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Huisman K, Johnson SB, Walker GV. Paging Dr. Google: Characterizing Direct to Consumer Internet Advertisements from Oncology Treatment Centers. Int J Radiat Oncol Biol Phys 2023; 117:e631-e632. [PMID: 37785886 DOI: 10.1016/j.ijrobp.2023.06.2028] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients increasingly use internet searches to compare treatment options and decide on oncology treatment centers. The objective of this study is to examine the type of oncology treatment centers that were advertised on web-based searches. MATERIALS/METHODS A series of keyword searches were conducted using the Google search engine. Based on search trends, 3 of the top relevant search phrases were used ("best cancer doctor", "best cancer treatment", and "cancer treatment near me"). Modifiers were added to each search term to reflect the cancer categories with the highest prevalence: "breast", "prostate", and "lung". This yielded 12 search phrases that were used on a search hub that simulates Google searches from different geographic locations. The 30 most populous city locations were used. Of the four paid advertisements at the top of each search, the cancer treatment centers were categorized into centers that are National Cancer Institute-Designated (NCIs), Commission on Cancer (CoC) accredited, non-CoC accredited, and non-traditional treatment centers. Advertisements that weren't for cancer treatment centers were excluded. RESULTS Of the 360 searches and 817 subsequent cancer treatment center advertisements, 51.2% were for NCI, 12.2% were CoC accredited, 26.9% were non-CoC accredited, and 9.7% were non-traditional treatment centers. The search phrase that yielded the highest ratio of NCI results was "best cancer doctor" at 74.4% and the phrase that yielded the lowest was "prostate cancer treatment near me" at 37.1%. Of the known 71 NCI centers in the country, 42 (59.2%) did not have any advertisements. Of the 35 NCI centers located in one of the target cities, 12 (34.3%) did not have any advertisements. Notably, two specific NCI centers accounted for 49.5% of the NCI advertisements. Similarly, one specific non-traditional treatment center accounted for 48.1% of the non-traditional center advertisements. Regarding non-traditional treatment centers, there was geographic variation with Boston having 38.1% of searches yielding non-traditional treatment center advertisements as opposed to six cities having 0%. The ratio of non-traditional treatment center advertisements by region were as follows: Northeast with 13.6%, West with 12.6%, South with 7.7%, and Midwest with 5.0%. CONCLUSION These results indicate that most direct-to-consumer cancer advertisements come from CoC or NCI centers. Among advertisements coming from NCI centers, relatively few centers account for the majority of advertisements with most NCI centers having no advertising presence. Future research is needed to evaluate claims, costs, and the ethical considerations of direct-to-consumer marketing, where the potential for mischaracterizing the strength of the scientific evidence to vulnerable cancer populations requires more scrutiny.
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Affiliation(s)
- K Huisman
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ
| | - S B Johnson
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - G V Walker
- Banner MD Anderson Cancer Center, Gilbert, AZ
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Gravbrot N, Hutten R, Lloyd S, Suneja G, Johnson SB. Delay in Time to Oncologic Therapies for Patients with Positive COVID-19 Test. Int J Radiat Oncol Biol Phys 2023; 117:e586. [PMID: 37785775 DOI: 10.1016/j.ijrobp.2023.06.1930] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) For several cancers, delays between diagnosis and initiation of treatment has important clinical implications, often affecting trial eligibility, treatment intention, and oncologic outcomes. The coronavirus disease-19 (COVID-19) pandemic placed an extraordinary strain on the United States healthcare system, and its effect on oncologic patterns of care has yet to be established. We hypothesize that patients who received a new cancer diagnosis and subsequently tested positive for COVID-19 had delayed oncologic treatment compared to those who did not test positive for COVID-19. MATERIALS/METHODS The National Cancer Database (NCDB) was queried to identify patients who were diagnosed and treated for any of 10 common malignancies from 2019-2020. Included disease sites were head and neck, esophagus, rectum, anus, lung, breast, cervix, uterus, prostate, and primary brain. Those who tested positive for COVID-19 between time of diagnosis and first oncologic treatment (including surgery, radiation, or systemic therapy) were compared to those who did not test positive for COVID-19. COVID-19 positivity was assessed using a new variable in the NCDB, "SARSCOV2_POS," which captures whether patients received a positive COVID-19 test via reverse transcriptase-polymerase chain reaction testing in inpatient, outpatient, or emergency room settings in 2020. Duration in days from cancer diagnosis to time to first treatment (TTFT) was analyzed using two-sample t-tests, with significance level of p<0.05. RESULTS A total of 1,503,127 patients were identified for analysis. Of these, 7,340 (0.5%) tested positive for COVID-19 between diagnosis and start of treatment. Initial treatment was most commonly surgery (55.3%), followed by systemic therapy (17.4%) and radiation (12.7%). Overall, median TTFT was 55 days [interquartile range (IQR) 31-91] for the COVID-19 group versus 34 days (IQR 15-56) for the non-COVID-19 group (p <0.01). Subgroup analysis of the 10 individual sites of disease revealed statistically significant delays in each, with greatest absolute difference in median TTFT in prostate (31.5 days; 95.5 versus 64.0) and greatest relative difference in brain (>700%, 28.5 versus 4.0). CONCLUSION In the first year of the pandemic, patients who tested positive for COVID-19 between oncologic diagnosis and initial management experienced significant delays in initiation of cancer-directed therapy compared to those who did not test positive for COVID-19, with median increase in TTFT of 21 days. Additional follow-up is needed to evaluate the clinical impact of these delays, as well as change in patterns of care in later years of the pandemic.
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Affiliation(s)
- N Gravbrot
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - R Hutten
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - S Lloyd
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - G Suneja
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - S B Johnson
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
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Li K, Wang Y, Ge T, Larkin RP, Smart A, Johnson SB, Hao J. Risk Evaluation of Benzovindiflupyr Resistance of Verticillium dahliae Population in Maine. Plant Dis 2023; 107:834-839. [PMID: 35997670 DOI: 10.1094/pdis-06-22-1384-re] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Verticillium dahliae causes Verticillium wilt, resulting in significant losses to potato production. Benzovindiflupyr, a succinate dehydrogenase inhibitor, effectively controls V. dahliae. However, frequent applications of the chemical may expedite the development of fungicide resistance in the pathogen population. To evaluate the risk of benzovindiflupyr resistance, 38 V. dahliae strains were obtained from diseased potatoes in Maine. The sensitivity of the field population was determined based on effective concentration for 50% inhibition (EC50), which ranged from 0.07 to 11.28 μg ml-1 with a median of 1.08. Segregated clusters of EC50 values indicated that Maine V. dahliae populations have developed benzovindiflupyr resistance. By exposing conidia of V. dahliae to a high concentration of benzovindiflupyr, 18 benzovindiflupyr-resistant mutants were obtained. To examine their fitness, the mutants were continuously subculture-transferred for up to 10 generations. Mycelial growth, conidial production, competitiveness, pathogenicity, and cross resistance of the 10th generation mutants were examined. Results showed that 50% of the resistant mutants retained an adaptive level in mycelial growth, and 60% maintained conidial production similar to their parents. Pathogenicity did not change for any of the mutants. No cross resistance was detected between benzovindiflupyr and either azoxystrobin, boscalid, fluopyram, or pyrimethanil. Thus, the resistance risk in V. dahliae to benzovindiflupyr should be considered in Maine potato production.
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Affiliation(s)
- Kedi Li
- School of Food and Agriculture, University of Maine, Orono, ME 04469, U.S.A
| | - Yan Wang
- College of Plant Sciences, Jilin University, Changchun 130062, China
| | - Tongling Ge
- School of Food and Agriculture, University of Maine, Orono, ME 04469, U.S.A
| | - Robert P Larkin
- USDA-ARS, New England Plant, Soil, and Water Laboratory, University of Maine, Orono, ME 04469, U.S.A
| | - Alicyn Smart
- Cooperative Extension, University of Maine, Bangor, ME 04401, U.S.A
| | - Steven B Johnson
- Cooperative Extension, University of Maine, Presque Isle, ME 04769, U.S.A
| | - Jianjun Hao
- School of Food and Agriculture, University of Maine, Orono, ME 04469, U.S.A
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Zhang X, Ma X, Fan X, Ge T, Leiby RE, Swingle B, Johnson SB, Larkin R, Chim BK, Hao J. First Report of Pectobacterium brasiliense Causing Bacterial Blackleg and Soft Rot of Potato in Pennsylvania. Plant Dis 2023; 107:2512. [PMID: 36774584 DOI: 10.1094/pdis-09-22-2085-pdn] [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] [Indexed: 06/18/2023]
Abstract
Potato (Solanum tuberosum) plants showing blackleg and soft rot symptoms were collected at a commercial vegetable farm near Newmanstown, PA in August 2021 (Fig. S1). The incidence of potato blackleg in the unirrigated field was about 5 to 8%, but approximately 30% in the irrigated field. The diseased stems were cut into 5 cm and surface disinfected. The stem segments were placed into a 50-mL tube containing 15 mL of sterile water for 15 min for bacterial release. The bacterial suspension was streaked on crystal violet polypectate (CVP) (Hélias et al. 2012) plates and incubated at 28°C for 48 h. Three single colonies produced pits on CVP were picked and purified. Genomic DNA of all three isolates were extracted using the FastDNA Spin Kit (MP Biomedicals, Santa Ana, CA). Polymerase chain reaction (PCR) was performed using all three extracted DNAs as a template with the primer pairs gapA 7F/938R (Cigna et al. 2017), recA F/R (Waleron et al. 2001), dnaA F/R (Schneider et al. 2011) and dnaX F/R (Sławiak et al. 2009) targeting the gapA, recA, dnaA and dnaX genes, respectively. Isolate 21PA01 was further studied as a representative isolate. PCR amplicons derived from both forward and reverse primers were sequenced and analyzed using the BLAST algorithm against the NCBI database (https://www.ncbi.nlm.nih.gov). The regions of gapA (GenBank accession No. ON989738), recA (ON989739), dnaA (OP121183), and dnaX (OP121184) had 99.86%, 100%, 98.88%, and 100% identities with Pectobacterium brasiliense strains S1.16.01.3M (MN167062.1), BL-2 (MW721598.1), IPO:4132 (CP059956.1), and BL-2 (MW721603.1), respectively. A phylogenetic maximum-likelihood tree of the concatenated genes with the length of 2551 bp was constructed to visualize the relationship among different species of Dickeya and Pectobacterium. As a result, 21PA01 was in a single monophyletic cluster with other Pectobacterium brasiliense reference strains (Fig. S2 C). To confirm the pathogen, Koch's postulates were performed. Seed pieces of potato 'Lamoka' were planted in potting mix in one-gallon plastic pots in a greenhouse. Three weeks after emergence, the stems of three plants were each injected with 10 µL of bacteria suspension of either 21PA01 at 107 CFU/mL, P. parmentieri ME175 in tryptic soy broth (TSB) at 107 CFU/mL or TSB at 2 cm above the soil line. Seven days after inoculation, stems inoculated with 21PA01 and ME175 showed black and rotten symptoms, whereas the TSB-injected control plants remained symptomless. In addition, 'Lamoka' tubers were inoculated by placing 10 µL 21PA01 and ME175 suspensions at 107 CFU/mL, and TSB in a 1-cm-deep hole poked in a tuber separately and then sealed with petroleum gel, followed by incubation in a moist chamber at 22 °C for 4 d. The 21PA01 and ME175 inoculated tubers showed soft rot symptoms, but the TSB treatment had no symptoms. Bacterial colonies were isolated from the infected stems and confirmed by the DNA sequences as described above. PCR result was negative on control plant samples. Both stem and tuber inoculation trials were repeated two times, and the results were consistent. Thus, 21PA01 was identified as Pectobacterium brasiliense. To our knowledge, this is the first report of P. brasiliense infecting potatoes in Pennsylvania, USA, although it has been reported somewhere else (van der Merwe et al. 2010, Zhao et al. 2018). This could be a new species in Northeastern US.
