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Jones SE, Bradwell KR, Chan LE, McMurry JA, Olson-Chen C, Tarleton J, Wilkins KJ, Ly V, Ljazouli S, Qin Q, Faherty EG, Lau YK, Xie C, Kao YH, Liebman MN, Mariona F, Challa AP, Li L, Ratcliffe SJ, Haendel MA, Patel RC, Hill EL. Who is pregnant? Defining real-world data-based pregnancy episodes in the National COVID Cohort Collaborative (N3C). JAMIA Open 2023; 6:ooad067. [PMID: 37600074 PMCID: PMC10432357 DOI: 10.1093/jamiaopen/ooad067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/12/2023] [Accepted: 08/08/2023] [Indexed: 08/22/2023] Open
Abstract
Objectives To define pregnancy episodes and estimate gestational age within electronic health record (EHR) data from the National COVID Cohort Collaborative (N3C). Materials and Methods We developed a comprehensive approach, named Hierarchy and rule-based pregnancy episode Inference integrated with Pregnancy Progression Signatures (HIPPS), and applied it to EHR data in the N3C (January 1, 2018-April 7, 2022). HIPPS combines: (1) an extension of a previously published pregnancy episode algorithm, (2) a novel algorithm to detect gestational age-specific signatures of a progressing pregnancy for further episode support, and (3) pregnancy start date inference. Clinicians performed validation of HIPPS on a subset of episodes. We then generated pregnancy cohorts based on gestational age precision and pregnancy outcomes for assessment of accuracy and comparison of COVID-19 and other characteristics. Results We identified 628 165 pregnant persons with 816 471 pregnancy episodes, of which 52.3% were live births, 24.4% were other outcomes (stillbirth, ectopic pregnancy, abortions), and 23.3% had unknown outcomes. Clinician validation agreed 98.8% with HIPPS-identified episodes. We were able to estimate start dates within 1 week of precision for 475 433 (58.2%) episodes. 62 540 (7.7%) episodes had incident COVID-19 during pregnancy. Discussion HIPPS provides measures of support for pregnancy-related variables such as gestational age and pregnancy outcomes based on N3C data. Gestational age precision allows researchers to find time to events with reasonable confidence. Conclusion We have developed a novel and robust approach for inferring pregnancy episodes and gestational age that addresses data inconsistency and missingness in EHR data.
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Affiliation(s)
- Sara E Jones
- Office of Data Science and Emerging Technologies, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852, United States
| | | | - Lauren E Chan
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, United States
| | - Julie A McMurry
- Department of Biomedical Informatics, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, United States
| | - Courtney Olson-Chen
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14620, United States
| | - Jessica Tarleton
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Kenneth J Wilkins
- Biostatistics Program, Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, United States
| | - Victoria Ly
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14620, United States
| | - Saad Ljazouli
- Palantir Technologies, Denver, CO 80202, United States
| | - Qiuyuan Qin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14618, United States
| | - Emily Groene Faherty
- School of Public Health, University of Minnesota, Minneapolis, MN 55455, United States
| | | | - Catherine Xie
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14618, United States
| | - Yu-Han Kao
- Sema4, Stamford, CT 06902, United States
| | | | - Federico Mariona
- Beaumont Hospital, Dearborn, MI 48124, United States
- Wayne State University, Detroit, MI 48202, United States
| | - Anup P Challa
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN 37212, United States
| | - Li Li
- Sema4, Stamford, CT 06902, United States
| | - Sarah J Ratcliffe
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA 22903, United States
| | - Melissa A Haendel
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, United States
| | - Rena C Patel
- Department of Medicine and Global Health, University of Washington, Seattle, WA 98105, United States
| | - Elaine L Hill
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14620, United States
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14618, United States
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Long J, Ganakammal SR, Jones SE, Kothandaraman H, Dhawan D, Ogas J, Knapp DW, Beyers M, Lanman NA. cTULIP: application of a human-based RNA-seq primary tumor classification tool for cross-species primary tumor classification in canine. Front Oncol 2023; 13:1216892. [PMID: 37546395 PMCID: PMC10397722 DOI: 10.3389/fonc.2023.1216892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/27/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction The domestic dog, Canis familiaris, is quickly gaining traction as an advantageous model for use in the study of cancer, one of the leading causes of death worldwide. Naturally occurring canine cancers share clinical, histological, and molecular characteristics with the corresponding human diseases. Methods In this study, we take a deep-learning approach to test how similar the gene expression profile of canine glioma and bladder cancer (BLCA) tumors are to the corresponding human tumors. We likewise develop a tool for identifying misclassified or outlier samples in large canine oncological datasets, analogous to that which was developed for human datasets. Results We test a number of machine learning algorithms and found that a convolutional neural network outperformed logistic regression and random forest approaches. We use a recently developed RNA-seq-based convolutional neural network, TULIP, to test the robustness of a human-data-trained primary tumor classification tool on cross-species primary tumor prediction. Our study ultimately highlights the molecular similarities between canine and human BLCA and glioma tumors, showing that protein-coding one-to-one homologs shared between humans and canines, are sufficient to distinguish between BLCA and gliomas. Discussion The results of this study indicate that using protein-coding one-to-one homologs as the features in the input layer of TULIP performs good primary tumor prediction in both humans and canines. Furthermore, our analysis shows that our selected features also contain the majority of features with known clinical relevance in BLCA and gliomas. Our success in using a human-data-trained model for cross-species primary tumor prediction also sheds light on the conservation of oncological pathways in humans and canines, further underscoring the importance of the canine model system in the study of human disease.
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Affiliation(s)
- Jiaxin Long
- Department of Biochemistry, Purdue University, West Lafayette, IN, United States
- Purdue University Institute for Cancer Research, West Lafayette, IN, United States
| | - Satishkumar Ranganathan Ganakammal
- Cancer Science Data Initiatives, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, United States
| | - Sara E. Jones
- Cancer Science Data Initiatives, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, United States
| | - Harish Kothandaraman
- Purdue University Institute for Cancer Research, West Lafayette, IN, United States
| | - Deepika Dhawan
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, United States
| | - Joe Ogas
- Department of Biochemistry, Purdue University, West Lafayette, IN, United States
- Purdue University Institute for Cancer Research, West Lafayette, IN, United States
| | - Deborah W. Knapp
- Purdue University Institute for Cancer Research, West Lafayette, IN, United States
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN, United States
| | - Matthew Beyers
- Cancer Science Data Initiatives, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD, United States
| | - Nadia A. Lanman
- Purdue University Institute for Cancer Research, West Lafayette, IN, United States
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States
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Jones SE, Harvey PD. Cross-diagnostic determinants of cognitive functioning: the muscarinic cholinergic receptor as a model system. Transl Psychiatry 2023; 13:100. [PMID: 36973270 PMCID: PMC10042838 DOI: 10.1038/s41398-023-02400-x] [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] [Received: 01/11/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
Cognitive impairment is a predictor of disability across different neuropsychiatric conditions, and cognitive abilities are also strongly related to educational attainment and indices of life success in the general population. Previous attempts at drug development for cognitive enhancement have commonly attempted to remedy defects in transmitters systems putatively associated with the conditions of interest such as the glutamate system in schizophrenia. Recent studies of the genomics of cognitive performance have suggested influences that are common in the general population and in different neuropsychiatric conditions. Thus, it seems possible that transmitter systems that are implicated for cognition across neuropsychiatric conditions and the general population would be a viable treatment target. We review the scientific data on cognition and the muscarinic cholinergic receptor system (M1 and M4) across different diagnoses, in aging, and in the general population. We suggest that there is evidence suggesting potential beneficial impacts of stimulation of critical muscarinic receptors for the enhancement of cognition in a broad manner, as well as the treatment of psychotic symptoms. Recent developments make stimulation of the M1 receptor more tolerable, and we identify the potential benefits of M1 and M4 receptor stimulation as a trans-diagnostic treatment model.
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Affiliation(s)
- Sara E Jones
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Philip D Harvey
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA.
- Research Service, Bruce W. Carter VA Medical Center, Miami, FL, USA.
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Tom MC, DiFilippo F, Smile T, Jones SE, Suh JH, Murphy ES, Yu JS, Mohammadi AM, Barnett GH, Angelov L, Huang SS, Wu G, Johnson S, Obuchowski N, Ahluwalia M, Peereboom D, Stevens G, Chao S. P15.11.A 18F-Fluciclovine PET/CT to distinguish radiation necrosis from tumour progression in brain metastases treated with stereotactic radiosurgery: results of a prospective pilot study. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.301] [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
Background
Amino acid PET radiopharmaceutical, 18F-fluciclovine, shows increased uptake in brain tumors relative to normal tissue and may be a useful tool for detecting recurrent brain metastases. Here, we report results from a prospective pilot study evaluating the use of 18F-fluciclovine PET/CT to distinguish radiation necrosis from tumour progression among patients with brain metastases treated with stereotactic radiosurgery (SRS).
Material and Methods
The primary objective was to estimate the accuracy of 18F-fluciclovine PET/CT in distinguishing radiation necrosis from tumour progression. The trial included adults with brain metastases who underwent SRS and presented with a follow up MRI brain (with DSC MR perfusion) which was equivocal for radiation necrosis versus tumour progression. Within 30 days of equivocal MRI brain, patients underwent an 18F-fluciclovine PET/CT (Siemens mCT) acquired 5-15 min post-injection with images generated by PSF reconstruction. Quantitative metrics for each lesion were documented and lesion to normal brain SUVmean ratios were calculated. The reference standard for diagnosis of radiation necrosis vs tumour progression was clinical follow up with MRI brain every 2-4 months until multidisciplinary consensus or tissue confirmation.
Results
Of 16 patients enrolled between 7/2019-11/2020, 1 patient died prior to diagnosis, allowing 15 evaluable subjects with 20 lesions. Primary histology was NSCLC in 9 (45%) lesions, breast in 7 (35%), melanoma in 3 (15%), and endometrial in 1 (5%). The final diagnosis was radiation necrosis in 16 (80%) lesions and tumour progression in 4 (20%). SUVmax was a statistically significant predictor of tumour progression (P = 0.011), with higher SUVmax values indicative of tumour progression. The area under the ROC curve was 0.833 (95% CI: 0.590, 1.0). A cutoff of 4.3 provided a sensitivity to identify tumour progression of 1.0 (4/4) and specificity to rule out tumour progression of 0.63 (10/16). SUVmean (P = 0.018), SUVpeak (P = 0.007), and SUVpeak/normal (P = 0.002) also reached statistical significance as predictors of tumour progression, with higher SUVmax values indicative of tumour progression. SUVmax/normal (P = 0.1) and SUVmean/normal (P = 0.5) were not statistically significant. The AUC for SUVmax was not significantly higher than the AUCs for the other quantitative variables (P-values > 0.2).
Conclusion
In this prospective pilot study, 18F Fluciclovine PET/CT demonstrated promising accuracy to distinguish radiation necrosis from tumour progression among patients with brain metastases previously treated with SRS. Using SUVmax, a cutpoint of 4.3 provided a sensitivity of 1.0 and specificity of 0.63. Confirmatory phase II and III studies are ongoing.
