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Colón-Semenza C, Zajac JA, Schwartz A, Darbandsari P, Ellis TD. Experiences from the implementation of physical therapy via telehealth for individuals with Parkinson disease during the COVID-19 pandemic. Disabil Rehabil 2024; 46:1593-1601. [PMID: 37088939 DOI: 10.1080/09638288.2023.2202418] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE To (1) determine the characteristics and participation rate of adults with Parkinson disease (PD) in physical therapy (PT) delivered via telehealth, (2) identify the outcome measures and interventions implemented, (3) determine the safety of and (4) patient and therapist satisfaction with PT via telehealth in a clinic specializing in the care of people with PD during the coronavirus pandemic. MATERIALS & METHODS A retrospective analysis of PT services via telehealth was conducted. Participating patients completed a satisfaction survey. Physical therapists (PTs) who delivered this care were interviewed. Three coders conducted thematic analysis of interviews. Descriptive statistics described the participation rate, demographics, outcome measures, interventions, and safety. RESULTS There was a 71.4% participation rate. Participants (n = 55) were white (96%), non-Hispanic (100%), older adult (mean = 69.5 years (8.3)) males (65.5%). Non-participants (n = 22) had similar demographics. Therapists selected patient-reported measures more often than performance-based measures. Therapeutic exercise was the most common intervention. All patients (80% response rate) reported satisfaction with their experience. PTs reported the home enhanced specificity of training but impeded evaluation. Therapists endorsed a hybrid model for future practice. CONCLUSIONS Patients reported satisfaction with PT via telehealth during the pandemic. A hybrid model may support optimal delivery of PT.IMPLICATIONS FOR REHABILITATIONPhysical therapy via telehealth for patients with Parkinson disease was acceptable to patients and physical therapists in our study.Physical therapy via telehealth was safe for people with Parkinson disease in our study, although availability and benefits may not be reaching all populations equitably.Both physical therapists and patients endorse a hybrid model of care (a combination of in-person and remote assessment and treatment) to profit from the strengths of in-person and virtual formats while minimizing barriers to access.
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Affiliation(s)
- C Colón-Semenza
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - J A Zajac
- Department of Physical Therapy, Boston University, Boston, MA, USA
| | - A Schwartz
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - P Darbandsari
- Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - T D Ellis
- Department of Physical Therapy, Boston University, Boston, MA, USA
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Beeson AM, Baker M, Dell B, Schnitzler H, Oltean HN, Woodall T, Riedo F, Schwartz A, Petersen J, Hinckley AF, Marx GE. Francisella tularensis Bone and Joint Infections: United States, 2004-2023. Clin Infect Dis 2024; 78:S67-S70. [PMID: 38294110 DOI: 10.1093/cid/ciad688] [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] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Tularemia is caused by the highly infectious bacterium Francisella tularensis, which is recognized as a Tier 1 bioterrorism agent. Tularemia has a range of recognized clinical manifestations, but fewer than 20 bone or joint infections from 6 countries have been reported in the literature to date. This series includes 13 cases of F. tularensis septic arthritis or osteomyelitis in the United States during 2004-2023 and describes exposures, clinical presentation, diagnosis, and outcomes for this rare but severe form of tularemia. Clinicians should consider F. tularensis in patients with compatible exposures or a history of joint replacement or immunosuppression.
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Affiliation(s)
- Amy M Beeson
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, USA
| | - Molly Baker
- Missouri Department of Health and Senior Services, Jefferson City, Missouri, USA
| | - BreeAnna Dell
- Public Health-Seattle and King County, Seattle, Washington, USA
| | | | - Hanna N Oltean
- Washington State Department of Health, Shoreline, Washington, USA
| | - Tracy Woodall
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | | | - Amy Schwartz
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, USA
| | - Jeannine Petersen
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, USA
| | - Alison F Hinckley
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, USA
| | - Grace E Marx
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, USA
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Walker J, Tran T, Lappe B, Gastanaduy P, Paul P, Kracalik IT, Fields VL, Lopez A, Schwartz A, Lewis NM, Tate JE, Kirking HL, Hall AJ, Pevzner E, Khong H, Smithee M, Lowry J, Dunn A, Kiphibane T, Tran CH. Epidemiology of SARS-CoV-2 transmission and superspreading in Salt Lake County, Utah, March-May 2020. PLoS One 2023; 18:e0275125. [PMID: 37352280 PMCID: PMC10289415 DOI: 10.1371/journal.pone.0275125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/10/2022] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Understanding the drivers of SARS-CoV-2 transmission can inform the development of interventions. We evaluated transmission identified by contact tracing investigations between March-May 2020 in Salt Lake County, Utah, to quantify the impact of this intervention and identify risk factors for transmission. METHODS RT-PCR positive and untested symptomatic contacts were classified as confirmed and probable secondary case-patients, respectively. We compared the number of case-patients and close contacts generated by different groups, and used logistic regression to evaluate factors associated with transmission. RESULTS Data were collected on 184 index case-patients and up to six generations of contacts. Of 1,499 close contacts, 374 (25%) were classified as secondary case-patients. Decreased transmission odds were observed for contacts aged <18 years (OR = 0.55 [95% CI: 0.38-0.79]), versus 18-44 years, and for workplace (OR = 0.36 [95% CI: 0.23-0.55]) and social (OR = 0.44 [95% CI: 0.28-0.66]) contacts, versus household contacts. Higher transmission odds were observed for case-patient's spouses than other household contacts (OR = 2.25 [95% CI: 1.52-3.35]). Compared to index case-patients identified in the community, secondary case-patients identified through contract-tracing generated significantly fewer close contacts and secondary case-patients of their own. Transmission was heterogeneous, with 41% of index case-patients generating 81% of directly-linked secondary case-patients. CONCLUSIONS Given sufficient resources and complementary public health measures, contact tracing can contain known chains of SARS-CoV-2 transmission. Transmission is associated with age and exposure setting, and can be highly variable, with a few infections generating a disproportionately high share of onward transmission.
