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Shershneva M, Anderson B. In the Midst of Dealing With Changes in Continuing Education: A Mental Model to Support Well-Being and Action. J Contin Educ Health Prof 2024:00005141-990000000-00108. [PMID: 38511927 DOI: 10.1097/ceh.0000000000000550] [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] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
ABSTRACT Continuing education (CE) professionals are experiencing continuous changes in their practice, including situations where they see a need for change but feel overwhelmed with change implementation. This article is a reflection on our experience of (1) transitioning from independently operating health professions CE units in medicine, nursing, and pharmacy to becoming a Joint Accreditation provider of interprofessional CE and (2) developing and using a Diversity, Equity, and Inclusion Toolkit for Accredited Continuing Education. We examined these instances of substantial change to identify what made them achievable and supported our well-being throughout the process. We also considered a social cognitive theory, a schema theory, and a normalization process theory. As a result, we identified five steps of the CE planning and implementation process to be our trusted mental model and the key factor in making the changes doable for our team and supporting our resilience and a sense of well-being. Interviews with three clinician-learners, which were conducted in search of additional insights, reminded us that positive reinforcement occurs when we see the desired result. Thus, measuring the CE change and its impact on learners and their patients is also a tool to sustain emotional comfort during the turbulence of a change cascade, given the measures show progress in a desired direction. We hope this article will stimulate peer discussions, reflections, and sharing of lessons learned from similar journeys.
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Affiliation(s)
- Marianna Shershneva
- Dr. Shershneva: CPD Evaluation and Assessment Specialist, Office of Continuing Professional Development, University of Wisconsin School of Medicine and Public Health, Madison, WI, and Senior Director, Educational Development and Research, Forefront Collaborative. Ms. Anderson: Director, Office of Continuing Professional Development, University of Wisconsin School of Medicine and Public Health, and Chair, Interprofessional Continuing Education Partnership
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Jennifer A J, Vandenboer E, Anderson B, Lordly D, Macdonald B, Ann F. Changing Roles and Responsibilities of Dietitians from Diverse Settings During the First Three Waves of the COVID-19 Pandemic in Nova Scotia. CAN J DIET PRACT RES 2024; 85:12-19. [PMID: 38377041 DOI: 10.3148/cjdpr-2023-030] [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: 02/22/2024]
Abstract
Purpose: To explore the impact of the COVID-19 pandemic on Nova Scotian dietitian's roles, responsibilities, and professional development needs.Methods: We conducted a province-wide, online, exploratory survey with registered dietitians during the initial waves of the COVID-19 pandemic. Differences were explored with descriptive statistics by work sector (hospital/acute care; primary health/community or public health (PH); long-term care [LTC]; other [e.g., private practice, retail]).Results: Dietitians (n = 122) reported being most frequently challenged by stress and anxiety, changing work expectations, and rapidly evolving safety protocols during the pandemic. Those working in PH, primary health, and LTC reported experiencing more work responsibilities, more change, and perceived less employer support than dietitians in other sectors. Despite the identified challenges, most participants (70.7%) felt their education and training were sufficient to take on these new work roles. Primary and PH dietitians, however, more frequently perceived their skill sets to be under-utilized than other sectors. Key learnings from practice identified as being important for dietetic education included qualities such as resilience, problem-solving, flexibility, and self-care.Conclusion: These findings will be of interest to health administrators, professional bodies, and academic institutions to inform strategies for strengthening dietetic practice, building resilience, and preparing for future emergencies.