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Affiliation(s)
- Xiuyan Zhang
- University of Maine System, 6251, Ecology and Environmental Sciences, Orono, Maine, United States
- Orono, United States;
| | - Xing Ma
- Cornell University, Plant Pathology and Plant-Microbe Biology, 304 Plant Science Building, Ithaca, New York, United States, 14853;
| | - Xiaowei Fan
- University of Maine System, 6251, Orono, Maine, United States;
| | - Tongling Ge
- University of Maine, School of Food and Agriculture, 5735 Hitchner Hall, Room 296, University of Maine, Orono, Maine, United States, 04469
- United States;
| | - Robert E Leiby
- Co-Operative Potato Growers, Harrisburg, Pennsylvania, United States;
| | - Bryan Swingle
- Cornell University, Plant Pathology, Ithaca, United States;
| | - Steven B Johnson
- University of Maine, Cooperative Extension, PO BOX 727, 57 Houlton ROad, Presque Isle, Maine, United States, 04769-0727;
| | - Robert Larkin
- USDA-ARS NEPSWL, 57687, NE Plant Soil Water Lab, University of Maine, Portage Rd, Orono, Maine, United States, 04469;
| | - Bee Khim Chim
- University of Maine at Presque Isle, 14700, Presque Isle, Maine, United States;
| | - Jianjun Hao
- University of Maine, Plant, Soil & Environmental Sciences, 5735 Hitchner Hall, Room 174, Orono, Maine, United States, 04473
- University of Maine;
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Johnson SB, Lucivero F, Zimmermann BM, Stendahl E, Samuel G, Phillips A, Hangel N. Ethical Reasoning During a Pandemic: Results of a Five Country European Study. AJOB Empir Bioeth 2022; 13:67-78. [PMID: 35262468 DOI: 10.1080/23294515.2022.2040645] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Introduction: There has been no work that identifies the hidden or implicit normative assumptions on which participants base their views during the COVID-19 pandemic, and their reasoning and how they reach moral or ethical judgements. Our analysis focused on participants' moral values, ethical reasoning and normative positions around the transmission of SARS-CoV-2.Methods: We analyzed data from 177 semi-structured interviews across five European countries (Germany, Ireland, Italy, Switzerland and the United Kingdom) conducted in April 2020.Results: Findings are structured in four themes: ethical contention in the context of normative uncertainty; patterns of ethical deliberation when contemplating restrictions and measures to reduce viral transmission; moral judgements regarding "good" and "bad" people; using existing structures of meaning for moral reasoning and ethical judgement.Discussion: Moral tools are an integral part of people's reaction to and experience of a pandemic. 'Moral preparedness' for the next phases of this pandemic and for future pandemics will require an understanding of the moral values and normative concepts citizens use in their own decision-making. Three important elements of this preparedness are: conceptual clarity over what responsibility or respect mean in practice; better understanding of collective mindsets and how to encourage them; and a situated, rather than universalist, approach to the development of normative standards.
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Affiliation(s)
- S B Johnson
- Ethox Centre and Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - F Lucivero
- Ethox Centre and Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - B M Zimmermann
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany
| | - E Stendahl
- University College Dublin, Dublin, Ireland
| | - G Samuel
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - A Phillips
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - N Hangel
- Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany
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Ge T, Jiang H, Tan EH, Johnson SB, Larkin RP, Charkowski AO, Secor G, Hao J. Pangenomic Analysis of Dickeya dianthicola Strains Related to the Outbreak of Blackleg and Soft Rot of Potato in the United States. Plant Dis 2021; 105:3946-3955. [PMID: 34213964 DOI: 10.1094/pdis-03-21-0587-re] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Dickeya dianthicola has caused an outbreak of blackleg and soft rot of potato in the eastern half of the United States since 2015. To investigate genetic diversity of the pathogen, a comparative analysis was conducted on genomes of D. dianthicola strains. Whole genomes of 16 strains from the United States outbreak were assembled and compared with 16 previously sequenced genomes of D. dianthicola isolated from potato or carnation. Among the 32 strains, eight distinct clades were distinguished based on phylogenomic analysis. The outbreak strains were grouped into three clades, with the majority of the strains in clade I. Clade I strains were unique and homogeneous, suggesting a recent incursion of this strain into potato production from alternative hosts or environmental sources. The pangenome of the 32 strains contained 6,693 genes, 3,377 of which were core genes. By screening primary protein subunits associated with virulence from all U.S. strains, we found that many virulence-related gene clusters, such as plant cell wall degrading enzyme genes, flagellar and chemotaxis related genes, two-component regulatory genes, and type I/II/III secretion system genes, were highly conserved but that type IV and type VI secretion system genes varied. The clade I strains encoded two clusters of type IV secretion systems, whereas the clade II and III strains encoded only one cluster. Clade I and II strains encoded one more VgrG/PAAR spike protein than did clade III. Thus, we predicted that the presence of additional virulence-related genes may have enabled the unique clade I strain to become predominant in the U.S. outbreak.
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Affiliation(s)
- Tongling Ge
- School of Food and Agriculture, University of Maine, Orono, ME 04469
| | - He Jiang
- School of Food and Agriculture, University of Maine, Orono, ME 04469
| | - Ek Han Tan
- School of Biology and Ecology, University of Maine, Orono, ME 04469
| | | | - Robert P Larkin
- USDA-ARS, New England Plant, Soil, and Water Laboratory, University of Maine, Orono, ME 04469
| | - Amy O Charkowski
- Department of Agricultural Biology, Colorado State University, Fort Collins, CO 80523
| | - Gary Secor
- Department of Plant Pathology, North Dakota State University, Fargo, ND58108
| | - Jianjun Hao
- School of Food and Agriculture, University of Maine, Orono, ME 04469
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Ge T, Jiang H, Johnson SB, Larkin RP, Charkowski AO, Secor G, Hao J. Genotyping Dickeya dianthicola Causing Potato Blackleg and Soft Rot Outbreak Associated With Inoculum Geography in the United States. Plant Dis 2021; 105:1976-1983. [PMID: 33210970 DOI: 10.1094/pdis-10-20-2138-re] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
An outbreak of blackleg and soft rot of potato, caused primarily by the bacterial pathogen Dickeya dianthicola, has resulted in significant economic losses in the northeastern United States since 2015. The spread of this seedborne disease is highly associated with seed distribution; therefore, the pathogen likely spread with seed tubers. To describe the blackleg epidemic and track inoculum origins, a total of 1,183 potato samples were collected from 11 states associated with blackleg outbreak from 2015 to 2019. Of these samples, 39.8% tested positive for D. dianthicola. Seventeen isolates of D. dianthicola were recovered from these samples and the genetic diversity of these isolates was examined. Fingerprinting with BOX-A1R-based repetitive extragenic palindromic PCR and phylogenetic analysis based on sequences of the 16S rRNA and gapA genes indicated that D. dianthicola isolates were divided into three genotypes, denoted types I, II, and III. Ninety-five percent of samples from Maine were type I. Type II was found in Maine only in 2015 and 2018. Type II was present throughout the 5 years in some states at a lower percentage than type I. Type III was found in Pennsylvania, New Jersey, and Massachusetts, but not in Maine. Therefore, type I appears to be associated with Maine, but type II appeared to be distributed throughout the northeastern United States. The type II and rarer type III strains were closer to the D. dianthicola type strain isolated from the United Kingdom. This work provides evidence that the outbreak of blackleg of potato in the northeastern United States was caused by multiple strains of D. dianthicola. The geographic origins of these strains remain unknown.
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Affiliation(s)
- Tongling Ge
- School of Food and Agriculture, University of Maine, Orono, ME
| | - He Jiang
- School of Food and Agriculture, University of Maine, Orono, ME
| | | | - Robert P Larkin
- New England Plant, Soil, and Water Laboratory, U.S. Department of Agriculture Agricultural Research Service, University of Maine, Orono, ME
| | - Amy O Charkowski
- Department of Agricultural Biology, Colorado State University, Fort Collins, CO
| | - Gary Secor
- Department of Plant Pathology, North Dakota State University, Fargo, ND
| | - Jianjun Hao
- School of Food and Agriculture, University of Maine, Orono, ME
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Rodriguez-Rodriguez M, Chikh-Ali M, Johnson SB, Gray SM, Malseed N, Crump N, Karasev AV. The Recombinant Potato virus Y (PVY) Strain, PVY NTN, Identified in Potato Fields in Victoria, Southeastern Australia. Plant Dis 2020; 104:3110-3114. [PMID: 33058718 DOI: 10.1094/pdis-05-20-0961-sc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Potato virus Y (PVY) is one of the main viruses affecting potato in Australia. However, molecular characterization of PVY isolates circulating in potato in different states of Australia has not yet been thoroughly conducted. Only nonrecombinant isolates of three biological PVY strains collected from potato were reported previously from Western Australia and one from Queensland. Here, PVY isolates collected from seed potato originating in Victoria, Australia, and printed on FTA cards, were subjected to strain typing by RT-PCR, with three isolates subjected to whole genome sequencing. All the 59 PVY isolates detected during two growing seasons were identified to be recombinants based on two RT-PCR assays. No nonrecombinant PVY isolates were identified. All the RT-PCR typed isolates belonged to the PVYNTN strain. Sequence analysis of the whole genomes of three isolates suggested a single introduction of the PVYNTN strain to Australia but provided no clues as to where this introduction originated. Given the association of the PVYNTN strain with potato tuber damage, growers in Australia should implement appropriate strategies to manage PVYNTN in potato.
