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Zabida A, Zahavi G, Bartoszko J, Otálora-Esteban M, Weinstein J, Frogel J, Miller L, Sivan E, Orkin D, Dolgoker I, Berkenstadt H. Improving blood product management in placenta accreta patients with severe bleeding: institutional experience. Int J Obstet Anesth 2023; 56:103904. [PMID: 37364347 DOI: 10.1016/j.ijoa.2023.103904] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/10/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Placenta accrete spectrum (PAS) is a significant risk factor for postpartum hemorrhage and effective blood product management is critical in ensuring patient safety. In PAS patients undergoing cesarean section (CS) blood transfusion management guided by the combined clinical experience of the anesthesiologist and surgeon with point-of-care coagulation testing appears safe and effective. We describe and evaluate our experience and identify potential areas for improvement with blood product management in this patient population. METHODS A retrospective chart review of peri-operative demographic, anesthetic, and obstetric data was conducted for all patients with PAS undergoing CS between 2012 and 2018 at our center. To facilitate a practical evaluation of blood product management, we divided patients into two groups based on the severity of bleeding. RESULTS A total of 221 parturients with PAS underwent CS, with 133 in group 1 requiring excessive amounts of transfusion and 88 in group 2 requiring management similar to other uncomplicated CS cases. There were no deaths or instances of disseminated intravascular coagulation, and intensive care unit admission occurred in five cases (2.2%). Patients in group 1 had higher mean nadir values of intra-operative hemoglobin and platelet count. We observed a high rate of missing data for peri-operative measurement of lactate and fibrinogen, PAS grade documentation, and temperature monitoring. CONCLUSION Given no significant morbidity or mortality, clinical judgment in experienced centers appears safe for the management of PAS patients undergoing CS. The adoption of an institutional protocol and point-of-care coagulation testing could decrease over-transfusion and associated complications.
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Affiliation(s)
- A Zabida
- Department of Anesthesiology, Chaim Sheba Medical Centre, Tel-Hashomer, Israel.
| | - G Zahavi
- Department of Anesthesiology, Chaim Sheba Medical Centre, Tel-Hashomer, Israel
| | - J Bartoszko
- Department of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, Ontario, Canada
| | - M Otálora-Esteban
- Department of Anesthesiology, Hospital Universitario San Ignacio, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - J Weinstein
- Department of Anesthesiology, Chaim Sheba Medical Centre, Tel-Hashomer, Israel
| | - J Frogel
- Department of Anesthesiology, Chaim Sheba Medical Centre, Tel-Hashomer, Israel
| | - L Miller
- Blood Bank, Sheba Medical Centre, Tel-Hashomer, Israel
| | - E Sivan
- Josef Buchman Gynecology and Maternity Centre, Sheba Medical Centre, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - D Orkin
- Department of Anesthesiology, Chaim Sheba Medical Centre, Tel-Hashomer, Israel
| | - I Dolgoker
- Department of Anesthesiology, Chaim Sheba Medical Centre, Tel-Hashomer, Israel
| | - H Berkenstadt
- Department of Anesthesiology, Chaim Sheba Medical Centre, Tel-Hashomer, Israel
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Miller L, Imms C, Cross A, Pozniak K, O'Connor B, Martens R, Cavalieros V, Babic R, Novak-Pavlic M, Rodrigues M, Balram A, Hughes D, Ziviani J, Rosenbaum P. Impact of "early intervention" parent workshops on outcomes for caregivers of children with neurodisabilities: a mixed-methods study. Disabil Rehabil 2023; 45:3900-3911. [PMID: 36404703 DOI: 10.1080/09638288.2022.2143579] [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: 05/04/2022] [Revised: 10/25/2022] [Accepted: 10/30/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE This study explored the feasibility, impact and parent experiences of ENVISAGE (ENabling VISions And Growing Expectations)-Families, a parent-researcher co-designed and co-led program for parents/caregivers raising children with early-onset neurodisabilities. METHODS Parents/caregivers of a child with a neurodisability aged ≤6 years, recruited in Australia and Canada, participated in five weekly online workshops with other parents. Self-report measures were collected at baseline, immediately after, and 3 months post-ENVISAGE-Families; interviews were done following program completion. Quantitative data were analyzed with generalized estimating equations and qualitative data using interpretive description methodology. RESULTS Sixty-five parents (86% mothers) were recruited and 60 (92%) completed the program. Strong evidence was found of effects on family empowerment and parent confidence (all p ≤ 0.05 after the program and maintained at 3-month follow-up). The ENVISAGE-Families program was relevant to parents' needs for: information, connection, support, wellbeing, and preparing for the future. Participants experienced opportunities to reflect on and/or validate their perspectives of disability and development, and how these perspectives related to themselves, their children and family, and their service providers. CONCLUSIONS ENVISAGE was feasible and acceptable for parent/caregivers. The program inspired parents to think, feel and do things differently with their child, family and the people who work with them.Implications for rehabilitationENVISAGE (ENabling VISions And Growing Expectations)-Families is a co-designed, validated parent/researcher "early intervention and orientation" program for caregivers raising a child with neurodevelopmental disabilities (NDDs).ENVISAGE-Families empowered parents' strengths-based approaches to their child, family, disability, and parenting.ENVISAGE-Families increased caregivers' confidence in parenting children with NDD's and provided them tools to support connection, collaboration, and wellbeing.Raising children with NDD can have a profound impact on caregivers, who can benefit from strengths-based, future focused supports early in their parenting experience.
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Affiliation(s)
- L Miller
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - C Imms
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - A Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Pediatrics, McMaster University, Hamilton, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - K Pozniak
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - B O'Connor
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - R Martens
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - V Cavalieros
- Murdoch Children's Research Institute, Melbourne, Australia
| | - R Babic
- Murdoch Children's Research Institute, Melbourne, Australia
| | - M Novak-Pavlic
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - M Rodrigues
- Department of Health Research Methods, Evidence and Impact, Health Research Methodology Graduate Program, McMaster University, Hamilton, Canada
| | - A Balram
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - D Hughes
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - J Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - P Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
- Department of Pediatrics, McMaster University, Hamilton, Canada
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Miller L, Duncan JC, Handel IG, Shaw DJ, McKenzie HE, Greenhalgh SN. Association between body mass and hypotension in dogs under general anaesthesia. J Small Anim Pract 2023; 64:687-695. [PMID: 37770103 DOI: 10.1111/jsap.13671] [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] [Received: 07/10/2022] [Revised: 03/19/2023] [Accepted: 08/08/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES To investigate the association between body mass and hypotension during general anaesthesia in dogs undergoing surgical and diagnostic procedures within a referral hospital. MATERIALS AND METHODS Retrospective evaluation of the anaesthetic records of 1789 dogs was performed. Data on signalment, anaesthetic protocol and physiological variables, including mean arterial pressure, were collected. A multivariable generalised linear model was used to identify associations between explanatory variables, including body mass, and hypotension. RESULTS In the population studied, increasing body mass (per 10 kg) was significantly associated with decreasing odds of hypotension (odds ratio 0.68; 95% confidence interval: 0.60 to 0.77). Additional variables associated with a decreased odds of hypotension were pre-anaesthetic medication with alpha-2 agonists (odds ratio 0.63; 95% confidence interval 0.48 to 0.82) and increased body temperature (per 1°C) during general anaesthesia (odds ratio 0.77; 95% confidence interval 0.67 to 0.88). Brachycephaly (odds ratio 1.72; 95% confidence interval 1.25 to 2.38), ASA physical status classification >3 (odds ratio 2.03; 95% confidence interval 1.16 to 3.56), undergoing a surgical procedure (versus diagnostic) (odds ratio 1.57; 95% confidence interval 1.10 to 2.23) and bradycardia (odds ratio 1.37; 95% confidence interval 1.05 to 1.80) were independently associated with increased odds of hypotension. CLINICAL SIGNIFICANCE Dogs of lower body mass and brachycephalic breeds may be at higher risk of hypotension during general anaesthesia or alternatively represent subpopulations in which accurate blood pressure measurement presents a greater challenge. Monitoring blood pressure accurately in these groups requires particular attention and provisions for treating hypotension should be readily accessible.
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Affiliation(s)
- L Miller
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - J C Duncan
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - I G Handel
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - D J Shaw
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - H E McKenzie
- PDSA, Whitechapel Way, Priorslee, Telford, Shropshire, TF2 9PQ, UK
| | - S N Greenhalgh
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
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Chen GF, Kang Y, Stroedecke N, Luon S, Boothe K, Renauer M, Miller L, Cohen JM. The medication management program in dermatology: a novel collaborative initiative. Int J Dermatol 2023; 62:e496-e498. [PMID: 37021709 DOI: 10.1111/ijd.16668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/28/2023] [Accepted: 03/15/2023] [Indexed: 04/07/2023]
Affiliation(s)
| | - Youna Kang
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, CT, USA
| | - Natasha Stroedecke
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, CT, USA
| | - Stephanie Luon
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, CT, USA
| | | | - Marie Renauer
- Corporate Pharmacy Services, Yale New Haven Health, New Haven, CT, USA
| | - LeeAnn Miller
- Corporate Pharmacy Services, Yale New Haven Health, New Haven, CT, USA
| | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
- Section of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, USA
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Rangel TL, Saul T, Bindler R, Roney JK, Penders RA, Faulkner R, Miller L, Sperry M, James L, Wilson ML. Exercise, diet, and sleep habits of nurses working full-time during the COVID-19 pandemic: An observational study. Appl Nurs Res 2023; 69:151665. [PMID: 36635006 PMCID: PMC9743780 DOI: 10.1016/j.apnr.2022.151665] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/14/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Healthy diet, exercise, and sleep practices may mitigate stress and prevent illness. However, lifestyle behaviors of acute care nurses working during stressful COVID-19 surges are unclear. PURPOSE To quantify sleep, diet, and exercise practices of 12-hour acute care nurses working day or night shift during COVID-19-related surges. METHODS Nurses across 10 hospitals in the United States wore wrist actigraphs and pedometers to quantify sleep and steps and completed electronic diaries documenting diet over 7-days. FINDINGS Participant average sleep quantity did not meet national recommendations; night shift nurses (n = 23) slept significantly less before on-duty days when compared to day shift nurses (n = 34). Proportionally more night shift nurses did not meet daily step recommendations. Diet quality was low on average among participants. DISCUSSION Nurses, especially those on night shift, may require resources to support healthy sleep hygiene, physical activity practices, and diet quality to mitigate stressful work environments.
