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Malinowski F, Noto C, Cavalcante D, Belangero S, Ziebold C, Bressan R, Gadelha A. Urban distance to mental healthcare units and public transport increases duration of untreated psychosis in first-episode patients. Int J Soc Psychiatry 2023; 69:1938-1948. [PMID: 37332226 DOI: 10.1177/00207640231180825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND There is a growing interest in environmental and social determinants of mental health. However, how distance to healthcare and public transportation affect illness is neglected in schizophrenia research. Here, we are interested in how the availability of mental healthcare and the ways to reach it may be associated with psychosis. AIMS We aim to investigate the association between distances to healthcare units and subway stations and duration of untreated psychosis (DUP) and greater initial severity in an antipsychotic-naïve first episode of psychosis (FEP) sample. METHOD Using 212 untreated FEP patients' data, we calculated the distances from their residences to the places of interest. Diagnoses comprehended schizophrenia spectrum disorders, depressive and bipolar affective disorders, and substance-induced disorders. Linear regressions were performed with distances as independent variables, DUP and Positive and Negative Syndrome Scale (PANSS) scores as dependent variables. RESULTS Longer distance to emergency mental healthcare was related to longer DUP (95% CI: p = .034, B = 0.152) and higher total PANSS (95% CI: p = .007, B = 0.0189); longer distance to community mental healthcare units was related to longer DUP (95% CI: p = .004, B = 0.0204) and higher total PANSS (95% CI: p = .030, B = 0.152). Moreover, a longer distance to the closest subway station predicted longer DUP (95% CI: p = .019, B = 0.170). CONCLUSION Our results indicate that poor healthcare access is related to longer DUP and higher initial PANSS scores. Future research should investigate how investments in mental health access and actions to improve public transport access could impact DUP and treatment outcomes in psychosis patients.
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Affiliation(s)
- Fernando Malinowski
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Cristiano Noto
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
- Grupo de Atenção às Psicoses Iniciais (GAPi), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Daniel Cavalcante
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Grupo de Atenção às Psicoses Iniciais (GAPi), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Síntia Belangero
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Morphology and Genetics, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Carolina Ziebold
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Rodrigo Bressan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Programa de Esquizofrenia (PROESQ), Departamento de Psiquiatria, EPM-UNIFESP, São Paulo, SP, Brazil
| | - Ary Gadelha
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
- Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e Uso de Álcool e Outras Drogas (CEPIPREV), EPM-UNIFESP, São Paulo, SP, Brazil
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Beran K, Hermans E, Holm R, Sepassi K, Dressman J. Projection of Target Drug Particle Size in Oral Formulations Using the Refined Developability Classification System (rDCS). Pharmaceutics 2023; 15:1909. [PMID: 37514095 PMCID: PMC10385664 DOI: 10.3390/pharmaceutics15071909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Dissolution limitations to oral absorption can occur if the time required for dissolution is longer than the transit time across the small intestine and/or if dissolution is slower than the drug's permeation through the gut wall. These limitations most often occur for poorly soluble drugs. A standard method for overcoming dissolution issues is to reduce the particle size of the (solid) drug. Building on the refined Developability Classification System (rDCS), this work establishes a novel set of equations with which the appropriate degree of particle size reduction needed to mitigate dissolution limitations to absorption can be calculated. According to the type of data available, the appropriate equation(s) for each situation can be applied. Three case examples are used to illustrate implementation of the equations: voriconazole, lemborexant and istradefylline. Although for voriconazole (rDCS Class I) target radius (rtarget) estimates indicate that particle size reduction is unnecessary, for lemborexant (rDCS Class I) a radius of ≤20 µm would be required to improve absorption. For istradefylline (rDCS Class IIb) the rtarget was approximately 12 µm. Results are commensurate with literature information for these three drugs, signaling that the equations are suitable for application to a wide variety of drug substances.
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Affiliation(s)
- Kristian Beran
- Fraunhofer Institute of Translational Medicine and Pharmacology, 60596 Frankfurt am Main, Germany
- Janssen Research & Development, Pharmaceutical & Material Sciences, 2340 Beerse, Belgium
| | - Eline Hermans
- Janssen Research & Development, Pharmaceutical & Material Sciences, 2340 Beerse, Belgium
| | - René Holm
- Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, 5230 Odense, Denmark
| | - Kia Sepassi
- Janssen Research & Development, Discovery Pharmaceutics, La Jolla, CA 92121, USA
| | - Jennifer Dressman
- Fraunhofer Institute of Translational Medicine and Pharmacology, 60596 Frankfurt am Main, Germany
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Sagear S, Ballard S. The orbital eccentricity distribution of planets orbiting M dwarfs. Proc Natl Acad Sci U S A 2023; 120:e2217398120. [PMID: 37252955 PMCID: PMC10265968 DOI: 10.1073/pnas.2217398120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/11/2023] [Indexed: 06/01/2023] Open
Abstract
We investigate the underlying distribution of orbital eccentricities for planets around early-to-mid M dwarf host stars. We employ a sample of 163 planets around early- to mid-M dwarfs across 101 systems detected by NASA's Kepler Mission. We constrain the orbital eccentricity for each planet by leveraging the Kepler lightcurve together with a stellar density prior, constructed using metallicity from spectroscopy, Ks magnitude from 2MASS, and stellar parallax from Gaia. Within a Bayesian hierarchical framework, we extract the underlying eccentricity distribution, assuming alternately Rayleigh, half-Gaussian, and Beta functions for both single- and multi-transit systems. We described the eccentricity distribution for apparently single-transiting planetary systems with a Rayleigh distribution with [Formula: see text], and for multitransit systems with [Formula: see text]. The data suggest the possibility of distinct dynamically warmer and cooler subpopulations within the single-transit distribution: The single-transit data prefer a mixture model composed of two distinct Rayleigh distributions with [Formula: see text] and [Formula: see text] over a single Rayleigh distribution, with 7:1 odds. We contextualize our findings within a planet formation framework, by comparing them to analogous results in the literature for planets orbiting FGK stars. By combining our derived eccentricity distribution with other M dwarf demographic constraints, we estimate the underlying eccentricity distribution for the population of early- to mid-M dwarf planets in the local neighborhood.
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Affiliation(s)
- Sheila Sagear
- Department of Astronomy, University of Florida, 211 Bryant Space Science Center, Gainesville, FL32611
| | - Sarah Ballard
- Department of Astronomy, University of Florida, 211 Bryant Space Science Center, Gainesville, FL32611
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Boyer A, Lanot A, Legendre B, Clause AL, Kabbali N, Lobbedez T, Bechade C. From transfer to transition: review and proposition of the SFNDT dialysis Commission. Nephrol Ther 2023; 19:1-8. [PMID: 37190678 DOI: 10.1684/ndt.2023.17] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Over the course of their disease, patients with chronic kidney disease (CKD) will be treated by several kidney replacement therapy (KRT) modalities. The transitions between KRT modalities can be experienced as traumatic by patients, and are associated with an increased morbidity and mortality, notably when they are not anticipated. Planning these transition phases could reduce the psychological trauma induced by the transfer, as well as reduce the risk of morbidity and mortality. However, the lack of a clear definition of a transfer, and the lack of criteria enabling the identification of patients at risk of transfer, prevents the anticipation of these transition phases at high risk for patients. We here discuss the various possible causes and risk factors of transfer from peritoneal dialysis (PD) to hemodialysis as well as transfer from hemodialysis to PD. The dialysis Commission of the Société francophone de néphrologie, dialyse et transplantation (SFNDT) makes some proposals to improve transition phases, such as the identification of patients at risk, specific PD programs for unplanned PD start, transition unit and hybrid therapy.
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Affiliation(s)
- Annabel Boyer
- Centre universitaire des maladies rénales, CHU de Caen, Avenue de la côte de Nacre, 14033 Caen Cedex 9, France
- U1086 Inserm-Anticipe, Centre régional de lutte contre le cancer François Baclesse, 3, avenue du général Harris, 14076 Caen Cedex 5, France
| | - Antoine Lanot
- Centre universitaire des maladies rénales, CHU de Caen, Avenue de la côte de Nacre, 14033 Caen Cedex 9, France
- U1086 Inserm-Anticipe, Centre régional de lutte contre le cancer François Baclesse, 3, avenue du général Harris, 14076 Caen Cedex 5, France
- Normandie Université, Unicaen, UFR de médecine, 2, rue des Rochambelles, 14032 Caen Cedex, France
| | - Bruno Legendre
- Centre universitaire des maladies rénales, CHU de Caen, Avenue de la côte de Nacre, 14033 Caen Cedex 9, France
- U1086 Inserm-Anticipe, Centre régional de lutte contre le cancer François Baclesse, 3, avenue du général Harris, 14076 Caen Cedex 5, France
| | - Anne-Lorraine Clause
- Hôpital Erasme, ULB, département de néphrologie, dialyse et transplantation, Route de Lennik 808, 1070 Bruxelles, Belgique
| | - Nadia Kabbali
- Hôpital universitaire Hassan II, service néphrologie, dialyse et transplantation, Fez, Maroc
- Laboratoire d’épidémiologie et de recherche en sciences de la santé (ERESS), Faculté de médecine, Université Sidi Mohammed Ben Abdellah, Fez, Maroc
| | - Thierry Lobbedez
- Centre universitaire des maladies rénales, CHU de Caen, Avenue de la côte de Nacre, 14033 Caen Cedex 9, France
- U1086 Inserm-Anticipe, Centre régional de lutte contre le cancer François Baclesse, 3, avenue du général Harris, 14076 Caen Cedex 5, France
- Normandie Université, Unicaen, UFR de médecine, 2, rue des Rochambelles, 14032 Caen Cedex, France
| | - Clémence Bechade
- Centre universitaire des maladies rénales, CHU de Caen, Avenue de la côte de Nacre, 14033 Caen Cedex 9, France
- U1086 Inserm-Anticipe, Centre régional de lutte contre le cancer François Baclesse, 3, avenue du général Harris, 14076 Caen Cedex 5, France
- Normandie Université, Unicaen, UFR de médecine, 2, rue des Rochambelles, 14032 Caen Cedex, France
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Mashrur SM, Wang K, Loa P, Hossain S, Nurul Habib K. Application of Protection Motivation Theory to Quantify the Impact of Pandemic Fear on Anticipated Postpandemic Transit Usage. Transp Res Rec 2023; 2677:267-286. [PMID: 37153204 PMCID: PMC10149485 DOI: 10.1177/03611981211065439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The COVID-19 pandemic had an unprecedented impact on transit usage, primarily owing to the fear of infection. Social distancing measures, moreover, could alter habitual travel behavior, for example, using transit for commuting. This study explored the relationships among pandemic fear, the adoption of protective measures, changes in travel behavior, and anticipated transit usage in the post-COVID era, through the lens of protection motivation theory. Data containing multidimensional attitudinal responses about transit usage at several pandemic stages were utilized for the investigation. They were collected through a web-based survey in the Greater Toronto Area, Canada. Two structural equation models were estimated to examine the factors influencing anticipated postpandemic transit usage behavior. The results revealed that people taking relatively higher protective measures were comfortable taking a cautious approach such as complying with transit safety policies (TSP) and getting vaccinated to make transit trips. However, the intention to use transit on vaccine availability was found to be lower than in the case of TSP implementation. Conversely, those who were uncomfortable taking transit with caution and who were inclined to avoid travel and rely on e-shopping were most unlikely to return to transit in the future. A similar finding was observed for females, those with vehicle access, and middle-income individuals. However, frequent transit users during the pre-COVID period were more likely to continue to use transit after the pandemic. The study's findings also indicated that some travelers might be avoiding transit specifically because of the pandemic, implying they are likely to return in the future.
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Affiliation(s)
- Sk. Md. Mashrur
- Department of Civil & Mineral
Engineering, University of Toronto, Toronto, ON, Canada
| | - Kaili Wang
- Department of Civil & Mineral
Engineering, University of Toronto, Toronto, ON, Canada
| | - Patrick Loa
- Department of Civil & Mineral
Engineering, University of Toronto, Toronto, ON, Canada
| | - Sanjana Hossain
- Department of Civil & Mineral
Engineering, University of Toronto, Toronto, ON, Canada
| | - Khandker Nurul Habib
- Percy Edward Hart Professor in Civil
& Mineral Engineering, University of Toronto, Toronto, ON, Canada
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Moghimi B, Kamga C, Safikhani A, Mudigonda S, Vicuna P. Non-Stationary Time Series Model for Station-Based Subway Ridership During COVID-19 Pandemic: Case Study of New York City. Transp Res Rec 2023; 2677:463-477. [PMID: 37153164 PMCID: PMC10152224 DOI: 10.1177/03611981221084698] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The COVID-19 pandemic in 2020 has caused sudden shocks in transportation systems, specifically the subway ridership patterns in New York City (NYC), U.S. Understanding the temporal pattern of subway ridership through statistical models is crucial during such shocks. However, many existing statistical frameworks may not be a good fit to analyze the ridership data sets during the pandemic, since some of the modeling assumptions might be violated during this time. In this paper, utilizing change point detection procedures, a piecewise stationary time series model is proposed to capture the nonstationary structure of subway ridership. Specifically, the model consists of several independent station based autoregressive integrated moving average (ARIMA) models concatenated together at certain time points. Further, data-driven algorithms are utilized to detect the changes of ridership patterns as well as to estimate the model parameters before and during the COVID-19 pandemic. The data sets of focus are daily ridership of subway stations in NYC for randomly selected stations. Fitting the proposed model to these data sets enhances understanding of ridership changes during external shocks, both in relation to mean (average) changes and the temporal correlations.
