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Ransome E, Hobbs F, Jones S, Coleman CM, Harris ND, Woodward G, Bell T, Trew J, Kolarević S, Kračun-Kolarević M, Savolainen V. Evaluating the transmission risk of SARS-CoV-2 from sewage pollution. Sci Total Environ 2023; 858:159161. [PMID: 36191696 PMCID: PMC9525188 DOI: 10.1016/j.scitotenv.2022.159161] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 09/23/2022] [Accepted: 09/28/2022] [Indexed: 06/02/2023]
Abstract
The presence of SARS-CoV-2 in untreated sewage has been confirmed in many countries but its incidence and infection risk in contaminated waters is poorly understood. The River Thames in the UK receives untreated sewage from 57 Combined Sewer Overflows (CSOs), with many discharging dozens of times per year. This study investigated if such discharges provide a pathway for environmental transmission of SARS-CoV-2. Samples of wastewater, surface water, and sediment collected close to six CSOs on the River Thames were assayed over eight months for SARS-CoV-2 RNA and infectious virus. Bivalves were also sampled as an indicator species of viral bioaccumulation. Sediment and water samples from the Danube and Sava rivers in Serbia, where raw sewage is also discharged in high volumes, were assayed as a positive control. No evidence of SARS-CoV-2 RNA or infectious virus was found in UK samples, in contrast to RNA positive samples from Serbia. Furthermore, this study shows that infectious SARS-CoV-2 inoculum is stable in Thames water and sediment for <3 days, while SARS-CoV-2 RNA is detectable for at least seven days. This indicates that dilution of wastewater likely limits environmental transmission, and that detection of viral RNA alone is not an indication of pathogen spillover.
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Affiliation(s)
- E Ransome
- Georgina Mace Centre for the Living Planet, Department of Life Sciences, Imperial College London, Silwood Park Campus, Ascot, Berkshire SL5 7PY, UK.
| | - F Hobbs
- Georgina Mace Centre for the Living Planet, Department of Life Sciences, Imperial College London, Silwood Park Campus, Ascot, Berkshire SL5 7PY, UK
| | - S Jones
- Georgina Mace Centre for the Living Planet, Department of Life Sciences, Imperial College London, Silwood Park Campus, Ascot, Berkshire SL5 7PY, UK
| | - C M Coleman
- Wolfson Centre for Global Virus Research, Department of Life Sciences, University of Nottingham, Nottingham NG7 2UH, UK
| | - N D Harris
- Georgina Mace Centre for the Living Planet, Department of Life Sciences, Imperial College London, Silwood Park Campus, Ascot, Berkshire SL5 7PY, UK
| | - G Woodward
- Georgina Mace Centre for the Living Planet, Department of Life Sciences, Imperial College London, Silwood Park Campus, Ascot, Berkshire SL5 7PY, UK
| | - T Bell
- Georgina Mace Centre for the Living Planet, Department of Life Sciences, Imperial College London, Silwood Park Campus, Ascot, Berkshire SL5 7PY, UK
| | - J Trew
- Georgina Mace Centre for the Living Planet, Department of Life Sciences, Imperial College London, Silwood Park Campus, Ascot, Berkshire SL5 7PY, UK
| | - S Kolarević
- University of Belgrade, Institute for Biological Research "Siniša Stanković", National Institute of Republic of Serbia, Department of Hydroecology and Water Protection, Bulevar despota Stefana 142, 11000 Belgrade, Serbia
| | - M Kračun-Kolarević
- University of Belgrade, Institute for Biological Research "Siniša Stanković", National Institute of Republic of Serbia, Department of Hydroecology and Water Protection, Bulevar despota Stefana 142, 11000 Belgrade, Serbia
| | - V Savolainen
- Georgina Mace Centre for the Living Planet, Department of Life Sciences, Imperial College London, Silwood Park Campus, Ascot, Berkshire SL5 7PY, UK
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Abdul-Mutakabbir JC, Hirsch EB, Ko C, Brown BR, Bandali A, Mordino J, Yoke LH, Bell T, Swartz TH, Syed U, Hlatshwayo M, Saunders IM. A call to action: A need for initiatives that increase equitable access to COVID-19 therapeutics. The Lancet Regional Health - Americas 2022; 11:100263. [PMID: 35600636 PMCID: PMC9114692 DOI: 10.1016/j.lana.2022.100263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- Andrea Ciaranello
- Division of Infectious Disease, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Taison Bell
- Divisions of Infectious Disease and Pulmonary/Critical Care, University of Virginia School of Medicine, Charlottesville
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Park S, Attai AE, Enfield K, Bell T, Hill B, Carpenter R, Cox HL, Mathers A. 394. Pseudo-outbreak of Coagulase-negative Staphylococcus Species from Blood Cultures Highlights Unique Challenges in Care of Critically Ill Patients With COVID-19. Open Forum Infect Dis 2020. [PMCID: PMC7777669 DOI: 10.1093/ofid/ofaa439.589] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background In response to the COVID-19 pandemic, a dedicated intensive care unit for patients infected with SARS-CoV-2 was created at our institution. We noticed a marked increase in the number of blood cultures positive for coagulase-negative Staphylococcus species (CoNS) that highlights unique challenges that arise with the creation of new units and workflows. Methods We reviewed all blood culture results from the COVID-19 intensive care unit (CoVICU) from April 15 to May 29. We reviewed all blood cultures taken from the oncology ward, medical intensive care unit (MICU), and emergency department (ED) for the same time frame as a comparison. We calculated contamination rates, using the clinical microbiology laboratory criteria for possible contaminants based on species and number of positive blood cultures. Results There were 324 total blood cultures collected from the CoVICU with 27/324 (8.3%) positive for organisms deemed contaminant, 10/324 (3.1%) were positive considered bloodstream infections (BSI); the ratio of BSI:contaminant was 1:2.7. For the MICU, ED, and oncology units contamination rates were 2/197 (1%), 33/747 (4.4%), and 2/334 (0.6%), respectively; and the ratio of BSI:contaminant was 5:1, 2.2:1, and 17.5:1, respectively. There was a significant relationship between contamination rates and unit, X2(3, N = 1602) = 30.85, p < 0.001. Conclusion Upon investigation, peripheral blood draw kits were not stocked in the CoVICU. Additionally, certain components of standard work for blood culture collection (e.g. glove exchange) could not be performed per usual practice due to isolation precautions. Peripheral blood draws were routinely performed by nurses in CoVICU and MICU while phlebotomy performed these in other comparison units. We suspect that lack of availability of blood draw kits and disruption of typical workflow in isolation rooms contributed to an unusually high number of contaminated blood cultures among patients admitted to the CoVICU. Notably, the CoVICU and MICU providers were the same pool of caregivers, further supporting a process issue related to isolation precautions. Institutions should be aware of the need for extra attention to supply chain management and examination of disruption to standard work that arise in the management of COVID-19 patients. Disclosures All Authors: No reported disclosures
