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Maloney E, Villeneuve D, Jensen K, Blackwell B, Kahl M, Poole S, Vitense K, Feifarek D, Patlewicz G, Dean K, Tilton C, Randolph E, Cavallin J, LaLone C, Blatz D, Schaupp C, Ankley G. Evaluation of Complex Mixture Toxicity in the Milwaukee Estuary (WI, USA) Using Whole-Mixture and Component-Based Evaluation Methods. Environ Toxicol Chem 2023; 42:1229-1256. [PMID: 36715369 PMCID: PMC10775314 DOI: 10.1002/etc.5571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/13/2022] [Accepted: 01/22/2023] [Indexed: 05/27/2023]
Abstract
Anthropogenic activities introduce complex mixtures into aquatic environments, necessitating mixture toxicity evaluation during risk assessment. There are many alternative approaches that can be used to complement traditional techniques for mixture assessment. Our study aimed to demonstrate how these approaches could be employed for mixture evaluation in a target watershed. Evaluations were carried out over 2 years (2017-2018) across 8-11 study sites in the Milwaukee Estuary (WI, USA). Whole mixtures were evaluated on a site-specific basis by deploying caged fathead minnows (Pimephales promelas) alongside composite samplers for 96 h and characterizing chemical composition, in vitro bioactivity of collected water samples, and in vivo effects in whole organisms. Chemicals were grouped based on structure/mode of action, bioactivity, and pharmacological activity. Priority chemicals and mixtures were identified based on their relative contributions to estimated mixture pressure (based on cumulative toxic units) and via predictive assessments (random forest regression). Whole mixture assessments identified target sites for further evaluation including two sites targeted for industrial/urban chemical mixture effects assessment; three target sites for pharmaceutical mixture effects assessment; three target sites for further mixture characterization; and three low-priority sites. Analyses identified 14 mixtures and 16 chemicals that significantly contributed to cumulative effects, representing high or medium priority targets for further ecotoxicological evaluation, monitoring, or regulatory assessment. Overall, our study represents an important complement to single-chemical prioritizations, providing a comprehensive evaluation of the cumulative effects of mixtures detected in a target watershed. Furthermore, it demonstrates how different tools and techniques can be used to identify diverse facets of mixture risk and highlights strategies that can be considered in future complex mixture assessments. Environ Toxicol Chem 2023;42:1229-1256. © 2023 SETAC.
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Affiliation(s)
| | - D.L. Villeneuve
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - K.M. Jensen
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - B.R. Blackwell
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - M.D. Kahl
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - S.T. Poole
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - K. Vitense
- Scientific Computing and Data Curation Division, US EPA,
Duluth, MN, USA
| | - D.J. Feifarek
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - G. Patlewicz
- Centre for Computational Toxicology and Exposure, US EPA,
Research Triangle Park, NC, USA
| | - K. Dean
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - C. Tilton
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - E.C. Randolph
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - J.E. Cavallin
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - C.A. LaLone
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - D. Blatz
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - C. Schaupp
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
| | - G.T. Ankley
- Great Lakes Toxicology and Ecology Division, US EPA,
Duluth, MN, USA
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2
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Koontz NA, Tomblinson CM, Shatzkes DR, Glastonbury CM, Phillips CD, Dean K, Strauss S, Agarwal M, Robson CD, Wiggins RH. A Gamified Social Media-Based Head and Neck Radiology Education Initiative of the American Society of Head and Neck Radiology: Viewership and Engagement Trends at 3 Years. AJNR Am J Neuroradiol 2022; 43:1784-1791. [PMID: 36456082 DOI: 10.3174/ajnr.a7711] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 09/21/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND AND PURPOSE Social media has made inroads in medical education. We report the creation and 3-year (2018-2021) longitudinal assessment of the American Society of Head and Neck Radiology Case of the Week (#ASHNRCOTW), assessing viewership, engagement, and impact of the coronavirus disease 2019 (COVID-19) pandemic on this Twitter-based education initiative. MATERIALS AND METHODS Unknown cases were tweeted from the American Society of Head and Neck Radiology account weekly. Tweet impressions (number of times seen), engagements (number of interactions), and new followers were tabulated. A social media marketing platform identified worldwide distribution of Twitter followers. Summary and t test statistics were performed. RESULTS #ASHNRCOTW was highly visible with 2,082,280 impressions and 203,137 engagements. There were significantly greater mean case impressions (9917 versus 6346), mean case engagements (1305 versus 474), case engagement rates (13.06% versus 7.76%), mean answer impressions (8760 versus 5556), mean answer engagements (908 versus 436), answer engagement rates (10.38% versus 7.87%), mean total (case + answer) impressions (18,677 versus 11,912), mean total engagements (2214 versus 910), and total engagement rates (11.79% versus 7.69%) for cases published after the pandemic started (all P values < .001). There was a significant increase in monthly new followers after starting #ASHNRCOTW (mean, 134 versus 6; P < .001) and significantly increased monthly new followers after the pandemic started compared with prepandemic (mean, 178 versus 101; P = .003). The American Society of Head and Neck Radiology has 7564 Twitter followers throughout 130 countries (66% outside the United States). CONCLUSIONS Social media affords substantial visibility, engagement, and global outreach for radiology education. #ASHNRCOTW viewership and engagement increased significantly during the COVID-19 pandemic.
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Affiliation(s)
- N A Koontz
- From the Department of Radiology and Imaging Sciences (N.A.K.), Indiana University School of Medicine, Indianapolis, Indiana
| | - C M Tomblinson
- Department of Radiology and Radiological Sciences (C.M.T.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - D R Shatzkes
- Department of Radiology (D.R.S.), Lenox Hill Hospital, New York, New York
| | - C M Glastonbury
- Department of Radiology and Biomedical Imaging (C.M.G.), University of California San Francisco, San Francisco, California
| | - C D Phillips
- Department of Radiology (C.D.P., K.D., S.S.), Weill Cornell Medicine, New York, New York
| | - K Dean
- Department of Radiology (C.D.P., K.D., S.S.), Weill Cornell Medicine, New York, New York
| | - S Strauss
- Department of Radiology (C.D.P., K.D., S.S.), Weill Cornell Medicine, New York, New York
| | - M Agarwal
- Department of Radiology (M.A.), Medical College of Wisconsin, Milwaukee, Wisconsin
| | - C D Robson
- Department of Radiology and Harvard Medical School (C.D.R.), Boston Children's Hospital, Boston, Massachusetts
| | - R H Wiggins
- Department of Radiology and Imaging Sciences (R.H.W.), University of Utah School of Medicine, Salt Lake City, Utah
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Abstract
Elizabethkingia spp. are common environmental pathogens responsible for infections in more vulnerable populations. Although the exposure routes of concern are not well understood, some hospital-associated outbreaks have indicated possible waterborne transmission. In order to facilitate quantitative microbial risk assessment (QMRA) for Elizabethkingia spp., this study fit dose-response models to frog and mice datasets that evaluated intramuscular and intraperitoneal exposure to Elizabethkingia spp. The frog datasets could be pooled, and the exact beta-Poisson model was the best fitting model with optimized parameters α = 0.52 and β = 86,351. Using the exact beta-Poisson model, the dose of Elizabethkingia miricola resulting in a 50% morbidity response (LD50 ) was estimated to be approximately 237,000 CFU. The model developed herein was used to estimate the probability of infection for a hospital patient under a modeled exposure scenario involving a contaminated medical device and reported Elizabethkingia spp. concentrations isolated from hospital sinks after an outbreak. The median exposure dose was approximately 3 CFU/insertion event, and the corresponding median risk of infection was 3.4E-05. The median risk estimated in this case study was lower than the 3% attack rate observed in a previous outbreak, however, there are noted gaps pertaining to the possible concentrations of Elizabethkingia spp. in tap water and the most likely exposure routes. This is the first dose-response model developed for Elizabethkingia spp. thus enabling future risk assessments to help determine levels of risk and potential effective risk management strategies.
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Affiliation(s)
- Kara Dean
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Natalie Coaster
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
| | - Kyana Young
- Department of Engineering, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Jade Mitchell
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, Michigan, USA
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Dean K, Mitchell J. Meta-Analysis Addressing the Implications of Model Uncertainty in Understanding the Persistence of Indicators and Pathogens in Natural Surface Waters. Environ Sci Technol 2022; 56:12106-12115. [PMID: 35984692 DOI: 10.1021/acs.est.1c07552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study evaluates the impact persistence model selection has on the prediction of persistence values of interest and the identification of influential water quality and environmental factors for microorganisms in natural surface waters. Five persistence models representing first-order decay and nonlinear decay profiles were fit to a comprehensive database of 629 data sets for fecal indicator bacteria (FIB), bacteriophages, bacteria, viruses, and protozoa mined from the literature. Initial periods of minimal decay and decay rates tapering off over time were often observed, and a two-parameter model, based on the logistic probability distribution, provided the best fit to the data most frequently. First-order decay kinetics provided the best fit to less than 20% of the analyzed data. Using the best fitting models in this analysis, T90 and T99 metrics were calculated for each data set and used as the dependent variable in a variety of exploratory factor analyses. Random forest methods identified temperature and predation as some of the most important water quality factors influencing persistence, and the protozoa target type differed the most from FIB. This analysis further confirmed the interactions between temperature and predation and suggests that pH and turbidity be more frequently documented in persistence studies to further elucidate their impact on target persistence. The findings from this analysis and the calculated persistence metrics can be used to better inform quantitative microbial risk assessments and may lead to improved predictions of human health risks and water management decisions.