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Affiliation(s)
- T L Rangel
- Providence Health System, United States of America.
| | - T Saul
- Providence Health System, United States of America
| | - R Bindler
- Providence Health System, United States of America; Washington State University, United States of America
| | - J K Roney
- Providence Health System, United States of America
| | - R A Penders
- Providence Health System, United States of America
| | - R Faulkner
- Providence Health System, United States of America
| | - L Miller
- Lincoln Memorial University, United States of America
| | - M Sperry
- Providence Health System, United States of America
| | - L James
- Washington State University, United States of America
| | - M L Wilson
- Washington State University, United States of America
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Bergam S, Harrison AD, Benghu N, Khumalo S, Tesfay N, Exner T, Miller L, Dolezal C, Hanass-Hancock J, Hoffman S. Women's Perceptions of HIV- and Sexuality-Related Stigma in Relation to PrEP: Qualitative Findings from the Masibambane Study, Durban, South Africa. AIDS Behav 2022; 26:2881-2890. [PMID: 35218452 PMCID: PMC9378426 DOI: 10.1007/s10461-022-03632-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 11/01/2022]
Abstract
Daily oral pre-exposure prophylaxis (PrEP) offers effective HIV prevention. In South Africa, PrEP is publicly available, but use among young women remains low. We explored young women's perceptions of PrEP to inform a gender-focused intervention to promote PrEP uptake. Six focus group discussions and eight in-depth interviews exploring perceptions of PrEP were conducted with forty-six women not using PrEP, ages 18-25, from central Durban. Data were thematically analyzed using a team-based consensus approach. The study was conducted among likely PrEP users: women were highly-educated, with 84.8% enrolled in post-secondary education. Qualitative data revealed intersecting social stigmas related to HIV and women's sexuality. Women feared that daily PrEP pills would be confused with anti-retroviral treatment, creating vulnerability to misplaced HIV stigma. Women also anticipated that taking PrEP could expose them to assumptions of promiscuity from the community. To address these anticipated community-level reactions, women suggested community-facing interventions to reduce the burden on young women considering PrEP. Concerns around PrEP use in this group of urban, educated women reflects layered stigmas that may inhibit future PrEP use. Stigma-reducing strategies, such as media campaigns and educational interventions directed at communities who could benefit from PrEP, should re-frame PrEP as an empowering and responsible choice for young women.
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Affiliation(s)
- S Bergam
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
- Department of Paediatric Infectious Disease, Nelson Mandela School of Medicine, University of KwaZulu Natal, Umbilo, Durban, Kwa-Zulu Natal, South Africa.
| | - A D Harrison
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - N Benghu
- Gender and Health Research Unit, South African Medical Research Council, Durban, Kwa-Zulu Natal, South Africa
| | - S Khumalo
- Gender and Health Research Unit, South African Medical Research Council, Durban, Kwa-Zulu Natal, South Africa
| | - N Tesfay
- Gender and Health Research Unit, South African Medical Research Council, Durban, Kwa-Zulu Natal, South Africa
| | - T Exner
- Department of Psychiatry, Columbia University, New York, NY, USA
- HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute, Columbia University, New York, NY, USA
| | - L Miller
- ICAP, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - C Dolezal
- Department of Psychiatry, Columbia University, New York, NY, USA
- HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute, Columbia University, New York, NY, USA
| | - J Hanass-Hancock
- Gender and Health Research Unit, South African Medical Research Council, Durban, Kwa-Zulu Natal, South Africa
| | - S Hoffman
- Department of Psychiatry, Columbia University, New York, NY, USA
- HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Miller L, Waibler Z, Regourd E, Jouette S. Collaborative study for the establishment of Human immunoglobulin for anticomplementary activity BRP replacement batches 3, 4, 5 and 6. Pharmeur Bio Sci Notes 2022; 2022:10-21. [PMID: 35384837] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Human immunoglobulin products are used for the treatment of a number of diseases, such as primary or secondary immunodeficiencies and autoimmune conditions due to the complete absence of antibodies or the production of defective immunoglobulins. Quality control of human immunoglobulin products is essential to ensure therapeutic functionality and safety. This includes testing for Fc function and anticomplementary activity (ACA), as well as verification of appropriate molecular size distribution using size-exclusion chromatography as prescribed in the European Pharmacopoeia (Ph. Eur.) monographs 0338, 0918, 2788 and 1928. To this end, specific biological reference preparations (BRPs) must be used. Stocks of the Ph. Eur. Human immunoglobulin for anticomplementary activity BRP were running low and therefore a collaborative study was run by the European Directorate for the Quality of Medicines & HealthCare (EDQM), under the aegis of the Biological Standardisation Programme, to calibrate replacement batches. Six laboratories, including manufacturers and one Official Medicines Control Laboratory, took part in the study. Several batches of candidate BRPs were calibrated against Ph. Eur. Human immunoglobulin for anticomplementary activity BRP batch 2 to ensure continuity. Based on the study results, the candidate BRPs were adopted by the Ph. Eur. Commission as Ph. Eur. human immunoglobulin for anticomplementary activity BRP batch 3, 4, 5 and 6.
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Affiliation(s)
- L Miller
- Paul-Ehrlich-Institut, Paul-Ehrlich-Strasse 51-59, D-63225 Langen, Germany
| | - Z Waibler
- Paul-Ehrlich-Institut, Paul-Ehrlich-Strasse 51-59, D-63225 Langen, Germany
| | - E Regourd
- European Directorate for the Quality of Medicines & HealthCare (EDQM), 7 allée Kastner, CS 30026, F-67081 Strasbourg, France
| | - S Jouette
- European Directorate for the Quality of Medicines & HealthCare (EDQM), 7 allée Kastner, CS 30026, F-67081 Strasbourg, France
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Affiliation(s)
- R Logan Murray
- Department of Pharmacy Services, University of Alabama at Birmingham Hospital, Birmingham, AL.,Department of Pharmacy Services, Yale New Haven Hospital, New Haven, CT, USA
| | | | - Marjorie Lazarre
- Corporate Pharmacy Services, Yale New Haven Health, West Haven, CT, USA
| | - LeeAnn Miller
- Corporate Pharmacy Services, Yale New Haven Health, West Haven, CT, USA
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Dong X, Wang G, Miller L, Kim B, Garza L, Archer N, Dong X. 218 Neutrophil-specific defensin receptors that prevent skin dysbiosis and bacterial infection. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.239] [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]
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10
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Wang G, Sweren E, Liu H, Wier E, Alphonse M, Xue Y, Archer N, Grice E, Miller L, Garza L. 613 Bacteria induce skin regeneration via IL-1β signaling. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Orlando N, Youn C, Nolan S, Alphonse M, Dikeman D, Wang Y, Patrick G, Miller L, Archer N. 210 Eosinophil-derived IL-17 protects against epicutaneous Staphylococcus aureus infections. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.231] [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]
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Ammar MA, Tran LJ, McGill B, Ammar AA, Huynh P, Amin N, Guerra M, Rouse GE, Lemieux D, McManus D, Topal JE, Davis MW, Miller L, Yazdi M, Leber MB, Pulk RA. Pharmacists leadership in a medication shortage response: Illustrative examples from a health system response to the COVID-19 crisis. J Am Coll Clin Pharm 2021; 4:1134-1143. [PMID: 34230910 PMCID: PMC8250559 DOI: 10.1002/jac5.1443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/10/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 12/17/2022]
Abstract
As medication experts, clinical pharmacists play an active and dynamic role in a medication shortage response. Supplementing existing guidelines with an actionable framework of discrete activities to support effective medication shortage responses can expand the scope of pharmacy practice and improve patient care. Dissemination of best practices and illustrative, networked examples from health systems can support the adoption of innovative solutions. In this descriptive report, we document the translation of published shortage mitigation guidelines into system success through broad pharmacist engagement and the adaption and implementation of targeted strategies. The profound, wide‐reaching medication shortages that accompanied the coronavirus disease 2019 (COVID‐19) pandemic are used to highlight coordinated but distinct practices and how they have been combined to expand the influence of the pharmacy enterprise.