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Affiliation(s)
| | - Mohamad Chikh-Ali
- University of Idaho, Department of EPPN, Moscow, ID 83844-2329, U.S.A
| | - Steven B Johnson
- University of Maine Cooperative Extension, Orono, ME 04469, U.S.A
| | - Stewart M Gray
- USDA-ARS and Section of Plant Pathology and Plant-Microbe Biology, School of Integrated Plant Science, Cornell University, Ithaca, NY 14853, U.S.A
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Smith-Uffen MES, Johnson SB, Martin AJ, Tattersall MHN, Stockler MR, Bell ML, Detering K, Clayton JM, Silvester W, Clarke S, Vaccaro L, Beale P, Kiely BE. Estimating survival in advanced cancer: a comparison of estimates made by oncologists and patients. Support Care Cancer 2020; 28:3399-3407. [PMID: 31781946 DOI: 10.1007/s00520-019-05158-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 08/09/2019] [Accepted: 10/29/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare estimates of expected survival time (EST) made by patients with advanced cancer and their oncologists. METHODS At enrolment patients recorded their "understanding of how long you may have to live" in best-case, most-likely, and worst-case scenarios. Oncologists estimated survival time for each of their patients as the "median survival of a group of identical patients". We hypothesized that oncologists' estimates of EST would be unbiased (~ 50% longer or shorter than the observed survival time [OST]), imprecise (< 33% within 0.67 to 1.33 times OST), associated with OST, and more accurate than patients' estimates of their own survival. RESULTS Twenty-six oncologists estimated EST for 179 patients. The median estimate of EST was 6.0 months, and the median OST was 6.2 months. Oncologists' estimates were unbiased (56% longer than OST), imprecise (27% within 0.67 to 1.33 times OST), and significantly associated with OST (HR 0.88, 95% CI 0.82 to 0.93, p < 0.01). Only 41 patients (23%) provided a numerical estimate of their survival with 107 patients (60%) responding "I don't know". The median estimate by patients for their most-likely scenario was 12 months. Patient estimates of their most-likely scenario were less precise (17% within 0.67 to 1.33 times OST) and more likely to overestimate survival (85% longer than OST) than oncologist estimates. CONCLUSION Oncologists' estimates were unbiased and significantly associated with survival. Most patients with advanced cancer did not know their EST or overestimated their survival time compared to their oncologist, highlighting the need for improved prognosis communication training. Trial registration ACTRN1261300128871.
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Affiliation(s)
- M E S Smith-Uffen
- Department of Cancer Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - S B Johnson
- Department of Cancer Medicine, University of Sydney, Sydney, New South Wales, Australia
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - A J Martin
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - M H N Tattersall
- Department of Cancer Medicine, University of Sydney, Sydney, New South Wales, Australia
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - M R Stockler
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
- Department of Medical Oncology, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - M L Bell
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - K Detering
- Advance Care Planning Department, Austin Hospital, Melbourne, Victoria, Australia
| | - J M Clayton
- HammondCare Palliative and Supportive Care Service, Greenwich Hospital, Sydney, New South Wales, Australia
- Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - W Silvester
- University of Melbourne, Melbourne, Victoria, Australia
| | - S Clarke
- Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
- Department of Medical Oncology, Royal North Shore Hospital Sydney, Sydney, New South Wales, Australia
| | - L Vaccaro
- Department of Cancer Medicine, University of Sydney, Sydney, New South Wales, Australia
- Pain Management Research Institute, The University of Sydney, Sydney, Australia
| | - P Beale
- Department of Cancer Medicine, University of Sydney, Sydney, New South Wales, Australia
- Department of Medical Oncology, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - B E Kiely
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
- Department of Medical Oncology, Concord Repatriation General Hospital, Concord, NSW, Australia.
- Department of Medical Oncology, Campbelltown Hospital, Campbelltown, New South Wales, Australia.
- NHMRC Clinical Trials Centre, Locked Bag 77, Camperdown, New South Wales, 1450, Australia.
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Ogle S, Hair CE, Beitchman JA, Tallent BR, Adelson DP, Lifshitz J, Thomas TC, Johnson SB. Synaptogenic Molecules Thrombospondin-1 and Brain Derived Neurotrophic Factor Rise in the Amygdala after Experimental Diffuse Traumatic Brain Injury. J Am Coll Surg 2017. [DOI: 10.1016/j.jamcollsurg.2017.07.1037] [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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Hansen ZR, Everts KL, Fry WE, Gevens AJ, Grünwald NJ, Gugino BK, Johnson DA, Johnson SB, Judelson HS, Knaus BJ, McGrath MT, Myers KL, Ristaino JB, Roberts PD, Secor GA, Smart CD. Genetic Variation within Clonal Lineages of Phytophthora infestans Revealed through Genotyping-By-Sequencing, and Implications for Late Blight Epidemiology. PLoS One 2016; 11:e0165690. [PMID: 27812174 PMCID: PMC5094694 DOI: 10.1371/journal.pone.0165690] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 10/17/2016] [Indexed: 01/24/2023] Open
Abstract
Genotyping-by-sequencing (GBS) was performed on 257 Phytophthora infestans isolates belonging to four clonal lineages to study within-lineage diversity. The four lineages used in the study were US-8 (n = 28), US-11 (n = 27), US-23 (n = 166), and US-24 (n = 36), with isolates originating from 23 of the United States and Ontario, Canada. The majority of isolates were collected between 2010 and 2014 (94%), with the remaining isolates collected from 1994 to 2009, and 2015. Between 3,774 and 5,070 single-nucleotide polymorphisms (SNPs) were identified within each lineage and were used to investigate relationships among individuals. K-means hierarchical clustering revealed three clusters within lineage US-23, with US-23 isolates clustering more by collection year than by geographic origin. K-means hierarchical clustering did not reveal significant clustering within the smaller US-8, US-11, and US-24 data sets. Neighbor-joining (NJ) trees were also constructed for each lineage. All four NJ trees revealed evidence for pathogen dispersal and overwintering within regions, as well as long-distance pathogen transport across regions. In the US-23 NJ tree, grouping by year was more prominent than grouping by region, which indicates the importance of long-distance pathogen transport as a source of initial late blight inoculum. Our results support previous studies that found significant genetic diversity within clonal lineages of P. infestans and show that GBS offers sufficiently high resolution to detect sub-structuring within clonal populations.
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Affiliation(s)
- Zachariah R. Hansen
- Plant Pathology and Plant-Microbe Biology Section, Cornell University, Geneva, NY, United States of America
| | - Kathryne L. Everts
- Department of Plant Science and Landscape Architecture, University of Maryland, Salisbury, MD, United States of America
| | - William E. Fry
- Plant Pathology and Plant-Microbe Biology Section, Cornell University, Ithaca, NY, United States of America
| | - Amanda J. Gevens
- Department of Plant Pathology, University of Wisconsin, Madison, WI, United States of America
| | - Niklaus J. Grünwald
- Horticultural Crops Research Laboratory, United States Department of Agriculture–Agricultural Research Service, Corvallis, OR, United States of America
| | - Beth K. Gugino
- Department of Plant Pathology and Environmental Microbiology, The Pennsylvania State University, University Park, PA, United States of America
| | - Dennis A. Johnson
- Department of Plant Pathology, Washington State University, Pullman, WA, United States of America
| | - Steven B. Johnson
- University of Maine Cooperative Extension, Presque Isle, ME, United States of America
| | - Howard S. Judelson
- Department of Plant Pathology and Microbiology, University of California Riverside, Riverside, CA, United States of America
| | - Brian J. Knaus
- Horticultural Crops Research Laboratory, United States Department of Agriculture–Agricultural Research Service, Corvallis, OR, United States of America
| | - Margaret T. McGrath
- Plant Pathology and Plant-Microbe Biology Section, Cornell University, Riverhead, NY, United States of America
| | - Kevin L. Myers
- Plant Pathology and Plant-Microbe Biology Section, Cornell University, Ithaca, NY, United States of America
| | - Jean B. Ristaino
- Department of Plant Pathology, North Carolina State University, Raleigh, NC, United States of America
| | - Pamela D. Roberts
- Department of Plant Pathology, University of Florida, Immokalee, FL, United States of America
| | - Gary A. Secor
- Department of Plant Pathology, North Dakota State University, Fargo, ND, United States of America
| | - Christine D. Smart
- Plant Pathology and Plant-Microbe Biology Section, Cornell University, Geneva, NY, United States of America
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Setter SM, Corbett CF, Sclar DA, Gates BJ, Johnson SB. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Research to Help Your Patients Use them Safely. Home Health Care Management & Practice 2016. [DOI: 10.1177/108482230101300609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective medications for the treatment of many chronically painful medical conditions. However, it is estimated that 25% of all serious adverse drug reactions involve NSAIDs, with more than 100,000 hospitalizations and 16,000 deaths occurring annually due to NSAID-induced gastrointestinal (GI) events. Advanced age; concurrent anticoagulant, aspirin, corticosteroid, or antacid use; and a history of cardiovascular disease, peptic ulcer disease, or GI hemorrhage all increase the risk of NSAID-induced gastropathy. Home care patients often have many of these characteristics. This article will provide evidence-based information about interventions that can reduce patients’ NSAID-induced gastropathy risk, including knowledge gained from a home care–specific study.
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Fry WE, Birch PRJ, Judelson HS, Grünwald NJ, Danies G, Everts KL, Gevens AJ, Gugino BK, Johnson DA, Johnson SB, McGrath MT, Myers KL, Ristaino JB, Roberts PD, Secor G, Smart CD. Five Reasons to Consider Phytophthora infestans a Reemerging Pathogen. Phytopathology 2015; 105:966-81. [PMID: 25760519 DOI: 10.1094/phyto-01-15-0005-fi] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Phytophthora infestans has been a named pathogen for well over 150 years and yet it continues to "emerge", with thousands of articles published each year on it and the late blight disease that it causes. This review explores five attributes of this oomycete pathogen that maintain this constant attention. First, the historical tragedy associated with this disease (Irish potato famine) causes many people to be fascinated with the pathogen. Current technology now enables investigators to answer some questions of historical significance. Second, the devastation caused by the pathogen continues to appear in surprising new locations or with surprising new intensity. Third, populations of P. infestans worldwide are in flux, with changes that have major implications to disease management. Fourth, the genomics revolution has enabled investigators to make tremendous progress in terms of understanding the molecular biology (especially the pathogenicity) of P. infestans. Fifth, there remain many compelling unanswered questions.
