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Gold J, Kripke CM, Drivas TG. Universal Exome Sequencing in Critically Ill Adults: A Diagnostic Yield of 25% and Race-Based Disparities in Access to Genetic Testing. medRxiv 2024:2024.03.11.24304088. [PMID: 38559092 PMCID: PMC10980115 DOI: 10.1101/2024.03.11.24304088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Numerous studies have underscored the diagnostic and therapeutic potential of exome or genome sequencing in critically ill pediatric populations. However, an equivalent investigation in critically ill adults remains conspicuously absent. We retrospectively analyzed whole exome sequencing (WES) data available through the PennMedicine Biobank (PMBB) from all 365 young adult patients, aged 18-40 years, with intensive care unit (ICU) admissions at the University of Pennsylvania Health System who met inclusion criteria for our study. For each participant, two Medical Genetics and Internal Medicine-trained clinicians reviewed WES reports and patient charts for variant classification, result interpretation, and identification of genetic diagnoses related to their critical illness. Of the 365 individuals in our study, 90 (24.7%) were found to have clearly diagnostic results on WES; an additional 40 (11.0%) had a suspicious variant of uncertain significance (VUS) identified; and an additional 16 (4.4%) had a medically actionable incidental finding. The diagnostic rate of exome sequencing did not decrease with increasing patient age. Affected genes were primarily involved in cardiac function (18.8%), vascular health (16.7%), cancer (16.7%), and pulmonary disease (11.5%). Only half of all diagnostic findings were known and documented in the patient chart at the time of ICU admission. Significant disparities emerged in subgroup analysis by EHR-reported race, with genetic diagnoses known/documented for 63.5% of White patients at the time of ICU admission but only for 28.6% of Black or Hispanic patients. There was a trend towards patients with undocumented genetic diagnoses having a 66% increased mortality rate, making these race-based disparities in genetic diagnosis even more concerning. Altogether, universal exome sequencing in ICU-admitted adult patients was found to yield a new definitive diagnosis in 11.2% of patients. Of these diagnoses, 76.6% conferred specific care-altering medical management recommendations. Our study suggests that the diagnostic utility of exome sequencing in critically ill young adults is similar to that observed in neonatal and pediatric populations and is age-independent. The high diagnostic rate and striking race-based disparities we find in genetic diagnoses argue for broad and universal approaches to genetic testing for critically ill adults. The widespread implementation of comprehensive genetic sequencing in the adult population promises to enhance medical care for all individuals and holds the potential to rectify disparities in genetic testing referrals, ultimately promoting more equitable healthcare delivery.
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Affiliation(s)
- Jessica Gold
- Division of Clinical Genetics, Department of Pediatrics, Northwell Health, Great Neck, NY 11021, USA
| | - Colleen M. Kripke
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19194, USA
| | | | | | - Theodore G. Drivas
- Division of Translational Medicine and Human Genetics, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19194, USA
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19194, USA
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Jerves Serrano T, Gold J, Cooper JA, Church HJ, Tylee KL, Wu HY, Kim SY, Stepien KM. Hepatomegaly and Splenomegaly: An Approach to the Diagnosis of Lysosomal Storage Diseases. J Clin Med 2024; 13:1465. [PMID: 38592278 PMCID: PMC10932313 DOI: 10.3390/jcm13051465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
Clinical findings of hepatomegaly and splenomegaly, the abnormal enlargement of the liver and spleen, respectively, should prompt a broad differential diagnosis that includes metabolic, congestive, neoplastic, infectious, toxic, and inflammatory conditions. Among the metabolic diseases, lysosomal storage diseases (LSDs) are a group of rare and ultrarare conditions with a collective incidence of 1 in 5000 live births. LSDs are caused by genetic variants affecting the lysosomal enzymes, transporters, or integral membrane proteins. As a result, abnormal metabolites accumulate in the organelle, leading to dysfunction. Therapeutic advances, including early diagnosis and disease-targeted management, have improved the life expectancy and quality of life of people affected by certain LSDs. To access these new interventions, LSDs must be considered in patients presenting with hepatomegaly and splenomegaly throughout the lifespan. This review article navigates the diagnostic approach for individuals with hepatosplenomegaly particularly focusing on LSDs. We provide hints in the history, physical exam, laboratories, and imaging that may identify LSDs. Additionally, we discuss molecular testing, arguably the preferred confirmatory test (over biopsy), accompanied by enzymatic testing when feasible.
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Affiliation(s)
| | - Jessica Gold
- Division of Genetics, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
| | - James A. Cooper
- Willink Biochemical Genetics Laboratory, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (J.A.C.); (H.J.C.); (K.L.T.); (H.Y.W.)
| | - Heather J. Church
- Willink Biochemical Genetics Laboratory, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (J.A.C.); (H.J.C.); (K.L.T.); (H.Y.W.)
| | - Karen L. Tylee
- Willink Biochemical Genetics Laboratory, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (J.A.C.); (H.J.C.); (K.L.T.); (H.Y.W.)
| | - Hoi Yee Wu
- Willink Biochemical Genetics Laboratory, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK; (J.A.C.); (H.J.C.); (K.L.T.); (H.Y.W.)
| | - Sun Young Kim
- Division of Human Genetics, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45219, USA;
| | - Karolina M. Stepien
- Salford Royal Organization, Northern Care Alliance NHS Foundation Trust, Adult Inherited Metabolic Diseases Department, Salford M6 8HD, UK
- Division of Cardiovascular Sciences, University of Manchester, Manchester M13 9PL, UK
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Hoang K, Gold J, Powell C, Lee HC, Floyd B, Schroeder A, Chadwick W. Concordance between electronic health record-recorded race/ethnicity and parental report in hospitalized children. J Hosp Med 2023. [PMID: 37226928 DOI: 10.1002/jhm.13140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Electronic health records (EHRs) have become an important repository for patient race and ethnicity. Misclassification could negatively affect efforts to monitor and reduce health disparities and structural discrimination. OBJECTIVE We assessed the concordance of parental reports of race/ethnicity for their hospitalized children with EHR-documented demographics. We also aimed to describe parents' preferences on how race/ethnicity should be captured in the hospital's EHR. DESIGNS, SETTINGS, AND PARTICIPANTS From December 2021 to May 2022, we conducted a single-center cross-sectional survey of parents of hospitalized children asking to describe their child's race/ethnicity and compared these responses to the race/ethnicity documented in the EHR. MAIN OUTCOME AND MEASURES Concordance was analyzed with a kappa statistic (κ). Additionally, we queried respondents about their awareness of and preferences for race/ethnicity documentation. RESULTS Of the 275 participants surveyed (79% response rate), there was 69% agreement (κ = 0.56) for race and 80% agreement (κ = 0.63) for ethnicity between parent report and EHR documentation. Sixty-eight parents (21%) felt that the designated categories poorly represent their child's race/ethnicity. Twenty-two (8%) were uncomfortable with their child's race/ethnicity being displayed on the hospital's EHR. Eighty-nine (32%) preferred a more comprehensive list of race/ethnicity categories. CONCLUSIONS Nonconcordance between EHR-recorded race/ethnicity and parental report exists in the EHR for our hospitalized patients, which has implications for describing patient populations and for understanding racial and ethnic disparities. Current EHR categories may be limited in their ability to capture the complexity of these constructs. Future efforts should focus on ensuring that demographic information in the EHR is accurately collected and appropriately reflects families' preferences.
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Affiliation(s)
- Kim Hoang
- Division of Pediatrics Hospital Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Jessica Gold
- Division of Pediatrics Hospital Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Carmin Powell
- Division of Pediatrics Hospital Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Henry C Lee
- Division of Neonatology, University of California San Diego, La Jolla, California, USA
| | - Baraka Floyd
- Division of General Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Alan Schroeder
- Division of Pediatrics Hospital Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Whitney Chadwick
- Division of Pediatrics Hospital Medicine, Stanford University School of Medicine, Palo Alto, California, USA
- Department of Information Services, Stanford Children's Health, Palo Alto, California, USA
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Strong A, Rao S, von Hardenberg S, Li D, Cox LL, Lee PC, Zhang LQ, Awotoye W, Diamond T, Gold J, Gooch C, Gowans LJJ, Hakonarson H, Hing A, Loomes K, Martin N, Marazita ML, Mononen T, Piccoli D, Pfundt R, Raskin S, Scherer SW, Sobriera N, Vaccaro C, Wang X, Watson D, Weksberg R, Bhoj E, Murray JC, Lidral AC, Butali A, Buckley MF, Roscioli T, Koolen DA, Seaver LH, Prows CA, Stottmann RW, Cox TC. A mutational hotspot in AMOTL1 defines a new syndrome of orofacial clefting, cardiac anomalies, and tall stature. Am J Med Genet A 2023; 191:1227-1239. [PMID: 36751037 PMCID: PMC10081944 DOI: 10.1002/ajmg.a.63130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/03/2023] [Accepted: 01/17/2023] [Indexed: 02/09/2023]
Abstract
AMOTL1 encodes angiomotin-like protein 1, an actin-binding protein that regulates cell polarity, adhesion, and migration. The role of AMOTL1 in human disease is equivocal. We report a large cohort of individuals harboring heterozygous AMOTL1 variants and define a core phenotype of orofacial clefting, congenital heart disease, tall stature, auricular anomalies, and gastrointestinal manifestations in individuals with variants in AMOTL1 affecting amino acids 157-161, a functionally undefined but highly conserved region. Three individuals with AMOTL1 variants outside this region are also described who had variable presentations with orofacial clefting and multi-organ disease. Our case cohort suggests that heterozygous missense variants in AMOTL1, most commonly affecting amino acid residues 157-161, define a new orofacial clefting syndrome, and indicates an important functional role for this undefined region.
