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L Harris S, Bailey AK. Work-related perceptions and coping strategies of acute care chaplains: a qualitative analysis. J Health Care Chaplain 2023:1-19. [PMID: 37853721 DOI: 10.1080/08854726.2023.2270395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Hospital-based chaplains provide crucial spiritual and emotional care to patients, families, and staff during times of intense life changes and crises. Chaplains are regularly exposed to suffering and their work may result in personal mental and emotional health challenges. To understand chaplains' perceptions of the impact of their work and methods to cope, a secondary analysis of a mixed-methods study on chaplain well-being was undertaken. Qualitative interviews were conducted with nine hospital-based chaplains and data were coded and analyzed using thematic analysis. Results revealed that participants perceive their work as offering both trials and rewards, and their efforts to cope with trials include interpersonal support, intrapersonal resources, and spiritual resilience. Personal insights into chaplains' experiences may help inform organizational interventions to support these essential members of the care team.
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Harris SL, Sawyer AT, Tao H, Bailey AK. A Mixed-Methods Pilot Study of a Well-Being Intervention for Healthcare Chaplains. J Pastoral Care Counsel 2023; 77:101-112. [PMID: 36591899 DOI: 10.1177/15423050221146510] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This mixed-methods pilot study explored the psychological and emotional experiences of chaplains and the feasibility, acceptability, and impact of workshops designed to support chaplain well-being. After the workshops, scores on a measure of self-compassion increased, while secondary traumatic stress and burnout scores decreased. Qualitative data reflected the range of experiences of chaplaincy as well as the benefits of the workshops. This pilot study supports further exploration of organizational interventions to promote chaplain well-being.
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Affiliation(s)
| | | | - Hong Tao
- AdventHealth Research Institute, Orlando, FL, USA
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Fusco KM, Hylind RJ, Cirino AL, Harris SL, Lubitz SA, Abrams DJR, Lakdawala NK. Cascade testing for inherited cardiac conditions: Risk perception and screening after a negative genetic test result. J Genet Couns 2022; 31:1273-1281. [PMID: 35763674 DOI: 10.1002/jgc4.1602] [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: 11/22/2021] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 12/14/2022]
Abstract
First-degree relatives of a proband with an inherited cardiac condition (ICC) are offered predictive genetic testing for the pathogenic or likely pathogenic (P/LP) cardiac gene variant (CGV) to clarify their risk for the familial condition. Relatives who test negative for a familial P/LP CGV typically do not require longitudinal cardiac surveillance. To our knowledge, no previous study has investigated adjustment to risk reduction and subsequent screening practices in genotype-negative relatives from an ICC population. We thus investigated risk perception and ongoing screening practices in genotype-negative adults who received cardiac genetic counseling. Correlations between clinical and demographic variables and risk perception and screening practices were also investigated. On average, participants (n = 71) reported a perceived 19.5% lifetime risk of developing the ICC in their family, despite their negative genetic test result. The majority (54%) of participants reported having undergone cardiac screening after disclosure of their negative result. There were no significant correlations between clinical and demographic variables and risk perception or screening practices. Furthermore, risk perception was not found to impact the likelihood of cardiac screening. These findings suggest that even with comprehensive cardiac genetic counseling, a proportion of this population did not accurately comprehend or recall their cardiac disease risk. Additional interventions beyond traditional result disclosure should be explored to help genotype-negative individuals adjust to their reduction in risk for a familial ICC.
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Affiliation(s)
- Kelsey M Fusco
- MGH Institute of Health Professions Genetic Counseling Program, Boston, Massachusetts, USA.,New England Cancer Specialists, Scarborough, Maine, USA
| | - Robyn J Hylind
- Boston Children's Hospital Inherited Cardiac Arrhythmia Program, Boston, Massachusetts, USA
| | - Allison L Cirino
- MGH Institute of Health Professions Genetic Counseling Program, Boston, Massachusetts, USA.,Brigham and Women's Hospital Cardiovascular Genetics Center, Boston, Massachusetts, USA
| | - Stephanie L Harris
- Massachusetts General Hospital Cardiovascular Genetics Program, Boston, Massachusetts, USA
| | - Steven A Lubitz
- Massachusetts General Hospital Cardiovascular Genetics Program, Boston, Massachusetts, USA
| | - Dominic J R Abrams
- Boston Children's Hospital Inherited Cardiac Arrhythmia Program, Boston, Massachusetts, USA
| | - Neal K Lakdawala
- Brigham and Women's Hospital Cardiovascular Genetics Center, Boston, Massachusetts, USA
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Cirino AL, Harris SL, Murad AM, Hansen B, Malinowski J, Natoli JL, Kelly MA, Christian S. The uptake and utility of genetic testing and genetic counseling for hypertrophic cardiomyopathy-A systematic review and meta-analysis. J Genet Couns 2022; 31:1290-1305. [PMID: 35799446 DOI: 10.1002/jgc4.1604] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/18/2022] [Accepted: 05/30/2022] [Indexed: 12/14/2022]
Abstract
Genetic testing and genetic counseling are routinely indicated for patients with hypertrophic cardiomyopathy (HCM); however, the uptake and utility of these services is not entirely understood. This systematic review and meta-analysis summarizes the uptake and utility of genetic counseling and genetic testing for patients with HCM and their at-risk family members, as well as the impact of genetic counseling/testing on patient-reported outcomes (PROs). A systematic search was performed through March 12, 2021. Meta-analyses were performed whenever possible; other findings were qualitatively summarized. Forty-eight studies met inclusion criteria (47 observational, 1 randomized). Uptake of genetic testing in probands was 57% (95% confidence interval [CI]: 40, 73). Uptake of cascade screening for at-risk relatives were as follows: 61% for cascade genetic testing (95% CI: 45, 75), 58% for cardiac screening (e.g. echocardiography) (95% CI: 40, 73), and 69% for either/both approaches (95% CI: 43, 87). In addition, relatives of probands with a positive genetic test result were significantly more likely to undergo cascade screening compared to relatives of probands with a negative result (odds ratio = 3.17, 95% CI: 2.12, 4.76). Overall, uptake of genetic counseling in both probands and relatives ranged from 37% to 84%. Multiple studies found little difference in PROs between individuals receiving positive versus negative genetic test results; however, other studies found that individuals with positive genetic test results experienced worse psychological outcomes. Genetic testing may also inform life choices, particularly decisions related to reproduction and insurance. Genetic counseling was associated with high satisfaction, increased perceived personal control and empowerment, and decreased anxiety. Approximately half to three-quarters of patients with HCM and their relatives undergo genetic testing or cascade screening. PROs after genetic testing varied and genetic counseling was associated with high satisfaction and improved PROs.
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Affiliation(s)
- Allison L Cirino
- Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.,MGH Institute of Health Professions, Boston, Massachusetts, USA
| | - Stephanie L Harris
- Cardiovascular Genetics Program, Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Andrea M Murad
- Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Brittany Hansen
- Center for Personalized Genetic Healthcare, Genomic Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Jaime L Natoli
- Kaiser Permanente, Southern California Permanente Medical Group, Pasadena, California, USA
| | - Melissa A Kelly
- Geisinger, Genomic Medicine Institute, Danville, Pennsylvania, USA
| | - Susan Christian
- Department of Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
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Nauffal V, Morrill VN, Jurgens SJ, Choi SH, Hall AW, Weng LC, Halford JL, Austin-Tse C, Haggerty CM, Harris SL, Wong EK, Alonso A, Arking DE, Benjamin EJ, Boerwinkle E, Min YI, Correa A, Fornwalt BK, Heckbert SR, Kooperberg C, Lin HJ, J F Loos R, Rice KM, Gupta N, Blackwell TW, Mitchell BD, Morrison AC, Psaty BM, Post WS, Redline S, Rehm HL, Rich SS, Rotter JI, Soliman EZ, Sotoodehnia N, Lunetta KL, Ellinor PT, Lubitz SA. Monogenic and Polygenic Contributions to QTc Prolongation in the Population. Circulation 2022; 145:1524-1533. [PMID: 35389749 PMCID: PMC9117504 DOI: 10.1161/circulationaha.121.057261] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Rare sequence variation in genes underlying cardiac repolarization and common polygenic variation influence QT interval duration. However, current clinical genetic testing of individuals with unexplained QT prolongation is restricted to examination of monogenic rare variants. The recent emergence of large-scale biorepositories with sequence data enables examination of the joint contribution of rare and common variations to the QT interval in the population. METHODS We performed a genome-wide association study of the QTc in 84 630 UK Biobank participants and created a polygenic risk score (PRS). Among 26 976 participants with whole-genome sequencing and ECG data in the TOPMed (Trans-Omics for Precision Medicine) program, we identified 160 carriers of putative pathogenic rare variants in 10 genes known to be associated with the QT interval. We examined QTc associations with the PRS and with rare variants in TOPMed. RESULTS Fifty-four independent loci were identified by genome-wide association study in the UK Biobank. Twenty-one loci were novel, of which 12 were replicated in TOPMed. The PRS composed of 1 110 494 common variants was significantly associated with the QTc in TOPMed (ΔQTc/decile of PRS=1.4 ms [95% CI, 1.3 to 1.5]; P=1.1×10-196). Carriers of putative pathogenic rare variants had longer QTc than noncarriers (ΔQTc=10.9 ms [95% CI, 7.4 to 14.4]). Of individuals with QTc>480 ms, 23.7% carried either a monogenic rare variant or had a PRS in the top decile (3.4% monogenic, 21% top decile of PRS). CONCLUSIONS QTc duration in the population is influenced by both rare variants in genes underlying cardiac repolarization and polygenic risk, with a sizeable contribution from polygenic risk. Comprehensive assessment of the genetic determinants of QTc prolongation includes incorporation of both polygenic and monogenic risk.
