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Nelson M, Zhang X, Podgaetz E, Melmed A, Spechler SJ, Souza RF. In Human Esophageal Epithelial and Muscle Cells Treated With Th2 Cytokines, Upadacitinib Decreases Eotaxin-3 Secretion and Muscle Tension. Gastroenterology 2024:S0016-5085(24)00173-2. [PMID: 38364911 DOI: 10.1053/j.gastro.2024.02.011] [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] [Received: 11/17/2023] [Revised: 01/23/2024] [Accepted: 02/11/2024] [Indexed: 02/18/2024]
Affiliation(s)
- Melissa Nelson
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center, Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Xi Zhang
- Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Eitan Podgaetz
- Center for Thoracic Surgery, Center for Esophageal Diseases, Baylor University Medical Center, Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Ava Melmed
- Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Stuart J Spechler
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center, Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Rhonda F Souza
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center, Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas.
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Jenkins W, Starke EM, Nelson M, Milleman K, Milleman J, Ward M. The effects of scaling and root planing plus home oral hygiene maintenance in Stage I/II periodontitis population: A 24-week randomized clinical trial. Int J Dent Hyg 2024. [PMID: 38289823 DOI: 10.1111/idh.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 07/11/2023] [Accepted: 01/07/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVES To compare the effects of powered and manual toothbrushing following scaling and root planing on bleeding on probing and other clinical indicators of periodontitis. MATERIALS AND METHODS This was a randomized, examiner-blind, parallel-design, 24-week clinical study. Eligible subjects were 18-75 years of age with Stage I or II periodontitis. All subjects received scaling and root planing (SRP) within 28 days of enrollment. Thereafter, subjects were randomized to twice daily at-home use of either a powered toothbrush (PTB) or a manual toothbrush (MTB). Randomization was balanced for gender and periodontitis stage. No other oral hygiene aids were permitted. Subjects were evaluated every 4 weeks for the following measures: bleeding on probing (BOP), surface plaque (MPI), probing pocket depth (PPD) and clinical attachment level until Week 24. RESULTS Of 328 randomized subjects, 299 subjects completed the study. For BOP at Week 24, the Least Squares (LS) Mean, standard error (SE) reduction from baseline was 0.24 (0.01) for the PTB group and 0.02 (0.01) for the MTB group, resulting in a statistically significant treatment difference of 0.22 (0.01), p-value < 0.0001. There were also concomitant reductions in MPI and PPD at Week 24, resulting in statistically significant (p-value < 0.0001) LS Mean (SE) treatment differences of 0.86 (0.04) and 0.24 (0.01), for MPI and PPD, respectively. CONCLUSION When combined with SRP, daily home oral hygiene maintenance including a powered toothbrush significantly reduced clinical symptoms of periodontitis and surface plaque levels compared to a manual toothbrush in a Stage I/II periodontitis population. (ClinicalTrials.gov Identifier: NCT04254770).
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Affiliation(s)
| | | | - Melissa Nelson
- Innovation and Strategy Chief Medical Office Philips, Bothell, Washington, USA
| | | | | | - Marilyn Ward
- Philips Oral Healthcare, Bothell, Washington, USA
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Scarone P, Chatterjea A, Jenniskens I, Klüter T, Weuster M, Lippross S, Presilla S, Distefano D, Chianca V, Sedaghat S, Nelson M, Lampe F, Seekamp A. Correction: Percutaneous thoraco‑lumbar‑sacral pedicle screw placement accuracy results from a multi‑center, prospective clinical study using a skin marker‑based optical navigation system. Eur Spine J 2023; 32:4470. [PMID: 37861725 DOI: 10.1007/s00586-023-07989-7] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Affiliation(s)
- Pietro Scarone
- Department of Neurosurgery, Neurocenter of Southern Switzerland, Ospedale Regionale Di Lugano Civico E Italiano, Lugano, Switzerland
| | - Anindita Chatterjea
- Image Guided Therapy Systems, Philips Healthcare, Veenpluis 6, 5684 PC, Best, The Netherlands.
| | - Inge Jenniskens
- Image Guided Therapy Systems, Philips Healthcare, Veenpluis 6, 5684 PC, Best, The Netherlands
| | - Tim Klüter
- Klinik Für Orthopädie Und Unfallchirurgie, UKSH, Campus Kiel, Kiel, Germany
| | - Matthias Weuster
- Klinik Für Orthopädie Und Unfallchirurgie, UKSH, Campus Kiel, Kiel, Germany
| | - Sebastian Lippross
- Klinik Für Orthopädie Und Unfallchirurgie, UKSH, Campus Kiel, Kiel, Germany
| | - Stefano Presilla
- Department of Neurosurgery, Neurocenter of Southern Switzerland, Ospedale Regionale Di Lugano Civico E Italiano, Lugano, Switzerland
| | - Daniela Distefano
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Ospedale Regionale Di Lugano Civico E Italiano, Lugano, Switzerland
| | - Vito Chianca
- Clinica di Radiologia EOC IIMSI, Lugano, Switzerland
- Ospedale Evangelico Betania, Naples, Italy
| | - Sam Sedaghat
- Department of Neurosurgery, Neurocenter of Southern Switzerland, Ospedale Regionale Di Lugano Civico E Italiano, Lugano, Switzerland
| | - Melissa Nelson
- Image Guided Therapy Systems, Philips Healthcare, Veenpluis 6, 5684 PC, Best, The Netherlands
| | - Finn Lampe
- Klinik Für Orthopädie Und Unfallchirurgie, UKSH, Campus Kiel, Kiel, Germany
| | - Andreas Seekamp
- Klinik Für Orthopädie Und Unfallchirurgie, UKSH, Campus Kiel, Kiel, Germany
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Marudo C, Nicotra C, Fletcher M, Lanning R, Nelson M, Hancock C. Bridging Health Disparities and Improving Reproductive Outcomes With Health Center-Affiliated Doula Programs. Obstet Gynecol 2023; 142:886-892. [PMID: 37678910 PMCID: PMC10510774 DOI: 10.1097/aog.0000000000005337] [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: 03/22/2023] [Revised: 05/11/2023] [Accepted: 05/25/2023] [Indexed: 09/09/2023]
Abstract
Doulas are community perinatal professionals trained in pregnancy health, childbirth preparation, labor support, lactation counseling, and postnatal care. Doulas serve as patient advocates and provide laboring patients with continuous one-to-one support including informational, physical, and emotional support. Research shows that access to continuous labor support contributes to positive health outcomes such as increasing rates of spontaneous vaginal delivery, shorter labor, less need for analgesics, and increased satisfaction with the birthing process. However, despite their benefits, socioeconomic, structural, and systemic factors limit doula accessibility and manifest in low utilization among patients who could benefit from doulas the most. Given the positive health implications of doula support and the need for these services in underserved populations, there is an urgency to increase the accessibility of doulas. Several health centers in the United States have created successful doula programs to meet the needs of their patient populations. To better understand these programs, we interviewed and collaborated on this paper with program representatives from Boston Medical Center's Birth Sisters and DREAM: Delivery Resources, Education, and Advocacy for Moms; UNC Health's Birth Partners; and Michigan Medicine's Dial-A-Doula. Because many health centers serve as large public safety-net hospitals, having more health center-affiliated doula programs nationwide could be a positive step in bridging disparities and improving maternal and child health.
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Affiliation(s)
- Catherine Marudo
- University of Miami Miller School of Medicine, Miami, Florida; the University of North Carolina School of Nursing, UNC Medical Center, Chapel Hill, North Carolina; Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts; and the University of Michigan, Michigan Medicine, Ann Arbor, Michigan
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Lavery BM, Nelson M, Firican D, Prestley N, Kumru R, Jabs F, O'Loughlin J, Brotto LA. #DebunkingDesire: Sexual Science, Social Media, and Strategy in the Pursuit of Knowledge Dissemination. J Sex Marital Ther 2023; 50:1-17. [PMID: 37566559 DOI: 10.1080/0092623x.2023.2243923] [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] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Approximately 1 in 3 women experience low sexual desire. Despite this being a common concern, many women never seek professional help for their difficulties and will instead turn to online resources for information. We sought to address this need for digitally-accessible, evidence-based information on low sexual desire by creating a social media Knowledge Translation (KT) campaign called #DebunkingDesire. Our team led a 10 month social media campaign where our primary outcomes for the campaign were impressions, reach, and engagement. We generated over 300,000 social media impressions; appeared on 11 different podcasts that were listened to/downloaded 154,700 times; hosted and participated in eight online events; and attracted website users from 110 different countries. Over the course of the campaign we compiled lessons learned on what worked for disseminating our key messages and the importance of creating community for this population. These findings point to the utility of using social media as part of KT campaigns in sexual health, and to the importance of collaborating with patient partners and considering social media ads and podcasts to meet reach goals.
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Affiliation(s)
- Brynn M Lavery
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Melissa Nelson
- Women's Health Research Institute, BC Women's Hospital and Health Care, Vancouver, Canada
| | | | - Nicole Prestley
- Women's Health Research Institute, BC Women's Hospital and Health Care, Vancouver, Canada
| | - Rayka Kumru
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Faith Jabs
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Julia O'Loughlin
- Department of Educational and Counselling Psychology, University of British Columbia, Vancouver, Canada
| | - Lori A Brotto
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Women's Health Research Institute, BC Women's Hospital and Health Care, Vancouver, Canada
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Kyriakopoulos C, Taleb I, Wever-Pinzon O, Selzman C, Bonios M, Dranow E, Wever-Pinzon J, Yin M, Tseliou E, Stehlik J, Alharethi R, Kfoury A, Hanff T, Fang J, Koliopoulou A, Sideris K, Krauspe E, Nelson M, Elmer A, Singh R, Psotka M, Birks E, Slaughter M, Koenig S, Kyvernitakis A, Hoffman K, Guglin M, Kotter J, Campbell K, Silvestry S, Vidic A, Raval N, Mehra M, Cowger J, Kanwar M, Shah P, Drakos S. Multicenter Development and Validation of a Machine Learning Model to Predict Myocardial Recovery During LVAD Support: The UCAR Score. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1519] [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: 04/05/2023] Open
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Jefferies J, Kallish S, Biondetti G, Aguiar P, Nelson M, Giuliano J, Zabinksi J, Boussios C, Curhan G, Bandaria J, Gliklich R, Warnock D. Estimation of Stroke Risk in Patients with Fabry Disease Using a Machine Learning Model. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.767] [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: 04/05/2023] Open
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Jefferies J, Aguiar P, Biondetti G, Warnock D, Kallish S, Nelson M, Giuliano J, Zabinksi J, Boussios C, Curhan G, Bandaria J, Gliklich R. Estimation of Arrhythmia Risk in Patients with Fabry Disease Using a Machine Learning Model. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.765] [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: 04/05/2023] Open
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ter Avest E, Tunnicliff M, Griggs J, Griffiths D, Cody D, Nelson M, Hurst T, Lyon R. In-hospital extracorporeal cardiopulmonary resuscitation for patients with an out-of-hospital cardiac arrest in a semi-rural setting: An observational study on the implementation of a helicopter emergency medical services pathway. Resusc Plus 2022; 12:100339. [PMID: 36561209 PMCID: PMC9763671 DOI: 10.1016/j.resplu.2022.100339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Aim In this study, we aimed to investigate the efficacy of a helicopter emergency medical service (HEMS) facilitated pathway for in-hospital extracorporeal cardiopulmonary resuscitation (ECPR) for patients with an out of hospital cardiac arrest (OHCA) in a semi-rural setting. Methods We retrospectively reviewed all patients with an OHCA attended by a UK HEMS service between 1 January 2018 and 20 September 2021, when a dedicated ECPR pathway was in effect to facilitate transport of eligible patients to the nearest ECLS centre. The primary endpoint was the number of patients meeting ECPR eligibility criteria at three pre-defined time points: at HEMS dispatch, during on-scene evaluation and upon arrival in hospital. Results During the study period, 162 patients attended met ECPR pathway dispatch criteria. After on-scene evaluation, 74 patients (45%) had a return of spontaneously circulation before arrival of HEMS, 60 (37%) did not meet eligibility criteria regarding initial rhythm or etiology of the OHCA, and 15 (9%) had deteriorated (mainly into asystole) and were no longer suitable candidates upon arrival of HEMS. Eleven patients were eligible for ECPR and transported to hospital in arrest, and a further two patients were transported for post-ROSC ECLS. Nine patients deteriorated during transport and were no longer suitable ECPR candidates upon arrival. ECLS was successfully initiated in two patients (one intra-arrest, and one post-ROSC). Conclusion In-hospital ECPR is of limited value for patients with refractory OHCA in a semi-rural setting, even when a dedicated pathway is in place. Potentially eligible patients often cannot be transported within an appropriate timeframe and/or deteriorate before arrival in hospital.