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Affiliation(s)
- Mahmoud A Ammar
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - Lydia J Tran
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - Bryan McGill
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - Abdalla A Ammar
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - Phu Huynh
- Corporate Pharmacy Services Yale New Haven Health New Haven Connecticut USA
| | - Nilesh Amin
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - Michael Guerra
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - Ginger E Rouse
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - Diana Lemieux
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - Dayna McManus
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - Jeffrey E Topal
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - Matthew W Davis
- Department of Pharmacy Services Yale-New Haven Hospital New Haven Connecticut USA
| | - LeeAnn Miller
- Corporate Pharmacy Services Yale New Haven Health New Haven Connecticut USA
| | - Marina Yazdi
- Corporate Pharmacy Services Yale New Haven Health New Haven Connecticut USA
| | | | - Rebecca A Pulk
- Corporate Pharmacy Services Yale New Haven Health New Haven Connecticut USA
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Miller L, Gozalo-Marcilla M, Pollock P, Panti A. Anesthetic management of a pregnant broodmare with gastrointestinal colic. VLAAMS DIERGEN TIJDS 2021. [DOI: 10.21825/vdt.v90i1.17769] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Gastrointestinal colic in mares during early pregnancy may require general anesthesia for surgical correction. There is a scarcity of literature identifying anesthetic risk factors associated with negative outcome in the pregnant mare. In this case report, a seven-year-old Thoroughbred broodmare, presenting for the investigation and treatment of colic in the fifth month of pregnancy, underwent surgery for the correction of right dorsal displacement of the large colon. Intraoperatively, interventions for maternal hypoxemia and hypotension were necessary. The mare recovered well from general anesthesia and was discharged from the hospital eleven days postoperatively. In this case report, the successful anesthetic management of a pregnant broodmare is described, and all aspects that may improve the outcome for both mare and fetus are considered, with emphasis on the prevention of cardiovascular and respiratory disturbances.
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Gunn H, Stevens KN, Creanor S, Andrade J, Paul L, Miller L, Green C, Ewings P, Barton A, Berrow M, Vickery J, Marshall B, Zajicek J, Freeman JA. Balance Right in Multiple Sclerosis (BRiMS): a feasibility randomised controlled trial of a falls prevention programme. Pilot Feasibility Stud 2021; 7:2. [PMID: 33390184 PMCID: PMC7780657 DOI: 10.1186/s40814-020-00732-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/14/2019] [Accepted: 11/23/2020] [Indexed: 11/24/2022] Open
Abstract
Background Balance, mobility impairments and falls are problematic for people with multiple sclerosis (MS). The “Balance Right in MS (BRiMS)” intervention, a 13-week home and group-based exercise and education programme, aims to improve balance and minimise falls. This study aimed to evaluate the feasibility of undertaking a multi-centre randomised controlled trial and to collect the necessary data to design a definitive trial. Methods This randomised controlled feasibility study recruited from four United Kingdom NHS clinical neurology services. Patients ≥ 18 years with secondary progressive MS (Expanded Disability Status Scale 4 to 7) reporting more than two falls in the preceding 6 months were recruited. Participants were block-randomised to either a manualised 13-week education and exercise programme (BRiMS) plus usual care, or usual care alone. Feasibility assessment evaluated recruitment and retention rates, adherence to group assignment and data completeness. Proposed outcomes for the definitive trial (including impact of MS, mobility, quality of life and falls) and economic data were collected at baseline, 13 and 27 weeks, and participants completed daily paper falls diaries. Results Fifty-six participants (mean age 59.7 years, 66% female, median EDSS 6.0) were recruited in 5 months; 30 randomised to the intervention group. Ten (18%) participants withdrew, 7 from the intervention group. Two additional participants were lost to follow up at the final assessment point. Completion rates were > 98% for all outcomes apart from the falls diary (return rate 62%). After adjusting for baseline score, mean intervention—usual care between-group differences for the potential primary outcomes at week 27 were MS Walking Scale-12v2: − 7.7 (95% confidence interval [CI] − 17.2 to 1.8) and MS Impact Scale-29v2: physical 0.6 (CI − 7.8 to 9), psychological − 0.4 (CI − 9.9 to 9). In total, 715 falls were reported, rate ratio (intervention:usual care) for falls 0.81 (0.41 to 2.26) and injurious falls 0.44 (0.41 to 2.23). Conclusions Procedures were practical, and retention, programme engagement and outcome completion rates satisfied a priori progression criteria. Challenges were experienced in completion and return of daily falls diaries. Refinement of methods for reporting falls is therefore required, but we consider a full trial to be feasible. Trial registration ISRCTN13587999 Date of registration: 29 September 2016
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Affiliation(s)
- H Gunn
- Faculty of Health, School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Derriford Road, Plymouth, PL6 8BH, England.
| | - K N Stevens
- Faculty of Health, Medical Statistics Group, Room N15, Plymouth Science Park, Plymouth, PL6 8BX, England.,Peninsula Clinical Trials Unit, University of Plymouth, Room N16, Plymouth Science Park, Plymouth, PL6 8BX, England
| | - S Creanor
- Faculty of Health, Medical Statistics Group, Room N15, Plymouth Science Park, Plymouth, PL6 8BX, England.,University of Exeter Medical School, College of Medicine & Health, University of Exeter, Exeter, England
| | - J Andrade
- Faculty of Health, School of Psychology, University of Plymouth, Portland Square Building, Drake Circus Campus, Plymouth, PL4 8AA, England
| | - L Paul
- School of Health & Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland
| | - L Miller
- Douglas Grant Rehabilitation Unit, Ayrshire Central Hospital, Kilwinning Road, Irvine, KA12 8SS, Scotland
| | - C Green
- University of Exeter Medical School, Health Economics Group, University of Exeter, St. Luke's Campus, Exeter, EX1 2LU, England
| | - P Ewings
- NIHR Research Design Service (South West), Musgrove Park Hospital, Taunton, TA1 5DA, England
| | - A Barton
- Faculty of Medicine and Dentistry, NIHR Research Design Service South West, ITTC Building, Plymouth Science Park, Plymouth, PL6 8BX, England
| | - M Berrow
- Faculty of Health, Medical Statistics Group, Room N15, Plymouth Science Park, Plymouth, PL6 8BX, England
| | - J Vickery
- Faculty of Health, Medical Statistics Group, Room N15, Plymouth Science Park, Plymouth, PL6 8BX, England
| | - B Marshall
- Faculty of Health, School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Derriford Road, Plymouth, PL6 8BH, England
| | - J Zajicek
- School of Medicine, Medical and Biological Sciences, University of St. Andrews, North Haugh, St. Andrews, KY16 9TF, Scotland
| | - J A Freeman
- Faculty of Health, School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Derriford Road, Plymouth, PL6 8BH, England
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15
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Pulk RA, Leber M, Tran L, Ammar M, Amin N, Miller L, Yazdi M. Dynamic pharmacy leadership during the COVID-19 crisis: Optimizing patient care through formulary and drug shortage management. Am J Health Syst Pharm 2020; 77:1874-1884. [PMID: 32710774 PMCID: PMC7454264 DOI: 10.1093/ajhp/zxaa219] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The coronavirus disease 2019 (COVID-19) pandemic has created unprecedented challenges for health systems around the world. We describe our approach to adapting the pharmacy leadership structure to address critical medication shortages through innovative data analysis, procurement strategies, and rapid implementation of medication policy. Summary Yale New Haven Health deployed a system incident management command structure to effectively respond to the COVID-19 crisis. System pharmacy services adopted a similar framework to enable efficient communication and quick decision-making in key domains, including drug procurement and policy. By refining a model to project health-system medication needs, we were able to anticipate challenges and devise alternative treatment algorithms. By leveraging big data and creating a system knowledge base, we were able to consolidate reporting and coordinate efforts to ensure system success. Various procurement strategies were employed to ensure adequate supply, including frequent communication with our wholesaler, sourcing direct from suppliers, outsourcing of sterile products compounding to registered 503B outsourcing facilities, and acquisition of active pharmaceutical ingredients for compounding of essential medications. Strategic positioning of pharmacists within the health system’s incident command response teams and rapid adaption of drug use policy governance fueled accelerated response and nimble implementation. Communication was streamlined and executed via multiple outlets to reach a broad audience across the health system. Conclusion With medication shortages posing a threat to patient care, dynamic pharmacy leadership proved essential to providing patient care at the height of the COVID-19 pandemic. System alignment and the rapid adaption of the existing framework for drug shortage management and medication use policy were crucial to success in crisis response.