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Affiliation(s)
- Victor Nauffal
- Division of Cardiovascular Medicine (V.N.), Brigham and Women's Hospital, Boston, MA
- Cardiovascular Disease Initiative (V.N., V.N.M., S.J.J., S.H.C., L.-C.W., J.L.H., P.T.E., S.A.L.), Broad Institute, Cambridge, MA
| | - Valerie N Morrill
- Cardiovascular Disease Initiative (V.N., V.N.M., S.J.J., S.H.C., L.-C.W., J.L.H., P.T.E., S.A.L.), Broad Institute, Cambridge, MA
| | - Sean J Jurgens
- Cardiovascular Disease Initiative (V.N., V.N.M., S.J.J., S.H.C., L.-C.W., J.L.H., P.T.E., S.A.L.), Broad Institute, Cambridge, MA
- Department of Experimental Cardiology, Amsterdam University Medical Centers, The Netherlands (S.J.J.)
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge (N.G., S.J.J., S.H.C., L.C.W., J.L.H., C.A.T., H.L.R., P.T.E., S.A.L.)
| | - Seung Hoan Choi
- Cardiovascular Disease Initiative (V.N., V.N.M., S.J.J., S.H.C., L.-C.W., J.L.H., P.T.E., S.A.L.), Broad Institute, Cambridge, MA
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge (N.G., S.J.J., S.H.C., L.C.W., J.L.H., C.A.T., H.L.R., P.T.E., S.A.L.)
| | - Amelia W Hall
- Gene Regulation Observatory (A.W.H.), Broad Institute, Cambridge, MA
| | - Lu-Chen Weng
- Cardiovascular Disease Initiative (V.N., V.N.M., S.J.J., S.H.C., L.-C.W., J.L.H., P.T.E., S.A.L.), Broad Institute, Cambridge, MA
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge (N.G., S.J.J., S.H.C., L.C.W., J.L.H., C.A.T., H.L.R., P.T.E., S.A.L.)
| | - Jennifer L Halford
- Cardiovascular Disease Initiative (V.N., V.N.M., S.J.J., S.H.C., L.-C.W., J.L.H., P.T.E., S.A.L.), Broad Institute, Cambridge, MA
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge (N.G., S.J.J., S.H.C., L.C.W., J.L.H., C.A.T., H.L.R., P.T.E., S.A.L.)
| | - Christina Austin-Tse
- Center for Genomic Medicine (C.A.-T., H.L.R.), Massachusetts General Hospital, Boston
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge (N.G., S.J.J., S.H.C., L.C.W., J.L.H., C.A.T., H.L.R., P.T.E., S.A.L.)
| | - Christopher M Haggerty
- Department of Translational Data Science and Informatics, Geisinger, Danville, PA (C.M.H., B.K.F.)
| | - Stephanie L Harris
- Cardiovascular Genetics Program (S.L.H., E.K.W.), Massachusetts General Hospital, Boston
| | - Eugene K Wong
- Cardiovascular Genetics Program (S.L.H., E.K.W.), Massachusetts General Hospital, Boston
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (A.A.)
| | - Dan E Arking
- McKusick-Nathans Institute, Department of Genetic Medicine (D.E.A.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Emelia J Benjamin
- Boston University School of Public Health, MA (E.J.B., K.L.L.)
- Boston University School of Medicine, MA (E.J.B.)
| | - Eric Boerwinkle
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston (E.B., A.C.M.)
| | - Yuan-I Min
- Department of Medicine, University of Mississippi Medical Center, Jackson (Y.-I.M., A.C.)
| | - Adolfo Correa
- Department of Medicine, University of Mississippi Medical Center, Jackson (Y.-I.M., A.C.)
| | - Brandon K Fornwalt
- Department of Translational Data Science and Informatics, Geisinger, Danville, PA (C.M.H., B.K.F.)
| | - Susan R Heckbert
- Cardiovascular Health Research Unit and Department of Epidemiology (S.R.H.)
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA (C.K.)
| | - Henry J Lin
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Lundquist Institute for Biomedical Innovation at Harbor-University of California-Los Angeles Medical Center, Torrance (H.J.L., J.I.R.)
| | - Ruth J F Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York (R.J.F.L.)
| | | | - Namrata Gupta
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge (N.G., S.J.J., S.H.C., L.C.W., J.L.H., C.A.T., H.L.R., P.T.E., S.A.L.)
| | - Thomas W Blackwell
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor (T.W.B.)
| | - Braxton D Mitchell
- Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore (B.D.M.)
| | - Alanna C Morrison
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston (E.B., A.C.M.)
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Systems and Population Health, University of Washington, Seattle, WA (B.M.P.)
| | - Wendy S Post
- Division of Cardiology, Department of Medicine (W.S.P.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Susan Redline
- Harvard Medical School (S.R.), Brigham and Women's Hospital, Boston, MA
| | - Heidi L Rehm
- Center for Genomic Medicine (C.A.-T., H.L.R.), Massachusetts General Hospital, Boston
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge (N.G., S.J.J., S.H.C., L.C.W., J.L.H., C.A.T., H.L.R., P.T.E., S.A.L.)
| | - Stephen S Rich
- Center for Public Health Genomics and Department of Public Health Sciences, University of Virginia, Charlottesville (S.S.R.)
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Lundquist Institute for Biomedical Innovation at Harbor-University of California-Los Angeles Medical Center, Torrance (H.J.L., J.I.R.)
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center, Wake Forest School of Medicine, Winston-Salem, NC (E.Z.S.)
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, Cardiology, University of Washington, Seattle, WA (N.S.)
| | | | - Patrick T Ellinor
- Cardiovascular Disease Initiative (V.N., V.N.M., S.J.J., S.H.C., L.-C.W., J.L.H., P.T.E., S.A.L.), Broad Institute, Cambridge, MA
- Cardiac Arrhythmia Service and Cardiovascular Research Center (P.T.E., S.A.L.), Massachusetts General Hospital, Boston
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge (N.G., S.J.J., S.H.C., L.C.W., J.L.H., C.A.T., H.L.R., P.T.E., S.A.L.)
| | - Steven A Lubitz
- Cardiovascular Disease Initiative (V.N., V.N.M., S.J.J., S.H.C., L.-C.W., J.L.H., P.T.E., S.A.L.), Broad Institute, Cambridge, MA
- Cardiac Arrhythmia Service and Cardiovascular Research Center (P.T.E., S.A.L.), Massachusetts General Hospital, Boston
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge (N.G., S.J.J., S.H.C., L.C.W., J.L.H., C.A.T., H.L.R., P.T.E., S.A.L.)
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Harris SL, Green JF, Tao H, Robinson PS. Examining Associations With Mental, Well-Being and Faith in Nurses (LIFT). J Nurs Adm 2021; 51:106-113. [PMID: 33449601 DOI: 10.1097/nna.0000000000000978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to explore the association between religion/spirituality (r/s) and mental health outcomes in hospital-based nursing staff. BACKGROUND The relationship between r/s and health has been studied extensively. Most frequently, r/s has been studied in association with mental health outcomes, including depression, anxiety, and distress among patients. However, hospital-based nurses suffer from the mental health effects of working in high-stress work environments. To date, little research has focused on the relationship between r/s and mental health outcomes in nurses. METHODS A cross-sectional online survey was completed by 207 nurses from 6 community hospitals. RESULTS Approximately half of the nurses sampled identified as religious, whereas nearly 75% identified as spiritual. There were significant associations between measures of r/s and mental health outcomes such as depression, anxiety, and mental well-being. CONCLUSIONS This whole-person assessment of nurses may inform future retention and engagement strategies focused on faith-based interventions.
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Affiliation(s)
- Stephanie L Harris
- Author Affiliation: Research Scientist (Ms Harris, Dr Green, and Dr Tao) and Scientific Director of Nursing, Population Health, and Academic Research (Dr Robinson), Center for Whole-Person Research AdventHealth, Orlando, Florida
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Abstract
PURPOSE OF REVIEW Thoracic aortic aneurysms (TAA) have a strong heritable basis, and identification of a genetic etiology has important implications for patients with TAA and their relatives. This review provides an overview of Mendelian causes of TAA, discusses important considerations for genetic testing, and summarizes the impact a genetic diagnosis may have on a patient's medical care. RECENT FINDINGS Thoracic aortic disease may be non-syndromic or seen as part of a genetic syndrome, such as Marfan syndrome, Loeys-Dietz syndrome, or vascular Ehlers-Danlos syndrome. Expanded access to genetic testing has revealed the wide and overlapping phenotypic spectrum of these conditions, highlighting the need for genetic testing to establish an accurate diagnosis. Important aspects of genetic evaluation include thorough phenotyping through family history and physical examination, selection of an appropriate genetic test driven by the patient's phenotype, and careful interpretation of genetic test results. Improved understanding of the natural history of these conditions has led to tailored management recommendations, including gene-based recommendations for prophylactic surgical repair. Identification of a genetic etiology allows for careful monitoring of disease progression, informs the timing of prophylactic surgical repair, and facilitates the identification of other at-risk relatives through cascade genetic testing.
