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Abstract
This Special Issue of Neuropharmacology on psychedelics provides a timely and comprehensive update on progress following the previous Neuropharmacology Special Issue "Psychedelics: New Doors, Altered Perceptions". Remarkable advances have been made in basic and clinical research on psychedelics in the five years since 2018. It is partly based on the seminar series focused on psilocybin organized by the National Institutes of Health (NIH), USA from April to June 2021, the "NIH Psilocybin Research Speaker Series". Participants were world leading experts, including scientists, medical practitioners, clinical psychologists and oncologists, and attendees from additional disciplines of patient advocacy, law, government science policy and regulatory policy. To provide a global perspective, their contributions are complemented with reviews by some of the world's most eminent scientists in the field. The US Food and Drug Administration (FDA) has granted two breakthrough therapy designations for psilocybin in treatment resistant depression (TRD) in 2018 and major depressive disorder (MDD) in 2019, as well as for MDMA for the treatment of post-traumatic stress disorder (PTSD) in 2017. Clinical trials are in progress to assess the therapeutic value of psilocybin in MDD and TRD, and in other indications such as cancer-related anxiety and depression, anorexia, PTSD, substance use disorders and various types of chronic pain. The contributors' insights should assist basic and applied science for transition of psychedelics from bench to potential mainstream therapies. The implications are global, because FDA approval of these new medicines will increase international interest and efforts.
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Affiliation(s)
- D J Heal
- DevelRx Ltd, BioCity, Nottingham NG1 1GF, UK; Department of Life Sciences, University of Bath, Bath BA2 7AY, UK.
| | - S L Smith
- DevelRx Ltd, BioCity, Nottingham NG1 1GF, UK.
| | - S J Belouin
- United States Public Health Service (USPHS), Germantown, MD, USA; Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, MD, USA; NIH Clinical Research Center, Pain and Palliative Care, Bethesda, MD, USA.
| | - J E Henningfield
- Pinney Associates, 4800 Montgomery Ln Suite 400, Bethesda, MD 20814, USA; Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA.
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Heal DJ, Gosden J, Smith SL, Atterwill CK. Experimental strategies to discover and develop the next generation of psychedelics and entactogens as medicines. Neuropharmacology 2023; 225:109375. [PMID: 36529260 DOI: 10.1016/j.neuropharm.2022.109375] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 08/10/2022] [Revised: 11/18/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
Research on classical psychedelics (psilocybin, LSD and DMT) and entactogen, MDMA, has produced a renaissance in the search for more effective drugs to treat psychiatric, neurological and various peripheral disorders. Psychedelics and entactogens act though interaction with 5-HT2A and other serotonergic receptors and/or monoamine reuptake transporters. 5-HT, which serves as a neurotransmitter and hormone, is ubiquitously distributed in the brain and peripheral organs, tissues and cells where it has vasoconstrictor, pro-inflammatory and pro-nociceptive actions. Serotonergic psychedelics and entactogens have known safety and toxicity risks. For these drugs, the risks been extensively researched and empirically assessed through human experience. However, novel drug-candidates require thorough non-clinical testing not only to predict clinical efficacy, but also to address the risks they pose during clinical development and later after approval as prescription medicines. We have defined the challenges researchers will encounter when developing novel serotonergic psychedelics and entactogens. We describe screening techniques to predict clinical efficacy and address the safety/toxicity risks emerging from our knowledge of the existing drugs: 1) An early-stage, non-clinical screening cascade to pharmacologically characterise novel drug-candidates. 2) Models to detect hallucinogenic activity. 3) Models to differentiate hallucinogens from entactogens. 4) Non-clinical preclinical lead optimisation technology (PLOT) screening to select drug-candidates. 5) Modified animal models to evaluate the abuse and dependence risks of novel psychedelics in Safety Pharmacology testing. Our intention has been to design non-clinical screening strategies that will reset the balance between benefits and harms to deliver more effective and safer novel psychedelics for clinical use. This article is part of the Special Issue on 'National Institutes of Health Psilocybin Research Speaker Series'.
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Affiliation(s)
- D J Heal
- DevelRx Ltd, BioCity, Nottingham, NG1 1GF, UK; Department of Life Sciences, University of Bath, Bath, BA2 7AY, UK.
| | - J Gosden
- DevelRx Ltd, BioCity, Nottingham, NG1 1GF, UK.
| | - S L Smith
- DevelRx Ltd, BioCity, Nottingham, NG1 1GF, UK.
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Brand W, Wells AT, Smith SL, Denholm SJ, Wall E, Coffey MP. Predicting pregnancy status from mid-infrared spectroscopy in dairy cow milk using deep learning. J Dairy Sci 2021; 104:4980-4990. [PMID: 33485687 DOI: 10.3168/jds.2020-18367] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 10/01/2020] [Indexed: 01/15/2023]
Abstract
Accurately identifying pregnancy status is imperative for a profitable dairy enterprise. Mid-infrared (MIR) spectroscopy is routinely used to determine fat and protein concentrations in milk samples. Mid-infrared spectra have successfully been used to predict other economically important traits, including fatty acid content, mineral content, body energy status, lactoferrin, feed intake, and methane emissions. Machine learning has been used in a variety of fields to find patterns in vast quantities of data. This study aims to use deep learning, a sub-branch of machine learning, to establish pregnancy status from routinely collected milk MIR spectral data. Milk spectral data were obtained from National Milk Records (Chippenham, UK), who collect large volumes of data continuously on a monthly basis. Two approaches were followed: using genetic algorithms for feature selection and network design (model 1), and transfer learning with a pretrained DenseNet model (model 2). Feature selection in model 1 showed that the number of wave points in MIR data could be reduced from 1,060 to 196 wave points. The trained model converged after 162 epochs with validation accuracy and loss of 0.89 and 0.18, respectively. Although the accuracy was sufficiently high, the loss (in terms of predicting only 2 labels) was considered too high and suggested that the model would not be robust enough to apply to industry. Model 2 was trained in 2 stages of 100 epochs each with spectral data converted to gray-scale images and resulted in accuracy and loss of 0.97 and 0.08, respectively. Inspection on inference data showed prediction sensitivity of 0.89, specificity of 0.86, and prediction accuracy of 0.88. Results indicate that milk MIR data contains features relating to pregnancy status and the underlying metabolic changes in dairy cows, and such features can be identified by means of deep learning. Prediction equations from trained models can be used to alert farmers of nonviable pregnancies as well as to verify conception dates.
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Affiliation(s)
- W Brand
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh, EH9 3JG, UK
| | - A T Wells
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh, EH9 3JG, UK
| | - S L Smith
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh, EH9 3JG, UK
| | - S J Denholm
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh, EH9 3JG, UK
| | - E Wall
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh, EH9 3JG, UK
| | - M P Coffey
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh, EH9 3JG, UK.
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Patterson EI, Elia G, Grassi A, Giordano A, Desario C, Medardo M, Smith SL, Anderson ER, Prince T, Patterson GT, Lorusso E, Lucente MS, Lanave G, Lauzi S, Bonfanti U, Stranieri A, Martella V, Solari Basano F, Barrs VR, Radford AD, Agrimi U, Hughes GL, Paltrinieri S, Decaro N. Evidence of exposure to SARS-CoV-2 in cats and dogs from households in Italy. Nat Commun 2020; 11:6231. [PMID: 33277505 PMCID: PMC7718263 DOI: 10.1038/s41467-020-20097-0] [Citation(s) in RCA: 237] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/13/2020] [Indexed: 01/20/2023] Open
Abstract
SARS-CoV-2 emerged from animals and is now easily transmitted between people. Sporadic detection of natural cases in animals alongside successful experimental infections of pets, such as cats, ferrets and dogs, raises questions about the susceptibility of animals under natural conditions of pet ownership. Here, we report a large-scale study to assess SARS-CoV-2 infection in 919 companion animals living in northern Italy, sampled at a time of frequent human infection. No animals tested PCR positive. However, 3.3% of dogs and 5.8% of cats had measurable SARS-CoV-2 neutralizing antibody titers, with dogs from COVID-19 positive households being significantly more likely to test positive than those from COVID-19 negative households. Understanding risk factors associated with this and their potential to infect other species requires urgent investigation.
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Affiliation(s)
- E I Patterson
- Centre for Neglected Tropical Disease, Departments of Vector Biology and Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - G Elia
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - A Grassi
- I-VET srl, Laboratorio di Analisi Veterinarie, Via Ettore Majorana, 10 - 25020, Flero, BS, Italy
| | - A Giordano
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - C Desario
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - M Medardo
- La Vallonèa Veterinary Diagnostic Laboratory, via G. Sirtori 9, 20017, Passirana di Rho, MI, Italy
| | - S L Smith
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - E R Anderson
- Centre for Neglected Tropical Disease, Departments of Vector Biology and Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - T Prince
- NIHR Health Protection Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - G T Patterson
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - E Lorusso
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - M S Lucente
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - G Lanave
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - S Lauzi
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - U Bonfanti
- La Vallonèa Veterinary Diagnostic Laboratory, via G. Sirtori 9, 20017, Passirana di Rho, MI, Italy
| | - A Stranieri
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - V Martella
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy
| | - F Solari Basano
- Arcoblu s.r.l., via Alessandro Milesi 5, 20133, Milan, Italy
| | - V R Barrs
- City University's Jockey Club College of Veterinary Medicine and Life Sciences, 5/F, Block 1A, To Yuen Building, 31 To Yuen Street, Kowloon, Hong Kong
| | - A D Radford
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - U Agrimi
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - G L Hughes
- Centre for Neglected Tropical Disease, Departments of Vector Biology and Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - S Paltrinieri
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Milan, Via dell'Università 6, 26900, Lodi, Italy
| | - N Decaro
- Department of Veterinary Medicine, University of Bari Aldo Moro, Strada Prov. per Casamassima Km 3, 70010, Valenzano, BA, Italy.
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Denholm SJ, Brand W, Mitchell AP, Wells AT, Krzyzelewski T, Smith SL, Wall E, Coffey MP. Predicting bovine tuberculosis status of dairy cows from mid-infrared spectral data of milk using deep learning. J Dairy Sci 2020; 103:9355-9367. [PMID: 32828515 DOI: 10.3168/jds.2020-18328] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/09/2020] [Indexed: 11/19/2022]
Abstract
Bovine tuberculosis (bTB) is a zoonotic disease in cattle that is transmissible to humans, distributed worldwide, and considered endemic throughout much of England and Wales. Mid-infrared (MIR) analysis of milk is used routinely to predict fat and protein concentration, and is also a robust predictor of several other economically important traits including individual fatty acids and body energy. This study predicted bTB status of UK dairy cows using their MIR spectral profiles collected as part of routine milk recording. Bovine tuberculosis data were collected as part of the national bTB testing program for Scotland, England, and Wales; these data provided information from over 40,500 bTB herd breakdowns. Corresponding individual cow life-history data were also available and provided information on births, movements, and deaths of all cows in the study. Data relating to single intradermal comparative cervical tuberculin (SICCT) skin-test results, culture, slaughter status, and presence of lesions were combined to create a binary bTB phenotype labeled 0 to represent nonresponders (i.e., healthy cows) and 1 to represent responders (i.e., bTB-affected cows). Contemporaneous individual milk MIR spectral data were collected as part of monthly routine milk recording and matched to bTB status of individual animals on the single intradermal comparative cervical tuberculin test date (±15 d). Deep learning, a sub-branch of machine learning, was used to train artificial neural networks and develop a prediction pipeline for subsequent use in national herds as part of routine milk recording. Spectra were first converted to 53 × 20-pixel PNG images, then used to train a deep convolutional neural network. Deep convolutional neural networks resulted in a bTB prediction accuracy (i.e., the number of correct predictions divided by the total number of predictions) of 71% after training for 278 epochs. This was accompanied by both a low validation loss (0.71) and moderate sensitivity and specificity (0.79 and 0.65, respectively). To balance data in each class, additional training data were synthesized using the synthetic minority over sampling technique. Accuracy was further increased to 95% (after 295 epochs), with corresponding validation loss minimized (0.26), when synthesized data were included during training of the network. Sensitivity and specificity also saw a 1.22- and 1.45-fold increase to 0.96 and 0.94, respectively, when synthesized data were included during training. We believe this study to be the first of its kind to predict bTB status from milk MIR spectral data. We also believe it to be the first study to use milk MIR spectral data to predict a disease phenotype, and posit that the automated prediction of bTB status at routine milk recording could provide farmers with a robust tool that enables them to make early management decisions on potential reactor cows, and thus help slow the spread of bTB.
