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Colón-Semenza C, Zajac JA, Schwartz A, Darbandsari P, Ellis TD. Experiences from the implementation of physical therapy via telehealth for individuals with Parkinson disease during the COVID-19 pandemic. Disabil Rehabil 2024; 46:1593-1601. [PMID: 37088939 DOI: 10.1080/09638288.2023.2202418] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE To (1) determine the characteristics and participation rate of adults with Parkinson disease (PD) in physical therapy (PT) delivered via telehealth, (2) identify the outcome measures and interventions implemented, (3) determine the safety of and (4) patient and therapist satisfaction with PT via telehealth in a clinic specializing in the care of people with PD during the coronavirus pandemic. MATERIALS & METHODS A retrospective analysis of PT services via telehealth was conducted. Participating patients completed a satisfaction survey. Physical therapists (PTs) who delivered this care were interviewed. Three coders conducted thematic analysis of interviews. Descriptive statistics described the participation rate, demographics, outcome measures, interventions, and safety. RESULTS There was a 71.4% participation rate. Participants (n = 55) were white (96%), non-Hispanic (100%), older adult (mean = 69.5 years (8.3)) males (65.5%). Non-participants (n = 22) had similar demographics. Therapists selected patient-reported measures more often than performance-based measures. Therapeutic exercise was the most common intervention. All patients (80% response rate) reported satisfaction with their experience. PTs reported the home enhanced specificity of training but impeded evaluation. Therapists endorsed a hybrid model for future practice. CONCLUSIONS Patients reported satisfaction with PT via telehealth during the pandemic. A hybrid model may support optimal delivery of PT.IMPLICATIONS FOR REHABILITATIONPhysical therapy via telehealth for patients with Parkinson disease was acceptable to patients and physical therapists in our study.Physical therapy via telehealth was safe for people with Parkinson disease in our study, although availability and benefits may not be reaching all populations equitably.Both physical therapists and patients endorse a hybrid model of care (a combination of in-person and remote assessment and treatment) to profit from the strengths of in-person and virtual formats while minimizing barriers to access.
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Affiliation(s)
- C Colón-Semenza
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - J A Zajac
- Department of Physical Therapy, Boston University, Boston, MA, USA
| | - A Schwartz
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - P Darbandsari
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - T D Ellis
- Department of Physical Therapy, Boston University, Boston, MA, USA
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Nilsson AH, Eichstaedt JC, Lomas T, Schwartz A, Kjell O. The Cantril Ladder elicits thoughts about power and wealth. Sci Rep 2024; 14:2642. [PMID: 38302578 PMCID: PMC10834405 DOI: 10.1038/s41598-024-52939-y] [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] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/25/2024] [Indexed: 02/03/2024] Open
Abstract
The Cantril Ladder is among the most widely administered subjective well-being measures; every year, it is collected in 140+ countries in the Gallup World Poll and reported in the World Happiness Report. The measure asks respondents to evaluate their lives on a ladder from worst (bottom) to best (top). Prior work found Cantril Ladder scores sensitive to social comparison and to reflect one's relative position in the income distribution. To understand this, we explored how respondents interpret the Cantril Ladder. We analyzed word responses from 1581 UK adults and tested the impact of the (a) ladder imagery, (b) scale anchors of worst to best possible life, and c) bottom to top. Using three language analysis techniques (dictionary, topic, and word embeddings), we found that the Cantril Ladder framing emphasizes power and wealth over broader well-being and relationship concepts in comparison to the other study conditions. Further, altering the framings increased preferred scale levels from 8.4 to 8.9 (Cohen's d = 0.36). Introducing harmony as an anchor yielded the strongest divergence from the Cantril Ladder, reducing mentions of power and wealth topics the most (Cohen's d = -0.76). Our findings refine the understanding of historical Cantril Ladder data and may help guide the future evolution of well-being metrics and guidelines.
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Affiliation(s)
- August Håkan Nilsson
- Department of Psychology, Lund University, Lund, Sweden.
- Oslo Business School, Oslo Metropolitan University, Oslo, Norway.
| | - Johannes C Eichstaedt
- Department of Psychology, Institute for Human-Centered A.I., Stanford University, Stanford, CA, USA
| | - Tim Lomas
- Department of Epidemiology, Harvard University, Cambridge, USA
| | - Andrew Schwartz
- Department of Computer Science, Stony Brook University, Stony Brook, NY, USA
| | - Oscar Kjell
- Department of Psychology, Lund University, Lund, Sweden
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Maahs E, Schwartz A, Berezowitz A, Davis S, Guzman RJ. An ultrasound-based femoral artery calcification score. J Vasc Surg Cases Innov Tech 2024; 10:101381. [PMID: 38130366 PMCID: PMC10731664 DOI: 10.1016/j.jvscit.2023.101381] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023] Open
Abstract
Objective Duplex ultrasound (US) of the lower extremities is commonly used to assess patients with lower extremity atherosclerosis. Arterial calcification can often be visualized in these images; however, efforts to quantify its extent have been limited. We, thus, sought to develop a new scoring system to measure calcification on duplex US studies of the femoral artery and correlate it with standard computed tomography (CT)-based methods. We then made preliminary attempts to correlate US-based femoral artery calcification scores with limb-specific outcomes in patients with peripheral arterial disease. Methods Patients who underwent CT evaluation of the lower extremities and arterial duplex US of either lower extremity within 6 months of each examination were included in the study. CT-based calcium scores of the femoral artery were generated using calcium scoring software. To determine the US score, five standard arterial segments (ie, common femoral artery, proximal superficial femoral artery [SFA], mid-SFA, distal SFA, and above the knee popliteal artery) were scored using a scale of 0 to 2 (0, a completely normal vessel segment; 1, a vessel with hyperechoic irregularities of the vessel wall; and 2, clear anechoic shadowing). The available scores were then averaged to yield a single femoral calcium score for each leg. Predictors of femoral calcification scores were then assessed and compared with the CT-based methods. The correlation between the US- and CT-based femoral calcification was assessed, and then the association between the US-based femoral calcification score and limb outcomes was evaluated. Results A total of 113 patients met the inclusion criteria and were included in the final analysis. US-based calcification scores were increased in patients with diabetes, renal failure, and the presence of chronic limb threatening ischemia similar to CT-based femoral calcification. The US- and CT-based calcification scores showed a moderate to strong correlation (r = 0.64). An elevated US-based femoral artery calcification score was associated with decreased amputation-free survival. Conclusions A novel US-based method shows promise as a simple method for quantifying the extent of femoral artery calcification in patients with peripheral arterial disease. The US-based method correlates with standard CT-based methods. Preliminary studies show that it could be useful for predicating outcomes for patients with peripheral arterial disease.
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Affiliation(s)
- Ethan Maahs
- Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT
| | - Andrew Schwartz
- Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT
| | - Alexa Berezowitz
- Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT
| | - Sean Davis
- Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT
| | - Raul J. Guzman
- Division of Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, CT
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Zhang Y, Luo A, Hou L, Chen S, Zhang W, Schwartz A, Clouston SAP. Crisis response during the COVID-19 pandemic: Changes in social contact and social participation of older Americans. PLoS One 2023; 18:e0284935. [PMID: 37498870 PMCID: PMC10374158 DOI: 10.1371/journal.pone.0284935] [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] [Received: 06/30/2022] [Accepted: 04/11/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE This study aimed to assess changes in social contact with family, friends and healthcare providers, as well as social participation in working, volunteering, religious services and other organized activities, among older adults during the COVID-19 pandemic while examining the role of pre-COVID sociodemographic characteristics or cognitive and physical limitations in changes in social contact and participation. METHODS We conducted secondary data analyses in the National Health and Aging Trends Study (NHATS) COVID-19 questionnaire, collected in 2020 during a period of workplace closures and social distancing guidelines. We linked data to pre-COVID sociodemographic and medical information collected in 2019 before COVID interrupted social life. The frequency of participants' social contact and social participation prior to and during the COVID-19 pandemic, were compared using paired t-tests for summed scores. Multivariate linear regression was used to relate participants' socio-demographic, prior physical and cognitive performance with levels of social contact and participation and with changes reported during the COVID-19 pandemic. RESULTS In total, results from 2,486 eligible participants revealed that COVID-19 was associated with decreased social contact among family and friends (change: -0.62; SE: 0.06; p<0.0001), and social participation among older adults (change: -0.58; SE: 0.02; p<0.0001). Pre-COVID characteristics including older age, lower educational attainment, poorer physical performance, and more chronic conditions were associated with lower social contact and social participation and with how older adults adapted their social lives during the COVID-19 pandemic. DISCUSSION These results emphasize the importance of increasing digital inclusion for older adults in a major crisis.
