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White LK, Hillman N, Ruparel K, Moore TM, Gallagher RS, McClellan EJ, Roalf DR, Scott JC, Calkins ME, McGinn DE, Giunta V, Tran O, Crowley TB, Zackai EH, Emanuel BS, McDonald-McGinn DM, Gur RE, Gur RC. Remote assessment of the Penn computerised neurocognitive battery in individuals with 22q11.2 deletion syndrome. J Intellect Disabil Res 2024; 68:369-376. [PMID: 38229473 DOI: 10.1111/jir.13115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Neurocognitive functioning is an integral phenotype of 22q11.2 deletion syndrome relating to severity of psychopathology and outcomes. A neurocognitive battery that could be administered remotely to assess multiple cognitive domains would be especially beneficial to research on rare genetic variants, where in-person assessment can be unavailable or burdensome. The current study compares in-person and remote assessments of the Penn computerised neurocognitive battery (CNB). METHODS Participants (mean age = 17.82, SD = 6.94 years; 48% female) completed the CNB either in-person at a laboratory (n = 222) or remotely (n = 162). RESULTS Results show that accuracy of CNB performance was equivalent across the two testing locations, while slight differences in speed were detected in 3 of the 11 tasks. CONCLUSIONS These findings suggest that the CNB can be used in remote settings to assess multiple neurocognitive domains.
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Affiliation(s)
- L K White
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - N Hillman
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - K Ruparel
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - T M Moore
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - R S Gallagher
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - E J McClellan
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - D R Roalf
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - J C Scott
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- VISN4 Mental Illness Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - M E Calkins
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - D E McGinn
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - V Giunta
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - O Tran
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - T B Crowley
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - E H Zackai
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - B S Emanuel
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - D M McDonald-McGinn
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Human Biology and Medical Genetics, Sapienza University, Rome, Italy
| | - R E Gur
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - R C Gur
- Lifespan Brain Institute (LiBI) of, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
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Rosen AC, Bhat JV, Cardenas VA, Ehrlich TJ, Horwege AM, Mathalon DH, Roach BJ, Glover GH, Badran BW, Forman SD, George MS, Thase ME, Yurgelun-Todd D, Sughrue ME, Doyen SP, Nicholas PJ, Scott JC, Tian L, Yesavage JA. Targeting location relates to treatment response in active but not sham rTMS stimulation. Brain Stimul 2021; 14:703-709. [PMID: 33866020 PMCID: PMC8884259 DOI: 10.1016/j.brs.2021.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Precise targeting of brain functional networks is believed critical for treatment efficacy of rTMS (repetitive pulse transcranial magnetic stimulation) in treatment resistant major depression. Objective: To use imaging data from a “failed” clinical trial of rTMS in Veterans to test whether treatment response was associated with rTMS coil location in active but not sham stimulation, and compare fMRI functional connectivity between those stimulation locations. Methods: An imaging substudy of 49 Veterans (mean age, 56 years; range, 27e78 years; 39 male) from a randomized, sham-controlled, double-blinded clinical trial of rTMS treatment, grouping participants by clinical response, followed by group comparisons of treatment locations identified by individualized fiducial markers on structural MRI and resting state fMRI derived networks. Results: The average stimulation location for responders versus nonresponders differed in the active but not in the sham condition (P = .02). The average responder location derived from the active condition showed significant negative functional connectivity with the subgenual cingulate (P < .001) while the nonresponder location did not (P = .17), a finding replicated in independent cohorts of 84 depressed and 35 neurotypical participants. The responder and nonresponder stimulation locations evoked different seed based networks (FDR corrected clusters, all P < .03), revealing additional brain regions related to rTMS treatment outcome. Conclusion: These results provide evidence from a randomized controlled trial that clinical response to rTMS is related to accuracy in targeting the region within DLPFC that is negatively correlated with subgenual cingulate. These results support the validity of a neuro-functionally informed rTMS therapy target in Veterans.
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Affiliation(s)
- A C Rosen
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry, Stanford University, Stanford, CA, 94305, USA.
| | - J V Bhat
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Palo Alto Veterans Institute for Research, Palo Alto, CA, 94304, USA
| | - V A Cardenas
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - T J Ehrlich
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; University of Michigan, Ann Arbor, USA
| | - A M Horwege
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - D H Mathalon
- Mental Health Service, San Francisco Veterans Affairs Health Care System, University of California, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - B J Roach
- Mental Health Service, San Francisco Veterans Affairs Health Care System, University of California, San Francisco, CA, USA; Northern California Institute for Research and Education, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, CA, USA
| | - G H Glover
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - B W Badran
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - S D Forman
- Department of Veterans Affairs, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - M S George
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - M E Thase
- VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - D Yurgelun-Todd
- Rocky Mountain Network Mental Illness Research Education and Clinical Centers (VISN 19), VA Salt Lake City Health Care System, Salt Lake City, UT, USA; Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - M E Sughrue
- Omniscient Neurotechnologies, Sydney, Australia; Prince of Wales Hospital, Randwick, NSW, Australia
| | - S P Doyen
- Omniscient Neurotechnologies, Sydney, Australia
| | | | - J C Scott
- VISN4 Mental Illness Research, Education, and Clinical Center at the Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - L Tian
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - J A Yesavage
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry, Stanford University, Stanford, CA, 94305, USA
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Fazeli PL, Casaletto KB, Woods SP, Umlauf A, Scott JC, Moore DJ. Everyday Multitasking Abilities in Older HIV+ Adults: Neurobehavioral Correlates and the Mediating Role of Metacognition. Arch Clin Neuropsychol 2018; 32:917-928. [PMID: 28575231 DOI: 10.1093/arclin/acx047] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Indexed: 11/14/2022] Open
Abstract
Objective The prevalence of older adults living with HIV is rising, as is their risk for everyday functioning problems associated with neurocognitive dysfunction. Multitasking, the ability to maintain and carry out subgoals in support of a larger goal, is a multidimensional skill ubiquitous during most real-life tasks and associated with prefrontal networks that are vulnerable in HIV. Understanding factors associated with multitasking will improve characterization of HIV-associated neurocognitive disorders. Metacognition is also associated with frontal systems, is impaired among individuals with HIV, and may contribute to multitasking. Method Ninety-nine older (≥50 years) adults with HIV completed: the Everyday Multitasking Test (MT), a performance-based measure during which participants concurrently attempt four everyday tasks (e.g., medication management) within a time limit; a comprehensive neuropsychological battery; measures of metacognition regarding their MT performance (e.g., metacognitive knowledge and online awareness). Results Better global neuropsychological performance (i.e., average T-score across all domains) was associated with better Everyday MT total scores (rho = 0.34; p < .001), as was global metacognition (rho = 0.37, p < .01). Bootstrapping mediation analysis revealed global metacognition was a significant partial mediator between neurocognition and Everyday MT (b = 0.09, 95% confidence interval [CI] = 0.01, 0.25). Specifically, metacognitive knowledge (but not online awareness) drove this mediation (b = 0.13, 95% CI = 0.03, 0.27). Conclusions Consistent with findings among younger persons with HIV, neuropsychological performance is strongly associated with a complex, laboratory-based test of everyday multitasking, and metacognition of task performance was a pathway through which successful multitasking occurred. Interventions aimed at modifying metacognition to improve daily functioning may be warranted among older adults with HIV.