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Affiliation(s)
- M C Tom
- Baptist Health South Florida , Miami, FL , United States
| | - F DiFilippo
- Cleveland Clinic , Cleveland, OH , United States
| | - T Smile
- Cleveland Clinic , Cleveland, OH , United States
| | - S E Jones
- Cleveland Clinic , Cleveland, OH , United States
| | - J H Suh
- Cleveland Clinic , Cleveland, OH , United States
| | - E S Murphy
- Cleveland Clinic , Cleveland, OH , United States
| | - J S Yu
- Cleveland Clinic , Cleveland, OH , United States
| | | | - G H Barnett
- Cleveland Clinic , Cleveland, OH , United States
| | - L Angelov
- Cleveland Clinic , Cleveland, OH , United States
| | - S S Huang
- Cleveland Clinic , Cleveland, OH , United States
| | - G Wu
- Cleveland Clinic , Cleveland, OH , United States
| | - S Johnson
- Cleveland Clinic , Cleveland, OH , United States
| | - N Obuchowski
- Cleveland Clinic , Cleveland, OH , United States
| | - M Ahluwalia
- Baptist Health South Florida , Miami, FL , United States
| | - D Peereboom
- Cleveland Clinic , Cleveland, OH , United States
| | - G Stevens
- Cleveland Clinic , Cleveland, OH , United States
| | - S Chao
- Cleveland Clinic , Cleveland, OH , United States
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Paterson KL, Hinman RS, Metcalf BR, McManus F, Jones SE, Menz HB, Munteanu SE, Bennell KL. Effect of foot orthoses vs sham insoles on first metatarsophalangeal joint osteoarthritis symptoms: a randomized controlled trial. Osteoarthritis Cartilage 2022; 30:956-964. [PMID: 35272050 DOI: 10.1016/j.joca.2022.01.014] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To compare contoured foot orthoses to sham flat insoles for first MTP joint OA walking pain. DESIGN This was a participant- and assessor-blinded, sham-controlled, multi-centre randomized clinical trial set in community-based private practices. Eighty-eight adults aged ≥45 years with symptomatic radiographic first MTP joint OA were randomized to receive contoured foot orthoses (n = 47) or sham flat insoles (n = 41), worn at all times when wearing shoes for 12 weeks. Primary outcome was change in first MTP joint walking pain (11-point numerical rating scale (NRS), 0-10) over 12 weeks. Secondary outcomes included additional first MTP joint and foot pain measures, physical function, quality of life and physical activity. Separate linear regression models for primary and secondary outcomes on treatment group were fit, adjusting for the outcome at baseline and podiatrist. Other measures included adverse events. RESULTS 88 participants were randomized and 87 (99%) completed the 12-week primary outcome. There was no evidence foot orthoses were superior to sham insoles for reducing pain (mean difference -0.3 NRS units (95% CI -1.2 to 0.6), p = 0.53). Similarly, foot orthoses were not superior to sham on any secondary outcomes. Sensitivity analyses yielded similar results. Adverse events were generally minor and transient. CONCLUSION Contoured foot orthoses are no more effective than flat sham insoles for the clinical management of first MTP joint OA. Given the dearth of evidence on treatments for first MTP joint OA, further research is needed to identify effective management approaches for this common and debilitating condition.
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Affiliation(s)
- K L Paterson
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia.
| | - R S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - B R Metcalf
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - F McManus
- Biostatistics Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - S E Jones
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - H B Menz
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - S E Munteanu
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - K L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
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Jones SE, Moore RC, Depp CA, Ackerman RA, Pinkham AE, Harvey PD. Daily Ecological Momentary Assessments of happy and sad moods in people with schizophrenia and bipolar disorders: What do participants who are never sad think about their activities and abilities? Schizophr Res Cogn 2021; 26:100202. [PMID: 34189061 PMCID: PMC8219985 DOI: 10.1016/j.scog.2021.100202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 10/26/2022]
Abstract
OBJECTIVES People with schizophrenia have challenges in their self-assessments of everyday functioning and those who report no sadness also tend to overestimate their everyday functional abilities. While previous studies were cross-sectional, this study related longitudinal assessments of sadness to self-reports of abilities in domains of everyday functioning and cognitive abilities. METHODS 71 people with bipolar illness (BPI) were compared to 102 people with schizophrenia (SCZ). Participants were sampled 3 times per day for 30 days with a smartphone-based Ecological Momentary Assessment (EMA) survey. Each survey asked where they were, with whom they were, what they were doing, and if they were sad. Performance based assessments of executive functioning, social competence, and everyday activities were collected after the EMA period, at which time the participants and observers were asked to provide ratings of three different domains of everyday functioning and neurocognitive ability. RESULTS 18% of participants with SCZ reported that they were never sad on any one of the 90 EMA surveys. Reports of never being sad were associated with overestimated functioning compared to observers and SCZ participants who reported that they were never sad were more commonly home and alone than both SCZ participants who reported occasional sadness and participants with BPI. These participants reported being significantly happier than all people in the study. IMPLICATIONS Reporting that you were never sad was associated with overestimation of everyday functioning and cognitive abilities. Although participants who were never sad did not perform more poorly on objective measures than those were occasionally sad, their self-assessed functioning was significantly elevated. These data suggest that negative symptoms constructs such as reduced emotional experience need to consider reduced ability to subjectively evaluate emotional experience as a feature of negative symptoms.
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Affiliation(s)
- Sara E. Jones
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Colin A. Depp
- UCSD Health Sciences Center, La Jolla, CA, USA
- San Diego VA Medical Center, La Jolla, CA, USA
| | | | - Amy E. Pinkham
- University of Texas at Dallas, Richardson, TX, USA
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Philip D. Harvey
- University of Miami Miller School of Medicine, Miami, FL, USA
- Bruce W. Carter VA Medical Center, Miami, FL, USA
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Jones SE, Moore RC, Pinkham AE, Depp CA, Granholm E, Harvey PD. A cross-diagnostic study of Adherence to Ecological Momentary Assessment: Comparisons across study length and daily survey frequency find that early adherence is a potent predictor of study-long adherence. ACTA ACUST UNITED AC 2021; 29-30. [PMID: 34541425 DOI: 10.1016/j.pmip.2021.100085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background Ecological momentary assessment (EMA) offers a highly valid strategy to assess everyday functioning in people with severe mental illness. Adherence is generally good, but several questions regarding the impact of study length, daily density of sampling, and symptom severity on adherence remain. Methods EMA adherence in two separate studies was examined. One sampled participants with schizophrenia (n=106) and healthy controls (n=76) 7 times per day for 7 days and the other sampled participants with schizophrenia (n=104) and participants with bipolar illness (n=76) 3 times per day for 30 days. Participants were asked where they were, who they were with, what they were doing and how they were feeling in both studies. The impact of rates of very early adherence on eventual adherence was investigated across the samples, and adherence rates were examined for associations with mood state and most common location when answering surveys. Results Median levels of adherence were over 80% across the samples, and the 10th percentile for adherence was approximately 45% of surveys answered. Early adherence predicted study-long adherence quite substantially in every sample. Mood states did not correlate with adherence in the patient samples and being home correlated with adherence in only the bipolar sample. Implications Adherence was quite high and was not correlated with the length of the study or the density of sampling per study day. There was a tendency for bipolar participants who were more commonly away from home to answer fewer surveys but overall adherence for the bipolar patients was quite high. These data suggest that early nonadherence is a potential predictor of eventual nonadherence and study noncompletion.
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Affiliation(s)
- Sara E Jones
- University of Miami Miller School of Medicine, Miami, FL
| | | | - Amy E Pinkham
- University of Texas at Dallas, Richardson, TX.,University of Texas Southwestern Medical Center, Dallas TX
| | - Colin A Depp
- UCSD Health Sciences Center, La Jolla, CA.,San Diego VA Medical Center La Jolla, CA
| | - Eric Granholm
- UCSD Health Sciences Center, La Jolla, CA.,San Diego VA Medical Center La Jolla, CA
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL.,Bruce W. Carter VA Medical Center, Miami, FL
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Lawford BJ, Bennell KL, Jones SE, Keating C, Brown C, Hinman RS. "It's the single best thing I've done in the last 10 years": a qualitative study exploring patient and dietitian experiences with, and perceptions of, a multi-component dietary weight loss program for knee osteoarthritis. Osteoarthritis Cartilage 2021; 29:507-517. [PMID: 33434629 DOI: 10.1016/j.joca.2021.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/14/2020] [Accepted: 01/02/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Explore patient and dietitian experiences with a multi-component dietary weight loss program for knee osteoarthritis to understand enablers and challenges to success at 6-months. DESIGN Qualitative study embedded within a randomised controlled trial. Semi-structured individual interviews with 24 patients with knee osteoarthritis who undertook, and five dietitians who supervised, a weight management program (involving a ketogenic very low calorie diet (VLCD), video consultations, educational resources) over 6 months. Data were thematically analysed. RESULTS Five themes were developed: (1) ease and convenience of program facilitated adherence (structure and simplicity of the meal replacements; not feeling hungry on diet; convenience of consulting via video) (2) social and professional support crucial for success (encouragement from partner, family, and friends; guidance from, and accountability to, dietitian; anxiety around going at it alone) (3) program was engaging and motivating (determination to stick to program; rapid weight loss helped motivation) (4) holistic nature of program was important (suite of high-quality educational resources; exercise important to compliment weight loss) (5) rewarding experience and lifelong impact (improved knee pain and function; positive lifestyle change). CONCLUSIONS Patients and dietitians described positive experiences with the weight management program, valuing its simplicity, effectiveness, and convenience. Support from dietitians and a comprehensive suite of educational resources, incorporated with an exercise program, were considered crucial for success. Findings suggest this multi-component dietary program is an acceptable weight loss method in people with knee osteoarthritis that may benefit symptoms. Strategies for supporting long-term independent weight management should be a focus of future research.
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Affiliation(s)
- B J Lawford
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Victoria, Australia.
| | - K L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Victoria, Australia.
| | - S E Jones
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Victoria, Australia.
| | - C Keating
- Medibank Private, Melbourne, Vic, Australia.
| | - C Brown
- Medibank Private, Melbourne, Vic, Australia.
| | - R S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Victoria, Australia.
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Macaron G, Baldassari LE, Nakamura K, Rao SM, McGinley MP, Moss BP, Li H, Miller DM, Jones SE, Bermel RA, Cohen JA, Ontaneda D, Conway DS. Cognitive processing speed in multiple sclerosis clinical practice: association with patient-reported outcomes, employment and magnetic resonance imaging metrics. Eur J Neurol 2020; 27:1238-1249. [PMID: 32222019 DOI: 10.1111/ene.14239] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 03/19/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE To analyze the relationship between cognitive processing speed, patient-reported outcome measures (PROMs), employment and magnetic resonance imaging (MRI) metrics in a large multiple sclerosis cohort. METHODS Cross-sectional clinical data, PROMs, employment and MRI studies within 90 days of completion of the Processing Speed Test (PST), a technology-enabled adaptation of the Symbol Digit Modalities Test, were collected. MRI was analyzed using semi-automated methods. Correlations of PST score with PROMs and MRI metrics were examined using Spearman's rho. Wilcoxon rank sum testing compared MRI metrics across PST score quartiles and linear regression models identified predictors of PST performance. Effects of employment and depression were also investigated. RESULTS In 721 patients (mean age 47.6 ± 11.4 years), PST scores were significantly correlated with all MRI metrics, including cord atrophy and deep gray matter volumes. Linear regression demonstrated self-reported physical disability, cognitive function, fatigue and social domains (adjusted R2 = 0.44, P < 0.001) as the strongest clinical predictors of PST score, whereas that of MRI variables included T2 lesion volume, whole-brain fraction and cord atrophy (adjusted R2 = 0.42, P < 0.001). An inclusive model identified T2 lesion volume, whole-brain fraction, self-reported upper extremity function, cognition and social participation as the strongest predictors of PST score (adjusted R2 = 0.51, P < 0.001). There was significant effect modification by depression on the relationship between self-reported cognition and PST performance. Employment status was associated with PST scores independent of age and physical disability. CONCLUSION The PST score correlates with PROMs, MRI measures of focal and diffuse brain injury, and employment. The PST score is a feasible and meaningful measure for routine multiple sclerosis care.
