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Kiptoo M, Brooks J, Lihana RW, Sandstrom P, Ng'ang'a Z, Kinyua J, Lagat N, Okoth F, Songok EM. HIV-1 drug resistance-associated mutations among HIV-1 infected drug-naïve antenatal clinic attendees in rural Kenya. BMC Infect Dis 2013; 13:517. [PMID: 24180455 PMCID: PMC4228423 DOI: 10.1186/1471-2334-13-517] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/28/2013] [Indexed: 04/16/2023] Open
Abstract
Background Access to antiretroviral therapy (ART) has increased dramatically in Sub-Saharan Africa. In Kenya, 560,000 people had access to ART by the end of 2011. This scaling up of ART has raised challenges to the Kenyan health system due to emergence of drug resistant viruses among those on treatment and possible onward transmission. To counter this, and come up with an effective treatment strategy, it has become vital to determine baseline mutations associated with drug resistance among the circulating strains of HIV-1in Kenya. Methods The prevalence of mutations associated with drug resistance in HIV-1 protease (PR) and reverse transcriptase (RT) regions from 188 HIV-1 infected treatment-naïve pregnant women was investigated in Kapsabet, Nandi Hills and Kitale district hospitals of Kenya. Blood samples were collected between April 2005 and June 2006. The HIV-1 pol gene was amplified using primers for HIV-1 PR and RT and sequenced using the BigDye chemistry. The mutations were analyzed based on the IAS algorithm as well as the Stanford University HIV Drug Resistance Database. Results Based on the PR and RT sequences, HIV-1 subtypes A1 (n=117, 62.2%), A2 (n=2, 1.1%), D (n=27, 14.4%), C (n=13, 6.9%), G (n=3, 1.6%), and possible recombinants (n=26, 13.8%) were detected. Mutations associated with nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside RTI (NNRTI)-resistance were detected in 1.6% (3 of 188) and 1.1% (2 of 188), respectively. Mutations associated with PI resistance were detected in 0.5% (1 of 188) of the study population. Conclusion The prevalence of drug resistance among drug-naïve pregnant women in rural North Rift, Kenya in 2006 was 3.2%. Major drug resistance mutations associated with PIs, NRTIs and NNRTIs do exist among treatment-naïve pregnant women in North Rift, Kenya. There is a need for consistent follow-up of drug-naïve individuals in this region to determine the impact of mutations on treatment outcomes.
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Kathpal M, Brand T, Ninneman S, Hughs G, Katz L, Brown M, Halligan J, Brooks J, Macdonald D, Tinnel B. Differences Between Beacon-Localized and Cone Beam CT (CBCT)-Localized Radiation Therapy to the Prostatic Fossa. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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103
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Jimenez Diaz VA, Baz Alonso JA, Ortiz A, Castro A, Gomez I, Bastos G, Sepulveda J, Ponce J, Brooks J, Iniguez A. Same-day discharge vs overnight stay after elective percutaneous coronary intervention: feasibility, safety, and outcome. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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104
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Fitz LJ, DeClercq C, Brooks J, Kuang W, Bates B, Demers D, Winkler A, Nocka K, Jiao A, Greco RM, Mason LE, Fleming M, Quazi A, Wright J, Goldman S, Hubeau C, Williams CM. Acidic mammalian chitinase is not a critical target for allergic airway disease in mice. J Inflamm (Lond) 2013. [PMCID: PMC3750992 DOI: 10.1186/1476-9255-10-s1-p5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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105
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Brooks J, Chadwick A, Romei V, Rees G. Spontaneous pre-stimulus oscillations predict direction of ambiguous figure-ground assignment. J Vis 2013. [DOI: 10.1167/13.9.1029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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106
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Wheeler-Kingshott CA, Stroman PW, Schwab JM, Bacon M, Bosma R, Brooks J, Cadotte DW, Carlstedt T, Ciccarelli O, Cohen-Adad J, Curt A, Evangelou N, Fehlings MG, Filippi M, Kelley BJ, Kollias S, Mackay A, Porro CA, Smith S, Strittmatter SM, Summers P, Thompson AJ, Tracey I. The current state-of-the-art of spinal cord imaging: applications. Neuroimage 2013; 84:1082-93. [PMID: 23859923 DOI: 10.1016/j.neuroimage.2013.07.014] [Citation(s) in RCA: 155] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Revised: 06/30/2013] [Accepted: 07/04/2013] [Indexed: 12/14/2022] Open
Abstract
A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small crosssectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of "critical mass" of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research.