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Affiliation(s)
- Yun Zhang
- Program in Public Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
- Pediatric Cardiovascular Clinical Research Core, Pediatric Heart Center, Columbia University Vagelos College of Physicians and Surgeons, Morgan Stanley Children's Hospital of New York-Presbyterian, New York, New York, United States of America
| | - Amber Luo
- Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Luke Hou
- Ward Melville High School, Stony Brook, New York, United States of America
| | - Shanquan Chen
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Wei Zhang
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America
| | - Andrew Schwartz
- Department of Computer Science, Stony Brook University, Stony Brook, New York, United States of America
| | - Sean A P Clouston
- Program in Public Health and Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
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Wu M, Kim B, Schwartz A, Wellman S, Cochrane N, Bolognesi MP, Ryan SP. "Does order of operation matter in patients who have concomitant hip and spine pathology?". J Arthroplasty 2023:S0883-5403(23)00394-7. [PMID: 37105328 DOI: 10.1016/j.arth.2023.04.038] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION In patients who have coexisting lumbar spine and degenerative hip disease, there remains uncertainty regarding whether hip or spine surgery should be performed first. We hypothesized that undergoing total hip arthroplasty (THA) would protect against subsequent lumbar spine surgery (LSS) in patients who have 'hip-spine syndrome.' METHODS A retrospective cohort study was performed from 2013 to 2021 on patients who had radiographically-confirmed hip osteoarthritis and degenerative lumbar spine pathology, evaluated separately in spine and arthroplasty clinics prior to surgical intervention. Included patients ultimately underwent THA and/or LSS. The primary outcome was survivorship free of LSS or THA after the other was initially performed. RESULTS Of 256 patients, 206 (80.5%) underwent THA first. Only 14 of 206 (6.8%) who underwent THA required subsequent LSS, while 31 of 50 (62%) who underwent LSS required subsequent THA, (P<0.001). At 5 years, there was 93.9% survivorship-free of LSS in the THA first group, compared to 44.7% survivorship-free of subsequent THA in the LSS group. Multivariate analyses showed that patients who had THA first had lower odds of undergoing subsequent surgery (Odds Ratio (OR): 0.61, Confidence Interval (CI): 0.52-0.70, P<0.001) compared to those who underwent LSS first. Additionally, those who have higher initial Kellgren Lawrence (KL) grade hip osteoarthritis had lower odds (OR:0.94,CI:0.89-0.99, P=0.04), and those who have progressive neurologic deficits (OR:2.64, CI:1.89-3.7, P<0.001) and neurogenic claudication (OR:1.15, CI:1.06-1.24, P=0.001) had increased odds of undergoing subsequent LSS. CONCLUSION 'Hip-spine syndrome' patients may receive more initial benefit from undergoing THA, potentially reducing the subsequent need for LSS. The exceptions were those patients who had lower-severity hip osteoarthritis and symptoms of major spinal stenosis.
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Affiliation(s)
- Mark Wu
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
| | - Billy Kim
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Andrew Schwartz
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Samuel Wellman
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Niall Cochrane
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Michael P Bolognesi
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Sean P Ryan
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
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Schwartz A, Cochrane NH, Jiranek WA, Ryan SP. Periarticular Injection in Total Knee Arthroplasty. J Am Acad Orthop Surg 2023:00124635-990000000-00672. [PMID: 37071876 DOI: 10.5435/jaaos-d-22-01179] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/19/2023] [Indexed: 04/20/2023] Open
Abstract
Optimal pain management after total knee arthroplasty (TKA) can expedite postoperative recovery, improve perioperative outcomes, and increase patient satisfaction. Periarticular injections (PAIs) have become increasingly used to improve pain management after TKA. Similar to peripheral nerve blocks, the use of intraoperative PAIs can lower pain scores and expedite discharge from the hospital. However, there is notable variability in the ingredients and administration techniques of PAIs. Currently, no standard of care exists for PAIs, especially in the setting of adjuvant peripheral nerve blocks. This study seeks to evaluate the ingredients, administration techniques, and outcomes of PAIs used during TKA.
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Affiliation(s)
- Andrew Schwartz
- From the Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC (Schwartz, Cochrane, Jiranek, and Ryan), and the Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA (Schwartz)
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Kim BI, Schwartz A, Wixted CM, Prado IP, Polascik B, Hendershot EF, Jiranek WA, Seidelman J, Seyler TM. 986. Pseudomonas Prosthetic Joint Infections: Is there a role for monotherapy? Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.828] [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: 12/23/2022] Open
Abstract
Abstract
Background
Pseudomonas species are a less common but devastating pathogen family in prosthetic joint infections (PJI). Despite advancements in management, Pseudomonas PJI remains particularly difficult to treat due to fewer antibiotic options and robust biofilm formation. The purpose of this study was to better evaluate outcomes after Pseudomonas PJI treatment.
Methods
All hip or knee PJIs, at a single institution, with positive Pseudomonas culture were analyzed. 51 patients (29 hips and 22 knees) meeting inclusion criteria were identified. The primary outcome of interest was infection clearance at 1-year after surgical treatment, defined as reassuring aspirate without ongoing antibiotic treatment or death within one year post-operatively. Monomicrobial and polymicrobial infections were evaluated separately.
Results
Among monomicrobial PJIs, ten (50.0%) patients were clear of infection at one year post-operatively. Patients treated with 2-stage exchange (n=11) had a 1-year clearance rate of 54.5% compared to 60.0% with DAIR (n=5) and 25.0% with resection or amputation (n=4). Two of six patients treated with fluoroquinolone monotherapy met 1-year infection clearance, despite fluoroquinolone sensitivity, compared to four of five patients meeting 1-year clearance when treated with combined intravenous and oral therapy for at least 6 weeks. Resistance to anti-pseudomonal agents was infrequent (20%, n=4/20), and three of ten mono- and polymicrobial PJI patients with recurrent Pseudomonas PJI developed resistance to anti-pseudomonal therapy. Polymicrobial infections were the most common presentation (54.9%) of Pseudomonas positive PJI with a mortality rate of 46.4% (n=13/28) at a median follow-up of 4.2 years [IQR: 3.4-5.7].
Conclusion
Despite surgical and antibiotic treatment regimens consistent with traditional treatment algorithms, our data portrays poor clearance rate of Pseudomonas PJI with relatively poor outcomes in patients treated with oral or intravenous monotherapy. Pseudomonas infections are difficult to eradicate and likely require deviations from classical therapeutic protocols to improve treatment success.
Disclosures
William A. Jiranek, MD, Biomech Holdings LLC: Stocks/Bonds|DePuy, A Johnson & Johnson Company: IP royalties Thorsten M. Seyler, MD, PhD, Heraeus: Paid consultant|Pattern Health: IP royalties|Restor3d: IP royalties|Smith & Nephew: Paid consultant|Total Joint Orthopedics: Paid consultant|Zimmer: research.
