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Hatch MA, Laschober TC, Paschen-Wolff M, Ertl MM, Nelson CM, Wright L, Lancaster C, Feaster DJ, Forrest D, Hankey C, Monger M, Fegley JP, Irving R, Young C, Rose J, Spector A, Dresser L, Moran L, Jelstrom E, Tross S. PrEP for people who use opioids: A NIDA clinical trials network survey study in Southern U.S. cities where HIV incidence is high. Drug Alcohol Depend 2024; 257:111133. [PMID: 38447393 DOI: 10.1016/j.drugalcdep.2024.111133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND People who use opioids (PWUO) are at increased risk for HIV. Pre-exposure prophylaxis (PrEP) is effective but underutilized as HIV prevention among PWUO. This study examined predictors of willingness to take daily oral PrEP and long-acting injectable (LAI) PrEP among PWUO across eight Southern urban cities with high HIV incidence. METHODS HIV-negative PWUO (N = 308) seeking services in community-based programs participated in this cross-sectional survey study. Measures included demographics, sexual risk behavior, substance use frequency, and awareness of and willingness to take oral and injectable PrEP. Data were analyzed using mixed-effects models. RESULTS Willingness to take daily oral and LAI PrEP was moderately high (69.16% and 62.02%, respectively). Half had heard of PrEP, but only 4% had ever taken it. Only education and condomless vaginal sex predicted willingness to take oral PrEP. Only education predicted willingness to take LAI PrEP. Polysubstance use was prevalent, with substantial proportions of PWUO reporting frequent use of injection drugs (opioids or stimulants, 79.5%), non-injection opioids (73.3%), non-injection stimulants (71.1%), cannabis (62.6%), and hazardous drinking (29.6%). About 20% reported past-year condomless anal sex, and one-third reported past-year condomless vaginal sex. CONCLUSIONS PWUO in this study were amenable to PrEP, particularly in light of education and condomless vaginal sex. Careful consideration for matching PrEP messaging to the PWUO audience is needed. PrEP promotion should expand beyond men who have sex with men to include groups such as these predominantly heterosexual, polysubstance-using PWUO with HIV risk who were open to both formulations of PrEP.
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Affiliation(s)
- Mary A Hatch
- University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA 98185, USA.
| | - Tanja C Laschober
- University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA 98185, USA
| | - Margaret Paschen-Wolff
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center at New York State Psychiatric Institute, New York, NY 10032, USA
| | - Melissa M Ertl
- University of Minnesota-Twin Cities, Department of Psychology, Minneapolis, MN 55455, USA
| | - C Mindy Nelson
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL 33136, USA
| | - Lynette Wright
- University of Washington Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, Seattle, WA 98185, USA
| | - Chloe Lancaster
- University of South Florida, Department of Leadership, Policy, and Lifelong Learning, Tampa, FL 33620, USA
| | - Daniel J Feaster
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL 33136, USA
| | - David Forrest
- University of Miami, Department of Anthropology, Coral Gables, FL, USA
| | - Colby Hankey
- Aspire Health Partners, HIV Services, Orlando, FL 32804, USA
| | - Mauda Monger
- My Brother's Keeper, 710 Avignon Dr, Ridgeland, MS 39157, USA
| | - Joshua P Fegley
- CrescentCare, 330 Tulane Ave, 1st Floor, New Orleans, LA 70119, USA
| | - Rhonda Irving
- Capitol Area Reentry Program, Baton Rouge, LA 70807, USA
| | - Cynthia Young
- Capitol Area Reentry Program, Baton Rouge, LA 70807, USA
| | - Juliana Rose
- Gateway Community Services, Research Department, Jacksonville, FL, USA
| | - Anya Spector
- Stella and Charles Guttman Community College, City University of New York, New York, NY, USA
| | | | - Landhing Moran
- Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Susan Tross
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY 10032, USA
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2
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Dang CM, Nelson CM, Feaster DJ, Kizhner A, Forrest DW, Nakamura N, Iyer A, Ghanta PP, Jayaweera DT, Rodriguez AE, Pahwa RN, Tookes HE, Pallikkuth S, Pahwa SG. Opioids exacerbate inflammation in people with well-controlled HIV. Front Immunol 2023; 14:1277491. [PMID: 38022645 PMCID: PMC10646416 DOI: 10.3389/fimmu.2023.1277491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction People with HIV (PWH) are known to have underlying inflammation and immune activation despite virologic control. Substance use including opioid dependence is common in this population and is associated with increased morbidity and reduced lifespan. The primary objective of the present study termed opioid immunity study (OPIS), was to investigate the impact of chronic opioids in PWH. Methods The study recruited people with and without HIV who had opioid use disorder (OUD). Study participants (n=221) were categorized into four groups: HIV+OP+, n=34; HIV-OP+, n=66; HIV+OP-, n=55 and HIV-OP-, n=62 as controls. PWH were virally suppressed on ART and those with OUD were followed in a syringe exchange program with confirmation of OP use by urine drug screening. A composite cytokine score was developed for 20 plasma cytokines that are linked to inflammation. Cellular markers of immune activation (IA), exhaustion, and senescence were determined in CD4 and CD8 T cells. Regression models were constructed to examine the relationships of HIV status and opioid use, controlling for other confounding factors. Results HIV+OP+ participants exhibited highest inflammatory cytokines and cellular IA, followed by HIV-OP+ for inflammation and HIV+OP- for IA. Inflammation was found to be driven more by opioid use than HIV positivity while IA was driven more by HIV than opioid use. In people with OUD, expression of CD38 on CD28-CD57+ senescent-like T cells was elevated and correlated positively with inflammation. Discussion Given the association of inflammation with a multitude of adverse health outcomes, our findings merit further investigations to understand the mechanistic pathways involved.
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Affiliation(s)
- Christine M. Dang
- Department of Microbiology and Immunology, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - C. Mindy Nelson
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Daniel J. Feaster
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Alexander Kizhner
- Department of Microbiology and Immunology, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - David W. Forrest
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Nobuyo Nakamura
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Akshay Iyer
- Department of Microbiology and Immunology, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Priya P. Ghanta
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Dushyantha T. Jayaweera
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Allan E. Rodriguez
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Rajendra N. Pahwa
- Department of Microbiology and Immunology, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Hansel E. Tookes
- Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Suresh Pallikkuth
- Department of Microbiology and Immunology, University of Miami, Miller School of Medicine, Miami, FL, United States
| | - Savita G. Pahwa
- Department of Microbiology and Immunology, University of Miami, Miller School of Medicine, Miami, FL, United States
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3
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Frimpong JA, Parish C, Feaster DJ, Gooden LK, Matheson T, Haynes L, Linas BP, Assoumou SA, Tross S, Kyle T, Nelson CM, Liguori TK, Toussaint O, Siegel K, Annane D, Metsch LR. A study protocol for Project I-Test: a cluster randomized controlled trial of a practice coaching intervention to increase HIV testing in substance use treatment programs. Res Sq 2023:rs.3.rs-3059783. [PMID: 37461594 PMCID: PMC10350190 DOI: 10.21203/rs.3.rs-3059783/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Background People with substance use disorders are vulnerable to acquiring HIV. Testing is fundamental to diagnosis, treatment, and prevention; however, in the past decade, there has been a decline in the number of substance use disorder (SUD) treatment programs offering on-site HIV testing. Fewer than half of SUDs in the United States offer on-site HIV testing. In addition, nearly a quarter of newly diagnosed cases have AIDS at the time of diagnosis. Lack of testing is one of the main reasons that annual HIV incidences have remained constant over time. Integration of HIV testing with testing for HCV, an infection prevalent among persons vulnerable to HIV infection, and in settings where they receive health services, including opioid treatment programs (OTPs), is of great public health importance. Methods/Design In this 3-arm cluster-RCT of opioid use disorders treatment programs, we test the effect of two evidence-based "practice coaching" (PC) interventions on: the provision and sustained implementation of on-site HIV testing, on-site HIV/HCV testing, and linkage to care. Using the National Survey of Substance Abuse Treatment Services data available from SAMHSA, 51 sites are randomly assigned to one of the three conditions: practice coach facilitated structured conversations around implementing change, with provision of resources and documents to support the implementation of (1) HIV testing only, or (2) HIV/HCV testing, and (3) a control condition that provides a package with information only. We collect quantitative (e,g., HIV and HCV testing at six-month-long intervals) and qualitative site data near the time of randomization, and again approximately 7-12 months after randomization. Discussion Innovative and comprehensive approaches that facilitate and promote the adoption and sustainability of HIV and HCV testing in opioid treatment programs are important for addressing and reducing HIV and HCV infection rates. This study is one of the first to test organizational approaches (practice coaching) to increase HIV and HIV/HCV testing and linkage to care among individuals receiving treatment for opioid use disorder. The study may provide valuable insight and knowledge on the multiple levels of intervention that, if integrated, may better position OTPs to improve and sustain testing practices and improve population health. Trial registration ClinicalTrials.gov: NCT03135886. (02 05 2017).
