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Powers A, Angelos P, Bond A, Farina E, Fredericks C, Gandhi J, Greenwald M, Hernandez-Busot G, Hosein G, Kelley M, Mourgues C, Palmer W, Rodriguez-Sanchez J, Seabury R, Toribio S, Vin R, Weleff J, Benrimoh D. A computational account of the development and evolution of psychotic symptoms. ArXiv 2024:arXiv:2404.10954v1. [PMID: 38699166 PMCID: PMC11065053] [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] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
The mechanisms of psychotic symptoms like hallucinations and delusions are often investigated in fully-formed illness, well after symptoms emerge. These investigations have yielded key insights, but are not well-positioned to reveal the dynamic forces underlying symptom formation itself. Understanding symptom development over time would allow us to identify steps in the pathophysiological process leading to psychosis, shifting the focus of psychiatric intervention from symptom alleviation to prevention. We propose a model for understanding the emergence of psychotic symptoms within the context of an adaptive, developing neural system. We will make the case for a pathophysiological process that begins with cortical hyperexcitability and bottom-up noise transmission, which engenders inappropriate belief formation via aberrant prediction error signaling. We will argue that this bottom-up noise drives learning about the (im)precision of new incoming sensory information because of diminished signal-to-noise ratio, causing an adaptive relative over-reliance on prior beliefs. This over-reliance on priors predisposes to hallucinations and covaries with hallucination severity. An over-reliance on priors may also lead to increased conviction in the beliefs generated by bottom-up noise and drive movement toward conversion to psychosis. We will identify predictions of our model at each stage, examine evidence to support or refute those predictions, and propose experiments that could falsify or help select between alternative elements of the overall model. Nesting computational abnormalities within longitudinal development allows us to account for hidden dynamics among the mechanisms driving symptom formation and to view established symptomatology as a point of equilibrium among competing biological forces.
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Affiliation(s)
- Albert Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Philip Angelos
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Alexandria Bond
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Emily Farina
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Carolyn Fredericks
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Jay Gandhi
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Maximillian Greenwald
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | | | - Gabriel Hosein
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Megan Kelley
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Catalina Mourgues
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - William Palmer
- Yale University Department of Psychology, New Haven, CT USA
| | | | - Rashina Seabury
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Silmilly Toribio
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Raina Vin
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Jeremy Weleff
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - David Benrimoh
- Department of Psychiatry, McGill University, Montreal, Canada
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Del Rio M, Kafadar E, Fisher V, D'Costa R, Powers A, Ward J. The mechanisms underlying conditioning of phantom percepts differ between those with hallucinations and synesthesia. Sci Rep 2024; 14:5607. [PMID: 38453946 PMCID: PMC10920618 DOI: 10.1038/s41598-024-53663-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 02/03/2024] [Indexed: 03/09/2024] Open
Abstract
There are many different kinds of 'phantom' percepts but it is unknown whether they are united by common mechanisms. For example, synaesthesia (e.g., numbers evoking colour) and hallucinations appear conceptually and phenomenologically similar: both result in a percept that does not have an environmental correlate. Here, people with synaesthesia (n = 66) performed a conditioned hallucinations paradigm known to be sensitive to hallucination susceptibility, and we asked whether synaesthetes would show the same behavioural profile as hallucinators in this task. Repeated pairing of checkerboards with tones, and gratings with colours encourages the participant to draw on prior knowledge when asked to report on the presence of the difficult-to-detect target stimulus. Synaesthetes show increased modelled expectancies for the stimulus association across the board, resulting in a higher number of detections at all stimulus intensities. This is in contrast to the pattern observed in hallucinators, who weigh their prior beliefs more strongly than controls, giving rise to more conditioned hallucinations. Results indicate that fundamentally different perceptual processes may be at the core of these seemingly similar experiences.
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Affiliation(s)
- Magdalena Del Rio
- School of Psychology and Sussex Neuroscience, University of Sussex, Brighton, UK.
| | - Eren Kafadar
- Yale University School of Medicine, Yale University, Connecticut, USA
| | - Victoria Fisher
- Yale University School of Medicine, Yale University, Connecticut, USA
| | - Rhys D'Costa
- School of Psychology and Sussex Neuroscience, University of Sussex, Brighton, UK
| | - Albert Powers
- Yale University School of Medicine, Yale University, Connecticut, USA
| | - Jamie Ward
- School of Psychology and Sussex Neuroscience, University of Sussex, Brighton, UK
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Benrimoh D, Fisher VL, Seabury R, Sibarium E, Mourgues C, Chen D, Powers A. Evidence for Reduced Sensory Precision and Increased Reliance on Priors in Hallucination-Prone Individuals in a General Population Sample. Schizophr Bull 2024; 50:349-362. [PMID: 37830405 PMCID: PMC10919780 DOI: 10.1093/schbul/sbad136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND There is increasing evidence that people with hallucinations overweight perceptual beliefs relative to incoming sensory evidence. Past work demonstrating prior overweighting has used simple, nonlinguistic stimuli. However, auditory hallucinations in psychosis are often complex and linguistic. There may be an interaction between the type of auditory information being processed and its perceived quality in engendering hallucinations. STUDY DESIGN We administered a linguistic version of the conditioned hallucinations (CH) task to an online sample of 88 general population participants. Metrics related to hallucination-proneness, hallucination severity, stimulus thresholds, and stimulus detection rates were collected. Data were used to fit parameters of a Hierarchical Gaussian Filter (HGF) model of perceptual inference to determine how latent perceptual states influenced task behavior. STUDY RESULTS Replicating past results, higher CH rates were observed both in those with recent hallucinatory experiences as well as participants with high hallucination-proneness; CH rates were positively correlated with increased prior weighting; and increased prior weighting was related to hallucination severity. Unlike past results, participants with recent hallucinatory experiences as well as those with higher hallucination-proneness had higher stimulus thresholds, lower sensitivity to stimuli presented at the highest threshold, and had lower response confidence, consistent with lower precision of sensory evidence. CONCLUSIONS We replicate the finding that increased CH rates and recent hallucinations correlate with increased prior weighting using a linguistic version of the CH task. Results support a role for reduced sensory precision in the interplay between prior weighting and hallucination-proneness.
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Affiliation(s)
- David Benrimoh
- Department of Psychiatry, McGill University School of Medicine, Montreal, Canada
| | - Victoria L Fisher
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Rashina Seabury
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Ely Sibarium
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Catalina Mourgues
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Doris Chen
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Albert Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
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Dickstein DR, Lehrer EJ, Bloom JR, Hsieh K, Jones B, Runnels J, Powers A, Barlow J, Chen S, Monrose E, Sindhu K, Factor O, Liu JT, Gupta V, Roof S, Kirke D, Misiukiewicz K, Posner M, Genden E, Bakst RL. Is 80 the New 70? Octogenarians with Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e577-e578. [PMID: 37785756 DOI: 10.1016/j.ijrobp.2023.06.1915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) As the human papilloma virus (HPV) pandemic evolves and life expectancy increases, the number of older adults with oropharyngeal squamous cell carcinoma (OPSCC) continues to increase. However, there is a paucity of data regarding the fastest growing subset of this population: octogenarians (OGs). We sought to understand differences in treatment tolerability and clinical outcomes between septuagenarians (SGs) and OGs with OPSCC. MATERIALS/METHODS We identified SGs (age 70-79) and OGs (age 80-89) with OPSCC from a cohort of older adults with nonrecurrent, nonmetastatic head and neck squamous cell carcinoma (HNSCC) treated curatively from 2007-2020. We compared demographics, treatment characteristics and toxicities using Fischer's exact test. Time-to-event outcomes, overall survival (OS), locoregional control (LRC), and disease-specific survival (DSS), were evaluated using the Kaplan-Meier method. RESULTS Of 293 patients (age 70-89) with HNSCC, 39% (n = 114) had OPSCC: 93 SGs (median age: 73; interquartile range [IQR]: 71-76), and 21 OGs (median age: 81, IQR: 80-84). The median follow-up for included patients was 2.4 years; 82% were male, 64% white, 48% > 20 pack year smoking history, 37% ECOG 1. Patients had AJCC 8th edition Stage: I (27%); II (33%); III (18%); IV (22%) OPSCC. Treatment consisted of adjuvant radiation (RT) (19%), adjuvant chemoradiation (CRT) (8%), surgery alone (6%), induction/concurrent CRT (27%), concurrent CRT (28%), or RT (12%), with no significant differences in stage or treatment modalities noted between SGs and OGs. Of note, 69% of SGs and 76% of OGs were HPV+. Among 107 patients who received any RT, 24% experienced a treatment interruption (19% of SGs vs. 48% of OGs, p = 0.001) and 2 patients (both HPV- SGs) died on treatment due to unrelated health conditions. Percutaneous endoscopic gastrostomy (PEG) tubes were placed prior to or during treatment in 43% of SGs and 62% of OGs, with OGs more likely to have a PEG placed during treatment (p = 0.025). There was no difference in the prevalence of late (> 6 months) CTCAE grade 2+ dysphagia (36%) or xerostomia (31%) between SGs and OGs. Estimated 3-year LRC, DSS, and OS were not significantly different between SGs (LRC:85%; DSS:87%; OS:76%) and OGs (LRC: 81%; DSS:94%; OS: 55%, p-values: 0.98, 0.42, 0.052, respectively). However, HPV+ disease significantly increased estimated 3-year OS for both SGs (HPV+: 84%; HPV-: 56%, p = 0.0006) and OGs (HPV+: 68%; HPV-: 20%, p = 0.008). CONCLUSION In our cohort, OGs had a higher proportion of HPV+ OPSCC, which was associated with improved OS. This finding may provide insight into the latency of the virus. While there were similar amounts of toxicities among SGs and OGs, OGs more frequently underwent PEG tube placement and experienced more treatment interruptions. Given high rates of HPV+ OPSCC in OGs, our findings suggest that de-escalation strategies should be further investigated to improve tolerability and maximize outcomes for this neglected population.