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Affiliation(s)
- Stephanie L Harris
- Cardiology Division and Cardiovascular Genetics Program, Massachusetts General Hospital, Boston, MA, USA
| | - Mark E Lindsay
- Cardiology Division and Cardiovascular Genetics Program, Massachusetts General Hospital, Boston, MA, USA.
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Senter L, Austin JC, Carey M, Cho MT, Harris SL, Linnenbringer EL, MacFarlane IM, Pan VY, Quillin JM, Wynn J, Hooker GW. Advancing the genetic counseling profession through research: Identification of priorities by the National Society of Genetic Counselors research task force. J Genet Couns 2020; 29:884-887. [PMID: 32969094 DOI: 10.1002/jgc4.1330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/12/2022]
Abstract
To help advance research critical to the achievement of the National Society of Genetic Counselors' (NSGC) strategic objectives, coordination and prioritization of society resources are needed. NSGC convened a task force to advance research necessary for the achievement of our strategic objectives by reviewing existing society-supported research efforts identifying gaps in current research, and coordinating society resources, the task force was formed in order to coordinate and prioritize society resources to advance research critical to the achievement of our strategic objectives. The task force developed a research agenda outlining high-priority research questions for the next 5 years. The questions are organized into four domains: (a) Genetic Counseling Clients; (b) Genetic Counseling Process and Outcomes; (c) Value of Genetic Counseling Services; and (d) Access to Genetic Counseling Services. This framework can be used to advocate for research and funding priorities within NSGC and with other key research entities to stimulate the growth and advancement of the genetic counseling profession.
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Affiliation(s)
- Leigha Senter
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Jehannine C Austin
- Departments of Psychiatry and Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Meghan Carey
- National Society of Genetic Counselors, Chicago, Illinois, USA
| | - Megan T Cho
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Stephanie L Harris
- Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erin L Linnenbringer
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Ian M MacFarlane
- Department of Psychology, Elizabethtown College, Elizabethtown, Pennsylvania, USA
| | | | - John M Quillin
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Julia Wynn
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
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9
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Harris SL, Lubitz SA. Clinical and genetic evaluation after sudden cardiac arrest. J Cardiovasc Electrophysiol 2020; 31:570-578. [PMID: 31909521 DOI: 10.1111/jce.14333] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/27/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022]
Abstract
Sudden cardiac arrest (SCA) and sudden cardiac death (SCD) can be attributed to cardiac, respiratory, metabolic, and toxicologic etiologies. Most cases of SCD are caused by coronary artery disease and approximately 40% of cardiac arrests are unexplained. Inherited arrythmias and cardiomyopathies are important contributors to SCA and SCD. Identifying an inherited condition after such an event not only has important ramifications for the individual, but also for relatives who may be at risk for the familial condition. This review will provide an overview of inherited cardiovascular disorders than can predispose to SCA/SCD, review the diagnostic evaluation for an individual and/or family after an SCA/SCD, and discuss the role of genetic testing.
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Affiliation(s)
- Stephanie L Harris
- Cardiology Division, Cardiovascular Genetics Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Steven A Lubitz
- Cardiology Division, Cardiovascular Genetics Program, Massachusetts General Hospital, Boston, Massachusetts.,Cardiology Division, Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts.,Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
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10
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Abstract
This review identified associations between illness perception and health outcomes of patients with a medical diagnosis included in the Hospital Readmissions Reduction Program. Inclusion criteria were English language, use of quantitative methodology, health outcomes specified, and identifiable effect size and statistical significance of the relationship. Most of the 31 studies in this review showed that favorable illness perception has been associated with better health outcomes, while unfavorable illness perception has been associated with worse outcomes. A multifaceted approach might include behavioral, clinical, educational, and psychosocial components to improve one’s illness perception through educative, cognitive-behavioral, or psychodynamic counseling.
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11
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Abstract
UNLABELLED A case of extensive deep venous thrombosis in a four a day old infant was presented. Unusually this patient was shown to be heterozygous for three thrombophilia genes; Factor V Leiden, prothrombin and antithrombin gene mutations, the latter being novel. CONCLUSION There are no randomized controlled trials to guide management in deep venous thrombosis in the newborn but knowledge of the prothrombotic risk factors may help direct treatment.
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Affiliation(s)
- S L Harris
- Neonatal Unit, Christchurch Women's Hospital, Christchurch, New Zealand
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Harris SL, Johnson N, Brookes SM, Hutson AM, Fooks AR, Jones G. The application of genetic markers for EBLV surveillance in European bat species. Dev Biol (Basel) 2008; 131:347-363. [PMID: 18634497] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The United Kingdom has performed passive surveillance for European bat lyssaviruses (EBLVs) since 1987, and species-targeted surveillance since 2003. One critical component of these studies is the accurate identification of bats either submitted for testing or sampled in the field. Identification is dependent on numerous morphological characteristics. Whilst this is an effective means of bat identification, a number of problems remain with this approach. It relies on the experience of bat specialists and can lead to problems in differentiating members of the Myotis genus, particularly between Myotis mystacinus (whiskered bat) and Myotis brandtii (Brandt's bat), and between the most common species of the genus Pipistrellus. Furthermore, degradation of bats submitted for testing can also lead to problems in making an accurate species identification. Comparison of genetic sequence data could offer an alternative approach to differentiating bat species when morphological characterisation is not possible. Using tissue samples from UK resident bat species, sequence analysis of the mitochondrial DNA cytochrome b gene, and the beta-actin gene allowed for identification of many of the most common bat species in the UK, and genetic separation of two morphologically cryptic species. Application of this approach identified the species of a bat infected with EBLV-2 in Surrey as Myotis daubentoni (Daubenton's bat).
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Affiliation(s)
- S L Harris
- Rabies and Wildlife Zoonoses Group, Veterinary Laboratories Agency (VLA), WHO Collaborating Centre for the Characterisation of Rabies and Rabies-Related Viruses, Surrey, UK
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Harris SL, Mansfield K, Marston DA, Johnson N, Pajamo K, O'brien N, Black C, McElhinney LM, Fooks AR. Isolation of European bat lyssavirus type 2 from a Daubenton's bat (Myotis daubentonii
) in Shropshire. Vet Rec 2007; 161:384-6. [PMID: 17873269 DOI: 10.1136/vr.161.11.384] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- S L Harris
- Rabies and Wildlife Zoonoses Group, who Collaborating Centre for the Characterisation of Rabies and Rabies-related Viruses, Veterinary Laboratories Agency - Weybridge, New Haw, Addlestone, Surrey
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Abstract
Passive surveillance for European bat lyssaviruses (eblvs) in the uk began in 1987, and between 1987 and 2004, 4,883 bats of European origin (4,871 belonging to 17 UK resident species and 12 belonging to seven non-uk resident species) were tested. The proportions and numbers of each species submitted from different regions varied considerably, partly owing to inherent biases in the passive surveillance, and there were seasonal variations in the numbers, sex and age of the bats. Contact with cats was reported in approximately 30 per cent of the bats submitted. Daubenton's bat (Myotis daubentonii) was the only species found to be positive for lyssavirus infection, with four cases of eblv type 2 identified, in 1996, 2002, 2003 and 2004. No active infection with eblv type 1 was recorded.
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Affiliation(s)
- S L Harris
- School of Biological Sciences, University of Bristol, Woodland Road, Bristol BS8 1UG
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Smith GC, Brookes SM, Harris SL, Aegerter JN, Jones G, Fooks AR. EBLV-2 prevalence in the United Kingdom as determined by surveillance testing. Dev Biol (Basel) 2006; 125:265-71. [PMID: 16878484] [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] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Five cases of EBLV-2 have been detected in the UK since 1996, with all wildlife cases in the Daubenton's bat: one on the south coast in Sussex in 1996, one in Lancashire in 2002, another in 2003, one in Surrey in 2004 and a human fatality in Angus, Scotland, in 2002. As a result of the human case, a seroprevalence study, aimed primarily at the Daubenton's bat was conducted in 2003 in Scotland and at some sites in England. In Scotland, 198 Daubenton's, 20 Natterer's and 6 pipistrelles were caught at 19 sites and analysed, while in England 67 Daubenton, 2 Brandts/ Whiskered and 4 pipistrelle bats were analysed from four sites in Lancashire. Analysis of blood was performed by a modified fluorescent antibody virus neutralisation test (mFAVN) to determine antibody titre to EBLV-2. Ignoring those sites where we had a priori reason to expect infected bats, the overall seroprevalence was between 0.7-5.1 % (95 % confidence interval), with a maximum likelihood estimate of 2.2 %. Mouth swabs were taken and tested for virus genome by RT-PCR and live virus by tissue culture isolation. All of the PCR and isolation results were negative suggesting that none of the bats sampled were actively excreting virus. This suggests a low level of active infection in Britain and raises the possibility that bats may recover following exposure to EBLV-2.
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Affiliation(s)
- G C Smith
- Central Science Laboratory, York, UK.