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Affiliation(s)
- Joseph Walker
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Tiffany Tran
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Brooke Lappe
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Paul Gastanaduy
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Prabasaj Paul
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ian T. Kracalik
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Victoria L. Fields
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Adriana Lopez
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amy Schwartz
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nathaniel M. Lewis
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Utah Department of Health, Salt Lake City, Utah, United States of America
| | - Jacqueline E. Tate
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hannah L. Kirking
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Aron J. Hall
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Eric Pevzner
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ha Khong
- Salt Lake County Health Department, Salt Lake City, Utah, United States of America
| | - Maureen Smithee
- Salt Lake County Health Department, Salt Lake City, Utah, United States of America
| | - Jason Lowry
- Salt Lake County Health Department, Salt Lake City, Utah, United States of America
| | - Angela Dunn
- Utah Department of Health, Salt Lake City, Utah, United States of America
| | - Tair Kiphibane
- Salt Lake County Health Department, Salt Lake City, Utah, United States of America
| | - Cuc H. Tran
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Fleury Curado T, Pham L, Freire C, Amorim M, Abdelwahab M, Huang A, Taheri N, Hong Y, Dedhia R, Liu S, Capasso R, Polotsky V, Eisele D, Schwartz A. Changes in Tongue Morphology Predict Responses in Pharyngeal Patency to Selective Hypoglossal Nerve Stimulation. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Curado TF, Pho H, Freire C, Amorim M, Sennes LU, Taheri N, Hong Y, Abdelwahab M, Huang A, Fishbein K, Liu S, Capasso R, Schwartz A, Fuller D, Polotsky V. Designer Receptors Exclusively Activated by Designer Drugs Treatment of Sleep-disordered Breathing. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Elowsky J, Bajaj S, Bashford-Largo J, Zhang R, Mathur A, Schwartz A, Dobbertin M, Blair KS, Leibenluft E, Pardini D, Blair RJR. Differential associations of conduct disorder, callous-unemotional traits and irritability with outcome expectations and values regarding the consequences of aggression. Child Adolesc Psychiatry Ment Health 2022; 16:38. [PMID: 35606814 PMCID: PMC9128221 DOI: 10.1186/s13034-022-00466-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/04/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Previous work has examined the association of aggression levels and callous-unemotional traits with outcome expectations and values regarding the consequences of aggression. Less work has examined the outcome expectations and values regarding the consequences of aggression of adolescents with Conduct Disorder (CD). Also, no studies have examined links between irritability (a second socio-affective trait associated with CD) and these social cognitive processes despite the core function of anger in retaliatory aggression and establishing dominance. METHOD The current study, investigating these issues, involved 193 adolescents (typically developing [TD; N = 106], 87 cases with CD [N = 87]). Participants completed an adaptation of the Outcomes Expectations and Values Questionnaire and were assessed for CU traits and irritability via the Inventory of Callous-Unemotional traits and the Affective Reactivity Index. RESULTS While CD was associated with atypical outcome expectations this was not seen within statistical models including CU traits and irritability. CU traits were associated with decreased expectation that aggression would result in feelings of remorse and victim suffering, as well as decreased concern that aggressive acts would result in punishment and victim suffering. Irritability was associated with increased expectations and concern that aggression would result in dominance and forced respect. CONCLUSIONS The results suggest that CU traits and irritability, often present in youth with CD, are associated with different forms of maladaptive outcome expectations and values regarding the consequences of aggression. This suggests that the atypical social cognitive processes underlying aggressive behavior among youth exhibiting CU traits may differ from those exhibiting problems regulating anger.
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Affiliation(s)
- J. Elowsky
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - S. Bajaj
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - J. Bashford-Largo
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.24434.350000 0004 1937 0060Center for Brain, Biology, and Behavior, University of Nebraska-Lincoln, Lincoln, NE USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - R. Zhang
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - A. Mathur
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - A. Schwartz
- grid.266862.e0000 0004 1936 81633Department of Psychology, University of North Dakota, Grand Forks, ND USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - M. Dobbertin
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - K. S. Blair
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - E. Leibenluft
- grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - D. Pardini
- grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA
| | - R. J. R. Blair
- grid.414583.f0000 0000 8953 4586Center for Neurobehavioral Research, Boys Town National Research Hospital, 14015 Flanagan Blvd. Suite #102, Boys Town, NE 68010 USA ,grid.94365.3d0000 0001 2297 5165Section on Mood Dysregulation and Neuroscience, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA ,grid.215654.10000 0001 2151 2636School of Criminology & Criminal Justice, Arizona State University, Phoenix, AZ USA ,grid.466916.a0000 0004 0631 4836Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
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Devchand R, Koehler L, Hook S, Marx GE, Hooks H, Schwartz A, Hinckley A. Understanding consumer and clinician perceptions of a potential Lyme disease vaccine. Health Educ Res 2022; 36:494-504. [PMID: 34529775 PMCID: PMC10911045 DOI: 10.1093/her/cyab032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/01/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
Each year, over 450 000 Lyme disease diagnoses are estimated to occur in the United States, and current preventive measures have been insufficient to stem the rising incidence. An effective human Lyme disease vaccine could be a powerful intervention for population-level impact. In advance of new Lyme disease vaccines coming to market, this study explored barriers to acceptability and motivations for the uptake of a new Lyme disease vaccine. Researchers conducted 9 online focus groups among consumers who may potentially benefit from the vaccine and 30 in-depth interviews among clinician groups who may provide the vaccine. All participants were recruited from three US regions of high Lyme disease incidence. Researchers found that participants shared common motivators to either recommend (clinicians) or accept (consumers) a Lyme disease vaccine, largely driven by perceived benefits of the vaccine, the lack of current effective preventive measures and a greater peace of mind. The concern about the challenges associated with diagnosing and treating Lyme disease is a primary motivator for clinicians to recommend the vaccine, while the concern about getting Lyme disease is a primary motivator for consumers to desire the vaccine.