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Affiliation(s)
- Jamieson Jennifer A
- Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS
| | - Erik Vandenboer
- Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Barbara Anderson
- School of Nutrition & Dietetics, Acadia University, Wolfville, NS
| | - Daphne Lordly
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Brenda Macdonald
- Nutrition and Food Services, Nova Scotia Health Authority, Halifax, NS
| | - Fox Ann
- Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS
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Kerr HL, Krumm K, Lee I(I, Anderson B, Christiani A, Strait L, Breckheimer BA, Irwin B, Jiang A(S, Rybachok A, Chen A, Caeiro L, Dacek E, Hall DB, Kostyla CH, Hales LM, Soliman TM, Garcia JM. EXT418, a novel long-acting ghrelin, mitigates Lewis lung carcinoma induced cachexia in mice. J Cachexia Sarcopenia Muscle 2023; 14:1337-1348. [PMID: 36942661 PMCID: PMC10235874 DOI: 10.1002/jcsm.13211] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/10/2023] [Accepted: 02/02/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Ghrelin is a potential therapy for cachexia due to its orexigenic properties and anabolic effects on muscle and fat. However, its clinical use is limited by the short half-life of active (acylated) ghrelin (~11 min in humans). EXT418 is a novel long-acting, constitutively active ghrelin analog created by covalently linking it to a vitamin D derivative. Here, we evaluated the effects and mechanisms of action of EXT418 on Lewis lung carcinoma (LLC)-induced cachexia in mice. METHODS Male C57BL/6J mice (5- to 7-month-old) were implanted with 1 × 106 heat-killed (HK) or live LLC cells. When the tumour was palpable, mice were injected with vehicle (T + V) or EXT418 daily (T + 418 Daily, 0.25 mg/kg/day) or every other day (T + 418 EOD, 0.5 mg/kg/EOD) for up to 14 days, whereas HK-treated mice were given vehicle (HK + V). Subsets of T + 418 Daily or EOD-treated mice were pair-fed to the T + V group. Body composition and grip strength were evaluated before tumour implantation and at the end of the experiment. Molecular markers were probed in muscles upon termination. RESULTS In tumour-bearing mice, administration of EXT418 daily or EOD partially prevented weight loss (T + V vs. T + 418 Daily, P = 0.030; and vs. T + 418 EOD, P = 0.020). Similar effects were observed in whole body fat and lean body mass. Grip strength in tumour-bearing mice was improved by EXT418 daily (P = 0.010) or EOD (P = 0.008) administration compared with vehicle-treated mice. These effects of EXT418 on weight and grip strength were partially independent of food intake. EXT418 daily administration also improved type IIA (P = 0.015), IIB (P = 0.037) and IIX (P = 0.050) fibre cross-sectional area (CSA) in tibialis anterior (TA) and EXT418 EOD improved CSA of IIB fibres in red gastrocnemius (GAS; P = 0.005). In skeletal muscles, tumour-induced increases in atrogenes Fbxo32 and Trim63 were ameliorated by EXT418 treatments (TA and GAS/plantaris, PL), which were independent of food intake. EXT418 administration decreased expression of the mitophagy marker Bnip3 (GAS/PL; P ≤ 0.010). Similar effects of EXT418 EOD were observed in p62 (GAS/PL; P = 0.039). In addition, EXT418 treatments ameliorated the tumour-induced elevation in muscle Il6 transcript levels (TA and GAS/PL), independently of food intake. Il-6 transcript levels in adipose tissue and circulating IL-10 were elevated in response to the tumour but these increases were not significant with EXT418 administration. Tumour mass was not altered by EXT418. CONCLUSIONS EXT418 mitigates LLC-induced cachexia by attenuating skeletal muscle inflammation, proteolysis, and mitophagy, without affecting tumour mass and partially independent of food intake.
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Affiliation(s)
- Haiming L. Kerr
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Kora Krumm
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Ian (In‐gi) Lee
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Barbara Anderson
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Anthony Christiani
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Lena Strait
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Beatrice A. Breckheimer
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Brynn Irwin
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Alice (Siyi) Jiang
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Artur Rybachok
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Amanda Chen
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Lucas Caeiro
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | - Elizabeth Dacek
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
| | | | - Caroline H. Kostyla
- Extend Biosciences, Inc.St. NewtonMassachusettsUSA
- Present address:
Atalanta TherapeuticsBostonMassachusettsUSA
| | | | | | - Jose M. Garcia
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWashingtonUSA
- Department of Medicine, Division of Gerontology and Geriatric MedicineUniversity of Washington School of MedicineWashingtonSeattleUSA