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Affiliation(s)
- G Macaron
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.,Faculty of Medicine, Université Saint Joseph de Beyrouth, Beirut, Lebanon
| | - L E Baldassari
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - K Nakamura
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - S M Rao
- Schey Center for Cognitive Neuroimaging, Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - M P McGinley
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - B P Moss
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - H Li
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - D M Miller
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - S E Jones
- Neuroradiology Department, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| | - R A Bermel
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - J A Cohen
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - D Ontaneda
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - D S Conway
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
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10
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Locey KJ, Muscarella ME, Larsen ML, Bray SR, Jones SE, Lennon JT. Dormancy dampens the microbial distance-decay relationship. Philos Trans R Soc Lond B Biol Sci 2020; 375:20190243. [PMID: 32200741 DOI: 10.1098/rstb.2019.0243] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Much of Earth's biodiversity has the capacity to engage in dormancy, a reversible state of reduced metabolic activity. By increasing resilience to unfavourable conditions, dormancy leads to the accumulation of 'seed banks'. These reservoirs of genetic and phenotypic diversity should diminish the strength of environmental filtering and increase rates of dispersal. Although prevalent among single-celled organisms, evidence that dormancy influences patterns of microbial biogeography is lacking. We constructed geographical and environmental distance-decay relationships (DDRs) for the total (DNA) and active (RNA) portions of bacterial communities in a regional-scale 16S rRNA survey of forested ponds in Indiana, USA. As predicted, total communities harboured greater diversity and exhibited weaker DDRs than active communities. These observations were robust to random resampling and different community metrics. To evaluate the processes underlying the biogeographic patterns, we developed a platform of mechanistic models that used the geographical coordinates and environmental characteristics of our study system. Based on more than 106 simulations, our models approximated the empirical DDRs when there was strong environmental filtering along with the presence of long-lived seed banks. By contrast, the inclusion of dispersal generally decreased model performance. Together, our findings support recent theoretical predictions that seed banks can influence the biogeographic patterns of microbial communities. This article is part of the theme issue 'Conceptual challenges in microbial community ecology'.
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Affiliation(s)
- K J Locey
- Department of Biology, Indiana University, Bloomington, Indiana, USA
| | - M E Muscarella
- Department of Biology, Indiana University, Bloomington, Indiana, USA
| | - M L Larsen
- Department of Biology, Indiana University, Bloomington, Indiana, USA
| | - S R Bray
- Department of Biology, Transylvania University, Lexington, Kentucky, USA
| | - S E Jones
- Department of Biological Sciences, University of Notre Dame, South Bend, Indiana, USA
| | - J T Lennon
- Department of Biology, Indiana University, Bloomington, Indiana, USA
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11
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van Hees VT, Sabia S, Jones SE, Wood AR, Anderson KN, Kivimäki M, Frayling TM, Pack AI, Bucan M, Trenell MI, Mazzotti DR, Gehrman PR, Singh-Manoux BA, Weedon MN. Estimating sleep parameters using an accelerometer without sleep diary. Sci Rep 2018; 8:12975. [PMID: 30154500 PMCID: PMC6113241 DOI: 10.1038/s41598-018-31266-z] [Citation(s) in RCA: 210] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/08/2018] [Indexed: 11/24/2022] Open
Abstract
Wrist worn raw-data accelerometers are used increasingly in large-scale population research. We examined whether sleep parameters can be estimated from these data in the absence of sleep diaries. Our heuristic algorithm uses the variance in estimated z-axis angle and makes basic assumptions about sleep interruptions. Detected sleep period time window (SPT-window) was compared against sleep diary in 3752 participants (range = 60-82 years) and polysomnography in sleep clinic patients (N = 28) and in healthy good sleepers (N = 22). The SPT-window derived from the algorithm was 10.9 and 2.9 minutes longer compared with sleep diary in men and women, respectively. Mean C-statistic to detect the SPT-window compared to polysomnography was 0.86 and 0.83 in clinic-based and healthy sleepers, respectively. We demonstrated the accuracy of our algorithm to detect the SPT-window. The value of this algorithm lies in studies such as UK Biobank where a sleep diary was not used.
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Affiliation(s)
| | - S Sabia
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Université Paris-Saclay, Paris, France
- Department of Epidemiology & Public Health, University College London (UCL), London, UK
| | - S E Jones
- University of Exeter Medical School, Genetics of Complex Traits, Exeter, UK
| | - A R Wood
- University of Exeter Medical School, Genetics of Complex Traits, Exeter, UK
| | - K N Anderson
- Regional Sleep Service, Freeman Hospital, Newcastle-upon-Tyne, UK
| | - M Kivimäki
- Department of Epidemiology & Public Health, University College London (UCL), London, UK
| | - T M Frayling
- University of Exeter Medical School, Genetics of Complex Traits, Exeter, UK
| | - A I Pack
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - M Bucan
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - M I Trenell
- Movelab, Newcastle University, Newcastle-upon-Tyne, UK
| | - Diego R Mazzotti
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - P R Gehrman
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - B A Singh-Manoux
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Université Paris-Saclay, Paris, France
- Department of Epidemiology & Public Health, University College London (UCL), London, UK
| | - M N Weedon
- University of Exeter Medical School, Genetics of Complex Traits, Exeter, UK
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12
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Mazzotti DR, Jones SE, van Hees V, Pack AI, Frayling TM, Weedon MN, Gehrman PR, Wood AR. 0055 Genome-Wide Association Analysis of Accelerometer-Derived Traits Reveals Novel Genetic Loci Associated with Rest-Activity Patterns in the UK Biobank. Sleep 2018. [DOI: 10.1093/sleep/zsy061.054] [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: 11/13/2022] Open
Affiliation(s)
| | - S E Jones
- University of Exeter Medical School, Exeter, UNITED KINGDOM
| | - V van Hees
- Netherlands eScience Center, Amsterdan, NETHERLANDS
| | - A I Pack
- University of Pennsylvania, Philadelphia, PA
| | - T M Frayling
- University of Exeter Medical School, Exeter, UNITED KINGDOM
| | - M N Weedon
- University of Exeter Medical School, Exeter, UNITED KINGDOM
| | - P R Gehrman
- University of Pennsylvania, Philadelphia, PA
| | - A R Wood
- University of Exeter Medical School, Exeter, UNITED KINGDOM
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13
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Abstract
Seven patients with advanced nodular sclerosing Hodgkin's disease who relapsed after initial intensive combination chemotherapy were selected for individualized pathologic restaging and comprehensive radiotherapy. One patient failed to respond completely to mantle-field irradiation and no further staging or radiotherapy was undertaken. Six other patients underwent staging laparotomy and received total nodal irradiation including prophylactic lung irradiation (5 cases) and hepatic irradiation (3 cases). Irradiation was well tolerated. Complete remission was achieved by 5 patients and 2 continue in remission 29+ and 32+ months after beginning of irradiation. Five of the 7 patients remain alive. This study indicates that comprehensive irradiation is a relatively well tolerated and effective treatment for carefully selected patients with advanced Hodgkin's disease who have relapsed after combination chemotherapy. For selected patients, pathologic restaging and comprehensive radiotherapy can be considered as an alternative to further chemotherapy.
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14
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Unsal AB, Mattingly AS, Jones SE, Purdy JB, Reynolds JC, Kopp JB, Hazra R, Hadigan CM. Effect of Antiretroviral Therapy on Bone and Renal Health in Young Adults Infected With HIV in Early Life. J Clin Endocrinol Metab 2017; 102:2896-2904. [PMID: 28531309 PMCID: PMC5546869 DOI: 10.1210/jc.2017-00197] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 05/17/2017] [Indexed: 01/01/2023]
Abstract
Context HIV antiretroviral (ARV) therapy is associated with renal and bone toxicity, but little is known about the potential cumulative effects in adults exposed to ARVs from birth. Objective To prospectively evaluate renal and bone health in young adults with lifelong HIV and extensive ARV exposure. Design Cross-sectional comparison of bone mineral density (BMD) by dual-energy X-ray absorptiometry, bone turnover, and renal function in young adults infected with HIV in early life (n = 65) to matched healthy controls (n = 23) and longitudinal evaluation (mean follow-up = 4.4 years) within a subset of the HIV cohort (n = 33). Setting Government outpatient research clinic. Results Albumin/creatinine ratio, protein/creatinine ratio, anion gap, N-terminal telopeptides, and osteocalcin were significantly increased in persons with HIV compared with controls, whereas whole-body BMD and BMD z scores were lower. Within the HIV group, duration of tenofovir disoproxil fumarate (TDF) correlated with higher anion gap but did not correlate with bone parameters. Longer duration of didanosine and stavudine use correlated with lower BMD and BMD z scores. Longitudinal analyses revealed that BMD and bone metabolism significantly improved over time. No subject had an estimated glomerular filtration rate (eGFR) <60, but decline in eGFR correlated with increasing years of TDF exposure. Conclusions Subclinical markers of renal dysfunction were increased in HIV-infected young adults and associated with TDF exposure, whereas lower bone density was associated with didanosine and stavudine exposure. The tendency for improvement in markers of bone health over time and the availability of less toxic ARV alternatives may herald improvements in renal and bone health for perinatally infected patients in adulthood.