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Prado IP, Kim BI, Schwartz A, Wixted CM, Polascik B, Hendershot E, Jiranek WA, Seidelman J, Seyler TM. 980. Enterobacter: An Early-Onset Pathogen of Prosthetic Hip and Knee Infections with Poor Prognoses. Open Forum Infect Dis 2022. [PMCID: PMC9752486 DOI: 10.1093/ofid/ofac492.822] [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: 12/23/2022] Open
Abstract
Background Enterobacter sp. is a gram-negative, often drug-resistant bacillus that is classically identified from mucosal surfaces, such as pulmonary or urinary tracts. Despite its virulence, Enterobacter represents a less common pathogen in prosthetic joint infections (PJI). This study aims to resolve the current paucity of described clinical characteristics and treatment success of Enterobacter PJI. Methods Thirty-three patients with Enterobacter aerogenes-, cloaecae/asburiae-, or hormachei-positive PJIs were identified at a single institution. Infection clearance was defined as absence of infection or repeat surgery at one year and off all adjunct antibiotic therapy. Patient demographics, PJI characteristics, treatments, and clinical outcomes were compared between patients with and without clearance. Results In this cohort, mean age was 66.8 years (SD: 11.6), mean BMI was 31.0 (SD: 7.1), and mean Elixhauser Comorbidity Score was 9.1 (SD: 4.5). 54.5% had a prior PJI in the same joint, and 87.9% had more than one prior surgery in that joint. Median time of PJI diagnosis after surgery was 22 days [IQR: 18-60]. Patients initially treated with debridement antibiotics and implant retention (n=11) had a 45.5% clearance rate, compared to 23.1% for 2-stage exchange (n=13) and 44.4% for those requiring resection arthroplasty or amputation (n=9). With a median follow-up of 2.9 years, final joint outcomes included resection arthroplasty in 9 (27.3%), above-knee amputation in 7 (21.2%), definitive treatment with an articulating spacer in 6 (18.2%), and arthrodesis in 2 (6.1%) patients. Conclusion Enterobacter PJI often presents acutely and is a difficult pathogen to treat. The outcomes of our cohort reflect the virulence of Enterobacter, with high rates of failure and ultimate joint- or limb-sacrificing procedure. Despite being a less common cause of PJI, prognosis is exceptionally poor with traditional treatment algorithms when compared to historical cohorts of more common pathogens. Disclosures William A. Jiranek, MD, Biomech Holdings LLC: Stocks/Bonds|DePuy, A Johnson & Johnson Company: IP royalties Thorsten M. Seyler, MD, PhD, Heraeus: Paid consultant|Pattern Health: IP royalties|Restor3d: IP royalties|Smith & Nephew: Paid consultant|Total Joint Orthopedics: Paid consultant|Zimmer: research.
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Fleury Curado T, Pham L, Freire C, Amorim M, Abdelwahab M, Huang A, Taheri N, Hong Y, Dedhia R, Liu S, Capasso R, Polotsky V, Eisele D, Schwartz A. Changes in Tongue Morphology Predict Responses in Pharyngeal Patency to Selective Hypoglossal Nerve Stimulation. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.647] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Curado TF, Pho H, Freire C, Amorim M, Sennes LU, Taheri N, Hong Y, Abdelwahab M, Huang A, Fishbein K, Liu S, Capasso R, Schwartz A, Fuller D, Polotsky V. Designer Receptors Exclusively Activated by Designer Drugs Treatment of Sleep-disordered Breathing. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.657] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Erewele EO, Castellon M, Loya O, Marshboom G, Schwartz A, Yerlioglu K, Callahan C, Chen J, Minshall RD, Oliveira SD. Hypoxia-induced pulmonary hypertension upregulates eNOS and TGF-β contributing to sex-linked differences in BMPR2 +/R899X mutant mice. Pulm Circ 2022; 12:e12163. [PMID: 36484056 PMCID: PMC9722973 DOI: 10.1002/pul2.12163] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/28/2022] Open
Abstract
Dysfunctional bone morphogenetic protein receptor 2 (BMPR2) and endothelial nitric oxide synthase (eNOS) have been largely implicated in the pathogenesis of pulmonary arterial hypertension (PAH); a life-threatening cardiopulmonary disease. Although the incident of PAH is about three times higher in females, males with PAH usually have a worse prognosis, which seems to be dependent on estrogen-associated cardiac and vascular protection. Here, we evaluated whether hypoxia-induced pulmonary hypertension (PH) in humanized BMPR2+/R899X loss-of-function mutant mice contributes to sex-associated differences observed in PAH by altering eNOS expression and inducing expansion of hyperactivated TGF-β-producing pulmonary myofibroblasts. To test this hypothesis, male and female wild-type (WT) and BMPR2+/R899X mutant mice were kept under hypoxic or normoxic conditions for 4 weeks, and then right ventricular systolic pressure (RVSP) and right ventricular hypertrophy (RVH) were measured. Chronic hypoxia exposure elevated RVSP, inducing RVH in both groups, with a greater effect in BMPR2+/R899X female mice. Lung histology revealed no differences in vessel thickness/area between sexes, suggesting RVSP differences in this model are unlikely to be in response to sex-dependent vascular narrowing. On the other hand, hypoxia exposure increased vascular collagen deposition, the number of TGF-β-associated α-SMA-positive microvessels, and eNOS expression, whereas it also reduced caveolin-1 expression in the lungs of BMPR2+/R899X females compared to males. Taken together, this brief report reveals elevated myofibroblast-derived TGF-β and eNOS-derived oxidants contribute to pulmonary microvascular muscularization and sex-linked differences in incidence, severity, and outcome of PAH.
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Affiliation(s)
- Ejehi O. Erewele
- Department of Anesthesiology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Maricela Castellon
- Department of Anesthesiology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Cardiovascular Research Center, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Omar Loya
- Department of Anesthesiology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Glenn Marshboom
- Department of Pharmacology and Regenerative Medicine, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Andrew Schwartz
- Department of Anesthesiology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Kayla Yerlioglu
- Department of Anesthesiology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Christopher Callahan
- Department of Anesthesiology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Jiwang Chen
- Cardiovascular Research Center, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Department of Medicine, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Richard D. Minshall
- Department of Anesthesiology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Department of Pharmacology and Regenerative Medicine, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Suellen D. Oliveira
- Department of Anesthesiology, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Department of Physiology & Biophysics, College of MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
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Elowsky J, Bajaj S, Bashford-Largo J, Zhang R, Mathur A, Schwartz A, Dobbertin M, Blair KS, Leibenluft E, Pardini D, Blair RJR. Differential associations of conduct disorder, callous-unemotional traits and irritability with outcome expectations and values regarding the consequences of aggression. Child Adolesc Psychiatry Ment Health 2022; 16:38. [PMID: 35606814 PMCID: PMC9128221 DOI: 10.1186/s13034-022-00466-x] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/04/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Previous work has examined the association of aggression levels and callous-unemotional traits with outcome expectations and values regarding the consequences of aggression. Less work has examined the outcome expectations and values regarding the consequences of aggression of adolescents with Conduct Disorder (CD). Also, no studies have examined links between irritability (a second socio-affective trait associated with CD) and these social cognitive processes despite the core function of anger in retaliatory aggression and establishing dominance. METHOD The current study, investigating these issues, involved 193 adolescents (typically developing [TD; N = 106], 87 cases with CD [N = 87]). Participants completed an adaptation of the Outcomes Expectations and Values Questionnaire and were assessed for CU traits and irritability via the Inventory of Callous-Unemotional traits and the Affective Reactivity Index. RESULTS While CD was associated with atypical outcome expectations this was not seen within statistical models including CU traits and irritability. CU traits were associated with decreased expectation that aggression would result in feelings of remorse and victim suffering, as well as decreased concern that aggressive acts would result in punishment and victim suffering. Irritability was associated with increased expectations and concern that aggression would result in dominance and forced respect. CONCLUSIONS The results suggest that CU traits and irritability, often present in youth with CD, are associated with different forms of maladaptive outcome expectations and values regarding the consequences of aggression. This suggests that the atypical social cognitive processes underlying aggressive behavior among youth exhibiting CU traits may differ from those exhibiting problems regulating anger.