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Overstreet AMC, Anderson B, Burge M, Zhu X, Tao Y, Cham CM, Michaud B, Horam S, Sangwan N, Dwidar M, Liu X, Santos A, Finney C, Dai Z, Leone VA, Messer JS. HMGB1 acts as an agent of host defense at the gut mucosal barrier. bioRxiv 2023:2023.05.30.542477. [PMID: 37398239 PMCID: PMC10312563 DOI: 10.1101/2023.05.30.542477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Mucosal barriers provide the first line of defense between internal body surfaces and microbial threats from the outside world. 1 In the colon, the barrier consists of two layers of mucus and a single layer of tightly interconnected epithelial cells supported by connective tissue and immune cells. 2 Microbes colonize the loose, outer layer of colonic mucus, but are essentially excluded from the tight, epithelial-associated layer by host defenses. 3 The amount and composition of the mucus is calibrated based on microbial signals and loss of even a single component of this mixture can destabilize microbial biogeography and increase the risk of disease. 4-7 However, the specific components of mucus, their molecular microbial targets, and how they work to contain the gut microbiota are still largely unknown. Here we show that high mobility group box 1 (HMGB1), the prototypical damage-associated molecular pattern molecule (DAMP), acts as an agent of host mucosal defense in the colon. HMGB1 in colonic mucus targets an evolutionarily conserved amino acid sequence found in bacterial adhesins, including the well-characterized Enterobacteriaceae adhesin FimH. HMGB1 aggregates bacteria and blocks adhesin-carbohydrate interactions, inhibiting invasion through colonic mucus and adhesion to host cells. Exposure to HMGB1 also suppresses bacterial expression of FimH. In ulcerative colitis, HMGB1 mucosal defense is compromised, leading to tissue-adherent bacteria expressing FimH. Our results demonstrate a new, physiologic role for extracellular HMGB1 that refines its functions as a DAMP to include direct, virulence limiting effects on bacteria. The amino acid sequence targeted by HMGB1 appears to be broadly utilized by bacterial adhesins, critical for virulence, and differentially expressed by bacteria in commensal versus pathogenic states. These characteristics suggest that this amino acid sequence is a novel microbial virulence determinant and could be used to develop new approaches to diagnosis and treatment of bacterial disease that precisely identify and target virulent microbes.
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Anderson B, Penner G, Larson K, McKinnon J, Damiran D, Pereira M, Lardner H. Effects of 3-day versus 9-day whole-plant corn allocation and hay supplementation on performance, grazing preference, and ruminal fermentation of beef cows. Applied Animal Science 2023. [DOI: 10.15232/aas.2022-02358] [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: 03/29/2023]
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Anderson B, Mandin V, Bouquet M. Abdominal pain takes a turn. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00373-7] [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: 01/28/2023]
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Fiala K, Shershneva M, Anderson B. Safe Opioid Prescribing for Pediatric Patients: An Interprofessional Learning Activity. WMJ 2022; 121:239-242. [PMID: 36301653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION An innovative online course on safe opioid prescribing for pediatric patients was designed by an interprofessional team of experts for an interprofessional target audience of clinicians in Wisconsin. METHODS The 2-hour accredited course included recorded TED Talks-style presentations and interactive patient cases. A total of 227 course completers responded to pre- and posttests and a 20-item Interprofessional Collaborative Competency Attainment Scale (ICCAS). A Fisher exact test was used to compare pre/post first-attempt test responses and a 2-tailed t test compared the before/after ratings of ICCAS statements. RESULTS Improvement on pre/posttest assessment was not significant. ICCAS showed significant increase of interprofessional competence for each statement. DISCUSSION Interprofessional learning can be effectively incorporated in opioid-related continuing education.
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Affiliation(s)
- Kenneth Fiala
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Marianna Shershneva
- Office of Continuing Professional Development, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin,
| | - Barbara Anderson
- Office of Continuing Professional Development, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Findley S, Pesarsick J, Hendricks B, Anderson B, Hansroth J. 122 Number of Acute Care Beds Is Not a Reliable Predictor of Emergency Department Volumes in Small Rural/Critical Access Hospitals. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.146] [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: 11/28/2022]
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Massard C, Cassier PA, Azaro A, Anderson B, Yuen E, Yu D, Oakley G, Benhadji KA, Pant S. A phase 1b study of crenigacestat (LY3039478) in combination with gemcitabine and cisplatin or gemcitabine and carboplatin in patients with advanced or metastatic solid tumors. Cancer Chemother Pharmacol 2022; 90:335-344. [DOI: 10.1007/s00280-022-04461-z] [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] [Received: 07/20/2021] [Accepted: 08/02/2022] [Indexed: 11/28/2022]
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Sunderland A, Naveh Y, Ju L, Blair DG, Lockwood R, Anderson B, Dransfield M. Acoustic and vibration isolation for a gravity gradiometer. Rev Sci Instrum 2022; 93:064502. [PMID: 35778035 DOI: 10.1063/5.0091900] [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] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
Vibration in the audio frequency band affects the performance of rotating gravity gradiometers used for airborne mineral exploration. This is probably due to translation to rotation coupling inside the gradiometer platform. It was found that the DC gravity gradient signal was proportional to the square of the third time derivative of position, or jerk squared. The demanding airborne environment for such instrumentation demands a light weight broadband acoustic shield and vibration isolator. This paper presents the design principles for such an isolator, based on vibration isolated spherical shell structures. Performance data are presented as well as flight test data that demonstrated a 14% gravity gradient noise reduction compared with an unshielded instrument.