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Affiliation(s)
- P L Fazeli
- Department of Family, Community and Health Systems, School of Nursing, Birmingham, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - S P Woods
- Department of Psychiatry, University of San Diego, San Diego, CA, USA.,Department of Psychology, University of Houston, TX, USA
| | - A Umlauf
- Department of Psychiatry, University of San Diego, San Diego, CA, USA
| | - J C Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - D J Moore
- Department of Psychiatry, University of San Diego, San Diego, CA, USA
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4
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Moore RC, Kaufmann CN, Rooney AS, Moore DJ, Eyler LT, Granholm E, Woods SP, Swendsen J, Heaton RK, Scott JC, Depp CA. Feasibility and Acceptability of Ecological Momentary Assessment of Daily Functioning Among Older Adults with HIV. Am J Geriatr Psychiatry 2017; 25:829-840. [PMID: 28065496 PMCID: PMC5453849 DOI: 10.1016/j.jagp.2016.11.019] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [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: 05/15/2016] [Revised: 11/17/2016] [Accepted: 11/23/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study aimed to examine the feasibility, acceptability, and initial validity of using smartphone-based ecological momentary assessment (EMA) to assess daily functioning and other behavioral factors among older HIV+ adults. METHODS Twenty older HIV+ adults (mean age: 59 years) completed laboratory-based neurobehavioral and functional assessments then completed EMA surveys via smartphones five times per day for one week. RESULTS Excellent EMA adherence (86.4%) was found, and participants rated their experience with EMA methods positively. Time-use data indicated participants were spending 74% of their waking-sampled time at home, 63% of their time alone, and 32% of their time engaged in passive leisure activities (e.g., watching TV). Better neurocognitive and functional capacity abilities were correlated with less time spent in passive leisure activities. Lastly, mood and cognitive symptom data collected via EMA were significantly associated with scores from laboratory-based assessments of these same constructs. CONCLUSIONS EMA via smartphones is a feasible and acceptable data collection method among older HIV+ adults and appears to be a promising mobile tool to assess daily functioning behaviors in HIV. These preliminary findings indicate older HIV+ adults are spending a considerable amount of time at home, alone, and engaged in passive leisure activities, primarily watching TV. EMA may contribute to future research examining functional disability among the growing population of older HIV+ adults.
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Affiliation(s)
- Raeanne C Moore
- Department of Psychiatry, University of California San Diego, La Jolla, CA; VA San Diego Healthcare System, San Diego, CA; the Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA.
| | - Christopher N Kaufmann
- Department of Psychiatry, University of California San Diego, La Jolla, CA; VA San Diego Healthcare System, San Diego, CA; the Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Alexandra S Rooney
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, CA; VA San Diego Healthcare System, San Diego, CA; the Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Eric Granholm
- Department of Psychiatry, University of California San Diego, La Jolla, CA; VA San Diego Healthcare System, San Diego, CA
| | - Steven Paul Woods
- Department of Psychiatry, University of California San Diego, La Jolla, CA; Department of Psychology, University of Houston, Houston, TX
| | - Joel Swendsen
- National Center for Scientific Research, University of Bordeaux, EPHE, Bordeaux, France
| | - Robert K Heaton
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - J C Scott
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA; VISN4 Mental Illness Research, Education, and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA
| | - Colin A Depp
- Department of Psychiatry, University of California San Diego, La Jolla, CA; VA San Diego Healthcare System, San Diego, CA; the Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
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Scott JC, Harb GC, Brownlow JA, Greene JL, Gur RC, Ross RJ. 1075 VERBAL MEMORY FUNCTIONING MODERATES RESPONSE TO TREATMENT FOR RECURRENT NIGHTMARES IN PTSD. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abdallah CG, Wrocklage KM, Averill CL, Akiki T, Schweinsburg B, Roy A, Martini B, Southwick SM, Krystal JH, Scott JC. Anterior hippocampal dysconnectivity in posttraumatic stress disorder: a dimensional and multimodal approach. Transl Psychiatry 2017; 7:e1045. [PMID: 28244983 PMCID: PMC5545643 DOI: 10.1038/tp.2017.12] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 12/30/2016] [Indexed: 02/07/2023] Open
Abstract
The anterior hippocampus (aHPC) has a central role in the regulation of anxiety-related behavior, stress response, emotional memory and fear. However, little is known about the presence and extent of aHPC abnormalities in posttraumatic stress disorder (PTSD). In this study, we used a multimodal approach, along with graph-based measures of global brain connectivity (GBC) termed functional GBC with global signal regression (f-GBCr) and diffusion GBC (d-GBC), in combat-exposed US Veterans with and without PTSD. Seed-based aHPC anatomical connectivity analyses were also performed. A whole-brain voxel-wise data-driven investigation revealed a significant association between elevated PTSD symptoms and reduced medial temporal f-GBCr, particularly in the aHPC. Similarly, aHPC d-GBC negatively correlated with PTSD severity. Both functional and anatomical aHPC dysconnectivity measures remained significant after controlling for hippocampal volume, age, gender, intelligence, education, combat severity, depression, anxiety, medication status, traumatic brain injury and alcohol/substance comorbidities. Depression-like PTSD dimensions were associated with reduced connectivity in the ventromedial and dorsolateral prefrontal cortex. In contrast, hyperarousal symptoms were positively correlated with ventromedial and dorsolateral prefrontal connectivity. We believe the findings provide first evidence of functional and anatomical dysconnectivity in the aHPC of veterans with high PTSD symptomatology. The data support the putative utility of aHPC connectivity as a measure of overall PTSD severity. Moreover, prefrontal global connectivity may be of clinical value as a brain biomarker to potentially distinguish between PTSD subgroups.
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Affiliation(s)
- C G Abdallah
- Clinical Neurosciences Division, VA National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Clinical Neurosciences Division, VA National Center for PTSD, US Department of Veterans Affairs or Department of Psychiatry, Yale University School of Medicine, 950 Campbell Avenue, 151E West Haven, CT 06516, USA. E-mail:
| | - K M Wrocklage
- Clinical Neurosciences Division, VA National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - C L Averill
- Clinical Neurosciences Division, VA National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - T Akiki
- Clinical Neurosciences Division, VA National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - B Schweinsburg
- Clinical Neurosciences Division, VA National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - A Roy
- Clinical Neurosciences Division, VA National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - B Martini
- Clinical Neurosciences Division, VA National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - S M Southwick
- Clinical Neurosciences Division, VA National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - J H Krystal
- Clinical Neurosciences Division, VA National Center for PTSD, US Department of Veterans Affairs, West Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - J C Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,VISN4 Mental Illness Research, Education, and Clinical Center, Philadelphia VA Medical Center, Philadelphia, PA, USA
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Moore TM, Martin IK, Gur OM, Jackson CT, Scott JC, Calkins ME, Ruparel K, Port AM, Nivar I, Krinsky HD, Gur RE, Gur RC. Characterizing social environment's association with neurocognition using census and crime data linked to the Philadelphia Neurodevelopmental Cohort. Psychol Med 2016; 46:599-610. [PMID: 26492931 PMCID: PMC7263021 DOI: 10.1017/s0033291715002111] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The contribution of 'environment' has been investigated across diverse and multiple domains related to health. However, in the context of large-scale genomic studies the focus has been on obtaining individual-level endophenotypes with environment left for future decomposition. Geo-social research has indicated that environment-level variables can be reduced, and these composites can then be used with other variables as intuitive, precise representations of environment in research. METHOD Using a large community sample (N = 9498) from the Philadelphia area, participant addresses were linked to 2010 census and crime data. These were then factor analyzed (exploratory factor analysis; EFA) to arrive at social and criminal dimensions of participants' environments. These were used to calculate environment-level scores, which were merged with individual-level variables. We estimated an exploratory multilevel structural equation model (MSEM) exploring associations among environment- and individual-level variables in diverse communities. RESULTS The EFAs revealed that census data was best represented by two factors, one socioeconomic status and one household/language. Crime data was best represented by a single crime factor. The MSEM variables had good fit (e.g. comparative fit index = 0.98), and revealed that environment had the largest association with neurocognitive performance (β = 0.41, p < 0.0005), followed by parent education (β = 0.23, p < 0.0005). CONCLUSIONS Environment-level variables can be combined to create factor scores or composites for use in larger statistical models. Our results are consistent with literature indicating that individual-level socio-demographic characteristics (e.g. race and gender) and aspects of familial social capital (e.g. parental education) have statistical relationships with neurocognitive performance.