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Affiliation(s)
- Aylin B. Unsal
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Disease, Bethesda, Maryland 20892
| | - Aviva S. Mattingly
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Disease, Bethesda, Maryland 20892
| | - Sara E. Jones
- Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., NCI Campus at Frederick, Frederick, Maryland 21701
| | - Julia B. Purdy
- Critical Care Medicine Department, Clinical Center, Bethesda, Maryland 20892
| | - James C. Reynolds
- Radiology and Imaging Sciences, Nuclear Medicine Division, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland 20892
| | - Jeffrey B. Kopp
- Kidney Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 20892
| | - Rohan Hazra
- Maternal and Pediatric Infectious Disease, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland 20892
| | - Colleen M. Hadigan
- Laboratory of Immunoregulation, National Institute of Allergy and Infectious Disease, Bethesda, Maryland 20892
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15
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Lee JK, Wu J, Banks S, Bernick C, Massand MG, Modic MT, Ruggieri P, Jones SE. Prevalence of Traumatic Findings on Routine MRI in a Large Cohort of Professional Fighters. AJNR Am J Neuroradiol 2017; 38:1303-1310. [PMID: 28473342 PMCID: PMC7959893 DOI: 10.3174/ajnr.a5175] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 02/10/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Previous studies investigating MR imaging abnormalities among fighters have had small sample sizes. This investigation assessed a large number of fighters using the same conventional sequences on the same scanner. MATERIALS AND METHODS Conventional 3T MR imaging was used to assess 499 fighters (boxers, mixed martial artists, and martial artists) and 62 controls for nonspecific WM changes, cerebral microhemorrhage, cavum septum pellucidum, and cavum vergae. The lengths of the cavum septum pellucidum and cavum vergae and the ratio of cavum septum pellucidum to the septum pellucidum lengths were assessed. RESULTS The prevalence of nonspecific WM changes was similar between groups. Fighters had a prevalence of cerebral microhemorrhage (4.2% versus 0% for controls, P = .152). Fighters had a higher prevalence of cavum septum pellucidum versus controls (53.1% versus 17.7%, P < .001) and cavum vergae versus controls (14.4% versus 0%, P < .001). The lengths of the cavum septum pellucidum plus the cavum vergae (P < .001), cavum septum pellucidum (P = .025), and cavum septum pellucidum to the septum pellucidum length ratio (P = .009) were higher in fighters than in controls. The number of fights slightly correlated with cavum septum pellucidum plus cavum vergae length (R = 0.306, P < .001) and cavum septum pellucidum length (R = 0.278, P < .001). When fighters were subdivided into boxers, mixed martial artists, and martial artists, results were similar to those in the whole-group analysis. CONCLUSIONS This study assessed MR imaging findings in a large cohort demonstrating a significantly increased prevalence of cavum septum pellucidum among fighters. Although cerebral microhemorrhages were higher in fighters than in controls, this finding was not statistically significant, possibly partially due to underpowering of the study.
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Affiliation(s)
- J K Lee
- From the Imaging Institute (J.K.L., J.W., M.G.M., M.T.M., P.R., S.E.J.)
| | - J Wu
- From the Imaging Institute (J.K.L., J.W., M.G.M., M.T.M., P.R., S.E.J.)
| | - S Banks
- Lou Ruvo Center for Brain Health (S.B., C.B.), Cleveland Clinic, Cleveland, Ohio
| | - C Bernick
- Lou Ruvo Center for Brain Health (S.B., C.B.), Cleveland Clinic, Cleveland, Ohio
| | - M G Massand
- From the Imaging Institute (J.K.L., J.W., M.G.M., M.T.M., P.R., S.E.J.)
| | - M T Modic
- From the Imaging Institute (J.K.L., J.W., M.G.M., M.T.M., P.R., S.E.J.)
| | - P Ruggieri
- From the Imaging Institute (J.K.L., J.W., M.G.M., M.T.M., P.R., S.E.J.)
| | - S E Jones
- From the Imaging Institute (J.K.L., J.W., M.G.M., M.T.M., P.R., S.E.J.)
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16
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Weimer JM, Jones SE, Frontera JA. Acute Cytotoxic and Vasogenic Edema after Subarachnoid Hemorrhage: A Quantitative MRI Study. AJNR Am J Neuroradiol 2017; 38:928-934. [PMID: 28364004 DOI: 10.3174/ajnr.a5181] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 12/15/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE The mechanism of early brain injury following subarachnoid hemorrhage is not well understood. We aimed to evaluate if cytotoxic and vasogenic edema are contributing factors. MATERIALS AND METHODS A retrospective analysis was conducted in patients with SAH undergoing diffusion-weighted MR imaging within 72 hours of onset. Apparent diffusion coefficient values derived from DWI were evaluated by using whole-brain histograms and 19 prespecified ROIs in patients with SAH and controls with normal findings on MRI. Cytotoxic edema observed outside the ROIs was assessed in patients with SAH. The average median ADC values were compared between patients with SAH and controls and patients with SAH with mild (Hunt and Hess 1-3) versus severe early brain injury (Hunt and Hess 4-5). RESULTS We enrolled 33 patients with SAH and 66 controls. The overall average median whole-brain ADC was greater for patients with SAH (808 × 10-6 mm2/s) compared with controls (788 × 10-6 mm2/s, P < .001) and was higher in patients with SAH across ROIs after adjusting for age: cerebral gray matter (826 versus 803 × 10-6 mm2/s, P = .059), cerebral white matter (793 versus 758 × 10-6 mm2/s, P = .023), white matter tracts (797 versus 739 × 10-6 mm2/s, P < .001), and deep gray matter (754 versus 713 × 10-6 mm2/s, P = .016). ADC values trended higher in patients with Hunt and Hess 4-5 versus those with Hunt and Hess 1-3. Early cytotoxic edema was observed in 13 (39%) patients with SAH and was more prevalent in those with severe early brain injury (87.5% of patients with Hunt and Hess 4-5 versus 24.0% of those with Hunt and Hess 1-3, P = .001). CONCLUSIONS Age-adjusted ADC values were globally increased in patients with SAH compared with controls, even in normal-appearing brain regions, suggesting diffuse vasogenic edema. Cytotoxic edema was also present in patients with SAH and correlated with more severe early brain injury.
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Affiliation(s)
- J M Weimer
- From the Cerebrovascular Center of the Neurological Institute (J.M.W., J.A.F.)
| | - S E Jones
- the Imaging Institute (S.E.J.), Cleveland Clinic, Cleveland, Ohio
| | - J A Frontera
- From the Cerebrovascular Center of the Neurological Institute (J.M.W., J.A.F.)
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17
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Wang ZI, Krishnan B, Shattuck DW, Leahy RM, Moosa ANV, Wyllie E, Burgess RC, Al-Sharif NB, Joshi AA, Alexopoulos AV, Mosher JC, Udayasankar U, Jones SE. Automated MRI Volumetric Analysis in Patients with Rasmussen Syndrome. AJNR Am J Neuroradiol 2016; 37:2348-2355. [PMID: 27609620 DOI: 10.3174/ajnr.a4914] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 07/04/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Rasmussen syndrome, also known as Rasmussen encephalitis, is typically associated with volume loss of the affected hemisphere of the brain. Our aim was to apply automated quantitative volumetric MR imaging analyses to patients diagnosed with Rasmussen encephalitis, to determine the predictive value of lobar volumetric measures and to assess regional atrophy differences as well as monitor disease progression by using these measures. MATERIALS AND METHODS Nineteen patients (42 scans) with diagnosed Rasmussen encephalitis were studied. We used 2 control groups: one with 42 age- and sex-matched healthy subjects and the other with 42 epileptic patients without Rasmussen encephalitis with the same disease duration as patients with Rasmussen encephalitis. Volumetric analysis was performed on T1-weighted images by using BrainSuite. Ratios of volumes from the affected hemisphere divided by those from the unaffected hemisphere were used as input to a logistic regression classifier, which was trained to discriminate patients from controls. Using the classifier, we compared the predictive accuracy of all the volumetric measures. These ratios were used to further assess regional atrophy differences and correlate with epilepsy duration. RESULTS Interhemispheric and frontal lobe ratios had the best prediction accuracy for separating patients with Rasmussen encephalitis from healthy controls and patient controls without Rasmussen encephalitis. The insula showed significantly more atrophy compared with all the other cortical regions. Patients with longitudinal scans showed progressive volume loss in the affected hemisphere. Atrophy of the frontal lobe and insula correlated significantly with epilepsy duration. CONCLUSIONS Automated quantitative volumetric analysis provides accurate separation of patients with Rasmussen encephalitis from healthy controls and epileptic patients without Rasmussen encephalitis, and thus may assist the diagnosis of Rasmussen encephalitis. Volumetric analysis could also be included as part of follow-up for patients with Rasmussen encephalitis to assess disease progression.
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Affiliation(s)
- Z I Wang
- From the Epilepsy Center (Z.I.W., B.K., A.N.V.M., E.W., R.C.B., A.V.A., J.C.M.)
| | - B Krishnan
- From the Epilepsy Center (Z.I.W., B.K., A.N.V.M., E.W., R.C.B., A.V.A., J.C.M.)
| | - D W Shattuck
- Ahmanson-Lovelace Brain Mapping Center (D.W.S., N.B.A.-S.), Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - R M Leahy
- Signal and Image Processing Institute (A.A.J., R.M.L.), University of Southern California, Los Angeles, California
| | - A N V Moosa
- From the Epilepsy Center (Z.I.W., B.K., A.N.V.M., E.W., R.C.B., A.V.A., J.C.M.)
| | - E Wyllie
- From the Epilepsy Center (Z.I.W., B.K., A.N.V.M., E.W., R.C.B., A.V.A., J.C.M.)
| | - R C Burgess
- From the Epilepsy Center (Z.I.W., B.K., A.N.V.M., E.W., R.C.B., A.V.A., J.C.M.)
| | - N B Al-Sharif
- Ahmanson-Lovelace Brain Mapping Center (D.W.S., N.B.A.-S.), Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - A A Joshi
- Signal and Image Processing Institute (A.A.J., R.M.L.), University of Southern California, Los Angeles, California
| | - A V Alexopoulos
- From the Epilepsy Center (Z.I.W., B.K., A.N.V.M., E.W., R.C.B., A.V.A., J.C.M.)
| | - J C Mosher
- From the Epilepsy Center (Z.I.W., B.K., A.N.V.M., E.W., R.C.B., A.V.A., J.C.M.)
| | - U Udayasankar
- Department of Radiology (U.U.), University of Arizona College of Medicine, Tucson, Arizona
| | | | - S E Jones
- Imaging Institute (S.E.J.), Cleveland Clinic, Cleveland, Ohio
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18
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Thomas CM, Saulnier DMA, Spinler JK, Hemarajata P, Gao C, Jones SE, Grimm A, Balderas MA, Burstein MD, Morra C, Roeth D, Kalkum M, Versalovic J. FolC2-mediated folate metabolism contributes to suppression of inflammation by probiotic Lactobacillus reuteri. Microbiologyopen 2016; 5:802-818. [PMID: 27353144 PMCID: PMC5061717 DOI: 10.1002/mbo3.371] [Citation(s) in RCA: 34] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 03/20/2016] [Accepted: 03/30/2016] [Indexed: 12/16/2022] Open
Abstract
Bacterial‐derived compounds from the intestinal microbiome modulate host mucosal immunity. Identification and mechanistic studies of these compounds provide insights into host–microbial mutualism. Specific Lactobacillus reuteri strains suppress production of the proinflammatory cytokine, tumor necrosis factor (TNF), and are protective in a mouse model of colitis. Human‐derived L. reuteri strain ATCC PTA 6475 suppresses intestinal inflammation and produces 5,10‐methenyltetrahydrofolic acid polyglutamates. Insertional mutagenesis identified the bifunctional dihydrofolate synthase/folylpolyglutamate synthase type 2 (folC2) gene as essential for 5,10‐methenyltetrahydrofolic acid polyglutamate biosynthesis, as well as for suppression of TNF production by activated human monocytes, and for the anti‐inflammatory effect of L. reuteri 6475 in a trinitrobenzene sulfonic acid‐induced mouse model of acute colitis. In contrast, folC encodes the enzyme responsible for folate polyglutamylation but does not impact TNF suppression by L. reuteri. Comparative transcriptomics between wild‐type and mutant L. reuteri strains revealed additional genes involved in immunomodulation, including previously identified hdc genes involved in histidine to histamine conversion. The folC2 mutant yielded diminished hdc gene cluster expression and diminished histamine production, suggesting a link between folate and histadine/histamine metabolism. The identification of genes and gene networks regulating production of bacterial‐derived immunoregulatory molecules may lead to improved anti‐inflammatory strategies for digestive diseases.