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Affiliation(s)
- E. ter Avest
- Kent, Surrey and Sussex Air Ambulance Trust, Redhill Airfield, Redhill, Surrey, UK,Department of Emergency Medicine, University Hospital Groningen, the Netherlands,Corresponding author at: Kent, Surrey & Sussex Air Ambulance Trust, Redhill Airfield, Redhill, Surrey RH1 5YP, UK.
| | - M. Tunnicliff
- Kent, Surrey and Sussex Air Ambulance Trust, Redhill Airfield, Redhill, Surrey, UK,Kings College NHS Trust, Department of Emergency Medicine, UK
| | - J. Griggs
- Kent, Surrey and Sussex Air Ambulance Trust, Redhill Airfield, Redhill, Surrey, UK
| | - D. Griffiths
- Kent, Surrey and Sussex Air Ambulance Trust, Redhill Airfield, Redhill, Surrey, UK
| | - D. Cody
- South East Coast Ambulance Service, UK
| | - M. Nelson
- Kent, Surrey and Sussex Air Ambulance Trust, Redhill Airfield, Redhill, Surrey, UK,South East Coast Ambulance Service, UK
| | - T. Hurst
- Kings College NHS Trust, Department of Intensive Care Medicine, UK,London’s Airambulance, UK
| | - R.M. Lyon
- Kent, Surrey and Sussex Air Ambulance Trust, Redhill Airfield, Redhill, Surrey, UK,School of Health Sciences, University of Surrey, UK
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Scarone P, Chatterjea A, Jenniskens I, Klüter T, Weuster M, Lippross S, Presilla S, Distefano D, Chianca V, Sedaghat S, Nelson M, Lampe F, Seekamp A. Percutaneous thoraco-lumbar-sacral pedicle screw placement accuracy results from a multi-center, prospective clinical study using a skin marker-based optical navigation system. Eur Spine J 2022; 31:3098-3108. [PMID: 36149493 DOI: 10.1007/s00586-022-07387-5] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/05/2022] [Accepted: 09/11/2022] [Indexed: 06/16/2023]
Abstract
STUDY DESIGN Prospective multi-center study. OBJECTIVE The study aimed to evaluate the accuracy of pedicle screw placement using a skin marker-based optical surgical navigation system for minimal invasive thoraco-lumbar-sacral pedicle screw placement. METHODS The study was performed in a hybrid Operating Room with a video camera-based navigation system integrated in the imaging hardware. The patient was tracked with non-invasive skin markers while the instrument tracking was via an on-shaft optical marker pattern. The screw placement accuracy assessment was performed by three independent reviewers, using the Gertzbein grading. The screw placement time as well as the staff and patient radiation doses was also measured. RESULTS In total, 211 screws in 39 patients were analyzed for screw placement accuracy. Of these 32.7% were in the thoracic region, 59.7% were in the lumbar region, and 7.6% were in the sacral region. An overall accuracy of 98.1% was achieved. No screws were deemed severely misplaced (Gertzbein grading 3). The average time for screw placement was 6 min and 25 secs (± 3 min 33 secs). The average operator radiation dose per subject was 40.3 µSv. The mean patient effective dose (ED) was 11.94 mSv. CONCLUSION Skin marker-based ON can be used to achieve very accurate thoracolumbarsacral pedicle screw placements.
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Affiliation(s)
- Pietro Scarone
- Department of Neurosurgery, Neurocenter of Southern Switzerland, Ospedale Regionale Di Lugano Civico E Italiano, Lugano, Switzerland
| | - Anindita Chatterjea
- Image Guided Therapy Systems, Philips Healthcare, Veenpluis 6, 5684 PC, Best, The Netherlands.
| | - Inge Jenniskens
- Image Guided Therapy Systems, Philips Healthcare, Veenpluis 6, 5684 PC, Best, The Netherlands
| | - Tim Klüter
- Klinik Für Orthopädie Und Unfallchirurgie, UKSH, Campus Kiel, Kiel, Germany
| | - Matthias Weuster
- Klinik Für Orthopädie Und Unfallchirurgie, UKSH, Campus Kiel, Kiel, Germany
| | - Sebastian Lippross
- Klinik Für Orthopädie Und Unfallchirurgie, UKSH, Campus Kiel, Kiel, Germany
| | - Stefano Presilla
- Department of Neurosurgery, Neurocenter of Southern Switzerland, Ospedale Regionale Di Lugano Civico E Italiano, Lugano, Switzerland
| | - Daniela Distefano
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Ospedale Regionale Di Lugano Civico E Italiano, Lugano, Switzerland
| | - Vito Chianca
- Clinica di Radiologia EOC IIMSI, Lugano, Switzerland
- Ospedale Evangelico Betania, Naples, Italy
| | - Sam Sedaghat
- Department of Neurosurgery, Neurocenter of Southern Switzerland, Ospedale Regionale Di Lugano Civico E Italiano, Lugano, Switzerland
| | - Melissa Nelson
- Image Guided Therapy Systems, Philips Healthcare, Veenpluis 6, 5684 PC, Best, The Netherlands
| | - Finn Lampe
- Klinik Für Orthopädie Und Unfallchirurgie, UKSH, Campus Kiel, Kiel, Germany
| | - Andreas Seekamp
- Klinik Für Orthopädie Und Unfallchirurgie, UKSH, Campus Kiel, Kiel, Germany
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Shroyer JE, Nelson M, Walters L, Johnson BR. A scalable cryogenic LED module for selectively illuminating kinetic inductance detector arrays. Rev Sci Instrum 2022; 93:113107. [PMID: 36461559 DOI: 10.1063/5.0103968] [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] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/30/2022] [Indexed: 06/17/2023]
Abstract
We present the design and measured performance of a light emitting diode (LED) module for spatially mapping kinetic inductance detector (KID) arrays in the laboratory. Our novel approach uses a multiplexing scheme that only requires seven wires to control 480 red LEDs, and the number of LEDs can be scaled up without adding any additional wires. This multiplexing approach relies on active surface mount components that can operate at cryogenic temperatures down to 10 K. Cryogenic tests in liquid nitrogen and inside our cryostat demonstrate that the multiplexer circuit works at 77 and 10 K, respectively. The LED module presented here is tailored for our millimeter-wave detector modules, but the approach could be adapted for use with other KID-based detector systems.
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Affiliation(s)
- J E Shroyer
- Department of Astronomy, University of Virginia, Charlottesville, Virginia 22904, USA
| | - M Nelson
- Department of Astronomy, University of Virginia, Charlottesville, Virginia 22904, USA
| | - L Walters
- Department of Astronomy, University of Virginia, Charlottesville, Virginia 22904, USA
| | - B R Johnson
- Department of Astronomy, University of Virginia, Charlottesville, Virginia 22904, USA
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Hayden H, Nelson M, Ross S, Vo A, Penewit K, Eng A, Salipante S, Hoffman L, Sanders D. 541 Effect of therapeutic antibiotic exposure on oropharyngeal and fecal microbiota in infants with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01231-0] [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: 11/05/2022]
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Henry FJ, Lawrence B, Nelson M. Comparative cost of diets for low-income families in the Caribbean. Rev Panam Salud Publica 2022; 46:e120. [PMID: 36042704 PMCID: PMC9409605 DOI: 10.26633/rpsp.2022.120] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 06/09/2022] [Indexed: 02/02/2023] Open
Abstract
Objective. To assess the ability of low-income families to obtain a standard basket of healthy foods before and during the COVID-19 pandemic. Methods. The costs of 191 food items were averaged from supermarkets, municipal markets, wholesalers, and community food outlets in high- and low-income areas in three Caribbean countries. The analysis compared foods not only by selecting high- and low-ranked commodities but by the proportions of those foods, by food group, that will be required to meet a low-cost, nutritionally balanced diet of 2 400 kcal. Results. The main finding was that low-income households will need between 22% and 47% of their earnings to obtain a healthy diet. Despite higher food prices in Saint Kitts and Nevis, low-income households there will need a smaller proportion of their income to obtain a similar basket of foods than in Jamaica or Saint Vincent and the Grenadines. Conclusions. While the COVID-19 pandemic has added economic stressors to low-income households the basic vulnerability of the poor to obtain a healthy diet remains. Despite country variations, the findings point to the need for an increase in the minimum wage, particularly in Jamaica. It is essential to embed policies that ensure reduced economic and social vulnerability at the household level.
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Phyo AZZ, Ryan J, Gonzalez-Chica D, Stocks N, Woods R, Murray A, Reid C, Nelson M, Tonkin A, Storey E, Gasevic D, Orchard, Shah R, Freak-Poli R. 1005 HEALTH-RELATED QUALITY OF LIFE AND FUTURE RISK OF HEALTH OUTCOMES AMONG OLDER ADULTS LIVING IN AUSTRALIA AND THE UNITED STATES. Age Ageing 2022. [DOI: 10.1093/ageing/afac124.009] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Poor health-related quality of life (HRQoL) is associated with higher morbidity and mortality in patient populations. However, whether HRQoL is associated with health outcomes among community-dwelling older people requires further investigation. This study aimed to examine whether HRQoL predicts cognitive decline, dementia, cardiovascular disease (CVD), and mortality in community-dwelling older people living in Australia and the United States.
Method
A cohort of 19,106 individuals from the ASPirin in Reducing Events in the Elderly (ASPREE) study, aged 65–98 years, initially free of dementia or CVD, and who completed the HRQoL 12-item short form (SF-12, version-2) at baseline (2010–2014), were followed until June 2017. The physical (PCS) and mental component scores (MCS) of SF-12 were generated using standardized norm-based method.