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Affiliation(s)
| | - Laura Koehler
- Hager Sharp, 1030 15th Street NW, Washington, DC 20005, USA
| | - Sarah Hook
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD), 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Grace E. Marx
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD), 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Holley Hooks
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD), 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Amy Schwartz
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD), 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Alison Hinckley
- Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Vector-Borne Diseases (DVBD), 3156 Rampart Road, Fort Collins, CO 80521, USA
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Capozza K, Schwartz A, Lang JE, Chalmers J, Camilo J, Abuabara K, Kelley K, Harrison J, Vastrup A, Stancavich L, Tai A, Kimball AB, Finlay AY. The Impact of Childhood Atopic Dermatitis on Life Decisions for Caregivers and Families. J Eur Acad Dermatol Venereol 2022; 36:e451-e454. [DOI: 10.1111/jdv.17943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. Capozza
- Global Parents for Eczema Research Santa Barbara USA
| | - A. Schwartz
- Departments of Medical Education and Pediatrics University of Illinois Chicago USA
| | - JE Lang
- Global Parents for Eczema Research Santa Barbara USA
| | - J Chalmers
- Centre of Evidence Based Dermatology University of Nottingham Nottingham UK
| | - J Camilo
- ADERMAP ‐ Associação Dermatite Atópica Portugal Lisboa Portugal
| | - K Abuabara
- Department of Dermatology University of California San Francisco USA
| | - K. Kelley
- Global Parents for Eczema Research Santa Barbara USA
| | - J. Harrison
- Global Parents for Eczema Research Santa Barbara USA
| | - A. Vastrup
- Atopisk Eksem Forening Copenhagen Denmark
| | - L. Stancavich
- Global Parents for Eczema Research Santa Barbara USA
| | - A. Tai
- Global Parents for Eczema Research Santa Barbara USA
| | | | - AY Finlay
- Division of Infection and Immunity School of Medicine Cardiff University Cardiff UK
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Fields VL, Kracalik IT, Carthel C, Lopez A, Schwartz A, Lewis NM, Bray M, Claflin C, Jorgensen K, Khong H, Richards W, Risk I, Smithee M, Clawson M, Booth LC, Scribellito T, Lowry J, Huynh J, Davis L, Birch H, Tran T, Walker J, Fry A, Hall A, Baker J, Pevzner E, Dunn AC, Tate JE, Kirking HL, Kiphibane T, Tran CH. Coronavirus Disease Contact Tracing Outcomes and Cost, Salt Lake County, Utah, USA, March-May 2020. Emerg Infect Dis 2021; 27:2999-3008. [PMID: 34698628 PMCID: PMC8632199 DOI: 10.3201/eid2712.210505] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Outcomes and costs of coronavirus disease (COVID-19) contact tracing are limited. During March–May 2020, we constructed transmission chains from 184 index cases and 1,499 contacts in Salt Lake County, Utah, USA, to assess outcomes and estimate staff time and salaries. We estimated 1,102 staff hours and $29,234 spent investigating index cases and contacts. Among contacts, 374 (25%) had COVID-19; secondary case detection rate was ≈31% among first-generation contacts, ≈16% among second- and third-generation contacts, and ≈12% among fourth-, fifth-, and sixth-generation contacts. At initial interview, 51% (187/370) of contacts were COVID-19–positive; 35% (98/277) became positive during 14-day quarantine. Median time from symptom onset to investigation was 7 days for index cases and 4 days for first-generation contacts. Contact tracing reduced the number of cases between contact generations and time between symptom onset and investigation but required substantial resources. Our findings can help jurisdictions allocate resources for contact tracing.
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Tompkins WP, Ciunci CA, Walker S, Patton K, Schwartz A, Davella C. Serious illness conversation and end of life care utilization at an academic medical center. J Clin Oncol 2021. [DOI: 10.1200/jco.2020.39.28_suppl.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
29 Background: Hospice has been associated with improved quality of life for patients, cost savings, and reduction in caregiver-grief-related depression. While cancer patients make up a plurality of hospice utilizers nationally, many patients are only on hospice for a limited period (in Medicare patients, a median of 18 days). Studies suggest engaging cancer patients to discuss goals and priorities using the Serious Illness Conversation (SIC) Guide has a positive impact on prognostic understanding and end-of-life planning. More frequent utilization of SICs may prompt earlier enrollment of oncology patients in hospice when appropriate. Methods: We identified cancer patients enrolled in hospice at the Abramson Cancer Center at Penn Presbyterian Medical Center from 2019-2020 after all providers received SIC training. Patient demographics, cancer diagnosis, type of hospice (home versus inpatient), SIC usage, palliative care referral patterns and time on hospice were abstracted. Results: 104 patients were enrolled in hospice during the study period. The majority of patients were female (51%). 45% were Caucasian, and 31% were African American. The most common cancer diagnoses were thoracic (52%) and gastrointestinal (32%) malignancies. 85 patients (82%) were enrolled on home hospice and 19 patients (18%) inpatient hospice. Palliative care usage included 50 inpatient and 24 outpatient consultations; 30 patients (29%) in the cohort never utilized palliative care. 52 (50%) of patients did not have a SIC. 47% (40 patients) enrolled in home hospice had an SIC while 63% (12 patients) on inpatient hospice had an SIC. The median time interval between a patient’s SIC conversation and hospice enrollment was longer in home hospice patients (74 days) compared to inpatient hospice (33 days). Patients on home hospice spent an average of 44 days on hospice versus 2 days in the inpatient setting. Conclusions: Half of the patients at Penn Presbyterian Medical Center enrolled in hospice during the study period did not have an SIC, and 29% did not see palliative care prior to starting hospice. The median time from SIC initiation to hospice enrollment was significantly longer for patients on home hospice compared to inpatient hospice suggesting a need for earlier SIC interventions. Patients enrolled in inpatient hospice spent a considerably shorter period of time on hospice also underscoring the importance of earlier end of life planning. Our findings indicate a need for additional interventions to facilitate earlier SIC conversations in the outpatient setting and a demand for increased palliative care access.
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Affiliation(s)
- William P. Tompkins
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Christine Agnes Ciunci
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Suzanne Walker
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Kelly Patton
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Amy Schwartz
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Christopher Davella
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Lorenzen B, Ciennik A, Hauck T, Chiang C, Schwartz A. 347 The Effect of Electronic Assignment of Patients to Physicians in the Emergency Department on Operational Metrics. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Combs E, Barr M, Jackson Y, Schwartz A, Stephenson T. High-fidelity Simulations for Dietetics Students’ Perceptions of Readiness to Serve as Entry-level Dietitians. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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François J, Kandasamy A, Yeh YT, Schwartz A, Ayala C, Meili R, Chien S, Lasheras JC, Del Álamo JC. The interplay between matrix deformation and the coordination of turning events governs directed neutrophil migration in 3D matrices. Sci Adv 2021; 7:7/29/eabf3882. [PMID: 34261650 PMCID: PMC8279509 DOI: 10.1126/sciadv.abf3882] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 05/28/2021] [Indexed: 06/13/2023]
Abstract
Neutrophils migrating through extravascular spaces must negotiate narrow matrix pores without losing directional movement. We investigated how chemotaxing neutrophils probe matrices and adjust their migration to collagen concentration ([col]) changes by tracking 20,000 cell trajectories and quantifying cell-generated 3D matrix deformations. In low-[col] matrices, neutrophils exerted large deformations and followed straight trajectories. As [col] increased, matrix deformations decreased, and neutrophils turned often to circumvent rather than remodel matrix pores. Inhibiting protrusive or contractile forces shifted this transition to lower [col], implying that mechanics play a crucial role in defining migratory strategies. To balance frequent turning and directional bias, neutrophils used matrix obstacles as pivoting points to steer toward the chemoattractant. The Actin Related Protein 2/3 complex coordinated successive turns, thus controlling deviations from chemotactic paths. These results offer an improved understanding of the mechanisms and molecular regulators used by neutrophils during chemotaxis in restrictive 3D environments.
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Affiliation(s)
- Joshua François
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, USA.
