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Huisman K, Johnson SB, Walker GV. Paging Dr. Google: Characterizing Direct to Consumer Internet Advertisements from Oncology Treatment Centers. Int J Radiat Oncol Biol Phys 2023; 117:e631-e632. [PMID: 37785886 DOI: 10.1016/j.ijrobp.2023.06.2028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients increasingly use internet searches to compare treatment options and decide on oncology treatment centers. The objective of this study is to examine the type of oncology treatment centers that were advertised on web-based searches. MATERIALS/METHODS A series of keyword searches were conducted using the Google search engine. Based on search trends, 3 of the top relevant search phrases were used ("best cancer doctor", "best cancer treatment", and "cancer treatment near me"). Modifiers were added to each search term to reflect the cancer categories with the highest prevalence: "breast", "prostate", and "lung". This yielded 12 search phrases that were used on a search hub that simulates Google searches from different geographic locations. The 30 most populous city locations were used. Of the four paid advertisements at the top of each search, the cancer treatment centers were categorized into centers that are National Cancer Institute-Designated (NCIs), Commission on Cancer (CoC) accredited, non-CoC accredited, and non-traditional treatment centers. Advertisements that weren't for cancer treatment centers were excluded. RESULTS Of the 360 searches and 817 subsequent cancer treatment center advertisements, 51.2% were for NCI, 12.2% were CoC accredited, 26.9% were non-CoC accredited, and 9.7% were non-traditional treatment centers. The search phrase that yielded the highest ratio of NCI results was "best cancer doctor" at 74.4% and the phrase that yielded the lowest was "prostate cancer treatment near me" at 37.1%. Of the known 71 NCI centers in the country, 42 (59.2%) did not have any advertisements. Of the 35 NCI centers located in one of the target cities, 12 (34.3%) did not have any advertisements. Notably, two specific NCI centers accounted for 49.5% of the NCI advertisements. Similarly, one specific non-traditional treatment center accounted for 48.1% of the non-traditional center advertisements. Regarding non-traditional treatment centers, there was geographic variation with Boston having 38.1% of searches yielding non-traditional treatment center advertisements as opposed to six cities having 0%. The ratio of non-traditional treatment center advertisements by region were as follows: Northeast with 13.6%, West with 12.6%, South with 7.7%, and Midwest with 5.0%. CONCLUSION These results indicate that most direct-to-consumer cancer advertisements come from CoC or NCI centers. Among advertisements coming from NCI centers, relatively few centers account for the majority of advertisements with most NCI centers having no advertising presence. Future research is needed to evaluate claims, costs, and the ethical considerations of direct-to-consumer marketing, where the potential for mischaracterizing the strength of the scientific evidence to vulnerable cancer populations requires more scrutiny.
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Affiliation(s)
- K Huisman
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ
| | - S B Johnson
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - G V Walker
- Banner MD Anderson Cancer Center, Gilbert, AZ
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Gravbrot N, Hutten R, Lloyd S, Suneja G, Johnson SB. Delay in Time to Oncologic Therapies for Patients with Positive COVID-19 Test. Int J Radiat Oncol Biol Phys 2023; 117:e586. [PMID: 37785775 DOI: 10.1016/j.ijrobp.2023.06.1930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) For several cancers, delays between diagnosis and initiation of treatment has important clinical implications, often affecting trial eligibility, treatment intention, and oncologic outcomes. The coronavirus disease-19 (COVID-19) pandemic placed an extraordinary strain on the United States healthcare system, and its effect on oncologic patterns of care has yet to be established. We hypothesize that patients who received a new cancer diagnosis and subsequently tested positive for COVID-19 had delayed oncologic treatment compared to those who did not test positive for COVID-19. MATERIALS/METHODS The National Cancer Database (NCDB) was queried to identify patients who were diagnosed and treated for any of 10 common malignancies from 2019-2020. Included disease sites were head and neck, esophagus, rectum, anus, lung, breast, cervix, uterus, prostate, and primary brain. Those who tested positive for COVID-19 between time of diagnosis and first oncologic treatment (including surgery, radiation, or systemic therapy) were compared to those who did not test positive for COVID-19. COVID-19 positivity was assessed using a new variable in the NCDB, "SARSCOV2_POS," which captures whether patients received a positive COVID-19 test via reverse transcriptase-polymerase chain reaction testing in inpatient, outpatient, or emergency room settings in 2020. Duration in days from cancer diagnosis to time to first treatment (TTFT) was analyzed using two-sample t-tests, with significance level of p<0.05. RESULTS A total of 1,503,127 patients were identified for analysis. Of these, 7,340 (0.5%) tested positive for COVID-19 between diagnosis and start of treatment. Initial treatment was most commonly surgery (55.3%), followed by systemic therapy (17.4%) and radiation (12.7%). Overall, median TTFT was 55 days [interquartile range (IQR) 31-91] for the COVID-19 group versus 34 days (IQR 15-56) for the non-COVID-19 group (p <0.01). Subgroup analysis of the 10 individual sites of disease revealed statistically significant delays in each, with greatest absolute difference in median TTFT in prostate (31.5 days; 95.5 versus 64.0) and greatest relative difference in brain (>700%, 28.5 versus 4.0). CONCLUSION In the first year of the pandemic, patients who tested positive for COVID-19 between oncologic diagnosis and initial management experienced significant delays in initiation of cancer-directed therapy compared to those who did not test positive for COVID-19, with median increase in TTFT of 21 days. Additional follow-up is needed to evaluate the clinical impact of these delays, as well as change in patterns of care in later years of the pandemic.
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Affiliation(s)
- N Gravbrot
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - R Hutten
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - S Lloyd
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - G Suneja
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - S B Johnson
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
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Johnson SB, Lucivero F, Zimmermann BM, Stendahl E, Samuel G, Phillips A, Hangel N. Ethical Reasoning During a Pandemic: Results of a Five Country European Study. AJOB Empir Bioeth 2022; 13:67-78. [PMID: 35262468 DOI: 10.1080/23294515.2022.2040645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Introduction: There has been no work that identifies the hidden or implicit normative assumptions on which participants base their views during the COVID-19 pandemic, and their reasoning and how they reach moral or ethical judgements. Our analysis focused on participants' moral values, ethical reasoning and normative positions around the transmission of SARS-CoV-2.Methods: We analyzed data from 177 semi-structured interviews across five European countries (Germany, Ireland, Italy, Switzerland and the United Kingdom) conducted in April 2020.Results: Findings are structured in four themes: ethical contention in the context of normative uncertainty; patterns of ethical deliberation when contemplating restrictions and measures to reduce viral transmission; moral judgements regarding "good" and "bad" people; using existing structures of meaning for moral reasoning and ethical judgement.Discussion: Moral tools are an integral part of people's reaction to and experience of a pandemic. 'Moral preparedness' for the next phases of this pandemic and for future pandemics will require an understanding of the moral values and normative concepts citizens use in their own decision-making. Three important elements of this preparedness are: conceptual clarity over what responsibility or respect mean in practice; better understanding of collective mindsets and how to encourage them; and a situated, rather than universalist, approach to the development of normative standards.
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Affiliation(s)
- S B Johnson
- Ethox Centre and Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - F Lucivero
- Ethox Centre and Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - B M Zimmermann
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany
| | - E Stendahl
- University College Dublin, Dublin, Ireland
| | - G Samuel
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - A Phillips
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - N Hangel
- Institute of History and Ethics in Medicine, Technical University of Munich, Munich, Germany
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Bruce J, Johnson SB. Exploring the ethics of genetic prioritisation for COVID-19 vaccines. Eur J Hum Genet 2022; 30:875-879. [PMID: 35250030 PMCID: PMC8898655 DOI: 10.1038/s41431-022-01058-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/13/2021] [Accepted: 01/25/2022] [Indexed: 01/20/2023] Open
Abstract
There is evidence to suggest that host genomic factors may account for disease response variability in COVID-19 infection. In this paper, we consider if and how host genomics should influence decisions about vaccine allocation. Three potential host genetic factors are explored: vulnerability to infection, resistance to infection, and increased infectivity. We argue for the prioritisation of the genetically vulnerable in vaccination schemes, and evaluate the potential for ethical de-prioritisation of individuals with genetic markers for resistance. Lastly, we discuss ethical prioritisation of individuals with genetic markers for increased infectivity (those more likely to spread COVID-19).
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Affiliation(s)
- Jago Bruce
- Wellcome Centre for Ethics and Humanities and Ethox Centre, Nuffield Department of Population Health, University of Oxford, Big Data Institute, Oxford, OX3 7LF, USA
| | - Stephanie B Johnson
- Wellcome Centre for Ethics and Humanities and Ethox Centre, Nuffield Department of Population Health, University of Oxford, Big Data Institute, Oxford, OX3 7LF, USA.