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Affiliation(s)
- S J Denholm
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh EH9 3JG, UK.
| | - W Brand
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh EH9 3JG, UK
| | - A P Mitchell
- Animal and Plant Health Agency (APHA), Woodham Lane, Addlestone, Surrey KT15 3NB, UK
| | - A T Wells
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh EH9 3JG, UK
| | - T Krzyzelewski
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh EH9 3JG, UK
| | - S L Smith
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh EH9 3JG, UK
| | - E Wall
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh EH9 3JG, UK
| | - M P Coffey
- Scotland's Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh EH9 3JG, UK
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Patterson EI, Elia G, Grassi A, Giordano A, Desario C, Medardo M, Smith SL, Anderson ER, Prince T, Patterson GT, Lorusso E, Lucente MS, Lanave G, Lauzi S, Bonfanti U, Stranieri A, Martella V, Basano FS, Barrs VR, Radford AD, Agrimi U, Hughes GL, Paltrinieri S, Decaro N. Evidence of exposure to SARS-CoV-2 in cats and dogs from households in Italy. bioRxiv 2020. [PMID: 32743588 DOI: 10.1101/2020.07.21.214346] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
SARS-CoV-2 originated in animals and is now easily transmitted between people. Sporadic detection of natural cases in animals alongside successful experimental infections of pets, such as cats, ferrets and dogs, raises questions about the susceptibility of animals under natural conditions of pet ownership. Here we report a large-scale study to assess SARS-CoV-2 infection in 817 companion animals living in northern Italy, sampled at a time of frequent human infection. No animals tested PCR positive. However, 3.4% of dogs and 3.9% of cats had measurable SARS-CoV-2 neutralizing antibody titers, with dogs from COVID-19 positive households being significantly more likely to test positive than those from COVID-19 negative households. Understanding risk factors associated with this and their potential to infect other species requires urgent investigation. One Sentence Summary SARS-CoV-2 antibodies in pets from Italy.
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Smith SL, Denholm SJ, Coffey MP, Wall E. Energy profiling of dairy cows from routine milk mid-infrared analysis. J Dairy Sci 2019; 102:11169-11179. [PMID: 31587910 DOI: 10.3168/jds.2018-16112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 12/06/2018] [Accepted: 07/24/2019] [Indexed: 01/04/2023]
Abstract
The balance of body energy within and across lactations can have health and fertility consequences for the dairy cow. This study aimed to create a large calibration data set of dairy cow body energy traits across the cow's productive life, with concurrent milk mid-infrared (MIR) spectral data, to generate a prediction tool for use in commercial dairy herds. Detailed phenotypic data from 1,101 Holstein Friesian cows from the Langhill research herd (SRUC, Scotland) were used to generate energy balance (EB) and effective energy intake (EI), both in megajoules per day. Pretreatment of spectral data involved standardization to account for drift over time and machine. Body energy estimates were aligned with their spectral data to generate a prediction of these traits based on milk MIR spectroscopy. After data edits, partial least squares analysis generated prediction equations with a coefficient of determination from split sample 10-fold cross validation of 0.77 and 0.75 for EB and EI, respectively. These prediction equations were applied to national milk MIR spectra on over 11 million animal test dates (January 2013 to December 2016) from 4,453 farms. The predictions generated from these were subject to phenotypic analyses with a fixed regression model highlighting differences between the main dairy breeds in terms of energy traits. Genetic analyses generated heritability estimates for EB and EI ranging from 0.12 to 0.17 and 0.13 to 0.15, respectively. This study shows that MIR-based predictions from routinely collected national data can be used to generate predictions of dairy cow energy turnover profiles for both animal management and genetic improvement of such difficult and expensive-to-record traits.
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Affiliation(s)
- S L Smith
- Scotland's Rural College (SRUC), Edinburgh EH9 3JG, UK
| | - S J Denholm
- Scotland's Rural College (SRUC), Edinburgh EH9 3JG, UK.
| | - M P Coffey
- Scotland's Rural College (SRUC), Edinburgh EH9 3JG, UK
| | - E Wall
- Scotland's Rural College (SRUC), Edinburgh EH9 3JG, UK
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Smith SL, Chahroudi AM, Camacho-Gonzalez AF, Gillespie S, Wynn BA, Badell ML, Swartzendruber A, Hazra R, Wortley P, Chakraborty R. Evaluating Facility Infrastructure for Prevention of Mother-to-Child Transmission of HIV-A 2015 Assessment of Major Delivery Hospitals in Atlanta, Georgia. J Pediatric Infect Dis Soc 2018; 7:e102-e106. [PMID: 29986059 PMCID: PMC6097576 DOI: 10.1093/jpids/piy058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 06/12/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Our goal was to evaluate the infrastructure of programs for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) in major delivery units in the Atlanta, Georgia, metropolitan statistical area and to assess the knowledge, attitude, and practice of providers in these facilities around PMTCT. METHODS Hospital assessments and individual knowledge and practices were surveyed among 71 healthcare providers from March 2015 to March 2016 in 11 hospitals that deliver 40000 infants annually, which represents 70% of all deliveries in the Atlanta metropolitan statistical area. Included were questions about HIV testing for mother-infant pairs, test result turnaround times, policies and procedures for PMTCT, opt-out versus opt-in testing, availability of rapid point-of-care testing on labor and delivery units, and postnatal prophylaxis. RESULTS Seventy-three percent (8 of 11) of the hospitals had limitations in their PMTCT infrastructure, and 36% (4 of 11) reported no standardized policies for care of HIV-infected women. Three labor and delivery units used opt-in HIV testing of women. Only 27% (3 of 11) of the hospitals reported nucleic acid testing of HIV-exposed infants. Oral zidovudine for infant prophylaxis was available in all the hospitals, but 64% (7 of 11) of them did not stock nevirapine. Fifty-nine percent (24 of 44) of the obstetricians did not routinely offer rapid testing at delivery without a third-trimester HIV test, and 78% (n = 32 of 41) of them did not offer testing at delivery if the woman declined antenatal testing. The facility with the most annual births in Georgia did not offer rapid testing at delivery for women with an unknown HIV status. CONCLUSION We identified several limitations in PMTCT infrastructure that might have contributed to perinatal HIV transmissions. The need to address these healthcare gaps to eliminate mother-to-child transmission of HIV in the United States is urgent.
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Affiliation(s)
- Somer L Smith
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia,Correspondence: S. L. Smith, PharmD, BCPS, AAHIVP, 2015 Uppergate Dr., Suite 500, Atlanta, GA 30322 ()
| | - Ann M Chahroudi
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Andres F Camacho-Gonzalez
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Scott Gillespie
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Bridget A Wynn
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Martina L Badell
- Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Andrea Swartzendruber
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Rohan Hazra
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, Maryland
| | - Pascale Wortley
- HIV Epidemiology Section, Georgia Department of Public Health, Atlanta
| | - Rana Chakraborty
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
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Dell'Isola A, Smith SL, Andersen MS, Steultjens M. Knee internal contact force in a varus malaligned phenotype in knee osteoarthritis (KOA). Osteoarthritis Cartilage 2017; 25:2007-2013. [PMID: 28882753 DOI: 10.1016/j.joca.2017.08.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 02/27/2017] [Revised: 08/23/2017] [Accepted: 08/26/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE Multiple phenotypes characterized by different disease mechanisms have been hypothesized to explain the large variability in the knee osteoarthritis (KOA) population. The purpose of this study was: to estimate and compare the medial and lateral knee compression forces (CF) during gait of three subgroups of KOA subjects characterized by different alignment and cartilage disruption patterns. METHODS A secondary data analysis was conducted on a sample of 39 KOA subjects and 18 controls (C). The patients were classified in the different groups according to the following criteria: Varus medial disease (VMD) (12): varus alignment and predominant medial cartilage degeneration Varus generalized disease (VGD) (17): varus alignment and cartilage degeneration that extends to the lateral compartment. Neutral alignment (NA) (10): neutral alignment. The total, medial and lateral CF corrected for body weight were estimated using an inverse dynamics model (AnyBody Modeling System, AnyBody Technology) during stance. RESULTS The impulse of the medial compressive force (MCF) (overall effect of the CF over the stance) was significantly higher (P < 0.01) in the VMD compared to all the other groups. Peak MCF was higher in the VMD compared to all the other groups, but the difference reached significance only when compared to the VGD group (P < 0.05). The results of the regression analysis showed a significant relationship in the VMD group between alignment and impulse of the MCF (R2 = 0.62; P < 0.01). This relationship disappears in the other groups. CONCLUSIONS These findings suggest the existence of a phenotype characterized by increased MCF.
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Affiliation(s)
- A Dell'Isola
- Institute of Applied Health Research/School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.
| | - S L Smith
- Institute of Applied Health Research/School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.
| | - M S Andersen
- Department of Mechanical, Manufacturing and Management Engineering, Aalborg University, Denmark.
| | - M Steultjens
- Institute of Applied Health Research/School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.
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Nyirandagijimana B, Edwards JK, Venables E, Ali E, Rusangwa C, Mukasakindi H, Borg R, Fabien M, Tharcisse M, Nshimyiryo A, Park PH, Raviola GJ, Smith SL. Closing the gap: decentralising mental health care to primary care centres in one rural district of Rwanda. Public Health Action 2017; 7:231-236. [PMID: 29201658 DOI: 10.5588/pha.16.0130] [Citation(s) in RCA: 9] [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] [Received: 12/31/2016] [Accepted: 06/27/2017] [Indexed: 11/10/2022] Open
Abstract
Setting: Programmes that integrate mental health care into primary care settings could reduce the global burden of mental disorders by increasing treatment availability in resource-limited settings, including Rwanda. Objective: We describe patient demographics, service use and retention of patients in care at health centres (HC) participating in an innovative primary care integration programme, compared to patients using existing district hospital-based specialised out-patient care. Design: This was a retrospective cohort study using routinely collected data from six health centres and one district hospital from October 2014 to March 2015. Results: Of 709 patients, 607 were cared for at HCs; HCs accounted for 88% of the total visits for mental disorders. Patients with psychosis used HC services more frequently, while patients with affective disorders were seen more frequently at the district hospital. Of the 68% of patients who returned to care within 90 days of their first visit, 76% had a third visit within a further 90 days. There were no significant differences in follow-up rates between clinical settings. Conclusion: This study suggests that a programme of mentorship for primary care nurses can facilitate the decentralisation of out-patient mental health care from specialised district hospital mental health services to HCs in rural Rwanda.