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Affiliation(s)
- D R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - E J Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J R Bloom
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Hsieh
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - B Jones
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J Runnels
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - A Powers
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J Barlow
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - S Chen
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - E Monrose
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Sindhu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - O Factor
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J T Liu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - V Gupta
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - S Roof
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - D Kirke
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Misiukiewicz
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - M Posner
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - E Genden
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - R L Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
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Schultebraucks K, Stevens JS, Michopoulos V, Maples-Keller J, Lyu J, Smith RN, Rothbaum BO, Ressler KJ, Galatzer-Levy IR, Powers A. Development and validation of a brief screener for posttraumatic stress disorder risk in emergency medical settings. Gen Hosp Psychiatry 2023; 81:46-50. [PMID: 36764261 PMCID: PMC10866012 DOI: 10.1016/j.genhosppsych.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Predicting risk of posttraumatic stress disorder (PTSD) in the acute care setting is challenging given the pace and acute care demands in the emergency department (ED) and the infeasibility of using time-consuming assessments. Currently, no accurate brief screening for long-term PTSD risk is routinely used in the ED. One instrument widely used in the ED is the 27-item Immediate Stress Reaction Checklist (ISRC). The aim of this study was to develop a short screener using a machine learning approach and to investigate whether accurate PTSD prediction in the ED can be achieved with substantially fewer items than the IRSC. METHOD This prospective longitudinal cohort study examined the development and validation of a brief screening instrument in two independent samples, a model development sample (N = 253) and an external validation sample (N = 93). We used a feature selection algorithm to identify a minimal subset of features of the ISRC and tested this subset in a predictive model to investigate if we can accurately predict long-term PTSD outcomes. RESULTS We were able to identify a reduced subset of 5 highly predictive features of the ISRC in the model development sample (AUC = 0.80), and we were able to validate those findings in the external validation sample (AUC = 0.84) to discriminate non-remitting vs. resilient trajectories. CONCLUSION This study developed and validated a brief 5-item screener in the ED setting, which may help to improve the diagnostic process of PTSD in the acute care setting and help ED clinicians plan follow-up care when patients are still in contact with the healthcare system. This could reduce the burden on patients and decrease the risk of chronic PTSD.
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Affiliation(s)
- K Schultebraucks
- Department of Psychiatry, NYU Grossman School of Medicine, New York, USA; Department of Population Health, NYU Grossman School of Medicine, New York, USA.
| | - J S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans' Affairs Health Care System, Atlanta, GA, USA
| | - V Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - J Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - J Lyu
- Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, NY, USA
| | - R N Smith
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA; Department of Behavioral, Social and Health Education Sciences, Emory University School of Public Health, Atlanta, GA, USA
| | - B O Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - K J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - I R Galatzer-Levy
- Department of Psychiatry, NYU Grossman School of Medicine, New York, USA
| | - A Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Luhrmann TM, Alderson-Day B, Chen A, Corlett P, Deeley Q, Dupuis D, Lifshitz M, Moseley P, Peters E, Powell A, Powers A. Learning to Discern the Voices of Gods, Spirits, Tulpas, and the Dead. Schizophr Bull 2023; 49:S3-S12. [PMID: 36840538 PMCID: PMC9959996 DOI: 10.1093/schbul/sbac005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
There are communities in which hearing voices frequently is common and expected, and in which participants are not expected to have a need for care. This paper compares the ideas and practices of these communities. We observe that these communities utilize cultural models to identify and to explain voice-like events-and that there are some common features to these models across communities. All communities teach participants to "discern," or identify accurately, the legitimate voice of the spirit or being who speaks. We also observe that there are roughly two methods taught to participants to enable them to experience spirits (or other invisible beings): trained attention to inner experience, and repeated speech to the invisible other. We also observe that all of these communities model a learning process in which the ability to hear spirit (or invisible others) becomes more skilled with practice, and in which what they hear becomes clearer over time. Practice-including the practice of discernment-is presumed to change experience. We also note that despite these shared cultural ideas and practices, there is considerable individual variation in experience-some of which may reflect psychotic process, and some perhaps not. We suggest that voice-like events in this context may be shaped by cognitive expectation and trained practice as well as an experiential pathway. We also suggest that researchers could explore these common features both as a way to help those struggling with psychosis, and to consider the possibility that expectations and practice may affect the voice-hearing experience.
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Affiliation(s)
- Tanya M Luhrmann
- Department of Anthropology, Stanford University, Stanford, CA, USA
| | | | - Ann Chen
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Philip Corlett
- Department of Psychiatry, Yale School of Medicine, Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Quinton Deeley
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, Department of Forensic & Neurodevelopmental Sciences, London, UK
| | - David Dupuis
- Quai Branly Museum (Paris), Research Department, Paris, France
| | - Michael Lifshitz
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada
| | - Peter Moseley
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Emmanuelle Peters
- Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, Department of Psychology, London, UK
| | - Adam Powell
- Department of Theology and Religion, Durham University, Durham, UK
| | - Albert Powers
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
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Drusko A, Baumeister D, McPhee Christensen M, Kold S, Fisher VL, Treede RD, Powers A, Graven-Nielsen T, Tesarz J. A novel computational approach to pain perception modelling within a Bayesian framework using quantitative sensory testing. Sci Rep 2023; 13:3196. [PMID: 36823292 PMCID: PMC9950064 DOI: 10.1038/s41598-023-29758-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/09/2023] [Indexed: 02/25/2023] Open
Abstract
Pain perception can be studied as an inferential process in which prior information influences the perception of nociceptive input. To date, there are no suitable psychophysical paradigms to measure this at an individual level. We developed a quantitative sensory testing paradigm allowing for quantification of the influence of prior expectations versus current nociceptive input during perception. Using a Pavlovian-learning task, we investigated the influence of prior expectations on the belief about the varying strength of association between a painful electrical cutaneous stimulus and a visual cue in healthy subjects (N = 70). The belief in cue-pain associations was examined with computational modelling using a Hierarchical Gaussian Filter (HGF). Prior weighting estimates in the HGF model were compared with the established measures of conditioned pain modulation (CPM) and temporal summation of pain (TSP) assessed by cuff algometry. Subsequent HGF-modelling and estimation of the influence of prior beliefs on perception showed that 70% of subjects had a higher reliance on nociceptive input during perception of acute pain stimuli, whereas 30% showed a stronger weighting of prior expectations over sensory evidence. There was no association between prior weighting estimates and CPM or TSP. The data demonstrates relevant individual differences in prior weighting and suggests an importance of top-down cognitive processes on pain perception. Our new psychophysical testing paradigm provides a method to identify individuals with traits suggesting greater reliance on prior expectations in pain perception, which may be a risk factor for developing chronic pain and may be differentially responsive to learning-based interventions.
