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Mattke S, Gustavsson A, Jacobs L, Kern S, Palmqvist S, Eriksdotter M, Skoog I, Winblad B, Wimo A, Jönsson L. Estimates of Current Capacity for Diagnosing Alzheimer's Disease in Sweden and the Need to Expand Specialist Numbers. J Prev Alzheimers Dis 2024; 11:155-161. [PMID: 38230728 PMCID: PMC10995070 DOI: 10.14283/jpad.2023.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND The emergence of disease-modifying Alzheimer's (AD) treatments provides new hope to patients and families but concerns have been raised about the preparedness of healthcare systems to provide timely access to such treatments because of a combination of a complex diagnostic process and a large prevalent pool. OBJECTIVES We assess the preparedness of Sweden, a high-income country known for its dementia-friendly policies, to diagnose AD patients eligible for treatment within a six-month window, given current capacity for specialist evaluations and biomarker testing. We calculate the investment requirements for Sweden to achieve this target over a timeframe of 20 years. DESIGN Desk research to identify data for population, mortality, disease burden, cost of services and current capacity, expert consultation to inform assumptions about patient journey, and use of a Markov model to predict waiting times. The model simulates the patients' journey through different evaluation stages: initial evaluation by a primary care specialist, neurocognitive testing by an AD specialist, and confirmatory biomarker testing with PET scanning or cerebrospinal fluid (CSF) testing. The model assumes specialist appointments and PET scans are capacity constrained, and patients progress from cognitively normal to MCI and from MCI to dementia in the resulting waiting times. MEASUREMENTS Projected waiting times for diagnosis of eligibility for disease-modifying Alzheimer's treatment from 2023 to 2042 assuming current capacity, assuming 20% of Swedish residents aged 60 years and above would seek an evaluation for cognitive decline. Investments required to scale capacity up to reach target of providing diagnosis within six months on average. RESULTS Initial average waiting times for AD specialist appointments would be around 21 months in 2023 and remain around 55 months through 2042, as demand would continue to outstrip supply throughout the 20-year model horizon. Waiting times for biomarker testing would be stable at less than four weeks, as patients would be held up in the queue for their first specialist consultations, and use of CSF testing is widely accepted in Sweden. An additional 25% of AD specialists would have to be added above the current growth trend to reduce waiting times to less than 6 months at an average annual cost of approximately 805 million SEK. The increased cost of volume of biomarker testing would amount to about 106 million SEK per year. CONCLUSIONS At current capacity, the Swedish healthcare system is unable to provide timely diagnosis of patients eligible for disease-modifying AD treatment. Although future diagnostic technologies, such as digital cognitive assessments and blood tests for the AD pathology, might decrease demand for capacity-constrained services, substantial investments will be required to meet a target of less than six months of waiting time for a diagnosis.
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Affiliation(s)
- S Mattke
- Soeren Mattke, University of Southern California, 635 Downey Way, #505N, Los Angeles, CA 90089, Mobile: +1 202 468 5797,
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Neary JM, Guthrie AP, Jacobs L. Public and industry knowledge and perceptions of US swine industry castration practices. Anim Welf 2023; 32:e79. [PMID: 38487455 PMCID: PMC10936257 DOI: 10.1017/awf.2023.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/18/2023] [Accepted: 11/21/2023] [Indexed: 03/17/2024]
Abstract
In the United States (US), surgical castration of male piglets is typically performed without any form of analgesia. This may raise concerns with the public; however, there is no information regarding current public knowledge on swine industry practices in the US. In this study we gained insight into public knowledge and perception on castration with and without analgesia in comparison to knowledge of industry stakeholders on these same topics. Through an online survey, 119 respondents were asked four questions about castration in the US swine industry. Industry respondents were contacted via social media and networking. The general public sample was accessed through Mechanical Turk. Survey responses were categorised by experience (industry vs public). Industry respondents were more aware of practices compared to the general public. Most public respondents were unaware of castration practices and the lack of analgesia use. Respondents from rural communities were more aware of castration practices than (sub)urban communities and more aware of analgesia use than those from urban communities. Those with more education had greater awareness of castration practices (occurrence not frequency). Based on the results from this first US sample, knowledge on industry practices was especially lacking for public respondents, but also for a minority of industry respondents, indicating opportunities for education and further research on the topic.
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Affiliation(s)
- JM Neary
- School of Animal Sciences, Virginia Tech, 175 West Campus Drive, Blacksburg, Virginia24061, USA
| | - AP Guthrie
- Department of Statistics, Virginia Tech, Blacksburg, VA, USA, 250 Drillfield Drive, 24061
| | - L Jacobs
- School of Animal Sciences, Virginia Tech, 175 West Campus Drive, Blacksburg, Virginia24061, USA
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Hill-Kayser CE, Szalda D, Vachani C, Ginsberg J, Hobbie W, Jacobs L, Hampshire MK, Metz JM, Schwartz L. Patterns of Independence in Adolescent/Young Adult (AYA) Survivors of Childhood Cancer Having Received Radiotherapy (RT). Int J Radiat Oncol Biol Phys 2023; 117:e235. [PMID: 37784935 DOI: 10.1016/j.ijrobp.2023.06.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) AYA cancer survivors are at risk for missed care opportunities due to transitions of care and movement towards independence. This study was undertaken to evaluate steps towards independence of AYA survivors voluntarily using a free, Internet-based tool for creation of survivorship care plans (SCP). MATERIALS/METHODS A free, publicly accessible tool, Smart-ALACC (Smart Adult Living after Childhood Cancer) was made available on Oncolink.org. Analysis of convenience sample frame was performed with IRB approval. RESULTS From 12/2017-12/2022, 676 AYA survivors utilized the tool; 55% (372) identified as female. Most (75%, 506) were white, 7% (48) Black, 7% (46) Asian, 6% (42) Hispanic, 5% other/ mixed race. Median age was 20y (R <16 - 46y) and median age at diagnosis was 11 y (R <1y - 21). Most common diagnoses were leukemia (31%, 212), lymphoma (21%, 140), sarcoma (14%, 95), CNS (9%, 54), and neuroblastoma (5%, 37). 311 pts (46%) reported having had RT, most commonly brain (PB) (19%, 60), "mantle" (14%, 43), craniospinal (CSI) (12%, 36), total body irradiation (TBI) (11%, 34), and head/ neck (8%, 26). Most (92%, 619) denied recurrence /secondary malignancy. Users reported being students (64%, 434) or working (24% (163)) full-time (20%) or part-time (4%); 4% (25) were neither. Most reported living with parents (71%, 482), 14% (92) with a partner/ spouse, 7% (46) alone, and 4% (30) with a roommate. Most reported using parental insurance (54%, 368), while 24% (163) had their own private insurance, 7% (49) public, and 2% uninsured. Of 466 users 18+ (466), more were employed (34%, 155, p = 0.04), living separately from parents (40%, 168, p < 0.001), and had independent insurance (52%, 184, p = 0.03). Of users 23+ (244), 141 (57%) were being employed (p < 0.001), 83% (153) living separately from parents (p < 0.001), and 165 (67%) had independent insurance (p < 0.001). Among users age 23+, survivors who had received brain RT (CSI, brain, or TBI) were less likely to live separately parents or with a spouse/ partner (p < 0.001), but equally likely to be employed (Table 1). CONCLUSION AYA survivors choosing to use a SCP tool have diagnoses reflective of diagnostic patterns in pediatric oncology; many have had RT expected to be associated with cognitive and developmental late effects. Despite this, trends towards employment and independence were evident in young adult population compared to adolescent; somewhat less so in survivors having had brain RT. These data suggest that AYA survivors display independence from parents and require population directed survivorship support; future efforts should aim to include a more diverse body of users.