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Affiliation(s)
| | - J K Edwards
- Médecins Sans Frontières, Luxembourg Operational Research Unit (LuxOR), Brussels Operational Centre, Luxembourg City, Luxembourg.,School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - E Venables
- Médecins Sans Frontières, Luxembourg Operational Research Unit (LuxOR), Brussels Operational Centre, Luxembourg City, Luxembourg.,Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - E Ali
- Médecins Sans Frontières, Luxembourg Operational Research Unit (LuxOR), Brussels Operational Centre, Luxembourg City, Luxembourg
| | - C Rusangwa
- Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda
| | - H Mukasakindi
- Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda
| | - R Borg
- Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda
| | - M Fabien
- Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda
| | | | - A Nshimyiryo
- Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda
| | - P H Park
- Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda.,Harvard Medical School, Boston, Massachusetts, USA.,Boston Children's Hospital, Boston, Massachusetts, USA
| | - G J Raviola
- Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda.,Harvard Medical School, Boston, Massachusetts, USA.,Boston Children's Hospital, Boston, Massachusetts, USA
| | - S L Smith
- Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda.,Harvard Medical School, Boston, Massachusetts, USA.,Brigham and Women's Hospital, Boston, Massachusetts, USA
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11
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Hinks A, Bowes J, Cobb J, Ainsworth HC, Marion MC, Comeau ME, Sudman M, Han B, Becker ML, Bohnsack JF, de Bakker PIW, Haas JP, Hazen M, Lovell DJ, Nigrovic PA, Nordal E, Punnaro M, Rosenberg AM, Rygg M, Smith SL, Wise CA, Videm V, Wedderburn LR, Yarwood A, Yeung RSM, Prahalad S, Langefeld CD, Raychaudhuri S, Thompson SD, Thomson W. Fine-mapping the MHC locus in juvenile idiopathic arthritis (JIA) reveals genetic heterogeneity corresponding to distinct adult inflammatory arthritic diseases. Ann Rheum Dis 2016; 76:765-772. [PMID: 27998952 PMCID: PMC5530326 DOI: 10.1136/annrheumdis-2016-210025] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/12/2016] [Accepted: 11/05/2016] [Indexed: 11/06/2022]
Abstract
Objectives Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases, comprising seven categories. Genetic data could potentially be used to help redefine JIA categories and improve the current classification system. The human leucocyte antigen (HLA) region is strongly associated with JIA. Fine-mapping of the region was performed to look for similarities and differences in HLA associations between the JIA categories and define correspondences with adult inflammatory arthritides. Methods Dense genotype data from the HLA region, from the Immunochip array for 5043 JIA cases and 14 390 controls, were used to impute single-nucleotide polymorphisms, HLA classical alleles and amino acids. Bivariate analysis was performed to investigate genetic correlation between the JIA categories. Conditional analysis was used to identify additional effects within the region. Comparison of the findings with those in adult inflammatory arthritic diseases was performed. Results We identified category-specific associations and have demonstrated for the first time that rheumatoid factor (RF)-negative polyarticular JIA and oligoarticular JIA are genetically similar in their HLA associations. We also observe that each JIA category potentially has an adult counterpart. The RF-positive polyarthritis association at HLA-DRB1 amino acid at position 13 mirrors the association in adult seropositive rheumatoid arthritis (RA). Interestingly, the combined oligoarthritis and RF-negative polyarthritis dataset shares the same association with adult seronegative RA. Conclusions The findings suggest the value of using genetic data in helping to classify the categories of this heterogeneous disease. Mapping JIA categories to adult counterparts could enable shared knowledge of disease pathogenesis and aetiology and facilitate transition from paediatric to adult services.
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Affiliation(s)
- A Hinks
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK
| | - J Bowes
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK
| | - J Cobb
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK.,NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - H C Ainsworth
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - M C Marion
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - M E Comeau
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - M Sudman
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - B Han
- Divisions of Genetics and Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.,Department of Convergence Medicine, University of Ulsan College of Medicine & Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | | | - M L Becker
- Division of Rheumatology and Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation, Children's Mercy-Kansas City, Kansas City, Missouri, USA
| | - J F Bohnsack
- Division of Allergy, Immunology and Paediatric Rheumatology, University of Utah, Salt Lake City, Utah, USA
| | - P I W de Bakker
- Department of Medical Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J P Haas
- German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | - M Hazen
- Division of Immunology, Department of Rheumatology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - D J Lovell
- Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - P A Nigrovic
- Division of Immunology, Department of Rheumatology, Boston Children's Hospital, Boston, Massachusetts, USA.,Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - E Nordal
- Department of Paediatrics, University Hospital of North Norway, and UIT The Arctic University of Norway, Tromsø, Norway
| | - M Punnaro
- Arthritis Clinic Texas Scottish Rite Hospital for Children, Dallas, Texas, USA.,Department of Paediatrics, UT Southwestern Medical Center, Dallas, Texas, USA
| | - A M Rosenberg
- Division of Rheumatology, Department of Paediatrics, University of Saskatchewan, Saskatoon, Canada
| | - M Rygg
- Department of Laboratory Medicine, Children's and Women's Health, NTNU - Norwegian University of Science and Technology, and St. Olavs University Hospital, Trondheim, Norway
| | - S L Smith
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK
| | - C A Wise
- Sarah M. and Charles E. Seay Center for Musculoskeletal Research, Texas Scottish Rite Hospital for Children, Dallas, Texas, USA.,Department of Orthopaedic Surgery, Paediatrics, and McDermott Center for Human Growth and Development, UT Southwestern Medical Center, Dallas, Texas, USA
| | - V Videm
- Department of Laboratory Medicine, Children's and Women's Health, NTNU - Norwegian University of Science and Technology, and St. Olavs University Hospital, Trondheim, Norway
| | - L R Wedderburn
- Arthritis Research UK Centre for Adolescent Rheumatology, UCL GOS Institute of Child Health, University College London, London, UK.,NIHR-Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - A Yarwood
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK
| | - R S M Yeung
- The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - S Prahalad
- Department of Paediatrics, Emory University School of Medicine, and Children's Healthcare of Atlanta, Atlanta, USA
| | - C D Langefeld
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - S Raychaudhuri
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK.,Divisions of Genetics and Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, USA.,Department of Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden
| | - S D Thompson
- Center for Autoimmune Genomics and Etiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - W Thomson
- Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, University Of Manchester, Manchester, UK.,NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
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12
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Abstract
Maxillary sinus volumetric and surface area data and growth models from longitudinal samples of children and adolescents are presented. Cone-beam radiographic CT scans from two small retrospective longitudinal samples, one from the Baylor College of Dentistry, Dallas, TX (N=17, 12 females, 5 males, 10.9-17.4 years) and one from a group private orthodontic practice in Nevada (N=15, 9 females, 6 males, 6.4-13.4 years) were used to collect maxillary sinus volumes and surface areas from each individual imaged at two times separated by variable intervals. Volume and surface area values were collected in Analyze® (Mayo Clinic) and growth models were produced in MLwiN®, a multi-level modeling program. There is a large degree of inter-individual variation. Surface area and surface-area-to-volume ratio (SA:V) changes are particularly variable. Growth models suggest linear growth in both volume and surface area, without growth spurts.
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Affiliation(s)
- S L Smith
- Department of Sociology and Anthropology, University of Texas at Arlington, Arlington, TX 76019, USA.
| | - P H Buschang
- Department of Orthodontics, Texas A&M University, Baylor College of Dentistry, Dallas, TX 75246, USA
| | - P C Dechow
- Department of Biomedical Sciences, Texas A&M University, Baylor College of Dentistry, Dallas, TX 75246, USA
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13
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Dell'Isola A, Allan R, Smith SL, Marreiros SSP, Steultjens M. Identification of clinical phenotypes in knee osteoarthritis: a systematic review of the literature. BMC Musculoskelet Disord 2016; 17:425. [PMID: 27733199 PMCID: PMC5062907 DOI: 10.1186/s12891-016-1286-2] [Citation(s) in RCA: 183] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 10/07/2016] [Indexed: 01/08/2023] Open
Abstract
Background Knee Osteoarthritis (KOA) is a heterogeneous pathology characterized by a complex and multifactorial nature. It has been hypothesised that these differences are due to the existence of underlying phenotypes representing different mechanisms of the disease. Methods The aim of this study is to identify the current evidence for the existence of groups of variables which point towards the existence of distinct clinical phenotypes in the KOA population. A systematic literature search in PubMed was conducted. Only original articles were selected if they aimed to identify phenotypes of patients aged 18 years or older with KOA. The methodological quality of the studies was independently assessed by two reviewers and qualitative synthesis of the evidence was performed. Strong evidence for existence of specific phenotypes was considered present if the phenotype was supported by at least two high-quality studies. Results A total of 24 studies were included. Through qualitative synthesis of evidence, six main sets of variables proposing the existence of six phenotypes were identified: 1) chronic pain in which central mechanisms (e.g. central sensitisation) are prominent; 2) inflammatory (high levels of inflammatory biomarkers); 3) metabolic syndrome (high prevalence of obesity, diabetes and other metabolic disturbances); 4) Bone and cartilage metabolism (alteration in local tissue metabolism); 5) mechanical overload characterised primarily by varus malalignment and medial compartment disease; and 6) minimal joint disease characterised as minor clinical symptoms with slow progression over time. Conclusions This study identified six distinct groups of variables which should be explored in attempts to better define clinical phenotypes in the KOA population. Electronic supplementary material The online version of this article (doi:10.1186/s12891-016-1286-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A Dell'Isola
- Institute of Applied Health Research/School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, Scotland, UK.
| | - R Allan
- Institute of Applied Health Research/School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, Scotland, UK
| | - S L Smith
- Institute of Applied Health Research/School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, Scotland, UK
| | - S S P Marreiros
- Institute of Applied Health Research/School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, Scotland, UK
| | - M Steultjens
- Institute of Applied Health Research/School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, Scotland, UK
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14
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Rimawi BH, Smith SL, Badell ML, Zahedi-Spung LD, Sheth AN, Haddad L, Chakraborty R. HIV and reproductive healthcare in pregnant and postpartum HIV-infected women: adapting successful strategies. Future Virol 2016; 11:577-581. [PMID: 28348636 PMCID: PMC5365084 DOI: 10.2217/fvl-2016-0065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Linkage and retention in care for many HIV-infected women in the postpartum period is suboptimal, which compromises long-term virologic suppression and the HIV Care Continuum. Efforts are needed to improve individual outcomes by addressing transitions in care. We summarize some successful strategies to engage and retain HIV-infected women in care during the postpartum period.
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Affiliation(s)
- Bassam H Rimawi
- Division of Maternal Fetal Medicine, Department of Gynecology & Obstetrics, Emory University School of Medicine, 550 Peachtree Street, 8th Floor, Atlanta, GA 30303, USA
| | - Somer L Smith
- Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive NE, 5th Floor, Atlanta, GA 30322, USA
| | - Martina L Badell
- Division of Maternal Fetal Medicine, Department of Gynecology & Obstetrics, Emory University School of Medicine, 550 Peachtree Street, 8th Floor, Atlanta, GA 30303, USA
| | - Leilah D Zahedi-Spung
- Division of Maternal Fetal Medicine, Department of Gynecology & Obstetrics, Emory University School of Medicine, 550 Peachtree Street, 8th Floor, Atlanta, GA 30303, USA
| | - Anandi N Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, USA
| | - Lisa Haddad
- Division of Maternal Fetal Medicine, Department of Gynecology & Obstetrics, Emory University School of Medicine, 550 Peachtree Street, 8th Floor, Atlanta, GA 30303, USA
| | - Rana Chakraborty
- Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive NE, 5th Floor, Atlanta, GA 30322, USA
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15
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Smith SL, Bowers D, Jennings P, Soomal R. Pulmonary radiofrequency ablation in a district general hospital: is it a safe and effective treatment? Clin Radiol 2016; 71:939.e1-8. [PMID: 27157314 DOI: 10.1016/j.crad.2016.03.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 04/07/2016] [Accepted: 03/31/2016] [Indexed: 11/29/2022]
Abstract
AIM To analyse the technical success of ablation therapy and the incidence of complications in patients treated with pulmonary ablation and to assess factors affecting local disease control and patient survival in a subgroup with metastatic colorectal cancer. MATERIALS AND METHODS Technical success and complications in all patients undergoing lung ablation between June 2009 and July 2015 were recorded. Overall survival and local disease control in a subgroup with metastases from a colorectal primary were calculated. Factors influencing outcome were explored. RESULTS Two hundred and seven pulmonary ablations were performed in 86 patients at 156 attendances. Technical success was achieved in 207/207 (100%). Thirty and 90-day mortality was 0%. The major complication rate was 13/86 (15%). One hundred and one metastases were treated in 46 patients with a colorectal primary. This group had a mean ± standard error survival time of 53.58±3.47 months with a 1, 2, 3, 4, and 5-year survival rate of 97.4%, 91.3%, 81.5%, 59.8%, and 48%. There was no statistically significant difference in survival regarding time to development of metastatic disease, the total number of lesions ablated, the initial number of lesions ablated, the maximum size of lesion treated, or unilateral versus bilateral disease. Patients with extrapulmonary disease were found to have a shorter survival from the primary diagnosis. Seventy-eight (77.2%) of the 101 lesions were stable after first RFA. Local relapse was more likely when a metastasis was close to a large (>3 mm) vessel. CONCLUSION RFA is a safe and effective procedure that can be performed without on-site cardiothoracic support. Good outcomes depend upon careful patient selection. This study supports its use in oligometastatic disease.