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Affiliation(s)
- Stacy Park
- University of Virginia, Charlottesville, Virginia
| | - April E Attai
- University of Virgnia Health System, Charlottesville, VA
| | - Kyle Enfield
- University of Virginia, Charlottesville, Virginia
| | | | | | | | - Heather L Cox
- University of Virginia Health System, Charlottesville, VA
| | - Amy Mathers
- University of Virginia, Charlottesville, Virginia
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Zimmet A, Lake D, Zimmet AM, Gadrey SM, Bell T, Moorman R, Moore C. 303. Physiological Changes Due to Bloodstream Infection in Intensive Care Unit Patients Differ According to Transplant Status. Open Forum Infect Dis 2020. [PMCID: PMC7777999 DOI: 10.1093/ofid/ofaa439.346] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Transplant recipients are at increased risk of bloodstream infection (BSI), which often leads to critical illness. Due to immunosuppression, BSI in these patients may manifest with different pathophysiology compared to non-transplant recipients. We aimed to identify different trends in the pathophysiology of critically ill patients with BSI based on transplant status. Methods We reviewed data from patients admitted to the medical and surgical/trauma intensive care units (ICUs) at the University of Virginia Medical Center from 2011 to 2015. We included both solid organ and hematopoietic stem cell transplant recipients. We performed univariate logistic regression modeling to evaluate trends in different physiological features in both transplant and non-transplant recipients in the 96 hours surrounding a positive blood culture. We then performed multivariate logistic regression modeling to identify features independently associated with a positive blood culture in the next 24 hours in transplant recipients. Results We analyzed 9,954 ICU patient-admissions (including 505 transplant recipients), with a total of 144 patient-years of physiological data, 1.3 million hourly measurements, and 15,577 blood culture instances. Of the 1,068 blood culture instances in transplant recipients, 125 (12%) were positive, compared to 1,051 of 14,509 (7%) blood culture instances in non-transplant recipients. Critically ill transplant recipients with BSI had greater abnormalities in vital signs, oxygen requirement, markers of organ damage, APACHE score, and Charlson Comorbidity Index (CCI) compared to non-transplant recipients (Figure 1). Trends in many of these features also differed based on transplant status. The multivariable logistic regression model of BSI in transplant recipients included, in decreasing strength of association: total bilirubin, systolic blood pressure, fraction of inspired oxygen, number of intravenous lines, and CCI. This model had an AUC of 0.75. Figure 1. Trends in pathophysiological abnormalities in 9,954 critically ill patients with BSI based on transplant status, 2011–2015. Each graph demonstrates the average value of the physiological variable over time relative to the acquisition of a positive blood culture. Blue curves depict trends in transplant recipients, while red curves depict trends in non-transplant recipients. We assessed 108 physiological features and show the 24 features with the greatest change around the time of blood culture. ![]()
Conclusion Critically ill transplant recipients have a higher prevalence of BSI and different pathophysiological manifestations of BSI compared to non-transplant recipients. This may have implications regarding early detection and treatment of BSI in these patients. Disclosures Randall Moorman, MD, Advanced Medical Predictive Devices, Diagnostics, and Displays (Board Member, Shareholder)
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Affiliation(s)
| | - Douglas Lake
- University of Virginia, Charlottesville, Virginia
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Zimmet A, Clark M, Gadrey SM, Bell T, Randall Moorman J, Moore C. 112. Physiological Signature of Bloodstream Infection in Critically Ill Patients. Open Forum Infect Dis 2019. [PMCID: PMC6809796 DOI: 10.1093/ofid/ofz360.187] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Bloodstream infection (BSI) is associated with high mortality rates in critically ill patients but is difficult to identify clinically. This uncertainty results in frequent blood culture testing, which exposes patients to additional costs and the potential harms of unnecessary antibiotics. Accordingly, we aimed to identify signatures in physiological data from critically ill adults that characterize BSI.
Methods
We reviewed all blood culture, vital sign, laboratory, and cardiorespiratory monitoring (CRM) data from patients admitted to the medical and surgical/trauma ICUs at the University of Virginia Medical Center from February 2011 to June 2015. Blood culture results were categorized as positive, negative, or contaminant. For the BSI population, we included data obtained within 12 hours before or 24 hours after the acquisition of a positive blood culture. The control population included data greater than 12 hours before or 24 hours after the acquisition of a positive blood culture, and all data from patients without BSI. We used multivariable logistic regression to identify the physiological characteristics of BSI.
Results
We analyzed 9,955 ICU admissions with 144 patient-years of vital sign and CRM data (1.3M hourly measurements). The average age was 59 years; the population was mostly Caucasian (81%) and male (56%). There were 5,671 (57%) admissions with ≥1 blood culture, and 744 (7%) had a BSI. The in-hospital mortality rate for patients with BSI was 28% vs. 12% for all others. The physiological signature of BSI was characterized by abnormalities in 12 parameters (Figure 1)—e.g., BSI was more likely in patients with a higher pulse and lower platelets. Several associations were nonlinear—e.g., temperature and WBC had U-shaped relationships with BSI. The internally validated C-statistic was 0.77.
Conclusion
Statistical modeling revealed a clinically sensible physiological signature of BSI that could assist with bedside decisions regarding the utility of blood culture testing in critically ill adults.
Disclosures
All authors: No reported disclosures.