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Affiliation(s)
- Jemima A Frimpong
- Jemima A. Frimpong, New York University Abu Dhabi, PO BOX 129188, Saadiyat Island, Abu Dhabi, UAE
| | - Carrigan Parish
- Columbia University, Department of Sociomedical Sciences Miami Research Center, 1120 NW 14 Street Room 1030, Miami, FL 33136
| | - Daniel J Feaster
- University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14th Street, Room 1059, Miami, FL 33136
| | - Lauren K Gooden
- Columbia University, Department of Sociomedical Sciences Miami Research Center, 1120 NW 14 Street Room 1030, Miami, FL 33136
| | - Tim Matheson
- San Francisco Dept of Public Health (SFDPH), 25 Van Ness Avenue; Suite 500, San Francisco, CA 94102
| | - Louise Haynes
- Medical University of South Carolina, 67 President Street, Charleston, SC 29425
| | - Benjamin P Linas
- Boston Medical Center, Crosstown Building, 801 Massachusetts Ave office 2007, Boston, MA, 02118
| | | | - Susan Tross
- HIV Center For Clinical and Behavioral Studies, NYS Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, N.Y. 10032
| | - Tiffany Kyle
- University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14th Street, Room 1064, Miami, FL 33136
| | - C Mindy Nelson
- University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14th Street, Room 1064, Miami, FL 33136
| | - Terri K Liguori
- Columbia University, Department of Sociomedical Sciences Miami Research Center, 1120 NW 14 Street Room 1031, Miami, FL 33136
| | - Oliene Toussaint
- Columbia University, Department of Sociomedical Sciences Miami Research Center, 1120 NW 14 Street Room 1031, Miami, FL 33136
| | - Karolynn Siegel
- Columbia University, Department of Sociomedical Sciences, 722 West 168 Street, NY, NY 10032
| | - Debra Annane
- Health Foundation of South Florida, 2 South Biscayne Blvd., Suite 1710, Miami, FL 33131
| | - Lisa R Metsch
- Columbia University, Department of Sociomedical Sciences and Columbia School of General Studies, 2970 Broadway, 612 Lewisohn Hall, New York, NY 10026
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Dale SK, Nelson CM, Wright IA, Etienne K, Lazarus K, Gardner N, Bolden R, Adeojo L, Patrick J, Wallen C, Liu J, Ironson G, Alcaide ML, Safren S, Feaster D. Structural equation model of intersectional microaggressions, discrimination, resilience, and mental health among black women with hiv. Health Psychol 2023; 42:299-313. [PMID: 37141016 PMCID: PMC10167554 DOI: 10.1037/hea0001275] [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] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Compared to non-Black women, Black women in the United States are more likely to be diagnosed with HIV, living with HIV, and have suboptimal HIV outcomes, disparities largely linked to structural and psychosocial factors that may impact mental health. METHOD 151 Black women living with HIV (BWLWH) enrolled in a longitudinal cohort study completed baseline assessments between October 2019 and January 2020 in the Southeastern United States. Measures captured microaggressions (gendered-racial, HIV, and Lesbian/Gay/Bisexual/Transgender/Queer), "macro" discrimination acts (gender, race, HIV, sexual orientation), resilience factors (self-efficacy, trait resilience, posttraumatic growth, positive religious coping, and social support), and mental health (depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and posttraumatic cognitions). Four structural equation models were estimated with latent discrimination (LD), latent microaggression (LM), and latent resilience (LR) as predictors and depressive symptoms, PTSD symptoms, posttraumatic cognitions, and latent mental health (LH) as outcomes. Indirect pathways from LD and LM via LR and LR as a moderator were estimated. RESULTS Models fit well based on indices. There were significant direct pathways from LM and LR to depressive symptoms, posttraumatic cognitions, and LH and a significant direct pathway from LM to PTSD symptoms, but not from LD to any mental health outcome. Indirect pathways were not significant. However, LR moderated the relationships between both LM and LD with PTSD symptoms. CONCLUSION Intersectional microaggressions and resilience factors may play key roles in BWLWH's mental health. Research is needed to examine these pathways overtime and provide opportunities to improve mental health and HIV outcomes among BWLWH. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Sannisha K. Dale
- Department of Psychology, University of Miami
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - C. Mindy Nelson
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Ian A. Wright
- Department of Economics, University of Miami School of Business
| | | | | | | | | | | | | | | | | | | | - Maria L Alcaide
- Department of Medicine (Infectious Diseases), OB/GYN and Public Health, University of Miami Miller School of Medicine
| | | | - Daniel Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
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Kenworthy T, Harmon SL, Delouche A, Abugattas N, Zwiebel H, Martinez J, Sauvigné KC, Nelson CM, Horigian VE, Gwynn L, Pulgaron ER. Community voices on factors influencing COVID-19 concerns and health decisions among racial and ethnic minorities in the school setting. Front Public Health 2022; 10:1002209. [PMID: 36339209 PMCID: PMC9627500 DOI: 10.3389/fpubh.2022.1002209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/27/2022] [Indexed: 01/27/2023] Open
Abstract
Racial and ethnic minority communities have been disproportionately affected by COVID-19, but the uptake of COVID-19 mitigation strategies like vaccination and testing have been slower in these populations. With the continued spread of COVID-19 while in-person learning is a priority, school-aged youth and their caregivers must make health-related decisions daily to ensure health at school. It is critical to understand factors associated with COVID-related health decisions such as vaccination, testing, and other health behaviors (e.g., wearing masks, hand washing). Community-engaged campaigns are necessary to overcome barriers to these health behaviors and promote health equity. The aim of this study was to examine COVID-19-related concerns and influences on health decisions in middle and high schools serving primarily racial and ethnic minority, low-income families. Seven focus groups were conducted with school staff, parents, and students (aged 16 years and older). Qualitative data were analyzed using a general inductive approach. Factors related to COVID-19 concerns and health decisions centered on (1) vaccine hesitancy, (2) testing hesitancy, (3) developmental stage (i.e., ability to engage in health behaviors based on developmental factors like age), (4) cultural and family traditions and beliefs, (5) compatibility of policies and places with recommended health behaviors, (6) reliability of information, and (7) perceived risk. We explore sub-themes in further detail. It is important to understand the community's level of concern and identify factors that influence COVID-19 medical decision making to better address disparities in COVID-19 testing and vaccination uptake.
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6
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Wright IA, Reid R, Shahid N, Ponce A, Nelson CM, Sanders J, Gardner N, Liu J, Simmons E, Phillips A, Pan Y, Alcaide ML, Rodriguez A, Ironson G, Feaster DJ, Safren SA, Dale SK. Neighborhood Characteristics, Intersectional Discrimination, Mental Health, and HIV Outcomes Among Black Women Living With HIV, Southeastern United States, 2019‒2020. Am J Public Health 2022; 112:S433-S443. [PMID: 35763751 PMCID: PMC9241469 DOI: 10.2105/ajph.2021.306675] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 12/14/2022]
Abstract
Objectives. To examine the effects of within-neighborhood and neighboring characteristics on discrimination, stigma, mental health, and HIV outcomes among Black women living with HIV (BWLWH). Methods. A total of 151 BWLWH in a southeastern US city provided baseline data (October 2019‒January 2020) on experienced microaggressions and discrimination (race-, gender-, sexual orientation-, or HIV-related), mental health (e.g., depression, posttraumatic stress disorder), and HIV outcomes (e.g., viral load, antiretroviral therapy adherence). Neighborhood characteristics by census tract were gathered from the American Community Survey and the National Center for Charitable Statistics. Spatial econometrics guided the identification strategy, and we used the maximum likelihood technique to estimate relationships between a number of predictors and outcomes. Results. Within-neighborhood and neighboring characteristics (employment, education, crime, income, number of religious organizations, and low-income housing) were significantly related to intersectional stigma, discrimination, mental health, HIV viral load, and medication adherence. Conclusions. Policy, research, and interventions for BWLWH need to address the role of neighborhood characteristics to improve quality of life and HIV outcomes. (Am J Public Health. 2022;112(S4):S433-S443. https://doi.org/10.2105/AJPH.2021.306675).
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Affiliation(s)
- Ian A Wright
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Rachelle Reid
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Naysha Shahid
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Amanda Ponce
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - C Mindy Nelson
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Jasmyn Sanders
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Nadine Gardner
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Jingxin Liu
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Ervin Simmons
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Arnetta Phillips
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Yue Pan
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Maria L Alcaide
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Allan Rodriguez
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Gail Ironson
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Daniel J Feaster
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Steven A Safren
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
| | - Sannisha K Dale
- Ian A. Wright is with the Department of Economics, University of Miami Herbert Business School, Miami, FL. Rachelle Reid, Naysha Shahid, Amanda Ponce, Jasmyn Sanders, Nadine Gardner Sanders, Ervin Simmons, Gail Ironson, Steven A. Safren, and Sannisha K. Dale are with the Department of Psychology, College of Arts and Sciences, University of Miami. C. Mindy Nelson, Jingxin Liu, Yue Pan, and Daniel J. Feaster are with the Department of Public Health Sciences, University of Miami Miller School of Medicine. Arnetta Phillips is with the Department of Psychiatry, University of Miami Miller School of Medicine. Maria L. Alcaide and Allan Rodriguez are with the Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine
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Metsch LR, Feaster DJ, Gooden LK, Masson C, Perlman DC, Jain MK, Matheson T, Nelson CM, Jacobs P, Tross S, Haynes L, Lucas GM, Colasanti JA, Rodriguez A, Drainoni ML, Osorio G, Nijhawan AE, Jacobson JM, Sullivan M, Metzger D, Vergara-Rodriguez P, Lubelchek R, Duan R, Batycki JN, Matthews AG, Munoz F, Jelstrom E, Mandler R, Del Rio C. Care Facilitation Advances Movement Along the Hepatitis C Care Continuum for Persons With Human Immunodeficiency Virus, Hepatitis C, and Substance Use: A Randomized Clinical Trial (CTN-0064). Open Forum Infect Dis 2021; 8:ofab334. [PMID: 34377726 PMCID: PMC8339611 DOI: 10.1093/ofid/ofab334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022] Open
Abstract
Background Direct-acting antivirals can cure hepatitis C virus (HCV). Persons with HCV/HIV and living with substance use are disadvantaged in benefiting from advances in HCV treatment. Methods In this randomized controlled trial, participants with HCV/HIV were randomized between February 2016 and January 2017 to either care facilitation or control. Twelve-month follow-up assessments were completed in January 2018. Care facilitation group participants received motivation and strengths-based case management addressing retrieval of HCV viral load results, engagement in HCV/HIV care, and medication adherence. Control group participants received referral to HCV evaluation and an offer of assistance in making care appointments. Primary outcome was number of steps achieved along a series of 8 clinical steps (eg, receiving HCV results, initiating treatment, sustained virologic response [SVR]) of the HCV/HIV care continuum over 12 months postrandomization. Results Three hundred eighty-one individuals were screened and 113 randomized. Median age was 51 years; 58.4% of participants were male and 72.6% were Black/African American. Median HIV-1 viral load was 27 209 copies/mL, with 69% having a detectable viral load. Mean number of steps completed was statistically significantly higher in the intervention group vs controls (2.44 vs 1.68 steps; χ 2 [1] = 7.36, P = .0067). Men in the intervention group completed a statistically significantly higher number of steps than controls. Eleven participants achieved SVR with no difference by treatment group. Conclusions The care facilitation intervention increased progress along the HCV/HIV care continuum, as observed for men and not women. Study findings also highlight continued challenges to achieve individual-patient SVR and population-level HCV elimination. Clinical Trials Registration NCT02641158.