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Affiliation(s)
- Kara Dean
- Department of Biosystems and Agricultural Engineering, Michigan State University, 524 S. Shaw Lane, East Lansing, Michigan48824, United States
| | - Jade Mitchell
- Department of Biosystems and Agricultural Engineering, Michigan State University, 524 S. Shaw Lane, East Lansing, Michigan48824, United States
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Dean K, Mitchell J. Identifying water quality and environmental factors that influence indicator and pathogen decay in natural surface waters. Water Res 2022; 211:118051. [PMID: 35051677 DOI: 10.1016/j.watres.2022.118051] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
Biphasic decay has been observed for indicators and pathogens in bench-scale and in-situ water experiments for decades, however, first-order decay kinetics continue to be applied to persistence data because of their simplicity and ease of application. Model uncertainty introduced by broadly applying first-order decay kinetics to persistence data may lead to erroneous decision making in the fields of water management and protection. As surface waters are exposed to highly variable environmental and water quality factors that influence microbial and viral persistence, it is expected that first-order decay kinetics are not representative of most of the persistence literature for indicators and pathogens in surface water matrices. This review compiled the methods and results of 61 studies that conducted experiments evaluating the persistence of fecal indicator bacteria (FIB), bacteriophages, pathogenic bacteria, viruses, and protozoa in natural surface water matrices. The goals of this review were trifold: (1) collate studies in the literature with data available for future persistence modeling, (2) present the current state of knowledge with regards to the environmental and water quality factors affecting persistence in natural surface waters, and (3) identify recurrent evidence for interactions between the frequently studied factors to inform future factor analyses. Comparing the methods and results across the 61 studies suggest potential interactions between sunlight and water type; sunlight and method of detection; predation and water type; predation and temperature; and water type and method of detection. The majority of the identified literature evaluated FIB or bacteria persistence; future experiments are needed that focus on protozoa, brackish or marine water types, and molecular-based methods of detection.
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Affiliation(s)
- Kara Dean
- Department of Biosystems and Agricultural Engineering, Michigan State University, USA
| | - Jade Mitchell
- Department of Biosystems and Agricultural Engineering, Michigan State University, USA.
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Kline A, Dean K, Kossik AL, Harrison JC, Januch JD, Beck NK, Zhou NA, Shirai JH, Boyle DS, Mitchell J, Meschke JS. Persistence of poliovirus types 2 and 3 in waste-impacted water and sediment. PLoS One 2022; 17:e0262761. [PMID: 35081146 PMCID: PMC8791527 DOI: 10.1371/journal.pone.0262761] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 01/04/2022] [Indexed: 11/19/2022] Open
Abstract
Eradication of poliovirus (PV) is a global public health priority, and as clinical cases decrease, the role of environmental surveillance becomes more important. Persistence of PV and the environmental factors that influence it (such as temperature and sample type) are an important part of understanding and interpreting positive environmental surveillance samples. The objective of this study was to evaluate the persistence of poliovirus type 2 (PV2) and type 3 (PV3) in wastewater and sediment. Microcosms containing either 1) influent wastewater or 2) influent wastewater with a sediment matrix were seeded with either PV2 or PV3, and stored for up to 126 days at three temperatures (4°C, room temperature [RT], and 30°C). Active PV in the liquid of (1), and the sediment and liquid portions of (2) were sampled and quantified at up to 10 time points via plaque assay and RT-qPCR. A suite of 17 models were tested for best fit to characterize decay of PV2 and PV3 over time and determine the time points at which >90% (T90) and >99% (T99) reduction was reached. Linear models assessed the influence of experimental factors (matrix, temperature, virus type and method of detection) on the predicted T90 and T99 values. Results showed that when T90 was the dependent variable, virus type, matrix, and temperature significantly affected decay, and there was a clear interaction between the sediment matrix and temperature. When T99 was the dependent variable, only temperature and matrix type significantly influenced the decay metric. This study characterizes the persistence of both active and molecular PV2 and PV3 in relevant environmental conditions, and demonstrates that temperature and sediment both play important roles in PV viability. As eradication nears and clinical cases decrease, environmental surveillance and knowledge of PV persistence will play a key role in understanding the silent circulation in endemic countries.
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Affiliation(s)
- Allison Kline
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States of America
| | - Kara Dean
- Biosystems & Agricultural Engineering, Michigan State University, East Lansing, Michigan, United States of America
| | - Alexandra L. Kossik
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States of America
| | - Joanna Ciol Harrison
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States of America
| | - James D. Januch
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States of America
| | - Nicola K. Beck
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States of America
| | - Nicolette A. Zhou
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States of America
| | - Jeffry H. Shirai
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States of America
| | | | - Jade Mitchell
- Biosystems & Agricultural Engineering, Michigan State University, East Lansing, Michigan, United States of America
| | - John Scott Meschke
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States of America
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Dean K, Tamrakar S, Huang Y, Rose JB, Mitchell J. Modeling the Dose Response Relationship of Waterborne Acanthamoeba. Risk Anal 2021; 41:79-91. [PMID: 33047815 DOI: 10.1111/risa.13603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/30/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023]
Abstract
This study developed dose response models for determining the probability of eye or central nervous system infections from previously conducted studies using different strains of Acanthamoeba spp. The data were a result of animal experiments using mice and rats exposed corneally and intranasally to the pathogens. The corneal inoculations of Acanthamoeba isolate Ac 118 included varied amounts of Corynebacterium xerosis and were best fit by the exponential model. Virulence increased with higher levels of C. xerosis. The Acanthamoeba culbertsoni intranasal study with death as an endpoint of response was best fit by the beta-Poisson model. The HN-3 strain of A. castellanii was studied with an intranasal exposure and three different endpoints of response. For all three studies, the exponential model was the best fit. A model based on pooling data sets of the intranasal exposure and death endpoint resulted in an LD50 of 19,357 amebae. The dose response models developed in this study are an important step towards characterizing the risk associated with free-living amoeba like Acanthamoeba in drinking water distribution systems. Understanding the human health risk posed by free-living amoeba will allow for quantitative microbial risk assessments that support building design decisions to minimize opportunities for pathogen growth and survival.
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Affiliation(s)
- Kara Dean
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA
| | - Sushil Tamrakar
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA
- Freelancer
| | - Yin Huang
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA
- Current address: Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | - Joan B Rose
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, USA
| | - Jade Mitchell
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA
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Mitchell J, Dean K, Haas C. Ebola Virus Dose Response Model for Aerosolized Exposures: Insights from Primate Data. Risk Anal 2020; 40:2390-2398. [PMID: 32638435 DOI: 10.1111/risa.13551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 03/21/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
This study develops dose-response models for Ebolavirus using previously published data sets from the open literature. Two such articles were identified in which three different species of nonhuman primates were challenged by aerosolized Ebolavirus in order to study pathology and clinical disease progression. Dose groups were combined and pooled across each study in order to facilitate modeling. The endpoint of each experiment was death. The exponential and exact beta-Poisson models were fit to the data using maximum likelihood estimation. The exact beta-Poisson was deemed the recommended model because it more closely approximated the probability of response at low doses though both models provided a good fit. Although transmission is generally considered to be dominated by person-to-person contact, aerosolization is a possible route of exposure. If possible, this route of exposure could be particularly concerning for persons in occupational roles managing contaminated liquid wastes from patients being treated for Ebola infection and the wastewater community responsible for disinfection. Therefore, this study produces a necessary mathematical relationship between exposure dose and risk of death for the inhalation route of exposure that can support quantitative microbial risk assessment aimed at informing risk mitigation strategies including personal protection policies against occupational exposures.
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Affiliation(s)
- Jade Mitchell
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA
| | - Kara Dean
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA
| | - Charles Haas
- Department of Civil, Architectural and Environmental Engineering, Drexel University, Philadelphia, PA, USA
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Julien R, Dreelin E, Whelton AJ, Lee J, Aw TG, Dean K, Mitchell J. Knowledge gaps and risks associated with premise plumbing drinking water quality. ACTA ACUST UNITED AC 2020. [DOI: 10.1002/aws2.1177] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Ryan Julien
- Department of Biosystems and Agricultural EngineeringMichigan State University East Lansing Michigan
| | - Erin Dreelin
- Department of Fisheries and WildlifeMichigan State University East Lansing Michigan
| | - Andrew J. Whelton
- Lyles School of Civil Engineering and Environmental and Ecological EngineeringPurdue University West Lafayette Indiana
| | - Juneseok Lee
- Department of Civil and Environmental EngineeringManhattan College Riverdale New York
| | - Tiong Gim Aw
- Department of Environmental Health Sciences, School of Public Health and Tropical MedicineTulane University New Orleans Louisiana
| | - Kara Dean
- Department of Biosystems and Agricultural EngineeringMichigan State University East Lansing Michigan
| | - Jade Mitchell
- Department of Biosystems and Agricultural EngineeringMichigan State University East Lansing Michigan
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Dean K, Wissler A, Hernandez-Suarez JS, Nejadhashemi AP, Mitchell J. Modeling the persistence of viruses in untreated groundwater. Sci Total Environ 2020; 717:134599. [PMID: 31836219 DOI: 10.1016/j.scitotenv.2019.134599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/18/2019] [Accepted: 09/20/2019] [Indexed: 05/21/2023]
Abstract
Several factors can affect virus behavior and persistence in water sources. Historically linear models have been used to describe persistence over time; however, these models do not consider all of the factors that can affect inactivation kinetics or the observed patterns of decay. Meanwhile, applying the appropriate persistence model is critical for ensuring that decision makers are minimizing human health risk in the event of contamination and exposure to contaminated groundwater. Therefore, to address uncertainty in predictions of decay or virus concentrations over time, this study fit seventeen different linear and nonlinear mathematical models to persistence data from a previously conducted sampling study on drinking water wells throughout the United States. The models were fit using Maximum Likelihood Estimation and the best fitting models were determined by the Bayesian Information Criterion. The purpose of the study was to identify the best model for estimating decay of viruses in groundwater and to determine if model uncertainty contributes to erroneous predictions of viral contamination when only conventional models are considered. For the datasets analyzed in this study, the Juneja and Marks models and the exponential damped model were more representative of the persistence of viruses in groundwater than the traditionally used linear models. The results from this study were then evaluated with classification trees in order to identify more relevant modeling methodology for future research. The classification trees aid in narrowing the scope of appropriate persistence models based on characteristics of the experimental conditions and water sampled.
