101
|
Montgomery RA, Redilla KM, Ortiz‐Calo W, Smith T, Keller B, Millspaugh JJ. Evaluating the individuality of animal-habitat relationships. Ecol Evol 2018; 8:10893-10901. [PMID: 30519415 PMCID: PMC6262913 DOI: 10.1002/ece3.4554] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/25/2018] [Accepted: 05/16/2018] [Indexed: 11/25/2022] Open
Abstract
Examining the ways in which animals use habitat and select resources to satisfy their life history requirements has important implications for ecology, evolution, and conservation. The advent of radio-tracking in the mid-20th century greatly expanded the scope of animal-habitat modeling. Thereafter, it became common practice to aggregate telemetry data collected on a number of tagged individuals and fit one model describing resource selection at the population level. This convention, however, runs the risk of masking important individuality in the nature of associations between animals and their environment. Here, we investigated the importance of individual variation in animal-habitat relationships via the study of a highly gregarious species. We modeled elk (Cervus elaphus) location data, collected from Global Positioning System (GPS) collars, using Bayesian discrete choice resource selection function (RSF) models. Using a high-performance computing cluster, we batch-processed these models at the level of each individual elk (n = 88) and evaluated the output with respect to: (a) the composition of parameters in the most supported models, (b) the estimates of the parameters featured in the global models, and (c) spatial maps of the predicted relative probabilities of use. We detected considerable individual variation across all three metrics. For instance, the most supported models varied with respect to parameter composition with a range of seven to 17 and an average of 14.4 parameters per individual elk. The estimates of the parameters featured in the global models also varied greatly across individual elk with little conformity detected across age or sex classes. Finally, spatial mapping illustrated stark differences in the predicted relative probabilities of use across individual elk. Our analysis identifies that animal-habitat relationships, even among the most gregarious of species, can be highly variable. We discuss the implications of our results for ecology and present some guiding principles for the development of RSF models at the individual-animal level.
Collapse
|
102
|
Abade L, Cusack J, Moll RJ, Strampelli P, Dickman AJ, Macdonald DW, Montgomery RA. Spatial variation in leopard (Panthera pardus) site use across a gradient of anthropogenic pressure in Tanzania's Ruaha landscape. PLoS One 2018; 13:e0204370. [PMID: 30304040 PMCID: PMC6179245 DOI: 10.1371/journal.pone.0204370] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 09/05/2018] [Indexed: 11/18/2022] Open
Abstract
Understanding large carnivore occurrence patterns in anthropogenic landscapes adjacent to protected areas is central to developing actions for species conservation in an increasingly human-dominated world. Among large carnivores, leopards (Panthera pardus) are the most widely distributed felid. Leopards occupying anthropogenic landscapes frequently come into conflict with humans, which often results in leopard mortality. Leopards' use of anthropogenic landscapes, and their frequent involvement with conflict, make them an insightful species for understanding the determinants of carnivore occurrence across human-dominated habitats. We evaluated the spatial variation in leopard site use across a multiple-use landscape in Tanzania's Ruaha landscape. Our study region encompassed i) Ruaha National Park, where human activities were restricted and sport hunting was prohibited; ii) the Pawaga-Idodi Wildlife Management Area, where wildlife sport hunting, wildlife poaching, and illegal pastoralism all occurred at relatively low levels; and iii) surrounding village lands where carnivores and other wildlife were frequently exposed to human-carnivore conflict related-killings and agricultural habitat conversion and development. We investigated leopard occurrence across the study region via an extensive camera trapping network. We estimated site use as a function of environmental (i.e. habitat and anthropogenic) variables using occupancy models within a Bayesian framework. We observed a steady decline in leopard site use with downgrading protected area status from the national park to the Wildlife Management Area and village lands. Our findings suggest that human-related activities such as increased livestock presence and proximity to human households exerted stronger influence than prey availability on leopard site use, and were the major limiting factors of leopard distribution across the gradient of human pressure, especially in the village lands outside Ruaha National Park. Overall, our study provides valuable information about the determinants of spatial distribution of leopards in human-dominated landscapes that can help inform conservation strategies in the borderlands adjacent to protected areas.