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Affiliation(s)
- C E Hill-Kayser
- University of Pennsylvania, Department of Radiation Oncology, Philadelphia, PA
| | - D Szalda
- Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - J Ginsberg
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - W Hobbie
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - L Jacobs
- University of Pennsylvania, Department of Internal Medicine, Division of Oncology, Philadelphia, PA
| | | | - J M Metz
- University of Pennsylvania, Department of Radiation Oncology, Philadelphia, PA
| | - L Schwartz
- Children's Hospital of Philadelphia, Philadelphia, PA
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Lourenço-Silva MI, Ulans A, Campbell AM, Almeida Paz ICL, Jacobs L. Social-pair judgment bias testing in slow-growing broiler chickens raised in low- or high-complexity environments. Sci Rep 2023; 13:9393. [PMID: 37296295 PMCID: PMC10256692 DOI: 10.1038/s41598-023-36275-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
Impacts of environmental complexity on affective states in slow-growing broiler chickens (Gallus gallus domesticus) are unknown. Chickens' performance in judgment bias tests (JBT) can be limited as they are tested individually, causing fear and anxiety. The objectives were to apply a social-pair JBT to assess the effect of environmental complexity on slow-growing broiler chickens` affective states, and assess the impact of fearfulness, anxiety, and chronic stress on JBT performance. Six-hundred Hubbard Redbro broilers were housed in six low-complexity (similar to commercial) or six high-complexity (permanent and temporary enrichments) pens. Twelve chicken pairs were trained (1 pair/pen, n = 24 chickens) using a multimodal approach (visual and spatial cues), with reward and neutral cues of opposing color and location. Three ambiguous cues were tested: near-positive, middle, and near-neutral cues. Approach and pecking behavior were recorded. Eighty-three percent of chickens (20/24) were successfully trained in 13 days. Fearfulness, anxiety, and chronic stress did not impact chickens' performance. Chickens successfully discriminated between cues. Low-complexity chickens approached the middle cue faster than high-complexity chickens, indicating that they were in a more positive affective state. The environmental complexity provided in this study did not improve affective states in slow-growing broiler chickens compared to a control. A social-pair JBT resulted in excellent learning and testing outcomes in slow-growing broilers.
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Affiliation(s)
- M I Lourenço-Silva
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Sciences (FMVZ), São Paulo State University "Júlio de Mesquita Filho" (UNESP), Botucatu, São Paulo, Brazil
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, 24061, USA
| | - A Ulans
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, 24061, USA
| | - A M Campbell
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, 24061, USA
| | - I C L Almeida Paz
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Sciences (FMVZ), São Paulo State University "Júlio de Mesquita Filho" (UNESP), Botucatu, São Paulo, Brazil
| | - L Jacobs
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, 24061, USA.
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Jacobs L, Blatchford RA, de Jong IC, Erasmus MA, Levengood M, Newberry RC, Regmi P, Riber AB, Weimer SL. Enhancing their quality of life: environmental enrichment for poultry. Poult Sci 2022; 102:102233. [PMID: 36351344 PMCID: PMC9647224 DOI: 10.1016/j.psj.2022.102233] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 11/07/2022] Open
Abstract
Providing environmental enrichments that increase environmental complexity can benefit poultry welfare. This Poultry Science Association symposium paper is structured around four themes on 1) poultry preferences and affective states 2) species-specific behavior, including play behavior and the relationship between behavior, activity level and walking ability, 3) environmental enrichment and its relationship with indicators of welfare, and 4) a case study focusing on the application of enrichments in commercial broiler chicken production. For effective enrichment strategies, the birds' perspective matters most, and we need to consider individual variation, social dynamics, and previous experience when assessing these strategies. Play behavior can be a valuable indicator of positive affect, and while we do not yet know how much play would be optimal, absence of play suggests a welfare deficit. Activity levels and behavior can be improved by environmental modifications and prior research has shown that the activity level of broilers can be increased, at least temporarily, by increasing the environmental complexity. However, more research on impacts of enrichments on birds' resilience, on birds in commercial conditions, and on slow(er)-growing strains is needed. Finally, incorporating farmers' expertise can greatly benefit enrichment design and implementation on commercial farms.
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Affiliation(s)
- L Jacobs
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, USA.
| | - R A Blatchford
- Department of Animal Science, Center for Animal Welfare, University of California, Davis, CA, USA
| | - I C de Jong
- Wageningen Livestock Research, Wageningen, the Netherlands
| | - M A Erasmus
- Department of Animal Sciences, Purdue University, West Lafayette, IA, USA
| | | | - R C Newberry
- Department of Animal and Aquacultural Sciences, Faculty of Biosciences, Norwegian University of Life Sciences, Ås, Norway
| | - P Regmi
- Department of Poultry Science, University of Georgia, Athens, GA, USA
| | - A B Riber
- Department of Animal Science, Aarhus University, Aarhus, Denmark
| | - S L Weimer
- Department of Poultry Science, University of Arkansas, Fayetteville, AR, USA
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Boyal R, Buhr R, Harris C, Jacobs L, Bourassa D. Evaluation of mechanical cervical dislocation, captive bolt, carbon dioxide, and electrical methods for individual on-farm euthanasia of broiler breeders. Poult Sci 2022; 101:102000. [PMID: 35901644 PMCID: PMC9334341 DOI: 10.1016/j.psj.2022.102000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/24/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022] Open
Abstract
Efficacious euthanasia by applying manual cervical dislocation can be difficult on large and mature poultry. The challenge with using manual cervical dislocation is that the strength required to hold heavy poultry and swiftly apply cervical dislocation can be physically impossible for most people. Therefore, alternative methods of euthanasia are needed for mature and large poultry. Mechanical cervical dislocation using the Koechner Euthanizing Device (KED), captive bolt using the Turkey Euthanasia Device (TED), carbon dioxide (CO2), and electrical euthanasia were evaluated for use on 65-wk-old broiler breeders at flock termination. Following application of each method, physiological reflexes including the eye nictitating membrane reflex, mouth gaping, and body movement, broken skin, blood loss, kill success, time to cessation of heartbeat, and blood plasma corticosterone levels were assessed. Birds euthanized using the KED had longer response durations for eye nictitating membrane (91 s) and reflexive mouth gaping (161 s) compared to TED, CO2, and electrical euthanasia (0–7 s). Body movement durations were also longer for KED (214 s) and TED (209 s) than for CO2 and electrical euthanasia (0–8 s). The highest percentages of broken skin (93%) and blood loss (96%) were observed for TED, followed by KED (71%, 68%), then CO2 (0%, 6%) and electrical euthanasia (0%, 3%). No significant differences (P = 0.1781) were observed for kill success rates with 98% for KED, 100% for TED, 97% for CO2, and 100% for electrical euthanasia at 4-min. Time to heartbeat cessation did not differ between KED (659 s), TED (427 s), or CO2 (583 s) euthanasia methods. No heartbeat was detected following electrical euthanasia. Blood plasma corticosterone levels did not differ between preeuthanasia or posteuthanasia from any of the methods applied. Based on these results each euthanasia method is acceptable for use with broiler breeders.