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Affiliation(s)
- Kara Dean
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, United States
| | - Austin Wissler
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, United States; Water Resources Graduate Program, Oregon State University, Corvallis, OR, United States
| | - J Sebastian Hernandez-Suarez
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, United States
| | - A Pouyan Nejadhashemi
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, United States
| | - Jade Mitchell
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, United States.
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Abstract
This study develops novel dose-response models for Naegleria fowleri from selected peer-reviewed experiments on the virulence based on the intranasal exposure pathway. One data set measured the response of mice intranasally inoculated with the amebae and the other study addressed the response of mice swimming in N. fowleri infected water. The measured response for both studies was death. All experimental data were best fit by the beta-Poisson dose-response model. The three swimming experiments could be pooled, and this is the final recommended model with an LD50 of 13,257 amebae. The results of this study provide a better estimate of the probability of the risk to N. fowleri exposure than the previous models developed based on an intravenous exposure. An accurate dose-response model is the first step in quantifying the risk of free-living amebae like N. fowleri, which pose risks in recreational environments and have been detected in drinking water and premise plumbing systems. A better understanding of this risk will allow for risk management that limits the ability for pathogen growth, proliferation, and exposure.
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Affiliation(s)
- Kara Dean
- College of Engineering, Michigan State University, East Lansing, MI, USA
| | - Mark H Weir
- Environmental Health Sciences, The Ohio State University, College of Public Health, Columbus, OH, USA
| | - Jade Mitchell
- Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA E-mail:
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Samson J, Cronin S, Dean K. BC200 (BCYRN1) - The shortest, long, non-coding RNA associated with cancer. Noncoding RNA Res 2018; 3:131-143. [PMID: 30175286 PMCID: PMC6114260 DOI: 10.1016/j.ncrna.2018.05.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 05/14/2018] [Accepted: 05/17/2018] [Indexed: 12/22/2022] Open
Abstract
With the discovery that the level of RNA synthesis in human cells far exceeds what is required to express protein-coding genes, there has been a concerted scientific effort to identify, catalogue and uncover the biological functions of the non-coding transcriptome. Long, non-coding RNAs (lncRNAs) are a diverse group of RNAs with equally wide-ranging biological roles in the cell. An increasing number of studies have reported alterations in the expression of lncRNAs in various cancers, although unravelling how they contribute specifically to the disease is a bigger challenge. Originally described as a brain-specific, non-coding RNA, BC200 (BCYRN1) is a 200-nucleotide, predominantly cytoplasmic lncRNA that has been linked to neurodegenerative disease and several types of cancer. Here we summarise what is known about BC200, primarily from studies in neuronal systems, before turning to a review of recent work that aims to understand how this lncRNA contributes to cancer initiation, progression and metastasis, along with its possible clinical utility as a biomarker or therapeutic target.
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Affiliation(s)
| | | | - K. Dean
- School of Biochemistry and Cell Biology, Western Gateway Building, University College Cork, Cork, Ireland
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Mohan A, Dean K, Han S, Welf E, Danuser G. LB993 Focal adhesions mediate Rac1P29S-dependent drug resistance to MAPK inhibitors in melanoma. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Grabowski D, Hatfield L, Jena A, Cristman D, Flair M, Kator K, Dean K, Nudd G. CARE COORDINATION FOR HOME CARE RECIPIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - L. Hatfield
- Harvard Medical School, Boston, Massachusetts,
| | - A. Jena
- Harvard Medical School, Boston, Massachusetts,
| | - D. Cristman
- Clear Care Online, San Francisco, California,
| | | | | | - K. Dean
- Harvard Medical School, Boston, Massachusetts,
| | - G. Nudd
- Clear Care Online, San Francisco, California,
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Laurens KR, Tzoumakis S, Kariuki M, Green MJ, Hamde M, Harris F, Carr VJ, Dean K. Pervasive influence of maternal and paternal criminal offending on early childhood development: a population data linkage study. Psychol Med 2017; 47:889-901. [PMID: 27894371 PMCID: PMC5341495 DOI: 10.1017/s0033291716003007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/13/2016] [Accepted: 10/18/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Parental criminal offending is an established risk factor for offending among offspring, but little evidence is available indicating the impact of offending on early childhood functioning. We used data from a large Australian population cohort to determine associations between exposure to parental offending and a range of developmental outcomes at age 5 years. METHOD Multi-generation data in 66 477 children and their parents from the New South Wales Child Development Study were combined using data linkage. Logistic and multinomial regressions tested associations between any and violent offending histories of parents (fathers, mothers, or both parents) obtained from official records, and multiple measures of early childhood developmental functioning (social, emotional-behavioural, cognitive, communication and physical domains) obtained from the teacher-reported 2009 Australian Early Development Census. RESULTS Parental offending conferred significantly increased risk of vulnerability on all domains, particularly the cognitive domain. Greater risk magnitudes were observed for offending by both parents and by mothers than by fathers, and for violent than for any offending. For all parental offending exposures, vulnerability on multiple domains (where medium to large effects were observed) was more likely than on a single domain (small to medium effects). Relationships remained significant and of comparable magnitude following adjustment for sociodemographic covariates. CONCLUSIONS The effect of parental offending on early childhood developmental outcomes is pervasive, with the strongest effects on functioning apparent when both parents engage in violent offending. Supporting affected families in early childhood might mitigate both early developmental vulnerability and the propensity for later delinquency among these offspring.
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Affiliation(s)
- K. R. Laurens
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Institute, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - S. Tzoumakis
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Institute, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - M. Kariuki
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Institute, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - M. J. Green
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Institute, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - M. Hamde
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - F. Harris
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Institute, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - V. J. Carr
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Institute, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - K. Dean
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Institute, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
- Justice Health & Forensic Mental Health Network, Matraville, NSW, Australia
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Abstract
We reviewed the imaging findings of 14 splenic abscesses in 13 patients. All patients underwent chest radiography, 12 ultrasonography (US), 9 CT, 4 plain abdominal radiography, 2 99mTc-HMPAO leukocyte scan and 2 99mTc-HIG scan. Three patients were treated with percutaneous catheter drainage, and 5 with diagnostic or therapeutic fine-needle aspiration (FNA). At US the abscess was hypoechoic (n = 9), anechoic (n = 2), or anechoic with gasbubbles (n = 1), or the entire spleen was inhomogeneous with gasbubbles (n = 1). At CT the abscesses appeared as low density (18–30 HU) lesions with (n = 2) or without (n = 7) gas. In 2 cases 99mTc-HMPAO leukocyte scan, and in one case 99mTc-HIG scan showed an intrasplenic defect, and in one case 99mTc-HIG scan was considered normal. At plain abdominal radiography extraintestinal gas was suggested in 2 patients, and the findings were normal in 2. US-guided FNA confirmed infectious etiology of the lesion in 4 patients, and a necrotic specimen suggested infection in one. One patient was cured with repeated aspirations. Catheter drainage was successful in all 3 patients who underwent the procedure. We conclude that US and CT are accurate in detecting splenic abscesses. Our results in splenic interventions advocate wider use of the procedures.
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Fogle J, Jacob M, Blikslager A, Edwards A, Wagner B, Dean K, Fogle C. Comparison of lipopolysaccharides and soluble CD14 measurement between clinically endotoxaemic and nonendotoxaemic horses. Equine Vet J 2016; 49:155-159. [PMID: 27060869 DOI: 10.1111/evj.12582] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 03/27/2016] [Indexed: 12/31/2022]
Abstract
REASONS FOR PERFORMING STUDY Clinically useful biomarkers are needed for early identification of endotoxaemic horses. Soluble CD14 (sCD14) is amplified early in response to inflammatory signals, including bacterial lipopolysaccharide (LPS), and may prove a useful biomarker for clinical endotoxaemia. OBJECTIVES The aim of this study was to determine if sCD14 could serve as a more reliable biomarker of the clinical signs of endotoxaemia, compared to measuring LPS alone. STUDY DESIGN Prospective observational study in horses at a veterinary teaching hospital. METHODS Plasma samples were collected from 20 healthy horses and 35 horses presenting for emergency evaluation. Horses were classified as clinically endotoxaemic, using previously established criteria, if they had a heart rate >70 beats/min, packed cell volume >45% and/or a lesion likely to result in endotoxaemia. Soluble CD14 was measured using a cytometric bead-based assay and LPS was measured using a Limulus amoebocyte lysate (LAL) assay. RESULTS Soluble CD14 was higher in horses classified as clinically endotoxaemic (median 1102 ng/ml, interquartile range 439 ng/ml), compared to clinically nonendotoxaemic (median 692 ng/ml, interquartile range 455 ng/ml, P = 0.03. There was no difference in LPS concentrations between clinically nonendotoxaemic (median 5.4 endotoxin units [EU]/ml, interquartile range 5 EU/ml) and endotoxaemic horses (median 7.2 EU/ml, interquartile range 17 EU/ml, P = 0.2). There was no correlation between sCD14 and LPS values in paired serum samples. LPS and sCD14 values were used to generate a receiver operating characteristic curve. The area under the curve for LPS and sCD14 was <0.7, suggesting that sCD14 and LPS were poor predictors of clinical endotoxaemia for the horses in this study. CONCLUSIONS Further investigation is warranted to assess the utility of sCD14 measurement as a clinically useful biomarker to identify endotoxaemia in horses.