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Affiliation(s)
- Alex Zimmet
- University of Virginia Medical Center, Charlottesville, Virginia
| | - Matthew Clark
- Advanced Medical Predictive Devices, Diagnostics, and Displays, Charlottesville, Virginia
| | | | - Taison Bell
- UVa Health System, Charlottesville, Virginia
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Osovizky A, Laster B, Wilson AA, Bloomfield P, Sarusi B, Vasdev N, Bell T, Garcia A, Houle S. New detection configuration for low activity levels of PET tracers during the analysis of plasma samples. Appl Radiat Isot 2019; 151:317-330. [PMID: 31376719 DOI: 10.1016/j.apradiso.2019.05.025] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 03/21/2019] [Accepted: 05/16/2019] [Indexed: 11/28/2022]
Abstract
A new radio-HPLC detection system for measuring radioactivity in plasma samples during Positron Emission Tomography [PET] studies was developed. It is based on detecting both the positron and one of the annihilation photons. The system focused on improving the measurement of radioactivity concentrations on an unmetabolized positron emitting a radiopharmaceutical [PER] in the presence of its radioactive metabolites, all containing the same positron emitter. This paper presents a new detection configuration that improves the minimal detectible activity (MDA), simplify the measuring systems and reduces the error caused by the metabolites. The detector is based on a plastic scintillator and a BGO scintillation crystal, that produces different light output spectra for signal and noise events. By summing the positron and the annihilated photon light outputs, different spectra are obtained for the metabolite and for the parent compound tracer and for tracer marked by different positron emitting isotopes. This new detection system can improve quantitative analysis of plasma samples. The spectrum change provides up to a three-fold improvement in sensitivity compared to the currently used detection systems that measure only the annihilation coincidence events. Results showed that for 11C the MDA was improved by approximately 520%. Furthermore, it provides the additional advantage of reliability by providing a method for separating the signal and noise readings from the gross detector readout. Accurate reconstruction algorithm of the signal was achieved over a wide measuring range even when the signal was only 5% of the gross measurement.
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Affiliation(s)
- A Osovizky
- Jerry J. Cohen Radiobiology Research Laboratory, Nuclear Engineering Department, Ben-Gurion University of the Negev, Israel; Centre for Addiction and Mental Health, Toronto, Canada; Rotem Industries Ltd, Beer-Sheva, Israel.
| | - B Laster
- Jerry J. Cohen Radiobiology Research Laboratory, Nuclear Engineering Department, Ben-Gurion University of the Negev, Israel
| | - A A Wilson
- Centre for Addiction and Mental Health, Toronto, Canada
| | - P Bloomfield
- Centre for Addiction and Mental Health, Toronto, Canada
| | - B Sarusi
- Rotem Industries Ltd, Beer-Sheva, Israel
| | - N Vasdev
- Centre for Addiction and Mental Health, Toronto, Canada
| | - T Bell
- Centre for Addiction and Mental Health, Toronto, Canada
| | - A Garcia
- Centre for Addiction and Mental Health, Toronto, Canada
| | - S Houle
- Centre for Addiction and Mental Health, Toronto, Canada; University of Toronto, Toronto, Canada
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Bell T, Stavrinos D. HOW TEMPERAMENT AND PERSONALITY IMPACT SUBJECTIVE EXECUTIVE FUNCTION IN OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Bell
- University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - D Stavrinos
- University of Alabama at Birmingham, Birmingham, AL, USA
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Meyer M, Kelbauskas L, Katdare R, Presley C, Hamilton C, Sussman D, Bell T, Nelson A. P2.11-14 Malignancy Associated Change and The LuCED® Test for Detection of Early Stage Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1361] [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: 12/01/2022]
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Sussman D, Meyer M, Katdare R, Presley C, Bell T, Reyna J, Lakers F, Hamilton C, Zulueta J, Miller Y, Ghosh M, Nelson A. P3.03-026 Cell-CT® Differential Detection of Dysplastic Bronchial Epithelial Cells from Patient Explants. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Chan KH, Moser EA, Cain M, Carroll A, Benneyworth BD, Bell T. Validation of antibiotic charges in administrative data for outpatient pediatric urologic procedures. J Pediatr Urol 2017; 13:185-186. [PMID: 28262540 DOI: 10.1016/j.jpurol.2017.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 01/06/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The use of administrative health data for research has prompted questions about its validity for this purpose. OBJECTIVE/STUDY DESIGN The purpose of this study was to determine the concordance of Pediatric Health Information System (PHIS) perioperative antibiotic charges with the institution's medication administration data for males <10 years old and who underwent outpatient penile/inguinal procedures from July 2013 to March 2015. RESULTS There was 93.9% positive and negative agreement between perioperative antibiotic charges versus administration. The sensitivity and specificity were 96.8% and 87.2%, respectively. The positive and negative predictive values were 94.6% and 92.2%, respectively. CONCLUSION This study indicated strong agreement between PHIS pharmacy charges and medication administration.
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Affiliation(s)
- K H Chan
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, IN, USA; Center for Pediatric and Adolescent Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - E A Moser
- Department of Biostatistics, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - M Cain
- Division of Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Carroll
- Center for Pediatric and Adolescent Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - B D Benneyworth
- Section of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA; Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - T Bell
- Center for Outcomes Research in Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
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Hackett C, Furgal C, Angnatok D, Sheldon T, Karpik S, Baikie D, Pamak C, Bell T. Going Off, Growing Strong: Building Resilience of Indigenous Youth. ACTA ACUST UNITED AC 2016. [DOI: 10.7870/cjcmh-2016-028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- C. Hackett
- McMaster University and Nunatsiavut Government
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Jewett A, Bell T, Cohen NJ, Buckley K, Leino V, Even S, Beavers S, Brown C, Marano N. US college and university student health screening requirements for tuberculosis and vaccine-preventable diseases, 2012. J Am Coll Health 2016; 64:409-15. [PMID: 26730492 PMCID: PMC4879121 DOI: 10.1080/07448481.2015.1117465] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the US college student health screening requirements among US resident and international students for tuberculosis (TB) and vaccine-preventable diseases (VPDs) as they relate to the American College Health Association (ACHA) guidelines. Methods/Participants: In April 2012, US college health administrators (N = 2,858) were sent online surveys to assess their respective school's TB screening and immunization requirements. RESULTS Surveys were completed by 308 (11%) schools. Most schools were aware of the ACHA immunization (78%) and TB screening (76%) guidelines. Schools reported having policies related to immunization screening (80.4%), immunization compliance (93%), TB screening (55%), and TB compliance (87%). CONCLUSION Most colleges were following ACHA guidelines. However, there are opportunities for improvement to fully utilize the recommendations and prevent outbreaks of communicable diseases among students in colleges.
