hair follicle structures have been developed. Since there is a common shared pathway between AA and other autoimmune disorders, we aimed to investigate a possible association between the MTHFR gene C677T mutation and AA susceptibility in the Turkish population. METHODS The study included 136 patients affected by AA and 130 healthy controls. Genomic DNA was isolated and genotyped using a polymerase chain reaction (PCR)-based restriction fragment length polymorphism (RFLP) assay for the MTHFR gene C677T mutation. RESULTS The distributions of genotype and allele frequencies of MTHFR gene C677T mutation were statistically different between AA patients and the control group (p=0.036 and p=0.011, respectively). High differences were also observed when the patients and controls were compared according to CC versus CT+TT (p=0.012). CT+TT genotypes and T allele of MTHFR gene C677T mutation were found to be a susceptibility factor for AA in the Turkish population. CONCLUSION The results suggest that MTHFR gene C677T mutation may have an effect on the risk of alopecia areata in the Turkish population. This is the first study reporting the association between the MTHFR (C677T) genotype and AA.
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Affiliation(s)
- Göknur Kalkan
- Gaziosmanpasa University, School of Medicine, Department of Dermatology, Tokat, Turkey.
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Wahlström T, Belikov S, Arsenian Henriksson M. Chromatin dynamics at the hTERT promoter during transcriptional activation and repression by c-Myc and Mnt in Xenopus leavis oocytes. Exp Cell Res 2013; 319:3160-9. [PMID: 23860446 DOI: 10.1016/j.yexcr.2013.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 07/03/2013] [Accepted: 07/05/2013] [Indexed: 12/22/2022]
Abstract
The transcription factors c-Myc and Mnt regulate gene expression through dimerization with Max and binding to E-boxes in target genes. While c-Myc activates gene expression via recruitment of histone modifying complexes, Mnt acts as a transcriptional repressor. Here, we used the Xenopus leavis oocyte system to address the effect of c-Myc and Mnt on transcription and chromatin remodeling over the E-box region in the human telomerase reverse transcriptase (hTERT) promoter. As expected we found elevated and decreased levels of hTERT transcription upon exogenously expressed c-Myc/Max and Mnt/Max, respectively. In addition, we confirmed binding of these heterodimers to both E-boxes already enriched with H3K9ac and H4K16ac. These chromatin marks were further enhanced upon c-Myc/Max binding followed by increased DNA accessibility in the E-box region. In contrast, Mnt/Max inhibited Myc-induced transcription and mediated repression through complete chromatin condensation and deacetylation of H3K9 and H4K16 across the E-box region. Importantly, Mnt was able to counteract c-Myc mediated activation even when expressed at low levels, suggesting Mnt to act as a strong repressor by closing the chromatin structure. Collectively our data demonstrate that the balance between c-Myc and Mnt activity determines the transcriptional outcome of the hTERT promoter by modulation of the chromatin architecture.
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Affiliation(s)
- Therese Wahlström
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Box 280, SE-171 77 Stockholm, Sweden
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Smith A, Wu AH, Lynch KL, Ko N, Grenache DG. Multi-wavelength spectrophotometric analysis for detection of xanthochromia in cerebrospinal fluid and accuracy for the diagnosis of subarachnoid hemorrhage. Clin Chim Acta 2013; 424:231-6. [PMID: 23800427 DOI: 10.1016/j.cca.2013.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 06/12/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cerebrospinal fluid (CSF) was examined for bilirubin, an important indicator for diagnosis of subarachnoid hemorrhage (SAH). METHODS A multi-wavelength (340, 415, and 460 nm) spectrophotometric assay was developed for the quantitative measurement of bilirubin in CSF, enabling the mathematical correction for absorbance of hemoglobin and proteins. Bilirubin and hemoglobin results were correlated to HPLC and a standard colorimetric assay, respectively. A subset of samples was sent for an absorbance reading at 450 nm following baseline correction. The multi-wavelength bilirubin assay was validated on 70 patients with confirmed SAH and 70 patients with neurologic symptoms who ruled out for SAH. RESULTS The multi-wavelength spectrophometric assay demonstrated no interferences due to proteins (albumin) up to 30 g/l or oxyhemoglobin up to 260 mg/l. The assay limit of detection was 0.2 mg/l, linear to 20 mg/l, and CVs ranged from 1 to 6% at bilirubin concentrations of 0.84 and 2.1mg/l. The spectrophotometric assay correlated to HPLC and the colorimetric assay for bilirubin and hemoglobin, respectively. Results also correlated to the absorbance method (with removal of samples with high hemoglobin and proteins). The area under the ROC curve for diagnosis of SAH was 0.971 and 0.954 for the HPLC and spectrophotometric assay, respectively. At a cutoff of 0.2mg/l, the clinical specificity was 100% for both assays, and the clinical sensitivity was 94.3% and 88.6% for SAH for the HPLC and spectrophotometric asays, respectively. CONCLUSIONS The multi-wavelength spectrophotometric assay is an objective alternative to visual inspection, HPLC, and absorbance for CSF bilirubin.