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Gallimore MJ, Harris SL, Tappenden KA, Winter M, Jones DW. Urokinase induced fibrinolysis in thromboelastography: a model for studying fibrinolysis and coagulation in whole blood. J Thromb Haemost 2005; 3:2506-13. [PMID: 16241949 DOI: 10.1111/j.1538-7836.2005.01615.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The contact system (CS) proteins, factor XII and prekallikrein are thought to have roles in blood coagulation and fibrinolysis. Recent research has suggested that the CS proteins might be more important in fibrinolysis and cell function than in coagulation. Most studies on fibrinolysis have used plasma or euglobulin assays, ignoring the influence of cellular elements of blood on the fibrinolytic process. OBJECTIVE AND METHODS In order to study both coagulation and fibrinolysis in whole blood (WB), we have developed a thromboelastography (TEG) assay to investigate both coagulation and fibrinolysis in the same blood sample. In this assay, named urokinase (UK) induced fibrinolysis in thromboelastography (UKIFTEG), TEG is performed on recalcified citrated WB in the presence of UK. Large variations in Ly60 (percentage lysis 60 min after clot formation) were obtained between different donors with the same UK concentration. The UKIFTEG assay was therefore performed using UK concentrations that gave Ly60 values in the approximate range of 20-40%. RESULTS The effect of CS activation was investigated in the presence or absence of celite (10 mg mL(-1) blood). Celite shortened the clotting time (CT), and increased Ly60 values. Factor XIIa (FXIIa) and plasma kallikrein (KK) produced concentration dependent reductions in CT (significant at concentrations of 1303 and 2600 ng mL(-1) blood, respectively) and increased Ly60 values (significant at concentrations of 652 and 1300 ng mL(-1) blood, respectively). CONCLUSIONS Our results show that CS activation and both FXIIa and KK produce reductions in clotting time and enhanced fibrinolysis in UKIFTEG.
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Affiliation(s)
- M J Gallimore
- Kent Haemophilia Centre, Kent and Canterbury Hospital, Canterbury, Kent, UK.
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Harris SL, Jones DW, Gallimore MJ, Nicholls PJ, Winter M. The antigenic binding site(s) of antibodies to factor XII associated with the antiphospholipid syndrome. J Thromb Haemost 2005; 3:969-75. [PMID: 15869593 DOI: 10.1111/j.1538-7836.2005.01334.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Phospholipid binding proteins, including factor XII (FXII), are known to be targeted by antiphospholipid antibodies (aPA). Factor XII antibodies (FXIIab) have been described in some patients with the antiphospholipid syndrome (APS) and have been shown to lead to reduced levels of FXII. The antigenic binding site(s) and the pathophysiological effects of FXIIab are unknown. In an attempt to elucidate the binding site of these antibodies, immobilized plasma kallikrein was used to cleave FXII into its 52-kDa heavy-chain (HCFXII) and 28-kDa light-chain (LCFXII) components. Plasma samples from 12 female patients with definite APS and FXIIab were investigated for the presence of antibodies to FXII, HCFXII and LCFXII. All but one patient's plasma reacted to FXII, HCFXII and LCFXII in a similar manner. One patient gave markedly reduced positivity to HCFXII and LCFXII, suggesting that the FXIIab in this patient had a higher affinity for the intact FXII molecule. To further investigate the antigenic binding site(s) of FXII, 150 biotinylated peptides of the known FXII sequence were synthesized using a Multipin(TM) peptide synthesis procedure. The IgG and IgM fractions of the 12 patients' plasma were purified by affinity chromatography. The synthesized peptides were captured on streptavidin plates and individual patients' purified FXIIab assayed against the peptides in a modified enzyme-linked immunosorbent assay (ELISA). Two regions were identified as possible antigenic binding site(s) for FXIIab: one in the growth factor domain and the other in the catalytic domain.
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Affiliation(s)
- S L Harris
- Kent Haemophilia Centre, Kent and Canterbury Hospital, Canterbury, Kent, UK.
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Harris SL, Gil G, Hu W, Robins H, Bond E, Hirshfield K, Feng Z, Yu X, Teresky AK, Bond G, Levine AJ. Single-nucleotide polymorphisms in the p53 pathway. Cold Spring Harb Symp Quant Biol 2005; 70:111-9. [PMID: 16869744 DOI: 10.1101/sqb.2005.70.024] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
A cell culture assay has been developed that detects and validates single-nucleotide polymorphisms (SNPs) in genes that populate the p53 pathway. One hundred thirteen EBV-transformed human B-lymphocyte cell lines obtained from a diverse population were employed to measure the apoptotic response to gamma radiation. Each cell line undergoes a reproducible, characteristic frequency of apoptosis, and the response of the population forms a normal distribution around a median of 35.5% apoptosis with a range from 12% to 58% apoptosis. Polymorphisms in the AKT1 and Perp genes significantly affect the frequency of apoptosis. The assay can detect both racial and sexual dimorphisms in these genes and has the ability to demonstrate epistatic relationships within the p53 pathway. The cell lines used in this assay provide biological materials to explore the molecular basis of the polymorphisms.
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Affiliation(s)
- S L Harris
- The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, 08903, USA
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Abstract
The treatment of social skills deficits remains one of the most challenging areas in meeting the needs of people with autism. Difficulties in understanding social stimuli, in initiating and responding to social bids, and in appreciating the affect that is intrinsic to social interactions can be baffling for people with autism. Researchers and practitioners of applied behavior analysis have tried a variety of strategies for teaching social skills. This article examines a range of useful procedures for teaching social skills to people with autism, including skills that are adult mediated, peer mediated, and child-with-autism mediated. The authors also consider the potential of classwide interventions in inclusive settings, pivotal response training, and the use of scripts to teach social initiations.
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Affiliation(s)
- M J Weiss
- Rutgers, State University of New Jersey, USA
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Harris SL, Spears PA, Havell EA, Hamrick TS, Horton JR, Orndorff PE. Characterization of Escherichia coli type 1 pilus mutants with altered binding specificities. J Bacteriol 2001; 183:4099-102. [PMID: 11395476 PMCID: PMC95295 DOI: 10.1128/jb.183.13.4099-4102.2001] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PCR mutagenesis and a unique enrichment scheme were used to obtain two mutants, each with a single lesion in fimH, the chromosomal gene that encodes the adhesin protein (FimH) of Escherichia coli type 1 pili. These mutants were noteworthy in part because both were altered in the normal range of cell types bound by FimH. One mutation altered an amino acid at a site previously shown to be involved in temperature-dependent binding, and the other altered an amino acid lining the predicted FimH binding pocket.
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Affiliation(s)
- S L Harris
- Department of Microbiology, Pathology, and Parasitology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina 27606, USA
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Abstract
Even in the age of antibiotics, Streptococcus pneumoniae causes significant morbidity, especially in the young, the elderly, and the immunocompromised. While a carbohydrate-based vaccine exists, it is poorly immunogenic in the at-risk populations. In mice, antibodies directed against phosphorylcholine (PC), an epitope present on the cell wall C polysaccharide of all pneumococcal serotypes, protect against infection. However, PC itself is a poor vaccine candidate. We report here peptide mimics of PC based on the anti-idiotypic interaction of T15 anti-PC antibodies. T15 antibodies, the dominant and protective idiotype induced in mice by PC immunization, self-associate via a 24-amino-acid region in the PC binding site (ASRNKANDYTTEYSASVKGRFIVS; peptide 1). Peptide 1 has been shown to bind in the PC binding site. We demonstrated that amino acid sequences derived from peptide 1 starting at amino acid 9, 11, or 13 inhibit PC binding. Therefore, we immunized mice with bovine serum albumin (BSA) conjugates of peptide 1 or either of two selected 12-mers. The 12-mer peptides were not immunogenic. Mice immunized with peptide 1-BSA developed an anti-PC response consisting mainly immunoglobulin G1 and expressed the T15 heavy chain. Nonetheless, neither BALB/c nor CBA/N mice were protected from lethal pneumococcal infections by immunization with peptide 1-BSA. Preliminary data suggest that peptide 1-BSA is not able to elicit the canonical T15 light chain, explaining the absence of protection. This idiotype-derived mimotope of PC is a useful tool for understanding immunologic cross-reactivity and learning to design T-cell-dependent vaccines for S. pneumoniae.
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Affiliation(s)
- S L Harris
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York 10461, USA
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Jones DW, Gallimore MJ, MacKie IJ, Harris SL, Winter M. Reduced factor XII levels in patients with the antiphospholipid syndrome are associated with antibodies to factor XII. Br J Haematol 2000; 110:721-6. [PMID: 10997986 DOI: 10.1046/j.1365-2141.2000.02251.x] [Citation(s) in RCA: 50] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Antibodies to factor XII (FXII) have previously been identified in some patients who were lupus anti-coagulant-positive. The relationship between these antibodies and FXII levels appeared to be variable. The aim of the present study was to confirm the presence of antibodies to FXII in patients with well characterized antiphospholipid syndrome (APS) and to establish their potential effect on levels of FXII. Forty-two patients with APS were studied; 21 patients were found to have either immunoglobulin (Ig)G or IgM antibodies to FXII by enzyme-linked immunosorbent assay (ELISA) using a highly purified preparation of FXII (> 99% pure). Levels of FXII were statistically significantly lower (P = 0.02) in patients with antibodies to FXII when compared with patients without antibodies to FXII (median = 91 micro/dl, s.d. = 39.1, median = 122 micro/dl, s.d. = 41.1 respectively). Four of the 21 patients with antibodies to FXII were found to have FXII levels below the laboratory normal range. Antibodies to FXII are present in significant numbers of patients with APS and may lead to acquired FXII deficiency.
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Affiliation(s)
- D W Jones
- Kent Haemophilia Centre, Kent and Canterbury Hospital, Canterbury, Kent, United Kingdom.