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Affiliation(s)
- J. Elowsky
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - S. Bajaj
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - J. Bashford-Largo
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.24434.350000 0004 1937 0060Center for Brain, Biology, and Behavior, University of Nebraska-Lincoln, Lincoln, NE USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - R. Zhang
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - A. Mathur
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - A. Schwartz
- grid.266862.e0000 0004 1936 81633Department of Psychology, University of North Dakota, Grand Forks, ND USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - M. Dobbertin
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - K. S. Blair
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - E. Leibenluft
- grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - D. Pardini
- grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - R. J. R. Blair
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA ,grid.466916.a0000 0004 0631 4836Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
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13
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Heggli A, Hatchett B, Schwartz A, Bardsley T, Hand E. Toward snowpack runoff decision support. iScience 2022; 25:104240. [PMID: 35494240 PMCID: PMC9051623 DOI: 10.1016/j.isci.2022.104240] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/15/2022] [Accepted: 04/06/2022] [Indexed: 11/18/2022] Open
Abstract
Rain-on-snow (ROS) events are commonly linked to large historic floods in the United States. Projected increases in the frequency and magnitude of ROS multiply existing uncertainties and risks in operational decision making. Here, we introduce a framework for quality-controlling hourly snow water content, snow depth, precipitation, and temperature data to guide the development of an empirically based snowpack runoff decision support framework at the Central Sierra Snow Laboratory for water years 2006-2019. This framework considers the potential for terrestrial water input from the snowpack through decision tree classification of rain-on-snow and warm day melt events to aid in pattern recognition of prominent weather and antecedent snowpack conditions capable of producing snowpack runoff. Our work demonstrates how (1) present weather and (2) antecedent snowpack risk can be "learned" from hourly data to support eventual development of basin-specific snowpack runoff decision support systems aimed at providing real-time guidance for water resource management.
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Affiliation(s)
- Anne Heggli
- Division of Atmospheric Sciences, Desert Research Institute, 2215 Raggio Parkway, Reno 89512, NV, USA
- Corresponding author
| | - Benjamin Hatchett
- Division of Atmospheric Sciences, Desert Research Institute, 2215 Raggio Parkway, Reno 89512, NV, USA
| | - Andrew Schwartz
- University of California, Berkeley, Central Sierra Snow Laboratory, Soda Springs, 95728 CA, USA
| | - Tim Bardsley
- National Weather Service, Reno, 1000 Dandini Road, Reno 89512, NV, USA
| | - Emily Hand
- Department of Computer Science, University of Nevada, Reno, 1664 North Virginia Street, Reno 89503, Nevada, USA
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14
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Oliveira SD, Erewele E, Castellon M, Schwartz A, Williams DL, Morrell N, Bonini M, Silva CLM, Lutz SE, Erzurum S, Minshall RD. Abstract 388: Role Of The Antiapoptotic C-iap2 On The Generation Of An Endothelial Memory In Schistosomiasis-associated Pulmonary Arterial Hypertension. Arterioscler Thromb Vasc Biol 2022. [DOI: 10.1161/atvb.42.suppl_1.388] [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: 12/05/2022]
Abstract
Introduction:
Schistosomiasis-associated Pulmonary Arterial Hypertension (Sch-PAH) is a life-threatening complication of chronic
S. mansoni
infection, which can evolve to heart failure and death. During PAH, hyperproliferation of apoptosis-resistant endothelial cells (ECs) has been extensively reported, but therapeutic approaches to reverse this pathological phenotype remain clinically challenging.
Hypothesis:
Thus, our hypothesis is that antigenic molecules from
S. mansoni
eggs amplify the secretion of inhibitor of apoptosis protein 2 (c-IAP2), leading to generation of an abnormal EC memory of survival and the development of PAH.
Methods/Results:
Previously, we showed that depletion of the anti-apoptotic protein Caveolin-1 (Cav-1) via shedding of extracellular vesicles (EVs) leads to the survival of an abnormal EC phenotype through an unclear mechanism. Analysis of survival-associated genes in isolated murine lung ECs from
Flk1
+/GFP
;Cav1
-/-
mice, revealed high expression of the anti-apoptotic genes BIRC3 and BIRC5 (which encodes cIAP2 and survivin, respectively) when compared to control ECs. Interesting, exposure to 1 μg/mL of the major
S. mansoni
egg antigen Sm-p40 induced time-dependent phosphorylation of Cav-1 at residue Tyr14 in human lung microvascular EC (HMVEC-L: 228.2 +/- 38.28% of control; p<0.05; n=4), culminating in c-IAP2 expression with no difference on the constitutive expression of c-IAP1. Furthermore, Sm-p40 treatment of HMVEC-L in the presence of pro-inflammatory mediators IL-6, TNF-α, and ATP induced a significant release of EVs containing c-IAP2. Finally, in vivo analysis of lungs from
S. mansoni
-infected mice confirmed a significant decrease in Cav-1 expression unique to the egg-dependent granuloma area, indicating that local inflammatory response due to egg-derived antigenic molecules is essential for reprogramming and survival of an abnormal EC phenotype during Sch-PAH.
Conclusions:
Our data suggest that
S. mansoni
-induced Cav-1 depletion promotes the secretion of the anti-apoptotic c-IAP2 protein, which may be critical for prolonged survival of a pathogenic EC phenotype during the development of Sch-PAH.
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15
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Capozza K, Schwartz A, Lang JE, Chalmers J, Camilo J, Abuabara K, Kelley K, Harrison J, Vastrup A, Stancavich L, Tai A, Kimball AB, Finlay AY. The Impact of Childhood Atopic Dermatitis on Life Decisions for Caregivers and Families. J Eur Acad Dermatol Venereol 2022; 36:e451-e454. [DOI: 10.1111/jdv.17943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. Capozza
- Global Parents for Eczema Research Santa Barbara USA
| | - A. Schwartz
- Departments of Medical Education and Pediatrics University of Illinois Chicago USA
| | - JE Lang
- Global Parents for Eczema Research Santa Barbara USA
| | - J Chalmers
- Centre of Evidence Based Dermatology University of Nottingham Nottingham UK
| | - J Camilo
- ADERMAP ‐ Associação Dermatite Atópica Portugal Lisboa Portugal
| | - K Abuabara
- Department of Dermatology University of California San Francisco USA
| | - K. Kelley
- Global Parents for Eczema Research Santa Barbara USA
| | - J. Harrison
- Global Parents for Eczema Research Santa Barbara USA
| | - A. Vastrup
- Atopisk Eksem Forening Copenhagen Denmark
| | - L. Stancavich
- Global Parents for Eczema Research Santa Barbara USA
| | - A. Tai
- Global Parents for Eczema Research Santa Barbara USA
| | | | - AY Finlay
- Division of Infection and Immunity School of Medicine Cardiff University Cardiff UK
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16
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Lorenzen B, Ciennik A, Hauck T, Chiang C, Schwartz A. 347 The Effect of Electronic Assignment of Patients to Physicians in the Emergency Department on Operational Metrics. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.361] [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: 10/20/2022]
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17
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Chandrasekaran S, Fifer M, Bickel S, Osborn L, Herrero J, Christie B, Xu J, Murphy RKJ, Singh S, Glasser MF, Collinger JL, Gaunt R, Mehta AD, Schwartz A, Bouton CE. Historical perspectives, challenges, and future directions of implantable brain-computer interfaces for sensorimotor applications. Bioelectron Med 2021; 7:14. [PMID: 34548098 PMCID: PMC8456563 DOI: 10.1186/s42234-021-00076-6] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
Almost 100 years ago experiments involving electrically stimulating and recording from the brain and the body launched new discoveries and debates on how electricity, movement, and thoughts are related. Decades later the development of brain-computer interface technology began, which now targets a wide range of applications. Potential uses include augmentative communication for locked-in patients and restoring sensorimotor function in those who are battling disease or have suffered traumatic injury. Technical and surgical challenges still surround the development of brain-computer technology, however, before it can be widely deployed. In this review we explore these challenges, historical perspectives, and the remarkable achievements of clinical study participants who have bravely forged new paths for future beneficiaries.