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Affiliation(s)
- Carissa M Thomas
- Integrative Molecular and Biomedical Sciences (IMBS), Baylor College of Medicine, One Baylor Plaza, Houston, Texas, 77030
| | - Delphine M A Saulnier
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas.,Department of Pathology, Texas Children's Hospital, 1102 Bates Ave, Houston, Texas, 77030
| | - Jennifer K Spinler
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas.,Department of Pathology, Texas Children's Hospital, 1102 Bates Ave, Houston, Texas, 77030
| | - Peera Hemarajata
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas
| | - Chunxu Gao
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas.,Department of Pathology, Texas Children's Hospital, 1102 Bates Ave, Houston, Texas, 77030
| | - Sara E Jones
- Integrative Molecular and Biomedical Sciences (IMBS), Baylor College of Medicine, One Baylor Plaza, Houston, Texas, 77030
| | - Ashley Grimm
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas.,Department of Pathology, Texas Children's Hospital, 1102 Bates Ave, Houston, Texas, 77030
| | - Miriam A Balderas
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas.,Department of Pathology, Texas Children's Hospital, 1102 Bates Ave, Houston, Texas, 77030
| | - Matthew D Burstein
- Structural and Computational Biology and Molecular Biophysics Graduate Program, Baylor College of Medicine, Houston, Texas
| | - Christina Morra
- Integrative Molecular and Biomedical Sciences (IMBS), Baylor College of Medicine, One Baylor Plaza, Houston, Texas, 77030.,Department of Pathology, Texas Children's Hospital, 1102 Bates Ave, Houston, Texas, 77030
| | - Daniel Roeth
- Department of Molecular Immunology, Beckman Research Institute of the City of Hope, 1500 E Duarte Rd., Duarte, California, 91010
| | - Markus Kalkum
- Department of Molecular Immunology, Beckman Research Institute of the City of Hope, 1500 E Duarte Rd., Duarte, California, 91010
| | - James Versalovic
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas. .,Department of Pathology, Texas Children's Hospital, 1102 Bates Ave, Houston, Texas, 77030.
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19
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Paynich ML, Jones SE, Knight KL. Commensal exopolysaccharides induce M2 macrophages that prevent pathogen-induced colitis. The Journal of Immunology 2016. [DOI: 10.4049/jimmunol.196.supp.131.3] [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: 01/03/2023]
Abstract
Abstract
Trillions of bacteria live within the gastrointestinal tract and are critical for maintaining intestinal homeostasis; however, the mechanisms utilized by specific bacterial molecules to contribute to homeostasis are not well understood. We utilize a mouse model in which a single oral dose of the probiotic, B. subtilis, protects mice from acute colitis induced by the enteric pathogen C. rodentium. Our goal is to elucidate the mechanism by which B. subtilis prevents inflammation. We identified exopolysaccharides (EPS) to be the active molecule of B. subtilis, and a single dose of EPS protects mice from disease. EPS binds F4/80+CD11b+ peritoneal macrophages (MΦ), and following EPS treatment, MΦ increase expression of CD206, Arg1, YM-1, and IL-4Rα, and inhibit T cell activation and proliferation in vitro, indicative of M2 MΦ. Induction of M2 MΦ is TLR4-dependent, and in mice treated with clodronate liposomes to deplete MΦ, EPS no longer protects mice from disease. Addition of anti-TGFβ neutralizing antibodies removed the inhibitory effect of M2 MΦ suggesting that EPS-induced M2 MΦ produce TGFβ to inhibit T cell proliferation in vitro. CD4+ T cells drive much of the inflammation associated with C. rodentium infection, and we hypothesized that EPS inhibits CD4+ T cell responses in vivo. Accordingly, we measured levels of IFNγ (Th1), IL-17 (Th17), and IL-13 (Th2) in splenic T cells following EPS treatment and found decreased levels of these cytokines. We hypothesize that EPS-induced M2 MΦ mediate inhibition of CD4+ cell responses in vivo, preventing acute colitis induced by C. rodentium. The data suggest that EPS-induced M2 MΦ mediate protection from C. rodentium disease by inhibiting CD4+ T cell responses through production of TGFβ.
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Laiyemo R, Dudill W, Jones SE, Browne H. Do postmenopausal women with thickened endometrium on trans-vaginal ultrasound in the absence of vaginal bleeding need hysteroscopic assessment? A Pilot Study. J OBSTET GYNAECOL 2015; 36:223-6. [PMID: 26466745 DOI: 10.3109/01443615.2015.1050649] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 11/13/2022]
Abstract
We aimed to determine the incidence of endometrial cancer in a cohort of postmenopausal women with thickened endometrium but no bleeding referred for hysteroscopy and determine the risk estimate of cancer using a cut-off of > 11 mm. This retrospective study of asymptomatic postmenopausal women with thickened endometrium on trans-vaginal scan referred for hysteroscopy was performed using data from 2008 to 2010. In total 63 women were identified. 2 cases of endometrial cancer were identified with an incidence of 3.17%. 22 cases had endometrial thickness (ET) > 11 mm of which 2 were malignant giving a risk estimate for endometrial cancer of 9.1%. 61 women had benign pathology, 40.98% had atrophic endometrium and 59.02% had benign polyp. In conclusion, the incidence of endometrial cancer in postmenopausal women with thickened endometrium on transvaginal scan without vaginal bleeding is low and ET of 11 mm or more seems realistic to use as a cut-off for referral for hysteroscopy.
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Affiliation(s)
- R Laiyemo
- a Department of Obstetrics and Gynaecology , Kingsmill Hospital , Sutton in Ashfield , UK
| | - W Dudill
- a Department of Obstetrics and Gynaecology , Kingsmill Hospital , Sutton in Ashfield , UK
| | - S E Jones
- b Department of Obstetrics and Gynaecology , Bradford Royal Infirmary , Bradford , UK
| | - H Browne
- c Department of Obstetrics and Gynaecology , St James Hospital , Leeds , UK
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Jones SE, Brain PF. An illustration of simple sequence analysis with reference to the agonistic behaviour of four strains of laboratory mouse. Behav Processes 2014; 11:365-88. [PMID: 24896696 DOI: 10.1016/0376-6357(85)90003-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/1985] [Indexed: 11/19/2022]
Abstract
Many authors have assumed that the functions of behavioural elements may be deduced from the sequence in which they occur. This study explains from basic principles a simple procedure, based of the X(2) test, for analysing behavioural sequences. The formation of groups of "similar" elements (cluster analysis) and their interpretation is discussed with reference to the agonistic behaviour of individually-housed male mice from four different strains. Associations between elements are found to be consistent with the functions assigned them by previous authors though strain differences in behavioural organisation are evident. Behav. Processes 11: 365-388.
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Affiliation(s)
- S E Jones
- Department of Zoology, University College of Swansea, Singleton Park, Swansea, SA2 8PP, Wales, U.K
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Abstract
Host inflammatory responses against pathogenic organisms can be abrogated by commensals; however, the molecular mechanisms by which pathogenesis is prevented are still poorly understood. Previous studies demonstrated that administration of a single dose of Bacillus subtilis prevented disease and inflammation by the enteric mouse pathogen Citrobacter rodentium, which causes disease similar to the human pathogen enteropathogenic Escherichia coli. No protection was observed when an exopolysaccharide (EPS)-deficient mutant of B. subtilis was used, suggesting that EPS are the protective factor. In this study, we isolated and characterized EPS and showed that they also prevent C. rodentium-associated intestinal disease after a single injection. Protection is TLR4 dependent because EPS-treated TLR4 knockout mice developed disease. Furthermore, protection could be conveyed to wild-type mice by adoptive transfer of macrophage-rich peritoneal cells from EPS-treated mice. We found that EPS specifically bind peritoneal macrophages, and because mice lacking MyD88 signaling in myeloid cells were not protected by EPS, we conclude that bacterial EPS prevent colitis in a TLR4-dependent manner that requires myeloid cells. These studies provide a simple means of preventing intestinal inflammation caused by enteric pathogens.
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Affiliation(s)
- Sara E Jones
- Department of Microbiology and Immunology, Loyola University Chicago, Maywood, IL 60153
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Obusez EC, Hui F, Hajj-Ali RA, Cerejo R, Calabrese LH, Hammad T, Jones SE. High-resolution MRI vessel wall imaging: spatial and temporal patterns of reversible cerebral vasoconstriction syndrome and central nervous system vasculitis. AJNR Am J Neuroradiol 2014; 35:1527-32. [PMID: 24722305 DOI: 10.3174/ajnr.a3909] [Citation(s) in RCA: 189] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE High-resolution MR imaging is an emerging tool for evaluating intracranial artery disease. It has an advantage of defining vessel wall characteristics of intracranial vascular diseases. We investigated high-resolution MR imaging arterial wall characteristics of CNS vasculitis and reversible cerebral vasoconstriction syndrome to determine wall pattern changes during a follow-up period. MATERIALS AND METHODS We retrospectively reviewed 3T-high-resolution MR imaging vessel wall studies performed on 26 patients with a confirmed diagnosis of CNS vasculitis and reversible cerebral vasoconstriction syndrome during a follow-up period. Vessel wall imaging protocol included black-blood contrast-enhanced T1-weighted sequences with fat suppression and a saturation band, and time-of-flight MRA of the circle of Willis. Vessel wall characteristics including enhancement, wall thickening, and lumen narrowing were collected. RESULTS Thirteen patients with CNS vasculitis and 13 patients with reversible cerebral vasoconstriction syndrome were included. In the CNS vasculitis group, 9 patients showed smooth, concentric wall enhancement and thickening; 3 patients had smooth, eccentric wall enhancement and thickening; and 1 patient was without wall enhancement and thickening. Six of 13 patients had follow-up imaging; 4 patients showed stable smooth, concentric enhancement and thickening; and 2 patients had resoluton of initial imaging findings. In the reversible cerebral vasoconstriction syndrome group, 10 patients showed diffuse, uniform wall thickening with negligible-to-mild enhancement. Nine patients had follow-up imaging, with 8 patients showing complete resolution of the initial findings. CONCLUSIONS Postgadolinium 3T-high-resolution MR imaging appears to be a feasible tool in differentiating vessel wall patterns of CNS vasculitis and reversible cerebral vasoconstriction syndrome changes during a follow-up period.