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Affiliation(s)
- S L Smith
- Department of Radiology, Ipswich Hospital NHS Trust, Heath Road, Ipswich, Suffolk IP4 5PD, UK.
| | - D Bowers
- Department of Science and Technology, University Campus Suffolk, Neptune Quay, Ipswich, Suffolk IP4 1QJ, UK
| | - P Jennings
- Department of Radiology, Ipswich Hospital NHS Trust, Heath Road, Ipswich, Suffolk IP4 5PD, UK
| | - R Soomal
- Department of Oncology, Ipswich Hospital NHS Trust, Heath Road, Ipswich, Suffolk IP4 5PD, UK
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16
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Smith KJ, Wildfong KW, Hoiland RL, Harper M, Lewis NC, Pool A, Smith SL, Kuca T, Foster GE, Ainslie PN. Role of CO2 in the cerebral hyperemic response to incremental normoxic and hyperoxic exercise. J Appl Physiol (1985) 2016; 120:843-54. [PMID: 26769951 DOI: 10.1152/japplphysiol.00490.2015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 06/11/2015] [Accepted: 01/11/2016] [Indexed: 11/22/2022] Open
Abstract
Cerebral blood flow (CBF) is temporally related to exercise-induced changes in partial pressure of end-tidal carbon dioxide (PetCO2 ); hyperoxia is known to enhance this relationship. We examined the hypothesis that preventing PetCO2 from rising (isocapnia) during submaximal exercise with and without hyperoxia [end-tidal Po2(PetO2 ) = 300 mmHg] would attenuate the increases in CBF. Additionally, we aimed to identify the magnitude that breathing, per se, influences the CBF response to normoxic and hyperoxic exercise. In 14 participants, CBF (intra- and extracranial) measurements were measured during exercise [20, 40, 60, and 80% of maximum workload (Wmax)] and during rest while ventilation (V̇e) was volitionally increased to mimic volumes achieved during exercise (isocapnic hyperpnea). While V̇ewas uncontrolled during poikilocapnic exercise, during isocapnic exercise and isocapnic hyperpnea, V̇ewas increased to prevent PetCO2 from rising above resting values (∼40 mmHg). Although PetCO2 differed by 2 ± 3 mmHg during normoxic poikilocapnic and isocapnic exercise, except for a greater poikilocapnic compared with isocapnic increase in blood velocity in the posterior cerebral artery at 60% Wmax, the between condition increases in intracranial (∼12-15%) and extracranial (15-20%) blood flow were similar at each workload. The poikilocapnic hyperoxic increases in both intra- and extracranial blood-flow (∼17-29%) were greater compared with poikilocapnic normoxia (∼8-20%) at intensities >40% Wmax(P< 0.01). During both normoxic and hyperoxic conditions, isocapnia normalized both the intracranial and extracranial blood-flow differences. Isocapnic hyperpnea did not alter CBF. Our findings demonstrate a differential effect of PetCO2 on CBF during exercise influenced by the prevailing PetO2.
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Affiliation(s)
- K J Smith
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada; and
| | - K W Wildfong
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada; and
| | - R L Hoiland
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada; and
| | - M Harper
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada; and
| | - N C Lewis
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada; and
| | - A Pool
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada; and
| | - S L Smith
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada; and
| | - T Kuca
- Department of Anesthesia, Pain and Perioperative Medicine, Department of Critical Care Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - G E Foster
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada; and
| | - P N Ainslie
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada; and
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17
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Smith SL, Singh P, Harding D, Lun D, Chambers JP. Thalidomide pharmacokinetics in sheep. N Z Vet J 2016; 64:238-42. [PMID: 26727254 DOI: 10.1080/00480169.2015.1130663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM To determine the half life (T1/2), time taken to reach maximum plasma concentration (Tmax) and maximum plasma concentration (Cmax) of thalidomide in sheep following I/V, oral and topical treatment with a single dose of thalidomide. METHOD Three groups of 4-6-month-old ram lambs were treated with thalidomide dissolved in dimethylsulphoxide (DMSO). The first group (n=10) was treated I/V with 100 mg thalidomide in 2 mL DMSO; the second group (n=8) received 400 mg thalidomide in 2 mL DMSO orally, and the third group (n=8) had 400 mg thalidomide in 4 mL DMSO applied topically. Plasma samples were collected up to 36 hours after treatment, snap-frozen at -80°C and analysed for concentrations of thalidomide using high performance liquid chromatography. RESULTS Following I/V administration, T1/2 was 5.0 (SEM 0.4) hours, volume of distribution was 3,372.0 (SEM 244.3) mL/kg and clearance was 487.1 (SEM 46.1) mL/hour.kg. Topical application of 400 mg thalidomide did not increase plasma concentrations. Following oral administration, thalidomide bioavailability was 89%, with T1/2, Tmax, and Cmax being 7.2 (SEM 0.8) hours, 3.0 (SEM 0.4) hours and 1,767.3 (SEM 178.1) ng/mL, respectively. CONCLUSION Topical administration using DMSO as a solvent did not increase concentrations of thalidomide in plasma. The mean pharmacokinetic parameters determined following oral treatment with 400 mg of thalidomide were similar to those reported in humans receiving a single 400 mg oral dose (T1/2 7.3 hours; Tmax 4.3 hours and Cmax 2,820 ng/mL). There is potential for thalidomide to be used as a model for the treatment of chronic inflammatory conditions in sheep, such as Johne's disease, where tumour necrosis factor alpha plays a pathogenic role.
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Affiliation(s)
- S L Smith
- a Institute of Veterinary, Animal and Biological Sciences , Massey University , Tennent Drive, Palmerston North 4443 , New Zealand
| | - P Singh
- a Institute of Veterinary, Animal and Biological Sciences , Massey University , Tennent Drive, Palmerston North 4443 , New Zealand
| | - D Harding
- b Institute of Fundamental Sciences , Massey University , Tennent Drive, Palmerston North 4474 , New Zealand
| | - D Lun
- b Institute of Fundamental Sciences , Massey University , Tennent Drive, Palmerston North 4474 , New Zealand
| | - J P Chambers
- a Institute of Veterinary, Animal and Biological Sciences , Massey University , Tennent Drive, Palmerston North 4443 , New Zealand
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18
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Webster AP, Smith SL, Worthington J, Barton A, Plant D. Cryopreservation of cells does not substantially alter the DNA methylome of CD3+CD4+ T cells. Scand J Rheumatol 2015; 45:329-30. [PMID: 26690697 DOI: 10.3109/03009742.2015.1115896] [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]
Affiliation(s)
- A P Webster
- a Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester , Manchester , UK
| | - S L Smith
- a Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester , Manchester , UK
| | - J Worthington
- a Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester , Manchester , UK.,b NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester Academy of Health Sciences , Manchester , UK
| | - A Barton
- a Arthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, University of Manchester , Manchester , UK.,b NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester Academy of Health Sciences , Manchester , UK
| | - D Plant
- b NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester Academy of Health Sciences , Manchester , UK
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19
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Smith SL, Li BL, Buniya A, Lin SH, Scholes SC, Johnson G, Joyce TJ. In vitro wear testing of a contemporary design of reverse shoulder prosthesis. J Biomech 2015; 48:3072-9. [PMID: 26278181 DOI: 10.1016/j.jbiomech.2015.07.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 07/18/2015] [Accepted: 07/23/2015] [Indexed: 11/28/2022]
Abstract
Reverse shoulder arthroplasty is an increasingly common surgical intervention. However there are concerns and known limitations in relation to such joint replacement, while novel designs of reverse shoulder prostheses continue to appear on the market. Many claim to offer improvements over older designs but such assertions are difficult to validate when there is no consensus as to how such implants should be tested in vitro or even if such testing is necessary. In order to permit appropriate in vitro testing of reverse shoulder prostheses a unique, multi-station test rig was designed which was capable of applying motion in three axes to test prostheses. The shoulder simulator can apply up to 110° of motion in the flexion-extension and abduction-adduction axes and up to 90° in the internal-external rotation axis. Dynamic loading of up to 1500 N can be provided. The simulator is computer controlled so that the motions and loading associated with particular activities of daily living can be applied. A 4.5 million cycle wear test of commercially available reverse shoulder prostheses was undertaken using a 'mug to mouth' activity of daily living. Gravimetric analysis was used to characterise wear. After 4.5 million cycles of 'mug to mouth', the average wear rate of the test components was 14.3mm(3)/million cycles. Polyethylene test components showed a reduction in roughness and the median wear particle diameter was 167 nm. A three axis shoulder simulator has been designed and used to successfully test multiple samples of a commercially available reverse shoulder prosthesis.
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Affiliation(s)
- S L Smith
- School of Mechanical and Systems Engineering, Newcastle University, Claremont Road, Newcastle upon Tyne, NE1 7RU England, UK
| | - B L Li
- School of Engineering, Technology and Maritime Operations, Liverpool John Moores University, James Parsons Building, Byrom Street, England, UK
| | - A Buniya
- Biomedical Engineering Department, Al-khwarizmi Engineering College, Baghdad University, Iraq
| | - S Ho Lin
- School of Mechanical and Systems Engineering, Newcastle University, Claremont Road, Newcastle upon Tyne, NE1 7RU England, UK
| | - S C Scholes
- School of Mechanical and Systems Engineering, Newcastle University, Claremont Road, Newcastle upon Tyne, NE1 7RU England, UK
| | - G Johnson
- School of Mechanical and Systems Engineering, Newcastle University, Claremont Road, Newcastle upon Tyne, NE1 7RU England, UK
| | - T J Joyce
- School of Mechanical and Systems Engineering, Newcastle University, Claremont Road, Newcastle upon Tyne, NE1 7RU England, UK.
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Smith SL, Jennings PE. Lung radiofrequency and microwave ablation: a review of indications, techniques and post-procedural imaging appearances. Br J Radiol 2014; 88:20140598. [PMID: 25465192 DOI: 10.1259/bjr.20140598] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Lung ablation can be used to treat both primary and secondary thoracic malignancies. Evidence to support its use, particularly for metastases from colonic primary tumours, is now strong, with survival data in selected cases approaching that seen after surgery. Because of this, the use of ablative techniques (particularly thermal ablation) is growing and the Royal College of Radiologists predict that the number of patients who could benefit from such treatment may reach in excess of 5000 per year in the UK. Treatment is often limited to larger regional centres, and general radiologists often have limited awareness of the current indications and the techniques involved. Furthermore, radiologists without any prior experience are frequently expected to interpret post-treatment imaging, often performed in the context of acute complications, which have occurred after discharge. This review aims to provide an overview of the current indications for pulmonary ablation, together with the techniques involved and the range of post-procedural appearances.