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Affiliation(s)
- Rebecca Ann Pulk
- Corporate Pharmacy Services, Yale New Haven Health, New Haven, CT
| | - Molly Leber
- Corporate Pharmacy Services, Yale New Haven Health, New Haven, CT
| | - Lydia Tran
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, CT
| | - Mahmoud Ammar
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, CT
| | - Nilesh Amin
- Department of Pharmacy Services, Yale New Haven Hospital, New Haven, CT
| | - LeeAnn Miller
- Corporate Pharmacy Services, Yale New Haven Health, New Haven, CT
| | - Marina Yazdi
- Corporate Pharmacy Services, Yale New Haven Health, New Haven, CT
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16
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Curry B, Kotha J, Miller L, Dixon M, Herr M, Dragutsky B, Bhula R, McGrew F, Jennings L. Ex vivo synergistic effects of apixaban with dual anti-platelet therapy (DAPT) in lowering platelet reactivity and thrombin generation (SEARCH). Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1546] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Direct oral anticoagulants such as apixaban are increasingly being evaluated clinically for the secondary prevention of cardiovascular events; however, their effects on platelet function in combination with dual anti-platelet therapy (DAPT) have not been fully investigated. The purpose of this translational, in vitro study was to determine if apixaban via inhibition of thrombin generation exhibits synergistic activity with DAPT to reduce platelet reactivity. Consented subjects with a prior history (<12 mo) of ACS on DAPT regime with aspirin and clopidogrel (n=15; DAPT-C) or aspirin and ticagrelor (n=15; DAPT-T) were recruited, along with the age-matched healthy subjects as controls. Enrolled DAPT subjects had taken their prescribed regimen >7 days prior to blood collection. Platelet-rich plasma from TSC anticoagulated blood was prepared and treated in vitro with nothing, a carrier control or apixaban (40, 90 and 220 ng/mL). The range of 40 to 220 ng/mL brackets the expected apixaban exposure at steady state with all three approved regimens with the 40 ng/mL treatment corresponding to <5th percentile for the 2.5 mg bid dose, the 90 ng/mL corresponding to Cmax after the 2.5 mg bid or to Cmin after the 5 mg bid dose, and the 220 ng/mL corresponding to the Cmax after 10 mg bid dose. Platelet aggregation was measured by light transmission aggregometry (LTA) with tissue factor (TF) as agonist. Platelet p-selectin expression was measured by flow cytometry and thrombin generation was quantified. TF agonist was chosen to evaluate endogenous thrombin effects via Factor Xa activation (fXa). The CaCl2 concentration in the TF was titrated in the presence of peptide GPRP which minimized fibrin generation. The baseline maximal aggregation (MA) response was similar for both DAPT-T and DAPT-C (64%). Compared to DAPT alone, 90 and 220 ng/mL apixaban treatments decreased MA from 64% to 36% and 17% in the DAPT-T group and from 64% to 28% and 9% in the DAPT-C group (p<0.009), respectively. Platelet P-selectin expression decreased by 53% in the DAPT-T group with 220 ng/mL apixaban treatment (p<0.02) and in the DAPT-C group by 70% and 76% with 90 and 220 ng/mL apixaban treatment (p<0.004), respectively, compared to DAPT alone. Apixaban treatment (90 and 220 ng/mL) significantly increased thrombin generation lag time and time-to-peak results and significantly decreased peak thrombin in both DAPT groups (p<0.05). ACS patients on a DAPT regimen were susceptible to thrombin-mediated platelet activation via fXa. Apixaban treatment in vitro caused a larger reduction in thrombin-mediated platelet activation in the clopidogrel group compared to the ticagrelor group, consistent with ticagrelor having a more potent anti-platelet effect compared to clopidogrel. The in vitro addition of apixaban that corresponded to currently approved dosing regimens and at plasma drug levels routinely achieved demonstrated synergy with DAPT to reduce platelet reactivity and thrombin generation.
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Bristol-Myers Squibb
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Affiliation(s)
- B Curry
- CirQuest Labs, Memphis, United States of America
| | - J Kotha
- CirQuest Labs, Memphis, United States of America
| | - L Miller
- CirQuest Labs, Memphis, United States of America
| | - M Dixon
- CirQuest Labs, Memphis, United States of America
| | - M.J Herr
- University of Tennessee Health Science Center, Memphis, United States of America
| | - B Dragutsky
- The Stern Cardiovascular Foundation, Germantown, United States of America
| | - R Bhula
- The Stern Cardiovascular Foundation, Germantown, United States of America
| | - F McGrew
- The Stern Cardiovascular Foundation, Germantown, United States of America
| | - L.K Jennings
- CirQuest Labs, Memphis, United States of America
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18
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Abstract
Gambling in moderation is a socially acceptable behavior and over 60% of the Swedish population gambles every year. It has been seen that slot machines are one of the most addictive and problematic forms of gambling and contribute highly to an addictive behavior.
It is unclear why some individuals intensify their gambling behavior over time to extreme levels while others do not. Initial positive response of a drug or as in this case a gambling behavior, most likely influences the likelihood of continuing use in non-addicted individuals. Therefore, we wanted to investigate if recreational gamblers show an altered subjective response to an online gambling challenge, e.g. to casino gambling. The present study was designed to examine the subjective effects after an acute gambling challenge, in healthy recreational gamblers compared with non-gamblers. Eighty-two subjects participated in the study. They were challenged with an acute online slot machine gambling challenge and self-report questionnaires of mood and blood pressure were taken before and after gambling. The gamblers, and more specifically the high recreational gamblers, reported increased stimulative effects after the gambling challenge in comparison to the non-gamblers. Findings suggests that gamblers experience significantly higher arousal effects to an acute online slot machine challenge. This response may be a uniquely predictive behavior for increased risk of gambling addiction.
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Affiliation(s)
- L Miller
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Blå stråket 15, SU/Sahlgrenska, 413 45, Gothenburg, Sweden.
| | - A Söderpalm Gordh
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Blå stråket 15, SU/Sahlgrenska, 413 45, Gothenburg, Sweden.,Beroendekliniken, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
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Abstract
Two general models for auditory compensation attending visual loss, structural and strategic, are discussed in the light of available research. It is suggested that previous dismissals of structural forms of auditory compensation may be in error, at least for those who are more profoundly and congenitally impaired.
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Affiliation(s)
- L. Miller
- Department of Psychology, University of Illinois at Chicago, Chicago, IL 60680
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20
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Feldsine PT, Lienau AH, Forgey RL, Calhoon RD, Al-Hasani S, Arling V, Bandiera T, Barnes M, Beatty S, Beaudoin A, Beyer D, Bryant J, Burzynski M, Carey B, Copeland F, Culver D, Danisavich T, Destro C, Diaz B, Fitzgerald S, Gallagher D, Franke W, Freshly J, Gary J, Harper M, Hermann C, Isakson T, Jenkins P, Johnson S, Ke J, Krause C, Lange K, Maki G, McDonagh S, McKee B, McLenaghan J, Miller L, Phebus R, Raghubeer E, Redding R, Retzlaff D, Richter D, Ritger C, Robinson J, Saunders L, Schwants D, Trottier Y, Tuncan E, Vanderbilt K, Ward D, West D, Woo L, Zebchek A. Visual Immunoprecipitate Assay (VIP) for Listeria monocytogenes and Related Listeria Species Detection in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.791] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Six foods representing a variety of food products were analyzed by the Assurance Listeria polyclonal enzyme immunoassay (EIA) and by either the Bacteriological Analytical Manual or the U.S. Department of Agriculture culture method for detecting Listeria monocytogenes and related Listeria species. Samples of each food type, at each inoculation level, were analyzed simultaneously by both methods. A total of 19 laboratories representing federal government agencies and private industry in the United States and Canada participated. Food types were inoculated with Listeria species including L. monocytogenes, with the exception of 3 lots of green beans, which were naturally contaminated. During this study, 1764 samples and controls were analyzed and confirmed, of which 492 were positive and 947 were negative by both methods. There were 159 samples that were positive by culture method but negative by the EIA and 188 that were negative by culture method but positive by EIA. Twenty-two samples were negative by EIA and by culture method but confirmed positive when Assurance selective enrichment broths were subcultured to selective agar. The Assurance polyclonal EIA for detecting L. monocytogenes and related Listeria species in foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Roger D Calhoon
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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21
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Feldsine PT, Falbo-Nelson MT, Brunelle SL, Forgey RL, Al-Hasani S, Ball C, Beatty S, Blanchfield B, Bowen B, Bremer N, Brookman D, Brookman S, Brushaber M, Bryant J, Bryant D, Bryant R, Chlebowski ET, Copeland F, Culak DA, Dalley E, Destro C, Finkenbiner D, Frissora R, Fung DYC, Garcia GR, Gray MR, Hagen CJ, Harshavardhan T, Hart-Thakur R, Inami G, Johnson S, Kandakai LV, Lessard D, Lin S, Liu V, Matiuck S, McAteer L, Miller L, Moon B, Nasri H, Pack L, Pilot K, Price C, Pruett P, Ramirez C, Richter D, Schmieg JA, Schultz G, Sloan EM, Sprague DM, Tebay D, Tomer J, Tuncan E, Warburton D, Watson M, West D. Assurance Enzyme Immunoassay for Detection of Enterohemorrhagic Escherichia coli 0157:H7 in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.3.530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Five foods types were analyzed by the Assurance EHEC (Escherichia coli 0157:H7) enzyme immunoassay (EIA) and by the Bacteriological Analytical Manual (BAM) culture method. Each sample of each food type at each inoculation level was simultaneously analyzed by both methods. A total of 21 laboratories representing state and federal government agencies and private industry in the United States and Canada participated. Samples were inoculated with E. coli 0157:H7, except for one lot of poultry that was naturally contaminated. A total of 1304 samples and controls were analyzed and confirmed, of which 473 were positive and 818 were negative by both methods. Thirteen samples were positive by BAM but negative by EIA. Because of the study design, it was not possible for the BAM method to produce false-negative or falsepositive results. The Assurance method for detection of E. coli OI57:H7 in selected foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | | | | | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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22
