1
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Mejia EM, Hizon NA, Dueck CE, Lidder R, Daigle J, Wonitowy Q, Medina NG, Mohammed UP, Cox GW, Safronetz D, Hagan M, Strong J, Nichani A, Mulvey MR, Mangat CS. Detection of mpox virus in wastewater provides forewarning of clinical cases in Canadian cities. Sci Total Environ 2024; 933:173108. [PMID: 38729376 DOI: 10.1016/j.scitotenv.2024.173108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
Wastewater-based surveillance (WBS) has shown to be an effective tool in monitoring the spread of SARS-CoV-2 and has helped guide public health actions. Consequently, WBS has expanded to now include the monitoring of mpox virus (MPXV) to contribute to its mitigation efforts. In this study, we demonstrate a unique sample processing and a molecular diagnostic strategy for MPXV detection that can inform on the epidemiological situation of mpox outbreaks through WBS. We conducted WBS for MPXV in 22 Canadian wastewater treatment plants (WWTPs) for 14 weeks. Three MPXV qPCR assays were assessed in this study for the detection of MPXV which include the G2R assays (G2R_WA and G2R_G) developed by the Centers for Disease Control and Prevention (CDC) in 2010, and an in-house-developed assay that we have termed G2R_NML. The G2R_NML assay was designed using reference genomes from the 2022 MPXV outbreak and provides a larger qPCR amplicon size to facilitate Sanger sequencing. Results show that all three assays have similar limits of detection and are able to detect the presence of MPXV in wastewater. The G2R_NML assay produced a significantly greater number of Sanger sequence-confirmed MPXV results compared to the CDC G2R assays. Detection of MPXV was possible where provincial surveillance indicated overall low caseloads, and in some sites forewarning of up to several weeks was observed. Overall, this study proposes that WBS of MPXV provides additional information to help fill knowledge gaps in clinical case-surveillance and is potentially an essential component to the management of mpox.
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Affiliation(s)
- Edgard M Mejia
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.
| | - Nikho A Hizon
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Codey E Dueck
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Ravinder Lidder
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Jade Daigle
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Quinn Wonitowy
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nestor G Medina
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Umar P Mohammed
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Graham W Cox
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - David Safronetz
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada; Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mable Hagan
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Jim Strong
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada; Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Anil Nichani
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Michael R Mulvey
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada; Antimicrobial Resistance Nosocomial Infections, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada; Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Chand S Mangat
- Wastewater Surveillance Unit, Bacterial Pathogens, AMR, and Wastewater, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada; Antimicrobial Resistance Nosocomial Infections, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada; Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Sprecher A, Cross R, Marzi A, Martins KA, Wolfe D, Montgomery JM, Spiropoulou CF, Cihlar T, Ahuka-Mundeke S, Nyhuis T, Teicher C, Crozier I, Strong J, Kobinger G, Woolsey C, Geisbert TW, Feldmann H, Muyembe JJ. Perspectives on Advancing Countermeasures for Filovirus Disease: Report From a Multisector Meeting. J Infect Dis 2023; 228:S474-S478. [PMID: 37596837 PMCID: PMC10651188 DOI: 10.1093/infdis/jiad354] [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: 06/22/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/20/2023] Open
Abstract
Although there are now approved treatments and vaccines for Ebola virus disease, the case fatality rate remains unacceptably high even when patients are treated with the newly approved therapeutics. Furthermore, these countermeasures are not expected to be effective against disease caused by other filoviruses. A meeting of subject-matter experts was held during the 10th International Filovirus Symposium to discuss strategies to address these gaps. Several investigational therapeutics, vaccine candidates, and combination strategies were presented. The greatest challenge was identified to be the implementation of well-designed clinical trials of safety and efficacy during filovirus disease outbreaks. Preparing for this will require agreed-upon common protocols for trials intended to bridge multiple outbreaks across all at-risk countries. A multinational research consortium including at-risk countries would be an ideal mechanism to negotiate agreement on protocol design and coordinate preparation. Discussion participants recommended a follow-up meeting be held in Africa to establish such a consortium.
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Affiliation(s)
| | - Robert Cross
- Galveston National Laboratory, University of Texas Medical Branch, Galveston
| | - Andrea Marzi
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Karen A Martins
- Biomedical Advanced Research and Development Authority, Administration for Strategic Preparedness and Response, US Department of Health and Human Services, Washington, District of Columbia
| | - Daniel Wolfe
- Biomedical Advanced Research and Development Authority, Administration for Strategic Preparedness and Response, US Department of Health and Human Services, Washington, District of Columbia
| | - Joel M Montgomery
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christina F Spiropoulou
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Steve Ahuka-Mundeke
- Institut National de Recherche Biomédicale, Kinshasa, Republic of the Congo
- Kinshasa Teaching Hospital, School of Medicine, Kinshasa University, Democratic Republic of the Congo
| | - Tara Nyhuis
- Mapp Biopharmaceutical, Inc, San Diego, California
| | | | - Ian Crozier
- Clinical Monitoring Program Research Directorate, Frederick National Laboratory for Cancer Research, Maryland
| | - Jim Strong
- Special Pathogens Program, National Microbiology Laboratory Branch, Public Health Agency of Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg
| | - Gary Kobinger
- Galveston National Laboratory, University of Texas Medical Branch, Galveston
| | - Courtney Woolsey
- Galveston National Laboratory, University of Texas Medical Branch, Galveston
| | - Thomas W Geisbert
- Galveston National Laboratory, University of Texas Medical Branch, Galveston
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Jean-Jacques Muyembe
- Institut National de Recherche Biomédicale, Kinshasa, Republic of the Congo
- Kinshasa Teaching Hospital, School of Medicine, Kinshasa University, Democratic Republic of the Congo
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3
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Strong J, Mann TN, Tarr GS, Reuter H. Development of active tuberculosis in patients treated with biological disease-modifying antirheumatic drugs. S Afr Med J 2022; 112:13498. [PMID: 35139986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Biological disease-modifying antirheumatic drugs (bDMARDs) have been shown to be highly effective in the treatment of rheumatic conditions, but may increase the risk of infections. Development of tuberculosis (TB) while on bDMARD therapy is of particular concern in high TB burden settings such as Western Cape Province, South Africa. OBJECTIVES To describe the diagnosis, management and outcome of patients who developed active TB while receiving a bDMARD. RESULTS Ten patients who screened negative for TB prior to initiation of a bDMARD subsequently developed active TB. TB was diagnosed between 10 months and 9 years from bDMARD initiation, suggesting new infection, and included 6 cases of extrapulmonary TB. All patients required multiple tests to confirm the diagnosis of TB, and all were successfully treated. CONCLUSIONS TB can occur in patients on bDMARD therapy despite initial screening, and may have unusual, extrapulmonary manifestations that pose a diagnostic challenge.
