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Schütz H, Burger DA, Cobo E, Dubins DD, Farkás T, Labes D, Lang B, Ocaña J, Ring A, Shitova A, Stus V, Tomashevskiy M. Correction: Group-by-Treatment Interaction Effects in Comparative Bioavailability Studies. AAPS J 2024; 26:58. [PMID: 38710975 DOI: 10.1208/s12248-024-00927-5] [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: 05/08/2024] Open
Affiliation(s)
- Helmut Schütz
- Center for Medical Data Science of the Medical University of Vienna, 1090, Vienna, Austria.
- Faculty of Pharmacy, Universidade de Lisboa, 1649-004, Lisbon, Portugal.
- BEBAC, Neubaugasse 36/11, 1070, Vienna, Austria.
| | - Divan A Burger
- University of Pretoria, Pretoria, South Africa
- Syneos Health, Bloemfontein, South Africa
| | - Erik Cobo
- Department of Statistics and Operations Research, Universitat Politecnica de Catalunya, Barcelona, Catalunya, Spain
| | - David D Dubins
- Leslie Dan Faculty of Pharmacy, Toronto, Ontario, Canada
| | | | | | - Benjamin Lang
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
| | - Jordi Ocaña
- Department of Genetics, Microbiology and Statistics, Universitat de Barcelona, Barcelona, Catalunya, Spain
| | - Arne Ring
- Hexal - a Sandoz Brand, Holzkirchen, Germany
- University of the Free State, Bloemfontein, South Africa
| | | | - Volodymyr Stus
- Zakłady Farmaceutyczne Polpharma S.A, Starogard Gdanski, Poland
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Kostick-Quenet KM, Lang B, Dorfman N, Estep J, Mehra MR, Bhimaraj A, Civitello A, Jorde U, Trachtenberg B, Uriel N, Kaplan H, Gilmore-Szott E, Volk R, Kassi M, Blumenthal-Barby JS. Patients' and physicians' beliefs and attitudes towards integrating personalized risk estimates into patient education about left ventricular assist device therapy. Patient Educ Couns 2024; 122:108157. [PMID: 38290171 DOI: 10.1016/j.pec.2024.108157] [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] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 01/06/2024] [Accepted: 01/14/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Personalized risk (PR) estimates may enhance clinical decision making and risk communication by providing individualized estimates of patient outcomes. We explored stakeholder attitudes toward the utility, acceptability, usefulness and best-practices for integrating PR estimates into patient education and decision making about Left Ventricular Assist Device (LVAD). METHODS AND RESULTS As part of a 5-year multi-institutional AHRQ project, we conducted 40 interviews with stakeholders (physicians, nurse coordinators, patients, and caregivers), analyzed using Thematic Content Analysis. All stakeholder groups voiced positive views towards integrating PR in decision making. Patients, caregivers and coordinators emphasized that PR can help to better understand a patient's condition and risks, prepare mentally and logistically for likely outcomes, and meaningfully engage in decision making. Physicians felt it can improve their decision making by enhancing insight into outcomes, enhance tailored pre-emptive care, increase confidence in decisions, and reduce bias and subjectivity. All stakeholder groups also raised concerns about accuracy, representativeness and relevance of algorithms; predictive uncertainty; utility in relation to physician's expertise; potential negative reactions among patients; and overreliance. CONCLUSION Stakeholders are optimistic about integrating PR into clinical decision making, but acceptability depends on prospectively demonstrating accuracy, relevance and evidence that benefits of PR outweigh potential negative impacts on decision making quality.
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Affiliation(s)
| | - Benjamin Lang
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Natalie Dorfman
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | | | | | | | | | | | | | - Nir Uriel
- Columbia University Irving Medical Center, New York, NY, USA
| | - Holland Kaplan
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Eleanor Gilmore-Szott
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Robert Volk
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | | | - J S Blumenthal-Barby
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
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3
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Schütz H, Burger DA, Cobo E, Dubins DD, Farkás T, Labes D, Lang B, Ocaña J, Ring A, Shitova A, Stus V, Tomashevskiy M. Group-by-Treatment Interaction Effects in Comparative Bioavailability Studies. AAPS J 2024; 26:50. [PMID: 38632178 DOI: 10.1208/s12248-024-00921-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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
Comparative bioavailability studies often involve multiple groups of subjects for a variety of reasons, such as clinical capacity limitations. This raises questions about the validity of pooling data from these groups in the statistical analysis and whether a group-by-treatment interaction should be evaluated. We investigated the presence or absence of group-by-treatment interactions through both simulation techniques and a meta-study of well-controlled trials. Our findings reveal that the test falsely detects an interaction when no true group-by-treatment interaction exists. Conversely, when a true group-by-treatment interaction does exist, it often goes undetected. In our meta-study, the detected group-by-treatment interactions were observed at approximately the level of the test and, thus, can be considered false positives. Testing for a group-by-treatment interaction is both misleading and uninformative. It often falsely identifies an interaction when none exists and fails to detect a real one. This occurs because the test is performed between subjects in crossover designs, and studies are powered to compare treatments within subjects. This work demonstrates a lack of utility for including a group-by-treatment interaction in the model when assessing single-site comparative bioavailability studies, and the clinical trial study structure is divided into groups.
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Affiliation(s)
- Helmut Schütz
- Center for Medical Data Science of the Medical University of Vienna, 1090, Vienna, Austria.
- Faculty of Pharmacy, Universidade de Lisboa, 1649-004, Lisbon, Portugal.
- BEBAC, Neubaugasse 36/11, 1070, Vienna, Austria.
| | - Divan A Burger
- University of Pretoria, Pretoria, South Africa
- Syneos Health, Bloemfontein, South Africa
| | - Erik Cobo
- Department of Statistics and Operations Research, Universitat Politecnica de Catalunya, Barcelona, Catalunya, Spain
| | - David D Dubins
- Leslie Dan Faculty of Pharmacy, Toronto, Ontario, Canada
| | | | | | - Benjamin Lang
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany
| | - Jordi Ocaña
- Department of Genetics, Microbiology and Statistics, Universitat de Barcelona, Barcelona, Catalunya, Spain
| | - Arne Ring
- University of the Free State, Bloemfontein, South Africa
- Hexal - a Sandoz Brand, Holzkirchen, Germany
| | | | - Volodymyr Stus
- Zakłady Farmaceutyczne Polpharma S.A., Starogard Gdanski, Poland
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4
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Schwarzl T, Sahadevan S, Lang B, Miladi M, Backofen R, Huber W, Hentze MW, Tartaglia GG. Improved discovery of RNA-binding protein binding sites in eCLIP data using DEWSeq. Nucleic Acids Res 2024; 52:e1. [PMID: 37962298 PMCID: PMC10783507 DOI: 10.1093/nar/gkad998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/04/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023] Open
Abstract
Enhanced crosslinking and immunoprecipitation (eCLIP) sequencing is a method for transcriptome-wide detection of binding sites of RNA-binding proteins (RBPs). However, identified crosslink sites can deviate from experimentally established functional elements of even well-studied RBPs. Current peak-calling strategies result in low replication and high false positive rates. Here, we present the R/Bioconductor package DEWSeq that makes use of replicate information and size-matched input controls. We benchmarked DEWSeq on 107 RBPs for which both eCLIP data and RNA sequence motifs are available and were able to more than double the number of motif-containing binding regions relative to standard eCLIP processing. The improvement not only relates to the number of binding sites (3.1-fold with known motifs for RBFOX2), but also their subcellular localization (1.9-fold of mitochondrial genes for FASTKD2) and structural targets (2.2-fold increase of stem-loop regions for SLBP. On several orthogonal CLIP-seq datasets, DEWSeq recovers a larger number of motif-containing binding sites (3.3-fold). DEWSeq is a well-documented R/Bioconductor package, scalable to adequate numbers of replicates, and tends to substantially increase the proportion and total number of RBP binding sites containing biologically relevant features.
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Affiliation(s)
- Thomas Schwarzl
- European Molecular Biology Laboratory (EMBL), Meyerhofstraße 1, 69117 Heidelberg, Germany
| | - Sudeep Sahadevan
- European Molecular Biology Laboratory (EMBL), Meyerhofstraße 1, 69117 Heidelberg, Germany
| | - Benjamin Lang
- Department of Structural Biology and Center of Excellence for Data-Driven Discovery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Milad Miladi
- Bioinformatics Group, Department of Computer Science, University of Freiburg, 79098 Freiburg im Breisgau, Germany
| | - Rolf Backofen
- Bioinformatics Group, Department of Computer Science, University of Freiburg, 79098 Freiburg im Breisgau, Germany
| | - Wolfgang Huber
- European Molecular Biology Laboratory (EMBL), Meyerhofstraße 1, 69117 Heidelberg, Germany
| | - Matthias W Hentze
- European Molecular Biology Laboratory (EMBL), Meyerhofstraße 1, 69117 Heidelberg, Germany
| | - Gian Gaetano Tartaglia
- Center for Life Nano & Neuroscience, Italian Institute of Technology, 00161 Rome, Italy and Department of Biology, Sapienza University of Rome, 00185 Rome, Italy
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5
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Leslie BJ, Lang B, Babu MM. A genome-wide view of disordered proteins. Nat Biotechnol 2024; 42:32-34. [PMID: 37783848 DOI: 10.1038/s41587-023-01955-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Affiliation(s)
- Benjamin J Leslie
- Center of Excellence for Data-Driven Discovery, Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Benjamin Lang
- Center of Excellence for Data-Driven Discovery, Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - M Madan Babu
- Center of Excellence for Data-Driven Discovery, Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA.
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Kahnau P, Mieske P, Wilzopolski J, Kalliokoski O, Mandillo S, Hölter SM, Voikar V, Amfim A, Badurek S, Bartelik A, Caruso A, Čater M, Ey E, Golini E, Jaap A, Hrncic D, Kiryk A, Lang B, Loncarevic-Vasiljkovic N, Meziane H, Radzevičienė A, Rivalan M, Scattoni ML, Torquet N, Trifkovic J, Ulfhake B, Thöne-Reineke C, Diederich K, Lewejohann L, Hohlbaum K. A systematic review of the development and application of home cage monitoring in laboratory mice and rats. BMC Biol 2023; 21:256. [PMID: 37953247 PMCID: PMC10642068 DOI: 10.1186/s12915-023-01751-7] [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: 03/20/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Traditionally, in biomedical animal research, laboratory rodents are individually examined in test apparatuses outside of their home cages at selected time points. However, the outcome of such tests can be influenced by various factors and valuable information may be missed when the animals are only monitored for short periods. These issues can be overcome by longitudinally monitoring mice and rats in their home cages. To shed light on the development of home cage monitoring (HCM) and the current state-of-the-art, a systematic review was carried out on 521 publications retrieved through PubMed and Web of Science. RESULTS Both the absolute (~ × 26) and relative (~ × 7) number of HCM-related publications increased from 1974 to 2020. There was a clear bias towards males and individually housed animals, but during the past decade (2011-2020), an increasing number of studies used both sexes and group housing. In most studies, animals were kept for short (up to 4 weeks) time periods in the HCM systems; intermediate time periods (4-12 weeks) increased in frequency in the years between 2011 and 2020. Before the 2000s, HCM techniques were predominantly applied for less than 12 h, while 24-h measurements have been more frequent since the 2000s. The systematic review demonstrated that manual monitoring is decreasing in relation to automatic techniques but still relevant. Until (and including) the 1990s, most techniques were applied manually but have been progressively replaced by automation since the 2000s. Independent of the year of publication, the main behavioral parameters measured were locomotor activity, feeding, and social behaviors; the main physiological parameters were heart rate and electrocardiography. External appearance-related parameters were rarely examined in the home cages. Due to technological progress and application of artificial intelligence, more refined and detailed behavioral parameters have been investigated in the home cage more recently. CONCLUSIONS Over the period covered in this study, techniques for HCM of mice and rats have improved considerably. This development is ongoing and further progress as well as validation of HCM systems will extend the applications to allow for continuous, longitudinal, non-invasive monitoring of an increasing range of parameters in group-housed small rodents in their home cages.