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Affiliation(s)
- Santosh Chandrasekaran
- Neural Bypass and Brain Computer Interface Laboratory, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Matthew Fifer
- Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - Stephan Bickel
- The Human Brain Mapping Laboratory, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
- Department of Neurosurgery, Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
- Department of Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Luke Osborn
- Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - Jose Herrero
- The Human Brain Mapping Laboratory, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Breanne Christie
- Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - Junqian Xu
- Departments of Radiology and Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Rory K J Murphy
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Sandeep Singh
- Good Shepherd Rehabilitation Hospital, Allentown, PA, USA
| | - Matthew F Glasser
- Departments of Radiology and Neuroscience, Washington University in St Louis, Saint Louis, MO, USA
| | - Jennifer L Collinger
- Rehabilitation Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert Gaunt
- Rehabilitation Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ashesh D Mehta
- The Human Brain Mapping Laboratory, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
- Department of Neurosurgery, Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Andrew Schwartz
- McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chad E Bouton
- Neural Bypass and Brain Computer Interface Laboratory, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA.
- Department of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA.
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18
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Combs E, Barr M, Jackson Y, Schwartz A, Stephenson T. High-fidelity Simulations for Dietetics Students’ Perceptions of Readiness to Serve as Entry-level Dietitians. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.114] [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: 10/20/2022]
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19
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Oliveira SD, Schwartz A, Williams D, Bonini M, Silva CLM, Minshall RD. Abstract P138:
Schistosoma Mansoni-
Induced Shedding Of Extracellular Vesicles From Lung Microvascular Endothelial Cells. Arterioscler Thromb Vasc Biol 2021. [DOI: 10.1161/atvb.41.suppl_1.p138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Schistosomiasis-associated Pulmonary Arterial Hypertension (Sch-PAH) is a life-threatening complication of chronic
Schistosoma mansoni
infection. Sch-PAH is marked by obliteration and remodeling of the pulmonary vasculature in response to
S. mansoni
eggs. Remodeled and occluded vessels increase vascular resistance and can lead to heart failure and death. Currently, there are no target therapies for the treatment of Sch-PAH.
Hypothesis:
S. mansoni
egg-derived antigens alter pulmonary endothelial cell (EC) Caveolin-1 (Cav-1) expression and phosphorylation contributing to the loading and shedding of extracellular vesicles (EVs), which in turn stimulates abnormal EC survival leading to Sch-PAH.
Methods/Results:
Immunohistology and western blot analysis of lungs from
S. mansoni
-infected mice revealed a significant decrease in Cav-1 expression in the egg-dependent granuloma area when compared to uninfected control animals, indicating that local
S. mansoni
-associated molecules and inflammatory mediators contribute to Cav-1 depletion. Previously we showed that upon vascular injury, Cav-1 deficiency leads to the survival of an abnormal EC phenotype through an unclear mechanism. Analysis of survival-associated genes in isolated lung ECs from Flk1
+/GFP
;
Cav1
-/-
mice, revealed a high expression of the anti-apoptotic BIRC2 and BIRC5 (known as c-IAP2 and surviving, respectively) when compared to control ECs. Interesting, in vitro exposure to the major
S. mansoni
egg antigen, Sm-p40 (1 μg/mL), induced time-dependent phosphorylation of Cav-1 Tyr14 in human lung microvascular ECs (HMVEC-L; 228.2 +/- 38.28% of control; p<0.05; n=4), which culminated in c-IAP2 expression. Furthermore, Sm-p40 treatment of HMVEC-L increased ERK1/2 phosphorylation, which in presence of pro-inflammatory mediators IL-6, TNF-a, and ATP, significantly increased the shedding of EVs implicating P-ERK1/2 in the mechanism of shedding of Cav-1-EVs.
Conclusions:
This work is uncovering the biological role and potential translational relevance of pathogen-induced EC-Cav-1 depletion via shedding of EVs during Sch-PAH.
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20
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Barlinn J, Winzer S, Worthmann H, Urbanek C, Häusler KG, Günther A, Erdur H, Görtler M, Busetto L, Wojciechowski C, Schmitt J, Shah Y, Büchele B, Sokolowski P, Kraya T, Merkelbach S, Rosengarten B, Stangenberg-Gliss K, Weber J, Schlachetzki F, Abu-Mugheisib M, Petersen M, Schwartz A, Palm F, Jowaed A, Volbers B, Zickler P, Remi J, Bardutzky J, Bösel J, Audebert HJ, Hubert GJ, Gumbinger C. [Telemedicine in stroke-pertinent to stroke care in Germany]. Nervenarzt 2021; 92:593-601. [PMID: 34046722 PMCID: PMC8184549 DOI: 10.1007/s00115-021-01137-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/24/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Telemedical stroke networks improve stroke care and provide access to time-dependent acute stroke treatment in predominantly rural regions. The aim is a presentation of data on its utility and regional distribution. METHODS The working group on telemedical stroke care of the German Stroke Society performed a survey study among all telestroke networks. RESULTS Currently, 22 telemedical stroke networks including 43 centers (per network: median 1.5, interquartile range, IQR, 1-3) as well as 225 cooperating hospitals (per network: median 9, IQR 4-17) operate in Germany and contribute to acute stroke care delivery to 48 million people. In 2018, 38,211 teleconsultations (per network: median 1340, IQR 319-2758) were performed. The thrombolysis rate was 14.1% (95% confidence interval 13.6-14.7%) and transfer for thrombectomy was initiated in 7.9% (95% confidence interval 7.5-8.4%) of ischemic stroke patients. Financial reimbursement differs regionally with compensation for telemedical stroke care in only three federal states. CONCLUSION Telemedical stroke care is utilized in about 1 out of 10 stroke patients in Germany. Telemedical stroke networks achieve similar rates of thrombolysis and transfer for thrombectomy compared with neurological stroke units and contribute to stroke care in rural regions. Standardization of network structures, financial assurance and uniform quality measurements may further strengthen the importance of telestroke networks in the future.