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Anderson MG, Campbell AM, Crump A, Arnott G, Jacobs L. Environmental complexity positively impacts affective states of broiler chickens. Sci Rep 2021; 11:16966. [PMID: 34417475 PMCID: PMC8379235 DOI: 10.1038/s41598-021-95280-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023] Open
Abstract
Affective state can bias an animal's judgement. Animals in positive affective states can interpret ambiguous cues more positively ("optimistically") than animals in negative affective states. Thus, judgement bias tests can determine an animal's affective state through their responses to ambiguous cues. We tested the effects of environmental complexity and stocking density on affective states of broiler chickens through a multimodal judgement bias test. Broilers were trained to approach reinforced locations signaled by one color and not to approach unreinforced locations signaled by a different color. Trained birds were tested for latencies to approach three ambiguous cues of intermediate color and location. Broilers discriminated between cues, with shorter latencies to approach ambiguous cues closest to the reinforced cue than cues closest to the unreinforced cue, validating the use of the test in this context. Broilers housed in high-complexity pens approached ambiguous cues faster than birds in low-complexity pens-an optimistic judgement bias, suggesting the former were in a more positive affective state. Broilers from high-density pens tended to approach all cues faster than birds from low-density pens, possibly because resource competition in their home pen increased food motivation. Overall, our study suggests that environmental complexity improves broilers' affective states, implying animal welfare benefits of environmental enrichment.
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Affiliation(s)
- M. G. Anderson
- grid.438526.e0000 0001 0694 4940Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA USA
| | - A. M. Campbell
- grid.438526.e0000 0001 0694 4940Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA USA
| | - A. Crump
- grid.13063.370000 0001 0789 5319Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, London, UK
| | - G. Arnott
- grid.4777.30000 0004 0374 7521School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - L. Jacobs
- grid.438526.e0000 0001 0694 4940Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA USA
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de Ronde W, Jacobs L, Smit DL. [Outpatient clinic for users of anabolic androgenic; experiences and practical tools]. Ned Tijdschr Geneeskd 2021; 165:D5715. [PMID: 34346623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In the Netherlands, an estimated 20,000 men abuse illegal androgens. The confrontation with a patient who uses illegal substances can evoke questions and emotions. We advise not to moralize users of anabolic steroids, but to strive for harm reduction by starting a discussion about the pros and cons of androgen abuse, taking into account your assumptions and judgments about this subject. Underlying psychopathology should be recognized and treated if the user is open to it. We recommend against prescribing anabolic steroids without medical indication and not to perform health checks routinely while the patient continues using anabolic steroids as long as it is not established that this can prevent health damage. If the user reports with health problems, this should be used as a starting point to (re) open the conversation about the advantages and disadvantages of use. Harmful effects of use must be handled according to appropriate guidelines.
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Affiliation(s)
- W de Ronde
- Spaarne Gasthuis, afd. Interne Geneeskunde, Haarlem
- Contact: W. de Ronde
| | - L Jacobs
- Spaarne Gasthuis, afd. Interne Geneeskunde, Haarlem
| | - D L Smit
- Elisabeth-TweeSteden Ziekenhuis, afd. Interne Geneeskunde, Tilburg
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Jacobs L, Gorovets D, Burleson S, Happersett L, Zhang Z, Hunt M, McBride S, Kollmeier M, Zelefsky M. Predictors of Intra-Fraction Prostate Motion during Stereotactic Body Radiation Therapy (SBRT). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hill-Kayser C, Szalda D, Vachani C, Virgilio L, Psihogios A, O'Hagan B, Cope C, velazquez-Martin B, Hobbie W, Ginsberg J, Daniel L, Barakat L, Fleisher L, Jacobs L, Hampshire M, Metz J, Lunsford N, Sabatino S, Schwartz L. Feasibility and Acceptability of Survivorship Care Plans for Adolescent/ Young Adult Survivors of Childhood Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jacobs L, Delezie E, Duchateau L, Goethals K, Vermeulen D, Buyse J, Tuyttens FAM. Fit for transport? Broiler chicken fitness assessment for transportation to slaughter. Anim Welf 2017. [DOI: 10.7120/09627286.26.3.335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Yang W, Zhang Z, Thijs L, Bijnens E, Janssen B, Vanpoucke C, Cauwenberghs N, Wei F, Jacobs L, Luttun A, Verhamme P, Van Hecke E, Kuznetsova T, Nawrot T, Staessen J. P2510Left ventricular function in relation to chronic residential air pollution in a general population. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2510] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fadl El Mula F, Feng Y, Jacobs L, Larstorp A, Persu A, Kjeldsen S, Staessen J. 2220Sham or no-sham control in trials of renal denervation for treatment resistant hypertension: a systematic meta-analysis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.2220] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Y. Feng
- Capital Medical University, Beijing, China People's Republic of
| | - L. Jacobs
- University of Leuven, KU Leuven Department of Cardiovascular Sciences, Leuven, Belgium
| | | | - A. Persu
- Universite Catholique de Louvain, Brussels, Belgium
| | - S.E. Kjeldsen
- Oslo University Hospital, and University of Oslo, Oslo, Norway
| | - J.A. Staessen
- University of Leuven, KU Leuven Department of Cardiovascular Sciences, Leuven, Belgium
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Chen K, Liu J, Zhu L, Song E, Su F, Jacobs L. Abstract P2-01-09: The development of nomograms to predict axillary lymph node status in breast cancer patients. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-01-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- K Chen
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
| | - J Liu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
| | - L Zhu
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
| | - E Song
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
| | - F Su
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
| | - L Jacobs
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Hospital, Johns Hopkins University, Baltimore
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Arepally A, Tully M, Stein L, Jacobs L, Rubin R, Bosley M, Citron S, Shrestha R. Frequency of complete pathological necrosis in HCC of explanted livers: radioembolization with resin vs drug-eluting beads with doxorubicin. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ha D, Schlenz A, Jacobs L, Lehn K, Jensen R, Rivera N, Han S, Araujo A, Beristain-Barajas A, Kim K, Geronimo L, Wilkes M. Assessing contraceptive use in Nicaragua: a cross-sectional survey
comparing social attitudes, access, education, and modern contraceptive use
in women of reproductive age in rural and urban clinics. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.634] [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: 11/29/2022] Open
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Lehn K, Jensen R, Rivera N, Ha D, Schlenz A, Jacobs L, Soucy Z. Assessing point of care ultrasound in Nicaragua: A survey of utility,
access, training, and interest amongst health care providers in rural and
urban centers. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.303] [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: 10/21/2022] Open
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Mertens K, Jacobs L, Maes J, Kabaseke C, Maertens M, Poesen J, Kervyn M, Vranken L. The direct impact of landslides on household income in tropical regions: A case study from the Rwenzori Mountains in Uganda. Sci Total Environ 2016; 550:1032-1043. [PMID: 26855356 DOI: 10.1016/j.scitotenv.2016.01.171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 01/25/2016] [Accepted: 01/25/2016] [Indexed: 06/05/2023]
Abstract
Landslides affect millions of people worldwide, but theoretical and empirical studies on the impact of landslides remain scarce, especially in Sub-Saharan Africa. This study proposes and applies a method to estimate the direct impact of landslides on household income and to investigate the presence of specific risk sharing and mitigation strategies towards landslides in a tropical and rural environment. An original cross-sectional household survey is used in combination with geographical data to acquire detailed information on livelihoods and on hazards in the Rwenzori mountains, Uganda. Ordinary least square regressions and probit estimations with village fixed effects are used to estimate the impact of landslides and the presence of mitigation strategies. Geographical information at household level allows to disentangle the direct impact from the indirect effects of landslides. We show that the income of affected households is substantially reduced during the first years after a landslide has occurred. We find that members of recently affected households participate more in wage-employment or in self-employed activities, presumably to address income losses following a landslide. Yet, we see that these jobs do not provide sufficient revenue to compensate for the loss of income from agriculture. Given that landslides cause localized shocks, finding a significant direct impact in our study indicates that no adequate risk sharing mechanisms are in place in the Rwenzori sub-region. These insights are used to derive policy recommendations for alleviating the impact of landslides in the region. By quantifying the direct impact of landslides on household income in an agricultural context in Africa this study draws the attention towards a problem that has been broadly underestimated so far and provides a sound scientific base for disaster risk reduction in the region. Both the methodology and the findings of this research are applicable to other tropical regions with high landslide densities.