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Johnson SB, Butcher F. Doctors during the COVID-19 pandemic: what are their duties and what is owed to them? J Med Ethics 2021; 47:12-15. [PMID: 33060186 PMCID: PMC7565272 DOI: 10.1136/medethics-2020-106266] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/15/2020] [Accepted: 10/02/2020] [Indexed: 06/01/2023]
Abstract
Doctors form an essential part of an effective response to the COVID-19 pandemic. We argue they have a duty to participate in pandemic response due to their special skills, but these skills vary between different doctors, and their duties are constrained by other competing rights. We conclude that while doctors should be encouraged to meet the demand for medical aid in the pandemic, those who make the sacrifices and increased efforts are owed reciprocal obligations in return. When reciprocal obligations are not met, doctors are further justified in opting out of specific tasks, as long as this is proportionate to the unmet obligation.
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Affiliation(s)
- Stephanie B Johnson
- Nuffield Department of Population Health, Department of Medicine, Univerity of Oxford Nuffield, Oxford, Oxfordshire, UK
| | - Frances Butcher
- Nuffield Department of Population Health, Department of Medicine, Univerity of Oxford Nuffield, Oxford, Oxfordshire, UK
- Honorary Specialty Registrar in Public Health, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
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Abstract
In the coming weeks and months SARS-CoV-2 may ravage countries with weak health systems and populations disproportionately affected by HIV, tuberculosis (TB), and other infectious diseases. Without safeguards and proper attention to global health equity and justice, the effects of this pandemic are likely to exacerbate existing health and socio-economic inequalities. This paper argues that achieving global health equity in the context of COVID-19 will require that notions of reciprocity and relational equity are introduced to the response.
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Affiliation(s)
- Stephanie B Johnson
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK.
- Ethox Centre, University of Oxford, Oxford, UK.
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Vaccaro L, Butow PN, Lee D, Johnson SB, Bell M, Clayton J, Detering KM, Tattersall M. Fidelity is fundamental: intervention predictors in advance care plans in terminal cancer. BMJ Support Palliat Care 2019; 9:397-403. [PMID: 31537578 DOI: 10.1136/bmjspcare-2019-001917] [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] [Received: 06/06/2019] [Revised: 08/26/2019] [Accepted: 09/04/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Assessing whether interventions are implemented as intended (fidelity) is critical to establishing efficacy in clinical research yet rarely applied in advance care planning (ACP) interventions. We aimed to develop and implement a fidelity audit tool for an ACP intervention. METHODS We developed a fidelity audit tool assessing: (A) content; (B) quality (general communication, eliciting EOL preferences and prognostic communication); and (C) family/caregiver involvement. We audited (double-coded) 55 audio-recordings of ACP discussions delivered to advanced cancer patients and caregivers, within a clinical trial. RESULTS Fidelity to content was high: mean=9.38/11 but lower for the quality of general communication (mean=12.47/20), discussion of patient preferences (mean=4.67/7), prognosis (mean=3.9/6) and family/caregiver involvement (mean=2.67/4). Older patient age and caregiver religiosity were associated with higher fidelity. Higher fidelity to content was associated with the trial primary outcome of family caregiver report of patient wishes being discussed and met. CONCLUSIONS Fidelity to content, but not quality, of the ACP intervention is strong. Communication skills training is critical for ACP interventionists. Adherence was higher with older patients and religious carers, factors that may influence acceptance of death and readiness to undertake ACP, making the discussion easier. TRIAL REGISTRATION NUMBER ACTRN12613001288718.
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Affiliation(s)
- Lisa Vaccaro
- School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Sydney, New South Wales, Australia
| | - Phyllis N Butow
- School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Sydney, New South Wales, Australia
| | - Deborah Lee
- School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie B Johnson
- Nuffield Department of Population Health, Wellcome Centre for Ethics and Humanities and Ethox Centre, University of Oxford, Oxford, UK
| | - Melanie Bell
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Josephine Clayton
- Centre for Learning & Research in Palliative Care, Hammond Care, Greenwich Hospital and University of Sydney, Sydney, New South Wales, Australia
| | - Karen Margaret Detering
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia.,Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Martin Tattersall
- Department of Medical Oncology, University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Johnson SB, Butow PN, Kerridge I, Tattersall MH. What do patients with cancer and their families value most at the end of life? A critical analysis of advance care planning. Int J Palliat Nurs 2019; 23:596-604. [PMID: 29272197 DOI: 10.12968/ijpn.2017.23.12.596] [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] [Indexed: 11/11/2022]
Abstract
BACKGROUND Advance care planning (ACP) is defined in a variety of ways, although it is widely understood as a process undertaken by patients, when they have capacity, to define and communicate their treatment preferences for future care. Few studies have explored the meaning and importance patients place on their ability to participate in directing their medical care. AIM This study aimed to explore how cancer patients and their family members value autonomy at the end of life (EoL) and understand how this may impact on the way they develop and act on EoL decisions and planning. METHODS Data were collected through in-depth semi-structured interviews with patients and family members of people with cancer. Participants were recruited from metropolitan cancer centres in Sydney, Australia. Interviews were analysed using thematic analysis. FINDINGS Findings from 11 participant interviews (five patients with cancer and six family members) were organised into four themes: 'the threat of death and cancer'; 'patients seek trust and safety at the end of life'; 'doctors are human and the healthcare system has limitations'; and 'the role of ACP'. Participants experienced cancer and death as a 'threat', to self and others and as something 'uncontrollable'. ACP was seen to have the potential to enhance EoL care by contributing to decreasing uncertainty, enhancing comfort, helping to achieve 'the small things', and in helping the family 'know what to do'. However, participants were, in general, distrustful of documentation and cognisant of uncertainty around medical outcomes and the legal limitations of their capacity to influence care. CONCLUSIONS These findings suggest that models of ACP which are constructed around patients' 'rights' to determine what happens to their bodies may do little to enhance the quality of EoL care, as patients value veracity, trust and comfort at the EoL more than autonomy. Quality EoL care should focus on paying increased attention to the relational and social aspects of care.
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Affiliation(s)
- Stephanie B Johnson
- Research associate and PhD candidate, the Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, NSW, Australia
| | - Phyllis N Butow
- Principal research fellow, National Health and Medical Research Council, Australia; Director, the Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, NSW, Australia
| | - Ian Kerridge
- Professor of Bioethics and Medicine, Sydney Health Ethics, University of Sydney, Sydney, NSW, Australia
| | - Martin Hn Tattersall
- Professor of Cancer Medicine, the Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, NSW, Australia
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Johnson SB, Butow PN, Kerridge I, Bell ML, Tattersall MHN. How Well Do Current Measures Assess the Impact of Advance Care Planning on Concordance Between Patient Preferences for End-of-Life Care and the Care Received: A Methodological Review. J Pain Symptom Manage 2018; 55:480-495. [PMID: 28943359 DOI: 10.1016/j.jpainsymman.2017.09.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/04/2017] [Accepted: 09/04/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Research has begun to focus on whether Advance Care Planning (ACP) has the capacity to influence care, and to examine whether ACP can be effective in meeting patients' wishes at the end of their lives. Little attention has been paid, however, to the validity and clinical relevance of existing measures. METHODS A search of Medline and CINHAL identified ACP studies measuring concordance between end-of-life (EoL) preferences and the care received. Databases were searched from 2000 to August 2016. We developed a checklist to evaluate the quality of included studies. Data were collected on the proportion of patients who received concordant care, extracted from manuscript tables or calculated from the text. OUTCOMES Of 2941 papers initially identified, nine eligible studies were included. Proportions of patients who received concordant care varied from 14% to 98%. Studies were heterogeneous and methodologically poor, with limited attention paid to bias/external validity. Studies varied with regards to design of measures, the meaning of relevant terms like "preference" "EoL care" and "concordance," and the completeness of reported data. CONCLUSION Methodological variations and weaknesses compromise the validity of study results, and prevent meaningful comparisons between studies or synthesis of the results. Effectively evaluating whether ACP interventions enhance a patient's capacity to receive the care they want requires harmonization of research. This demands standardization of methods across studies, validating of instruments, and consensus based on a consistent conceptual framework regarding what constitutes a meaningful outcome measure.