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, USA
- Department of Systems Biology, Harvard Medical School, Boston, MA, USA
| | - Adithan Kandasamy
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, USA
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
- Center for Cardiovascular Biology, University of Washington, Seattle, WA, USA
| | - Yi-Ting Yeh
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, USA
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, USA
| | - Amy Schwartz
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, USA
| | - Cindy Ayala
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, USA
- Department of Bioengineering, University of California, Berkeley, Berkeley, CA, USA
- Department of Bioengineering, University of California, San Francisco, San Francisco, CA, USA
| | - Ruedi Meili
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, USA
| | - Shu Chien
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, USA
| | - Juan C Lasheras
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, USA
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, USA
| | - Juan C Del Álamo
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, USA.
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
- Center for Cardiovascular Biology, University of Washington, Seattle, WA, USA
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Barlinn J, Winzer S, Worthmann H, Urbanek C, Häusler KG, Günther A, Erdur H, Görtler M, Busetto L, Wojciechowski C, Schmitt J, Shah Y, Büchele B, Sokolowski P, Kraya T, Merkelbach S, Rosengarten B, Stangenberg-Gliss K, Weber J, Schlachetzki F, Abu-Mugheisib M, Petersen M, Schwartz A, Palm F, Jowaed A, Volbers B, Zickler P, Remi J, Bardutzky J, Bösel J, Audebert HJ, Hubert GJ, Gumbinger C. [Telemedicine in stroke-pertinent to stroke care in Germany]. Nervenarzt 2021; 92:593-601. [PMID: 34046722 PMCID: PMC8184549 DOI: 10.1007/s00115-021-01137-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/24/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Telemedical stroke networks improve stroke care and provide access to time-dependent acute stroke treatment in predominantly rural regions. The aim is a presentation of data on its utility and regional distribution. METHODS The working group on telemedical stroke care of the German Stroke Society performed a survey study among all telestroke networks. RESULTS Currently, 22 telemedical stroke networks including 43 centers (per network: median 1.5, interquartile range, IQR, 1-3) as well as 225 cooperating hospitals (per network: median 9, IQR 4-17) operate in Germany and contribute to acute stroke care delivery to 48 million people. In 2018, 38,211 teleconsultations (per network: median 1340, IQR 319-2758) were performed. The thrombolysis rate was 14.1% (95% confidence interval 13.6-14.7%) and transfer for thrombectomy was initiated in 7.9% (95% confidence interval 7.5-8.4%) of ischemic stroke patients. Financial reimbursement differs regionally with compensation for telemedical stroke care in only three federal states. CONCLUSION Telemedical stroke care is utilized in about 1 out of 10 stroke patients in Germany. Telemedical stroke networks achieve similar rates of thrombolysis and transfer for thrombectomy compared with neurological stroke units and contribute to stroke care in rural regions. Standardization of network structures, financial assurance and uniform quality measurements may further strengthen the importance of telestroke networks in the future.
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Affiliation(s)
- J Barlinn
- Klinik für Neurologie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
| | - S Winzer
- Klinik für Neurologie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - H Worthmann
- Klinik für Neurologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - C Urbanek
- Klinik für Neurologie, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Deutschland
| | - K G Häusler
- Neurologische Klinik und Poliklinik, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - A Günther
- Klinik für Neurologie, Universitätsklinikum Jena, Jena, Deutschland
| | - H Erdur
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - M Görtler
- Klinik für Neurologie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland
| | - L Busetto
- Klinik für Neurologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Wojciechowski
- Klinik für Neurologie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Dresden, Dresden, Deutschland
| | - Y Shah
- Klinik für Neurologie, Klinikum Kassel, Kassel, Deutschland
| | - B Büchele
- Klinik für Neurologie, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland
| | - P Sokolowski
- Klinik für Neurologie und neurologische Intensivmedizin, Fachkrankenhaus Hubertusburg, Hubertusburg, Deutschland
| | - T Kraya
- Klinik für Neurologie, Klinikum St.Georg Leipzig, Leipzig, Deutschland
| | - S Merkelbach
- Klinik für Neurologie, Heinrich-Braun-Klinikum Zwickau, Zwickau, Deutschland
| | - B Rosengarten
- Klinik für Neurologie, Klinikum Chemnitz, Chemnitz, Deutschland
| | - K Stangenberg-Gliss
- Klinik für Neurologie, BG Klinikum Unfallkrankenhaus Berlin, Berlin, Deutschland
| | - J Weber
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - F Schlachetzki
- Klinik für Neurologie, Universität Regensburg, Regensburg, Deutschland
| | - M Abu-Mugheisib
- Klinik für Neurologie, Städtisches Klinikum Braunschweig, Braunschweig, Deutschland
| | - M Petersen
- Klinik für Neurologie, Klinikum Osnabrück, Osnabrück, Deutschland
| | - A Schwartz
- Klinik für Neurologie, Klinikum Region Hannover, Hannover, Deutschland
| | - F Palm
- Klinik für Neurologie, Helios Klinikum Schleswig, Schleswig, Deutschland
| | - A Jowaed
- Klinik für Neurologie, Westküstenkliniken Heide, Heide, Deutschland
| | - B Volbers
- Klinik für Neurologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - P Zickler
- Klinik für Neurologie und Klinische Neurophysiologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - J Remi
- Klinik für Neurologie, Klinikum der LMU München-Großhadern, München, Deutschland
| | - J Bardutzky
- Klinik für Neurologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - J Bösel
- Klinik für Neurologie, Klinikum Kassel, Kassel, Deutschland
| | - H J Audebert
- Klinik und Hochschulambulanz für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.,Centrum für Schlaganfallforschung Berlin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - G J Hubert
- Klinik für Neurologie, München-Klinik Harlaching, München, Deutschland
| | - C Gumbinger
- Klinik für Neurologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
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15
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Fields VL, Kiphibane T, Eason JT, Hafoka SF, Lopez AS, Schwartz A, Henry A, Tran CH, Tate JE, Kirking HL, Laws RL, Venkatappa T, Mosites E, Montgomery MP. Assessment of contact tracing for COVID-19 among people experiencing homelessness, Salt Lake County Health Department, March-May 2020. Ann Epidemiol 2021; 59:50-55. [PMID: 33894384 PMCID: PMC8061086 DOI: 10.1016/j.annepidem.2021.04.002] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/02/2021] [Accepted: 04/14/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Contact tracing is intended to reduce the spread of coronavirus disease 2019 (COVID-19), but it is difficult to conduct among people who live in congregate settings, including people experiencing homelessness (PEH). This analysis compares person-based contact tracing among two populations in Salt Lake County, Utah, from March-May 2020. METHODS All laboratory-confirmed positive cases among PEH (n = 169) and documented in Utah's surveillance system were included in this analysis. The general population comparison group (n = 163) were systematically selected from all laboratory-confirmed cases identified during the same period. RESULTS Ninety-three PEH cases (55%) were interviewed compared to 163 (100%) cases among the general population (P < .0001). PEH were more likely to be lost to follow-up at end of isolation (14.2%) versus the general population (0%; P-value < .0001) and provided fewer contacts per case (0.3) than the general population (4.7) (P-value < .0001). Contacts of PEH were more often unreachable (13.0% vs. 7.1%; P-value < .0001). CONCLUSIONS These findings suggest that contact tracing among PEH should include a location-based approach, along with a person-based approach when resources allow, due to challenges in identifying, locating, and reaching cases among PEH and their contacts through person-based contact tracing efforts alone.