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Affiliation(s)
- Pia Kahnau
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany
| | - Paul Mieske
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany
| | - Jenny Wilzopolski
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany
| | - Otto Kalliokoski
- Department of Experimental Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Silvia Mandillo
- Institute of Biochemistry and Cell Biology, National Research Council CNR, Rome, Italy
| | - Sabine M Hölter
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Munich, Germany
| | - Vootele Voikar
- Neuroscience Center, Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Adriana Amfim
- Faculty of Veterinary Medicine, Spiru Haret University, Bucharest, Romania
| | - Sylvia Badurek
- Preclinical Phenotyping Facility, Vienna Biocenter Core Facilities (VBCF), member of the Vienna Biocenter (VBC), Vienna, Austria
| | - Aleksandra Bartelik
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Angela Caruso
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Rome, Italy
| | - Maša Čater
- Department of Animal Science, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Elodie Ey
- Université de Strasbourg, CNRS, Inserm, Institut de Génétique et de Biologie Moléculaire et Cellulaire UMR 7104- UMR-S 1258, Illkirch, 67400, France
| | - Elisabetta Golini
- Institute of Biochemistry and Cell Biology, National Research Council CNR, Rome, Italy
| | - Anne Jaap
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany
| | - Dragan Hrncic
- Institute of Medical Physiology "Richard Burian", Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Anna Kiryk
- Laboratory of Preclinical Testing of Higher Standard, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Science, Warsaw, Poland
| | - Benjamin Lang
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany
| | - Natasa Loncarevic-Vasiljkovic
- iNOVA4Health, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Hamid Meziane
- Université de Strasbourg, CNRS, INSERM, Institut Clinique de La Souris (ICS), CELPHEDIA, PHENOMIN, 1 Rue Laurent Fries, Illkirch, 67404, France
| | - Aurelija Radzevičienė
- Lithuanian University of Health Sciences, Medical Academy, Institute of Physiology and Pharmacology, Kaunas, Lithuania
| | - Marion Rivalan
- Research Institute for Experimental Medicine (FEM) and NeuroCure Cluster of Excellence, Animal Behaviour Phenotyping Facility, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Luisa Scattoni
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Rome, Italy
| | - Nicolas Torquet
- Université de Strasbourg, CNRS, Inserm, IGBMC, Institut Clinique de la Souris (ICS), CELPHEDIA, PHENOMIN, UMR 7104- UMR-S 1258, Illkirch, 67400, France
| | - Julijana Trifkovic
- Department of Veterinary Medicine, Faculty of Agriculture, University of East Sarajevo, East Sarajevo, Bosnia and Herzegovina
| | - Brun Ulfhake
- Div. Clinical Physiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christa Thöne-Reineke
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany
| | - Kai Diederich
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany
| | - Lars Lewejohann
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany
| | - Katharina Hohlbaum
- German Federal Institute for Risk Assessment (BfR), German Centre for the Protection of Laboratory Animals (Bf3R), Berlin, Germany.
- Science of Intelligence, Research Cluster of Excellence, Marchstr. 23, 10587, Berlin, Germany.
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7
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Tripathi S, Shirnekhi HK, Gorman SD, Chandra B, Baggett DW, Park CG, Somjee R, Lang B, Hosseini SMH, Pioso BJ, Li Y, Iacobucci I, Gao Q, Edmonson MN, Rice SV, Zhou X, Bollinger J, Mitrea DM, White MR, McGrail DJ, Jarosz DF, Yi SS, Babu MM, Mullighan CG, Zhang J, Sahni N, Kriwacki RW. Defining the condensate landscape of fusion oncoproteins. Nat Commun 2023; 14:6008. [PMID: 37770423 PMCID: PMC10539325 DOI: 10.1038/s41467-023-41655-2] [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: 11/10/2022] [Accepted: 09/13/2023] [Indexed: 09/30/2023] Open
Abstract
Fusion oncoproteins (FOs) arise from chromosomal translocations in ~17% of cancers and are often oncogenic drivers. Although some FOs can promote oncogenesis by undergoing liquid-liquid phase separation (LLPS) to form aberrant biomolecular condensates, the generality of this phenomenon is unknown. We explored this question by testing 166 FOs in HeLa cells and found that 58% formed condensates. The condensate-forming FOs displayed physicochemical features distinct from those of condensate-negative FOs and segregated into distinct feature-based groups that aligned with their sub-cellular localization and biological function. Using Machine Learning, we developed a predictor of FO condensation behavior, and discovered that 67% of ~3000 additional FOs likely form condensates, with 35% of those predicted to function by altering gene expression. 47% of the predicted condensate-negative FOs were associated with cell signaling functions, suggesting a functional dichotomy between condensate-positive and -negative FOs. Our Datasets and reagents are rich resources to interrogate FO condensation in the future.
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Affiliation(s)
- Swarnendu Tripathi
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Hazheen K Shirnekhi
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Scott D Gorman
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Arrakis Therapeutics, 830 Winter St, Waltham, MA, 02451, USA
| | - Bappaditya Chandra
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - David W Baggett
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Cheon-Gil Park
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ramiz Somjee
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Rhodes College, Memphis, TN, USA
- Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110, USA
| | - Benjamin Lang
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Center of Excellence for Data-Driven Discovery, Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Seyed Mohammad Hadi Hosseini
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Center of Excellence for Data-Driven Discovery, Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Brittany J Pioso
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Yongsheng Li
- Livestrong Cancer Institutes, Department of Oncology, Dell Medical School, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Ilaria Iacobucci
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Qingsong Gao
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Michael N Edmonson
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Stephen V Rice
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Xin Zhou
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - John Bollinger
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Diana M Mitrea
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Dewpoint Therapeutics, 451 D Street, Suite 104, Boston, MA, 02210, USA
| | - Michael R White
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
- IDEXX Laboratories, Inc., One IDEXX Drive, Westbrook, ME, 04092, USA
| | - Daniel J McGrail
- Center for Immunotherapy and Precision Immuno-Oncology, Cleveland Clinic, Cleveland, OH, USA
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Daniel F Jarosz
- Department of Chemical and Systems Biology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - S Stephen Yi
- Livestrong Cancer Institutes, Department of Oncology, Dell Medical School, The University of Texas at Austin, Austin, TX, 78712, USA
- Department of Biomedical Engineering, and Oden Institute for Computational Engineering and Sciences, The University of Texas at Austin, Austin, TX, USA
| | - M Madan Babu
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Center of Excellence for Data-Driven Discovery, Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Charles G Mullighan
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jinghui Zhang
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Nidhi Sahni
- Department of Epigenetics and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Program in Quantitative and Computational Biosciences, Baylor College of Medicine, Houston, TX, USA
| | - Richard W Kriwacki
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN, USA.
- Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Sciences Center, Memphis, TN, USA.
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8
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Lang B, Kahnau P, Hohlbaum K, Mieske P, Andresen NP, Boon MN, Thöne-Reineke C, Lewejohann L, Diederich K. Challenges and advanced concepts for the assessment of learning and memory function in mice. Front Behav Neurosci 2023; 17:1230082. [PMID: 37809039 PMCID: PMC10551171 DOI: 10.3389/fnbeh.2023.1230082] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
The mechanisms underlying the formation and retrieval of memories are still an active area of research and discussion. Manifold models have been proposed and refined over the years, with most assuming a dichotomy between memory processes involving non-conscious and conscious mechanisms. Despite our incomplete understanding of the underlying mechanisms, tests of memory and learning count among the most performed behavioral experiments. Here, we will discuss available protocols for testing learning and memory using the example of the most prevalent animal species in research, the laboratory mouse. A wide range of protocols has been developed in mice to test, e.g., object recognition, spatial learning, procedural memory, sequential problem solving, operant- and fear conditioning, and social recognition. Those assays are carried out with individual subjects in apparatuses such as arenas and mazes, which allow for a high degree of standardization across laboratories and straightforward data interpretation but are not without caveats and limitations. In animal research, there is growing concern about the translatability of study results and animal welfare, leading to novel approaches beyond established protocols. Here, we present some of the more recent developments and more advanced concepts in learning and memory testing, such as multi-step sequential lockboxes, assays involving groups of animals, as well as home cage-based assays supported by automated tracking solutions; and weight their potential and limitations against those of established paradigms. Shifting the focus of learning tests from the classical experimental chamber to settings which are more natural for rodents comes with a new set of challenges for behavioral researchers, but also offers the opportunity to understand memory formation and retrieval in a more conclusive way than has been attainable with conventional test protocols. We predict and embrace an increase in studies relying on methods involving a higher degree of automatization, more naturalistic- and home cage-based experimental setting as well as more integrated learning tasks in the future. We are confident these trends are suited to alleviate the burden on animal subjects and improve study designs in memory research.
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Affiliation(s)
- Benjamin Lang
- Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Institute for Animal Welfare, Free University of Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Berlin, Germany
| | - Pia Kahnau
- Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Katharina Hohlbaum
- Science of Intelligence, Research Cluster of Excellence, Berlin, Germany
- Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Paul Mieske
- Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Institute for Animal Welfare, Free University of Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Berlin, Germany
- Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Niek P. Andresen
- Science of Intelligence, Research Cluster of Excellence, Berlin, Germany
- Computer Vision and Remote Sensing, Technical University Berlin, Berlin, Germany
| | - Marcus N. Boon
- Science of Intelligence, Research Cluster of Excellence, Berlin, Germany
- Modeling of Cognitive Processes, Technical University of Berlin, Berlin, Germany
| | - Christa Thöne-Reineke
- Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Institute for Animal Welfare, Free University of Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Berlin, Germany
| | - Lars Lewejohann
- Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Institute for Animal Welfare, Free University of Berlin, Berlin, Germany
- Science of Intelligence, Research Cluster of Excellence, Berlin, Germany
- Federal Institute for Risk Assessment (BfR), Berlin, Germany
| | - Kai Diederich
- Federal Institute for Risk Assessment (BfR), Berlin, Germany
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9
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Jenkins PC, Lin A, Ames SG, Newgard CD, Lang B, Winslow JE, Marin JR, Cook JNB, Goldhaber-Fiebert JD, Papa L, Zonfrillo MR, Hansen M, Wall SP, Malveau S, Kuppermann N. Emergency Department Pediatric Readiness and Disparities in Mortality Based on Race and Ethnicity. JAMA Netw Open 2023; 6:e2332160. [PMID: 37669053 PMCID: PMC10481245 DOI: 10.1001/jamanetworkopen.2023.32160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/27/2023] [Indexed: 09/06/2023] Open
Abstract
Importance Presentation to emergency departments (EDs) with high levels of pediatric readiness is associated with improved pediatric survival. However, it is unclear whether children of all races and ethnicities benefit equitably from increased levels of such readiness. Objective To evaluate the association of ED pediatric readiness with in-hospital mortality among children of different races and ethnicities with traumatic injuries or acute medical emergencies. Design, Setting, and Participants This cohort study of children requiring emergency care in 586 EDs across 11 states was conducted from January 1, 2012, through December 31, 2017. Eligible participants included children younger than 18 years who were hospitalized for an acute medical emergency or traumatic injury. Data analysis was conducted between November 2022 and April 2023. Exposure Hospitalization for acute medical emergency or traumatic injury. Main Outcomes and Measures The primary outcome was in-hospital mortality. ED pediatric readiness was measured through the weighted Pediatric Readiness Score (wPRS) from the 2013 National Pediatric Readiness Project assessment and categorized by quartile. Multivariable, hierarchical, mixed-effects logistic regression was used to evaluate the association of race and ethnicity with in-hospital mortality. Results The cohort included 633 536 children (median [IQR] age 4 [0-12] years]). There were 557 537 children (98 504 Black [17.7%], 167 838 Hispanic [30.1%], 311 157 White [55.8%], and 147 876 children of other races or ethnicities [26.5%]) who were hospitalized for acute medical emergencies, of whom 5158 (0.9%) died; 75 999 children (12 727 Black [16.7%], 21 604 Hispanic [28.4%], 44 203 White [58.2%]; and 21 609 of other races and ethnicities [27.7%]) were hospitalized for traumatic injuries, of whom 1339 (1.8%) died. Adjusted mortality of Black children with acute medical emergencies was significantly greater than that of Hispanic children, White children, and of children of other races and ethnicities (odds ratio [OR], 1.69; 95% CI, 1.59-1.79) across all quartile levels of ED pediatric readiness; but there were no racial or ethnic disparities in mortality when comparing Black children with traumatic injuries with Hispanic children, White children, and children of other races and ethnicities with traumatic injuries (OR 1.01; 95% CI, 0.89-1.15). When compared with hospitals in the lowest quartile of ED pediatric readiness, children who were treated at hospitals in the highest quartile had significantly lower mortality in both the acute medical emergency cohort (OR 0.24; 95% CI, 0.16-0.36) and traumatic injury cohort (OR, 0.39; 95% CI, 0.25-0.61). The greatest survival advantage associated with high pediatric readiness was experienced for Black children in the acute medical emergency cohort. Conclusions and Relevance In this study, racial and ethnic disparities in mortality existed among children treated for acute medical emergencies but not traumatic injuries. Increased ED pediatric readiness was associated with reduced disparities; it was estimated that increasing the ED pediatric readiness levels of hospitals in the 3 lowest quartiles would result in an estimated 3-fold reduction in disparity for pediatric mortality. However, increased pediatric readiness did not eliminate disparities, indicating that organizations and initiatives dedicated to increasing ED pediatric readiness should consider formal integration of health equity into efforts to improve pediatric emergency care.