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Affiliation(s)
- J Fogle
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, USA
| | - M Jacob
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, USA
| | - A Blikslager
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, USA
| | - A Edwards
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, USA
| | - B Wagner
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - K Dean
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, USA
| | - C Fogle
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, USA
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Abstract
BACKGROUND The link between psychotic disorders and violent offending is well established; knowledge about risk of post-illness-onset offending across the full spectrum of psychiatric disorders is lacking. We aimed to compare rates of any offending and violent offending committed after the onset of illness, according to diagnostic group, with population controls. METHOD A 25% random sample of the Danish population (n = 521 340) was followed from their 15th birthday until offending occurred. Mental health status was considered as a time-varying exposure in a Poisson regression model used to examine the duration from service contact to the offence. RESULTS Males with any psychiatric contact had an incidence rate ratio (IRR) of 2.91 [95% confidence interval (CI) 2.80-3.02] for any offending; 4.18 (95% CI 3.99-4.38) for violent offending. Associations were stronger for women (IRR 4.17, 95% CI 3.95-4.40 for any offending; 8.02, 95% CI 7.20-8.94 for violent offending). Risk was similar across diagnostic groups for any offending in males, while variation between diagnostic groups was seen for male violent and female offending, both any and violent. CONCLUSIONS Risk of offending, particularly violent offending, was elevated across a range of mental disorders following first contact with mental health services. The extent of variation in strength of effect across diagnoses differed by gender.
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Affiliation(s)
- H Stevens
- National Centre for Register-based Research,Aarhus University,Aarhus,Denmark
| | - T M Laursen
- National Centre for Register-based Research,Aarhus University,Aarhus,Denmark
| | - P B Mortensen
- National Centre for Register-based Research,Aarhus University,Aarhus,Denmark
| | - E Agerbo
- National Centre for Register-based Research,Aarhus University,Aarhus,Denmark
| | - K Dean
- School of Psychiatry,University of New South Wales, and Justice Health & Forensic Mental Health Network,NSW,Australia
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Khalifeh H, Johnson S, Howard LM, Borschmann R, Osborn D, Dean K, Hart C, Hogg J, Moran P. Violent and non-violent crime against adults with severe mental illness. Br J Psychiatry 2015; 206:275-82. [PMID: 25698767 DOI: 10.1192/bjp.bp.114.147843] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [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: 03/04/2014] [Accepted: 09/25/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Little is known about the relative extent of crime against people with severe mental illness (SMI). AIMS To assess the prevalence and impact of crime among people with SMI compared with the general population. METHOD A total of 361 psychiatric patients were interviewed using the national crime survey questionnaire, and findings compared with those from 3138 general population controls participating in the contemporaneous national crime survey. RESULTS Past-year crime was experienced by 40% of patients v. 14% of controls (adjusted odds ratio (OR) = 2.8, 95% CI 2.0-3.8); and violent assaults by 19% of patients v. 3% of controls (adjusted OR = 5.3, 95% CI 3.1-8.8). Women with SMI had four-, ten- and four-fold increases in the odds of experiencing domestic, community and sexual violence, respectively. Victims with SMI were more likely to report psychosocial morbidity following violence than victims from the general population. CONCLUSIONS People with SMI are at greatly increased risk of crime and associated morbidity. Violence prevention policies should be particularly focused on people with SMI.
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Affiliation(s)
- H Khalifeh
- H. Khalifeh, MSc, MRCPsych, S. Johnson, MD, MRCPsych, Division of Psychiatry, University College London, London; L. M. Howard, PhD, MRCPsych, R. Borschmann, DClinPsy, David Goldberg Centre, Institute of Psychiatry, London; D. Osborn, PhD, MRCPsych, Division of Psychiatry, University College London, London; K. Dean, PhD, MRCPsych, Institute of Psychiatry, London, and School of Psychiatry, University of New South Wales and Justice Health & Forensic Mental Health Network; C. Hart, MSc, J. Hogg, MSc, P. Moran, PhD, MRCPsych, David Goldberg Centre, Institute of Psychiatry, London, UK
| | - S Johnson
- H. Khalifeh, MSc, MRCPsych, S. Johnson, MD, MRCPsych, Division of Psychiatry, University College London, London; L. M. Howard, PhD, MRCPsych, R. Borschmann, DClinPsy, David Goldberg Centre, Institute of Psychiatry, London; D. Osborn, PhD, MRCPsych, Division of Psychiatry, University College London, London; K. Dean, PhD, MRCPsych, Institute of Psychiatry, London, and School of Psychiatry, University of New South Wales and Justice Health & Forensic Mental Health Network; C. Hart, MSc, J. Hogg, MSc, P. Moran, PhD, MRCPsych, David Goldberg Centre, Institute of Psychiatry, London, UK
| | - L M Howard
- H. Khalifeh, MSc, MRCPsych, S. Johnson, MD, MRCPsych, Division of Psychiatry, University College London, London; L. M. Howard, PhD, MRCPsych, R. Borschmann, DClinPsy, David Goldberg Centre, Institute of Psychiatry, London; D. Osborn, PhD, MRCPsych, Division of Psychiatry, University College London, London; K. Dean, PhD, MRCPsych, Institute of Psychiatry, London, and School of Psychiatry, University of New South Wales and Justice Health & Forensic Mental Health Network; C. Hart, MSc, J. Hogg, MSc, P. Moran, PhD, MRCPsych, David Goldberg Centre, Institute of Psychiatry, London, UK
| | - R Borschmann
- H. Khalifeh, MSc, MRCPsych, S. Johnson, MD, MRCPsych, Division of Psychiatry, University College London, London; L. M. Howard, PhD, MRCPsych, R. Borschmann, DClinPsy, David Goldberg Centre, Institute of Psychiatry, London; D. Osborn, PhD, MRCPsych, Division of Psychiatry, University College London, London; K. Dean, PhD, MRCPsych, Institute of Psychiatry, London, and School of Psychiatry, University of New South Wales and Justice Health & Forensic Mental Health Network; C. Hart, MSc, J. Hogg, MSc, P. Moran, PhD, MRCPsych, David Goldberg Centre, Institute of Psychiatry, London, UK
| | - D Osborn
- H. Khalifeh, MSc, MRCPsych, S. Johnson, MD, MRCPsych, Division of Psychiatry, University College London, London; L. M. Howard, PhD, MRCPsych, R. Borschmann, DClinPsy, David Goldberg Centre, Institute of Psychiatry, London; D. Osborn, PhD, MRCPsych, Division of Psychiatry, University College London, London; K. Dean, PhD, MRCPsych, Institute of Psychiatry, London, and School of Psychiatry, University of New South Wales and Justice Health & Forensic Mental Health Network; C. Hart, MSc, J. Hogg, MSc, P. Moran, PhD, MRCPsych, David Goldberg Centre, Institute of Psychiatry, London, UK
| | - K Dean
- H. Khalifeh, MSc, MRCPsych, S. Johnson, MD, MRCPsych, Division of Psychiatry, University College London, London; L. M. Howard, PhD, MRCPsych, R. Borschmann, DClinPsy, David Goldberg Centre, Institute of Psychiatry, London; D. Osborn, PhD, MRCPsych, Division of Psychiatry, University College London, London; K. Dean, PhD, MRCPsych, Institute of Psychiatry, London, and School of Psychiatry, University of New South Wales and Justice Health & Forensic Mental Health Network; C. Hart, MSc, J. Hogg, MSc, P. Moran, PhD, MRCPsych, David Goldberg Centre, Institute of Psychiatry, London, UK
| | - C Hart
- H. Khalifeh, MSc, MRCPsych, S. Johnson, MD, MRCPsych, Division of Psychiatry, University College London, London; L. M. Howard, PhD, MRCPsych, R. Borschmann, DClinPsy, David Goldberg Centre, Institute of Psychiatry, London; D. Osborn, PhD, MRCPsych, Division of Psychiatry, University College London, London; K. Dean, PhD, MRCPsych, Institute of Psychiatry, London, and School of Psychiatry, University of New South Wales and Justice Health & Forensic Mental Health Network; C. Hart, MSc, J. Hogg, MSc, P. Moran, PhD, MRCPsych, David Goldberg Centre, Institute of Psychiatry, London, UK
| | - J Hogg
- H. Khalifeh, MSc, MRCPsych, S. Johnson, MD, MRCPsych, Division of Psychiatry, University College London, London; L. M. Howard, PhD, MRCPsych, R. Borschmann, DClinPsy, David Goldberg Centre, Institute of Psychiatry, London; D. Osborn, PhD, MRCPsych, Division of Psychiatry, University College London, London; K. Dean, PhD, MRCPsych, Institute of Psychiatry, London, and School of Psychiatry, University of New South Wales and Justice Health & Forensic Mental Health Network; C. Hart, MSc, J. Hogg, MSc, P. Moran, PhD, MRCPsych, David Goldberg Centre, Institute of Psychiatry, London, UK
| | - P Moran
- H. Khalifeh, MSc, MRCPsych, S. Johnson, MD, MRCPsych, Division of Psychiatry, University College London, London; L. M. Howard, PhD, MRCPsych, R. Borschmann, DClinPsy, David Goldberg Centre, Institute of Psychiatry, London; D. Osborn, PhD, MRCPsych, Division of Psychiatry, University College London, London; K. Dean, PhD, MRCPsych, Institute of Psychiatry, London, and School of Psychiatry, University of New South Wales and Justice Health & Forensic Mental Health Network; C. Hart, MSc, J. Hogg, MSc, P. Moran, PhD, MRCPsych, David Goldberg Centre, Institute of Psychiatry, London, UK
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Khalifeh H, Moran P, Borschmann R, Dean K, Hart C, Hogg J, Osborn D, Johnson S, Howard LM. Domestic and sexual violence against patients with severe mental illness. Psychol Med 2015; 45:875-886. [PMID: 25180908 PMCID: PMC4413870 DOI: 10.1017/s0033291714001962] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 07/08/2014] [Accepted: 07/18/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND Domestic and sexual violence are significant public health problems but little is known about the extent to which men and women with severe mental illness (SMI) are at risk compared with the general population. We aimed to compare the prevalence and impact of violence against SMI patients and the general population. METHOD Three hundred and three randomly recruited psychiatric patients, in contact with community services for ⩾ 1 year, were interviewed using the British Crime Survey domestic/sexual violence questionnaire. Prevalence and correlates of violence in this sample were compared with those from 22 606 general population controls participating in the contemporaneous 2011/12 national crime survey. RESULTS Past-year domestic violence was reported by 27% v. 9% of SMI and control women, respectively [odds ratio (OR) adjusted for socio-demographics, aOR 2.7, 95% confidence interval (CI) 1.7-4.0], and by 13% v. 5% of SMI and control men, respectively (aOR 1.6, 95% CI 1.0-2.8). Past-year sexual violence was reported by 10% v. 2.0% of SMI and control women respectively (aOR 2.9, 95% CI 1.4-5.8). Family (non-partner) violence comprised a greater proportion of overall domestic violence among SMI than control victims (63% v. 35%, p < 0.01). Adulthood serious sexual assault led to attempted suicide more often among SMI than control female victims (53% v. 3.4%, p < 0.001). CONCLUSIONS Compared to the general population, patients with SMI are at substantially increased risk of domestic and sexual violence, with a relative excess of family violence and adverse health impact following victimization. Psychiatric services, and public health and criminal justice policies, need to address domestic and sexual violence in this at-risk group.