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Affiliation(s)
- A Sunderland
- Physics Department, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Y Naveh
- Physics Department, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - L Ju
- Physics Department, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - D G Blair
- Physics Department, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - R Lockwood
- Xcalibur Multiphysics, 10 Compass Road, Jandakot, WA 6164, Australia
| | - B Anderson
- Xcalibur Multiphysics, 10 Compass Road, Jandakot, WA 6164, Australia
| | - M Dransfield
- Xcalibur Multiphysics, 10 Compass Road, Jandakot, WA 6164, Australia
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Anderson LJ, Lee J, Anderson B, Lee B, Migula D, Sauer A, Chong N, Liu H, Wu PC, Dash A, Li Y, Garcia JM. Whole-body and adipose tissue metabolic phenotype in cancer patients. J Cachexia Sarcopenia Muscle 2022; 13:1124-1133. [PMID: 35088949 PMCID: PMC8977952 DOI: 10.1002/jcsm.12918] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 05/06/2021] [Revised: 10/18/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Altered adipose tissue (AT) metabolism in cancer-associated weight loss via inflammation, lipolysis, and white adipose tissue (WAT) browning is primarily implicated from rodent models; their contribution to AT wasting in cancer patients is unclear. METHODS Energy expenditure (EE), plasma, and abdominal subcutaneous WAT were obtained from men (aged 65 ± 8 years) with cancer, with (CWL, n = 27) or without (CWS, n = 47) weight loss, and weight-stable non-cancer patients (CON, n = 26). Clinical images were assessed for adipose and muscle area while plasma and WAT were assessed for inflammatory, lipolytic, and browning markers. RESULTS CWL displayed smaller subcutaneous AT (SAT; P = 0.05) and visceral AT (VAT; P = 0.034) than CWS, and displayed higher circulating interleukin (IL)-6 (P = 0.01) and WAT transcript levels of IL-6 (P = 0.029), IL-1β (P = 0.042), adipose triglyceride lipase (P = 0.026), and browning markers (Dio2, P = 0.03; PGC-1a, P = 0.016) than CWS and CON. There was no difference across groups in absolute REE (P = 0.061), %predicted REE (P = 0.18), circulating free fatty acids (FFA, P = 0.13) or parathyroid hormone-related peptide (PTHrP; P = 0.88), or WAT protein expression of inflammation (IL-6, P = 0.51; IL-1β, P = 0.29; monocyte chemoattractant protein-1, P = 0.23) or WAT protein or gene expression of browning (uncoupling protein-1, UCP-1; P = 0.13, UCP-1, P = 0.14). In patients with cancer, FFA was moderately correlated with WAT hormone-sensitive lipase transcript (r = 0.38, P = 0.018, n = 39); circulating cytokines were not correlated with expression of WAT inflammatory markers and circulating PTHrP was not correlated with expression of WAT browning markers. In multivariate regression using cancer patients only, body mass index (BMI) directly predicted SAT (N = 25, R2 = 0.72, P < 0.001), VAT (N = 28, R2 = 0.64, P < 0.001), and absolute REE (N = 22, R2 = 0.43, P = 0.001), while BMI and WAT UCP-1 protein were indirectly associated with %predicted REE (N = 22, R2 = 0.45, P = 0.02), and FFA was indirectly associated with RQ (N = 22, R2 = 0.52, P < 0.001). CONCLUSIONS Cancer-related weight loss was associated with elevated circulating IL-6 and elevations in some WAT inflammatory, lipolytic and browning marker transcripts. BMI, not weight loss, was associated with increased energy expenditure. The contribution of inflammation and lipolysis, and lack thereof for WAT browning, will need to be clarified in other tumour types to increase generalizability. Future studies should consider variability in fat mass when exploring the relationship between cancer and adipose metabolism and should observe the trajectory of lipolysis and energy expenditure over time to establish the clinical significance of these associations and to inform more mechanistic interpretation of causation.