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Genevieve M, Vivot A, Gonzalez C, Raffaitin C, Barberger-Gateau P, Gin H, Rigalleau V. Skin autofluorescence is associated with past glycaemic control and complications in type 1 diabetes mellitus. Diabetes Metab 2013; 39:349-54. [PMID: 23643347 DOI: 10.1016/j.diabet.2013.03.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 03/01/2013] [Accepted: 03/12/2013] [Indexed: 11/20/2022]
Abstract
As skin autofluorescence (AF) can assess subcutaneous accumulation of fluorescent advanced glycation end-products (AGEs), this study aimed to investigate whether it was linked to glycaemic control and complications in patients with type 1 diabetes mellitus (T1DM). Using the AGE Reader™, AF was measured in T1DM patients referred to Haut-Levêque Hospital (Bordeaux, France); data on their HbA1c levels measured every 6months as far back as the last 5years were also collected. The association of AF with the patients' past glucose control, based on their latest HbA1c values, and the means of the last five and 10 HbA1c values, and with diabetic complications was also examined by linear regression analysis. The sample included 300 patients: 58% were male; the mean age was 49 (SD 17) years and the mean diabetes duration was 21 (SD 13) years. The median skin AF measurement was 2.0 [25th-75th percentiles: 1.7-2.4] arbitrary units (AU), and this was associated with age (β=0.15 per 10years, P<0.001) and diabetes duration (β=0.17 per 10years, P<0.001). After adjusting for age and estimated glomerular filtration rate (eGFR), the skin AF measurement was also related to the means of the last five and 10 HbA1c values (β=0.10 per 1% of HbA1c, P=0.005, and β=0.13 per 1% of HbA1c, P=0.001, respectively). In addition, the skin AF was associated with retinopathy (P<0.001), albuminuria (P<0.001) and decreased eGFR (P<0.001). In conclusion, the skin AF is related to the long-term glucose control and diabetic complications.
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Affiliation(s)
- M Genevieve
- Nutrition-Diabétologie, Bordeaux hospital, 33600 Pessac, France; Université Bordeaux Segalen, 33000 Bordeaux, France
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Gremmel T, Panzer S, Steiner S, Seidinger D, Koppensteiner R, Pabinger I, Kopp CW, Ay C. Response to antiplatelet therapy is independent of endogenous thrombin generation potential. Thromb Res 2013; 132:e24-30. [PMID: 23623170 DOI: 10.1016/j.thromres.2013.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 03/14/2013] [Accepted: 04/07/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND Thrombin is the most potent platelet activator, and achieves rapid platelet activation even in the presence of antiplatelet therapy. Since activated platelets respond stronger to additional stimuli, the extent of endogenous thrombin generation may in part be responsible for the reported response variability to aspirin and clopidogrel therapy. PATIENTS AND METHODS Thrombin generation potential was measured with a commercially available assay, and platelet reactivity was assessed with the vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay, light transmission aggregometry (LTA), the VerifyNow aspirin and P2Y12 assays, and multiple electrode aggregometry (MEA) in 316 patients on dual antiplatelet therapy undergoing angioplasty and stenting. RESULTS Peak thrombin, the lag phase and the area under the curve of thrombin generation correlated poorly with on-treatment platelet reactivity by all test systems. High on-treatment residual platelet reactivity (HRPR) in response to arachidonic acid was seen in 33 (10.5%), 41 (13%), and 79 (25.7%) patients by LTA, the VerifyNow aspirin assay, and MEA, respectively. HRPR in response to adenosine diphosphate was seen in 150 (48.1%), 48 (15.3%), 106 (33.7%), and 118 (38.3%) patients by the VASP assay, LTA, the VerifyNow P2Y12 assay, and MEA, respectively. Peak thrombin generation did not differ between patients without and with HRPR by the VASP assay, LTA, the VerifyNow P2Y12 assay and MEA. In the VerifyNow aspirin assay, patients without HRPR had higher peak thrombin generation than patients with HRPR (p=0.01). Finally, patients without and with high peak thrombin generation exhibited similar on-treatment platelet reactivity by all test systems, and high peak thrombin generation occurred to a similar extent in patients without and with HRPR. CONCLUSION Response to antiplatelet therapy with aspirin and clopidogrel is not associated with thrombin generation potential.
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Affiliation(s)
- Thomas Gremmel
- Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
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