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Affiliation(s)
- K Mertens
- Department of Earth and Environmental sciences, KU Leuven, Geo-instituut, Celestijnenlaan 200E, B-3001 Leuven-Heverlee, Belgium.
| | - L Jacobs
- Department of Geography, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - J Maes
- Department of Earth and Environmental sciences, KU Leuven, Geo-instituut, Celestijnenlaan 200E, B-3001 Leuven-Heverlee, Belgium; Department of Geography, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - C Kabaseke
- School of Agricultural and Environmental Sciences, Mountains of the Moon University, Fort Portal, Uganda
| | - M Maertens
- Department of Earth and Environmental sciences, KU Leuven, Geo-instituut, Celestijnenlaan 200E, B-3001 Leuven-Heverlee, Belgium
| | - J Poesen
- Department of Earth and Environmental sciences, KU Leuven, Geo-instituut, Celestijnenlaan 200E, B-3001 Leuven-Heverlee, Belgium
| | - M Kervyn
- Department of Geography, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - L Vranken
- Department of Earth and Environmental sciences, KU Leuven, Geo-instituut, Celestijnenlaan 200E, B-3001 Leuven-Heverlee, Belgium
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Tuyttens F, de Graaf S, Heerkens J, Jacobs L, Nalon E, Ott S, Stadig L, Van Laer E, Ampe B. Observer bias in animal behaviour research: can we believe what we score, if we score what we believe? Anim Behav 2014. [DOI: 10.1016/j.anbehav.2014.02.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Verbrugge FH, Nijst P, Van Herendael H, De Vusser P, Jacobs L, Vercammen J, Verhaert D, Vandervoort P, Dupont M, Mullens W, Rivero-Ayerza M. Asymptomatic episodes of device-registered atrial tachyarrhythmia are not associated with worse cardiac resynchronization therapy response. Europace 2014; 16:1197-204. [DOI: 10.1093/europace/eut434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hara A, Thijs L, Asayama K, Gu YM, Jacobs L, Zhang ZY, Liu YP, Nawrot T, Staessen J. P4.6 PULSATILE AND STEADY BLOOD PRESSURE COMPONENTS IN RELATION TO ENVIRONMENTAL LEAD EXPOSURE IN THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY 2003–2010. Artery Res 2014. [DOI: 10.1016/j.artres.2014.09.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Liu YP, Gu YM, Thijs L, Knapen M, Salvi E, Citterio L, Petit T, Carpini S, Zhang ZY, Jacobs L, Jin Y, Barlassina C, Manunta P, Kuznetsova T, Verhamme P, Struijker-Boudier H, Cusi D, Vermeer C, Staessen J. 3.2 INACTIVE MATRIX GLA PROTEIN IS CAUSALLY RELATED TO HEALTH OUTCOMES: A MENDELIAN RANDOMIZATION STUDY IN A FLEMISH POPULATION. Artery Res 2014. [DOI: 10.1016/j.artres.2014.09.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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de Souza-Lawrence L, Ford E, Sbaity E, Frassica D, Jacobs L, Cooney D, Micherdzinska A, Zellars R. A Novel Radio-Opaque Hydrogel Marker Can Be Used to Decrease Interobserver Variability in the Delineation of the Lumpectomy Cavity. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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M'Buyamba-Kabangu JR, Anisiuba BC, Ndiaye MB, Lemogoum D, Jacobs L, Ijoma CK, Thijs L, Boombhi HJ, Kaptue J, Kolo PM, Mipinda JB, Osakwe CE, Odili A, Ezeala-Adikaibe B, Kingue S, Omotoso BA, Ba SA, Ulasi II, Staessen JA. Efficacy of newer versus older antihypertensive drugs in black patients living in sub-Saharan Africa. J Hum Hypertens 2013; 27:729-35. [PMID: 23803591 PMCID: PMC3831294 DOI: 10.1038/jhh.2013.56] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/06/2013] [Accepted: 05/31/2013] [Indexed: 11/09/2022]
Abstract
To address the epidemic of hypertension in blacks born and living in sub-Saharan Africa, we compared in a randomised clinical trial (NCT01030458) single-pill combinations of old and new antihypertensive drugs in patients (30-69 years) with uncomplicated hypertension (140-179/90-109 mm Hg). After ≥4 weeks off treatment, 183 of 294 screened patients were assigned to once daily bisoprolol/hydrochlorothiazide 5/6.25 mg (n=89; R) or amlodipine/valsartan 5/160 mg (n=94; E) and followed up for 6 months. To control blood pressure (<140/<90 mm Hg), bisoprolol and amlodipine could be doubled (10 mg per day) and α-methyldopa (0.5-2 g per day) added. Sitting blood pressure fell by 19.5/12.0 mm Hg in R patients and by 24.8/13.2 mm Hg in E patients and heart rate decreased by 9.7 beats per minute in R patients with no change in E patients (-0.2 beats per minute). The between-group differences (R minus E) were 5.2 mm Hg (P<0.0001) systolic, 1.3 mm Hg (P=0.12) diastolic, and 9.6 beats per minute (P<0.0001). In 57 R and 67 E patients with data available at all visits, these estimates were 5.5 mm Hg (P<0.0001) systolic, 1.8 mm Hg (P=0.07) diastolic and 9.8 beats per minute (P<0.0001). In R compared with E patients, 45 vs 37% (P=0.13) proceeded to the higher dose of randomised treatment and 33 vs 9% (P<0.0001) had α-methyldopa added. There were no between-group differences in symptoms except for ankle oedema in E patients (P=0.012). In conclusion, new compared with old drugs lowered systolic blood pressure more and therefore controlled hypertension better in native African black patients.