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Affiliation(s)
| | | | | | | | | | - Amy Schwartz
- Centers for Disease Control and Prevention, Atlanta, GA
| | - Ankita Henry
- Centers for Disease Control and Prevention, Atlanta, GA
| | - Cuc H Tran
- Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | | | | | - Emily Mosites
- Centers for Disease Control and Prevention, Atlanta, GA
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16
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Bodas M, Givon A, Peleg K, Abbod N, Bahouth H, Bala M, Becker A, Ben Eli M, Braslavsky A, Grevtsev I, Jeroukhimov I, Karawani M, Kessel B, Klein Y, Lin G, Merin O, Mnouskin Y, Rivkind A, Shaked G, Soffer D, Stein M, Schwartz A, Weiss M. Are casualties from mass-casualty Motor Vehicle Crashes different from casualties of other Motor Vehicle Crashes? Journal of Transport & Health 2020; 19:100928. [DOI: 10.1016/j.jth.2020.100928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
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17
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Schwartz A, Yogev Y, Zilberman A, Alpern S, Many A, Yousovich R, Gamzu R. Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vaginal swabs of women with acute SARS-CoV-2 infection: a prospective study. BJOG 2020; 128:97-100. [PMID: 33021026 PMCID: PMC7675593 DOI: 10.1111/1471-0528.16556] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 11/27/2022]
Abstract
Objective To determine whether severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is present in the vaginal secretions of both reproductive‐aged and postmenopausal women during acute SARS‐CoV‐2 infection. Design Prospective study. Setting A single tertiary, university‐affiliated medical centre in Israel. Time period, 1 June 2020 through to 31 July 2020. Population Women who were hospitalised in a single tertiary medical centre, who were diagnosed with acute SARS‐CoV‐2 infection by a nasopharyngeal RT‐PCR test. Methods Women were diagnosed with acute SARS‐CoV‐2 infection by a nasopharyngeal RT‐PCR test. Vaginal RT‐PCR swabs were obtained from all study participants after a proper cleansing of the perineum. Main outcome measures Detection of SARS‐CoV‐2 in vaginal RT‐PCR swabs. Results Vaginal and nasopharyngeal swabs were obtained from 35 women, aged 21–93 years. Twenty‐one women (60%) were in their reproductive years, of whom, five were in their third trimester of pregnancy. Most of the participants (57%) were healthy without any underlying medical conditions. Of the 35 patients sampled, 2 (5.7%) had a positive vaginal RT‐PCR for SARS‐CoV‐2, one was premenopausal and the other was a postmenopausal woman. Both women had mild disease. Conclusion Our findings contradict most previous reports, which did not detect the presence of viral colonisation in the vagina. Although passage through the birth canal exposes neonates to the vaginal polymicrobial flora, an acquisition of pathogens does not necessarily mandate neonatal infection or clinical disease. Nevertheless, when delivering the infant of a woman with acute SARS‐CoV‐2 infection, a clinician should consider the possibility of vaginal colonisation, even if it is uncommon. Tweetable abstract When delivering the infant of a woman with acute SARS‐CoV‐2 infection, a clinician should consider the possibility of vaginal colonisation. When delivering the infant of a woman with acute SARS‐CoV‐2 infection, a clinician should consider the possibility of vaginal colonisation.
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Affiliation(s)
- A Schwartz
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y Yogev
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Zilberman
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Alpern
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Many
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Yousovich
- Maccabi Healthcare Services, Herzliya, Israel
| | - R Gamzu
- Department of Obstetrics and Gynaecology, Lis Maternity Hospital, Sourasky Medical Centre, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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18
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Dhar PK, Grupp IL, Schwartz A, Grupp G, Matlib MA. Reduction of Carnitine Content by Inhibition of Its Biosynthesis Results in Protection of Isolated Guinea Pig Hearts against Hypoxic Damage. J Cardiovasc Pharmacol Ther 2020; 1:235-242. [PMID: 10684422 DOI: 10.1177/107424849600100307] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background3-(2,2,2-trimethylhydrazinium) propionate (THP or mildronate) is an inhibitor of carnitine biosynthesis. This study was carried out to determine whether feeding of guinea pigs with THP results in decreased myocardial-free carnitine content and, as a result, attenuates hypoxic damage in isolated and paced work-performing hearts.Methods and ResultsGuinea pigs were administered either distilled water or 100 mg THP/kg/day orally for 10 days. The treatment resulted in about a 50% decline in myocardial-free carnitine content, from 11.1 ± 0.2 (n = 5) to 5.6 ± 0.2 (n = 5) μM/g dry weight of the heart. The left ventricular contractile function of the hearts was measured during normoxic perfusion (PO2= 590 mmHg), hypoxic perfusion (PO2= 149 mmHg), and reperfusion (PO2= 590 mmHg). In both untreated and THP-treated groups, the rate of development of intraventricular pressure (+dP/dt) under normoxic perfusion was similar; however, +dP/dt declined to about 10% of the initial rate within 20 minutes of hypoxic perfusion. In the THP-treated group of hearts, the initial decline was slower than that of the untreated animal hearts. After 20 minutes of normoxic reperfusion following 60 minutes of hypoxic perfusion, the recovery of +dP/dt and -dP/dt was greater in the THP-treated group than in the untreated group. The elevation of end-diastolic pressure during hypoxia was completely reversed by normoxic reperfusion of the THP-treated group but not in the untreated group. Mitochondria isolated from hearts from the THP-treated group after normoxic reperfusion following hypoxic perfusion exhibited better respiratory function than those from untreated hearts.ConclusionThe data suggest that feeding guinea pigs with THP results in reduced myocardial-free carnitine content and attenuation of hypoxic and reperfusion injury in isolated hearts.
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Affiliation(s)
- PK Dhar
- Department of Pharmacology and Cell Biophysics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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19
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Abstract
In this study, we assess changes in the education of students with disabilities (SWDs) in the nation’s largest school district, New York City (NYC), over the decade 2005–2015. Specifically, we examine progress toward the twin legislative goals of both the federal Individuals with Disability Education Act (IDEA) and NYC district goals of (a) including SWDs in general education settings and (b) improving their academic performance. We find that the inclusion of SWDs with their general education peers (GENs) has increased in elementary and middle schools, but decreased in high school. Furthermore, although more SWDs are completing high school, their graduation rate remains considerably below that of GENs (50% vs. 80%). In assessing these patterns, we provide empirical evidence of the changing context of education in NYC before, during, and after policy changes that affected special education.