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Affiliation(s)
- Alanna Strong
- The Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Soumya Rao
- Department of Oral & Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City Kansas City, Missouri
| | | | - Dong Li
- The Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Liza L. Cox
- Department of Oral & Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City Kansas City, Missouri
| | - Paul C. Lee
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Li Q. Zhang
- Department of Oral & Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City Kansas City, Missouri
| | - Waheed Awotoye
- Department of Orthodontics, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - Tamir Diamond
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Gastroenterology, Hepatology and Nutrition. Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Jessica Gold
- The Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Catherine Gooch
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Lord Jephthah Joojo Gowans
- Department of Biochemistry and Biotechnology, Kwame Nkurumah University of Science and Technology, Kumasi, Ghana
| | - Hakon Hakonarson
- The Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Pulmonary Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Anne Hing
- Division of Craniofacial Medicine, Department of Pediatrics, University of Washington, Seattle, Washington
| | - Kathleen Loomes
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Gastroenterology, Hepatology and Nutrition. Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Nicole Martin
- Division of Clinical & Metabolic Genetics and Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute of Medical Sciences and Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Mary L. Marazita
- Department of Oral and Craniofacial Sciences, Center for Craniofacial and Dental Genetics School of Dental Medicine, Pittsburgh, Pennsylvania
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tarja Mononen
- Department of Clinical Genetics, Kuopio University Hospital, Kuopio, Finland
| | - David Piccoli
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Gastroenterology, Hepatology and Nutrition. Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Rolph Pfundt
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands
| | - Salmo Raskin
- Assistance Center for Cleft Lip and Palate (CAIF), Curitiba-PR, Brazil
| | - Stephen W. Scherer
- The Centre for Applied Genomics and Department of Genetics & Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- McLaughlin Centre and Dept. of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Nara Sobriera
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Courtney Vaccaro
- The Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Xiang Wang
- The Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Deborah Watson
- The Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Rosanna Weksberg
- Institute of Medical Sciences and Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Division of Clinical & Metabolic Genetics, Department of Pediatrics, and Genetics and Genome Biology Program, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elizabeth Bhoj
- The Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Genomic Diagnostics and Department of Pathology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | | | - Azeez Butali
- Departments of Oral Pathology, Radiology and Medicine, College of Dentistry & Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Michael F. Buckley
- NSW Health Pathology Genomics Laboratory, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Tony Roscioli
- NSW Health Pathology Genomics Laboratory, Prince of Wales Hospital, Randwick, NSW, Australia
- Centre for Clinical Genetics, Sydney Children’s Hospital, Randwick, NSW, Australia
- Neuroscience Research Australia and Prince of Wales Clinical School, University of New South Wales, Kensington, NSW, Australia
| | - David A. Koolen
- Department of Human Genetics, Radboud university medical center, Nijmegen, The Netherlands
| | - Laurie H. Seaver
- Spectrum Health Helen DeVos Children’s Hospital, Grand Rapids, Michigan
- Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Grand Rapids, Michigan
| | - Cynthia A. Prows
- Divisions of Human Genetics and Patient Services, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Rolf W. Stottmann
- Divisions of Human Genetics and Patient Services, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Steve & Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children’s Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University School of Medicine, Columbus, Ohio, USA
| | - Timothy C. Cox
- Department of Oral & Craniofacial Sciences, School of Dentistry, University of Missouri-Kansas City Kansas City, Missouri
- Department of Pediatrics, School of Medicine, University of Missouri-Kansas City Kansas City, Missouri, 64108, USA
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Ritter AL, Gold J, Hayashi H, Ackermann AM, Hanke S, Skraban C, Cuddapah S, Bhoj E, Li D, Kuroda Y, Wen J, Takeda R, Bibb A, El Chehadeh S, Piton A, Ohl J, Kukolich MK, Nagasaki K, Kato K, Ogi T, Bhatti T, Russo P, Krock B, Murrell JR, Sullivan JA, Shashi V, Stong N, Hakonarson H, Sawano K, Torti E, Willaert R, Si Y, Wilcox WR, Wirgenes KV, Thomassen K, Carlotti K, Erwin A, Lazier J, Marquardt T, He M, Edmondson AC, Izumi K. Expanding the phenotypic spectrum of ARCN1-related syndrome. Genet Med 2022; 24:1227-1237. [PMID: 35300924 PMCID: PMC9923403 DOI: 10.1016/j.gim.2022.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 01/18/2023] Open
Abstract
PURPOSE This study aimed to describe the phenotypic and molecular characteristics of ARCN1-related syndrome. METHODS Patients with ARCN1 variants were identified, and clinician researchers were connected using GeneMatcher and physician referrals. Clinical histories were collected from each patient. RESULTS In total, we identified 14 cases of ARCN1-related syndrome, (9 pediatrics, and 5 fetal cases from 3 families). The clinical features these newly identified cases were compared to 6 previously reported cases for a total of 20 cases. Intrauterine growth restriction, micrognathia, and short stature were present in all patients. Other common features included prematurity (11/15, 73.3%), developmental delay (10/14, 71.4%), genitourinary malformations in males (6/8, 75%), and microcephaly (12/15, 80%). Novel features of ARCN1-related syndrome included transient liver dysfunction and specific glycosylation abnormalities during illness, giant cell hepatitis, hepatoblastoma, cataracts, and lethal skeletal manifestations. Developmental delay was seen in 73% of patients, but only 3 patients had intellectual disability, which is less common than previously reported. CONCLUSION ARCN1-related syndrome presents with a wide clinical spectrum ranging from a severe embryonic lethal syndrome to a mild syndrome with intrauterine growth restriction, micrognathia, and short stature without intellectual disability. Patients with ARCN1-related syndrome should be monitored for liver dysfunction during illness, cataracts, and hepatoblastoma. Additional research to further define the phenotypic spectrum and possible genotype-phenotype correlations are required.
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Affiliation(s)
- Alyssa L Ritter
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jessica Gold
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Hiroshi Hayashi
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Amanda M Ackermann
- Division of Endocrinology and Diabetes, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Stephanie Hanke
- Division of Endocrinology and Diabetes, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Cara Skraban
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Sanmati Cuddapah
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Elizabeth Bhoj
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Dong Li
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Yukiko Kuroda
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jessica Wen
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Ryojun Takeda
- Division of Genetics, Nagano Children's Hospital, Nagano, Japan
| | - Audrey Bibb
- Department of Human Genetics, Emory University School of Medicine, Emory University, Atlanta, GA
| | - Salima El Chehadeh
- Service de Génétique Médicale, Institut de Génétique Médicale d'Alsace (IGMA), Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Laboratoire de Génétique Médicale, UMR_S1112, Institut de Génétique Médicale d'Alsace (IGMA), Université de Strasbourg et INSERM, Strasbourg, France
| | - Amélie Piton
- Department of Translational Medicine and Neurogenetics, Institut Génétique Biologie Moléculaire Cellulaire, IGBMC - CNRS UMR 7104 - Inserm U 1258, Illkirch, France; Laboratoire de Diagnostic Génétique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jeanine Ohl
- Service d'assistance Médicale à la Procréation, Centre médico-chirurgical et obstétrical (CMCO), Schiltigheim, France
| | - Mary K Kukolich
- Department of Genetics, Cook Children's Medical Center, Cook Children's Health Care System, Fort Worth, TX
| | - Keisuke Nagasaki
- Department of Pediatrics, Niigata University Medical & Dental Hospital, Niigata, Japan
| | - Kohji Kato
- Department of Genetics, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
| | - Tomoo Ogi
- Department of Genetics, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
| | - Tricia Bhatti
- Division of Anatomic Pathology, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Pierre Russo
- Division of Anatomic Pathology, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Bryan Krock
- Division of Genomic Diagnostics, Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jill R Murrell
- Division of Genomic Diagnostics, Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jennifer A Sullivan
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Duke University School of Medicine, Durham, NC
| | - Vandana Shashi
- Division of Medical Genetics, Department of Pediatrics, Duke University Medical Center, Duke University School of Medicine, Durham, NC
| | - Nicholas Stong
- Institute for Genomic Medicine, Columbia University, New York, NY
| | - Hakon Hakonarson
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Kentaro Sawano
- Department of Pediatrics, Niigata University Medical & Dental Hospital, Niigata, Japan
| | | | | | | | - William Ross Wilcox
- Department of Human Genetics, Emory University School of Medicine, Emory University, Atlanta, GA
| | - Katrine Verena Wirgenes
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristian Thomassen
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Angelika Erwin
- Genomic Medicine Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Joanna Lazier
- Department of Medical Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Thorsten Marquardt
- Department of Pediatrics, University Hospital of Muenster, Muenster, Germany
| | - Miao He
- Metabolic and Advanced Diagnostics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Andrew C Edmondson
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Kosuke Izumi
- Division of Human Genetics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA.
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Dean A, Foradori DM, Kumar S, Player B, Hochreiter D, Hainstock L, Kumta J, Gold J, Fromme HB. How Perceived Burnout Alters Frontline Educators' Assessments in the Clinical Learning Environment. Acad Pediatr 2022; 22:495-500. [PMID: 34929385 DOI: 10.1016/j.acap.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 08/30/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study explores frontline educators' experience with learner burnout in the clinical learning environment (CLE) and how perceived burnout may impact assessment. METHODS A survey was sent to 105 Pediatric Hospital Medicine faculty and fellows at 7 sites across the United States representing diverse CLEs. They were invited to participate in an 11-question web-based survey that was developed, edited, and revised in step-wise fashion. It consisted of 5-point Likert scale, forced-choice, and dichotomous questions. Data from the web-based survey were compiled for descriptive purposes and analyzed for trends. RESULTS The response rate was 53%. Most respondents (83%) perceive learner burnout at least once per year, but median comfort in identifying burnout was 3 (scale 1-5, 3 = neutral). Factors associated with comfort were education as primary niche (P = .01) and having wellness training (P = .045). In terms of the impact of perceived learner burnout impacts on assessment, 88% report impact on feedback sessions and 60% reported impact on summative assessment; most are more lenient. Stated belief in whether perceived burnout should or should not impact assessment had 60% sensitivity and 84% specificity in predicting whether it does. CONCLUSIONS Frontline educators routinely perceive learner burnout in the CLE and it often impacts educators' assessment of a learner. The discrepancy between the expected and actual impact may suggest amplification of known barriers to accurate assessment in the CLE. Comfort associated with wellness training suggests that interventions targeting frontline educators in the CLE may improve their ability to simultaneously support and assess learners.
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Affiliation(s)
- Andrea Dean
- Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital (A Dean and S Kumar), Houston, Tex.
| | - Dana M Foradori
- Department of Pediatrics, Cleveland Clinic Learner College of Medicine of Case Western Reserve University (DM Foradori), Cleveland, Ohio
| | - Shelley Kumar
- Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital (A Dean and S Kumar), Houston, Tex
| | - Brittany Player
- Department of Pediatrics, Medical College of Wisconsin (B Player), Milwaukee, Wis
| | - Daniela Hochreiter
- Department of Pediatrics, Yale School of Medicine (D Hochreiter), New Haven, Conn
| | - Lisa Hainstock
- Department of Pediatrics, University of Virginia Children's Hospital (L Hainstock), Charlottesville, Va
| | - Jayshree Kumta
- Department of Pediatrics, Children's Hospital of New Jersey at Newark Beth Israel Medical Center (J Kumta), Newark, NJ
| | - Jessica Gold
- Department of Pediatrics, Lucile Packard Children's Hospital Stanford (J Gold), Stanford, Calif
| | - H Barrett Fromme
- Department of Pediatrics, University of Chicago Pritzker School of Medicine (HB Fromme), Chicago, Ill
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7
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Gold NB, Harrison SM, Rowe JH, Gold J, Furutani E, Biffi A, Duncan CN, Shimamura A, Lehmann LE, Green RC. Low frequency of treatable pediatric disease alleles in gnomAD: An opportunity for future genomic screening of newborns. HGG Adv 2022; 3:100059. [PMID: 35047849 PMCID: PMC8756496 DOI: 10.1016/j.xhgg.2021.100059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 09/20/2021] [Indexed: 01/18/2023] Open
Abstract
Hematopoietic stem cell transplant (HSCT) can prevent progression of several genetic disorders. Although a subset of these disorders are identified on newborn screening panels, others are not identified until irreversible symptoms develop. Genetic testing is an efficient methodology to ascertain pre-symptomatic children, but the penetrance of risk-associated variants in the general population is not well understood. We developed a list of 127 genes associated with disorders treatable with HSCT. We identified likely pathogenic or pathogenic (LP/P) and loss-of-function (LoF) variants in these genes in the Genome Aggregation Database (gnomAD), a dataset containing exome and genome sequencing data from 141,456 healthy adults. Within gnomAD, we identified 59 individuals with a LP/P or LoF variant in 15 genes. Genes were associated with bone marrow failure syndromes, bleeding disorders, primary immunodeficiencies, osteopetrosis, metabolic disorders, and epidermolysis bullosa. In conclusion, few ostensibly healthy adults had genotypes associated with pediatric disorders treatable with HSCTs. Given that most of these disorders do not have biomarkers that could be cheaply and universally assessed on a standard newborn screen, our data suggest that genetic testing may be a complementary approach to traditional newborn screening methodology that has the potential to improve mortality and is not expected to lead to a high burden of false-positive results.