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Feldsine PT, Albo-Nelson MT, Brunelle SL, Forgey RL, Al-Hasani S, Ball C, Beatty S, Blanchfield B, Bowen B, Bremer N, Brookman D, Brookman S, Brushaber M, Bryant J, Bryant D, Bryant R, Chlebowski ET, Copeland F, Culak DA, Dalley E, Destro C, Finkenbiner D, Frissora R, Fung DYC, Garcia GR, Gray MR, Hagen CJ, Harshavardhan T, Hart-Thakur R, Inami G, Johnson S, Kandakai LV, Lessard D, Lin S, Liu V, Matiuck S, McAteer L, Miller L, Moon B, Nasri H, Pack L, Pilot K, Price C, Pruett P, Ramirez C, Richter D, Schmieg JA, Schultz G, Sloan EM, Sprague DM, Tebay D, Tomer J, Tuncan E, Warburton D, Watson M, West D. Visual Immunoprecipitate Assay (VIP) for Detection of Enterohemorrhagic Escherichia coli (EHEC) 0157:H7 in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.3.517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Five foods representative of a variety of food products were analyzed by the Visual Immunoprecipitate Assay (VIP) and the Bacteriological Analytical Manual (BAM) culture method for the presence of Escherichia coli 0157: H7. A total of 21 laboratories representing state and federal government agencies, as well as private industry, in the United States and Canada participated. Food types were inoculated with strains of E. coli 0157:H7, with the exception of one lot of poultry, which was naturally contaminated. During this study, a total of 1377 samples and controls were analyzed and confirmed, of which 508 were positive and 867 were negative by both methods. Two samples were positive by BAM and negative by VIP. Because of the study design, it was not possible for the BAM method to produce false-negative or false-positive results. The VIP assay for detection of EHEC in selected foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | | | | | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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23
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Feldsine PT, Lienau AH, Forgey RL, Calhoon RD, Al-Hasani S, Arling V, Bandiera T, Barnes M, Beatty S, Beaudoin A, Beyer D, Bryant J, Burzynski M, Carey B, Copeland F, Culver D, Destro C, Diaz B, Franke W, Gallagher D, Gary J, Harper M, Hermann C, Isakson T, Jenkins P, Johnson S, Ke J, Krause C, Lange K, Trottier YL, Maki G, McDonagh S, McLenaghan J, Miller L, Phebus R, Raghubeer E, Redding R, Retzlaff D, Richter D, Ritger C, Robinson J, Saunders L, Schwants D, Tuncan E, Vanderbilt K, Ward D, West D, Woo L, Zebchek A. Assurance Polyclonal Enzyme Immunoassay for Detection of Listeria monocytogenes and Related Listeria Species in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.775] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Six foods representing a variety of food products were analyzed by the Assurance Listeria polyclonal enzyme immunoassay (EIA) and by either the Bacteriological Analytical Manual or the U.S. Department of Agriculture culture method for detecting Listeria monocytogenes and related Listeria species. Samples of each food type, at each inoculation level, were analyzed simultaneously by both methods. A total of 19 laboratories representing federal government agencies and private industry in the United States and Canada participated. Food types were inoculated with Listeria species including L. monocytogenes, with the exception of 3 lots of green beans, which were naturally contaminated. During this study, 1764 samples and controls were analyzed and confirmed, of which 492 were positive and 947 were negative by both methods. There were 159 samples that were positive by culture method but negative by the EIA and 188 that were negative by culture method but positive by EIA. Twenty-two samples were negative by EIA and by culture method but confirmed positive when Assurance selective enrichment broths were subcultured to selective agar. The Assurance polyclonal EIA for detecting L. monocytogenes and related Listeria species in foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Roger D Calhoon
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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24
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Feldsine PT, Mui LA, Forgey RL, Kerr DE, Al-Hasani S, Arling V, Beatty S, Bohannon J, Brannan J, Brown N, Bryant J, Burford M, Chavez C, Chinault K, Cooan N, Copeland F, Dixon L, Fitzgerald S, Franke W, Frissora R, Gailbreath K, Godon S, Good M, Ha T, Hagen H, Hanson S, Johnson K, Koch S, Leung S, Lienau A, Lin J, Lin S, Marolla B, Maycock L, McDonagh S, Miller L, Otten N, Post R, Resutek J, Rice B, Richter D, Ritger C, Schwantes D, Simon J, Smith J, Smith S, Stokes R, Thibideau J, Tuncan E, Uber D, Van Landingham V, Vrana D, West D. Equivalence of Assurance® Gold Enzyme Immunoassay for Visual or Instrumental Detection of Motile and Nonmotile Salmonella in All Foods to AOAC Culture Method: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/83.4.871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Six foods representative of a wide variety of processed, dried powder processed, and raw food types were analyzed by the Assurance® Gold Salmonella Enzyme Immunoassay (EIA) and AOAC INTERNATIONAL culture method. Paired samples of each food type were simultaneously analyzed; one sample by the Assurance method and one by the AOAC culture method. The results for Assurance method were read visually and instrumentally with a microplate reader. A total of 24 laboratories representing federal government agencies and private industry, in the United States and Canada, participated in this collaborative study. Food types were inoculated with species of Salmonella with the exception of raw ground chicken, which was naturally contaminated. No statistical differences (p < 0.05) were observed between Assurance Gold Salmonella EIA with either visual or instrumental interpretation and the AOAC culture method for any inoculation level of any food type or naturally contaminated food. The Assurance visual and instrumental options of reading sample reactions produced the same results for 1277 of the 1296 sample and controls analyzed.
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Affiliation(s)
| | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - Robin L Forgey
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - David E Kerr
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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25
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Jaworski L, Griffith K, Mancini B, Jolly S, Boike T, Moran J, Dominello M, Wilson M, Parker J, Burmeister J, Gardner S, Fraser C, Miller L, Baldwin K, Mietzel M, Grubb M, Kendrick D, Pierce L, Spratt D, Hayman J. Contemporary Practice Patterns for Radiotherapy of Bone Metastases: Preliminary Analysis of Prospective Data from a Statewide Consortium Focusing on Extended Fractionation. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.162] [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]
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Jean K, Chummar S, Miller L. C-04 Cognitive Status, Tau levels, and Depression in Older Adults. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.166] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Worsening cognitive status has been related to depression in older adults. The purpose of this study was to examine the relation between cognitive status and depression and whether this relation was dependent upon tau levels, a biomarker for brain pathology related to Alzheimer’s disease (AD) and other dementias.
Method
This study consisted of 507 older adults with a mean age of 74. Participants were 40.9% female and 93.9% Caucasian. Neuropsychological assessments, collateral report, and clinician ratings were used to classify each participant by their cognitive status (i.e., cognitively normal (CN), early mild cognitive impairment (MCI), late MCI, or AD). Depression was based on the total score of the Geriatric Depression Scale (GDS). A hierarchical multiple regression was used to analyze the amount of variance explained in depression scores, controlling for age.
Results
There was a significant relation between cognitive status and GDS, with cognitive status explaining 2.8% of the variance (R-squared = .028, p < .001). Tau explained .6% of the variance in depression scores above and beyond what was explained by cognitive status and age (p = .089). The interaction between cognitive status and tau explained .4% of the variance in depression scores, ΔR-squared = .004, p = .160.
Conclusions
While this suggests cognitive status and depression may not be dependent upon tau levels in this sample, further research should be done to determine whether other sensitive measures of brain pathology, such as the ratio between phosphorylated tau and total tau, may be relevant in the prediction and diagnosis of depression in individuals with varying levels of cognitive status.
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Wyrzykowska-Ceradini B, Calfee MW, Touati A, Wood J, Mickelsen RL, Miller L, Colby M, Slone C, Gatchalian NG, Pongur SG, Aslett D. The use of bacteriophage MS2 for the development and application of a virucide decontamination test method for porous and heavily soiled surfaces. J Appl Microbiol 2019; 127:1315-1326. [PMID: 31379024 DOI: 10.1111/jam.14406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 07/11/2019] [Accepted: 07/23/2019] [Indexed: 11/29/2022]
Abstract
AIMS (i) To develop an analytical method for recovery and quantification of bacteriophage MS2-as a surrogate for foot-and-mouth disease virus-from complex porous surfaces, with and without the presence of laboratory-developed agricultural grime; (ii) to evaluate, with a 4-log dynamic range, the virucidal activity of common biocides for their ability to decontaminate surfaces and hence remediate facilities, following a foreign animal disease contamination incident. METHODS AND RESULTS An analytical method was developed and optimized for MS2 recovery from simulated agricultural surfaces. The addition of Dey-Engley neutralizing broth to an extraction buffer improved MS2 viability in liquid extracts, with optimal analytical holding times determined as <8 to ≤24 h, depending on matrix. The recovery of MS2 from surface materials decreased in the order: nonporous reference material >grimed porous materials >nongrimed porous materials. In disinfectant testing, two spray applications of pAB were effective against MS2 (≥4-log reduction) on all operational-scale materials. Two per cent citric acid had limited effectiveness, with a ≥4-log reduction observed on a selected subset of grimed concrete samples. CONCLUSIONS Decontamination efficacy test results can be affected by surface characteristics, extraction buffer composition, analytical holding time and surface-specific organism survivability. Efficacy should be evaluated using a test method that reflects the environmental characteristics of the intended application. SIGNIFICANCE AND IMPACT OF THE STUDY The results of this study demonstrate the importance of analytical method verification tests for disinfectant testing prior to application in complex environments.