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Johnson SB, Butow PN, Kerridge I, Tattersall MHN. Patient autonomy and advance care planning: a qualitative study of oncologist and palliative care physicians' perspectives. Support Care Cancer 2017; 26:565-574. [PMID: 28849351 DOI: 10.1007/s00520-017-3867-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 08/21/2017] [Indexed: 11/25/2022]
Abstract
IMPORTANCE Patients' are encouraged to participate in advance care planning (ACP) in order to enhance their autonomy. However, controversy exists as to what it means to be autonomous and there is limited understanding of how social and structural factors may influence cancer patients' ability to exercise their autonomy. OBJECTIVE The objective of this study is to explore oncologists' and palliative care physicians' understanding of patient autonomy, how this influences reported enactment of decision-making at the end of life (EOL), and the role of ACP in EOL care. DESIGN AND SETTING Qualitative semi-structured interviews were conducted with consultant oncologists (n = 11) and palliative medicine doctors (n = 7) working in oncology centres and palliative care units across Australia. RESULTS We found that doctors generally conceptualized autonomy in terms of freedom from interference but that there was a profound disconnect between this understanding of autonomy and clinical practice in EOL decision-making. The clinicians in our study privileged care, relationships and a 'good death' above patient autonomy, and in practice were reluctant to 'abandon' their patients to total non-interference in decision-making. Patient autonomy in healthcare is bounded, as while patients were generally encouraged to express their preferences for care, medical norms about the quality and 'reasonableness' of care, the availability of services and the patients' family relationships act to enhance or limit patients' capacity to realize their preferences. While for many, this disconnect between theory and practice did not diminish the rhetorical appeal of ACP; for others, this undermined the integrity of ACP, as well as its relevance to care. For some, ACP had little to do with patient autonomy and served numerous other ethical, practical and political functions. CONCLUSION The ethical assumptions regarding patient autonomy embedded in academic literature and policy documents relating to ACP are disconnected from the realities of clinical care. Medical norms and professional boundaries surrounding 'good deaths' have a greater influence on care than patient preference. ACP programs, therefore, may be rejected by healthcare professionals as irrelevant to care or may have the unintended consequence of limiting patient autonomy when used as a professional tool to encourage a 'right' way to die. A singular focus on bureaucratic ACP programs, which reduce patient autonomy to a 'tick box' exercise, may fail to enhance EOL care in any meaningful way.
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Affiliation(s)
- Stephanie B Johnson
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology and Department of Medicine, University of Sydney, Sydney, NSW, Australia.
- Level 6 - North, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Phyllis N Butow
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology and Department of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Ian Kerridge
- Sydney Health Ethics, University of Sydney, Sydney, NSW, Australia
| | - Martin H N Tattersall
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology and Department of Medicine, University of Sydney, Sydney, NSW, Australia
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Fry WE, Birch PRJ, Judelson HS, Grünwald NJ, Danies G, Everts KL, Gevens AJ, Gugino BK, Johnson DA, Johnson SB, McGrath MT, Myers KL, Ristaino JB, Roberts PD, Secor G, Smart CD. Five Reasons to Consider Phytophthora infestans a Reemerging Pathogen. Phytopathology 2015; 105:966-81. [PMID: 25760519 DOI: 10.1094/phyto-01-15-0005-fi] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Phytophthora infestans has been a named pathogen for well over 150 years and yet it continues to "emerge", with thousands of articles published each year on it and the late blight disease that it causes. This review explores five attributes of this oomycete pathogen that maintain this constant attention. First, the historical tragedy associated with this disease (Irish potato famine) causes many people to be fascinated with the pathogen. Current technology now enables investigators to answer some questions of historical significance. Second, the devastation caused by the pathogen continues to appear in surprising new locations or with surprising new intensity. Third, populations of P. infestans worldwide are in flux, with changes that have major implications to disease management. Fourth, the genomics revolution has enabled investigators to make tremendous progress in terms of understanding the molecular biology (especially the pathogenicity) of P. infestans. Fifth, there remain many compelling unanswered questions.
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Affiliation(s)
- W E Fry
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - P R J Birch
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - H S Judelson
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - N J Grünwald
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - G Danies
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - K L Everts
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - A J Gevens
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - B K Gugino
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - D A Johnson
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - S B Johnson
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - M T McGrath
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - K L Myers
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - J B Ristaino
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - P D Roberts
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - G Secor
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
| | - C D Smart
- First, fifth, and twelfth authors: Cornell University, Section of Plant Pathology and Plant-Microbe Biology, 334 Plant Science Bldg., Ithaca, NY 14850; second author: Division of Plant Sciences, University of Dundee at James Hutton Institute, Invergowrie, Dundee, DD2 4DA, UK; third author: Department of Plant Pathology and Microbiology, University of California, Riverside 92521; fourth author: Horticultural Crops Research Laboratory, United States Department of Agriculture-Agricultural Research Service, 3420 NW Orchard Ave., Corvallis, OR 97330; sixth author: Plant Pathology Department, University of Maryland, 27664 Nanticoke Rd., Salisbury 21801; seventh author: University of Wisconsin Department of Plant Pathology, 1630 Linden Dr., Madison 53706-1598; eighth author: Department of Plant Pathology and Environmental Microbiology, College of Agricultural Sciences, The Pennsylvania State University, 219 Buckhout Lab, University Park 16802; ninth author: Department of Plant Pathology, Washington State University, PO Box 646430, Pullman; tenth author: University of Maine Cooperative Extension, 57 Houlton Road, Presque Isle 04769; eleventh author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Long Island Horticultural Research & Extension Center, Riverhead, NY 11901-1098; thirteenth author: Department of Plant Pathology, Room 2419 Gardner Hall, NC State University, Raleigh 27695; fourteenth author: Department of Plant Pathology, University of Florida, Southwest Florida Research and Education Center, 2685 SR 29 N, Immokalee 34142-9515; fifteenth author: Department of Plant Pathology, North Dakota State University, 328 Walster Hall, Dept. 7660, PO Box6050, Fargo 58108-6050; and sixteenth author: Section of Plant Pathology and Plant-Microbe Biology, Cornell University, Barton Lab, NYSAES, 630 West North Street, Geneva, NY 14456
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Rettmann ME, Holmes DR, Johnson SB, Lehmann HI, Robb RA, Packer DL. Analysis of Left Atrial Respiratory and Cardiac Motion for Cardiac Ablation Therapy. Proc SPIE Int Soc Opt Eng 2015; 9415. [PMID: 26405370 DOI: 10.1117/12.2081209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Cardiac ablation therapy is often guided by models built from preoperative computed tomography (CT) or magnetic resonance imaging (MRI) scans. One of the challenges in guiding a procedure from a preoperative model is properly synching the preoperative models with cardiac and respiratory motion through computational motion models. In this paper, we describe a methodology for evaluating cardiac and respiratory motion in the left atrium and pulmonary veins of a beating canine heart. Cardiac catheters were used to place metal clips within and near the pulmonary veins and left atrial appendage under fluoroscopic and ultrasound guidance and a contrast-enhanced, 64-slice multidetector CT scan was collected with the clips in place. Each clip was segmented from the CT scan at each of the five phases of the cardiac cycle at both end-inspiration and end-expiration. The centroid of each segmented clip was computed and used to evaluate both cardiac and respiratory motion of the left atrium. A total of three canine studies were completed, with 4 clips analyzed in the first study, 5 clips in the second study, and 2 clips in the third study. Mean respiratory displacement was 0.2±1.8 mm in the medial/lateral direction, 4.7±4.4 mm in the anterior/posterior direction (moving anterior on inspiration), and 9.0±5.0 mm superior/inferior (moving inferior with inspiration). At end inspiration, the mean left atrial cardiac motion at the clip locations was 1.5±1.3 mm in the medial/lateral direction, and 2.1±2.0 mm in the anterior/posterior and 1.3±1.2 mm superior/inferior directions. At end expiration, the mean left atrial cardiac motion at the clip locations was 2.0±1.5 mm in the medial/lateral direction, 3.0±1.8 mm in the anterior/posterior direction, and 1.5±1.5 mm in the superior/inferior directions.
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Affiliation(s)
- M E Rettmann
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - D R Holmes
- Biomedical Imaging Resource, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - S B Johnson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - H I Lehmann
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - R A Robb
- Biomedical Imaging Resource, Mayo Clinic, Rochester, Minnesota, 55905, USA
| | - D L Packer
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, 55905, USA
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13
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Benzon CR, Johnson SB, McCue DL, Li D, Green TA, Hommel JD. Neuromedin U receptor 2 knockdown in the paraventricular nucleus modifies behavioral responses to obesogenic high-fat food and leads to increased body weight. Neuroscience 2013; 258:270-9. [PMID: 24269937 DOI: 10.1016/j.neuroscience.2013.11.023] [Citation(s) in RCA: 47] [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: 07/29/2013] [Revised: 10/25/2013] [Accepted: 11/11/2013] [Indexed: 11/29/2022]
Abstract
Neuromedin U (NMU) is a highly conserved neuropeptide which regulates food intake and body weight. Transgenic mice lacking NMU are hyperphagic and obese, making NMU a novel target for understanding and treating obesity. Neuromedin U receptor 2 (NMUR2) is a high-affinity receptor for NMU found in discrete regions of the central nervous system, in particular the paraventricular nucleus of the hypothalamus (PVN), where it may be responsible for mediating the anorectic effects of NMU. We hypothesized that selective knock down of NMUR2 in the PVN of rats would increase their sensitivity to the reinforcing properties of food resulting in increased intake and preference for high-fat obesogenic food. To this end, we used viral-mediated RNAi to selectively knock down NMUR2 gene expression in the PVN. In rats fed a standard chow, NMUR2 knockdown produced no significant effect on food intake or body weight. However, when the same rats were fed a high-fat diet (45% fat), they consumed significantly more food, gained more body weight, and had increased feed efficiency relative to controls. Furthermore, NMUR2 knockdown rats demonstrated significantly greater binge-type food consumption of the high-fat diet and showed a greater preference for higher-fat food. These results demonstrate that NMUR2 signaling in the PVN regulates consumption and preference for high-fat foods without disrupting feeding behavior associated with non-obesogenic standard chow.