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Affiliation(s)
- J Strong
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
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Funk DJ, Bullard J, Lother S, Grande GV, Garnett L, Doan K, Dust K, Kumar A, Poliquin G, Strong J. Persistence of live virus in critically ill patients infected with SARS-COV-2: a prospective observational study. Crit Care 2022; 26:10. [PMID: 34983614 PMCID: PMC8724747 DOI: 10.1186/s13054-021-03884-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/27/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Research on the duration of infectivity of ICU patients with COVID-19 has been sparse. Tests based on Reverse Transcriptase polymerase chain reaction (RT-PCR) detect both live virus and non-infectious viral RNA. We aimed to determine the duration of infectiousness based on viral culture of nasopharyngeal samples of patients with COVID-19. METHODS Prospective observational study in adult intensive care units with a diagnosis of COVID-19 Pneumonia. Patients had repeated nasopharyngeal sampling performed after day 10 of ICU admission. Culture positive rate (based on viral culture on Vero cells in a level 4 lab) and Cycle threshold from RT-PCR were measured. RESULTS Nine patients of the 108 samples (8.3%, 95% CI 3.9-15.2%) grew live virus at a median of 13 days (interquartile range 11-19) after their initial positive test. 74.1% of patients were RT-PCR positive but culture negative, and the remaining (17.6%) were RT-PCR and culture negative. Cycle threshold showed excellent ability to predict the presence of live virus, with a Ct < 25 with an AUC of 0.90 (95% CI 0.83-0.97, p < 0.001). The specificity of a Ct > 25 to predict negative viral culture was 100% (95% CI 70-100%). CONCLUSION 8.3% of our ICU patients with COVID-19 grew live virus at a median of 13 days post-initial positive RT-PCR test. Severity of illness, use of mechanical ventilation, and time between tests did not predict the presence of live virus. Cycle threshold of > 25 had the best ability to determine the lack of live virus in these patents.
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Affiliation(s)
- Duane J Funk
- Departments of Anesthesiology and Medicine, Section of Critical Care, Max Rady College of Medicine, University of Manitoba, 2nd Floor Harry Medovy House, 671 William Avenue, Winnipeg, MB, R3E 0Z2, Canada. .,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
| | - Jared Bullard
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, MB, Canada.,Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Sylvan Lother
- Department of Medicine, Sections of Infectious Disease and Critical Care, University of Manitoba, Winnipeg, MB, Canada
| | - Gloria Vazquez Grande
- Department of Medicine, Sections of Infectious Disease and Critical Care, University of Manitoba, Winnipeg, MB, Canada
| | - Lauren Garnett
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Kaylie Doan
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Kerry Dust
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Anand Kumar
- Department of Medicine, Sections of Infectious Disease and Critical Care, University of Manitoba, Winnipeg, MB, Canada
| | - Guillaume Poliquin
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Jim Strong
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada.,National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
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5
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Strong J, Drummond S, Hanson J, Pole JD, Engstrom T, Copeland K, Lipman B, Sullivan C. Outcomes of rapid digital transformation of large-scale communications during the COVID-19 pandemic. AUST HEALTH REV 2021; 45:696-703. [PMID: 34856118 DOI: 10.1071/ah21125] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 09/14/2021] [Indexed: 11/23/2022]
Abstract
Objective This study examined the content and impact of a new digital communication medium, called a VIDCAST, implemented at a large hospital and health service when the COVID-19 pandemic was announced, and the key concerns held by staff at the time when the health service was preparing for the COVID-19 pandemic to arrive in this health service. Methods A mixed-methods approach was used. Thematic analysis of 20 transcripts of daily VIDCASTS broadcast between 30 March and 24 April 2020 was undertaken, in addition to descriptive analysis of feedback from an anonymous online survey. Results Survey feedback from 322 staff indicated almost universal satisfaction with this new communication method. The VIDCASTS provided a new COVID-safe method for the Executive to connect to staff at a time of uncertainty. Thematic analysis of the content of the VIDCASTS revealed three themes: 'Accurate Information', 'Reassurance and Support' and 'Innovation'. The Executive was able to reassure staff about what the organisation was doing to safeguard the health and wellbeing of all, and enabled an effective response to the pandemic. Conclusions The digital communication channel of VIDCASTS, rapidly operationalised at a major Australian hospital and health service in March 2020, provided important information and support for staff as it prepared for the anticipated COVID-19 surge. What is known about the topic? When the COVID-19 pandemic began, traditional face-to-face staff meetings were disrupted and many hospitals and their staff were left scrambling for information, and for reassurance about their safety, as they prepared to receive increasing numbers of COVID-19 patients. What does this paper add? The implementation of a digital communication tool was able to address many of the concerns raised by hospital staff in other geographic locations dealing with surging COVID-19 cases and underpinned a globally leading COVID-19 response. What are the implications for practitioners? New digitised communication methods provided an effective vehicle to inform and support staff in the early stages of pandemic preparation.