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Affiliation(s)
- Bahman Moghimi
- Department of Civil Engineering, City College of New York, NY
- Bahman Moghimi,
| | - Camille Kamga
- Department of Civil Engineering, City College of New York, NY
| | | | | | - Patricio Vicuna
- Department of Civil Engineering, City College of New York, NY
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A Hoffman D, Strezhnev A. Longer trips to court cause evictions. Proc Natl Acad Sci U S A 2023; 120:e2210467120. [PMID: 36595690 DOI: 10.1073/pnas.2210467120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Studying ∼200,000 evictions filed against ∼300,000 Philadelphians from 2005 to 2021, we focus on the role of transit to court in preventing tenants from asserting their rights. In this period, nearly 40% of tenants facing eviction were ordered to leave their residences because they did not show up to contest cases against them and received a default judgment. Controlling for a variety of potential confounds at the tenant and landlord level, we find that residents of private tenancies with longer transit travel time to the courthouse were more likely to default. A 1-h increase in estimated travel time increases the probability of default by between 3.8% and 8.6% points across different model specifications. The effect holds after adjusting for direct distance to the court, unobserved landlord characteristics, and even baseline weekend travel time. However, it is absent in public housing evictions, where timing rules are significantly laxer, and during the COVID-19 pandemic, when tenants had the opportunity to be present virtually. We estimate that had all tenants been equally able to get to the court in 10 min, there would have been 4,000 to 9,000 fewer default evictions over the sample period. We replicate this commuting effect in another dataset of over 800,000 evictions from Harris County, Texas. These results open up a new way to study the physical determinants of access to justice, illustrating that the location and accessibility of a courthouse can affect individual case outcomes. We suggest that increased use of video technology in court may reduce barriers to justice.
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Nelson AC, Hibberd R. Influence of Transit Station Proximity on Demographic Change Including Displacement and Gentrification with Implications for Transit and Land Use Planning After the COVID-19 Pandemic. Transp Res Rec 2023; 2677:1721-1731. [PMID: 36618819 PMCID: PMC9805924 DOI: 10.1177/03611981221105872] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
A key purpose of fixed-route transit systems is to attract people and households to live near transit stations. There is very little research into the extent to which this occurs, however. This article is the first to apply a consistent methodology using census data to evaluate the extent to which people and households are attracted to transit stations. Using census American Community Survey 5-year sample data applied to 30 metropolitan areas for 2013 and 2019-a period between the Great Recession and the COVID-19 pandemic-we found that nearly all people and households were attracted to transit stations located within the first 100 m with very little occurring in the rest of the "½-mi circle" (about 800 m). With the exception of streetcar systems that serve mostly downtowns, we found that most of the change in residents in the first 100 m involved minority persons, which is somewhat inconsistent with displacement and gentrification expectations. Also, with the exception of streetcar systems, large to very large shares of all new households with children were attracted to the first 100 m from transit stations, which was again somewhat inconsistent with expectations. We use analysis to suggest implications for the post COVID-19 pandemic period. Although major cities have lost population as households have moved mostly into nearby suburbs, recent trends combined with data from preference surveys suggest that future demand for transit station proximity may be higher than before the pandemic. We conclude with long-term implications for transit and land use planning.
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Affiliation(s)
- Arthur C. Nelson
- School of Landscape Architecture and Planning, University of Arizona, Tucson, AZ
| | - Robert Hibberd
- School of Geography and Development, University of Arizona, Tucson, AZ
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Van Hemelrijck WMJ, Vandenheede H, Argeseanu Cunningham S. Diabetes management in the face of adversity: Experiences of asylum-seekers in Belgian reception centres. Diabet Med 2022; 39:e14742. [PMID: 34773673 DOI: 10.1111/dme.14742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/03/2021] [Accepted: 11/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Diabetes poses a heavy burden on patients due to its progressive and chronic nature; it requires continuous management to promote a high-quality and long life. Disease management is especially challenging in emergency settings. We examined how displaced people with diabetes experienced managing their illness before and throughout the process of fleeing their home communities and seeking resettlement in Europe. DESIGN We designed an interview instrument with closed- and open-ended questions about diabetes diagnosis and management before fleeing the home country, during migration, stays in transit countries and reception in the European Union. We interviewed 20 asylum-seekers living in Belgian reception centres with diagnosed diabetes mellitus. RESULTS Primary topics emerging from interviews were availability, accessibility, and quality. Belgium was described as a setting with high availability, accessibility and quality of diabetes management components (medication, tools, care) compared with other settings before and during migration. Even in Belgium, maintaining a healthy diet as an asylum-seeker was difficult. Other concerns such as safety, other health issues and the asylum request itself often outweighed diabetes management. CONCLUSIONS Displaced people in non-Western countries need attention for nutrition and diabetes medicine, so aid agencies should consider providing for those needs. For people seeking asylum in the West and living in temporary facilities, care should be paid to the dietary options available for those with diabetes. For irregular migrants, diabetes can be deadly, and resources should be made available for their basic diabetes needs, even if they are not eligible for regular health services.
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Affiliation(s)
- Wanda Monika Johanna Van Hemelrijck
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
- The Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW/University of Groningen, The Hague, the Netherlands
| | - Hadewijch Vandenheede
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
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Gargano MC, Ajduković D, Vukčević Marković M. Mental Health in the Transit Context: Evidence from 10 Countries. Int J Environ Res Public Health 2022; 19:ijerph19063476. [PMID: 35329157 PMCID: PMC8954994 DOI: 10.3390/ijerph19063476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022]
Abstract
Most interventions for mental health and psychosocial support (MHPSS) have been developed in contexts and with populations that differ significantly from the realities of migration. There is an urgent need for MHPSS in transit; however, transit-specific aspects of MHPSS provision are often neglected due to the inherent challenges transit poses to traditional conceptualizations of practice. The Delphi method, which consisted of three iterative rounds of surveys, was applied with the goal of identifying challenges to and adaptations of MHPSS in the transit context. Twenty-six MHPSS providers working with refugees in 10 European transit countries participated; 69% of participants completed all three survey rounds. There was consensus that a flexible model of MHPSS, which can balance low intensity interventions and specialized care, is needed. Agreement was high for practice-related and sociopolitical factors impacting MHPSS in transit; however, the mandate of MHPSS providers working in the transit context achieved the lowest consensus and is yet to be defined. There is a need to rethink MHPSS in the refugee transit context. Providing MHPSS to refugees on the move has specificities, most of which are related to the instability and uncertainty of the context. Future directions for improving mental health protection for refugees, asylum seekers, and migrants in transit are highlighted.
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Affiliation(s)
- Maria Caterina Gargano
- Department of Psychology, Kroc Institute for International Peace Studies, University of Notre Dame, 390 Corbett Family Hall, Notre Dame, IN 46556, USA;
| | - Dean Ajduković
- Department of Psychology, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia;
| | - Maša Vukčević Marković
- Department of Psychology, Faculty of Philosophy, University of Belgrade, 11000 Belgrade, Serbia
- Psychosocial Innovation Network, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-63-723-4658
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Saelens BE, Meenan RT, Keast EM, Frank LD, Young DR, Kuntz JL, Dickerson JF, Fortmann SP. Transit Use and Health Care Costs: A Cross-sectional Analysis. J Transp Health 2022; 24:101294. [PMID: 34926159 PMCID: PMC8682981 DOI: 10.1016/j.jth.2021.101294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Greater transit use is associated with higher levels of physical activity, which is associated with lower health risks and better health outcomes. However, there is scant evidence about whether health care costs differ based on level of transit ridership. METHODS A sample (n=947) of members of Kaiser Permanente in the Portland, Oregon area were surveyed in 2015 about their typical use of various modes of travel including transit. Electronic medical record-derived health care costs were obtained among these members for the prior three years. Analysis examined proportional costs between High transit users (3+ days/week), Low transit users (1-2 days/week), and Non-users adjusting for age and sex, and then individually (base models) and together for demographic and health status variables. RESULTS In separate base models across individual covariates, High transit users had lower total health care costs (59-69% of Non-user's costs) and medication costs (31-37% of Non-users' costs) than Non-users. Low transit users also had lower total health care (69%-76% of Non-users' costs) and medication costs (43-57% transit of Non-user's costs) than Non-users. High transit users' outpatient costs were also lower (77-82% of Non-users). In fully-adjusted models, total health care and medication costs were lower among High transit users' (67% and 39%) and Low transit users' (75% and 48%) compared to Non-users, but outpatient costs did not differ by transit use. CONCLUSIONS Findings have implications for the potential cost benefit of encouraging and supporting more transit use, although controlled longitudinal and experimental evidence is needed to confirm findings and understand mechanisms.
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Affiliation(s)
- B E Saelens
- Seattle Children's Research Institute and the Department of Pediatrics at the University of Washington, 1920 Terry Avenue, Seattle, Washington USA 98101
| | - R T Meenan
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave, Portland, Oregon USA 97227-1098
| | - E M Keast
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave, Portland, Oregon USA 97227-1098
| | - L D Frank
- Urban Design 4 Health, Inc., Rochester, NY and Health & Community Design Lab, Schools of Population and Public Health and Community and Regional Planning, University of British Columbia, 433 - 6333 Memorial Road Vancouver, BC Canada V6T 1Z2
| | - D R Young
- Center for Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave, Pasadena, CA U.S. 91101
| | - J L Kuntz
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave, Portland, Oregon USA 97227-1098
| | - J F Dickerson
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave, Portland, Oregon USA 97227-1098
| | - S P Fortmann
- Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave, Portland, Oregon USA 97227-1098
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Sangnes DA, Lundervold K, Bekkelund M, von Volkmann HL, Berentsen B, Gilja OH, Dimcevski G, Søfteland E. Gastrointestinal transit and contractility in diabetic constipation: A wireless motility capsule study on diabetes patients and healthy controls. United European Gastroenterol J 2021; 9:1168-1177. [PMID: 34687494 PMCID: PMC8672085 DOI: 10.1002/ueg2.12169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/29/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diabetic constipation is traditionally attributed to slow colonic transit, despite limited evidence. More than half of patients find treatment unsatisfactory. To improve treatment, there is a need for better diagnostic understanding of the condition. OBJECTIVE In this wireless motility capsule study, we aimed to investigate gastrointestinal transit and contractility in diabetes patients with and without constipation, and in healthy controls. METHODS We prospectively included type 1 or type 2 diabetes patients with gastrointestinal symptoms. Based on the Gastrointestinal Symptom Rating Scale we distinguished into two groups: with constipation and without constipation. Non-diabetic controls were asymptomatic. All were examined with wireless motility capsule, determining transit times and contractility parameters. RESULTS 57 patients (42 women, 46 with type 1 diabetes) and 26 healthy controls (14 women) were included. We found no difference in transit times between diabetes patients with and without constipation. Compared to healthy controls (35:55, h:min), whole-gut transit was slower in both diabetes patients with constipation (66:15, p = 0.03) and without constipation (71:16, p < 0.001). Small bowel motility index correlated rs = -0.32 (p = 0.01) with constipation symptoms. CONCLUSIONS Diabetes patients with constipation had similar transit times as those without constipation. Both groups had slower whole-gut transit than healthy controls. Constipation was associated with reduced small bowel, but not colonic contractility. Our results imply that other mechanisms than slow colonic transit may be more important in the pathogenesis of diabetic constipation.
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Affiliation(s)
- Dag A. Sangnes
- Department of MedicineHaukeland University HospitalBergenNorway
- Department of Clinical MedicineUniversity of BergenBergenNorway
| | - Katarina Lundervold
- The National Centre for Functional Gastrointestinal DisordersHaukeland University HospitalBergenNorway
- National Centre for Ultrasound in GastroenterologyHaukeland University HospitalBergenNorway
- Department of NeurologyHaukeland University HospitalBergenNorway
| | - Mattis Bekkelund
- The National Centre for Functional Gastrointestinal DisordersHaukeland University HospitalBergenNorway
- Department of Clinical MedicineUniversity of OsloOsloNorway
| | | | - Birgitte Berentsen
- Department of MedicineHaukeland University HospitalBergenNorway
- The National Centre for Functional Gastrointestinal DisordersHaukeland University HospitalBergenNorway
| | - Odd Helge Gilja
- Department of MedicineHaukeland University HospitalBergenNorway
- Department of Clinical MedicineUniversity of BergenBergenNorway
- National Centre for Ultrasound in GastroenterologyHaukeland University HospitalBergenNorway
| | - Georg Dimcevski
- Department of Clinical MedicineUniversity of BergenBergenNorway
- National Centre for Ultrasound in GastroenterologyHaukeland University HospitalBergenNorway
| | - Eirik Søfteland
- Department of MedicineHaukeland University HospitalBergenNorway
- Department of Clinical ScienceUniversity of BergenBergenNorway
- Hormone LaboratoryHaukeland University HospitalBergenNorway
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Essa H, Hamdy S, Green D, Lal S, McLaughlin J, Hoffmann S, Leitao E, Paine P. Hydrogen and methane breath test results are negatively associated with IBS and may reflect transit time in post-surgical patients. Neurogastroenterol Motil 2021; 33:e14033. [PMID: 33184950 DOI: 10.1111/nmo.14033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Contention surrounds hydrogen and methane breath tests as putative measures of small intestinal bacterial overgrowth. We aimed to explore the clinical characteristics associated with positive and negative results to help clarify their role. METHODS 525 glucose hydrogen/methane breath tests completed over 3 years were analyzed to look for positively and negatively associated predictive factors. Characteristics such as height and weight and underlying medical conditions, medications, and surgical history were collated. KEY RESULTS There were 85 and 42 positive hydrogen and methane tests, respectively. Patients with irritable bowel syndrome (IBS) (HR = 0.17, p = 0.004) and those with a higher body mass index (HR = 0.93, p = 0.004) were significantly less likely to have a positive test. Patients who underwent the test post-surgically were significantly more likely to have a positive test (HR = 2.76, p = 0.001). A sub-analysis of post-surgical patients by type and region of surgical resection demonstrated that none were statistically more likely than the next to have a positive test. However, for the surgical group as a whole the number of motility-depressing drugs taken (such as opioids) was associated with a significantly decreased likelihood of a positive test (HR = 0.752, p = 0.045). CONCLUSION Our data suggest that patients with a diagnosis of IBS are statistically less likely to have a positive test and it is of limited utility in this group. Post-surgical patients are more likely to have a positive test, possibly secondary to fast transit rather than bacterial overgrowth, as suggested by a significantly negative association with motility-suppressing drugs in this sub-group.