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Affiliation(s)
- A. Jewett
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
| | - T Bell
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
- Council of State and Territorial Epidemiologists, Atlanta, GA
| | - NJ. Cohen
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
| | - K. Buckley
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
| | - V. Leino
- American College of Health Association, Hanover, MD
| | - S. Even
- American College of Health Association, Hanover, MD
| | - S. Beavers
- Centers for Disease Control and Prevention, Division of Tuberculosis Elimination, Atlanta, GA
| | - C. Brown
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
| | - N. Marano
- Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, Atlanta, GA
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Bell T, Crown JP, Lang I, Bhattacharyya H, Zanotti G, Randolph S, Kim S, Huang X, Huang Bartlett C, Finn RS, Slamon D. Impact of palbociclib plus letrozole on pain severity and pain interference with daily activities in patients with estrogen receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer as first-line treatment. Curr Med Res Opin 2016; 32:959-65. [PMID: 26894413 DOI: 10.1185/03007995.2016.1157060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Palbociclib is a recently approved drug for use in combination with letrozole as initial endocrine-based therapy for the treatment of postmenopausal women with advanced estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER+/HER2-) breast cancer. This report assesses the impact of palbociclib in combination with letrozole versus letrozole alone on patient-reported outcomes of pain. Methods Palbociclib was evaluated in an open-label, randomized, phase II study (PALOMA-1/TRIO-18) among postmenopausal women with advanced ER+/HER2- breast cancer who had not received prior systemic treatment for their advanced disease. Patients received continuous oral letrozole 2.5 mg daily alone or the same letrozole dose and schedule plus oral palbociclib 125 mg, given once daily for 3 weeks followed by 1 week off over repeated 28-day cycles. The primary study endpoint was investigator-assessed progression-free survival in the intent-to-treat population, and these results have recently been published (Finn et al., Lancet Oncol 2015;16:25-35). One of the key secondary endpoints was the evaluation of pain, as measured using the Brief Pain Inventory (BPI) patient-reported outcome tool. The BPI was administered at baseline and on day 1 of every cycle thereafter until disease progression and/or treatment discontinuation. Clinical trial registration This study is registered with ClinicalTrials.gov (NCT00721409). Results There were no statistically significant differences in Pain Severity or Pain Interference scores of the BPI between the two treatment groups for the overall population or among those with any bone disease at baseline. A limitation of the study is that results were not adjusted for the concomitant use of opioids or other medications used to control pain. Conclusions The addition of palbociclib to letrozole was associated with increased efficacy without negatively impacting pain severity or pain interference with daily activities.
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Affiliation(s)
- T Bell
- a Pfizer Inc. , New York , NY , USA
| | - J P Crown
- b St. Vincent's University Hospital , Dublin , Ireland
| | - I Lang
- c Orszagos Onkologiai Intezet, Kemoterapia B , Budapest , Hungary
| | | | | | | | - S Kim
- d Pfizer Inc. , San Diego , CA , USA
| | - X Huang
- d Pfizer Inc. , San Diego , CA , USA
| | | | - R S Finn
- e David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
| | - D Slamon
- e David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
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Dupont AÖC, Griffiths RI, Bell T, Bass D. Differences in soil micro-eukaryotic communities over soil pH gradients are strongly driven by parasites and saprotrophs. Environ Microbiol 2016; 18:2010-24. [DOI: 10.1111/1462-2920.13220] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 12/29/2015] [Accepted: 01/08/2016] [Indexed: 11/30/2022]
Affiliation(s)
- A. Ö. C. Dupont
- Department of Life Sciences; the Natural History Museum; Cromwell Road London SW7 5BD UK
| | - R. I. Griffiths
- Centre for Ecology & Hydrology; Benson Lane; Crowmarsh Gifford; Wallingford OX10 8BB UK
| | - T. Bell
- Imperial College London; Silwood Park Campus; Buckhurst Road Ascot Berkshire SL5 7PY UK
| | - D. Bass
- Department of Life Sciences; the Natural History Museum; Cromwell Road London SW7 5BD UK
- Cefas; Barrack Road The Nothe Weymouth DT4 8UB UK
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De Laurentiis M, Mitra D, Bell T, Nuzzo CMA, De Placido S. Abstract OT2-04-02: A non-interventional study to characterize the real world treatment patterns and outcomes of women with ER+, HER2- advanced or metastatic breast cancer in Italy. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot2-04-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Breast cancer is the most common type of cancer in women. There were an estimated 1.67 million new cases of breast cancer worldwide in 2012. Approximately 75% of women have hormone receptor positive (ER positive or PR positive) disease (Buzdar et al., 2009) and most of these patients have HER2-negative disease (Partridge et al., 2014). Although there is evidence via clinical trials on the efficacy of a number of ER+, HER2- breast cancer treatments, real world treatment patterns and related outcomes among this population are poorly characterized. This study aims at examining real world practice patterns and its impact on outcomes to gain a better understanding of the limitations of current treatments, identify specific areas and subpopulations with the greatest unmet need, and demonstrate the economic impact of current treatments. Additionally, this study will provide a longitudinal assessment of the impact of breast cancer on quality of life and work productivity in this subpopulation.
Study design: This study uses a prospective, observational cohort design. Approximately 500 women with ER+, HER2- ABC or mBC within Italy will be enrolled across 50 to 80 sites that represent diverse geographical and treatment settings. All patients will be followed for a minimum of two years (or until patient withdrawal from the study, death, or study discontinuation).
Eligibility criteria: Women who have been diagnosed with ER+, HER2- mBC or locoregionally recurrent ABC not amenable to resection or radiation therapy with curative intent and are initiating their first or second therapy in the ABC/mBC setting will be eligible to participate. Patients could have a de novo diagnosis of ABC or mBC or recur from an earlier stage. Patients participating in any interventional clinical trial that includes investigational products at the time of enrollment will be excluded from the study.
Specific aims: The key measures of interest are demographic and clinical characteristics, treatment patterns, clinical outcomes (e.g. objective response, progression-free survival, and overall survival, disease specific health care resource use, patient reported quality of life (EQ-5D), work productivity (WPAI-SHP), and disease specific symptoms and functioning (FACT-B and FACT-ES).