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Affiliation(s)
- Nina B. Gold
- Massachusetts General Hospital for Children, Division of Medical Genetics and Metabolism, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Jared H. Rowe
- Harvard Medical School, Boston, MA, USA
- Boston Children’s Hospital, Division of Hematology and Oncology, Boston, MA, USA
- Dana-Farber Cancer Institute Division of Pediatric Oncology, Boston, MA, USA
| | - Jessica Gold
- Department of Pediatrics, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Elissa Furutani
- Boston Children’s Hospital, Division of Hematology and Oncology, Boston, MA, USA
| | - Alessandra Biffi
- Harvard Medical School, Boston, MA, USA
- Boston Children’s Hospital, Division of Hematology and Oncology, Boston, MA, USA
- Dana-Farber Cancer Institute Division of Pediatric Oncology, Boston, MA, USA
| | - Christine N. Duncan
- Harvard Medical School, Boston, MA, USA
- Boston Children’s Hospital, Division of Hematology and Oncology, Boston, MA, USA
- Dana-Farber Cancer Institute Division of Pediatric Oncology, Boston, MA, USA
| | - Akiko Shimamura
- Harvard Medical School, Boston, MA, USA
- Boston Children’s Hospital, Division of Hematology and Oncology, Boston, MA, USA
- Dana-Farber Cancer Institute Division of Pediatric Oncology, Boston, MA, USA
| | - Leslie E. Lehmann
- Harvard Medical School, Boston, MA, USA
- Boston Children’s Hospital, Division of Hematology and Oncology, Boston, MA, USA
- Dana-Farber Cancer Institute Division of Pediatric Oncology, Boston, MA, USA
| | - Robert C. Green
- Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Brigham and Women’s Hospital, Boston, MA, USA
- Ariadne Labs, Boston, MA, USA
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8
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Strong A, Skraban C, Meyers K, Amaral S, Furth S, Drant S, Hsiao W, Galea L, Gold J, Gold NB, Leonard J, Lopez S, Zackai EH, Pyeritz RE. Expanding the phenotypic spectrum of Mendelian connective tissue disorders to include prominent kidney phenotypes. Am J Med Genet A 2021; 185:3762-3769. [PMID: 34355836 PMCID: PMC9888756 DOI: 10.1002/ajmg.a.62449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 02/02/2023]
Abstract
Heritable connective tissue disorders are a group of diseases, each rare, characterized by various combinations of skin, joint, musculoskeletal, organ, and vascular involvement. Although kidney abnormalities have been reported in some connective tissue disorders, they are rarely a presenting feature. Here we present three patients with prominent kidney phenotypes who were found by whole exome sequencing to have variants in established connective tissue genes associated with Loeys-Dietz syndrome and congenital contractural arachnodactyly. These cases highlight the importance of considering connective tissue disease in children presenting with structural kidney disease and also serves to expand the phenotype of Loeys-Dietz syndrome and possibly congenital contractural arachnodactyly to include cystic kidney disease and cystic kidney dysplasia, respectively.
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Affiliation(s)
- Alanna Strong
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA,The Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Cara Skraban
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kevin Meyers
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA,Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sandra Amaral
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA,Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Susan Furth
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA,Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Stacey Drant
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA,Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Wendy Hsiao
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lauren Galea
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jessica Gold
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Nina B. Gold
- Division of Medical Genetics and Metabolism, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Jacqueline Leonard
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sonya Lopez
- Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Elaine H. Zackai
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Reed E. Pyeritz
- Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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9
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Strong A, Gold J, Gold NB, Yudkoff M. Hepatic Manifestations of Urea Cycle Disorders. Clin Liver Dis (Hoboken) 2021; 18:198-203. [PMID: 34745578 PMCID: PMC8549711 DOI: 10.1002/cld.1115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 02/04/2023] Open
Abstract
Content available: Author Interview and Audio Recording.
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Affiliation(s)
- Alanna Strong
- Division of Human GeneticsChildren's Hospital of PhiladelphiaPhiladelphiaPA,The Center for Applied GenomicsChildren's Hospital of PhiladelphiaPhiladelphiaPA
| | - Jessica Gold
- Division of Human GeneticsChildren's Hospital of PhiladelphiaPhiladelphiaPA
| | - Nina B. Gold
- Division of Medical Genetics and MetabolismMassachusetts General HospitalBostonMA,Department of PediatricsHarvard Medical SchoolBostonMA
| | - Marc Yudkoff
- Division of Human GeneticsChildren's Hospital of PhiladelphiaPhiladelphiaPA,Department of PediatricsPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPA
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10
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Cioci A, Kedar W, Urrechaga E, Gold J, Parreco JP, Coll AS, Curry CL, Rattan R. Uncaptured rates of postpartum venous thromboembolism: a US national analysis. BJOG 2021; 128:1694-1702. [PMID: 33686733 DOI: 10.1111/1471-0528.16693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To quantify the proportion of postpartum venous thromboembolism (VTE) readmissions, including those that occur at different hospitals from index admission, and describe risk factors for this outcome. DESIGN Retrospective observational study. SETTING US hospitals included in the Nationwide Readmissions Database. SAMPLE A total of 3 719 238 patients >14 years of age with a delivery-associated hospitalisation in 2014. METHODS Univariate analysis was performed to identify patient and hospital factors associated with readmissions. Significant factors were included in multivariate logistic regression to identify independent risk factors. Results were weighted for national estimates. MAIN OUTCOME MEASURES Readmission with VTE to both index and different hospitals at 30, 60 and 90 days. RESULTS The VTE cumulative readmission rate was 0.053% (n = 1477), 0.063% (n = 1765) and 0.069% (n = 1938) at 30, 60 and 90 days, respectively. Patients were readmitted to different hospitals 31% of the time within 90 days. Risk factors for different hospital VTE readmission were unique and included younger age and initial admission to a small/medium-sized hospital. Initial admission to a for-profit hospital increased the likelihood of readmission to a different hospital. CONCLUSIONS Nearly one in three postpartum VTEs are missed by the current quality metrics, with significant implications for outcomes and quality. For-profit hospitals have a significant portion of their VTE readmissions hidden, falsely lowering their readmission rates relative to public hospitals. TWEETABLE ABSTRACT US analysis shows 1 in 3 readmissions for postpartum venous thromboembolism currently missed.
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Affiliation(s)
- A Cioci
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - W Kedar
- Kupot Holim Clalit, Jerusalem, Israel
| | - E Urrechaga
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - J Gold
- University of Tennessee - Memphis, Memphis, TN, USA
| | - J P Parreco
- Lawnwood Regional Medical Center, Fort Pierce, FL, USA
| | - A S Coll
- Baptist Health South Florida, Coral Gables, FL, USA
| | | | - R Rattan
- University of Miami Miller School of Medicine, Miami, FL, USA
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11
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Mittal V, Hall M, Antoon J, Gold J, Kenyon C, Parikh K, Morse R, Quinonez R, Teufel RJ, Shah SS. Trends in Intravenous Magnesium Use and Outcomes for Status Asthmaticus in Children's Hospitals from 2010 to 2017. J Hosp Med 2020; 15:403-406. [PMID: 32584247 PMCID: PMC7402601 DOI: 10.12788/jhm.3405] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 03/04/2020] [Indexed: 11/20/2022]
Abstract
Intravenous (IV) magnesium is used as an adjunct therapy in management of status asthmaticus with a goal of reducing intubation rate. A recent review suggests that IV magnesium use in status asthmaticus reduces admission rates. This is contrary to the observation of practicing emergency room physicians. The goal of this study was to assess trends in IV magnesium use for status asthmaticus in US children's hospitals over 8 years through a retrospective analysis of children younger than 18 years using the Pediatric Health Information System database. Outcomes were IV magnesium use, inpatient and intensive care unit admission rate, geometric mean length of stay, and 7-day all-cause readmission rate. IV magnesium use for asthma hospitalization more than doubled over 8 years (17% vs. 36%; P < .001). Yearly trends were not significantly associated with hospital or intensive care unit admission rate or 7-day all-cause readmissions, although length of stay was reduced (P < .001).
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Affiliation(s)
- Vineeta Mittal
- Division of Pediatric Hospital Medicine, Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas
- Department of Pediatrics, Children’s Health System, Dallas, Texas
- Corresponding Author: Vineeta Mittal, MD, MBA; ; Telephone: 214-456-5527; Twitter: @Vmittal
| | - Matt Hall
- Informatics, Children’s Hospital Association, Lenexa, Kansas
| | - James Antoon
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Vanderbilt University School of Medicine
| | - Jessica Gold
- Pediatrics, Stanford University School of Medicine/Lucile Packard Children’s Hospital, San Mateo, California
| | - Chen Kenyon
- Department of Pediatrics, Children’s Hospital of Pennsylvania, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kavita Parikh
- Hospitalist Division, Children’s National Medical Center, Washington, District of Columbia
- Hospitalist Division, George Washington School of Medicine, Washington, District of Columbia
| | - Rustin Morse
- Department of Quality and Safety, Children’s Health System of Texas, Dallas, Texas
| | - Ricardo Quinonez
- Division of Pediatric Hospital Medicine, Texas Children’s Hospital, Houston, Texas
- Division of Pediatric Hospital Medicine, Baylor College of Medicine, Houston, Texas
| | - Ronald J Teufel
- Departemnt of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Samir S Shah
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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12
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Growcott EJ, Cariaga TA, Morris L, Zang X, Lopez S, Ansaldi DA, Gold J, Gamboa L, Roth T, Simmons RL, Osborne CS. Pharmacokinetics and pharmacodynamics of the novel monobactam LYS228 in a neutropenic murine thigh model of infection. J Antimicrob Chemother 2020; 74:108-116. [PMID: 30325447 DOI: 10.1093/jac/dky404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/06/2018] [Indexed: 12/19/2022] Open
Abstract
Objectives The neutropenic murine thigh infection model and a dose-fractionation approach were used to determine the pharmacokinetic/pharmacodynamic (PK/PD) relationship of LYS228, a novel monobactam antibiotic with activity against Enterobacteriaceae including carbapenem-resistant strains. Methods Mice (n = 4 per group) were inoculated with Enterobacteriaceae strains via intramuscular injection. Two hours post-bacterial inoculation, treatment with LYS228 was initiated. Animals were euthanized with CO2 24 h after the start of therapy and bacterial counts (log10 cfu) per thigh were determined. PK parameters were calculated using free (f) plasma drug levels. Results Following a dose-fractionation study, non-linear regression analysis determined that the predominant PK/PD parameter associated with antibacterial efficacy of LYS228 was the percentage of the dosing interval that free drug concentrations remained above the MIC (%fT>MIC). In a dose-dependent manner, LYS228 reduced the thigh bacterial burden in models established with Enterobacteriaceae producing β-lactamase enzymes of all classes (e.g. ESBLs, NDM-1, KPC, CMY-2 and OXA-48). The range of the calculated static dose was 86-649 mg/kg/day for the isolates tested, and the magnitude of the driver of efficacy was 37-83 %fT>MIC. %fT>MIC was confirmed as the parameter predominantly driving efficacy as evidenced by a strong coefficient of determination (r2 = 0.68). Neutrophils had minimal impact on the effect of LYS228 in the murine thigh infection model. Conclusions LYS228 is efficacious in murine thigh infection models using β-lactamase-producing strains of Enterobacteriaceae, including those expressing metallo-β-lactamases, ESBLs and serine carbapenemases, with the PK/PD driver of efficacy identified as %T>MIC.