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25
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Crockett DP, Harris SL, Egger MD. Neurotrophin receptor (p75) in the trigeminal thalamus of the rat: development, response to injury, transient vibrissa-related patterning, and retrograde transport. Anat Rec 2000; 259:446-60. [PMID: 10903536 DOI: 10.1002/1097-0185(20000801)259:4<446::aid-ar80>3.0.co;2-9] [Citation(s) in RCA: 8] [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: 01/07/2023]
Abstract
We report on the transient, patterned expression of p75 in the ventrobasal (VB) thalamus, the major thalamic relay for somatosensation. We immunostained the brains of developing rats ranging in age from embryonic day (E) 14.5 to postnatal day (PD) 15 with an antibody against p75. To compare p75 expression with the developing synaptic organization within VB, we also immunolocalized the synaptic-vesicle-associated protein, synaptophysin (SYN), on alternate sections. p75-immunoreactivity (IR) was dense and uniform in the ventroposterior medial nucleus (VPM) in the late embryonic and early postnatal periods (E 16.5 to PD 3). In contrast, from PD 4-10, p75-IR in the VPM was patterned, reminiscent of cytochrome-oxidase-stained barreloids, a characteristic feature of the VB in rodents. By PD 14, p75-IR in the VPM was no longer detectable. The ventroposterior lateral nucleus (VPL), in contrast, exhibited no p75-IR. No p75-IR was detected in the ventroposterior lateral nucleus (VPL) at any developmental stage in which VPM could be distinguished from VPL. Light, but clearly patterned SYN-IR, first detectable on PD 2-3, increased in intensity in both VPL and VPM through PD 15. Sectioning the infraorbital nerve on PD 0 resulted in blurred patterns of p75- and SYN-IR within VPM in PD 7-9 rat pups. Removing large portions of the somatosensory cortex on PD 0 resulted in subsequent greatly reduced p75- and SYN-IR within VB. To specify the source of the p75-IR terminals, we stereotaxically injected into the VPM of PD 4-5 rats a monoclonal antibody to p75. One to 2 days later, IR of retrogradely transported p75 antibodies could be traced within axons and cell bodies of neurons associated with the trigeminothalamic pathway through the caudal diencephalon and mesencephalon; labelling was confined to the contralateral trigeminal principal sensory nucleus. The observed, transiently patterned p75-IR in VPM the early postpartum period suggests a role for p75 in synaptogenesis and pattern formation.
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Affiliation(s)
- D P Crockett
- Department of Neuroscience and Cell Biology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway, New Jersey 08854-5635, USA.
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Hamrick TS, Harris SL, Spears PA, Havell EA, Horton JR, Russell PW, Orndorff PE. Genetic characterization of Escherichia coli type 1 pilus adhesin mutants and identification of a novel binding phenotype. J Bacteriol 2000; 182:4012-21. [PMID: 10869080 PMCID: PMC94587 DOI: 10.1128/jb.182.14.4012-4021.2000] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Five Escherichia coli type 1 pilus mutants that had point mutations in fimH, the gene encoding the type 1 pilus adhesin FimH, were characterized. FimH is a minor component of type 1 pili that is required for the pili to bind and agglutinate guinea pig erythrocytes in a mannose-inhibitable manner. Point mutations were located by DNA sequencing and deletion mapping. All mutations mapped within the signal sequence or in the first 28% of the predicted mature protein. All mutations were missense mutations except for one, a frameshift lesion that was predicted to cause the loss of approximately 60% of the mature FimH protein. Bacterial agglutination tests with polyclonal antiserum raised to a LacZ-FimH fusion protein failed to confirm that parental amounts of FimH cross-reacting material were expressed in four of the five mutants. The remaining mutant, a temperature-sensitive (ts) fimH mutant that agglutinated guinea pig erythrocytes after growth at 31 degrees C but not at 42 degrees C, reacted with antiserum at both temperatures in a manner similar to the parent. Consequently, this mutant was chosen for further study. Temperature shift experiments revealed that new FimH biosynthesis was required for the phenotypic change. Guinea pig erythrocyte and mouse macrophage binding experiments using the ts mutant grown at the restrictive and permissive temperatures revealed that whereas erythrocyte binding was reduced to a level comparable to that of a fimH insertion mutant at the restrictive temperature, mouse peritoneal macrophages were bound with parental efficiency at both the permissive and restrictive temperatures. Also, macrophage binding by the ts mutant was insensitive to mannose inhibition after growth at 42 degrees C but sensitive after growth at 31 degrees C. The ts mutant thus binds macrophages with one receptor specificity at 31 degrees C and another at 42 degrees C.
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Affiliation(s)
- T S Hamrick
- Department of Microbiology, Pathology and Parasitology, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA
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Abstract
The predictive power of age and IQ at time of admission to an intensive treatment program using applied behavior analysis were examined in a 4- to 6-year follow-up of educational placement. Twenty-seven children with autistic disorder who were between the ages of 31 and 65 months and had IQs on the Stanford Binet between 35 and 109 at time of admission to the Douglass Developmental Disabilities Center were followed up 4 to 6 years after they left the preschool. The results showed that having a higher IQ at intake (M = 78) and being of younger age (M = 42 months) were both predictive of being in a regular education class after discharge, whereas having a lower IQ (M = 46) and being older at intake (M = 54 months) were closely related to placement in a special education classroom. The results are interpreted as pointing to the need for very early intervention for children with Autistic Disorder. It is also emphasized that older children and those with lower IQs in the present study showed measurable gains in IQ from treatment. The data should not be taken to suggest that children older than 4 years of age do not merit high quality treatment.
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Affiliation(s)
- S L Harris
- Rutgers, The State University of New Jersey, Piscataway 08854-8085, USA.
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Pitner JB, Beyer WF, Venetta TM, Nycz C, Mitchell MJ, Harris SL, Mariño-Albernas JR, Auzanneau FI, Forooghian F, Pinto BM. Bivalency and epitope specificity of a high-affinity IgG3 monoclonal antibody to the Streptococcus group A carbohydrate antigen. Molecular modeling of a Fv fragment. Carbohydr Res 2000; 324:17-29. [PMID: 10723608 DOI: 10.1016/s0008-6215(99)00279-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The binding of Strep 9, a mouse monoclonal antibody (mAb) of the IgG3 subclass directed against the cell-wall polysaccharide of Group A Streptococcus (GAS), has been characterized. The intact antibody and proteolytic fragments of Strep 9 bind differently to GAS: the intact mAb and F(ab)2' have greater affinity for the carbohydrate epitope than the monomeric Fab or F(ab)'. A mode of binding in which Strep 9 binds bivalently to portions of the polysaccharide on adjacent chains on GAS is proposed. A competitive ELISA protocol using a panel of carbohydrate inhibitors shows that the branched trisaccharide, beta-D-GlcpNAc-(1-->3)-[alpha-L-Rhap-(1-->2)]-alpha-L-Rhap, and an extended surface are key components of the epitope recognized by Strep 9. Microcalorimetry measurements with the mAb and two synthetic haptens, a tetrasaccharide and a hexasaccharide, show enthalpy-entropy compensation as seen in other oligosaccharide-protein interactions. Molecular modeling of the antibody variable region by homology modeling techniques indicates a groove-shaped combining site that can readily accommodate extended surfaces. Visual docking of an oligosaccharide corresponding to the cell-wall polysaccharide into the site provides a putative model for the complex, in which a heptasaccharide unit occupies the site and the GlcpNAc residues of two adjacent branched trisaccharide units occupy binding pockets within the groove-shaped binding site.
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Affiliation(s)
- J B Pitner
- Becton Dickinson Research Center, Research Triangle Park, NC 27709, USA
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Anderson CA, Sandberg E, Filley CM, Harris SL, Tyler KL. One and one-half syndrome with supranuclear facial weakness: magnetic resonance imaging localization. Arch Neurol 1999; 56:1509-11. [PMID: 10593308 DOI: 10.1001/archneur.56.12.1509] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To provide clinicoanatomical correlation for a small pontine tegmental ischemic stroke producing the one and one-half syndrome associated with supranuclear facial weakness. DESIGN Case report. SETTING Tertiary care center. PATIENT A 70-year-old man developed left-sided facial weakness sparing the forehead, a left internuclear ophthalmoplegia, and a complete left horizontal gaze palsy immediately after percutaneous transluminal coronary angioplasty. Magnetic resonance imaging demonstrated a small lesion in the left paramedian aspect of the dorsal pontine tegmentum. MAIN OUTCOME AND RESULTS Electromyographic findings were consistent with supranuclear facial involvement. The patient had nearly complete recovery after 1 year. CONCLUSIONS To our knowledge, this is the first report of supranuclear facial weakness in association with the one and one-half syndrome. The location of the lesion provides evidence of the existence of corticofugal fibers that extend to the facial nucleus in the dorsal paramedian pontine tegmentum.