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Affiliation(s)
- S L Smith
- Department of Radiology, Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK
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Zagorski C, Forbes S, Jennings PE, Soomal R, Smith SL. Patient outcome after pulmonary radiofrequency ablation: a prospective analysis of results from a single centre. Cancer Imaging 2014. [PMCID: PMC4242541 DOI: 10.1186/1470-7330-14-s1-p8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Smith SL, Wilson PR, Collett MG, Heuer C, West DM, Stevenson M, Chambers JP. Liver biopsy histopathology for diagnosis of Johne's disease in sheep. Vet Pathol 2014; 51:915-8. [PMID: 24676594 DOI: 10.1177/0300985813516644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 11/15/2022]
Abstract
Sheep with Johne's disease develop epithelioid macrophage microgranulomas, specific to Mycobacterium avium subsp. paratuberculosis (Map) infection, in the terminal ileum, mesenteric lymph nodes, and organs distant to the alimentary tract such as the liver. The objectives of this study were to determine whether liver pathology was present in ewes affected by Map and whether liver cores provide adequate tissue for this potential diagnostic marker. One hundred and twenty-six adult, low body condition ewes were euthanized, necropsied, and underwent simulated liver biopsy. Ileal lesions typical of Map were found in 60 ewes. Hepatic epithelioid microgranulomas were observed in all ewes with Type 3b (n = 40) and 82% (n = 11) with Type 3c ileal lesions. None were found in ewes unaffected by Map or with Type 1, 2, or 3a ileal lesions. Liver biopsy core samples provided adequate tissue for histopathology with a sensitivity and specificity of 96% (95% confidence interval [CI], 0.87-0.99) and 100% (95% CI, 0.95-1), respectively for detection of types 3b and 3c ileal lesions.
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Affiliation(s)
- S L Smith
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - P R Wilson
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - M G Collett
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - C Heuer
- Epicentre, Massey University, Palmerston North, New Zealand
| | - D M West
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
| | - M Stevenson
- Epicentre, Massey University, Palmerston North, New Zealand
| | - J P Chambers
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand
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Syed-Hussain SS, Howe L, Pomroy WE, West DM, Smith SL, Williamson NB. Adaptation of a commercial ELISA to determine the IgG avidity in sheep experimentally and naturally infected with Neospora caninum. Vet Parasitol 2014; 203:21-8. [PMID: 24582279 DOI: 10.1016/j.vetpar.2014.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 01/07/2014] [Accepted: 01/07/2014] [Indexed: 10/25/2022]
Abstract
Recent reports indicate Neospora caninum has a possible role in causing abortions in sheep in New Zealand. Knowledge about the epidemiology of neosporosis in sheep is limited. This study aimed to adapt and validate a commercially available ELISA assay as an IgG avidity assay to discriminate between acute (primary and re-inoculated) and chronic N. caninum infections in sheep. In addition, it was used to compare the antibody avidity values between lambs from ewes inoculated with N. caninum either during the pregnancy or in the previous year. The avidity assay was undertaken by using 6M urea for the first wash after incubation with the primary antibody in the commercial ELISA (Chekit* Neospora antibody test kit, IDEXX Laboratories, Australia). Sequential serum samples were obtained from naïve ewes (n=16) experimentally inoculated with live N. caninum tachyzoites. All ewes were seropositive by two weeks post-inoculation and remained seropositive for 20 weeks post-inoculation. There was a linear relationship between time after inoculation and avidity values (p<0.05) over the first 24 weeks. In Week 4, all animals had avidity values <35% and by Week 8, 8/16 animals had avidity values of >35%. These results suggest that an avidity value of <35% indicates a recent primary infection while a value of >35% is indicative of a chronic infection. The assay was then validated using samples from other groups of experimentally inoculated sheep as well as samples from naturally infected ewes. When comparing sample to positive ratio (S/P) and avidity values from lambs born from recently inoculated ewes with those from ewes inoculated the previous year and re-inoculated in the current year, it was possible to differentiate the lambs at 2 weeks of age. Lambs from recently inoculated ewes had low S/P and avidity values at 2 weeks of age which increased by 12 weeks of age. In comparison, lambs from re-inoculated ewes had high S/P and avidity values at 2 weeks of age, due to maternal antibody influence but values were similar to those from lambs that were born from recently inoculated ewes at 12 weeks of age. Avidity values for four naturally infected ewes were all >60% indicating chronic infection. These results suggest that the assay is able to discriminate between recent and chronic infection in sheep as well as able to differentiate lambs with maternal immunity compared to their own de novo immunity. As such it can be utilized to understand the kinetics of N. caninum infection in sheep.
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Affiliation(s)
- S S Syed-Hussain
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia; Institute of Veterinary Animal and Biomedical Sciences, Massey University, Palmerston North 4412, New Zealand
| | - L Howe
- Institute of Veterinary Animal and Biomedical Sciences, Massey University, Palmerston North 4412, New Zealand
| | - W E Pomroy
- Institute of Veterinary Animal and Biomedical Sciences, Massey University, Palmerston North 4412, New Zealand.
| | - D M West
- Institute of Veterinary Animal and Biomedical Sciences, Massey University, Palmerston North 4412, New Zealand
| | - S L Smith
- Institute of Veterinary Animal and Biomedical Sciences, Massey University, Palmerston North 4412, New Zealand
| | - N B Williamson
- Institute of Veterinary Animal and Biomedical Sciences, Massey University, Palmerston North 4412, New Zealand
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Dan T, Hewitt SM, Ohri N, Ly D, Soule BP, Smith SL, Matsuda K, Council C, Shankavaram U, Lippman ME, Mitchell JB, Camphausen K, Simone NL. CD44 is prognostic for overall survival in the NCI randomized trial on breast conservation with 25 year follow-up. Breast Cancer Res Treat 2013; 143:11-8. [PMID: 24276281 DOI: 10.1007/s10549-013-2758-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 10/28/2013] [Indexed: 12/18/2022]
Abstract
CD44 is a transmembrane glycoprotein involved in numerous cellular functions, including cell adhesion and extracellular matrix interactions. It is known to be functionally diverse, with alternative splice variants increasingly implicated as a marker for tumor-initiating stem cells associated with poor prognosis. Here, we evaluate CD44 as a potential marker of long-term breast cancer outcomes. Tissue specimens from patients treated on the National Cancer Institute 79-C-0111 randomized trial of breast conservation versus mastectomy between 1979 and 1987 were collected, and immunohistochemistry was performed using the standard isoform of CD44. Specimens were correlated with patient characteristics and outcomes. Survival analysis was performed using the log rank test. Fifty-one patients had evaluable tumor sections and available long-term clinical follow up data at a median follow up of 25.7 years. Significant predictors of OS were tumor size (median OFS 25.4 years for ≤2 cm vs. 7.5 years for >2 cm, p = 0.001), nodal status (median OS 17.2 years for node-negative patients vs. 6.7 years for node positive patients, p = 0.017), and CD44 expression (median OS 18.9 years for CD44 positive patients vs. 8.6 years for CD44 negative patients, p = 0.049). There was a trend toward increased PFS for patients with CD44 positive tumors (median PFS 17.9 vs. 4.3 years, p = 0.17), but this did not reach statistical significance. These findings illustrate the potential utility of CD44 as a prognostic marker for early stage breast cancer. Subgroup analysis in patients with lymph node involvement revealed CD44 positivity to be most strongly associated with increased survival, suggesting a potential role of CD44 in decision making for axillary management. As there is increasing interest in CD44 as a therapeutic target in ongoing clinical trials, the results of this study suggest additional investigation regarding the role CD44 in breast cancer is warranted.
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Affiliation(s)
- T Dan
- Department of Radiation Oncology, Bodine Center for Cancer Treatment, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University, 111 S. 11th Street G-301G, Philadelphia, PA, 19107, USA
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Abstract
AIM To determine the time taken for rams to develop antibodies to Brucella ovis in serum, shed B. ovis in semen and develop lesions of epididymitis following infection with B. ovis. METHODS Fifteen 19-month-old rams were artificially infected with B. ovis by inoculation of infected semen onto the nasal and rectal mucus membranes (Day 0). Serum was collected from each ram at 2 to 8-day intervals and tested at commercial laboratories using a complement fixation test (CFT) and an ELISA. Cut-off values for the CFT were 0-4/4 negative; 1/8-3/8 suspicious and 4/8-4/128 positive, and for the ELISA were <10% negative; ≥10 to <50% suspicious and ≥50% positive. Selected serum samples were also tested using a gel diffusion test (GDT). At 7 to 8-day intervals semen was collected for bacterial culture and the scrotal contents were palpated to identify lesions of epididymitis. The study was terminated after 56 days. RESULTS On Day 28 B. ovis was isolated from the semen of one ram and by Day 49 it was isolated from the semen of 10 rams. All 10 rams had suspicious or positive ELISA or CFT titres by Day 36 and 56, respectively. The GDT results were all negative on Day 36 and in general did not become positive in individual rams until 7-28 days after semen shedding commenced. Epididymitis was detected in one ram on Day 36; by Day 56 eight rams had epididymitis detectable by scrotal palpation. CONCLUSIONS The B. ovis ELISA test identified infected rams at an earlier stage than the CFT; this was at 19-36 days after exposure. Rams can begin shedding B. ovis in semen as early as 28 days after exposure and lesions of epididymitis develop as early as 36 days after exposure. CLINICAL RELEVANCE During a test and slaughter campaign for the control of B. ovis, the most appropriate serological re-testing interval is likely to be around 28 days (4 weeks) using the ELISA with or without the CFT, although caution is required in interpretation of "suspicious" ELISA results. Following a B. ovis breakdown, two negative CFT or ELISA tests 60 days apart are recommended to confirm freedom from infection, supporting current guidelines.
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Affiliation(s)
- A L Ridler
- a Institute of Veterinary, Animal and Biomedical Sciences, Massey University , Private Bag 11222, Palmerston North , New Zealand
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Strom BL, Smith SL, Brownie C. Attractant and disruptant semiochemicals for Dendroctonus jeffreyi (Coleoptera: Curculionidae: Scolytinae). Environ Entomol 2013; 42:323-332. [PMID: 23575023 DOI: 10.1603/en12300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Jeffrey pine, Pinus jeffreyi Greville and Balfour, is a dominant yellow pine and important overstory component of forests growing on diverse sites from southwestern Oregon to Baja California to western Nevada. The Jeffrey pine beetle, Dendroctonus jeffreyi Hopkins (Coleoptera: Curculionidae: Scolytinae), is monophagous on Jeffrey pine and its primary insect pest. Despite the importance of P. jeffreyi, difficult terrain, environmental concerns, and lack of roads can constrain pest management activities. Semiochemicals are often easier to apply and more environmentally acceptable than other options, but they are lacking in this system. Attractants have been identified, but field bioassays have been limited because of infrequent or short duration outbreaks and a lack of beetles during nonoutbreak periods. Disruptant semiochemicals have not been assessed for D. jeffreyi during outbreak conditions; however, commercially available semiochemicals have been implicated as disruptants for this bark beetle. The objective of this study was to identify the most effective commercially available attractant and disruptant semiochemicals for D. jeffreyi. Our highest observed catch occurred with the blend of 5% 1-heptanol and 95% n-heptane. When this was used to challenge potential disruptant semiochemicals, the combination of S-(-)-verbenone and the green leaf volatile blend (cis-3-Hexenol and 1-Hexanol) reduced trap catch by ≍80%. However, frontalin was most effective, reducing the number of D. jeffreyi caught by >96%. Within each year of the study, the percentage female of D. jeffreyi caught with our attractant decreased from start to end of the experimental period. On average, our first collection in a year (mid-June to early July) was 59% female, whereas our last (mid-August) was 34%. Frontalin was equally or more effective against females (the pioneering sex) than males, providing optimism that semiochemical disruption may be possible for protecting Jeffrey pines from D. jeffreyi.
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Affiliation(s)
- B L Strom
- USDA Forest Service, Southern Research Station, 2500 Shreveport Hwy., Pineville, LA 71360, USA.