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Affiliation(s)
- J Barlinn
- Klinik für Neurologie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
| | - S Winzer
- Klinik für Neurologie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - H Worthmann
- Klinik für Neurologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - C Urbanek
- Klinik für Neurologie, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Deutschland
| | - K G Häusler
- Neurologische Klinik und Poliklinik, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - A Günther
- Klinik für Neurologie, Universitätsklinikum Jena, Jena, Deutschland
| | - H Erdur
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - M Görtler
- Klinik für Neurologie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland
| | - L Busetto
- Klinik für Neurologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Wojciechowski
- Klinik für Neurologie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Dresden, Dresden, Deutschland
| | - Y Shah
- Klinik für Neurologie, Klinikum Kassel, Kassel, Deutschland
| | - B Büchele
- Klinik für Neurologie, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland
| | - P Sokolowski
- Klinik für Neurologie und neurologische Intensivmedizin, Fachkrankenhaus Hubertusburg, Hubertusburg, Deutschland
| | - T Kraya
- Klinik für Neurologie, Klinikum St.Georg Leipzig, Leipzig, Deutschland
| | - S Merkelbach
- Klinik für Neurologie, Heinrich-Braun-Klinikum Zwickau, Zwickau, Deutschland
| | - B Rosengarten
- Klinik für Neurologie, Klinikum Chemnitz, Chemnitz, Deutschland
| | - K Stangenberg-Gliss
- Klinik für Neurologie, BG Klinikum Unfallkrankenhaus Berlin, Berlin, Deutschland
| | - J Weber
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - F Schlachetzki
- Klinik für Neurologie, Universität Regensburg, Regensburg, Deutschland
| | - M Abu-Mugheisib
- Klinik für Neurologie, Städtisches Klinikum Braunschweig, Braunschweig, Deutschland
| | - M Petersen
- Klinik für Neurologie, Klinikum Osnabrück, Osnabrück, Deutschland
| | - A Schwartz
- Klinik für Neurologie, Klinikum Region Hannover, Hannover, Deutschland
| | - F Palm
- Klinik für Neurologie, Helios Klinikum Schleswig, Schleswig, Deutschland
| | - A Jowaed
- Klinik für Neurologie, Westküstenkliniken Heide, Heide, Deutschland
| | - B Volbers
- Klinik für Neurologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - P Zickler
- Klinik für Neurologie und Klinische Neurophysiologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - J Remi
- Klinik für Neurologie, Klinikum der LMU München-Großhadern, München, Deutschland
| | - J Bardutzky
- Klinik für Neurologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - J Bösel
- Klinik für Neurologie, Klinikum Kassel, Kassel, Deutschland
| | - H J Audebert
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.,Centrum für Schlaganfallforschung Berlin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - G J Hubert
- Klinik für Neurologie, München-Klinik Harlaching, München, Deutschland
| | - C Gumbinger
- Klinik für Neurologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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21
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Bodas M, Givon A, Peleg K, Abbod N, Bahouth H, Bala M, Becker A, Ben Eli M, Braslavsky A, Grevtsev I, Jeroukhimov I, Karawani M, Kessel B, Klein Y, Lin G, Merin O, Mnouskin Y, Rivkind A, Shaked G, Soffer D, Stein M, Schwartz A, Weiss M. Are casualties from mass-casualty Motor Vehicle Crashes different from casualties of other Motor Vehicle Crashes? Journal of Transport & Health 2020; 19:100928. [DOI: 10.1016/j.jth.2020.100928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
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22
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Schwartz A, Yogev Y, Zilberman A, Alpern S, Many A, Yousovich R, Gamzu R. Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vaginal swabs of women with acute SARS-CoV-2 infection: a prospective study. BJOG 2020; 128:97-100. [PMID: 33021026 PMCID: PMC7675593 DOI: 10.1111/1471-0528.16556] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 11/27/2022]
Abstract
Objective To determine whether severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is present in the vaginal secretions of both reproductive‐aged and postmenopausal women during acute SARS‐CoV‐2 infection. Design Prospective study. Setting A single tertiary, university‐affiliated medical centre in Israel. Time period, 1 June 2020 through to 31 July 2020. Population Women who were hospitalised in a single tertiary medical centre, who were diagnosed with acute SARS‐CoV‐2 infection by a nasopharyngeal RT‐PCR test. Methods Women were diagnosed with acute SARS‐CoV‐2 infection by a nasopharyngeal RT‐PCR test. Vaginal RT‐PCR swabs were obtained from all study participants after a proper cleansing of the perineum. Main outcome measures Detection of SARS‐CoV‐2 in vaginal RT‐PCR swabs. Results Vaginal and nasopharyngeal swabs were obtained from 35 women, aged 21–93 years. Twenty‐one women (60%) were in their reproductive years, of whom, five were in their third trimester of pregnancy. Most of the participants (57%) were healthy without any underlying medical conditions. Of the 35 patients sampled, 2 (5.7%) had a positive vaginal RT‐PCR for SARS‐CoV‐2, one was premenopausal and the other was a postmenopausal woman. Both women had mild disease. Conclusion Our findings contradict most previous reports, which did not detect the presence of viral colonisation in the vagina. Although passage through the birth canal exposes neonates to the vaginal polymicrobial flora, an acquisition of pathogens does not necessarily mandate neonatal infection or clinical disease. Nevertheless, when delivering the infant of a woman with acute SARS‐CoV‐2 infection, a clinician should consider the possibility of vaginal colonisation, even if it is uncommon. Tweetable abstract When delivering the infant of a woman with acute SARS‐CoV‐2 infection, a clinician should consider the possibility of vaginal colonisation. When delivering the infant of a woman with acute SARS‐CoV‐2 infection, a clinician should consider the possibility of vaginal colonisation.
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Affiliation(s)
- A Schwartz
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y Yogev
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Zilberman
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Alpern
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Many
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Yousovich
- Maccabi Healthcare Services, Herzliya, Israel
| | - R Gamzu
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Yaden M, Yaden D, Buffone A, Eichstaedt J, Crutchley P, Smith L, Cass J, Callahan C, Rosenthal S, Ungar L, Schwartz A, Hojat M. Linguistic analysis of empathy in medical school admission essays. Int J Med Educ 2020; 11:186-190. [PMID: 32949231 PMCID: PMC7882128 DOI: 10.5116/ijme.5f2d.0359] [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] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This study aimed to determine whether words used in medical school admissions essays can predict physician empathy. METHODS A computational form of linguistic analysis was used for the content analysis of medical school admissions essays. Words in medical school admissions essays were computationally grouped into 20 'topics' which were then correlated with scores on the Jefferson Scale of Empathy. The study sample included 1,805 matriculants (between 2008-2015) at a single medical college in the North East of the United States who wrote an admissions essay and completed the Jefferson Scale of Empathy at matriculation. RESULTS After correcting for multiple comparisons and controlling for gender, the Jefferson Scale of Empathy scores significantly correlated with a linguistic topic (r = .074, p < .05). This topic was comprised of specific words used in essays such as "understanding," "compassion," "empathy," "feeling," and "trust." These words are related to themes emphasized in both theoretical writing and empirical studies on physician empathy. CONCLUSIONS This study demonstrates that physician empathy can be predicted from medical school admission essays. The implications of this methodological capability, i.e. to quantitatively associate linguistic features or words with psychometric outcomes, bears on the future of medical education research and admissions. In particular, these findings suggest that those responsible for medical school admissions could identify more empathetic applicants based on the language of their application essays.
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Affiliation(s)
- Mary Yaden
- Department of Psychiatry at the University of Pennsylvania, Philadelphia, PA, USA
| | - David Yaden
- Department of Psychiatry and Behavioral Sciences at Johns Hopkins Medicine, Baltimore, MD, USA
| | - Anneke Buffone
- Department of Psychology at the University of Pennsylvania, Philadelphia, PA, USA
| | - Johannes Eichstaedt
- Department of Psychology at the University of Pennsylvania, Philadelphia, PA, USA
| | - Patrick Crutchley
- Department of Psychology at the University of Pennsylvania, Philadelphia, PA, USA
| | - Laura Smith
- Department of Psychology at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jonathan Cass
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Clara Callahan
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Susan Rosenthal
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Lyle Ungar
- Department of Computer and Information Science at the University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew Schwartz
- Department of Computer Science at Stony Brook University, Stony Brook, New York, USA
| | - Mohammadreza Hojat
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
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Dhar PK, Grupp IL, Schwartz A, Grupp G, Matlib MA. Reduction of Carnitine Content by Inhibition of Its Biosynthesis Results in Protection of Isolated Guinea Pig Hearts against Hypoxic Damage. J Cardiovasc Pharmacol Ther 2020; 1:235-242. [PMID: 10684422 DOI: 10.1177/107424849600100307] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background3-(2,2,2-trimethylhydrazinium) propionate (THP or mildronate) is an inhibitor of carnitine biosynthesis. This study was carried out to determine whether feeding of guinea pigs with THP results in decreased myocardial-free carnitine content and, as a result, attenuates hypoxic damage in isolated and paced work-performing hearts.Methods and ResultsGuinea pigs were administered either distilled water or 100 mg THP/kg/day orally for 10 days. The treatment resulted in about a 50% decline in myocardial-free carnitine content, from 11.1 ± 0.2 (n = 5) to 5.6 ± 0.2 (n = 5) μM/g dry weight of the heart. The left ventricular contractile function of the hearts was measured during normoxic perfusion (PO2= 590 mmHg), hypoxic perfusion (PO2= 149 mmHg), and reperfusion (PO2= 590 mmHg). In both untreated and THP-treated groups, the rate of development of intraventricular pressure (+dP/dt) under normoxic perfusion was similar; however, +dP/dt declined to about 10% of the initial rate within 20 minutes of hypoxic perfusion. In the THP-treated group of hearts, the initial decline was slower than that of the untreated animal hearts. After 20 minutes of normoxic reperfusion following 60 minutes of hypoxic perfusion, the recovery of +dP/dt and -dP/dt was greater in the THP-treated group than in the untreated group. The elevation of end-diastolic pressure during hypoxia was completely reversed by normoxic reperfusion of the THP-treated group but not in the untreated group. Mitochondria isolated from hearts from the THP-treated group after normoxic reperfusion following hypoxic perfusion exhibited better respiratory function than those from untreated hearts.ConclusionThe data suggest that feeding guinea pigs with THP results in reduced myocardial-free carnitine content and attenuation of hypoxic and reperfusion injury in isolated hearts.