Results
Over a median of 4.7 years, there were 2,412 cognitive declines, 574 dementia, 922 incident CVD events, and 1,052 deaths. Using Cox proportional-hazard regression adjusted for a range of covariates, every 10-unit increase in PCS was associated with a 6% lower risk of cognitive decline, a 14% lower risk of incident CVD, and 17% lower risk of all-cause mortality, but was not associated with incident dementia. In contrast, higher MCS was only associated with a 12% and 15% lower risk of cognitive decline and dementia, respectively. Findings did not differ by sex.
Conclusion
Our study provides some of the first evidence that HRQoL can be used in combination with clinical data to identify the future risks of health outcomes among older individuals living in the community. Our findings support the decision of the Australian Commission on Safety and Quality in Health Care to incorporate the SF-12 into the annual Patient-Reported Outcome Measures (PROMs assessment.
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Affiliation(s)
| | - J Ryan
- Monash University , Australia
| | | | - N Stocks
- The University of Adelaide , Australia
| | - R Woods
- Monash University , Australia
| | - A Murray
- Berman Center for Outcomes and Clinical Research , Minneapolis, Minnesota, USA
| | - C Reid
- Monash University , Australia
- Curtin University , Australia
| | - M Nelson
- Monash University , Australia
- University of Tasmania , Australia
| | | | | | - D Gasevic
- Monash University , Australia
- University of Edinburgh , UK
| | - Orchard
- Monash University , Australia
| | - R Shah
- Rush University Medical Center , Chicago, Illinois, USA
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Lacaze P, Marquina C, Tiller J, Riaz M, Sturm A, Nelson M, Ference B, Pang J, Watts G, Nicholls S, Zoungas S, Liew D, McNeil J, Ademi Z. Population Genomic Screening of Young Adults for Familial Hypercholesterolaemia: A Cost-Effectiveness Analysis. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Blake H, Buckley J, Coates A, D’Unienville N, Hill A, Nelson M. Polyphenol consumption and endurance exercise performance: A systematic review and meta-analysis of randomised controlled trials. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.109] [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: 10/19/2022]
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Rahman AU, Jones HP, Hosler SC, Geddes S, Nelson M, Barber NA. Disturbance-Induced Trophic Niche Shifts In Ground Beetles (Coleoptera: Carabidae) In Restored Grasslands. Environ Entomol 2021; 50:1075-1087. [PMID: 34268568 DOI: 10.1093/ee/nvab065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Indexed: 06/13/2023]
Abstract
Ecosystem restoration is a critical component of land management, countering the loss of native biodiversity. Restoration efforts are enhanced by reintroducing naturally occurring ecosystem processes, including disturbances that may impact species characteristics such as niche position or niche size. In grasslands, grazing and fire affect plant diversity and habitat complexity, which potentially influence insect dietary behaviors and thus their contributions to functions like seed and arthropod predation. Using carbon and nitrogen stable isotopes, we characterized variation in the dietary niche of six ground beetle species (Coleoptera: Carabidae) in response to grazing by reintroduced bison and prescribed fire disturbances in twenty tallgrass prairies. Management disturbances did not affect activity density for most beetle species and mean trophic position was mostly unaffected. However, five of six species exhibited increased trophic niche area and breadth with disturbances, indicating a switch to a more generalist diet that incorporated a wider range of food items. The combination of bison and fire impacts may increase vegetation patchiness and heterogeneity, driving these diet changes. Morphological traits and microhabitat preferences might mediate response to disturbances and the resulting heterogeneity. Combining prescribed fire and grazing, which increases plant diversity and vegetation structural diversity, may help beetle communities establish over time and support the ecological functions to which these insects contribute.
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Affiliation(s)
- Azeem U Rahman
- Department of Biology, San Diego State University, 5500 Campanile Dr., San Diego, CA, USA
| | - Holly P Jones
- Department of Biological Sciences, Northern Illinois University, 1425 W Lincoln Hwy, DeKalb, IL, USA
- Institute for the Study of the Environment, Sustainability, and Energy, Northern Illinois University, 1425 W Lincoln Hwy, DeKalb, IL, USA
| | - Sheryl C Hosler
- Department of Biological Sciences, Northern Illinois University, 1425 W Lincoln Hwy, DeKalb, IL, USA
- Department of Biological Sciences, University of Illinois Chicago, 845 W. Taylor St, Chicago, IL, USA
| | - Seth Geddes
- Department of Biological Sciences, Northern Illinois University, 1425 W Lincoln Hwy, DeKalb, IL, USA
| | - Melissa Nelson
- Department of Biological Sciences, Northern Illinois University, 1425 W Lincoln Hwy, DeKalb, IL, USA
| | - Nicholas A Barber
- Department of Biology, San Diego State University, 5500 Campanile Dr., San Diego, CA, USA
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18
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Ademi Z, Marquina C, Lacaze P, Tiller J, Riaz M, Sturm AC, Nelson M, Ference BA, Pang J, Watts GF, Nicholls SJ, Zoungas S, Liew D, McNeil J. Population genomic screening of all young adults in Australia to detect familial hypercholesterolemia: a cost-effectiveness analysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Heterozygous familial hypercholesterolemia (FH) is a highly-penetrant, autosomal dominant monogenic disorder that causes elevated plasma low-density cholesterol (LDL-C) levels and risk of premature coronary heart disease (CHD). To date, the cost-effectiveness of the emerging strategy of genomic screening of adult populations for FH has not been investigated.
Purpose
To assess the impact and cost-effectiveness of offering population genomic screening to all young adults in Australia to detect heterozygous familial hypercholesterolemia (FH).
Methods
We designed a decision analysis model to compare the current standard of care for heterozygous FH diagnosis in Australia (opportunistic cholesterol screening and genetic cascade testing) with population genomic screening of adults aged 18–40 years to detect pathogenic variants in the LDLR/APOB/PCSK9 genes. The model captured morbidity/mortality due to coronary heart disease (CHD) over a lifetime horizon, from a healthcare perspective. Risk of CHD, treatment effects, prevalence, and healthcare costs were estimated from published studies. Outcomes included quality adjusted life years (QALYs), costs and incremental cost-effectiveness ratio (ICER), discounted 5% annually. Sensitivity analyses were undertaken to explore the impact of key input parameters on the robustness of the model. The model structure was designed to be transferable to countries with different healthcare systems.
Results
Over the lifetime of the population (4,167,768 men; 4,129,961 women), the model estimated a gain of 62,722 years of life lived and 73,959 QALYs due to CHD prevention. Population genomic screening for FH would be cost-effective from a healthcare perspective if the cost per test was ≤AU$300 (∼US$233) which would yield an ICER AU$28,000 cost-saving.
Conclusion
Based on our model, offering population genomic screening to all young adults to detect FH could be cost-effective in the Australian healthcare system, at testing costs that are currently feasible.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): This work was supported by the Australian National Heart Foundation and Monash University Faculty of Medicine, Nursing and Health Sciences Results from scenario analysesResults from Monte Carlo simulations
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Affiliation(s)
- Z Ademi
- Monash University, Melbourne, Australia
| | | | - P Lacaze
- Monash University, Melbourne, Australia
| | - J Tiller
- Monash University, Melbourne, Australia
| | - M Riaz
- Monash University, Melbourne, Australia
| | - A C Sturm
- Genomic Medicine Institute, Geisinger, United States of America
| | - M Nelson
- Monash University, Melbourne, Australia
| | - B A Ference
- University of Cambridge, Cambridge, United Kingdom
| | - J Pang
- The University of Western Australia, Perth, Australia
| | - G F Watts
- The University of Western Australia, Perth, Australia
| | | | - S Zoungas
- Monash University, Melbourne, Australia
| | - D Liew
- Monash University, Melbourne, Australia
| | - J McNeil
- Monash University, Melbourne, Australia
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19
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Cohen A, Gold A, Rolston D, Li T, Nelson M. 127 Bubble Time: Assessing Right Ventricular Function with Point-of-Care Ultrasonography Using Saline Flushes. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.137] [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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20
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Rolston D, Li T, Huang H, Johnson A, van Loveren K, Kearney E, Pettit D, Haverty J, Nelson M, Cohen A. 204 A Higher Initial VExUS Score Is Associated With Inferior Outcomes in Septic Emergency Department Patients. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.216] [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: 10/20/2022]
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21
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Huang H, Gold A, Friedman M, Cohen A, Bajaj T, Nelson M. 303 The Interrater Reliability of Venous Excess Ultrasound Score by Emergency Physicians. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.317] [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: 10/20/2022]
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22
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Cohen A, Li T, Johnson A, Loveren K, Tam M, Zhou J, Nelson M, Rolston D. 304 Lack of Early Left Ventricular Outflow Tract Velocity Time Integral Estimated Volume Responsiveness is Associated With Increased Morbidity and Mortality. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.318] [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: 10/20/2022]
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23
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Bhowmik S, Galeta J, Havel V, Nelson M, Faouzi A, Bechand B, Ansonoff M, Fiala T, Hunkele A, Kruegel AC, Pintar JE, Majumdar S, Javitch JA, Sames D. Site selective C-H functionalization of Mitragyna alkaloids reveals a molecular switch for tuning opioid receptor signaling efficacy. Nat Commun 2021; 12:3858. [PMID: 34158473 PMCID: PMC8219695 DOI: 10.1038/s41467-021-23736-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 05/13/2021] [Indexed: 12/25/2022] Open
Abstract
Mitragynine (MG) is the most abundant alkaloid component of the psychoactive plant material "kratom", which according to numerous anecdotal reports shows efficacy in self-medication for pain syndromes, depression, anxiety, and substance use disorders. We have developed a synthetic method for selective functionalization of the unexplored C11 position of the MG scaffold (C6 position in indole numbering) via the use of an indole-ethylene glycol adduct and subsequent iridium-catalyzed borylation. Through this work we discover that C11 represents a key locant for fine-tuning opioid receptor signaling efficacy. 7-Hydroxymitragynine (7OH), the parent compound with low efficacy on par with buprenorphine, is transformed to an even lower efficacy agonist by introducing a fluorine substituent in this position (11-F-7OH), as demonstrated in vitro at both mouse and human mu opioid receptors (mMOR/hMOR) and in vivo in mouse analgesia tests. Low efficacy opioid agonists are of high interest as candidates for generating safer opioid medications with mitigated adverse effects.
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Affiliation(s)
- Srijita Bhowmik
- Department of Chemistry, Columbia University, New York, NY, USA
| | - Juraj Galeta
- Department of Chemistry, Columbia University, New York, NY, USA
- Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences (IOCB Prague), 160 00, Prague 6, Czech Republic
| | - Václav Havel
- Department of Chemistry, Columbia University, New York, NY, USA
| | - Melissa Nelson
- Department of Psychiatry, and Department of Molecular Pharmacology and Therapeutics, Columbia University, New York, NY, USA
- Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, NY, USA
| | - Abdelfattah Faouzi
- Center for Clinical Pharmacology, St Louis College of Pharmacy and Washington University School of Medicine, St Louis, MO, 63110, USA
- University of California San Diego, La Jolla, CA, 92161, USA
| | | | - Mike Ansonoff
- Department of Neuroscience and Cell Biology, Rutgers University, New Jersey, NJ, 08854, USA
| | - Tomas Fiala
- Department of Chemistry, Columbia University, New York, NY, USA
- Laboratory of Organic Chemistry, ETH Zürich, 8093, Zürich, Switzerland
| | - Amanda Hunkele
- Center for Clinical Pharmacology, St Louis College of Pharmacy and Washington University School of Medicine, St Louis, MO, 63110, USA
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, NY, 10021, USA
| | | | - John E Pintar
- Department of Neuroscience and Cell Biology, Rutgers University, New Jersey, NJ, 08854, USA
| | - Susruta Majumdar
- Center for Clinical Pharmacology, St Louis College of Pharmacy and Washington University School of Medicine, St Louis, MO, 63110, USA
| | - Jonathan A Javitch
- Department of Psychiatry, and Department of Molecular Pharmacology and Therapeutics, Columbia University, New York, NY, USA
- Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, NY, USA
| | - Dalibor Sames
- Department of Chemistry, Columbia University, New York, NY, USA.