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Affiliation(s)
- J Strong
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ; ; and School of Health and Rehabilitation Sciences, The University of Queensland, 84a Services Road, St Lucia, Qld 4067, Australia; and Corresponding author.
| | - S Drummond
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ;
| | - J Hanson
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ;
| | - J D Pole
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia. ;
| | - T Engstrom
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia. ;
| | - K Copeland
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ;
| | - B Lipman
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ;
| | - C Sullivan
- Metro North Hospital and Health Services, 7 Butterfield Street, Herston, Qld 4029, Australia. ; ; ; ; ; ; and Centre for Health Services Research, Faculty of Medicine, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia. ;
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6
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Crofton E, Meredith P, Gray P, O'Reilly S, Strong J. Response to letter to the editor: Efficacy of pressure garment on prevention and regression of scars. Burns 2021; 48:247-248. [PMID: 34857417 DOI: 10.1016/j.burns.2021.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/15/2022]
Affiliation(s)
- E Crofton
- The University of Queensland, Australia; Queensland Health, Australia.
| | - P Meredith
- Central Queensland University, Australia.
| | - P Gray
- The University of Queensland, Australia; Queensland Health, Australia.
| | - S O'Reilly
- The University of Queensland, Australia; Queensland Health, Australia.
| | - J Strong
- The University of Queensland, Australia; Queensland Health, Australia.
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7
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Crofton E, Meredith P, Gray P, Strong J. Compression garment wear and sensory variables after burn: a single-site study. Burns 2020; 46:1903-1913. [DOI: 10.1016/j.burns.2020.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/13/2020] [Accepted: 06/06/2020] [Indexed: 11/28/2022]
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Crofton E, Meredith P, Gray P, O’Reilly S, Strong J. Non-adherence with compression garment wear in adult burns patients: A systematic review and meta-ethnography. Burns 2020; 46:472-482. [DOI: 10.1016/j.burns.2019.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/13/2019] [Accepted: 08/16/2019] [Indexed: 12/21/2022]
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9
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Hinrichs KL, Strong J. CARING FOR LGBT VETERANS AND FAMILIES AT END-OF-LIFE: A CASE FROM A VA HOSPICE UNIT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K L Hinrichs
- VA Boston Healthcare System, Brockton, Massachusetts, United States
| | - J Strong
- VA Boston Healthcare System, Brockton, MA, USA
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10
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Moye J, Wynn M, Strong J, Carpenter B. DEVELOPING THE EDUCATOR WORKFORCE: DEVELOPMENT AND IMPLEMENTATION OF A NATIONAL WEBINAR ON GERIATRIC EDUCATION. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Moye
- VA Medical Center, Jamaica Plain, Massachusetts, United States
| | - M Wynn
- Washington University, St. Louis MA, USA
| | - J Strong
- VA New England GRECC, Boston MA, USA
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11
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Bamonti P, Strong J. DEVELOPMENT OF A TRAINING CLINIC IN CAPACITY ASSESSMENT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- P Bamonti
- VA Boston Healthcare, Boston, Massachusetts, United States
| | - J Strong
- Advanced Fellow in Geriatrics, New England GRECC, VA Boston Healthcare System, Boston, MA
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12
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Tran Q, Strong J, Al Rebh H, Gatz J, Pope K, Jenkins R, Nguyen T, Tuteja G, Vuchula S, Chang WT. 123 Emergency Providers Adequately Manage Mechanical Ventilation in Critically Ill Patients With Spontaneous Intracranial Hemorrhage and Elevated Intracranial Pressure. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
A longitudinal study of 55 adults with severe traumatic brain injury was conducted to investigate the development of self-awareness, emotional distress and motivation during the first year after injury. Cluster analysis was performed on data gathered at one year post-Injury. Three clusters labelled ‘high self-awareness’, ‘low self-awareness’ and ‘good recovery’ were retrieved. A case study is presented from each cluster, contrasting the stages in the development of self-awareness of deficits over the year. This research suggests that clients with acquired brain injury can be classified on the basis of level of self-awareness. Issues for the rehabilitation of and occupational therapy with clients from the three groups are raised.
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Johnston V, Strong J, Gargett S, Jull G, Ellis N. Enhancing the vocational outcomes of people with chronic disabilities caused by a musculoskeletal condition: development and evaluation of content of self-management training modules. Work 2016; 49:455-64. [PMID: 24004780 DOI: 10.3233/wor-131722] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND No self-management interventions have been developed to empower those chronically disabled by a musculoskeletal condition to find and/or remain at work. OBJECTIVE Developand evaluate the content of two self-management training modules to improve vocational outcomes for those with chronic musculoskeletal disorders. METHODS Stanford University's Chronic Disease Self-Management Program provided the framework for the new modules. Focus groups with the eightpersons with workdisabilities and concept-mapping sessions with the 12 experienced vocational rehabilitation professionals were conducted to identify factors and themes contributing to workers remaining/returning to work post-injury. Five experienced self-management trainers reviewed the modules for consistency with self-management principles. RESULTS Two new self-management modules: 'Navigating the System' and 'Managing a Return to Work' were developed.The persons with work disabilitiesgenerated four themes: accepting and coping with injury; skills to manage pain and life; positive working relationships and, re-inventing self, whereas the rehabilitation professionals identified three themes:communication and support of others; the injured worker's abilities and resources, and knowledge and education. CONCLUSIONS Anintervention developed to enhance self-management skills and facilitate positive vocational outcomes of those seeking to return to work post-injury was confirmed as relevant by persons with work disabilities, rehabilitation professionals and self-management trainers.
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Affiliation(s)
- V Johnston
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - J Strong
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - S Gargett
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia
| | - G Jull
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - N Ellis
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia
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Wong G, Qiu X, de La Vega MA, Fernando L, Wei H, Bello A, Fausther-Bovendo H, Audet J, Kroeker A, Kozak R, Tran K, He S, Tierney K, Soule G, Moffat E, Günther S, Gao GF, Strong J, Embury-Hyatt C, Kobinger G. Pathogenicity Comparison Between the Kikwit and Makona Ebola Virus Variants in Rhesus Macaques. J Infect Dis 2016; 214:S281-S289. [PMID: 27651412 DOI: 10.1093/infdis/jiw267] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Enhanced virulence and/or transmission of West African Ebola virus (EBOV) variants, which are divergent from their Central African counterparts, are suspected to have contributed to the sizable toll of the recent Ebola virus disease (EVD) outbreak. This study evaluated the pathogenicity and shedding in rhesus macaques infected with 1 of 2 West African isolates (EBOV-C05 or EBOV-C07) or a Central African isolate (EBOV-K). All animals infected with EBOV-C05 or EBOV-C07 died of EVD, whereas 2 of 3 EBOV-K-infected animals died. The viremia level was elevated 10-fold in EBOV-C05-infected animals, compared with EBOV-C07- or EBOV-K-infected animals. More-severe lung pathology was observed in 2 of 6 EBOV-C05/C07-infected macaques. This is the first detailed analysis of the recently circulating EBOV-C05/C07 in direct comparison to EBOV-K with 6 animals per group, and it showed that EBOV-C05 but not EBOV-C07 can replicate at higher levels and cause more tissue damage in some animals. Increased virus shedding from individuals who are especially susceptible to EBOV replication is possibly one of the many challenges facing the community of healthcare and policy-making responders since the beginning of the outbreak.