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Affiliation(s)
- C R Benzon
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States
| | - S B Johnson
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States
| | - D L McCue
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States
| | - D Li
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States
| | - T A Green
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States
| | - J D Hommel
- Center for Addiction Research, Department of Pharmacology & Toxicology, University of Texas Medical Branch, United States.
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Fry WE, McGrath MT, Seaman A, Zitter TA, McLeod A, Danies G, Small IM, Myers K, Everts K, Gevens AJ, Gugino BK, Johnson SB, Judelson H, Ristaino J, Roberts P, Secor G, Seebold K, Snover-Clift K, Wyenandt A, Grünwald NJ, Smart CD. The 2009 Late Blight Pandemic in the Eastern United States - Causes and Results. Plant Dis 2013; 97:296-306. [PMID: 30722376 DOI: 10.1094/pdis-08-12-0791-fe] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The tomato late blight pandemic of 2009 made late blight into a household term in much of the eastern United States. Many home gardeners and many organic producers lost most if not all of their tomato crop, and their experiences were reported in the mainstream press. Some CSAs (Community Supported Agriculture) could not provide tomatoes to their members. In response, many questions emerged: How did it happen? What was unusual about this event compared to previous late blight epidemics? What is the current situation in 2012 and what can be done? It's easiest to answer these questions, and to understand the recent epidemics of late blight, if one knows a bit of the history of the disease and the biology of the causal agent, Phytophthora infestans.
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Affiliation(s)
- W E Fry
- Cornell University, Ithaca, NY
| | | | | | | | - A McLeod
- University of Stellenbosch, Stellenbosch, South Africa
| | | | | | - K Myers
- Cornell University, Ithaca, NY
| | - K Everts
- University of Maryland, Salisbury
| | | | - B K Gugino
- The Pennsylvania State University, University Park
| | - S B Johnson
- University of Maine Cooperative Extension, Presque Isle
| | | | - J Ristaino
- North Carolina State University, Raleigh
| | | | - G Secor
- North Dakota State University, Fargo
| | | | | | - A Wyenandt
- Rutgers Agricultural Research and Extension Center, Bridgeton, NJ
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Abstract
A 20-year-old male was involved in a motor vehicle accident and computed tomography revealed a completely transected right mainstem bronchus. An Emergency Department (ED) right anterior thoracotomy was necessary soon after arrival at our institution secondary to acute desaturation that was unresponsive to ventilator and chest tube management. This allowed direct intubation and ventilation of the right middle and lower lobes directly through the thoracotomy incision, which stabilized the patient for transport to the operating room. Once there, percutaneous cardiopulmonary support (CPS) was initiated to allow primary surgical repair of the transected bronchus. Post surgery, the patient was transported to the surgical intensive care unit on CPS which he required for an additional two days. The patient eventually did well and was discharged home. To our knowledge this is the first successful reported case of using the Avalon Elite dual lumen veno-venous cannula for CPS in a patient with complete right main-stem bronchus transection and bilateral pulmonary contusions.
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Affiliation(s)
- JL Walker
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - J Wiersch
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - C Benson
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - HA Young
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - DT Dearmond
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - SB Johnson
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Lissauer ME, Smitz-Naranjo L, Johnson SB. Gender influences end-of-life decisions. Crit Care 2011. [PMCID: PMC3068451 DOI: 10.1186/cc9942] [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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Johnson SB, Warén A, Lee RW, Kano Y, Kaim A, Davis A, Strong EE, Vrijenhoek RC. Rubyspira, new genus and two new species of bone-eating deep-sea snails with ancient habits. Biol Bull 2010; 219:166-177. [PMID: 20972261 DOI: 10.1086/bblv219n2p166] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Rubyspira, a new genus of deep-sea snails (Gastropoda: Abyssochrysoidea) with two living species, derives its nutrition from decomposing whalebones. Molecular phylogenetic and morphological evidence places the new genus in an exclusively deep-sea assemblage that includes several close relatives previously known as fossils associated with Cretaceous cold seeps, plesiosaur bones, and Eocene whalebones. The ability to exploit a variety of marine reducing environments may have contributed to the evolutionary longevity of this gastropod lineage.
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Affiliation(s)
- S B Johnson
- Monterey Bay Aquarium Research Institute, Moss Landing, California 95039, USA.
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Rouse GW, Worsaae K, Johnson SB, Jones WJ, Vrijenhoek RC. Acquisition of dwarf male "harems" by recently settled females of Osedax roseus n. sp. (Siboglinidae; Annelida). Biol Bull 2008; 214:67-82. [PMID: 18258777 DOI: 10.2307/25066661] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
After the deployment of several whale carcasses in Monterey Bay, California, a time-series analysis revealed the presence of a new species of Osedax, a genus of bone-eating siboglinid annelids. That species is described here as Osedax roseus n. sp. It is the fifth species described since the erection of this genus and, like its congeners, uses a ramifying network of "roots" to house symbiotic bacteria. In less than 2 months, Osedax roseus n. sp. colonized the exposed bones of a whale carcass deposited at 1018-m depth, and many of the females were fecund in about 3 months post-deployment. As with other Osedax spp., the females have dwarf males in their tube lumens. The males accrue over time until the sex ratio is markedly male-biased. This pattern of initial female settlement followed by gradual male accumulation is consistent with the hypothesis that male sex may be environmentally determined in Osedax. Of the previously described species in this genus, Osedax roseus n. sp. is most similar to O. rubiplumus, but it has several anatomical differences, as well as much smaller females, dwarf males, and eggs. Osedax roseus n. sp. is markedly divergent (minimally 16.6%) for mitochondrial cytochrome oxidase subunit I (mtCOI) sequences from any other Osedax species.
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Affiliation(s)
- G W Rouse
- Scripps Institution of Oceanography, 9500 Gilman Drive, La Jolla, California 92093-0202, USA.
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19
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Roth R, Johnson SB, Lernmark B, Simell T, Baxter J, Mcleod W. Psychosozialer Stress: Negative Life Events in der TEDDY (The Environmental Determinants of Diabetes in the Young) Studie. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Roth R, Johnson SB, Lernmark B, Baxter J, Simell T, McLeod W. Risiko für Typ1 Diabetes (T1D): Angst der Eltern als Reaktion auf das genetische Screening von Neugeborenen in der TEDDY (The Environmental Determinants of Diabetes in the Young)-Studie. DIABETOL STOFFWECHS 2007. [DOI: 10.1055/s-2007-982291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Matsuoka N, Patki A, Tiwari HK, Allison DB, Johnson SB, Gregersen PK, Leibel RL, Chung WK. Association of K121Q polymorphism in ENPP1 (PC-1) with BMI in Caucasian and African-American adults. Int J Obes (Lond) 2006; 30:233-7. [PMID: 16231022 DOI: 10.1038/sj.ijo.0803132] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To test for association of the ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) K121Q polymorphism with body mass index (BMI) and diabetes in a large sample of Caucasians and African-Americans by selectively genotyping individuals at the extremes of the phenotypic distribution. SUBJECTS Subsets comprising the extremes of the BMI distribution (10th-20th and above the 90th BMI percentile for Caucasians and between the 10th-30th and above the 80th percentile for African-Americans) from a group of 10,260 Caucasian and 2268 African-American adults participating in New York Cancer Project were studied. METHODS Subjects were genotyped for the ENPP1 K121Q polymorphism by pyrosequencing and tested for association with BMI and diabetes by regression analysis. RESULTS Regression analysis with BMI as the dependent variable demonstrated a significant association (P = 0.02) of genotype at K121Q with BMI, with no significant race-by-genotype interaction (P = 0.30). Compared with Q/Q or Q/K individuals, the K/K individuals had a BMI approximately 1.3 kg/m2 higher, without effects of age, gender or race. By logistic regression analysis, the K121Q alleles had no significant effect on diabetes status (P = 0.37) in obese subjects. CONCLUSION In both Caucasians and African-Americans, the K121 polymorphism in ENPP1 was associated with increased BMI, but not with diabetes.
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Affiliation(s)
- N Matsuoka
- Division of Molecular Genetics, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
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Abstract
OBJECTIVES To assess youth perceptions of the causes and consequences of violence generally, the causes and consequences of fighting specifically, and to determine how best to approach fighting in the context of violence prevention activities. METHODS Thirteen structured focus group interviews with youths from three high violence urban settings: a large, urban high school, a training center for disadvantaged youths, and a school for adjudicated youths. Participants were 120 urban, predominately African-American youths and young adults ages 14-22 years (mean: 17.2 years). Seven focus groups were conducted with females, and six with males. RESULTS Adolescents identified the causes of violence on multiple levels including: individual, family, interpersonal, and community level factors. Most youths (89%) had been in a physical fight. Participants felt that fighting was not "right", but identified situations in which it was necessary. Specifically, fighting was used as a problem solving tool, and could prevent escalation of violence. Youths felt that the adults in their lives, including physicians, were generally ill equipped to give advice about violence, as adults' experiences were so removed from their own. Participants looked to experienced role models to offer problem solving and harm reduction strategies. Youths were open to receiving anticipatory guidance about violence and fighting from primary care physicians they felt comfortable with, and who showed respect for their experiences. CONCLUSIONS Interventions that include blanket admonitions against fighting should be reassessed in light of youth perceptions that fighting plays a complex role in both inciting and preventing more serious violence.