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Affiliation(s)
- W E Fry
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - P R J Birch
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - H S Judelson
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - N J Grünwald
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - G Danies
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - K L Everts
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - A J Gevens
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - B K Gugino
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - D A Johnson
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - S B Johnson
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - M T McGrath
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - K L Myers
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - J B Ristaino
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - P D Roberts
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - G Secor
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - C D Smart
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
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Rettmann ME, Holmes DR, Johnson SB, Lehmann HI, Robb RA, Packer DL. Analysis of Left Atrial Respiratory and Cardiac Motion for Cardiac Ablation Therapy. Proc SPIE Int Soc Opt Eng 2015; 9415. [PMID: 26405370 DOI: 10.1117/12.2081209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Cardiac ablation therapy is often guided by models built from preoperative computed tomography (CT) or magnetic resonance imaging (MRI) scans. One of the challenges in guiding a procedure from a preoperative model is properly synching the preoperative models with cardiac and respiratory motion through computational motion models. In this paper, we describe a methodology for evaluating cardiac and respiratory motion in the left atrium and pulmonary veins of a beating canine heart. Cardiac catheters were used to place metal clips within and near the pulmonary veins and left atrial appendage under fluoroscopic and ultrasound guidance and a contrast-enhanced, 64-slice multidetector CT scan was collected with the clips in place. Each clip was segmented from the CT scan at each of the five phases of the cardiac cycle at both end-inspiration and end-expiration. The centroid of each segmented clip was computed and used to evaluate both cardiac and respiratory motion of the left atrium. A total of three canine studies were completed, with 4 clips analyzed in the first study, 5 clips in the second study, and 2 clips in the third study. Mean respiratory displacement was 0.2±1.8 mm in the medial/lateral direction, 4.7±4.4 mm in the anterior/posterior direction (moving anterior on inspiration), and 9.0±5.0 mm superior/inferior (moving inferior with inspiration). At end inspiration, the mean left atrial cardiac motion at the clip locations was 1.5±1.3 mm in the medial/lateral direction, and 2.1±2.0 mm in the anterior/posterior and 1.3±1.2 mm superior/inferior directions. At end expiration, the mean left atrial cardiac motion at the clip locations was 2.0±1.5 mm in the medial/lateral direction, 3.0±1.8 mm in the anterior/posterior direction, and 1.5±1.5 mm in the superior/inferior directions.
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Affiliation(s)
- M E Rettmann
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - D R Holmes
- Biomedical Imaging Resource, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - S B Johnson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - H I Lehmann
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - R A Robb
- Biomedical Imaging Resource, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - D L Packer
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, 55905, USA
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Skubic J, Johnson SB, Salvino C. Do speed cameras reduce collisions? Ann Adv Automot Med 2014; 57:365-8. [PMID: 24406979 PMCID: PMC3861844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We investigated the effects of speed cameras along a 26 mile segment in metropolitan Phoenix, Arizona. Motor vehicle collisions were retrospectively identified according to three time periods - before cameras were placed, while cameras were in place and after cameras were removed. A 14 mile segment in the same area without cameras was used for control purposes. Five cofounding variables were eliminated. In this study, the placement or removal of interstate highway speed cameras did not independently affect the incidence of motor vehicle collisions.
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Affiliation(s)
- Jeffrey Skubic
- Department of Trauma, Banner Good Samaritan Medical Center, Phoenix, Arizona, USA
| | - Steven B. Johnson
- Department of Trauma, Banner Good Samaritan Medical Center, Phoenix, Arizona, USA
| | - Chris Salvino
- Department of Trauma, Banner Good Samaritan Medical Center, Phoenix, Arizona, USA
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16
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Benzon CR, Johnson SB, McCue DL, Li D, Green TA, Hommel JD. Neuromedin U receptor 2 knockdown in the paraventricular nucleus modifies behavioral responses to obesogenic high-fat food and leads to increased body weight. Neuroscience 2013; 258:270-9. [PMID: 24269937 DOI: 10.1016/j.neuroscience.2013.11.023] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 10/25/2013] [Accepted: 11/11/2013] [Indexed: 11/29/2022]
Abstract
Neuromedin U (NMU) is a highly conserved neuropeptide which regulates food intake and body weight. Transgenic mice lacking NMU are hyperphagic and obese, making NMU a novel target for understanding and treating obesity. Neuromedin U receptor 2 (NMUR2) is a high-affinity receptor for NMU found in discrete regions of the central nervous system, in particular the paraventricular nucleus of the hypothalamus (PVN), where it may be responsible for mediating the anorectic effects of NMU. We hypothesized that selective knock down of NMUR2 in the PVN of rats would increase their sensitivity to the reinforcing properties of food resulting in increased intake and preference for high-fat obesogenic food. To this end, we used viral-mediated RNAi to selectively knock down NMUR2 gene expression in the PVN. In rats fed a standard chow, NMUR2 knockdown produced no significant effect on food intake or body weight. However, when the same rats were fed a high-fat diet (45% fat), they consumed significantly more food, gained more body weight, and had increased feed efficiency relative to controls. Furthermore, NMUR2 knockdown rats demonstrated significantly greater binge-type food consumption of the high-fat diet and showed a greater preference for higher-fat food. These results demonstrate that NMUR2 signaling in the PVN regulates consumption and preference for high-fat foods without disrupting feeding behavior associated with non-obesogenic standard chow.
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Affiliation(s)
- C R Benzon
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States
| | - S B Johnson
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States
| | - D L McCue
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States
| | - D Li
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States
| | - T A Green
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States
| | - J D Hommel
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States.
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17
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Fry WE, McGrath MT, Seaman A, Zitter TA, McLeod A, Danies G, Small IM, Myers K, Everts K, Gevens AJ, Gugino BK, Johnson SB, Judelson H, Ristaino J, Roberts P, Secor G, Seebold K, Snover-Clift K, Wyenandt A, Grünwald NJ, Smart CD. The 2009 Late Blight Pandemic in the Eastern United States - Causes and Results. Plant Dis 2013; 97:296-306. [PMID: 30722376 DOI: 10.1094/pdis-08-12-0791-fe] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The tomato late blight pandemic of 2009 made late blight into a household term in much of the eastern United States. Many home gardeners and many organic producers lost most if not all of their tomato crop, and their experiences were reported in the mainstream press. Some CSAs (Community Supported Agriculture) could not provide tomatoes to their members. In response, many questions emerged: How did it happen? What was unusual about this event compared to previous late blight epidemics? What is the current situation in 2012 and what can be done? It's easiest to answer these questions, and to understand the recent epidemics of late blight, if one knows a bit of the history of the disease and the biology of the causal agent, Phytophthora infestans.
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Affiliation(s)
- W E Fry
- Cornell University, Ithaca, NY
| | | | | | | | - A McLeod
- University of Stellenbosch, Stellenbosch, South Africa
| | | | | | - K Myers
- Cornell University, Ithaca, NY
| | - K Everts
- University of Maryland, Salisbury
| | | | - B K Gugino
- The Pennsylvania State University, University Park
| | - S B Johnson
- University of Maine Cooperative Extension, Presque Isle
| | | | - J Ristaino
- North Carolina State University, Raleigh
| | | | - G Secor
- North Dakota State University, Fargo
| | | | | | - A Wyenandt
- Rutgers Agricultural Research and Extension Center, Bridgeton, NJ
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Abstract
Intensive insulin therapy can reduce mortality. Hypoglycemia related to intensive therapy may worsen outcomes. This study compared risk adjusted mortality for different glycemic states. A retrospective review of patients admitted to a surgical intensive care unit over 4 years was performed. Patients were divided into glycemic groups: HYPER (≥1 episode > 180 mg/dL, any <60), HYPO (≥1 episode < 60 mg/dL, any >180), BOTH (≥1 episode < 60 and ≥1 episode > 180 mg/dL), NORMO (all episodes 60-180 mg/dL), HYPER-Only (≥1 episode > 180, none <60 mg/dL), and HYPO-Only (≥1 episode < 60, none >180 mg/dL). Observed to expected Acute Physiology and Chronic Health Evaluation (APACHE) III mortality ratios (O/E) were studied. Number of adverse glycemic events was compared with mortality. Hypoglycemia and hyperglycemia occurred in 18 per cent and 50 per cent of patients. Mortality was 12.4 per cent (O/E = 0.88). BOTH had the highest O/E ratio (1.43) with HYPO the second highest (1.30). Groups excluding hypoglycemia (NORMO and HYPER-only) had the lowest O/E ratios: 0.56 and 0.88. Increasing number of hypoglycemic events were associated with increasing O/E ratio: 0.69 O/E for no events, 1.19 for 1-3 events, 1.35 for 4-6 events, 1.9 for 7-9 events, and 3.13 for ≥ 10 events. Ten or more hyperglycemic events were needed to significantly associate with worse mortality (O/E 1.53). Hyper- and hypoglycemia increase mortality compared with APACHE III expected mortality, with highest mortality risk if both are present. Hypoglycemia is associated with worse risk. Glucose control may need to be loosened to prevent hypoglycemia and reduce glucose variability.
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Affiliation(s)
- Albert Chi
- R. Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland 21201, USA
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Lissauer ME, Naranjo LS, Kirchoffner J, Scalea TM, Johnson SB. Patient Characteristics Associated with End-of-Life Decision Making in Critically Ill Surgical Patients. J Am Coll Surg 2011; 213:766-70. [DOI: 10.1016/j.jamcollsurg.2011.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 09/02/2011] [Accepted: 09/02/2011] [Indexed: 11/25/2022]
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Abstract
A 20-year-old male was involved in a motor vehicle accident and computed tomography revealed a completely transected right mainstem bronchus. An Emergency Department (ED) right anterior thoracotomy was necessary soon after arrival at our institution secondary to acute desaturation that was unresponsive to ventilator and chest tube management. This allowed direct intubation and ventilation of the right middle and lower lobes directly through the thoracotomy incision, which stabilized the patient for transport to the operating room. Once there, percutaneous cardiopulmonary support (CPS) was initiated to allow primary surgical repair of the transected bronchus. Post surgery, the patient was transported to the surgical intensive care unit on CPS which he required for an additional two days. The patient eventually did well and was discharged home. To our knowledge this is the first successful reported case of using the Avalon Elite dual lumen veno-venous cannula for CPS in a patient with complete right main-stem bronchus transection and bilateral pulmonary contusions.