Collapse
|
103
|
Cohen EO, Hen O, Piasetzky E, Weinstein LB, Duer M, Schmidt A, Korover I, Hakobyan H, Adhikari S, Akbar Z, Amaryan MJ, Avakian H, Ball J, Barion L, Battaglieri M, Beck A, Bedlinskiy I, Biselli AS, Boiarinov S, Briscoe W, Burkert VD, Cao F, Carman DS, Celentano A, Charles G, Chatagnon P, Chetry T, Ciullo G, Clary BA, Contalbrigo M, Crede V, Cruz Torres R, D'Angelo A, Dashyan N, De Vita R, De Sanctis E, Defurne M, Deur A, Diehl S, Djalali C, Duer M, Dupre R, Egiyan H, Ehrhart M, El Alaoui A, Fassi LE, Eugenio P, Fedotov G, Fersch R, Filippi A, Ghandilyan Y, Giovanetti KL, Girod FX, Golovatch E, Gothe RW, Griffioen KA, Hafidi K, Harrison N, Hauenstein F, Heddle D, Hicks K, Holtrop M, Ireland DG, Ishkhanov BS, Isupov EL, Jenkins D, Jo HS, Johnston S, Kabir ML, Keller D, Khachatryan G, Khachatryan M, Khandaker M, Kim A, Kim W, Klein A, Klein FJ, Korover I, Kubarovsky V, Kuhn SE, Lanza L, Lenisa P, Livingston K, MacGregor IJD, Marchand D, McKinnon B, Mey-Tal Beck S, Meyer CA, Mirazita M, Mokeev V, Montgomery RA, Movsisyan A, Munoz Camacho C, Mustapha B, Nadel-Turonski P, Niccolai S, Niculescu G, Osipenko M, Ostrovidov AI, Paolone M, Paremuzyan R, Pasyuk E, Pogorelko O, Price JW, Prok Y, Protopopescu D, Ripani M, Riser D, Rizzo A, Rosner G, Rossi P, Sabatié F, Schmookler BA, Schumacher RA, Sharabian YG, Sokhan D, Sparveris N, Stepanyan S, Strauch S, Taiuti M, Tan JA, Ungaro M, Voskanyan H, Voutier E, Wang R, Watts DP, Wei X, Wood MH, Zachariou N, Zhang J, Zheng X, Zhao ZW. Center of Mass Motion of Short-Range Correlated Nucleon Pairs studied via the A(e,e^{'}pp) Reaction. PHYSICAL REVIEW LETTERS 2018; 121:092501. [PMID: 30230869 DOI: 10.1103/physrevlett.121.092501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Indexed: 06/08/2023]
Abstract
Short-range correlated (SRC) nucleon pairs are a vital part of the nucleus, accounting for almost all nucleons with momentum greater than the Fermi momentum (k_{F}). A fundamental characteristic of SRC pairs is having large relative momenta as compared to k_{F}, and smaller center of mass (c.m.) which indicates a small separation distance between the nucleons in the pair. Determining the c.m. momentum distribution of SRC pairs is essential for understanding their formation process. We report here on the extraction of the c.m. motion of proton-proton (pp) SRC pairs in carbon and, for the first time in heavier and ansymetric nuclei: aluminum, iron, and lead, from measurements of the A(e,e^{'}pp) reaction. We find that the pair c.m. motion for these nuclei can be described by a three-dimensional Gaussian with a narrow width ranging from 140 to 170 MeV/c, approximately consistent with the sum of two mean-field nucleon momenta. Comparison with calculations appears to show that the SRC pairs are formed from mean-field nucleons in specific quantum states.
Collapse
|
104
|
Boyer RA, Coluccy JM, Montgomery RA, Redilla KM, Winterstein SR. The effect of habitat on the breeding season survival of Mallards ( Anas platyrhynchos) in the Great Lakes region. CAN J ZOOL 2018. [DOI: 10.1139/cjz-2017-0224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Modeling the effect of habitat on animal survival is critical for understanding population dynamics and developing effective habitat management strategies. Despite the importance of this information, knowledge of survival–habitat associations are often lacking, particularly for waterfowl species. Here we evaluated female Mallard (Anas platyrhynchos Linnaeus, 1758) survival during the breeding season in relation to habitat conditions within each individual’s home range. We implanted telemetry transmitters and tracked 283 female Mallards across nine study sites in the Great Lakes region. For each Mallard, we quantified core breeding season home ranges via the creation of utilization distributions (UDs). We then fit known-fate models in the program MARK to predict breeding season survival as a function of the proximity of core home ranges to various habitat types, the proportion of habitat types within the core areas, number of core areas, and home range size. We found that breeding season survival decreased as the proportion of forestland habitat within core home ranges increased (β = −1.740, SE = 0.787). No additional upland or wetland habitat types significantly affected breeding season survival. Managers striving to increase breeding season survival for Mallards should focus their efforts on restoring habitats in areas with low proportions of forestland habitat to mitigate the risk of predation.
Collapse
|
105
|
Bouquegneau A, Loheac C, Aubert O, Bouatou Y, Viglietti D, Empana J, Ulloa C, Hassan Murad M, Legendre C, Glotz D, Jackson AM, Zeevi A, Schaub S, Taupin J, Reed EF, Friedewald JJ, Tyan DB, Süsal C, Shapiro R, Woodle ES, Hidalgo LG, O’Leary J, Montgomery RA, Kobashigawa J, Jouven X, Jabre P, Lefaucheur C, Loupy A. Complement-activating donor-specific anti-HLA antibodies and solid organ transplant survival: A systematic review and meta-analysis. PLoS Med 2018; 15:e1002572. [PMID: 29799874 PMCID: PMC5969739 DOI: 10.1371/journal.pmed.1002572] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/26/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Anti-human leukocyte antigen donor-specific antibodies (anti-HLA DSAs) are recognized as a major barrier to patients' access to organ transplantation and the major cause of graft failure. The capacity of circulating anti-HLA DSAs to activate complement has been suggested as a potential biomarker for optimizing graft allocation and improving the rate of successful transplantations. METHODS AND FINDINGS To address the clinical relevance of complement-activating anti-HLA DSAs across all solid organ transplant patients, we performed a meta-analysis of their association with transplant outcome through a systematic review, from inception to January 31, 2018. The primary outcome was allograft loss, and the secondary outcome was allograft rejection. A comprehensive search strategy was conducted through several databases (Medline, Embase, Cochrane, and Scopus). A total of 5,861 eligible citations were identified. A total of 37 studies were included in the meta-analysis. Studies reported on 7,936 patients, including kidney (n = 5,991), liver (n = 1,459), heart (n = 370), and lung recipients (n = 116). Solid organ transplant recipients with circulating complement-activating anti-HLA DSAs experienced an increased risk of allograft loss (pooled HR 3.09; 95% CI 2.55-3.74, P = 0.001; I2 = 29.3%), and allograft rejection (pooled HR 3.75; 95% CI: 2.05-6.87, P = 0.001; I2 = 69.8%) compared to patients without complement-activating anti-HLA DSAs. The association between circulating complement-activating anti-HLA DSAs and allograft failure was consistent across all subgroups and sensitivity analyses. Limitations of the study are the observational and retrospective design of almost all included studies, the higher proportion of kidney recipients compared to other solid organ transplant recipients, and the inclusion of fewer studies investigating allograft rejection. CONCLUSIONS In this study, we found that circulating complement-activating anti-HLA DSAs had a significant deleterious impact on solid organ transplant survival and risk of rejection. The detection of complement-activating anti-HLA DSAs may add value at an individual patient level for noninvasive biomarker-guided risk stratification. TRIAL REGISTRATION National Clinical Trial protocol ID: NCT03438058.