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Affiliation(s)
- Gary Wong
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Medical Microbiology CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing
| | - Xiangguo Qiu
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Medical Microbiology
| | - Marc-Antoine de La Vega
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Immunology, University of Manitoba
| | - Lisa Fernando
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Haiyan Wei
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Alexander Bello
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Medical Microbiology
| | | | - Jonathan Audet
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Medical Microbiology
| | - Andrea Kroeker
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Robert Kozak
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Kaylie Tran
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Shihua He
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Kevin Tierney
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Geoff Soule
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Estella Moffat
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Stephan Günther
- Bernhard-Nocht-Institute for Tropical Medicine, World Health Organization Collaborating Center for Arboviruses and Hemorrhagic Fever Reference and Research, Hamburg, Germany
| | - George F Gao
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing
| | - Jim Strong
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
| | - Carissa Embury-Hyatt
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Gary Kobinger
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada Department of Medical Microbiology Department of Immunology, University of Manitoba Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia
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16
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Chien CW, Bagraith K, Khan A, Deen M, Syu JJ, Strong J. Establishment of cutpoints to categorize the severity of chronic pain using composite ratings with Rasch analysis. Eur J Pain 2016; 21:82-91. [DOI: 10.1002/ejp.906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2016] [Indexed: 11/06/2022]
Affiliation(s)
- C.-W. Chien
- Occupational Therapy Division; School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Qld Australia
- Department of Rehabilitation Sciences; The Hong Kong Polytechnic University; Kowloon Hong Kong (SAR) China
| | - K.S. Bagraith
- Occupational Therapy Division; School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Qld Australia
- Interdisciplinary Persistent Pain Centre; Gold Coast Hospital and Health Service; Gold Coast Qld Australia
| | - A. Khan
- School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Qld Australia
| | - M. Deen
- Metro South Persistent Pain Management Service; Princess Alexandra Hospital; Woolloongabba Qld Australia
| | - J.-J. Syu
- School of Public Health; The University of Queensland; Brisbane Qld Australia
| | - J. Strong
- Occupational Therapy Division; School of Health and Rehabilitation Sciences; The University of Queensland; Brisbane Qld Australia
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17
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Choi JH, Jonsson-Schmunk K, Qiu X, Shedlock DJ, Strong J, Xu JX, Michie KL, Audet J, Fernando L, Myers MJ, Weiner D, Bajrovic I, Tran LQ, Wong G, Bello A, Kobinger GP, Schafer SC, Croyle MA. A Single Dose Respiratory Recombinant Adenovirus-Based Vaccine Provides Long-Term Protection for Non-Human Primates from Lethal Ebola Infection. Mol Pharm 2014; 12:2712-31. [PMID: 25363619 PMCID: PMC4525323 DOI: 10.1021/mp500646d] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
![]()
As
the Ebola outbreak in West Africa continues and cases appear
in the United States and other countries, the need for long-lasting
vaccines to preserve global health is imminent. Here, we evaluate
the long-term efficacy of a respiratory and sublingual (SL) adenovirus-based
vaccine in non-human primates in two phases. In the first, a single
respiratory dose of 1.4 × 109 infectious virus particles
(ivp)/kg of Ad-CAGoptZGP induced strong Ebola glycoprotein (GP) specific
CD8+ and CD4+ T cell responses and Ebola GP-specific
antibodies in systemic and mucosal compartments and was partially
(67%) protective from challenge 62 days after immunization. The same
dose given by the SL route induced Ebola GP-specific CD8+ T cell responses similar to that of intramuscular (IM) injection,
however, the Ebola GP-specific antibody response was low. All primates
succumbed to infection. Three primates were then given the vaccine
in a formulation that improved the immune response to Ebola in rodents.
Three primates were immunized with 2.0 × 1010 ivp/kg
of vaccine by the SL route. Diverse populations of polyfunctional
Ebola GP-specific CD4+ and CD8+ T cells and
significant anti-Ebola GP antibodies were present in samples collected
150 days after respiratory immunization. The formulated vaccine was
fully protective against challenge 21 weeks after immunization. While
diverse populations of Ebola GP-specific CD4+ T cells were
produced after SL immunization, antibodies were not neutralizing and
the vaccine was unprotective. To our knowledge, this is the first
time that durable protection from a single dose respiratory adenovirus-based
Ebola vaccine has been demonstrated in primates.