- NeuroTechnology Center at Columbia University, New York, NY, USA.
- The Zuckerman Mind Brain Behavior Institute at Columbia University, New York, NY, USA.
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24
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Burns JE, Stöhr W, Kinloch-De Loes S, Fox J, Clarke A, Nelson M, Thornhill J, Babiker A, Frater J, Pett SL, Fidler S. Tolerability of four-drug antiretroviral combination therapy in primary HIV-1 infection. HIV Med 2021; 22:770-774. [PMID: 33964099 PMCID: PMC8612356 DOI: 10.1111/hiv.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 11/30/2022]
Abstract
Objectives Rapid initiation of antiretroviral therapy (ART) is important for individuals with high baseline viral loads, such as in primary HIV‐1 infection (PHI). Four‐drug regimens are sometimes considered; however, data are lacking on tolerability. We aimed to evaluate the tolerability of four‐drug regimens used in the Research in Viral Eradication of HIV‐1 Reservoirs (RIVER) study. Methods At enrolment, ART‐naïve adult participants or those newly commenced on ART were initiated or intensified to four‐drug regimens within 4 weeks of PHI. Rapid start was defined as pre‐confirmation or ≤ 7 days of confirmed diagnosis. Primary and secondary outcomes were patient‐reported adherence measured by 7‐day recall and regimen switches between enrolment and randomization, respectively. Results Overall, 54 men were included: 72.2% were of white ethnicity, with a median age of 32 years old, 42.6% had a viral load of ≥ 100 000 HIV‐1 RNA copies/mL, and in 92.6% sex with men was the mode of acquisition of HIV‐1. Twenty (37%) started a four‐drug regimen and 34 (63%) were intensified. Rapid ART initiation occurred in 28%, 100% started in ≤ 4 weeks. By weeks 4, 12, and 24, 37.0%, 69.0%, and 94.0% were undetectable (viral load < 50 copies/mL), respectively. Adherence rates of 100% at weeks 4, 12, 22 and 24 were reported in 88.9%, 87.0%, 82.4% and 94.1% of participants, respectively. Five individuals switched to three drugs, four changed their regimen constituents, and two switched post‐randomization. Conclusions Overall, four‐drug regimens were well tolerated and had high levels of adherence. Whilst their benefit over three‐drug regimens is lacking, our findings should provide reassurance if a temporarily intensified regimen is clinically indicated to help facilitate treatment.
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Affiliation(s)
- J E Burns
- Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, UK
| | - W Stöhr
- Medical Research Council Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - S Kinloch-De Loes
- Department of Infection and Immunity, Royal Free Hospital, London, UK.,Institute of Immunity & Transplantation, University College London, London, UK
| | - J Fox
- Department of Genitourinary Medicine and Infectious Diseases, Guys and St, Thomas' NHS Trust, London, UK.,Department of Genitourinary Medicine and Infectious Diseases, NIHR Biomedical Research Centre, King's College London, London, UK
| | - A Clarke
- Elton John Centre, Brighton, UK.,Department of HIV and Sexual Health, Sussex University Hospital, Brighton, UK.,Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - M Nelson
- Department of HIV Medicine, Chelsea and Westminster Hospital, Imperial College London, London, UK
| | - J Thornhill
- Department of Infectious Disease, Imperial College London, London, UK.,NIHR Imperial Biomedical Research Centre, London, UK
| | - A Babiker
- Medical Research Council Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - J Frater
- Nuffield Department of Medicine, Oxford University, Oxford, UK.,Nuffield Department of Medicine, Oxford NIHR Biomedical Research Centre, Oxford, UK
| | - S L Pett
- Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, UK.,Medical Research Council Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - S Fidler
- Department of Infectious Disease, Imperial College London, London, UK.,NIHR Imperial Biomedical Research Centre, London, UK
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25
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Griggs JE, Barrett JW, Ter Avest E, de Coverly R, Nelson M, Williams J, Lyon RM. Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger? Scand J Trauma Resusc Emerg Med 2021; 29:62. [PMID: 33962682 PMCID: PMC8103626 DOI: 10.1186/s13049-021-00877-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 04/21/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Helicopter Emergency Medical Services (HEMS) respond to serious trauma and medical emergencies. Geographical disparity and the regionalisation of trauma systems can complicate accurate HEMS dispatch. We sought to evaluate HEMS dispatch sensitivity in older trauma patients by analysing critical care interventions and conveyance in a well-established trauma system. METHODS All trauma patients aged ≥65 years that were attended by the Air Ambulance Kent Surrey Sussex over a 6-year period from 1 July 2013 to 30 June 2019 were included. Patient characteristics, critical care interventions and hospital disposition were stratified by dispatch type (immediate, interrogate and crew request). RESULTS 1321 trauma patients aged ≥65 were included. Median age was 75 years [IQR 69-89]. HEMS dispatch was by immediate (32.0%), interrogation (43.5%) and at the request of ambulance clinicians (24.5%). Older age was associated with a longer dispatch interval and was significantly longer in the crew request category (37 min [34-39]) compared to immediate dispatch (6 min [5-6] (p = .001). Dispatch by crew request was common in patients with falls < 2 m, whereas pedestrian road traffic collisions and falls > 2 m more often resulted in immediate dispatch (p = .001). Immediate dispatch to isolated head injured patients often resulted in pre-hospital emergency anaesthesia (PHEA) (39%). However, over a third of head injured patients attended after dispatch by crew request received PHEA (36%) and a large proportion were triaged to major trauma centres (69%). CONCLUSIONS Many patients who do not fulfil the criteria for immediate HEMS dispatch need advanced clinical interventions and subsequent tertiary level care at a major trauma centre. Further studies should evaluate if HEMS activation criteria, nuanced by age-dependant triggers for mechanism and physiological parameters, optimise dispatch sensitivity and HEMS utilisation.
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Affiliation(s)
- J E Griggs
- Air Ambulance Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK. .,University of Surrey, Guilford, GU2 7XH, UK.
| | - J W Barrett
- University of Surrey, Guilford, GU2 7XH, UK.,South East Coast Ambulance Service NHS Foundation Trust, Nexus House, 4 Gatwick Road, Crawley, RH10 9BG, UK
| | - E Ter Avest
- Air Ambulance Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK.,Department of Emergency Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - R de Coverly
- Air Ambulance Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK
| | - M Nelson
- Air Ambulance Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK.,South East Coast Ambulance Service NHS Foundation Trust, Nexus House, 4 Gatwick Road, Crawley, RH10 9BG, UK.,Royal Sussex County Hospital, Eastern Road, Brighton, BN2 5BE, UK
| | - J Williams
- South East Coast Ambulance Service NHS Foundation Trust, Nexus House, 4 Gatwick Road, Crawley, RH10 9BG, UK.,University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK
| | - R M Lyon
- Air Ambulance Kent Surrey Sussex, Hanger 10 Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK.,University of Surrey, Guilford, GU2 7XH, UK
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26
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Nelson M, Zhang X, Podgaetz E, Spechler S, Souza R. IL‐13/IL4Rα Signaling Increases Tension in Human Circular and Longitudinal Esophageal Smooth Muscle Through Distinct Molecular Pathways: Potential Contribution to Reduced Esophageal Distensibility in EoE. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.00251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Melissa Nelson
- Baylor University Medical Center, Center for Esophageal ResearchDallasTX
| | - Xi Zhang
- Baylor University Medical Center, Center for Esophageal ResearchDallasTX
| | - Eitan Podgaetz
- Center for Thoracic Surgery, Center for Esophageal DiseasesBaylor University Medical Center, Center for Esophageal ResearchDallasTX
| | - Stuart Spechler
- Baylor University Medical Center, Center for Esophageal ResearchDallasTX
| | - Rhonda Souza
- Baylor University Medical Center, Center for Esophageal ResearchDallasTX
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27
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Spechler SJ, Nelson M, Souza RF. Invited response to letter to the editor by Tustumi et al. Neurogastroenterol Motil 2021; 33:e14114. [PMID: 33634917 DOI: 10.1111/nmo.14114] [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] [Received: 01/13/2021] [Accepted: 02/09/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Stuart Jon Spechler
- Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Melissa Nelson
- Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Rhonda F Souza
- Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, TX, USA
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28
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Brotto LA, Nelson M, Barry L, Maher C. Correction to: #ItsNotInYourHead: A Social Media Campaign to Disseminate Information on Provoked Vestibulodynia. Arch Sex Behav 2021; 50:1843. [PMID: 33733309 PMCID: PMC8213584 DOI: 10.1007/s10508-021-01970-5] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A correction to this paper has been published: https://doi.org/10.1007/s10508-021-01970-5
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Affiliation(s)
- Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
- Women's Health Research Institute, Vancouver, BC, Canada.
| | - Melissa Nelson
- Women's Health Research Institute, Vancouver, BC, Canada
| | - Lana Barry
- Self‑Management Programs, University of Victoria, Victoria, BC, Canada
| | - Ciana Maher
- Women's Health Research Institute, Vancouver, BC, Canada
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29
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Nelson M, Zhang X, Genta RM, Turner K, Podgaetz E, Paris S, Cardenas J, Gu J, Leeds S, Ward M, Nguyen A, Konda V, Furuta GT, Pan Z, Souza RF, Spechler SJ. Lower esophageal sphincter muscle of patients with achalasia exhibits profound mast cell degranulation. Neurogastroenterol Motil 2021; 33:e14055. [PMID: 33280206 DOI: 10.1111/nmo.14055] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 06/29/2020] [Revised: 10/23/2020] [Accepted: 11/17/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Eosinophils and mast cells are key effectors of allergy. When they accumulate in the esophagus, their myoactive, pro-inflammatory, and cytotoxic products potentially could cause achalasia-like motility abnormalities and neuronal degeneration. We hypothesized that there is an allergy-mediated form of achalasia. METHODS LES muscle samples obtained during Heller myotomy from patients with achalasia or EGJ outflow obstruction (EGJOO) and from organ donor controls were immunostained for tryptase. Eosinophil and mast cell density, and mast cell degranulation were assessed. LES muscle was evaluated by qPCR for genes mediating smooth muscle Ca2+ handling and contraction. KEY RESULTS There were 13 patients (7 men, median age 59; 10 achalasia, 3 EGJOO) and 7 controls (4 men, median age 42). Eosinophils were infrequent in LES muscle, but mast cells were plentiful. Patients and controls did not differ significantly in LES mast cell density. However, 12 of 13 patients exhibited profound LES mast cell degranulation involving perimysium and myenteric plexus nerves, while only mild degranulation was seen in 2 of 7 controls. Hierarchical clustering analysis of qPCR data revealed two "mototype" LES gene expression patterns, with all type II patients in one mototype, and type I and III patients in the other. CONCLUSIONS & INFERENCES LES muscle of patients with achalasia or EGJOO exhibits striking mast cell degranulation, and patients with different achalasia manometric phenotypes exhibit different LES patterns of expression for genes mediating Ca2+ handling and muscle contraction. Although these findings are not definitive, they support our hypothesis that achalasia can be allergy-driven.