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Affiliation(s)
- Peter C. Jenkins
- Department of Surgery, Indiana University School of Medicine, Indianapolis
| | - Amber Lin
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Stefanie G. Ames
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Craig D. Newgard
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Benjamin Lang
- Department of Pediatrics, Dell Medical School, University of Texas at Austin
- Department of Surgery, Dell Medical School, University of Texas at Austin
| | - James E. Winslow
- Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
- North Carolina Office of Emergency Medical Services, Raleigh
| | - Jennifer R. Marin
- Departments of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jennifer N. B. Cook
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Jeremy D. Goldhaber-Fiebert
- Centers for Health Policy, Primary Care, and Outcomes Research, Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Linda Papa
- Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida
| | - Mark R. Zonfrillo
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Matthew Hansen
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Stephen P. Wall
- Ronald O. Perelman Department of Emergency Medicine, Department of Population Health, New York University School of Medicine, New York, New York
| | - Susan Malveau
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Nathan Kuppermann
- Department of Emergency Medicine, University of California, Davis, School of Medicine, Sacramento
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10
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Luo Z, Wang J, Zhou Y, Mao Q, Lang B, Xu S. Workplace bullying and suicidal ideation and behaviour: a systematic review and meta-analysis. Public Health 2023; 222:166-174. [PMID: 37544128 DOI: 10.1016/j.puhe.2023.07.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/11/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVES Suicidal ideation and behaviour are potential outcomes of workplace bullying. This review aimed to determine the extent of the association between workplace bullying and suicidal ideation and behaviour. STUDY DESIGN The study incorporated a systematic review and meta-analysis. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed to conduct a comprehensive systematic review and meta-analysis. A combination of subject terms and free words was used to search nine electronic databases. Two reviewers independently screened articles and extracted information according to the inclusion criteria. A meta-analysis was performed with averaged weighted correlations across samples using the STATA software (version 16.0) from pooled estimates of the main results from all studies. RESULTS In total, 25 articles of high or medium quality were included in the systematic review; 15 of these were included in the meta-analysis. The prevalence of suicidal ideation and behaviour was 18% and 4%, respectively. Individuals who experienced workplace bullying had 2.03-times and 2.67-times higher odds of reporting suicidal ideation and behaviour, respectively, after adjustment for confounding factors. Moderating and mediating factors may help reduce the risk of suicidal ideation and behaviour for individuals experiencing workplace bullying. CONCLUSION This study indicated that exposure to workplace bullying significantly increased the risk of suicidal ideation and behaviour.
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Affiliation(s)
- Z Luo
- Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region (West China Hospital Sichuan University Tibet Chengdu Branch Hospital), No. 20 Ximianqiao Hengjie, Chengdu 610041, China.
| | - J Wang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 610041, China
| | - Y Zhou
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 610041, China
| | - Q Mao
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Jinniu District, Chengdu 6100752, China
| | - B Lang
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Jinniu District, Chengdu 6100752, China
| | - S Xu
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39, Shierqiao Road, Jinniu District, Chengdu 6100752, China
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11
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Hintze J, Lang B, Subramaniam T, Kruseman N, O'Regan E, Brennan S, Lennon P. Factors influencing nodal yield in neck dissections for head and neck malignancies. J Laryngol Otol 2023; 137:925-929. [PMID: 36651334 DOI: 10.1017/s0022215122002687] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE A standard lateral neck dissection should yield at least 18 lymph nodes. The goal of the present study was to examine what factors might influence the number of lymph nodes retrieved during a neck dissection. METHODS This was a retrospective cohort study in a tertiary academic referral centre for head and neck oncology. Two hundred and nineteen consecutive neck dissections were examined. Age of the patient and primary site were recorded, along with tumour histology, previous radiotherapy and final nodal count. RESULTS The mean age was 62.2 ± 13.0 years. The most common primary site was the oral cavity (38.8 per cent). The mean number of lymph nodes was 30.63 ± 13.9. In total, 17.8 per cent had undergone previous radiotherapy. The mean number of lymph nodes was 33.26 ± 13.27 in patients with no previous radiation exposure and 18.47 ± 9.46 in those with previous radiation treatment. CONCLUSION Lymph node yield from a neck dissection is likely multi-factorial in nature. Previous radiotherapy, the only significant contributor, led to a mean reduction of lymph node yield from 33.3 to 18.5.
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Affiliation(s)
- J Hintze
- Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Dublin, University of Dublin, Ireland
| | - B Lang
- Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Dublin, University of Dublin, Ireland
| | - T Subramaniam
- Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Dublin, University of Dublin, Ireland
| | - N Kruseman
- Department of Histopathology, St James's Hospital, Dublin, Ireland
- Trinity College Dublin, University of Dublin, Ireland
| | - E O'Regan
- Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland
- Department of Histopathology, St James's Hospital, Dublin, Ireland
- Trinity College Dublin, University of Dublin, Ireland
| | - S Brennan
- Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland
- Department of Radiation Oncology, St James's Hospital, Dublin, Ireland
- Trinity College Dublin, University of Dublin, Ireland
| | - P Lennon
- Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland
- Trinity College Dublin, University of Dublin, Ireland
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12
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Smitherman EA, Chahine RA, Beukelman T, Lewandowski LB, Rahman AKMF, Wenderfer SE, Curtis JR, Hersh AO, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar‐Smiley F, Barillas‐Arias L, Basiaga M, Baszis K, Becker M, Bell‐Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang‐Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel‐Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie‐Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui‐Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein‐Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PM, McGuire S, McHale I, McMonagle A, McMullen‐Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O'Brien B, O'Brien T, Okeke O, Oliver M, Olson J, O'Neil K, Onel K, Orandi A, Orlando M, Osei‐Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan‐Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas‐Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth‐Wojcicki E, Rouster – Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert‐Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner‐Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care. Arthritis Care Res (Hoboken) 2023; 75:1553-1562. [PMID: 36775844 PMCID: PMC10500561 DOI: 10.1002/acr.25002] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/14/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis. METHODS We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded. RESULTS We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers. CONCLUSION In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.
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Glund S, Hoefler J, Lang B, Cafiero S, Panova-Noeva M, Place C, Wolff M. Bioequivalence of Intravenous Alteplase from Two Different Manufacturing Processes in Healthy Male Volunteers: Results from a Two-Stage, Adaptive-Design Study. Clin Pharmacokinet 2023; 62:1023-1030. [PMID: 37248330 PMCID: PMC10338556 DOI: 10.1007/s40262-023-01253-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Alteplase is a recombinant tissue plasminogen activator used for thrombolytic treatment in several indications and is currently approved in Europe under the brand name Actilyse®. The current manufacturing process for alteplase was recently modified to meet increasing global demands. The aim of this randomized, open-label, adaptive two-stage design, two-way crossover study was to establish bioequivalence of alteplase derived from the two manufacturing processes (modified versus current). METHODS The two alteplase formulations (modified and current, 0.2 mg/kg body weight) were compared in healthy male volunteers after intravenous infusion over a period of 30 min. The trial was put on hold after treatment of 12 subjects (Part A) and restarted as Part B (n = 18) with design adaptations, including a heparin bolus. RESULTS Pharmacokinetic parameters of alteplase were determined from plasma concentration-time profiles. The pharmacokinetic parameters tested (AUC0-tz, Cmax, and AUC0-∞) for alteplase after single intravenous infusion demonstrated no differences between alteplase obtained from the modified and current processes. An analysis of variance (ANOVA) model was applied to test for bioequivalence. The geometric means ratio and the respective 92.83% confidence intervals (CIs) for all primary and secondary pharmacokinetic endpoints were well within the prespecified equivalence boundaries of 80-125%. The CIs also included unity, suggesting no statistically significant differences between the two treatments. CONCLUSIONS The results show that alteplase exposure was virtually identical for the formulations tested, and statistical evaluation demonstrated bioequivalence of the formulations. Both formulations of alteplase were well tolerated by the subjects at the single intravenous doses in the trial. TRIAL REGISTRATION Trial registration number: NCT04419493, 2019-004932-40 (EudraCT Number).
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Affiliation(s)
- Stephan Glund
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany.
| | | | - Benjamin Lang
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Stephen Cafiero
- Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| | | | - Corina Place
- Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| | - Michael Wolff
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
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Glantschnigg-Eisl U, Klang A, Kneissl S, Lang B, Waters P, Irani SR, Binks SNM, Pakozdy A. A feline model of spontaneously occurring autoimmune limbic encephalitis. Vet J 2023; 296-297:105974. [PMID: 36958405 DOI: 10.1016/j.tvjl.2023.105974] [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: 02/25/2022] [Revised: 03/08/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023]
Abstract
Autoimmune encephalitis (AE) is an important cause of encephalitis in humans and occurs at a similar rate to infectious encephalitis. It is frequently associated with antibodies against the extracellular domain of neuronal proteins. Among human AE, that with antibodies against leucine-rich glioma-inactivated 1 (LGI1) is one of the most prevalent forms, and was recently described in cats with limbic encephalitis (LE). In this study, we describe a large cohort (n = 32) of cats with AE, tested positive for voltage gated potassium channel (VGKC)-antibodies, of which 26 (81%) harboured LGI1-antibodies. We delineate their clinical and paraclinical features as well as long-term outcomes up to 5 years. Similar to human cases, most cats with LGI1-antibodies had a history of focal seizures (83%), clustering in the majority (88%), with interictal behavioural changes (73%). Among feline AE patients, there was no seizure type or other clinical characteristic that could distinguish LGI1-antibody positive from negative cats, unlike the pathognomic faciobrachial dystonic seizures seen in humans. Although six cats were euthanased in the first year for epilepsy-associated reasons, those attaining at least 1-year survival had good seizure control and quality of life with appropriate veterinary care and medication. Acute-phase immunotherapy (prednisolone) was given to the most severely unwell cases and its effect is retrospectively evaluated in 10 cats. Our data show LGI1-antibodies are an important cause of feline encephalitis, sharing many features with human AE. Further research should examine optimal therapeutic management strategies and the cause of LE in seronegative cats, building on paradigms established in the counterpart human disease.
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Affiliation(s)
- U Glantschnigg-Eisl
- Clinic for Small Animals, Internal Medicine, University of Veterinary Medicine Vienna, Austria.
| | - A Klang
- Institute for Pathology and Forensic Veterinary Medicine, Universitiy of Veterinary Medicine Vienna, Austria
| | - S Kneissl
- Diagnostic Imaging, University of Veterinary Medicine Vienna, Austria
| | - B Lang
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK
| | - P Waters
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK
| | - S R Irani
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK; Department of Neurology, John Radcliffe Hospital, Oxford University Hospitals Foundation Trust, Oxford OX3 9DU, UK
| | - S N M Binks
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK; Department of Neurology, John Radcliffe Hospital, Oxford University Hospitals Foundation Trust, Oxford OX3 9DU, UK
| | - A Pakozdy
- Clinic for Small Animals, Internal Medicine, University of Veterinary Medicine Vienna, Austria
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Mészáros B, Park E, Malinverni D, Sejdiu BI, Immadisetty K, Sandhu M, Lang B, Babu MM. Recent breakthroughs in computational structural biology harnessing the power of sequences and structures. Curr Opin Struct Biol 2023; 80:102608. [PMID: 37182396 DOI: 10.1016/j.sbi.2023.102608] [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: 02/05/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/16/2023]
Abstract
Recent advances in computational approaches and their integration into structural biology enable tackling increasingly complex questions. Here, we discuss several key areas, highlighting breakthroughs and remaining challenges. Theoretical modeling has provided tools to accurately predict and design protein structures on a scale currently difficult to achieve using experimental approaches. Molecular Dynamics simulations have become faster and more precise, delivering actionable information inaccessible by current experimental methods. Virtual screening workflows allow a high-throughput approach to discover ligands that bind and modulate protein function, while Machine Learning methods enable the design of proteins with new functionalities. Integrative structural biology combines several of these approaches, pushing the frontiers of structural and functional characterization to ever larger systems, advancing towards a complete understanding of the living cell. These breakthroughs will accelerate and significantly impact diverse areas of science.
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Affiliation(s)
- Bálint Mészáros
- Department of Structural Biology and Center of Excellence for Data Driven Discovery, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
| | - Electa Park
- Department of Structural Biology and Center of Excellence for Data Driven Discovery, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
| | - Duccio Malinverni
- Department of Structural Biology and Center of Excellence for Data Driven Discovery, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA. https://twitter.com/DucMalinverni
| | - Besian I Sejdiu
- Department of Structural Biology and Center of Excellence for Data Driven Discovery, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA. https://twitter.com/bisejdiu
| | - Kalyan Immadisetty
- Department of Bone Marrow Transplantation & Cellular Therapy, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA. https://twitter.com/k_immadisetty
| | - Manbir Sandhu
- Department of Structural Biology and Center of Excellence for Data Driven Discovery, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA. https://twitter.com/M5andhu
| | - Benjamin Lang
- Department of Structural Biology and Center of Excellence for Data Driven Discovery, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA. https://twitter.com/langbnj
| | - M Madan Babu
- Department of Structural Biology and Center of Excellence for Data Driven Discovery, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
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Juhl R, Birnbaum B, Barnes A, Gibson W, Mullapudi B, Lang B, Faseler M, Heble D, Urban V, Fischer R, Gannon J, Sutcliffe D. A Metabolic, Mechanical, Multi-Organ Masterpiece: Durable Device Support Bridge to Heart-Liver Transplantation in Propionic Acidemia. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1320] [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: 04/05/2023] Open
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17
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Tanzer M, Lang B, Bergmann A. Fabrication of a Low-Cost, Fiber-Coupled, and Air-Spaced Fabry-Pérot Etalon. J Vis Exp 2023. [PMID: 36808116 DOI: 10.3791/65174] [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: 02/05/2023] Open
Abstract
Fabry-Pérot etalons (FPE) have found their way into many applications. In fields such as spectroscopy, telecommunications, and astronomy, FPEs are used for their high sensitivity as well as their exceptional filtering capability. However, air-spaced etalons with high finesse are usually built by specialized facilities. Their production requires a clean room, special glass handling, and coating machinery, meaning commercially available FPEs are sold for a high price. In this article, a new and cost-effective method to fabricate fiber-coupled FPEs with standard photonic laboratory equipment is presented. The protocol should serve as a step-by-step guide for the construction and characterization of these FPEs. We hope this will enable researchers to conduct fast and cost-effective prototyping of FPEs for various fields of application. The FPE, as presented here, is used for spectroscopic applications. As shown in the representative results section via proof of principle measurements of water vapor in ambient air, this FPE has a finesse of 15, which is sufficient for the photothermal detection of trace concentrations of gases.