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Grace ND, West DM, Smith SL, Knowles SO. The impact of highly concentrated Mo and Cu dietary supplements, fed as a bolus, on the efficacy of chelated versus inorganic Cu in cattle on a low-Cu diet. N Z Vet J 2013; 61:345-8. [PMID: 23442050 DOI: 10.1080/00480169.2012.760398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM To compare the efficacy of chelated versus inorganic forms of dietary Cu supplements, fed as a bolus, when challenged by a daily bolus of dietary Mo in cattle on a low-Cu diet. METHODS Forty non-lactating, Friesian dairy cows of adequate Cu status were assigned to four groups and fed a basal diet of baled silage containing 5.3 mg Cu and 0.4 mg Mo/kg DM. The experimental design was a factorial of two chemical forms of supplemental Cu and two levels of Mo intake, provided as pelleted grain supplements made from crushed barley/molasses plus Cu and Mo. The supplements contained 140 mg Cu/kg as Cu sulphate pentahydrate (CS), 140 mg Cu/kg as Cu glycinate (CG), CS plus 38 mg Mo/kg as sodium molybdate (CS+Mo), or CG plus 38 mg Mo/kg (CG+Mo). Commencing on Day 0, supplements were fed once daily (offered 1-1.2 kg/cow) and were completely consumed within 5-10 minutes, which constitutes a bolus type of administration. Liver samples were collected by biopsy at Days -24, 13, 41 or 47, and 69 for Cu determinations. RESULTS The diets fed to the Cu+Mo groups were roughly equivalent to 25 mg Cu and 5.7 mg Mo/kg DM. Mean initial concentration of Cu in liver for all groups was 516 (SE 54) μmol Cu/kg fresh tissue. In cows supplemented with CS and CG, the final (Day 69) concentrations increased (p<0.01) to 939 (SE 166) and 853 (SE 163) μmol Cu/kg, respectively. These values were not different (p=0.72). For groups CS+Mo and CG+Mo, the final concentrations of 535 (SE 122) and 453 (SE 102) μmol Cu/kg were not different from initial values or from each other (p>0.25). The rate of accumulation of Cu in liver following bolus Cu and Mo intake was highly variable but was not affected by initial concentration of Cu in liver (p>0.9) or by the form of Cu (p>0.6). Mean rates of accumulation of Cu in liver were 4.0 (SD 3.8) and 0.65 (SD 2.0) μmol Cu/kg fresh tissue/day for the Cu-only treatments and the Cu+Mo treatments, respectively. CONCLUSIONS When fed together as a bolus, high Mo intake negated the effect of supplemental Cu but it did not reduce liver Cu stores. There was no difference in the reaction of dietary Mo with chelated Cu (as glycinate) versus inorganic Cu (as sulphate) dietary supplements.
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Affiliation(s)
- N D Grace
- a AgResearch Limited, Grasslands Research Centre , Private Bag 11008, Palmerston North 4442 , New Zealand
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Canavan F, Harding S, Gustard L, Murphy AM, Miller JF, Smith SL. Computer-aided detection of screening breast cancer: a novel approach based on genetic programming. Breast Cancer Res 2012. [PMCID: PMC3542646 DOI: 10.1186/bcr3303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Smith SL, Larson PG, Hall ED. A comparison of the effects of tirilazad on subarachnoid hemorrhage-induced blood-brain barrier permeability in male and female rats. J Stroke Cerebrovasc Dis 2012; 6:389-93. [PMID: 17895039 DOI: 10.1016/s1052-3057(97)80039-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/1997] [Accepted: 04/07/1997] [Indexed: 11/25/2022] Open
Abstract
Phase III subarachnoid hemorrhage clinical trials have shown a beneficial effect of tirilazad only in men. One explanation for the decreased efficacy in women is that women metabolize the drug up to 60% faster than men. However, it is also possible that other more subtle differences between the sexes alter the pharmacodynamic response of women to tirilazad. The purpose of the present study was to compare the efficacy of tirilazad in attenuating early post-subarachnoid hemorrhage-induced blood-brain barrier damage in the rat, a species in which single-dose metabolism of the drug is comparable between males and females. Male and female rats were treated with 0.1, 0.3, 1.0, or 3.0 mg/kg tirilazad (intravenous) 10 minutes before and 2 hours after subarachnoid hemorrhage. At 3 hours posthemorrhage, the extent of blood-brain barrier damage, as measured by Evan's blue extravasation, did not differ between male and female vehicle-treated rats. In addition, treatment with tirilazad produced a similar effect in both males and females at all doses tested. At 0.3 mg/kg, blood-brain barrier damage was reduced 43.4% in males and 48.0% in females (P</=.01 vs vehicle), at 1.0 mg/kg, 33.1% in males and 29.1% in females (P</=.05), and at 3.0 mg/kg, 28.0% in males and 23.8% in females (P=NS). The lowest dose, 0.1 mg/kg, failed to protect the blood-brain barrier in both genders. These results suggest that gender differences do not significantly effect the blood-brain barrier protective efficacy of tirilazad following subarachnoid hemorrhage in the rat.
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Smith SL, West DM, Wilson PR, de Lisle GW, Collett MG, Heuer C, Chambers JP. The prevalence of disseminated Mycobacterium avium subsp. paratuberculosis infection in tissues of healthy ewes from a New Zealand farm with Johne's disease present. N Z Vet J 2012; 61:41-4. [PMID: 22984988 DOI: 10.1080/00480169.2012.704627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM To determine the prevalence of disseminated Mycobacterium avium subsp. paratuberculosis (Map) infection in healthy ewes in a flock with a history of clinical Johne's disease. METHODS Twenty-four healthy ewes, from a large sheep and cattle farm with a history of clinical Johne's disease in the ewe flock, were randomly selected, euthanased, blood sampled, and examined at necropsy. BACTEC™ radiometric culture for Map was performed on samples of faeces, ileum, mesenteric lymph node, biceps femoris muscle and mononuclear cells in peripheral blood. Serum antibody ELISA tests were performed. Histological sections and Ziehl Neelsen (ZN) stains of impression smears of ileum and mesenteric lymph node were examined for pathological lesions characteristic of Johne's disease and acid fast organisms (AFO). Indirect quantification of Map was performed, using BACTEC radiometric growth indices measuring the time taken for the production of (14)CO(2.) RESULTS No histological evidence of Johne's disease or AFO was found in the ileum and mesenteric lymph nodes. Twelve of the 24 ewes (50%) had Map cultured from the ileum (n=6) and/or mesenteric lymph nodes (n=8) while none had Map cultured from the faeces, biceps femoris muscle or blood mononuclear cells. One of the 12 Map culture positive ewes was serum ELISA positive. The culture growth rates in liquid medium suggest low numbers of Map were present in the tissues of the culture positive ewes. CONCLUSION Fifty per cent of clinically healthy ewes exposed to Map within a Johne's infected flock were Map culture positive in the ileum and/or mesenteric lymph node(s), while the ELISA was positive in 8% of those animals (n=1). There was no faecal shedding of Map and no Map was cultured from skeletal muscle or from blood mononuclear cells suggesting that systemic Map infection, defined as positive culture of Map from skeletal muscle and/or blood, may be uncommon in healthy mixed age ewes without clinical Johne's disease. CLINICAL RELEVANCE ELISA serology detected 1 of 12 ewes infected with Map whilst none were detected from faecal BACTEC radiometric culture, suggesting biosecurity measures used to control the spread of Map may be of limited use. Map was not cultured from blood mononuclear cells or skeletal muscle, indicating that meat from healthy ewes, from farms where Johne's disease is present, is an unlikely source of Map exposure for humans. Further research is warranted to establish the prevalence and dissemination of Map in tissues outside the alimentary tract of healthy ewes from farms throughout New Zealand where Map is present.
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Affiliation(s)
- S L Smith
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand.
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Abstract
AIM To determine how the concentration of Cu in liver affects the rate of depletion of that Cu when cows are fed a Cu-deficient diet under experimental conditions, and to mathematically model the rate of depletion of Cu over time. METHODS In June 2010, 25 non-lactating Friesian cows were assigned to three groups such that initial mean concentrations of Cu in liver were 265, 534 and 1,486 μmol Cu/kg fresh tissue (Day 0). All cows were managed as a single group and fed a Cu-deficient diet of primarily baled silage. No mineral Cu supplements were given. Liver biopsies were collected from cows on Days 0, 53, 98 and 161 to determine concentrations of Cu. At about the same time, samples of silage and pasture herbage were collected to determine Cu, Mo and S concentrations. RESULTS Median concentration of Cu in silage was 6.5 (min 6, max 9) mg/kg DM. Concentration of Cu in liver decreased in all groups (p<0.001), over the duration of the study. The amount of Cu depleted from liver was greater in groups that started the study with higher initial concentrations of Cu in liver. The rate of decline followed exponential first-order kinetics with an elimination rate constant k of 0.0057 (CI 95%=0.0039-0.0074), meaning that about 0.57% of liver Cu reserves were depleted each day. For individual cows this loss amounted to 0.1-14 μmol Cu/kg liver/day. CONCLUSIONS AND CLINICAL RELEVANCE Depletion of Cu from liver was dependent on initial concentration of Cu. These results can be used to predict how long an unsupplemented herd will remain in adequate Cu status, which adds confidence to decisions about when Cu supplementation should be withdrawn or reinstated. Cows with high concentrations of Cu in liver can maintain adequate Cu status for months without supplements. Intake of less Cu and more Mo would increase the rate of depletion, and seasonal factors would also have some influence.
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Affiliation(s)
- N D Grace
- AgResearch Limited, Grasslands Research Centre, New Zealand
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Abstract
Obesity is an important causative factor in morbidity, disability and premature death. Increasing levels of obesity will impose enormous health, financial and social burdens on worldwide society unless effective interventions are implemented. For many obese individuals, diet and behavioural modification need to be supplemented by pharmacotherapy. Preclinical research has revealed a greater understanding of the complex nature of the hypothalamic regulation of food intake and has generated a wide range of new molecular targets for the development of drug candidates for obesity treatment. As shown by the clinical results that have been obtained with this next generation of therapies, some approaches, for example, fixed-dose drug combinations, have already demonstrated an ability to deliver levels of efficacy that are not achievable with the current antiobesity drug therapies. The regulatory and marketing landscape for development, registration and commercialisation of novel centrally acting drugs for treatment of obesity and related metabolic disorders has changed substantially in recent years. Now a much greater emphasis is placed on tolerability and safety, as well as efficacy. In this review we briefly describe the therapeutic approaches to tackle obesity that are in late-stage clinical development. We then discuss drugs in late-stage development for the treatment of obesity and also future directions.
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Affiliation(s)
- D J Heal
- RenaSci Consultancy Limited, Biocity, Nottingham, UK.
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Abstract
Careful management is necessary to ensure the reproductive success in any small ruminant farm and to maximise the productive longevity of rams and bucks. Rams and bucks are frequently overlooked outside of the breeding period, but year-round attention to nutrition, parasite control and general disease control is important in keeping them healthy and sound for breeding. Pre-mating soundness examinations are an inexpensive and relatively easy way to assess the potential ability of a ram or buck to perform during the breeding period and should be incorporated annually into the management of any flock. During the breeding period, careful thought should be given to the appropriate use of males, and the effectiveness of mating should be monitored.
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Affiliation(s)
- A L Ridler
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand.
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Abstract
BACKGROUND AND OBJECTIVES Increasing numbers of women are surviving breast cancer, and survivorship care is becoming more complex. Primary care physicians provide care for most survivors of breast cancer in the Canadian province of British Columbia. The present study offers insight into the confidence of primary care physicians in their abilities to provide such care. It also explores potential ways to assist those providers in enhancing this aspect of their practice. METHODS A questionnaire was mailed to 1000 primary care physicians caring for survivors of breast cancer. The questionnaire explored the perspectives of the responding physicians on their ability to manage various aspects of survivorship care for breast cancer patients, identified preferences for the content and format of communication from oncologists at the time of transition from active oncology treatment to survivorship, and determined the means most commonly used to obtain knowledge about breast cancer. This 1-page, 31-item checkbox and open-answer questionnaire assessed the perceptions of primary care physicians about the care of breast cancer survivors after completion of active treatment and their personal preferences for resources providing information about breast cancer. RESULTS The questionnaire response rate was 59%. Primary care physicians reported being most confident in screening for recurrence and managing patient anxiety; they were least confident in managing lymphedema and providing psychosocial counselling. Compared with physicians following fewer survivors of breast cancer, those who followed more breast cancer survivors had higher confidence in managing the biomedical aspects of follow-up and in providing counselling about nutrition and exercise. Most physicians found discharge letters from oncologists to be useful. Point-form discharge information was preferred by 43%; detailed description, by 19%; and both formats, by 38%. The most useful information items identified for inclusion in a discharge letter were a diagnosis and treatment summary and the recommended surveillance and endocrine therapy. Continuing medical education events and online resources were the means most commonly used to obtain knowledge about breast cancer. CONCLUSIONS Primary care physicians who provide follow-up for survivors of breast cancer report that they are confident in managing care and satisfied with discharge letters containing a diagnosis and treatment summary, and recommendations for surveillance and endocrine treatment. At the time of patient discharge, additional information about common medical and psychosocial issues in this patient population would be useful to primary care physicians. Preferred means to access current breast cancer information include continuing medical education events and online resources.