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Affiliation(s)
- E C Obusez
- From the Department of Diagnostic Radiology (E.C.O., S.E.J.), Imaging Institute
| | - F Hui
- Cerebrovascular Center (F.H.)
| | - R A Hajj-Ali
- Department of Neurology (R.A.H., R.C.), Neurological Institute
| | - R Cerejo
- Department of Neurology (R.A.H., R.C.), Neurological Institute
| | - L H Calabrese
- Department of Rheumatology (L.H.C., T.H.), Orthopaedic and Rheumatology Institute, Cleveland Clinic, Cleveland, Ohio
| | - T Hammad
- Department of Rheumatology (L.H.C., T.H.), Orthopaedic and Rheumatology Institute, Cleveland Clinic, Cleveland, Ohio
| | - S E Jones
- From the Department of Diagnostic Radiology (E.C.O., S.E.J.), Imaging Institute
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Wang ZI, Alexopoulos AV, Jones SE, Najm IM, Ristic A, Wong C, Prayson R, Schneider F, Kakisaka Y, Wang S, Bingaman W, Gonzalez-Martinez JA, Burgess RC. Linking MRI post-processing with Magnetic source imaging in MRI-negative epilepsy. Ann Neurol 2014. [DOI: 10.1002/ana.24097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- ZI Wang
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - AV Alexopoulos
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - SE Jones
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - IM Najm
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - A Ristic
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - C Wong
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - R Prayson
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - F Schneider
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - Y Kakisaka
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - S Wang
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - W Bingaman
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - JA Gonzalez-Martinez
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
| | - RC Burgess
- Cleveland Clinic Epilepsy Center; 9500 Euclid Avenue, Desk S-51 Cleveland OH 44195
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Fleming SL, Jones SE, Green S, Clark AL, Howe C, Kon SSC, Dickson M, Godden J, Bell D, Haselden BM, Man WDC. P43 Patients’ experiences of early post-hospitalisation pulmonary rehabilitation: A quality improvement initiative. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Canavan JI, Kon SSC, Nolan CM, Jones SE, Polkey MI, Man WDC. P36 Physical activity levels according to gold grouping in patients with COPD. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jones SE, Kon SSC, Green SA, Bell D, Canavan JL, Nolan CM, Clark AL, Dickson M, Nolan AM, Fleming S, Haselden M, Man WDC. P47 Patient characteristics of those referred and not referred for early post-hospitalisation pulmonary rehabilitation: Abstract P47 Table 1. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kon SSC, Canavan JL, Clark AL, Jones SE, Nolan CM, Polkey MI, Man WDC. P34 The minimal clinically important difference of the COPD assessment test. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Diaz MA, Bik EM, Carlin KP, Venn-Watson SK, Jensen ED, Jones SE, Gaston EP, Relman DA, Versalovic J. Identification of Lactobacillus strains with probiotic features from the bottlenose dolphin (Tursiops truncatus). J Appl Microbiol 2013; 115:1037-51. [PMID: 23855505 PMCID: PMC4063339 DOI: 10.1111/jam.12305] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 06/30/2013] [Accepted: 07/06/2013] [Indexed: 01/09/2023]
Abstract
Aims In order to develop complementary health management strategies for marine mammals, we used culture-based and culture-independent approaches to identify gastrointestinal lactobacilli of the common bottlenose dolphin, Tursiops truncatus. Methods and Results We screened 307 bacterial isolates from oral and rectal swabs, milk and gastric fluid, collected from 38 dolphins in the U.S. Navy Marine Mammal Program, for potentially beneficial features. We focused our search on lactobacilli and evaluated their ability to modulate TNF secretion by host cells and inhibit growth of pathogens. We recovered Lactobacillus salivarius strains which secreted factors that stimulated TNF production by human monocytoid cells. These Lact. salivarius isolates inhibited growth of selected marine mammal and human bacterial pathogens. In addition, we identified a novel Lactobacillus species by culture and direct sequencing with 96·3% 16S rDNA sequence similarity to Lactobacillus ceti. Conclusions Dolphin-derived Lact. salivarius isolates possess features making them candidate probiotics for clinical studies in marine mammals. Significance and Impact of the Study This is the first study to isolate lactobacilli from dolphins, including a novel Lactobacillus species and a new strain of Lact. salivarius, with potential for veterinary probiotic applications. The isolation and identification of novel Lactobacillus spp. and other indigenous microbes from bottlenose dolphins will enable the study of the biology of symbiotic members of the dolphin microbiota and facilitate the understanding of the microbiomes of these unique animals.
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Affiliation(s)
- M A Diaz
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA; Department of Pathology, Texas Children's Hospital, Houston, TX, USA
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Jones SE, Mahmoud SY, Gonzalez-Martinez J, Lockwood DS, Moon D, Smith AS, Stultz TW, Tievsky AL, Phillips MD. Application of a computerized language lateralization index from FMRI by a group of clinical neuroradiologists. AJNR Am J Neuroradiol 2013; 34:564-9. [PMID: 22976237 PMCID: PMC7964916 DOI: 10.3174/ajnr.a3271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 03/15/2012] [Accepted: 06/16/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Deriving accurate language lateralization from fMRI studies in the clinical context can be difficult, with 10%-20% incorrect conclusions. Most interpretations are qualitative, performed by neuroimaging experts. Quantitative lateralization has been widely described but with little implementation in the clinical setting and is disadvantaged by the use of arbitrary threshold techniques. We investigated the application and utility of a nonthreshold CLI, in a clinical setting, as applied by a group of practicing neuroradiologists. MATERIALS AND METHODS Twenty-two patients with known language lateralization (11 left and 11 nonleft dominant) had their images reviewed by 8 neuroradiologists in 2 settings, all randomized, once by using a CLI and once without using a CLI. For each review, neuroradiologists recorded their impressions of lateralization for each language sequence, the overall lateralization conclusion, their impression of scan quality and noise, and the subjective confidence in their conclusion. RESULTS The inter-rater κ for lateralization was 0.64, which increased to 0.70 with the use of CLI. The group accuracy of overall lateralization was 78%, which increased to 81% with the use of a CLI. Using a CLI removed 2 instances of significant errors, with a neuroradiologist's impression of left lateralization in a patient with known right lateralization. Using a CLI had no effect on examinations with conclusions formed with either high confidence or no confidence. CONCLUSIONS Although the overall clinical benefit of a CLI is modest, the most significant impact is to reduce the most harmful misclassification errors, particularly in fMRI examinations that are suboptimal.
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Affiliation(s)
- S E Jones
- Division of Neuroradiology, Imaging Institute, Cleveland Clinic, Cleveland Ohio, USA.
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Kon SSC, Clark AL, Dilaver D, Peasey MM, Canavan JL, Jones SE, Ng MGS, Patel MS, Polkey MI, Man WDC. P104 Response of the COPD Assessment Test (CAT) to Pulmonary Rehabilitation in Non-COPD Patients: Abstract P104 Table 1. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mittal MM, Kon SSC, Clark AL, Dilaver D, Peasey MM, Canavan JL, Jones SE, Ng MGS, Polkey MI, Man WDC. P106 Validity of the Clinical COPD Questionaire (CCQ) in Non-COPD Patients: Abstract P106 Table 1. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Peasey MM, Kon SS, Dilaver D, Canavan JL, Ng MG, Jones SE, Clark AL, Polkey MI, Man WDC. P99 Pulmonary Rehabilitation in Interstitial Lung Disease Patients: Effects on Maximum Exercise Capacity, Anxiety and Depression. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dilaver D, Peasey MM, Clark AL, Ng MGS, Mittal M, Kon SSC, Canavan JL, Jones SE, Polkey MI, Man WDC. P100 The Clinical COPD Questionnaire: Response to Pulmonary Rehabilitation: Abstract P100 Table 1. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jones SE, Kon SSC, Canavan JL, Clark AL, Patel MS, Dilaver D, Peasey M, Ng MGS, Polkey MI, Man WDC. S109 Five-Repetition Sit-To-Stand Test: Reliability, Validity and Response to Pulmonary Rehabilitation in COPD. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jones SE, Green SA, Clark AL, Dickson MJ, Nolan AM, Moloney C, Kon SSC, Godden J, Howe C, Haselden BM, Fleming S, Man WDC. P102 Post-Hospitalisation Outpatient Pulmonary Rehabilitation: A Translational Gap? Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hendriksz CJ, Hughes DA, Mehta AB, Wraith JE, Jones SE, Ramaswami U, Deegan P, Lachmann R, Murphy E, Hiwot T, Vijay SV, Stewart F, Cleary M. Transfer of high cost drugs to NICE risks fragmentation of care of rare diseases. BMJ 2012; 345:e5727. [PMID: 22923539 DOI: 10.1136/bmj.e5727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wang ZI, Jones SE, Ristic AJ, Wong C, Kakisaka Y, Jin K, Schneider F, Gonzalez-Martinez JA, Mosher JC, Nair D, Burgess RC, Najm IM, Alexopoulos AV. Voxel-based morphometric MRI post-processing in MRI-negative focal cortical dysplasia followed by simultaneously recorded MEG and stereo-EEG. Epilepsy Res 2012; 100:188-93. [PMID: 22391138 DOI: 10.1016/j.eplepsyres.2012.02.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 02/07/2012] [Accepted: 02/12/2012] [Indexed: 11/28/2022]
Abstract
We aim to report on the usefulness of a voxel-based morphometric MRI post-processing technique in detecting subtle epileptogenic structural lesions. The MRI post-processing technique was implemented in a morphometric analysis program (MAP), in a 30-year-old male with pharmacoresistant focal epilepsy and negative MRI. MAP gray-white matter junction file facilitated the identification of a suspicious structural lesion in the right frontal opercular area. The electrophysiological data by simultaneously recorded stereo-EEG and MEG confirmed the epileptogenicity of the underlying subtle structural abnormality. The patient underwent a limited right frontal opercular resection, which completely included the area detected by MAP. Surgical pathology revealed focal cortical dysplasia (FCD) type IIb. Postoperatively the patient has been seizure-free for 2 years. This study demonstrates that MAP has promise in increasing the diagnostic yield of MRI reading in challenging patients with "non-lesional" MRIs. The clinical relevance and epileptogenicity of MAP abnormalities in patients with epilepsy have not been investigated systematically; therefore it is important to confirm their pertinence by performing electrophysiological recordings. When confirmed to be epileptogenic, such MAP abnormalities may reflect an underlying subtle cortical dysplasia whose complete resection can lead to seizure-free outcome.
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Affiliation(s)
- Z I Wang
- Epilepsy Center, Neurological Institute, Cleveland Clinic Foundation, United States.
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Jones SE, Whitehead K, Saulnier D, Thomas CM, Versalovic J, Britton RA. Cyclopropane fatty acid synthase mutants of probiotic human-derived Lactobacillus reuteri are defective in TNF inhibition. Gut Microbes 2011; 2:69-79. [PMID: 21637024 PMCID: PMC3225771 DOI: 10.4161/gmic.2.2.15282] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [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: 02/03/2023] Open
Abstract
Although commensal microbes have been shown to modulate host immune responses, many of the bacterial factors that mediate immune regulation remain unidentified. Select strains of human-derived Lactobacillus reuteri synthesize immunomodulins that potently inhibit production of the inflammatory cytokine TNF. In this study, genetic and genomic approaches were used to identify and investigate L. reuteri genes required or human TNF immunomodulatory activity. Analysis of membrane fatty acids from multiple L. reuteri strains cultured in MRS medium showed that only TNF inhibitory strains produced the cyclopropane fatty acid (CFA) lactobacillic acid. The enzyme cyclopropane fatty acid synthase is required for synthesis of CFAs such as lactobacillic acid, therefore the cfa gene was inactivated and supernatants from the cfa mutant strain were assayed for TNF inhibitory activity. We found that supernatants from the wild-type strain, but not the cfa mutant, suppressed TNF production by activated THP-1 human monocytoid cells Although this suggested a direct role for lactobacillic acid in immunomodulation, purified lactobacillic acid did not suppress TNF at physiologically relevant concentrations. We further analyzed TNF inhibitory and TNF non-inhibitory strains under different growth conditions and found that lactobacillic acid production did not correlate with TNF inhibition. These results indicate that cfa indirectly contributed to L. reuter immunomodulatory activity and suggest that other mechanisms, such as decreased membrane fluidity or altered expression of immunomodulins, result in the loss of TNF inhibitory activity. By increasing our understanding of immunomodulation by probiotic species, beneficial microbes can be rationally selected to alleviate intestinal inflammation.