Collapse
|
106
|
Montgomery RA, Elliott KC, Hayward MW, Gray SM, Millspaugh JJ, Riley SJ, Kissui BM, Kramer DB, Moll RJ, Mudumba T, Tans ED, Muneza AB, Abade L, Beck JM, Hoffmann CF, Booher CR, Macdonald DW. Examining Evident Interdisciplinarity Among Prides of Lion Researchers. Front Ecol Evol 2018. [DOI: 10.3389/fevo.2018.00049] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
107
|
Shumba T, Montgomery RA, Rasmussen GSA, Macdonald DW. African Wild Dog Habitat Use Modelling Using Telemetry Data and Citizen Scientist Sightings: Are the Results Comparable? AFRICAN JOURNAL OF WILDLIFE RESEARCH 2018. [DOI: 10.3957/056.048.013002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
|
108
|
Orandi BJ, Luo X, King EA, Garonzik-Wang JM, Bae S, Montgomery RA, Stegall MD, Jordan SC, Oberholzer J, Dunn TB, Ratner LE, Kapur S, Pelletier RP, Roberts JP, Melcher ML, Singh P, Sudan DL, Posner MP, El-Amm JM, Shapiro R, Cooper M, Lipkowitz GS, Rees MA, Marsh CL, Sankari BR, Gerber DA, Nelson PW, Wellen J, Bozorgzadeh A, Gaber AO, Segev DL. Hospital readmissions following HLA-incompatible live donor kidney transplantation: A multi-center study. Am J Transplant 2018; 18:650-658. [PMID: 28834181 PMCID: PMC5820188 DOI: 10.1111/ajt.14472] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/06/2017] [Accepted: 08/11/2017] [Indexed: 01/25/2023]
Abstract
Thirty percent of kidney transplant recipients are readmitted in the first month posttransplantation. Those with donor-specific antibody requiring desensitization and incompatible live donor kidney transplantation (ILDKT) constitute a unique subpopulation that might be at higher readmission risk. Drawing on a 22-center cohort, 379 ILDKTs with Medicare primary insurance were matched to compatible transplant-matched controls and to waitlist-only matched controls on panel reactive antibody, age, blood group, renal replacement time, prior kidney transplantation, race, gender, diabetes, and transplant date/waitlisting date. Readmission risk was determined using multilevel, mixed-effects Poisson regression. In the first month, ILDKTs had a 1.28-fold higher readmission risk than compatible controls (95% confidence interval [CI] 1.13-1.46; P < .001). Risk peaked at 6-12 months (relative risk [RR] 1.67, 95% CI 1.49-1.87; P < .001), attenuating by 24-36 months (RR 1.24, 95% CI 1.10-1.40; P < .001). ILDKTs had a 5.86-fold higher readmission risk (95% CI 4.96-6.92; P < .001) in the first month compared to waitlist-only controls. At 12-24 (RR 0.85, 95% CI 0.77-0.95; P = .002) and 24-36 months (RR 0.74, 95% CI 0.66-0.84; P < .001), ILDKTs had a lower risk than waitlist-only controls. These findings of ILDKTs having a higher readmission risk than compatible controls, but a lower readmission risk after the first year than waitlist-only controls should be considered in regulatory/payment schemas and planning clinical care.
Collapse
|
109
|
Philogene MC, Zhou S, Lonze BE, Bagnasco S, Alasfar S, Montgomery RA, Kraus E, Jackson AM, Leffell MS, Zachary AA. Pre-transplant Screening for Non-HLA Antibodies: Who should be Tested? Hum Immunol 2018; 79:195-202. [PMID: 29428484 DOI: 10.1016/j.humimm.2018.02.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/16/2018] [Accepted: 02/02/2018] [Indexed: 12/12/2022]
Abstract
Retrospective studies of angiotensin II type 1 receptor antibodies (AT1R-Ab) and anti-endothelial cell antibodies (AECA) have linked these antibodies to allograft injury. Because rising healthcare costs dictate judicious use of laboratory testing, we sought to define characteristics of kidney transplant recipients who may benefit from screening for non-HLA antibodies. Kidney recipients transplanted between 2011 and 2016 at Johns Hopkins, were evaluated for AT1R-Ab and AECA. Pre-transplant antibody levels were compared to clinical and biopsy indications of graft dysfunction. Biopsies were graded using the Banff' 2009-2013 criteria. AT1R-Ab and AECA were detected using ELISA and endothelial cell crossmatches, respectively. AT1R-Ab levels were higher in patients who were positive for AECAs. Re-transplanted patients (p < 0.0001), males (p = 0.008) and those with FSGS (p = 0.04) and younger (p = 0.04) at time of transplantation were more likely to be positive for AT1R-Ab prior to transplantation. Recipients who were positive for AT1R-Ab prior to transplantation had increases in serum creatinine within 3 months post-transplantation (p < 0.0001) and developed abnormal biopsies earlier than did AT1R-Ab negative patients (126 days versus 368 days respectively; p = 0.02). Defining a clinical protocol to identify and preemptively treat patients at risk for acute rejection with detectable non-HLA antibodies is an important objective for the transplant community.