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Affiliation(s)
- Lisa R Metsch
- Department of Sociomedical Sciences, Columbia University, New York, New York, USA
| | - Daniel J Feaster
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
| | - Lauren K Gooden
- Department of Sociomedical Sciences, Columbia University, New York, New York, USA
| | - Carmen Masson
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - David C Perlman
- Division of Infectious Diseases, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mamta K Jain
- Division of Infectious Diseases, University of Texas Southwestern Medical Center and Parkland Health & Hospital System, Dallas, Texas, USA
| | - Tim Matheson
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, California, USA
| | - C Mindy Nelson
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
| | - Petra Jacobs
- Center for Clinical Trials Network, National Institute on Drug Abuse, Rockville, Maryland, USA
| | - Susan Tross
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Louise Haynes
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Gregory M Lucas
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Allan Rodriguez
- Infectious Disease, University of Miami, Miami, Florida, USA
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Georgina Osorio
- Division of Infectious Diseases, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ank E Nijhawan
- Division of Infectious Diseases, University of Texas Southwestern Medical Center and Parkland Health & Hospital System, Dallas, Texas, USA
| | - Jeffrey M Jacobson
- Division of Infectious Diseases and HIV Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Meg Sullivan
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - David Metzger
- HIV/AIDS Prevention Research Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Pamela Vergara-Rodriguez
- Mental Health and Substance Abuse Division, John H. Stroger, Jr Hospital of Cook County, Chicago, Illinois, USA
| | - Ronald Lubelchek
- Infectious Diseases, John H. Stroger, Jr Hospital of Cook County, Chicago, Illinois, USA
| | - Rui Duan
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
| | - Jacob N Batycki
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
| | - Abigail G Matthews
- Data Statistical Center, The Emmes Company, LLC, Rockville, Maryland, USA
| | - Felipe Munoz
- Data Statistical Center, The Emmes Company, LLC, Rockville, Maryland, USA
| | - Eve Jelstrom
- Clinical Coordinating Center, The Emmes Company, LLC, Rockville, Maryland, USA
| | - Raul Mandler
- Clinical/Medical Branch, National Institute on Drug Abuse, Rockville, Maryland, USA
| | - Carlos Del Rio
- Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA
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8
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Pang MF, Georgoudaki AM, Lambut L, Johansson J, Tabor V, Hagikura K, Jin Y, Jansson M, Alexander JS, Nelson CM, Jakobsson L, Betsholtz C, Sund M, Karlsson MCI, Fuxe J. TGF-β1-induced EMT promotes targeted migration of breast cancer cells through the lymphatic system by the activation of CCR7/CCL21-mediated chemotaxis. Oncogene 2015; 35:748-60. [PMID: 25961925 PMCID: PMC4753256 DOI: 10.1038/onc.2015.133] [Citation(s) in RCA: 219] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 03/05/2015] [Accepted: 03/23/2015] [Indexed: 02/06/2023]
Abstract
Tumor cells frequently disseminate through the lymphatic system during metastatic spread of breast cancer and many other types of cancer. Yet it is not clear how tumor cells make their way into the lymphatic system and how they choose between lymphatic and blood vessels for migration. Here we report that mammary tumor cells undergoing epithelial–mesenchymal transition (EMT) in response to transforming growth factor-β (TGF-β1) become activated for targeted migration through the lymphatic system, similar to dendritic cells (DCs) during inflammation. EMT cells preferentially migrated toward lymphatic vessels compared with blood vessels, both in vivo and in 3D cultures. A mechanism of this targeted migration was traced to the capacity of TGF-β1 to promote CCR7/CCL21-mediated crosstalk between tumor cells and lymphatic endothelial cells. On one hand, TGF-β1 promoted CCR7 expression in EMT cells through p38 MAP kinase-mediated activation of the JunB transcription factor. Blockade of CCR7, or treatment with a p38 MAP kinase inhibitor, reduced lymphatic dissemination of EMT cells in syngeneic mice. On the other hand, TGF-β1 promoted CCL21 expression in lymphatic endothelial cells. CCL21 acted in a paracrine fashion to mediate chemotactic migration of EMT cells toward lymphatic endothelial cells. The results identify TGF-β1-induced EMT as a mechanism, which activates tumor cells for targeted, DC-like migration through the lymphatic system. Furthermore, it suggests that p38 MAP kinase inhibition may be a useful strategy to inhibit EMT and lymphogenic spread of tumor cells.
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Affiliation(s)
- M-F Pang
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden.,Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ, USA
| | - A-M Georgoudaki
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - L Lambut
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - J Johansson
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - V Tabor
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - K Hagikura
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden.,Division of Cell Regeneration and Transplantation, Department of Functional Morphology, Nihon University School of Medicine, Tokyo, Japan
| | - Y Jin
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - M Jansson
- Department of Surgical and Perioperative Sciences/Surgery, Umea University, Umea, Sweden
| | - J S Alexander
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - C M Nelson
- Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ, USA
| | - L Jakobsson
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - C Betsholtz
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
| | - M Sund
- Department of Surgical and Perioperative Sciences/Surgery, Umea University, Umea, Sweden
| | - M C I Karlsson
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - J Fuxe
- Division of Vascular Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden
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Nelson CM, Schuppenhauer MR, Clark DS. Effects of hyperbaric pressure on a deep-sea archaebacterium in stainless steel and glass-lined vessels. Appl Environ Microbiol 2010; 57:3576-80. [PMID: 16348606 PMCID: PMC184015 DOI: 10.1128/aem.57.12.3576-3580.1991] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The effects of hyperbaric helium pressures on the growth and metabolism of the deep-sea isolate ES4 were investigated. In a stainless steel reactor, cell growth was completely inhibited but metabolic gas production was observed. From 85 to 100 degrees C, CO(2) production proceeded two to three times faster at 500 atm (1 atm = 101.29 kPa) than at 8 atm. At 105 degrees C, no CO(2) was produced until the pressure was increased to 500 atm. Hydrogen and H(2)S were also produced biotically but were not quantifiable at pressures above 8 atm because of the high concentration of helium. In a glass-lined vessel, growth occurred but the growth rate was not accelerated by pressure. In most cases at temperatures below 100 degrees C, the growth rate was lower at elevated pressures; at 100 degrees C, the growth rates at 8, 250, and 500 atm were nearly identical. Unlike in the stainless steel vessel, CO(2) production was exponential during growth and continued for only a short time after growth. In addition, relatively little H(2) was produced in the glass-lined vessel, and there was no growth or gas production at 105 degrees C at any pressure. The behavior of ES4 as a function of temperature and pressure was thus very sensitive to the experimental conditions.
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Affiliation(s)
- C M Nelson
- Department of Chemical Engineering, University of California, Berkeley, California 94720-9989
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10
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Miller JF, Nelson CM, Ludlow JM, Shah NN, Clark DS. High pressure-temperature bioreactor: assays of thermostable hydrogenase with fiber optics. Biotechnol Bioeng 2009; 34:1015-21. [PMID: 18588192 DOI: 10.1002/bit.260340715] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- J F Miller
- Department of Chemical Enginering, University of California, Berkley, California 94720, USA
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11
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Amdam GV, Rueppell O, Fondrk MK, Page RE, Nelson CM. The nurse's load: early-life exposure to brood-rearing affects behavior and lifespan in honey bees (Apis mellifera). Exp Gerontol 2009; 44:467-71. [PMID: 19264121 DOI: 10.1016/j.exger.2009.02.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2008] [Revised: 02/21/2009] [Accepted: 02/23/2009] [Indexed: 10/21/2022]
Abstract
Long-lived honey bees (Apis mellifera) develop in fall. This pattern may be explained by reduced nurse loads. When the amount of brood in colonies declines as a function of adverse foraging conditions, adult bees build up surplus nutrient stores that include vitellogenin, a behavioral affector protein that also can increase lifespan. Although the seasonal reduction in exposure to nursing tasks predictably results in vitellogenin accumulation, the assumption that long-lived adults thereby develop is confounded by a concomitant decline in foraging effort. Foraging activity reduces lifespan, and is influenced by colony resource consumption, brood pheromones, availability of nectar and pollen, and weather. Here, we perform the first controlled experiment where the nursing environment of pre-foraging sister bees was set to vary, while their foraging environment later was set to be the same. We measure vitellogenin, age at foraging onset and lifespan. We establish that reduced brood-rearing increases vitellogenin levels, and delays foraging onset and death. Longevity is largely explained by the effect of nursing on the onset of foraging behavior, but is also influenced by the level of brood-rearing independent of behavioral change. Our findings are consistent with the roles of vitellogenin in regulation of honey bee behavior and lifespan.
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Affiliation(s)
- Gro V Amdam
- School of Life Sciences, Arizona State University, Tempe, AZ 85287-4501, USA.
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12
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Nelson CM, Ihle KE, Fondrk MK, Page RE, Amdam GV. The gene vitellogenin has multiple coordinating effects on social organization. PLoS Biol 2007; 5:e62. [PMID: 17341131 PMCID: PMC1808115 DOI: 10.1371/journal.pbio.0050062] [Citation(s) in RCA: 322] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Accepted: 01/02/2007] [Indexed: 11/18/2022] Open
Abstract
Temporal division of labor and foraging specialization are key characteristics of honeybee social organization. Worker honeybees (Apis mellifera) initiate foraging for food around their third week of life and often specialize in collecting pollen or nectar before they die. Variation in these fundamental social traits correlates with variation in worker reproductive physiology. However, the genetic and hormonal mechanisms that mediate the control of social organization are not understood and remain a central question in social insect biology. Here we demonstrate that a yolk precursor gene, vitellogenin, affects a complex suite of social traits. Vitellogenin is a major reproductive protein in insects in general and a proposed endocrine factor in honeybees. We show by use of RNA interference (RNAi) that vitellogenin gene activity paces onset of foraging behavior, primes bees for specialized foraging tasks, and influences worker longevity. These findings support the view that the worker specializations that characterize hymenopteran sociality evolved through co-option of reproductive regulatory pathways. Further, they demonstrate for the first time how coordinated control of multiple social life-history traits can originate via the pleiotropic effects of a single gene that affects multiple physiological processes. Animals that live in groups often specialize in different tasks, creating a division of labor. One extreme example can be seen in honeybees, in which most tasks are performed by thousands of worker females that are essentially sterile helpers. Workers start out as nurse bees that care for larvae in the nest. Later they embark on foraging trips, specializing in either pollen or nectar collection, and continue to forage until they die. The age when workers initiate foraging and the tendency to collect pollen or nectar have been linked to a rudimentary reproductive physiology in which the protein vitellogenin appears to play a central role. Vitellogenin is normally used to produce egg yolk, but it may affect behavior and lifespan in workers. We tested this hypothesis by knocking down the vitellogenin gene of worker bees. Workers with suppressed vitellogenin levels foraged earlier, preferred nectar, and lived shorter lives. Thus, vitellogenin has multiple effects on honeybee social organization. By using gene knockdown to understand insect social behavior, our study supports the view that social life in bees evolved by co-opting genes involved in reproduction. vitellogenin gene activity paces onset of foraging behavior in worker bees, demonstrating how coordinated control of multiple social life-history traits can originate via the pleiotropic effects of a single gene.