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Affiliation(s)
- C A Anderson
- Department of Neurology, University of Colorado School of Medicine, and the Denver Veterans Affairs Medical Center, 80262, USA
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Jones DW, Gallimore MJ, Harris SL, Winter M. Antibodies to factor XII associated with lupus anticoagulant. Thromb Haemost 1999; 81:387-90. [PMID: 10102466] [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: 02/11/2023]
Abstract
Falsely low levels of factor XII (FXII) have been documented in patients who are lupus anticoagulant positive (LA+). In addition, we have previously noted a surprisingly high incidence (20.9%) of apparently true FXII deficiency in patients who were LA+. We have hypothesised that this may be partly due to the presence of antibodies to FXII. The aim of the present study was to investigate whether LA+ patient plasmas contain antibodies directed either against FXII or FXII in association with phospholipids. Plasma samples from 60 blood donors, all LA negative, and 51 LA+ patients were tested using ELISA assays employing purified FXII, phosphatidylserine (PS) and phosphatidylethanolamine (PE). We have identified seven patients whose plasma contained either IgG or IgM that reacted with purified FXII in the absence of PS or PE. When PS was included in the assay system four additional patient plasmas were shown to contain either IgG or IgM that reacted with FXII. The plasma of one patient contained IgG that reacted with FXII both in the presence and absence of PS. There was no reactivity to FXII with either IgG or IgM when PE was included in the assay system. Affinity purified IgG from three patients whose plasma reacted with FXII in the ELISA assay in the absence of PS, gave a positive reaction in an immunoblot assay. These results suggest that FXII antibodies are present in a significant proportion of LA+ patients and may lead to an erroneous diagnosis of FXII deficiency.
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Affiliation(s)
- D W Jones
- Kent Haemophilia Centre, Canterbury Hospitals NHS Trust, United Kingdom.
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Harris SL, Auldist MJ, Clark DA, Jansen EB. Effects of white clover content in the diet on herbage intake, milk production and milk composition of New Zealand dairy cows housed indoors. J DAIRY RES 1998; 65:389-400. [PMID: 9718492 DOI: 10.1017/s0022029998002969] [Citation(s) in RCA: 41] [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: 11/07/2022]
Abstract
The effect of the proportion of clover in the diet (200, 500 or 800 g/kg total dry matter (DM) on milk production of cows housed indoors and fed on a mixture of perennial rye-grass and white clover was measured in mid (Expt I) and late (Expt II) lactation. Higher clover contents increased the nutritive value of the diets, resulting in increased energy and protein intakes. DM intakes of cows offered 500 or 800 g clover/kg DM diets ad lib. (Expt I and Expt II, Period 1) were not significantly different but were 11-17% greater (P < 0.05) than intakes of cows fed on 200 g clover/kg total DM diets. Cows offered restricted allowances (Expt II, Period 2) had similar intakes irrespective of diet. In Expt I cows fed on 500 or 800 g clover/kg DM diets ad lib. produced 30 or 33% respectively more milk (P < 0.05) than cows fed on 200 g clover/kg total DM diets. During Expt II, Period 1, cows fed on 500 or 800 g clover/kg DM diets ad lib. produced 18 or 16% more milk (P < 0.05) respectively than cows given 200 g clover/kg total DM diets. In both these experiments the increased milk yields were due to increased intake and the higher nutritive value of the high clover diets. There was no difference in the feed conversion efficiencies of cows if maintenance energy requirements were taken into account. However, cows on restricted allowances (Expt II, Period 2) showed no significant difference in milk yield, indicating that the effect of increased nutritive value was very slight. There were no consistent effects on milk fat, protein or lactose concentrations. Concentrations of blood and milk urea increased as the clover content of the diet increased (Expt 1 only), and this was associated with increased milk non-protein N and a decreased ratio of casein N: total N. Both trials indicated an optimum clover content in the diet for milk production of 600-700 g/kg total DM.
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Affiliation(s)
- S L Harris
- Dairying Research Corporation Ltd, Hamilton, New Zealand
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Smith MB, Bergmann JS, Harris SL, Woods GL. Evaluation of the Roche AMPLICOR MTB assay for the detection of Mycobacterium tuberculosis in sputum specimens from prison inmates. Diagn Microbiol Infect Dis 1997; 27:113-6. [PMID: 9154406 DOI: 10.1016/s0732-8893(97)00029-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The reliability of the Roche Mycobacterium tuberculosis polymerase chain reaction (PCR) assay (AMPLICOR MTB) for the diagnosis of pulmonary tuberculosis was evaluated by testing expectorated sputum specimens from 187 inmates in Texas state prisons and comparing the results to culture and medical history. Of the 80 specimens that were culture positive for mycobacteria, 36 specimens from 16 patients grew M. tuberculosis. Forty-six specimens were smear positive for acid-fast bacilli (AFB), and of these, M. tuberculosis was isolated from 24. On initial testing, 52 specimens were PCR positive. Thirty-one of these 52 were culture positive for M. tuberculosis, and 21 were culture negative, resulting in a PCR sensitivity and specificity of 86.1 and 96.1%, respectively. After resolving discrepancies by review of the medical history and repeat testing, PCR sensitivity, specificity, and positive and negative predictive values, respectively, were 92.8, 99.8, 98.1, and 99.2%. For AFB smear-positive specimens, the sensitivity, specificity, and positive and negative predictive values, were 95.8, 100, 100, and 93.3, respectively; whereas, for AFB smear-negative specimens, these values were 87.5, 99.7, 95.5, and 99.4%, respectively. These results confirm the reliability of the AMPLICOR MTB assay for direct detection of M. tuberculosis in AFB smear-positive sputum specimens and suggest a potential role in evaluating AFB smear-negative sputum specimens.
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Affiliation(s)
- M B Smith
- Department of Pathology, University of Texas Medical Branch, Galveston 77555-0740, USA
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Harris SL, Craig L, Mehroke JS, Rashed M, Zwick MB, Kenar K, Toone EJ, Greenspan N, Auzanneau FI, Marino-Albernas JR, Pinto BM, Scott JK. Exploring the basis of peptide-carbohydrate crossreactivity: evidence for discrimination by peptides between closely related anti-carbohydrate antibodies. Proc Natl Acad Sci U S A 1997; 94:2454-9. [PMID: 9122216 PMCID: PMC20109 DOI: 10.1073/pnas.94.6.2454] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
To investigate the molecular basis of antigenic mimicry by peptides, we studied a panel of closely related mAbs directed against the cell-wall polysaccharide of group A Streptococcus. These antibodies have restricted V-gene usage, indicating a shared mechanism of binding to a single epitope. Epitope mapping studies using synthetic fragments of the cell-wall polysaccharide supported this conclusion. All of the mAbs isolated crossreactive peptides from a panel of phage-displayed libraries, and competition studies indicated that many of the peptides bind at or near the carbohydrate binding site. Surprisingly, the peptides isolated by each mAb fell into distinct consensus-sequence groups that discriminated between the mAbs, and in general, the peptides bound only to the mAbs used for their isolation. Similar results were obtained with polyclonal antibodies directed against synthetic oligosaccharide fragments of the streptococcal cell-wall polysaccharide. Thus, the peptides appear to be specific for their isolating antibodies and are not recognized by the same mechanism as their carbohydrate counterparts.
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Affiliation(s)
- S L Harris
- Institute of Molecular Biology and Biochemistry, Department of Chemistry, Simon Fraser University, Burnaby, BC, Canada
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Celiberti DA, Bobo HE, Kelly KS, Harris SL, Handleman JS. The differential and temporal effects of antecedent exercise on the self-stimulatory behavior of a child with autism. Res Dev Disabil 1997; 18:139-150. [PMID: 9172282 DOI: 10.1016/s0891-4222(96)00032-7] [Citation(s) in RCA: 42] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The effects of two levels of exercise (walking versus jogging) in suppressing the self-stimulatory behavior of a five-year-old boy with autism were examined. The exercise conditions were applied immediately before periods of academic programming. Maladaptive self-stimulatory behaviors were separately tracked, enabling identification of behaviors that were more susceptible to change (e.g., physical self-stimulation and "out of seat" behavior) versus those that were more resistant (e.g., visual self-stimulation). Examination of temporal effects indicated a decrease in physical self-stimulation and "out of seat" behavior, but only for the jogging condition. In addition, sharp reductions in these behaviors were observed immediately following the jogging intervention and gradually increased but did not return to baseline levels over a 40 min period. Implications for further research and clinical intervention are discussed.
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Affiliation(s)
- D A Celiberti
- Douglass Developmental Disabilities Center, Gibbons Cabin Douglass College, New Brunswick, NJ 08903-0270, USA
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Abstract
In 1994 a Texas prison containing a population of mentally retarded inmates experienced a large tuberculosis outbreak. Fifteen cases of tuberculosis were identified (8 confirmed by positive cultures for Mycobacterium tuberculosis) and more than 100 inmates became infected. The culture-confirmed patients were infected with an identical strain of tuberculosis as demonstrated by polymerase chain reaction (PCR) based DNA fingerprinting technique. The prison followed standard tuberculosis infection control policies, but these controls were inadequate to prevent tuberculosis transmission in this special population. Two hundred and thirty inmates (119 inmates showing evidence of new tuberculosis infection or active disease and 111 healthy controls) were enrolled in the investigation. Inmate cell assignments, job duties, and educational classes were identified and medical chart reviews were conducted on all inmates. Tuberculosis transmission was associated with residing on the D Wing of the prison (OR = 25.84, P < 0.01), attending school in Classroom A (OR = 8.34, P = 0.01) and working on the prison utility work crew (OR = 2.52, P < 0.01). The index case in the outbreak had been prescribed 6 months of isoniazid (INH) chemoprophylaxis in 1988.