Collapse
|
110
|
Montgomery RA, Loupy A, Segev DL. Antibody-mediated rejection: New approaches in prevention and management. Am J Transplant 2018; 18 Suppl 3:3-17. [PMID: 29292861 DOI: 10.1111/ajt.14584] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/26/2017] [Accepted: 11/04/2017] [Indexed: 01/25/2023]
Abstract
Despite the success of desensitization protocols, antibody-mediated rejection (AMR) remains a significant contributor to renal allograft failure in patients with donor-specific antibodies. Plasmapheresis and high-dose intravenous immunoglobulin have proved to be effective treatments to prevent and treat AMR, but irreversible injury in the form of transplant glomerulopathy can commonly manifest months to years later. There is an unmet need to improve the outcomes for patients at risk for AMR. Updated Banff criteria now take into account the increasing understanding of the complex and heterogeneous nature of AMR phenotypes, including the timing of rejection, subclinical and chronic AMR, C4d-negative AMR, and antibody-mediated vascular rejection. Treatment for AMR is not standardized, and there is little in the way of evidence-based treatment guidelines. Refining more precisely the mechanisms of injury responsible for different AMR phenotypes and establishing relevant surrogate endpoints to facilitate more informative studies will likely allow for more accurate determination of prognosis and efficacious intervention using new therapeutic approaches. In addition to plasma exchange and intravenous immunoglobulin, a number of other add-on therapies have been tried in small studies without consistent benefit, including anti-CD20, proteasome inhibitors, complement inhibitors, anti-interleukin-6 receptor blockers, and immunoglobulin G-degrading enzyme of Streptococcus pyogenes (called IdeS).
Collapse
|
111
|
Tatapudi VS, Lonze BE, Wu M, Montgomery RA. Early Conversion from Tacrolimus to Belatacept in a Highly Sensitized Renal Allograft Recipient with Calcineurin Inhibitor-Induced de novo Post-Transplant Hemolytic Uremic Syndrome. Case Rep Nephrol Dial 2018; 8:10-19. [PMID: 29594146 PMCID: PMC5836164 DOI: 10.1159/000486158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 12/06/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Kidney transplantation is the first-line therapy for patients with end-stage renal disease since it offers greater long-term survival and improved quality of life when compared to dialysis. The advent of calcineurin inhibitor (CNI)-based maintenance immunosuppression has led to a clinically significant decline in the rate of acute rejection and better short-term graft survival rates. However, these gains have not translated into improvement in long-term graft survival. CNI-related nephrotoxicity and metabolic side effects are thought to be partly responsible for this. CASE PRESENTATION Here, we report the conversion of a highly sensitized renal transplant recipient with pretransplant donor-specific antibodies from tacrolimus to belatacept within 1 week of transplantation. This substitution was necessitated by the diagnosis of CNI-induced de novo post-transplant hemolytic uremic syndrome. CONCLUSION Belatacept is a novel costimulation blocker that is devoid of the nephrotoxic properties of CNIs and has been shown to positively impact long-term graft survival and preserve renal allograft function in low-immunologic-risk kidney transplant recipients. Data regarding its use in patients who are broadly sensitized to human leukocyte antigens are scarce, and the increased risk of rejection associated with belatacept has been a deterrent to more widespread use of this immunosuppressive agent. This case serves as an example of a highly sensitized patient that has been successfully converted to a belatacept-based CNI-free regimen.
Collapse
|
112
|
Axelrod D, Lentine KL, Schnitzler MA, Luo X, Xiao H, Orandi BJ, Massie A, Garonzik-Wang J, Stegall MD, Jordan SC, Oberholzer J, Dunn TB, Ratner LE, Kapur S, Pelletier RP, Roberts JP, Melcher ML, Singh P, Sudan DL, Posner MP, El-Amm JM, Shapiro R, Cooper M, Lipkowitz GS, Rees MA, Marsh CL, Sankari BR, Gerber DA, Nelson PW, Wellen J, Bozorgzadeh A, Osama Gaber A, Montgomery RA, Segev DL. The Incremental Cost of Incompatible Living Donor Kidney Transplantation: A National Cohort Analysis. Am J Transplant 2017; 17:3123-3130. [PMID: 28613436 DOI: 10.1111/ajt.14392] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 05/04/2017] [Accepted: 05/22/2017] [Indexed: 01/25/2023]
Abstract
Incompatible living donor kidney transplantation (ILDKT) has been established as an effective option for end-stage renal disease patients with willing but HLA-incompatible living donors, reducing mortality and improving quality of life. Depending on antibody titer, ILDKT can require highly resource-intensive procedures, including intravenous immunoglobulin, plasma exchange, and/or cell-depleting antibody treatment, as well as protocol biopsies and donor-specific antibody testing. This study sought to compare the cost and Medicare reimbursement, exclusive of organ acquisition payment, for ILDKT (n = 926) with varying antibody titers to matched compatible transplants (n = 2762) performed between 2002 and 2011. Data were assembled from a national cohort study of ILDKT and a unique data set linking hospital cost accounting data and Medicare claims. ILDKT was more expensive than matched compatible transplantation, ranging from 20% higher adjusted costs for positive on Luminex assay but negative flow cytometric crossmatch, 26% higher for positive flow cytometric crossmatch but negative cytotoxic crossmatch, and 39% higher for positive cytotoxic crossmatch (p < 0.0001 for all). ILDKT was associated with longer median length of stay (12.9 vs. 7.8 days), higher Medicare payments ($91 330 vs. $63 782 p < 0.0001), and greater outlier payments. In conclusion, ILDKT increases the cost of and payments for kidney transplantation.