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Affiliation(s)
- C. Mindy Nelson
- Department of Entomology, University of California Davis, Davis, California, United States of America
| | - Kate E Ihle
- School of Life Sciences, Arizona State University, Tempe, Arizona, United States of America
| | - M. Kim Fondrk
- School of Life Sciences, Arizona State University, Tempe, Arizona, United States of America
| | - Robert E Page
- School of Life Sciences, Arizona State University, Tempe, Arizona, United States of America
| | - Gro V Amdam
- School of Life Sciences, Arizona State University, Tempe, Arizona, United States of America
- Department of Animal and Aquacultural Sciences, Norwegian University of Life Sciences, Aas, Norway
- * To whom correspondence should be addressed. E-mail:
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Abstract
AIMS To investigate alternative relations between cumulative exposures to hand-transmitted vibration (taking account of vibration magnitude, lifetime exposure duration, and frequency of vibration) and the development of white finger (Raynaud's phenomenon). METHODS Three previous studies have been combined to provide a group of 1557 users of powered vibratory tools in seven occupational subgroups: stone grinders, stone carvers, quarry drillers, dockyard caulkers, dockyard boilermakers, dockyard painters, and forest workers. The estimated total operating duration in hours was thus obtained for each subject, for each tool, and for all tools combined. From the vibration magnitudes and exposure durations, seven alternative measurements of cumulative exposure were calculated for each subject, using expressions of the form: dose = summation operator a(m)(i)t(i), where a(i) is the acceleration magnitude on tool i, t(i) is the lifetime exposure duration for tool i, and m = 0, 1, 2, or 4. RESULTS For all seven alternative dose measures, an increase in dose was associated with a significant increase in the occurrence of vibration-induced white finger, after adjustment for age and smoking. However, dose measures with high powers of acceleration (m > 1) faired less well than measures in which the weighted or unweighted acceleration, and lifetime exposure duration, were given equal weight (m = 1). Dose determined solely by the lifetime exposure duration (without consideration of the vibration magnitude) gave better predictions than measures with m greater than unity. All measures of dose calculated from the unweighted acceleration gave better predictions than the equivalent dose measures using acceleration frequency-weighted according to current standards. CONCLUSIONS Since the total duration of exposure does not discriminate between exposures accumulated over the day and those accumulated over years, a linear relation between vibration magnitude and exposure duration seems appropriate for predicting the occurrence of vibration-induced white finger. Poorer predictions were obtained when the currently recommended frequency weighting was employed than when accelerations at all frequencies were given equal weight. Findings suggest that improvements are possible to both the frequency weighting and the time dependency used to predict the development of vibration-induced white finger in current standards.
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Affiliation(s)
- M J Griffin
- Human Factors Research Unit, Institute of Sound and Vibration Research, University of Southampton, Southampton SO17 1BJ, UK.
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14
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Jauron SD, Nelson CM, Fingerle V, Ravyn MD, Goodman JL, Johnson RC, Lobentanzer R, Wilske B, Munderloh UG. Host cell-specific expression of a p44 epitope by the human granulocytic ehrlichiosis agent. J Infect Dis 2001; 184:1445-50. [PMID: 11709787 DOI: 10.1086/324428] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2001] [Revised: 08/10/2001] [Indexed: 11/04/2022] Open
Abstract
The human granulocytic ehrlichiosis agent (HGEa) survives extreme differences between ticks and humans, possibly by use of differential expression of specific antigens for survival in different hosts. The role of the immunodominant p44 antigens is unknown. In this study, HGEa cultured in human or tick cells was probed with human, mouse, and hamster serum and with monoclonal antibodies (MAbs). p44 antigens were strongly expressed in human HL-60 cells but were strikingly reduced in tick cells. In HGEa alternately grown in HL-60 or tick cells, a p44 epitope recognized by MAb R5E4 was expressed in human but not tick cells. This was not a temperature effect, because incubation of infected tick cells at 37 degrees C did not induce expression of the p44 epitope. The p44 antigen predominates in human but not tick cells and may be involved in regulatory changes that mediate survival of the HGEa by immune modulation after tick transmission.
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Affiliation(s)
- S D Jauron
- Department of Entomology, University of Minnesota, St. Paul, MN 55108, USA.
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15
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Nelson CM. Falls prevention in older adults. Geriatr Nurs 2001; 22:174-5. [PMID: 11505242 DOI: 10.1067/mgn.2001.jgn01022402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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16
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Nelson CM. Ferdinand V. Hayden: entrepreneur of science. [Review of: Cassidy, J.G. Ferdinand V. Hayden: entrepreneur of science. Lincoln: U. of Nebraska Pr., 2000]. West Hist Q 2001; 32:383-4. [PMID: 16845784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Nelson CM, Sutanto A, Gessner BD, Suradana IG, Steinhoff MC, Arjoso S. Age- and cause-specific childhood mortality in Lombok, Indonesia, as a factor for determining the appropriateness of introducing Haemophilus influenzae type b and pneumococcal vaccines. J Health Popul Nutr 2000; 18:131-138. [PMID: 11262765] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Using age and cause-specific childhood mortality in Lombok, Indonesia, as a factor for determining the appropriateness of introducing Haemophilus influenzae type b (Hib) and pneumococcal vaccines, the study describes a cross-sectional, hamlet-level mortality survey in 40 of 305 villages in Lombok Island, Indonesia. Causes of death were assessed with a standardized verbal-autopsy questionnaire. One thousand four hundred ninety-nine births and 141 deaths occurring among children aged less than 2 years were identified, with 43% of deaths occurring during the first 2 months of life. The infant mortality rate was 89 (95% CI: 75, 104) per 1,000 live-births. All mortality rates are reported per 1,000 live-births. To examine children whose deaths could potentially have been prevented through vaccination with Hib or pneumococcal vaccine, deaths due to acute respiratory infection (ARI) and central nervous system (CNS) infections among children, aged 2-23 months, were analyzed. ARI and CNS infections caused 58% (mortality rate: 31 per 1,000 live-births; 95% CI: 23, 41) and 17% (mortality rate: 9 per 1,000 live-births; 95% CI: 5, 16), respectively, of all deaths within this age group. Between the ages of 2 and 23 months, 5% of all babies born alive died of ARI, and another 1% died of CNS infections. Our results indicate that current efforts to reduce childhood mortality should focus on reducing ARI and meningitis. These efforts should include evaluating the impact of Hib and pneumococcal vaccines within the routine Expanded Programme on Immunization system.
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Affiliation(s)
- C M Nelson
- PATH (Program for Appropriate Technology in Health), 4 Nickerson St., Seattle, WA 98109, USA.
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Herron MJ, Nelson CM, Larson J, Snapp KR, Kansas GS, Goodman JL. Intracellular parasitism by the human granulocytic ehrlichiosis bacterium through the P-selectin ligand, PSGL-1. Science 2000; 288:1653-6. [PMID: 10834846 DOI: 10.1126/science.288.5471.1653] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Human granulocytic ehrlichiosis (HGE) is a febrile tick-borne illness caused by a recently discovered intracellular bacterium remarkable for its tropism for professionally phagocytic neutrophils. Monoclonal antibodies against the P-selectin binding domain of the leukocyte P-selectin glycoprotein ligand, PSGL-1, prevented HGE cell binding and infection, as did enzymatic digestion of PSGL-1. Furthermore, simultaneous neoexpression in nonsusceptible cells of complementary DNAs for both PSGL-1 and its modifying alpha-(1,3) fucosyltransferase, Fuc-TVII, allowed binding and infection by HGE. Thus, the HGE bacterium specifically bound to fucosylated leukocyte PSGL-1. Selectin mimicry is likely central to the organism's unique ability to target and infect neutrophils.
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Affiliation(s)
- M J Herron
- Division of Infectious Diseases, Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN 55455, USA
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Abstract
This review describes the mechanisms by which polyunsaturated fatty acids regulate the activity of the nuclear transcription factors, peroxisome proliferator-activated receptor and sterol regulatory element binding protein-1, and it describes the role that the peroxisome proliferator-activated receptor and sterol regulatory element binding protein-1 play in coordinating the regulation of lipid synthesis, lipid oxidation, and thermogenesis. Finally, the requirement for dietary polyunsaturated fatty acids, particularly n-3 fatty acids, is defined in terms of the effects polyunsaturated fatty acids exert on gene expression and the role that these effects play in overall energy balance.
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Affiliation(s)
- P T Price
- Division of Nutritional Sciences, and the Institute for Cellular and Molecular Biology, University of Texas at Austin, 78712-1097, USA.