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Affiliation(s)
- Hani Essa
- Department of Gastroenterology, Salford Royal Hospital, Salford, UK
| | - Shaheen Hamdy
- Department of Gastroenterology, Salford Royal Hospital, Salford, UK.,Division of Diabetes, Endocrinology and Gastroenterology, Centre for GI Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Darren Green
- Department of Renal Medicine, Salford Royal Hospital, Salford, UK
| | - Simon Lal
- Department of Gastroenterology, Salford Royal Hospital, Salford, UK.,Division of Diabetes, Endocrinology and Gastroenterology, Centre for GI Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - John McLaughlin
- Department of Gastroenterology, Salford Royal Hospital, Salford, UK.,Division of Diabetes, Endocrinology and Gastroenterology, Centre for GI Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Sandra Hoffmann
- Department of Nuclear Medicine, Salford Royal Hospital, Salford, UK
| | - Eugena Leitao
- Department of Nuclear Medicine, Salford Royal Hospital, Salford, UK
| | - Peter Paine
- Department of Gastroenterology, Salford Royal Hospital, Salford, UK.,Division of Diabetes, Endocrinology and Gastroenterology, Centre for GI Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Sharif H, Hoad CL, Abrehart N, Gowland PA, Spiller RC, Kirkham S, Loganathan S, Papadopoulos M, Benninga MA, Devadason D, Marciani L. Colonic Volume Changes in Paediatric Constipation Compared to Normal Values Measured Using MRI. Diagnostics (Basel) 2021; 11:diagnostics11060974. [PMID: 34071217 PMCID: PMC8226615 DOI: 10.3390/diagnostics11060974] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Functional constipation in children is common. Management of this condition can be challenging and is often based on symptom reports. Increased, objective knowledge of colonic volume changes in constipation compared to health could provide additional information. However, very little data on paediatric colonic volume is available except from methods that are invasive or require unphysiological colonic preparations. OBJECTIVES (1) To measure volumes of the undisturbed colon in children with functional constipation (FC) using magnetic resonance imaging (MRI) and provide initial normal range values for healthy controls, and (2) to investigate possible correlation of colonic volume with whole gut transit time (WGTT). METHODS Total and regional (ascending, transverse, descending, sigmoid, and rectum) colon volumes were measured from MRI images of 35 participants aged 7-18 years (16 with FC and 19 healthy controls), and corrected for body surface area. Linear regression was used to explore the relationship between total colon volume and WGTT. RESULTS Total colonic volume was significantly higher, with a median (interquartile range) of 309 mL (243-384 mL) for the FC group than for the healthy controls of 227 mL (180-263 mL). The largest increase between patients and controls was in the sigmoid colon-rectum region. In a linear regression model, there was a positive significant correlation between total colonic volume and WGTT (R = 0.56, p = 0.0005). CONCLUSIONS This initial study shows increased volumes of the colon in children with FC, in a physiological state, without use of any bowel preparation. Increased knowledge of colonic morphology may improve understanding of FC in this age group and help to direct treatment.
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Affiliation(s)
- Hayfa Sharif
- Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (H.S.); (N.A.); (R.C.S.)
- Ministry of Health, Civil Service Commission, Amiri Hospital, Kuwait City 15300, Kuwait
| | - Caroline L. Hoad
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK; (C.L.H.); (P.A.G.)
| | - Nichola Abrehart
- Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (H.S.); (N.A.); (R.C.S.)
| | - Penny A. Gowland
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK; (C.L.H.); (P.A.G.)
| | - Robin C. Spiller
- Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (H.S.); (N.A.); (R.C.S.)
| | - Sian Kirkham
- Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK; (S.K.); (S.L.); (M.P.); (D.D.)
| | - Sabarinathan Loganathan
- Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK; (S.K.); (S.L.); (M.P.); (D.D.)
| | - Michalis Papadopoulos
- Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK; (S.K.); (S.L.); (M.P.); (D.D.)
| | - Marc A. Benninga
- Department of Pediatric Gastroenterology, Emma Children’s Hospital, Amsterdam UMC, 9, 1105 AZ Amsterdam, The Netherlands;
| | - David Devadason
- Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK; (S.K.); (S.L.); (M.P.); (D.D.)
| | - Luca Marciani
- Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham NG7 2UH, UK; (H.S.); (N.A.); (R.C.S.)
- Correspondence:
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Tilaye T, Tessema B, Alemu K. Malaria Infection is High at Transit and Destination Phases Among Seasonal Migrant Workers in Development Corridors of Northwest Ethiopia: A Repeated Cross-Sectional Study. Res Rep Trop Med 2021; 12:107-121. [PMID: 34079425 PMCID: PMC8165298 DOI: 10.2147/rrtm.s306001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/24/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose Malaria is a leading public health problem in Ethiopia. Every year, thousands of seasonal farm workers travel to farm corridors in Northwest Ethiopia and fall at risk of malaria infection. However, the magnitude of malaria infection and risk factors during harvest time were not well identified. This study aimed at estimating the prevalence and risk factors of malaria infection among seasonal migrant workers in Northwest Ethiopia. Methods A repeated cross-sectional study was conducted at transit and destination phases in Metema district from September 15, 2018 to October 30, 2019. Data were collected using a structured questionnaire. A capillary blood sample was collected to examine infection with malaria parasite using a microscope. A multivariate logistic regression technique was used to determine risk factors. Results The malaria prevalence at transit and destination phases among migrant workers was 13.5% (95% CI: 12.07–14.93%) and 18.7% (95% CI: 16.40–21.02%), respectively. The combined prevalence was 16.1% (95% CI: 14.67–17.63%). The odds of malaria infection among migrant workers at the destination phase was 1.5 (OR=1.5, 95% CI 1.167–1.846) times higher compared to the transit phase. Education (AOR=8.198; 95% CI: 4.318–15.564), knowledge of antimalarial drugs (AOR=2.4; 95% CI: 1.43–3.95), and use of long-lasting insecticidal nets (AOR=5.0; 95% CI: 3.34–4.43) were significantly associated with malaria infection at migration phases. Conclusion This study showed that the burden of malaria among seasonal migrant workers was high at transit and destination phases. Malaria prevalence was higher at the destination phase compared to the transit phase. A tailored malaria prevention intervention is needed including awareness creation, screening, treatment, repellent, and prophylaxis at both phases to reduce malaria infections.
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Affiliation(s)
- Tesfaye Tilaye
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belay Tessema
- Department of Medical Microbiology, School of Biomedical and Medical Laboratory, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Le Feunteun S, Al-Razaz A, Dekker M, George E, Laroche B, van Aken G. Physiologically Based Modeling of Food Digestion and Intestinal Microbiota: State of the Art and Future Challenges. An INFOGEST Review. Annu Rev Food Sci Technol 2021; 12:149-167. [PMID: 33400557 DOI: 10.1146/annurev-food-070620-124140] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This review focuses on modeling methodologies of the gastrointestinal tract during digestion that have adopted a systems-view approach and, more particularly, on physiologically based compartmental models of food digestion and host-diet-microbiota interactions. This type of modeling appears very promising for integrating the complex stream of mechanisms that must be considered and retrieving a full picture of the digestion process from mouth to colon. We may expect these approaches to become more and more accurate in the future and to serve as a useful means of understanding the physicochemical processes occurring in the gastrointestinaltract, interpreting postprandial in vivo data, making relevant predictions, and designing healthier foods. This review intends to provide a scientific and historical background of this field of research, before discussing the future challenges and potential benefits of the establishment of such a model to study and predict food digestion and absorption in humans.
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Affiliation(s)
| | - Ahmed Al-Razaz
- Essex Pathways, University of Essex, CO4 3SQ Colchester, United Kingdom;
| | - Matthijs Dekker
- Food Quality and Design Group, Department of Agrotechnology and Food Sciences, Wageningen University, 6700 AA Wageningen, The Netherlands;
| | - Erwin George
- School of Computing and Mathematical Sciences, University of Greenwich, SE10 9LS London, United Kingdom;
| | - Beatrice Laroche
- Université Paris-Saclay, INRAE, MaIAGE, 78350 Jouy-en-Josas, France;
| | - George van Aken
- Cosun Innovation Center, Royal Cosun, 4670 VA Dinteloord, The Netherlands;
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17
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Chia J, Lee JB, Han H. How Does the Location of Transfer Affect Travellers and Their Choice of Travel Mode?-A Smart Spatial Analysis Approach. Sensors (Basel) 2020; 20:E4418. [PMID: 32784752 DOI: 10.3390/s20164418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 11/29/2022]
Abstract
This study explores the relationship between the spatial distribution of relative transfer location (i.e., the location of the transfer point in relation to the trip origin and destination points) and the attractiveness of the transit service using smart card data. Transfer is an essential component of the transit trip that allows people to reach more destinations, but it is also the main factor that deters the smartness of the public transit. The literature quantifies the inconvenience of transfer in terms of extra travel time or cost incurred during transfer. Unlike this conventional approach, the new “transfer location” variable is formulated by mapping the spatial distribution of relative transfer locations on a homogeneous geocoordinate system. The clustering of transfer points is then quantified using grid-based hierarchical clustering. The transfer location factor is formulated as a new explanatory variable for mode choice modelling. This new variable is found to be statistically significant, and no correlation is observed with other explanatory variables, including transit travel time. These results imply that smart transit users may perceive the travel direction (to transfer) as important, in addition to the travel time factor, which would influence their mode choice. Travellers may disfavour even adjacent transfer locations depending on their relative location. The findings of this study will contribute to improving the understanding of transit user behaviour and impact of the smartness of transfer, assist smart transport planning and designing of new transit routes and services to enhance the transfer performance.
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18
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Deters EL, Hansen SL. Effect of supplementing a Saccharomyces cerevisiae fermentation product during a preconditioning period prior to transit on receiving period performance, nutrient digestibility, and antioxidant defense by beef steers. Transl Anim Sci 2020; 3:1227-1237. [PMID: 32704886 PMCID: PMC7200456 DOI: 10.1093/tas/txz140] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 08/16/2019] [Indexed: 11/13/2022] Open
Abstract
Forty-eight newly weaned crossbred beef steers from a single-source were used to determine the effects of feeding a Saccharomyces cerevisiae fermentation product (SCFP; NaturSafe, Diamond V) on receiving period performance, nutrient digestibility, and antioxidant defense. Seven days after arrival, steers were stratified by BW (257 ± 18 kg), sorted into pens (n = 1 pen/treatment), and pens assigned to dietary treatments: SCFP at 0 (CON), 12 (SCFP12), 18 (SCFP18), or 0 g·steer-1·d-1 during preconditioning (PRE; days -19 to 0), then 18 g·steer-1·d-1 during receiving (REC; days 0 to 58; CON18). On day -1 BW and blood were collected, steers were loaded onto a semitruck and transported 1,748 km over 19 h. Upon return, steers were weighed, stratified by BW within treatment and sorted into pens with GrowSafe bunks (n = 12 steers/treatment). Steers were weighed on days -1, 0, 29, 30, 57, and 58. Blood was collected from all steers on days -1, 1, and 8 and liver biopsies were performed on all steers on days -20, -3, and 59. Titanium dioxide was included as an indigestible marker in the diet of all steers from days 14 through 29 to determine total tract nutrient digestibility. Data were analyzed as a completely randomized design using ProcMixed of SAS with the fixed effect of treatment. Steer was the experimental unit for REC period variables. Contrast statements compared the linear and quadratic effects of feeding SCFP throughout the trial (CON, SCFP12, and SCFP18) and the effect of supplementation at 18 g·steer-1·d-1 for the entire trial or starting in REC (SCFP18 vs. CON18). Steers fed SCFP12 exhibited the greatest ADG and G:F from days 0 to 30 (quadratic P ≤ 0.04). Total tract digestibility of NDF and ADF was linearly decreased by SCFP (linear P ≤ 0.03). On day -3, SCFP12-fed steers tended to have the greatest liver concentrations of total, oxidized, and reduced glutathione (quadratic P = 0.06). Red blood cell lysate Mn:total-superoxide dismutase activity was 16% greater 1 d posttransit compared with pretransit values (day P ≤ 0.01). Timing of SCFP supplementation (SCFP18 vs. CON18) did not affect any of the variables assessed herein (P ≥ 0.19). Supplementing SCFP at 12 g·steer-1·d-1 tended to affect antioxidant capacity prior to transit and improved early receiving period performance; however, overall receiving period performance was not affected by SCFP supplementation. Further research is necessary to determine the optimal dose and timing of SCFP supplementation for beef cattle.