Statistical methods: The study is descriptive and not designed for formal hypothesis testing. A sample size of 500 patients ensures that the half-width of the 95% CIs on the proportion of patients with objective response at one year is less than 0.06.
Accrual: Patient enrollment is expected to begin in September 2015.
Disclosure: This study is sponsored by Pfizer Inc.
Citation Format: De Laurentiis M, Mitra D, Bell T, Nuzzo CMA, De Placido S. A non-interventional study to characterize the real world treatment patterns and outcomes of women with ER+, HER2- advanced or metastatic breast cancer in Italy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT2-04-02.
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Affiliation(s)
- M De Laurentiis
- National Cancer Institute "Fondazione Pascale", Naples, Italy; Pfizer, Inc; Pfizer, srl, Italy; University of Naples Federico II, Naples, Italy
| | - D Mitra
- National Cancer Institute "Fondazione Pascale", Naples, Italy; Pfizer, Inc; Pfizer, srl, Italy; University of Naples Federico II, Naples, Italy
| | - T Bell
- National Cancer Institute "Fondazione Pascale", Naples, Italy; Pfizer, Inc; Pfizer, srl, Italy; University of Naples Federico II, Naples, Italy
| | - CMA Nuzzo
- National Cancer Institute "Fondazione Pascale", Naples, Italy; Pfizer, Inc; Pfizer, srl, Italy; University of Naples Federico II, Naples, Italy
| | - S De Placido
- National Cancer Institute "Fondazione Pascale", Naples, Italy; Pfizer, Inc; Pfizer, srl, Italy; University of Naples Federico II, Naples, Italy
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Fisher RM, Bell T, West SA. Multicellular group formation in response to predators in the alga Chlorella vulgaris. J Evol Biol 2016; 29:551-9. [PMID: 26663204 DOI: 10.1111/jeb.12804] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 11/25/2015] [Accepted: 11/26/2015] [Indexed: 11/27/2022]
Abstract
A key step in the evolution of multicellular organisms is the formation of cooperative multicellular groups. It has been suggested that predation pressure may promote multicellular group formation in some algae and bacteria, with cells forming groups to lower their chance of being eaten. We use the green alga Chlorella vulgaris and the protist Tetrahymena thermophila to test whether predation pressure can initiate the formation of colonies. We found that: (1) either predators or just predator exoproducts promote colony formation; (2) higher predator densities cause more colonies to form; and (3) colony formation in this system is facultative, with populations returning to being unicellular when the predation pressure is removed. These results provide empirical support for the hypothesis that predation pressure promotes multicellular group formation. The speed of the reversion of populations to unicellularity suggests that this response is due to phenotypic plasticity and not evolutionary change.
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Affiliation(s)
- R M Fisher
- Department of Zoology, University of Oxford, Oxford, UK.,Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - T Bell
- Department of Life Sciences, Silwood Park Campus, Imperial College London, Ascot, UK
| | - S A West
- Department of Zoology, University of Oxford, Oxford, UK
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Austin G, Bell T, Duncan M. Active By Community Design (ABCD): Evidence in action. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.357] [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: 11/27/2022]
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Hall RG, Blaszczyk AT, Thompson KA, Brouse SD, Giuliano CA, Frei CR, Forcade NA, Mortensen EM, Bell T, Bedimo RJ, Alvarez CA. Impact of empiric weight-based vancomycin dosing on nephrotoxicity and mortality in geriatric patients with methicillin-resistant Staphylococcus aureus bacteraemia. J Clin Pharm Ther 2014; 39:653-7. [PMID: 25200273 DOI: 10.1111/jcpt.12203] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 08/12/2014] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Few studies have evaluated the effect of vancomycin dosing on the health outcomes in geriatric patients. Data are needed to determine whether higher vancomycin dosing strategies are more effective in geriatric patients and/or lead to excessive rates of adverse events. METHODS This study used a subset of patients aged ≥65 years from a multicentre, retrospective, cohort study of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia. Patients received ≥ 48 h of empiric vancomycin between 1 July 2002 and 30 June 2008. We compared the incidence of nephrotoxicity and in-hospital mortality in patients who received guideline-recommended dosing (at least 15 mg/kg/dose) to patients who received lower dosing. Multivariable generalized mixed-effect models were constructed to determine independent risk factors for nephrotoxicity and in-hospital mortality. RESULTS AND DISCUSSION Half of the cohort (46% of 92 patients) received guideline-recommended dosing. Empiric use of weight-based dosing did increase the percentage of patients achieving a vancomycin trough ≥ 15 mg/L (57% vs. 42%). Nephrotoxicity occurred in 32% of patients and 26% died during their hospitalization. Guideline-recommended dosing was not associated with significant changes in nephrotoxicity (OR 1·13; 95% CI 0·40-3·19) or in-hospital mortality (OR 1·14; 95% CI 0·41-3·18) in the multivariable analysis. WHAT IS NEW AND CONCLUSION In this study of geriatric patients, guideline-recommended dosing was not associated with significant changes in nephrotoxicity or mortality. As 40% of the patients who received guideline-recommended dosing failed to achieve a target vancomycin trough of ≥ 15 mg/L, future studies should focus on dosing strategies to increase target attainment rate.