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Asthagiri AR, Nelson CM, Horwitz AF, Lauffenburger DA. Quantitative relationship among integrin-ligand binding, adhesion, and signaling via focal adhesion kinase and extracellular signal-regulated kinase 2. J Biol Chem 1999; 274:27119-27. [PMID: 10480927 DOI: 10.1074/jbc.274.38.27119] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Because integrin-mediated signals are transferred through a physical architecture and synergistic biochemical network whose properties are not well defined, quantitative relationships between extracellular integrin-ligand binding events and key intracellular responses are poorly understood. We begin to address this by quantifying integrin-mediated FAK and ERK2 responses in CHO cells for varied alpha(5)beta(1) expression level and substratum fibronectin density. Plating cells on fibronectin-coated surfaces initiated a transient, biphasic ERK2 response, the magnitude and kinetics of which depended on integrin-ligand binding properties. Whereas ERK2 activity initially increased with a rate proportional to integrin-ligand bond number for low fibronectin density, the desensitization rate was independent of integrin and fibronectin amount but proportional to the ERK2 activity level with an exponential decay constant of 0.3 (+/- 0.08) min(-1). Unlike the ERK2 activation time course, FAK phosphorylation followed a superficially disparate time course. However, analysis of the early kinetics of the two signals revealed them to be correlated. The initial rates of FAK and ERK2 signal generation exhibited similar dependence on fibronectin surface density, with both rates monotonically increasing with fibronectin amount until saturating at high fibronectin density. Because of this similar initial rate dependence on integrin-ligand bond formation, the disparity in their time courses is attributed to differences in feedback regulation of these signals. Whereas FAK phosphorylation increased to a steady-state level as new integrin-ligand bond formation continued during cell spreading, ERK2 activity was decoupled from the integrin-ligand stimulus and decayed back to a basal level. Accordingly, we propose different functional metrics for representing these two disparate dynamic signals: the steady-state tyrosine phosphorylation level for FAK and the integral of the pulse response for ERK2. These measures of FAK and ERK2 activity were found to correlate with short term cell-substratum adhesivity, indicating that signaling via FAK and ERK2 is proportional to the number of integrin-fibronectin bonds.
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Affiliation(s)
- A R Asthagiri
- Department of Chemical Engineering, Division of Bioengineering and Environmental Health, and Center for Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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21
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Munderloh UG, Jauron SD, Fingerle V, Leitritz L, Hayes SF, Hautman JM, Nelson CM, Huberty BW, Kurtti TJ, Ahlstrand GG, Greig B, Mellencamp MA, Goodman JL. Invasion and intracellular development of the human granulocytic ehrlichiosis agent in tick cell culture. J Clin Microbiol 1999; 37:2518-24. [PMID: 10405394 PMCID: PMC85271 DOI: 10.1128/jcm.37.8.2518-2524.1999] [Citation(s) in RCA: 159] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human granulocytotropic ehrlichias are tick-borne bacterial pathogens that cause an acute, life-threatening illness, human granulocytic ehrlichiosis (HGE). Ehrlichias within neutrophil granulocytes that invade tick bite sites are likely ingested by the vector, to be transmitted to another mammalian host during the tick's next blood meal. Thus, the cycle of replication and development in the vector is prerequisite to mammalian infection, and yet these events have not been described. We report tick cell culture isolation of two strains of the HGE agent directly from an infected horse and a dog and have also established a human isolate from HL60 culture in tick cells, proving that the blood stages of the HGE agent are infectious for tick cells, as are those replicating in the human cell line HL60. This required changes to the culture system, including a new tick cell line. In tick cell layers, the HGE agent induced foci of infection that caused necrotic plaques and eventual destruction of the culture. Using the human isolate and electron microscopy, we monitored adhesion, internalization, and replication in vector tick cells. Both electron-lucent and -dense forms adhered to and entered cells by a mechanism reminiscent of phagocytosis. Ehrlichial cell division was initiated soon after, resulting in endosomes filled with numerous ehrlichias. During early development, pale ehrlichias with a tight cell wall dominated, but by day 2, individual bacteria condensed into dark forms with a rippled membrane. These may become compacted into clumps where individual organisms are barely discernible. Whether these are part of an ehrlichia life cycle or are degenerating is unknown.
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Affiliation(s)
- U G Munderloh
- Department of Entomology, University of Minnesota, St. Paul, Minnesota 55108, USA.
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22
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Weston BW, Hiller KM, Mayben JP, Manousos G, Nelson CM, Klein MB, Goodman JL. A cloned CD15s-negative variant of HL60 cells is deficient in expression of FUT7 and does not adhere to cytokine-stimulated endothelial cells. Eur J Haematol 1999; 63:42-9. [PMID: 10414454 DOI: 10.1111/j.1600-0609.1999.tb01849.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The initial steps of leukocyte adhesion depend on selectin/ligand interactions. Surface ligands on leukocytes are often modified by addition of the sialyl Lewis x (CD15s) determinant. Biosynthesis of CD15s is dependent upon alpha(2,3)sialyltransferases and alpha(1,3)fucosyltransferases. We report the isolation of an HL60 cell line variant, HL60A2, that no longer expresses CD15s. HL60A2 cells do not adhere to cytokine-stimulated endothelial cells. Enzymatic assays reveal that this cell line has normal alpha(2,3)sialyltransferase activity but is deficient in the alpha(1,3)fucosyltransferase responsible for biosynthesis of CD15s (FUT7). The fucosyltransferase that constructs the non-sialylated antigen, Lewis x (CD15), is expressed at high levels (FUT4). Transcript analyses show that FUT7 and FUT4 are inversely expressed in HL60 and variant cell lines. HL60A2 cells provide a tool to study the regulation of selectin ligands and corresponding human fucosyltransferase genes.
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Affiliation(s)
- B W Weston
- The Lineberger Comprehensive Cancer Center and the Department of Pediatrics, University of North Carolina, Chapel Hill 27599-7220, USA.
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23
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Nelson CM, Innis SM. Plasma lipoprotein fatty acids are altered by the positional distribution of fatty acids in infant formula triacylglycerols and human milk. Am J Clin Nutr 1999; 70:62-9. [PMID: 10393140 DOI: 10.1093/ajcn/70.1.62] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Triacylglycerol digestion involves hydrolysis of fatty acids esterified at the glycerol 1,3 positions by gastric and pancreatic lipase to produce 2-monoacylglycerols and unesterified fatty acids, which are then absorbed, reesterified to triacylglycerol, and secreted in chylomicrons. Palmitic acid (16:0) is predominantly esterified to the 2 position of human milk triacylglycerol but to the 1,3 positions in the oils used in infant formulas. OBJECTIVE We aimed to determine whether the position of 16:0 in human milk and infant formula triacylglycerol influences the position of fatty acids in postprandial plasma chylomicron triacylglycerol. DESIGN Full-term infants were fed formula with 25-27% 16:0 with either 39% of the 16:0(synthesized triacylglycerol) or 6% of the 16:0 (standard formula) esterified at the triacylglycerol 2 position, or were breast-fed (23% 16:0, 81% at the triacylglycerol 2 position) from birth to 120 d of age. Chylomicron fatty acids and plasma lipids were assessed at 30 and 120 d of age. RESULTS Infants fed the synthesized triacylglycerol formula, standard formula, or breast milk had 15.8%,8.3%, and 28.0% 16:0 in the chylomicron triacylglycerol 2 position (P < 0.05). These results suggest that >/=50% of the dietary triacylglycerol 2-position 16:0 is conserved through digestion, absorption, and chylomicron triacylglycerol synthesis in breast-fed and formula-fed infants. Infants fed the synthesized triacylglycerol formula had significantly lower HDL-cholesterol and apolipoprotein A-I and higher apolipoprotein B concentrations than infants fed the standard formula. CONCLUSION Dietary triacylglycerol fatty acid distribution may alter lipoprotein metabolism in young infants.
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Affiliation(s)
- C M Nelson
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
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24
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Goodman JL, Nelson CM, Klein MB, Hayes SF, Weston BW. Leukocyte infection by the granulocytic ehrlichiosis agent is linked to expression of a selectin ligand. J Clin Invest 1999; 103:407-12. [PMID: 9927502 PMCID: PMC407896 DOI: 10.1172/jci4230] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Human granulocytic ehrlichiosis (HGE) is an emerging tickborne illness caused by an intracellular bacterium that infects neutrophils. Cells susceptible to HGE express sialylated Lewis x (CD15s), a ligand for cell selectins. We demonstrate that adhesion of HGE to both HL60 cells and normal bone marrow cells directly correlates with their CD15s expression. HGE infection of HL60 cells, bone marrow progenitors, granulocytes, and monocytes was blocked by monoclonal antibodies against CD15s. However, these antibodies did not inhibit HGE binding, and anti-CD15s was capable of inhibiting the growth of HGE after its entry into the target cell. In contrast, neuraminidase treatment of HL60 cells prevented both HGE binding and infection. A cloned cell line (HL60-A2), derived from HL60 cells and resistant to HGE, was deficient in the expression of alpha-(1, 3)fucosyltransferase (Fuc-TVII), an enzyme known to be required for CD15s biosynthesis. Less than 1% of HL60-A2 cells expressed CD15s, and only these rare CD15s-expressing cells bound HGE and became infected. After transfection with Fuc-TVII, cells regained CD15s expression, as well as their ability to bind HGE and become infected. Thus, CD15s expression is highly correlated with susceptibility to HGE, and it, and/or a closely related sialylated and alpha-(1,3) fucosylated molecule, plays a key role in HGE infection, an observation that may help explain the organism's tropism for leukocytes.
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Affiliation(s)
- J L Goodman
- Department of Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota 55455, USA.
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25
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Nelson CM, Sutanto A, Suradana IG. Use of SoloShot autodestruct syringes compared with disposable syringes, in a national immunization campaign in Indonesia. Bull World Health Organ 1999; 77:29-33. [PMID: 10063658 PMCID: PMC2557576] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Autodestruct syringes can reduce the improper reuse of syringes, which present a significant risk in the transmission of bloodborne pathogens in developing countries, especially during immunization campaigns owing to the high number of injections given per session. SoloShot is an autodestruct syringe, distributed by UNICEF, which has been shown to be safer and easier to use than standard syringes. This study analyses the accuracy and dose-efficiency of SoloShot, compared with disposable syringes, during a national tetanus toxoid immunization campaign on the Indonesian island of Lombok. Observation and dose measurements revealed that SoloShot syringes delivered more precise and consistent doses and 15% more doses per vial than disposable syringes. Vaccine savings may partially be offset by the higher price of SoloShot. Vaccinators preferred SoloShot, describing it as easier to use, faster, and more accurate than the disposable syringe. The study indicates that SoloShot is highly appropriate for use in immunization campaigns by reducing vaccine wastage and improving injection safety.