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Affiliation(s)
- J R M'Buyamba-Kabangu
- 1] Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium [2] Hypertension Unit, Department of Internal Medicine, University of Kinshasa Hospital, Kinshasa, Democratic Republic of Congo
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Woodfield H, Dickholtz M, Bell B, Jacobs L. P02.67. An alternative for Chronic Fatigue Syndrome, an observational case series. BMC Complement Altern Med 2012. [PMCID: PMC3373462 DOI: 10.1186/1472-6882-12-s1-p123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Schutte R, Thijs L, Liu Y, Asayama K, Gu Y, Kuznetsova T, Jacobs L, Staessen J. P1.35 BLOOD PRESSURE VARIABILITY ASSOCIATES WITH CAROTID INTIMA-MEDIA THICKNESS BUT NOT CAROTID DISTENSIBILITY AND PULSE WAVE VELOCITY IN 1125 PARTICIPANTS. Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.072] [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: 10/27/2022] Open
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Emmerechts J, Jacobs L, Van Kerckhoven S, Loyen S, Mathieu C, Fierens F, Nemery B, Nawrot TS, Hoylaerts MF. Air pollution-associated procoagulant changes: the role of circulating microvesicles. J Thromb Haemost 2012; 10:96-106. [PMID: 22066779 DOI: 10.1111/j.1538-7836.2011.04557.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Epidemiological studies suggest an association between exposure to particulate matter (PM) in air pollution and the risk of venous thromboembolism (VTE). OBJECTIVES To investigate the underlying pathophysiological pathways linking PM exposure and VTE. PATIENTS AND METHODS We assessed potential associations between PM exposure and coagulation and inflammation parameters, including circulating microvesicles, in a group of 233 patients with diabetes. RESULTS The numbers of circulating blood platelet-derived and annexin V-binding microvesicles were inversely associated with the current levels of PM(2.5) or PM(10), measured on the day of sampling. Recent past exposure to PM(10), up to 1 week prior to blood sampling, estimated at the patients' residential addresses, was associated with elevated high-sensitivity C-reactive protein (CRP), leukocytes and fibrinogen, as well as with tissue factor (TF)-dependent procoagulant changes in thrombin generation assays. When longer windows of past exposure were considered, up to 1 year preceding blood sampling, procoagulant changes were evident from the strongly increased numbers of red blood cell-derived circulating microvesicles and annexin V-binding microvesicles, but they no longer associated with TF. Past PM exposure was never associated with activated partial thromboplastin time (aPTT), prothrombin time (PT), or factor (F) VII, FVIII, FXII or D-dimers. Residential distance to a major road was only marginally correlated with procoagulant changes in FVIII and thrombin generation. CONCLUSIONS Increases in the number of microvesicles and in their procoagulant properties, rather than increases in coagulation factors per se, seem to contribute to the risk of VTE, developing during prolonged exposure to air pollutants.
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Affiliation(s)
- J Emmerechts
- Center for Molecular and Vascular Biology, Unit of Lung Toxicology, University of Leuven, Leuven, Belgium
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Jacobs L, Samson MM, Verhaar HJJ, Koek HL. Therapeutic challenges in elderly patients with symptomatic hypercalcaemia caused by primary hyperparathyroidism. Neth J Med 2012; 70:35-38. [PMID: 22271812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Hypercalcaemia resulting from primary hyperparathyroidism (PHPT) can cause a wide range of symptoms, including cognitive disorders, psychiatric symptoms and muscle weakness. Parathyroid surgery is the only definite cure for PHPT. When surgery is contraindicated or patients decide against it, several non-surgical treatment options are available. OBJECTIVE To illustrate the treatment options of symptomatic hypercalcaemia caused by PHPT in the elderly and discuss these options in consideration of the available evidence. DESIGN Consecutive case series. SETTING University hospital. PATIENTS Four older patients aged 79-87 years with symptomatic hypercalcaemia resulting from PHPT. RESULTS Three patients had a parathyroid adenoma shown on a sestamibi scan. Normocalcaemia and resolution of symptoms was achieved by different treatment scenarios encompassing forced saline hydration, forced diuresis, intravenous pamidronate and cinacalcet, a calcimimetic drug. In one patient, no parathyroid abnormalities were revealed with imaging. Treatment with cinacalcet resulted in normocalcaemia and a strong improvement of symptoms. CONCLUSION In clinical practice, different treatment scenarios are chosen for the treatment of elderly patients with symptomatic hypercalcaemia caused by PHPT. The introduction of cinacalcet offers a new treatment paradigm. We propose to apply cinacalcet preceding elective surgery as an alternative option to standard therapy or as maintenance dose when surgery is not possible.
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Affiliation(s)
- L Jacobs
- Department of Internal Medicine, St Antonius Hospital Nieuwegein, Nieuwegein, the Netherlands.
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Bos I, Jacobs L, Nawrot TS, de Geus B, Torfs R, Int Panis L, Degraeuwe B, Meeusen R. No exercise-induced increase in serum BDNF after cycling near a major traffic road. Neurosci Lett 2011; 500:129-32. [PMID: 21708224 DOI: 10.1016/j.neulet.2011.06.019] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 06/09/2011] [Indexed: 01/09/2023]
Abstract
Commuting by bike has a clear health enhancing effect. Moreover, regular exercise is known to improve brain plasticity, which results in enhanced cognition and memory performance. Animal research has clearly shown that exercise upregulates brain-derived neurotrophic factor (BDNF - a neurotrophine) enhancing brain plasticity. Studies in humans found an increase in serum BDNF concentration in response to an acute exercise bout. Recently, more evidence is emerging suggesting that exposure to air pollution (such as particulate matter (PM)) is higher in commuter cyclists compared to car drivers. Furthermore, exposure to PM is linked to negative neurological effects, such as neuroinflammation and cognitive decline. We carried-out a cross-over experiment to examine the acute effect of exercise on serum BDNF, and the potential effect-modification by exposure to traffic-related air pollution. Thirty eight physically fit, non-asthmatic volunteers (mean age: 43, 26% women) performed two cycling trials, one near a major traffic road (Antwerp Ring, R1, up to 260,000 vehicles per day) and one in an air-filtered room. The air-filtered room was created by reducing fine particles as well as ultrafine particles (UFP). PM10, PM2.5 and UFP were measured. The duration (∼20min) and intensity of cycling were kept the same for each volunteer for both cycling trials. Serum BDNF concentrations were measured before and 30min after each cycling trial. Average concentrations of PM10 and PM2.5 were 64.9μg/m(3) and 24.6μg/m(3) in cycling near a major ring way, in contrast to 7.7μg/m(3) and 2.0μg/m(3) in the air-filtered room. Average concentrations of UFP were 28,180 particles/cm(3) along the road in contrast to 496 particles/cm(3) in the air-filtered room. As expected, exercise significantly increased serum BDNF concentration after cycling in the air-filtered room (+14.4%; p=0.02). In contrast, serum BDNF concentrations did not increase after cycling near the major traffic route (+0.5%; p=0.42). Although active commuting is considered to be beneficial for health, this health enhancing effect could be negatively influenced by exercising in an environment with high concentrations of PM. Whether this effect is also present with chronic exercise and chronic exposure must be further elucidated.