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Affiliation(s)
- H. Khalifeh
- Division of Psychiatry, Faculty of Brain
Sciences, UCL (University College London),
UK
| | - P. Moran
- Health Service and Population Research Department,
Institute of Psychiatry, King's College London,
UK
| | - R. Borschmann
- Health Service and Population Research Department,
Institute of Psychiatry, King's College London,
UK
| | - K. Dean
- School of Psychiatry, UNSW
and Justice Health and Forensic Mental Health Network,
NSW, Australia
| | - C. Hart
- Health Service and Population Research Department,
Institute of Psychiatry, King's College London,
UK
| | - J. Hogg
- Health Service and Population Research Department,
Institute of Psychiatry, King's College London,
UK
| | - D. Osborn
- Division of Psychiatry, Faculty of Brain
Sciences, UCL (University College London),
UK
| | - S. Johnson
- Division of Psychiatry, Faculty of Brain
Sciences, UCL (University College London),
UK
| | - L. M. Howard
- Health Service and Population Research Department,
Institute of Psychiatry, King's College London,
UK
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Khalifeh H, Moran P, Borschmann R, Dean K, Hart C, Hogg J, Osborn D, Johnson S, Howard L. Domestic and sexual violence against people with severe mental illness: comparisons with the 2011/2012 National Crime survey for England and Wales. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku162.048] [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: 11/12/2022] Open
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Abstract
Abstract
Melt strength of polylactic acid (PLA) was improved through various modifications including grafting, crosslinking, chain extension, blending, plasticizing and nucleation. The results showed that melt strength was increased, to varying degrees, by crosslinking, chain extension and blending. In addition, melt strain (detected by velocity) was increased by chain extension, blending with elastomer, and plasticizing, but was decreased by crosslinking. The molecular weights, thermal properties and viscosity of the modified PLAs were also studied to investigate the causes of the observed variations in melt strength. Viscosity results generally corresponded with that of melt strength, but not with that of melt strain. With the exception of plasticizing and nucleation, the modifications had no significant effect on the thermal properties of PLA. The molecular weight (in particular the extremely large molecules representing by Mz) and the polydispersity of PLA were significantly increased after crosslinking and chain extension, which accounts for the observed increase in melt strength.
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Affiliation(s)
- X. Liu
- Centre for Polymer from Renewable Recourses, SCUT, Guangzhou, PRC
- Commonwealth Scientific and Industrial Research Organisation, Division of Materials Science and Engineering, Clayton South, Australia
| | - L. Yu
- Commonwealth Scientific and Industrial Research Organisation, Division of Materials Science and Engineering, Clayton South, Australia
| | - K. Dean
- Commonwealth Scientific and Industrial Research Organisation, Division of Materials Science and Engineering, Clayton South, Australia
| | - G. Toikka
- Commonwealth Scientific and Industrial Research Organisation, Division of Materials Science and Engineering, Clayton South, Australia
| | - S. Bateman
- Commonwealth Scientific and Industrial Research Organisation, Division of Materials Science and Engineering, Clayton South, Australia
| | - T. Nguyen
- Commonwealth Scientific and Industrial Research Organisation, Division of Materials Science and Engineering, Clayton South, Australia
| | - Q. Yuan
- Commonwealth Scientific and Industrial Research Organisation, Division of Materials Science and Engineering, Clayton South, Australia
| | - C. Filippou
- Commonwealth Scientific and Industrial Research Organisation, Division of Materials Science and Engineering, Clayton South, Australia
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Hampl SE, Davis AM, Sampilo ML, Stephens KL, Dean K. Insurer and employer views on pediatric obesity treatment: a qualitative study. Obesity (Silver Spring) 2013; 21:795-9. [PMID: 23712982 PMCID: PMC4152225 DOI: 10.1002/oby.20112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 05/08/2012] [Accepted: 09/25/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The effectiveness of group-based comprehensive, multidisciplinary (stage 3) pediatric weight management programs is backed by a growing body of literature, yet insurance coverage of these programs is scarce to nonexistent, limiting their reach and long-term survival. The objective of this study was to better understand the perspectives of insurers and large employers on the issue of group-based treatment coverage. DESIGN AND METHODS The authors performed a qualitative study utilizing structured interviews with these stakeholders, following accepted techniques. RESULTS Six major themes emerged: cost, program effectiveness, corporate social responsibility, secondary parental (employee) benefits, coverage options and new benefit determination. CONCLUSION Future efforts to secure payment for group-based pediatric weight management programs should address these key themes.
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Affiliation(s)
- S E Hampl
- Department of General Pediatrics, Children's Mercy Hospitals and Clinics/University of MO-Kansas City School of Medicine, Kansas City, Missouri, USA.
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Xie F, Yu L, Liu H, Dean K. Effect of Compatibilizer Distribution on Thermal and Rheological Properties of Gelatinized Starch/Biodegradable Polyesters Blends. INT POLYM PROC 2013. [DOI: 10.3139/217.0119] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Thermal and rheological properties of various blends of gelatinized starch and biodegradable polyester, polycaprolactone (PCL) or poly(butylene succinate adipate) (PBSA), were studied by DSC, TGA and rheometry. Methylenediphenyl diisocyanate (MDI) was used as a compatibilizer and was distributed in different phases through controlled processing. The addition of MDI showed a stronger effect on thermal and rheological properties when it was mainly distributed in the polyester phase prior to blending. Starch was shown to increase the shear viscosity of both types of polyesters. The two blends, starch/PCL and starch/PBSA, showed a similar pattern of a power law dependence of viscosity on shear rate. MDI was shown to enhance the effect of starch on the melting and decomposition temperatures, especially when distributed in the polyester phase.
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Affiliation(s)
- F. Xie
- Centre for Polymer from Renewable Resources, South China University of Technology, Guangzhou, P.R. China
| | - L. Yu
- Centre for Polymer from Renewable Resources, South China University of Technology, Guangzhou, P.R. China
- Commonwealth Scientific and Industrial Research Organization, Clayton, Melbourne, Australia
| | - H. Liu
- Centre for Polymer from Renewable Resources, South China University of Technology, Guangzhou, P.R. China
| | - K. Dean
- Commonwealth Scientific and Industrial Research Organization, Clayton, Melbourne, Australia
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Abstract
BACKGROUND There is a well-established association between psychotic disorders and subsequent offending but the extent to which those who develop psychosis might have a prior history of offending is less clear. Little is known about whether the association between illness and offending exists in non-psychotic disorders. The aim of this study was to determine whether the association between mental disorder and offending is present prior to illness onset in psychotic and non-psychotic disorders. METHOD In a nested case-control study, cases (n=101,890) with a first psychiatric contact during the period 1995 to 2006 were identified and matched by age and gender to population-based controls (n=2,236,195). Exposure was defined as prior criminal and violent offending. RESULTS Males with one offence had an incidence rate ratio (IRR) of 2.32 [95% confidence interval (CI) 2.26-2.40] for psychiatric admission whereas two or more convictions yielded an IRR of 4.97 (95% CI 4.83-5.11). For violent offending the associations were stronger and IRRs of 3.97 (95% CI 3.81-4.12) and 6.18 (95% CI 5.85-6.52) were found for one and several offences respectively. Estimates for females were of a similar magnitude. The pattern was consistent across most diagnostic subgroups, although some variability in effect sizes was seen, and persisted after adjustment for substance misuse and socio-economic status (SES). CONCLUSIONS A prior history of offending is present in almost one in five patients presenting to mental health services, which makes it an important issue for clinicians to consider when assessing current and future risks and vulnerabilities.
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Affiliation(s)
- H Stevens
- National Centre for Register-Based Research, Aarhus University, Aarhus C, Denmark.