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Affiliation(s)
- Jin Huk Choi
- †Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin, Austin, Texas 78712, United States
| | - Kristina Jonsson-Schmunk
- †Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin, Austin, Texas 78712, United States
| | - Xiangguo Qiu
- §Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Devon J Shedlock
- ∥Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Jim Strong
- §Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Jason X Xu
- †Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin, Austin, Texas 78712, United States
| | - Kelly L Michie
- ⊥The University of Texas College of Natural Sciences Institute for Cellular and Molecular Biology, The University of Texas at Austin, Austin, Texas 78712, United States
| | - Jonathan Audet
- §Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Lisa Fernando
- §Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Mark J Myers
- †Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin, Austin, Texas 78712, United States
| | - David Weiner
- ∥Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Irnela Bajrovic
- #Department of Biochemistry, College of Natural Sciences, The University of Texas at Austin, Austin, Texas 78712, United States
| | - Lilian Q Tran
- †Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin, Austin, Texas 78712, United States
| | - Gary Wong
- §Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Alexander Bello
- §Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Gary P Kobinger
- §Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada.,∥Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Stephen C Schafer
- †Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin, Austin, Texas 78712, United States
| | - Maria A Croyle
- †Division of Pharmaceutics, College of Pharmacy, The University of Texas at Austin, Austin, Texas 78712, United States.,⊥The University of Texas College of Natural Sciences Institute for Cellular and Molecular Biology, The University of Texas at Austin, Austin, Texas 78712, United States.,¶Center for Infectious Disease, The University of Texas at Austin, Austin, Texas 78712, United States
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18
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Qiu X, Wong G, Fernando L, Audet J, Bello A, Strong J, Alimonti JB, Kobinger GP. mAbs and Ad-vectored IFN-α therapy rescue Ebola-infected nonhuman primates when administered after the detection of viremia and symptoms. Sci Transl Med 2014; 5:207ra143. [PMID: 24132638 DOI: 10.1126/scitranslmed.3006605] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
ZMAb is a promising treatment against Ebola virus (EBOV) disease that has been shown to protect 50% (two of four) of nonhuman primates (NHPs) when administered 2 days post-infection (dpi). To extend the treatment window and improve protection, we combined ZMAb with adenovirus-vectored interferon-α (Ad-IFN) and evaluated efficacy in EBOV-infected NHPs. Seventy-five percent (three of four) and 100% (four of four) of cynomolgus and rhesus macaques survived, respectively, when treatment was initiated after detection of viremia at 3 dpi. Fifty percent (two of four) of the cynomolgus macaques survived when Ad-IFN was given at 1 dpi, followed by ZMAb starting at 4 dpi, after positive diagnosis. The treatment was able to suppress viremia reaching ~10(5) TCID50 (median tissue culture infectious dose) per milliliter, leading to survival and robust specific immune responses. This study describes conditions capable of saving 100% of EBOV-infected NHPs when initiated after the presence of detectable viremia along with symptoms.
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Affiliation(s)
- Xiangguo Qiu
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
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19
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Strong J, Chipchase L, Allen S, Eley D, McAllister L, Davidson B. Interprofessional Learning during an International Fieldwork Placement. ACTA ACUST UNITED AC 2014. [DOI: 10.11120/pblh.2014.00032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
OBJECTIVES This study evaluated the implementation of recommendations from a prior review of functional capacity evaluation practice in a regionalised rehabilitation service. The evaluation considered the acceptance of the recommendations and the current level of consistency of approach in practice. STUDY DESIGN The study was qualitative in nature, using a descriptive survey and a focus group. Participants were occupational therapists of a major rehabilitation provider in Queensland, Australia. Eighteen of 48 therapists (38%) responded to the questionnaire. Eight therapists participated in the focus group. RESULTS The results indicated some acceptance of the recommendations for functional capacity evaluation in areas such as procedure, reporting, equipment and model of evaluation. Further research into the reliability and validity of functional capacity evaluation was indicated. DISCUSSION The low response rate did not allow conclusive results. However, the findings provided some evidence of consistency in functional capacity evaluation practice. The results are discussed in relation to current issues in functional capacity evaluation practice.
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Affiliation(s)
- L Gibson
- Department of Occupational Therapy, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - J Strong
- Department of Occupational Therapy, The University of Queensland, Brisbane, Queensland 4072, Australia
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21
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Chen H, Zheng D, Liu L, Bartee MY, Davids J, Macaulay C, Strong J, Feldmann H, McFadden G, Lomas DA, Virgin HW, Lucas A. 40. Cytokine 2013. [DOI: 10.1016/j.cyto.2013.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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Bagraith K, Hayes J, Strong J. Mapping patient goals to the International Classification of Functioning, Disability and Health (ICF): Examining the content validity of the low back pain core sets. J Rehabil Med 2013; 45:481-7. [DOI: 10.2340/16501977-1134] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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23
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24
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Allman MS, Altomare F, Whittaker JD, Cicak K, Li D, Sirois A, Strong J, Teufel JD, Simmonds RW. rf-SQUID-mediated coherent tunable coupling between a superconducting phase qubit and a lumped-element resonator. Phys Rev Lett 2010; 104:177004. [PMID: 20482130 DOI: 10.1103/physrevlett.104.177004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Indexed: 05/29/2023]
Abstract
We demonstrate coherent tunable coupling between a superconducting phase qubit and a lumped-element resonator. The coupling strength is mediated by a flux-biased rf SQUID operated in the nonhysteretic regime. By tuning the applied flux bias to the rf SQUID we change the effective mutual inductance, and thus the coupling energy, between the phase qubit and resonator. We verify the modulation of coupling strength from 0 to 100 MHz by observing modulation in the size of the splitting in the phase qubit's spectroscopy, as well as coherently by observing modulation in the vacuum Rabi oscillation frequency when on resonance. The measured spectroscopic splittings and vacuum Rabi oscillations agree well with theoretical predictions.
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Affiliation(s)
- M S Allman
- National Institute of Standards and Technology, 325 Broadway, Boulder, Colorado 80305-3328, USA
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25
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Strong J, Mathews T, Sussex R, New F, Hoey S, Mitchell G. Pain language and gender differences when describing a past pain event. Pain 2009; 145:86-95. [DOI: 10.1016/j.pain.2009.05.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Revised: 05/13/2009] [Accepted: 05/19/2009] [Indexed: 11/25/2022]
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26
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Strong J. Quieten your inner critic. CMAJ 2009; 180:208-9. [DOI: 10.1503/cmaj.081970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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27
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28
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Ownsworth T, Fleming J, Shum D, Kuipers P, Strong J. Comparison of individual, group and combined intevention formats in a randomized controlled trial for facilitating goal attainment and improving psychosocial function following acquired brain injury. J Rehabil Med 2008; 40:81-8. [DOI: 10.2340/16501977-0124] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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31
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Patel A, Zhang Y, Croyle M, Tran K, Gray M, Strong J, Feldmann H, Wilson J, Kobinger G. Mucosal Delivery of Adenovirus‐Based Vaccine Protects against Ebola Virus Infection in Mice. J Infect Dis 2007; 196 Suppl 2:S413-20. [DOI: 10.1086/520603] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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32
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Ebihara H, Qiu X, Theriault S, Klassen M, Stroeher U, Strong J, Jones S, Wilson JM, Feldmann H, Kobinger G. 604. Comparative Analysis of Different Methods for Quantitative Evaluation of Neutralizing Antibody to Ebola Virus in a Biosafety Level 2 or 4 Environment. Mol Ther 2006. [DOI: 10.1016/j.ymthe.2006.08.678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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33
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Bennett S, McKenna K, Hoffmann T, McCluskey A, Tooth L, Strong J. In search of evidence for occupational therapy: A new tool. International Journal of Therapy and Rehabilitation 2004. [DOI: 10.12968/ijtr.2004.11.9.19586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Where is the evidence that occupational therapy intervention can make a difference? In short, it may be found somewhere among thousands of articles, spread over hundreds of journals. It is not surprising that surveys show that a major difficulty facing occupational therapists implementing evidence-based practice is the limited time they have to locate relevant research (Humphris et al, 2000; Bennett et al, 2003).