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Affiliation(s)
- Armin Drusko
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - David Baumeister
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Megan McPhee Christensen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Sebastian Kold
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Victoria Lynn Fisher
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Rolf-Detlef Treede
- Mannheim Center for Translational Neuroscience (MCTN), Heidelberg University, Heidelberg, Germany
| | - Albert Powers
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
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Hickey A, Brown O, Powers A. Development of Alabama Campus Coalition for Basic Needs: An Innovative Approach to Address College Student Food Insecurity. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.06.171] [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: 11/26/2022]
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Leptourgos P, Bansal S, Dutterer J, Culbreth A, Powers A, Suthaharan P, Kenney J, Erickson M, Waltz J, Wijtenburg SA, Gaston F, Rowland LM, Gold J, Corlett P. Relating Glutamate, Conditioned, and Clinical Hallucinations via 1H-MR Spectroscopy. Schizophr Bull 2022; 48:912-920. [PMID: 35199836 PMCID: PMC9212089 DOI: 10.1093/schbul/sbac006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Hallucinations may be driven by an excessive influence of prior expectations on current experience. Initial work has supported that contention and implicated the anterior insula in the weighting of prior beliefs. STUDY DESIGN Here we induce hallucinated tones by associating tones with the presentation of a visual cue. We find that people with schizophrenia who hear voices are more prone to the effect and using computational modeling we show they overweight their prior beliefs. In the same participants, we also measured glutamate levels in anterior insula, anterior cingulate, dorsolateral prefrontal, and auditory cortices, using magnetic resonance spectroscopy. STUDY RESULTS We found a negative relationship between prior-overweighting and glutamate levels in the insula that was not present for any of the other voxels or parameters. CONCLUSIONS Through computational psychiatry, we bridge a pathophysiological theory of psychosis (glutamate hypofunction) with a cognitive model of hallucinations (prior-overweighting) with implications for the development of new treatments for hallucinations.
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Affiliation(s)
- Pantelis Leptourgos
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT,USA
| | - Sonia Bansal
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Catonsville, MD,USA
| | - Jenna Dutterer
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Catonsville, MD,USA
| | - Adam Culbreth
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Catonsville, MD,USA
| | - Albert Powers
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT,USA
| | - Praveen Suthaharan
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT,USA
| | - Joshua Kenney
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT,USA
| | - Molly Erickson
- Department of Psychiatry, University of Chicago, Chicago, IL,USA
| | - James Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Catonsville, MD,USA
| | - S Andrea Wijtenburg
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Catonsville, MD,USA
| | - Frank Gaston
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Catonsville, MD,USA
| | - Laura M Rowland
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Catonsville, MD,USA
| | - James Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Catonsville, MD,USA
| | - Philip Corlett
- To whom correspondence should be addressed; 34 Park Street, New Haven, CT 06511, USA; tel: 203-974-7866, fax: 203 974 7866, e-mail:
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Morlock R, Divino V, Dekoven M, Lamoreaux B, Powers A, Barretto N, Holt R, Taylor S. AB1051 CLINICAL OUTCOMES AND HEALTHCARE RESOURCE UTILIZATION OF UNCONTROLLED GOUT PRIOR TO PEGLOTICASE THERAPY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundBy definition, uncontrolled gout (UG) cannot be managed with oral urate lowering therapies (ULTs) and is associated with substantial morbidity. UG, also known as refractory gout, results in escalated treatment and management. Recent American College of Rheumatology guidelines recommend treating gout to serum uric acid targets; if targets are not achieved or patients continue to have symptoms, pegloticase is recommended. There is a paucity of data documenting the clinical and economic burden of UG patients.ObjectivesAssess clinical outcomes and healthcare resource utilization (HCRU) of UG prior to pegloticase initiation.MethodsA retrospective observational database analysis was conducted among patients initiating pegloticase between April 1, 2011 and August 31, 2020 using the PharMetrics Plus database. Eligible subjects had ≥1 pegloticase claim (first claim = index date) and continuous enrollment for 24 months prior to index. Relevant clinical and economic (HCRU) outcomes were evaluated over a 24-month pre-index period and compared between two different time intervals prior to index: time interval 1 (Day -720 to Day -361) and time interval 2 (Day -360 to Day -1). Assessment of comorbid disease burden included Charlson Comorbidity Index (CCI) and relevant health conditions. Dependent pairwise comparisons were conducted to compare clinical and economic outcomes between time intervals prior to pegloticase initiation. To assess statistical differences, paired t-tests (continuous variables) or McNemar’s tests (categorical variables) were used.ResultsOf the 408 eligible subjects, most were male (88.5%), with an average age (SD) of 55.2 (11.3) years, 66.9% were between the ages of 45-64 years and 78.2% had a preferred provider organization (PPO) health plan. Most often (34.8% of patients), a rheumatologist was associated with initiation of pegloticase therapy, while primary care physicians accounted for 23.8% of initiations. Mean (SD) CCI score was 2.4 (2.4) with 37.3% of subjects having a CCI score of >3. Prevalence of relevant health conditions over the 24-month pre-index period included tophi (62.5%), urolithiasis (8.6%), chronic kidney disease (34.6%) and chronic pain/fibromyalgia (76.5%), all of which significantly increased from time interval 1 (Day -720 to Day -361) to time interval 2 (Day -360 to Day -1) prior to pegloticase initiation (Table 1). Of patients initiating pegloticase, 57.4% had 1 ULT (excluding probenecid), 11.3% had >2 ULT (excluding probenecid), and 10.3% UG patients had ≥1 probenecid claim over the 24-month pre-index period. Most patients (98.3%) had ≥1 physician office visit, 27.2% had ≥1 hospitalization and 45.3% had ≥1 emergency room (ER) visit over the 24-month pre-index period. HCRU significantly increased from time interval 1 to time interval 2, prior to pegloticase (Figure 1).Table 1.Relevant Health Conditions and Disease-specific Health Care Resource Utilization (HCRU)Overall N= 408Time Interval 1Time Interval 2Tophi62.5%15.4%61.5%***Urolithiasis8.6%4.2%6.9%*Chronic kidney disease34.6%22.5%31.6%***Cardiovascular disease32.6%21.3%28.4%**Type 2 diabetes mellitus31.4%23.3%28.9%**Hypertension76.2%58.1%70.3%***≥1 gout flare87.7%48.5%83.8%***Mean number of gout flare (SD)3.5 (2.4)1.02.1***Gout-related medications ≥1 claim for colchicine56%39.5%63.7%***≥1 claim for opioids71%52.9%60.3%*≥1 claim for oral corticosteroids80%50.2%75.7%***≥1 claim for injectable corticosteroids64%38.5%53.7%***†Time Interval 1: Day -720 to Day -361 prior to pegloticase initiation; ††Time Interval 2: Day -360 to Day -1 prior to pegloticase initiation***, p<0.0001; **, p<0.001; *, p<0.05ConclusionOverall, these data demonstrate the progressive nature of UG as confirmed by significant increases in gout-related conditions and healthcare resource utilization prior to pegloticase initiation. Further research is needed on healthcare resource utilization among patients with UG post-pegloticase use.Disclosure of InterestsRobert Morlock Consultant of: Horizon Therapeutics, Victoria Divino Grant/research support from: Horizon Therapeutics, Mitchell DeKoven Grant/research support from: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Atsuko Powers Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Naina Barretto Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Robert Holt Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Stephanie Taylor Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics
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Pelzek C, Kellihan HB, Sheehan N, Powers A, Peek SF. Aortopulmonary window, left coronary artery aneurysm, and redundant aortic valve leaflet in a calf: the use of multimodal imaging to diagnose congenital heart disease. J Vet Cardiol 2021; 34:48-54. [PMID: 33561812 DOI: 10.1016/j.jvc.2021.01.003] [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: 08/27/2020] [Revised: 12/20/2020] [Accepted: 01/07/2021] [Indexed: 11/29/2022]
Abstract
A 2-month-old male Holstein calf was presented for evaluation of a continuous systolic murmur. A grade V/VI left basilar continuous murmur and a grade IV/VI right basilar continuous murmur was auscultated upon evaluation with increased respiratory effort, wheezes, and crackles. Multimodality diagnostics were performed on this patient for further workup and included transthoracic and transesophageal echocardiography, fluoroscopy guided angiography, and gross necropsy with histopathology. An aortopulmonary window with continuous left-to-right shunting was identified at the level of the left aortic sinus of Valsalva with a severely dilated left coronary artery and left-sided congestive heart failure. This case report outlines the diagnostic workup of a rare congenital heart defect and secondary cardiac abnormalities not previously identified in veterinary literature.