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Affiliation(s)
- Manuel Tanzer
- Institute of Electrical Measurement and Sensor Systems, Technical University of Graz;
| | - Benjamin Lang
- Institute of Electrical Measurement and Sensor Systems, Technical University of Graz
| | - Alexander Bergmann
- Institute of Electrical Measurement and Sensor Systems, Technical University of Graz
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18
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Newgard CD, Lin A, Malveau S, Cook JNB, Smith M, Kuppermann N, Remick KE, Gausche-Hill M, Goldhaber-Fiebert J, Burd RS, Hewes HA, Salvi A, Xin H, Ames SG, Jenkins PC, Marin J, Hansen M, Glass NE, Nathens AB, McConnell KJ, Dai M, Carr B, Ford R, Yanez D, Babcock SR, Lang B, Mann NC. Emergency Department Pediatric Readiness and Short-term and Long-term Mortality Among Children Receiving Emergency Care. JAMA Netw Open 2023; 6:e2250941. [PMID: 36637819 PMCID: PMC9857584 DOI: 10.1001/jamanetworkopen.2022.50941] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
IMPORTANCE Emergency departments (EDs) with high pediatric readiness (coordination, personnel, quality improvement, safety, policies, and equipment) are associated with lower mortality among children with critical illness and those admitted to trauma centers, but the benefit among children with more diverse clinical conditions is unknown. OBJECTIVE To evaluate the association between ED pediatric readiness, in-hospital mortality, and 1-year mortality among injured and medically ill children receiving emergency care in 11 states. DESIGN, SETTING, AND PARTICIPANTS This is a retrospective cohort study of children receiving emergency care at 983 EDs in 11 states from January 1, 2012, through December 31, 2017, with follow-up for a subset of children through December 31, 2018. Participants included children younger than 18 years admitted, transferred to another hospital, or dying in the ED, stratified by injury vs medical conditions. Data analysis was performed from November 1, 2021, through June 30, 2022. EXPOSURE ED pediatric readiness of the initial ED, measured through the weighted Pediatric Readiness Score (wPRS; range, 0-100) from the 2013 National Pediatric Readiness Project assessment. MAIN OUTCOMES AND MEASURES The primary outcome was in-hospital mortality, with a secondary outcome of time to death to 1 year among children in 6 states. RESULTS There were 796 937 children, including 90 963 (11.4%) in the injury cohort (mean [SD] age, 9.3 [5.8] years; median [IQR] age, 10 [4-15] years; 33 516 [36.8%] female; 1820 [2.0%] deaths) and 705 974 (88.6%) in the medical cohort (mean [SD] age, 5.8 [6.1] years; median [IQR] age, 3 [0-12] years; 329 829 [46.7%] female, 7688 [1.1%] deaths). Among the 983 EDs, the median (IQR) wPRS was 73 (59-87). Compared with EDs in the lowest quartile of ED readiness (quartile 1, wPRS of 0-58), initial care in a quartile 4 ED (wPRS of 88-100) was associated with 60% lower in-hospital mortality among injured children (adjusted odds ratio, 0.40; 95% CI, 0.26-0.60) and 76% lower mortality among medical children (adjusted odds ratio, 0.24; 95% CI, 0.17-0.34). Among 545 921 children followed to 1 year, the adjusted hazard ratio of death in quartile 4 EDs was 0.59 (95% CI, 0.42-0.84) for injured children and 0.34 (95% CI, 0.25-0.45) for medical children. If all EDs were in the highest quartile of pediatric readiness, an estimated 288 injury deaths (95% CI, 281-297 injury deaths) and 1154 medical deaths (95% CI, 1150-1159 medical deaths) may have been prevented. CONCLUSIONS AND RELEVANCE These findings suggest that children with injuries and medical conditions treated in EDs with high pediatric readiness had lower mortality during hospitalization and to 1 year.
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Affiliation(s)
- Craig D. Newgard
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Amber Lin
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Susan Malveau
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Jennifer N. B. Cook
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - McKenna Smith
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Nathan Kuppermann
- Department of Emergency Medicine, University of California, Davis School of Medicine, Sacramento
- Department of Pediatrics, University of California, Davis School of Medicine, Sacramento
| | - Katherine E. Remick
- Department of Pediatric, Dell Medical School, University of Texas at Austin, Austin
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin
| | - Marianne Gausche-Hill
- Los Angeles County Emergency Medical Services, Harbor-UCLA Medical Center, Torrance, California
| | - Jeremy Goldhaber-Fiebert
- Centers for Health Policy, Primary Care and Outcomes Research, Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Randall S. Burd
- Division of Trauma and Burn Surgery, Department of Surgery, Children’s National Hospital, Washington, DC
| | - Hilary A. Hewes
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Apoorva Salvi
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Haichang Xin
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Stefanie G. Ames
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Peter C. Jenkins
- Department of Surgery, Indiana University School of Medicine, Indianapolis
| | - Jennifer Marin
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Matthew Hansen
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Nina E. Glass
- Department of Surgery, Rutgers New Jersey Medical School, Newark
| | - Avery B. Nathens
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - K. John McConnell
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
- Center for Health Systems Effectiveness, Department of Emergency Medicine, Oregon Health & Science University, Portland
| | - Mengtao Dai
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
| | - Brendan Carr
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rachel Ford
- Oregon Emergency Medical Services for Children Program, Oregon Health Authority, Portland
| | - Davis Yanez
- Department of Anesthesia, Yale School of Medicine, New Haven, Connecticut
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Sean R. Babcock
- Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, Portland
| | - Benjamin Lang
- Department of Pediatric, Dell Medical School, University of Texas at Austin, Austin
- Department of Surgery, Dell Medical School, University of Texas at Austin, Austin
| | - N. Clay Mann
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
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Hahn T, Daymont C, Beukelman T, Groh B, Hays K, Bingham CA, Scalzi L, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J 2022; 20:107. [PMID: 36434731 PMCID: PMC9701017 DOI: 10.1186/s12969-022-00770-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months. METHODS We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed. RESULTS We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05). CONCLUSION While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.
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Affiliation(s)
- Timothy Hahn
- Department of Pediatrics, Penn State Children's Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA, 17033-0855, USA.
| | - Carrie Daymont
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Timothy Beukelman
- grid.265892.20000000106344187Department of Pediatrics, University of Alabama at Birmingham, CPPN G10, 1600 7th Ave South, Birmingham, AL 35233 USA
| | - Brandt Groh
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | | | - Catherine April Bingham
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Lisabeth Scalzi
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
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Radeschnig U, Bergmann A, Lang B. Flow-Enhanced Photothermal Spectroscopy. Sensors (Basel) 2022; 22:7148. [PMID: 36236246 PMCID: PMC9570771 DOI: 10.3390/s22197148] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
Photothermal spectroscopy (PTS) is a promising sensing technique for the measurement of gases and aerosols. PTS systems using a Fabry-Pérot interferometer (FPI) are considered particularly promising owing to their robustness and potential for miniaturization. However, limited information is available on viable procedures for signal improvement through parameter tuning. In our work, we use an FPI-based PTS configuration, in which the excitation laser irradiates the target collinearly to the flowing gas. We demonstrate that the generated thermal wave, and thus the signal intensity, is significantly affected by the ratio between excitation modulation frequency and gas flow velocity towards another. We provide an analytical model that predicts the signal intensity with particular considerations of these two parameter settings and validate the findings experimentally. The results reveal the existence of an optimal working regime, depending on the modulation frequency and flow velocity.
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Menter A, McCabe D, Lang B. 33221 Further clinical outcomes in patients with moderate-to-severe chronic plaque psoriasis receiving adalimumab reference product continuously or switching between BI 695501 and adalimumab RP in the phase III, randomized, interchangeability VOLTAIRE-X trial. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Menter A, Cohen S, Kay J, Strand V, Gottlieb A, Hanauer S, Eduru SK, Buschke S, Lang B, Liesenfeld KH, Schaible J, McCabe D. Switching Between Adalimumab Reference Product and BI 695501 in Patients with Chronic Plaque Psoriasis (VOLTAIRE-X): A Randomized Controlled Trial. Am J Clin Dermatol 2022; 23:719-728. [PMID: 35934770 PMCID: PMC9464749 DOI: 10.1007/s40257-022-00708-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/26/2022]
Abstract
Background BI 695501 is an FDA-approved biosimilar to adalimumab reference product (RP). VOLTAIRE-X was a randomized clinical trial to assess outcomes with a biosimilar monoclonal antibody in line with the FDA requirements for designation as an ‘interchangeable’ biosimilar. Objective The aim of this study was to assess whether multiple switches between adalimumab RP and BI 695501 lead to equivalent pharmacokinetics and a similar safety and immunogenicity profile compared with continuous adalimumab RP. Methods We conducted a phase III, double-blind, randomized controlled trial between July 19, 2017, and April 16, 2019. There were 49 investigational sites across Europe and North America. Of 323 screened patients with moderate-to-severe chronic plaque psoriasis, 259 were treated with adalimumab RP during the run-in period. Of these, 118 and 120 were randomized to the continuous or switching arms, respectively. Interventions consisted of a run-in period with adalimumab RP 80 mg subcutaneously (SC) on Day 1, then 40 mg SC every other week (EOW) Weeks 2–12. Patients were then randomized to receive adalimumab RP 40 mg EOW Weeks 14–48 (continuous arm) or BI 695501 40 mg Weeks 14 and 16, adalimumab RP 40 mg Weeks 18 and 20, and BI 695501 40 mg EOW Weeks 22 to 48 (switching arm); all interventions were given SC. Primary endpoints were pharmacokinetics parameters, area under the plasma concentration–time curve (AUCτ,30–32) and maximum observed drug plasma concentration (Cmax,30–32), measured after the third switch during the Week 30–32 dosing interval. Results 238 patients (mean [standard deviation] age 44.9 [13.8]; 66.0% male) were treated in the switching (n = 118) or continuous arms (n = 120). Adjusted mean Cmax,30–32 was 7.08 and 7.00 μg/mL in the switching and continuous treatment arms, respectively; adjusted mean AUCτ,30–32 was 2025.8 and 1925.9 μg h/mL. Point estimate for mean ratio for AUCτ,30–32 was 105.2% (90.2% confidence interval [CI] 96.6–114.6), and 101.1% (90.2% CI 93.3–109.7) for Cmax,30–32. Both CIs were within a predefined bioequivalence range of 80.0–125.0%. Treatment-emergent adverse events led to discontinuation in 0.8% and 1.7% of patients in the switching and continuous treatment arms, and Psoriasis Area and Severity Index (PASI) scores were highly similar in the two arms across the entire trial period. Conclusions Pharmacokinetic equivalence was demonstrated, with highly similar efficacy and immunogenicity, and comparable safety observed in patients with chronic plaque psoriasis who received either adalimumab RP continuously or who switched between adalimumab RP and BI 695501. Trial Registration ClinicalTrials.gov: NCT03210259 (registered July 2017); Eudract.ema.europa.eu: 2016-002254-20. Video abstract Switching between adalimumab reference product and BI 695501 in patients with chronic plaque psoriasis (VOLTAIRE-X): a randomized controlled trial (MP4 9244 kb)
Supplementary Information The online version contains supplementary material available at 10.1007/s40257-022-00708-w.