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Affiliation(s)
- S B Johnson
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
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Vernick JS, O'Brien M, Hepburn LM, Johnson SB, Webster DW, Hargarten SW. Unintentional and undetermined firearm related deaths: a preventable death analysis for three safety devices. Inj Prev 2004; 9:307-11. [PMID: 14693889 PMCID: PMC1731016 DOI: 10.1136/ip.9.4.307] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [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: 11/03/2022]
Abstract
OBJECTIVE To determine the proportion of unintentional and undetermined firearm related deaths preventable by three safety devices: personalization devices, loaded chamber indicators (LCIs), and magazine safeties. A personalized gun will operate only for an authorized user, a LCI indicates when the gun contains ammunition, and a magazine safety prevents the gun from firing when the ammunition magazine is removed. DESIGN Information about all unintentional and undetermined firearm deaths from 1991-98 was obtained from the Office of the Chief Medical Examiner for Maryland, and from the Wisconsin Firearm Injury Reporting System for Milwaukee. Data regarding the victim, shooter, weapon, and circumstances were abstracted. Coding rules to classify each death as preventable, possibly preventable, or not preventable by each of the three safety devices were also applied. RESULTS There were a total of 117 firearm related deaths in our sample, 95 (81%) involving handguns. Forty three deaths (37%) were classified as preventable by a personalized gun, 23 (20%) by a LCI, and five (4%) by a magazine safety. Overall, 52 deaths (44%) were preventable by at least one safety device. Deaths involving children 0-17 (relative risk (RR) 3.3, 95% confidence interval (CI) 2.1 to 5.1) and handguns (RR 8.1, 95% CI 1.2 to 53.5) were more likely to be preventable. Projecting the findings to the entire United States, an estimated 442 deaths might have been prevented in 2000 had all guns been equipped with these safety devices. CONCLUSION Incorporating safety devices into firearms is an important injury intervention, with the potential to save hundreds of lives each year.
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Affiliation(s)
- J S Vernick
- Johns Hopkins School of Public Health, Center for Gun Policy and Research, Baltimore, Maryland 21205, USA.
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Lambert DH, Levy L, Mavrodieva VA, Johnson SB, Babcock MJ, Vayda ME. First Report of Potato mop-top virus on Potato from the United States. Plant Dis 2003; 87:872. [PMID: 30812901 DOI: 10.1094/pdis.2003.87.7.872a] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Potato mop-top virus (PMTV) is a tripartite pomovirus vectored by the powdery scab plasmodiophoromycete Spongospora subterranea pv. subterranea (1). PMTV occurs on potato (Solanum tuberosum) in Europe, the Andes, Asia, and Canada. Internal necrotic arc and fleck tuber symptoms ("spraing") may reduce commercial acceptance of some cultivars (3). PMTV symptoms were discovered in 'Shepody' tubers at the Aroostook Research Farm, Presque Isle, ME in May 2002 and subsequently in 'Russet Burbank' tubers in commercial storage from the 2001 Maine crop. Symptomatic tubers exhibited single or multiple concentric necrotic arcs that were partial or complete, but exhibited no distinct external symptoms. The presence of PMTV in eight 'Shepody' tubers was indicated by positive enzyme-linked immunosorbent assay (ELISA; Adgen, Ltd., Auchincruive, Ayr, Scotland) and confirmed by reverse transcription polymerase chain reaction (RT-PCR). 'Russet Burbank' potatoes were visually diagnosed, and the corresponding halves of 128 symptomatic tubers were forwarded to the University of Maine and APHIS (Beltsville, MD). Of these, ELISA readings in Maine were strongly positive (>3 × background) for 88, ambiguous (1.5-3 × background) for 13, and negative for 27. Subsamples from these three categories were positive by PCR in 17 of 17, 9 of 9, and 12 of 14 cases, respectively. A similar rating, positive or ambiguous, in ELISA testing was identical for all but one case at Beltsville. Confirmation of PMTV required PCR testing, resulting in a characteristic PCR product of 401 bp that was generated from the coat protein coding region on RNA 2 (2) using the primer pair PMTV 1 5'-GCAGCCGTCGAGAATAGATA-3' (RNA nucleotides 316-335) and PMTV 4 5'-GCGAGTTGATGTGCC ACATT-3' (complementary to RNA 2 nucleotides 716-697). An immunocapture RT-PCR using this primer set and the coating antibody from the Adgen ELISA kit was also successful in detecting PMTV. In separate reactions, a second product of 646 bp was generated from the triple gene block on RNA 3 (4) using the primer pair PMTV 5 5'-GGTGAACACGAGGACAAGGT-3' (RNA 3 nucleotides 1417-1436) and PMTV 7 5'-AACAGTCCGGTCTTGTGAAC-3' (complementary to RNA 3 nucleotides 2063-2044). The sequence of these products was 98 to 100% identical to PMTV published sequences. The discovery of this virus will result in adjustments to U.S. and Canadian seed potato certification standards and symptom characterization for common North American cultivars. References: (1) R. A. C. Jones and B. D. Harrison. Ann. Appl. Biol 63:1, 1969. (2) S. Kashiwazak et al. Virology 206:701, 1995. (3) M. Sandgren et al. Am. J. Potato Res. 79:205, 2002. (4) K. P. Scott et al. J. Gen. Virol.75:3561, 1994.
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Affiliation(s)
- D H Lambert
- Department of Plant, Soil and Environmental Sciences, University of Maine, Orono 04469
| | - L Levy
- APHIS-PPQ-CPHST, National Plant Germplasm and Biotechnology Laboratory, Beltsville, MD 20705
| | - V A Mavrodieva
- APHIS-PPQ-CPHST, National Plant Germplasm and Biotechnology Laboratory, Beltsville, MD 20705
| | - S B Johnson
- University of Maine Cooperative Extension, Presque Isle 04769
| | - M J Babcock
- Department of Biochemistry, Microbiology and Molecular Biology, University of Maine, Orono 04469
| | - M E Vayda
- Department of Biochemistry, Microbiology and Molecular Biology, University of Maine, Orono 04469
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Shortliffe EH, Johnson SB. Medical Informatics Training and Research at Columbia University. Yearb Med Inform 2002:173-180. [PMID: 27706367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Affiliation(s)
- E H Shortliffe
- Edward H. Shortliffe, MD, PhD, Professor and Chair, Department of Medical Informatics, 622 West 168th Street, VC-5, New York, NY 10032-3720, 212-305-6896, Fax: 212-543-8788, E-mail:
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Baughcum AE, Powers SW, Johnson SB, Chamberlin LA, Deeks CM, Jain A, Whitaker RC. Maternal feeding practices and beliefs and their relationships to overweight in early childhood. J Dev Behav Pediatr 2001; 22:391-408. [PMID: 11773804 DOI: 10.1097/00004703-200112000-00007] [Citation(s) in RCA: 276] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To better explore possible factors that may lead to childhood obesity, we developed and analyzed two new instruments that assess maternal feeding practices and beliefs. The Infant Feeding Questionnaire (IFQ) assesses feeding during the entire first year of life and was administered to 453 mothers of children 11 to 23 months old. The Preschooler Feeding Questionnaire (PFQ) assesses feeding of young children between the ages of 2 to 5 years and was administered to 634 mothers of children this age. Each questionnaire was factor analyzed and mean factor scores were calculated and linked with the children's measured and mothers' self-reported weight and height. Mean factor scores from the IFQ and PFQ were compared between mothers who were obese (body mass index > or = 30 kg/m2) and those who were nonobese, between those who did and those who did not have an overweight child (weight-for-height > or = 90th percentile), and between those who had a low income (< or = 185% of the poverty level) and those who had a high income. To control for confounding variables and to detect interaction among variables, hierarchical linear regression was used. Results from this study did not suggest that there is a particular "feeding style" that is associated with overweight in young children; however, there were differences found in feeding behaviors between high and low income mothers.