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Affiliation(s)
- JL Walker
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - J Wiersch
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - C Benson
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - HA Young
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - DT Dearmond
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - SB Johnson
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Abstract
INTRODUCTION Hyperglycemia is a frequent sequela of critical illness. Rosiglitazone is an oral hypoglycemic agent of the thiazolinedione class. Thiazolinediones are known to activate peroxisome proliferator-activated receptor gamma (PPAR-gamma) that decreases inflammation in humans and decreases shock induced by zymosan in mice. HYPOTHESIS Rosiglitazone can assist with hyperglycemic control in the intensive care unit (ICU). METHODS A hospital billing query identified patients prescribed rosiglitazone while in a major university ICU. Patients who received rosiglitazone as an outpatient prior to hospitalization were excluded. Glycemic control was determined by average daily blood glucose, 24-hour insulin dose, and number of patients requiring an insulin drip. Glycemic control was evaluated on days 0, 3, and 7. Student t test was used to compare means. Fisher exact testing was used to compare insulin regimen before and after starting rosiglitazone. RESULTS 34 patients were identified. The average Acute Physiology and Chronic Health Evaluation (APACHE) II score was 17.2 +/- 4.4. Sixty-five percent were male, 62% were preexisting diabetics. The mean daily blood glucose was 159 +/- 30 mg/dL on day 0, 146 +/- 37 mg/dL on day 3, and 140 +/- 33 mg/dL on day 7 (P < .03 vs day 0). The mean 24-hour insulin dose was 80.6 +/- 87.9 U on day 0, 72.2 +/- 73.4 U on day 3, and 46.3 +/- 57.2 U on day 7 (P < .003 vs day 0). There was 1 major hypoglycemic event. CONCLUSION Rosiglitazone may assist glycemic control in the ICU. Despite recent concerns of cardiac safety, further research should be done to evaluate its potential as a short-term therapeutic agent in the ICU, given its anti-inflammatory and antishock profile.
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Affiliation(s)
- Matthew Lissauer
- Department of Surgical Critical Care, University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.
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Lissauer ME, Smitz-Naranjo L, Johnson SB. Gender influences end-of-life decisions. Crit Care 2011. [PMCID: PMC3068451 DOI: 10.1186/cc9942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Johnson SB, Warén A, Lee RW, Kano Y, Kaim A, Davis A, Strong EE, Vrijenhoek RC. Rubyspira, new genus and two new species of bone-eating deep-sea snails with ancient habits. Biol Bull 2010; 219:166-177. [PMID: 20972261 DOI: 10.1086/bblv219n2p166] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Rubyspira, a new genus of deep-sea snails (Gastropoda: Abyssochrysoidea) with two living species, derives its nutrition from decomposing whalebones. Molecular phylogenetic and morphological evidence places the new genus in an exclusively deep-sea assemblage that includes several close relatives previously known as fossils associated with Cretaceous cold seeps, plesiosaur bones, and Eocene whalebones. The ability to exploit a variety of marine reducing environments may have contributed to the evolutionary longevity of this gastropod lineage.
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Affiliation(s)
- S B Johnson
- Monterey Bay Aquarium Research Institute, Moss Landing, California 95039, USA.
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24
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Lissauer M, Johnson SB. Reply. Shock 2010; 33:225; author reply 225-6. [DOI: 10.1097/shk.0b013e3181b0ff8d] [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: 11/25/2022]
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Sonna LA, Hawkins L, Lissauer ME, Maldeis P, Towns M, Johnson SB, Moore R, Singh IS, Cowan MJ, Hasday JD. Core temperature correlates with expression of selected stress and immunomodulatory genes in febrile patients with sepsis and noninfectious SIRS. Cell Stress Chaperones 2010; 15:55-66. [PMID: 19496026 PMCID: PMC2866972 DOI: 10.1007/s12192-009-0121-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 04/29/2009] [Accepted: 05/01/2009] [Indexed: 12/25/2022] Open
Abstract
Environmental hyperthermia and exercise produce extensive changes in gene expression in human blood cells, but it is unknown whether this also happens during febrile-range hyperthermia. We tested the hypothesis that heat shock protein (HSP) and immunomodulatory stress gene expression correlate with fever in intensive care unit patients. Whole blood messenger RNA was obtained over consecutive days from 100 hospitalized patients suffering from sepsis or noninfectious systemic inflammatory response syndrome (SIRS) as defined by conventional criteria. The most abnormal body temperature in the preceding 24 h was recorded for each sample. Expression analysis was performed using the Affymetrix U133 chip. ANCOVA followed by correlation analysis was performed on a subset of 278 prospectively identified sequences of interest. Temperature affected expression of 60 sequences, either independently or as a function of clinical diagnosis. Forty-eight of these (representing 38 genes) were affected by temperature only, including several HSPs, transcription factors heat shock factor (HSF)-1 and HSF-4, cellular adhesion molecules such as ICAM1/CD54 and JAM3, toll receptors TLR-6 and TLR-7, ribosomal proteins, and a number of molecules involved in inflammatory pathways. Twelve sequences demonstrated temperature-dependent responses that differed significantly between patients with sepsis and noninfectious SIRS: CXCL-13; heat shock proteins DNAJB12 and DNAJC4; the F11 receptor; folate hydrolase 1; HSF-2; HSP 70 proteins HSPA1A, HSPA1B, and HSPA1L; interleukin 8; lipopolysaccharide binding protein; and prostaglandin E synthase. Febrile-range temperatures achieved during sepsis and noninfectious SIRS correlate with detectable changes in stress gene expression in vivo, suggesting that fever can activate HSP gene expression and modify innate immune responses. For some genes, it appears that clinical condition can alter temperature-sensitive gene expression. Collectively, these data underscore the potential importance of body temperature in shaping the immune response to infection and injury.
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Affiliation(s)
- Larry A Sonna
- University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Suding PN, Orrico RP, Johnson SB, Wilson SE. Concordance of interrater assessments of surgical methods to achieve source control of intra-abdominal infections. Am J Surg 2008; 196:70-3. [PMID: 18436178 DOI: 10.1016/j.amjsurg.2007.06.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Revised: 06/04/2007] [Accepted: 06/04/2007] [Indexed: 10/22/2022]
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Scalea TM, Bochicchio GV, Bochicchio KM, Johnson SB, Joshi M, Pyle A. Tight Glycemic Control in Trauma Patients. Ann Surg 2008. [DOI: 10.1097/sla.0b013e31816ffb5a] [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: 11/25/2022]
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Rouse GW, Worsaae K, Johnson SB, Jones WJ, Vrijenhoek RC. Acquisition of dwarf male "harems" by recently settled females of Osedax roseus n. sp. (Siboglinidae; Annelida). Biol Bull 2008; 214:67-82. [PMID: 18258777 DOI: 10.2307/25066661] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
After the deployment of several whale carcasses in Monterey Bay, California, a time-series analysis revealed the presence of a new species of Osedax, a genus of bone-eating siboglinid annelids. That species is described here as Osedax roseus n. sp. It is the fifth species described since the erection of this genus and, like its congeners, uses a ramifying network of "roots" to house symbiotic bacteria. In less than 2 months, Osedax roseus n. sp. colonized the exposed bones of a whale carcass deposited at 1018-m depth, and many of the females were fecund in about 3 months post-deployment. As with other Osedax spp., the females have dwarf males in their tube lumens. The males accrue over time until the sex ratio is markedly male-biased. This pattern of initial female settlement followed by gradual male accumulation is consistent with the hypothesis that male sex may be environmentally determined in Osedax. Of the previously described species in this genus, Osedax roseus n. sp. is most similar to O. rubiplumus, but it has several anatomical differences, as well as much smaller females, dwarf males, and eggs. Osedax roseus n. sp. is markedly divergent (minimally 16.6%) for mitochondrial cytochrome oxidase subunit I (mtCOI) sequences from any other Osedax species.
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Affiliation(s)
- G W Rouse
- Scripps Institution of Oceanography, 9500 Gilman Drive, La Jolla, California 92093-0202, USA.
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Roth R, Johnson SB, Lernmark B, Simell T, Baxter J, Mcleod W. Psychosozialer Stress: Negative Life Events in der TEDDY (The Environmental Determinants of Diabetes in the Young) Studie. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076157] [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: 10/21/2022]
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Abstract
OBJECTIVES Evaluate the impact of a tight glucose control (TGC) protocol during the first week of admission in critically injured trauma patients. METHODS A prospective quasi-experimental interrupted time-series design was used to evaluate the impact of TGC [24-month preintervention phase (no TGC) vs. 24-month postintervention phase]. Patients were stratified by serum glucose level on day 1 to 7 (low, 0-150 mg/dL; medium-high, 151-219 mg/dL; and high, >/=220 mg/dL), age, gender, and injury severity. Patients were further stratified by pattern of glucose control (all low, all medium high, all high, improving, worsening, highly variable). Outcome was measured by ventilator days, infection, hospital (HLOS) and ICU (ILOS) length of stay, and mortality. RESULTS One thousand twenty-one patients were evaluated in the preintervention phase as compared with 1108 patients in the postintervention phase. There was no significant difference in mechanism of injury (83% vs. 84% blunt), gender (74% vs. 73% male), age (44 vs. 43 years), and Injury Severity Score (ISS) (26 vs. 25). The TGC group was more likely to be in the all low and improving pattern of glucose control (P<0.001). The incidence of infection significantly decreased (over the first 2 weeks) from 29% to 21% in the TGC group (P<0.001). Ventilator days (OR=3.9, 1.8, 8.1), ILOS (OR=4.3, 2.1, 7.5), and HLOS (OR=5.5, 2.2, 11) and mortality (OR=1.4, 1.1, 10) were significantly higher in the non-TGC group when controlled for age, ISS, obesity, and diabetes (P<0.01). CONCLUSION The positive outcomes associated with the implementation of a TGC protocol necessitates further evaluation in a randomized prospective trial.