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Affiliation(s)
- Erin L Deters
- Department of Animal Science, Iowa State University, Ames, IA
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Triguero-Mas M, Martínez-Solanas È, Barrera-Gómez J, Agis D, Pérez N, Reche C, Alastuey A, Querol X, Pérez K, Basagaña X. Public Transport Strikes and Their Relationships With Air Pollution, Mortality, and Hospital Admissions. Am J Epidemiol 2020; 189:116-119. [PMID: 31566673 DOI: 10.1093/aje/kwz202] [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: 11/23/2018] [Revised: 09/02/2019] [Accepted: 09/03/2019] [Indexed: 11/14/2022] Open
Abstract
There is limited suggestive evidence of relationships between public transport strikes and either increased air pollution or worse population health. In this study we aimed to assess whether public transport strikes were associated with increases in health events (overall, cardiovascular and respiratory mortality, and cardiovascular and respiratory hospitalizations). We also explored whether air pollution mediated those associations. We used data from the city of Barcelona (Spain) for the period 2005-2016 on strikes, health events, and ambient air pollution (nitrogen dioxide, nitrogen monoxide, particulate matter (PM) with an aerodynamic diameter ≤10 μm, PM with an aerodynamic diameter ≤2.5μm, PM with an aerodynamic diameter ≤1μm, number of particles with a diameter greater than 5 nm per cm3 (particle number concentration), and black carbon). We used linear and quasi-Poisson regression models to explore the associations between air pollution and public transport strikes and between public transport strikes and health outcomes. We also investigated potential causal mediation by air pollution. Overall, this study suggested that public transport strikes are associated with increased overall mortality, respiratory mortality, and respiratory hospitalizations. However, our findings suggest that such increases are not mediated by the increase in air pollution. Our results indicate the need to further investigate these relationships and potential mechanisms.
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Affiliation(s)
- Margarita Triguero-Mas
- ISGlobal (Barcelona Institute for Global Health), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Èrica Martínez-Solanas
- ISGlobal (Barcelona Institute for Global Health), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jose Barrera-Gómez
- ISGlobal (Barcelona Institute for Global Health), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - David Agis
- ISGlobal (Barcelona Institute for Global Health), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Noemí Pérez
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Barcelona, Spain
| | - Cristina Reche
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Barcelona, Spain
| | - Andrés Alastuey
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Barcelona, Spain
| | - Xavier Querol
- Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Barcelona, Spain
| | - Katherine Pérez
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain
- Institut d’Investigació Biomédica (IIB Sant Pau), Barcelona, Spain
| | - Xavier Basagaña
- ISGlobal (Barcelona Institute for Global Health), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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20
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Sharif H, Devadason D, Abrehart N, Stevenson R, Marciani L. Imaging Measurement of Whole Gut Transit Time in Paediatric and Adult Functional Gastrointestinal Disorders: A Systematic Review and Narrative Synthesis. Diagnostics (Basel) 2019; 9:E221. [PMID: 31847098 PMCID: PMC6963386 DOI: 10.3390/diagnostics9040221] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND functional gastrointestinal disorders (FGID) are common conditions in children and adults, often associated with abnormalities of whole gut transit. Currently, transit tests can be performed using several imaging methods, including tracking of radiopaque markers, gamma scintigraphy with the use of radioisotopes, magnetic tracking methods, tracking of movement of wireless motility capsules, and emerging magnetic resonance imaging (MRI) approaches. OBJECTIVES to review recent literature on diagnostic imaging techniques used to investigate whole gut transit in FGIDs. METHODS a systematic review was carried out. The different techniques are described briefly, with particular emphasis on contemporary literature and new developments, particularly in the field of MRI. CONCLUSIONS emerging MRI capsule marker methods are promising new tools to study whole gut transit in FGIDs.
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Affiliation(s)
- Hayfa Sharif
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham NG7 2UH, UK; (H.S.); (N.A.)
- Amiri Hospital, Ministry of Health, Civil Service Commission, Kuwait City 12025, Kuwait
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK
| | - David Devadason
- Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK;
| | - Nichola Abrehart
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham NG7 2UH, UK; (H.S.); (N.A.)
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK
| | - Rebecca Stevenson
- Precision Imaging Beacon, University of Nottingham, Nottingham NG7 2UH, UK;
| | - Luca Marciani
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham NG7 2UH, UK; (H.S.); (N.A.)
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK
- Precision Imaging Beacon, University of Nottingham, Nottingham NG7 2UH, UK;
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Airaksinen K, Yeung N, Lyra A, Lahtinen SJ, Huttunen T, Shanahan F, Ouwehand AC. The effect of a probiotic blend on gastrointestinal symptoms in constipated patients: a double blind, randomised, placebo controlled 2-week trial. Benef Microbes 2019; 10:617-627. [PMID: 31131616 DOI: 10.3920/bm2018.0163] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Selected strains of lactobacilli and bifidobacteria are known to ameliorate constipation-related symptoms and have previously shown efficacy on digestive health. In this clinical trial, the safety and effectiveness of a probiotic blend containing lactobacilli and bifidobacteria were evaluated in adults with self-reported bloating and functional constipation. Constipation was diagnosed by the Rome III criteria. A total of 156 adults were randomised into this double-blind and placebo-controlled trial. Participants consumed the combination of Lactobacillus acidophilus NCFM (1010 cfu), Lactobacillus paracasei Lpc-37 (2.5×109 cfu), Bifidobacterium animalis subsp. lactis strains Bl-04 (2.5×109 cfu), Bi-07 (2.5×109 cfu) and HN019 (1010 cfu) (n=78), or placebo (microcrystalline cellulose) (n=78) for two weeks. After treatment the following were measured: primary outcome of bloating and secondary outcomes of colonic transit time, bowel movement frequency, stool consistency, other gastrointestinal symptoms (flatulence, abdominal pain, and burbling), constipation-related questionnaires (PAC-SYM and PAC-QoL) and product satisfaction. Faecal recovery of consumed strains was determined. The enrolled population was defined as constipated, however, the initial bloating severity was lower than in previous similar studies. No clinically significant observations related to the safety of the product were reported. Product efficacy was not shown in the primary analysis for bloating nor for the secondary efficacy analyses. The placebo functioned similarly as the probiotic product. In post-hoc analysis, a statistically significant decrease in flatulence in favour of the probiotic group was observed; day 7 (intention-to-treat (ITT): P=0.0313; per-protocol (PP): 0.0253) and on day 14 (ITT: P=0.0116; PP: P=0.0102) as measured by area under the curve (AUC) analysis. The mean AUC of all symptoms decreased in favour of the probiotic group, indicating less digestive discomfort. The study was registered at the ISRCTN registry (ISRCTN41607808).
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Affiliation(s)
- K Airaksinen
- DuPont Nutrition and Health, Global Health & Nutrition Science, Sokeritehtaantie 20, 02460 Kantvik, Finland
| | - N Yeung
- DuPont Nutrition and Health, Global Health & Nutrition Science, Sokeritehtaantie 20, 02460 Kantvik, Finland
| | - A Lyra
- DuPont Nutrition and Health, Global Health & Nutrition Science, Sokeritehtaantie 20, 02460 Kantvik, Finland
| | - S J Lahtinen
- DuPont Nutrition and Health, Global Health & Nutrition Science, Sokeritehtaantie 20, 02460 Kantvik, Finland
| | - T Huttunen
- 4Pharma Ltd, Tykistökatu 4, 20520 Turku, Finland
| | - F Shanahan
- Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
| | - A C Ouwehand
- DuPont Nutrition and Health, Global Health & Nutrition Science, Sokeritehtaantie 20, 02460 Kantvik, Finland
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22
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Posselt M, Eaton H, Ferguson M, Keegan D, Procter N. Enablers of psychological well-being for refugees and asylum seekers living in transitional countries: A systematic review. Health Soc Care Community 2019; 27:808-823. [PMID: 30417476 PMCID: PMC7380010 DOI: 10.1111/hsc.12680] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/21/2018] [Accepted: 10/12/2018] [Indexed: 05/13/2023]
Abstract
The purpose of this systematic review was to locate and synthesise existing peer-reviewed quantitative and qualitative evidence regarding enablers of psychological well-being among refugees and asylum seekers living in transitional countries and for whom migration status is not final. Systematic searches were conducted in nine databases: Academic Search Premier, CINAHL, Embase, Emcare, Medline, Psychology and Behavioral Science, PsycINFO, Scopus, and Web of Science. Search terms were related to refugees and asylum seekers, enablers, and psychological well-being. Studies were limited to those conducted in the last 20 years, with participants who were refugees and asylum seekers with no legal residency status, aged 16 years and above, and living in transit host countries without UNHCR resettlement programmes. This systematic review was conducted between March and June 2018 and followed the PRISMA guidelines. Results were screened by two reviewers at two stages: title and abstracts, and full-text. Critical appraisal and data extraction were also completed by two reviewers. Initial database searching yielded 3,133 results. Following the addition of two records from relevant reference lists and the removal of duplicates, a total of 1,624 results were included for screening. A total of 16 articles were deemed eligible for inclusion in this review, reporting on a collective sample of 1,352 participants. Twelve qualitative and four quantitative studies identified eight enablers of psychological well-being: social support; faith, religion and spirituality; cognitive strategies; education and training opportunities; employment and economic activities; behavioural strategies; political advocacy; and environmental conditions. Despite many challenges associated with forced displacement and the transit period, this review highlights multiple factors that promote well-being and suggest areas for intervention development and resource allocation.
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Affiliation(s)
- Miriam Posselt
- Mental Health and Suicide Prevention Research GroupUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Heather Eaton
- Mental Health and Suicide Prevention Research GroupUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - Monika Ferguson
- Mental Health and Suicide Prevention Research GroupUniversity of South AustraliaAdelaideSouth AustraliaAustralia
| | - David Keegan
- HOST InternationalSydneyNew South WalesAustralia
| | - Nicholas Procter
- Mental Health and Suicide Prevention Research GroupUniversity of South AustraliaAdelaideSouth AustraliaAustralia
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23
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Purić D, Vukčević Marković M. Development and validation of the Stressful Experiences in Transit Questionnaire (SET-Q) and its Short Form (SET-SF). Eur J Psychotraumatol 2019; 10:1611091. [PMID: 31164967 PMCID: PMC6534217 DOI: 10.1080/20008198.2019.1611091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/18/2019] [Accepted: 04/10/2019] [Indexed: 11/29/2022] Open
Abstract
Background: Previous studies have demonstrated that traumatic experiences from countries of origin (so-called pre-migratory factors), as well as stressors in countries of destination (so-called post-migratory factors), are related to the extent of mental health difficulties and psychological well-being of refugees. However, numerous risks that this population is exposed to during transit have so far been neglected. Objective: The aim of this research was to construct and validate a questionnaire for assessing stressful and traumatic experiences in transit as well as its short form, which would at the same time provide information on one's stressful experiences as well as existing risks that refugees are exposed to on their journey. Method: The study was realized in three phases - item construction, item revision and instrument validation. In the validation phase, a total of 226 refugees completed the Stressful Experiences in Transit Questionnaire (SET-Q), along with Harvard Trauma Questionnaire (HTQ) Parts I and IV, Hopkins Symptom Checklist-25 (HSCL-25) and Beck Depression Inventory - II (BDI-II). Results: Refugees were exposed to an average of 13 stressful events during transit. SET-Q total score was positively correlated with HTQ Part IV Post-Traumatic Stress Disorder (PTSD) and Self-Perception of Functioning scales (SPFS) while the number of stressful experiences with the local population was positively related to BDI-II depression symptoms. Moreover, SET-Q scores were significant predictors of PTSD and SPFS even after traumatic experiences in the country of origin, assessed by HTQ Part I, were taken into account. A short form of the questionnaire (SET-SF) has also been developed. Conclusions: SET-Q is a valid instrument for measuring the scope of stressful experiences refugees have been exposed to during transit, targeted for this population specifically. Furthermore, SET-SF has the potential to assess the same extent of stressful experiences with a significantly reduced number of items.