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Affiliation(s)
- Lindsey J. Anderson
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric Medicine‐Department of MedicineUniversity of WashingtonSeattleWAUSA
| | - Jonathan Lee
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
| | - Barbara Anderson
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
| | - Benjamin Lee
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
| | - Dorota Migula
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
| | - Adam Sauer
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
| | - Nicole Chong
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
| | - Haiming Liu
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric Medicine‐Department of MedicineUniversity of WashingtonSeattleWAUSA
| | - Peter C. Wu
- Department of SurgeryVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Department of SurgeryUniversity of WashingtonSeattleWAUSA
| | - Atreya Dash
- Department of UrologyVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Department of UrologyUniversity of WashingtonSeattleWAUSA
| | - Yi‐Ping Li
- Department of Integrative Biology and PharmacologyUniversity of Texas Health Science CenterHoustonTXUSA
| | - Jose M. Garcia
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric Medicine‐Department of MedicineUniversity of WashingtonSeattleWAUSA
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Buxton M, Anderson B, Lord J. Moths can transfer pollen between flowers under experimental conditions. NEW ZEAL J ECOL 2022. [DOI: 10.20417/nzjecol.46.7] [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: 11/19/2022]
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Liu H, Zang P, Lee I(I, Anderson B, Christiani A, Strait‐Bodey L, Breckheimer BA, Storie M, Tewnion A, Krumm K, Li T, Irwin B, Garcia JM. Growth hormone secretagogue receptor-1a mediates ghrelin's effects on attenuating tumour-induced loss of muscle strength but not muscle mass. J Cachexia Sarcopenia Muscle 2021; 12:1280-1295. [PMID: 34264027 PMCID: PMC8517358 DOI: 10.1002/jcsm.12743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/11/2021] [Accepted: 06/08/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Ghrelin may ameliorate cancer cachexia (CC) by preventing anorexia, muscle, and fat loss. However, the mechanisms mediating these effects are not fully understood. This study characterizes the pathways involved in muscle mass and strength loss in the Lewis lung carcinoma (LLC)-induced cachexia model, and the effects of ghrelin in mice with or without its only known receptor: the growth hormone secretagogue receptor-1a ((GHSR-1a), Ghsr+/+ and Ghsr-/- ). METHODS Five to 7-month-old male C57BL/6J Ghsr+/+ and Ghsr-/- mice were inoculated with 1 × 106 heat-killed (HK) or live LLC cells (tumour implantation, TI). When tumours were palpable (7 days after TI), tumour-bearing mice were injected with vehicle (T + V) or ghrelin twice/day for 14 days (T + G, 0.8 mg/kg), while HK-treated mice were given vehicle (HK + V). Body weight and grip strength were evaluated before TI and at termination (21 days after TI). Hindlimb muscles were collected for analysis. RESULTS Less pronounced body weight (BW) loss (87.70 ± 0.98% vs. 83.92 ± 1.23%, percentage of baseline BW in tumour-bearing Ghsr+/+ vs. Ghsr-/- , P = 0.008), and lower upregulation of ubiquitin-proteasome system (UPS, MuRF1/Trim63, 5.71 ± 1.53-fold vs. 9.22 ± 1.94-fold-change from Ghsr+/+ HK + V in tumour-bearing Ghsr+/+ vs. Ghsr-/- , P = 0.036) and autophagy markers (Becn1, Atg5, Atg7, tumour-bearing Ghsr+/+ < Ghsr-/- , all P < 0.02) were found in T + V Ghsr+/+ vs. Ghsr-/- mice. Ghrelin attenuated LLC-induced UPS marker upregulation in both genotypes, [Trim63 was decreased from 5.71 ± 1.53-fold to 1.96 ± 0.47-fold in Ghsr+/+ (T + V vs. T + G: P = 0.032) and 9.22 ± 1.94-fold to 4.72 ± 1.06-fold in Ghsr-/- (T + V vs. T + G: P = 0.008)]. Only in Ghsr+/+ mice ghrelin ameliorated LLC-induced grip strength loss [improved from 89.24 ± 3.48% to 97.80 ± 2.31% of baseline (T + V vs. T + G: P = 0.042)], mitophagy markers [Bnip3 was decreased