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Affiliation(s)
- I Bos
- Department of Human Physiology & Sports Medicine, Vrije Universiteit Brussel, Brussels, Belgium
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Rudick RA, Fisher E, Lee JC, Simon J, Jacobs L. Use of the brain parenchymal fraction to measure whole brain atrophy in relapsing-remitting MS. Neurology 2011. [DOI: 10.1212/01.wnl.0000398732.43701.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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de Souza Lawrence L, Stearns V, Frassica D, Asrari F, Tsangaris T, Myers L, DiPasquale S, Lange J, Jacobs L, Emens L, Armstrong D, Fetting J, Garrett-Mayer E, Davidson N, Wolff A, Zellars R. 750 poster COSMETIC OUTCOME AFTER PARTIAL BREAST IRRADIATION WITH CONCURRENT CHEMOTHERAPY IN EARLY-STAGE BREAST CANCER. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70872-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Multiple sclerosis (MS), a chronic inflammatory demyelinating disease of the central nervous system, is the most common crippling neurological disease of young adults in the US. The 2 basic clinical forms of the disease (relapsing and progressive), which can occur singly or in combination, encompass a wide range of clinical severities are usually established between 18 and 35 years of age and can persist an entire lifetime. Life expectancy of 20 years is 85% of normal. Historically, the standard proven and generally accepted clinical treatment of the disease has been corticotropin (ACTH) and methylprednisolone, which benefited clinical relapses but had no effect on clinical disability (the most important factor influencing the lives of individual MS patients) or other aspects of the chronic course of the disease. The most important new development in the treatment of MS has been the introduction of interferon beta into the clinic. Two forms of recombinant interferon beta have been approved by the FDA for use in relapsing MS: interferon beta-1b (IFN-beta-1b) and interferon beta-1a (IFN-beta-1a). The efficacy of IFN-beta-1b in the treatment of relapsing-remitting MS was established first but no effect on physical disability progression was discerned. In contrast, well designed trials of intramuscular IFN-beta-1a (Avonex((R))) 6.0 MIU (30micro) weekly and subcutaneous IFN-alpha-1a (Rebif((R))) 6 MIU (22microg) or 12 MIU (44microg) 3 times weekly produced a significant delay in the time to sustained progression in physical disability, the first MS treatment to exert such a prophylactic effect. Additionally, IFN-beta-1a significantly reduced clinical relapses and acute and chronic brain lesions revealed by MRI examinations. It is currently believed that IFN-beta-1a treatment alters the fundamental course of relapsing MS. The mechanisms of the therapeutic benefit of recombinant interferon betas are incompletely understood but may include augmentation of suppressor T cell function, inhibition of interferon gamma actions, inhibition of T cell activation, or induction of interleukin-10 gene transcription.
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Affiliation(s)
- L Jacobs
- State University of New York at Buffalo, Department of Neurology, Buffalo General Hospital, Buffalo, New York 14203, USA.
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Jacobs L, Rizvi SNF, Baart JA, Allard RHB. [Interactions and side-effects of non-steroidal anti-inflammatory drugs]. Ned Tijdschr Tandheelkd 2010; 117:233-237. [PMID: 20446553 DOI: 10.5177/ntvt2010.04.09135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Non-steroidal anti-inflammatory drugs are often used analgetics in dentistry because of their analgetic and anti-inflammatory effects. Oral health care providers should know their interactions and side-effects meticulously. The automatic prescription of another analgetic just to avoid the side-affects is not always an option, since then the specific properties of NSAID's are missed. A correct patient information, specific medical controls, a combination with other medication or other measures may providefor a safe use of NSAID's. In case of healthy patients younger than 70 years of age and a medication time less than two weeks seldom specific measures are indicated.
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Affiliation(s)
- L Jacobs
- Masterprofiel 'Chirurgische tandheelkunde, Academisch Centrum Tandheelkunde Amsterdam (ACTA)
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Vanaudenaerde B, Nawrot T, Vos R, Verleden S, Jacobs L, Faes C, Hoet P, Van Raemdonck D, Dupont L, Nemery B. 273: The Impact of Air Pollution on Bronchiolitis Obliterans Syndrome and Mortality after Lung Transplantation. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Stearns V, Jacobs L, Khouri N, Jeter S, Powers P, Shahverdi K, Brown R, Rudek M, Gabrielson E, Zhang Z, Tsangaris T, Sukumar S. A phase 1 study assessing the feasibility and safety of intraductal pegylated liposomal doxorubicin (PLD) in women awaiting mastectomy. BMC Proc 2009. [PMCID: PMC2727122 DOI: 10.1186/1753-6561-3-s5-s28] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Mingels A, Jacobs L, Kleijnen V, Wodzig W, Dieijen-Visser MV. Cystatin C a Marker for Renal Function after Exercise. Int J Sports Med 2009; 30:668-71. [DOI: 10.1055/s-0029-1220733] [Citation(s) in RCA: 21] [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: 10/20/2022]
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Williot P, Rouault T, Pelard M, Mercier D, Jacobs L. Artificial reproduction and larval rearing of captive endangered Atlantic sturgeon Acipenser sturio. ENDANGER SPECIES RES 2009. [DOI: 10.3354/esr00174] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Katzman MA, Vermani M, Jacobs L, Marcus M, Kong B, Lessard S, Galarraga W, Struzik L, Gendron A. Quetiapine as an adjunctive pharmacotherapy for the treatment of non-remitting generalized anxiety disorder: a flexible-dose, open-label pilot trial. J Anxiety Disord 2008; 22:1480-6. [PMID: 18455360 DOI: 10.1016/j.janxdis.2008.03.002] [Citation(s) in RCA: 40] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2007] [Revised: 02/27/2008] [Accepted: 03/05/2008] [Indexed: 11/17/2022]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is a chronic disorder associated with significant morbidity and disability. Traditional therapies are associated with poor levels of remission, and often result in troublesome side effects. METHODS This was a 12-week, open-label, flexible-dose study to assess the efficacy and tolerability of quetiapine as an adjunctive treatment to traditional medication. 40 outpatients with GAD who had not achieved remission following at least 8 weeks of an adequate dose of traditional therapy were enrolled. The primary endpoint was the mean change from pre-treatment to week 12 in the Hamilton Anxiety Rating Scale (HAM-A) total scores. Secondary endpoints included: the proportion of patients achieving remission (HAM-A total score of < or =10 at week 12), Clinical Global Impressions-Severity of Illness (CGI-S), Clinical Global Impressions-Global Improvement (CGI-I), Pittsburgh Sleep Quality Index (PSQI) and Penn State Worry Questionnaire (PSWQ). RESULTS Adjunctive quetiapine (mean dose 386mg/day at week 12) significantly reduced the HAM-A total scores from pre-treatment (29.8+/-9.0) to week 12 (9.0+/-10.2) (-20.6; p<0.001). The HAM-A remission rate was 72.1% at week 12. Adjunctive quetiapine resulted in a significant reduction in all efficacy measures by study end. Quetiapine was well tolerated: the most common adverse event (AE) was sedation, with no incidence of serious AEs and no clinically significant changes in vital signs, weight (mean gain 0.5kg at week 12) or laboratory assessments. CONCLUSION The results of this small pilot trial suggest that quetiapine adjunctive to traditional therapy may be a useful treatment in patients with GAD or treatment-resistant GAD, and warrant further investigation.
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Affiliation(s)
- M A Katzman
- START Clinic for Mood and Anxiety Disorders, Canada.