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Affiliation(s)
- D Bergmire-Sweat
- Infectious Disease Epidemiology and Surveillance Division, Texas Department of Health, Austin 78756, USA
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Abstract
To analyze the mechanism of integral membrane protein localization in the early Golgi apparatus of Saccharomyces cerevisiae, we have used Och1p, a cis-Golgi mannosyltransferase. A series of influenza virus hemagglutinin (HA) epitope-tagged fusion proteins was constructed in which invertase is appended to the Golgi-luminal carboxy terminus of full-length Och1p. Several constructs included a Kex2p cleavage site between the Och1p and invertase moieties to monitor transit to the Kex2p-containing TGN. Cells expressing an Och1p-invertase fusion do not secrete invertase, but those expressing an Och1p-Kex2p site-invertase fusion protein secrete high levels of invertase in a Kex2p-dependent manner. The Och1p-Kex2p site-invertase fusion protein is cleaved with a half-time of 5 min, and the process proceeds to completion. Before cleavage the protein receives glycosyl modifications indicative of passage through the medial- and trans-Golgi, therefore cleavage occurs after ordered anterograde transport through the Golgi to the TGN. Transit to distal compartments is not induced by the invertase moiety, since noninvertase fusion constructs encounter the same glycosyltransferases and Kex2p as well. The Och1p-HA moiety, irrespective of whether it is generated by cleavage of the fusion protein in the TGN or synthesized de novo, is degraded with a half-time of about 60 min. Thus, the half-time of degradation is 12-fold longer than the time required to reach the TGN. At steady state, de novo-synthesized and TGN-generated HA epitope-tagged Och1p reside in a compartment with a buoyant density identical to that of wild-type Och1p and distinct from that of the vacuole or the TGN. Finally, och1 null cells that express an Ochlp fusion construct known to rapidly encounter the TGN glycosylate invertase to the same extent as wild-type cells, indicating that they have phenotypically wild-type Och1p activity. These results lead us to propose a model for Och1p-HA localization that involves movement to distal compartments, at least as far as the TGN, followed by retrieval to the cis compartment, presumably by vesicular transport.
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Affiliation(s)
- S L Harris
- Department of Molecular Biology, Princeton University, New Jersey 08544, USA
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Weimar T, Harris SL, Pitner JB, Bock K, Pinto BM. Transferred nuclear Overhauser enhancement experiments show that the monoclonal antibody strep 9 selects a local minimum conformation of a Streptococcus group A trisaccharide-hapten. Biochemistry 1995; 34:13672-81. [PMID: 7577958 DOI: 10.1021/bi00041a049] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Transferred nuclear Overhauser enhancement (TRNOE) experiments have been performed to investigate the bound conformation of the trisaccharide repeating unit of the Streptococcus Group A cell-wall polysaccharide. Thus, the conformations of propyl 3-O-(2-acetamido-2-deoxy-beta-D-glucopyranosyl)-2-O-(alpha-L-rhamnopyran osyl)- alpha-L-rhamnopyranoside [C(A')B] (1) as a free ligand and when complexed to the monoclonal antibody Strep 9 were examined. Improved insights about the conformational preferences of the glycosidic linkages of the trisaccharide ligand showed that the free ligand populates various conformations in aqueous solution, thus displaying relatively flexible behavior. The NOE HNAc-H2A', which was not detected in previous work, accounts for a conformation at the beta-(1-->3) linkage with a phi angle of approximately 180 degrees. Observed TRNOEs for the complex are weak, and their analysis was further complicated by spin diffusion. With the use of transferred rotating-frame Overhauser enhancement (TRROE) experiments, the amount of spin diffusion was assessed experimentally, proving that all of the observed long-range TRNOEs arose through spin diffusion. Four interglycosidic distances, derived from the remaining TRNOEs and TRROEs, together with repulsive constraints, derived from the absence of TRROE effects, were used as input parameters in simulated annealing and molecular mechanics calculations to determine the bound conformation of the trisaccharide. Complexation by the antibody results in the selection of one defined conformation of the carbohydrate hapten. This bound conformation, which is a local energy minimum on the energy maps calculated for the trisaccharide ligand, shows only a change from a +gauche to a -gauche orientation at the psi angle of the alpha-(1-->2) linkage when compared to the global minimum conformation. The results infer that the bound conformation of the Streptococcus Group A cell-wall polysaccharide is different from its previously proposed solution structure (Kreis et al., 1995).
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Affiliation(s)
- T Weimar
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia, Canada
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Harryman DT, Sidles JA, Harris SL, Lippitt SB, Matsen FA. The effect of articular conformity and the size of the humeral head component on laxity and motion after glenohumeral arthroplasty. A study in cadavera. J Bone Joint Surg Am 1995; 77:555-63. [PMID: 7713972 DOI: 10.2106/00004623-199504000-00008] [Citation(s) in RCA: 139] [Impact Index Per Article: 4.8] [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: 02/01/2023]
Abstract
We used a cadaveric model to examine the mechanical effects of changes in the conformity of the articular surfaces and the size of the humeral head component in glenohumeral arthroplasty. The experimental system permitted a manual clinical examination of the glenohumeral joint while sensors monitored the humeroscapular position and orientation as well as the forces and torques applied by the examiner. Four preparations were compared: an anatomical humeroscapular preparation and three glenohumeral arthroplasty preparations (one with anatomically sized components and a radius of curvature of the glenoid that was four millimeters larger than that of the humeral head, one with anatomically sized components and a radius of curvature of the glenoid that was equal to that of the humeral head, and one with a non-anatomical, large humeral head component and a radius of curvature of the glenoid that was equal to that of the humeral head). All motions, including flexion, external and internal rotation, and maximum elevation, were diminished with use of the non-anatomical, large humeral head component. Laxity of the joint on drawer and sulcus tests was not affected by the conformity of the articular surfaces but was decreased significantly by implantation of the large humeral head component. The kinematics of the glenohumeral joint were not markedly altered by reduction of the uniformity between the articular surfaces of the prosthetic components. In all preparations, obligate displacement of the humeral head associated with a passive range of motion occurred at smaller angles with the large humeral head component.
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Affiliation(s)
- D T Harryman
- Department of Orthopaedics, School of Medicine, University of Washington, Seattle 98195, USA
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Gartland FA, Harris SL. Quality improvement in the operating room. The University of Chicago Hospitals' experience. QRC Advis 1995; 11:1, 4-6. [PMID: 10140911] [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] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Abstract
A time delay procedure was used to teach 3 children with autism to ask the question "What's that?" when novel stimuli were presented during an instructional task. Once the ability to ask the question was acquired, the children's ability to learn novel information by asking the question was assessed. The children were then taught to ask the question within a less structured context. All three studies used a multiple baseline across participants. Generalization was assessed in a different room, to a new person, and to novel stimuli. All of the children learned to ask the question within the instructional context, while on a walk in the school building, and to request information about three-dimensional objects. The acquisition of novel information was consistent for receptive and expressive tests for 2 of the children, with varied results for the 3rd. These studies indicate that children with autism can be taught to ask questions that lead to the acquisition of new information.
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Harris SL, Na S, Zhu X, Seto-Young D, Perlin DS, Teem JH, Haber JE. Dominant lethal mutations in the plasma membrane H(+)-ATPase gene of Saccharomyces cerevisiae. Proc Natl Acad Sci U S A 1994; 91:10531-5. [PMID: 7937988 PMCID: PMC45055 DOI: 10.1073/pnas.91.22.10531] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The plasma membrane H(+)-ATPase of Saccharomyces cerevisiae is an essential protein that is required to establish cellular membrane potential and maintain a normal internal pH. An Asp-378 to Asn substitution at the residue phosphorylated during catalysis is dominant lethal when the pma1-D378N mutation is expressed along with a wild-type plasma membrane H(+)-ATPase (PMA1) gene. Several mutations in the first two putative transmembrane domains are also dominant lethal. However, these dominant lethal mutants often appear to be innocuous, because they are frequently lost by gene conversion to the wild-type sequence during the process of introducing the mutant sequence and subsequently removing the wild-type gene. Loss of the mutation by gene conversion does not occur while introducing recessive lethal mutations. Cells carrying the wild-type PMA1 gene on the chromosome and a dominant lethal mutation under the control of a GAL1 promoter on a centromere-containing plasmid exhibit a galactose-dependent lethality. Indirect immunofluorescence staining using anti-Pma1 antibodies shows that induction of dominant lethal PMA1 mutations leads to the accumulation of a number of intensely staining cytoplasmic structures that are not coincident with the nucleus and its immediately surrounding endoplasmic reticulum. These structures also accumulate the endoplasmic reticulum protein Kar2. Expression of the dominant lethal protein also prevents transport of the wild-type ATPase to the plasma membrane.
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Affiliation(s)
- S L Harris
- Rosenstiel Basic Medical Sciences Research Center, Brandeis University,Waltham, MA 02254
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42
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Abstract
The purpose of this study was to determine whether the magnitude of glenohumeral translation on clinical laxity tests could distinguish between clinically stable shoulders and shoulders with traumatic or atraumatic instability. Subjects included eight male volunteers with no history of symptoms of glenohumeral instability, eight patients with documented traumatic anterior instability and Bankart lesions, and eight patients with documented atraumatic multidirectional instability. The patients in the two instability groups had disabling instability that was refractory to nonoperative management and thus met the indications for surgical repair. All subjects were examined by an experienced shoulder surgeon using five standard manual tests: anterior drawer, posterior drawer, sulcus, push-pull, and fulcrum. The glenohumeral translations occurring during these laxity tests were quantitated with a spatial sensing system that had six degrees of freedom and was rigidly fixed to the scapula and humerus. The result showed substantial overlap in the translations found in members of the three groups for each of the laxity tests. Standard laxity tests demonstrate considerable translation in normal glenohumeral joints and do not reliably differentiate normal shoulders from those with two common forms of glenohumeral instability. This study suggests that assessment of the magnitude of glenohumeral translation on clinical laxity tests is not a specific test for the diagnosis of glenohumeral instability. Healthy subjects without symptoms may have as much translation as patients needing surgical repair for symptomatic shoulder instability. The need for and the type of surgical reconstruction for the unstable shoulder must be based on the patient's history and on duplication of the symptoms of instability on directed physical examination rather than on the magnitude of glenohumeral translation.