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Affiliation(s)
- C M Nelson
- Program for Appropriate Technology in Health/Lombok, Mataram, Indonesia
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26
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Sutanto A, Suarnawa IM, Nelson CM, Stewart T, Soewarso TI. Home delivery of heat-stable vaccines in Indonesia: outreach immunization with a prefilled, single-use injection device. Bull World Health Organ 1999; 77:119-26. [PMID: 10083709 PMCID: PMC2557593] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Extending immunization coverage to underserved populations will require innovative immunization strategies. This study evaluated one such strategy: the use of a prefilled, single-use injection device for outreach immunization by village midwives. The device, UniJect, is designed to prevent refilling or reuse. Stored at ambient temperatures for up to 1 month in midwives' homes, vaccine-filled UniJect devices were immediately available for outreach. Between July 1995 and April 1996, 110 midwives on the Indonesia islands of Lombok and Bali visited the homes of newborn infants to deliver hepatitis B vaccine to the infants and tetanus toxoid to their mothers. Observations and interviews showed that the midwives used the device properly and safely to administer approximately 10,000 sterile injections in home settings. There were no problems with excessive heat exposure during the storage or delivery of vaccine. Injection recipients and midwives expressed a strong preference for the UniJect device over a standard syringe. Use of the prefilled device outside the cold chain simplified the logistics and facilitated the speed and efficiency of home visits, while the single-dose format minimized vaccine wastage.
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Affiliation(s)
- A Sutanto
- Disease Prevention and Health Promotion, NTB Province, Ministry of Health, Indonesia
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27
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Abstract
Animals assess the quality and quantity of food and choose among different foods based on these assessments. We explored whether there was genetic variation for assessment of pollen quality by foraging honey bees, Apis mellifera. Honey bees derived from two genotypic strains foraged for pollen of varying quality from a petri dish placed inside an outdoor flight cage. The strains were the result of a colony-level, two-way selection on amount of stored pollen. We used the forager's round dance to quantify the assessments of pollen quality by individually marked worker bees. The dance rate (number of 180 degrees turns per minute) and the probability of dancing were each greater when bees foraged for pure pollen compared with a lower-quality mixture of pollen and alpha-cellulose (1:1 by volume). Bees from the high-pollen genotypic strain had a higher dance rate than those from the low-pollen strain, suggesting different assessments. Bees from the low-pollen strain, however, had a higher probability of dancing than did bees from the high-pollen strain. Dance duration was not affected by a bee's strain or by the quality of pollen. We conclude that the dance rate may be used to quantify a forager's subjective evaluation of pollen quality and that this evaluation has a genetic component. Our results also suggest that the dance may function at the colony level to recruit bees to more profitable pollen sources. Copyright 1998 The Association for the Study of Animal Behaviour.
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Affiliation(s)
- KD Waddington
- Department of Biology, University of Miami at Coral Gables
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28
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Ravyn MD, Goodman JL, Kodner CB, Westad DK, Coleman LA, Engstrom SM, Nelson CM, Johnson RC. Immunodiagnosis of human granulocytic ehrlichiosis by using culture-derived human isolates. J Clin Microbiol 1998; 36:1480-8. [PMID: 9620365 PMCID: PMC104863 DOI: 10.1128/jcm.36.6.1480-1488.1998] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/1997] [Accepted: 03/02/1998] [Indexed: 02/07/2023] Open
Abstract
Human granulocytic ehrlichiosis (HGE) is an emerging infection caused by an Ehrlichia species closely related to Ehrlichia equi and Ehrlichia phagocytophila. Recent advances in the isolation and cultivation of this organism have allowed us to develop an immunofluorescence assay (IFA), enzyme immunoassay (EIA), and Western immunoblotting (WB) using HL-60 cell culture-derived human isolates. Antibody was detected in sera from culture-confirmed HGE patients by IFA and EIA, and these samples were reactive when analyzed by immunoblot analysis. HGE patient sera had high antibody titers and did not react with uninfected HL-60 cells. When IFA, EIA, and WB were used to analyze sera from healthy donors or those with a range of other disorders, including infections caused by Ehrlichia chaffeensis, Rickettsia rickettsii, and Coxiella burnetti, no significant cross-reactivity could be detected by EIA or immunoblot analysis with the exception of two of four serum samples from R. rickettsii-infected patients that were reactive by IFA only. Sera from HGE patients did not significantly cross-react in serologic tests for Borrelia burgdorferi. Using sera from patients previously enrolled in two clinical trials of treatment for early Lyme disease, we evaluated a two-step approach for estimation of the seroprevalence of antibodies reactive with the etiologic agent of HGE. On the basis of the immunoblot assay results for sera from culture-confirmed HGE patients, WB was used to confirm the specificity of the antibody detected by EIA and IFA. EIA was found to be superior to IFA in the ability to detect WB-confirmed antibodies to the HGE agent. When EIA and WB were used, 56 (19.9%) patients with early Lyme disease (n = 281) had either specific immunoglobulin M (IgM) or IgG antibodies; 38 patients (13.5%) had IgM only, 6 (2.1%) had IgG only, and 12 (4.3%) had both IgM and IgG. Therefore, Lyme disease patients are at high potential risk for exposure to Ehrlichia. Analysis by immunoblotting of serial samples from persons with culture-confirmed HGE or patients with Lyme disease and antibodies to the agent of HGE revealed a reproducible pattern of the immune response to specific antigens. These samples confirmed the importance of the 42- to 45-kDa antigens as early, persistent, and specific markers of HGE infection. Other significant immunogenic proteins appear at 20, 21, 28, 30, and 60 kDa. Use of the two-test method of screening by EIA and confirming the specificity by WB appears to offer a sound approach to the clinical immunodiagnosis of HGE.
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Affiliation(s)
- M D Ravyn
- Department of Microbiology, University of Minnesota Academic Health Center, Minneapolis 55455-0312, USA.
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29
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Petit MA, Nelson CM, Rhodes EC. Comparison of a mathematical model to predict 10-km performance from the Conconi test and ventilatory threshold measurements. Can J Appl Physiol 1997; 22:562-72. [PMID: 9415829 DOI: 10.1139/h97-036] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The purpose of this study was to validate a mathematical model (MM) that evaluates the Conconi test and predicts 10-km race time. In addition, the relationship between ventilatory threshold (Tvent) determined from a laboratory test and heart rate deflection (HRd) from the Conconi test were examined. Seventeen trained runners performed the Conconi test, and performance times were predicted using a MM based on a logistics function. A correlational analysis indicated a highly significant relationship (r = .98, p < .01) between MM predicted time and actual time. Significant relationships were found between velocity at Tvent and HRd (r = .95, p < .01), and predicted times from each method (r = .96, p < .01). Heart rates from Tvent and HRd were also related (r = .79, p < .01). These results suggest that a MM of the Conconi test is a valid method of predicting 10-km performance and is closely related to traditional laboratory measures.
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Affiliation(s)
- M A Petit
- School of Human Kinetics, University of British Columbia, Vancouver
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30
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Klein MB, Miller JS, Nelson CM, Goodman JL. Primary bone marrow progenitors of both granulocytic and monocytic lineages are susceptible to infection with the agent of human granulocytic ehrlichiosis. J Infect Dis 1997; 176:1405-9. [PMID: 9359749 DOI: 10.1086/517332] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Human granulocytic ehrlichiosis (HGE) is an emerging tickborne infection resulting in an acute febrile illness associated with cytopenias and characteristic intracellular organisms within peripheral blood granulocytes. The etiologic agent of HGE has recently been isolated and cultivated in the HL-60 promyelocytic leukemia cell line, but the spectrum of host cells that it naturally infects remains unknown. To determine if normal hematopoietic progenitors could be targets of infection, CD34+ primary human bone marrow cells, stimulated to differentiate along myelomonocytic lineages, were incubated with the HGE agent. Immature marrow progenitors and, remarkably, not only granulocytic but also CD14+ monocytic cells from these cultures supported replication of the HGE agent, suggesting that all are potential targets of infection in vivo. Infection of bone marrow progenitors may contribute to the hematologic manifestations of HGE. Furthermore, the ability of the agent to interact with monocytes has significant implications regarding disease pathogenesis and host response.
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Affiliation(s)
- M B Klein
- Department of Medicine, University of Minnesota, Minneapolis, USA
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31
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Innis SM, Nelson CM, Wadsworth LD, MacLaren IA, Lwanga D. Incidence of iron-deficiency anaemia and depleted iron stores among nine-month-old infants in Vancouver, Canada. Can J Public Health 1997. [PMID: 9170683 DOI: 10.1007/bf03403865] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The iron status and feeding practices of 434 infants in Vancouver were determined at 39 +/- 1 week of age. Iron-deficiency anaemia (haemoglobin < or = 101 g/L, or < or = 110 g/L with two or three abnormal results from tests of serum ferritin, zinc erythrocyte protoporphyrin and total iron binding capacity) occurred in 7% of infants. Low iron stores (serum ferritin < 10 micrograms/l) occurred in about 24% of infants. Iron-deficiency anaemia was significantly associated (p < 0.001) with duration of breastfeeding. The prevalence of iron-deficiency anaemia among infants breastfed for 8 months was 15%. At 39 weeks (9 months) of age, about 5% and 13% of the infants were bottle-fed with cows milk or low iron infant formula, respectively, and this was also significantly associated (p < 0.02) with low iron stores. Iron-fortified infant cereals had been introduced to 95% of the infants by six months of age. This study shows iron-deficiency anaemia is a problem among a significant number of nine-month-old infants in Canada, and is not explained by failure to introduce iron-fortified infant cereals.
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Affiliation(s)
- S M Innis
- Department of Paediatrics, University of British Columbia.
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32
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Eber L, Nelson CM. School-based wraparound planning: integrating services for students with emotional and behavioral needs. Am J Orthopsychiatry 1997; 67:385-395. [PMID: 9250340 DOI: 10.1037/h0080241] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The wraparound process for planning unique and flexible services emerged from community-based human-service programs for children and youth exhibiting serious emotional disturbance. The application of wraparound in schools is described and illustrated via examples of local, statewide, and national initiatives. These experiences suggest strategies that can improve the school's effectiveness in serving students with, or at risk of, emotional and behavioral challenges.