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Affiliation(s)
- C Pelzek
- University of Wisconsin Veterinary Medical Teaching Hospital, Madison, WI 53706, USA
| | - H B Kellihan
- University of Wisconsin Veterinary Medical Teaching Hospital, Madison, WI 53706, USA.
| | - N Sheehan
- University of Wisconsin Veterinary Medical Teaching Hospital, Madison, WI 53706, USA
| | - A Powers
- University of Wisconsin Veterinary Medical Teaching Hospital, Madison, WI 53706, USA
| | - S F Peek
- University of Wisconsin Veterinary Medical Teaching Hospital, Madison, WI 53706, USA
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Frässle S, Harrison SJ, Heinzle J, Clementz BA, Tamminga CA, Sweeney JA, Gershon ES, Keshavan MS, Pearlson GD, Powers A, Stephan KE. Regression dynamic causal modeling for resting-state fMRI. Hum Brain Mapp 2021; 42:2159-2180. [PMID: 33539625 PMCID: PMC8046067 DOI: 10.1002/hbm.25357] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/05/2021] [Accepted: 01/20/2021] [Indexed: 02/03/2023] Open
Abstract
“Resting‐state” functional magnetic resonance imaging (rs‐fMRI) is widely used to study brain connectivity. So far, researchers have been restricted to measures of functional connectivity that are computationally efficient but undirected, or to effective connectivity estimates that are directed but limited to small networks. Here, we show that a method recently developed for task‐fMRI—regression dynamic causal modeling (rDCM)—extends to rs‐fMRI and offers both directional estimates and scalability to whole‐brain networks. First, simulations demonstrate that rDCM faithfully recovers parameter values over a wide range of signal‐to‐noise ratios and repetition times. Second, we test construct validity of rDCM in relation to an established model of effective connectivity, spectral DCM. Using rs‐fMRI data from nearly 200 healthy participants, rDCM produces biologically plausible results consistent with estimates by spectral DCM. Importantly, rDCM is computationally highly efficient, reconstructing whole‐brain networks (>200 areas) within minutes on standard hardware. This opens promising new avenues for connectomics.
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Affiliation(s)
- Stefan Frässle
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
| | - Samuel J Harrison
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
| | - Jakob Heinzle
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
| | - Brett A Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, Georgia, USA
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - John A Sweeney
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Elliot S Gershon
- Department of Psychiatry, University of Chicago, Chicago, Illinois, USA.,Department of Human Genetics, University of Chicago, Chicago, Illinois, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, Hartford Hospital, Institute of Living, Hartford, Connecticut, USA.,Department of Psychiatry & Neuroscience, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Albert Powers
- Department of Psychiatry & Neuroscience, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Klaas E Stephan
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland.,Max Planck Institute for Metabolism Research, Cologne, Germany
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13
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Barron DS, Baker JT, Budde KS, Bzdok D, Eickhoff SB, Friston KJ, Fox PT, Geha P, Heisig S, Holmes A, Onnela JP, Powers A, Silbersweig D, Krystal JH. Decision Models and Technology Can Help Psychiatry Develop Biomarkers. Front Psychiatry 2021; 12:706655. [PMID: 34566711 PMCID: PMC8458705 DOI: 10.3389/fpsyt.2021.706655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/02/2021] [Indexed: 12/02/2022] Open
Abstract
Why is psychiatry unable to define clinically useful biomarkers? We explore this question from the vantage of data and decision science and consider biomarkers as a form of phenotypic data that resolves a well-defined clinical decision. We introduce a framework that systematizes different forms of phenotypic data and further introduce the concept of decision model to describe the strategies a clinician uses to seek out, combine, and act on clinical data. Though many medical specialties rely on quantitative clinical data and operationalized decision models, we observe that, in psychiatry, clinical data are gathered and used in idiosyncratic decision models that exist solely in the clinician's mind and therefore are outside empirical evaluation. This, we argue, is a fundamental reason why psychiatry is unable to define clinically useful biomarkers: because psychiatry does not currently quantify clinical data, decision models cannot be operationalized and, in the absence of an operationalized decision model, it is impossible to define how a biomarker might be of use. Here, psychiatry might benefit from digital technologies that have recently emerged specifically to quantify clinically relevant facets of human behavior. We propose that digital tools might help psychiatry in two ways: first, by quantifying data already present in the standard clinical interaction and by allowing decision models to be operationalized and evaluated; second, by testing whether new forms of data might have value within an operationalized decision model. We reference successes from other medical specialties to illustrate how quantitative data and operationalized decision models improve patient care.
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Affiliation(s)
- Daniel S Barron
- Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States.,Department of Anesthesiology and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States.,Department of Psychiatry, Yale University, New Haven, CT, United States.,Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
| | - Justin T Baker
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, United States
| | - Kristin S Budde
- Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States.,Department of Psychiatry, Yale University, New Haven, CT, United States.,Department of Psychiatry, University of Washington, Seattle, WA, United States
| | - Danilo Bzdok
- Department of Biomedical Engineering, Faculty of Medicine, McConnell Brain Imaging Centre (BIC), Montreal Neurological Institute (MNI), McGill University, Montreal, QC, Canada.,Mila-Quebec Artificial Intelligence Institute, Montreal, QC, Canada
| | - Simon B Eickhoff
- Medical Faculty, Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Karl J Friston
- The Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, United Kingdom
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health, San Antonio, TX, United States
| | - Paul Geha
- Departments of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
| | - Stephen Heisig
- T.J. Watson IBM Research Laboratory, Yorktown Heights, NY, United States.,Department of Neurology, Icahn School of Medicine, New York, NY, United States
| | - Avram Holmes
- Department of Psychiatry, Yale University, New Haven, CT, United States.,Department of Psychology, Yale University, New Haven, CT, United States
| | - Jukka-Pekka Onnela
- Department of Biostatistics, T. H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Albert Powers
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - David Silbersweig
- Department of Psychiatry, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States
| | - John H Krystal
- Department of Psychiatry, Yale University, New Haven, CT, United States
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14
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Browning M, Carter CS, Chatham C, Den Ouden H, Gillan CM, Baker JT, Chekroud AM, Cools R, Dayan P, Gold J, Goldstein RZ, Hartley CA, Kepecs A, Lawson RP, Mourao-Miranda J, Phillips ML, Pizzagalli DA, Powers A, Rindskopf D, Roiser JP, Schmack K, Schiller D, Sebold M, Stephan KE, Frank MJ, Huys Q, Paulus M. Realizing the Clinical Potential of Computational Psychiatry: Report From the Banbury Center Meeting, February 2019. Biol Psychiatry 2020; 88:e5-e10. [PMID: 32113656 DOI: 10.1016/j.biopsych.2019.12.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/30/2019] [Accepted: 12/30/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Michael Browning
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health National Health Service Foundation Trust, Warneford Hospital, Oxford, United Kingdom.
| | - Cameron S Carter
- Department of Psychiatry, University of California, Davis, Davis, California; Department of Psychology, University of California, Davis, Davis, California
| | - Christopher Chatham
- Department of Neuroscience and Rare Diseases, Roche Pharma Research and Early Development, Roche Innovation Center, Basel, Switzerland
| | - Hanneke Den Ouden
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Claire M Gillan
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Justin T Baker
- McLean Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | | | - Roshan Cools
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter Dayan
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - James Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Rita Z Goldstein
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Adam Kepecs
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, New York
| | - Rebecca P Lawson
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Janaina Mourao-Miranda
- Centre for Medical Image Computing, University College London, London, United Kingdom; Department of Computer Science, Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Diego A Pizzagalli
- Department of Psychiatry, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Albert Powers
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - David Rindskopf
- Educational Psychology, Graduate School and University Center of the City University of New York, New York, New York
| | - Jonathan P Roiser
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Katharina Schmack
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, New York
| | - Daniela Schiller
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Miriam Sebold
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Klaas Enno Stephan
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom; Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland; Eidgenössische Technische Hochschule Zürich, Zurich, Switzerland; Max Planck Institute for Metabolism Research, Cologne, Germany
| | - Michael J Frank
- J. & Nancy D. Carney Institute for Brain Science, Department of Cognitive, Linguistic & Psychological Sciences, Brown University, Providence, Rhode Island
| | - Quentin Huys
- Department of Computer Science, Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom; Division of Psychiatry, University College London, London, United Kingdom; Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland; Eidgenössische Technische Hochschule Zürich, Zurich, Switzerland
| | - Martin Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma
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15
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Dickstein D, Gallitto M, Egerman M, Powers A, Gupta V, Sharma S, Miles B, Posner M, Misiukiewicz K, Bakst R. Treatment Tolerability and Outcomes in Advanced-Age Oropharyngeal Cancer Patients. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Sasmono R, Dhenni R, Yohan B, Pronyk P, Hadinegoro S, Soepardi E, Ma’roef C, Satari H, Menzies H, Hawley W, Powers A, Rosenberg R, Myint K, Soebandrio A. Endemicity of Zika virus in Indonesia: serological evidence in pediatric population. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.050] [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: 10/27/2022] Open
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17
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Funderburk K, Parmer S, Struempler B, Powers A. Texts and Recipes Engage Parents in School-based Nutrition Education. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.035] [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: 11/30/2022]
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18
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Sheu R, Powers A, McGee H, Stock R, Lo Y. SU-F-T-44: A Comparison of the Pre-Plan, Intra-Operative Plan, and Post-Implant Dosimetry for a Prostate Implant Case Using Prefabricated Linear Polymer-Encapsulated Pd-103. Med Phys 2016. [DOI: 10.1118/1.4956179] [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: 11/07/2022] Open
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19
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Napolitano A, Pellegrini L, Dey A, Larson D, Tanji M, Flores EG, Kendrick B, Lapid D, Powers A, Kanodia S, Pastorino S, Pass HI, Dixit V, Yang H, Carbone M. Abstract LB-220: Minimal asbestos exposure in germline BAP1 heterozygous mice is associated with deregulated inflammatory response and increased risk of mesothelioma. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-lb-220] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Germline BAP1 mutations predispose to several cancers, in particular malignant mesothelioma (MM). MM pathogenesis is generally associated to professional exposure to asbestos. However, to date we found that none of the mesothelioma patients carrying germline BAP1 mutations were professionally exposed to asbestos. We hypothesized that germline BAP1 mutations might influence the asbestos-induced inflammatory response that is linked to asbestos carcinogenesis, thereby increasing the risk of developing mesothelioma after even minimal exposure.