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Affiliation(s)
- E J Growcott
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
| | - T A Cariaga
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
| | - L Morris
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
| | - X Zang
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
| | - S Lopez
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
| | - D A Ansaldi
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
| | - J Gold
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
| | - L Gamboa
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
| | - T Roth
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
| | - R L Simmons
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
| | - C S Osborne
- Novartis Institutes for BioMedical Research, Emeryville, CA, USA
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13
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Öhrling K, Cai M, Felici D, Gold J, Tran N, Smit M, Raskin L. P2.12-17 Treatment Patterns in Small Cell Lung Cancer (SCLC): An Observational Study of 2016–2018 EHR Data. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1762] [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: 11/24/2022]
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14
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Montalbano A, Quiñonez RA, Hall M, Morse R, Ishman SL, Antoon JW, Gold J, Teufel RJ, Mittal V, Shah SS, Parikh K. Achievable Benchmarks of Care for Pediatric Readmissions. J Hosp Med 2019; 14:534-540. [PMID: 31112497 DOI: 10.12788/jhm.3201] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Most inpatient care for children occurs outside tertiary children's hospitals, yet these facilities often dictate quality metrics. Our objective was to calculate the mean readmission rates and the Achievable Benchmarks of Care (ABCs) for pediatric diagnoses by different hospital types: metropolitan teaching, metropolitan nonteaching, and nonmetropolitan hospitals. METHODS We used a cross-sectional retrospective study of 30-day, all-cause, same-hospital readmission of patients less than 18 years old using the 2014 Healthcare Utilization Project National Readmission Database. For each hospital type, we calculated the mean readmission rates and corresponding ABCs for the 17 most common readmission diagnoses. We define outlier as any hospital whose readmission rate fell outside the 95% CI for an ABC within their hospital type. RESULTS We analyzed 690,949 discharges at 525 metropolitan teaching hospitals (550,039 discharges), 552 metropolitan nonteaching hospitals (97,207 discharges), and 587 nonmetropolitan hospitals (43,703 discharges). Variation in readmission rates existed among hospital types; however, sickle cell disease (SCD) had the highest readmission rate and ABC across all hospital types: metropolitan teaching hospitals 15.7% (ABC 7.0%), metropolitan nonteaching 14.7% (ABC 2.6%), and nonmetropolitan 12.8% (ABC not calculated). For diagnoses in which ABCs were available, outliers were prominent in bipolar disorders, major depressive disorders, and SCD. CONCLUSIONS ABCs based on hospital type may serve as a better metric to explain case-mix variation among different hospital types in pediatric inpatient care. The mean rates and ABCs for SCD and mental health disorders were much higher and with more outlier hospitals, which indicate high-value targets for quality improvement.
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Affiliation(s)
- Amanda Montalbano
- Division of Urgent Care and Department of Pediatrics, Children's Mercy Hospital, University of Missouri, Kansas City, Missouri
| | - Ricardo A Quiñonez
- Pediatric Hospital Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Matt Hall
- Children's Hospital Association, Overland Park, Kansas City, Missouri
| | - Rustin Morse
- Chief Quality Officer, Children's Health System of Texas, Dallas, Texas
| | - Stacey L Ishman
- Division of Otolaryngology, Head and Neck Surgery, and Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - James W Antoon
- Department of Pediatrics, the University of Illinois at the Chicago College of Medicine, Chicago, Illinois
| | - Jessica Gold
- Division of Hospital Medicine, Department of Pediatrics, Lucile Packard Children's Hospital Stan-ford, Stanford, University School of Medicine, Stanford, California
| | - Ronald J Teufel
- Division of General Pediatrics, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Vineeta Mittal
- Division of Hospital Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center and Children's Health System of Texas, Dallas, Texas
| | - Samir S Shah
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kavita Parikh
- Division of Hospital Medicine, Children's National Health System, George Washington School of Medicine, Washington, DC
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15
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Kasimanickam R, Kasimanickam V, Gold J, Moore D, Kastelic JP, Pyrdek D, Ratzburg K. Injectable or transdermal flunixin meglumine improves pregnancy rates in embryo transfer recipient beef cows without altering returns to estrus. Theriogenology 2019; 140:8-17. [PMID: 31421533 DOI: 10.1016/j.theriogenology.2019.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/10/2019] [Accepted: 08/07/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES were to determine effects of 1) injectable or transdermal flunixin meglumine (FM) at embryo transfer (ET) compared to an untreated control group on pregnancy per ET (P/ET; ∼35 d after ET); 2) embryo and recipient factors on P/ET; 3) FM on hormone concentrations; and 4) FM on returns to estrus. Angus-cross beef cows (n = 1145) at five locations were scored for body condition (BCS; 1-9) and temperament (0 or 1) and given Select-Synch + CIDR. Recipient cows with a corpus luteum (CL) ≥1.5 cm received a frozen-thawed embryo 7 d after estrus and were concurrently given 1.1 mg/kg injectable FM im (INJFM; n = 384), 3.3 mg/kg transdermal FM pour on (TDFM; n = 388), or nothing (CON group; n = 373). Blood samples were collected at ET and 7 d later (60 cows). Accounting for temperament (P < 0.05), ET difficulty score (1-3, easy to difficult; P < 0.01), treatment by temperament (P < 0.001) and treatment by embryo quality (P < 0.05), FM treatments affected P/ET (P < 0.05). The P/ET for cows given INJFM [62.8% (241/384)] or TDFM [58.7% (228/388)] were not different (P = 0.26), but they were greater (P = 0.01 and P = 0.04, respectively) than P/ET for controls [51.2% (191/373)]. The P/ET was greater for calm versus excitable cows, 60.2 (463/769) and 52.4% (197/376), respectively (P < 0.01) and was lower for difficulty score 3 [49.2% (156/317)] compared to score 1 [62.7% (254/405; P < 0.001) or score 2 [59.1% (250/423; P < 0.01)]. There was no effect (P > 0.1) of cow age, BCS, or stage of embryo development on P/ET. Pregnancy rates for embryo quality grade 1 (excellent/good) and grade 2 (fair) were 60.4% (314/520) and 55.4% (346/625), respectively (P > 0.05). Percentages of non-pregnant recipient cows in estrus from Days 18-26 did not differ among treatment groups (P > 0.1). Control cows had lower progesterone concentrations and greater substance-P, PGFM and 8-isoprostane PGF2α concentrations at 7 d after ET compared to FM-treated cows (P < 0.05). In conclusion, injectable or transdermal FM improved pregnancy rates in ET recipients, without affecting nonpregnant cows return to estrus.
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Affiliation(s)
- R Kasimanickam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA.
| | - V Kasimanickam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - J Gold
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - D Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - J P Kastelic
- Department of Production Animal Health, University of Calgary, Faculty of Veterinary Medicine, Calgary, AB, Canada
| | - D Pyrdek
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - K Ratzburg
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
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16
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Duprat R, Linn K, Satterthwaite T, Ciric R, Sheline Y, Platt M, Gold J, Kable J, Adams G, Kalamveetil-Meethal S, Dallstream A, Long H, Scully M, Shinohara R, Oathes D. Functional connectivity as a tool to individualize DLPFC targeting in TMS. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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17
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Gold J, Hametz P, Sen AI, Maykowski P, Leone N, Lee DS, Gagliardo C, Hymes S, Biller R, Saiman L. Provider Knowledge, Attitudes, and Practices Regarding Bronchiolitis and Pneumonia Guidelines. Hosp Pediatr 2019; 9:87-91. [PMID: 30610012 DOI: 10.1542/hpeds.2018-0211] [Citation(s) in RCA: 7] [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: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Practice guidelines have been published for bronchiolitis and community-acquired pneumonia (CAP), but little is known about pediatricians' knowledge of and attitudes toward these guidelines since their publication. METHODS We surveyed pediatric providers at 6 children's hospitals in the New York City area. Two vignettes, an infant with bronchiolitis and a child with CAP, were provided, and respondents were asked about management. Associations between respondent characteristics and their reported practices were examined using χ2 and Fisher's exact tests. Associations between questions probing knowledge and attitude barriers relevant to guideline adherence and reported practices were examined using Cochran-Mantel-Haenszel relative risk estimates. RESULTS Of 283 respondents, 58% were trainees; 57% of attending physician respondents had finished training within 10 years. Overall, 76% and 45% of respondents reported they had read the bronchiolitis and CAP guidelines, respectively. For the bronchiolitis vignette, 40% reported ordering a chest radiograph (CXR), and 38% prescribed bronchodilators (neither recommended). For the CAP vignette, 38% prescribed ceftriaxone (not recommended). Study site, level of training, and practice locations were associated with nonrecommended practices. Site-adjusted knowledge and attitude barriers were used to identify that those who agreed CXRs were useful in managing bronchiolitis were more likely to order CXRs, and those who felt bronchodilators shortened length of stay were more likely to prescribe them. Concerns about ampicillin resistance and lack of confidence using local susceptibility patterns to guide prescribing were associated with ordering ceftriaxone. CONCLUSIONS Provider-level factors and knowledge gaps were associated with ordering nonrecommended treatments for bronchiolitis and CAP.