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Affiliation(s)
- L Eber
- Illinois State Board of Education EBD Network, La Grange, Area Department of Special Education, USA
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33
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Klein MB, Nelson CM, Goodman JL. Antibiotic susceptibility of the newly cultivated agent of human granulocytic ehrlichiosis: promising activity of quinolones and rifamycins. Antimicrob Agents Chemother 1997; 41:76-9. [PMID: 8980758 PMCID: PMC163663 DOI: 10.1128/aac.41.1.76] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Human granulocytic ehrlichiosis (HGE) is a rapidly emerging tick-borne infection which presents as an acute febrile illness and is associated with hematologic abnormalities, elevated hepatic transaminase levels, and characteristic intracellular organisms in peripheral blood granulocytes. Although HGE has been successfully treated with tetracyclines, its susceptibility to other antibiotics remains unknown. No clear treatment alternative exist for young children, pregnant women, or allergic individuals, in whom tetracyclines are contra-indicated. We performed in vitro antibiotic susceptibility tests with this recently isolated agent grown in the human promyelocytic leukemia cell line HL-60. Doxycycline (MIC, 0.25 micrograms/ml), rifampin (MIC, 0.5 micrograms/ml), rifabutin (MIC, < or = 0.125 micrograms/ml), ciprofloxacin and ofloxacin (both with MICs of 2 micrograms/ml), and trovafloxacin (MIC, < or = 0.125 micrograms/ml) ciprofloxacin and ofloxacin (both with MICs of 2 micrograms/ml), and trovafloxacin (MIC, < or = 0.125 micrograms/ml) demonstrated significant activity against the HGE agent. These agents were also bactericidal. The HGE agent was resistant to clindamycin, trimethoprim-sulfamethoxazole, and imipenem-cilastatin, as well as to ampicillin, ceftriaxone, erythromycin, and azithromycin, antibiotics commonly used to treat Lyme disease. Both chloramphenicol and gentamicin had weak inhibitory activities but were not bactericidal. Our findings confirm the observed clinical efficacy of doxycycline and further suggest that the rifamycins and quinolones, particularly trovafloxacin, hold promise as alternative agents for treating this new infection.
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Affiliation(s)
- M B Klein
- Department of Medicine, University of Minnesota, Minneapolis 55455, USA
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34
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Innis SM, Nelson CM, Lwanga D, Rioux FM, Waslen P. Feeding formula without arachidonic acid and docosahexaenoic acid has no effect on preferential looking acuity or recognition memory in healthy full-term infants at 9 mo of age. Am J Clin Nutr 1996; 64:40-6. [PMID: 8669412 DOI: 10.1093/ajcn/64.1.40] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Preferential looking acuity and novelty preference (a test of recognition memory) were determined by using Teller Acuity Cards and the Fagan Test of Infant Intelligence, respectively, for 399-433 healthy full-term infants at 39 +/- 1 wk of age. Duration of breast-feeding and age of infant at introduction and amount and type of formula were determined by questionnaire. Seventy-four infants (17%) were never breast-fed; another 92 infants (21%) were still receiving breast milk as the milk source at 39 wk of age. There were no differences in visual acuity or novelty preference among the infants when they were stratified by incidence or duration of breast-feeding. The formulas met current Canadian guidelines with > or = 0.7% of energy as linolenic acid, but had no docosahexaenoic or arachidonic acid. The studies indicate that formulas containing adequate linoleic and linolenic acids, without arachidonic or docosahexaenoic acid, impose no measurable deficits in performance in these visual and cognitive developmental tests at 9 mo of age in healthy full-term infants.
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Affiliation(s)
- S M Innis
- Department of Paediatrics, University of British Columbia, Vancouver, Canada.
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35
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Abstract
Pharmacologic induction of exercise with dobutamine hydrochloride, coupled with the technology of echocardiography, is an alternate method for evaluating ischemic heart disease. Dobutamine stress echocardiography involves obtaining echocardiographic images before, during, and after a titrated dobutamine infusion is administered. The study is positive if global or regional ventricular wall motion abnormalities develop. With our changing health care environment, this cost-effective, noninvasive diagnostic procedure is becoming a standard for determining the presence of coronary artery disease in those individuals who are unable or unwilling to undergo exercise stress testing.
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Munderloh UG, Madigan JE, Dumler JS, Goodman JL, Hayes SF, Barlough JE, Nelson CM, Kurtti TJ. Isolation of the equine granulocytic ehrlichiosis agent, Ehrlichia equi, in tick cell culture. J Clin Microbiol 1996; 34:664-70. [PMID: 8904434 PMCID: PMC228866 DOI: 10.1128/jcm.34.3.664-670.1996] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The equine granulocytic ehrlichiosis agent, Ehrlichia equi, is closely related or identical to the human granulocytic ehrlichiosis (HGE) agent. Both are suspected of being transmitted by ticks. We have successfully isolated E. equi in a cell line, IDE8, derived from a putative vector, the tick Ixodes scapularis. Peripheral blood leukocytes from an experimentally infected horse were inoculated onto IDE8 monolayers. Cultures were incubated in a candle jar at 34 degrees C in tick cell culture medium with NaHCO3 and an organic buffer [3-(N-morpholino)-propanesulfonic acid] (MOPS). Within 2 weeks, infected cells were detected in Giemsa-stained culture samples, and the organisms subsequently spread to uninfected cells in the cultures. E. equi was passaged serially by transferring a portion of an infected culture to new cell layers every 2 to 3 weeks. The identity of the organisms was confirmed by PCR using oligonucleotide primers specific for E. equi and the HGE agent and by immunocytology. Homologous equine antibodies and human anti-HGE convalescent serum recognized E. equi grown in tick cell culture. Electron microscopy revealed electron-lucent and -dense ehrlichia-like forms developing within host cell endosomes. E. equi passaged twice in tick cell culture retained infectivity and pathogenicity for the equine host, as demonstrated by intravenous inoculation of a suspension of infected tick cells and subsequent reisolation from peripheral blood, in fulfillment of Koch's postulates. The horse developed severe clinical signs, i.e., fever, inappetence, thrombocytopenia, icterus, and limb edema, typical of granulocytic equine ehrlichiosis, within 1 week.
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Affiliation(s)
- U G Munderloh
- Department of Entomology, University of Minnesota, St. Paul 55108, USA.
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de Arruda M, Cocchiaro CA, Nelson CM, Grinnell CM, Janssen B, Haupt A, Barlozzari T. LU103793 (NSC D-669356): a synthetic peptide that interacts with microtubules and inhibits mitosis. Cancer Res 1995; 55:3085-92. [PMID: 7606731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
LU103793 (NSC D-669356) is a new synthetic derivative of Dolastatin 15, an antiproliferative compound which was isolated from the mollusk Dolabella auricularia. Like Dolastatin 15, LU103793 is highly cytotoxic in vitro (IC50 = 0.1 nM). To investigate the mechanism of action of LU103793, we used a combination of biochemical and cellular methods. Turbidity assays with bovine brain microtubules demonstrated that LU103793 inhibits microtubule polymerization in a concentration-dependent manner (IC50 = 7 microM). Treatment with this compound also induced depolymerization of preassembled microtubules. Cell cycle analysis of tumor cell lines treated with LU103793 indicated a block in the G2-M phase. At the cellular level, it induced depolymerization of microtubules in interphase cells and development of abnormal spindles and chromosome distribution in mitotic cells. Although these effects are very similar to the cellular alterations caused by vinblastine, LU103793 does not inhibit vinblastine binding to unpolymerized tubulin in vitro. Our results suggest that LU103793 exerts its cytotoxic activity primarily through disruption of microtubule organization.
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Affiliation(s)
- M de Arruda
- BASF Bioresearch Corporation, Worcester, Massachusetts 01605-4314, USA
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Kramolowsky EV, Wood NL, Rollins KL, Glasheen WP, Nelson CM. Impact of physician awareness on hospital charges for radical retropubic prostatectomy. J Urol 1995; 154:139-42. [PMID: 7776408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE We determine if physician awareness of hospital costs for radical retropubic prostatectomy affects physician practice patterns. MATERIALS AND METHODS We reviewed 256 consecutive radical retropubic prostatectomies performed by 14 urologists during 4 years at a community hospital. After 2 years the physicians were provided information on factors that may decrease charges. RESULTS Charges decreased significantly following intervention, from +f417,134 within the initial 2 years to +f413,826 within the last 2 years (p < 0.005). Significant decreases were noted for length of stay, need for intensive care, operating time and blood loss. CONCLUSIONS Traditional methods of physician education can impact practice patterns to decrease hospital charges for radical retropubic prostatectomy.
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Affiliation(s)
- E V Kramolowsky
- Urology Center, Trigon Blue Cross and Blue Shield of Virginia, Richmond, USA
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Kramolowsky EV, Wood NL, Rollins KL, Glasheen WP, Nelson CM. The role of the physician in effecting change in hospital charge for radical prostatectomy. J Am Coll Surg 1995; 180:513-8. [PMID: 7749525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Continuing effort is being made to provide the best medical care in a cost-effective manner, requiring an evaluation of factors that control charges. The number of cases of carcinoma of the prostate gland and the number of radical retropubic prostatectomies performed have increased in recent years, with an estimate of several hundred million dollars being spent annually on this procedure in the United States of America. Because physicians are reported to effect the majority of charges for a hospitalization, this study examines the influence of notification of the physician of hospital charges on the overall hospital charges for radical retropubic prostatectomy. STUDY DESIGN Total hospital charge and duration per hospitalization were determined for all patients having radical prostatectomies performed at five community hospitals in Richmond, VA, between January 1991 and December 1993. Patients included 625 males diagnosed with carcinoma of the prostate gland undergoing radical prostatectomy by one of 20 urologists from several different private practice groups. Halfway into the time period studied, physicians were notified of data collection and of factors that seemed to have a role in hospital charges. Total hospital charges before and after physician notification were measured to determine whether or not physicians could effect hospital charges. RESULTS Overall, hospital charges decreased significantly after notification of physicians in the study. The decline in total charges continued throughout the follow-up period. Duration of hospitalization decreased throughout the entire study period, while total charge per hospital day increased. CONCLUSIONS Physician awareness of hospital charges for operative procedures and accompanying hospitalizations may influence the overall decrease in charges.