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Affiliation(s)
- Melissa Nelson
- Department of Medicine, Center forEsophageal Diseases/Baylor University Medical Center, Center for Esophageal Research/Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Xi Zhang
- Department of Medicine, Center forEsophageal Diseases/Baylor University Medical Center, Center for Esophageal Research/Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Robert M Genta
- Inform Diagnostics, Irving, TX, USA.,Department of Pathology, Baylor College of Medicine, Houston, TX, USA
| | | | - Eitan Podgaetz
- Center for Thoracic Surgery, Center for Esophageal Diseases, Baylor University Medical Center, Center for Esophageal Research/Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Shere Paris
- Department of Medicine, Center forEsophageal Diseases/Baylor University Medical Center, Center for Esophageal Research/Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Jacob Cardenas
- Biostatistics Core, Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Jinghua Gu
- Biostatistics Core, Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Steven Leeds
- Department of Surgery, Center for Esophageal Diseases, Baylor University Medical Center, Center for Esophageal Research/Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Marc Ward
- Department of Surgery, Center for Esophageal Diseases, Baylor University Medical Center, Center for Esophageal Research/Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Anh Nguyen
- Department of Medicine, Center forEsophageal Diseases/Baylor University Medical Center, Center for Esophageal Research/Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Vani Konda
- Department of Medicine, Center forEsophageal Diseases/Baylor University Medical Center, Center for Esophageal Research/Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Glenn T Furuta
- Department of Pediatrics and Mucosal Inflammation Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - Zui Pan
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Rhonda F Souza
- Department of Medicine, Center forEsophageal Diseases/Baylor University Medical Center, Center for Esophageal Research/Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Stuart Jon Spechler
- Department of Medicine, Center forEsophageal Diseases/Baylor University Medical Center, Center for Esophageal Research/Baylor Scott & White Research Institute, Dallas, TX, USA
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30
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Odiase E, Zhang X, Chang Y, Nelson M, Balaji U, Gu J, Zhang Q, Pan Z, Jon Spechler S, Souza RF. In Esophageal Squamous Cells From Eosinophilic Esophagitis Patients, Th2 Cytokines Increase Eotaxin-3 Secretion Through Effects on Intracellular Calcium and a Non-Gastric Proton Pump. Gastroenterology 2021; 160:2072-2088.e6. [PMID: 33581123 PMCID: PMC9013281 DOI: 10.1053/j.gastro.2021.02.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 06/09/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS In upper airway cells, T helper 2 cytokines that signal through interleukin-4 (IL-4) receptor-α have been shown to stimulate eotaxin-3 secretion via a nongastric proton pump (ngH+,K+ATPase). To seek novel targets for eosinophilic esophagitis (EoE) treatments, we evaluated ngH+,K+ATPase expression in EoE squamous cells, and explored molecular pathways involved in eotaxin-3 secretion by IL-4 receptor-α signaling. METHODS ngH+,K+ATPase expression in EoE cells was evaluated by quantitative real-time polymerase chain reaction and Western blotting. IL-4-stimulated eotaxin-3 secretion was measured by enzyme-linked immunosorbent assay after treatment with omeprazole, SCH 28080 (potassium-competitive acid blocker), ethylene glycol-bis(β-aminoethyl)-N,N,N',N'-tetraacetoxymethyl ester (calcium chelator), 2-aminoethoxydiphenyl borate (inhibitor of endoplasmic reticulum calcium release), verapamil, and diltiazem (L-type calcium channel inhibitors). Intracellular calcium transients were measured by Fluo-4 fluorescence. Key experiments were confirmed in EoE primary cells and in RNA sequencing datasets from mucosal biopsies of patients with EoE and controls. RESULTS EoE cells expressed ngH+,K+ATPase messenger RNA and protein. Omeprazole and SCH 28080 decreased IL-4-stimulated eotaxin-3 secretion. IL-4 increased intracellular calcium transients, and IL-4-stimulated eotaxin-3 secretion was blocked by ethylene glycol-bis(β-aminoethyl)-N,N,N',N'-tetraacetoxymethyl ester, 2-aminoethoxydiphenyl borate, verapamil, and diltiazem. The combination of omeprazole and verapamil suppressed IL-4-stimulated eotaxin-3 secretion more than either agent alone. EoE biopsies expressed higher ngH+,K+ATPase and exhibited more calcium signaling than controls. CONCLUSIONS EoE cells express a nongastric proton pump that mediates T helper 2 cytokine-stimulated eotaxin-3 secretion. IL-4 induces calcium release from the endoplasmic reticulum and calcium entry via L-type calcium channels, increasing intracellular calcium that contributes to eotaxin-3 secretion by EoE cells. L-type calcium channel inhibitors block T helper 2 cytokine-stimulated eotaxin-3 secretion, suggesting a potential role for these agents in EoE treatment.
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Affiliation(s)
- Eunice Odiase
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas,Department of Pediatrics, Children’s Hospital of Colorado, Aurora, Colorado
| | - Xi Zhang
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Yan Chang
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas
| | - Melissa Nelson
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Uthra Balaji
- Biostatistics Core, Baylor Scott & White Research Institute, Dallas, Texas
| | - Jinghua Gu
- Biostatistics Core, Baylor Scott & White Research Institute, Dallas, Texas
| | - Qiuyang Zhang
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Zui Pan
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas
| | - Stuart Jon Spechler
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Rhonda F. Souza
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
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Nelson M, Zhang X, Pan Z, Spechler SJ, Souza RF. Mast cell effects on esophageal smooth muscle and their potential role in eosinophilic esophagitis and achalasia. Am J Physiol Gastrointest Liver Physiol 2021; 320:G319-G327. [PMID: 33355505 DOI: 10.1152/ajpgi.00290.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Indexed: 02/07/2023]
Abstract
Mast cells and eosinophils are the key effector cells of allergic disorders. Although most studies on eosinophilic esophagitis (EoE), an allergic disorder of the esophagus, have focused on the role of eosinophils, recent studies suggest a major role for mast cells in causing the clinical manifestations of this disease. Cellular and animal studies have demonstrated that mast cells can cause esophageal muscle cells to proliferate and differentiate into a more contractile phenotype, and that mediators released by degranulating mast cells such as tryptase and histamine can activate smooth muscle contraction pathways. Thus, activated mast cells in the esophageal muscularis propria might cause esophageal motility abnormalities, including the failure of lower esophageal sphincter relaxation typical of achalasia. In addition, mast cells have been implicated in the pathogenesis of a number of neurodegenerative disorders of the central nervous system such as Alzheimer's and Parkinson's diseases, because degranulating mast cells release proinflammatory and cytotoxic mediators capable of damaging neurons. Such mast cell degranulation in the myenteric plexus of the esophagus could cause the loss of enteric neurons that characterizes achalasia. In this report, we review the molecular mechanisms of esophageal smooth muscle contraction, and how mast cells products might affect that muscle and cause neurodegeneration in the esophagus. Based on these data, we present our novel, conceptual model for an allergy-induced form of achalasia mediated by mast cell activation in the esophageal muscularis propria.
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Affiliation(s)
- Melissa Nelson
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Xi Zhang
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Zui Pan
- College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas
| | - Stuart Jon Spechler
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
| | - Rhonda F Souza
- Department of Medicine, Center for Esophageal Diseases, Baylor University Medical Center and Center for Esophageal Research, Baylor Scott & White Research Institute, Dallas, Texas
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Uprety R, Che T, Zaidi SA, Grinnell SG, Varga BR, Faouzi A, Slocum ST, Allaoa A, Varadi A, Nelson M, Bernhard SM, Kulko E, Le Rouzic V, Eans SO, Simons CA, Hunkele A, Subrath J, Pan YX, Javitch JA, McLaughlin JP, Roth BL, Pasternak GW, Katritch V, Majumdar S. Controlling opioid receptor functional selectivity by targeting distinct subpockets of the orthosteric site. eLife 2021; 10:e56519. [PMID: 33555255 PMCID: PMC7909954 DOI: 10.7554/elife.56519] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 02/07/2021] [Indexed: 12/12/2022] Open
Abstract
Controlling receptor functional selectivity profiles for opioid receptors is a promising approach for discovering safer analgesics; however, the structural determinants conferring functional selectivity are not well understood. Here, we used crystal structures of opioid receptors, including the recently solved active state kappa opioid complex with MP1104, to rationally design novel mixed mu (MOR) and kappa (KOR) opioid receptor agonists with reduced arrestin signaling. Analysis of structure-activity relationships for new MP1104 analogs points to a region between transmembrane 5 (TM5) and extracellular loop (ECL2) as key for modulation of arrestin recruitment to both MOR and KOR. The lead compounds, MP1207 and MP1208, displayed MOR/KOR Gi-partial agonism with diminished arrestin signaling, showed efficient analgesia with attenuated liabilities, including respiratory depression and conditioned place preference and aversion in mice. The findings validate a novel structure-inspired paradigm for achieving beneficial in vivo profiles for analgesia through different mechanisms that include bias, partial agonism, and dual MOR/KOR agonism.