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Gollapenne RP, Anwar M, Jacobs L. Flexor digitorum profundus avulsion through an enchondroma of the distal phalanx. J Hand Surg Eur Vol 2007; 32:596-7. [PMID: 17950232 DOI: 10.1016/j.jhse.2007.04.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Revised: 04/04/2007] [Accepted: 04/18/2007] [Indexed: 02/03/2023]
Affiliation(s)
| | - M. Anwar
- Royal Oldham Hospital, Oldham, UK E-mail:
| | - L. Jacobs
- Royal Oldham Hospital, Oldham, UK E-mail:
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Abstract
4592 Background: Testicular cancer survivors (TCS) who receive cisplatin-based chemotherapy (CBCT) are reported to have an increased risk of coronary heart disease (CHD) compared to chemo-naive TCS (J Clin Oncol 21:1513–1523, 2003). We hypothesized that TCS treated with CBCT would demonstrate abnormal objective measures of future CHD risk compared to chemo-naive TCS. Methods: TCS ≥ 2 years from diagnosis underwent evaluation using established objective measures predictive of future CHD risk: body mass index (BMI), Framingham relative risk (RR), flow-mediated endothelium-dependent vasodilation of the brachial artery (FMD), carotid artery intima-media thickness (IMT), serum intercellular adhesion molecule-1 (ICAM-1), and high sensitivity C-reactive protein (hs-CRP). Data were analyzed using parametric and non-parametric statistics as appropriate. Results: 30 TCS who received CBCT and 20 chemo-naive TCS were recruited. The mean age and time from diagnosis were similar between the 2 groups. Both groups demonstrated elevated BMI, increased Framingham RR, and impaired FMD, consistent with an increased risk of CHD. However, there were no statistically significant differences in these measures between the two groups. Carotid IMT, ICAM-1, and hs-CRP were not significantly abnormal and these measures also did not differ between the two groups. Conclusions: TCS demonstrate abnormal objective measures of CHD risk in both CBCT-treated and chemo-naive groups. These data suggest that behavioral interventions to modify CHD risk should target all TCS independent of chemotherapy status. All values reported are mean ± standard deviation [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
| | - J. Carver
- Abramson Cancer Center, Philadelphia, PA
| | - L. Jacobs
- Abramson Cancer Center, Philadelphia, PA
| | | | - C. Fung
- Abramson Cancer Center, Philadelphia, PA
| | - E. Mohler
- Abramson Cancer Center, Philadelphia, PA
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Zellars RC, Frassica D, Stearns V, Fetting JH, Armstrong DK, Myers L, Tsangaris TN, Jacobs L, Lange JR, Wolf AC. Partial breast irradiation (PBI) concurrent with adjuvant dose-dense doxorubicin and dyclophosphamide (ddAC) chemotherapy in early-stage breast cancer: Preliminary safety results from a feasibility trial. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10675 Background: Adjuvant anthracycline-based chemotherapy regimens and radiation therapy as part of breast conservation therapy (BCT) are given sequentially to avoid excessive skin toxicity. PBI employs a shorter course of radiation therapy to a smaller breast field and is the subject of randomized efficacy trials. Concurrent administration of PBI and adjuvant chemotherapy would decrease duration of therapy, allow more women to pursue BCT, improve compliance, and potentially enhance local control. Methods: To examine the feasibility, safety, and short-term risk of recurrence of concurrent PBI with adjuvant ddAC, we are conducting a prospective one-stage, single-arm trial of PBI during the first 2 of 4 cycles of ddAC (60 and 600 mg/m2, respectively) delivered q14d with growth factor support. Patients (pts) with T1–2 N0–1 breast cancer and lumpectomy margins ≥ 3mm are eligible. PBI starts within 3 days of first chemo dose and treats the lumpectomy bed plus margin with 270 cGy fractions × 15 (4050 cGy total). Primary endpoints (skin/soft tissue toxicity and cosmetic outcome) are graded by a panel of physicians using commonly accepted scales. Digital images at baseline, during, and q 3–6 months after PBI are obtained for comparison. Additional chemo and endocrine Rx post ddAC given at the physician’s discretion. We report preliminary safety data. Results: Between 11/04 and 9/05, 10 pts were enrolled and received study therapy (accrual goal = 42); 2 pts also received dd paclitaxel 175 mg/m2 post ddAC. All pts received planned PBI (med. f/u 6 mos, range 3–12 mos). 2 pts missed 1 and 2 cycles of ddAC because of stomatitis (Gr 3) and diverticulitis, respectively. 3 other pts had 1–2 wk chemo delay because of hand-foot syndrome, brief pulmonary syndrome, and febrile neutropenia. No pts developed radiation dermatitis > Gr 1 or radiation recall. All pts had cosmetic outcome grades of good or excellent shortly after completion of therapy. No pts with ≥ 6 mos f/u since PBI had late skin toxicity. Conclusion: Early results suggest that PBI concurrent with ddAC appears feasible and safe. Trial enrolment continues and longer f/u is required. (Funded by The Breast Cancer Research Foundation). No significant financial relationships to disclose.
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Bigger BW, Siapati EK, Mistry A, Waddington SN, Nivsarkar MS, Jacobs L, Perrett R, Holder MV, Ridler C, Kemball-Cook G, Ali RR, Forbes SJ, Coutelle C, Wright N, Alison M, Thrasher AJ, Bonnet D, Themis M. Permanent partial phenotypic correction and tolerance in a mouse model of hemophilia B by stem cell gene delivery of human factor IX. Gene Ther 2005; 13:117-26. [PMID: 16163377 DOI: 10.1038/sj.gt.3302638] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Immune responses against an introduced transgenic protein are a potential risk in many gene replacement strategies to treat genetic disease. We have developed a gene delivery approach for hemophilia B based on lentiviral expression of human factor IX in purified hematopoietic stem cells. In both normal C57Bl/6J and hemophilic 129/Sv recipient mice, we observed the production of therapeutic levels of human factor IX, persisting for at least a year with tolerance to human factor IX antigen. Secondary and tertiary recipients also demonstrate long-term production of therapeutic levels of human factor IX and tolerance, even at very low levels of donor chimerism. Furthermore, in hemophilic mice, partial functional correction of treated mice and phenotypic rescue is achieved. These data show the potential of a stem cell approach to gene delivery to tolerize recipients to a secreted foreign transgenic protein and, with appropriate modification, may be of use in developing treatments for other genetic disorders.
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Affiliation(s)
- B W Bigger
- Gene Therapy Research Group, Faculty of Medicine, Imperial College London, South Kensington, UK.
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44
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Moonen P, Jacobs L, Crienen A, Dekker A. Detection of carriers of foot-and-mouth disease virus among vaccinated cattle. Vet Microbiol 2004; 103:151-60. [PMID: 15504586 DOI: 10.1016/j.vetmic.2004.07.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2003] [Revised: 06/21/2004] [Accepted: 07/18/2004] [Indexed: 11/30/2022]
Abstract
To investigate and optimise detection of carriers, we vaccinated 15 calves with an inactivated vaccine based on foot-and-mouth disease virus (FMDV) A Turkey strain and challenged them and two further non-vaccinated calves with the homologous virus four weeks later. To determine transmission to a sensitive animal, we put a sentinel calf among the infected cattle from 60 days post-infection until the end of the experiment at 609 days post-infection. Samples were tested for the presence of FMDV, viral genome, specific IgA antibodies, antibodies against FMDV non-structural (NS) proteins or neutralising antibodies. Virus and viral genome was intermittently isolated from probang samples and the number of isolations decreased over time. During the first 100 days significantly more samples were positive by RT-PCR than by virus isolation (VI), whereas, late after infection more samples were positive by virus isolation. All the inoculated cattle developed high titres of neutralising antibodies that remained high during the entire experiment. An IgA antibody response was intermittently detected in the oropharyngeal fluid of 14 of the 17 calves, while all of them developed detectable levels of antibodies to NS proteins of FMDV in serum, which declined slowly beyond 34 days post-infection. Nevertheless, at 609 days after inoculation, 10 cattle (60%) were still positive by NS ELISA. Of the 17 cattle in our experiment, 16 became carriers. Despite frequent reallocation between a different pair of infected cattle no transmission to the sentinel calf occurred. It remained negative in all assays during the entire experiment. The results of this experiment show that the NS ELISA is currently the most sensitive method to detect carriers in a vaccinated cattle population.