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Affiliation(s)
- Danka Purić
- Faculty of Philosophy, Department of Psychology, University of Belgrade, Belgrade, Serbia
- Faculty of Philosophy, Laboratory for Research of Individual Differences, University of Belgrade, Belgrade, Serbia
| | - Maša Vukčević Marković
- Faculty of Philosophy, Department of Psychology, University of Belgrade, Belgrade, Serbia
- Faculty of Philosophy, Laboratory for Research of Individual Differences and Psychosocial Innovation Network, Belgrade, Serbia
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24
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Sulaiman S, Marciani L. MRI of the Colon in the Pharmaceutical Field: The Future before us. Pharmaceutics 2019; 11:pharmaceutics11040146. [PMID: 30934716 PMCID: PMC6523257 DOI: 10.3390/pharmaceutics11040146] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/22/2019] [Accepted: 03/22/2019] [Indexed: 12/14/2022] Open
Abstract
Oral solid drug formulation is the most common route for administration and it is vital to increase knowledge of the gastrointestinal physiological environment to understand dissolution and absorption processes and to develop reliable biorelevant in vitro tools. In particular, colon targeted drug formulations have raised the attention of pharmaceutical scientists because of the great potential of colonic drug delivery. However, the distal bowel is still a relatively understudied part of the gastrointestinal tract. Recently, magnetic resonance imaging (MRI) has been gaining an emerging role in studying the colon. This article provides a comprehensive; contemporary review of the literature on luminal MRI of the colonic environment of the last 15 years with specific focus on colon physiological dimensions; motility; chyme and fluids; transit and luminal flow. The work reviewed provides novel physiological insight that will have a profound impact on our understanding of the colonic environment for drug delivery and absorption and will ultimately help to raise the in vitro/in vivo relevance of computer simulations and bench models.
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Affiliation(s)
- Sarah Sulaiman
- Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK.
| | - Luca Marciani
- Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK.
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25
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Ndraha N, Hsiao HI. Exposure Assessment and Sensitivity Analysis for Chilled Shrimp During Distribution: A Case Study of Home Delivery Services in Taiwan. J Food Sci 2019; 84:859-870. [PMID: 30912864 DOI: 10.1111/1750-3841.14498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 12/14/2022]
Abstract
In this study, we evaluated the temperature requirements for home delivery in Taiwan by considering food safety risks of chilled shrimp that may be contaminated with Vibrio parahaemolyticus. Pathogenic V. parahaemolyticus was chosen because it was the main cause of foodborne outbreaks originating from contaminated seafood in Taiwan. The risk of becoming ill due to consumption of raw shrimp was estimated to be 7.3 × 10-3 per serving, estimated based on the real-time temperature profile. Lowering the maximum temperature to 7 °C during transit and cooking shrimps at 100 °C for 5 min could reduce the risk by more than 94%. These interventions, therefore, were suggested to be used as an integral part of temperature management control in the home delivery cold chain. These findings can help food authorities to institute temperature management policies and regulations to prevent broken cold chains and reduce food safety risks. PRACTICAL APPLICATION: This research may be applicable to home delivery services that deliver low-temperature food products, such as seafood products.
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Affiliation(s)
- Nodali Ndraha
- Dept. of Food Science, National Taiwan Ocean Univ., No.2, Pei-Ning Rd., Keelung City, 20224, Taiwan
| | - Hsin-I Hsiao
- Dept. of Food Science, National Taiwan Ocean Univ., No.2, Pei-Ning Rd., Keelung City, 20224, Taiwan
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26
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Jalanka J, Major G, Murray K, Singh G, Nowak A, Kurtz C, Silos-Santiago I, Johnston JM, de Vos WM, Spiller R. The Effect of Psyllium Husk on Intestinal Microbiota in Constipated Patients and Healthy Controls. Int J Mol Sci 2019; 20:ijms20020433. [PMID: 30669509 PMCID: PMC6358997 DOI: 10.3390/ijms20020433] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/20/2022] Open
Abstract
Psyllium is a widely used treatment for constipation. It traps water in the intestine increasing stool water, easing defaecation and altering the colonic environment. We aimed to assess the impact of psyllium on faecal microbiota, whose key role in gut physiology is being increasingly recognised. We performed two randomised, placebo-controlled, double-blinded trials comparing 7 days of psyllium with a placebo (maltodextrin) in 8 healthy volunteers and 16 constipated patients respectively. We measured the patients’ gastrointestnal (GI) transit, faecal water content, short-chain fatty acid (SCFA) and the stool microbiota composition. While psyllium supplement had a small but significant effect on the microbial composition of healthy adults (increasing Veillonella and decreasing Subdoligranulum), in constipated subjects there were greater effects on the microbial composition (increased Lachnospira, Faecalibacterium, Phascolarctobacterium, Veillonella and Sutterella and decreased uncultured Coriobacteria and Christensenella) and alterations in the levels of acetate and propionate. We found several taxa to be associated with altered GI transit, SCFAs and faecal water content in these patients. Significant increases in three genera known to produce butyrate, Lachnospira, Roseburia and Faecalibacterium, correlated with increased faecal water. In summary, psyllium supplementation increased stool water and this was associated with significant changes in microbiota, most marked in constipated patients.
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Affiliation(s)
- Jonna Jalanka
- Immunobiology Research Program and Department of Bacteriology and Immunology, Faculty of Medicine, University of Helsinki, 00014 HY Helsinki, Finland.
- Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Notts NG7 2UH, UK.
| | - Giles Major
- Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Notts NG7 2UH, UK.
| | - Kathryn Murray
- Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Notts NG7 2UH, UK.
| | - Gulzar Singh
- Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Notts NG7 2UH, UK.
| | - Adam Nowak
- Nottingham University Hospitals NHS Trust, the University of Nottingham, Nottinghamshire NG5 1PB, UK.
| | | | | | - Jeffrey M Johnston
- Neurogastrx, Inc., Woburn, MA 01801, USA, formerly at Ironwood Pharmaceuticals, Cambridge, MA 02142, USA.
| | - Willem M de Vos
- Laboratory of Microbiology, Wageningen University, 6708WE Wageningen, The Netherlands.
| | - Robin Spiller
- Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Notts NG7 2UH, UK.
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27
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Dong S, Xie JW, Zhou JL, Zheng Z, Luo A. LAMOST telescope reveals that Neptunian cousins of hot Jupiters are mostly single offspring of stars that are rich in heavy elements. Proc Natl Acad Sci U S A 2018; 115:266-71. [PMID: 29284755 DOI: 10.1073/pnas.1711406115] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We discover a population of short-period, Neptune-size planets sharing key similarities with hot Jupiters: both populations are preferentially hosted by metal-rich stars, and both are preferentially found in Kepler systems with single-transiting planets. We use accurate Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST) Data Release 4 (DR4) stellar parameters for main-sequence stars to study the distributions of short-period [Formula: see text] Kepler planets as a function of host star metallicity. The radius distribution of planets around metal-rich stars is more "puffed up" compared with that around metal-poor hosts. In two period-radius regimes, planets preferentially reside around metal-rich stars, while there are hardly any planets around metal-poor stars. One is the well-known hot Jupiters, and the other one is a population of Neptune-size planets ([Formula: see text]), dubbed "Hoptunes." Also like hot Jupiters, Hoptunes occur more frequently in systems with single-transiting planets although the fraction of Hoptunes occurring in multiples is larger than that of hot Jupiters. About [Formula: see text] of solar-type stars host Hoptunes, and the frequencies of Hoptunes and hot Jupiters increase with consistent trends as a function of [Fe/H]. In the planet radius distribution, hot Jupiters and Hoptunes are separated by a "valley" at approximately Saturn size (in the range of [Formula: see text]), and this "hot-Saturn valley" represents approximately an order-of-magnitude decrease in planet frequency compared with hot Jupiters and Hoptunes. The empirical "kinship" between Hoptunes and hot Jupiters suggests likely common processes (migration and/or formation) responsible for their existence.
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Parthasarathy G, Chen J, Chia N, O'Connor HM, Gaskins HR, Bharucha AE. Reproducibility of assessing fecal microbiota in chronic constipation. Neurogastroenterol Motil 2017; 29:1-10. [PMID: 28752633 PMCID: PMC5593773 DOI: 10.1111/nmo.13172] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 06/29/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND While limited data suggest that the fecal microbiota in healthy people is stable over time, the intraindividual variability of the fecal microbiota in constipated patients is unknown. METHODS This study evaluated the intraindividual reproducibility of fecal microbiota analyzed with 16S rRNA gene sequencing in two stool samples collected without and after a laxative, respectively, in 25 healthy people and 25 constipated women. Participants completed a food record for 3 d before the stool collection. Colonic transit was measured with scintigraphy. KEY RESULTS The constipated patients were older (48±15 vs 39±10 y, P=.02) than healthy participants but had a similar BMI. The total daily caloric intake was less (P=.005) in constipated (1265±350 kcal) than healthy participants (1597±402 kcal). Fourteen patients but only two controls (P<.005), had delayed colonic transit. For most measures of alpha (eg, Observed OTU number, Shannon index) and beta diversity (eg, Bray-Curtis dissimilarity, UniFrac, phyla level abundance), the ICCs between two stool samples were high, indicating moderate or strong agreement, and similar in healthy people and constipated patients. The ICC for the weighted UniFrac distance, which is weighted by abundance, was lower than its unweighted counterpart, indicating that the unweighted measure is more robust and reproducible. CONCLUSIONS AND INFERENCES The intraindividual reproducibility of fecal microbiota in constipated patients is high and comparable to healthy participants. For most purposes, evaluating the fecal microbiota in a single stool sample should generally suffice in adequately powered studies of healthy and constipated patients.
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Affiliation(s)
- Gopanandan Parthasarathy
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, 55905 USA
| | - Jun Chen
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905 USA,Center for Individualized Medicine, Mayo Clinic, Rochester, MN, 55905 USA
| | - Nicholas Chia
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905 USA,Center for Individualized Medicine, Mayo Clinic, Rochester, MN, 55905 USA
| | - Helen M. O'Connor
- Clinical Research and Trials Unit, Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, 55905 USA
| | - H. Rex Gaskins
- Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana-Champaign, IL 61801 USA
| | - Adil E. Bharucha
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, 55905 USA
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29
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Wolf PG, Parthasarathy G, Chen J, O’Connor HM, Chia N, Bharucha AE, Gaskins HR. Assessing the colonic microbiome, hydrogenogenic and hydrogenotrophic genes, transit and breath methane in constipation. Neurogastroenterol Motil 2017; 29:1-9. [PMID: 28295896 PMCID: PMC5593760 DOI: 10.1111/nmo.13056] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 02/06/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Differences in the gut microbiota and breath methane production have been observed in chronic constipation, but the relationship between colonic microbiota, transit, and breath tests remains unclear. METHODS In 25 healthy and 25 constipated females we evaluated the sigmoid colonic mucosal and fecal microbiota using 16S rRNA gene sequencing, abundance of hydrogenogenic FeFe (FeFe-hydA) and hydrogenotrophic (methyl coenzyme M reductase A [mrcA] and dissimilatory sulfite reductase A [dsrA]) genes with real-time qPCR assays, breath hydrogen and methane levels after oral lactulose, and colonic transit with scintigraphy. KEY RESULTS Breath hydrogen and methane were not correlated with constipation, slow colon transit, or with abundance of corresponding genes. After adjusting for colonic transit, the abundance of FeFehydA, dsrA, and mcrA were greater (P<.005) in colonic mucosa, but not stool, of constipated patients. The abundance of the selected functional gene targets also correlated with that of selected taxa. The colonic mucosal abundance of FeFe-hydA, but not mcrA, correlated positively (P<.05) with breath methane production, slow colonic transit, and overall microbiome composition. In the colonic mucosa and feces, the abundance of hydrogenogenic and hydrogenotrophic genes were positively correlated (P<.05). Breath methane production was not associated with constipation or colonic transit. CONCLUSIONS & INFERENCES Corroborating our earlier findings with 16S rRNA genes, colonic mucosal but not fecal hydrogenogenic and hydrogenotrophic genes were more abundant in constipated vs. healthy subjects independent of colonic transit. Breath gases do not directly reflect the abundance of target genes contributing to their production.
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Affiliation(s)
- Patricia G. Wolf
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Gopanandan Parthasarathy
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jun Chen
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Helen M. O’Connor
- Clinical Research and Trials Unit, Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, 55905 USA
| | - Nicholas Chia
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA,Microbiome Program, Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Adil E. Bharucha
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - H. Rex Gaskins
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA,Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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30
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Ritz NL, Lin DM, Wilson MR, Barton LL, Lin HC. Sulfate-reducing bacteria slow intestinal transit in a bismuth-reversible fashion in mice. Neurogastroenterol Motil 2017; 29. [PMID: 27477318 DOI: 10.1111/nmo.12907] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 06/21/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Hydrogen sulfide (H2 S) serves as a mammalian cell-derived gaseous neurotransmitter. The intestines are exposed to a second source of this gas by sulfate-reducing bacteria (SRB). Bismuth subsalicylate binds H2 S rendering it insoluble. The aim of this study was to test the hypothesis that SRB may slow intestinal transit in a bismuth-reversible fashion. METHODS Eighty mice were randomized to five groups consisting of Live SRB, Killed SRB, SRB+Bismuth, Bismuth, and Saline. Desulfovibrio vulgaris, a common strain of SRB, was administered by gavage at the dose of 1.0 × 109 cells along with rhodamine, a fluorescent dye. Intestinal transit was measured 50 minutes after gavage by euthanizing the animals, removing the small intestine between the pyloric sphincter and the ileocecal valve and visualizing the distribution of rhodamine across the intestine using an imaging system (IVIS, Perkin-Elmer). Intestinal transit (n=50) was compared using geometric center (1=minimal movement, 100=maximal movement). H2 S concentration (n=30) was also measured when small intestinal luminal content was allowed to generate this gas. KEY RESULTS The Live SRB group had slower intestinal transit as represented by a geometric center score of 40.2 ± 5.7 when compared to Saline: 73.6 ± 5.7, Killed SRB: 77.9 ± 6.9, SRB+Bismuth: 81.0 ± 2.0, and Bismuth: 73.3 ± 4.2 (P<.0001). Correspondingly, the Live SRB group had the highest luminal H2 S concentration of 4181.0 ± 968.0 ppb compared to 0 ± 0 ppb for the SRB+Bismuth group (P<.0001). CONCLUSIONS & INFERENCES Live SRB slow intestinal transit in a bismuth-reversible fashion in mice. Our results demonstrate that intestinal transit is slowed by SRB and this effect could be abolished by H2 S-binding bismuth.