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Affiliation(s)
- E V Kramolowsky
- Urology Center, Medical College of Virginia/Virginia Commonwealth University, Richmond, USA
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Abstract
Herpes simplex virus type 1 (HSV-1) syncytial (syn) mutants cause formation of giant polykaryocytes and have been utilized to identify genes promoting or suppressing cell fusion. We previously described an HSV-1 recombinant, F1 (J.L. Goodman, M. L. Cook, F. Sederati, K. Izumi, and J. G. Stevens, J. Virol. 63:1153-1161, 1989), which has unique virulence properties and a syn mutation in the carboxy terminus of glycoprotein B (gB). We attempted to replace this single-base-pair syn mutation through cotransfection with a 379-bp PCR-generated fragment of wild-type gB. The nonsyncytial viruses isolated were shown by DNA sequencing not to have acquired the expected wild-type gB sequence. Instead, they had lost their cell-cell fusion properties because of alterations mapping to the UL45 gene. The mutant UL45 gene is one nonsyncytial derivative of F1, A4B, was found to have a deletion of a C at UL45 nucleotide 230, resulting in a predicted frame shift and termination at 92 rather than 172 amino acids. Northern (RNA) analysis showed that the mutant UL45 gene was normally transcribed. However, Western immunoblotting showed no detectable UL45 gene product from A4B or from another similarly isolated nonsyncytial F1 derivative, A61B, while another such virus, 1ACSS, expressed reduced amounts of UL45. When A4B was cotransfected with the wild-type UL45 gene, restoration of UL45 expression correlated with restoration of syncytium formation. Conversely, cloned DNA fragments containing the mutant A4B UL45 gene transferred the loss of cell-cell fusion to other gB syn mutants, rendering them UL45 negative and nonsyncytial. We conclude that normal UL45 expression is required to allow cell fusion induced by gB syn mutants and that the nonessential UL45 protein may play an important role as a mediator of fusion events during HSV-1 infection.
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Affiliation(s)
- E J Haanes
- Department of Medicine, University of Minnesota, Minneapolis 55455
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Innis SM, Nelson CM, Rioux MF, King DJ. Development of visual acuity in relation to plasma and erythrocyte omega-6 and omega-3 fatty acids in healthy term gestation infants. Am J Clin Nutr 1994; 60:347-52. [PMID: 8074064 DOI: 10.1093/ajcn/60.3.347] [Citation(s) in RCA: 120] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The development of preferential looking acuity was studied prospectively to 3 mo of age in exclusively breast-fed and formula-fed term gestation infants. The formula contained (% of total fatty acids) 17.9% linoleic acid (18:2 omega-6) and 2.1% alpha-linolenic acid (18:3 omega-3) but no docosahexaenoic acid (22:6 omega-3) or arachidonic acid (20:4 omega-6). The breast milk contained (mean +/- SEM) 13.4 +/- 0.8% 18:2 omega-6, 1.5 +/- 0.1% 18:3 omega-3, 0.51 +/- 0.03% 20:4 omega-6, and 0.22 +/- 0.02% 22:6 omega-3. Preferential looking acuity, assessed by the acuity-card procedure, and plasma phospholipid and erythrocyte phosphatidylcholine and phosphatidylethanolamine fatty acids were determined at 14 d and 3 mo of age. There were no significant differences in acuity at 14 d or 3 mo, despite substantial differences in erythrocyte and plasma lipid 22:6 omega-3. Visual acuity was [mean (cycles/degree) +/- SD (octaves)] 3.93 +/- 0.54 and 4.77 +/- 0.48 and erythrocyte phosphatidylethanolamine %22:6 omega-3 was (mean +/- SE) 7.6 +/- 0.5 and 4.0 +/- 0.2 in the 3-mo-old breast-fed and formula-fed infants, respectively. These studies show that feeding formula containing 2.1% 18:3 omega-3 (approximately 1.0% energy) results in development of visual acuity similar to breast-feeding in term infants to > or = 3 mo of age.
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Affiliation(s)
- S M Innis
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
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Abstract
Milk fatty acids consist of about 20-25% palmitic acid (16:0), with about 70% of 16:0 esterified to the sn-2 position of the milk triacylglycerols. Hydrolysis of dietary triacylglycerols by endogeneous lipases produces sn-2 monoacylglycerols and free fatty acids, which are absorbed, reesterified, and then secreted into plasma. Unesterified 16:0 is not well absorbed and readily forms soaps with calcium in the intestine. The positioning of 16:0 at the sn-2 position of milk triacylglycerols could explain the high coefficient of absorption of milk fat. However, the milk lipase, bile salt-stimulated lipase, has been suggested to complete the hydrolysis of milk fat to free fatty acids and glycerol. These studies determined whether 16:0 is absorbed from human milk as sn-2 monopalmitin by comparison of the plasma triacylglycerol total and sn-2 position fatty acid composition between breast-fed and formula-fed term gestation infants. The human milk and formula had 21.0 and 22.3% of 16:0, respectively, with 54.2 and 4.8% 16:0 in the fatty acids esterified to the 2 position. The plasma triacylglycerol total fatty acids had 26.0 +/- 0.6 and 26.2 +/- 0.6% of 16:0, and the sn-2 position fatty acids had 23.3 +/- 3.3 and 7.4 +/- 0.7% of 16:0 in the three-month-old exclusively breast-fed (n = 17) and formula-fed (n = 18) infants, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S M Innis
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
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Innis SM, Lupton BA, Nelson CM. Biochemical and functional approaches to study of fatty acid requirements for very premature infants. Nutrition 1994; 10:72-6. [PMID: 8199429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Plasma and RBC omega-6 and omega-3 fatty acids reflect the composition of these fatty acids in the diet, and their analyses seem unlikely to add little more to studies on infant fatty acid requirements than evidence that the milk or formula diet was adhered to. Tests of visual function, cognitive, and motor skill development, however, are sufficiently sensitive to demonstrate significant differences between groups of infants fed diets that differ only in fatty acid composition. These functional tests offer the potential for future research with modified formulas or expressed milk to determine not only fatty acid requirements but also to further fundamental understanding of the role of specific omega-6 and omega-3 fatty acids in CNS development and function.
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Affiliation(s)
- S M Innis
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
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Abstract
Chlorine nitrate photolysis has been investigated with the use of a molecular beam technique. Excitation at both 248 and 193 nanometers led to photodissociation by two pathways, CIONO(2) --> CIO + NO()2 and CIONO(2) --> Cl + NO3, with comparable yields. This experiment provides a direct measurement of the CIO product channel and consequently raises the possibility of an analogous channel in CIO dimer photolysis. Photodissociation of the CIO dimer is a critical step in the catalytic cycle that is presumed to dominate polar stratospheric ozone destruction. A substantial yield of CIO would reduce the efficiency of this cycle.
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Nelson CM, Schuppenhauer MR, Clark DS. High-pressure, high-temperature bioreactor for comparing effects of hyperbaric and hydrostatic pressure on bacterial growth. Appl Environ Microbiol 1992; 58:1789-93. [PMID: 1622255 PMCID: PMC195676 DOI: 10.1128/aem.58.5.1789-1793.1992] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
We describe a high-pressure reactor system suitable for simultaneous hyperbaric and hydrostatic pressurization of bacterial cultures at elevated temperatures. For the deep-sea thermophile ES4, the growth rate at 500 atm (1 atm = 101.29 kPa) and 95 degrees C under hydrostatic pressure was ca. three times the growth rate under hyperbaric pressure and ca. 40% higher than the growth rate at 35 atm.
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Affiliation(s)
- C M Nelson
- Department of Chemical Engineering, University of California, Berkeley 94720-9989
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Gehrz RC, Nelson CM, Kari BE. A combination of human cytomegalovirus (HCMV)-specific murine monoclonal antibodies exhibits synergistic antiviral activity in vitro. Antiviral Res 1992; 17:115-31. [PMID: 1313219 DOI: 10.1016/0166-3542(92)90046-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A combination of HCMV-specific monoclonal antibodies (MAbs) reactive with glycoproteins in gcI complexes which exhibit synergistic antiviral activity in vitro is described. MAbs directed against different structural and biological properties of HCMV have been selected to increase the antiviral activity against all possible strains, and to reduce the likelihood that resistant strains will emerge with prolonged exposure. Furthermore, in vitro analysis demonstrates that certain of the MAbs in the combination augment the virus-neutralizing activity of other component antibodies, thereby decreasing the amount of total antibody protein required to inhibit HCMV infection. Certain MAbs have been selected to inactivate extracellular virus during the early phase of HCMV infection, whereas others have been selected to prevent its spread once cells have been infected. These data suggest that a MAb cocktail may be useful for prophylaxis and treatment of patients at risk of life-threatening HCMV infections.
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Affiliation(s)
- R C Gehrz
- Children's Biomedical Research Institute, St. Paul, Minnesota 55102
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Abstract
An ELISA was developed to measure antibody, both IgG and IgA, against the streptococcal C5a peptidase (SCP), in human sera and saliva. Generally, sera and saliva from young, uninfected children lacked antibody to SCP. In contrast, most sera and saliva specimens from healthy adults had measurable levels of anti-SCP IgG and SCP-specific secretory IgA (anti-SCP sIgA). Paired acute and convalescent sera from patients with streptococcal pharyngitis possessed significantly higher levels of anti-SCP IgG than did sera from healthy individuals. Sera containing high concentrations of anti-SCP immunoglobulin were capable of neutralizing SCP activity. A survey of healthy adults and children also showed that the latter were significantly less likely to have anti-SCP sIgA in their saliva. Detection of this antibody in greater than 90% of the saliva specimens obtained from children who had recently experienced streptococcal pharyngitis demonstrated that children can produce a secretory response. This is thought to be the first report of a secretory IgA response in humans to a somatic antigen of Streptococcus pyogenes.
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Affiliation(s)
- S P O'Connor
- Department of Microbiology, University of Minnesota Medical School, Minneapolis
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Abstract
We reviewed 20 cases of ureteral strictures, 15 of which were secondary to ureteral trauma. Of the patients 6 were managed initially by open repair and 14 underwent endoscopic manipulation. All 6 open repairs were successful, compared to 9 of the 14 patients who underwent endoscopic dilation of the ureteral stricture. Of the 5 failures 3 were due to the inability to cannulate the strictured ureter with a guide wire and 2 failed to respond to balloon dilation. Of these 5 patients 4 were treated successfully by an open operation. There were no serious intraoperative or postoperative complications. The average hospitalization was less for the endoscopic group (2.1 days) compared to the open surgical group (8.3 days). Followup ranged from 6 to 48 months.
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Affiliation(s)
- E V Kramolowsky
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City
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