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MacManus D, Dean K, Jones M, Rona R, Hull L, Greenberg N, Fahy T, Wessely S, Fear N. OP92 The Impact of Military Deployment, Combat Experiences and Post-Deployment Mental Health Problems on Violent Behaviour among UK Military Personnel. Br J Soc Med 2012. [DOI: 10.1136/jech-2012-201753.092] [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: 11/04/2022]
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Kooyman I, Walsh E, Stevens H, Burns T, Tyrer P, Tattan T, Dean K. Criminal offending before and after the onset of psychosis: examination of an offender typology. Schizophr Res 2012; 140:198-203. [PMID: 22819123 DOI: 10.1016/j.schres.2012.06.041] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [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: 02/11/2011] [Revised: 06/26/2012] [Accepted: 06/29/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Clinicians often consider whether or not offenders with psychosis have a history of offending pre-dating the onset of their illness. The typology of offenders based on age at first offence, developed in the field of criminology, has been recently extended to mentally disordered groups, but this ignores the potential role of illness onset. METHOD Using a large UK cohort of individuals with both psychosis and offending histories (n=331), we compared those with a history of offending pre-dating their illness (pre-morbid offenders) to those who commenced offending after becoming unwell (post-morbid offenders). We compared the demographic, clinical and offending pattern characteristics of the two groups. RESULTS 198 (60%) had offended before the onset of psychosis. These pre-morbid offenders were more likely to be male, have a lower pre-morbid IQ and have had a history of neurological abnormality. Pre-morbid offenders also committed more crime overall, but this was due to an excess of acquisitive, drug and minor offending, rather than violent offending, which was comparable to the post-morbid offending group. CONCLUSION Currently, standardised clinical risk assessment tools view offenders with mental illness as a homogenous group with respect to life-course patterns of offending in relation to illness. Taking account of an individual's pathway to offending may improve risk assessment and management.
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Affiliation(s)
- I Kooyman
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Kings College London, UK.
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Loschky L, Ringer R, Larson A, Hughes G, Dean K, Weiser J, Flippo L, Johnson A, Neider M, Kramer A. Developing a New Measure of the Useful Field of View for Use in Dynamic Real-World Scene Viewing. J Vis 2012. [DOI: 10.1167/12.9.564] [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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Abstract
BACKGROUND There is growing concern about an alleged rise in violent behaviour amongst military personnel returning from deployment to Iraq and Afghanistan. The aims of this study were to determine the prevalence of violence in a sample of U.K. military personnel following homecoming from deployment in Iraq and to examine the impact of deployment-related experiences, such as combat trauma, on violence, and the role of sociodemographics and pre-enlistment antisocial behaviour. METHOD This study used baseline data from a cohort study of a large randomly selected sample of U.K. Armed Forces personnel in service at the time of the Iraq war (2003). Regular personnel (n=4928) who had been deployed to Iraq were included. Data, collected by questionnaire, included information on deployment experiences, sociodemographic and military characteristics, pre-enlistment antisocial behaviour, post-deployment health outcomes and a self-report measure of physical violence in the weeks following return from deployment. RESULTS Prevalence of violence was 12.6%. This was strongly associated with pre-enlistment antisocial behaviour [adjusted odds ratio (aOR) 3.6, 95% confidence interval (CI) 2.9-4.4]. After controlling for pre-enlistment antisocial behaviour, sociodemographics and military factors, violence was still strongly associated with holding a combat role (aOR 2.0, 95% CI 1.6-2.5) and having experienced multiple traumatic events on deployment (aOR for four or more traumatic events 3.7, 95% CI 2.5-5.5). Violence on homecoming was also associated with mental health problems such as post-traumatic stress disorder (aOR 4.8, 95% CI 3.2-7.2) and alcohol misuse (aOR 3.1, 95% CI 2.5-3.9). CONCLUSIONS Experiences of combat and trauma during deployment were significantly associated with violent behaviour following homecoming in U.K. military personnel. Post-deployment mental health problems and alcohol misuse are also associated with increased violence.
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Affiliation(s)
- D Macmanus
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, London, UK.
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Abstract
BACKGROUND Offspring of parents with mental disorder are at risk of a range of adverse outcomes. We sought to establish whether such risks extend to offending by examining rates of criminal conviction, including conviction for violent and sexual offences, among offspring of parents with mental disorder compared to offspring without parental disorder. METHOD From a random sample of the Danish population, a cohort aged ≤15 years (n=412,117) was followed for the occurrence of conviction between January 1981 and December 2006. Incidence rate ratios (IRRs) and cumulative incidences for offspring conviction by parental mental disorder status were calculated using a Cox regression model. Analyses were repeated for conviction for a serious first offence. RESULTS Offspring with history of parental mental disorder had higher rates of conviction than those without parental disorder; rates were highest for those with two affected parents [IRR 3.39, 95% confidence interval (CI) 3.08-3.73]. The association persisted when parental gender, offspring gender and the nature of parental disorder were considered. Absolute rates were lower but relative rates higher for female offspring (IRR 3.26 for males with two affected parents, 4.52 for females). Similar patterns were seen for conviction for serious offences. Associations were attenuated after adjustment was made for family socio-economic position (SEP) and parental criminality. CONCLUSIONS Offspring of parents with mental disorder represent a group at elevated risk of criminality. This raises the possibility of shared familial vulnerability for mental disorder and criminal behaviour, and highlights the need to consider early identification and intervention in this group.
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Affiliation(s)
- K Dean
- Institute of Psychiatry, King's College London, UK.
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Cullen AE, Clarke AY, Kuipers E, Hodgins S, Dean K, Fahy T. A multi-site randomized controlled trial of a cognitive skills programme for male mentally disordered offenders: social-cognitive outcomes. Psychol Med 2012; 42:557-569. [PMID: 21846425 DOI: 10.1017/s0033291711001553] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cognitive skills programmes have been associated with improvements on psychometric measures and reductions in antisocial behaviour in mentally disordered offenders (MDOs). However, to date there have been no randomized controlled trials (RCTs) of such programmes with this population. In the first RCT of a cognitive skills programme with MDOs we aimed to determine if participation in the Reasoning and Rehabilitation (R&R) programme was associated with improvements in social-cognitive skills and thinking styles. METHOD A total of 84 men with a primary diagnosis of psychotic disorder and a history of violence were recruited from medium-secure forensic units and allocated to receive R&R (n=44) or treatment as usual (TAU; n=40). At baseline and post-treatment interviews, participants completed questionnaires to assess social problem-solving, criminal attitudes, anger experience, blame externalizing and perspective-taking. Researchers were not blind to group status. RESULTS The R&R group demonstrated significant improvements on measures of social problem-solving relative to the TAU group, some of which were maintained at 12 months post-treatment. Only half of those allocated to receive R&R completed the full programme. In post-hoc analyses programme completers showed improvements in social problem-solving at the end of treatment and changes in criminal attitudes at 12 months post-treatment. CONCLUSIONS Among male MDOs, R&R participation was associated with improvements in social-cognitive skills, some of which were maintained for up to 12 months post-treatment. Our finding that programme completers do better may reflect pre-treatment patient characteristics. This study establishes that multi-site RCTs can be conducted in medium-secure forensic units.
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Affiliation(s)
- A E Cullen
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, London, UK.
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Woodhead C, Rona RJ, Iversen A, MacManus D, Hotopf M, Dean K, McManus S, Meltzer H, Brugha T, Jenkins R, Wessely S, Fear NT. Mental health and health service use among post-national service veterans: results from the 2007 Adult Psychiatric Morbidity Survey of England. Psychol Med 2011; 41:363-372. [PMID: 20406527 DOI: 10.1017/s0033291710000759] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is concern surrounding the psychological health and uptake of treatment services among veterans of the UK Armed Forces. METHOD Data from a cross-sectional, nationally representative sample were used to compare health outcomes and treatment seeking among 257 post-national service veterans aged 16-64 years and 504 age and sex frequency-matched non-veterans living in the community in England. Early leavers (<4 years service) were compared with longer serving veterans. RESULTS Male veterans reported more childhood adversity and were more likely to have experienced a major trauma in adulthood than non-veterans. There was no association between any measure of mental health and veteran status in males, except reporting more violent behaviours [adjusted odds ratio (aOR) 1.44, 95% confidence interval (CI) 1.01-2.06]. In females, a significant association was found between veteran status and ever having suicidal thoughts (aOR 2.82, 95% CI 1.13-7.03). No differences in treatment-seeking behaviour were identified between veterans and non-veterans with any mental disorder. Early service leavers were more likely to be heavy drinkers (aOR 4.16, 95% CI 1.08-16.00), to have had suicidal thoughts (aOR 2.37, 95% CI 1.21-4.66) and to have self-harmed (aOR 12.36, 95% CI 1.61-94.68) than longer serving veterans. CONCLUSIONS The findings of this study do not suggest that being a veteran is associated with adversity in terms of mental health, social disadvantage or reluctance to seek treatment compared with the general population. Some evidence implies that early service leavers may experience more mental health problems than longer-serving veterans.
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Affiliation(s)
- C Woodhead
- Academic Centre for Defence Mental Health, King's College London, UK
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Demjaha A, Morgan K, Morgan C, Landau S, Dean K, Reichenberg A, Sham P, Fearon P, Hutchinson G, Jones PB, Murray RM, Dazzan P. Combining dimensional and categorical representation of psychosis: the way forward for DSM-V and ICD-11? Psychol Med 2009; 39:1943-1955. [PMID: 19627645 DOI: 10.1017/s0033291709990651] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [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] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is good evidence that psychotic symptoms segregate into symptom dimensions. However, it is still unclear how these dimensions are associated with risk indicators and other clinical variables, and whether they have advantages over categorical diagnosis in clinical practice. We investigated symptom dimensions in a first-onset psychosis sample and examined their associations with risk indicators and clinical variables. We then examined the relationship of categorical diagnoses to the same variables. METHOD We recruited 536 patients as part of a population-based, incidence study of psychosis. Psychopathology was assessed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). A principal axis factor analysis was performed on symptom scores. The relationship of dimension scores with risk indicators and with clinical variables was then examined employing regression analyses. Finally, regression models were compared to assess the contribution of dimensions versus diagnosis in explaining these variables. RESULTS Factor analysis gave rise to a five-factor solution of manic, reality distortion, negative, depressive and disorganization symptom dimensions. The scores of identified dimensions were differentially associated with specific variables. The manic dimension had the highest number of significant associations; strong correlations were observed with shorter duration of untreated psychosis, acute mode of onset and compulsory admission. Adding dimensional scores to diagnostic categories significantly increased the amount of variability explained in predicting these variables; the reverse was also true but to a lesser extent. CONCLUSIONS Categorical and dimensional representations of psychosis are complementary. Using both appears to be a promising strategy in conceptualising psychotic illnesses.