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Affiliation(s)
- N L Ritz
- Section of Gastroenterology, New Mexico VA Health Care System, Albuquerque, NM, USA.,Department of Biology, University of New Mexico, Albuquerque, NM, USA
| | - D M Lin
- Section of Gastroenterology, New Mexico VA Health Care System, Albuquerque, NM, USA
| | - M R Wilson
- Section of Gastroenterology, New Mexico VA Health Care System, Albuquerque, NM, USA
| | - L L Barton
- Department of Biology, University of New Mexico, Albuquerque, NM, USA
| | - H C Lin
- Section of Gastroenterology, New Mexico VA Health Care System, Albuquerque, NM, USA.,Department of Medicine, University of New Mexico, Albuquerque, NM, USA
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31
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Chen YY, Sung FC, Chen ML, Mao IF, Lu CY. Indoor Air Quality in the Metro System in North Taiwan. Int J Environ Res Public Health 2016; 13:ijerph13121200. [PMID: 27918460 PMCID: PMC5201341 DOI: 10.3390/ijerph13121200] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 12/16/2022]
Abstract
Indoor air pollution is an increasing health concern, especially in enclosed environments such as underground subway stations because of increased global usage by urban populations. This study measured the indoor air quality of underground platforms at 10 metro stations of the Taipei Rapid Transit system (TRTS) in Taiwan, including humidity, temperature, carbon monoxide (CO), carbon dioxide (CO2), formaldehyde (HCHO), total volatile organic compounds (TVOCs), ozone (O3), airborne particulate matter (PM10 and PM2.5), bacteria and fungi. Results showed that the CO2, CO and HCHO levels met the stipulated standards as regulated by Taiwan’s Indoor Air Quality Management Act (TIAQMA). However, elevated PM10 and PM2.5 levels were measured at most stations. TVOCs and bacterial concentrations at some stations measured in summer were higher than the regulated standards stipulated by Taiwan’s Environmental Protection Administration. Further studies should be conducted to reduce particulate matters, TVOCs and bacteria in the air of subway stations.
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Affiliation(s)
- Ying-Yi Chen
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming University, Taipei 11221, Taiwan.
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung 40402, Taiwan.
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung 40402, Taiwan.
| | - Mei-Lien Chen
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming University, Taipei 11221, Taiwan.
| | - I-Fang Mao
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Chung-Yen Lu
- Department of Sport and Health Management, Da-Yeh University, No.168, University Rd., Dacun, Changhua 51591, Taiwan.
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
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Xie JW, Dong S, Zhu Z, Huber D, Zheng Z, De Cat P, Fu J, Liu HG, Luo A, Wu Y, Zhang H, Zhang H, Zhou JL, Cao Z, Hou Y, Wang Y, Zhang Y. Exoplanet orbital eccentricities derived from LAMOST-Kepler analysis. Proc Natl Acad Sci U S A 2016; 113:11431-5. [PMID: 27671635 DOI: 10.1073/pnas.1604692113] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The nearly circular (mean eccentricity [Formula: see text]) and coplanar (mean mutual inclination [Formula: see text]) orbits of the solar system planets motivated Kant and Laplace to hypothesize that planets are formed in disks, which has developed into the widely accepted theory of planet formation. The first several hundred extrasolar planets (mostly Jovian) discovered using the radial velocity (RV) technique are commonly on eccentric orbits ([Formula: see text]). This raises a fundamental question: Are the solar system and its formation special? The Kepler mission has found thousands of transiting planets dominated by sub-Neptunes, but most of their orbital eccentricities remain unknown. By using the precise spectroscopic host star parameters from the Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST) observations, we measure the eccentricity distributions for a large (698) and homogeneous Kepler planet sample with transit duration statistics. Nearly half of the planets are in systems with single transiting planets (singles), whereas the other half are multiple transiting planets (multiples). We find an eccentricity dichotomy: on average, Kepler singles are on eccentric orbits with [Formula: see text] 0.3, whereas the multiples are on nearly circular [Formula: see text] and coplanar [Formula: see text] degree) orbits similar to those of the solar system planets. Our results are consistent with previous studies of smaller samples and individual systems. We also show that Kepler multiples and solar system objects follow a common relation [[Formula: see text](1-2)[Formula: see text]] between mean eccentricities and mutual inclinations. The prevalence of circular orbits and the common relation may imply that the solar system is not so atypical in the galaxy after all.
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Hsu T, Joice R, Vallarino J, Abu-Ali G, Hartmann EM, Shafquat A, DuLong C, Baranowski C, Gevers D, Green JL, Morgan XC, Spengler JD, Huttenhower C. Urban Transit System Microbial Communities Differ by Surface Type and Interaction with Humans and the Environment. mSystems 2016; 1:e00018-16. [PMID: 27822528 DOI: 10.1128/mSystems.00018-16] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 03/28/2016] [Indexed: 01/01/2023] Open
Abstract
Public transit systems are ideal for studying the urban microbiome and interindividual community transfer. In this study, we used 16S amplicon and shotgun metagenomic sequencing to profile microbial communities on multiple transit surfaces across train lines and stations in the Boston metropolitan transit system. The greatest determinant of microbial community structure was the transit surface type. In contrast, little variation was observed between geographically distinct train lines and stations serving different demographics. All surfaces were dominated by human skin and oral commensals such as Propionibacterium, Corynebacterium, Staphylococcus, and Streptococcus. The detected taxa not associated with humans included generalists from alphaproteobacteria, which were especially abundant on outdoor touchscreens. Shotgun metagenomics further identified viral and eukaryotic microbes, including Propionibacterium phage and Malassezia globosa. Functional profiling showed that Propionibacterium acnes pathways such as propionate production and porphyrin synthesis were enriched on train holding surfaces (holds), while electron transport chain components for aerobic respiration were enriched on touchscreens and seats. Lastly, the transit environment was not found to be a reservoir of antimicrobial resistance and virulence genes. Our results suggest that microbial communities on transit surfaces are maintained from a metapopulation of human skin commensals and environmental generalists, with enrichments corresponding to local interactions with the human body and environmental exposures. IMPORTANCE Mass transit environments, specifically, urban subways, are distinct microbial environments with high occupant densities, diversities, and turnovers, and they are thus especially relevant to public health. Despite this, only three culture-independent subway studies have been performed, all since 2013 and all with widely differing designs and conclusions. In this study, we profiled the Boston subway system, which provides 238 million trips per year overseen by the Massachusetts Bay Transportation Authority (MBTA). This yielded the first high-precision microbial survey of a variety of surfaces, ridership environments, and microbiological functions (including tests for potential pathogenicity) in a mass transit environment. Characterizing microbial profiles for multiple transit systems will become increasingly important for biosurveillance of antibiotic resistance genes or pathogens, which can be early indicators for outbreak or sanitation events. Understanding how human contact, materials, and the environment affect microbial profiles may eventually allow us to rationally design public spaces to sustain our health in the presence of microbial reservoirs. Author Video: An author video summary of this article is available.
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Durand CP, Oluyomi AO, Gabriel KP, Salvo D, Sener IN, Hoelscher DM, Knell G, Tang X, Porter AK, Robertson MC, Kohl HW. The Effect of Light Rail Transit on Physical Activity: Design and Methods of the Travel-Related Activity in Neighborhoods Study. Front Public Health 2016; 4:103. [PMID: 27376051 PMCID: PMC4899453 DOI: 10.3389/fpubh.2016.00103] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/05/2016] [Indexed: 11/13/2022] Open
Abstract
Background Use of mass transit has been proposed as a way to incorporate regular physical activity into daily life because transit use typically requires additional travel to access and depart the stop or station. If this additional travel is active, a small but potentially important amount of physical activity can be achieved daily. Although prior research has shown that transit use is associated with physical activity, important questions remain unanswered. Utilizing a major expansion of the Houston, TX, USA light-rail system as a natural experiment, the Houston Travel-Related Activity in Neighborhoods (TRAIN) Study was developed to address these unanswered questions. Purpose The purpose of the TRAIN Study is to determine if the development of light-rail lines in Houston, TX, USA will prospectively affect both transit use and physical activity over 4 years. We also aim to understand how contextual effects (i.e., moderators or interaction effects), such as the neighborhood built environment and socioeconomic factors, affect the primary relations under study. Methods The TRAIN Study is a longitudinal cohort design, in which participants are recruited at baseline from a 3-mile buffer around each of the three new lines and measured annually four times. Recruitment is accomplished via telephone contact, ads in newspapers and advertising circulars, and targeted community outreach. Data are collected via mail and include questionnaire-assessed factors, such as perceived neighborhood characteristics, attitudes about transportation, demographics, and reported physical activity; a travel diary; and accelerometry. Additionally, field-based neighborhood audits are conducted to capture micro-scale environmental features. To assess macro-scale environmental characteristics, we utilize GIS mapping and spatial analyses. Statistical analyses will be conducted using latent growth curve modeling and discrete choice models, with a focus on identifying moderating factors (i.e., statistical interaction effects). Selection bias will be controlled via propensity score analysis. Conclusion The TRAIN study is a unique opportunity to study how a multi-billion dollar investment in mass transit can simultaneously affect transportation needs and physical activity behavior. This comprehensive evaluation will provide needed evidence for policy makers, and can inform health impact assessments of future transportation projects around the world.
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Affiliation(s)
- Casey P Durand
- Department of Health Promotion and Behavioral Science, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA; Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Abiodun O Oluyomi
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health , Austin, TX , USA
| | - Kelley Pettee Gabriel
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA; Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Deborah Salvo
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA; The University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA; Center for Nutrition and Health Research, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - Ipek N Sener
- Texas A&M Transportation Institute , Austin, TX , USA
| | - Deanna M Hoelscher
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA; Department of Health Promotion and Behavioral Science, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Gregory Knell
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA; Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Xiaohui Tang
- Department of Health Promotion and Behavioral Science, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA; Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Anna K Porter
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA; Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Michael C Robertson
- Department of Health Promotion and Behavioral Science, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA; Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Harold W Kohl
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA; Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA; University of Texas at Austin, Austin, TX, USA
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Norris ML, Harrison ME, Isserlin L, Robinson A, Feder S, Sampson M. Gastrointestinal complications associated with anorexia nervosa: A systematic review. Int J Eat Disord 2016; 49:216-37. [PMID: 26407541 DOI: 10.1002/eat.22462] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [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] [Accepted: 08/17/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE A systematic review identifying gastrointestinal (GI) complications attributable to anorexia nervosa (AN) was completed. METHOD Studies of any design exploring the pathogenesis of complications and treatment strategies were included. The review was completed in accordance with PRISMA standards. RESULTS A total of 123 articles were retained, including one randomized control trial. The majority of included studies were case reports and case series. Controlled studies demonstrated that patients with AN were more likely to have delays in gastric motility, gastric emptying and intestinal transit than comparator groups although results were not uniform across all studies. Published reports suggest that complications can occur at any segment of the GI tract. These issues may derive as a consequence of severe malnourishment, from eating disorder related symptoms such as self-induced purging or from the refeeding process itself. Multiple studies noted that patients with AN report high rates of GI symptoms although in the few cases where medical testing was undertaken, correlations between self-reported symptoms and measurable pathology were not demonstrated. DISCUSSION GI complications may occur throughout the entire GI tract in patients with AN. It is recommended that clinicians use careful judgment when pursuing targeted investigation or introducing symptom specific treatments in response to GI complaints. Evidence suggests that most GI complications resolve with refeeding and cessation of ED symptoms.
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Affiliation(s)
- Mark L Norris
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Megan E Harrison
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Leanna Isserlin
- Department of Psychiatry, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Amy Robinson
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Stephen Feder
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Margaret Sampson
- Library and Media Services, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Camilleri M, Bueno L, Andresen V, De Ponti F, Choi MG, Lembo A. Pharmacological, Pharmacokinetic, and Pharmacogenomic Aspects of Functional Gastrointestinal Disorders. Gastroenterology 2016; 150:S0016-5085(16)00220-1. [PMID: 27144621 DOI: 10.1053/j.gastro.2016.02.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 02/09/2016] [Indexed: 02/08/2023]
Abstract
This article reviews medications commonly used for the treatment of patients with functional gastrointestinal disorders. Specifically, we review the animal models that have been validated for the study of drug effects on sensation and motility; the preclinical pharmacology, pharmacokinetics, and toxicology usually required for introduction of new drugs; the biomarkers that are validated for studies of sensation and motility endpoints with experimental medications in humans; the pharmacogenomics applied to these medications and their relevance to the FGIDs; and the pharmacology of agents that are applied or have potential for the treatment of FGIDs, including psychopharmacologic drugs.