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Affiliation(s)
- Alan Menter
- Baylor Scott & White, 3900 Junius Street, suite 125, Dallas, TX, 75246, USA.
| | | | - Jonathan Kay
- UMass Memorial Medical Center and UMass Chan Medical School, Worcester, MA, USA
| | - Vibeke Strand
- Division of Immunology/Rheumatology, Stanford University, Palo Alto, CA, USA
| | - Alice Gottlieb
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen Hanauer
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Susanne Buschke
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
| | - Benjamin Lang
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
| | | | | | - Dorothy McCabe
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA
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Newgard CD, Malveau S, Mann NC, Hansen M, Lang B, Lin A, Carr BG, Berry C, Buchwalder K, Lerner EB, Hewes HA, Kusin S, Dai M, Wei R. A Geospatial Evaluation of 9-1-1 Ambulance Transports for Children and Emergency Department Pediatric Readiness. PREHOSP EMERG CARE 2022; 27:252-262. [PMID: 35394855 PMCID: PMC9681031 DOI: 10.1080/10903127.2022.2064020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Whether ambulance transport patterns are optimized to match children to high-readiness emergency departments (EDs) and the resulting effect on survival are unknown. We quantified the number of children transported by 9-1-1 emergency medical services (EMS) to high-readiness EDs, additional children within 30 minutes of a high-readiness ED, and the estimated effect on survival. METHODS This was a cross-sectional study using data from the National EMS Information System for 5,461 EMS agencies in 28 states from 1/1/2012 through 12/31/2019, matched to the 2013 National Pediatric Readiness Project assessment of ED pediatric readiness. We performed a geospatial analysis of children 0 to 17 years requiring 9-1-1 EMS transport to acute care hospitals, including day-, time-, and traffic-adjusted estimates for driving times to all EDs within 30 minutes of the scene. We categorized receiving hospitals by quartile of ED pediatric readiness using the weighted Pediatric Readiness Score (wPRS, range 0-100) and defined a high-risk subgroup of children as a proxy for admission. We used published estimates for the survival benefit of high readiness EDs to estimate the number of lives saved. RESULTS There were 808,536 children transported by EMS, of whom 253,541 (31.4%) were high-risk. Among the 2,261 receiving hospitals, the median wPRS was 70 (IQR 57-85, range 26-100) and the median number of receiving hospitals within 30 minutes was 4 per child (IQR 2-11, range 1 to 53). Among all children, 411,685 (50.9%) were taken to EDs in the highest quartile of pediatric readiness, and 180,547 (22.3%) children transported to lower readiness EDs were within 30 minutes of a high readiness ED. Findings were similar among high-risk children. Based on high-risk children, we estimated that 3,050 pediatric lives were saved by transport to high-readiness EDs and an additional 1,719 lives could have been saved by shifting transports to high readiness EDs within 30 minutes. CONCLUSIONS Approximately half of children transported by EMS were taken to high-readiness EDs and an additional one quarter could have been transported to such an ED, with measurable effect on survival.
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Affiliation(s)
- Craig D. Newgard
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine Oregon Health & Science University, Portland, Oregon
| | - Susan Malveau
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine Oregon Health & Science University, Portland, Oregon
| | - N. Clay Mann
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Matthew Hansen
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine Oregon Health & Science University, Portland, Oregon
| | - Benjamin Lang
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Amber Lin
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine Oregon Health & Science University, Portland, Oregon
| | - Brendan G. Carr
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Cherisse Berry
- Department of Surgery, New York University Grossman School of Medicine, New York, New York
| | - Kyle Buchwalder
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine Oregon Health & Science University, Portland, Oregon
| | - E. Brooke Lerner
- Department of Emergency Medicine, University at Buffalo, Buffalo, New York
| | - Hilary A. Hewes
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Shana Kusin
- Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine Oregon Health & Science University, Portland, Oregon
| | - Mengtao Dai
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Ran Wei
- School of Public Policy, University of California at Riverside, Riverside, California
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Blumenthal-Barby J, Lang B, Dorfman N, Kaplan H, Hooper WB, Kostick-Quenet K. Research on the Clinical Translation of Health Care Machine Learning: Ethicists Experiences on Lessons Learned. Am J Bioeth 2022; 22:1-3. [PMID: 35475968 DOI: 10.1080/15265161.2022.2059199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Kostick-Quenet K, Blumenthal-Barby J, Mehra M, Lang B, Dorfman N, Bhimaraj A, Civitello A, Jorde U, Trachtenberg B, Uriel N, Kaplan H, Gilmore-Szott E, Volk R, Estep J. Integrating Personalized Risk Scores in Decision Making About Left Ventricular Assist Device (LVAD) Therapy: Clinician and Patient Perspectives. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1714] [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: 10/18/2022] Open
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Soulsby WD, Balmuri N, Cooley V, Gerber LM, Lawson E, Goodman S, Onel K, Mehta B, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis. Pediatr Rheumatol Online J 2022; 20:18. [PMID: 35255941 PMCID: PMC8903717 DOI: 10.1186/s12969-022-00676-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry. METHODS In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months. RESULTS One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability. CONCLUSION High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.
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Affiliation(s)
- William Daniel Soulsby
- University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA, 94158, USA.
| | - Nayimisha Balmuri
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Victoria Cooley
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Linda M. Gerber
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Erica Lawson
- grid.266102.10000 0001 2297 6811University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA 94158 USA
| | - Susan Goodman
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Karen Onel
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Bella Mehta
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
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Cava C, Armaos A, Lang B, Tartaglia GG, Castiglioni I. Identification of long non-coding RNAs and RNA binding proteins in breast cancer subtypes. Sci Rep 2022; 12:693. [PMID: 35027621 PMCID: PMC8758778 DOI: 10.1038/s41598-021-04664-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 06/22/2021] [Accepted: 12/17/2021] [Indexed: 12/14/2022] Open
Abstract
Breast cancer is a heterogeneous disease classified into four main subtypes with different clinical outcomes, such as patient survival, prognosis, and relapse. Current genetic tests for the differential diagnosis of BC subtypes showed a poor reproducibility. Therefore, an early and correct diagnosis of molecular subtypes is one of the challenges in the clinic. In the present study, we identified differentially expressed genes, long non-coding RNAs and RNA binding proteins for each BC subtype from a public dataset applying bioinformatics algorithms. In addition, we investigated their interactions and we proposed interacting biomarkers as potential signature specific for each BC subtype. We found a network of only 2 RBPs (RBM20 and PCDH20) and 2 genes (HOXB3 and RASSF7) for luminal A, a network of 21 RBPs and 53 genes for luminal B, a HER2-specific network of 14 RBPs and 30 genes, and a network of 54 RBPs and 302 genes for basal BC. We validated the signature considering their expression levels on an independent dataset evaluating their ability to classify the different molecular subtypes with a machine learning approach. Overall, we achieved good performances of classification with an accuracy >0.80. In addition, we found some interesting novel prognostic biomarkers such as RASSF7 for luminal A, DCTPP1 for luminal B, DHRS11, KLC3, NAGS, and TMEM98 for HER2, and ABHD14A and ADSSL1 for basal. The findings could provide preliminary evidence to identify putative new prognostic biomarkers and therapeutic targets for individual breast cancer subtypes.
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Affiliation(s)
- Claudia Cava
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Via F.Cervi 93, 20090, Segrate-Milan, Milan, Italy.
| | - Alexandros Armaos
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, C/ Dr. Aiguader 88, 08003, Barcelona, Spain.,RNA System Biology Lab, Department of Neuroscience and Brain Technologies, Istituto Italiano Di Tecnologia (IIT), Via Morego 30, 16163, Genoa, Italy
| | - Benjamin Lang
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, C/ Dr. Aiguader 88, 08003, Barcelona, Spain.,Department of Structural Biology and Center for Data Driven Discovery (C3D), St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Gian G Tartaglia
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, C/ Dr. Aiguader 88, 08003, Barcelona, Spain.,RNA System Biology Lab, Department of Neuroscience and Brain Technologies, Istituto Italiano Di Tecnologia (IIT), Via Morego 30, 16163, Genoa, Italy.,Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Isabella Castiglioni
- Department of Physics "Giuseppe Occhialini", University of Milan-Bicocca Piazza dell'Ateneo Nuovo, 1 - 20126, Milan, Italy
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Kostick-Quenet KM, Lang B, Dorfman N, Blumenthal-Barby JS. A Call for Behavioral Science in Embedded Bioethics. Perspect Biol Med 2022; 65:672-679. [PMID: 36468396 PMCID: PMC10203975 DOI: 10.1353/pbm.2022.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Bioethicists today are taking a greater role in the design and implementation of emerging technologies by "embedding" within the development teams and providing their direct guidance and recommendations. Ideally, these collaborations allow ethical considerations to be addressed in an active, iterative, and ongoing process through regular exchanges between ethicists and members of the technological development team. This article discusses a challenge to this embedded ethics approach-namely, that bioethical guidance, even if embraced by the development team in theory, is not easily actionable in situ. Many of the ethical problems at issue in emerging technologies are associated with preexisting structural, socioeconomic, and political factors, making compliance with ethical recommendations sometimes less a matter of choice and more a matter of feasibility. Moreover, incentive structures within these systemic factors maintain them against reform efforts. The authors recommend that embedded bioethicists utilize principles from behavioral science (such as behavioral economics) to better understand and account for these incentive structures so as to encourage the ethically responsible uptake of technological innovations.
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Guo C, Reuss D, Coey JD, Sukumar S, Lang B, McLauchlan J, Boulant S, Stanifer ML, Bamford CGG. Conserved Induction of Distinct Antiviral Signalling Kinetics by Primate Interferon Lambda 4 Proteins. Front Immunol 2021; 12:772588. [PMID: 34868037 PMCID: PMC8636442 DOI: 10.3389/fimmu.2021.772588] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/18/2021] [Indexed: 11/23/2022] Open
Abstract
Interferon lambdas (IFNλ) (also known as type III IFNs) are critical cytokines that combat infection predominantly at barrier tissues, such as the lung, liver, and gastrointestinal tract. Humans have four IFNλs (1–4), where IFNλ1–3 show ~80%–95% homology, and IFNλ4 is the most divergent displaying only ~30% sequence identity. Variants in IFNλ4 in humans are associated with the outcome of infection, such as with hepatitis C virus. However, how IFNλ4 variants impact cytokine signalling in other tissues and how well this is conserved is largely unknown. In this study, we address whether differences in antiviral signalling exist between IFNλ4 variants in human hepatocyte and intestinal cells, comparing them to IFNλ3. We demonstrate that compared to IFNλ3, wild-type human IFNλ4 induces a signalling response with distinct magnitudes and kinetics, which is modified by naturally occurring variants P70S and K154E in both cell types. IFNλ4’s distinct antiviral response was more rapid yet transient compared to IFNλ1 and 3. Additionally, divergent antiviral kinetics were also observed using non-human primate IFNλs and cell lines. Furthermore, an IFNλ4-like receptor-interacting interface failed to alter IFNλ1’s kinetics. Together, our data provide further evidence that major functional differences exist within the IFNλ gene family. These results highlight the possible tissue specialisation of IFNλs and encourage further investigation of the divergent, non-redundant activities of IFNλ4 and other IFNλs.
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Affiliation(s)
- Cuncai Guo
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dorothee Reuss
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Jonathon D Coey
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
| | - Swathi Sukumar
- Institute of Virology, University of Münster, Münster, Germany
| | - Benjamin Lang
- Exzellenzcluster Science of Intelligence, Technische Universität Berlin, Berlin, Germany
| | - John McLauchlan
- Medical Research Council University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, United Kingdom
| | - Steeve Boulant
- Department of Infectious Diseases, Virology, University Hospital Heidelberg, Heidelberg, Germany.,Research Group "Cellular Polarity and Viral Infection", German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Megan L Stanifer
- Department of Molecular Genetics and Microbiology, College of Medicine, University of Florida, Gainesville, FL, United States.,Department of Infectious Diseases, Molecular Virology, University Hospital Heidelberg, Heidelberg, Germany
| | - Connor G G Bamford
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
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Kavanagh FG, James DL, Brinkman D, Cornyn S, Murphy C, O'Neill S, O'Shea R, Affendi A, Lang B, O'Connor A, Keogh I, Lang E, Russell J, O'Brien D, Sheahan P. Safety of elective paediatric surgery during the coronavirus disease 2019 pandemic. Int J Pediatr Otorhinolaryngol 2021; 150:110861. [PMID: 34583300 PMCID: PMC8349430 DOI: 10.1016/j.ijporl.2021.110861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/12/2021] [Accepted: 07/27/2021] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Corona-virus Disease 2019 (COVID-19) has had a huge impact on the delivery of healthcare worldwide, particularly elective surgery. There is a lack of data regarding risk of postoperative COVID-19 infection in children undergoing elective surgery, and regarding the utility of pre-operative COVID-19 testing, and preoperative "cocooning" or restriction of movements. The purpose of this present study was to examine the safety of elective paediatric Otolaryngology surgery during the COVID-19 pandemic with respect to incidence of postoperative symptomatic COVID-19 infection or major respiratory complications. MATERIALS AND METHODS Prospective cohort study of paediatric patients undergoing elective Otolaryngology surgery between September and December 2020. Primary outcome measure was incidence of symptomatic COVID-19 or major respiratory complications within the 14 days after surgery. Parents of prospectively enrolled patients were contacted 14 days after surgery and enquiry made regarding development of postoperative symptoms, COVID-19 testing, or diagnosis of COVID-19. RESULTS 302 patients were recruited. 125 (41.4%) underwent preoperative COVID-19 RT-PCR testing. 66 (21.8%) restricted movements prior to surgery. The peak 14-day COVID-19 incidence during the study was 302.9 cases per 100,000 population. No COVID-19 infections or major respiratory complications were reported in the 14 day follow-up period. CONCLUSION The results of our study support the safety of elective paediatric Otolaryngology surgery during the pandemic, in the setting of community incidence not exceeding that observed during the study period.