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Affiliation(s)
| | - M W Calfee
- Decontamination and Consequence Management Division, National Homeland Security Research Center, Office of Research and Development, US Environmental Protection Agency (US EPA), Research Triangle Park, NC, USA
| | - A Touati
- Jacobs Technology Inc., Tullahoma, TN, USA
| | - J Wood
- Decontamination and Consequence Management Division, National Homeland Security Research Center, Office of Research and Development, US Environmental Protection Agency (US EPA), Research Triangle Park, NC, USA
| | - R L Mickelsen
- CBRN Consequence Management Advisory Division, Office of Land and Emergency Management, US EPA, Research Triangle Park, NC, USA
| | - L Miller
- Animal and Plant Health Inspection Service, US Department of Agriculture (USDA), Riverdale, MD, USA
| | - M Colby
- National Institute of Food and Agriculture, USDA, Washington, DC, USA
| | - C Slone
- Jacobs Technology Inc., Tullahoma, TN, USA
| | | | - S G Pongur
- Jacobs Technology Inc., Tullahoma, TN, USA
| | - D Aslett
- Jacobs Technology Inc., Tullahoma, TN, USA
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Price NJ, Saunderson CE, O"neill J, Mcdiarmid AK, Erhayiem B, Miller L, Malhotra A, Sharma S, Plein S, Greenwood JP, Swoboda PP. P143Association of left atrial size and function and aerobic fitness in endurance athletes. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez117.006] [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)
- N J Price
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - C E Saunderson
- University of Leeds, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - J O"neill
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - A K Mcdiarmid
- University of Leeds, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - B Erhayiem
- University of Leeds, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - L Miller
- St George"s University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - A Malhotra
- St George"s University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - S Sharma
- St George"s University of London, London, United Kingdom of Great Britain & Northern Ireland
| | - S Plein
- University of Leeds, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - J P Greenwood
- University of Leeds, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - P P Swoboda
- University of Leeds, Leeds, United Kingdom of Great Britain & Northern Ireland
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Archer N, Kim D, Lee S, Ortines R, Wang Y, Liu H, Miller R, Dillen C, Marchitto M, Ashbaugh A, Uppal A, Cai S, Garza L, Miller L. 036 CXCL10 expression is regulated by keratinocyte STAT3 signaling and inhibits skin inflammation. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.112] [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]
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Kerns M, Miller R, Archer N, Byrd A, Mazhar M, Miller L, Chien A, Kang S. 766 NRF2-mediated inhibition of UVB-induced hyperpigmentation by topical sulforaphane is dependent on upregulation of IL6Rα expression on keratinocytes. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.842] [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]
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Wier E, Pielstick B, Hintelmann C, Archer N, Ortines R, Miller L, Garza L. 957 Local skin wounding reduces systemic antibody-mediated neutrophil depletion. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.1033] [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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Larson V, Tang O, Ständer S, Miller L, Kang S, Kwatra S. 238 Association between prurigo nodularis and malignancy in middle-aged adults. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.314] [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]
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Whang K, Huang A, Miller L, Kang S, Kwatra S. 175 Association of particulate matter air pollution and itch: a digital epidemiology approach. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.251] [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: 11/17/2022]
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Nolan S, Mazhar M, Liu H, Archer N, Dikeman D, Ortines R, Wang Y, Miller R, Alphonse M, Caviness G, Ramanujam M, Raymond E, Miller L. 505 Therapeutic activity of an anti-IL36R blocking antibody in inhibiting atopic dermatitis-like skin inflammation in mice. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.581] [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]
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Islam N, Silverman R, Liu H, Miller L, Huang W, Kane M, Kim D, Garza L. 959 Regulation of IL36-mediated skin regeneration by non-coding RNA sensing. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.1035] [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]
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Brooks E, Early SR, Gendel MH, Miller L, Gundersen DC. Helping the healer: population-informed workplace wellness recommendations for physician well-being. Occup Med (Lond) 2019; 68:279-281. [PMID: 29596682 DOI: 10.1093/occmed/kqy018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The need to keep physicians healthy and in practice is critical as demand for doctors grows faster than the supply. Workplace wellness programmes can improve employee health and retain skilled workers. Aims To broaden our understanding about ways to help doctors coping with mental health problems and to develop population-informed workplace wellness recommendations for physician populations. Methods Researchers surveyed physicians to document potential warning signs and prevention strategies. A survey was issued to doctors who presented to a physician health programme with mental health complaints. The survey captured respondents' feedback about how to identify and prevent mental health problems. Data were analyzed using simple descriptive statistics. Results There were 185 participants. Half of respondents believed their problems could have been recognized sooner and 60% said they exhibited signs that could aid in earlier detection. Potential warnings included fluctuations in mood (67%), increased comments about stress/burnout (49%) and behavioural changes (32%). To improve detection, prevention and care-seeking for mental health problems, doctors endorsed multiple items related to the use of interpersonal supports, personal factors and organizational dynamics throughout the survey. Conclusions The findings confirmed earlier work demonstrating the value of social and organizational support in maintaining physician health. It further indicated that earlier identification and/or prevention of mental health problems is not only possible, but that medical organizations are uniquely situated to carry out this work.
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Affiliation(s)
- E Brooks
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.,Colorado Physician Health Program, Denver, CO, USA
| | - S R Early
- Colorado Physician Health Program, Denver, CO, USA
| | - M H Gendel
- Colorado Physician Health Program, Denver, CO, USA
| | - L Miller
- University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
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Gunn H, Andrade J, Paul L, Miller L, Stevens K, Creanor S, Green C, Ewings P, Barton A, Berrow M, Vickery J, Marshall B, Marsden J, Freeman J. Balance Right in Multiple Sclerosis (BRiMS): Preliminary results of a randomised controlled feasibility trial. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.281] [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]
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Campbell R, Woodard J, Miller L, Davey A, Martin P, Poon L. SENSORY IMPAIRMENT IS RELATED TO BETTER MEMORY PERFORMANCE IN THE FULD OBJECT MEMORY EVALUATION. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.423] [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: 11/12/2022] Open
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Miller L, Jenny N, Rawlings A, Arnold A, Fitzpatrick A, Lopez O, Odden M. SEX DIFFERENCES IN THE ASSOCIATION BETWEEN PENTRAXIN 3 AND COGNITIVE DECLINE: THE CARDIOVASCULAR HEALTH STUDY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2614] [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: 11/12/2022] Open
Affiliation(s)
| | - N Jenny
- University of Vermont, Burlington, VT, USA
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Looney T, Lowman G, Miller L, Linch E. TCR beta chain convergence defines the tumor infiltrating T cell repertoire of melanoma and non-small cell lung carcinoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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Bauml J, Mick R, Ciunci C, Aggarwal C, Davis C, Evans T, Deshpande C, Miller L, Patel P, Alley E, Knepley C, Mutale F, Cohen R, Langer C. OA07.01 Phase II Study of Pembrolizumab for Oligometastatic Non-Small Cell Lung Cancer (NSCLC) Following Completion of Locally Ablative Therapy (LAT). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.269] [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: 11/24/2022]
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Miller L, Leeth EA, Johnson EK, Rosoklija I, Chen D, Aufox SA, Finlayson C. Attitudes toward 'Disorders of Sex Development' nomenclature among physicians, genetic counselors, and mental health clinicians. J Pediatr Urol 2018; 14:418.e1-418.e7. [PMID: 30224300 DOI: 10.1016/j.jpurol.2018.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/07/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION In 2006, nomenclature referencing atypical sex development (i.e., 'intersex') was updated, and the term disorder of sex development (DSD) was formally introduced. Clinicians, patients, and parents, however, have not universally accepted the new terminology, and some continue to use different nomenclature. This inconsistency in terminology can lead to confusion among clinicians and patients, affect clinician-patient relationships, and interfere with the recommended multidisciplinary model for DSD care. OBJECTIVE This study sought to (1) evaluate frequency of use and comfort with specific DSD terminology, (2) assess why clinicians are not using specific terms, and (3) determine what terms are being heard within the medical community and by the public in a sample of physicians, genetic counselors, and licensed mental health clinicians. STUDY DESIGN A Web-based survey assessing the use of DSD terminology was distributed to endocrinologists, urologists, genetic counselors, and mental health clinicians. The survey assessed frequency of use and comfort with specific terms, negative experiences related to specific nomenclature use, and the context in which terms are used (e.g. case conference, literature, patient/parents, and media). A qualitative analysis of open-ended responses was conducted to characterize reasons for avoiding specific terms. RESULTS The survey was completed by 286 clinicians. There were significant differences between specialties in comfort and frequency of use of specific terms, and significant differences were based on clinician gender, patient volume, length of time in practice, and practice setting. The study results also showed a difference in the nomenclature used within the medical community versus the media. DISCUSSION Study findings are consistent with previous research exploring medical professionals' use of the new term: disorder of sex development. However, there continues to be inconsistency in the uptake of this new terminology. Words that have been purposed in the literature to replace disorder, such as difference and variation, would be accepted by clinicians, and the word divergent would not. This study expands on the existing literature documenting high uptake of disorder of sex development nomenclature among medical professionals. In addition, this study demonstrates that the most common diagnostic terms used by the medical community are not the same terms being presented to the public by the media. CONCLUSION Medical professionals have varying preferences for terminology use when describing DSD, which can affect patient care. These results can be used in the future to compare with what patients and advocates prefer to develop a more universally accepted approach to nomenclature.