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Affiliation(s)
- T. M. Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - I. K. Martin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - O. M. Gur
- Department of Criminal Justice, Pennsylvania State University, Abington College, Abington, PA, USA
| | - C. T. Jackson
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J. C. Scott
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M. E. Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - K. Ruparel
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - A. M. Port
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - I. Nivar
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - H. D. Krinsky
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - R. E. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - R. C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Casaletto KB, Moore DJ, Woods SP, Umlauf A, Scott JC, Heaton RK. Abbreviated Goal Management Training Shows Preliminary Evidence as a Neurorehabilitation Tool for HIV-associated Neurocognitive Disorders among Substance Users. Clin Neuropsychol 2016; 30:107-30. [PMID: 26753986 DOI: 10.1080/13854046.2015.1129437] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Substance use disorders are highly comorbid with and contribute to the increased prevalence of neurocognitive dysfunction observed in HIV infection. Despite their adverse impact on everyday functioning, there are currently no compensatory-based neurorehabilitation interventions validated for use among HIV+ substance users (HIV/SUD). This study examined the effectiveness of goal management training (GMT) alone or GMT as part of a metacognitive training among HIV/SUD individuals with executive dysfunction. METHODS Ninety HIV/SUD individuals were randomized to a single 15-min session: (1) GMT (n = 30); (2) GMT plus metacognitive training (neurocognitive awareness; GMT + Meta; n = 30); or (3) active control (n = 30). Following a brief neurocognitive battery and study condition, participants performed a complex laboratory-based function task, Everyday Multitasking Test (Everyday MT), during which metacognition (awareness) was evaluated. RESULTS There was an increasing, but non-significant tendency for better Everyday MT performances across study conditions (Control ≤ GMT ≤ GMT + Meta; ps < .08). Post hoc analyses showed that GMT and GMT + Meta groups demonstrated small benefits (d = .20-.27) compared to the control arm but did not differ from one another (ds < .10). When GMT groups were combined, there were significant medium effect size benefits in Everyday MT performance and metacognitive task appraisals as compared to the control condition. Among participants who underwent GMT, benefits were most prominent in persons with poorer pre-training dual-tasking ability, depression, and methamphetamine use disorders (ds = .35-1.04). CONCLUSIONS A brief compensatory strategy has benefits for everyday multitasking and metacognition among HIV+ substance users with executive dysfunction. Future work exploring more intensive trainings, potentially complimentary to other restorative approaches and/or pharmacological treatments, is warranted.
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Affiliation(s)
- Kaitlin B Casaletto
- a SDSU/UCSD Joint Doctoral Program in Clinical Psychology , San Diego , CA , USA
| | - David J Moore
- b Department of Psychiatry , University of California , San Diego , CA , USA
| | - Steven Paul Woods
- c Department of Psychology , University of Houston , Houston , TX , USA
| | - Anya Umlauf
- b Department of Psychiatry , University of California , San Diego , CA , USA
| | - J C Scott
- d Department of Psychiatry , University of Pennsylvania , Philadelphia , PA , USA.,e VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center , Philadelphia , PA , USA
| | - Robert K Heaton
- b Department of Psychiatry , University of California , San Diego , CA , USA
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Dorsey ER, Deuel LM, Beck CA, Gardiner IF, Scoglio NJ, Scott JC, Marshall FJ, Biglan KM. Group patient visits for Parkinson disease: a randomized feasibility trial. Neurology 2011; 76:1542-7. [PMID: 21525426 DOI: 10.1212/wnl.0b013e3182194bad] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Group patient visits are medical appointments shared among patients with a common medical condition. This care delivery method has demonstrated benefits for individuals with chronic conditions but has not been evaluated for Parkinson disease (PD). METHODS We conducted a 12-month, randomized trial of group patient visits vs usual (one-on-one) care for patients with PD. Visits were led by one of 3 study physicians, included patients and caregivers, and lasted approximately 90 minutes. Those receiving group visits had 4 sessions over 12 months. The primary outcome measure was feasibility as measured by the ability to recruit participants and by the proportion of participants who completed the study. The primary efficacy outcome was quality of life as measured by the PD Questionnaire-39. RESULTS Thirty patients and 27 caregivers enrolled in the study. Thirteen of the 15 patients randomized to group patient visits and 14 of the 15 randomized to usual care completed the study. Quality of life measured 12 months after baseline between the 2 groups was not different (25.9 points for group patient visits vs 26.0 points for usual care; p = 0.99). CONCLUSIONS Group patient visits may be a feasible means of providing care to individuals with PD and may offer an alternative or complementary method of care delivery for some patients and physicians. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that group patient visits did not improve quality of life for individuals with PD over a 1-year period.
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Affiliation(s)
- E R Dorsey
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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11
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Orr-Ewing J, Scott JC, Gardner AD. Bacteriological Investigation of Wounds Treated by the Closed-plaster Method. Br Med J 2011; 1:877-82. [PMID: 20783705 DOI: 10.1136/bmj.1.4197.877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Affiliation(s)
- I Ott
- Professor of Physiology in the Medico-Chirurgical College of Philadelphia
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Scott JC, Gordon TR, Shaw DV, Koike ST. Effect of Temperature on Severity of Fusarium Wilt of Lettuce Caused by Fusarium oxysporum f. sp. lactucae. Plant Dis 2010; 94:13-17. [PMID: 30754388 DOI: 10.1094/pdis-94-1-0013] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The effect of temperature on Fusarium wilt of lettuce (Lactuca sativa), caused by Fusarium oxysporum f. sp. lactucae, was examined in a controlled environment. Nine lettuce cultivars planted in infested potting mix (500 or 5,000 CFU/g) were maintained under high/low diurnal temperature regimes of 26/18°C, 28/20°C, or 33/26°C. Three cultivars were resistant to Fusarium wilt under all test conditions, and thus were little affected by differences in inoculum level or temperature. The remaining cultivars were more susceptible and manifested more severe symptoms at the higher inoculum level and when maintained at higher temperatures. The tendency for the disease to be more severe under warmer conditions may be due, in part, to an effect of temperature on growth of the pathogen. Radial growth rates calculated for six isolates of F. oxysporum f. sp. lactucae were observed to increase from 10°C up to an apparent maximum near 25°C. The results of this study suggest that growers can reduce the risk of damage from Fusarium wilt by avoiding susceptible cultivars during the warmest planting periods. Further, isolates of F. oxysporum f. sp. lactucae were shown to have a distinctive colony morphology in culture, which made it possible to distinguish them from nonpathogenic strains.