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Affiliation(s)
- Rajendra Uprety
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer CenterNew YorkUnited States
| | - Tao Che
- Department of Pharmacology, University of North CarolinaChapel HillUnited States
- Center for Clinical Pharmacology, St. Louis College of Pharmacy and Washington University School of MedicineSt. LouisUnited States
- Department of Anesthesiology, Washington University in St. Louis School of MedicineSt. LouisUnited States
| | - Saheem A Zaidi
- Department of Quantitative and Computational Biology, Department of Chemistry, Bridge Institute, Michelson Center for Convergent Bioscience, University of Southern CaliforniaLos AngelesUnited States
| | - Steven G Grinnell
- Division of Molecular Therapeutics, New York State Psychiatric Institute and Departments of Psychiatry, Pharmacology, Columbia University Vagelos College of Physicians & SurgeonsNew YorkUnited States
| | - Balázs R Varga
- Center for Clinical Pharmacology, St. Louis College of Pharmacy and Washington University School of MedicineSt. LouisUnited States
- Department of Anesthesiology, Washington University in St. Louis School of MedicineSt. LouisUnited States
| | - Abdelfattah Faouzi
- Center for Clinical Pharmacology, St. Louis College of Pharmacy and Washington University School of MedicineSt. LouisUnited States
- Department of Anesthesiology, Washington University in St. Louis School of MedicineSt. LouisUnited States
| | - Samuel T Slocum
- Department of Pharmacology, University of North CarolinaChapel HillUnited States
| | - Abdullah Allaoa
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer CenterNew YorkUnited States
| | - András Varadi
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer CenterNew YorkUnited States
| | - Melissa Nelson
- Division of Molecular Therapeutics, New York State Psychiatric Institute and Departments of Psychiatry, Pharmacology, Columbia University Vagelos College of Physicians & SurgeonsNew YorkUnited States
| | - Sarah M Bernhard
- Center for Clinical Pharmacology, St. Louis College of Pharmacy and Washington University School of MedicineSt. LouisUnited States
| | - Elizaveta Kulko
- Division of Molecular Therapeutics, New York State Psychiatric Institute and Departments of Psychiatry, Pharmacology, Columbia University Vagelos College of Physicians & SurgeonsNew YorkUnited States
| | - Valerie Le Rouzic
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer CenterNew YorkUnited States
| | - Shainnel O Eans
- Department of Pharmacodynamics, University of FloridaGainesvilleUnited States
| | - Chloe A Simons
- Department of Pharmacodynamics, University of FloridaGainesvilleUnited States
| | - Amanda Hunkele
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer CenterNew YorkUnited States
| | - Joan Subrath
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer CenterNew YorkUnited States
| | - Ying Xian Pan
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer CenterNew YorkUnited States
- Department of Anesthesiology, Rutgers New Jersey Medical School, New JerseyNewarkUnited States
| | - Jonathan A Javitch
- Division of Molecular Therapeutics, New York State Psychiatric Institute and Departments of Psychiatry, Pharmacology, Columbia University Vagelos College of Physicians & SurgeonsNew YorkUnited States
| | - Jay P McLaughlin
- Department of Pharmacodynamics, University of FloridaGainesvilleUnited States
| | - Bryan L Roth
- Department of Pharmacology, University of North CarolinaChapel HillUnited States
| | - Gavril W Pasternak
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer CenterNew YorkUnited States
| | - Vsevolod Katritch
- Department of Quantitative and Computational Biology, Department of Chemistry, Bridge Institute, Michelson Center for Convergent Bioscience, University of Southern CaliforniaLos AngelesUnited States
| | - Susruta Majumdar
- Department of Neurology and Molecular Pharmacology, Memorial Sloan Kettering Cancer CenterNew YorkUnited States
- Center for Clinical Pharmacology, St. Louis College of Pharmacy and Washington University School of MedicineSt. LouisUnited States
- Department of Anesthesiology, Washington University in St. Louis School of MedicineSt. LouisUnited States
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Brotto LA, Nelson M, Barry L, Maher C. #ItsNotInYourHead: A Social Media Campaign to Disseminate Information on Provoked Vestibulodynia. Arch Sex Behav 2021; 50:57-68. [PMID: 32488646 PMCID: PMC7935819 DOI: 10.1007/s10508-020-01731-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/17/2020] [Accepted: 04/24/2020] [Indexed: 06/11/2023]
Abstract
Provoked Vestibulodynia (PVD) is a type of localized vulvodynia (or pain in the vulva). The estimated prevalence of this condition is about 12% of the general population and approximately 20% of women under the age of 19. Many women who live with PVD suffer in silence for years before receiving a diagnosis. Whereas cognitive behavioral therapy (CBT) was already known to be effective for managing symptoms of PVD, there has recently been a published head-to-head comparison of CBT versus mindfulness-based therapy for the primary outcome of pain intensity with penetration. The trial revealed that both treatments were effective and led to statistically and clinically meaningful improvements in sexual function, quality of life, and reduced genital pain, with improvements retained at both 6- and 12-month follow-ups. We then undertook an end-of-grant knowledge translation (KT) campaign focused on the use of social media to disseminate an infographic video depicting the findings. Social media was strategically chosen as the primary mode of dissemination for the video as it has broad reach of audience, the public can access information on social media for free, and it presented an opportunity to provide social support to the population of women with PVD who are characterized as suffering in silence by starting a sensitive and empowering dialogue on a public platform. In this paper, we summarize the social media reach of our campaign, describe how and why we partnered with social media influencers, and share lessons learned that might steer future KT efforts in this field.
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Affiliation(s)
- Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
- Women's Health Research Institute, Vancouver, BC, Canada.
| | - Melissa Nelson
- Women's Health Research Institute, Vancouver, BC, Canada
| | - Lana Barry
- Self-Management Programs, University of Victoria, Victoria, BC, Canada
| | - Ciana Maher
- Women's Health Research Institute, Vancouver, BC, Canada
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Nelson M, Hosler SC, Boetzl FA, Jones HP, Barber NA. Reintroduced grazers and prescribed fire effects on beetle assemblage structure and function in restored grasslands. Ecol Appl 2021; 31:e02217. [PMID: 32810923 DOI: 10.1002/eap.2217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/29/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Ecological restoration seeks to reestablish functioning ecosystems, but planning and evaluation often focus on taxonomic community structure and neglect consumers and their functional roles. The functional trait composition of insect assemblages, which make up the majority of animal diversity in many systems, can reveal how they are affected by restoration management and the consequences for ecosystem function. We sampled ground beetle (Coleoptera: Carabidae) assemblages in restored tallgrass prairies varying in management with prescribed fire and reintroduced American bison (Bison bison) to describe their taxonomic and functional trait structure. We also measured seed and arthropod predation to relate management, beetle assemblage characteristics, and function, and to test if function is maximized by trait diversity, dominant trait values, or beetle abundance. Beetle assemblages primarily varied with restoration age, declining over time in richness and both taxonomic and functional diversity, but bison presence also influenced taxonomic composition. Prescribed fire reduced seed predation in summer and arthropod predation in fall. Although seed predation was unrelated to beetle assemblages, arthropod predation was greater in sites with higher abundances of carnivorous ground beetles. The relatively weak impacts of fire and bison on functional assemblage structure is a promising sign that these management disturbances, aimed at supporting a diverse native plant community, are not detrimental to beetle assemblages. The significance of reduced predator function following prescribed fire will depend on the restoration context and whether seed or arthropod predation relates to management goals.
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Affiliation(s)
- Melissa Nelson
- Department of Biological Sciences, Northern Illinois University, 155 Castle Dr. DeKalb, Chicago, Illinois, 60115, USA
| | - Sheryl C Hosler
- Department of Biological Sciences, Northern Illinois University, 155 Castle Dr. DeKalb, Chicago, Illinois, 60115, USA
- Department of Biology, University of Illinois Chicago, Chicago, Illinois, 60607, USA
| | - Fabian A Boetzl
- Department of Animal Ecology and Tropical Biology, Biocenter, University of Würzburg, Am Hubland, 97074, Würzburg, Germany
| | - Holly P Jones
- Department of Biological Sciences, Northern Illinois University, 155 Castle Dr. DeKalb, Chicago, Illinois, 60115, USA
- Institute for the Study of the Environment, Sustainability, and Energy, Northern Illinois University, 155 Castle Dr. DeKalb, Chicago, Illinois, 60115, USA
| | - Nicholas A Barber
- Department of Biological Sciences, Northern Illinois University, 155 Castle Dr. DeKalb, Chicago, Illinois, 60115, USA
- Department of Biology, San Diego State University, 5500 Campanile Drive, San Diego, California, 92182, USA
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Black J, Campbell J, Sharman J, Nelson M, Parker S, Hamilton G, Marwick T. An absolute risk-guided approach to cardiovascular risk management within a chest pain clinic: the ARCPAC randomized trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2916] [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: 11/14/2022] Open
Abstract
Abstract
Background
The majority of patients attending chest pain clinics are found not to have a cardiac cause of their symptoms, but have a high burden of cardiovascular risk factors that may be opportunistically addressed. Absolute risk calculators are recommended to guide risk factor management, although it is uncertain to what extent these calculations may assist with patient engagement in risk factor modification.
Purpose
We sought to determine the usefulness of a proactive, absolute risk-based approach, to guide opportunistic cardiovascular risk factor management within a chest pain clinic.
Methods
This was a prospective, open-label, blinded-endpoint study in 192 enhanced risk (estimated 5-year risk ≥8%, based on Australian Absolute Risk Calculator) patients presenting to a tertiary hospital chest pain clinic. Patients were randomized to best practice usual care, or intervention with development of a proactive cardiovascular risk management strategy framed around a discussion of the individual's absolute risk. Patients found to have a cardiac cause of symptoms were excluded as they constitute a secondary prevention population. Primary outcome was 5-year absolute cardiovascular risk score at minimum 12 months follow up. Secondary outcomes were individual modifiable risk factors (lipid profile, blood pressure, smoking status).
Results
192 people entered the study; 100 in the intervention arm and 92 in usual care. There was no statistical difference between the two groups' baseline sociodemographic and clinical variables. The intervention group showed greater reduction in 5-year absolute risk scores (difference −2.77; p<0.001), and more favourable individual risk factors, although only smoking status and LDL cholesterol reached statistical significance (table).
Conclusion
An absolute risk-guided proactive risk factor management strategy employed opportunistically in a chest pain clinic significantly improves 5-year cardiovascular risk scores.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Tasmanian Community Fund
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Affiliation(s)
- J.A Black
- Menzies Research Institute, Hobart, Australia
| | - J Campbell
- Menzies Research Institute, Hobart, Australia
| | - J Sharman
- Menzies Research Institute, Hobart, Australia
| | - M Nelson
- Menzies Research Institute, Hobart, Australia
| | - S Parker
- Royal Hobart Hospital, Hobart, Australia
| | - G Hamilton
- Royal Hobart Hospital, Hobart, Australia
| | - T Marwick
- Baker Heart and Diabetes Institute, Melbourne, Australia
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Cusimano M, Sajewycz K, Nelson M, Jivraj N, Bowering V, Lee Y, Lheureux S, Ferguson S. Supported self-management as an innovative model of care for advanced gynecologic cancer patients with malignant bowel obstruction: A qualitative study. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- E R Anand
- Department of General Surgery, St Mary's Hospital, Isle of Wight NHS Trust, Newport, UK
| | - C Major
- Department of General Surgery, St Mary's Hospital, Isle of Wight NHS Trust, Newport, UK
| | - O Pickering
- Department of General Surgery, St Mary's Hospital, Isle of Wight NHS Trust, Newport, UK
| | - M Nelson
- Department of General Surgery, St Mary's Hospital, Isle of Wight NHS Trust, Newport, UK
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Ramstack D, Faull D, Riley K, Bowman A, Nelson M, Molina K. Upgrading Pediatric Transition: Combining Best Practices for Success. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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McInerney C, Ibiebele I, Torvaldsen S, Ford JB, Morris JM, Nelson M, Randall D. Defining a study population using enhanced reporting of Aboriginality and the effects on study outcomes. Int J Popul Data Sci 2020; 5:1114. [PMID: 32935046 PMCID: PMC7473280 DOI: 10.23889/ijpds.v5i1.1114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Introduction The under-reporting of Aboriginal and Torres Strait Islander people on routinely collected health datasets has important implications for understanding the health of this population. By pooling available information on individuals' Aboriginal or Torres Strait Islander status from probabilistically linked datasets, methods have been developed to adjust for this under-reporting. Objectives To explore different algorithms that enhance reporting of Aboriginal status in birth data to define a cohort of Aboriginal women, examine any differences between women recorded as Aboriginal and those assigned enhanced Aboriginal status, and assess the effects of using different reported populations to estimate within-group comparisons for Aboriginal people. Methods Three algorithms, with different levels of inclusiveness, were used to establish different study populations all of which aimed to include all singleton babies born to Aboriginal or Torres Strait Islander women residing in New South Wales, Australia between 2010 and 2014 and their mothers. The demographics of the four study populations were described and compared using frequencies and percentages. In order to assess the impact on research outcomes and conclusions of using study populations derived from different algorithms, estimates of the associations between smoking during pregnancy and selected perinatal outcomes were compared using rates and relative risks. Results Women included in the study population through enhanced reporting were older, less disadvantaged and more commonly resided in urban areas than those recorded as Aboriginal in the birth data. Although rates of smoking and some perinatal outcomes differed between the different study populations, the relative risks of each outcome comparing smoking and non-smoking Aboriginal mothers were very similar when estimated from each of the study populations. Conclusions This work provides evidence that estimates of within-group relative risks are reliable regardless of the assumptions made for establishing the study population through the enhanced reporting of indigenous peoples.