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Affiliation(s)
- PK Dhar
- Department of Pharmacology and Cell Biophysics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Boissonneault A, Mener A, Schwartz A, Wilson J, Staley C, Schenker M. Impact of Frailty on 30-Day Morbidity and Mortality of Patients With Intertrochanteric Femur Fractures. Orthopedics 2019; 42:344-348. [PMID: 31587075 DOI: 10.3928/01477447-20191001-05] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 11/16/2018] [Indexed: 02/03/2023]
Abstract
The aim of this study was to evaluate the association between frailty and 30-day morbidity and mortality in patients with intertrochanteric femur fractures. Furthermore, the authors sought to identify a specific frailty index score that would help identify high-risk patients. This retrospective study evaluated 229 consecutive patients 50 years or older who presented to a single level I trauma center for surgical fixation of an intertrochanteric femur fracture. Frailty was determined using a previously validated 11-point modified frailty index (mFI) scale. Primary outcome variables included 30-day morbidity and mortality. Of the 229 patients included in this study, 82 (36%) had a postoperative complication and there were 10 (4%) mortalities. The most common complications were delirium (n=40; 17%) and acute kidney injury (n=25; 11%). Mean mFI score for those who developed a postoperative complication was 0.24 compared with 0.14 for those who did not (P<.001). The mortality rate increased from 0% for mFI of 0 to 11% for mFI of 0.27 or more. Patients with an mFI of 0.27 or more were more than 9 times as likely to have a mortality compared with patients with an mFI of less than 0.27 (P=.006). This study demonstrates that the mFI is associated with 30-day morbidity and mortality in patients aged 50 years or older with intertrochanteric femur fractures. The authors identified an mFI score of 0.27 or more as the most robust predictor of increased 30-day morbidity and mortality following surgical fixation of intertrochanteric femur fractures. [Orthopedics. 2019; 42(6):344-348.].
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de la Salle C, Charmantier JL, Baas MJ, Schwartz A, Wiesel ML, Grunebaum L, Cazenave JP. A Deletion Located in the 3′ Non Translated Part of the Factor IX Gene Responsible for Mild Haemophilia B. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1649582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- C de la Salle
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - J-L Charmantier
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - M-J Baas
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - A Schwartz
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - M-L Wiesel
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - L Grunebaum
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - J-P Cazenave
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
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Berger S, Pho H, Fleury Curado T, Schwartz A, Polotsky V. 0077 Intranasal Leptin Approach To Treat Sleep-disordered Breathing. Sleep 2018. [DOI: 10.1093/sleep/zsy061.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Berger
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - H Pho
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - T Fleury Curado
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - A Schwartz
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - V Polotsky
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
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Caballero Eraso C, Shin M, Pho H, Schwartz A, Tang W, Sham J, Polotsky V. 0080 Leptin Induces Upregulation Of The Hypoxic Ventilatory Response Acting In The Carotid Bodies. Sleep 2018. [DOI: 10.1093/sleep/zsy061.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Caballero Eraso
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
| | - M Shin
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
| | - H Pho
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
| | - A Schwartz
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
| | - W Tang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - J Sham
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
| | - V Polotsky
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
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Abstract
SummaryMagnetic resonance imaging (MRI) has recently been demonstrated to be sensitive to changes in neuronal activity of cortical areas. We report our initial experiences with functional MR brain mapping at high spatial resolution using a conventional whole-body MR system. A total of 10 visual and motor cortex activation studies were carried out on 8 healthy volunteers. In each examination, a time course series of 15 strongly T2*-weighted FLASH images was measured from three adjacent slices. The image analysis revealed a subtle but highly significant signal increase in cortical layers of gray matter in primary and associative visual as well as sensorimotoric cortex regions during periods of excessive brain activity provoked by photic stimuli or motoric tasks, respectively. To correlate brain structure and brain function, the computed MR brain activation maps were directly superimposed on T1-weighted anatomic spin-echo images. With this advance into the area of functional neuroimaging, MRI is moving into an established domain of positron emission tomography (PET). We, therefore, discuss the advantages and limitations of the MR method in comparison to PET as far as this can be done at present.
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Schwartz A, Silver M, Antoline M, Brodmann K. 111 Utilization of Business Intelligence Software for an Emergency Department Dashboard. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.137] [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: 11/15/2022]
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Kauffmann G, McKillip R, Schwartz A, Farnan J, Park Y, Golden D. Objective Evaluation of a Structured Didactic Radiation Oncology Clerkship Curriculum: A Report from the Radiation Oncology Education Collaborative Study Group. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.892] [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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Sagawa N, Boudreau R, Vinik A, Schwartz A, Waters T, Cauley J, Harris T, Strotmeyer E. DIABETES, IMPAIRED FASTING GLUCOSE, AND FALL INJURY RISK IN OLDER ADULTS: THE HEALTH ABC STUDY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N. Sagawa
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - R. Boudreau
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - A. Vinik
- Eastern Virginia Medical School, Norfolk, Virginia,
| | - A. Schwartz
- University of California, San Francisco, San Francisco, California,
| | - T. Waters
- University of Tennessee, Memphis, Tennessee
| | - J.A. Cauley
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - T.B. Harris
- National Institute on Aging, Bethesda, Maryland,
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Schwartz A. Pesticide Effect on Populations of Tetranychus urticae Koch (Acari: Tetranychidae) and a Predaceous Mite on Table Grapes in the Hex River Valley. S AFR J ENOL VITIC 2017. [DOI: 10.21548/11-1-2245] [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: 11/06/2022] Open
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Schwartz A, Deklerk CA. The Relationship between the Mite, Eriophyes vitis (Pagst.) and Leaf Curl on Vitis vinifera L. cv. Shiraz. S AFR J ENOL VITIC 2017. [DOI: 10.21548/5-2-2362] [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: 11/06/2022] Open
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Schwartz A, Siebert M. Field Trials with Toxic Bait for the Control of the Brown Garden Snail (Helix aspersa, Muller). S AFR J ENOL VITIC 2017. [DOI: 10.21548/8-2-2320] [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: 11/06/2022] Open
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Schwartz A. Efficacy of Trunk Barriers for the Control of Key Pests on Trellised Grapevines. S AFR J ENOL VITIC 2017. [DOI: 10.21548/9-1-2304] [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: 11/06/2022] Open
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Schwartz A. Seasonal Occurrence of a Predaceous Mite Amblyseius addoensis Van der Merwe & Ryke (Acari: Phytoseiidae) on Table Grapes. S AFR J ENOL VITIC 2017. [DOI: 10.21548/8-2-2319] [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: 11/06/2022] Open
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Schwartz A, Capatos D. An Evaluation of Chemicals for the Toxicity to Brown Snail (Helix aspersa Muller) on Grapevines. S AFR J ENOL VITIC 2017. [DOI: 10.21548/11-1-2264] [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: 11/06/2022] Open
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Schwartz A. The Incidence of Heliothrips sylvanus Faure (Thysanoptera: Thripidae) on Table Grapes. S AFR J ENOL VITIC 2017. [DOI: 10.21548/10-2-2287] [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: 11/06/2022] Open
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Schwartz A. The Seasonal Occurrence of the Snoutbeetle, Phlyctinus callosus Boheman ( Coleoptera: Curculionidae) on Vines in the Robertson Area. S AFR J ENOL VITIC 2017. [DOI: 10.21548/6-1-2356] [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: 11/06/2022] Open