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Affiliation(s)
- R G Hall
- Department of Pharmacy Practice, Texas Tech University Health Sciences Center, School of Pharmacy, Dallas, TX, USA; Department of Clinical Sciences, University of Texas Southwestern, Dallas, TX, USA
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Maurice SB, Bell T, Daniels T, Fetterly CR, Nelson DR, Winwood PJ, Bourque WT, Harris RL. Tibial bone versican content decreases with zoledronate treatment in adult mice. Osteoporos Int 2014; 25:1975-81. [PMID: 24839166 DOI: 10.1007/s00198-014-2700-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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] [Received: 09/04/2013] [Accepted: 03/20/2014] [Indexed: 02/06/2023]
Abstract
UNLABELLED In bone remodeling, the expression and turnover of the proteoglycans versican and aggrecan are poorly understood. We report changes in adult mouse bone contents of versican and aggrecan associated with both age and treatment with the drug zoledronate. The data may have implications for experimental animal models of osteoporosis and related conditions. INTRODUCTION Versican and aggrecan are large, aggregating proteoglycans involved in skeletal development, but little is known about their roles in bone remodeling. The purpose of this study was to investigate versican and aggrecan contents in adult mouse bones, and changes in their contents in response to the bisphosphonate zoledronate (ZOL). METHODS Mice (9 weeks old) were treated with 125 μg/kg ZOL or vehicle for 3 or 15 weeks. Versican and aggrecan were isolated from tibial bones for Western blotting, automated integrated densitometry, and analysis (two-way ANOVA, α = 0.05). RESULTS In ZOL-treated mouse bones, compared to vehicle, 340 and 60 kDa versican content decreased significantly, and 100 and 60 kDa aggrecan content decreased significantly (drug effect). In 24-week-old mouse bones, compared to 12 weeks, statistically significant decreases were observed in 340, 80, 60, and 11 kDa versican, and in 100, 70, and 40 kDa aggrecan (age effect). There was a statistically significant ZOL-age interaction for 330 kDa aggrecan. CONCLUSION This is the first study to assess physiological versican and aggrecan adaptations in adult mammalian bone tissue, in the presence and absence of ZOL. We observed large decreases in some versican and aggrecan species from 12 to 24 weeks. We also observed decreases in several versican and aggrecan species in the presence of ZOL. This indicates that bone proteoglycan expression and turnover may be important in bone remodeling.
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Affiliation(s)
- S B Maurice
- Northern Medical Program, University of Northern British Columbia, Prince George, BC, Canada
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Tucker J, Grim R, Bell T, Martin J, Mueller M, Ahuja V. Changing Demographics in Laparoscopic Cholecystectomy Performed in the United States Hospitalizations from 1998-2010. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yanagawa F, Bhuva K, Martin J, Bell T, Grim R, Ahuja V. Non-Robotic versus Robotic Cardiac Surgery: An Investigation of Critical Outcomes. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Perez M, Galbreath T, Tucker J, Bell T, Grim R, Martin J, Wesner V, Mueller M, Ahuja V. Appendicitis in the Absence of Leukocytosis; A Community Hospital Experience. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Galbreath T, Perez M, Tucker J, Bell T, Grim R, Martin J, Wesner V, Mueller M, Ahuja V. Appendicitis in the Community Center: Validation that CT scan is Not Indicated in Adult Males with Suggestive Clinical Evaluation and Leukocytosis. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bair-Brake H, Bell T, Higgins A, Bailey N, Duda M, Shapiro S, Eves HE, Marano N, Galland G. Is that a rodent in your luggage? A mixed method approach to describe bushmeat importation into the United States. Zoonoses Public Health 2013; 61:97-104. [PMID: 23678947 DOI: 10.1111/zph.12050] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Indexed: 01/25/2023]
Abstract
Bushmeat, defined as meat derived from wild animals, is a potential source of zoonotic pathogens. Bushmeat from restricted animals is illegal to import into the United States under US federal regulations. We reviewed US Centers for Disease Control and Prevention (CDC) port of entry surveillance records from September 2005 through December 2010 and conducted focus group studies to describe trends in and reasons for bushmeat importation into the United States. In total, 543 confiscated bushmeat items were recorded. Half of the confiscated bushmeat items identified were rodents. Africa was the most frequent continent of origin. Seasonality was evident, with bushmeat confiscations peaking in late spring to early summer. Four times more bushmeat was confiscated during an enhanced surveillance period in June 2010 compared with the same period in previous years, suggesting that routine surveillance underestimated the amount of bushmeat detected at US Ports of Entry. Focus groups held in three major US cities revealed that bushmeat importation is a multifaceted issue. Longstanding cultural practices of hunting and eating bushmeat make it difficult for consumers to acknowledge potential health and ecologic risks. Also, US merchants selling African goods, including bushmeat, in their stores have caused confusion among importers as to whether importation is truly illegal. Enhancing routine surveillance for bushmeat and consistent enforcement of penalties at all ports of entry, along with health education aimed at bushmeat importers, might be useful to deter illegal importation.
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Affiliation(s)
- H Bair-Brake
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Murali S, Rai B, Dombrowski C, Lee JLJ, Lim ZXH, Bramono DS, Ling L, Bell T, Hinkley S, Nathan SS, Hui JH, Wong HK, Nurcombe V, Cool SM. Affinity-selected heparan sulfate for bone repair. Biomaterials 2013; 34:5594-605. [PMID: 23632323 DOI: 10.1016/j.biomaterials.2013.04.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 04/07/2013] [Indexed: 12/01/2022]
Abstract
Bone morphogenetic protein (BMP)-2 is a potent bone healing compound produced at sites of bone trauma. Here we present a therapeutic strategy to harness the activity of endogenously produced BMP-2 by delivery of an affinity-matched heparan sulfate (HS) glycos aminoglycan biomaterial that increases the bioavailability, bioactivity and half-life of this growth factor. We have developed a robust, cost effective, peptide-based affinity platform to isolate a unique BMP-2 binding HS variant from commercially available preparations of HS, so removing the manufacturing bottleneck for their translation into the clinic. This affinity-matched HS enhanced BMP-2-induced osteogenesis through improved BMP-2 kinetics and receptor modulation, prolonged pSMAD signaling and reduced interactions with its antagonist noggin. When co-delivered with a collagen implant, the HS was as potent as exogenous BMP-2 for the healing of critical-sized bone defects in rabbits. This affinity platform can be readily tuned to isolate HS variants targeted ata range of clinically-relevant growth and adhesive factors.