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Affiliation(s)
- C McInerney
- The University of Sydney Northern Clinical School, Women and Babies Research, St Leonards, New South Wales, Australia.,NSW Biostatistics Training Program, NSW Ministry of Health, Australia
| | - I Ibiebele
- The University of Sydney Northern Clinical School, Women and Babies Research, St Leonards, New South Wales, Australia.,Northern Sydney Local Health District, Kolling Institute, New South Wales, Australia
| | - S Torvaldsen
- The University of Sydney Northern Clinical School, Women and Babies Research, St Leonards, New South Wales, Australia.,Northern Sydney Local Health District, Kolling Institute, New South Wales, Australia.,School of Public Health and Community Medicine, UNSW Sydney, Australia
| | - J B Ford
- The University of Sydney Northern Clinical School, Women and Babies Research, St Leonards, New South Wales, Australia.,Northern Sydney Local Health District, Kolling Institute, New South Wales, Australia
| | - J M Morris
- The University of Sydney Northern Clinical School, Women and Babies Research, St Leonards, New South Wales, Australia.,Northern Sydney Local Health District, Kolling Institute, New South Wales, Australia
| | - M Nelson
- Centre for Epidemiology and Evidence, NSW Ministry of Health, Australia
| | - D Randall
- The University of Sydney Northern Clinical School, Women and Babies Research, St Leonards, New South Wales, Australia.,Northern Sydney Local Health District, Kolling Institute, New South Wales, Australia
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Carvalho L, Pillai S, Daniels E, Sellers P, Whyte R, Eveson L, Foxton M, Nelson M. Higher sustained virological response rates at 12 weeks in HIV-HCV co-infection; a tertiary centre experience. J Infect 2020; 80:232-254. [DOI: 10.1016/j.jinf.2019.10.019] [Citation(s) in RCA: 1] [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] [Received: 10/24/2019] [Accepted: 10/26/2019] [Indexed: 11/28/2022]
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Munot S, Redfern J, Bray J, Marschner S, Von Huben A, Semsarian C, Jennings G, Bauman A, Angell B, Coggins A, Kumar S, Middleton P, Ferry C, Kovoor P, Lai K, Oppermann I, Vukasovic M, Nelson M, Denniss A, Ware S, Chow C. 046 Bystander Cardiopulmonary Resuscitation (CPR) and use of Automated External Defibrillator (AED) for Out-of-hospital Cardiac Arrest (OHCA): Urban Versus Regional NSW. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.053] [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: 10/23/2022]
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Hessou S, Glele Ahanhanzo Y, Kpozehouen A, Biaou A, Yadouleton T, Sodoloufo O, Capo-Chichi V, Dossoh B, Gnanhoui-David B, Nelson M. Knowledge and sexual behaviors of transgender individuals faced with the risk of STI/HIV in Benin. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The issue of sexually transmitted infections (STIs) and Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) cannot be solved without considering the transgender population. This research aims to describe the knowledge, attitudes and sexual behaviors of transgender individuals faced with the risk of STIs and HIV/AIDS in Benin.
Methods
Transgender individuals were selected by respondent-driven sampling throughout the country in 2017. Included in this analysis were individuals who identified as transgender and adopted its mode of expression, aged 15 years and greater, and who gave their consent to participate.
Results
A total of 308 transgender individuals were surveyed, of which 89.6% were of male gender at birth. The participants had a good level of knowledge in the matter of STI and HIV/AIDS. In fact, 99.9% among them cited at least one symptom of STIs; 95.1% cited the three main methods of transmission of HIV and 54% are aware the risk of sexual transmission of HIV is higher between men. Participants were more than 90% likely to declare a positive attitude to care for persons living with HIV (PLWHIV) or to share the same room with them (93.2%). Concerning sexual behaviors, the average age at the first sexual encounter as a transgender individual was 14 years old. During the last three months, transgender individuals declared three regular male partners on average. The usage of condoms during the last sexual intercourse was reported in 86.6% of cases. Knowledge of the serological status of the sexual partner (31.7%) and the loss of sensation induced by the condom (26.8%) constituted the main reasons of non-usage of condoms.
Conclusions
Although adopting some risky sexual behavior, transgender individuals are a population that is relatively well informed and with favorable attitudes regarding STIs and HIV/AIDS. These factors are significant assets to be considered in the development of programs for STIs and HIV/AIDS control.
Key messages
Transgender individuals good level of knowledge is an asset for STIs/HIV control. Sexual multi-partnership seems to be common despite a good level of knowledge.
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Affiliation(s)
- S Hessou
- Plan International Benin, Cotonou, Benin
| | - Y Glele Ahanhanzo
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
| | - A Kpozehouen
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
| | - A Biaou
- Programme National de Lutte contre l’Ulcère de Buruli, Cotonou, Benin
| | | | | | | | - B Dossoh
- Leadds Consulting, Cotonou, Benin
| | | | - M Nelson
- Plan International Canada, Ottawa, Canada
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Abstract
Older adults, a rapidly growing population in the United States, have fewer physiological reserves and are more likely to be affected by stress, making them especially susceptible to depression symptoms. Meditation offers promising potential as an effective treatment; however, few studies have evaluated meditation interventions for this demographic. The objectives of this pilot study were to evaluate the feasibility and acceptability of an iRest meditation program in older adults with depression symptoms and to collect preliminary data on its effect on depression and depression-related symptoms compared to a vacation control. The study occurred at the Institute of Noetic Sciences EarthRise Retreat Center and participants' homes. Thirty generally healthy older adults, aged 55-90, with depression symptoms were recruited. Participants were randomly assigned to a 2-day retreat of either iRest meditation training or vacation. After the retreat, participants were asked to complete 20 minutes of home practice per day for 6 weeks; this consisted of either guided meditations (iRest) or music (vacation). Data were collected pre- and post-retreat and then 6 weeks later. Measures included depression-related variables (expectancy, depression symptoms, perceived stress, resilience, pain, sleep quality, and spirituality) and biomarkers (voice stress analysis, heart rate, heart rate variability). We found the iRest intervention for older adults with depression symptoms to be feasible and acceptable. Preliminary results at 6 weeks demonstrated improvements in sleep impairment in older adults compared to the control group and promising trends in improvements in depression symptoms and pain severity.
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Cohen A, Friedman D, Stankard B, Li T, Stevens G, Nelson M. 37 Point-of-Care Lung Ultrasound to Predict Hospital Re-admission Rates in Patients With Acute Heart Failure Exacerbations. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Buckley J, D’Unienville N, Nelson M, Blake H, Bellenger C. Maximal rate of heart rate increase tracks fatigue-induced changes in peak power and 30-sec maximal work in power athletes. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Zamani SZ, Samuel TJ, Wei J, Thomson LEJ, Tamarappoo B, Bairey Merz CN, Nelson M. P2715Diastolic dysfunction in women with ischemia and no obstructive coronary artery disease: novel insight from left atrial feature tracking. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1032] [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: 11/14/2022] Open
Abstract
Abstract
Background
Women with signs and symptoms of ischemia but no obstructive coronary artery disease (INOCA) are at increased risk of developing heart failure with preserved ejection fraction (HFpEF); however, the exact mechanism for HFpEF progression remains to be elucidated. Prior studies have focused specifically on impaired left ventricular diastolic function in INOCA. We hypothesized that extending our evaluation to include the left atrium (LA)– a key constituent of the transmitral pressure gradient and left ventricular filling– would provide additional, novel, pathophysiological insight.
Purpose
To evaluate LA function in women with INOCA using cardiac MRI (CMR).
Methods
We performed retrospective feature tracking analysis of cine images from CMR (Figure 1A), to evaluate LA strain, in 58 INOCA women with normal sinus rhythm (three were excluded due to suboptimal image quality). All strain measurements were performed in duplicate by an experienced investigator blinded to clinical status. We subdivided the cohort by an established threshold of resting left ventricular end diastolic pressure (LVEDP) <12 mmHg vs >12 mmHg, performed invasively within a median of 27 days of the CMR. As illustrated in Figure 1B, LA function was divided into three established phases: (1) reservoir strain, passive expansion of the left atrium from the pulmonary circulation while the mitral valve is closed; (2) conduit strain, passive emptying of the atrium into the ventricle; and (3) booster strain, active emptying of the left atrium following atrial depolarization.
Results
Reservoir strain was higher in the elevated LVEDP group (n=20, 26.1 + 1.3%) vs. not elevated group (n=35, 22.8 + 0.9%, p=0.03; Figure 1C). In contrast, we observed no group difference in conduit strain (16.5 + 1.0 and 16.5 + 0.7, p=0.78, respectively; Figure 1D), resulting in significantly higher atrial booster strain in the elevated LVEDP group (10.0 + 1.1% and 7.0 + 0.6, p<0.01, respectively; Figure 1E).
Conclusions
To our knowledge, this is the first report of LA function in women with INOCA. That reservoir strain was higher in subjects with elevated LVEDP provides important pathophysiologic insight regarding diastolic hemodynamics of the LA. The similar conduit function between groups– despite different LVEDP's– strongly suggests a ventricular contribution to the impaired transmitral pressure gradient. Together, these initial proof-of-concept data support the evaluation of LA function in our quest to better understand heart failure progression in INOCA.
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Affiliation(s)
- S Z Zamani
- The University of Texas at Arlington, Arlington, United States of America
| | - T J Samuel
- The University of Texas at Arlington, Arlington, United States of America
| | - J Wei
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - L E J Thomson
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - B Tamarappoo
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - C N Bairey Merz
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - M Nelson
- The University of Texas at Arlington, Arlington, United States of America
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Chu H, Shillingford JM, Reddy JA, Westrick E, Nelson M, Wang EZ, Parker N, Felten AE, Vaughn JF, Xu LC, Lu YJ, Vlahov IR, Leamon CP. Detecting Functional and Accessible Folate Receptor Expression in Cancer and Polycystic Kidneys. Mol Pharm 2019; 16:3985-3995. [PMID: 31356752 DOI: 10.1021/acs.molpharmaceut.9b00624] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Folate-based small molecule drug conjugates (SMDCs) are currently under development and have shown promising preclinical and clinical results against various cancers and polycystic kidney disease. Two requisites for response to a folate-based SMDC are (i) folate receptor alpha (FRα) protein is expressed in the diseased tissues, and (ii) FRα in those tissues is accessible and functionally competent to bind systemically administered SMDCs. Here we report on the development of a small molecule reporter conjugate (SMRC), called EC2220, which is composed of a folate ligand for FRα binding, a multilysine containing linker that can cross-link to FRα in the presence of formaldehyde fixation, and a small hapten (fluorescein) used for immunohistochemical detection. Data show that EC2220 produces a far greater IHC signal in FRα-positive tissues over that produced with EC17, a folate-fluorescein SMRC that is released from the formaldehyde-denatured FRα protein. Furthermore, the extent of the EC2220 IHC signal was proportional to the level of FRα expression. This EC2220-based assay was qualified both in vitro and in vivo using normal tissue, cancer tissue, and polycystic kidneys. Overall, EC2220 is a sensitive and effective reagent for evaluating functional and accessible receptor expression in vitro and in vivo.