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Schwartz A, Capatos D. Evaluation of a Wing-Type Against a Bucket-Type Fruit Fly Trap for Use in Table Grape Vineyards. S AFR J ENOL VITIC 2017. [DOI: 10.21548/15-1-2278] [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: 11/06/2022] Open
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Schwartz A. Laboratory Evaluation of Toxicity of Registered Pesticides to Adult Amblyseius addoensis (Van der Merwe & Ryke) (Acari: Phytoseiidae). S AFR J ENOL VITIC 2017. [DOI: 10.21548/12-2-2217] [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: 11/06/2022] Open
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Schwartz A. Population Dynamics of Thrips tabaci Lindeman (Thysanoptera: Thripidae) on Table Grapes. S AFR J ENOL VITIC 2017. [DOI: 10.21548/9-1-2305] [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: 11/06/2022] Open
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Fleury Curado TA, Fishbein K, Pho H, Brennick M, Dergacheva O, Pham L, Ladenheim E, Spencer R, Sennes LU, Schwartz A, Polostky V. 0008 CHEMOGENETIC STIMULATION OF THE HYPOGLOSSAL NEURONS IMPROVES THE UPPER AIRWAY PATENCY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.007] [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: 11/14/2022] Open
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Abstract
Neural populations from various sensory regions demonstrate dynamic range adaptation in response to changes in the statistical distribution of their input stimuli. These adaptations help optimize the transmission of information about sensory inputs. Here, we show a similar effect in the firing rates of primary motor cortical cells. We trained monkeys to operate a brain-computer interface in both two- and three-dimensional virtual environments. We found that neurons in primary motor cortex exhibited a change in the amplitude of their directional tuning curves between the two tasks. We then leveraged the simultaneous nature of the recordings to test several hypotheses about the population-based mechanisms driving these changes and found that the results are most consistent with dynamic range adaptation. Our results demonstrate that dynamic range adaptation is neither limited to sensory regions nor to rescaling of monotonic stimulus intensity tuning curves, but may rather represent a canonical feature of neural encoding. DOI:http://dx.doi.org/10.7554/eLife.21409.001 Most cameras are equipped with an auto-contrast feature that enables them to take high quality pictures in a wide range of lighting conditions. Auto-contrast works by increasing the sensitivity of the camera to light in dimly lit surroundings, but reducing it in bright conditions to ensure that images do not become saturated. Our visual system is equipped with a similar feature. Neurons in the visual system increase or decrease their sensitivity to light as appropriate to enable us to see in both dimly lit rooms and dazzling sunshine. This process, which is known as dynamic range adaptation, also occurs in neurons that are sensitive to sound or touch. Rasmussen et al. therefore wondered whether the same might hold true for neurons that encode non-sensory stimuli such as the direction of movement. Would these neurons change their sensitivity to direction if presented with a wide range of possible directions instead of a narrow range? If so, this would suggest that dynamic range adaptation occurs throughout the nervous system. To find out, Rasmussen et al. trained two rhesus macaque monkeys to use their brain activity to move a cursor on a virtual reality screen in either 2D or 3D. Studying this brain activity showed that neurons became less sensitive to the cursor’s direction of movement when the task switched from 2D to 3D. This makes sense because in a 3D task, which also features depth, the neurons have a greater range of possible movement directions to encode. Conversely, the neurons became more sensitive to the direction of movement when the task switched from 3D to 2D. Under these circumstances the neurons can use activity that was previously dedicated to encoding depth to instead represent the 2D space in finer detail. These results presented by Rasmussen et al. raise several additional questions. Are the mechanisms that support dynamic range adaptation the same in sensory and motor neurons? If these neurons also encode other aspects of movement, such as speed, would these also be included in the same range as direction or is the adaptation process segregated by specific parameter categories? And how do these changes in sensitivity affect the movements that animals produce? DOI:http://dx.doi.org/10.7554/eLife.21409.002
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Affiliation(s)
- Robert G Rasmussen
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, United States.,Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, United States
| | - Andrew Schwartz
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, United States.,Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, United States.,Department of Neurobiology, University of Pittsburgh, Pittsburgh, United States
| | - Steven M Chase
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, United States.,Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, United States
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Schwartz A, Poole C, Schleien C. Characterization of the Development of Acute-on-Chronic Exertional Compartment Syndrome A Case Report of Symmetric Compartment Syndromes and Review of the Literature. Bull Hosp Jt Dis (2013) 2017; 75:148-152. [PMID: 28583063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Acute-on-chronic exertional compartment syndrome is a rare and severe progression of the likely common and more benign chronic exertional compartment syndrome. This is a report of one 17-year-old male on a pediatric inpatient service with bilateral anterior leg pain of unknown origin. Because of the nonspecific nature of pain, a high level of suspicion is required for timely diagnosis to avoid compartment ischemia and irreversible soft tissue and nerve damage. While high-energy orthopaedic trauma, orthopaedic surgery, or closed reduction and casting are common preceding events for compartment syndrome, this patient presented with acute-on-chronic exertional compartment syndrome. A dearth of literature of this condition hampered its morbiditysparing diagnosis. While there is a spectrum of clinical findings for the acute decompensation of chronic exertional compartment syndrome, like any compartment syndrome, pain disproportionate to physical exam is the most sensitive sign. Understanding the exertional compartment syndrome spectrum is tantamount to avoid the devastating complications of a missed diagnosis of acute compartment syndrome.
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Schwartz A, Huffman L, Ashley C, Saha S, Rose S, Kushner D, Hartenbach E, Rice L, Barroilhet L, Al-Niaimi A. Surviving vulvar cancer, does obesity matter? Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Carr A, Grund B, Neuhaus J, Schwartz A, Bernardino JI, White D, Badel-Faesen S, Avihingsanon A, Ensrud K, Hoy J. Prevalence of and risk factors for low bone mineral density in untreated HIV infection: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial. HIV Med 2015; 16 Suppl 1:137-46. [PMID: 25711332 DOI: 10.1111/hiv.12242] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVES HIV infection is associated with a higher prevalence of low bone mineral density (BMD) and fractures than that found in the general population. There are limited data in HIV-positive adults, naïve to antiretroviral therapy (ART), with which to estimate the relative contribution of untreated HIV infection to bone loss. METHODS The primary objective of the Strategic Timing of AntiRetroviral Treatment (START) Bone Mineral Density Substudy is to compare the effect of immediate versus deferred initial ART on bone. We evaluated traditional, demographic, HIV-related and immunological factors for their associations with baseline hip and lumbar spine BMD, measured by dual-energy X-ray absorptiometry, using multiple regression. RESULTS A total of 424 ART-naïve participants were enrolled at 33 sites on six continents; the mean age was 34 years [standard deviation (SD) 10.1 years], 79.0% were nonwhite, 26.0% were women, and 12.5% had a body mass index (BMI) < 20 kg/m(2) . Mean (SD) Z-scores were -0.41 (0.94) at the spine and -0.36 (0.88) for total hip; 1.9% had osteoporosis and 35.1% had low BMD (hip or spine T-score < -1.0). Factors independently associated with lower BMD at the hip and spine were female sex, Latino/Hispanic ethnicity, lower BMI and higher estimated glomerular filtration rate. Longer time since HIV diagnosis was associated with lower hip BMD. Current or nadir CD4 cell count and HIV viral load were not associated with BMD. CONCLUSIONS In this geographically and racially diverse population of ART-naïve adults with normal CD4 cell counts, low BMD was common, but osteoporosis was rare. Lower BMD was significantly associated with traditional risk factors but not with CD4 cell count or viral load.
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Affiliation(s)
- A Carr
- Centre for Applied Medical Research, St Vincent's Hospital, Sydney, Australia
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