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Affiliation(s)
- Thomas M Scalea
- R Adams Cowley Shock Trauma Center, Division of Clinical and Outcomes Research, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Lissauer ME, Johnson SB, Siuzdak G, Bochicchio G, Whiteford C, Nussbaumer B, Moore R, Scalea TM. Coagulation and complement protein differences between septic and uninfected systemic inflammatory response syndrome patients. ACTA ACUST UNITED AC 2007; 62:1082-92; discussion 1092-4. [PMID: 17495706 DOI: 10.1097/ta.0b013e31804d23e1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [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: 01/03/2023]
Abstract
BACKGROUND Systemic inflammatory response syndrome (SIRS) represents a host response to various insults. Recent advances have demonstrated an interconnection between inflammation, complement, and coagulation. This experiment was designed to evaluate differences in plasma protein profiles between clinically identical patients: septic versus uninfected SIRS patients, prior to clinical diagnosis of infection. METHODS Patients admitted to an intensive care unit of a major university, meeting two of four SIRS criteria were followed prospectively for development of sepsis. Plasma samples were collected daily and divided into two groups: a preseptic group that subsequently developed sepsis and a SIRS group that remained uninfected. Protein profiling was accomplished by three-dimensional liquid chromatography fractionation with electrospray ion trap mass spectrometry after immunodepletion of abundant proteins and a trypsin digest. Spectra peaks were identified using Agilent Technologies Spectrum Mill Workbench software. Relevance to biologic pathways was analyzed and statistical significance determined with DAVID 2.1 available at the National Institutes of Health. RESULTS A total of 134 unique proteins were significantly different between groups. Thirty-two of these (23.5%) mapped to the complement and coagulation cascade (KEGG), 10 (7.5%) mapped to classic complement pathway; 11 (8.2%) mapped to complement pathway, and 8 (6.0%) mapped to lectin binding complement pathway (Biocarta). These pathways were all significantly (p<0.0001) over-represented in sepsis patients compared to SIRS-only patients. CONCLUSION Using novel mass spectrometry methodology, we were able to demonstrate differential protein profiles in septic versus uninfected SIRS patients prior to clinical diagnosis of sepsis.
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Affiliation(s)
- Matthew E Lissauer
- R. Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore 21201, USA.
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Abstract
INTRODUCTION The systemic inflammatory response syndrome (SIRS) occurs frequently in critically ill patients and presents similar clinical appearances despite diverse infectious and noninfectious etiologies. Despite similar phenotypic expression, these diverse SIRS etiologies may induce divergent genotypic expressions. We hypothesized that gene expression differences are present between sepsis and uninfected SIRS prior to the clinical appearance of sepsis. METHODS Critically ill uninfected SIRS patients were followed longitudinally for the development of sepsis. All patients had whole blood collected daily for gene expression analysis by Affymetrix Hg_U133 2.0 Plus microarrays. SIRS patients developing sepsis were compared with those remaining uninfected for differences in gene expression at study entry and daily for 3 days prior to conversion to sepsis. Acceptance criteria for differentially expressed genes required: >1.2 median fold change between groups and significance on univariate and multivariate analysis. Differentially expressed genes were annotated to pathways using DAVID 2.0/EASE analysis. RESULTS A total of 12,782 (23.4%) gene probes were differentially expressed on univariate analysis 0 to 48 hours before clinical sepsis. 626 (1.1%) probes met acceptance criteria, corresponding to 459 unique genes, 65 (14.2%) down and 395 (85.8%) up expressed. These genes annotated to 10 pathways that functionally categorized to 4 themes involving innate immunity, cytokine receptors, T cell differentiation, and protein synthesis regulation. CONCLUSIONS Sepsis has a unique gene expression profile that is different from uninfected inflammation and becomes apparent prior to expression of the clinical sepsis phenotype.
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Affiliation(s)
- Steven B Johnson
- R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Affiliation(s)
- James Haan
- R. Adams Cowley Shock Trauma Center, University of Maryland, MD 21201-1595, USA.
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Roth R, Johnson SB, Lernmark B, Baxter J, Simell T, McLeod W. Risiko für Typ1 Diabetes (T1D): Angst der Eltern als Reaktion auf das genetische Screening von Neugeborenen in der TEDDY (The Environmental Determinants of Diabetes in the Young)-Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982291] [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: 10/21/2022]
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Matsuoka N, Patki A, Tiwari HK, Allison DB, Johnson SB, Gregersen PK, Leibel RL, Chung WK. Association of K121Q polymorphism in ENPP1 (PC-1) with BMI in Caucasian and African-American adults. Int J Obes (Lond) 2006; 30:233-7. [PMID: 16231022 DOI: 10.1038/sj.ijo.0803132] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To test for association of the ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) K121Q polymorphism with body mass index (BMI) and diabetes in a large sample of Caucasians and African-Americans by selectively genotyping individuals at the extremes of the phenotypic distribution. SUBJECTS Subsets comprising the extremes of the BMI distribution (10th-20th and above the 90th BMI percentile for Caucasians and between the 10th-30th and above the 80th percentile for African-Americans) from a group of 10,260 Caucasian and 2268 African-American adults participating in New York Cancer Project were studied. METHODS Subjects were genotyped for the ENPP1 K121Q polymorphism by pyrosequencing and tested for association with BMI and diabetes by regression analysis. RESULTS Regression analysis with BMI as the dependent variable demonstrated a significant association (P = 0.02) of genotype at K121Q with BMI, with no significant race-by-genotype interaction (P = 0.30). Compared with Q/Q or Q/K individuals, the K/K individuals had a BMI approximately 1.3 kg/m2 higher, without effects of age, gender or race. By logistic regression analysis, the K121Q alleles had no significant effect on diabetes status (P = 0.37) in obese subjects. CONCLUSION In both Caucasians and African-Americans, the K121 polymorphism in ENPP1 was associated with increased BMI, but not with diabetes.
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Affiliation(s)
- N Matsuoka
- Division of Molecular Genetics, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
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Bochicchio GV, Smit PA, Moore R, Bochicchio K, Auwaerter P, Johnson SB, Scalea T, Bartlett JG. Pilot study of a web-based antibiotic decision management guide. J Am Coll Surg 2006; 202:459-67. [PMID: 16500251 DOI: 10.1016/j.jamcollsurg.2005.11.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2005] [Revised: 11/04/2005] [Accepted: 11/09/2005] [Indexed: 12/18/2022]
Abstract
BACKGROUND Use of electronic medical information resources by health-care professionals is increasing. Portable handheld computers have facilitated access to medical knowledge at the point of patient care. Little is known about the impact of mobile medical information tools on physician learning or improvement in decision-making. STUDY DESIGN A 6-month prospective, randomized pilot study of 12 first-year trauma and critical care Fellows at the R Adams Cowley Shock Trauma Center was conducted from November 1, 2001 to May 31, 2002 at the University of Maryland. Six Fellows were randomized to use the Johns Hopkins Antibiotic Guide (JHABX) on the RIM Blackberry personal digital assistant (PDA) for 6 months of their clinical rotation. Six Fellows were randomized to the non-PDA-use arm. Three-month and 6-month examination raw scores on knowledge of infectious diseases management among Blackberry PDA users versus non-PDA users were obtained. Measurement of antibiotic decision accuracy by diagnosis at 3 and 6 months among Fellows randomized to use the JHABX on the RIM Blackberry PDA was also evaluated. RESULTS PDA group demonstrated a considerable improvement in test scores over the 3-month time interval, compared with their baseline score (40.8 +/- 2.3 versus 34.3 +/- 4.6, p < 0.05) and compared with the non-PDA group (40.8 +/- 2.3 versus 36.8 +/- 3.3, p < 0.01). Improvement became even more notable at the 6-month interval again, compared with themselves (43.8 +/- 4.5 versus 34.3, p < 0.001) and the non-PDA group (43.8 +/- 4.5 versus 38.1 +/- 5.1, p < 0.001). There was no notable improvement in test scores at 3 months or 6 months in the control group. Overall antibiotic decision accuracy substantially improved from 66% during the initial 3-month period to 86.6% during the second 3-month period (p = 0.005) among users of the JHABX. This was most evident in respiratory, blood, and skin and soft tissue infections. CONCLUSIONS Web-based handheld technology is highly effective for supplying information to support infectious disease clinical practice. In a hospital intensive care setting, results of this study demonstrate that resident physician knowledge and antibiotic decision selection accuracy improved among Fellows using the JHABX. Reasons for this difference can be multifold and not thoroughly evaluated from this small pilot study. Future studies on the impact of point-of-care technology on patient outcomes are warranted.
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Affiliation(s)
- Grant V Bochicchio
- R Adams Cowley Shock Trauma Center and the University of Maryland School of Medicine, Baltimore 21201, USA.
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Como JJ, Sutton ERH, McCunn M, Dutton RP, Johnson SB, Aarabi B, Scalea TM. Characterizing the need for mechanical ventilation following cervical spinal cord injury with neurologic deficit. ACTA ACUST UNITED AC 2006; 59:912-6; discussion 916. [PMID: 16374281 DOI: 10.1097/01.ta.0000187660.03742.a6] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients who sustain cervical spinal cord injury (C-SCI) with neurologic deficit may require a definitive airway and/or prolonged mechanical ventilation. The purpose of this study was to characterize factors associated with a high risk for respiratory failure and/or the need for mechanical ventilation in C-SCI patients. METHODS Patients with C-SCI and neurologic deficit admitted to a Level I Trauma Center between July 1, 2000 and June 30, 2002 were retrospectively reviewed for demographics, level and completeness of neurologic deficit, need for definitive airway, need for tracheostomy, need for mechanical ventilation at hospital discharge (MVDC), and outcomes. The level and completeness of injury were defined by American Spinal Injury Association standards. RESULTS One hundred nineteen patients with C-SCI and neurologic deficit were identified over this period. Of these, 45 were identified as complete C-SCI: 12 (27%) patients had levels of C1 to C4; 19 (42%) had a level of C5; and 14 (31%) had levels of C6 and below. There were 37 males and 8 females. There were 36 blunt and 9 penetrating injuries. The average age of these patients was 40 +/- 21, and the average ISS was 45+/-22. Eight of the patients with complete C-SCI died, for a mortality of 18%. Of the 37 survivors, 92% received a definitive airway, 81% received tracheostomy, and 51% required MVDC. All patients with complete injuries at the C5 level and above required a definitive airway and tracheostomy, and 71% of survivors required MVDC. Of the patients with complete injuries of C6 and below, 79% received a definitive airway, 50% required tracheostomy, and 15% of survivors required MVDC. Only 35% of incomplete injuries required a definitive airway, and only 7% required tracheostomy. CONCLUSIONS The need for definitive airway control, tracheostomy, and ventilator dependence is significant, especially for patients with high complete C-SCI. Based on these results we recommend consideration of early intubation and tracheostomy for patients with complete C-SCI, especially for those with levels of C5 and above.