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107
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Wallace TC, MacKay D, Ritz BW, McBurney M, Shao A, Miller J, Brooks J, Hendricks L. An industry perspective: dietary supplements and mortality rates in older women. J Diet Suppl 2013; 10:85-92. [PMID: 23679573 DOI: 10.3109/19390211.2013.783661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This special article seeks to provide balance and clarity to the confusion brought about by the conclusions resulting from a recent study published in Archives of Internal Medicine by Mursu et al. (2011). An examination of three key limitations of the study provides context to why additional research is needed: (a) Nonusers were poorly defined; (b) supplement users were healthier than nonusers; and (c) the number of supplement users increased throughout the study. Although the literature is limited, other similar observational studies have also shown positive effects on the risk mortality for both multivitamins and single-nutrient supplements. Observational trials are an essential component of evidence-based nutrition but do not offer certainty because other data, such as the one generated from randomized controlled trials, are equally important in regard to the totality of evidence. The Senior Scientific Advisory Committee for the Council for Responsible Nutrition, an industry trade group, feels that the conclusions of the study by Mursu et al. (2011) are overstated and suggests that researchers analyze cohort(s) designed to specifically examine vitamin and mineral supplements free of confounding from factors, such as hormone replacement therapy, to better assess their benefits to the general population.
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108
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Stroman PW, Wheeler-Kingshott C, Bacon M, Schwab JM, Bosma R, Brooks J, Cadotte D, Carlstedt T, Ciccarelli O, Cohen-Adad J, Curt A, Evangelou N, Fehlings MG, Filippi M, Kelley BJ, Kollias S, Mackay A, Porro CA, Smith S, Strittmatter SM, Summers P, Tracey I. The current state-of-the-art of spinal cord imaging: methods. Neuroimage 2013; 84:1070-81. [PMID: 23685159 DOI: 10.1016/j.neuroimage.2013.04.124] [Citation(s) in RCA: 217] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 04/08/2013] [Accepted: 04/16/2013] [Indexed: 12/28/2022] Open
Abstract
A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small cross-sectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of "critical mass" of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research.
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109
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Leppert J, Fan A, Liliental J, Xu L, Thong A, Yost C, Yaghi A, Metzner T, Brooks J, Harshman L, Sabatti C, Srinivas S, Felsher D. 603 NANO-SCALE PROTEOMIC PROFILING TO DEFINE DIAGNOSTIC SIGNATURES AND BIOMARKERS OF THERAPEUTIC ACTIVITY IN RCC. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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110
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Surapaneni L, Haley‐Zitlin V, Bodine A, Jiang X, Brooks J. Relationship Between In Vitro Absorption of Chondroitin Sulfate (CS) and Its Molecular Weight. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.125.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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111
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Surapaneni L, Haley‐Zitlin V, Bodine A, Jiang X, Brooks J. Examination of Chondroitin Sulfate Molecular Weights on In Vitro Anti‐inflammatory Activity. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.846.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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112
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Ji H, Li Y, Liang B, Pilon R, MacPherson P, Bergeron M, Kim J, Graham M, Van Domselaar G, Sandstrom P, Brooks J. Pyrosequencing dried blood spots reveals differences in HIV drug resistance between treatment naïve and experienced patients. PLoS One 2013; 8:e56170. [PMID: 23409150 PMCID: PMC3567018 DOI: 10.1371/journal.pone.0056170] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 01/07/2013] [Indexed: 11/18/2022] Open
Abstract
Dried blood spots (DBS) are an alternative specimen collection format for HIV-1 genotyping. DBS produce HIV genotyping results that are robust and equivalent to plasma when using conventional sequencing methods. However, using tagged, pooled pyrosequencing, we demonstrate that concordance between plasma and DBS is not absolute and varies according to viral load (VL), duration of HIV infection and antiretroviral therapy (ART) status. The plasma/DBS concordance is the highest when VL is ≥5,000 copies/ml and/or the patient has no ART exposure and/or when the duration of HIV infection is ≤2 years. Stepwise regression analysis revealed that VL is most important independent predictor for concordance of DBS with plasma genotypes. This is the first study to use next generation sequencing to identify discordance between DBS and plasma genotypes. Consideration should be given to VL, duration of infection, and ART exposure when interpreting DBS genotypes produced using next generation sequencing. These findings are of particular significance when DBS are to be used for clinical monitoring purposes.