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Affiliation(s)
- Sara E Jones
- Interdepartmental Program of Cell and Molecular Biology; Texas Children's Hospital; Houston, TX USA,Department of Pathology & Immunology; Baylor College of Medicine; Texas Children's Hospital; Houston, TX USA
| | - Kristi Whitehead
- Department of Microbiology and Molecular Genetics; Michigan State University; East Lansing, MI USA
| | - Delphine Saulnier
- Department of Pathology & Immunology; Baylor College of Medicine; Texas Children's Hospital; Houston, TX USA,Department of Pathology; Texas Children's Hospital; Houston, TX USA
| | - Carissa M Thomas
- Interdepartmental Program of Cell and Molecular Biology; Texas Children's Hospital; Houston, TX USA,Department of Pathology & Immunology; Baylor College of Medicine; Texas Children's Hospital; Houston, TX USA
| | - James Versalovic
- Interdepartmental Program of Cell and Molecular Biology; Texas Children's Hospital; Houston, TX USA,Department of Pathology & Immunology; Baylor College of Medicine; Texas Children's Hospital; Houston, TX USA,Department of Pathology; Texas Children's Hospital; Houston, TX USA
| | - Robert A Britton
- Department of Microbiology and Molecular Genetics; Michigan State University; East Lansing, MI USA
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Mahmoud SY, Ahmed M, Emch TM, Masood P, Moon D, Phillips MD, Ruggieri PM, Smith AS, Stultz TW, Tievsky AL, Jones SE. Effect of a prescan patient-radiologist encounter on functional MR image quality. AJNR Am J Neuroradiol 2011; 32:210-5. [PMID: 20705700 DOI: 10.3174/ajnr.a2220] [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: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A substantial number of clinical fMRI examinations inadequately assess language localization or lateralization, usually due to patient movement and suboptimal participation. We hypothesized that a prescan interview of the patient by the radiologist would reduce the fraction of nondiagnostic scans. MATERIALS AND METHODS A single noise score for each acquisition was produced from time-series data on the basis of a weighted sum of 22 factors. Scores were recorded as the following quartiles: 0-5 = excellent, 5-10 = adequate, 10-15= marginal, and >15 = unacceptable. This measure was evaluated for 202 consecutive fMRI patients: 96 without and 106 with a physician prescan interview. The data were analyzed to compute the fraction of all nondiagnostic sequences and entire studies and were compared between the 2 groups. Image-noise characteristics included the SDs of linear and angular displacements of the head and the number of time-series outliers caused by focal motion. RESULTS Of 999 sequences acquired, 539 had a prescan interview. The mean noise score significantly decreased for both individual sequence (from 7.9 to 6.3, P = <.001) and study-based (from 7.7 to 6.2, P = .05) methods. The fraction of sequences or studies scored as unacceptable decreased for sequence-based (from 15.2% to 10.9%, P = .04) and study-based (from 9.4% to 1.9%, P = .02) analyses. SDs of head motion decreased for linear (by 12%-14%, P < .01) and angular displacement (by 38%-48%, P < .001). The number of time-series spikes decreased by 10% (P = .004). CONCLUSIONS We report that a prescan physician-patient interview modestly but significantly reduces fMRI noise scores. These results support the newly added billable costs of professional intervention before fMRI scans.
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Affiliation(s)
- S Y Mahmoud
- Division of Neuroradiology, Imaging Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
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Jones SE, Putter H, Hasenburg A, van de Velde CJH, Rea D, Vannetzel JM, Paridaens R, Markopoulos C, Hozumi Y, Seynaeve C. Abstract PD08-03: Competing Causes of Mortality vs. Breast Cancer Mortality at 5-Years among 9766 Postmenopausal Women with Hormone Receptor Positive Early Breast Cancer Treated on the TEAM Study of Adjuvant Hormonal Therapy. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-pd08-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The TEAM (Tamoxifen Exemestane Adjuvant Multinational) trial is a contemporary multinational study of the effects of 5 years of adjuvant hormonal therapy, either exemestane (E) or tamoxifen switching to E (TàE). Five-year results were presented at SABCS 2009 showing no difference in outcome between E vs TàE (Rea D, SABCS Abstract 11), thus giving us the opportunity to analyze the causes of mortality in the entire population of 9766 women.
Methods: Postmenopausal women with hormone receptor positive (HR+) early breast cancer (BC) were randomized to E or TàE for 5 years after completion of surgery, adjuvant chemotherapy (when indicated), and radiation therapy based on local guidelines. All data were collected and analyzed at the Central Data Center in Leiden. The primary outcome of DFS as well as safety and other secondary outcomes were analyzed in 2009 after 1285 events had occurred to trigger the analysis. Results: Between 2001 and January 2006, 9766 women were randomized; 100% were HR+, 50% had node negative disease, 68% received adjuvant radiotherapy, and 36% received adjuvant chemotherapy. The median follow-up was 5.1 years with over 60% of women having been followed for 5 or more years. Among 961 deaths, 568 (59%) were caused by BC and 393 (41%) by causes other than BC. The cumulative incidence of death from BC vs. other causes at 5-years for all women and by nodal status is as follows (see table):
There was a general relationship with non-breast cancer deaths and increasing age at diagnosis (≥70 years), as expected. Non-breast cancer causes of mortality included second malignancy (105); cardiac (71), cerebral (33), or pulmonary (28) events; miscellaneous other causes (105); and unknown (51).
Conclusions: Among 9766 postmenopausal women with HR+ BC treated with contemporary hormonal strategies following standard primary treatment, the probability of death from causes other than BC was nearly as high as the probability of dying from BC.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD08-03.
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Affiliation(s)
- SE Jones
- US Oncology Research, Inc., The Woodlands, TX; Leiden University Medical Center, Netherlands; University Hospital Freiburg, Germany; The University of Birmingham, United Kingdom; Institut du Sein Henri Hartmann (ISHH), Neuilly sur Seine, France; U. Z. Gasthuisberg, Leuven, Belgium; Athens University Medical School, Athens, Greece; Jichi Medical University, Shimotsuke, Japan; Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands
| | - H Putter
- US Oncology Research, Inc., The Woodlands, TX; Leiden University Medical Center, Netherlands; University Hospital Freiburg, Germany; The University of Birmingham, United Kingdom; Institut du Sein Henri Hartmann (ISHH), Neuilly sur Seine, France; U. Z. Gasthuisberg, Leuven, Belgium; Athens University Medical School, Athens, Greece; Jichi Medical University, Shimotsuke, Japan; Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands
| | - A Hasenburg
- US Oncology Research, Inc., The Woodlands, TX; Leiden University Medical Center, Netherlands; University Hospital Freiburg, Germany; The University of Birmingham, United Kingdom; Institut du Sein Henri Hartmann (ISHH), Neuilly sur Seine, France; U. Z. Gasthuisberg, Leuven, Belgium; Athens University Medical School, Athens, Greece; Jichi Medical University, Shimotsuke, Japan; Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands
| | - CJH van de Velde
- US Oncology Research, Inc., The Woodlands, TX; Leiden University Medical Center, Netherlands; University Hospital Freiburg, Germany; The University of Birmingham, United Kingdom; Institut du Sein Henri Hartmann (ISHH), Neuilly sur Seine, France; U. Z. Gasthuisberg, Leuven, Belgium; Athens University Medical School, Athens, Greece; Jichi Medical University, Shimotsuke, Japan; Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands
| | - D Rea
- US Oncology Research, Inc., The Woodlands, TX; Leiden University Medical Center, Netherlands; University Hospital Freiburg, Germany; The University of Birmingham, United Kingdom; Institut du Sein Henri Hartmann (ISHH), Neuilly sur Seine, France; U. Z. Gasthuisberg, Leuven, Belgium; Athens University Medical School, Athens, Greece; Jichi Medical University, Shimotsuke, Japan; Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands
| | - J-M Vannetzel
- US Oncology Research, Inc., The Woodlands, TX; Leiden University Medical Center, Netherlands; University Hospital Freiburg, Germany; The University of Birmingham, United Kingdom; Institut du Sein Henri Hartmann (ISHH), Neuilly sur Seine, France; U. Z. Gasthuisberg, Leuven, Belgium; Athens University Medical School, Athens, Greece; Jichi Medical University, Shimotsuke, Japan; Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands
| | - R Paridaens
- US Oncology Research, Inc., The Woodlands, TX; Leiden University Medical Center, Netherlands; University Hospital Freiburg, Germany; The University of Birmingham, United Kingdom; Institut du Sein Henri Hartmann (ISHH), Neuilly sur Seine, France; U. Z. Gasthuisberg, Leuven, Belgium; Athens University Medical School, Athens, Greece; Jichi Medical University, Shimotsuke, Japan; Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands
| | - C Markopoulos
- US Oncology Research, Inc., The Woodlands, TX; Leiden University Medical Center, Netherlands; University Hospital Freiburg, Germany; The University of Birmingham, United Kingdom; Institut du Sein Henri Hartmann (ISHH), Neuilly sur Seine, France; U. Z. Gasthuisberg, Leuven, Belgium; Athens University Medical School, Athens, Greece; Jichi Medical University, Shimotsuke, Japan; Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands
| | - Y Hozumi
- US Oncology Research, Inc., The Woodlands, TX; Leiden University Medical Center, Netherlands; University Hospital Freiburg, Germany; The University of Birmingham, United Kingdom; Institut du Sein Henri Hartmann (ISHH), Neuilly sur Seine, France; U. Z. Gasthuisberg, Leuven, Belgium; Athens University Medical School, Athens, Greece; Jichi Medical University, Shimotsuke, Japan; Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands
| | - C. Seynaeve
- US Oncology Research, Inc., The Woodlands, TX; Leiden University Medical Center, Netherlands; University Hospital Freiburg, Germany; The University of Birmingham, United Kingdom; Institut du Sein Henri Hartmann (ISHH), Neuilly sur Seine, France; U. Z. Gasthuisberg, Leuven, Belgium; Athens University Medical School, Athens, Greece; Jichi Medical University, Shimotsuke, Japan; Erasmus MC Daniel Den Hoed, Rotterdam, Netherlands
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Shipman AR, Jones SE, Smith G, Stewart B, McCarthy N. A case of verocytotoxin-producing Escherichia coli O157 from a private barbecue in South East England. Euro Surveill 2009; 14. [DOI: 10.2807/ese.14.29.19273-en] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The following case report describes a cluster of Escherichia coli O157 cases in the United Kingdom related to undercooked beef at a barbecue, resulting in an intensive care admission in France with haemolytic uraemic syndrome and highlighting the need to cook beef properly.