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Affiliation(s)
- F G Kavanagh
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland; Institute of Research, Royal College of Surgeons in Ireland, 121 St. Stephens Green, Dublin, Ireland.
| | - D L James
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland
| | - D Brinkman
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Waterford, Waterford, Ireland
| | - S Cornyn
- Department of Otolaryngology, Children's Health Ireland @ Temple Street, Temple Street, Dublin 1, Ireland
| | - C Murphy
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Ireland
| | - S O'Neill
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Ireland
| | - R O'Shea
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland
| | - A Affendi
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland
| | - B Lang
- Department of Otolaryngology, Children's Health Ireland @ Crumlin, Cooley Road, Dublin 12, Ireland
| | - A O'Connor
- Department of Otolaryngology, Children's Health Ireland @ Temple Street, Temple Street, Dublin 1, Ireland
| | - I Keogh
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Ireland
| | - E Lang
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Waterford, Waterford, Ireland
| | - J Russell
- Department of Otolaryngology, Children's Health Ireland @ Crumlin, Cooley Road, Dublin 12, Ireland
| | - D O'Brien
- Department of Microbiology, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland
| | - P Sheahan
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Old Blackrock Road, Cork, Ireland; ENTO Research Unit, College of Medicine and Health, University College Cork, College Road, Cork, Ireland; Department of Surgery, University College Cork, College Road, Cork, Ireland
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Kavanagh FG, Brinkman D, James DL, O’Neill S, Murphy C, O’Riordan I, O’Flanagan G, Lang B, Keogh I, Lang E, Casserly P, Russell J, O’Brien D, Sheahan P. Outcomes of preoperative real-time polymerase chain reaction testing for SARS CoV-2 in elective otolaryngology surgical patients during the pandemic: a prospective cohort study. Br J Surg 2021; 108:znab266. [PMID: 34426824 PMCID: PMC8499765 DOI: 10.1093/bjs/znab266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/22/2021] [Indexed: 11/29/2022]
Abstract
Real-time polymerase chain reaction (RT-PCR) is used to rule out SARS-CoV-2 prior to surgery, however few studies have evaluated patients with negative testing after surgery. Some 499 patients with negative tests were followed for 14 days after surgery, 39 were retested but none developed positive RT-PCR after operation. The risk of developing a positive RT-PCR after surgery was 0.74 per cent.
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Affiliation(s)
- F G Kavanagh
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Republic of Ireland
- Institute of Research, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland
| | - D Brinkman
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Waterford, Waterford, Republic of Ireland
| | - D L James
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Republic of Ireland
| | - S O’Neill
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Republic of Ireland
| | - C Murphy
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Republic of Ireland
| | - I O’Riordan
- Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Republic of Ireland
| | - G O’Flanagan
- Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Republic of Ireland
| | - B Lang
- Department of Otolaryngology, Children’s Health Ireland @ Crumlin, Dublin, Republic of Ireland
| | - I Keogh
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Republic of Ireland
| | - E Lang
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Waterford, Waterford, Republic of Ireland
| | - P Casserly
- Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Republic of Ireland
| | - J Russell
- Department of Otolaryngology, Children’s Health Ireland @ Crumlin, Dublin, Republic of Ireland
| | - D O’Brien
- Department of Microbiology, South Infirmary Victoria University Hospital, Cork, Republic of Ireland
| | | | - P Sheahan
- Department of Otolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Republic of Ireland
- ENTO Research Unit, College of Medicine and Health, University College Cork, Cork, Republic of Ireland
- Department of Surgery, University College Cork, Cork, Republic of Ireland
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Lang B, Yang JS, Garriga-Canut M, Speroni S, Aschern M, Gili M, Hoffmann T, Tartaglia GG, Maurer SP. Matrix-screening reveals a vast potential for direct protein-protein interactions among RNA binding proteins. Nucleic Acids Res 2021; 49:6702-6721. [PMID: 34133714 PMCID: PMC8266617 DOI: 10.1093/nar/gkab490] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/23/2021] [Accepted: 05/20/2021] [Indexed: 01/02/2023] Open
Abstract
RNA-binding proteins (RBPs) are crucial factors of post-transcriptional gene regulation and their modes of action are intensely investigated. At the center of attention are RNA motifs that guide where RBPs bind. However, sequence motifs are often poor predictors of RBP-RNA interactions in vivo. It is hence believed that many RBPs recognize RNAs as complexes, to increase specificity and regulatory possibilities. To probe the potential for complex formation among RBPs, we assembled a library of 978 mammalian RBPs and used rec-Y2H matrix screening to detect direct interactions between RBPs, sampling > 600 K interactions. We discovered 1994 new interactions and demonstrate that interacting RBPs bind RNAs adjacently in vivo. We further find that the mRNA binding region and motif preferences of RBPs deviate, depending on their adjacently binding interaction partners. Finally, we reveal novel RBP interaction networks among major RNA processing steps and show that splicing impairing RBP mutations observed in cancer rewire spliceosomal interaction networks. The dataset we provide will be a valuable resource for understanding the combinatorial interactions of RBPs with RNAs and the resulting regulatory outcomes.
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Affiliation(s)
- Benjamin Lang
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology (BIST), Doctor Aiguader 88, Barcelona 08003, Spain.,Department of Structural Biology and Center of Excellence for Data-Driven Discovery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Jae-Seong Yang
- Centre de Recerca en Agrigenòmica, Consortium CSIC-IRTA-UAB-UB (CRAG), Cerdanyola del Vallès, 08193 Barcelona, Spain
| | - Mireia Garriga-Canut
- Division of Engineering, New York University Abu Dhabi (NYUAD), Abu Dhabi 129188, UAE
| | - Silvia Speroni
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology (BIST), Doctor Aiguader 88, Barcelona 08003, Spain
| | - Moritz Aschern
- Centre de Recerca en Agrigenòmica, Consortium CSIC-IRTA-UAB-UB (CRAG), Cerdanyola del Vallès, 08193 Barcelona, Spain
| | - Maria Gili
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology (BIST), Doctor Aiguader 88, Barcelona 08003, Spain
| | - Tobias Hoffmann
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology (BIST), Doctor Aiguader 88, Barcelona 08003, Spain
| | - Gian Gaetano Tartaglia
- Center for Human Technologies, Istituto Italiano di Tecnologia, Via Enrico Melen 83, 16152, Genoa, Italy.,Biology and Biotechnology Department "Charles Darwin", Sapienza University of Rome, P.le A. Moro 5, Rome 00185, Italy
| | - Sebastian P Maurer
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology (BIST), Doctor Aiguader 88, Barcelona 08003, Spain.,Universitat Pompeu Fabra (UPF), Department of Experimental and Health Sciences, Barcelona, Spain
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Affiliation(s)
- Benjamin Lang
- Department of Structural Biology and the Center for Data Driven Discovery, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - M Madan Babu
- Department of Structural Biology and the Center for Data Driven Discovery, St. Jude Children's Research Hospital, Memphis, TN, USA.
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Lang B. Concerning a seemingly intractable feature of the accountability gap. J Med Ethics 2021:medethics-2021-107353. [PMID: 33827908 DOI: 10.1136/medethics-2021-107353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Benjamin Lang
- Bioethics, New York University College of Global Public Health, New York, NY 10039, USA
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Macho Rendón J, Lang B, Ramos Llorens M, Gaetano Tartaglia G, Torrent Burgas M. DualSeqDB: the host-pathogen dual RNA sequencing database for infection processes. Nucleic Acids Res 2021; 49:D687-D693. [PMID: 33084904 PMCID: PMC7779005 DOI: 10.1093/nar/gkaa890] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 12/30/2022] Open
Abstract
Despite antibiotic resistance being a matter of growing concern worldwide, the bacterial mechanisms of pathogenesis remain underexplored, restraining our ability to develop new antimicrobials. The rise of high-throughput sequencing technology has made available a massive amount of transcriptomic data that could help elucidate the mechanisms underlying bacterial infection. Here, we introduce the DualSeqDB database, a resource that helps the identification of gene transcriptional changes in both pathogenic bacteria and their natural hosts upon infection. DualSeqDB comprises nearly 300 000 entries from eight different studies, with information on bacterial and host differential gene expression under in vivo and in vitro conditions. Expression data values were calculated entirely from raw data and analyzed through a standardized pipeline to ensure consistency between different studies. It includes information on seven different strains of pathogenic bacteria and a variety of cell types and tissues in Homo sapiens, Mus musculus and Macaca fascicularis at different time points. We envisage that DualSeqDB can help the research community in the systematic characterization of genes involved in host infection and help the development and tailoring of new molecules against infectious diseases. DualSeqDB is freely available at http://www.tartaglialab.com/dualseq.
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Affiliation(s)
- Javier Macho Rendón
- Systems Biology of Infection Lab, Department of Biochemistry and Molecular Biology, Biosciences Faculty, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
| | - Benjamin Lang
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain.,Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Marc Ramos Llorens
- Systems Biology of Infection Lab, Department of Biochemistry and Molecular Biology, Biosciences Faculty, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
| | - Gian Gaetano Tartaglia
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain.,Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genoa, Italy.,Department of Biology 'Charles Darwin', Sapienza University of Rome, Ple A. Moro 5, 00185 Rome, Italy
| | - Marc Torrent Burgas
- Systems Biology of Infection Lab, Department of Biochemistry and Molecular Biology, Biosciences Faculty, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
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Hintze JM, Fitzgerald C, Lang B, O'Shea J, Barry C, Brennan S, Lennon P. Tracheostomy stomal seeding following oral cavity resection. Oral Oncol 2020; 115:105097. [PMID: 33229202 DOI: 10.1016/j.oraloncology.2020.105097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Tracheal stoma recurrence following oral cavity surgery is exceedingly rare. Although several different mechanisms for this have been described, the pathogenesis still remains uncertain. METHODS We present the case of a gentleman who presented 6-months following oral cavity SCC resection with a large fungating mass at his previous tracheostomy site, and also review the reported literature on this rare phenomenon. RESULTS Four weeks after diagnosis of his recurrence he underwent a total laryngectomy, wide-local skin excision and reconstruction with a pectoralis major pedicled flap. He recovered well initially following his operation, however unfortunately contracted nosocomial SARS-Cov2 and succumbed from respiratory complications during his post-operative recovery. CONCLUSION Stomal recurrence after temporary tracheostomy for oral cavity malignancies are very rare. Previously reported management of these can vary from surgical to palliative treatment. Methods to prevent these include delaying tracheostomy until after surgical resection, packing the pharynx during resection and adjuvant radiotherapy.
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Affiliation(s)
- J M Hintze
- Department of Otolaryngology - Head and Neck Surgery, St James Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Ireland; Trinity College, University of Dublin, Dublin, Ireland.
| | - C Fitzgerald
- Department of Otolaryngology - Head and Neck Surgery, St James Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Ireland; Trinity College, University of Dublin, Dublin, Ireland
| | - B Lang
- Department of Otolaryngology - Head and Neck Surgery, St James Hospital, Dublin, Ireland; Royal College of Surgeons in Ireland, Ireland; Trinity College, University of Dublin, Dublin, Ireland
| | - J O'Shea
- Trinity College, University of Dublin, Dublin, Ireland; Department of Radiation Oncology, St James Hospital, Dublin, Ireland
| | - C Barry
- Royal College of Surgeons in Ireland, Ireland; Trinity College, University of Dublin, Dublin, Ireland; Department of Maxillofacial Surgery, St James Hospital, Dublin, Ireland
| | - S Brennan
- Trinity College, University of Dublin, Dublin, Ireland; Department of Radiation Oncology, St James Hospital, Dublin, Ireland
| | - P Lennon
- Department of Otolaryngology - Head and Neck Surgery, St James Hospital, Dublin, Ireland; Trinity College, University of Dublin, Dublin, Ireland
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Conrad T, Ntini E, Lang B, Cozzuto L, Andersen JB, Marquardt JU, Ponomarenko J, Tartaglia GG, Vang Ørom UA. Determination of primary microRNA processing in clinical samples by targeted pri-miR-sequencing. RNA 2020; 26:1726-1730. [PMID: 32669295 PMCID: PMC7566579 DOI: 10.1261/rna.076240.120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/11/2020] [Indexed: 06/11/2023]
Abstract
MicroRNA expression is important for gene regulation and deregulated microRNA expression is often observed in diseases such as cancer. The processing of primary microRNA transcripts is an important regulatory step in microRNA biogenesis. Due to low expression level and association with chromatin, primary microRNAs are challenging to study in clinical samples where input material is limited. Here, we present a high-sensitivity targeted method to determine processing efficiency of several hundred primary microRNAs from total RNA that requires relatively few RNA sequencing reads. We validate the method using RNA from HeLa cells and show the applicability to clinical samples by analyzing RNA from normal liver and hepatocellular carcinoma. We identify 24 primary microRNAs with significant changes in processing efficiency from normal liver to hepatocellular carcinoma, among those the highly expressed miRNA-122 and miRNA-21, demonstrating that differential processing of primary microRNAs is occurring and could be involved in disease. With our method presented here we provide means to study pri-miRNA processing in disease from clinical samples.