Collapse
|
113
|
Lonze BE, Dagher NN, Alachkar N, Jackson AM, Montgomery RA. Nontraditional sites for vascular anastomoses to enable kidney transplantation in patients with major systemic venous thromboses. Clin Transplant 2017; 31. [DOI: 10.1111/ctr.13127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2017] [Indexed: 11/30/2022]
|
114
|
Hattawy M, Baltzell NA, Dupré R, Hafidi K, Stepanyan S, Bültmann S, De Vita R, El Alaoui A, El Fassi L, Egiyan H, Girod FX, Guidal M, Jenkins D, Liuti S, Perrin Y, Torayev B, Voutier E, Adhikari KP, Adhikari S, Adikaram D, Akbar Z, Amaryan MJ, Anefalos Pereira S, Armstrong WR, Avakian H, Ball J, Bashkanov M, Battaglieri M, Batourine V, Bedlinskiy I, Biselli AS, Boiarinov S, Briscoe WJ, Brooks WK, Burkert VD, Thanh Cao F, Carman DS, Celentano A, Charles G, Chetry T, Ciullo G, Clark L, Colaneri L, Cole PL, Contalbrigo M, Cortes O, Crede V, D'Angelo A, Dashyan N, De Sanctis E, Deur A, Djalali C, Elouadrhiri L, Eugenio P, Fedotov G, Fegan S, Fersch R, Filippi A, Fleming JA, Forest TA, Fradi A, Garçon M, Gevorgyan N, Ghandilyan Y, Gilfoyle GP, Giovanetti KL, Gleason C, Gohn W, Golovatch E, Gothe RW, Griffioen KA, Guo L, Hakobyan H, Hanretty C, Harrison N, Heddle D, Hicks K, Holtrop M, Hughes SM, Ireland DG, Ishkhanov BS, Isupov EL, Jiang H, Joo K, Joosten S, Keller D, Khachatryan G, Khachatryan M, Khandaker M, Kim A, Kim W, Klein A, Klein FJ, Kubarovsky V, Kuhn SE, Kuleshov SV, Lanza L, Lenisa P, Livingston K, Lu HY, MacGregor IJD, Markov N, Mayer M, McCracken ME, McKinnon B, Meyer CA, Meziani ZE, Mineeva T, Mirazita M, Mokeev V, Montgomery RA, Moutarde H, Movsisyan A, Munoz Camacho C, Nadel-Turonski P, Net LA, Niccolai S, Niculescu G, Niculescu I, Osipenko M, Ostrovidov AI, Paolone M, Paremuzyan R, Park K, Pasyuk E, Phelps E, Phelps W, Pisano S, Pogorelko O, Price JW, Prok Y, Protopopescu D, Ripani M, Ritchie BG, Rizzo A, Rosner G, Rossi P, Sabatié F, Salgado C, Schumacher RA, Seder E, Sharabian YG, Simonyan A, Skorodumina I, Smith GD, Sokhan D, Sparveris N, Strauch S, Taiuti M, Ungaro M, Voskanyan H, Walford NK, Watts DP, Wei X, Weinstein LB, Wood MH, Zachariou N, Zana L, Zhang J, Zhao ZW. First Exclusive Measurement of Deeply Virtual Compton Scattering off ^{4}He: Toward the 3D Tomography of Nuclei. PHYSICAL REVIEW LETTERS 2017; 119:202004. [PMID: 29219329 DOI: 10.1103/physrevlett.119.202004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Indexed: 06/07/2023]
Abstract
We report on the first measurement of the beam-spin asymmetry in the exclusive process of coherent deeply virtual Compton scattering off a nucleus. The experiment uses the 6 GeV electron beam from the Continuous Electron Beam Accelerator Facility (CEBAF) accelerator at Jefferson Lab incident on a pressurized ^{4}He gaseous target placed in front of the CEBAF Large Acceptance Spectrometer (CLAS). The scattered electron is detected by CLAS and the photon by a dedicated electromagnetic calorimeter at forward angles. To ensure the exclusivity of the process, a specially designed radial time projection chamber is used to detect the recoiling ^{4}He nuclei. We measure beam-spin asymmetries larger than those observed on the free proton in the same kinematic domain. From these, we are able to extract, in a model-independent way, the real and imaginary parts of the only ^{4}He Compton form factor, H_{A}. This first measurement of coherent deeply virtual Compton scattering on the ^{4}He nucleus, with a fully exclusive final state via nuclear recoil tagging, leads the way toward 3D imaging of the partonic structure of nuclei.