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Affiliation(s)
- S L Smith
- Division of Radiation Oncology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, and BC Cancer Agency-Vancouver Island Centre, Victoria, BC
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Smith SL, Palma D, Parhar T, Alexander CS, Wai ES. Inoperable early stage non-small cell lung cancer: comorbidity, patterns of care and survival. Lung Cancer 2011; 72:39-44. [PMID: 20801544 DOI: 10.1016/j.lungcan.2010.07.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [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: 04/19/2010] [Revised: 07/10/2010] [Accepted: 07/29/2010] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate comorbidities, patterns of care and outcomes for patients with inoperable stage I and II non-small cell lung cancer (NSCLC). MATERIALS AND METHODS Patients diagnosed with stage I or II NSCLC in British Columbia between 1996 and 2005 who did not undergo primary surgery and were referred for oncology assessment were identified in a retrospective analysis. Baseline comorbidity and pulmonary function data for patients treated with curative radiotherapy (CurRT; biologically effective dose [BED]>58 Gy(10)) were abstracted by chart review. Kaplan-Meier and Cox regression were used to determine factors associated with overall survival (OS) and cause-specific survival (CSS) based on treatment group [no radiotherapy (NoRT), palliative radiotherapy (PallRT), or CurRT]. RESULTS Of 1043 patients identified, approximately 1/3 received CurRT, and these patients had better performance status and lower stage disease than the other groups. There was a high prevalence of comorbid conditions in the CurRT group; 90% of CurRT patients had an age-adjusted Charlson comorbidity index (CCI) score ≥5. CurRT patients had a median survival 1-year longer than patients treated with PallRT or NoRT (p < 0.0001). In CurRT patients, CCI was predictive of OS (HR 1.1 per point CCI increase; p = 0.044), but not CSS. Patients receiving PallRT with a BED > 50 Gy(10) had significantly longer OS than those receiving PallRT of ≤50 Gy(10) (p < 0.0001). CONCLUSIONS Treatment of medically inoperable early stage NSCLC patients with CurRT is associated with a significantly longer survival, and for these patients CCI is a significant predictor of OS. For patients treated with PallRT, higher doses of palliative thoracic RT is associated with improved OS.
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Affiliation(s)
- S L Smith
- Radiation Therapy Program, British Columbia Cancer Agency, Vancouver Island Centre, 410 Lee Avenue, Victoria, British Columbia V8R 6V5, Canada.
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Abstract
The last decade has seen dramatic changes in the working arrangements and training requirements of junior medical staff employed in neonatal units. As a result, there is a need for the professional roles in service provision to be reappraised. In many neonatal services, advanced neonatal nurse practitioners (ANNPs) have been introduced and have been shown to be effective in providing an alternative option for the provision of neonatal care at both junior and middle-grade medical staffing level. One of the key factors of the success of this role is the underpinning years spent in clinical practice, a foundation that provides a valuable and unique perspective for professional functioning at a senior level. For this potential to be fully exploited, a more integrated approach to the development of career pathways for ANNPs is needed. However, there are challenges related to recruitment, and the relatively small numbers of ANNPs available means that they are unlikely to provide an immediate solution for many units. The introduction of physicians' assistants (PAs) would seem to be worthy of consideration as part of the neonatal workforce, but it is likely that their functioning will be best integrated with that of ANNPs. In the longer term, economic factors will be a powerful determinant of the relative proportion of consultants, trainee doctors, ANNPs and PAs in the workforce.
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Affiliation(s)
- S L Smith
- Department of Neonatal Medicine, Princess Anne Hospital, Southampton University NHS Trust, Coxford Road, Southampton, UK
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Simone NL, Dan TD, Smith SL, Shih JH, Lita E, Sciuto L, Danforth D, Camphausen K. Abstract P4-10-01: Twenty-Five Year Results in the Treatment of Early Breast Carcinoma with Mastectomy Versus Breast Conservation Therapy: The National Cancer Institute Randomized Trial. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p4-10-01] [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: Breast conservation therapy (BCT) has become an accepted treatment in women with early stage breast cancer due to multiple randomized trials showing equivalent mortality rates when compared to modified radical mastectomy (MRM). Results of the National Cancer Institute's prospective randomized trial comparing MRM to BCT are now reported at a median follow up of 25.4 years.
Methods: Between 1979 and 1987, 237 evaluable patients with biopsy proven clinical Stage I or Stage II primary breast cancer were randomized to receive a MRM or a lumpectomy followed by definitive radiation to the entire breast followed by a boost to the tumor bed. An axillary dissection was performed in both arms. Negative margins were not required. Patients with node positive disease in either arm were treated with adriamycin and cytoxan. The primary endpoints were overall survival and disease-free survival.
Results: At a median follow-up of 25.4 years, there was no statistical difference in overall survival between either arm, with 45.7% of patients alive in the MRM group and 38.0% alive in the BCT group (p=0.43). Although disease-free survival was significantly worse in patients randomized to BCT (57% vs 82%, P<0.001), the additional treatment failures in the BCT group were primarily isolated ipsilateral breast tumor recurrences (IBTR's) which were salvaged by MRM. 22.3% of BCT patients experienced an IBTR but those patients had no significant decrease in overall survival. There were no differences in distant metastasis between the groups. Clinical factors associated with a worse prognosis include the presence of nodal disease (HR 2.46, 95% CI 1.71-2.71, P<0.05) and tumor size (HR 1.91, 95% CI 1.346-2.711, P<0.05).
Conclusion: The 25 year survival rate among women receiving BCT vs MRM in the National Cancer Institute randomized trial appears to be equivalent and is consistent with findings across multiple trials. In patients receiving BCT there is an increased incidence of IBTR's. Despite a higher risk of local failure in the BCT group, there is no increased risk of distant failure or mortality. The risk of local failure however, should be discussed when counseling patients regarding their treatment options.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-10-01.
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Affiliation(s)
- NL Simone
- National Cancer Institute/NIH, Bethesda, MD; National Cancer Institute, Bethesda, MD
| | - TD Dan
- National Cancer Institute/NIH, Bethesda, MD; National Cancer Institute, Bethesda, MD
| | - SL Smith
- National Cancer Institute/NIH, Bethesda, MD; National Cancer Institute, Bethesda, MD
| | - JH Shih
- National Cancer Institute/NIH, Bethesda, MD; National Cancer Institute, Bethesda, MD
| | - E Lita
- National Cancer Institute/NIH, Bethesda, MD; National Cancer Institute, Bethesda, MD
| | - L Sciuto
- National Cancer Institute/NIH, Bethesda, MD; National Cancer Institute, Bethesda, MD
| | - D Danforth
- National Cancer Institute/NIH, Bethesda, MD; National Cancer Institute, Bethesda, MD
| | - K. Camphausen
- National Cancer Institute/NIH, Bethesda, MD; National Cancer Institute, Bethesda, MD
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White DL, Savas LS, Daci K, Elserag R, Graham DP, Fitzgerald SJ, Smith SL, Tan G, El-Serag HB. Trauma history and risk of the irritable bowel syndrome in women veterans. Aliment Pharmacol Ther 2010; 32:551-61. [PMID: 20528828 PMCID: PMC2906642 DOI: 10.1111/j.1365-2036.2010.04387.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Over 1.8 million women in the U.S. are veterans of the armed services. They are at increased risk of occupational traumas, including military sexual trauma. AIM To evaluate the association between major traumas and irritable bowel syndrome among women veterans accessing Veteran Affairs (VA) healthcare. METHODS We administered questionnaires to assess trauma history as well as IBS, post-traumatic stress disorder (PTSD) and depression symptoms to 337 women veterans seen for primary care at VA Women's Clinic between 2006 and 2007. Logistic regression was used to evaluate the association between individual traumas and IBS risk after adjustment for age, ethnicity, PTSD and depression. RESULTS Irritable bowel syndrome prevalence was 33.5%. The most frequently reported trauma was sexual assault (38.9%). Seventeen of eighteen traumas were associated with increased IBS risk after adjusting for age, ethnicity, PTSD and depression, with six statistically significant [range of adjusted odds ratios (OR) between 1.85 (95% CI, 1.08-3.16) and 2.6 (95% CI, 1.28-3.67)]. Depression and PTSD were significantly more common in IBS cases than controls, but neither substantially explained the association between trauma and increased IBS risk. CONCLUSIONS Women veterans report high frequency of physical and sexual traumas. A lifetime history of a broad range of traumas is independently associated with an elevated risk of the irritable bowel syndrome.
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Affiliation(s)
- D L White
- Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA
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Balemi SC, Grace ND, West DM, Smith SL, Knowles SO. Accumulation and depletion of liver copper stores in dairy cows challenged with a Cu-deficient diet and oral and injectable forms of Cu supplementation. N Z Vet J 2010; 58:137-41. [DOI: 10.1080/00480169.2010.67515] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kenyon PR, Smith SL, Morel PCH, Morris ST, West DM. The effect of the maturity and prior breeding activity of rams and body condition score of ewe hoggets on the reproductive performance of ewe hoggets. N Z Vet J 2009; 57:290-4. [PMID: 19802043 DOI: 10.1080/00480169.2009.58623] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM To determine the effect of age and prior use of mature rams at a given ram-to-ewe ratio, and the effect of body condition on breeding performance and pregnancy rate of ewe hoggets. METHODS Ewe hoggets (n=733) aged 7-8 months were weighed and their body condition scored, then randomly assigned to one of three treatment groups (Day 0) and joined with either four two-tooth rams (20 months of age) not used previously (n=244; Two-tooth), four mixed-aged mature rams that had not been used earlier in the season (n=244; Mature-fresh), or four mixed-aged mature rams that had been used with mature ewes immediately prior to joining with hoggets (n=245; Mature-used). The breeding period was 34 days. Ewe hoggets were identified as having been marked during the first 17 days only, during both 17-day periods, during the second 17 days only, or not marked. Hoggets were re-weighed on Day 34, and pregnancy status determined using ultrasound on Day 92. The breeding soundness of the rams was assessed on Days -34 and -1. RESULTS Semen samples obtained from the rams did not differ significantly in any of the parameters measured (p>0.05). Ewe hoggets joined with Mature-fresh rams were less likely (p<0.05) to be marked in the second 17 days of breeding only than those joined with either Two-tooth or Mature-used rams. No other breeding parameters were affected by breeding group (p>0.05). Hoggets marked in the first 17 days only were heavier (p<0.05) at Day 0 than those marked in the second 17 days only or not marked. Hoggets diagnosed as twin-bearing were heavier (p<0.05) than non-pregnant or single-bearing hoggets. Those hoggets marked in the first 17 days only had a greater (p<0.05) body condition score (BCS) than those marked in the second 17 days only or not marked at all. These differences were no longer apparent after correction for liveweight (LW).Correction for LW at Day 0 or change in LW during the breeding period did not affect the results for breeding performance. CONCLUSIONS Under the conditions of this study, two-tooth rams and mature rams that had been used previously were just as suitable as mature rams that had not been used previously for breeding with ewe hoggets. Further studies are warranted to verify this result. The re-use of rams without reducing breeding performance would reduce breeding costs and may make breeding hoggets a more viable option for farmers. The BCS of ewe hoggets affected breeding performance, and can thus be used to identify those animals most suitable for breeding.
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Affiliation(s)
- P R Kenyon
- Sheep Research Group, Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North 4442, New Zealand.