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Affiliation(s)
- Jessica Gold
- Morgan Stanley Children's Hospital, Columbia University Medical Center and
| | - Patricia Hametz
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
| | - Anita I Sen
- Morgan Stanley Children's Hospital, Columbia University Medical Center and
| | - Philip Maykowski
- College of Medicine-Phoenix, University of Arizona, Phoenix, Arizona
| | - Nicole Leone
- Cohen Children's Medical Center, Northwell Health, Queens, New York
| | - Diana S Lee
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
| | - Christina Gagliardo
- Goryeb Children's Hospital, Morristown Medical Center, Morristown, New Jersey
| | - Saul Hymes
- Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, New York; and
| | - Rachel Biller
- Department of Pediatrics, Maria Fareri Children's Hospital, Westchester Medical Center, Valhalla, New York
| | - Lisa Saiman
- Morgan Stanley Children's Hospital, Columbia University Medical Center and.,Department of Infection Prevention and Control, New York-Presbyterian Hospital, New York City, New York
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18
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Growcott EJ, Cariaga TA, Morris L, Zang X, Lopez S, Ansaldi DA, Gold J, Gamboa L, Roth T, Simmons RL, Osborne CS. Pharmacokinetics and pharmacodynamics of the novel monobactam LYS228 in a neutropenic murine thigh model of infection. J Antimicrob Chemother 2019; 74:280. [PMID: 30412250 DOI: 10.1093/jac/dky478] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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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19
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Nanduri SA, Metcalf BJ, Arwady MA, Edens C, Lavin MA, Morgan J, Clegg W, Beron A, Albertson JP, Link-Gelles R, Ogundimu A, Gold J, Jackson D, Chochua S, Stone N, Van Beneden C, Fleming-Dutra K, Beall B. Prolonged and large outbreak of invasive group A Streptococcus disease within a nursing home: repeated intrafacility transmission of a single strain. Clin Microbiol Infect 2018; 25:248.e1-248.e7. [PMID: 29783026 DOI: 10.1016/j.cmi.2018.04.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 12/11/2017] [Revised: 04/19/2018] [Accepted: 04/30/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Multiple invasive group A Streptococcus (GAS) infections were reported to public health by a skilled nursing facility (facility A) in Illinois between May 2014 and August 2016. Cases continued despite interventions including antibiotic prophylaxis for all residents and staff. Two other geographically close facilities reported contemporaneous outbreaks of GAS. We investigated potential reasons for ongoing transmission. METHODS We obtained epidemiologic data from chart review of cases and review of facility and public health records from previous investigations into the outbreak. Infection control practices at facility A were observed and evaluated. Whole genome sequencing followed by phylogenetic analysis was performed on available isolates from the three facilities. RESULTS From 2014 to 2016, 19 invasive and 60 noninvasive GAS infections were identified at facility A occurring in three clusters. Infection control evaluations during clusters 2 and 3 identified hand hygiene compliance rates of 14% to 25%, appropriate personal protective equipment use in only 33% of observed instances, and deficient wound-care practices. GAS isolates from residents and staff of all three facilities were subtype emm89.0; on phylogenetic analysis, facility A isolates were monophyletic and distinct. CONCLUSIONS Inadequate infection control and improper wound-care practices likely led to this 28-month-long outbreak of severe infections in a skilled nursing facility. Whole genome sequencing and phylogenetic analysis suggested that intrafacility transmission of a single highly transmissible GAS strain was responsible for the outbreak in facility A. Integration of genomic epidemiology tools with traditional epidemiology and infection control assessments was helpful in investigation of a facility-wide outbreak.
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Affiliation(s)
- S A Nanduri
- National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - B J Metcalf
- National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M A Arwady
- Chicago Department of Public Health, Chicago, IL, USA
| | - C Edens
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M A Lavin
- Lavin Consulting LLC, San Francisco, CA, USA
| | - J Morgan
- Illinois Department of Public Health, Springfield, IL, USA
| | - W Clegg
- Chicago Department of Public Health, Chicago, IL, USA
| | - A Beron
- Illinois Department of Public Health, Springfield, IL, USA
| | - J P Albertson
- Illinois Department of Public Health, Springfield, IL, USA
| | - R Link-Gelles
- National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Ogundimu
- National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J Gold
- National Center for Emerging and Zoonotic Infectious Diseases, Division of Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D Jackson
- National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S Chochua
- National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - N Stone
- National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - C Van Beneden
- National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - K Fleming-Dutra
- National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - B Beall
- National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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20
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Parikh K, Hall M, Kenyon CC, Teufel RJ, Mussman GM, Montalbano A, Gold J, Antoon JW, Subramony A, Mittal V, Morse RB, Wilson KM, Shah SS. Impact of Discharge Components on Readmission Rates for Children Hospitalized with Asthma. J Pediatr 2018; 195:175-181.e2. [PMID: 29395170 PMCID: PMC8666980 DOI: 10.1016/j.jpeds.2017.11.062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 06/14/2017] [Revised: 10/24/2017] [Accepted: 11/29/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To describe hospital-based asthma-specific discharge components at children's hospitals and determine the association of these discharge components with pediatric asthma readmission rates. STUDY DESIGN This is a multicenter retrospective cohort study of pediatric asthma hospitalizations in 2015 at children's hospitals participating in the Pediatric Health Information System. Children ages 5 to 17 years were included. An electronic survey assessing 13 asthma-specific discharge components was sent to quality leaders at all 49 hospitals. Correlations of combinations of asthma-specific discharge components and adjusted readmission rates were calculated. RESULTS The survey response rate was 92% (45 of 49 hospitals). Thirty-day and 3-month adjusted readmission rates varied across hospitals, ranging from 1.9% to 3.9% for 30-day readmissions and 5.7% to 9.1% for 3-month readmissions. No individual or combination discharge components were associated with lower 30-day adjusted readmission rates. The only single-component significantly associated with a lower rate of readmission at 3 months was having comprehensive content of education (P < .029). Increasing intensity of discharge components in bundles was associated with reduced adjusted 3-month readmission rates, but this did not reach statistical significance. This was seen in a 2-discharge component bundle including content of education and communication with the primary medical doctor, as well as a 3-discharge component bundle, which included content of education, medications in-hand, and home-based environmental mitigation. CONCLUSIONS Children's hospitals demonstrate a range of asthma-specific discharge components. Although we found no significant associations for specific hospital-level discharge components and asthma readmission rates at 30 days, certain combinations of discharge components may support hospitals to reduce healthcare utilization at 3 months.
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Affiliation(s)
- Kavita Parikh
- Children's National Medical Center and George Washington School of Medicine, Washington, DC.
| | - Matt Hall
- Children's Hospital Association, Lenexa, KS
| | - Chén C Kenyon
- The Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA
| | | | - Grant M Mussman
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Amanda Montalbano
- Children's Mercy and University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Jessica Gold
- Lucile Packard Children's Hospital Stanford and Stanford University School of Medicine, Stanford, CA
| | - James W Antoon
- Children's Hospital, University of Illinois Hospital & Health Sciences System, Chicago, IL
| | - Anupama Subramony
- Cohen Children's Medical Center, Northwell Health, Hofstra School of Medicine, New Hyde Park, NY
| | - Vineeta Mittal
- Children's Health, Children's Medical Center, Dallas, TX
| | - Rustin B Morse
- Children's Health, Children's Medical Center, Dallas, TX
| | | | - Samir S Shah
- Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
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Schuster E, Wallin P, Klose F, Gold J, Ström A. Correlating network structure with functional properties of capillary alginate gels for muscle fiber formation. Food Hydrocoll 2017. [DOI: 10.1016/j.foodhyd.2017.05.036] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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Wong E, Pedrana A, Draper B, Gold J, Richmond J, Stoove M, Doyle J, Thompson A, Hellard M. O17 Eliminate Hepatitis C Partnership: clinical site scoping. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30900-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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23
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Mullin ASJ, Hilsenroth MJ, Gold J, Farber BA. Changes in Object Relations over the Course of Psychodynamic Psychotherapy. Clin Psychol Psychother 2016; 24:501-511. [DOI: 10.1002/cpp.2021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 03/08/2016] [Accepted: 04/21/2016] [Indexed: 11/10/2022]
Affiliation(s)
- A. S. J. Mullin
- The Derner Institute; Adelphi University; Garden City NY USA
| | | | - J. Gold
- The Derner Institute; Adelphi University; Garden City NY USA
| | - B. A. Farber
- Teachers College; Columbia University; New York NY USA
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24
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Krueger CR, Gold J, Barrett MF, Aboellail TA. Diagnosis of lumbosacral intervertebral disc disease and protrusion in a horse using ultrasonographic evaluation and computed tomography. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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)
- C. R. Krueger
- Colorado State University; James L. Voss Teaching Hospital; Fort Collins USA
| | - J. Gold
- Washington State University; Department of Clinical Sciences; Pullman USA
| | - M. F. Barrett
- Colorado State University; Department of Radiological Sciences; Fort Collins USA
| | - T. A. Aboellail
- Department of Microbiology, Immunology and Pathology; Fort Collins Colorado USA
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25
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Cardozo ER, Karmon AE, Gold J, Petrozza JC, Styer AK. Reproductive outcomes in oocyte donation cycles are associated with donor BMI. Hum Reprod 2015; 31:385-92. [PMID: 26677960 DOI: 10.1093/humrep/dev298] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 11/06/2015] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION When adjusting for recipient BMI, is donor body mass index (BMI) associated with IVF outcomes in donor oocyte IVF cycles? SUMMARY ANSWER Increasing oocyte donor BMI is associated with a reduction in clinical pregnancy and live birth rates. WHAT IS KNOWN ALREADY Increased BMI has been associated with suboptimal reproductive outcomes, particularly in assisted reproductive technology (ART) cycles. However, it remains unclear if this association implies an effect of BMI on oocyte quality and/or endometrial receptivity. STUDY DESIGN, SIZE, DURATION A retrospective cohort study of two hundred and thirty five consecutive fresh donor oocyte IVF cycles from 1 January 2007 through 31 December 2013 at the Massachusetts General Hospital (MGH) Fertility Center. PARTICIPANTS/MATERIALS, SETTING, METHODS Analyses included a total of 202 oocyte donors and 235 total cycles. Following adjustments for recipient BMI, the relationship between donor BMI (categorized into quartiles) and IVF outcomes was assessed. MAIN RESULTS AND THE ROLE OF CHANCE In the entire (anonymous and known) donor population, a reduced odds of clinical pregnancy (P-trend = 0.046) and live birth (P-trend = 0.06) was observed with increasing BMI quartile. Compared with quartile 1 (BMI 17.8-21.1), odds ratio (OR) (95% CI) of clinical pregnancy was 0.9 (0.4-2.0), 0.5 (0.2-1.1) and 0.5 (0.2-1.1), and OR of live birth was 1.1 (0.5-2.6), 0.6 (0.3-1.2) and 0.6 (0.3-1.2) for quartiles 2 through 4 respectively. In anonymous donors only, the odds of clinical pregnancy (P-trend = 0.02) and live birth (P-trend = 0.03) also declined as BMI quartile increased. Compared with quartile 1 (BMI 17.8-21.1), odds ratio (OR) (95% CI) of clinical pregnancy was 0.7 (0.3-1.7), 0.5 (0.2-1.1) and 0.4 (0.1-0.9), and OR of live birth was 0.9 (0.4-2.2), 0.5 (0.3-1.2) and 0.4 (0.2-1.1) for quartiles 2 through 4 respectively. LIMITATIONS, REASONS FOR CAUTION Limitations include the retrospective design, sample size and data from a single institution. Clinical application may not be limited to oocyte donors, though caution should be used prior to applying these principles to the general population. Data should not be interpreted to mean that all oocyte donors should be restricted to a BMI of less than 21.2 kg/m(2). WIDER IMPLICATIONS OF THE FINDINGS Following adjustments for the respective BMI of the oocyte donor and recipient, this study demonstrates an association of preconception BMI with subsequent IVF outcomes. The observations of this study are consistent with prior animal studies, suggest a possible effect of BMI at the oocyte level prior to fertilization and implantation, and warrant further investigation. STUDY FUNDING/COMPETING INTERESTS None.