Collapse
|
115
|
Lefaucheur C, Viglietti D, Hidalgo LG, Ratner LE, Bagnasco SM, Batal I, Aubert O, Orandi BJ, Oppenheimer F, Bestard O, Rigotti P, Reisaeter AV, Kamar N, Lebranchu Y, Duong Van Huyen JP, Bruneval P, Glotz D, Legendre C, Empana JP, Jouven X, Segev DL, Montgomery RA, Zeevi A, Halloran PF, Loupy A. Complement-Activating Anti-HLA Antibodies in Kidney Transplantation: Allograft Gene Expression Profiling and Response to Treatment. J Am Soc Nephrol 2017; 29:620-635. [PMID: 29042454 DOI: 10.1681/asn.2017050589] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 09/14/2017] [Indexed: 12/22/2022] Open
Abstract
Complement-activating anti-HLA donor-specific antibodies (DSAs) are associated with impaired kidney transplant outcome; however, whether these antibodies induce a specific rejection phenotype and influence response to therapy remains undetermined. We prospectively screened 931 kidney recipients for complement-activating DSAs and used histopathology, immunostaining, and allograft gene expression to assess rejection phenotypes. Effector cells were evaluated using in vitro human cell cultures. Additionally, we assessed the effect of complement inhibition on kidney allograft rejection phenotype and the clinical response to complement inhibition in 116 independent kidney recipients with DSAs at transplant receiving rejection prophylaxis with eculizumab or standard of care (plasma exchange and intravenous Ig) at ten international centers. The histomolecular rejection phenotype associated with complement-activating DSA was characterized by complement deposition and accumulation of natural killer cells and monocytes/macrophages in capillaries and increased expression of five biologically relevant genes (CXCL11, CCL4, MS4A7, MS4A6A, and FCGR3A) indicative of endothelial activation, IFNγ response, CD16-mediated natural killer cell activation, and monocyte/macrophage activation. Compared with standard of care, eculizumab specifically abrogated this histomolecular rejection phenotype and associated with a decreased 3-month rejection incidence rate in patients with complement-activating DSAs (56%; 95% confidence interval [95% CI], 38% to 74% versus 19%; 95% CI, 8% to 35%; P=0.001) but not in those with noncomplement-activating DSAs (9%; 95% CI, 2% to 25% versus 13%; 95% CI, 2% to 40%; P=0.65). In conclusion, circulating complement-activating anti-HLA DSAs are associated with a specific histomolecular kidney allograft rejection phenotype that can be abrogated by complement inhibition.
Collapse
|
116
|
Ellwood SA, Newman C, Montgomery RA, Nicosia V, Buesching CD, Markham A, Mascolo C, Trigoni N, Pasztor B, Dyo V, Latora V, Baker SE, Macdonald DW. An active‐radio‐frequency‐identification system capable of identifying co‐locations and social‐structure: Validation with a wild free‐ranging animal. Methods Ecol Evol 2017. [DOI: 10.1111/2041-210x.12839] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
117
|
Ho D, Peng P, Bass C, Collins P, D'Angelo A, Deur A, Fleming J, Hanretty C, Kageya T, Khandaker M, Klein FJ, Klempt E, Laine V, Lowry MM, Lu H, Nepali C, Nikonov VA, O'Connell T, Sandorfi AM, Sarantsev AV, Schumacher RA, Strakovsky II, Švarc A, Walford NK, Wei X, Whisnant CS, Workman RL, Zonta I, Adhikari KP, Adikaram D, Akbar Z, Amaryan MJ, Anefalos Pereira S, Avakian H, Ball J, Bashkanov M, Battaglieri M, Batourine V, Bedlinskiy I, Biselli A, Briscoe WJ, Burkert VD, Carman DS, Celentano A, Charles G, Chetry T, Ciullo G, Clark L, Colaneri L, Cole PL, Contalbrigo M, Crede V, Dashyan N, De Sanctis E, De Vita R, Djalali C, Dupre R, El Alaoui A, El Fassi L, Elouadrhiri L, Eugenio P, Fedotov G, Fegan S, Fersch R, Filippi A, Fradi A, Ghandilyan Y, Gilfoyle GP, Girod FX, Glazier DI, Gleason C, Gohn W, Golovatch E, Gothe RW, Griffioen KA, Guidal M, Guo L, Hakobyan H, Harrison N, Hattawy M, Hicks K, Holtrop M, Hughes SM, Ilieva Y, Ireland DG, Ishkhanov BS, Isupov EL, Jenkins D, Jiang H, Jo HS, Joo K, Joosten S, Keller D, Khachatryan G, Kim A, Kim W, Klein A, Kubarovsky V, Kuleshov SV, Lanza L, Lenisa P, Livingston K, MacGregor IJD, Markov N, McKinnon B, Mineeva T, Mokeev V, Montgomery RA, Movsisyan A, Munoz Camacho C, Murdoch G, Niccolai S, Niculescu G, Osipenko M, Paolone M, Paremuzyan R, Park K, Pasyuk E, Phelps W, Pogorelko O, Price JW, Procureur S, Protopopescu D, Ripani M, Riser D, Ritchie BG, Rizzo A, Rosner G, Sabatié F, Salgado C, Sharabian YG, Skorodumina I, Smith GD, Sober DI, Sokhan D, Sparveris N, Strauch S, Tian Y, Torayev B, Ungaro M, Voskanyan H, Voutier E, Watts DP, Wood MH, Zachariou N, Zhang J, Zhao ZW. Beam-Target Helicity Asymmetry for γ[over →]n[over →]→π^{-}p in the N^{*} Resonance Region. PHYSICAL REVIEW LETTERS 2017; 118:242002. [PMID: 28665642 DOI: 10.1103/physrevlett.118.242002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Indexed: 06/07/2023]
Abstract
We report the first beam-target double-polarization asymmetries in the γ+n(p)→π^{-}+p(p) reaction spanning the nucleon resonance region from invariant mass W=1500 to 2300 MeV. Circularly polarized photons and longitudinally polarized deuterons in solid hydrogen deuteride (HD) have been used with the CEBAF Large Acceptance Spectrometer (CLAS) at Jefferson Lab. The exclusive final state has been extracted using three very different analyses that show excellent agreement, and these have been used to deduce the E polarization observable for an effective neutron target. These results have been incorporated into new partial wave analyses and have led to significant revisions for several γnN^{*} resonance photocouplings.