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Affiliation(s)
- Haiyan Chu
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Jonathan M Shillingford
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Joseph A Reddy
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Elaine Westrick
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Melissa Nelson
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Emilia Z Wang
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Nikki Parker
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Albert E Felten
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Jeremy F Vaughn
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Le-Cun Xu
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Yingjuan J Lu
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Iontcho R Vlahov
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
| | - Christopher P Leamon
- Endocyte, Inc. , 3000 Kent Avenue, Suite A1-100 , West Lafayette , Indiana 47906 , United States
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Andrew NE, Kim J, Cadilhac DA, Sundararajan V, Thrift AG, Churilov L, Lannin NA, Nelson M, Srikanth V, Kilkenny MF. Protocol for evaluation of enhanced models of primary care in the management of stroke and other chronic disease (PRECISE): A data linkage healthcare evaluation study. Int J Popul Data Sci 2019; 4:1097. [PMID: 34095531 PMCID: PMC8142961 DOI: 10.23889/ijpds.v4i1.1097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The growing burden of chronic diseases means some governments have been providing financial incentives for multidisciplinary care and self-management support delivered within primary care. Currently, population-based evaluations of the effectiveness of these policies are lacking. AIM To outline the methodological approach for our study that is designed to evaluate the effectiveness (including cost) of primary care policies for chronic diseases in Australia using stroke as a case study. METHODS Person-level linkages will be undertaken between registrants from the Australian Stroke Clinical Registry (AuSCR) and (i) Government-held Medicare Australia claims data, to identify receipt or not of chronic disease management and care coordination primary care items; (ii) state government-held hospital data, to define outcomes; and (iii) government-held pharmaceutical and aged care claims data, to define covariates. N=1500 randomly selected AuSCR registrants will be sent surveys to obtain patient experience information. In Australia, unique identifiers are unavailable. Therefore, personal-identifiers will be submitted to government data linkage units. Researchers will merge the de-identified datasets for analysis using a project identifier. An economic evaluation will also be undertaken. ANALYSIS The index event will be the first stroke recorded in the AuSCR. Multivariable competing risks Poisson regression for multiple events, adjusted by a propensity score, will be used to test for differences in the rates of hospital presentations and medication adherence for different care (policy) types. Our estimated sample size of 25,000 patients will provide 80% estimated power (ɑ>0.05) to detect a 6-8% difference in rates. The incremental costs per Quality-adjusted life years gained of community-based care following the acute event will be estimated from a health sector perspective. CONCLUSION Completion of this study will provide a novel and comprehensive evaluation of the effectiveness and cost-effectiveness of Australian primary care policies. Its success will enable us to highlight the value of data-linkage for this type of research.
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Affiliation(s)
- NE Andrew
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia
| | - J Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Stroke Division, the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg Victoria, Australia
| | - DA Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Stroke Division, the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg Victoria, Australia
| | - V Sundararajan
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - AG Thrift
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - L Churilov
- Stroke Division, the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg Victoria, Australia
| | - NA Lannin
- School of Allied Health, Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - M Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Victoria, Australia
| | - V Srikanth
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia
| | - MF Kilkenny
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Stroke Division, the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg Victoria, Australia
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Horne R, Glendinning E, King K, Chalder T, Sabin C, Walker AS, Campbell LJ, Mosweu I, Anderson J, Collins S, Jopling R, McCrone P, Leake Date H, Michie S, Nelson M, Perry N, Smith JA, Sseruma W, Cooper V. Protocol of a two arm randomised, multi-centre, 12-month controlled trial: evaluating the impact of a Cognitive Behavioural Therapy (CBT)-based intervention Supporting UPtake and Adherence to antiretrovirals (SUPA) in adults with HIV. BMC Public Health 2019; 19:905. [PMID: 31286908 PMCID: PMC6615195 DOI: 10.1186/s12889-019-6893-z] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/25/2019] [Indexed: 12/02/2022] Open
Abstract
Background Delay to start antiretroviral therapy (ART) and nonadherence compromise the health and wellbeing of people living with HIV (PLWH), raise the cost of care and increase risk of transmission to sexual partners. To date, interventions to improve adherence to ART have had limited success, perhaps because they have failed to systematically elicit and address both perceptual and practical barriers to adherence. The primary aim of this study is to determine the efficacy of the Supporting UPtake and Adherence (SUPA) intervention. Methods This study comprises 2 phases. Phase 1 is an observational cohort study, in which PLWH who are ART naïve and recommended to take ART by their clinician complete a questionnaire assessing their beliefs about ART over 12 months. Phase 2 is a randomised controlled trial (RCT) nested within the observational cohort study to investigate the effectiveness of the SUPA intervention on adherence to ART. PLWH at risk of nonadherence (based on their beliefs about ART) will be recruited and randomised 1:1 to the intervention (SUPA intervention + usual care) and control (usual care) arms. The SUPA intervention involves 4 tailored treatment support sessions delivered by a Research Nurse utilising a collaborative Cognitive Behavioural Therapy (CBT) and Motivational Interviewing (MI) approach. Sessions are tailored to individual needs and preferences based on the individual patient’s perceptions and practical barriers to ART. An animation series and intervention manual have been developed to communicate a rationale for the personal necessity for ART and illustrate concerns and potential solutions. The primary outcome is adherence to ART measured using Medication Event Monitoring System (MEMS). Three hundred seventy-two patients will be sufficient to detect a 15% difference in adherence with 80% power and an alpha of 0.05. Costs will be compared between intervention and control groups. Costs will be combined with the primary outcome in cost-effectiveness analyses. Quality adjusted life-years (QALYs) will also be estimated over the follow-up period and used in the analyses. Discussion The findings will enable patients, healthcare providers and policy makers to make informed decisions about the value of the SUPA intervention. Trial registration The trial was retrospectively registered 21/02/2014, ISRCTN35514212. Electronic supplementary material The online version of this article (10.1186/s12889-019-6893-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R Horne
- Department of Practice and Policy, Centre for Behavioural Medicine, UCL School of Pharmacy, Mezzanine Floor, Entrance A, BMA House, Tavistock Square, London, WC1H 9JP, UK.
| | - E Glendinning
- Department of Practice and Policy, Centre for Behavioural Medicine, UCL School of Pharmacy, Mezzanine Floor, Entrance A, BMA House, Tavistock Square, London, WC1H 9JP, UK
| | - K King
- Department of Practice and Policy, Centre for Behavioural Medicine, UCL School of Pharmacy, Mezzanine Floor, Entrance A, BMA House, Tavistock Square, London, WC1H 9JP, UK
| | - T Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16, De Crespigny Park, London, SE5 8AF, UK
| | - C Sabin
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, UCL, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - A S Walker
- MRC Clinical Trials Unit at UCL, 90 High Holborn, 2nd Floor, London, WC1V 6LJ, UK
| | - L J Campbell
- HIV Research Centre, King's College London, London, SE5 9RJ, UK
| | - I Mosweu
- Institute of Psychiatry at King's College London, Denmark Hill, London, SE5 8AF, UK
| | - J Anderson
- Centre for the Study of Sexual Health and HIV, Homerton University Hospital, E9 6RS, London, UK
| | - S Collins
- HIV i-Base, 107 The Maltings, 169 Tower Bridge Road, London, SE1 3LJ, UK
| | - R Jopling
- Department of Practice and Policy, Centre for Behavioural Medicine, UCL School of Pharmacy, Mezzanine Floor, Entrance A, BMA House, Tavistock Square, London, WC1H 9JP, UK
| | - P McCrone
- Institute of Psychiatry at King's College London, Denmark Hill, London, SE5 8AF, UK
| | - H Leake Date
- Departments of of Pharmacy and HIV Medicine, Brighton & Sussex University Hospitals NHS Trust, Brighton, BN2 5B, UK
| | - S Michie
- Department of Clinical, Educational and Health Psychology, UCL, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - M Nelson
- Kobler Clinic, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - N Perry
- Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE, UK
| | - J A Smith
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | - W Sseruma
- UK-CAB, 107 The Maltings, 169 Tower Bridge Road, London, SE1 3LJ, UK
| | - V Cooper
- Department of Practice and Policy, Centre for Behavioural Medicine, UCL School of Pharmacy, Mezzanine Floor, Entrance A, BMA House, Tavistock Square, London, WC1H 9JP, UK
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Vlahov I, Qi L, Santhapuram HK, Parham G, Wang K, Vaughn JF, Hahn SJ, Vetzel M, Nelson M, Reddy JA, Leamon CP. Abstract 216: pro-Pyrrolobenzodiazepine ( pro-PBD) bioconjugates, the legacy: Design and synthesis of pro-PBD conjugates containing self-immolative substituted disulfide linkers. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-216] [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
Naturally occurring pyrrolo[2,1-c][1,4]benzodiazepines (PBDs) are a group of highly potent antitumor antibiotics, isolated from various streptomycin species. PBDs covalently bond and cross-link with discrete sequences of base pairs in the minor groove of DNA. A wide range of synthetic PBDs and PBD dimers have been shown to be highly potent cytotoxic agents, and have been used as payloads in antibody drug conjugates (ADCs). However, all PBDs as stand-alone agents or as delivered via small molecule drug conjugates (SMDCs), cause undesired off-target toxicity. Recently, we designed folate conjugated pro-PBDs, masking the imine moiety with its synthetic precursors: namely, 1,3-oxazolidine carbamate and an aromatic amine. The 1,3-oxazolidine carbamate provided a conjugation site for attachment of pro-PBD to a targeting ligand. After delivery to the targeted cell and internalization, reductive cleavage of the linker system results in the generation of a 1,3-oxazolidine. The oxazolidine reacts with water to form an aldehyde which subsequently reacts intramolecularly to ultimately form the PBD diazepine ring. Herein, we report the design and synthesis of folate conjugates of pro-PBDs and self-immolative sterically hindered disulfide linker systems, which pave the way toward novel, highly-specific therapeutics which have the potential to minimize off-target toxicities.
One of the so designed conjugates, EC2629, satisfied all of our criteria for selection for pre-clinical development:
• EC2629 shows high affinity towards FR mediated binding.
• Cross-links DNA only following self-immolative release of free drug.
• Picomolar potency against FR-expressing cells.
• Curative activity with no weight loss in animal models.
• Active against drug resistant tumor xenograft models in-vivo.
• EC2629 is active against patient derived xenograft models in-vivo.
• Based on high cytotoxicity and minimal off target toxicity (in-vitro & in-vivo), EC2629 is selected for pre-clinical development.
• Biological evaluation of EC2629 was presented at World ADC, Berlin, Germany (March, 2018).
Citation Format: Iontcho Vlahov, Longwu Qi, Hari K. Santhapuram, Garth Parham, Kevin Wang, Jeremy F. Vaughn, Spencer J. Hahn, Marilynn Vetzel, Melissa Nelson, Joseph A. Reddy, Christopher P. Leamon. pro-Pyrrolobenzodiazepine (pro-PBD) bioconjugates, the legacy: Design and synthesis of pro-PBD conjugates containing self-immolative substituted disulfide linkers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 216.
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