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Affiliation(s)
- Thomas Conrad
- Berlin Institute for Medical Systems Biology, 10115 Berlin, Germany
| | - Evgenia Ntini
- Max Planck Institute for Molecular Genetic, 14195 Berlin, Germany
| | - Benjamin Lang
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, 08003 Barcelona, Spain
| | - Luca Cozzuto
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, 08003 Barcelona, Spain
| | - Jesper B Andersen
- Biotech Research and Innovation Centre (BRIC), Department of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | | | - Julia Ponomarenko
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, 08003 Barcelona, Spain
- University Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Gian Gaetano Tartaglia
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, 08003 Barcelona, Spain
- University Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Ulf A Vang Ørom
- Aarhus University, Department of Molecular Biology and Genetics, 8000 Aarhus, Denmark
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Wolfsegger MJ, Bauer A, Labes D, Schütz H, Vonk R, Lang B, Lehr S, Jaki TF, Engl W, Hale MD. Assessing goodness-of-fit for evaluation of dose-proportionality. Pharm Stat 2020; 20:272-281. [PMID: 33063443 DOI: 10.1002/pst.2074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/31/2020] [Accepted: 09/14/2020] [Indexed: 11/11/2022]
Abstract
For the clinical development of a new drug, the determination of dose-proportionality is an essential part of the pharmacokinetic evaluations, which may provide early indications of non-linear pharmacokinetics and may help to identify sub-populations with divergent clearances. Prior to making any conclusions regarding dose-proportionality, the goodness-of-fit of the model must be assessed to evaluate the model performance. We propose the use of simulation-based visual predictive checks to improve the validity of dose-proportionality conclusions for complex designs. We provide an illustrative example and include a table to facilitate review by regulatory authorities.
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Affiliation(s)
| | | | | | - Helmut Schütz
- BEBAC - Consultancy Services for Bioequivalence and Bioavailability Studies, Vienna, Austria
| | | | - Benjamin Lang
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
| | - Stephan Lehr
- Austrian Medicines and Medical Devices Agency, Wien, Austria
| | - Thomas F Jaki
- Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
| | - Werner Engl
- Baxalta Innovations GmbH, a Takeda company, Vienna, Austria
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Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 emerged in December 2019 in Wuhan, China, and was declared a global health emergency of international concern by the World Health Organization on 30th January 2020. It has resulted in almost 600 000 deaths to date worldwide. Sudden sensorineural hearing loss is a known complication of a number of viral infections, but there is little in the literature to date on its association with coronavirus disease 2019. CASE REPORT This paper presents the case of a 30-year-old female staff nurse who contracted coronavirus disease 2019 and presented to our department with a significant unilateral sensorineural hearing loss confirmed on audiogram. She was treated with a course of oral steroids, but unfortunately there was no improvement in her hearing. CONCLUSION This case report is important as it highlights the importance of having a low index of suspicion when patients present with a variety of symptoms not previously associated with coronavirus disease 2019. The paper also discusses the controversy surrounding the use of steroids in the management of this disease.
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Affiliation(s)
- B Lang
- Department of Otorhinolaryngology and Head and Neck Surgery, St James University Hospital, Dublin, Ireland
| | - J Hintze
- Department of Otorhinolaryngology and Head and Neck Surgery, St James University Hospital, Dublin, Ireland
| | - B Conlon
- Department of Otorhinolaryngology and Head and Neck Surgery, St James University Hospital, Dublin, Ireland
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Carvajal-González A, Jacobson L, Clover L, Wickremaratchi M, Shields S, Lang B, Vincent A. Systemic delivery of human GlyR IgG antibody induces GlyR internalization into motor neurons of brainstem and spinal cord with motor dysfunction in mice. Neuropathol Appl Neurobiol 2020; 47:316-327. [PMID: 32910464 PMCID: PMC7873718 DOI: 10.1111/nan.12666] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/05/2020] [Accepted: 08/22/2020] [Indexed: 01/24/2023]
Abstract
Aims Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a life‐threatening condition often associated with highly raised serum antibodies to glycine receptors (GlyRs); these bind to the surface of large neurons and interneurons in rodent brain and spinal cord sections and, in vitro, inhibit function and reduce surface expression of the GlyRs. The effects in vivo have not been reported. Methods Purified plasma IgG from a GlyR antibody‐positive patient with PERM, and a healthy control (HC), was injected daily into the peritoneal cavity of mice for 12 days; lipopolysaccharide (LPS) to open the blood–brain barrier, was injected on days 3 and 8. Based on preliminary data, behavioural tests were only performed 48 h post‐LPS on days 5–7 and 10–12. Results The GlyR IgG injected mice showed impaired ability on the rotarod from days 5 to 10 but this normalized by day 12. There were no other behavioural differences but, at termination (d13), the GlyR IgG‐injected mice had IgG deposits on the neurons that express GlyRs in the brainstem and spinal cord. The IgG was not only on the surface but also inside these large GlyR expressing neurons, which continued to express surface GlyR. Conclusions Despite the partial clinical phenotype, not uncommon in passive transfer studies, the results suggest that the antibodies had accessed the GlyRs in relevant brain regions, led to antibody‐mediated internalization and increased GlyR synthesis, compatible with the temporary loss of function.
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Affiliation(s)
- A Carvajal-González
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - L Jacobson
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - L Clover
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - M Wickremaratchi
- Hurstwood Park Neurological Centre, Brighton and Sussex University Hospitals NHS Trust, West Sussex, UK
| | - S Shields
- Neurosciences Department, Taunton and Somerset NS Foundation Trust, Musgrove Park Hospital, Taunton, UK
| | - B Lang
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - A Vincent
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
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Sohn AJ, Lang B, McCarroll M, Agarwal A. Primary pulmonary Ewing sarcoma/peripheral primitive neuroectodermal tumor. Proc AMIA Symp 2020; 33:646-648. [PMID: 33149376 PMCID: PMC7590833 DOI: 10.1080/08998280.2020.1798723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/06/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022] Open
Abstract
Ewing sarcoma/peripheral primitive neuroectodermal tumor (ES/pPNET) is a malignant small round cell sarcoma commonly occurring among children, adolescents, and adults. We report a rare case of ES/pPNET arising from the lung in a 49-year-old woman. She was found to have a mass in the right lung on a screening imaging study for her BRCA2 mutation. A lobectomy was performed and the mass had histological, immunohistochemical, and molecular features of ES/pPNET. Few cases of primary pulmonary Ewing sarcoma have been reported.
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Affiliation(s)
- Aaron J. Sohn
- Department of Pathology, Baylor University Medical Center, Dallas, Texas
| | - Benjamin Lang
- Department of Pathology, Baylor University Medical Center, Dallas, Texas
| | - Michael McCarroll
- Department of Radiology, Baylor University Medical Center, Dallas, Texas
| | - Atin Agarwal
- Department of Pathology, Baylor University Medical Center, Dallas, Texas
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Shubin C, Iyer S, Pearce J, Lang B, Gross I, Ciener D, Mazor S, Keilman A, Thomas A. Pediatric Emergency Medicine Didactics and Simulation (PEMDAS): Serotonin Syndrome. MedEdPORTAL 2020; 16:10928. [PMID: 32733995 PMCID: PMC7385927 DOI: 10.15766/mep_2374-8265.10928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 01/10/2020] [Indexed: 05/28/2023]
Abstract
Introduction Serotonin syndrome is caused by an accumulation of serotonin in the body from drug interactions or overdose of serotonergic medications, including commonly used antidepressants. Symptoms can be life-threatening and encompass both neurologic and cardiovascular toxicity, including agitation, seizure, tachycardia, rhabdomyolysis, and hyperthermia. Methods This simulation case was developed for pediatric emergency medicine fellows and emergency medicine residents in the pediatric emergency department and can be altered to accommodate other learners. The case involved a 16-year-old male, represented by a low- or high-fidelity manikin, who presented with altered mental status/agitation after an overdose of antidepressant medication. The team of learners was required to perform a primary and a secondary assessment; manage airway, breathing, and circulation; and recognize and initiate treatment for serotonin syndrome. The patient had a seizure resulting in airway compromise requiring advanced airway support, as well as developed rhabdomyolysis requiring aggressive fluid hydration. We created a debriefing guide and a participant evaluation form. Results Fifty-seven participants across five institutions completed this simulation, which included residents, fellows, faculty, and students. The scenario was rated by participants using a 5-point Likert scale and was generally well received. Participants rated the simulation case as effective in learning how to both recognize (M = 4.9) and manage (M = 4.8) serotonin syndrome. Discussion This pediatric emergency simulation scenario can be tailored for a range of learner backgrounds and simulation environments. We used the participant evaluation form to improve future iterations of the simulation.
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Affiliation(s)
- Corinne Shubin
- Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine and Seattle Children's Hospital
| | - Shweta Iyer
- Assistant Professor, Pediatrics and Emergency Medicine, Weill Cornell Medical College
| | - Jean Pearce
- Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, Medical College of Wisconsin
| | - Benjamin Lang
- Pediatrics Resident, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital
| | - Isabel Gross
- Clinical Instructor, Department of Pediatrics, Division of Emergency Medicine, Yale University School of Medicine and Yale New Haven Children's Hospital
| | - Daisy Ciener
- Assistant Professor, Clinical Pediatrics, Division of Pediatric Emergency Medicine, Vanderbilt University Medical Center
| | - Suzan Mazor
- Director of Pediatric Toxicology, University of Washington School of Medicine and Seattle Children's Hospital; Associate Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine and Seattle Children's Hospital
| | - Ashley Keilman
- Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine and Seattle Children's Hospital
| | - Anita Thomas
- Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine and Seattle Children's Hospital
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Breitegger P, Schweighofer B, Wegleiter H, Knoll M, Lang B, Bergmann A. Towards low-cost QEPAS sensors for nitrogen dioxide detection. Photoacoustics 2020; 18:100169. [PMID: 32309133 PMCID: PMC7155225 DOI: 10.1016/j.pacs.2020.100169] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 01/07/2020] [Accepted: 01/14/2020] [Indexed: 05/09/2023]
Abstract
Increasing awareness of the adverse health effects of air pollution leads to a demand of low-cost sensors for the measurement of pollutants such as NO2. However, commercially available low-cost sensors lack accuracy and long-term stability, and suffer from cross-sensitivity to other gases. These drawbacks can be overcome by the method of quartz-enhanced photoacoustic spectroscopy (QEPAS). In QEPAS modulated light is absorbed by the NO2 molecules, which results in the production of a sound wave. The sound wave is detected by resonance of a quartz tuning fork, which results in a measurable electric signal. Due to the small size of the tuning forks, the gas sensing element can be smaller than 1 cm3. We present the first bare fork QEPAS setup for the ppb-level detection of NO2, which is ideally suited for environmental trace gas detection without the need of using micro-resonators. Micro-resonators are commonly used to amplify photoacoustic signals. However, micro-resonators have different dependencies on environmental conditions than tuning forks, which makes them difficult to operate in changing conditions. In contrast, our bare fork QEPAS setup is more robust and easily adopted by the use of a low-cost temperature and humidity sensor. By using acoustic filters the integration time could be increased to offer higher sensitivity at a continuous flow rate of 200 std cm3 min-1. The 1σ noise equivalent concentration is determined to 21 ppb NO2 in synthetic air for 120 s measurement time, allowing detection which satisfies international health and safety standards thresholds.
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Affiliation(s)
- P Breitegger
- Institute of Electrical Measurement and Sensor Systems, Graz University of Technology, 8010 Graz, Austria
| | - B Schweighofer
- Institute of Electrical Measurement and Sensor Systems, Graz University of Technology, 8010 Graz, Austria
| | - H Wegleiter
- Institute of Electrical Measurement and Sensor Systems, Graz University of Technology, 8010 Graz, Austria
| | - M Knoll
- Institute of Electrical Measurement and Sensor Systems, Graz University of Technology, 8010 Graz, Austria
| | - B Lang
- Institute of Electrical Measurement and Sensor Systems, Graz University of Technology, 8010 Graz, Austria
| | - A Bergmann
- Institute of Electrical Measurement and Sensor Systems, Graz University of Technology, 8010 Graz, Austria
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Rendón JM, Lang B, Tartaglia GG, Burgas MT. BacFITBase: a database to assess the relevance of bacterial genes during host infection. Nucleic Acids Res 2020; 48:D511-D516. [PMID: 31665505 PMCID: PMC7145566 DOI: 10.1093/nar/gkz931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 08/15/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 11/24/2022] Open
Abstract
Bacterial infections have been on the rise world-wide in recent years and have a considerable impact on human well-being in terms of attributable deaths and disability-adjusted life years. Yet many mechanisms underlying bacterial pathogenesis are still poorly understood. Here, we introduce the BacFITBase database for the systematic characterization of bacterial proteins relevant for host infection aimed to enable the identification of new antibiotic targets. BacFITBase is manually curated and contains more than 90 000 entries with information on the contribution of individual genes to bacterial fitness under in vivo infection conditions in a range of host species. The data were collected from 15 different studies in which transposon mutagenesis was performed, including top-priority pathogens such as Acinetobacter baumannii and Campylobacter jejuni, for both of which increasing antibiotic resistance has been reported. Overall, BacFITBase includes information on 15 pathogenic bacteria and 5 host vertebrates across 10 different tissues. It is freely available at www.tartaglialab.com/bacfitbase.