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Affiliation(s)
| | | | - D V Shaw
- Department of Plant Sciences, University of California, Davis, CA 95616
| | - S T Koike
- University of California Cooperative Extension, Monterey County, Salinas, CA 93901
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Affiliation(s)
- L. B. Schein
- a IBM Research Division, Almaden Research Center , San Jose , CA , 95120
| | - J. C. Scott
- a IBM Research Division, Almaden Research Center , San Jose , CA , 95120
| | - L. Th. Pautmeier
- a IBM Research Division, Almaden Research Center , San Jose , CA , 95120
| | - R. H. Young
- b Eastman Kodak Company , Rochester , NY , 14650
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Affiliation(s)
- J. C. Scott
- a IBM Research Division , IBM Almaden Research Center , 650 Harry Road, San Jose , CA , 95120-6099
| | - J. H. Kaufman
- a IBM Research Division , IBM Almaden Research Center , 650 Harry Road, San Jose , CA , 95120-6099
| | - J. Salem
- a IBM Research Division , IBM Almaden Research Center , 650 Harry Road, San Jose , CA , 95120-6099
| | - J. A. Goitia
- a IBM Research Division , IBM Almaden Research Center , 650 Harry Road, San Jose , CA , 95120-6099
| | - P. J. Brock
- a IBM Research Division , IBM Almaden Research Center , 650 Harry Road, San Jose , CA , 95120-6099
| | - R. Dipietro
- a IBM Research Division , IBM Almaden Research Center , 650 Harry Road, San Jose , CA , 95120-6099
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Affiliation(s)
- Jean Orr-Ewing
- Sir William Dunn School of Pathology, University of Oxford
| | - J C Scott
- Sir William Dunn School of Pathology, University of Oxford
| | - F H Masina
- Sir William Dunn School of Pathology, University of Oxford
| | - J Trueta
- Sir William Dunn School of Pathology, University of Oxford
| | - A D Gardner
- Sir William Dunn School of Pathology, University of Oxford
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Bechgaard K, Carneiro K, Rasmussen FB, Olsen M, Rindorf G, Jacobsen CS, Pedersen HJ, Scott JC. Superconductivity in an organic solid. Synthesis, structure, and conductivity of bis(tetramethyltetraselenafulvalenium) perchlorate, (TMTSF)2ClO4. J Am Chem Soc 2002. [DOI: 10.1021/ja00399a065] [Citation(s) in RCA: 291] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Silence SM, Scott JC, Stankus JJ, Moerner WE, Moylan CR, Bjorklund GC, Twieg RJ. Photorefractive Polymers Based on Dual-Function Dopants. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100012a034] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Bodeker GE, Scott JC, Kreher K, McKenzie RL. Global ozone trends in potential vorticity coordinates using TOMS and GOME intercompared against the Dobson network: 1978-1998. ACTA ACUST UNITED AC 2001. [DOI: 10.1029/2001jd900220] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Scott JC, Kennedy MW, McManus DP. Molecular and immunological characterisation of a polymorphic cytosolic fatty acid binding protein from the human blood fluke of humans, Schistosoma japonicum. Biochim Biophys Acta 2000; 1517:53-62. [PMID: 11118616 DOI: 10.1016/s0167-4781(00)00254-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Most organisms obtain their fatty acids through their diet or by de novo synthesis, but human blood flukes belonging to the genus Schistosoma lack the oxygen-dependent pathways required for the synthesis of sterols and fatty acids so they are entirely dependent on their hosts for these and other complex lipids. Fatty acid binding proteins (FABPs) of the FABP/P2/CRABP/CRBP family of beta-barrel cytosolic lipid binding proteins (cLBP) appear to be particularly important to schistosomes in the uptake, transport and compartmentalisation of host-derived fatty acids and may provide important targets for immuno- and chemotherapy. Here we describe the isolation of a set of cDNAs prepared from the Asiatic schistosome, Schistosoma japonicum, which encode two groups of cLBPs based on sequence homology and unique cDNA restriction sites. Representative clones from the two groups, one encoding a complete Sj-FABP (F10), and the other encoding a deletion mutant (F25) were characterised at the nucleic acid level by Southern and Northern hybridisation analysis, and at the protein level by immunoblotting. The presence and size of introns in the genes encoding F10 and F25 were determined and, because of the interest in the Schistosoma mansoni FABP homologue (Sm14) as a putative vaccine candidate, the immunogenicity and protective efficacy of the two proteins were also evaluated. A particularly interesting finding was the degree of Sj-FABP amino acid sequence polymorphism found to occur within the S. japonicum worm population, which appears to be greater than that described from cLBPs from vertebrates or, indeed, any other group of organisms investigated to date.
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Affiliation(s)
- J C Scott
- Molecular Parisitology Unit, Ausalian Centre for International and Tropical Health and Nutrition, Herston, Queensland, Australia
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Scott JC, McManus DP. Molecular cloning and enzymatic expression of the 28-kDa glutathione S-transferase of Schistosoma japonicum: evidence for sequence variation but lack of consistent vaccine efficacy in the murine host. Parasitol Int 2000; 49:289-300. [PMID: 11077263 DOI: 10.1016/s1383-5769(00)00058-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [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: 01/10/2023]
Abstract
Glutathione S-transferases (GSTs) have long been regarded as attractive vaccine (and drug) targets in schistosomes due to their suspected role in detoxification processes. Indeed, the 28-kDa GST of Schistosoma mansoni (SmGST28) has proven efficacy as an antigen for protective immunity reducing worm burden, female fecundity and egg viability. In contrast, the vaccinating effects of the bacterial expressed homologue of Philippine S. japonicum (SjpGST28) have proved disappointing, possibly because this recombinant form was an incomplete sequence, lacking five N-terminal amino acids which may have affected its vaccination efficacy. Here we describe the cloning and functional enzymatic expression of a complete cDNA encoding SjpGST28. We report also on the immunogenicity and vaccine efficacy of this molecule as a purified recombinant protein and as a DNA plasmid vaccine in the murine model. We further describe the cloning of several complete cDNAs encoding the Chinese homologue of SjpGST28 and the identification of 3 SjcGST28 sequence variants which are probably encoded by distinct alleles.
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Affiliation(s)
- J C Scott
- Molecular Parasitology Unit, Australian Centre for International and Tropical Health and Nutrition, The University of Queensland, Post Office Royal Brisbane Hospital, Herston, Queensland 4029, Brisbane, Australia
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Kennedy MW, Scott JC, Lo S, Beauchamp J, McManus DP. Sj-FABPc fatty-acid-binding protein of the human blood fluke Schistosoma japonicum: structural and functional characterization and unusual solvent exposure of a portal-proximal tryptophan residue. Biochem J 2000; 349:377-84. [PMID: 10861250 PMCID: PMC1221159 DOI: 10.1042/0264-6021:3490377] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sj-FABPc of the blood fluke of humans, Schistosoma japonicum, is a member of the FABP/P2/CRBP/CRABP family of beta-barrel cytosolic fatty-acid-binding and retinoid-binding proteins. Sj-FABPc has at least eight different variants encoded by a single-copy polymorphic gene. In fluorescence-based assays, recombinant Sj-FABPc was found to bind 11-(dansylamino)undecanoic acid (DAUDA), inducing a shift in peak fluorescence emission from 543 to 493 nm. A similar spectral change was observed in dansyl-amino-octanoic acid (in which the dansyl fluorophore is attached at the alpha-carbon rather than the omega-carbon of DAUDA), indicating that the ligand enters entirely into the binding site. Sj-FABPc also bound the naturally fluorescent cis-parinaric acid, as well as oleic acid and arachidonic acid, by competition, but not all-trans-retinol. Dissociation constants were, for cis-parinaric acid, K(d)=2.5+/-0.1 microM (mean+/-S.E.M.) and an apparent stoichiometry consistent with one binding site per molecule of Sj-FABPc and, for oleic acid, K(i) approximately 80 nM. A deletion mutant from which alpha-II was absent failed to bind ligand. Sj-FABPc modelled well to known structures of the protein family; an unusually solvent-exposed Trp side chain was evident adjacent to the presumptive portal through which ligand is thought to enter and leave. Intrinsic fluorescence analyses of Sj-FABPc and of the deletion mutant (from which Trp-27 is absent) confirmed the unusual disposition of this side chain. Virtually all members of the FABP/P2/CRBP/CRABP protein family have prominent hydrophobic side chains in this position, with the exception of liver FABP and ileal FABP, which instead have charged side chains. Liver FABP is known to be distinct from other members of the protein family in that it does not seem to contact membranes to collect and deposit its ligand. It is therefore postulated that the unusually positioned apolar side chains in Sj-FABPc and others in the family are important in interactions with membranes or other cellular components.