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Affiliation(s)
- S B Lippitt
- From the Department of Orthopaedics, University of Washington, Seattle
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Abstract
Challenges associated with behavioral training approaches for individuals with mental retardation and mental illness in the community are reviewed in this article. Family and nonfamily facilitated training are considered. Professional practice issues are reviewed, and justification for multifactor behavioral assessment is offered. Future research directions are discussed.
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Affiliation(s)
- M R Petronko
- Graduate School of Applied and Professional Psychology, Rutgers, State University of New Jersey, Piscataway
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Abstract
The purpose of this study was to develop a new arthroscopic approach for traumatic instability that effectively reattaches avulsed capsulolabral tissue to the glenoid articular rim with sutures. This technique does not depend on fixation devices, trans-scapular drilling, or implantation of suture anchors. We attached a three-dimensional position sensor and force and torque transducer to the humerus and scapula of eight normal cadaveric shoulders to measure the normal, surgically unstable (arthroscopic Bankart lesion), and repaired preparations. We assessed eight motion ranges and six laxity tests. Capsulolabral release increased all passive ranges and allowed significant translational increases on posterior drawer and crank testing. After repair, motion was never decreased and there were no differences in laxity relative to normal. Neurovascular structures were never at risk. Our arthroscopic repair provides anatomic reattachment and effective deepening of the glenoid con-cavity similar to that achieved by open repair. This new method restores joint stability, preserves motion, and can withstand forceful loads. Ongoing clinical trials will substantiate whether the technique is as safe and reliable as shown cadaverically.
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Affiliation(s)
- D T Harryman
- Department of Orthopaedics, University of Washington, Seattle 98195
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45
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Abstract
The purpose of this study was to characterize humerothoracic motion and function after glenohumeral or scapulothoracic arthrodesis and to compare those results with those from normal shoulders. We evaluated 12 shoulders in 11 patients at an average of 71 months after glenohumeral arthrodesis and seven shoulders in six patients at an average of 32 months after scapulothoracic arthrodesis. The residual motion of the unfused articulation was measured with a spatial position sensor. Various activities of daily living and standard clinical range-of-motion tests were performed. Nearly all humerothoracic motions were significantly decreased in patients after either type of shoulder arthrodesis. Patients with a glenohumeral fusion maintained their scapulothoracic motion at levels comparable with that of normal subjects. Residual glenohumeral extension and external rotation after scapulothoracic fusion were significantly decreased; internal rotation remained unchanged compared with motion in subjects with normal shoulders. Glenohumeral fusion decreased the patients' ability to perform personal care activities requiring extremes of internal rotation or elevation. Although glenohumeral arthrodesis limited total humerothoracic motion considerably, the majority of patients were improved functionally and were relatively free from pain. Most personal care activities were performed successfully by all patients with scapulothoracic fusion.
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Affiliation(s)
- D T Harryman
- Department of Orthopaedics, University of Washington, Seattle, Wash
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Marian AJ, Harris SL, Pickett JD, Campbell E, Fromm RE. Inadvertent administration of rtPA to a patient with type 1 aortic dissection and subsequent cardiac tamponade. Am J Emerg Med 1993; 11:613-5. [PMID: 8240566 DOI: 10.1016/0735-6757(93)90015-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Administration of thrombolytic agents to patients with misdiagnosis of acute myocardial infarction can result in serious side effects. A case of aortic dissection that was misdiagnosed as acute myocardial infarction and received rtPA is reported. Within 1 hour of rtPA infusion, the patient developed cardiac tamponade. Type 1 aortic dissection was diagnosed by aortic angiogram. The patient underwent emergency resection of the dissection and evacuation of the pericardial and anterior mediastinal hematoma. Although he required massive transfusion of blood products intraoperatively, he is doing well 22 months after his surgery.
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Affiliation(s)
- A J Marian
- Baylor College of Medicine, Methodist Hospital, Houston, TX 77030
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Marino-Albernas JR, Harris SL, Varma V, Pinto BM. Convergent synthesis of an elusive hexasaccharide corresponding to the cell-wall polysaccharide of the beta-hemolytic Streptococcus group A. Carbohydr Res 1993; 245:245-57. [PMID: 8370024 DOI: 10.1016/0008-6215(93)80075-p] [Citation(s) in RCA: 19] [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] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A convergent synthesis of a hexasaccharide corresponding to the cell-wall polysaccharide of the beta-hemolytic Streptococcus Group A is described. The strategy relies on the preparation of a key linear trisaccharide unit beta-D-GlcpNAc-(1-->3)-alpha-L-Rhap-(1-->2)-alpha-L-Rhap which has previously resisted our efforts. The trisaccharide functions both as a glycosyl acceptor and donor to give an elusive hexasaccharide. This fully functionalized unit can serve, in turn, as a glycosyl acceptor or donor for the synthesis of higher-order structures. Deprotection gives a hitherto unknown hexasaccharide for use as a hapten in immunochemical studies. The characterization of all compounds by high-resolution 1H and 13C NMR spectroscopy is also described.
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Affiliation(s)
- J R Marino-Albernas
- Department of Chemistry, Simon Fraser University, Burnaby, British Columbia, Canada
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48
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Harris SL, Wood KW. Resolution of infantile Erb's palsy utilizing chiropractic treatment. J Manipulative Physiol Ther 1993; 16:415-8. [PMID: 8409790] [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: 01/30/2023]
Abstract
OBJECTIVE To present a case study of infantile Erb's palsy that responded to conservative chiropractic care. CLINICAL FEATURES A 5-wk-old infant boy suffered from a limp left arm. A clinical diagnosis of Erb-Duchenne palsy was made. Birth records were obtained to further substantiate the diagnosis. INTERVENTION AND OUTCOME The patient received specific chiropractic adjustments to the mid-cervical spine and muscle stimulation therapy with an upper extremity exercise program. The Erb's palsy resolved with only a mild residual "waiters tip" deformity within 2 months. CONCLUSION In this case, chiropractic adjustments with muscle stimulation therapy is suggested as an effective treatment for Erb's palsy. Further studies are required to better understand chiropractic's effectiveness in Erb's palsy cases.
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Affiliation(s)
- S L Harris
- Northwestern College of Chiropractic, Bloomington, MN 55431
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Abstract
Existing cytochrome oxidase (CO)-staining techniques were modified to enhance sensitivity and contrast in order to examine patterns of CO-activity in the dorsal column nuclei (DCN) of adult Long-Evans rats. Within a rostrocaudally limited region in the middle of the cuneate nucleus (CN) distinctive blotches of intense CO-activity were observed. The CO-staining was maximally differentiated approximately 0.3-0.7 mm caudal to the obex. No CO-blotches were observed anywhere else in the DCN. Transganglionic labelling (WGA-HRP) demonstrated that some of the CO-blotches in the rat CN are related to the terminal projection fields of primary afferents from the skin of the forepaws. The corresponding location of primary afferent termination fields and CO-staining patterns supports a tripartite rostrocaudal division in the rat CN, similar to that described by other investigators in cats, monkeys and raccoons. Comparing the patterns of CO-staining to (1) the cytoarchitecture (Nissl-stained sections), or to (2) the dendritoarchitecture (distribution of microtubule-associated protein 2 (MAP2) or to (3) the organization of retrogradely labelled (WGA-HRP/HRP) cuneothalamic cells, revealed no topographical organization corresponding to the CO-blotches. Postnatal (at least up to 11 days postpartum) forepaw deafferentation or removal disrupted the CO-staining pattern in the CN.
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Affiliation(s)
- D P Crockett
- Department of Neuroscience and Cell Biology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway 08854-5635
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50
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Woodall LD, Russell PW, Harris SL, Orndorff PE. Rapid, synchronous, and stable induction of type 1 piliation in Escherichia coli by using a chromosomal lacUV5 promoter. J Bacteriol 1993; 175:2770-8. [PMID: 8097517 PMCID: PMC204584 DOI: 10.1128/jb.175.9.2770-2778.1993] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Type 1 pili are filamentous proteinaceous appendages produced by certain members of the family Enterobacteriaceae. In Escherichia coli, the adhesive properties of these pili are due to the binding of at least one minor pilus component to mannose, a sugar common to cell surface molecules of many eukaryotic cells. The study of pilus assembly may be benefited by a rapid way of inducing pilus synthesis de novo. We describe herein the construction and characterization of a strain in which piliation can be rapidly induced by the addition of lactose or its analog isopropyl-beta-D-thiogalactopyranoside. This was accomplished by placing the chromosomal fimA gene (encoding the major structural subunit of pili) under lacUV5 promoter control. Further experiments suggested that transcription of genes downstream of fimA, whose products are required for normal pilus assembly and function, may also be controlled by the lacUV5 promoter. The construction described herein may have a variety of applications apart from aiding the study of pilus assembly since its adhesive properties can be rapidly and easily turned on and off.
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Affiliation(s)
- L D Woodall
- Department of Microbiology, Pathology and Parasitology, College of Veterinary Medicine, North Carolina State University, Raleigh 27606
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