Collapse
|
118
|
Lonze BE, Bae S, Kraus ES, Holechek MJ, King KE, Alachkar N, Naqvi FF, Dagher NN, Sharif A, Desai NM, Segev DL, Montgomery RA. Outcomes and risk stratification for late antibody-mediated rejection in recipients of ABO-incompatible kidney transplants: a retrospective study. Transpl Int 2017; 30:874-883. [DOI: 10.1111/tri.12969] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 10/20/2016] [Accepted: 03/27/2017] [Indexed: 12/29/2022]
|
119
|
Moll RJ, Redilla KM, Mudumba T, Muneza AB, Gray SM, Abade L, Hayward MW, Millspaugh JJ, Montgomery RA. The many faces of fear: a synthesis of the methodological variation in characterizing predation risk. J Anim Ecol 2017; 86:749-765. [PMID: 28390066 DOI: 10.1111/1365-2656.12680] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/17/2017] [Indexed: 12/13/2022]
Abstract
Predators affect prey by killing them directly (lethal effects) and by inducing costly antipredator behaviours in living prey (risk effects). Risk effects can strongly influence prey populations and cascade through trophic systems. A prerequisite for assessing risk effects is characterizing the spatiotemporal variation in predation risk. Risk effects research has experienced rapid growth in the last several decades. However, preliminary assessments of the resultant literature suggest that researchers characterize predation risk using a variety of techniques. The implications of this methodological variation for inference and comparability among studies have not been well recognized or formally synthesized. We couple a literature survey with a hierarchical framework, developed from established theory, to quantify the methodological variation in characterizing risk using carnivore-ungulate systems as a case study. Via this process, we documented 244 metrics of risk from 141 studies falling into at least 13 distinct subcategories within three broader categories. Both empirical and theoretical work suggest risk and its effects on prey constitute a complex, multi-dimensional process with expressions varying by spatiotemporal scale. Our survey suggests this multi-scale complexity is reflected in the literature as a whole but often underappreciated in any given study, which complicates comparability among studies and leads to an overemphasis on documenting the presence of risk effects rather than their mechanisms or scale of influence. We suggest risk metrics be placed in a more concrete conceptual framework to clarify inference surrounding risk effects and their cascading effects throughout ecosystems. We recommend studies (i) take a multi-scale approach to characterizing risk; (ii) explicitly consider 'true' predation risk (probability of predation per unit time); and (iii) use risk metrics that facilitate comparison among studies and the evaluation of multiple competing hypotheses. Addressing the pressing questions in risk effects research, including how, to what extent and on what scale they occur, requires leveraging the advantages of the many methods available to characterize risk while minimizing the confusion caused by variability in their application.
Collapse
|
120
|
Tatapudi VS, Montgomery RA. Pharmacologic Complement Inhibition in Clinical Transplantation. CURRENT TRANSPLANTATION REPORTS 2017; 4:91-100. [PMID: 29214126 PMCID: PMC5707230 DOI: 10.1007/s40472-017-0148-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose of Review Over the past two decades, significant strides made in our understanding of the etiology of antibody-mediated rejection (AMR) in transplantation have put the complement system in the spotlight. Here, we review recent progress made in the field of pharmacologic complement inhibition in clinical transplantation and aim to understand the impact of this therapeutic approach on outcomes in transplant recipients. Recent Findings Encouraged by the success of agents targeting the complement cascade in disorders of unrestrained complement activation like paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS), investigators are testing the safety and efficacy of pharmacologic complement blockade in mitigating allograft injury in conditions ranging from AMR to recurrent post-transplant aHUS, C3 glomerulopathies and antiphospholipid anti-body syndrome (APS). A recent prospective study demonstrated the efficacy of terminal complement inhibition with eculizumab in the prevention of acute AMR in human leukocyte antigen (HLA)-incompatible living donor renal transplant recipients. C1 esterase inhibitor (C1-INH) was well tolerated in two recent studies in the treatment of AMR and was associated with improved renal allograft function. Summary Pharmacologic complement inhibition is emerging as valuable therapeutic tool, especially in the management of highly sensitized renal transplant recipients. Novel and promising agents that target various elements in the complement cascade are in development. Graphical Abstractᅟ.