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Affiliation(s)
- John J Como
- Case Western Reserve University School of Medicine, MetroHealth Medical Center, Department of Surgery, Division of Trauma, Critical Care, Burns, and Metro Life Flight, Cleveland, OH 44109, USA.
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Johnson SB, Bochicchio G, Shanholtz C, Cross A, Hasday J, Townes M, Moore R, Scalea T. UNINFECTED SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS) OR FUTURE SEPSIS? DIFFERENCES IN EXTRACELLULAR MATRIX MODULATORS PRIOR TO ONSET OF CLINICAL SEPSIS. Chest 2005. [DOI: 10.1378/chest.128.4_meetingabstracts.221s] [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: 11/01/2022] Open
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Bochicchio GV, Sung J, Joshi M, Bochicchio K, Johnson SB, Meyer W, Scalea TM. Persistent hyperglycemia is predictive of outcome in critically ill trauma patients. ACTA ACUST UNITED AC 2005; 58:921-4. [PMID: 15920404 DOI: 10.1097/01.ta.0000162141.26392.07] [Citation(s) in RCA: 187] [Impact Index Per Article: 9.8] [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: 01/08/2023]
Abstract
OBJECTIVES Our objectives were to determine whether persistent hyperglycemia was predictive of outcome in critically ill trauma patients. METHODS Prospective data were collected daily on 942 consecutive trauma patients admitted to the ICU over a 2-year period. Patients were stratified by serum glucose level from day 1 to day 7 (low = 0-139 mg/dL, medium = 140-219 mg/dL, and high >220 mg/dL) age, gender, and ISS. Patients were further stratified by pattern of glucose control (all low, all moderate, all high, improving, worsening, highly variable (HV). Outcome was measured by ventilator days, infection, hospital (HLOS) and ICU (ILOS) length of stay and mortality. Multiple linear regression models were used to determine level of significance. RESULTS 71% were victims of blunt trauma. The majority (74%) were male with a mean ISS of 21.3 +/- 15. 41% of patients acquired an infection. Patients with medium, high, worsening, and highly variable hyperglycemia were found to have increased ILOS, HLOS, ventilator days, infection rate and mortality by univariate analysis (p < 0.01). When controlling for age, ISS, and glucose pattern, patients with high, worsening and HV hyperglycemia were most predictive of increased ventilator days, ILOS, HLOS, infection and mortality. (p < 0.01). CONCLUSION Trauma patients with persistent hyperglycemia have a significantly greater degree of morbidity and mortality. A prospective randomized controlled study instituting aggressive hyperglycemic control is warranted.
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Abstract
OBJECTIVES To assess youth perceptions of the causes and consequences of violence generally, the causes and consequences of fighting specifically, and to determine how best to approach fighting in the context of violence prevention activities. METHODS Thirteen structured focus group interviews with youths from three high violence urban settings: a large, urban high school, a training center for disadvantaged youths, and a school for adjudicated youths. Participants were 120 urban, predominately African-American youths and young adults ages 14-22 years (mean: 17.2 years). Seven focus groups were conducted with females, and six with males. RESULTS Adolescents identified the causes of violence on multiple levels including: individual, family, interpersonal, and community level factors. Most youths (89%) had been in a physical fight. Participants felt that fighting was not "right", but identified situations in which it was necessary. Specifically, fighting was used as a problem solving tool, and could prevent escalation of violence. Youths felt that the adults in their lives, including physicians, were generally ill equipped to give advice about violence, as adults' experiences were so removed from their own. Participants looked to experienced role models to offer problem solving and harm reduction strategies. Youths were open to receiving anticipatory guidance about violence and fighting from primary care physicians they felt comfortable with, and who showed respect for their experiences. CONCLUSIONS Interventions that include blanket admonitions against fighting should be reassessed in light of youth perceptions that fighting plays a complex role in both inciting and preventing more serious violence.
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Affiliation(s)
- S B Johnson
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
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Vernick JS, O'Brien M, Hepburn LM, Johnson SB, Webster DW, Hargarten SW. Unintentional and undetermined firearm related deaths: a preventable death analysis for three safety devices. Inj Prev 2004; 9:307-11. [PMID: 14693889 PMCID: PMC1731016 DOI: 10.1136/ip.9.4.307] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [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: 11/03/2022]
Abstract
OBJECTIVE To determine the proportion of unintentional and undetermined firearm related deaths preventable by three safety devices: personalization devices, loaded chamber indicators (LCIs), and magazine safeties. A personalized gun will operate only for an authorized user, a LCI indicates when the gun contains ammunition, and a magazine safety prevents the gun from firing when the ammunition magazine is removed. DESIGN Information about all unintentional and undetermined firearm deaths from 1991-98 was obtained from the Office of the Chief Medical Examiner for Maryland, and from the Wisconsin Firearm Injury Reporting System for Milwaukee. Data regarding the victim, shooter, weapon, and circumstances were abstracted. Coding rules to classify each death as preventable, possibly preventable, or not preventable by each of the three safety devices were also applied. RESULTS There were a total of 117 firearm related deaths in our sample, 95 (81%) involving handguns. Forty three deaths (37%) were classified as preventable by a personalized gun, 23 (20%) by a LCI, and five (4%) by a magazine safety. Overall, 52 deaths (44%) were preventable by at least one safety device. Deaths involving children 0-17 (relative risk (RR) 3.3, 95% confidence interval (CI) 2.1 to 5.1) and handguns (RR 8.1, 95% CI 1.2 to 53.5) were more likely to be preventable. Projecting the findings to the entire United States, an estimated 442 deaths might have been prevented in 2000 had all guns been equipped with these safety devices. CONCLUSION Incorporating safety devices into firearms is an important injury intervention, with the potential to save hundreds of lives each year.
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Affiliation(s)
- J S Vernick
- Johns Hopkins School of Public Health, Center for Gun Policy and Research, Baltimore, Maryland 21205, USA.
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Lambert DH, Levy L, Mavrodieva VA, Johnson SB, Babcock MJ, Vayda ME. First Report of Potato mop-top virus on Potato from the United States. Plant Dis 2003; 87:872. [PMID: 30812901 DOI: 10.1094/pdis.2003.87.7.872a] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Potato mop-top virus (PMTV) is a tripartite pomovirus vectored by the powdery scab plasmodiophoromycete Spongospora subterranea pv. subterranea (1). PMTV occurs on potato (Solanum tuberosum) in Europe, the Andes, Asia, and Canada. Internal necrotic arc and fleck tuber symptoms ("spraing") may reduce commercial acceptance of some cultivars (3). PMTV symptoms were discovered in 'Shepody' tubers at the Aroostook Research Farm, Presque Isle, ME in May 2002 and subsequently in 'Russet Burbank' tubers in commercial storage from the 2001 Maine crop. Symptomatic tubers exhibited single or multiple concentric necrotic arcs that were partial or complete, but exhibited no distinct external symptoms. The presence of PMTV in eight 'Shepody' tubers was indicated by positive enzyme-linked immunosorbent assay (ELISA; Adgen, Ltd., Auchincruive, Ayr, Scotland) and confirmed by reverse transcription polymerase chain reaction (RT-PCR). 'Russet Burbank' potatoes were visually diagnosed, and the corresponding halves of 128 symptomatic tubers were forwarded to the University of Maine and APHIS (Beltsville, MD). Of these, ELISA readings in Maine were strongly positive (>3 × background) for 88, ambiguous (1.5-3 × background) for 13, and negative for 27. Subsamples from these three categories were positive by PCR in 17 of 17, 9 of 9, and 12 of 14 cases, respectively. A similar rating, positive or ambiguous, in ELISA testing was identical for all but one case at Beltsville. Confirmation of PMTV required PCR testing, resulting in a characteristic PCR product of 401 bp that was generated from the coat protein coding region on RNA 2 (2) using the primer pair PMTV 1 5'-GCAGCCGTCGAGAATAGATA-3' (RNA nucleotides 316-335) and PMTV 4 5'-GCGAGTTGATGTGCC ACATT-3' (complementary to RNA 2 nucleotides 716-697). An immunocapture RT-PCR using this primer set and the coating antibody from the Adgen ELISA kit was also successful in detecting PMTV. In separate reactions, a second product of 646 bp was generated from the triple gene block on RNA 3 (4) using the primer pair PMTV 5 5'-GGTGAACACGAGGACAAGGT-3' (RNA 3 nucleotides 1417-1436) and PMTV 7 5'-AACAGTCCGGTCTTGTGAAC-3' (complementary to RNA 3 nucleotides 2063-2044). The sequence of these products was 98 to 100% identical to PMTV published sequences. The discovery of this virus will result in adjustments to U.S. and Canadian seed potato certification standards and symptom characterization for common North American cultivars. References: (1) R. A. C. Jones and B. D. Harrison. Ann. Appl. Biol 63:1, 1969. (2) S. Kashiwazak et al. Virology 206:701, 1995. (3) M. Sandgren et al. Am. J. Potato Res. 79:205, 2002. (4) K. P. Scott et al. J. Gen. Virol.75:3561, 1994.