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Affiliation(s)
- A R Shipman
- Thames Valley Health Protection Agency, Oxford, United Kingdom
| | - S E Jones
- Health Protection Agency Food Water and Environmental Microbiology Network (Southampton Laboratory), Southampton, United Kingdom
| | - G Smith
- Laboratory of Gastrointestinal Pathogens, Health Protection Agency Centre for Infections, London, United Kingdom
| | - B Stewart
- South Oxfordshire Environmental Health Office, Wallingford, United Kingdom
| | - N McCarthy
- Thames Valley Health Protection Agency, Oxford, United Kingdom
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Dandu S, Jones SE, Okeahialam MG. Rokitansky-Kuster-Hauser syndrome associated with chromosomal abnormality and fibroid arising from the rudimentary uterine horn. J OBSTET GYNAECOL 2009; 20:98. [PMID: 15512489 DOI: 10.1080/01443610063688] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- S Dandu
- Department of Obstetrics and Gynaecology, Bradford Royal Infirmary, UK
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Affiliation(s)
- J P Dwyer
- Department of Obstetrics and Gynaecology, Bradford Royal Infirmary, UK
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Jones SE, Versalovic J. Probiotic Lactobacillus reuteri biofilms produce antimicrobial and anti-inflammatory factors. BMC Microbiol 2009; 9:35. [PMID: 19210794 PMCID: PMC2653509 DOI: 10.1186/1471-2180-9-35] [Citation(s) in RCA: 244] [Impact Index Per Article: 16.3] [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] [Received: 07/12/2008] [Accepted: 02/11/2009] [Indexed: 02/08/2023] Open
Abstract
Background Commensal-derived probiotic bacteria inhibit enteric pathogens and regulate host immune responses in the gastrointestinal tract, but studies examining specific functions of beneficial microbes in the context of biofilms have been limited in scope. Results Lactobacillus reuteri formed biofilms that retained functions potentially advantageous to the host including modulation of cytokine output and the production of the antimicrobial agent, reuterin. Immunomodulatory activities of biofilms were demonstrated by the abilities of specific L. reuteri strains to suppress human TNF production by LPS-activated monocytoid cells. Quantification of the antimicrobial glycerol derivative, reuterin, was assessed in order to document the antipathogenic potential of probiotic biofilms. L. reuteri biofilms differed in the quantities of reuterin secreted in this physiological state. Conclusion L. reuteri biofilms secreted factors that confer specific health benefits such as immunomodulation and pathogen inhibition. Future probiotic selection strategies should consider a strain's ability to perform beneficial functions as a biofilm.
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Affiliation(s)
- Sara E Jones
- Department of Pathology, Baylor College of Medicine, Houston, Texas 77030, USA.
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Oppelt P, Fernandez H, Farrugia M, Jones SE, Mauskopf JA, Subramanian D. Cost of Invasive Interventions for Uterine Fibroids in Germany, France, and England. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089223] [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] Open
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Coombes RC, Kilburn LS, Snowdon CF, Paridaens R, Coleman RE, Jones SE, Jassem J, Van de Velde CJH, Delozier T, Alvarez I, Del Mastro L, Ortmann O, Diedrich K, Coates AS, Bajetta E, Holmberg SB, Dodwell D, Mickiewicz E, Andersen J, Lønning PE, Cocconi G, Forbes J, Castiglione M, Stuart N, Stewart A, Fallowfield LJ, Bertelli G, Hall E, Bogle RG, Carpentieri M, Colajori E, Subar M, Ireland E, Bliss JM. Survival and safety of exemestane versus tamoxifen after 2-3 years' tamoxifen treatment (Intergroup Exemestane Study): a randomised controlled trial. Lancet 2007; 369:559-70. [PMID: 17307102 DOI: 10.1016/s0140-6736(07)60200-1] [Citation(s) in RCA: 690] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Early improvements in disease-free survival have been noted when an aromatase inhibitor is given either instead of or sequentially after tamoxifen in postmenopausal women with oestrogen-receptor-positive early breast cancer. However, little information exists on the long-term effects of aromatase inhibitors after treatment, and whether these early improvements lead to real gains in survival. METHODS 4724 postmenopausal patients with unilateral invasive, oestrogen-receptor-positive or oestrogen-receptor-unknown breast cancer who were disease-free on 2-3 years of tamoxifen, were randomly assigned to switch to exemestane (n=2352) or to continue tamoxifen (n=2372) for the remainder of a 5-year endocrine treatment period. The primary endpoint was disease-free survival; overall survival was a secondary endpoint. Efficacy analyses were intention-to-treat. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN11883920. RESULTS After a median follow-up of 55.7 months (range 0-89.7), 809 events contributing to the analysis of disease-free survival had been reported (354 exemestane, 455 tamoxifen); unadjusted hazard ratio 0.76 (95% CI 0.66-0.88, p=0.0001) in favour of exemestane, absolute benefit 3.3% (95% CI 1.6-4.9) by end of treatment (ie, 2.5 years after randomisation). 222 deaths occurred in the exemestane group compared with 261 deaths in the tamoxifen group; unadjusted hazard ratio 0.85 (95% CI 0.71-1.02, p=0.08), 0.83 (0.69-1.00, p=0.05) when 122 patients with oestrogen-receptor-negative disease were excluded. CONCLUSIONS Our results suggest that early improvements in disease-free survival noted in patients who switch to exemestane after 2-3 years on tamoxifen persist after treatment, and translate into a modest improvement in overall survival.
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Affiliation(s)
- R C Coombes
- Cancer Research UK Department of Cancer Medicine, Division of Surgery, Oncology, Reproductive Biology and Anaesthetics, Imperial College London, Faculty of Medicine, Hammersmith Hospitals Trust, London W12 0NN, UK
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Yazici B, Sever AR, Mills P, Fish D, Jones SE, Jones PA. Scar formation after stereotactic vacuum-assisted core biopsy of benign breast lesions. Clin Radiol 2006; 61:619-24. [PMID: 16784949 DOI: 10.1016/j.crad.2006.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 12/26/2005] [Revised: 03/08/2006] [Accepted: 03/20/2006] [Indexed: 10/24/2022]
Abstract
AIM To evaluate scar formation of impalpable breast lesions with benign histological outcome using stereotactic 11-gauge vacuum-assisted core biopsy (VACB). MATERIALS AND METHODS Two hundred and ten lesions with benign histology for which follow-up mammograms were available, were assessed for scar formation at the biopsy site. All biopsies were performed using stereotactic VACB with 11-gauge needle. The incidence of post-biopsy scar formation and the number of specimens removed were determined. RESULTS In 4.3% (9/210) of the lesions for which a biopsy was performed with 11-gauge directional vacuum-assisted technique, the follow-up mammogram revealed a scar formation. Of these, six were minimal scars, two were moderate scars and one was a marked scar. Minimal and moderate scars were diagnosed on imaging only. However, the case with marked scar formation required tissue diagnosis to rule out malignancy. CONCLUSION Although uncommon, scar formation can be seen in the follow-up mammograms after percutaneous breast biopsies. It is important that the radiologist interpreting follow-up mammograms is aware of the features of this lesion and its relationship to the biopsy procedure.
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Affiliation(s)
- B Yazici
- Department of Radiology, Maidstone Hospital Breast Unit, Kent, UK
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Jones SE, White KE, Flyvbjerg A, Marshall SM. The effect of intrauterine environment and low glomerular number on the histological changes in diabetic glomerulosclerosis. Diabetologia 2006; 49:191-9. [PMID: 16365725 DOI: 10.1007/s00125-005-0052-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2005] [Accepted: 08/21/2005] [Indexed: 10/25/2022]
Abstract
AIMS/HYPOTHESIS We tested the hypothesis that diabetic glomerulosclerosis would develop more rapidly in animals with fewer glomeruli. METHODS We studied the female offspring of Wistar rats that had been fed a low-protein diet (LPD) containing 6% protein or a normal-protein diet (NPD) containing 18% protein during pregnancy. Streptozotocin diabetes was induced at 12 weeks and animals were killed at 40 weeks. RESULTS Non-diabetic LPD offspring were of lower birthweight than the NPD offspring (5.19+/-0.64 vs 6.45+/-0.67 g, p<0.001) and had fewer glomeruli (27,402+/-3,137 vs 34,203+/-6,471, p<0.05). Glomerular volume correlated inversely with glomerular number (r=-0.64, p=0.035), but total glomerular filtration surface area was reduced in the LPD animals (4,770+/-541 vs 5,779+/-1,302 mm(2), p=0.05). Other renal structural and functional parameters were similar. In LPD and NPD diabetic animals, glomerular volume and basement membrane width were significantly increased compared to their respective controls. Podocyte density was lowest in the LPD diabetic animals (not significant), and the area covered by each podocyte was greater in the LPD diabetic group (2.40+/-0.693 x10(-3) mm(2)) than in the LPD control group (1.68+/-0.374 x10(-3) mm(2), p<0.001) and in the NPD diabetic animals (1.71+/-0.291 x 10(-3) mm(2), p<0.05). There was no difference in any other structural or functional parameter between the LPD and NPD diabetic animals. CONCLUSIONS/INTERPRETATION A decrease in glomerular number was not deleterious to renal structure and function over 40 weeks in this animal model. Further work in models with progressive renal impairment and hypertension is necessary to clarify the impact of glomerular number on the development of renal disease.
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Affiliation(s)
- S E Jones
- Diabetes Research Group, School of Clinical Medical Sciences, University Of Newcastle upon Tyne, Newcastle upon Tyne, UK
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Jones SE, Erban J, Overmoyer B, Budd GT, Hutchins L, Lower E, Laufman L, Sundaram S, Urba WJ, Pritchard KI, Mennel R, Richards D, Olsen S, Meyers ML, Ravdin PM. Randomized Phase III Study of Docetaxel Compared With Paclitaxel in Metastatic Breast Cancer. J Clin Oncol 2005; 23:5542-51. [PMID: 16110015 DOI: 10.1200/jco.2005.02.027] [Citation(s) in RCA: 390] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PurposeThis randomized, controlled, multicenter, open-label, phase III study compared docetaxel versus paclitaxel in patients with advanced breast cancer that had progressed after an anthracycline-containing chemotherapy regimen.Patients and MethodsPatients (n = 449) were randomly assigned to receive either docetaxel 100 mg/m2(n = 225) or paclitaxel 175 mg/m2(n = 224) on day 1, every 21 days until tumor progression, unacceptable toxicity, or withdrawal of consent.ResultsIn the intent-to-treat population, both the median overall survival (OS, 15.4 v 12.7 months; hazard ratio [HR], 1.41; 95% CI, 1.15 to 1.73; P = .03) and the median time to progression (TTP, 5.7 months v 3.6 months; HR, 1.64; 95% CI, 1.33 to 2.02; P < .0001) for docetaxel were significantly longer than for paclitaxel, and the overall response rate (ORR, 32% v 25%; P = .10) was higher for docetaxel. These results were confirmed by multivariate analyses. The incidence of treatment-related hematologic and nonhematologic toxicities was greater for docetaxel than for paclitaxel; however, quality-of-life scores were not statistically different between treatment groups over time.ConclusionDocetaxel was superior to paclitaxel in terms of OS and TTP. ORR was higher for docetaxel. Hematologic and nonhematologic toxicities occurred more frequently in the docetaxel group. The global quality-of-life scores were similar for both agents over time.
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Affiliation(s)
- S E Jones
- Texas Oncology, 3535 Worth St, Suite 600, Dallas, TX 75246, USA.
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