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20
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Abstract
Measuring primary care (PC) performance and designing payment systems that reward value rather than volume have been a great challenge due in large part to lack of reliable risk adjustment mechanisms pertinent to primary care. Using risk scores designed for total resource needs to assess PC performance or set PC payment rates is inadequate because high-cost patients may not have high needs in PC and vice versa. The greatest challenge in developing a risk algorithm for PC is that significant components of PC providers' workload are unobservable but needed in the modeling. In this study, we sought to overcome this challenge by analyzing 5,172,773 patients in the U.S. Veterans Affairs (VA) healthcare system to identify potential proxies of the unobservable PC workload. By combining the number of PC visits and prescription drug classes, we formed a proxy for the expected PC workload, which enabled us to develop a case-mix algorithm pertaining to primary care. The resultant algorithm with high explanatory power (R2 = 0.702) is based on a publicly available patient classification system to account for patient comorbidities and thus can be used by other health systems to compare PC performance, workload, staffing levels, and to set more equitable payment rates.
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Affiliation(s)
- Jian Gao
- US Department of Veterans Affairs, Albany, USA
| | - Eileen Moran
- US Department of Veterans Affairs, Washington, USA
| | - Amy Schwartz
- Yale University School of Medicine, New Haven, USA
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Apangu T, Acayo S, Atiku LA, Apio H, Candini G, Okoth F, Basabose JK, Ojosia L, Ajoga S, Mongiba G, Wetaka MM, Kayiwa J, Balinandi S, Schwartz A, Yockey B, Sexton C, Dietrich EA, Pappert R, Petersen JM, Mead PS, Lutwama JJ, Kugeler KJ. Intervention To Stop Transmission of Imported Pneumonic Plague - Uganda, 2019. MMWR Morb Mortal Wkly Rep 2020; 69:241-244. [PMID: 32134908 PMCID: PMC7367092 DOI: 10.15585/mmwr.mm6909a5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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22
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Campbell SB, Klioueva A, Taylor J, Nelson C, Tomasi S, Replogle A, Kwit N, Sexton C, Schwartz A, Hinckley A. Evaluating the risk of tick-borne relapsing fever among occupational cavers-Austin, TX, 2017. Zoonoses Public Health 2019; 66:579-586. [PMID: 31152496 DOI: 10.1111/zph.12588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/24/2019] [Accepted: 05/06/2019] [Indexed: 11/28/2022]
Abstract
Tick-borne relapsing fever (TBRF) is a potentially serious spirochetal infection caused by certain species of Borrelia and acquired through the bite of Ornithodoros ticks. In 2017, Austin Public Health, Austin, TX, identified five cases of febrile illness among employees who worked in caves. A cross-sectional serosurvey and interview were conducted for 44 employees at eight organizations that conduct cave-related work. Antibodies against TBRF-causing Borrelia were detected in the serum of five participants, four of whom reported recent illness. Seropositive employees entered significantly more caves (Median 25 [SD: 15] versus Median 4 [SD: 16], p = 0.04) than seronegative employees. Six caves were entered more frequently by seropositive employees posing a potentially high risk. Several of these caves were in public use areas and were opened for tours. Education of area healthcare providers about TBRF and prevention recommendations for cavers and the public are advised.
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Affiliation(s)
| | | | | | - Christina Nelson
- Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Suzanne Tomasi
- Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Adam Replogle
- Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Natalie Kwit
- Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Amy Schwartz
- Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Alison Hinckley
- Centers for Disease Control and Prevention, Fort Collins, Colorado
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23
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Hyer K, Jester DJ, Badana ANS, D'Aoust R, Robinson BE, Guerra L, Michael M, Molinari V, Schwartz A, Schocken D, Wills T, Wilson C, Andel R. Medical Faculty Beliefs: Self-Rated Importance and Confidence in Teaching Geriatrics Primary Care. J Am Geriatr Soc 2019; 67:576-580. [PMID: 30839109 DOI: 10.1111/jgs.15759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate and contrast 25 content areas essential to the primary care of older adults by medical faculty, thus identifying faculty beliefs and areas of possible improvement. DESIGN Using measures from the Healthcare Effectiveness Data and Information Set, the Consumer Assessment of Healthcare Providers and Systems, and Healthy People 2020, nine practicing clinical faculty identified 25 content areas essential to the primary care of older adults. SETTING A large academic health center in southeastern United States. PARTICIPANTS Eighty-two university medical faculty. MEASUREMENTS Faculty rated importance, knowledge, and confidence in teaching the 25 content areas on a scale from 1 (low) to 10 (high). Gap scores reflecting the difference in ratings for importance and confidence in teaching were calculated and assessed. The survey had high internal consistency within each of the three domains-Cronbach's α > .94. RESULTS The most important content areas were being able to explain details about patient's condition and taking medication clearly, followed by taking age-appropriate history. The three largest gaps were: "evaluating sensory impairment," "identifying and counseling at-risk drivers," and "evaluating cognition." The three smallest gaps were: "explaining prescribed medications," "explaining health conditions in easy-to-understand language," and "taking an age-appropriate patient history and performing a physical assessment." CONCLUSION Medical faculty were comfortable with topics reflecting primary care expertise but expressed less confidence with more specialized topics, such as sensory or cognitive impairment and driving. This may represent key areas for geriatrics training applicable to all those involved in education and training of future healthcare professionals. Integration of specialists (eg, neurologists, psychiatrists) may improve the geriatrics curricula. J Am Geriatr Soc 67:576-580, 2019.