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113
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Ji H, Liang B, Li Y, Van Domselaar G, Graham M, Tyler S, Merks H, Sandstrom P, Brooks J. Low abundance drug resistance variants in transmitted HIV drug resistance surveillance specimens identified using tagged pooled pyrosequencing. J Virol Methods 2013; 187:314-20. [DOI: 10.1016/j.jviromet.2012.10.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 10/10/2012] [Accepted: 10/22/2012] [Indexed: 01/23/2023]
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114
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Murcray D, Brooks J, Murcray F, Shaw C. High altitude infrared studies of the atmosphere. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/jz063i002p00289] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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115
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Ragonnet-Cronin M, Aris-Brosou S, Joanisse I, Merks H, Vallée D, Caminiti K, Rekart M, Krajden M, Cook D, Kim J, Malloch L, Sandstrom P, Brooks J. Genetic Diversity as a Marker for Timing Infection in HIV-Infected Patients: Evaluation of a 6-Month Window and Comparison With BED. J Infect Dis 2012; 206:756-64. [DOI: 10.1093/infdis/jis411] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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116
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Brooks J, Gilaie-Dotan S, Rees G, Bentin S, Driver J. Preserved local but disrupted contextual figure-ground influences in a patient with abnormal function of intermediate visual areas. J Vis 2012. [DOI: 10.1167/12.9.1266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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117
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Burchell AN, Bayoumi AM, Rourke SB, Major C, Gardner S, Sandstrom P, Rachlis A, Taylor D, Mazzulli T, Fisher M, Brooks J. Increase in transmitted HIV drug resistance among persons undergoing genotypic resistance testing in Ontario, Canada, 2002-09. J Antimicrob Chemother 2012; 67:2755-65. [PMID: 22833637 DOI: 10.1093/jac/dks287] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To characterize persons undergoing HIV genotypic resistance testing (GRT) while treatment naive and to estimate the prevalence of transmitted HIV drug resistance (TDR) among HIV-positive outpatients in Ontario, Canada. METHODS We analysed data from a multi-site cohort of persons receiving HIV care. Data were obtained from medical chart abstractions, interviews and record linkage with the Public Health Laboratories, Public Health Ontario. The analysis was restricted to 626 treatment-naive persons diagnosed in 2002-09. TDR mutations were identified using the calibrated population resistance tool. We used descriptive statistics and regression methods to characterize treatment-naive GRT test uptake and patterns of TDR. RESULTS Overall, 53.2% (333/626) of participants had baseline GRT. The proportion increased with year of HIV diagnosis from 30.0% in 2002 to 82.6% in 2009 (P < 0.0001). Among those tested, 13.6% (CI 9.9-17.3%) had one or more drug resistance mutations, and 8.8% (CI 5.7-11.8%), 4.8% (CI 2.5-7.2%) and 2.7% (CI 1.0-4.5%) had mutations conferring resistance to nucleoside/tide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs), respectively. TDR prevalence increased from 2002-07 to 2008-09 (adjusted OR 3.7, 95% CI 1.7-8.2), driven by a higher proportion with NRTI (18.2% versus 5.9%, P = 0.0009) and NNRTI mutations (11.7% versus 2.8%, P = 0.004) in the later time period. PI TDR remained unchanged. CONCLUSIONS Baseline GRT increased dramatically since 2002, but remains below 100%. The prevalence of overall TDR tripled due to increases in NRTI and NNRTI mutations. These findings highlight the value of routine baseline GRT for TDR surveillance and patient care.
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118
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Ragonnet-Cronin M, Aris-Brosou S, Joanisse I, Merks H, Vallee D, Caminiti K, Sandstrom P, Brooks J. Adaptive evolution of HIV at HLA epitopes is associated with ethnicity in Canada. PLoS One 2012; 7:e36933. [PMID: 22693560 PMCID: PMC3365047 DOI: 10.1371/journal.pone.0036933] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 04/16/2012] [Indexed: 11/24/2022] Open
Abstract
Host immune selection pressure influences the development of mutations that allow for HIV escape. Mutation patterns induced in HIV by the human leukocyte antigen (HLA) are HLA-allele specific. As ethnic groups have distinct and characteristic HLA allele frequencies, we can expect divergent viral evolution within ethnicities. Here, we have sequenced and analyzed the HIV pol gene from 1248 subtype B infected, treatment-naïve individuals in Canada. Phylogenetic analysis showed no separation between pol sequences from five self-identified ethnic groups, yet fixation index (FST) values showed significant divergence between ethnicities. A total of 17 amino acid sites showed an ethnic-specific fixation pattern (0.015<FST <0.060, p<0.01), and 27 codons were inferred to be under positive selection (p<0.01), with each set of sites strongly associated with HLA sites (p = 1.78×10−6 and p = 1.91×10−7, respectively). Within the pol gene, eight sites under HLA selective pressure were correlated with ethnicity, indicating ‘adaptive divergence’ between the groups studied. Our findings highlight challenges in HIV vaccine design in ethnically diverse countries with subtype B epidemics.