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Affiliation(s)
- Michael Camilleri
- Professor of Medicine, Pharmacology, and Physiology, Mayo Clinic College of Medicine, Consultant in Gastroenterology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Viola Andresen
- Israelitic Hospital, University of Hamburg, Orchideenstieg 14, Hamburg, Germany
| | - Fabrizio De Ponti
- Professor of Pharmacology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Myung-Gyu Choi
- Professor of Gastroenterology, The Catholic University of Korea College of Medicine Internal Medicine , President, Korean Society of Neurogastroenterology and Motility , Seoul, Korea
| | - Anthony Lembo
- Associate Professor, Harvard Medical School, Director of the GI Motility Laboratory at the Beth Israel Deaconess Medical Center's (BIDMC) Division of Gastroenterology, Boston, MA, USA
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37
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Abstract
Bike sharing can play a role in providing access to transit stations and then to final destinations, but early implementation of these systems in North America has been opportunistic rather than strategic. This study evaluates local intermodal plan goals using trip data and associated infrastructure such as transit stops and bike share station locations in Austin, Texas, and Chicago, Illinois. Bike sharing use data from both cities suggest a weak relationship with existing rail stations that could be strengthened through collaborative, intermodal planning. The study suggests a planning framework and example language that could be tailored to help address the linkage between bike sharing and transit. Rather than an exhaustive study of the practice, this study provides evidence from these two cities that identify opportunities to improve intermodal planning. Cities that are planning or expanding a bike sharing system should consider carefully how to leverage this mode with existing modes of transport. Regardless of a city's status in implementing a bike sharing system, planners can leverage information on existing transport systems for planning at regional and local levels.
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Alyami J, Spiller RC, Marciani L. Magnetic resonance imaging to evaluate gastrointestinal function. Neurogastroenterol Motil 2015; 27:1687-92. [PMID: 26598049 DOI: 10.1111/nmo.12726] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 10/14/2015] [Indexed: 02/08/2023]
Abstract
Magnetic resonance imaging of gastrointestinal (GI) function has advanced substantially in the last few years. The ability to obtain high resolution images of the undisturbed bowel with tunable tissue contrast and using no ionizing radiation are clear advantages, particularly for children and women of reproductive age. Barriers to diffusion in clinical practice so far include the need to demonstrate clinical value and the burden of data processing. Both difficulties are being addressed and the technique is providing novel insights into both upper and lower GI disorders of function at an ever increasing rate.
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Affiliation(s)
- J Alyami
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR Nottingham Digestive Disease Biomedical Research Unit, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - R C Spiller
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR Nottingham Digestive Disease Biomedical Research Unit, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - L Marciani
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR Nottingham Digestive Disease Biomedical Research Unit, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
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Abstract
In 2009, two trains of Washington, DC's Metrorail system collided, resulting in nine deaths and 50 serious injuries. Based on a multiwave survey of Metrorail users in the months after the crash, this article reports how the accident appears to have (1) changed over time the tradeoffs among safety, speed, frequency of service, cost, and reliability that the transit users stated they were willing to make in the postaccident period and (2) altered transit users' concerns about safety as a function of time and distance from the accident site. We employ conditional logit models to examine tradeoffs among stated preferences for system performance measures after the accident, as well as the influence that respondent characteristics of transit use, location, income, age, and gender have on these preference tradeoffs. As expected, respondents appear averse to longer headways between trains, longer travel durations, higher travel costs, a higher number of late trains, and a higher number of fatalities. The models also show evidence of higher aversion to fatalities from transit system operation among females compared to males. In addition, respondents less experienced with Metrorail travel and those with lower household incomes show higher aversion to fatalities, and this aversion increases as a subject's psychological distance from the accident site decreases. Contrary to expectations shaped by previous studies, aversion to fatalities appears to have increased between the early months after the accident and the end of the survey period, and the expected relationship between age and aversion to fatalities is not statistically significant.
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Affiliation(s)
- Kris Wernstedt
- School of Public and International Affairs, Virginia Tech, Alexandria, VA, USA
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40
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Camilleri M, Shin A, Busciglio I, Carlson P, Acosta A, Bharucha AE, Burton D, Lamsam J, Lueke A, Donato LJ, Zinsmeister AR. Validating biomarkers of treatable mechanisms in irritable bowel syndrome. Neurogastroenterol Motil 2014; 26:1677-85. [PMID: 25244349 PMCID: PMC4245393 DOI: 10.1111/nmo.12421] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [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: 06/12/2014] [Accepted: 08/06/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND A valid biomarker is 'an indicator of normal biologic or pathogenic processes, or pharmacological responses to a therapeutic intervention'. There is no validated biomarker for irritable bowel syndrome (IBS). The aim of the study was to assess ability of three quantitative traits to identify treatable processes to discriminate between IBS-diarrhea (IBS-D) patients, IBS-constipation (IBS-C) patients and healthy volunteers (HV). METHODS In 30 HV, 30 IBS-C patients and 64 IBS-D patients, we characterized bowel symptoms and quantitated pathophysiological mechanisms: bile acid (BA) synthesis (serum C4 and FGF19), fecal BA and fat, colonic transit (CT), and intestinal permeability (IP). We used multiple logistic regression and receiver-operating characteristic (ROCAUC ) to appraise three factors (fecal BA, CT, and IP) individually and in combination to identify discriminant targets for treatment in IBS. KEY RESULTS There were significant associations between the three subgroups and symptoms reflecting bowel function and the quantitative traits. There were significant associations between fecal BA and CT at 48 h (r = 0.43; p < 0.001) and between fecal BA and IP (r = 0.23; p = 0.015). Individually, fecal BA and CT48 (but not IP) were significant independent predictors for distinguishing HV from IBS. In combination, they discriminated HV from IBS-D patients (ROCAUC 0.70), HV from IBS-C patients (ROCAUC 0.73), and IBS-C patients from IBS-D patients (ROCAUC 0.86). Colonic transit and fecal BA excretion together discriminate between healthy volunteers and IBS-C patients or IBS-D patients, or between the IBS subgroups with 75-90% specificity at 60% sensitivity. CONCLUSIONS & INFERENCES Colonic transit and fecal BA individually and together constitute useful biomarkers to identify treatable mechanisms in IBS and to differentiate subgroups of IBS.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Alan Lueke
- Department of Laboratory Medicine and Pathology, Mayo Clinic College
of Medicine, Rochester, Minnesota
| | - Leslie J. Donato
- Department of Laboratory Medicine and Pathology, Mayo Clinic College
of Medicine, Rochester, Minnesota
| | - Alan R. Zinsmeister
- Division of Biomedical Statistics and Informatics, Department of Health
Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
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Camilleri M, Shin A, Busciglio I, Carlson P, Acosta A, Bharucha AE, Burton D, Lamsam J, Lueke A, Donato LJ, Zinsmeister AR. Genetic variation in GPBAR1 predisposes to quantitative changes in colonic transit and bile acid excretion. Am J Physiol Gastrointest Liver Physiol 2014; 307:G508-16. [PMID: 25012842 PMCID: PMC4154122 DOI: 10.1152/ajpgi.00178.2014] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [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] [Received: 05/15/2014] [Accepted: 06/25/2014] [Indexed: 01/31/2023]
Abstract
The pathobiology of irritable bowel syndrome (IBS) is multifaceted. We aimed to identify candidate genes predisposing to quantitative traits in IBS. In 30 healthy volunteers, 30 IBS-constipation, and 64 IBS-diarrhea patients, we measured bowel symptoms, bile acid (BA) synthesis (serum 7α-hydroxy-4-cholesten-3-one and FGF19), fecal BA and fat, colonic transit (CT by scintigraphy), and intestinal permeability (IP by 2-sugar excretion). We assessed associations of candidate genes controlling BA metabolism (KLB rs17618244 and FGFR4 rs351855), BA receptor (GPBAR1 rs11554825), serotonin (5-HT) reuptake (SLC6A4 through rs4795541 which encodes for the 44-bp insert in 5HTTLPR), or immune activation (TNFSF15 rs4263839) with three primary quantitative traits of interest: colonic transit, BA synthesis, and fecal BA excretion. There were significant associations between fecal BA and CT at 48 h (r = 0.43; P < 0.001) and IP (r = 0.23; P = 0.015). GPBAR1 genotype was associated with CT48 (P = 0.003) and total fecal BA [P = 0.030, false detection rate (FDR) P = 0.033]. Faster CT48 observed with both CC and TT GPBAR1 genotypes was due to significant interaction with G allele of KLB, which increases BA synthesis and excretion. Other univariate associations (P < 0.05, without FDR correction) observed between GPBAR1 and symptom phenotype and gas sensation ratings support the role of GPBAR1 receptor. Associations between SLC6A4 and stool consistency, ease of passage, postprandial colonic tone, and total fecal BA excretion provide data in support of future hypothesis-testing studies. Genetic control of GPBAR1 receptor predisposing to pathobiological mechanisms in IBS provides evidence from humans in support of the importance of GPBAR1 to colonic motor and secretory functions demonstrated in animal studies.
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Affiliation(s)
- Michael Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic College of Medicine, Rochester, Minnesota;
| | - Andrea Shin
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Irene Busciglio
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Paula Carlson
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Andres Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Adil E Bharucha
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Duane Burton
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Jesse Lamsam
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Alan Lueke
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota; and
| | - Leslie J Donato
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota; and
| | - Alan R Zinsmeister
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota
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Sia TC, Whiting M, Kyloh M, Nicholas SJ, Oliver J, Brookes SJ, Dinning PG, Wattchow DA, Spencer NJ. 5-HT3 and 5-HT4 antagonists inhibit peristaltic contractions in guinea-pig distal colon by mechanisms independent of endogenous 5-HT. Front Neurosci 2013; 7:136. [PMID: 23935564 PMCID: PMC3732893 DOI: 10.3389/fnins.2013.00136] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 07/15/2013] [Indexed: 11/23/2022] Open
Abstract
Recent studies have shown that endogenous serotonin is not required for colonic peristalsis in vitro, nor gastrointestinal (GI) transit in vivo. However, antagonists of 5-Hydroxytryptamine (5-HT) receptors can inhibit peristalsis and GI-transit in mammals, including humans. This raises the question of how these antagonists inhibit GI-motility and transit, if depletion of endogenous 5-HT does not cause any significant inhibitory changes to either GI-motility or transit? We investigated the mechanism by which 5-HT3 and 5-HT4 antagonists inhibit distension-evoked peristaltic contractions in guinea-pig distal colon. In control animals, repetitive peristaltic contractions of the circular muscle were evoked in response to fixed fecal pellet distension. Distension-evoked peristaltic contractions were unaffected in animals with mucosa and submucosal plexus removed, that were also treated with reserpine (to deplete neuronal 5-HT). In control animals, peristaltic contractions were blocked temporarily by ondansetron (1–10 μM) and SDZ-205–557 (1–10 μM) in many animals. Interestingly, after this temporary blockade, and whilst in the continued presence of these antagonists, peristaltic contractions recovered, with characteristics no different from controls. Surprisingly, similar effects were seen in mucosa-free preparations, which had no detectable 5-HT, as detected by mass spectrometry. In summary, distension-evoked peristaltic reflex contractions of the circular muscle layer of the guinea-pig colon can be inhibited temporarily, or permanently, in the same preparation by selective 5-HT3 and 5-HT4 antagonists, depending on the concentration of the antagonists applied. These effects also occur in preparations that lack any detectable 5-HT. We suggest caution should be exercised when interpreting the effects of 5-HT3 and 5-HT4 antagonists; and the role of endogenous 5-HT, in the generation of distension-evoked colonic peristalsis.
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Affiliation(s)
- Tiong C Sia
- Discipline of Human Physiology and Center for Neuroscience, Flinders University Adelaide, SA, Australia
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Vazquez-Roque MI, Camilleri M, Smyrk T, Murray JA, Marietta E, O’Neill J, Carlson P, Lamsam J, Janzow D, Eckert D, Burton D, Zinsmeister AR. A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea: effects on bowel frequency and intestinal function. Gastroenterology 2013; 144:903-911.e3. [PMID: 23357715 PMCID: PMC3633663 DOI: 10.1053/j.gastro.2013.01.049] [Citation(s) in RCA: 303] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 01/10/2013] [Accepted: 01/15/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Patients with diarrhea-predominant irritable bowel syndrome (IBS-D) could benefit from a gluten-free diet (GFD). METHODS We performed a randomized controlled 4-week trial of a gluten-containing diet (GCD) or GFD in 45 patients with IBS-D; genotype analysis was performed for HLA-DQ2 and HLA-DQ8. Twenty-two patients were placed on the GCD (11 HLA-DQ2/8 negative and 11 HLA-DQ2/8 positive) and 23 patients were placed on the GFD (12 HLA-DQ2/8 negative and 11 HLA-DQ2/8 positive). We measured bowel function daily, small-bowel (SB) and colonic transit, mucosal permeability (by lactulose and mannitol excretion), and cytokine production by peripheral blood mononuclear cells after exposure to gluten and rice. We collected rectosigmoid biopsy specimens from 28 patients, analyzed levels of messenger RNAs encoding tight junction proteins, and performed H&E staining and immunohistochemical analyses. Analysis of covariance models was used to compare data from the GCD and GFD groups. RESULTS Subjects on the GCD had more bowel movements per day (P = .04); the GCD had a greater effect on bowel movements per day of HLA-DQ2/8-positive than HLA-DQ2/8-negative patients (P = .019). The GCD was associated with higher SB permeability (based on 0-2 h levels of mannitol and the lactulose:mannitol ratio); SB permeability was greater in HLA-DQ2/8-positive than HLA-DQ2/8-negative patients (P = .018). No significant differences in colonic permeability were observed. Patients on the GCD had a small decrease in expression of zonula occludens 1 in SB mucosa and significant decreases in expression of zonula occludens 1, claudin-1, and occludin in rectosigmoid mucosa; the effects of the GCD on expression were significantly greater in HLA-DQ2/8-positive patients. The GCD vs the GFD had no significant effects on transit or histology. Peripheral blood mononuclear cells produced higher levels of interleukin-10, granulocyte colony-stimulating factor, and transforming growth factor-α in response to gluten than rice (unrelated to HLA genotype). CONCLUSIONS Gluten alters bowel barrier functions in patients with IBS-D, particularly in HLA-DQ2/8-positive patients. These findings reveal a reversible mechanism for the disorder. Clinical trials.govNCT01094041.