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Affiliation(s)
- S Murali
- Glycotherapeutics Group, Institute of Medical Biology, A*STAR, 8A Biomedical Grove, #06-06 Immunos, Singapore 138648, Singapore
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Jones C, Norbury G, Bell T. Impacts of introduced European hedgehogs on endemic skinks and weta in tussock grassland. Wildl Res 2013. [DOI: 10.1071/wr12164] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Context Control of introduced pest species is based on the premise that there is a relationship between pest abundance and impact, but this relationship is rarely defined. Aim We investigated the impacts of introduced European hedgehogs (Erinaceus europaeus) on two species of small endemic skink (Oligosoma spp.) and flightless, nocturnal endemic orthopteran ground weta (Hemiandrus spp.), using an enclosure-based experimental manipulation of hedgehog density in tussock grasslands in the South Island of New Zealand. Methods We used capture–mark–recapture methods to estimate the densities of skinks before and after exposure to a range of hedgehog densities over a 3-month period and also compared changes in indices of abundance of skink demographic groups and ground weta. Key results Faecal analysis confirmed that hedgehogs consumed skinks and invertebrates in the enclosures. The proportional change between capture sessions in numbers of captured juvenile McCann’s skinks (O. maccanni) declined with increasing hedgehog density. Similarly, the proportional change in the numbers of ground weta encountered in pitfall traps showed a highly significant negative relationship with increasing hedgehog density. Total species abundances and numbers in other demographic skink groups did not change significantly in relation to hedgehog density. For overall skink abundance estimates, there was an apparent trend suggesting that changes in abundance were more negative with increasing hedgehog density, but this did not reach statistical significance for either skink species. Conclusions Our results confirmed that hedgehogs are important predators of small native fauna, but suggested that highly abundant prey populations may be buffered against significant impacts. Implications Less abundant prey and some demographic groups within populations, however, may be at significant risk from hedgehog predation.
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Poroyko V, Morowitz M, Bell T, Ulanov A, Wang M, Donovan S, Bao N, Gu S, Hong L, Alverdy JC, Bergelson J, Liu DC. Diet creates metabolic niches in the "immature gut" that shape microbial communities. NUTR HOSP 2012; 26:1283-95. [PMID: 22411374 DOI: 10.1590/s0212-16112011000600015] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 07/11/2011] [Indexed: 11/22/2022] Open
Abstract
Although diet composition has been implicated as a major factor in the etiology of various gastrointestinal diseases, conclusive evidence remains elusive. This is particularly true in diseases such as necrotizing enterocolitis where breast milk as opposed to commercial formula appears to confer a "protective effect" to the "immature gut." Yet the mechanism by which this occurs continues to remain speculative. In the present study we hypothesize that the basic chemical composition of diet fundamentally selects for specific intestinal microbiota which may help explain disparate disease outcome and therapeutic direction. Complimentary animal and human studies were conducted on young piglets (21 d.)(n = 8) (IACUC protocols 08070 and 08015) and premature infants (adjusted gestational age 34-36 weeks) (n = 11) (IRB Protocol 15895A). In each study, cecal or stool contents from two groups (Breast milk-fed (BF) vs. Formula-fed (FF)) were analyzed by gas chromatography/mass spectrometry (GC/MS) and comprehensive metabolic profiles generated and compared. Concurrently, bacterial community structure was assayed and respective representative microbiota of the groups determined by 16S rRNA gene amplicon pyrosequencing. Statistical modeling and analysis was done using SIMCA-P+ and R software. GC/MS metabolomics identified clear differences between BF and FF groups in the intestinal environment of piglets and humans. Sugars, amino-sugars, fatty acids, especially unsaturated fatty acids, and sterols were identified as being among the most important metabolites for distinguishing between BF and FF groups. Joint analysis of microbiota and metabolomics pinpointed specific sets of metabolites (p < 0.05) associated with the dominant bacterial taxa. The chemical composition of diet appears to have a significant role in defining the microbiota of the immature gut. Tandem analysis of intestinal microbial and metabolic profiles is potentially a powerful tool leading to better understanding of the role of diet in disease perhaps even leading to specific strategies to alter microbial behavior to improve clinical outcome.
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Affiliation(s)
- V Poroyko
- Department of Surgery, The University of Chicago, Chicago, IL, USA
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Wilson AA, Garcia A, Bell T, Harris-Brandts T, Houle S. Further progress on a remarkably simple captive solvent method for [11C]-methylations. J Labelled Comp Radiopharm 2012. [DOI: 10.1002/jlcr.25804401353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Tucker J, Yanagawa F, Ahuja N, Bell T, Grim R, Ahuja V. Lymph Node Evaluation by Tumor Location in Colon Cancer Elderly Patients: A SEER-Medicare Study. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.095] [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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Mehta C, Vaid S, Adedeji A, Vibhakar D, Bell T, Grim R, Ahuja V. Epidemiology of Clostridium Difficile Colitis in Hospitalized Patients in the United States. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.063] [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: 10/14/2022]
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Shokek O, Yacoub S, Bauer TL, Bell T, Fortier GA, Grim R, Hempling RE, Johnson DE, Kassas B, Lasher D, Mudge K, Pandelidis S, Pramanik R, Watson M, Wojcicka J, Shah A. MammoSite partial breast irradiation following breast-conserving surgery for early-stage breast cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
122 Background: Partial breast irradiation (PBI) remains investigational until comparisons to whole-breast external beam radiotherapy (EBRT) confirm noninferiority. Methods: From 2004 to 2010, 103 patients at York Cancer Center (Pennsylvania) who underwent margin-negative breast-conserving surgery for early-stage invasive or in situ breast carcinoma were enrolled on a prospective MammoSite PBI protocol. NSABP B39 stage and planning criteria were utilized, with unicentric tumors up to 3 cm and pN0-1 axillary staging for invasive carcinomas. PBI was prescribed to 1 cm from the applicator surface in 10 twice-daily fractions to 34 Gy. Results: With a median follow-up of 27 months, three patients experienced recurrence: one with isolated local in-breast tumor recurrence (local IBTR), one with IBTR remote from the surgical cavity (non-local IBTR) plus regional and distant recurrence, and one with regional and distant recurrence only 3- and 5-year freedom from local IBTR are 100% and 96% (non-local IBTR: 100% and 95%). Physician-reported cosmesis evaluations are available for 25 patients at 2-3 years after treatment, with a median score of “excellent.” 26 additional patients on protocol underwent insertion of the MammoSite applicator but had it removed without treatment, most commonly due to unsatisfactory cavity conformance (24 patients), uncommonly due to infection or seroma (two patients). Their characteristics (invasive vs. in situ disease, T/N stage, negative vs. close margins, age) were not statistically different than the 103 MammoSite-treated patients. All except one received EBRT, and none experienced IBTR, which is not statistically different than the IBTR rates of the 103 MammoSite-treated patients (p=0.84). Conclusions: MammoSite PBI in well-selected patients was associated with low rates of IBTR and not significantly different than a comparison cohort selected for MammoSite PBI but treated instead with EBRT. Randomized comparisons of PBI vs. EBRT are required to confirm PBI as standard.