In a set of short-term experiments, we intraperitoneally injected BAP1+/- and wild-type littermates with low doses of asbestos fibers and analyzed the inflammatory response both at a cellular and humoral level. In a long-term experiment following a similar protocol, we assessed the incidence of MM in mice with and without germline BAP1 mutations and their survival.
We found that, compared to their wild type littermates, BAP1+/- mice exposed to low doses of asbestos fibers showed significant alterations of the peritoneal inflammatory response. In particular, we observed significantly higher levels of pro-tumorigenic alternatively polarized M2 macrophages, and lower levels of several chemokines and cytokines. Consistent with these data, BAP1+/- mice had a significantly higher incidence of mesothelioma after exposure to very low doses of asbestos, and shorter survival.
Our findings suggest that minimal exposure to carcinogenic fibers may significantly increase the risk of malignant mesothelioma in genetically predisposed individuals carrying germline BAP1 mutations, possibly via alterations of the inflammatory response.
Citation Format: A. Napolitano, L. Pellegrini, A. Dey, D. Larson, M. Tanji, E. G. Flores, B. Kendrick, D. Lapid, A. Powers, S. Kanodia, S. Pastorino, H. I. Pass, V Dixit, H. Yang, M. Carbone. Minimal asbestos exposure in germline BAP1 heterozygous mice is associated with deregulated inflammatory response and increased risk of mesothelioma. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-220. doi:10.1158/1538-7445.AM2015-LB-220
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Affiliation(s)
| | | | - A. Dey
- 2Genentech, South San Francisco, CA
| | - D. Larson
- 1University of Hawaii Cancer Center, Honolulu, HI
| | - M. Tanji
- 1University of Hawaii Cancer Center, Honolulu, HI
| | - E. G. Flores
- 1University of Hawaii Cancer Center, Honolulu, HI
| | - B. Kendrick
- 1University of Hawaii Cancer Center, Honolulu, HI
| | - D. Lapid
- 1University of Hawaii Cancer Center, Honolulu, HI
| | - A. Powers
- 1University of Hawaii Cancer Center, Honolulu, HI
| | - S. Kanodia
- 3Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - S. Pastorino
- 1University of Hawaii Cancer Center, Honolulu, HI
| | | | - V Dixit
- 2Genentech, South San Francisco, CA
| | - H. Yang
- 1University of Hawaii Cancer Center, Honolulu, HI
| | - M. Carbone
- 1University of Hawaii Cancer Center, Honolulu, HI
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20
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Napolitano A, Pellegrini L, Dey A, Larson D, Tanji M, Flores EG, Kendrick B, Lapid D, Powers A, Kanodia S, Pastorino S, Pass HI, Dixit V, Yang H, Carbone M. Minimal asbestos exposure in germline BAP1 heterozygous mice is associated with deregulated inflammatory response and increased risk of mesothelioma. Oncogene 2015; 35:1996-2002. [PMID: 26119930 DOI: 10.1038/onc.2015.243] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 03/16/2015] [Accepted: 04/20/2015] [Indexed: 01/04/2023]
Abstract
Germline BAP1 mutations predispose to several cancers, in particular malignant mesothelioma. Mesothelioma is an aggressive malignancy generally associated with professional exposure to asbestos. However, to date, we found that none of the mesothelioma patients carrying germline BAP1 mutations were professionally exposed to asbestos. We hypothesized that germline BAP1 mutations might influence the asbestos-induced inflammatory response that is linked to asbestos carcinogenesis, thereby increasing the risk of developing mesothelioma after minimal exposure. Using a BAP1(+/-) mouse model, we found that, compared with their wild-type littermates, BAP1(+/-) mice exposed to low-dose asbestos fibers showed significant alterations of the peritoneal inflammatory response, including significantly higher levels of pro-tumorigenic alternatively polarized M2 macrophages, and lower levels of several chemokines and cytokines. Consistent with these data, BAP1(+/-) mice had a significantly higher incidence of mesothelioma after exposure to very low doses of asbestos, doses that rarely induced mesothelioma in wild-type mice. Our findings suggest that minimal exposure to carcinogenic fibers may significantly increase the risk of malignant mesothelioma in genetically predisposed individuals carrying germline BAP1 mutations, possibly via alterations of the inflammatory response.
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Affiliation(s)
- A Napolitano
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA.,Department of Molecular Biosciences and Bioengineering, University of Hawaii at Manoa, Honolulu, HI, USA
| | - L Pellegrini
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - A Dey
- Department of Discovery Oncology, Genentech, South San Francisco, CA, USA
| | - D Larson
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - M Tanji
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - E G Flores
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - B Kendrick
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - D Lapid
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - A Powers
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - S Kanodia
- Department of Biomedical Sciences and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - S Pastorino
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - H I Pass
- Department of Cardiothoracic Surgery, New York University, New York, NY, USA
| | - V Dixit
- Department of Discovery Oncology, Genentech, South San Francisco, CA, USA
| | - H Yang
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - M Carbone
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
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21
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Powers A, Sheu R, Blacksburg S. SU-E-J-20: Identifying Predictors for Translational and Rotational Shifts of Liver SBRT Patients. Med Phys 2015. [DOI: 10.1118/1.4924107] [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: 11/07/2022] Open
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22
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Sheu R, Ghafar R, Powers A, Green S, Lo Y. SU-D-BRD-06: Creating a Safety Net for a Fully Automated, Script Driven Electronic Medical Record. Med Phys 2015. [DOI: 10.1118/1.4923872] [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: 11/07/2022] Open
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23
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Sheu R, Tseng T, Powers A, Lo Y. SU-E-T-71: Commissioning and Acceptance Testing of a Commercial Monte Carlo Electron Dose Calculation Model (eMC) for TrueBeam. Med Phys 2014. [DOI: 10.1118/1.4888401] [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: 11/07/2022] Open
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Dumane V, Powers A, Sheu R, Green S, Svoboda A, Lo Y. SU-E-T-834: Comparison of Rapidarc, IMRT and 3D Conformal Planning for Treatment of Chestwall, and Regional Nodes. Med Phys 2011. [DOI: 10.1118/1.3612798] [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: 11/07/2022] Open
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26
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Stein K, Powers A, Knoth RL, Broder M, Chang E. Relationship between age and health care utilization in patients with myelodysplastic syndrome receiving supportive care. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6560] [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: 11/20/2022] Open
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27
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Powers A, Stein K, Knoth RL, Broder M, Chang E. Health care utilization and costs in patients with early onset myelodysplastic syndrome in a commercially insured population. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6552] [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: 11/20/2022] Open
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28
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Simons WR, Choe Y, Powers A, McQueen C. A real-world evaluation of the effectiveness of dalteparin in the prevention of recurrent venous thromboembolism compared to warfarin in patients with cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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29
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Morales-Betoulle ME, Monzón Pineda ML, Sosa SM, Panella N, López MRB, Cordón-Rosales C, Komar N, Powers A, Johnson BW. Culex flavivirus isolates from mosquitoes in Guatemala. J Med Entomol 2008; 45:1187-1190. [PMID: 19058647 DOI: 10.1603/0022-2585(2008)45[1187:cfifmi]2.0.co;2] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A new strain of Culex flavivirus (family Flaviviridae, genus Flavivirus, CxFV), an insect virus first described in Japan, was isolated from adult Culex quinquefasciatus Say (Diptera: Culicidae) collected in 2006 from Izabal Department on the Caribbean coast of Guatemala. Mosquito pools were assayed for flavivirus RNA by using flavivirus group-specific primers that amplified a 720-bp region of the nonstructural (NS) 5 gene by standard reverse transcriptase-polymerase chain reaction. From 210 pools (1,699 mosquitoes), eight tested positive, and six of these mosquito pools produced virus isolates in Aedes albopictus Skuse C6/36 cells. Nucleotide sequence comparison of the eight flavivirus RNA-positive pools showed that there was 100% identity among them, and phylogenetic analysis of the NS5 and envelope gene regions indicated that they represent a strain of the recently described CxFV from Japan. This is the first report of an insect flavivirus from Central America.