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Affiliation(s)
- Maria I. Vazquez-Roque
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.),Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Michael Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.)
| | - Thomas Smyrk
- Surgical Pathology, Department of Laboratory Medicine and Pathology
| | - Joseph A. Murray
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.)
| | - Eric Marietta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.)
| | - Jessica O’Neill
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.)
| | - Paula Carlson
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.)
| | | | | | - Deborah Eckert
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.)
| | - Duane Burton
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.)
| | - Alan R. Zinsmeister
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research; College of Medicine, Mayo Clinic, Rochester, Minnesota
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Camilleri M, Kolar GJ, Vazquez-Roque MI, Carlson P, Burton DD, Zinsmeister AR. Cannabinoid receptor 1 gene and irritable bowel syndrome: phenotype and quantitative traits. Am J Physiol Gastrointest Liver Physiol 2013; 304:G553-60. [PMID: 23306084 PMCID: PMC3602676 DOI: 10.1152/ajpgi.00376.2012] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Genetic variations in metabolism of endocannabinoids and in CNR1 (gene for cannabinoid 1 receptor) are associated with symptom phenotype, colonic transit, and left colon motility in irritable bowel syndrome (IBS). Our aim was to evaluate associations between two variations in CNR1 genotype (rs806378 and [AAT]n triplets) with symptom phenotype, small bowel and colonic transit, and rectal sensations in 455 patients with IBS and 228 healthy controls. Small bowel and colonic transit were measured by scintigraphy, rectal sensation by isobaric distensions. Associations with genotype were assessed by χ(2) test (symptom phenotype) and ANCOVA (quantitative traits) based on a dominant genetic model. Significant association of CNR1 rs806378 (but not CNR1 [AAT]n) genotype and symptom phenotype was observed (χ(2) P = 0.028). There was significant association of CNR1 rs806378 (P = 0.014; CC vs. CT/TT) with colonic transit in IBS-diarrhea (IBS-D) group; the TT group had the fastest colonic transit at 24 and 48 h. There was significant overall association of CNR1 rs806378 with sensation rating of gas (P = 0.025), but not pain; the strongest associations for gas ratings were in IBS-D (P = 0.002) and IBS-alternating (P = 0.025) subgroups. For CNR1 (AAT)n, gene-by-phenotype interactions were observed for colonic transit at 24 (P = 0.06) and 48 h (P = 0.002) and gas (P = 0.046, highest for IBS-D, P = 0.034), but not pain sensation; the strongest association with transit was in controls, not in IBS. These data support the hypothesis that cannabinoid receptors may play a role in control of colonic transit and sensation in humans and deserve further study as potential mediators or therapeutic targets in lower functional gastrointestinal disorders.
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Affiliation(s)
- Michael Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN 55905, USA.
| | - Gururaj J. Kolar
- 1Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, Minnesota; and
| | | | - Paula Carlson
- 1Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, Minnesota; and
| | - Duane D. Burton
- 1Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, Minnesota; and
| | - Alan R. Zinsmeister
- 2Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota; and
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Zinsmeister AR, Burton D, Camilleri M. Pharmacodynamic and clinical endpoints for functional colonic disorders: statistical considerations. Dig Dis Sci 2013; 58:509-18. [PMID: 22918691 DOI: 10.1007/s10620-012-2369-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 08/08/2012] [Indexed: 12/17/2022]
Abstract
BACKGROUND Intra- and inter-subject coefficients of variation (COV) of scintigraphic colonic transit (SCT) are well characterized. SCT response to therapy predicts clinical efficacy of experimental medications in lower functional gastrointestinal disorders (FGID). AIM To compare COVs for bowel function with pharmacodynamic (PD) colonic transit geometric center (GC) as endpoints in lower FGID studies. METHODS We evaluated data from placebo arm of 9 phase IIA, parallel-group, clinical trials of PD effects of linaclotide, dexloxiglumide, renzapride, elobixibat, ROSE 010, and chenodeoxycholate in lower FGID with constipation, and pexacerafont, VSL#3, and colesevelam in lower FGID with diarrhea. Patients completed daily diaries for at least 7 days of stool frequency, consistency (7-point Bristol Stool Form Scale), and ease of passage (7-point scale from manual disimpaction to incontinence). Seventeen patients received placebo in 2 separate studies allowing assessment of intra-patient COVs. We calculated sample sizes required to demonstrate a 30 % effect size for colonic transit, stool frequency, consistency and ease of passage for patients with lower FGID with constipation and, separately, diarrhea. RESULTS COV(inter) from 87 patients and COV(intra) from 17 patients are reported. Generally, COV(intra) is somewhat greater than COV(inter). The COVs for PD endpoints are lower than for clinical endpoints; however, clinically relevant effects can be identified with modest (~50 %) increases in the sample size using parallel-group design studies. CONCLUSION Phase IIA studies that incorporate clinical and PD endpoints are feasible in lower FGID associated with constipation or diarrhea. Crossover design would require lower sample size for most endpoints compared to parallel-group studies.
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Camilleri M, McKinzie S, Busciglio I, Low PA, Sweetser S, Burton D, Baxter K, Ryks M, Zinsmeister AR. Prospective study of motor, sensory, psychologic, and autonomic functions in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol 2008; 6:772-81. [PMID: 18456567 PMCID: PMC2495078 DOI: 10.1016/j.cgh.2008.02.060] [Citation(s) in RCA: 193] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2007] [Revised: 01/31/2008] [Accepted: 02/20/2008] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The aim of this study was to assess pathophysiology in irritable bowel syndrome (IBS). METHODS A total of 122 IBS patients (3 male) and 41 healthy females underwent the following: questionnaires (symptoms, psychology), autonomic function, gut transit, gastric volumes, satiation, rectal compliance, and sensation (thresholds and pain ratings) testing. Proportions of patients with abnormal (<10th and >90th percentiles) motor or sensory functions according to bowel symptoms (constipation [C], diarrhea [D], mixed [M),) pain/bloat, and number of primary symptoms were estimated. RESULTS IBS subgroups (C, D, M) were similar in age, gastric and small-bowel transit, satiation, gastric volumes, rectal compliance, sensory thresholds, and pain ratings. IBS was associated with body mass index, somatic symptoms, and anxiety and depression scores. Significant associations were observed with colonic transit (IBS-C [P = .078] and IBS-D [P < .05] at 24 h; IBS-D [P < .01] and IBS-M [P = .056] at 48 h): 32% of IBS patients had abnormal colonic transit: 20.5% at 24 hours and 11.5% at 48 hours. Overall, 20.5% of IBS patients had increased sensation to distensions: hypersensitivity (<10th percentile thresholds) in 7.6%, and hyperalgesia (pain sensation ratings to distension >90th percentile for ratings in health) in 13%. Conversely, 16.5% of IBS patients had reduced rectal sensation. Pain greater than 6 times per year and bloating were not associated significantly with motor, satiation, or sensory functions. Endorsing 1 to 2 or 3 to 4 primary IBS symptoms were associated with abnormal transit and sensation in IBS. CONCLUSIONS In tertiary referral (predominantly female) patients with IBS, colonic transit (32%) is the most prevalent physiologic abnormality; 21% had increased and 17% had decreased rectal pain sensations. Comprehensive physiologic assessment may help optimize management in IBS.
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Affiliation(s)
- Michael Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), College of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Sanna McKinzie
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), College of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Irene Busciglio
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), College of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Phillip A. Low
- Department of Neurology, College of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Seth Sweetser
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), College of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Duane Burton
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), College of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Kari Baxter
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), College of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Michael Ryks
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), College of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Alan R. Zinsmeister
- Department of Health Sciences Research, Division of Biostatistics, College of Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A
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Abstract
Mass transit is a critical infrastructure of urban environments worldwide. The public uses it extensively, with roughly 9 billion mass transit trips occurring annually in the United States alone according to the U.S. Department of Transportation data. Its benefits per traveler include lower emissions of air pollutants and energy usage and high speeds and safety records relative to many other common modes of transportation that contribute to human health and safety. However, mass transit is vulnerable to intrusions that compromise its use and the realization of the important benefits it brings. These intrusions pertain to physical conditions, security, external environmental conditions, and equity. The state of the physical condition of transit facilities overall has been summarized in the low ratings the American Society of Civil Engineers gives to mass transit, and the large dollar estimates to maintain existing conditions as well as to bring on new improvements, which are, however, many times lower than investments estimated for roadways. Security has become a growing issue, and numerous incidents point to the potential for threats to security in the US. External environmental conditions, such as unexpected inundations of water and electric power outages also make transit vulnerable. Equity issues pose constraints on the use of transit by those who cannot access it. Transit has shown a remarkable ability to rebound after crises, most notably after the September 11, 2001 attacks on the World Trade Center, due to a combination of design and operational features of the system. These experiences provide important lessons that must be captured to provide proactive approaches to managing and reducing the consequences of external factors that impinge negatively on transit.
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Affiliation(s)
- Rae Zimmerman
- Planning and Public Administration, Institute for Civil Infrastructure Systems at the Wagner Graduate School of Public Service, New York University, New York, New York 10012, USA.
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De Winter BY, Robberecht P, Boeckxstaens GE, De Man JG, Moreels TG, Herman AG, Pelckmans PA. Role of VIP1/PACAP receptors in postoperative ileus in rats. Br J Pharmacol 1998; 124:1181-6. [PMID: 9720789 PMCID: PMC1565509 DOI: 10.1038/sj.bjp.0701954] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
1. Vasoactive intestinal polypeptide (VIP) is an inhibitory neurotransmitter in the enteric nervous system. We investigated the role of VIP1/PACAP receptors in postoperative ileus in rats. 2. Different degrees of inhibition of the gastrointestinal transit, measured by the migration of Evans blue, were achieved by skin incision, laparotomy or laparotomy plus mechanical stimulation of the gut. 3. The transit after skin incision or laparotomy was not altered by the VIP1/PACAP receptor antagonist Ac-His1,D-Phe2, K15, R16, VIP(3-7), GRF(8-27)-NH2 nor by the VIP1/PACAP receptor agonist K15, R16, VIP(1-7), GRF(8-27)-NH2 and the VIP2/PACAP receptor agonist RO 25-1553 (5 microg kg(-1)). 4. However, the transit after laparotomy plus mechanical stimulation was significantly enhanced by the VIP1/PACAP receptor antagonist, whereas it was further inhibited by the VIP1/PACAP receptor agonist. The combination of the VIP1/PACAP receptor agonist and antagonist counteracted the effect of both drugs alone. The VIP2/PACAP receptor agonist did not alter the effect of the VIP1/PACAP receptor antagonist. 5. The combination of the VIP1/PACAP receptor antagonist plus the nitric oxide (NO) synthase inhibitor L-nitroarginine had no effect on the transit after laparotomy plus mechanical stimulation, while the transit after skin incision was significantly decreased. 6. These findings suggest the involvement of VIP1/PACAP receptors, next to NO, in the pathogenesis of postoperative ileus. However, the combination of the VIP1/PACAP antagonist and the NO synthase inhibitor abolished the beneficial effect of each drug alone, suggesting the need for one of the inhibitory neurotransmitters to enable normal gastrointestinal transit.
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MESH Headings
- Animals
- Dose-Response Relationship, Drug
- Gastrointestinal Transit
- Intestinal Obstruction/physiopathology
- Male
- Nitric Oxide/physiology
- Postoperative Complications
- Rats
- Receptors, Pituitary Adenylate Cyclase-Activating Polypeptide
- Receptors, Pituitary Hormone/agonists
- Receptors, Pituitary Hormone/antagonists & inhibitors
- Receptors, Pituitary Hormone/physiology
- Receptors, Vasoactive Intestinal Peptide/agonists
- Receptors, Vasoactive Intestinal Peptide/antagonists & inhibitors
- Receptors, Vasoactive Intestinal Peptide/physiology
- Receptors, Vasoactive Intestinal Polypeptide, Type I
- Vasoactive Intestinal Peptide/physiology
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Affiliation(s)
- B Y De Winter
- Division of Gastroenterology and Pharmacology, Faculty of Medicine, University of Antwerp, Belgium
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