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Affiliation(s)
- L Miller
- Northwestern University Graduate Program in Genetic Counseling Northwestern University, 645 N. Michigan Avenue, Suite 630-08 Chicago, IL 60611, USA.
| | - E A Leeth
- Northwestern University Center for Genetic Medicine, 645 N. Michigan Avenue, Suite 630-16 Chicago, IL 60611, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue Chicago, IL 60611, USA; Division Endocrinology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue Chicago, IL 60611, USA
| | - E K Johnson
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue Chicago, IL 60611, USA; Department of Urology, Northwestern University Feinberg School of Medicine, 676 N St Clair Suite 2300 Chicago, IL 60611, USA; Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, 633 N. Saint Clair 20th Floor Chicago, IL 60611, USA
| | - I Rosoklija
- Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue Chicago, IL 60611, USA
| | - D Chen
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue Chicago, IL 60611, USA; Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue Chicago, IL 60611, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 East Ontario #7-200 Chicago, IL 60611, USA; Department of Child and Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue Chicago, IL 60611, USA
| | - S A Aufox
- Northwestern University Graduate Program in Genetic Counseling Northwestern University, 645 N. Michigan Avenue, Suite 630-08 Chicago, IL 60611, USA; Northwestern University Center for Genetic Medicine, 645 N. Michigan Avenue, Suite 630-16 Chicago, IL 60611, USA
| | - C Finlayson
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 E. Chicago Avenue Chicago, IL 60611, USA; Division Endocrinology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue Chicago, IL 60611, USA
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Redondo MJ, Geyer S, Steck AK, Sharp S, Wentworth JM, Weedon MN, Antinozzi P, Sosenko J, Atkinson M, Pugliese A, Oram RA, Antinozzi P, Atkinson M, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Colman P, Gottlieb P, Herold K, Insel R, Kay T, Knip M, Marks J, Moran A, Palmer J, Peakman M, Philipson L, Pugliese A, Raskin P, Rodriguez H, Roep B, Russell W, Schatz D, Wherrett D, Wilson D, Winter W, Ziegler A, Benoist C, Blum J, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Kaufman F, Leschek E, Mahon J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Roncarolo M, Simell O, Sherwin R, Siegelman M, Steck A, Thomas J, Trucco M, Wagner J, Greenbaum ,CJ, Bourcier K, Insel R, Krischer JP, Leschek E, Rafkin L, Spain L, Cowie C, Foulkes M, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Kenyon NS, Santiago I, Sosenko JM, Bundy B, Abbondondolo M, Adams T, Amado D, Asif I, Boonstra M, Bundy B, Burroughs C, Cuthbertson D, Deemer M, Eberhard C, Fiske S, Ford J, Garmeson J, Guillette H, Browning G, Coughenour T, Sulk M, Tsalikan E, Tansey M, Cabbage J, Dixit N, Pasha S, King M, Adcock K, Geyer S, Atterberry H, Fox L, Englert K, Mauras N, Permuy J, Sikes K, Berhe T, Guendling B, McLennan L, Paganessi L, Hays B, Murphy C, Draznin M, Kamboj M, Sheppard S, Lewis V, Coates L, Moore W, Babar G, Bedard J, Brenson-Hughes D, Henderson C, Cernich J, Clements M, Duprau R, Goodman S, Hester L, Huerta-Saenz L, Karmazin A, Letjen T, Raman S, Morin D, Henry M, Bestermann W, Morawski E, White J, Brockmyer A, Bays R, Campbell S, Stapleton A, Stone N, Donoho A, Everett H, Heyman K, Hensley H, Johnson M, Marshall C, Skirvin N, Taylor P, Williams R, Ray L, Wolverton C, Nickels D, Dothard C, Hsiao B, Speiser P, Pellizzari M, Bokor L, Izuora K, Abdelnour S, Cummings P, Paynor S, Leahy M, Riedl M, Shockley S, Karges C, Saad R, Briones T, Casella S, Herz C, Walsh K, Greening J, Hay F, Hunt S, Sikotra N, Simons L, Keaton N, Karounos D, Oremus R, Dye L, Myers L, Ballard D, Miers W, Sparks R, Thraikill K, Edwards K, Fowlkes J, Kinderman A, Kemp S, Morales A, Holland L, Johnson L, Paul P, Ghatak A, Phelen K, Leyland H, Henderson T, Brenner D, Law P, Oppenheimer E, Mamkin I, Moniz C, Clarson C, Lovell M, Peters A, Ruelas V, Borut D, Burt D, Jordan M, Leinbach A, Castilla S, Flores P, Ruiz M, Hanson L, Green-Blair J, Sheridan R, Wintergerst K, Pierce G, Omoruyi A, Foster M, Linton C, Kingery S, Lunsford A, Cervantes I, Parker T, Price P, Urben J, Doughty I, Haydock H, Parker V, Bergman P, Liu S, Duncum S, Rodda C, Thomas A, Ferry R, McCommon D, Cockroft J, Perelman A, Calendo R, Barrera C, Arce-Nunez E, Lloyd J, Martinez Y, De la Portilla M, Cardenas I, Garrido L, Villar M, Lorini R, Calandra E, D’Annuzio G, Perri K, Minuto N, Malloy J, Rebora C, Callegari R, Ali O, Kramer J, Auble B, Cabrera S, Donohoue P, Fiallo-Scharer R, Hessner M, Wolfgram P, Maddox K, Kansra A, Bettin N, McCuller R, Miller A, Accacha S, Corrigan J, Fiore E, Levine R, Mahoney T, Polychronakos C, Martin J, Gagne V, Starkman H, Fox M, Chin D, Melchionne F, Silverman L, Marshall I, Cerracchio L, Cruz J, Viswanathan A, Miller J, Wilson J, Chalew S, Valley S, Layburn S, Lala A, Clesi P, Genet M, Uwaifo G, Charron A, Allerton T, Milliot E, Cefalu W, Melendez-Ramirez L, Richards R, Alleyn C, Gustafson E, Lizanna M, Wahlen J, Aleiwe S, Hansen M, Wahlen H, Moore M, Levy C, Bonaccorso A, Rapaport R, Tomer Y, Chia D, Goldis M, Iazzetti L, Klein M, Levister C, Waldman L, Muller S, Wallach E, Regelmann M, Antal Z, Aranda M, Reynholds C, Leech N, Wake D, Owens C, Burns M, Wotherspoon J, Nguyen T, Murray A, Short K, Curry G, Kelsey S, Lawson J, Porter J, Stevens S, Thomson E, Winship S, Wynn L, O’Donnell R, Wiltshire E, Krebs J, Cresswell P, Faherty H, Ross C, Vinik A, Barlow P, Bourcier M, Nevoret M, Couper J, Oduah V, Beresford S, Thalagne N, Roper H, Gibbons J, Hill J, Balleaut S, Brennan C, Ellis-Gage J, Fear L, Gray T, Pilger J, Jones L, McNerney C, Pointer L, Price N, Few K, Tomlinson D, Denvir L, Drew J, Randell T, Mansell P, Roberts A, Bell S, Butler S, Hooton Y, Navarra H, Roper A, Babington G, Crate L, Cripps H, Ledlie A, Moulds C, Sadler K, Norton R, Petrova B, Silkstone O, Smith C, Ghai K, Murray M, Viswanathan V, Henegan M, Kawadry O, Olson J, Stavros T, Patterson L, Ahmad T, Flores B, Domek D, Domek S, Copeland K, George M, Less J, Davis T, Short M, Tamura R, Dwarakanathan A, O’Donnell P, Boerner B, Larson L, Phillips M, Rendell M, Larson K, Smith C, Zebrowski K, Kuechenmeister L, Wood K, Thevarayapillai M, Daniels M, Speer H, Forghani N, Quintana R, Reh C, Bhangoo A, Desrosiers P, Ireland L, Misla T, Xu P, Torres C, Wells S, Villar J, Yu M, Berry D, Cook D, Soder J, Powell A, Ng M, Morrison M, Young K, Haslam Z, Lawson M, Bradley B, Courtney J, Richardson C, Watson C, Keely E, DeCurtis D, Vaccarcello-Cruz M, Torres Z, Alies P, Sandberg K, Hsiang H, Joy B, McCormick D, Powell A, Jones H, Bell J, Hargadon S, Hudson S, Kummer M, Badias F, Sauder S, Sutton E, Gensel K, Aguirre-Castaneda R, Benavides Lopez V, Hemp D, Allen S, Stear J, Davis E, Jones T, Baker A, Roberts A, Dart J, Paramalingam N, Levitt Katz L, Chaudhary N, Murphy K, Willi S, Schwartzman B, Kapadia C, Larson D, Bassi M, McClellan D, Shaibai G, Kelley L, Villa G, Kelley C, Diamond R, Kabbani M, Dajani T, Hoekstra F, Magorno M, Beam C, Holst J, Chauhan V, Wilson N, Bononi P, Sperl M, Millward A, Eaton M, Dean L, Olshan J, Renna H, Boulware D, Milliard C, Snyder D, Beaman S, Burch K, Chester J, Ahmann A, Wollam B, DeFrang D, Fitch R, Jahnke K, Bounmananh L, Hanavan K, Klopfenstein B, Nicol L, Bergstrom R, Noland T, Brodksy J, Bacon L, Quintos J, Topor L, Bialo S, Bream S, Bancroft B, Soto A, Lagarde W, Lockemer H, Vanderploeg T, Ibrahim M, Huie M, Sanchez V, Edelen R, Marchiando R, Freeman D, Palmer J, Repas T, Wasson M, Auker P, Culbertson J, Kieffer T, Voorhees D, Borgwardt T, 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Trunnel S, Transue D, Surhigh J, Bezzaire D, Moltz K, Zacharski E, Henske J, Desai S, Frizelis K, Khan F, Sjoberg R, Allen K, Manning P, Hendry G, Taylor B, Jones S, Couch R, Danchak R, Lieberman D, Strader W, Bencomo M, Bailey T, Bedolla L, Roldan C, Moudiotis C, Vaidya B, Anning C, Bunce S, Estcourt S, Folland E, Gordon E, Harrill C, Ireland J, Piper J, Scaife L, Sutton K, Wilkins S, Costelloe M, Palmer J, Casas L, Miller C, Burgard M, Erickson C, Hallanger-Johnson J, Clark P, Taylor W, Galgani J, Banerjee S, Banda C, McEowen D, Kinman R, Lafferty A, Gillett S, Nolan C, Pathak M, Sondrol L, Hjelle T, Hafner S, Kotrba J, Hendrickson R, Cemeroglu A, Symington T, Daniel M, Appiagyei-Dankah Y, Postellon D, Racine M, Kleis L, Barnes K, Godwin S, McCullough H, Shaheen K, Buck G, Noel L, Warren M, Weber S, Parker S, Gillespie I, Nelson B, Frost C, Amrhein J, Moreland E, Hayes A, Peggram J, Aisenberg J, Riordan M, Zasa J, Cummings E, Scott K, Pinto T, Mokashi A, McAssey K, Helden E, Hammond P, Dinning L, Rahman S, Ray S, Dimicri C, Guppy S, Nielsen H, Vogel C, Ariza C, Morales L, Chang Y, Gabbay R, Ambrocio L, Manley L, Nemery R, Charlton W, Smith P, Kerr L, Steindel-Kopp B, Alamaguer M, Tabisola-Nuesca E, Pendersen A, Larson N, Cooper-Olviver H, Chan D, Fitz-Patrick D, Carreira T, Park Y, Ruhaak R, Liljenquist D. A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk. Diabetes Care 2018; 41:1887-1894. [PMID: 30002199 PMCID: PMC6105323 DOI: 10.2337/dc18-0087] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/06/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals. RESEARCH DESIGN AND METHODS We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables. RESULTS Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002). CONCLUSIONS The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.