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Affiliation(s)
- D H Lambert
- Department of Plant, Soil and Environmental Sciences, University of Maine, Orono 04469
| | - L Levy
- APHIS-PPQ-CPHST, National Plant Germplasm and Biotechnology Laboratory, Beltsville, MD 20705
| | - V A Mavrodieva
- APHIS-PPQ-CPHST, National Plant Germplasm and Biotechnology Laboratory, Beltsville, MD 20705
| | - S B Johnson
- University of Maine Cooperative Extension, Presque Isle 04769
| | - M J Babcock
- Department of Biochemistry, Microbiology and Molecular Biology, University of Maine, Orono 04469
| | - M E Vayda
- Department of Biochemistry, Microbiology and Molecular Biology, University of Maine, Orono 04469
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Albertson TE, Panacek EA, MacArthur RD, Johnson SB, Benjamin E, Matuschak GM, Zaloga G, Maki D, Silverstein J, Tobias JK, Haenftling K, Black G, Cowens JW. Multicenter evaluation of a human monoclonal antibody to Enterobacteriaceae common antigen in patients with Gram-negative sepsis. Crit Care Med 2003; 31:419-27. [PMID: 12576946 DOI: 10.1097/01.ccm.0000045564.51812.3f] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [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: 11/26/2022]
Abstract
OBJECTIVE To evaluate in Gram-negative sepsis patients the human monoclonal immunoglobulin M antibody (MAB-T88) directed at the enterobacterial common antigen which is a specific surface antigen closely linked to lipopolysaccharide and shared by all members of the Enterobacteriaceae family of Gram-negative bacteria. DESIGN Prospective, randomized, double-blinded, placebo-controlled, multicenter trial. SETTING Thirty-three academic medical centers in the United States. PATIENTS Patients were entered with a clinical diagnosis of sepsis, the presence of either shock or multiple organ dysfunction, and presumptive evidence for Gram-negative infection. INTERVENTIONS Patients received a single intravenous infusion, over 30 mins, of either 300 mg of MAB-T88 formulated in albumin, or placebo (albumin). MEASUREMENTS AND MAIN RESULTS The primary analysis group was prospectively identified as those patients with documented evidence of an infection with bacteria of the family Enterobacteriaceae at any site. The primary end point was survival within the first 28 days. A total of 826 patients were enrolled with 55% (n = 455) in the primary analysis group. There were no significant differences between the intervention and control primary analysis group study groups for sites of infection, severity of illness, underlying medical conditions, adequacy of antibiotic or surgical treatment, or other baseline variables except for a higher frequency of chronic renal failure in the MAB-T88 group (4.4% vs. 1.3%, p=.051). The average Acute Physiology and Chronic Health Evaluation II scores were 26.8 +/- 8.6 (mean +/- sd) in the MAB-T88-treated group and 26.5 +/- 8.3 in the placebo-treated group (p =.72). There was no significant difference between MAB-T88- and placebo-treated groups during the first 28-day all-cause mortality in the primary analysis group (34.2% vs. 30.8%, p=.44) or in all 826 patients enrolled (37.0% vs. 34.0%, p=.36). On subset analysis, the use of MAB-T88 was not associated with significant mortality trends. More adverse events were seen with the use of MAB-T88 in the bacteremic enterobacterial common antigen group (p <.05). CONCLUSIONS Use of the human monoclonal antibody, MAB-T88, did not improve the mortality in patients with presumed Gram-negative sepsis or in those patients with proven enterobacterial common antigen infections. No subset trends were identified that would support further investigation of this agent in sepsis.
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Shortliffe EH, Johnson SB. Medical Informatics Training and Research at Columbia University. Yearb Med Inform 2002:173-180. [PMID: 27706367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Affiliation(s)
- E H Shortliffe
- Edward H. Shortliffe, MD, PhD, Professor and Chair, Department of Medical Informatics, 622 West 168th Street, VC-5, New York, NY 10032-3720, 212-305-6896, Fax: 212-543-8788, E-mail:
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Haidar SH, Johnson SB, Fossler MJ, Hussain AS. Modeling the pharmacokinetics and pharmacodynamics of a unique oral hypoglycemic agent using neural networks. Pharm Res 2002; 19:87-91. [PMID: 11837705 DOI: 10.1023/a:1013611617787] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE To develop a predictive population pharmacokinetic/ pharmacodynamic (PK/PD) model for repaglinide (REP), an oral hypoglycemic agent, using artificial neural networks (ANNs). METHODS REP, glucose concentrations, and demographic data from a dose ranging Phase 2 trial were divided into a training set (70%) and a test set (30%). NeuroShell Predictor was used to create predictive PK and PK/PD models using population covariates: evaluate the relative significance of different covariates; and simulate the effect of covariates on the PK/PD of REP. Predictive performance was evaluated by calculating root mean square error and mean error for the training and test sets. These values were compared to naive averaging (NA) and randomly generated numbers (RN). RESULTS Covariates found to have an influence on PK of REP include dose, gender. race, age, and weight. Covariates affecting the glucose response included dose, gender, and weight. These differences are not expected to be clinically significant. CONCLUSIONS We came to the following three conclusions: 1) ANNs are more precise than NA and RN for both PK and PD; 2) the bias was acceptable for ANNs as compared with NA and RN; and 3) neural networks offer a quick and simple method for predicting, for identifying significant covariates, and for generating hypotheses.
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Affiliation(s)
- Sam H Haidar
- Office of Clinical Pharmacology and Biopharmaceutics, FDA, Rockville, Maryland 20857, USA.
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Baughcum AE, Powers SW, Johnson SB, Chamberlin LA, Deeks CM, Jain A, Whitaker RC. Maternal feeding practices and beliefs and their relationships to overweight in early childhood. J Dev Behav Pediatr 2001; 22:391-408. [PMID: 11773804 DOI: 10.1097/00004703-200112000-00007] [Citation(s) in RCA: 276] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To better explore possible factors that may lead to childhood obesity, we developed and analyzed two new instruments that assess maternal feeding practices and beliefs. The Infant Feeding Questionnaire (IFQ) assesses feeding during the entire first year of life and was administered to 453 mothers of children 11 to 23 months old. The Preschooler Feeding Questionnaire (PFQ) assesses feeding of young children between the ages of 2 to 5 years and was administered to 634 mothers of children this age. Each questionnaire was factor analyzed and mean factor scores were calculated and linked with the children's measured and mothers' self-reported weight and height. Mean factor scores from the IFQ and PFQ were compared between mothers who were obese (body mass index > or = 30 kg/m2) and those who were nonobese, between those who did and those who did not have an overweight child (weight-for-height > or = 90th percentile), and between those who had a low income (< or = 185% of the poverty level) and those who had a high income. To control for confounding variables and to detect interaction among variables, hierarchical linear regression was used. Results from this study did not suggest that there is a particular "feeding style" that is associated with overweight in young children; however, there were differences found in feeding behaviors between high and low income mothers.
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Affiliation(s)
- A E Baughcum
- Department of Clinical and Health Psychology, University of Florida, Gainesville, USA
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Abstract
Despite the presence of well-described cardiac repolarization abnormalities in heart failure, d,l-sotalol effects on cardiac repolarization have not been evaluated in animal models of CHF. The authors hypothesized that the d,l-sotalol effects on cardiac repolarization are altered in canine dilated cardiomyopathy when compared to controls. Effects of d,l-sotalol were compared in seven dogs with tachycardia induced cardiomyopathy (CHF) and six control animals. In an open-chest model, contact monophasic action potential recordings were obtained from RV and LV endocardium/epicardium during and after two doses of d,l-sotalol (1 mg/kg and 3 mg/kg, each over 20 minutes). Effects of d,l-sotalol on action potential duration at 90% repolarization (APD90) were examined at pacing cycle lengths of 300-1,000 ms. Plasma d,l-sotalol levels were measured at baseline, 10, and 40 minutes following each dose. Prolongation of APD90 by d,l-sotalol, was significantly exaggerated in CHF animals versus controls (P < 0.05, ANOVA). These differences were magnified at slow heart rates (P < 0.05, ANOVA). There were no significant differences in plasma d,l-sotalol levels between the two groups. Effects of d,l-sotalol on cardiac repolarization are exaggerated in CHF without significant alterations in plasma drug levels. While using d,l-sotalol in heart failure, independent additional effects due to ventricular electrical remodeling may be a consideration.
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Affiliation(s)
- S S Chugh
- Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
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Abstract
Thymomas are relatively common tumors of the anterior superior mediastinum. They are usually relatively slowly growing tumors and their prognosis depends on the macroscopic and microscopic invasion of surrounding tissues. Surgery is the mainstay treatment of thymomas, and complete resection represents one of the most important prognostic factors in this disease. Other important prognostic indicators include the tumor stage and size and the presence of symptoms. Postoperative radiotherapy is indicated in tumors with invasion of surrounding tissues, even if resection was radical, since it improves local control and survival. Cytotoxic chemotherapy has been employed in several relatively small phase II studies and in advanced disease has been demonstrated to produce a 50%-80% objective response rate. Neoadjuvant cytotoxic chemotherapy and/or external beam radiotherapy has been used with some success in patients with tumors which are not readily resectable. Novel antiproliferative systemic agents, with both cytotoxic and cytostatic mechanisms of action, are being tested in ongoing prospective clinical trials.
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Affiliation(s)
- S B Johnson
- Division of Cardiothoracic Surgery, Department of Surgery, Academic Hospital, Vrije Universiteit, Amsterdam, The Netherlands
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Silverstein JH, Murray FT, Malasanos T, Myers S, Johnson SB, Frye K, Grossman M. Clinical testing results and high patient satisfaction with a new needle-free device for growth hormone in young children. Endocrine 2001; 15:15-7. [PMID: 11572320 DOI: 10.1385/endo:15:1:015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [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: 11/11/2022]
Abstract
Fifty children ages 4-10 yr with type 1 diabetes mellitus volunteered to participate in a study to evaluate and compare a new needle-free device developed for growth hormone delivery. Children answered descriptive questions related to nervousness and worry, hurt or pain, redness or bleeding, and stinging and wetness. Choices for answers for each of these five questions were none, a little, or a lot. None or a little was also combined to give a minimal category. Children also answered four questions that compared the needle-free device to their morning insulin needle injection in reference to ease of use, pain, nervousness, and overall preference. Half the children had single comfort rings inserted to increase the injection pressure. Results indicated no difference in question responses with or without pressure rings. Pain (92%), erythema (96%), worry (90%), stinging (86%) and wetness (96%) were minimal and significant (0.001 > p < 0.03) following all questions. Results of the comparative questionnaire indicated that the device was easier (p < 0.03) to use than needles and significantly preferred (p < 0.001) in 74% of children under age 10.
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Affiliation(s)
- J H Silverstein
- Department of Pediatric Endocrinology, University of Florida, Gainesville, USA
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Abstract
The large and rapidly growing number of information sources relevant to health care, and the increasing amounts of new evidence produced by researchers, are improving the access of professionals and students to valuable information. However, seeking and filtering useful, valid information can be still very difficult. An online information system that conducts searches based on individual patient data can have a beneficial influence on the particular patient's outcome and educate the healthcare worker. In this paper, we describe the underlying model for a system that aims to facilitate the search for evidence based on clinicians' needs. This paper reviews studies of information needs of clinicians, describes principles of information retrieval, and examines the role that standardized terminologies can play in the integration between a clinical system and literature resources, as well as in the information retrieval process. The paper also describes a model for a digital library system that supports the integration of clinical systems with online information sources, making use of information available in the electronic medical record to enhance searches and information retrieval. The model builds on several different, previously developed techniques to identify information themes that are relevant to specific clinical data. Using a framework of evidence-based practice, the system generates well-structured questions with the intent of enhancing information retrieval. We believe that by helping clinicians to pose well-structured clinical queries and including in them relevant information from individual patients' medical records, we can enhance information retrieval and thus can improve patient-care.
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Affiliation(s)
- E A Mendonça
- Department of Medical Informatics, Columbia University, 622 West 168th Street, Vanderbilt Clinic, 5th Floor, New York, NY 10032, USA.
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