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Affiliation(s)
- Javier Macho Rendón
- Systems Biology of Infection Lab, Department of Biochemistry and Molecular Biology, Biosciences Faculty, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
| | - Benjamin Lang
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Gian Gaetano Tartaglia
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain.,ICREA, 23 Passeig Lluis Companys 08010 and Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain.,Department of Biology 'Charles Darwin', Sapienza University of Rome, P.le A. Moro 5, Rome 00185, Italy.,Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genoa, Italy
| | - Marc Torrent Burgas
- Systems Biology of Infection Lab, Department of Biochemistry and Molecular Biology, Biosciences Faculty, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Spain
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Lang B, Armaos A, Tartaglia GG. RNAct: Protein-RNA interaction predictions for model organisms with supporting experimental data. Nucleic Acids Res 2020; 47:D601-D606. [PMID: 30445601 PMCID: PMC6324028 DOI: 10.1093/nar/gky967] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [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: 08/15/2018] [Accepted: 10/11/2018] [Indexed: 01/15/2023] Open
Abstract
Protein-RNA interactions are implicated in a number of physiological roles as well as diseases, with molecular mechanisms ranging from defects in RNA splicing, localization and translation to the formation of aggregates. Currently, ∼1400 human proteins have experimental evidence of RNA-binding activity. However, only ∼250 of these proteins currently have experimental data on their target RNAs from various sequencing-based methods such as eCLIP. To bridge this gap, we used an established, computationally expensive protein-RNA interaction prediction method, catRAPID, to populate a large database, RNAct. RNAct allows easy lookup of known and predicted interactions and enables global views of the human, mouse and yeast protein-RNA interactomes, expanding them in a genome-wide manner far beyond experimental data (http://rnact.crg.eu).
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Affiliation(s)
- Benjamin Lang
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona 08003, Spain
| | - Alexandros Armaos
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona 08003, Spain
| | - Gian G Tartaglia
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona 08003, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), 23 Passeig Lluís Companys, Barcelona 08010, Spain.,Universitat Pompeu Fabra (UPF), Department of Experimental and Health Sciences, Barcelona 08003, Spain.,Department of Biology 'Charles Darwin', Sapienza University of Rome, P.le A. Moro 5, Rome 00185, Italy
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Lingvay I, Beetz N, Sennewald R, Schuler-Metz A, Bertulis J, Loley C, Lang B, Lippert C, Lee J, Manning LS, Terada D. Triple fixed-dose combination empagliflozin, linagliptin, and metformin for patients with type 2 diabetes. Postgrad Med 2020; 132:337-345. [PMID: 32366156 DOI: 10.1080/00325481.2020.1750228] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Fixed-dose combination (FDC) therapy can improve outcomes in type 2 diabetes (T2D). We evaluated the bioequivalence of 2 doses of an FDC of extended-release metformin (metformin XR), empagliflozin, a sodium-glucose co-transporter 2 inhibitor, and linagliptin, a dipeptidyl peptidase-4 inhibitor, versus corresponding free tablet combinations. METHODS Two randomized, open-label, two-way crossover studies in healthy adults compared: 2 FDC tablets of empagliflozin 5 mg/linagliptin 2.5 mg/metformin XR 1000 mg (Study 1; N = 30), 1 FDC tablet of empagliflozin 25 mg/linagliptin 5 mg/metformin XR 1000 mg (Study 2; N = 30) versus corresponding dose of free combinations. Subjects received study medication under fed conditions; washout was ≥35 days between treatments. Primary endpoints: area under the plasma concentration-time curve (AUC) from time 0 to last quantifiable data point for empagliflozin and metformin; AUC from time 0 to 72 hours for linagliptin, and peak plasma concentration (Cmax) for empagliflozin, linagliptin, and metformin. Bioequivalence was defined as adjusted geometric mean ratios (FDC: free combination) and two-sided 90% confidence intervals (CIs) of AUC and Cmax for each component within 80.00-125.00%. RESULTS Study 1: 27/29 and 28/30 treated participants were included in the pharmacokinetic analysis for the FDC and free combination periods, respectively. Study 2: 29/29 treated participants were included in the pharmacokinetic analysis for both periods. The adjusted geometric mean ratios of FDCs to their respective free tablet combinations and two-sided 90% CIs were all within the predefined range. The shapes of the mean plasma concentration-time profile of empagliflozin, linagliptin, and metformin XR were similar for subjects in the FDC and free combination groups in both studies. No serious adverse events were reported. CONCLUSION The evaluated doses of empagliflozin/linagliptin/metformin XR FDC tablets were bioequivalent to the corresponding free combinations. Based on these two bioequivalence studies and existing phase 3 data, the FDA has recently approved this triple FDC to improve glycemic control in adults with T2D.
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Affiliation(s)
- Ildiko Lingvay
- Department of Internal Medicine/Endocrinology and Department of Population and Data Sciences, UT Southwestern Medical Center , Dallas, TX, USA
| | - Nadine Beetz
- Global Clinical Operations, Early Trials, Boehringer Ingelheim Pharma GmbH & Co. KG , Biberach an der Riß, Germany
| | - Regina Sennewald
- Global Clinical Operations, Early Trials, Boehringer Ingelheim Pharma GmbH & Co. KG , Biberach an der Riß, Germany
| | - Annette Schuler-Metz
- Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH & Co. KG , Biberach an der Riß, Germany
| | - Julia Bertulis
- Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH & Co. KG , Biberach an der Riß, Germany
| | - Christina Loley
- Biostatistics and Data Sciences, Clinical Statistics, Boehringer Ingelheim Pharma GmbH & Co. KG , Biberach an der Riß, Germany
| | - Benjamin Lang
- Biostatistics and Data Sciences, Clinical Statistics, Boehringer Ingelheim Pharma GmbH & Co. KG , Biberach an der Riß, Germany
| | - Caroline Lippert
- Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH & Co. KG , Biberach an der Riß, Germany
| | - Jisoo Lee
- Clinical Development & Cardiometabolism and Respiratory Medicine, Boehringer Ingelheim International GmbH , Ingelheim, Germany
| | - Linda Shapiro Manning
- Clinical Development & Medical Affairs - Cardiometabolism, Boehringer Ingelheim Pharmaceuticals Inc , Ridgefield, CT, USA
| | - Derek Terada
- Clinical Development & Medical Affairs - Cardiometabolism, Boehringer Ingelheim Pharmaceuticals Inc , Ridgefield, CT, USA
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Cid-Samper F, Gelabert-Baldrich M, Lang B, Lorenzo-Gotor N, Ponti RD, Severijnen LAWFM, Bolognesi B, Gelpi E, Hukema RK, Botta-Orfila T, Tartaglia GG. An Integrative Study of Protein-RNA Condensates Identifies Scaffolding RNAs and Reveals Players in Fragile X-Associated Tremor/Ataxia Syndrome. Cell Rep 2019; 25:3422-3434.e7. [PMID: 30566867 PMCID: PMC6315285 DOI: 10.1016/j.celrep.2018.11.076] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/26/2018] [Accepted: 11/19/2018] [Indexed: 12/21/2022] Open
Abstract
Recent evidence indicates that specific RNAs promote the formation of ribonucleoprotein condensates by acting as scaffolds for RNA-binding proteins (RBPs). We systematically investigated RNA-RBP interaction networks to understand ribonucleoprotein assembly. We found that highly contacted RNAs are structured, have long UTRs, and contain nucleotide repeat expansions. Among the RNAs with such properties, we identified the FMR1 3' UTR that harbors CGG expansions implicated in fragile X-associated tremor/ataxia syndrome (FXTAS). We studied FMR1 binding partners in silico and in vitro and prioritized the splicing regulator TRA2A for further characterization. In a FXTAS cellular model, we validated the TRA2A-FMR1 interaction and investigated implications of its sequestration at both transcriptomic and post-transcriptomic levels. We found that TRA2A co-aggregates with FMR1 in a FXTAS mouse model and in post-mortem human samples. Our integrative study identifies key components of ribonucleoprotein aggregates, providing links to neurodegenerative disease and allowing the discovery of therapeutic targets.
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Affiliation(s)
- Fernando Cid-Samper
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Mariona Gelabert-Baldrich
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Benjamin Lang
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Nieves Lorenzo-Gotor
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Riccardo Delli Ponti
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | | | - Benedetta Bolognesi
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Ellen Gelpi
- Neurological Tissue Biobank of the Hospital Clinic and Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer del Rosselló, 149, 08036, Barcelona, Spain; Institute of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Renate K Hukema
- Department of Clinical Genetics, Erasmus MC, 3000 CA Rotterdam, the Netherlands
| | - Teresa Botta-Orfila
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain.
| | - Gian Gaetano Tartaglia
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Dr. Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain; Department of Biology 'Charles Darwin', Sapienza University of Rome, P.le A. Moro 5, Rome 00185, Italy; Institució Catalana de Recerca i Estudis Avançats (ICREA), 23 Passeig Lluís Companys, 08010 Barcelona, Spain.
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Baum P, Visvanathan S, Bossert S, Lang B, Schmid R, Garcet S, Padula S, Bachelez H, Thoma C, Krueger J. LB1140 Treatment with BI 655130, an anti-interleukin-36 receptor antibody, in patients with generalized pustular psoriasis, is associated with the downregulation of biomarkers linked to innate, Th1/Th17, and neutrophilic pathways. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.06.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Baum P, Visvanathan S, Bossert S, Lang B, Schmid R, Garcet S, Padula S, Bachelez H, Thoma C, Krueger J. 388 Treatment with spesolimab, an anti-interleukin-36 receptor antibody, in patients with generalized pustular psoriasis, is associated with the downregulation of biomarkers linked to innate, Th1/17 and neutrophilic pathways. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Woods B, Lang B, Blayney C, O'Mahony L, Vander Tuig A, Rea T, Carlbom D, Sayre M, King M. Medic One Pediatric (MOPed) cards: standardising paramedic paediatric resuscitation. BMJ Open Qual 2019; 8:e000534. [PMID: 31523730 PMCID: PMC6711433 DOI: 10.1136/bmjoq-2018-000534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 04/22/2019] [Accepted: 07/24/2019] [Indexed: 11/04/2022] Open
Abstract
Objective Paediatric resuscitation is highly stressful, technically challenging and infrequently performed by paramedics. Length-based equipment selection, weight-based medication dosing and less familiar paediatric clinical scenarios create high cognitive load. Our project aimed to decrease cognitive load and increase paramedic comfort by providing standardised paediatric resuscitation cards across an entire Emergency Medical Services (EMS) system. Methods After 2 years of collaboration between EMS and regional paediatric subspecialists, we created and implemented a novel set of length-based, colour-coded cards: Medic One Pediatric (MOPed) cards. MOPed cards standardise the approach to paediatric scenarios, such as rapid sequence intubation (RSI), seizure management and cardiac arrest. We standardised drug concentrations across all five EMS agencies to allow for volume-based dosing, removing medication calculations, simplifying the process of medication administration and potentially decreasing both calculation error and time to intervention. We consolidated medications on MOPed cards to the 12 most commonly used in Paediatric Advanced Life Support scenarios. We surveyed 240 EMS personnel before and after implementation to determine use and effect on paramedic comfort. Results After 12 months of implementation, 97% of respondents reported using the new cards as their primary reference, and 94% reported improved speed and accuracy of medication administration. Specifically, RSI medication administration received the greatest improvement in comfort (p=0.001). Additionally, paramedics increased the use of MOPed cards when selecting endotracheal tubes: 45% of the respondents had done so by 6 months, and 60% had done so after 12 months of implementation (p=0.01). Conclusions MOPed cards were well adopted across a large EMS system, with improvement in paramedic comfort in managing some paediatric resuscitation scenarios.
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Affiliation(s)
- Brandon Woods
- Pediatric Critical Care, Seattle Children's Hospital, Seattle, Washington, USA
| | - Benjamin Lang
- Pediatrics, Seattle Children's Hospital, Seattle, Washington, USA.,Pediatrics, Harborview Medical Center, Seattle, Washington, USA
| | - Carolyn Blayney
- Pediatrics, Harborview Medical Center, Seattle, Washington, USA
| | - Lila O'Mahony
- Pediatric Critical Care, Seattle Children's Hospital, Seattle, Washington, USA
| | | | - Tom Rea
- Emergency Medicine, Harborview Medical Center, Seattle, Washington, USA
| | - David Carlbom
- Critical Care, Harborview Medical Center, Seattle, Washington, USA
| | - Michael Sayre
- Emergency Medicine, Harborview Medical Center, Seattle, Washington, USA
| | - Mary King
- Pediatric Critical Care, Seattle Children's Hospital, Seattle, Washington, USA
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