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Affiliation(s)
- S Bennett
- Department of Occupational Therapy The University of Queensland School of Health and Rehabilitation Sciences Faculty of Health Sciences Queensland 4072 Australia
| | - K McKenna
- Department of Occupational Therapy The University of Queensland School of Health and Rehabilitation Sciences Faculty of Health Sciences Queensland 4072 Australia
| | - T Hoffmann
- Department of Occupational Therapy The University of Queensland School of Health and Rehabilitation Sciences Faculty of Health Sciences Queensland 4072 Australia
| | - A McCluskey
- Department of Occupational Therapy The University of Queensland School of Health and Rehabilitation Sciences Faculty of Health Sciences Queensland 4072 Australia
| | - L Tooth
- Department of Occupational Therapy The University of Queensland School of Health and Rehabilitation Sciences Faculty of Health Sciences Queensland 4072 Australia
| | - J Strong
- Department of Occupational Therapy The University of Queensland School of Health and Rehabilitation Sciences Faculty of Health Sciences Queensland 4072 Australia
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Abstract
Over the past 30 years there has been increasing pressure for the establishment of a beef, quality grading system in Australia. During this time, many and varied options have been proposed and comparisons have often been made with the United States Department of Agriculture (USDA) and the Japanese Meat Grading Association (JMGA) systems. Australia has now developed a grading system that is driven by the consumer — Meat Standards Australia (MSA). Although some years (70+) behind the USDA, the Australian model has been scientifically proven to identify product that can achieve a guaranteed level of satisfaction to the consumer. While this paper evaluates the 3 systems and their specific operations, both the USDA and JMGA systems are compared with the potential performance of the MSA system applied on a cut by grade by cooking method basis.
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35
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Cherstniakova S, Garcia G, Strong J, Helbling N, Bi D, Roy M, Cantilena L. Simultaneous Determination of N,N-Diethyl-M-Toluamide and Permethrin by GC-MS and Pyridostigmine Bromide by HPLC in Human Plasma. Application to Pharmacokinetic Studies. Clin Pharmacol Ther 2003. [DOI: 10.1016/s0009-9236(03)90453-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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36
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37
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38
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Abstract
Absence of CD4 impairs the efficiency of T cell receptor (TCR) signaling in response to major histocompatibility complex (MHC) class II-presented peptides. Here we use mice carrying a conditional Cd4 allele to study the consequences of impaired TCR signaling after the completion of thymocyte development. We show that loss of CD4 decreases the steady-state proliferation of T cells as monitored by in vivo labeling with bromo-deoxyuridine. Moreover, T cells lacking CD4 compete poorly with CD4-expressing T cells during proliferative expansion after transfer into lymphopenic recipients. The data suggest that T cells compete with one another during homeostatic proliferation, and indicate that the basis of this competition is TCR signaling.
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Affiliation(s)
- Q Wang
- Department of Microbiology and Immunology, University of California at San Francisco, San Francisco, CA 94143-0414, USA
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39
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Janicak PG, Keck PE, Davis JM, Kasckow JW, Tugrul K, Dowd SM, Strong J, Sharma RP, Strakowski SM. A double-blind, randomized, prospective evaluation of the efficacy and safety of risperidone versus haloperidol in the treatment of schizoaffective disorder. J Clin Psychopharmacol 2001; 21:360-8. [PMID: 11476119 DOI: 10.1097/00004714-200108000-00002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The relative efficacy and safety of risperidone versus haloperidol in the treatment of schizoaffective disorder was studied. Sixty-two patients (29 depressed type; 33 bipolar type) entered a three-site, randomized, double-blind, 6-week trial of risperidone (up to 10 mg/day) or haloperidol (up to 20 mg/day). Trained raters assessed baseline, weekly, and end-of-study levels of psychopathology with the Positive and Negative Syndrome Scale (PANSS), the 24-item Hamilton Rating Scale for Depression (HAM-D-24) and the Clinician-Administered Rating Scale for Mania (CARS-M). The authors were unable to statistically distinguish between risperidone and haloperidol in the amelioration of psychotic and manic symptoms. In addition, there was no difference in worsening of mania between the two agents in either subgroup (i.e., depressed or bipolar subgroups). For the total PANSS, risperidone produced a mean decrease of 16 points from baseline compared with a 14-point decrease with haloperidol. For the total CARS-M scale, risperidone and haloperidol produced mean change scores of 5 and 8 points, respectively, and for the CARS-M Mania subscale, 3 and 7 points, respectively. Additionally, risperidone produced a mean decrease of 13 points from the baseline 24-item HAM-D, compared with an 8-point decrease with haloperidol. In those patients who had more severe depressive symptoms (i.e., HAM-D baseline score >20), risperidone produced at least a 50% mean improvement in 12 (75%) of 16 patients in comparison to 8 (38%) of 21 patients receiving haloperidol. Haloperidol produced significantly more extrapyramidal side effects and resulted in more dropouts caused by any side effect. There was no difference between risperidone and haloperidol in reducing both psychotic and manic symptoms in this group of patients with schizoaffective disorder. Risperidone did not demonstrate a propensity to precipitate mania and was better tolerated than haloperidol. In those subjects with higher baseline HAM-D scores (i.e., >20), risperidone produced a greater improvement in depressive symptoms than haloperidol.