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119
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Willer DO, Ambagala APN, Pilon R, Chan JK, Fournier J, Brooks J, Sandstrom P, MacDonald KS. Experimental infection of Cynomolgus Macaques (Macaca fascicularis) with human varicella-zoster virus. J Virol 2012; 86:3626-34. [PMID: 22258257 PMCID: PMC3302534 DOI: 10.1128/jvi.06264-11] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 01/06/2012] [Indexed: 11/20/2022] Open
Abstract
Varicella-zoster virus (VZV) is a member of the alphaherpesvirus family and the causative agent of chickenpox and shingles. To determine the utility of cynomolgus macaques (Macaca fascicularis) as a nonhuman primate model to evaluate VZV-based simian immunodeficiency virus/human immunodeficiency virus (SIV/HIV) vaccines, we experimentally inoculated 10 animals with the parental Oka (Oka-P) strain of VZV derived from MeWo or Telo-RF cells. VZV DNA could be detected in the lungs as late as 4 days postinfection, with replicating virus detected by shell vial culture assay in one case. Infection did not result in any overt clinical symptoms but was characterized by humoral and cell-mediated immunity in a time frame and at a magnitude similar to those observed following VZV vaccination in humans. The cell line source of VZV inoculum influenced both the magnitude and polyfunctionality of cell-mediated immunity. Animals mounted a vigorous anamnestic antibody response following a second inoculation 12 weeks later. Inoculations resulted in transient increases in CD4(+) T-cell activation and proliferation, as well as a sustained increase in CD4(+) T cells coexpressing CCR5 and α4β7 integrin. In contrast to previous failed attempts to successfully utilize attenuated VZV-Oka as an SIV vaccine vector in rhesus macaques due to suboptimal infectivity and cellular immunogenicity, the ability to infect cynomolgus macaques with Oka-P VZV should provide a valuable tool for evaluating VZV-vectored SIV/HIV vaccines.
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Truong M, Yang B, Kobayashi Y, Brooks J, Jarrard D. 1315
EVEN-SKIPPED HOMEOBOX 1
(
EVX1
) IS FREQUENTLY HYPERMETHYLATED IN PROSTATE CANCER AND PREDICTS PSA RECURRENCE. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.1662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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121
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Lin D, Newcomb L, Ellis W, Gleave M, Thompson I, Brooks J, Nelson P, Sanda M, Lance R, Wei J, Feng Z, Carroll P. 990 PROGRESSION AND TREATMENT IN A MULTI-INSTITUTIONAL, PROSPECTIVE ACTIVE SURVEILLANCE STUDY: RESULTS FROM CANARY PROSTATE ACTIVE SURVEILLANCE STUDY (PASS). J Urol 2012. [DOI: 10.1016/j.juro.2012.02.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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122
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Brooks J. Going to coroner’s court. Assoc Med J 2012. [DOI: 10.1136/bmj.e50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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123
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Zimmer M, Fan X, Bao J, Liang R, Wang B, Zhang C, Brooks J. Through-Thickness Thermal Conductivity Prediction Study on Nanocomposites and Multiscale Composites. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/msa.2012.33021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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124
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Brooks J, Lycett-Lambert K, Caminiti K, Merks H, McMillan R, Sandstrom P. No evidence of cross-species transmission of mouse retroviruses to animal workers exposed to mice. Transfusion 2011; 52:317-25. [DOI: 10.1111/j.1537-2995.2011.03463.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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125
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Meredith DJ, Clifton D, Charlton P, Brooks J, Pugh CW, Tarassenko L. Photoplethysmographic derivation of respiratory rate: a review of relevant physiology. J Med Eng Technol 2011; 36:1-7. [PMID: 22185462 DOI: 10.3109/03091902.2011.638965] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
An abnormal respiratory rate is often the earliest sign of critical illness. A reliable estimate of respiratory rate is vital in the application of remote telemonitoring systems, which may facilitate early supported discharge from hospital or prompt recognition of physiological deterioration in high-risk patient groups. Traditional approaches use analysis of respiratory sinus arrhythmia from the electrocardiogram (ECG), but this phenomenon is predominantly limited to the young and healthy. Analysis of the photoplethysmogram (PPG) waveform offers an alternative means of non-invasive respiratory rate monitoring, but further development is required to enable reliable estimates. This review conceptualizes the challenge by discussing the effect of respiration on the PPG waveform and the key physiological mechanisms that underpin the derivation of respiratory rate from the PPG.
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