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Affiliation(s)
- Kathryn Hyer
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida
| | - Dylan J Jester
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida
| | - Adrian N S Badana
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida
| | - Rita D'Aoust
- Department of Acute and Chronic Care, School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Bruce E Robinson
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida.,Department of Geriatrics, Sarasota Memorial Hospital, Sarasota, Florida
| | - Lucy Guerra
- College of Medicine, University of South Florida, Tampa, Florida
| | - Melanie Michael
- College of Nursing, University of South Florida, Tampa, Florida
| | - Victor Molinari
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida
| | - Amy Schwartz
- College of Pharmacy, University of South Florida, Tampa, Florida
| | - Dawn Schocken
- College of Medicine, University of South Florida, Tampa, Florida
| | - Todd Wills
- College of Medicine, University of South Florida, Tampa, Florida
| | - Cheryl Wilson
- College of Nursing, University of South Florida, Tampa, Florida
| | - Ross Andel
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa, Florida
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24
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Kwit NA, Schwartz A, Kugeler KJ, Mead PS, Nelson CA. Human tularaemia associated with exposure to domestic dogs-United States, 2006-2016. Zoonoses Public Health 2018; 66:417-421. [PMID: 30556330 DOI: 10.1111/zph.12552] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/16/2018] [Accepted: 11/23/2018] [Indexed: 12/01/2022]
Abstract
Dogs have been implicated in the zoonotic transmission of numerous pathogens. Whereas cats are known to transmit Francisella tularensis to humans via bite and other routes, the role of dogs in facilitating infection is much less understood. We reviewed tularaemia case investigation records collected through national surveillance during 2006-2016 to summarize those with dog involvement, characterize the nature of dog-related exposure and describe associated clinical characteristics. Among 1,814 human tularaemia cases, 735 (41%) supplemental case investigation records were available for review; and of those, 24 (3.3%) were classified as dog-related. Median age of patients was 51 years (range: 1-82); 54% were female. Two thirds (67%) of cases presented with ulceroglandular/glandular tularaemia; pneumonic (13%) and oropharyngeal (13%) illness occurred less frequently. Dog-related exposures were classified as follows: direct contact via bite, scratch or face snuggling/licking (n = 12; 50%); direct contact with dead animals retrieved by domestic dogs (n = 8; 33%); and contact with infected ticks acquired from domestic dogs (n = 4; 17%). Prevention of dog-related tularaemia necessitates enhanced tularaemia awareness and tick avoidance among pet owners, veterinarians, health care providers and the general public.
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Affiliation(s)
- Natalie A Kwit
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Amy Schwartz
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Kiersten J Kugeler
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Paul S Mead
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Christina A Nelson
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
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de la Salle C, Charmantier JL, Baas MJ, Schwartz A, Wiesel ML, Grunebaum L, Cazenave JP. A Deletion Located in the 3′ Non Translated Part of the Factor IX Gene Responsible for Mild Haemophilia B. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1649582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- C de la Salle
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - J-L Charmantier
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - M-J Baas
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - A Schwartz
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - M-L Wiesel
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - L Grunebaum
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
| | - J-P Cazenave
- INSERM U.311, Centre Régional de Transfusion Sanguine, 10 rue Spielmann, 67085 Strasbourg Cédex, France
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Schwartz A, Ruble M, Sellers KC, Rodriguez-Snapp N, Hill A, Tipparaju S. Incorporation of Professionalism Expectations and Evaluative Processes Within a College of Pharmacy. Am J Pharm Educ 2018; 82:6478. [PMID: 30013245 PMCID: PMC6041487 DOI: 10.5688/ajpe6478] [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] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 09/15/2017] [Indexed: 06/08/2023]
Abstract
Objective. To determine professionalism factors of interest to the University of South Florida (USF) College of Pharmacy (COP) and develop a programmatic plan to monitor the professionalization of students, faculty, preceptors and staff. Methods. In 2013, the USF COP began investigating how best to incorporate processes to capture professionalism across all aspects of the program. A Professionalism Task Force was convened to identify key professionalism factors valued by faculty and preceptors to be incorporated in pharmacy practice experiences, didactic courses, faculty, and preceptor performance evaluations. A factor analysis was performed to identify items for inclusion in professional practice experience evaluations, course syllabi, faculty, preceptor and staff evaluations. Results. The analysis identified 11 factors for practice experiences, three for syllabi, and five for performance evaluations. The information from the factor analysis spurred additional discussion that led to the development of a programmatic plan for professionalization. Conclusion. A brief description of the programmatic professionalization plan is provided, including possible assessment processes. The goal of this endeavor was to ensure appropriate support and development of professionalization across the COP community.
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Affiliation(s)
- Amy Schwartz
- University of South Florida College of Pharmacy, Tampa, Florida
| | - Melissa Ruble
- University of South Florida College of Pharmacy, Tampa, Florida
| | - Kevin C Sellers
- University of South Florida College of Pharmacy, Tampa, Florida
| | | | - Angela Hill
- University of South Florida College of Pharmacy, Tampa, Florida
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Berger S, Pho H, Fleury Curado T, Schwartz A, Polotsky V. 0077 Intranasal Leptin Approach To Treat Sleep-disordered Breathing. Sleep 2018. [DOI: 10.1093/sleep/zsy061.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Berger
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - H Pho
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - T Fleury Curado
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - A Schwartz
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - V Polotsky
- Division of Pulmonary and Critical Care Medicine Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
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Caballero Eraso C, Shin M, Pho H, Schwartz A, Tang W, Sham J, Polotsky V. 0080 Leptin Induces Upregulation Of The Hypoxic Ventilatory Response Acting In The Carotid Bodies. Sleep 2018. [DOI: 10.1093/sleep/zsy061.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Caballero Eraso
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
| | - M Shin
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
| | - H Pho
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
| | - A Schwartz
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
| | - W Tang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - J Sham
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
| | - V Polotsky
- Department of Medicine. Pulmonary and critical care, Johns Hopkins University, Baltimore, MD
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Abstract
SummaryMagnetic resonance imaging (MRI) has recently been demonstrated to be sensitive to changes in neuronal activity of cortical areas. We report our initial experiences with functional MR brain mapping at high spatial resolution using a conventional whole-body MR system. A total of 10 visual and motor cortex activation studies were carried out on 8 healthy volunteers. In each examination, a time course series of 15 strongly T2*-weighted FLASH images was measured from three adjacent slices. The image analysis revealed a subtle but highly significant signal increase in cortical layers of gray matter in primary and associative visual as well as sensorimotoric cortex regions during periods of excessive brain activity provoked by photic stimuli or motoric tasks, respectively. To correlate brain structure and brain function, the computed MR brain activation maps were directly superimposed on T1-weighted anatomic spin-echo images. With this advance into the area of functional neuroimaging, MRI is moving into an established domain of positron emission tomography (PET). We, therefore, discuss the advantages and limitations of the MR method in comparison to PET as far as this can be done at present.