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Affiliation(s)
- Maria J. Redondo
- Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | | | - Andrea K. Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Seth Sharp
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | - John M. Wentworth
- Walter and Eliza Hall Institute of Medical Research and Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Michael N. Weedon
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | | | | | | | | | - Richard A. Oram
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
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Looney T, Miller L, Lowman G, Linch E, Zheng J, Topacio-Hall D. 23 Evidence for antigen-driven TCRB chain convergence in the tumourinfiltrating t cell repertoire of 148 research subjects with melanoma. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.23] [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: 11/04/2022] Open
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Linch E, Miller L, Looney T, Zheng A, Topacio-Hall D, Nistala G, Lowman G, Hyland F, Andersen M. PO-394 Performance of a targeted T cell receptor beta immune repertoire sequencing panel in several FFPE tissue types – a tool for interrogation of the tumour microenvironment. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.906] [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: 11/03/2022] Open
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Ortines R, Liu H, Cheng L, Cohen T, Lawlor H, Gami A, Wang Y, Dillen C, Archer N, Miller R, Ashbaugh A, Pinsker B, Marchitto M, Tkaczyk C, Stover C, Sellman B, Miller L. 1431 Neutralizing α-toxin accelerates healing of Staphylococcus aureus-infected wounds in normal and diabetic mice. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1449] [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: 10/17/2022]
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Lowman G, Looney T, Glavin A, Linch E, Miller L, Topacio-Hall D, Pabla S, Glenn S, Pankov A, Zheng J, Hartberg R, Almåsbak H, Stav-Noraas T, Kullmann A, Conroy J, Morrison C, Hyland F, Andersen M. Insights into the tumor microenvironment and human TRBV gene polymorphism revealed by long-amplicon immune repertoire sequencing. Eur J Cancer 2018. [DOI: 10.1016/j.ejca.2018.01.028] [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]
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Kota K, Bossart E, Basudan A, Minteer T, Meier C, Brown D, Gurda GT, Miller L, Dabbs DJ, Lee A, Puhalla S, Jankowitz R, McAuliffe P, Lucas P, Oesterreich S. Abstract P5-06-03: Generation and characterization of a novel invasive lobular breast carcinoma cell line WCRC-25. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-06-03] [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
Background: Invasive Lobular Breast Carcinoma (ILC) is the second most common histologic subtype of breast cancer, comprising 10-15% of all cases. ILC is clinically and molecularly distinguished from the major subtype–Invasive Ductal Carcinoma (IDC)–by loss of E-cadherin (CDH1). Studies on ILC remain sparse, in part due to limited cell culture models. The Women's Cancer Research Center (WCRC) has therefore set up a combined effort of breast surgical oncologists, medical oncologists, pathologists, and cancer biologists to collect fresh tissues and establish additional ILC cell lines.
Methods: Tumor cells were grown using irradiated fibroblast conditioned media (CM) in hypoxic (5% O2) conditions. Sanger sequencing and Droplet Digital PCR (ddPCR) were utilized to test for mutation in CDH1 in tumor and circulating DNA (cfDNA), using germline DNA as control. DNA copy number status in the tumor was detected using nanoString approach. Expression of E-cadherin and a series of lineage markers was elucidated using Immunoblotting (IB) and Immunofluorescence (IF). A panel of ILC (MDA-MB-134, Sum44PE, IPH-926) and IDC (MCF-7, MDA-MB-231) cell lines was included for comparison. After establishment, WCRC-25 population doubling was compared between growth in CM or Dulbecco's Modified Eagle's Medium (DMEM), and hypoxic (5% O2) or normoxic (21% O2) conditions. Growth phenotypes were characterized in 2D, Ultra Low Attachment (ULA), and soft agar.
Results: WCRC-25 was successfully established from the pleural effusion of a 77-year old patient with metastatic ILC. The patient had stage IV (T3N3M1) ER+/PR-/HER2- ILC; was treated with bilateral mastectomy, radiation therapy, and multiple lines of chemotherapy (FOLFOX due to initial misdiagnosis; 2 cycles carboplatin/paclitaxel; anastrazole, fulvestrant, pegylated liposomal doxorubicin, gemcitabine, exemastane, and eribulin (with denosumab for bone lesions); had metastatic lesions in stomach, bone, pleura, and pericardium; and ultimately passed away from progressive pleural effusions roughly 3 years after diagnosis. A novel nonsense mutation of CDH1 was observed in exon 13 (Q705*) in cell line DNA, resulting in a premature stop codon. The same mutation was confirmed in cfDNA obtained from longitudinal blood samples from the patient. Copy number analysis revealed deletion of the second CDH1 copy in tumor, and E-cadherin protein loss was confirmed by IB and IF. WCRC-25 cells expressed epithelial cell markers CK8/18 and EpCAM, and as expected did not express stromal marker αSMA. ERα expression was very low, and not sufficient for measurable hormone response. Population doubling was significantly faster in hypoxic compared to normoxic conditions, regardless of media type, but minimal in 3D.
Conclusions: WCRC-25 is a novel ILC cell line, defined by CDH1 nonsense truncating mutation and LOH, resulting in loss of E-cadherin protein expression. Cells show favorable growth characteristics in hypoxic conditions and maintain epithelial-dominated protein expression. We are currently performing RNA seq analysis of the matched primary tumor and metastatic samples from the stomach, peritoneum/falciform ligament, pleural effusion and skin, which we will compare and contrast with that of the established WCRC-25 cell line.
Citation Format: Kota K, Bossart E, Basudan A, Minteer T, Meier C, Brown D, Gurda GT, Miller L, Dabbs DJ, Lee A, Puhalla S, Jankowitz R, McAuliffe P, Lucas P, Oesterreich S. Generation and characterization of a novel invasive lobular breast carcinoma cell line WCRC-25 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-06-03.
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Affiliation(s)
- K Kota
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - E Bossart
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - A Basudan
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - T Minteer
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - C Meier
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - D Brown
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - GT Gurda
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - L Miller
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - DJ Dabbs
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - A Lee
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - S Puhalla
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - R Jankowitz
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - P McAuliffe
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - P Lucas
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
| | - S Oesterreich
- University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Colgate University, Hamilton, NY; Gundersen Health Systems, La Crosse, WI
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Bauml J, Mick R, Ciunci C, Aggarwal C, Evans T, Miller L, Muhammad N, Alley E, Knepley C, Mutale F, Cohen R, Langer C. OA 17.08 Phase II Study of Pembrolizumab for Oligometastatic Non-Small Cell Lung Cancer (NSCLC) Following Completion of Locally Ablative Therapy (LAT). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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Lindbergh C, Lv J, Zhao Y, Mewborn C, Puente A, Terry D, Renzi-hammond L, Hammond B, Liu T, Miller L. Aging and Dementia-2Cognitive Reserve Moderates the Positive Relation Between Older Ages and Inter-connectivity of Resting State Networks. Arch Clin Neuropsychol 2017. [DOI: 10.1093/arclin/acx075.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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