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Affiliation(s)
- A Demjaha
- Division of Psychological Medicine, Institute of Psychiatry, King's College, London, UK.
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Abstract
BACKGROUND A clinical audit is a systematic, independent, and documented process to improve the quality of radiological processes and radiation safety for patients. PURPOSE To evaluate the effect of an audit process by comparing the results of two consecutive audits at the same units. MATERIAL AND METHODS Audits were carried out twice at each imaging unit in the southwest hospital district of Finland: first, at the end of 2003, and again in November 2007. Both evaluations were carried out in a similar way: by interviewing personnel and examining documents, independent experts from other hospital districts ensured that diagnostic medical imaging processes at each unit were carried out according to generally accepted standards for good medical radiological procedures. The results of the consecutive audits were compared in order to analyze the effects of the clinical audits. RESULTS The use of radiation was in accordance with the requirements and standards of good medical procedures at every audited unit during both evaluations. The list of audit criteria was fulfilled satisfactorily on both occasions at all of the audited units, and clearly better during the second run. In the first audit, the auditors made 80 recommendations for improving diagnostic procedures and, in the second audit, 53 recommendations. During the first audit, most of the recommendations (22/80) concerned instructions in the fundamental practice of examining a patient. During the second audit, most recommendations were in the category of radiation doses. CONCLUSION The clinical audit had a positive impact on the practice of work procedures in radiological departments. Most of the recommendations made after the first audit had been taken into consideration by the time of the second audit.
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Affiliation(s)
- M. Hirvonen-Kari
- Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland
| | - S. Salo
- Medical Imaging Centre of Southwest Finland, Turku, Finland
| | - K. Dean
- Medical Imaging Centre of Southwest Finland, Turku, Finland
| | - L. Kivisaari
- Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland
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Gorchynski J, Dean K, Anderson C. 75: Analysis of Urobilinogen and Urine Bilirubin for Intra-abdominal Injury in Blunt Trauma Patients. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Lloyd T, Dazzan P, Dean K, Park SBG, Fearon P, Doody GA, Tarrant J, Morgan KD, Morgan C, Hutchinson G, Leff J, Harrison G, Murray RM, Jones PB. Minor physical anomalies in patients with first-episode psychosis: their frequency and diagnostic specificity. Psychol Med 2008; 38:71-77. [PMID: 17662165 DOI: 10.1017/s0033291707001158] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND An increased prevalence of minor physical anomalies (MPAs) has been extensively documented in schizophrenia but their specificity for the disorder remains unclear. We investigated the prevalence and the predictive power of MPAs in a large sample of first-episode psychotic patients across a range of diagnoses. METHOD MPAs were examined in 242 subjects with first-episode psychosis (50% schizophrenia, 45% affective psychosis and 5% substance-induced psychosis) and 158 healthy controls. Categorical principal components analysis and analysis of variance were undertaken, and individual items with the highest loading were tested using the chi2 test. RESULTS Overall facial asymmetry, assymetry of the orbital landmarks, and frankfurt horizontal significantly differentiated patients with schizophrenia and affective psychosis from controls, as did a 'V-shaped' palate, reduced palatal ridges, abnormality of the left ear surface and the shape of the left and right ears. Patients with affective psychosis had significantly lowered eye fissures compared with control subjects. CONCLUSIONS MPAs are not specific to schizophrenia, suggesting a common developmental pathway for non-affective and affective psychoses. The topographical distribution of MPAs in this study is suggestive of an insult occurring during organogenesis in the first trimester of pregnancy.
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Affiliation(s)
- T Lloyd
- Nottinghamshire Healthcare NHS Trust, Nottingham, UK.
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Abstract
OBJECTIVE The aim of this study was to establish the prevalence and predictors of violent victimization amongst a community-dwelling sample of individuals with psychosis. METHOD The 2-year prevalence of self-reported violent victimization was estimated for a sample of 708 individuals with chronic psychosis living in the community in four urban UK centres. Baseline socio-demographic and clinical factors were examined as possible risk factors for victimization over the 2-year follow-up period. RESULTS The 2-year prevalence of violent victimization in the sample was 23%. Four factors were found to be independently predictive of victimization - history of victimization, less than daily family contact, young age at illness onset and the presence of co-morbid Cluster B personality disorder. CONCLUSION Those with psychotic illnesses are at elevated risk of being assaulted. Given the likely adverse health implications, clinicians should routinely enquire about victimization in their assessments of those with psychotic disorders particularly amongst those who are socially isolated, with a younger age of illness onset and in those with co-morbid personality disorder.
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Affiliation(s)
- K Dean
- Department of Forensic Mental Health Science, Institute of Psychiatry, Kings College London, London, UK.
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Boydell J, Dean K, Dutta R, Giouroukou E, Fearon P, Murray R. A comparison of symptoms and family history in schizophrenia with and without prior cannabis use: implications for the concept of cannabis psychosis. Schizophr Res 2007; 93:203-10. [PMID: 17462864 DOI: 10.1016/j.schres.2007.03.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [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: 10/05/2006] [Revised: 03/11/2007] [Accepted: 03/17/2007] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is considerable interest in cannabis use in psychosis. It has been suggested that the chronic psychosis associated with cannabis use, is symptomatically distinct from idiopathic schizophrenia. Several studies have reported differences in psychopathology and family history in people with schizophrenia according to whether or not they were cannabis users. We set out to test the hypotheses arising from these studies that cannabis use is associated with more bizarre behaviour, more thought disorder, fewer negative symptoms including blunted affect, more delusions of reference, more paranoid delusions and a stronger family history of schizophrenia. METHOD We used a case register that contained 757 cases of first onset schizophrenia, 182 (24%) of whom had used cannabis in the year prior to first presentation, 552 (73%) had not and 3% had missing data. We completed the OPCRIT checklist on all patients and investigated differences in the proportion of people with distractibility, bizarre behaviour, positive formal thought disorder, delusions of reference, well organised delusions, any first rank symptom, persecutory delusions, abusive/accusatory hallucinations, blunted affect, negative thought disorder, any negative symptoms (catatonia, blunted affect, negative thought disorder, or deterioration), lack of insight, suicidal ideation and a positive family history of schizophrenia, using chi square tests. Logistic regression modelling was then used to determine whether prior cannabis use affected the presence of the characteristics after controlling for age, sex and ethnicity. RESULTS There was no statistically significant effect of cannabis use on the presence of any of the above. There remained however a non-significant trend towards more insight (OR 0.65 p=0.055 for "loss of insight") and a finding of fewer abusive or accusatory hallucinations (OR 0.65 p=0.049) of borderline significance amongst the cannabis users. These were in the hypothesised direction. There was no evidence of fewer negative symptoms or greater family history amongst cannabis users. CONCLUSION We found few appreciable differences in symptomatology between schizophrenic patients who were or were not cannabis users. There were no differences in the proportion of people with a positive family history of schizophrenia between cannabis users and non-users. This argues against a distinct schizophrenia-like psychosis caused by cannabis.
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Affiliation(s)
- J Boydell
- Division of Psychological Medicine, PO Box 63, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, SE5 8AF, United Kingdom.
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Dean K, Walsh E, Morgan C, Demjaha A, Dazzan P, Morgan K, Lloyd T, Fearon P, Jones PB, Murray RM. Aggressive behaviour at first contact with services: findings from the AESOP First Episode Psychosis Study. Psychol Med 2007; 37:547-557. [PMID: 17018170 DOI: 10.1017/s0033291706008920] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Aggressive behaviour is increased among those with schizophrenia but less is known about those with affective psychoses. Similarly, little is known about aggressive behaviour occurring at the onset of illness. METHOD The main reasons for presentation to services were examined among those recruited to a UK-based first episode psychosis study. The proportion of individuals presenting with aggressive behaviour was determined and these individuals were compared to those who were not aggressive on a range of variables including sociodemographic, clinical, criminal history, service contact, and symptom characteristics. Among the aggressive group, those who were physically violent were distinguished from those who were not violent but who were still perceived to present a risk of violence to others. RESULTS Almost 40% (n=194) of the sample were aggressive at first contact with services; approximately half of these were physically violent (n=103). Younger age, African-Caribbean ethnicity and a history of previous violent offending were independently associated with aggression. Aggressive behaviour was associated with a diagnosis of mania and individual manic symptoms were also associated with aggression both for the whole sample and for those with schizophrenia. Factors differentiating violent from non-violent aggressive patients included male gender, lower social class and past violent offending. CONCLUSIONS Aggressive behaviour is not an uncommon feature in those presenting with first episode psychosis. Sociodemographic and past offending factors are associated with aggression and further differentiate those presenting with more serious violence. A diagnosis of mania and the presence of manic symptoms are associated with aggression.
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Affiliation(s)
- K Dean
- Institute of Psychiatry, Kings College London, UK.