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MESH Headings
- Amino Acid Sequence
- Animals
- Arachidonic Acid/metabolism
- Binding Sites
- Binding, Competitive
- Carrier Proteins/chemistry
- Carrier Proteins/genetics
- Carrier Proteins/metabolism
- Cell Membrane/metabolism
- DNA, Complementary/metabolism
- Databases, Factual
- Dose-Response Relationship, Drug
- Fatty Acid-Binding Proteins
- Fatty Acids/metabolism
- Fatty Acids, Unsaturated/chemistry
- Gene Deletion
- Helminth Proteins
- Kinetics
- Ligands
- Liver/metabolism
- Models, Molecular
- Molecular Sequence Data
- Mutation
- Neoplasm Proteins
- Oleic Acid/metabolism
- Polymorphism, Genetic
- Protein Binding
- Protein Structure, Secondary
- Recombinant Proteins/metabolism
- Schistosoma japonicum
- Sequence Homology, Amino Acid
- Spectrometry, Fluorescence
- Tryptophan/chemistry
- Vitamin A/metabolism
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Affiliation(s)
- M W Kennedy
- Division of Infection and Immunity, Institute of Biomedical and Life Sciences, Joseph Black Building, University of Glasgow, Glasgow G12 8QQ, Scotland, UK.
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Abstract
We describe the cloning of a full length calpain-encoding cDNA constructed from two truncated cDNAs isolated from a cDNA library prepared with mRNA isolated from adult worms of the Philippine strain of Schistosoma japonicum. The cDNA sequence is 2.456 kb in length and predicts a protein of 758 residues with a molecular mass of 86.61 kDa and an isoelectric point of 5.34. Probes spanning the entire calpain cDNA hybridised to multiple bands in genomic DNAs of Philippine (SjP) and Chinese (SjC) S. japonicum, with some restriction fragment length polymorphisms evident between the two strains. Northern hybridisation analysis indicated that the cDNA codes for a single RNA transcript between 2.6 and 3.6 kb in size in the SjP and SjC genomes. After subcloning in the QIA express vectors pQE-31 and pQE-40 and subsequent expression, the recombinant protein was purified and shown to bind calcium. The availability of recombinant S. japonicum calpain will allow its future evaluation as a vaccine candidate, especially in light of recent work with the S. mansoni homologue which has provided evidence that this protein may be a target of protective immunity.
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Affiliation(s)
- J C Scott
- Molecular Parasitology Unit, Australian Centre for International and Tropical Health and Nutrition, Cooperative Research Centre for Vaccine Technology, University of Queensland, Australia
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Abstract
To examine the risk of mortality following all clinical fractures, we followed 6459 women age 55-81 years participating in the Fracture Intervention Trial for an average of 3.8 years. All fractures and deaths were confirmed by medical record or death certificate. Clinical fractures were fractures that came to medical attention. Fracture status was used as a time-dependent covariate in proportional hazards models. The 907 women who experienced a fracture were older, had lower bone mineral density and were more likely to report a positive fracture history. A total of 122 women died over the course of the study with 23 of these deaths occurring after a clinical fracture. The age-adjusted relative risk (95% confidence intervals) of dying following a clinical fracture was 2.15 (1.36, 3.42). This primarily reflected the higher mortality following a hip fracture, 6.68 (3.08, 14.52); and clinical vertebral fracture, 8.64 (4.45, 16.74). Results were similar after adjusting for treatment assignment, health status and specific common comorbidities. There was no increase in mortality following a forearm or other fracture (non-hip, non-wrist, nonvertebral fracture). In conclusion, clinical vertebral fractures and hip fractures are associated with a substantial increase in mortality among a group of relatively healthy older women.
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Affiliation(s)
- J A Cauley
- University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, PA 15261, USA
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Scott JC. Axial dynamisation cannot be a static process. Injury 1999; 30:716-8; author reply 719-22. [PMID: 10707252 DOI: 10.1016/s0020-1383(99)00204-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Roblin DW, Juhn PI, Preston BJ, Della Penna R, Feitelberg SP, Khoury A, Scott JC. A low-cost approach to prospective identification of impending high cost outcomes. Med Care 1999; 37:1155-63. [PMID: 10549617 DOI: 10.1097/00005650-199911000-00007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The overall objective of this study was to define and evaluate patterns of use of medical services in the care of patients with chronic illness that represent circumstances which, if modified, might lead to reduction in risk of acute-level care. METHODS This was a retrospective observational study. The study population consisted of Kaiser Permanente enrollees at four sites during January 1993 through June 1995, who were 20 to 64 years of age and had two of three chronic diseases (diabetes, circulatory disorders, obstructive pulmonary disorders). Using logistic regression, the effect of primary care visit patterns and therapeutically risky drug combinations on likelihood of hospital admission in a subsequent 3-month period is adjusted for age, gender, and disease state in the prior 12-month period. RESULTS Enrollees with visits to three or more different primary care physicians were 46% more likely to be admitted than expected (P < 0.01) according to their age, gender, and disease state, and those with therapeutically risky drug combinations were 34% more likely to be admitted (P < 0.01). CONCLUSIONS The risk adjustment models evaluated in this study defined care processes associated with increased risk of subsequent acute-level services. Those processes may represent nascent acute disease states or suboptimal organization of care delivery. The results of these models can be used to inform changes in organization and delivery of outpatient care that might improve patient outcomes.
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Affiliation(s)
- D W Roblin
- Kaiser Permanente, Atlanta, Georgia 30305, USA
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Arden NK, Nevitt MC, Lane NE, Gore LR, Hochberg MC, Scott JC, Pressman AR, Cummings SR. Osteoarthritis and risk of falls, rates of bone loss, and osteoporotic fractures. Study of Osteoporotic Fractures Research Group. Arthritis Rheum 1999; 42:1378-85. [PMID: 10403265 DOI: 10.1002/1529-0131(199907)42:7<1378::aid-anr11>3.0.co;2-i] [Citation(s) in RCA: 130] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To examine the association between osteoarthritis (OA), as defined by radiographic evidence and self report, and osteoporotic fractures, falls, and bone loss in a cohort of elderly white women. METHODS A cohort of 5,552 elderly women from the Study of Osteoporotic Fractures was followed up prospectively for a mean of 7.4 years. Self-reported, physician-diagnosed OA was recorded at interview, and radiologic OA of the hip and hand were defined from pelvis and hand radiographs obtained at baseline by validated techniques. Prevalent and incident vertebral fractures were detected by vertebral morphometry, and data on incident fractures and falls were collected by postcard surveys; fractures were confirmed by radiography. Bone mineral density (BMD) was measured on 2 occasions at the hip, lumbar spine, and calcaneus, and rates of bone loss were calculated. RESULTS Women with radiographic hip OA had a reduced risk of recurrent falls in the first year (relative risk [RR] 0.7, 95% confidence interval [95% CI] 0.5-0.95). However, those with self-reported OA had an increased risk of falls (RR 1.4, 95% CI 1.2-1.5). Radiographic hip OA was associated with reduced bone loss in the femoral neck compared with controls (mean +/- SD -0.29+/-0.09%/year versus -0.51+/-0.03%/year; P = 0.018). However, radiographic hip OA showed nonsignificant trends toward increased bone loss at the calcaneus and lumbar spine. There was no significant association between self-reported OA or radiographic hand OA with bone loss. No definition of OA was associated with incident nonvertebral fracture, hip fracture, or vertebral fracture. CONCLUSION Despite having increased BMD compared with controls, subjects with OA did not have a significantly reduced risk of osteoporotic fracture, although there was a trend toward a reduced risk of femoral neck fractures in subjects with severe radiographic OA. The failure of the observed increase in BMD to translate into a reduced fracture risk may be due, in part, to the number and type of falls sustained by subjects with OA. Patients with OA should not be considered to be at a lower risk of fracture than the general population. Physicians should be aware that a high BMD in patients with OA may be falsely reassuring.