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Affiliation(s)
- M E Morales-Betoulle
- Centro de Estudios en Salud, CDC-CAP, Universidad del Valle de Guatemala, 11 calle 15-79 zona 15, Vista Hermosa III, Guatemala, Guatemala.
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Zoellner JM, Connell C, Santell R, Fungwe T, Strickland E, Yadrick K, Avis A, Lofton K, Rowser M, Powers A, Bogle M. Community‐based Participatory Research: Benefits and Challenges in the Hollandale Fit for Life Steps Program. FASEB J 2006. [DOI: 10.1096/fasebj.20.4.a130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J M Zoellner
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
| | - C Connell
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
| | - R Santell
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
| | - T Fungwe
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
| | - E Strickland
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
| | - K Yadrick
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
| | - A Avis
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
| | - K Lofton
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
| | - M Rowser
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
| | - A Powers
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
| | - M Bogle
- Delta Nutrition Intervention Research Initiative900 S. Shackleford RdLittle RockAR72211
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31
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Rizzo P, Matker C, Powers A, Setlak P, Heeney JL, Carbone M. No evidence of HIV and SIV sequences in two separate lots of polio vaccines used in the first U.S. polio vaccine campaign. Virology 2001; 287:13-7. [PMID: 11504537 DOI: 10.1006/viro.2001.0955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We obtained sealed vials of two different polio vaccine lots, expiration date 1955, which were used in the first U.S. polio vaccine campaign. These early lots were pulled from the market because they contained live infectious poliovirus which caused polio in some of the vaccines. Theoretically, these vaccines could have contained other infectious retroviruses, including HIV. No viral sequences were detected using RT-PCR analyses with primers capable of amplifying chimpanzee SIV and HIV-1-related viruses nor with primers for macaque SIV, sooty mangabey SIV, and HIV-2-related viruses. Poliovirus sequences were readily amplified by RT-PCR, suggesting that the technique used would have detected SIV or HIV sequences, if present.
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Affiliation(s)
- P Rizzo
- Cardinal Bernardin Cancer Center, Department of Pathology, Loyola University Chicago, Maywood, Illinois 60153, USA
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32
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Abstract
Media coverage of some cancers in the past often equated cancer with a death sentence. Breast cancer coverage in 1990s magazines, however, has become less fatalistic, more frequent, and discusses a broader range of issues than before. This study examined whether the visual images accompanying magazine articles about breast cancer have also evolved. We used Goffman's (1976) rituals of subordination to measure patient-blaming and subordinating, disempowering images. We also analyzed race/ethnicity, body type, and age of females in the images to gauge whether these demographic risk factors were represented in a random sample of images from nine magazines over a 30-year period. Magazines analyzed represented three genres-women's magazines, fashion/beauty, and general news. Findings suggest that patient-blaming images have decreased in some categories and women portrayed are slightly more representative of risk factors of age and race/ethnicity. Magazine images tended to reinforce stereotyped portrayals of femininity to the detriment of cancer patients. Fashion/beauty magazines, aimed at younger women, were most likely to portray breast cancer images in stereotyped, patient-blaming ways, with the least representative images of risk factors. The social construction of feminine beauty seems to overpower accuracy in creating these images.
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Affiliation(s)
- J L Andsager
- Edward R. Murrow School of Communication, Washington State University, Pullman 99164-2520, USA.
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33
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Abstract
Malignant mesothelioma, a tumor of the pleura, pericardium, and peritoneum, is presently a worldwide problem. Current therapy is ineffective in slowing the course of the disease, and median survival from the time of diagnosis is rarely greater than 1 year. While the tumor was almost unknown prior to the second half of the twentieth century, it is presently responsible for more than 2000 deaths per year in the US alone. Mesothelioma is frequently associated with exposure to asbestos, but the incidence of cases involving individuals with low levels of asbestos exposure is increasing. For this reason, there has been much interest in studying whether there are alternative factors that act alone or in conjunction with asbestos in producing this malignancy. In the last decade, simian virus 40 (SV40) has become the most notable suspected agent.
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Affiliation(s)
- P Rizzo
- Cancer Immunology Program, Cardinal Bernardin Cancer Center, Department of Pathology, Loyola University Chicago, Maywood, IL 60153, USA
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34
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Abstract
This study examined how women's magazines framed breast cancer and silicone implants to determine whether they used a sense-making framework. Sense-making calls for existing gaps to be closed between what one group views as real and what another group experiences (Parrott, 1996). Analysis included 86 articles on cancer and implants published in four women's magazines from 1990 to 1997. Overall findings suggest that women's magazines used a sense-making approach to cancer coverage, framing the disease in terms of coping with its effects, personal experiences, and risk factors. Themes in implant articles pertained to economic concerns of the medical industry and media.
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Affiliation(s)
- J L Andsager
- Edward R. Murrow School of Communication Washington State University, Pullman 99164-2520, USA.
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35
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Bocchetta M, Di Resta I, Powers A, Fresco R, Tosolini A, Testa JR, Pass HI, Rizzo P, Carbone M. Human mesothelial cells are unusually susceptible to simian virus 40-mediated transformation and asbestos cocarcinogenicity. Proc Natl Acad Sci U S A 2000; 97:10214-9. [PMID: 10954737 PMCID: PMC27818 DOI: 10.1073/pnas.170207097] [Citation(s) in RCA: 194] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2000] [Indexed: 11/18/2022] Open
Abstract
Mesothelioma, a malignancy associated with asbestos, has been recently linked to simian virus 40 (SV40). We found that infection of human mesothelial cells by SV40 is very different from the semipermissive infection thought to be characteristic of human cells. Mesothelial cells are uniformly infected but not lysed by SV40, a mechanism related to p53, and undergo cell transformation at an extremely high rate. Exposure of mesothelial cells to asbestos complemented SV40 mutants in transformation. Our data provide a mechanistic explanation for the ability of SV40 to transform mesothelial cells preferentially and indicate that asbestos and SV40 may be cocarcinogens.
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Affiliation(s)
- M Bocchetta
- Cancer Immunology Program, Department of Pathology, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL 60153, USA
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36
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Hindiyeh M, Goulding C, Morgan H, Kenyon B, Langer J, Fox L, Dean G, Woolstenhulme D, Turnbow A, Billetdeaux E, Shakib S, Gordon C, Powers A, Vardeny G, Johnson M, Skodack-Jones L, Carroll K. Evaluation of BioStar FLU OIA assay for rapid detection of influenza A and B viruses in respiratory specimens. J Clin Virol 2000; 17:119-26. [PMID: 10942092 DOI: 10.1016/s1386-6532(00)00081-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Demand for the rapid diagnosis of influenza infections has increased with the advent of the availability of neuraminidase antiviral therapy for influenza A and B. Several rapid assays that detect both influenza A and B are now available. OBJECTIVES In this study we compared the performance of the BioStar FLU OIA assay to Bartels Viral Respiratory Screening and Identification Kit (Bartels Inc., Issaquah, WA), and cell culture. STUDY DESIGN A total of 145 patient specimens for influenza virus detection submitted in either viral transport medium or in sterile containers were evaluated by the three methods. Specimen types included nasal washings, nasal swabs, sputum, throat swabs, and bronchial alveolar lavage (BAL) fluids. RESULTS Fifty six positive specimens were identified based on culture and/or DFA. Of these, 30 specimens were positive by the OIA assay for an overall sensitivity of 54%. The OIA assay detected 48% (n = 21) of the 44 culture positive specimens and 81% (n = 29) of the 36 DFA positive specimens. Eighty six of the 89 culture/DFA negative samples were negative by the OIA assay (97% specificity). Analysis of the OIA assay sensitivity from samples submitted in M4 transport medium or in sterile containers revealed that M4 transport medium does not reduce the sensitivity of the OIA assay. Fifteen of the 27 positive samples submitted in M4 transport medium were positive by the OIA assay (56% sensitivity) compared to 15 of 29 positive samples transported in sterile containers (52% sensitivity). Twelve specimens were either culture and/or DFA positive for viruses other than influenza, but negative by the OIA assay, suggesting that there was no cross reactivity of the OIA assay with the other virus types recovered in this study. CONCLUSIONS The overall excellent specificity of the BioStar FLU OIA allows for treatment of positive patients for influenza, however, a negative result should be confirmed by DFA and culture.