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Affiliation(s)
- P G Janicak
- The Psychiatric Clinical Research Center and Department of Psychiatry, College of Medicine, University of Illinois at Chicago, 60612, USA.
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40
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Tooth L, McKenna K, Strong J, Ottenbacher K, Connell J, Cleary M. Rehabilitation outcomes for brain injured patients in Australia: functional status, length of stay and discharge destination. Brain Inj 2001; 15:613-31. [PMID: 11429090 DOI: 10.1080/02699050010013923] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This study describes the rehabilitation length of stay (LOS), discharge destination and discharge functional status of 149 patients admitted with traumatic brain injury (TBI) to an Australian hospital over a 5-year period. Hospital charts of patients admitted between 1993-1998 were reviewed. Average LOS over the 5-year time period was 61.8 days and only decreased nominally over this time. Longer LOS was predicted by lower admission motor FIM scores and presence of comorbidities. Mean admission and discharge motor FIM scores were 58 and 79, which represented a gain of 21 points. Higher discharge motor FIM scores were predicted by higher admission motor FIM scores and younger age. FIM gain was predicted by cognitive status and age. Most patients, 88%, were discharged back to the community, with 30% changing their living setting or situation. Changing living status was predicted by living alone and having poorer functional status on admission.
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Affiliation(s)
- L Tooth
- Department of Social and Preventive Medicine, University of Queensland, Brisbane, Australia.
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41
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Street A, Strong J, Karp S. Improving patient recruitment to multicentre clinical trials: the case for employing a data manager in a district general hospital-based oncology centre. Clin Oncol (R Coll Radiol) 2001; 13:38-43. [PMID: 11292134 DOI: 10.1053/clon.2001.9212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
One of the most frequently cited reasons for poor recruitment to multicentre randomized clinical trials is the additional workload placed on clinical staff. We report the effect on patient recruitment of employing a data manager to support clinical staff in an English district general hospital (DGH). In addition, we explore the effect data managers have on the quality of data collected, proxied by the number of queries arising with the trial organizers. We estimate that the cost of employing a data manager on a full-time basis is 502 per patient recruited but may amount to 326 if the appointment is part-time. Data quality is high when full responsibility lies with a data manager but falls when responsibility is shared. Whether the costs of employing a data manager to recruit patients from a DGH are worth incurring depends on the value placed on the speed at which multicentre trials can be completed, how important it is to broaden the research base beyond the traditional setting of teaching hospitals, and the amount of evaluative data required.
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Affiliation(s)
- A Street
- Centre for Health Economics, University of York, UK.
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Abstract
PURPOSE To investigate the incidence of adverse events during hemodialysis treatments as a function of calories and fluid intake. METHODS The study period was August 3-26, 1999. Hemodialysis visits were studied. Twenty-three patients receiving hemodialysis during the 2nd shift on Tuesday, Thursday, and Saturday were studied. A total of 166 hemodialysis patient visits were studied. Data collected included: amount of fluid and food consumed, blood pressure levels, and mannitol use during each hemodialysis treatment; and any symptoms that occurred either during or after the dialysis treatment (hypotension, nausea, vomiting, diarrhea, cramping, and access problems). RESULTS Using regression analysis, calories and fluids were strong predictors of both hypotension (P =.003) and mannitol use (P =.000), but not of cramping or access problems. Patients were 3 times more likely to have hypotension if taking any fluids (P =.011). Patients consuming >200 calories were 2 times as likely to have hypotension (P =.058). Patients were 5 times more likely to use mannitol if taking any fluids (P =.005). Mannitol use increased significantly (P =.001) with those patients consuming >200 calories. CONCLUSION Patients who ate more than 200 calories and consumed more than 200 mL of fluid during hemodialysis had an increased incident of hypotensive events and increased use of mannitol.
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Affiliation(s)
- J Strong
- Dialysis Center of Lincoln, Lincoln, NE 68510, USA
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43
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Fisher I, Strong J, Tyack Z. Development, reliability, and concurrent validity of the modified inventory of potential reconstructive needs. J Burn Care Rehabil 2001; 22:154-62. [PMID: 11302605 DOI: 10.1097/00004630-200103000-00013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Documentation of burn sequelae can be a difficult and time-consuming task. To date a reliable and systematic format for recording postburn trauma is lacking. The purpose of this research was two-fold: first, to develop a Modified Inventory of Potential Reconstructive Needs from the original Inventory of Potential Reconstructive Needs to allow methodical documentation of functional and cosmetic burn sequelae in all body surface areas of children with burns and, second, to establish interrater reliability and concurrent validity of the instrument, thus allowing its clinical application. Two raters scored the Modified Inventory of Potential Reconstructive Needs on 41 children with a range of burns types and severity. Excellent interrater reliability was demonstrated for both total (intraclass correlation coefficient = 0.996) and subsection inventory scores. Concurrent validity was also established with total scores showing strong positive correlations (0.73-0.76) with three indicators of burn severity. These findings provide initial support for the tool's clinical applicability, particularly in relation to rehabilitative planning and documentation.
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Affiliation(s)
- I Fisher
- Occupational Therapy Department, The University of Queensland and the Royal Children's Hospital, Brisbane, Australia
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44
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Abstract
Signal transduction in response to ligand recognition by T cell receptors regulates T cell fate within and beyond the thymus. Herein we examine the involvement of the CD4 molecule in the regulation of T helper cell survival. T helper cells that lack CD4 expression are prone to apoptosis and show diminished survival after adoptive transfer to irradiated recipients. The helper lineage in CD4(-/-) animals shows a higher than normal apparent rate of cell division and is also enriched for cells exhibiting a memory cell phenotype. Thus the data point to a necessary role for CD4 in the regulation of T helper cell survival and homeostasis.