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Affiliation(s)
- N K Arden
- University of California, San Francisco, USA
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Lane NE, Gore LR, Cummings SR, Hochberg MC, Scott JC, Williams EN, Nevitt MC. Serum vitamin D levels and incident changes of radiographic hip osteoarthritis: a longitudinal study. Study of Osteoporotic Fractures Research Group. Arthritis Rheum 1999; 42:854-60. [PMID: 10323440 DOI: 10.1002/1529-0131(199905)42:5<854::aid-anr3>3.0.co;2-i] [Citation(s) in RCA: 156] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the relationship of serum levels of 25-vitamin D and 1,25-vitamin D to incident changes of radiographic hip osteoarthritis (OA) among elderly white women. METHODS Baseline and followup hip radiographs of 237 subjects were obtained an average of 8 years apart. Hips were scored for individual radiographic features (IRF) and assigned a summary grade based on the number and type of IRF present. Serum 25- and 1,25-vitamin D levels from baseline samples were analyzed by radioimmunoassay. Logistic and linear regression were used to examine the association of 25- and 1,25-vitamin D levels with radiographic changes, adjusting for age, health status, physical activity, weight, vitamin D supplement use, and calcaneal bone mineral density. RESULTS The risk of incident hip OA defined as the development of definite joint space narrowing was increased for subjects who were in the middle (odds ratio [OR] 3.21, 95% confidence interval [95% CI] 1.06, 9.68) and lowest (OR 3.34, 95% CI 1.13, 9.86) tertiles for 25-vitamin D compared with subjects in the highest tertile. Vitamin D levels were not associated with incident hip OA defined as the development of definite osteophytes or new disease according to the summary grade. No association between serum 1,25-vitamin D and changes in radiographic hip OA was found. CONCLUSION Low serum levels of 25-vitamin D may be associated with incident changes of radiographic hip OA characterized by joint space narrowing.
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Affiliation(s)
- N E Lane
- Division of Rheumatology, University of California, San Francisco 94143, USA
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Abstract
Distance and isolation profoundly affect the delivery of health care in the islands of Micronesia. The lack of specialty services on most of the islands has led to a costly off-island referral system that strains health care budgets. Care providers there have incorporated advances in telecommunications to create a telemedicine network amongst themselves and with a tertiary care hospital in Hawaii. They developed an interactive video conferencing system, a still-image transmission network, and a data transfer network for use principally in patient care and continuing education. Patients now receive earlier evaluation by off-island specialists as part of an effort to improve the appropriateness of off-island referrals. Regularly scheduled medical lectures are broadcast from Pohnpei, a main island, to physicians in several more remote locations. Transmission costs are kept low by using, when possible, preexisting public-service satellites, such as the PEACESAT system that serves the entire Pacific basin. The telemedicine system is evolving, and its success depends greatly on the cooperative relationships among the partners.
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Affiliation(s)
- S A Norton
- Department of Dermatology, Tripler Army Medical Center, Honolulu, HI, USA
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Lane NE, Hochberg MC, Pressman A, Scott JC, Nevitt MC. Recreational physical activity and the risk of osteoarthritis of the hip in elderly women. J Rheumatol 1999; 26:849-54. [PMID: 10229406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE The relationship between recreational physical activity and the risk of osteoarthritis (OA) of the hip in women is uncertain. We examined the cross sectional association of radiographic OA of the hip and past recreational and sports related physical activity in elderly women who are participants in the Study of Osteoporotic Fractures. METHODS An anteroposterior pelvic radiograph of 5818 subjects was assessed for hip OA using reliable measurements of individual radiographic features. Hips were graded on a summary scale of 0 (no findings) to 4 (severe OA) based on the number and type of radiographic features present. Logistic regression was used to examine the association of self-reported recreational physical activity (times/week) as a teenager, at age 30, and at age 50 with hip OA. All analyses were adjusted for age and body mass index at age 25 years. RESULTS The risk of moderate to severe radiographic hip OA in elderly women was modestly increased in elderly women who were in the highest quartile for all physical activities performed as a teenager (odds ratio 1.7, 95% confidence interval 1.1, 2.4), at age 50 (OR 1.4, 95% CI 1.0, 1.9) and weight bearing activities at age 30 (OR 1.4, 95% CI 1.0, 1.9) compared to women in the lowest quartile of activity. The risk of symptomatic hip OA (grade > or =2 hip OA + hip pain) was modestly increased in women who were in the highest quartile for all physical activities as a teenager (OR 2.0, 95% CI 1.2, 3.4), at age 50 (OR 1.6, 95% CI 1.0, 2.4), and weight bearing activities at age 30 (OR 1.6, 95% CI 1.0, 2.4) compared to women in the lowest quartile of activity. CONCLUSION Recreational physical activities performed by women before menopause may increase the risk of radiographic and symptomatic hip OA.
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Affiliation(s)
- N E Lane
- Department of Medicine and Epidemiology, University of California at San Francisco, 94143, USA
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Scott JC, McManus DP. Molecular cloning and functional expression of a cDNA encoding the major endoplasmic reticulum-associated calcium-binding protein, calreticulin, from Philippine strain Schistosoma japonicum. Parasitol Int 1999; 48:35-46. [PMID: 11269324 DOI: 10.1016/s1383-5769(98)00039-7] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We describe the cloning of a full length calreticulin (CR)-encoding cDNA clone isolated by immunoscreening of a cDNA library prepared with mRNA from adult worms of the Philippine strain of Schistosoma japonicum, the cause of Asian schistosomiasis. The sequence of the cDNA is presented, and its molecular characterisation and functional expression as a Ca2+-binding protein described. The potential role of CR in inducing protective immunity in the schistosomes is discussed.
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Affiliation(s)
- J C Scott
- Molecular Parasitology Unit, Australian Centre for International and Tropical Health and Nutrition, The University of Queensland and The Queensland Institute of Medical Research, Australia
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Abstract
A diverse range of organisms respond to a variety of chemical, physiological and temperature-associated stresses by a rapid and transient increase in the synthesis of heat shock proteins. We immunoscreened a Uni-ZAP XR cDNA library, prepared from mRNA isolated from the Philippine strain of the Asian bloodfluke, Schistosoma japonicum, using hyperimmune rabbit sera raised against soluble adult S. japonicum proteins. Six 70-kDa heat shock protein-encoding cDNA clones were identified which, upon further analysis, were separated into two distinct protein groups within the 70-kDa heat shock protein family, the 70-kDa heat shock proteins and the immunoglobulin heavy chain-binding proteins/glucose-related proteins (Grp78). A representative from both groups was fully sequenced and compared with homologous sequences available in the GenBank/EMBL database as the first stage in determining the role of their expression products in the regulation of S. japonicum development, in the induction of immunity, and whether they act as molecular chaperones capable of modulating the correct folding or repair of proteins within this species of schistosome.