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Affiliation(s)
- E R Cardozo
- Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA Present address: Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey 10A, 55 Fruit Street, Boston, MA 02114, USA
| | - A E Karmon
- Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA Present address: Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey 10A, 55 Fruit Street, Boston, MA 02114, USA
| | - J Gold
- Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA Present address: Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey 10A, 55 Fruit Street, Boston, MA 02114, USA
| | - J C Petrozza
- Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA Present address: Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey 10A, 55 Fruit Street, Boston, MA 02114, USA
| | - A K Styer
- Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA Present address: Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey 10A, 55 Fruit Street, Boston, MA 02114, USA
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Parikh K, Hall M, Mittal V, Montalbano A, Gold J, Mahant S, Wilson KM, Shah SS. Comparative Effectiveness of Dexamethasone versus Prednisone in Children Hospitalized with Asthma. J Pediatr 2015; 167:639-44.e1. [PMID: 26319919 DOI: 10.1016/j.jpeds.2015.06.038] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 05/21/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To study the comparative effectiveness of dexamethasone vs prednisone/prednisolone in children hospitalized with asthma exacerbation not requiring intensive care. STUDY DESIGN This multicenter retrospective cohort study, using the Pediatric Health Information System, included children aged 4-17 years who were hospitalized with a principal diagnosis of asthma between January 1, 2007 and December 31, 2012. Children with chronic complex condition and/or initial intensive care unit (ICU) management were excluded. Propensity score matching was used to detect differences in length of stay (LOS), readmissions, ICU transfer, and cost between groups. RESULTS 40,257 hospitalizations met inclusion criteria; 1166 (2.9%) received only dexamethasone. In the matched cohort (N = 1284 representing 34 hospitals), the LOS was significantly shorter in the dexamethasone group compared with the prednisone/prednisolone group. The proportion of subjects with a LOS of 3 days or more was 6.7% in the dexamethasone group and 12% in the prednisone/prednisolone group (P = .002). Differences in all-cause readmission at 7- and 30 days were not statistically significant. The dexamethasone group had lower costs of index admission ($2621 vs $2838; P < .001) and total episode of care (including readmissions) ($2624 vs $2856; P < .001) compared with the prednisone/prednisolone group. There were no clinical significant differences in ICU transfer or readmissions between groups. CONCLUSIONS Dexamethasone may be considered an alternative to prednisone/prednisolone for children hospitalized with asthma exacerbation not requiring admission to intensive care.
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Affiliation(s)
- Kavita Parikh
- Division of Hospital Medicine, Department of Pediatrics, Children's National Medical Center and George Washington School of Medicine, Washington, DC.
| | - Matt Hall
- Children's Hospital Association, Overland Park, KS
| | - Vineeta Mittal
- Children's Medical Center and University of Texas Southwestern Medical Center, Dallas, TX
| | - Amanda Montalbano
- Children's Mercy Hospitals and Clinics and University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Jessica Gold
- New York-Presbyterian Morgan Stanley Children's Hospital and Columbia University Medical Center, New York, NY
| | - Sanjay Mahant
- Division of Pediatric Medicine, Department of Pediatrics and Institute for Health Policy, Management and Evaluation, University of Toronto; SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen M Wilson
- Children's Hospital Colorado and the University of Colorado School of Medicine, Aurora, CO
| | - Samir S Shah
- Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
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27
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Gold J, Hansen C, Chatterjee A, Alcon A. Clavicular osteomyelitis: A case report and review of the literature. J PEDIAT INF DIS-GER 2015. [DOI: 10.3233/jpi-130402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jessica Gold
- Yale University School of Medicine, New Haven, CT, USA
| | | | | | - Andre Alcon
- Yale University School of Medicine, New Haven, CT, USA
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Mahant S, Hall M, Ishman SL, Morse R, Mittal V, Mussman GM, Gold J, Montalbano A, Srivastava R, Wilson KM, Shah SS. Association of National Guidelines With Tonsillectomy Perioperative Care and Outcomes. Pediatrics 2015; 136:53-60. [PMID: 26101361 DOI: 10.1542/peds.2015-0127] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate the association of the 2011 American Academy of Otolaryngology Head and Neck Surgery guidelines with perioperative care processes and outcomes in children undergoing tonsillectomy. METHODS We conducted a retrospective cohort study of otherwise healthy children undergoing tonsillectomy between January 2009 and January 2013 at 29 US children's hospitals participating in the Pediatric Health Information System. We measured evidence-based processes suggested by the guidelines (perioperative dexamethasone and no antibiotic use) and outcomes (30-day tonsillectomy complication-related revisits). We analyzed rates aggregated over the preguideline and postguideline periods and then by month over time by using interrupted time series. RESULTS Of 111,813 children who underwent tonsillectomy, 54,043 and 57,770 did so in the preguideline and postguideline periods, respectively. Dexamethasone use increased from 74.6% to 77.4% (P < .001) in the preguideline to postguideline period, as did its rate of change in use (percentage change per month, -0.02% to 0.29%; P < .001). Antibiotic use decreased from 34.7% to 21.8% (P < .001), as did its rate of change in use (percentage change per month, -0.17% to -0.56%; P < .001). Revisits for bleeding remained stable; however, total revisits to the hospital for tonsillectomy complications increased from 8.2% to 9.0% (P < .001) because of an increase in revisits for pain. Hospital-level results were similar. CONCLUSIONS The guidelines were associated with some improvement in evidence-based perioperative care processes but no improvement in outcomes. Dexamethasone use increased slightly, and antibiotic use decreased substantially. Revisits for tonsillectomy-related complications increased modestly over time because of revisits for pain.
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Affiliation(s)
- Sanjay Mahant
- Division of Pediatric Medicine, Pediatric Outcomes Research Team (PORT), Department of Pediatrics, Institute of Health Policy, Management and Evaluation, University of Toronto, Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada;
| | - Matt Hall
- Children's Hospital Association, Overland Park, Kansas
| | - Stacey L Ishman
- Division of Otolaryngology, Head & Neck Surgery, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, and Department of Otolaryngology, Head & Neck Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Rustin Morse
- Children's Medical Center and University of Texas Southwestern Medical Center, Dallas, Texas
| | - Vineeta Mittal
- Children's Medical Center and University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Jessica Gold
- New York-Presbyterian Morgan Stanley Children's Hospital and Columbia University Medical Center, New York, New York
| | - Amanda Montalbano
- Children's Mercy Hospitals and Clinics and University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Rajendu Srivastava
- Division of Inpatient Medicine, Department of Pediatrics, University of Utah Health Sciences Center, Institute for Healthcare Delivery Research, Intermountain Healthcare Inc., Salt Lake City, Utah; and
| | - Karen M Wilson
- Section of Pediatric Hospital Medicine, Children's Hospital Colorado, Aurora, Colorado
| | - Samir S Shah
- Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Katz A, Chui I, Powell M, Varuzza G, Gold J, Strauss G. C-08 * Impaired Cognitive Control and Goal Maintenance in Schizophrenia. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Cardozo E, Karmon A, Gold J, Petrozza J, Styer A. Impact of donor BMI on pregnancy outcome in oocyte donation cycles. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Karmon A, Cardozo E, Souter I, Gold J, Petrozza J, Styer A. Donor TSH level is associated with in vitro fertilization outcome among oocyte donation cycles. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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32
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Sullivan S, Strauss G, Ossenfort K, Katz A, Gold J. C-83 * The Role of IQ in Effort Test Performance in Schizophrenia. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.264] [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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33
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Ossenfort K, Frost K, Katz A, Chiu I, Strauss G, Gold J. C-18 * Negative Symptoms Predict Neuropsychological Impairment in Schizophrenia. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.199] [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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34
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Morra L, Gold J, Ossenfort K, Strauss G. C-78 * Predicting Insufficient Effort in Schizophrenia using the Repeated Battery for the Assessment of Neuropsychological Status Effort Index. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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35
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Frost K, Keller W, Buchanan R, Gold J, Koenig J, Ossenfort K, Katz A, Strauss G. C-14 * Plasma Oxytocin Levels are Associated with Impaired Social Cognition and Neurocognition in Schizophrenia. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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36
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Bratch A, Srinath A, Barr S, Bromfield W, Gold J. Configural superiority reduces efficiency. J Vis 2014. [DOI: 10.1167/14.10.244] [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: 11/24/2022] Open