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Affiliation(s)
- M Hindiyeh
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, USA.
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37
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Abstract
Newspaper coverage of the silicone breast implant controversy from 1992 through 1996 was analyzed to determine whether women in the United States were provided with a fair and balanced account. The paper also addressed whether or not Dow Corning's public relations campaign impacted newspaper coverage. All stories from the New York Times, the Chicago Tribune and the Wall Street Journal were analyzed. Findings suggested that early coverage of the controversy focused on the health risks of silicone breast implants while later coverage focused on the financial situations of the implant manufacturers. The most-interviewed sources were spokespersons for the implant manufacturers, while the least-interviewed sources were women with implants. The findings suggested that reporting patterns were influenced by the public relations efforts of the implant manufacturer, raising questions concerning the coverage of health care controversies involving large corporations seeking refuge from litigation.
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Affiliation(s)
- A Powers
- Department of Communication, Northern Illinois University, DeKalb 60115, USA.
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Abstract
A significant proportion of the general population is diagnosed with malignant melanoma each year, and more people die of melanoma now than at any time in the past. Consequently, treatment of melanoma at all stages of development is an important clinical issue. A variety of management options are discussed here, including biopsy techniques and treatment of the primary melanoma. The latter include lymphatic mapping and sentinel lymph node biopsy, hyperthermic isolated limb perfusion, and surgery for stage IV melanoma patients. Procedure-associated benefits and possible complications associated with each modality are also summarized.
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Affiliation(s)
- D Costello
- Cutaneous Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, 12902 Magnolia Drive, Tampa, FL 33612-9497, USA
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39
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Gamberi G, Benassi MS, Pompetti F, Ferrari C, Ragazzini P, Sollazzo MR, Molendini L, Merli M, Magagnoli G, Chiesa F, Gobbi AG, Powers A, Picci P. Presence and expression of the simian virus-40 genome in human giant cell tumors of bone. Genes Chromosomes Cancer 2000; 28:23-30. [PMID: 10738299 DOI: 10.1002/(sici)1098-2264(200005)28:1<23::aid-gcc3>3.0.co;2-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SV40 DNA sequences have been found in human tumors, such as mesotheliomas, ependymomas, and bone tumors, suggesting that SV40 may be involved in their etiology. The FOS oncogene could play an important role in bone development because SV40 is able to induce FOS in cell culture. In this study, the presence of SV40 sequences, large T antigen (Tag), and FOS protein expression were investigated in 120 giant cell tumors (GCTs), moderately benign bone tumors that in some cases can progress to a malignant phenotype. Polymerase chain reaction (PCR), using primers that amplify the RB1 pocket binding domain and the intron of Tag, was used to analyze GCT for the presence of SV40 DNA. Tag and FOS protein expression was evaluated by immunohistochemistry. SV40 sequences were found in 30/107 GCTs, and of these, 22/30 samples expressed Tag protein (73%) and 15/30 overexpressed the FOS oncogene (50%). FOS was undetectable in 77 SV40-negative GCTs. Sequence analysis of the amplified DNAs confirmed that the amplified sequences corresponded to SV40 DNA. The correlation between FOS overexpression and SV40-positive GCTs was highly statistically significant (P < 0.001). These results show that SV40 DNA sequences and SV40 Tag are present in GCTs and might induce FOS activity. These data suggest that SV40 might play a role in the development and progression of some GCTs.
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Affiliation(s)
- G Gamberi
- Laboratory of Oncologic Research, Rizzoli Institute, Bologna, Italy.
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40
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Cristaudo A, Powers A, Vivaldi A, Foddis R, Guglielmi G, Gattini V, Buselli R, Sensales G, Ciancia E, Ottenga F. SV40 can be reproducibly detected in paraffin-embedded mesothelioma samples. Anticancer Res 2000; 20:895-8. [PMID: 10810373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
We studied tissue sections from 18 paraffin embedded mesothelioma specimens diagnosed by the Pathology Department of S. Chiara Hospital of Pisa. Using PCR analysis and Southern blot hybridization we examined the specimens for the DNA regulatory region of the virus. 10/18 (55.5%) of the samples tested contained SV40 DNA regulatory sequences, and of these positive samples, 80% were found to contain Tag sequences by PCR and Southern Blot hybridization. These results confirm that SV40 can be amplified and detected in paraffin embedded mesothelioma samples.
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Affiliation(s)
- A Cristaudo
- Department of Endocrinology and Metabolism, University of Pisa, Italy
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41
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Affiliation(s)
- A Powers
- The Comprehensive Breast Cancer Program, H. Lee Moffitt Cancer Center & Research Institute, University of South Florida, Tampa, Florida 33612-9497, USA
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42
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Rizzo P, Di Resta I, Powers A, Ratner H, Carbone M. Unique strains of SV40 in commercial poliovaccines from 1955 not readily identifiable with current testing for SV40 infection. Cancer Res 1999; 59:6103-8. [PMID: 10626798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
SV40 was first identified as a contaminant of poliovaccines used from 1955 until 1963. Recently, SV40 has been detected in several human tumors. The virus detected in human tumors often contained only one 72-bp enhancer in the regulatory region, in contrast to the SV40 originally isolated from poliovaccines, which contained two 72-bp enhancers. The origin of viruses with one 72-bp enhancer in humans was unknown, because it was thought that these viruses were not present in poliovaccines. It was also thought that all poliovaccine vials produced from 1955 until 1963 had been discarded, thus the possibility that one 72-bp virions contaminated those vials could not be tested. We unexpectedly obtained what appear to be the last available vials of poliovaccine produced in 1955. In these vials, we detected and sequenced SV40 containing only one 72-bp enhancer in the regulatory region. The tissue culture cytopathic test currently used in the United States to screen oral poliovaccines was designed to detect rapidly proliferating SV40 virions containing two 72-bp enhancers. We found that this test is not sensitive enough to detect low amounts of the slow-replicating SV40 virions containing one 72-bp enhancer. This virus was easily detected in the same cells by immunostaining and PCR. Twelve current vials of poliovaccines tested uniformly negative for SV40, suggesting that the precaution of preparing poliovaccines from kidneys obtained from monkeys bred in isolated colonies prevented SV40 contamination. Our data demonstrate that humans were exposed to SV40 viruses with both one 72-bp enhancer and two 72-bp enhancers SV40 through contaminated vaccines. Our data also suggest that instead of cytopathic tests, immunohistochemical and/or molecular studies should be used to screen poliovaccines for SV40 to completely eliminate the risk of occasional contamination.
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Affiliation(s)
- P Rizzo
- Loyola University Medical Center, Cardinal Bernardin Cancer Center, Department of Pathology, Maywood, Illinois 60153, USA
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43
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Rizzo P, Carbone M, Fisher SG, Matker C, Swinnen LJ, Powers A, Di Resta I, Alkan S, Pass HI, Fisher RI. Simian virus 40 is present in most United States human mesotheliomas, but it is rarely present in non-Hodgkin's lymphoma. Chest 1999; 116:470S-473S. [PMID: 10619511 DOI: 10.1378/chest.116.suppl_3.470s] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Simian virus 40 (SV40) causes mesotheliomas, osteosarcomas, ependymomas, choroid plexus tumors, and lymphomas in hamsters. In humans, SV40 has been detected in tumors of the first four types. Using the polymerase chain reaction (PCR), we tested 29 non-Hodgkin's lymphomas (intermediate and high-grade), 25 posttransplant lymphoproliferative disorders, and 5 AIDS lymphomas for SV40 DNA. PCR analysis revealed that 3 of 29 lymphomas, 6 of 25 posttransplant lymphoproliferative disorders, and 2 of 5 AIDS lymphomas contained SV40 sequences corresponding to the retinoblastoma (RB)-pocket binding domain of SV40 tumor antigen (Tag). However, among positive samples, only one posttransplant lymphoproliferative disorder and one AIDS lymphoma contained the SV40 regulatory region, which suggest a higher viral load in these patients. In parallel experiments, 8 of 12 mesotheliomas tested positive for SV40 for both the RB-pocket binding domain of Tag and the SV40 regulatory region. These data confirm the presence of SV40 in most United States mesotheliomas and indicate that in human non-Hodgkin's lymphomas, the prevalence of SV40 is low.