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Affiliation(s)
- P Moonen
- Central Institute for Animal Disease Control (CIDC), P.O. Box 2004, 8204 AA Lelystad, The Netherlands.
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Ficińska J, Bieńkowska-Szewczyk K, Jacobs L, Płucienniczak G, Płucienniczak A, Szewczyk B. Characterization of changes in the short unique segment of pseudorabies virus BUK-TK900 (Suivac A) vaccine strain. Arch Virol 2003; 148:1593-612. [PMID: 12898333 DOI: 10.1007/s00705-003-0121-x] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Mutant strains of pseudorabies virus (PRV) of reduced virulence, such as Bartha or BUK-TK900, have been used for vaccination purposes for many years. In contrast to the Bartha strain, BUK-TK900 has not been well characterised at the molecular level. The detailed analysis of this vaccine strain was urged by the fact of the isolation in Poland of field strains which were suspected to originate from BUK-TK900. We characterised changes in the U(S) region of this strain, focusing our attention on gE and gI genes. The only deletion, about 300 bp, found in BamHI 7 fragment (covering most of the U(S) region) was located in the 28 K (US2) gene. BUK-TK 900 produced small plaques on all cell lines tested in our laboratory (SK6, Vero, MDBK, 3T3). The plaque size was restored to about 70% of wild type virus plaque size when growing BUK-TK900 virus on 3T3 complementing cell line expressing PRV gE and up to 100% when cell line producing gE and gI was used. Both gE and gI genes from BUK-TK900 and from some derivative field isolates have been amplified by PCR reaction but no deletions in these genes have been found. Molecular weight of gene products differed from wild type proteins: gE was bigger than wild type gE while gI was smaller. Both proteins were correctly recognised by all tested polyclonal and monoclonal antibodies. Radioimmunoprecipitation study showed that BUK-TK900 gE and gI interact forming a complex. The whole ORF of BUK-TK900 gE was sequenced and only few point mutations were found; only two of them led to changes of amino acids in the polypeptide chain. These were: methionine at position 124 replaced by threonine and glutamine at position 162 replaced by arginine. The introduction of first of these mutations (Met to Thr) to PRV wild type strain NIA-3 resulted in 22% reduction of plaque size. This result confirms the importance of this domain of gE for its function; it was found previously by others that deletion of amino acids 125 and 126 reduced virulence and neurotropism of PRV. More changes were found in BUK-TK900 gI sequence. Over 80% of these changes were located in the terminal 1/3rd of the sequence. Some of these mutations may have significant effect on the secondary structure of gI glycoprotein. The change of the secondary structure may be responsible for the decrease of gI stability and the observed reduction of gI molecular mass.
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Affiliation(s)
- J Ficińska
- Department of Molecular Virology, University of Gdańsk, Gdańsk, Poland
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Benedict RHB, Munschauer F, Linn R, Miller C, Murphy E, Foley F, Jacobs L. Screening for multiple sclerosis cognitive impairment using a self-administered 15-item questionnaire. Mult Scler 2003; 9:95-101. [PMID: 12617275 DOI: 10.1191/1352458503ms861oa] [Citation(s) in RCA: 237] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Since there is a need for cost-effective screening techniques to identify neuropsychological impairment in multiple sclerosis (MS) patients, and because existing methods require cognitive testing with subsequent interpretation by a neuropsychologist, a brief self-report procedure was developed to screen for neuropsychological impairment in MS. In the first phase of the study, a pool of 80 items was generated based on a literature review and consultation with healthcare professionals. The set was reduced to 15 via Rasch analysis. Using these items, a brief (five minute) MS Neuropsychological Screening Questionnaire (MSNQ), including patient- and informant-report forms, was composed. In phase II, 50 MS patients and their caregivers completed the MSNQ. A comprehensive neuropsychological test battery was also administered. Analyses covered the reliability of the MSNQ and correlations between both patient- and informant-report scores and objective neuropsychological testing. Cronbach's alpha coefficients were 0.93 and 0.94 for the patient- and informant-report forms, respectively, and both forms of the test were strongly correlated with a more general cognitive complaints questionnaire. The patient MSNQ form correlated significantly with measures of depression but not with objective tests of cognitive function. In contrast, the informant form was correlated with patient cognitive performance but not depression. A cut-off score of 27 on the informant form of the MSNQ optimally separated patients based on a neuropsychological summary score encompassing measures of processing speed and memory. There were two false-negatives and one false-positive, giving the test a sensitivity of 0.83 and a specificity of 0.97. It is concluded, therefore, that this self-administered neuropsychological screening test is reliable and predicts neuropsychological impairment in MS patients with a reasonable degree of accuracy.
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Affiliation(s)
- R H B Benedict
- Department of Neurology, State University of New York (SUNY) at Buffalo School of Medicine, Buffalo, New York, USA.
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Abstract
A pattern of injury observed in patients at high risk for MS described as transcallosal bands (TCB) is hypothesized to be the result of neuronal tract degeneration in earliest MS, extending from typical acute, focal demyelinating lesions located along the lateral borders of the corpus callosum. The TCB, a T2-hyperintense lesion traversing the corpus callosum is recognized on 3-mm thick, T2-weighted imaging, develops over months and persists over years.
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Affiliation(s)
- J H Simon
- Department of Radiology-Neuroradiology, University of Colorado Health Sciences Center, Denver 80262, USA.
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Jacobs L. Natural disasters. Revolution (Oakl) 2001; 2:14-7. [PMID: 12017971] [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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Medveczky I, Bálint A, Makranszky L, Steverink P, Jacobs L. Sequence analysis of the membrane protein gene and nucleocapsid gene of porcine reproductive and respiratory syndrome virus isolated from a swine herd in Hungary. Acta Vet Hung 2001; 49:237-44. [PMID: 11402653 DOI: 10.1556/004.49.2001.2.14] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Porcine reproductive and respiratory syndrome virus (PRRSV) was isolated from blood samples taken at a pig farm in Hungary from pigs showing clinical signs of the disease. The virus (ABV 32) was identified as belonging to the European genotype by using type-specific monoclonal antibodies. This was confirmed by comparing the sequence of the membrane protein gene (ORF 6) and the nucleocapsid gene (ORF 7) with the American VR2332 and the European LV genotype reference strain, respectively. Analysis of the amino acid sequence of the ORF 6 and ORF 7 of ABV 32 revealed five amino acid changes in both ORFs when compared with LV, of which two changes in ORF 7 were only found in the Spanish isolates. Additionally, the ORF 7 sequence was compared with corresponding sequences of a total of 21 other European strains. Phylogenetic analysis using the PHYLIP package confirmed the close relationship between the Hungarian and the Spanish isolates. Of all the isolates analysed, ABV 32 and LV were the least related.
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Affiliation(s)
- I Medveczky
- Department of Microbiology and Infectious Diseases, Faculty of Veterinary Science, Szent István University, H-1581 Budapest, P.O. Box 22, Hungary
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