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40
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Dean K, Dazzan P, Lloyd T, Morgan C, Morgan K, Doody GA, Hutchinson G, Orr K, Jones PB, Murray RM, Fearon P. Minor physical anomalies across ethnic groups in a first episode psychosis sample. Schizophr Res 2007; 89:86-90. [PMID: 17011170 DOI: 10.1016/j.schres.2006.08.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Revised: 08/15/2006] [Accepted: 08/19/2006] [Indexed: 11/22/2022]
Abstract
Minor physical anomalies (MPAs) are more prevalent amongst individuals with psychosis, supporting a neurodevelopmental model for psychotic disorders. The aim of this study was to investigate the possibility that neurodevelopmental adversity contributes to the excess of psychosis found in some ethnic groups in the UK. Subjects with first onset psychosis and healthy neighbourhood controls were enrolled in the AESOP study in South East London and Nottingham between 1997 and 1999. MPA rates were estimated in four broad ethnic groupings (White, African Caribbean, Black African and Other). Patients (n=245) had a higher mean total MPA score than healthy controls (n=158). This held true across each of the four ethnic groupings. The results of this study suggest that neurodevelopmental factors play a role in the aetiology of psychosis across all ethnic groups.
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Affiliation(s)
- K Dean
- Division of Psychological Medicine, Institute of Psychiatry, Kings College London, UK.
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Bubici C, Papa S, Dean K, Franzoso G. Mutual cross-talk between reactive oxygen species and nuclear factor-kappa B: molecular basis and biological significance. Oncogene 2006; 25:6731-48. [PMID: 17072325 DOI: 10.1038/sj.onc.1209936] [Citation(s) in RCA: 314] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Reactive oxygen species (ROS) are emerging as key effectors in signal transduction. This role of ROS is especially evident in the pathways leading to programmed cell death (PCD) elicited in response to certain stress stimuli and cytokines. In these pathways, cytotoxic ROS signaling appears to be mediated in part by activation of the c-Jun-N-terminal kinase (JNK) mitogen-activated protein kinase (MAPK) cascade. Another pathway that is under ROS-mediated control in some systems is that leading to activation of transcription factor nuclear factor-kappa B (NF-kappaB), which is a central regulator of immunity, inflammation and cell survival. Remarkably, new evidence has unveiled the existence of a reciprocal, negative control that NF-kappaB exerts on ROS and JNK activities. This NF-kappaB-imposed restraint on ROS and JNK signaling is crucial for antagonism of PCD elicited by the proinflammatory cytokine tumor necrosis factor (TNF)alpha and likely other triggers. Effectors of this antagonistic cross-talk between NF-kappaB and ROS/JNK pathways have recently been identified. Because of the key roles that the prosurvival function of NF-kappaB plays in organismal physiology and disease, gaining a further mechanistic understanding of this cross-talk and NF-kappaB-dependent survival may be key to developing new therapies for the treatment of widespread human illnesses, such as cancer and chronic inflammatory conditions.
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Affiliation(s)
- C Bubici
- The Ben May Institute for Cancer Research, The University of Chicago, Chicago, IL 60637, USA
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Dean K, Fearon P, Morgan K, Hutchinson G, Orr K, Chitnis X, Suckling J, Mallet R, Leff J, Jones PB, Murray RM, Dazzan P. Grey matter correlates of minor physical anomalies in the AeSOP first-episode psychosis study. Br J Psychiatry 2006; 189:221-8. [PMID: 16946356 DOI: 10.1192/bjp.bp.105.016337] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Minor physical anomalies are more prevalent among people with psychosis. This supports a neurodevelopmental aetiology for psychotic disorders, since these anomalies and the brain are both ectodermally derived. However, little is understood about the brain regions implicated in this association. AIMS To examine the relationship between minor physical anomalies and grey matter structure in a sample of patients with first-episode psychosis. METHOD Sixty patients underwent assessment of minor physical anomalies with the Lane scale. High-resolution magnetic resonance images and voxel-based methods of image analysis were used to investigate brain structure in these patients. RESULTS The total anomalies score was associated with a grey matter reduction in the prefrontal cortex and precuneus and with a grey matter excess in the basal ganglia, thalamus and lingual gyrus. CONCLUSIONS Minor physical anomalies in a sample of patients with first-episode psychosis are associated with regional grey matter changes. These regional changes may be important in the pathogenesis of psychotic disorder.
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Affiliation(s)
- K Dean
- Division of Psychological Medicine, Institute of Psychiatry, King's College London SE5 8AF, UK, and Department of Psychiatry, Sir Charles Gairdner Hospital, Perth, Australia.
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Papa S, Bubici C, Zazzeroni F, Pham CG, Kuntzen C, Knabb JR, Dean K, Franzoso G. The NF-κB-mediated control of the JNK cascade in the antagonism of programmed cell death in health and disease. Cell Death Differ 2006; 13:712-29. [PMID: 16456579 DOI: 10.1038/sj.cdd.4401865] [Citation(s) in RCA: 178] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
NF-kappaB/Rel transcription factors have recently emerged as crucial regulators of cell survival. Activation of NF-kappaB antagonizes programmed cell death (PCD) induced by tumor necrosis factor-receptors (TNF-Rs) and several other triggers. This prosurvival activity of NF-kappaB participates in a wide range of biological processes, including immunity, lymphopoiesis and development. It is also crucial for pathogenesis of various cancers, chronic inflammation and certain hereditary disorders. This participation of NF-kappaB in survival signaling often involves an antagonism of PCD triggered by TNF-R-family receptors, and is mediated through a suppression of the formation of reactive oxygen species (ROS) and a control of sustained activation of the Jun-N-terminal kinase (JNK) cascade. Effectors of this antagonistic activity of NF-kappaB on this ROS/JNK pathway have been recently identified. Indeed, further delineating the mechanisms by which NF-kappaB promotes cell survival might hold the key to developing new highly effective therapies for treatment of widespread human diseases.
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Affiliation(s)
- S Papa
- The Ben May Institute for Cancer Research, The University of Chicago, Chicago, IL 60637, USA
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Patrick MR, Dehn J, Dean K. Numerical modeling of lava flow cooling applied to the 1997 Okmok eruption: Comparison with advanced very high resolution radiometer thermal imagery. ACTA ACUST UNITED AC 2005. [DOI: 10.1029/2003jb002538] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M. R. Patrick
- Alaska Volcano Observatory, Geophysical Institute; University of Alaska Fairbanks; Fairbanks Alaska USA
| | - J. Dehn
- Alaska Volcano Observatory, Geophysical Institute; University of Alaska Fairbanks; Fairbanks Alaska USA
| | - K. Dean
- Alaska Volcano Observatory, Geophysical Institute; University of Alaska Fairbanks; Fairbanks Alaska USA
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Devoe ER, Dean K, Traube D, McKay MM. The SURVIVE Community Project: A Family-Based Intervention to Reduce the Impact of Violence Exposures in Urban Youth. J Aggress Maltreat Trauma 2005; 11:95-116. [PMID: 21369343 PMCID: PMC3045728 DOI: 10.1300/j146v11n04_05] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The purpose of this article is to describe the development of a family-based intervention designed to target the harmful effects of exposure to family and community violence on urban youth and their parents. The program, "Supporting Urban Residents to be Violence-Free in a Violent Environment (SURVIVE)," is a 12-week multiple family group (MEG) intervention modeled upon similar children's mental health programs implemented with urban youth of color and their families in several major U.S. cities. The design and implementation of the SURVIVE Community Project were guided by a collaborative partnership between community members, including mental health professionals, teachers, and parents from the Bronx, and an interdisciplinary team of university-based researchers. In order to establish the feasibility and relevance of the program for urban communities, 25 families with children ages 7-11 participated in a pilot test of the curriculum. The description of the SURVIVE Community Project provided here is based on this work, and includes a discussion of facilitation issues. Implications for family-based intervention targeting urban children and families affected by violence are highlighted.
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Merdas I, Tcharkhtchi A, Thominette F, Verdu J, Dean K, Cook W. Water absorption by uncrosslinked polymers, networks and IPNs having medium to high polarity. POLYMER 2002. [DOI: 10.1016/s0032-3861(02)00267-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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47
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Dean K. EMTALA and the nurse. Fla Nurse 2001; 49:21. [PMID: 12080529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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48
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49
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Spencer K, Weinert L, Mor-Avi V, Dean K, Balasia B, Solomon L, Pionke T, Sieb L, Lang RM. Electronic transmission of digital echocardiographic studies: effects of MPEG compression. Int J Cardiol 2000; 75:141-5. [PMID: 11077125 DOI: 10.1016/s0167-5273(00)00312-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The acquisition, storage and retrieval of digital echocardiographic studies greatly facilitates image review and quantitation and permits the transmission of studies electronically. However, the considerable size of digital echocardiographic data files makes transmission over existing networks slow and impractical. Reduction in the size of these data files can be accomplished with digital image compression. We sought to evaluate the effects of MPEG-1 compression on the transfer time of digital echocardiographic studies over currently available network connections. Ninety consecutive routine clinical echocardiographic studies were randomly compressed at one of three compression ratios 60:1, 80:1, or 120:1 and sent to a receiving terminal using simulated transmission rates. Compression of digital echocardiographic studies at these ratios which, have been shown to maintain diagnostic image quality, reduced the size of digital echocardiographic studies to less than 1% of their original sizes which allowed transmission of echocardiographic studies over networks using 3ISDN or T1 lines with minimal waiting time.
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Affiliation(s)
- K Spencer
- The Noninvasive Cardiac Imaging Laboratory, The University of Chicago, 5841 S. Maryland Avenue, MC5084, Chicago, IL 60637, USA.
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Lark K, Dean K, Mikos CA. Nursing liability risk--three perspectives. Fla Nurse 2000; 48:22-3. [PMID: 11995164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
A number of legal issues are raised by the above hypothetical. Only a few were briefly discussed herein. Not addressed were the employment law issues, corporate negligence issues and other similar topics possibly related to the fictional situation.
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