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Affiliation(s)
- A E Baughcum
- Department of Clinical and Health Psychology, University of Florida, Gainesville, USA
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Abstract
Despite the presence of well-described cardiac repolarization abnormalities in heart failure, d,l-sotalol effects on cardiac repolarization have not been evaluated in animal models of CHF. The authors hypothesized that the d,l-sotalol effects on cardiac repolarization are altered in canine dilated cardiomyopathy when compared to controls. Effects of d,l-sotalol were compared in seven dogs with tachycardia induced cardiomyopathy (CHF) and six control animals. In an open-chest model, contact monophasic action potential recordings were obtained from RV and LV endocardium/epicardium during and after two doses of d,l-sotalol (1 mg/kg and 3 mg/kg, each over 20 minutes). Effects of d,l-sotalol on action potential duration at 90% repolarization (APD90) were examined at pacing cycle lengths of 300-1,000 ms. Plasma d,l-sotalol levels were measured at baseline, 10, and 40 minutes following each dose. Prolongation of APD90 by d,l-sotalol, was significantly exaggerated in CHF animals versus controls (P < 0.05, ANOVA). These differences were magnified at slow heart rates (P < 0.05, ANOVA). There were no significant differences in plasma d,l-sotalol levels between the two groups. Effects of d,l-sotalol on cardiac repolarization are exaggerated in CHF without significant alterations in plasma drug levels. While using d,l-sotalol in heart failure, independent additional effects due to ventricular electrical remodeling may be a consideration.
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Affiliation(s)
- S S Chugh
- Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
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Abstract
Thymomas are relatively common tumors of the anterior superior mediastinum. They are usually relatively slowly growing tumors and their prognosis depends on the macroscopic and microscopic invasion of surrounding tissues. Surgery is the mainstay treatment of thymomas, and complete resection represents one of the most important prognostic factors in this disease. Other important prognostic indicators include the tumor stage and size and the presence of symptoms. Postoperative radiotherapy is indicated in tumors with invasion of surrounding tissues, even if resection was radical, since it improves local control and survival. Cytotoxic chemotherapy has been employed in several relatively small phase II studies and in advanced disease has been demonstrated to produce a 50%-80% objective response rate. Neoadjuvant cytotoxic chemotherapy and/or external beam radiotherapy has been used with some success in patients with tumors which are not readily resectable. Novel antiproliferative systemic agents, with both cytotoxic and cytostatic mechanisms of action, are being tested in ongoing prospective clinical trials.
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Affiliation(s)
- S B Johnson
- Division of Cardiothoracic Surgery, Department of Surgery, Academic Hospital, Vrije Universiteit, Amsterdam, The Netherlands
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Silverstein JH, Murray FT, Malasanos T, Myers S, Johnson SB, Frye K, Grossman M. Clinical testing results and high patient satisfaction with a new needle-free device for growth hormone in young children. Endocrine 2001; 15:15-7. [PMID: 11572320 DOI: 10.1385/endo:15:1:015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fifty children ages 4-10 yr with type 1 diabetes mellitus volunteered to participate in a study to evaluate and compare a new needle-free device developed for growth hormone delivery. Children answered descriptive questions related to nervousness and worry, hurt or pain, redness or bleeding, and stinging and wetness. Choices for answers for each of these five questions were none, a little, or a lot. None or a little was also combined to give a minimal category. Children also answered four questions that compared the needle-free device to their morning insulin needle injection in reference to ease of use, pain, nervousness, and overall preference. Half the children had single comfort rings inserted to increase the injection pressure. Results indicated no difference in question responses with or without pressure rings. Pain (92%), erythema (96%), worry (90%), stinging (86%) and wetness (96%) were minimal and significant (0.001 > p < 0.03) following all questions. Results of the comparative questionnaire indicated that the device was easier (p < 0.03) to use than needles and significantly preferred (p < 0.001) in 74% of children under age 10.
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Affiliation(s)
- J H Silverstein
- Department of Pediatric Endocrinology, University of Florida, Gainesville, USA
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Abstract
The large and rapidly growing number of information sources relevant to health care, and the increasing amounts of new evidence produced by researchers, are improving the access of professionals and students to valuable information. However, seeking and filtering useful, valid information can be still very difficult. An online information system that conducts searches based on individual patient data can have a beneficial influence on the particular patient's outcome and educate the healthcare worker. In this paper, we describe the underlying model for a system that aims to facilitate the search for evidence based on clinicians' needs. This paper reviews studies of information needs of clinicians, describes principles of information retrieval, and examines the role that standardized terminologies can play in the integration between a clinical system and literature resources, as well as in the information retrieval process. The paper also describes a model for a digital library system that supports the integration of clinical systems with online information sources, making use of information available in the electronic medical record to enhance searches and information retrieval. The model builds on several different, previously developed techniques to identify information themes that are relevant to specific clinical data. Using a framework of evidence-based practice, the system generates well-structured questions with the intent of enhancing information retrieval. We believe that by helping clinicians to pose well-structured clinical queries and including in them relevant information from individual patients' medical records, we can enhance information retrieval and thus can improve patient-care.
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Affiliation(s)
- E A Mendonça
- Department of Medical Informatics, Columbia University, 622 West 168th Street, Vanderbilt Clinic, 5th Floor, New York, NY 10032, USA.
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Abstract
The purpose of the present study was to characterize the psychological status (attitudes toward selective abortion, perceived risk, comprehension, patient satisfaction, coping, and state anxiety) of pregnant women at increased risk for fetal genetic anomalies who were referred for prenatal genetic counseling and amniocentesis; to determine which of these factors would predict amniocentesis use; and to identify patient outcomes associated with counseling and testing. Participants were 129 women aged 18 years and older who had one or more fetal genetic risk factors. All were recruited from an urban women's health clinic. The results revealed elevated perceptions of risk and moderate state anxiety despite adequate comprehension of, and patient satisfaction with, the process and content of genetic counseling. Approximately 78% agreed to testing; those who consented were more likely to hold favorable attitudes toward abortion than those who refused. Post-counseling, women experienced decrease in their perceived risk of having a baby born with a birth defect although perceived risk estimates remained higher than actual risks. Anxiety was clinically elevated and highest at the pre-counseling stage, though it dissipated to normal levels over time. Previous experience with prenatal diagnostic testing, increased perceived risk of a birth anomaly, and favorable attitudes toward abortion were independently associated with increased pre-counseling anxiety. Women who were more anxious pre-counseling remained more anxious post-counseling. Coping (high versus low monitoring) was unrelated to anxiety. These findings suggest that women who participate in prenatal counseling and testing may be subject to experience distress and unrealistic perceptions of their risk and may benefit from interventions designed to lessen these states.
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Affiliation(s)
- K P Tercyak
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
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Abstract
OBJECTIVE To examine the relationship between disordered eating attitudes and behaviors, BMI, and glycemic control in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS In a cross-sectional design, 152 adolescents (ages 11-19 years) completed three scales from the Eating Disorders Inventory (EDI): Body Dissatisfaction, Drive for Thinness, and Bulimia. All subjects had diabetes for > 1 year. Glycemic control was assessed by glycosylated hemoglobin (HbA1c). Height and weight were measured to assess BMI. RESULTS Adolescents with type 1 diabetes did not report more disordered eating attitudes and behaviors than the normative comparison sample. Male subjects with type 1 diabetes reported fewer symptoms of bulimia and female subjects with type 1 diabetes reported greater body satisfaction than the normative group. A higher BMI was a significant predictor of greater body dissatisfaction, more so for female than male subjects. Symptoms of bulimia were associated with older adolescence and female sex. Those with more symptoms of bulimia were also more likely to have a higher BMI. Sex (female) and body dissatisfaction (more dissatisfied) predicted a stronger desire to be thin. Longer duration of disease, more symptoms of bulimia, and obesity all predicted poorer glycemic control. CONCLUSIONS Female patients aged 13-14 years seem to be at greatest risk for developing disordered eating patterns. Using the clinical cutoff score (> or = 5) of the EDI Bulimia subscale as a screener in diabetes clinics may help identify adolescents whose disordered eating patterns are likely to compromise their glycemic control.
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Affiliation(s)
- L J Meltzer
- Department of Clinical and Health Psychology, University of Florida, Gainesville, USA
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Abstract
Screening programs to identify persons atrisk for diabetes mellitus (DM), before disease onset, are considered essential to understanding the natural history of the disease and for prevention program development. However, screening programs are complicated by imprecise markers of disease risk, the absence of a known effective prevention method, the use of children, and a wide variety of psychological, social, and educational challenges. Research relevant to four issues is presented: (1) parent and child anxiety in response to at-risk notification as well as how participants cope with this news; (2) accuracy of mothers' understanding of their babies' risk status; (3) predictors of participant recruitment and retention in longitudinal studies of this type; and (4) protocol compliance in prevention trials for type 1 DM. Integration of behavioral research into screening and prevention trials would help address the ethical concerns raised by such trials and improve their scientific quality.
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Affiliation(s)
- S B Johnson
- Center for Pediatric Psychology and Family Studies, University of Florida Health Sciences Center, Gainesville 32610-0165, USA.