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Affiliation(s)
- P Rizzo
- Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL 60153, USA
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44
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Abstract
OBJECTIVE To study the effect of music on state anxiety levels in patients undergoing flexible fiberoptic bronchoscopy (FFB). DESIGN Randomized clinical trial using pretests, posttests, and two groups. SETTING Pulmonary special-procedures unit of a tertiary-care referral center. PATIENTS Sixty adult patients: 30 patients received music during bronchoscopy and 30 control subjects received no music. RESULTS The study population had baseline state anxiety levels similar to those previously reported in surgical patients (42.6 +/- 13 vs 42.7 +/- 14; p value, not significant [NS]) and higher than those reported in normal working adults (42.6 +/- 13 vs 34.4 +/- 10; p < 0.001). Experimental and control groups were similar in patient and procedure-related characteristics and baseline pre-FFB state and trait anxiety scores. Although trait anxiety scores decreased significantly after the procedure (pooled post-FFB scores of 32.6 +/- 10 vs pre-FFB scores of 35.5 +/- 11; p < 0.001), no reductions were noted in state anxiety (pooled post-FFB scores of 42.8 +/- 13 vs pre-FFB scores of 42.6 +/- 13; p value, NS). More importantly, playing music through headphones during FFB did not result in a statistically or clinically significant reduction in either state or trait anxiety when compared to control subjects. CONCLUSION Relaxation music administered through headphones to patients during flexible bronchoscopy does not decrease procedure-related state anxiety.
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Affiliation(s)
- H G Colt
- Division of Pulmonary and Critical Care Medicine, UCSD Medical Center-Thornton Hospital, La Jolla, CA 92037-0975, USA
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45
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Abstract
Mesotheliomas are malignant tumors usually associated with occupational asbestos exposure. Simian virus 40 (SV40) is a DNA tumor virus that preferentially causes mesotheliomas when injected intracardially and/or intrapleurally into hamsters. SV40 also transforms human cells in tissue culture, and these cells contain extensive DNA damage. In the United States, at least 60% of human mesotheliomas contain and express SV40. In these tumor cells, the SV40 tumor antigen binds and inhibits the cellular tumor suppressors p53 and Rb. These findings suggest that SV40 may contribute to the development of those human mesotheliomas that occur in people not exposed to asbestos. SV40 may also facilitate asbestos-mediated carcinogenicity. The epidemiological data available are insufficient to address the role that SV40 may have played in contributing to the increased incidence of mesothelioma in the second half of this century.
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Affiliation(s)
- M Carbone
- Cancer Immunology Program, Cardinal Bernardin Cancer Center, Department of Pathology, Loyola Medical School, Maywood, Illinois 60153, USA
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46
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Matker CM, Rizzo P, Pass HI, Di Resta I, Powers A, Mutti L, Kast WM, Carbone M. The biological activities of simian virus 40 large-T antigen and its possible oncogenic effects in humans. Monaldi Arch Chest Dis 1998; 53:193-7. [PMID: 9689808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Simian virus 40 (SV40) is an oncogenic virus which induces tumors in hamsters and transforms human cells in tissue culture. Between 1955 and 1963, polio vaccines and adenovaccines were contaminated with SV40; therefore, millions of people were exposed to this oncogenic virus. The SV40 proteins responsible for in vivo oncogenesis and in vitro cell transformation are encoded by the early region of the virus. These proteins are called T (tumor) antigens (Tags), because animals with tumors induced by SV40 have antibodies against these viral proteins. Recently, we and other research laboratories have found SV40 in specific types of human tumors: mesothelioma, ependymoma and choroid plexus tumors, osteosarcoma and sarcoma. The same tumor types will develop in hamsters which have been injected systemically with SV40. SV40 causes cell transformation in tissue culture and tumors in animals, because SV40 Tag binds and inactivates the cellular tumor suppressor gene products, Rb and p53. We found that SV40 Tag binds p53 and Rb in human mesotheliomas, possibly contributing to the malignant phenotype.
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Affiliation(s)
- C M Matker
- Cardinal Bernardin Cancer Center, Loyola University of Chicago, Maywood, IL 60153, USA
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Rizzo P, Di Resta I, Powers A, Matker CM, Zhang A, Mutti L, Kast WM, Pass H, Carbone M. The detection of simian virus 40 in human tumors by polymerase chain reaction. Monaldi Arch Chest Dis 1998; 53:202-10. [PMID: 9689810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Simian virus (SV) 40 is a deoxyribonucleic acid (DNA) virus that induces mesotheliomas, ependymomas, bone tumors, and lymphomas in hamsters. In recent years SV40 sequences have been detected in approximately 60% of mesotheliomas and ependymomas, in 33% of bone tumors and sarcomas, and in 13% of lymphomas. Because the amount of human specimens available for molecular studies is usually minimal, the method most commonly used to demonstrate SV40 in human specimens is the polymerase chain reaction (PCR). PCR is a highly sensitive and useful technique. In the PCR reaction, different sets of primers are used for targeting different regions of DNA. The regions of the SV40 genome targeted by PCR include the large T-antigen, the small t-antigen, the origin of replication, and viral protein-1 capsid protein. The use of these different sets of primers to test human tumor specimens for SV40 produce a different percentage of positive results. This is because these experiments revealed that some primers are more specific than others which may also detect sequences belonging to other DNA papovaviruses. Therefore, the combined use of different sets of primers is recommended when it is important to distinguish SV40 from other related papovaviruses such as BK and JC, which can also be occasionally present in human cells. Furthermore, these experiments demonstrated that polymerase chain reaction analyses for simian virus 40 can be performed better and easier when using deoxyribonucleic acid extracted from fresh and/or frozen tissue. Deoxyribonucleic acid from paraffin embedded specimens should not be used routinely for simian virus 40 testing because of the high risk of obtaining false negative results. However, these paraffin derived deoxyribonucleic acids can be used reliably in molecular laboratories specialized in these type of analyses. This paper describes the methods that we have developed to test simian virus 40 in human specimens.
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Affiliation(s)
- P Rizzo
- Loyola University of Chicago, Cardinal Bernardin Cancer Center, Maywood, IL, USA
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Banco L, Powers A. Hospitals: unsafe environments for children. Pediatrics 1988; 82:794-7. [PMID: 3186363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- L Banco
- Department of Pediatrics, Hartford Hospital, CT 06115-0729
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Abstract
Magnetic resonance (MR) is of value in imaging intervertebral disk disease. We present the MR findings in two patients with thoracic disk herniations who required surgical intervention. The advantages of MR over CT myelography are ease of obtaining sagittal sections, rapid assessment of the entire thoracic spine, and a high rate of patient acceptance related to the noninvasive nature of MR and lack of morbidity and complications. For these reasons, we currently rely, almost exclusively, on MR for evaluating thoracic disk disease.
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Affiliation(s)
- T L Francavilla
- Department of Neurological Surgery, George Washington University, Washington, DC 20037
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James DE, Zorzano A, Böni-Schnetzler M, Nemenoff RA, Powers A, Pilch PF, Ruderman NB. Intrinsic differences of insulin receptor kinase activity in red and white muscle. J Biol Chem 1986; 261:14939-44. [PMID: 3021758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The sensitivity and responsiveness of glucose uptake and glycogen synthesis to insulin are 3-4-fold greater in red than in white skeletal muscle (James, D. E., Jenkins, A. B., and Kraegen, E. W. (1985) Am. J. Physiol. 248, E567-E574). In the present study, the insulin receptor tyrosine kinase activity has been examined in red and white muscle of rats. Partially purified insulin receptors were obtained from muscle following solubilization in detergent, ultracentrifugation, and lectin affinity chromatography. Total insulin receptor number per gram of tissue was slightly higher in red (30%) than in white muscle. In contrast, basal and insulin-stimulated autophosphorylation, normalized for receptor number, were 2.3-fold higher in red muscle. A similar difference was observed in the ability of partially purified receptors to phosphorylate the exogenous substrate polyglutamate/tyrosine. The integrity of the insulin receptor preparation in the two fiber types was identical as determined by affinity cross-linking of [125I-TyrB26]insulin to the receptor. Mixing partially purified receptors from red and white muscle resulted in an additive response for exogenous substrate phosphorylation, suggesting that the difference in tyrosine kinase activity was not due to the presence of an inhibitor or activator. The results suggest that there are differences in the insulin receptors of red and white muscles that lead to discordance in their basal and insulin-stimulated intrinsic tyrosine kinase activity. The correlation between these differences and insulin action in red and white muscle supports the concept that the insulin receptor tyrosine kinase activity is involved in the initiation of insulin action.
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