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Affiliation(s)
- J C Scott
- Molecular Parasitology Unit, Australian Centre for International and Tropical Health and Nutrition, The University of Queensland, Post Office Royal Brisbane Hospital, Herston
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37
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Abstract
A wide variety of experimental animal models have been used to investigate the mechanisms of synthesis, storage, and release of catecholamines. Whereas in vivo experimental models are situated at one end of the spectrum, cell culture models are situated at the other end. In the present study, we have characterized various aspects of the rat adrenal medulla cultured in vitro as a whole tissue, aiming to establish a new experimental model in between in vivo animal models and cell culture models. We adapted a bottle rotator system commonly used for culturing rodent whole embryos. Changes in histology, activities and mRNA levels of catecholamine-synthesizing enzymes, and concentrations of catecholamines in the adrenal medulla were studied. In addition, the effects of cholinergic stimulation on catecholamine release from the adrenal medulla were examined. Overall the results indicate that various aspects of the adrenal medulla become stable after 4 d of culture and the adrenal medulla at this stage releases catecholamines in response to cholinergic stimulation. The whole adrenal medulla culture system may be a useful tool for investigating catecholamine-related functions dependent on intercellular reactions or communications.
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Affiliation(s)
- M Fujinaga
- Department of Anesthesia, Stanford University School of Medicine, California 94305, USA
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Cummings SR, Black DM, Thompson DE, Applegate WB, Barrett-Connor E, Musliner TA, Palermo L, Prineas R, Rubin SM, Scott JC, Vogt T, Wallace R, Yates AJ, LaCroix AZ. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA 1998; 280:2077-82. [PMID: 9875874 DOI: 10.1001/jama.280.24.2077] [Citation(s) in RCA: 1448] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT Alendronate sodium reduces fracture risk in postmenopausal women who have vertebral fractures, but its effects on fracture risk have not been studied for women without vertebral fractures. OBJECTIVE To test the hypothesis that 4 years of alendronate would decrease the risk of clinical and vertebral fractures in women who have low bone mineral density (BMD) but no vertebral fractures. DESIGN Randomized, blinded, placebo-controlled trial. SETTING Eleven community-based clinical research centers. SUBJECTS Women aged 54 to 81 years with a femoral neck BMD of 0.68 g/cm2 or less (Hologic Inc, Waltham, Mass) but no vertebral fracture; 4432 were randomized to alendronate or placebo and 4272 (96%) completed outcome measurements at the final visit (an average of 4.2 years later). INTERVENTION All participants reporting calcium intakes of 1000 mg/d or less received a supplement containing 500 mg of calcium and 250 IU of cholecalciferol. Subjects were randomly assigned to either placebo or 5 mg/d of alendronate sodium for 2 years followed by 10 mg/d for the remainder of the trial. MAIN OUTCOME MEASURES Clinical fractures confirmed by x-ray reports, new vertebral deformities detected by morphometric measurements on radiographs, and BMD measured by dual x-ray absorptiometry. RESULTS Alendronate increased BMD at all sites studied (P<.001) and reduced clinical fractures from 312 in the placebo group to 272 in the intervention group, but not significantly so (14% reduction; relative hazard [RH], 0.86; 95% confidence interval [CI], 0.73-1.01). Alendronate reduced clinical fractures by 36% in women with baseline osteoporosis at the femoral neck (>2.5 SDs below the normal young adult mean; RH, 0.64; 95% CI, 0.50-0.82; treatment-control difference, 6.5%; number needed to treat [NNT], 15), but there was no significant reduction among those with higher BMD (RH, 1.08; 95% CI, 0.87-1.35). Alendronate decreased the risk of radiographic vertebral fractures by 44% overall (relative risk, 0.56; 95% CI, 0.39-0.80; treatment-control difference, 1.7%; NNT, 60). Alendronate did not increase the risk of gastrointestinal or other adverse effects. CONCLUSIONS In women with low BMD but without vertebral fractures, 4 years of alendronate safely increased BMD and decreased the risk of first vertebral deformity. Alendronate significantly reduced the risk of clinical fractures among women with osteoporosis but not among women with higher BMD.
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Affiliation(s)
- S R Cummings
- Department of Epidemiology and Biostatistics, University of California, San Francisco 94105, USA.
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Bliznyuk VN, Carter SA, Scott JC, Klärner G, Miller RD, Miller DC. Electrical and Photoinduced Degradation of Polyfluorene Based Films and Light-Emitting Devices. Macromolecules 1998. [DOI: 10.1021/ma9808979] [Citation(s) in RCA: 413] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Waine GJ, Yang W, Ross AG, Li YS, Sleigh AC, Kalinna BH, Scott JC, Mazzer D, Li Y, McManus DP. Differential antigen-stimulated proliferation of human mononuclear cells by recombinant Schistosoma japonicum antigens in a Chinese population. Clin Exp Immunol 1998; 112:69-73. [PMID: 9566792 PMCID: PMC1904938 DOI: 10.1046/j.1365-2249.1998.00542.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Peripheral blood mononuclear cells (PBMC) from 117 individuals living on two islands in an area (Dongting Lake) endemic for schistosomiasis japonica in China, and 15 control individuals from a non-endemic area of China, were assessed for antigen-stimulated proliferation against five recombinant Schistosoma japonicum antigens of recognized interest in the development of immunity to schistosomiasis. Two recombinant antigens, paramyosin and 28-kD glutathione-S-transferase, stimulated cellular proliferation (stimulation index > or = 3.0) in 38.5% and 42.5% of subjects, respectively, a level similar to that induced by a soluble whole parasite extract (51.3%). In contrast, three other recombinant antigens tested--a fatty acid binding protein, 22-kD tegumental membrane-associated antigen, and glyceraldehyde-3-phosphate dehydrogenase--stimulated PBMC proliferation in only 3-8% of subjects. Moreover, we also identified a positive association between the degree of exposure, and cellular proliferation following stimulation with recombinant paramyosin or whole parasite extract. Highly significant differences in antigen-stimulated proliferation were also observed between the two islands, Niangashan and Qingshan. The whole parasite extract stimulated proliferation in 90% of subjects from Niangashan island compared with only 42.1% of subjects from Qingshan island (chi2 = 16.88, P = 0.00004), while glutathione-S-transferase stimulated proliferation in 77.3% of subjects from Niangashan island compared with only 34.7% of subjects from Qingshan island (chi2 = 13.09, P = 0.003). A similar, but not significant, trend was observed for paramyosin and the fatty-acid binding protein. The identification of differential cellular proliferative responses to specific schistosome antigens within an infected human population may have important practical implications for vaccine development against schistosomiasis japonica.