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Affiliation(s)
| | | | | | - T. Bell
- York Cancer Center, York, PA
| | | | - R. Grim
- York Cancer Center, York, PA
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- York Cancer Center, York, PA
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Elerman Y, Dincer I, Ehrenberg H, Bell T. Structural, magnetic and magnetocaloric properties of CoMnGe 1.95Ga 0.05. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311079694] [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: 11/11/2022] Open
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Buckius M, McGrath B, Monk J, Grim R, Bell T, Wesner V, Ahuja V. Changing Epidemiology of Acute Appendicitis in the United States: Study Period 1993 to 2008. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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McGrath B, Bell T, Grim R, Buckius M, Ahuja V. Economics Of Appendicitis: Cost Trend Analysis Of Laparoscopic Versus Open Appendectomy From 1998 To 2008. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.422] [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: 11/17/2022]
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Dong Y, Li X, Bell T, Sammons R, Dong H. Surface microstructure and antibacterial property of an active-screen plasma alloyed austenitic stainless steel surface with Cu and N. Biomed Mater 2010; 5:054105. [DOI: 10.1088/1748-6041/5/5/054105] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Alur P, Cirelli J, Goodstein M, Bell T, Liss J. Audiovisual Presentations on a Handheld PC are Preferred As an Educational Tool by NICU Parents. Appl Clin Inform 2010; 1:142-8. [PMID: 23616833 DOI: 10.4338/aci-2010-01-ra-0005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 01/17/2010] [Accepted: 04/21/2010] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Health literacy is critical for understanding complex medical problems and necessary for the well being of the patient. Printed educational materials (PM) have limitations in explaining the dynamics of a disease process. Multimedia formats may be useful for enhancing the educational process. OBJECTIVE To evaluate whether a printed format or animation with commentary on a handheld personal computer (PC) is preferred as an educational tool by parents of a baby in the NICU. METHODS PARENTS EVALUATED TWO FORMATS: A 1-page illustrated document from the American Heart Association explaining patent ductus arteriosus (PDA) and animation with commentary on a handheld PC that explained the physiology of PDA in 1 minute. The reading grade level of the PM was 8.6 versus 18.6 for the audio portion of the animated presentation. Parents viewed each format and completed a four-item questionnaire. Parents rated both formats and indicated their preference as printed, animation, or both. RESULTS Forty-six parents participated in the survey. Parents preferred animation over PM (50% vs. 17.4%. p = 0.02); 39.1% expressed that the animation was excellent; whereas 4.3% expressed that the PM was excellent (p<0.001). The order of presentation of formats, sex, age, and educational level of parents did not influence the method preferred (p>0.05). CONCLUSION Parents preferred animation on a small screen handheld PC despite a much higher language level. Because handheld PCs are portable and inexpensive, they can be used effectively at the bedside with low-cost animation to enhance understanding of complex disease conditions.
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Affiliation(s)
- P Alur
- WellSpan Health - Pediatrics , York, Pennsylvania, United States
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Nipp R, Bell T, Ruhl D, Lee C, Kirkland J. Pilot study to determine feasibility of development of an influenza clinical diagnostic tool. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.555] [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: 11/29/2022] Open
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Renouf MAP, Bell T, Macpherson J. Hunter-Gatherer Impact on Subarctic Vegetation: Amerindian and Palaeoeskimo Occupations of Port au Choix, Northwestern Newfoundland. Arctic Anthropology 2009. [DOI: 10.1353/arc.0.0031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rudel L, Sawyer J, Wilson M, Bell T. Abstract: 145 THE CENTRAL ROLE OF ACAT2 AND CHOLESTERYL OLEATE IN ATHEROSCLEROSIS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70065-0] [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: 11/29/2022]
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Fish M, Bayer AJ, Gallacher JEJ, Bell T, Pickering J, Pedro S, Dunstan FD, Ben-Shlomo Y, Ebrahim S. Prevalence and pattern of cognitive impairment in a community cohort of men in South Wales: methodology and findings from the Caerphilly Prospective Study. Neuroepidemiology 2008; 30:25-33. [PMID: 18259098 DOI: 10.1159/000115439] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Accepted: 11/02/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The prevalence of dementia and cognitive impairment not dementia was investigated in the Caerphilly Prospective Study cohort (men currently aged 65-84 years). METHODS Of 1,633 men eligible for cognitive screening, 1,225 (75%) were seen, with those failing the screening criteria (CAMCOG <83 or decline in CAMCOG >9) being neurologically examined. RESULTS For dementia, diagnosed by DSM-IV criteria, the population prevalence was 5.2% rising to 6.1% in the screened population. For cognitive impairment not dementia, the prevalence in the screened population was 15.6% giving an overall prevalence of cognitive impairment of 21.8%. Prevalence rose fivefold between ages of 65 and 84 years to reach over 50%. CONCLUSION These figures are likely to underestimate actual prevalence in this population, and developing effective interventions should be a public health priority.
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Affiliation(s)
- M Fish
- Department of Geriatric Medicine, Centre for Health Sciences Research, Cardiff University, Cardiff, UK
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Davoren GK, May C, Penton P, Reinfort B, Buren A, Burke C, Andrews D, Montevecchi WA, Record N, deYoun B, Rose-Taylor C, Bell T, Anderson JT, Koen-Alonso M, Garthe S. An ecosystem-based research program for capelin (Mallotus villosus) in the northwest Atlantic: overview and results. ACTA ACUST UNITED AC 2007. [DOI: 10.2960/j.v39.m595] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Sabatowski R, Tark M, Frank L, Rentz A, Kleoudis C, Bell T, Pierce A, Snidow J. 696 EFFECT OF ALVIMOPAN ON HEALTH-RELATED QUALITY OF LIFE (HRQOL) IN SUBJECTS WITH OPIOID-INDUCED GASTROINTESTINAL (GI) SIDE EFFECTS: THE PAC-QOL QUESTIONNAIRE. Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60699-x] [Citation(s) in RCA: 1] [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: 11/26/2022]
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Bell T, Milanova T, Grove G, Williamson R, Bolge S. 663 PREVALENCE, SEVERITY AND IMPACT OF OPIOID-INDUCED GI SIDE EFFECTS IN THE EU: RESULTS OF A PATIENT SURVEY. Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60666-6] [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: 10/23/2022]
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