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Schwartz A, Silver M, Antoline M, Brodmann K. 111 Utilization of Business Intelligence Software for an Emergency Department Dashboard. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kauffmann G, McKillip R, Schwartz A, Farnan J, Park Y, Golden D. Objective Evaluation of a Structured Didactic Radiation Oncology Clerkship Curriculum: A Report from the Radiation Oncology Education Collaborative Study Group. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sagawa N, Boudreau R, Vinik A, Schwartz A, Waters T, Cauley J, Harris T, Strotmeyer E. DIABETES, IMPAIRED FASTING GLUCOSE, AND FALL INJURY RISK IN OLDER ADULTS: THE HEALTH ABC STUDY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N. Sagawa
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - R. Boudreau
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - A. Vinik
- Eastern Virginia Medical School, Norfolk, Virginia,
| | - A. Schwartz
- University of California, San Francisco, San Francisco, California,
| | - T. Waters
- University of Tennessee, Memphis, Tennessee
| | - J.A. Cauley
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - T.B. Harris
- National Institute on Aging, Bethesda, Maryland,
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Schwartz A. Pesticide Effect on Populations of Tetranychus urticae Koch (Acari: Tetranychidae) and a Predaceous Mite on Table Grapes in the Hex River Valley. S AFR J ENOL VITIC 2017. [DOI: 10.21548/11-1-2245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Schwartz A, Deklerk CA. The Relationship between the Mite, Eriophyes vitis (Pagst.) and Leaf Curl on Vitis vinifera L. cv. Shiraz. S AFR J ENOL VITIC 2017. [DOI: 10.21548/5-2-2362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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35
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Schwartz A, Siebert M. Field Trials with Toxic Bait for the Control of the Brown Garden Snail (Helix aspersa, Muller). S AFR J ENOL VITIC 2017. [DOI: 10.21548/8-2-2320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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36
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Schwartz A. Efficacy of Trunk Barriers for the Control of Key Pests on Trellised Grapevines. S AFR J ENOL VITIC 2017. [DOI: 10.21548/9-1-2304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Schwartz A. Seasonal Occurrence of a Predaceous Mite Amblyseius addoensis Van der Merwe & Ryke (Acari: Phytoseiidae) on Table Grapes. S AFR J ENOL VITIC 2017. [DOI: 10.21548/8-2-2319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Schwartz A, Capatos D. An Evaluation of Chemicals for the Toxicity to Brown Snail (Helix aspersa Muller) on Grapevines. S AFR J ENOL VITIC 2017. [DOI: 10.21548/11-1-2264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Schwartz A. The Incidence of Heliothrips sylvanus Faure (Thysanoptera: Thripidae) on Table Grapes. S AFR J ENOL VITIC 2017. [DOI: 10.21548/10-2-2287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Schwartz A. The Seasonal Occurrence of the Snoutbeetle, Phlyctinus callosus Boheman ( Coleoptera: Curculionidae) on Vines in the Robertson Area. S AFR J ENOL VITIC 2017. [DOI: 10.21548/6-1-2356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Schwartz A, Capatos D. Evaluation of a Wing-Type Against a Bucket-Type Fruit Fly Trap for Use in Table Grape Vineyards. S AFR J ENOL VITIC 2017. [DOI: 10.21548/15-1-2278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Schwartz A. Laboratory Evaluation of Toxicity of Registered Pesticides to Adult Amblyseius addoensis (Van der Merwe & Ryke) (Acari: Phytoseiidae). S AFR J ENOL VITIC 2017. [DOI: 10.21548/12-2-2217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Schwartz A. Population Dynamics of Thrips tabaci Lindeman (Thysanoptera: Thripidae) on Table Grapes. S AFR J ENOL VITIC 2017. [DOI: 10.21548/9-1-2305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Fleury Curado TA, Fishbein K, Pho H, Brennick M, Dergacheva O, Pham L, Ladenheim E, Spencer R, Sennes LU, Schwartz A, Polostky V. 0008 CHEMOGENETIC STIMULATION OF THE HYPOGLOSSAL NEURONS IMPROVES THE UPPER AIRWAY PATENCY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Schwartz A, Huffman L, Ashley C, Saha S, Rose S, Kushner D, Hartenbach E, Rice L, Barroilhet L, Al-Niaimi A. Surviving vulvar cancer, does obesity matter? Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Carr A, Grund B, Neuhaus J, Schwartz A, Bernardino JI, White D, Badel-Faesen S, Avihingsanon A, Ensrud K, Hoy J. Prevalence of and risk factors for low bone mineral density in untreated HIV infection: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial. HIV Med 2015; 16 Suppl 1:137-46. [PMID: 25711332 DOI: 10.1111/hiv.12242] [Citation(s) in RCA: 39] [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] [Accepted: 11/21/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVES HIV infection is associated with a higher prevalence of low bone mineral density (BMD) and fractures than that found in the general population. There are limited data in HIV-positive adults, naïve to antiretroviral therapy (ART), with which to estimate the relative contribution of untreated HIV infection to bone loss. METHODS The primary objective of the Strategic Timing of AntiRetroviral Treatment (START) Bone Mineral Density Substudy is to compare the effect of immediate versus deferred initial ART on bone. We evaluated traditional, demographic, HIV-related and immunological factors for their associations with baseline hip and lumbar spine BMD, measured by dual-energy X-ray absorptiometry, using multiple regression. RESULTS A total of 424 ART-naïve participants were enrolled at 33 sites on six continents; the mean age was 34 years [standard deviation (SD) 10.1 years], 79.0% were nonwhite, 26.0% were women, and 12.5% had a body mass index (BMI) < 20 kg/m(2) . Mean (SD) Z-scores were -0.41 (0.94) at the spine and -0.36 (0.88) for total hip; 1.9% had osteoporosis and 35.1% had low BMD (hip or spine T-score < -1.0). Factors independently associated with lower BMD at the hip and spine were female sex, Latino/Hispanic ethnicity, lower BMI and higher estimated glomerular filtration rate. Longer time since HIV diagnosis was associated with lower hip BMD. Current or nadir CD4 cell count and HIV viral load were not associated with BMD. CONCLUSIONS In this geographically and racially diverse population of ART-naïve adults with normal CD4 cell counts, low BMD was common, but osteoporosis was rare. Lower BMD was significantly associated with traditional risk factors but not with CD4 cell count or viral load.
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Affiliation(s)
- A Carr
- Centre for Applied Medical Research, St Vincent's Hospital, Sydney, Australia
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Wang L, Ko K, Yanez D, Kaverina N, Liarski V, Peng Y, Lan L, Perper S, Schwartz A, O'Connor L, Souers A, Elmore S, Olson L, Giger M, Clark M. OP0136 BCL-2 As a Potential Therapeutic Target in Human Lupus Tubulointerstitial Inflammation. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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49
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Wang L, Perper S, Schwartz A, Goess C, O'Connor L, Hartman D, Graff C, Souers A, Leverson J, Elmore S, Olson L. THU0382 Venetoclax (ABT-199), A Potent and Selective BCL-2 Inhibitor, Prevents Nephritis in Lupus Prone NZB/W F1 Mice by Depleting Selective Lymphocyte Populations While Sparing Platelets. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Schwartz A, Schlappe B, Wong C, Luebbers R, Everett E. Abstract number 18: Assessment of primary care providers' current clinical practices in determining a woman's risk for ovarian cancer. Gynecol Oncol 2014. [DOI: 10.1016/j.ygyno.2014.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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