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Affiliation(s)
- J Strong
- Department of Microbiology and Immunology, University of California, San Francisco, CA 94143-0414, USA
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45
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Randall DC, Strong J, Gibbons R. A longitudinal subspecialty experience for internal medicine residents. Mil Med 2001; 166:40-3. [PMID: 11197095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
OBJECTIVE Market and technology innovations have greatly changed the teaching and practice of medicine in the past 10 years. This report describes an innovation in the ambulatory education of internal medicine residents: a subspecialty continuity clinic. METHODS A subspecialty continuity clinic was developed to improve the training of internal medicine residents in caring for complex ambulatory patients. The clinic structure is discussed from the perspective of patients, residents, and subspecialists. Logistical challenges and solutions are described. RESULTS Two and one-half years into the program, feedback from residents and subspecialists has been positive. In-training examination scores are relatively higher in the involved specialties, and residents are managing illnesses they rarely saw in an outpatient setting before this program. CONCLUSION This experience suggests that a subspecialty continuity clinic is worthwhile and practical in educating primary care residents.
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Affiliation(s)
- D C Randall
- Department of Internal Medicine, Madigan Army Medical Center, Tacoma, WA, USA
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46
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Stuebe ET, Steward JQ, Chinwalla A, Cook LL, Cook M, Fronick B, Miller K, Mullen MK, O'Brien D, Panussis DA, Pohl C, Snider JE, Strong J, Williams D, Wilson RK, Tibbetts C, Mardis ER. Modification of a commercially available DNA sequencer to increase sample throughput. IEEE Eng Med Biol Mag 2000; 19:101-6. [PMID: 10738668 DOI: 10.1109/51.827413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- E T Stuebe
- Washington University School of Medicine's Genome Sequencing Center, St. Louis, MO, USA
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Peña-Rossi C, Zuckerman LA, Strong J, Kwan J, Ferris W, Chan S, Tarakhovsky A, Beyers AD, Killeen N. Negative regulation of CD4 lineage development and responses by CD5. J Immunol 1999; 163:6494-501. [PMID: 10586041] [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] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
CD5 deficiency results in a hyper-responsive phenotype to Ag receptor stimulation. Here we show that the development and responses of CD4 lineage T cells are regulated by the function of CD5. Thymocytes expressing the I-Ad-restricted DO11.10 TCR undergo abnormal selection without CD5. In H-2d mice, the absence of CD5 causes deletion of double-positive thymocytes, but allows for efficient selection of cells expressing high levels of the DO11.10 clonotype. By contrast, there is enhanced negative selection against the DO11.10 clonotype in the presence of I-Ab. T cell hybridomas and DO11.10 T cells are more responsive to TCR stimulation in the absence of CD5. Such hypersensitivity can be eliminated by expression of wild-type CD5, but not by a form of CD5 that lacks the cytoplasmic tail. Finally, CD5 deficiency partially suppresses the block of CD4 lineage development in CD4-deficient mice. Taken together, the data support a general role for CD5 as a negative regulator of Ag receptor signaling in the development and immune responses of CD4 lineage T cells.
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Affiliation(s)
- C Peña-Rossi
- Department of Microbiology and Immunology, University of California, San Francisco 94143, USA
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48
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Abstract
In recent years there has been a growing awareness amongst health professionals of the need to prepare undergraduate students more adequately for practice with clients who have pain. Occupational therapists have a central role in enabling such clients to have productive lives despite pain. In this study, an examination was made of the adequacy of preparation for pain practice in graduates from one Australian occupational therapy curriculum. Recent occupational therapy graduates from the University of Queensland, Australia, who responded to a postal survey, obtained an overall 53% correct response rate to a 69-item pain knowledge and attitudes questionnaire. Results indicated the need for further education in this area, especially in the areas of pharmacological management, and pain assessment and measurement. These results were comparable to those obtained from final year occupational therapy students at Dalhousie University in Halifax, Nova Scotia prior to undertaking an elective course about pain. Follow-up interviews with a number of new graduates supported the inclusion of an elective pain course in the undergraduate occupational therapy curriculum at the University of Queensland in Australia.
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Affiliation(s)
- J Strong
- Department of Occupational Therapy, University of Queensland, Brisbane, Australia.
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49
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Abstract
With pain a frequent precipitant in individuals seeking manual therapy, it is important for therapists to adequately assess pain. At one level, pain forms an important part of the diagnostic assessment. It is suggested that a simple, reliable and quantitative pain measure be used in patients who present with routine problems. At another level, when the therapist is presented with clients in whom pain does not make sense in terms of its pattern, distribution, history or features, it is advisable to go beyond a simple pain intensity measure.
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Affiliation(s)
- J Strong
- Department of Occupational Therapy, University of Queensland, Australia
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50
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Kitchen BJ, Moser A, Lowe E, Balis FM, Widemann B, Anderson L, Strong J, Blaney SM, Berg SL, O'Brien M, Adamson PC. Thioguanine administered as a continuous intravenous infusion to pediatric patients is metabolized to the novel metabolite 8-hydroxy-thioguanine. J Pharmacol Exp Ther 1999; 291:870-4. [PMID: 10525111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Thiopurine antimetabolites have been in clinical use for more than 40 years, yet the metabolism of thiopurines remains only partially understood. Data from our previous pediatric phase 1 trial of continuous i.v. infusion of thioguanine (CIVI-TG) suggested that TG was eliminated by saturable mechanism, with conversion of the drug to an unknown metabolite. In this study we have identified this metabolite as 8-hydroxy-thioguanine (8-OH-TG). The metabolite coeluted with the 8-OH-TG standard on HPLC and had an identical UV spectrum, with a lambda(max) of 350 nm. On mass spectroscopy, the positive ion, single quad scan of 8-OH-TG yielded a protonated molecular ion at 184 Da and contained diagnostic ions at m/z 167, 156, 142, and 125 Da. Incubation of TG in vitro with partially purified aldehyde oxidase resulted in 8-OH-TG formation. 8-OH-TG is the predominant circulating metabolite found in patients receiving CIVI-TG and is likely generated by the action of aldehyde oxidase.
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Affiliation(s)
- B J Kitchen
- Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland, USA
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