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Heal DJ, Cheetham SC, Smith SL. The neuropharmacology of ADHD drugs in vivo: insights on efficacy and safety. Neuropharmacology 2009; 57:608-18. [PMID: 19761781 DOI: 10.1016/j.neuropharm.2009.08.020] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.7] [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: 05/06/2009] [Revised: 07/15/2009] [Accepted: 08/11/2009] [Indexed: 11/19/2022]
Abstract
Results from in vivo techniques, especially intracerebral microdialysis in freely-moving rats, have provided insights into potential mechanisms responsible for the efficacy and safety of catecholaminergic drugs for ADHD treatment. The drugs reviewed come from distinct pharmacological classes: psychostimulant releasing agents, eg d-amphetamine; psychostimulant reuptake inhibitors, eg dl-threo-methylphenidate (dl-MPH), and non-stimulant reuptake inhibitors, eg atomoxetine. Psychostimulants, which currently deliver the best efficacy in treating ADHD, exhibit the following characteristics on extraneuronal catecholamine concentrations in rodent brain in vivo: 1) They enhance the efflux and function of both noradrenaline and dopamine in the central nervous system. 2) The increase of dopamine efflux that they produce is not limited to cortical regions. 3) They have a rapid onset of action with no ceiling on drug effect. d-Amphetamine has a mechanism independent of neuronal firing rate, displacing intraneuronal stores of catecholamines, delaying their reuptake and inhibiting catabolism by monoamine oxidase. dl-MPH has an enigmatic, extraneuronal action that is neuronal firing rate-dependent and reuptake transporter-mediated, yet paradoxically, almost as powerful as that of d-amphetamine. In safety terms, these powerful catecholaminergic effects also make the psychostimulants liable for abuse. Since efficacy and safety derive from the same pharmacological mechanisms, it has not yet been possible to separate these two components. However, the development of once-daily psychostimulant formulations and a prodrug, lisdexamfetamine, has improved patient compliance and markedly reduced scope for their diversion/abuse. This review will discuss the in vivo pharmacological profiles of approved catecholaminergic drugs for treatment of ADHD and implications for their clinical efficacy and abuse liability.
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Affiliation(s)
- D J Heal
- RenaSci Consultancy Ltd, BioCity, Nottingham NG1 1GF, UK.
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Smith SL, Hampson F, Duxbury M, Rae DM, Sinclair MT. Computed tomography after radical pancreaticoduodenectomy (Whipple's procedure). Clin Radiol 2008; 63:921-8. [PMID: 18625359 DOI: 10.1016/j.crad.2007.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 09/24/2007] [Accepted: 10/08/2007] [Indexed: 10/22/2022]
Abstract
Whipple's procedure (radical pancreaticoduodenectomy) is currently the only curative option for patients with periampullary malignancy. The surgery is highly complex and involves multiple anastomoses. Complications are common and can lead to significant postoperative morbidity. Early detection and treatment of complications is vital, and high-quality multidetector computed tomography (MDCT) is currently the best method of investigation. This review outlines the surgical technique and illustrates the range of normal postoperative appearances together with the common complications.
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Affiliation(s)
- S L Smith
- Department of Radiology, Ipswich Hospital, Ipswich, UK.
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Tian XC, Smith SL, Zhang SQ, Kubota C, Curchoe C, Xue F, Yang L, Du F, Sung LY, Yang X. Nuclear reprogramming by somatic cell nuclear transfer--the cattle story. ACTA ACUST UNITED AC 2007; 64:327-39. [PMID: 17491157 DOI: 10.5661/rdr-vi-327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Somatic cell nuclear transfer (cloning) returns a differentiated cell to a totipotent status; a process termed nuclear reprogramming. Nuclear transfer has potential applications in agriculture and biomedicine, but is limited by low efficiency. To understand the deficiencies of nuclear reprogramming, our research has focused on both candidate genes (imprinted and X-linked genes) and global gene expression patterns in cloned bovine embryos/offspring as compared to those generated by conventional reproduction. We found aberrant expression patterns of H19 and Igf2r as well as X-linked genes in term cloned calves. The expression profiles of cloned blastocysts, however, closely resembled those of the naturally fertilized embryos but were considerably different from those of their nuclear donor cells. Our findings suggest that cloned embryos have undergone significant nuclear reprogramming by the blastocyst stage. However, it is possible that during re-differentiation in later development gene expression aberrancies occur. Additionally, small initial nuclear reprogramming errors may be manifested during subsequent development.
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Affiliation(s)
- X C Tian
- Department of Animal Science/Center for Regenerative Biology, University of Connecticut, Storrs, CT, USA.
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Abstract
Parkinson's disease (PD) is a common neurodegenerative disease and the diagnosis of its idiopathic form remains challenging. The diagnosis of idiopathic form is based on clinical features which can have poor sensitivity with about 25% of patients diagnosed as having the disease actually having other conditions. In this study we assess the suitability and clinical value of a low cost computer-based system as an aid to diagnosis of PD, in particular the presence of tremor. All participants (12 patients and 10 controls) performed a shape-tracing task using a graphic tablet attached to a laptop. To assess the presence of tremors in the collected data, a statistical spectral analysis of the moment-to-moment fluctuations in the position signal of the output from the digitising tablet was performed. This allowed the comparison of power spectrums obtained from the control and patient responses respectively. A peak in log power between the 5 Hz & 6 Hz can clearly be identified in the patient's spectrum and is indicative of Parkinson's related tremor and no similar peak could be seen in the control's spectrum, suggesting this type of sequential task and automated data analysis may be useful in the diagnosis of tremor.
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Affiliation(s)
- N M Aly
- University Hospital Aintree, Liverpool, UK.
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Allen DP, Playfer JR, Aly NM, Duffey P, Heald A, Smith SL, Halliday DM. On the Use of Low-Cost Computer Peripherals for the Assessment of Motor Dysfunction in Parkinson's Disease Quantification of Bradykinesia Using Target Tracking Tasks. IEEE Trans Neural Syst Rehabil Eng 2007; 15:286-94. [PMID: 17601199 DOI: 10.1109/tnsre.2007.897020] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [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: 11/06/2022]
Abstract
The potential of computer games peripherals to measure the motor dysfunction in Parkinson's diseases is assessed. Of particular interest is the quantification of bradykinesia. Previous studies used modified or custom haptic interfaces, here an unmodified force feedback joystick and steering wheel are used with a laptop. During testing an on screen cursor moves in response to movements of the peripheral, the user has to track a continuously moving target (pursuit tracking), or move to a predetermined target (step tracking). All tasks use movement in the horizontal axis, allowing use of joystick or steering wheel. Two pursuit tracking tasks are evaluated, pseudo random movement, and a swept frequency task. Two step tracking tasks are evaluated, movement between two or between two of five fixed targets. Thirteen patients and five controls took part on a weekly basis. Patients were assessed for bradykinesia at each session using standard clinical measures. A range of quantitative measures was developed to allow comparison between and within patients and controls using analysis of variance (ANOVA). Both peripherals are capable of discriminating between controls and patients, and between patients with different levels of bradykinesia. Recommendations for test procedures and peripherals are given.
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Affiliation(s)
- D P Allen
- Department of Electronics, University of York, York Y017 IBJ, UK
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Smith SL, Pitt JP. Re: The CT appearances of sclerosing mesenteritis and associated diseases. Clin Radiol 2006; 61:1067-8. [PMID: 17097431 DOI: 10.1016/j.crad.2006.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Accepted: 09/01/2006] [Indexed: 11/17/2022]
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Suteevun T, Parnpai R, Smith SL, Chang CC, Muenthaisong S, Tian XC. Epigenetic characteristics of cloned and in vitro-fertilized swamp buffalo (Bubalus bubalis) embryos1. J Anim Sci 2006; 84:2065-71. [PMID: 16864866 DOI: 10.2527/jas.2005-695] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [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: 11/13/2022] Open
Abstract
Swamp buffalos are becoming endangered due to reproductive inefficiencies. This is of concern because many countries depend heavily on their products. Somatic cell nuclear transfer (SCNT) is a potential strategy for preserving endangered species. To date, SCNT in swamp buffalo has succeeded in the creation of blastocyst embryos. However, development to term of SCNT swamp buffalos is extremely limited, and only 1 live birth has been reported. An abnormal epigenetic mechanism is suspected to be the cause of developmental failure, as is also seen in other species. The DNA methylation and histone acetylation are key players in epigenetic modification and display marked variability during embryonic preimplantation development. Knowledge of epigenetic modifications will aid in solving the developmental problems of SCNT embryos and improving reproductive technology in the swamp buffalo. The objective of this study was to determine the relationship between preimplantation embryonic development and 2 epigenetic patterns, global DNA methylation and histone acetylation, in SCNT and in vitro-fertilized (IVF) swamp buffalo embryos. In addition, we examined the correlations between those 2 mechanisms in the SCNT and IVF swamp buffalo embryos throughout the developmental stages using double immunostaining and quantification of the emission intensities using confocal microscopy. We discovered an aberrant methylation pattern in early preimplantation-stage swamp buffalo SCNT embryos. In addition, greater variability in the DNA methylation levels among nuclei within SCNT embryos was discovered. Hyperacetylation was also observed in SCNT embryos compared with IVF embryos at the 4- and 8-cell stages (P < 0.05). Dynamic changes and interplay between these 2 epigenetic mechanisms could be crucial for embryonic development during the early preimplantation period. The aberrancies uncovered here may contribute to the low efficiency of SCNT.
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Affiliation(s)
- T Suteevun
- Embryo Technology and Stem Cell Research Center and School of Biotechnology, Institute of Agricultural Technology, Suranaree University of Technology, Nakhon Ratchasima, 30000, Thailand
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Suteevun T, Smith SL, Muenthaisong S, Yang X, Parnpai R, Tian XC. Anomalous mRNA levels of chromatin remodeling genes in swamp buffalo (Bubalus bubalis) cloned embryos. Theriogenology 2006; 65:1704-15. [PMID: 16256185 DOI: 10.1016/j.theriogenology.2005.09.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2005] [Accepted: 09/25/2005] [Indexed: 10/25/2022]
Abstract
The swamp buffalo (Bubalus bubalis) is a multi-purpose animal in agriculture that is challenged by extinction due to low reproductive efficiency. Nuclear transfer (NT) has been used to preserve special breeds of buffalo, as well as to increase the number of animals. However, cloned buffalo embryos have impaired development, as in other species. To understand the chromatin remodeling activities in cloned embryos and to improve NT technology, we examined the expression profiles of five genes involved in DNA and histone modifications, DNMT1, DNMT3A, DNMT3B, HAT1 and HDAC1, in single swamp buffalo metaphase II oocytes, NT and in vitro fertilized (IVF) embryos from the two-cell to the blastocyst stage, by quantitative real time RT-PCR. We observed similar expression dynamics for all genes studied in the NT and IVF embryos: relatively constant levels of expression for all genes were found from the MII oocyte up to the eight-cell stage; the levels of mRNA for HAT1 and DNMT3B continued to be stably expressed up to the blastocyst stage; while dramatic increases were seen for DNMT3A and HDAC1. Alternatively, the levels of DNMT1 started to decrease at the eight-cell stage. Despite the similarity in the dynamics of gene expression, dramatic differences in the relative levels of these genes between NT and IVF embryos were observed. The expression levels of all DNA modifying genes were higher in the NT embryos than in the IVF embryos at the eight-cell and blastocyst stages. The genes HDAC1 and HAT1 were also expressed significantly higher at the blastocyst stage in the NT embryos. Our results suggested differences in chromatin remodeling between NT and IVF embryos and that lower levels of DNA passive demethylation and higher levels of DNA de novo methylation occurred in the NT embryos. These observations are novel in the species of buffalo, and may be associated with developmental failure of cloned buffalo embryos due to the transcriptional repression effect of most genes studied here.
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Affiliation(s)
- T Suteevun
- Embryo Technology and Stem Cell Research Center and School of Biotechnology, Institute of Agricultural Technology, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
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