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Grisanti L, Repas A, Carter R, Talarico J, Gold J, Koch W, Tilley D. Differential temporal regulation of cardiac cytokine expression in response to chronic β‐adrenergic receptor stimulation (652.4). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.652.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | - Jessica Gold
- Thomas Jefferson UniversityPhiladelphiaPAUnited States
| | - Walter Koch
- Temple UniversityPhiladelphiaPAUnited States
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Carlisle N, Hahn BH, Robinson B, Gold J, Luck S. The Multiple Change Detection Approach to Estimating Visual Working Memory Capacity. J Vis 2013. [DOI: 10.1167/13.9.1350] [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: 11/24/2022] Open
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Affiliation(s)
- J. Gold
- a Centre for Population Health , Burnet Institute , Melbourne , 3004 , Australia
- b Department of Epidemiology and Preventive Medicine , Monash University , Melbourne , 3004 , Australia
| | - M.E. Hellard
- c Centre for Population Health , Burnet Institute , Melbourne , 3004 , Australia
- d Department of Epidemiology and Preventive Medicine , Monash University , Melbourne , 3004 , Australia
- e Nossal Institute for Global Health , University of Melbourne , Melbourne , 3010 , Australia
| | - M.S. Lim
- f Centre for Population Health , Burnet Institute , Melbourne , 3004 , Australia
| | - H. Dixon
- g Centre for Behavioural Research in Cancer , Cancer Council Victoria , Melbourne , 3053 , Australia
| | - M. Wakefield
- h Centre for Behavioural Research in Cancer , Cancer Council Victoria , Melbourne , 3053 , Australia
| | - C.K. Aitken
- i Centre for Population Health , Burnet Institute , Melbourne , 3004 , Australia
- j Department of Epidemiology and Preventive Medicine , Monash University , Melbourne , 3004 , Australia
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Barker J, Barr S, Bittner J, Bromfield D, Goode A, Lee D, Simmons M, Gold J. Dynamic and static expressions of emotion are recognized with equal efficiency. J Vis 2012. [DOI: 10.1167/12.9.966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Gold J, Simmons M. The integration of parts during visual completion is inefficient. J Vis 2012. [DOI: 10.1167/12.9.1056] [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: 11/24/2022] Open
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Barr S, Gold J. Groups detect wholes better than parts. J Vis 2012. [DOI: 10.1167/12.9.169] [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: 11/24/2022] Open
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Bromfield WD, Taylor C, Gold J. Efficiencies for parts and wholes in biological motion perception. J Vis 2012. [DOI: 10.1167/12.9.461] [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: 11/24/2022] Open
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Aizenman A, Bond S, Sekuler R, Gold J. Implicit Learning and Memory for Random Visual Noise. J Vis 2012. [DOI: 10.1167/12.9.1134] [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: 11/24/2022] Open
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Fayolle G, Levick W, Lajiness-O'Neill R, Fastenau P, Briskin S, Bass N, Silva M, Critchfield E, Nakase-Richardson R, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Anderson A, Peery S, Chafetz M, Maris M, Ramezani A, Sylvester C, Goldberg K, Constantinou M, Karekla M, Hall J, Edwards M, Balldin V, Strutt A, Pavlik V, Marquez de la Plata C, Cullum M, lacritz L, Reisch J, Massman P, Royall D, Barber R, Younes S, Wiechmann A, O'Bryant S, Patel K, Suhr J, Patel K, Suhr J, Chari S, Yokoyama J, Bettcher B, Karydas A, Miller B, Kramer J, Zec R, Fritz S, Kohlrus S, Robbs R, Ala T, Gifford K, Cantwell N, Romano R, Jefferson A, Holland A, Newton S, Bunting J, Coe M, Carmona J, Harrison D, Puente A, Terry D, Faraco C, Brown C, Patel A, Watts A, Kent A, Siegel J, Miller S, Ernst W, Chelune G, Holdnack J, Sheehan J, Duff K, Pedraza O, Crawford J, Terry D, Puente A, Brown C, Faraco C, Watts A, Patel A, Kent A, Siegel J, Miller L, Younes S, Hobson Balldin V, Benavides H, Johnson L, Hall J, Tshuma L, O'Bryant S, Dezhkam N, Hayes L, Love C, Stephens B, Webbe F, Allen C, Lemann E, Davis A, Pierson E, Lutz J, Piehl J, Holler K, Kavanaugh B, Tayim F, Llanes S, Mulligan K, Poston K, Riccio C, Beathard J, Cohen M, Stolberg P, Hart J, Jones W, Mayfield J, Allen D, Weller J, Dunham K, Demireva P, McInerney K, Suhr J, Dykstra J, Riddle T, Suhr J, Primus M, Riccio C, Highsmith J, Everhart D, Shadi S, Lehockey K, Sullivan S, Lucas M, Mandava S, Murphy B, Donovick P, Lalwani L, Rosselli M, Coad S, Carrasco R, Sofko C, Scarisbrick D, Golden C, Coad S, Zuckerman S, Golden C, Perna R, Loughan A, Hertza J, Brand J, Rivera Mindt M, Denney R, Schaffer S, Alper K, Devinsky O, Barr W, Langer K, Fraiman J, Scagliola J, Roman E, Martinez A, Cohen M, Dunham K, Riccio C, Martin P, Robbins J, Golden C, Axelrod B, Etherton J, Konopacki K, Moses J, Juliano A, Whiteside D, Rolin S, Widmann G, Franzwa M, Sokal B, Mark V, Doyle K, Morgan E, Weber E, Bondi M, Delano-Wood L, Grant I, Sibson J, Woods S, Andrews P, McGregor S, Golden C, Etherton J, Allen C, Cormier R, Cumley N, Elek M, Green M, Ogbeide S, Kruger A, Pacheco L, Robinson G, Welch H, Etherton J, Allen C, Cormier R, Cumley N, Kruger A, Pacheco L, Glover M, Parriott D, Jones W, Loe S, Hughes L, Natta L, Moses J, Vincent A, Roebuck-Spencer T, Bryan C, Padua M, Denney R, Moses J, Quenicka W, McGoldirck K, Bennett T, Soper H, Collier S, Connolly M, Hanratty A, Di Pinto M, Magnuson S, Dunham K, Handel E, Davidson K, Livers E, Frantz S, Allen J, Jerard T, Moses J, Pierce S, Sakhai S, Newton S, Warchol A, Holland A, Bunting J, Coe M, Carmona J, Harrison D, Barney S, Thaler N, Sutton G, Strauss G, Allen D, Hunter B, Bennett T, Quenicka W, McGoldrick K, Soper H, Sordahl J, Torrence N, John S, Gavett B, O'Bryant S, Shadi S, Denney R, Nichols C, Riccio C, Cohen M, Dennison A, Wasserman T, Schleicher-Dilks S, Adler M, Golden C, Olivier T, Schleicher-Dilks S, Golden C, LeMonda B, McGinley J, Pritchett A, Chang L, Cloak C, Cunningham E, Lohaugen G, Skranes J, Ernst T, Parke E, Thaler N, Etcoff L, Allen D, Andrews P, McGregor S, Golden C, Northington S, Daniels R, Loughan A, Perna R, Hertza J, Hochsztein N, Miles-Mason E, Granader Y, Vasserman M, MacAllister W, Casto B, Peery S, Patrick K, Hurewitz F, Chute D, Booth A, Koch C, Roid G, Balkema N, Kiefel J, Bell L, Maerlender A, Belkin T, Katzenstein J, Semerjian C, Culotta V, Band E, Yosick R, Burns T, Arenivas A, Bearden D, Olson K, Jacobson K, Ubogy S, Sterling C, Taub E, Griffin A, Rickards T, Uswatte G, Davis D, Sweeney K, Llorente A, Boettcher A, Hill B, Ploetz D, Kline J, Rohling M, O'Jile J, Holler K, Petrauskas V, Long J, Casey J, Long J, Petrauskas V, Duda T, Hodsman S, Casey J, Stricker S, Martner S, Hansen R, Ferraro F, Tangen R, Hanratty A, Tanabe M, O'Callaghan E, Houskamp B, McDonald L, Pick L, Guardino D, Pick L, Pietz T, Kayser K, Gray R, Letteri A, Crisologo A, Witkin G, Sanders J, Mrazik M, Harley A, Phoong M, Melville T, La D, Gomez R, Berthelson L, Robbins J, Lane E, Golden C, Rahman P, Konopka L, Fasfous A, Zink D, Peralta-Ramirez N, Perez-Garcia M, Puente A, Su S, Lin G, Kiely T, Gomez R, Schatzberg A, Keller J, Dykstra J, Suhr J, Feigon M, Renteria L, Fong M, Piper L, Lee E, Vordenberg J, Contardo C, Magnuson S, Doninger N, Luton L, Balkema N, Drane D, Phelan A, Stricker W, Poreh A, Wolkenberg F, Spira J, Lin G, Su S, Kiely T, Gomez R, Schatzberg A, Keller J, DeRight J, Jorgensen R, Fitzpatrick L, Crowe S, Woods S, Doyle K, Weber E, Cameron M, Cattie J, Cushman C, Grant I, Blackstone K, Woods S, Weber E, Grant I, Moore D, Roberg B, Somogie M, Thelen J, Lovelace C, Bruce J, Gerstenecker A, Mast B, Litvan I, Hargrave D, Schroeder R, Buddin W, Baade L, Heinrichs R, Thelen J, Roberg B, Somogie M, Lovelace C, Bruce J, Boseck J, Berry K, Koehn E, Davis A, Meyer B, Gelder B, Sussman Z, Espe-Pfeifer P, Musso M, Barker A, Jones G, Gouvier W, Weber E, Woods S, Grant I, Johnson V, Zaytsev L, Freier-Randall M, Sutton G, Thaler N, Ringdahl E, Allen D, Olsen J, Byrd D, Rivera-Mindt M, Fellows R, Morgello S, Wheaton V, Jaehnert S, Ellis C, Olavarria H, Loftis J, Huckans M, Pimental P, Frawley J, Welch M, Jennette K, Rinehardt E, Schoenberg M, Strober L, Genova H, Wylie G, DeLuca J, Chiaravalloti N, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Ibrahim E, Seiam A, Ibrahim E, Bohlega S, Rinehardt E, Lloyd H, Goldberg M, Marceaux J, Fallows R, McCoy K, Yehyawi N, Luther E, Hilsabeck R, Fulton R, Stevens P, Erickson S, Dodzik P, Williams R, Dsurney J, Najafizadeh L, McGovern J, Chowdhry F, Acevedo A, Bakhtiar A, Karamzadeh N, Amyot F, Gandjbakhche A, Haddad M, Taub E, Johnson M, Wade J, Harper L, Rickards T, Sterling C, Barghi A, Uswatte G, Mark V, Balkema N, Christopher G, Marcus D, Spady M, Bloom J, Wiechmann A, Hall J, Loughan A, Perna R, Hertza J, Northington S, Zimmer A, Webbe F, Miller M, Schuster D, Ebner H, Mortimer B, Webbe F, Palmer G, Happe M, Paxson J, Jurek B, Graca J, Meyers J, Lange R, Brickell T, French L, Lange R, Iverson G, Shewchuk J, Madler B, Heran M, Brubacher J, Brickell T, Lange R, Ivins B, French L, Baldassarre M, Paper T, Herrold A, Chin A, Zgaljardic D, Oden K, Lambert M, Dickson S, Miller R, Plenger P, Jacobson K, Olson K, Sutherland E, Glatts C, Schatz P, Walker K, Philip N, McClaughlin S, Mooney S, Seats E, Carnell V, Raintree J, Brown D, Hodges C, Amerson E, Kennedy C, Moore J, Schatz P, Ferris C, Roebuck-Spencer T, Vincent A, Bryan C, Catalano D, Warren A, Monden K, Driver S, Chau P, Seegmiller R, Baker M, Malach S, Mintz J, Villarreal R, Peterson A, Leininger S, Strong C, Donders J, Merritt V, Vargas G, Rabinowitz A, Arnett P, Whipple E, Schultheis M, Robinson K, Iacovone D, Biester R, Alfano D, Nicholls M, Vargas G, Rabinowitz A, Arnett P, Rabinowitz A, Vargas G, Arnett P, Klas P, Jeffay E, Zakzanis K, Vandermeer M, Jeffay E, Zakzanis K, Womble M, Rohling M, Hill B, Corley E, Considine C, Fichtenberg N, Harrison J, Pollock M, Mouanoutoua A, Brimager A, Lebby P, Sullivan K, Edmed S, Silva M, Nakase-Richardson R, Critchfield E, Kieffer K, McCarthy M, Wiegand L, Lindsey H, Hernandez M, Puente A, Noniyeva Y, Lapis Y, Padua M, Poole J, Brooks B, McKay C, Mrazik M, Meeuwisse W, Emery C, Brooks B, Mazur-Mosiewicz A, Sherman E, Brooks B, Mazur-Mosiewicz A, Kirkwood M, Sherman E, Gunner J, Miele A, Silk-Eglit G, Lynch J, McCaffrey R, Stewart J, Tsou J, Scarisbrick D, Chan R, Bure-Reyes A, Cortes L, Gindy S, Golden C, Hunter B, Biddle C, Shah D, Jaberg P, Moss R, Horner M, VanKirk K, Dismuke C, Turner T, Muzzy W, Dunnam M, Miele A, Warner G, Donnelly K, Donnelly J, Kittleson J, Bradshaw C, Alt M, Margolis S, Ostroy E, Rolin S, Higgins K, Denney R, Rolin S, Eng K, Biddle