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Abstract
OBJECTIVE Despite the frequent use of anti-arrhythmic drugs in the general population, the electrophysiologic effects of these agents have not been elucidated in congestive heart failure (CHF). METHODS To examine the impact of left ventricular dysfunction on actions of type III anti-arrhythmic drugs, we evaluated the actions of ibutilide in a canine model of pacing-induced dilated cardiomyopathy. Following ablation of the atrioventricular node, effects on action potential duration at 90% (APD(90)) were compared in vivo, between eight CHF animals and seven controls. Monophasic action potential recordings were obtained from right and left ventricular endocardium/epicardium during and after three doses of ibutilide (0. 01, 0.02 and 0.05 mg/kg), at pacing cycle lengths of 300-1000 ms. RESULTS APD(90) prolongation with ibutilide (0.01 mg/kg) was significantly greater in CHF vs. controls (P=0.0026, ANOVA). However, plasma ibutilide levels at this dose, were not significantly different between the two groups. In CHF, maximal effects were observed at the lowest dose, whereas effects were gradual and dose-dependent in controls. With ibutilide administration (0.01 mg/kg), an increased dispersion of left-right ventricular APD(90) was observed in CHF, but not in controls (P=0.03). A trend was observed, for increased incidence of non-sustained polymorphic ventricular tachycardia in CHF. CONCLUSIONS In the presence of CHF, the actions of ibutilide are altered significantly. These findings may reflect altered tissue effects, as a consequence of myocardial electrical remodeling in CHF.
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Affiliation(s)
- S S Chugh
- Division of Cardiovascular Disease, Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN, USA.
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35
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Campbell DA, Johnson SB. Comparing syntactic complexity in medical and non-medical corpora. Proc AMIA Symp 2001:90-4. [PMID: 11825160 PMCID: PMC2243419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
With the growing use of Natural Language Processing (NLP) techniques as solutions in Medical Informatics, the need to quickly and efficiently create the knowledge structures used by these systems has grown concurrently. Automatic discovery of a lexicon for use by an NLP system through machine learning will require information about the syntax of medical language. Understanding the syntactic differences between medical and non-medical corpora may allow more efficient acquisition of a lexicon. Three experiments designed to quantify the syntactic differences in medical and non-medical corpora were conducted. The results show that the syntax of medical language shows less variation than non-medical language and is likely simpler. The differences were great enough to question the applicability of general language tools on medical language. These differences may reduce the difficulty of some free text machine learning problems by capitalizing on the simpler nature of narrative medical syntax.
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Affiliation(s)
- D A Campbell
- Department of Medical Informatics, Columbia University, USA
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36
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Mendonça EA, Cimino JJ, Johnson SB. Using narrative reports to support a digital library. Proc AMIA Symp 2001:458-62. [PMID: 11825230 PMCID: PMC2243377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
The vast amount of information collected and stored in clinical systems can be a significant challenge in the integration of digital libraries and electronic medical records, especially the selection of clinical data to be used in the search, retrieval, and summarization processes. In this study, we describe the use of information retrieval measures with natural language processor output to identify critical information in narrative reports. Our hypothesis is that clinical data that occur often in narrative reports are less important to clinicians than findings that occur rarely. We used the information retrieval methods to analyze one year of discharge summaries. We then conducted a performance study, using physicians as subject. Results show that the methods can be used for filtering critical information from reports. Further studies need to be done on evaluation of the method based on an evaluation of the system performance in the context of a digital library.
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Affiliation(s)
- E A Mendonça
- Department of Medical Informatics, Columbia University, New York, NY, USA
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37
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La Greca AM, Delamater A, Patino AM, Blumberg MC, Marks J, Johnson SB, Shatz D, Anderson B. Early life stress and disease among offspring and siblings of individuals with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2001; 14 Suppl 1:661-8. [PMID: 11393560 DOI: 10.1515/jpem.2001.14.s1.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Major life events, recent life stressors, and childhood diseases were examined among children and adolescents who were offspring, siblings, or other relatives of persons with type 1 diabetes mellitus (DM). All youth were recruited as part of a multi-site nationwide trial on the prevention of type 1 DM; parents of 347 children (4 to 18 yr) completed measures that asked about children's life events, recent stressors, and childhood illnesses. Analyses compared age groups (young child, preadolescent, adolescent) and relative type (offspring, sibling, other relative). Findings revealed offspring and siblings did not differ from "other relatives" in terms of life events, recent life stress, and disease/illness variables. However, siblings were reported to have fewer major life events and fewer life stressors in the past 12 months than offspring; siblings also had fewer infectious diseases during the first two years of life compared to offspring. Few age-related differences were found. Overall, results suggest that offspring and siblings of persons with type 1 DM are not at a disadvantage in terms of early life stress or disease in comparison to youth who have other family members with diabetes. However, siblings may have some advantages relative to children who are offspring. The mechanisms underlying these relationships require further elucidation and study.
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Affiliation(s)
- A M La Greca
- Department of Psychology, University of Miami, Coral Gables, FL 33124, USA.
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38
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Barletta JF, Johnson SB, Nix DE, Nix LC, Erstad BL. Population pharmacokinetics of aminoglycosides in critically ill trauma patients on once-daily regimens. J Trauma 2000; 49:869-72. [PMID: 11086778 DOI: 10.1097/00005373-200011000-00013] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Once-daily dosing regimens of aminoglycosides are routinely used in critically ill trauma patients. However, the pharmacokinetic parameters are variable in these patients. The purpose of this study was to evaluate the pharmacokinetics of aminoglycosides in critically ill trauma patients receiving once-daily dosing regimens. METHODS At least two aminoglycoside concentrations were measured in each patient. Population pharmacokinetic parameters were estimated on the basis of a one-compartment structural model and the program nonlinear mixed effects modeling. RESULTS Fifty-three aminoglycoside concentrations from 19 patients were analyzed. The aminoglycoside clearance was 5.47 L/h. The mean volume of distribution was 22.2 L (0.3 L/kg). The mean half-life was 2.9 hours. Serum-aminoglycoside concentrations were undetectable for longer than 12 hours in 4 of 19 patients. Weight, age, or serum creatinine did not significantly explain the variability. CONCLUSION There is marked variability in aminoglycoside pharmacokinetic parameters in critically ill trauma patients. This may lead to prolonged drug-free intervals. Individualized dosing of critically ill trauma patients on the basis of at least two serum-aminoglycoside concentrations seems indicated when using once-daily dosing regimens.
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Affiliation(s)
- J F Barletta
- Department of Pharmacy Practice, University of Arizona Health Sciences Center, Tucson, USA.
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39
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Setter SM, Corbett CF, Cook D, Johnson SB. Exploring the clinical pharmacist's role in improving home care for patients with diabetes. Home Care Provid 2000; 5:185-92. [PMID: 11022164 DOI: 10.1067/mhc.2000.110686] [Citation(s) in RCA: 6] [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: 11/22/2022]
Abstract
Diabetes is a common condition among clients receiving home care services. Improved glycemic control can greatly thwart the long-term complications of diabetes. A study examining the role of a clinical pharmacist was performed in a home care agency in which 105 clients were interviewed and their respective charts reviewed with the following results: 37% were incorrectly classified as to type of diabetes, serum creatinine and HbA1c values were not commonly recorded, and clients tended to have complex drug regimens with a large number of potential drug-related problems. The clinical pharmacist's potential impact in this environment is great based on the data gathered from this study.
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Affiliation(s)
- S M Setter
- Washington State University's College of Pharmacy, USA
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40
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Johnson SB, Haug P, Curtis C, Defa T, Davoren B, Kolodner R, Monroe B. Where are they now? CPR leaders assess their progress. Interview by Anne Zender. J AHIMA 2000; 71:35-9. [PMID: 11186620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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41
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Abstract
While blood glucose monitoring has become increasingly important in diabetes care, studies have yet to address the accuracy of youngsters' performance of blood glucose testing with current reflectance meters. The present study examined testing skills and predictors of accurate testing skills in a sample of 7-14-year-old children attending a summer camp for youth with diabetes (n=266). A 15-item behavior observational skill test was used to assess accuracy of blood glucose monitoring skills with reflectance meters. Accurate performance of individual skills ranged between 14.6% and 99.6% for the sample. However, a number of children made critical errors (errors that were likely to lead to inaccurate blood glucose testing results). When duration of diabetes and metabolic control were controlled, female gender, older age, experience with a particular meter, and absence of hypoglycemia at the time of testing were positively associated with accurate skill performance. Findings suggest that younger children, children using a new blood glucose testing meter, and children suspected of having hypoglycemia should be supervised and observed when testing. Although all young children should be supervised when blood glucose testing, boys may need closer supervision until an older age than girls. This study underscores the need for health care providers to periodically observe children's blood glucose monitoring techniques to assure accurate testing habits and to correct problematic testing behaviors.