Collapse
|
121
|
Avery RK, Lonze BE, Kraus ES, Marr KA, Montgomery RA. Severe chronic norovirus diarrheal disease in transplant recipients: Clinical features of an under-recognized syndrome. Transpl Infect Dis 2017; 19. [PMID: 28176463 DOI: 10.1111/tid.12674] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/27/2016] [Accepted: 11/06/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Norovirus (NV) infection has been reported as a cause of severe chronic diarrhea in transplant recipients, but this entity remains under-recognized in clinical practice, leading to diagnostic delays. Transplant clinicians should become familiar with this syndrome in order to facilitate early detection and management. METHODS Demographic, clinical, and outcomes variables were summarized from a series of transplant recipients with positive stool NV reverse transcription polymerase chain reaction (RT-PCR) assays at Johns Hopkins in 2013-2014. Factors associated with longer duration of symptoms were compared using random forest analysis. RESULTS Thirty-one of 193 (16%) transplant recipients who were tested for NV had positive stool RT-PCRs. Symptoms included diarrhea (100%), nausea/vomiting (58%), abdominal pain (52%), and wasting (35%). Acute kidney injury occurred in 23%, and persisted in 21% after 6 months. Median duration of diarrheal symptoms was 4 months (range, <1-20) and 11/31 (35.4%) patients had relapses after improvement. Wasting, incompatible kidney transplant status, and plasmapheresis were associated with longer diarrhea durations. Treatments included nitazoxanide (in 74%), reduction of immunosuppression (58%), and intravenous immunoglobulin (32%). Six patients died, but no deaths were attributed to NV. CONCLUSIONS It is important for clinicians to recognize that NV can cause severe chronic diarrhea in transplant recipients. In this series, receipt of a human leukocyte antigen- and/or blood type-incompatible kidney transplant, and plasmapheresis were associated with longer symptom duration.
Collapse
|
122
|
Gray SM, Montgomery RA, Millspaugh JJ, Hayward MW. Spatiotemporal variation in African lion roaring in relation to a dominance shift. J Mammal 2017. [DOI: 10.1093/jmammal/gyx020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
123
|
Montgomery RA, Orandi BJ, Racusen L, Jackson AM, Garonzik-Wang JM, Shah T, Woodle ES, Sommerer C, Fitts D, Rockich K, Zhang P, Uknis ME. Plasma-Derived C1 Esterase Inhibitor for Acute Antibody-Mediated Rejection Following Kidney Transplantation: Results of a Randomized Double-Blind Placebo-Controlled Pilot Study. Am J Transplant 2016; 16:3468-3478. [PMID: 27184779 DOI: 10.1111/ajt.13871] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/22/2016] [Accepted: 05/09/2016] [Indexed: 01/25/2023]
Abstract
Antibody-mediated rejection (AMR) is typically treated with plasmapheresis (PP) and intravenous immunoglobulin (standard of care; SOC); however, there is an unmet need for more effective therapy. We report a phase 2b, multicenter double-blind randomized placebo-controlled pilot study to evaluate the use of human plasma-derived C1 esterase inhibitor (C1 INH) as add-on therapy to SOC for AMR. Eighteen patients received 20 000 units of C1 INH or placebo (C1 INH n = 9, placebo n = 9) in divided doses every other day for 2 weeks. No discontinuations, graft losses, deaths, or study drug-related serious adverse events occurred. While the study's primary end point, a difference between groups in day 20 pathology or graft survival, was not achieved, the C1 INH group demonstrated a trend toward sustained improvement in renal function. Six-month biopsies performed in 14 subjects (C1 INH = 7, placebo = 7) showed no transplant glomerulopathy (TG) (PTC+cg≥1b) in the C1 INH group, whereas 3 of 7 placebo subjects had TG. Endogenous C1 INH measured before and after PP demonstrated decreased functional C1 INH serum concentration by 43.3% (p < 0.05) for both cohorts (C1 INH and placebo) associated with PP, although exogenous C1 INH-treated patients achieved supraphysiological levels throughout. This new finding suggests that C1 INH replacement may be useful in the treatment of AMR.
Collapse
|
124
|
Moll RJ, Steel D, Montgomery RA. AIC and the challenge of complexity: A case study from ecology. STUDIES IN HISTORY AND PHILOSOPHY OF BIOLOGICAL AND BIOMEDICAL SCIENCES 2016; 60:35-43. [PMID: 27697630 DOI: 10.1016/j.shpsc.2016.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 09/09/2016] [Accepted: 09/22/2016] [Indexed: 06/06/2023]
Abstract
Philosophers and scientists alike have suggested Akaike's Information Criterion (AIC), and other similar model selection methods, show predictive accuracy justifies a preference for simplicity in model selection. This epistemic justification of simplicity is limited by an assumption of AIC which requires that the same probability distribution must generate the data used to fit the model and the data about which predictions are made. This limitation has been previously noted but appears to often go unnoticed by philosophers and scientists and has not been analyzed in relation to complexity. If predictions are about future observations, we argue that this assumption is unlikely to hold for models of complex phenomena. That in turn creates a practical limitation for simplicity's AIC-based justification because scientists modeling such phenomena are often interested in predicting the future. We support our argument with an ecological case study concerning the reintroduction of wolves into Yellowstone National Park, U.S.A. We suggest that AIC might still lend epistemic support for simplicity by leading to better explanations of complex phenomena.
Collapse
|
125
|
Rota CT, Wolf AJ, Renken RB, Gitzen RA, Fantz DK, Montgomery RA, Olson MG, Vangilder LD, Millspaugh JJ. Simulated data and code for analysis of herpetofauna response to forest management in the Missouri Ozarks. Data Brief 2016; 9:477-479. [PMID: 27722189 PMCID: PMC5048085 DOI: 10.1016/j.dib.2016.08.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 08/17/2016] [Accepted: 08/22/2016] [Indexed: 11/30/2022] Open
Abstract
We present predictor variables and R and Stan code for simulating and analyzing counts of Missouri Ozark herpetofauna in response to three forest management strategies. Our code performs four primary purposes: import predictor variables from spreadsheets; simulate synthetic response variables based on imported predictor variables and user-supplied values for data-generating parameters; format synthetic data for export to Stan; and analyze synthetic data.
Collapse
|