C, Akeson S, Wall J, Davis J, Hansel J, Hill B, Rohling M, Wang B, Womble M, Gervais R, Greiffenstein M, Denning J, Denning J, Schroeder R, Buddin W, Hargrave D, VonDran E, Campbell E, Brockman C, Heinrichs R, Baade L, Buddin W, Hargrave D, Schroeder R, Teichner G, Waid R, Buddin W, Schroeder R, Teichner G, Waid R, Buican B, Armistead-Jehle P, Bailie J, Dilay A, Cottingham M, Boyd C, Asmussen S, Neff J, Schalk S, Jensen L, DenBoer J, Hall S, DenBoer J, Schalk S, Jensen L, Hall S, Miele A, Lynch J, McCaffrey R, Holcomb E, Axelrod B, Demakis G, Rimland C, Ward J, Ross M, Bailey M, Stubblefield A, Smigielski J, Geske J, Karpyak V, Reese C, Larrabee G, Suhr J, Silk-Eglit G, Gunner J, Miele A, Lynch J, McCaffrey R, Allen L, Celinski M, Gilman J, Davis J, Wall J, LaDuke C, DeMatteo D, Heilbrun K, Swirsky-Sacchetti T, Lindsey H, Puente A, Dedman A, Withers K, Chafetz M, Deneen T, Denney R, Fisher J, Spray B, Savage R, Wiener H, Tyer J, Ningaonkar V, Devlin B, Go R, Sharma V, Tsou J, Golden C, Fontanetta R, Calderon C, Coad S, Golden C, Calderon C, Fontaneta R, Coad S, Golden C, Ringdahl E, Thaler N, Sutton G, Vertinski M, Allen D, Verbiest R, Thaler N, Snyder J, Kinney J, Allen D, Rach A, Young J, Crouse E, Schretlen D, Weaver J, Buchholz A, Gordon B, Macciocchi S, Seel R, Godsall R, Brotsky J, DiRocco A, Houghton-Faryna E, Bolinger E, Hollenbeck C, Hart J, Thaler N, Vertinski M, Ringdahl E, Allen D, Lee B, Strauss G, Adams J, Martins D, Catalano L, Waltz J, Gold J, Haas G, Brown L, Luther J, Goldstein G, Kiely T, Kelley E, Lin G, Su S, Raba C, Gomez R, Trettin L, Solvason H, Schatzberg A, Keller J, Vertinski M, Thaler N, Allen D, Gold J, Buchanan R, Strauss G, Baldock D, Ringdahl E, Sutton G, Thaler N, Allen D, Fallows R, Marceaux J, McCoy K, Yehyawi N, Luther E, Hilsabeck R, Etherton J, Phelps T, Richmond S, Tapscott B, Thomlinson S, Cordeiro L, Wilkening G, Parikh M, Graham L, Grosch M, Hynan L, Weiner M, Cullum C, Hobson Balldin V, Menon C, Younes S, Hall J, Strutt A, Pavlik V, Marquez de la Plata C, Cullum M, Lacritz L, Reisch J, Massman P, Royall D, Barber R, O'Bryant S, Castro-Couch M, Irani F, Houshyarnejad A, Norman M, Peery S, Fonseca F, Bure-Reyes A, Browne B, Alvarez J, Jiminez Y, Baez V, Cortes L, Golden C, Fonseca F, Bure-Reyes A, Coad S, Alvarez J, Browne B, Baez V, Golden C, Resendiz C, Scott B, Farias G, York M, Lozano V, Mahoney M, Strutt A, Hernandez Mejia M, Puente A, Bure-Reyes A, Fonseca F, Baez V, Alvarez J, Browne B, Coad S, Jiminez Y, Cortes L, Golden C, Bure-Reyes A, Pacheco E, Homs A, Acevedo A, Ownby R, Nici J, Hom J, Lutz J, Dean R, Finch H, Pierce S, Moses J, Mann S, Feinberg J, Choi A, Kaminetskaya M, Pierce C, Zacharewicz M, Axelrod B, Gavett B, Horwitz J, Edwards M, O'Bryant S, Ory J, Gouvier W, Carbuccia K, Ory J, Carbuccia K, Gouvier W, Morra L, Garcon S, Lucas M, Donovick P, Whearty K, Campbell K, Camlic S, Donovick P, Edwards M, Balldin V, Hall J, Strutt A, Pavlik V, Marquez de la Plata C, Cullum C, Lacritz L, Reisch J, Massman P, Barber R, Royall D, Younes S, O'Bryant S, Brinckman D, Schultheis M, Ehrhart L, Weisser V, Medaglia J, Merzagora A, Reckess G, Ho T, Testa S, Gordon B, Schretlen D, Woolery H, Farcello C, Klimas N, Thaler N, Allen D, Meyer J, Vargas G, Rabinowitz A, Barwick F, Arnett P, Womble M, Rohling M, Hill B, Corley E, Drayer K, Rohling M, Ploetz D, Womble M, Hill B, Baldock D, Ringdahl E, Sutton G, Thaler N, Allen D, Galusha J, Schmitt A, Livingston R, Stewart R, Quarles L, Pagitt M, Barke C, Baker A, Baker N, Cook N, Ahern D, Correia S, Resnik L, Barnabe K, Gnepp D, Benjamin M, Zlatar Z, Garcia A, Harnish S, Crosson B, Rickards T, Mark V, Taub E, Sterling C, Vaughan L, Uswatte G, Fedio A, Sexton J, Cummings S, Logemann A, Lassiter N, Fedio P, Gremillion A, Nemeth D, Whittington T, Hansen R, Reckow J, Ferraro F, Lewandowski C, Cole J, Lewandowski A, Spector J, Ford-Johnson L, Lengenfelder J, Genova H, Sumowski J, DeLuca J, Chiaravalloti N, Loughan A, Perna R, Hertza J, Morse C, McKeever J, Zhao L, Leist T, Schultheis M, Marcinak J, Piecora K, Al-Khalil K, Webbe F, Mulligan K, Robbins J, Berthelson L, Martin P, Golden C, Piecora K, Marcinak J, Al-Khalil K, Webbe F, Mulligan K, Stewart J, Acevedo A, Ownby R, Thompson L, Kowalczyk W, Golub S, Davis A, Lemann E, Piehl J, Rita N, Moss L, Davis A, Boseck J, Berry K, Koehn E, Meyer B, Gelder B, Davis A, Nogin R, Moss L, Drapeau C, Malm S, Davis A, Lemann E, Koehn E, Drapeau C, Malm S, Boseck J, Armstrong L, Glidewell R, Orr W, Mears G. Grand Rounds. Arch Clin Neuropsychol 2012. [DOI: 10.1093/arclin/acs070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Gold J, Peterson J, Lee E, Fuchs D, Price R, Yiannoutsos C, Robertson K, Spudich S. Depression and Mood States and Correlations with Biomarkers of Central Nervous System Disease in Primary-HIV Infection (P01.262). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hodder S, Arasteh K, De Wet J, Gathe J, Gold J, Kumar P, Mohapi L, Short W, Crauwels H, Vanveggel S, Boven K. Effect of gender and race on the week 48 findings in treatment-naïve, HIV-1-infected patients enrolled in the randomized, phase III trials ECHO and THRIVE. HIV Med 2012; 13:406-15. [PMID: 22416849 DOI: 10.1111/j.1468-1293.2012.00991.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVES A week 48 efficacy and safety analysis with respect to gender and race was conducted using pooled data from the phase III, double-blind, double-dummy efficacy comparison in treatment-naïve, HIV-infected subjects of TMC278 and efavirenz (ECHO) and TMC278 against HIV, in a once-daily regimen versus efavirenz (THRIVE) trials. METHODS Treatment-naïve, HIV-1-infected adults were randomized to receive rilpivirine (RPV; TMC278) 25 mg once a day (qd), or efavirenz (EFV) 600 mg qd, plus tenofovir/emtricitabine (ECHO) or tenofovir/emtricitabine, zidovudine/lamivudine or abacavir/lamivudine (THRIVE). RESULTS A total of 1368 participants (76% male and 61% White, of those with available race data) were randomized and treated. No gender-related differences in response rate (percentage of patients with HIV-1 viral load < 50 HIV-1 RNA copies/mL, using an intent-to-treat, time-to-loss-of-virological-response algorithm) were observed (RPV: men, 85%; women, 83%; EFV: men, 82%; women, 83%). Response rates were lower in Black compared with Asian and White participants (RPV: 75% vs. 95% and 85%, respectively; EFV: 74% vs. 93% and 83%, respectively); this finding was mostly a result of higher discontinuation and virological failure rates in Black patients. Safety findings were generally similar across race and gender subgroups. However, nausea occurred more commonly in women than in men in both treatment groups. In men, diarrhoea was more frequent in the EFV group, and abnormal dreams/nightmares were more frequent in men in both the EFV and RPV groups. CONCLUSIONS Overall response rates were high for both RPV and EFV. No gender differences were observed. However, response rates were lower among Black patients, regardless of treatment group. Gender appeared to influence the incidence of gastrointestinal adverse events and abnormal dreams/nightmares for both treatments.
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Affiliation(s)
- S Hodder
- UMDNJ-New Jersey Medical School, Newark, NJ 07103, USA
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Chen Y, Norton DJ, McBain R, Gold J, Frazier JA, Coyle JT. Enhanced local processing of dynamic visual information in autism: evidence from speed discrimination. Neuropsychologia 2012; 50:733-9. [PMID: 22261399 PMCID: PMC4094132 DOI: 10.1016/j.neuropsychologia.2012.01.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Revised: 12/08/2011] [Accepted: 01/04/2012] [Indexed: 01/08/2023]
Abstract
An important issue for understanding visual perception in autism concerns whether individuals with this neurodevelopmental disorder possess an advantage in processing local visual information, and if so, what is the nature of this advantage. Perception of movement speed is a visual process that relies on computation of local spatiotemporal signals but requires the comparison of information from more than a single spatial location or temporal point. This study examined speed discrimination in adolescents (ages 13-18 years old) with autism spectrum disorders (ASD). Compared to healthy controls (n=17), individuals with ASD (n=19) showed similarly precise speed discrimination when two comparison motion stimuli (random dot patterns) were presented closely in time (0.5s). With a longer temporal interval (3s) between the motion stimuli, individuals with ASD outperformed healthy controls on speed discrimination. On a second task--global motion perception--in which individuals were asked to detect coherent motion, individuals with ASD exhibited slightly degraded performance levels. The observed temporally selective enhancement in speed discrimination indicates that a local processing advantage in autism develops over a longer temporal range and is not limited to the spatial domain. These results suggest a dynamic perceptual mechanism for understanding, and therapeutically addressing, atypical visual processing in this neurodevelopmental disorder.
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Affiliation(s)
- Y Chen
- McLean Hospital, Department of Psychiatry, Harvard Medical School, United States.
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LeRoy B, Woolums A, Wass J, Davis E, Gold J, Foreman J, Lohmann K, Adams J. The Relationship between Serum Calcium Concentration and Outcome in Horses with Renal Failure Presented to Referral Hospitals. J Vet Intern Med 2011; 25:1426-30. [DOI: 10.1111/j.1939-1676.2011.00807.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 06/29/2011] [Accepted: 08/01/2011] [Indexed: 11/30/2022] Open
Affiliation(s)
- B. LeRoy
- Department of Veterinary Pathology; College of Veterinary Medicine; University of Georgia; Athens; GA
| | - A. Woolums
- Department of Large Animal Medicine; College of Veterinary Medicine; University of Georgia; Athens; GA
| | - J. Wass
- Quantum Cat Consultants; Lake Forest; IL
| | - E. Davis
- Department of Anatomy and Physiology; College of Veterinary Medicine; Kansas State University; Manhattan; KS
| | - J. Gold
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station; TX
| | - J.H. Foreman
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois at Urbana-Champaign; Urbana-Champaign; IL
| | - K. Lohmann
- Department of Large Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon; SK
| | - J. Adams
- Department of Small Animal Medicine; College of Veterinary Medicine; University of Georgia; Athens; GA
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