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Affiliation(s)
- A R Perwien
- Department of Clinical and Health Psychology, University of Florida Health Sciences Center, Gainesville, USA
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42
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Abstract
OBJECTIVE To assess the appropriateness of adolescents' responses to hypo- and hyperglycemia and to examine the relationship of patient age, gender, diabetes duration, diabetes knowledge, parental supervision, and glycemic control to response appropriateness. METHODS We assessed 125 adolescents' responses to daily episodes of hypo- and hyperglycemia by 24-hour recall interviews; responses were coded for type and appropriateness. RESULTS Adolescents responded inappropriately to 38% of hypoglycemic and 29% of hyperglycemic episodes. Parental supervision of blood glucose testing did not increase the likelihood of an appropriate response; in the case of hyperglycemic episodes, it appeared to be counterproductive. Adolescents who responded inappropriately to hyperglycemia were also older but not different from those who responded appropriately by gender, disease duration, diabetes knowledge, or glycemic control. CONCLUSIONS Health providers and family members may underestimate adolescents' difficulty managing hypo- and hyperglycemia appropriately. The presence of parental supervision does not ensure an appropriate response; parents may be particularly misinformed about the management of hyperglycemia.
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Affiliation(s)
- S B Johnson
- Center for Pediatric Psychology and Family Studies, University of Florida Health Science Center, Gainesville 32610-0165, USA.
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43
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Abstract
A variety of methods have been proposed for presenting medical data visually on computers. Discussion of and comparison among these methods have been hindered by a lack of consistent terminology. A taxonomy of medical data presentations based on object-oriented user interface principles is presented. Presentations are divided into five major classes-list, table, graph, icon, and generated text. These are subdivided into eight subclasses with simple inheritance and four subclasses with multiple inheritance. The various subclasses are reviewed and examples are provided. Issues critical to the development and evaluation of presentations are also discussed.
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Affiliation(s)
- J Starren
- Columbia University, New York, New York, USA.
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44
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Abstract
Necrotizing fasciitis is a rapidly spreading, life-threatening, bacterial disease. Mortality rates have been estimated to vary between 8.7% and 74%. Mortality depends on many factors, one of which is early recognition. Necrotizing fasciitis of dental origin has a low prevalence and as such presents diagnostic challenges for the dentist. The literature is reviewed, and a case history is presented.
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Affiliation(s)
- R A Dale
- Department of General Dentistry, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78284, USA
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Sisley AC, Johnson SB, Erickson W, Fortune JB. Use of an Objective Structured Clinical Examination (OSCE) for the assessment of physician performance in the ultrasound evaluation of trauma. J Trauma 1999; 47:627-31. [PMID: 10528594 DOI: 10.1097/00005373-199910000-00004] [Citation(s) in RCA: 44] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A reliable means of assessing physician competency in performing ultrasound (US) is critical for training and credentialing. Objective Structured Clinical Examinations (OSCE) have been used successfully to assess clinical competency in other areas of surgical education but have not been applied previously to trauma ultrasound training. The objectives of this study were to assess physician performance in the focused abdominal sonography in trauma (FAST) examination by using a specifically designed OSCE, and to determine whether the OSCE detects differences in two determinants of competency (knowledge acquisition and clinical interpretation skills). METHODS Eighty-two physicians in surgery (n = 49) and emergency medicine (n = 33) at a Level I trauma center were evaluated. All participated in a FAST course consisting of didactic sessions on US physics, indications, and technique, FAST examination videos, and a hands-on session with human models. The OSCE consisted of two parts: written examination that assessed factual knowledge, and videotape of real-time US examinations that assessed interpretation skills. The OSCE was administered before and after the FAST course. RESULTS Significant improvements in postcourse OSCE scores were observed for factual knowledge (52.5 +/- 2.0 vs. 87.5 +/- 1.1, p < 0.001) and interpretation skills (27.2 +/- 1.4 vs. 62.9 +/- 1.3, p < 0.007). Scores for US interpretation were significantly lower than those for factual knowledge at both precourse (27.2 +/- 1.4 vs. 52.5 - 2.0, p < 0.001) and postcourse (62.9 +/- 1.3 vs. 87.5 +/- 1.1, p < 0.01). No performance differences were observed between surgeons and emergency medicine physicians and no effect of training level on test scores was observed. CONCLUSION Knowledge acquisition and US interpretation skills can be assessed reliably with a specifically designed OSCE. Although both skills improved after participation in a FAST course, US interpretation scores were consistently lower than those for factual knowledge. This study supports the use of the objective structured clinical examination in both the design of ultrasound teaching programs and the assessment of physician competency.
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Affiliation(s)
- A C Sisley
- Department of Surgery, University of Arizona Health Sciences Center, Tucson 85724-5063, USA
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46
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Johnson SB, Robertson WO. Gastrointestinal decontamination. Am J Emerg Med 1999; 17:494-5. [PMID: 10496520 DOI: 10.1016/s0735-6757(99)90259-0] [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] [Indexed: 11/26/2022] Open
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47
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Johnson SB. Commentary: Psychologists' resistance to showcasing the profession's accomplishments: what is all the fuss about? J Pediatr Psychol 1999; 24:329-30. [PMID: 10431496 DOI: 10.1093/jpepsy/24.4.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S B Johnson
- Center for Pediatric Psychology and Family Studies, University of Florida Health Sciences Center, Gainesville 32610, USA
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Abstract
OBJECTIVE To summarize the current status of behavioral research and practice in diabetes and to identify promising future directions. RESEARCH DESIGN AND METHODS We review behavioral science contributions to diabetes in self-management and patient empowerment, interventions with children and adolescents, and special problems including blood glucose awareness training and complications such as depression. We also identify emerging areas in which behavioral science stands to make significant contributions, including quality of life, worksite and community programs, interventions using new information technologies, and translation research evaluating practical programs in representative settings. We then discuss the gap between the generally encouraging research on behavioral contributions to diabetes and the infrequent incorporation of such contributions in practice. Suggestions are made for how to close this gap, including ways to increase understanding of behavioral issues, opportunities for funding of key research and implementation questions, and how behavioral science principles can become more integrated into diabetes organizations and care. CONCLUSIONS Changes are required on the part of behavioral scientists in how they organize and present their research and on the part of potential users of this knowledge, including other health professions, organizations, and funding agencies. Integrating behavioral science advances with other promising genetic, medical, nutritional, technology, health care, and policy opportunities promises not only to broaden our understanding of diabetes but also to improve patient care, quality of life, and public health for persons with diabetes.
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Affiliation(s)
- R E Glasgow
- AMC Cancer Research Center, Denver, Colorado 80214, USA.
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Bohnen JM, Marshall JC, Fry DE, Johnson SB, Solomkin JS. Clinical and scientific importance of source control in abdominal infections: summary of a symposium. Can J Surg 1999; 42:122-6. [PMID: 10223073 PMCID: PMC3788974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
In May 1997, a panel of surgeon-investigators met to discuss the clinical importance and research implications of controlling the source of abdominal infections. It was concluded that source control is critical to therapeutic success and that antimicrobial therapy and other adjunctive interventions will fail if the source of infection is not controlled by resection, exteriorization or other means. The panelists presented different definitions of source control, depending on the scientific purpose of the definition. All participants agreed that failure to consider the adequacy of source control of infection has limited the value of most clinical trials of therapeutic anti-infective agents. Besides recognizing source control as an essential goal of patient care, the panelists emphasized the need for further investigative work to define, record and stratify the adequacy of source control in clinical trials of therapeutic agents for abdominal infections.
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Affiliation(s)
- J M Bohnen
- Department of Surgery, University of Toronto, Ont
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50
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Abstract
While some factors influencing size of RF lesions in ventricular tissue have been characterized, the effects of catheter electrode-endocardial surface orientation on lesion generation have not been investigated. Therefore, the effects of parallel versus perpendicular catheter electrode-endocardial surface orientation on dimensions of RF lesion produced with 4-, 6-, 8-, 10-, and 12-mm distal electrode lengths were studied in 20 closed-chested dogs. Orientation was established by biplane fluoroscopy and confirmed by intracardiac echocardiography for the majority of energy deliveries (71%). RF voltage was titrated to maintain constant catheter electrode temperature of 75 degrees C for 60 seconds. In the perpendicular orientation, lesion size did not change significantly with increasing electrode lengths. There was a statistically significant interaction between electrode orientation and maximum lesion length (analysis of variance [ANOVA] P = 0.04], lesion width (ANOVA P = 0.01), lesion area (ANOVA P = 0.02), and estimated lesion volume (ANOVA P < 0.005) over all electrode lengths. With parallel tip-tissue orientation, lesion size was a function of increasing electrode length. For 4-, 6-, 8-, 10-, and 12-mm electrodes, maximum lesion surface areas were 95 +/- 38, 97 +/- 38, 119 +/- 29, 147 +/- 52, and 147 +/- 67 mm2, respectively. For electrode lengths 8, 10, and 12 mm, estimated lesion volumes were significantly greater with parallel orientation (P < 0.05 for all). Thus, ventricular lesion size is dependent on catheter electrode length, but only when the catheter is oriented parallel to the endocardial surface. This information may be helpful in increasing lesion dimensions for RF ablation of ventricular tachycardias.
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Affiliation(s)
- S S Chugh
- Department of Internal Medicine, Mayo Foundation, Rochester, Minnesota, USA
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