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Affiliation(s)
- G J Waine
- Molecular Parasitology Unit, The Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Australia
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Kreyenschmidt M, Klaerner G, Fuhrer T, Ashenhurst J, Karg S, Chen WD, Lee VY, Scott JC, Miller RD. Thermally Stable Blue-Light-Emitting Copolymers of Poly(alkylfluorene). Macromolecules 1998. [DOI: 10.1021/ma970914e] [Citation(s) in RCA: 356] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. Kreyenschmidt
- IBM Almaden Research Center, 650 Harry Road, San Jose, California 95120-6099
| | - G. Klaerner
- IBM Almaden Research Center, 650 Harry Road, San Jose, California 95120-6099
| | - T. Fuhrer
- IBM Almaden Research Center, 650 Harry Road, San Jose, California 95120-6099
| | - J. Ashenhurst
- IBM Almaden Research Center, 650 Harry Road, San Jose, California 95120-6099
| | - S. Karg
- IBM Almaden Research Center, 650 Harry Road, San Jose, California 95120-6099
| | - W. D. Chen
- IBM Almaden Research Center, 650 Harry Road, San Jose, California 95120-6099
| | - V. Y. Lee
- IBM Almaden Research Center, 650 Harry Road, San Jose, California 95120-6099
| | - J. C. Scott
- IBM Almaden Research Center, 650 Harry Road, San Jose, California 95120-6099
| | - R. D. Miller
- IBM Almaden Research Center, 650 Harry Road, San Jose, California 95120-6099
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Waine GJ, Scott JC, Mazzer D, McManus DP. Mapping of linear B-cell epitopes on the 14-kDa fatty-acid binding protein of Chinese Schistosoma japonicum. Int J Parasitol 1998; 28:303-8. [PMID: 9512993 DOI: 10.1016/s0020-7519(97)00148-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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: 02/06/2023]
Abstract
The 14-kDa fatty-acid binding protein (FABP) of schistosomes is of recognised importance as a potential vaccine and/or drug target against schistosomiasis, but little is known of its antigenicity. In this study, we have identified and compared linear B-cell epitopes present on the FABP of Chinese strain Schistosoma japonicum, using sera obtained from experimentally infected mice, or from mice immunised with the functionally active recombinant antigen (rSjFABP). Sera from three strains of mice, CBA, C57BL/6 and BALB/c, representing different genetic backgrounds, were reacted with a series of overlapping peptides in epitope-scanning studies. Sera from experimentally infected mice reacted predominantly with peptides 9-12, encoding amino acids 91-132, in the C-terminal region of the molecule. This was in contrast to sera from mice immunised with rSjFABP, which reacted predominantly with peptides 4-9, encoding amino acids 41-101, in the central portion of the molecule. The results presented here describing the epitope mapping of this molecule may prove important in research aimed at further defining immune responses to schistosomal antigens. They indicate that epitopes recognised during vaccination with functionally active rSjFABP, at least in the murine model, differ from those recognised during natural infection.
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Affiliation(s)
- G J Waine
- Molecular Parasitology Unit, Australian Centre for International and Tropical Health and Nutrition, Queensland Institute of Medical Research, Post Office Royal Brisbane Hospital, Australia.
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Abstract
Timed-pregnant Sprague-Dawley rats were killed between gestational day (GD) 8 and 10, and embryos were explanted and separated into developmental stages according to a modified Theiler's system. Total RNA from each stage was isolated and subjected to reverse transcription-polymerase chain reaction (RT-PCR) assays to examine gene expression of catecholamine synthesizing enzymes and three subtypes of beta adrenoceptors. Expression of these genes was detected at much earlier stages than previously reported, and each enzyme and receptor subtype showed a different pattern of gene expression. For example, mRNA for tyrosine hydroxylase, the rate-limiting enzyme for catecholamine synthesis, was detected as early as stage 10a, late GD 8, before the neural crest cells appear (stage 12, mid GD 10). This contradicts the common belief that catecholamines are produced only in the cells of sympathoadrenal lineage which originate from the neural crest cells and the cells of central nervous system. Results from the present study indicate that catecholamine synthesis is not limited to the cells of sympathoadrenal lineage.
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Affiliation(s)
- M Fujinaga
- Department of Anesthesia, Stanford University School of Medicine, CA 94305, USA.
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44
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Scott JC. Epidemiology of osteoporosis. Rev Rhum Engl Ed 1997; 64:10S-14S. [PMID: 9273931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- J C Scott
- Division of Rheumatology, School of Medicine, University of Maryland, Baltimore 21201, USA
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Abstract
We have examined the efficacy of nucleic acid vaccination in inducing immunity to the multicellular parasite, Schistosoma japonicum, a trematode worm responsible for causing schistosomiasis in humans and other mammalian species. A panel of Schistosoma japonicum cDNAs were cloned into eukaryotic expression vectors, injected into animals, and tested for immunogenicity. The cDNAs tested encoded 26- and 28-kDa glutathione-S-transferases, calreticulin, glyceraldehyde-3-phosphate dehydrogenase, a 22.6 kDa membrane-associated antigen, a 14 kDa fatty-acid binding protein, fragments of paramyosin, full-length paramyosin, and a novel gene comprising the 26 kDa glutathione-S-transferase fused to a fragment of paramyosin cDNA. The paramyosin gene constructs, including the fusion, were all able to induce anti-paramyosin antibodies; with the fragments of paramyosin these were of the IgG1, IgG2a and IgG2b isotypes. In contrast, none of the other schistosome cDNAs tested were able to induce detectable antibody responses. The anti-paramyosin antibodies did not protect mice challenged with cercariae of S. japonicum.
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Affiliation(s)
- G J Waine
- Molecular Parasitology Unit, Australian Centre for International and Tropical Health and Nutrition, Queensland Institute of Medical Research, Royal Brisbane Hospital, Herston, Australia
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Zhang JZ, Kreger MA, Hu QS, Vitharana D, Pu L, Brock PJ, Scott JC. Femtosecond studies of exciton dynamics in a novel main chain chiral conjugated poly(arylenevinylene). J Chem Phys 1997. [DOI: 10.1063/1.473423] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Scott JC, Robertson BJ. Kaiser Colorado's Cooperative Health Care Clinic: a group approach to patient care. Manag Care Q 1997; 4:41-5. [PMID: 10159032] [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: 02/11/2023]
Abstract
A Kaiser Permanente pilot project demonstrates that managing health status with patients on a group basis versus one-on-one office visits can improve health care delivery services and reduce unnecessary resource utilization. Kaiser's Cooperative Health Care Clinic (CHCC) in Denver, Colorado, uses a multidisciplinary team to successfully provide care to elderly members with chronic conditions.
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Affiliation(s)
- J C Scott
- Colorado Permanente Medical Group, Denver, USA
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Scott JC, Stefaniak J, Pawlowski ZS, McManus DP. Molecular genetic analysis of human cystic hydatid cases from Poland: identification of a new genotypic group (G9) of Echinococcus granulosus. Parasitology 1997; 114 ( Pt 1):37-43. [PMID: 9011072 DOI: 10.1017/s0031182096008062] [Citation(s) in RCA: 109] [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: 02/03/2023]
Abstract
We have used nuclear (ribosomal ITS1) and mitochondrial (ND1) sequences to characterize human and pig isolates of Echinococcus granulosus collected by fine needle aspiration biopsy (FNAB) in Poland. The data indicate clearly that the Polish patients were not infected with the common sheep strain (G1 genotype) of E. granulosus, normally associated with human cystic hydatid infection. Instead, the hydatid parasite infecting the Polish patients shares very similar ND1 sequence with the previously characterized pig (G7) genotype but it also exhibits some clear differences. In particular, E. granulosus DNA from the Polish patients amplified a single ITS1 fragment in PCR and distinct ITS1-RFLP patterns were obtained after restriction digestion. The form of hydatid isolated from the Polish patients appears, therefore, to represent a distinct, previously undescribed genotype (designated G9) of E. granulosus.
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Affiliation(s)
- J C Scott
- Molecular Parasitology Unit, Australian Centre for International and Tropical Health and Nutrition, Brisbane, Australia
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Star VL, Scott JC, Sherwin R, Lane N, Nevitt MC, Hochberg MC. Validity of self-reported rheumatoid arthritis in elderly women. J Rheumatol 1996; 23:1862-5. [PMID: 8923357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine the validity of a self-reported physician diagnosis of rheumatoid arthritis (RA) in elderly women. METHODS Women with self-reported RA were contacted and permission requested to contact their physician. Physicians were mailed a questionnaire requesting information on the subject's arthritic condition. Hand radiographs obtained at study entry were read for changes of RA. RESULTS The self-reported diagnosis of RA could be confirmed in 26 (21%) individuals. CONCLUSION The positive predictive value of self-reported RA was low in this cohort. Caution needs to be exercised in the use and interpretation of self-report data concerning arthritic conditions in epidemiologic studies.
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Affiliation(s)
- V L Star
- Department of Medicine, University of Maryland School of Medicine, Baltimore, USA
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