from 2.28 ± 0.56 to 1.38 ± 0.14-fold (T + V vs. T + G: P ≤ 0.05)], and impaired mitochondrial respiration [State 3u improved from 698.23 ± 73.96 to 934.37 ± 95.21 pmol/min (T + V vs. T + G: P ≤ 0.05)], whereas these markers were not improved by ghrelin Ghsr-/- . Compared with Ghsr+/+ , Ghsr-/- tumour-bearing mice also showed decreased response to ghrelin in BW [T + G-treated Ghsr+/+ vs. Ghsr -/- : 91.75 ± 1.05% vs. 86.18 ± 1.13% of baseline BW, P < 0.001)], gastrocnemius (T + G-treated Ghsr+/+ vs. Ghsr-/- : 96.9 ± 2.08% vs. 88.15 ± 1.78% of Ghsr+/+ HK + V, P < 0.001) and quadriceps muscle mass (T + G-treated Ghsr+/+ vs. Ghsr-/- : 96.12 ± 2.31% vs. 88.36 ± 1.94% of Ghsr+/+ HK + V, P = 0.01), and gastrocnemius type IIA (T + G-treated Ghsr+/+ vs. Ghsr-/- : 1250.49 ± 31.72 vs. 1017.62 ± 70.99 μm2 , P = 0.027) and IIB fibre cross-sectional area (T + G-treated Ghsr+/+ vs. Ghsr-/- : 2496.48 ± 116.88 vs. 2183.04 ± 103.43 μm2 , P = 0.024). CONCLUSIONS Growth hormone secretagogue receptor-1a mediates ghrelin's effects on attenuating LLC-induced weakness but not muscle mass loss by modulating the autophagy-lysosome pathway, mitophagy, and mitochondrial respiration.
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Affiliation(s)
- Haiming Liu
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Pu Zang
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
- Department of EndocrinologyNanjing Jinling HospitalNanjingChina
| | - Ian (In‐gi) Lee
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Barbara Anderson
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Anthony Christiani
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Lena Strait‐Bodey
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Beatrice A. Breckheimer
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Mackenzie Storie
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Alison Tewnion
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Kora Krumm
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Theresa Li
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Brynn Irwin
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
| | - Jose M. Garcia
- Geriatric Research, Education and Clinical CenterVeterans Affairs Puget Sound Health Care SystemSeattleWAUSA
- Gerontology and Geriatric MedicineUniversity of Washington Department of MedicineSeattleWAUSA
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14
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Majidi S, Reid MW, Fogel J, Anderson B, Klingensmith GJ, Cain C, Berget C, Raymond JK. Psychosocial outcomes in young adolescents with type 1 diabetes participating in shared medical appointments. Pediatr Diabetes 2021; 22:787-795. [PMID: 33838078 DOI: 10.1111/pedi.13212] [Citation(s) in RCA: 9] [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: 08/10/2020] [Revised: 03/20/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022] Open
Abstract
For youth with type 1 diabetes (T1D), the early adolescent period is associated with worsening diabetes management and high rates of negative psychosocial issues, including depressive symptoms and family conflict. Alternative clinical models may help improve both diabetes and psychosocial outcomes. Our study aims to investigate whether Team Clinic, a shared medical appointment model developed specifically for adolescents with T1D, will improve psychosocial outcomes for middle school-aged youth. Youth with T1D, 11-13 years of age, and their caregivers, participated in a randomized controlled trial comparing Team Clinic to traditional clinic visits (control group). Diabetes characteristics were obtained at every visit. Participants and caregivers completed depression screening and family conflict questionnaires at baseline and end of study. Changes in mean scores on clinical and psychosocial outcomes from baseline to end of study were compared between groups using linear mixed-effects models. Eighty-six youth (51% female; 74% White; 10% Hispanic) completed at least one visit during the 12-month study period. At the end of the study, control group participants reported increases in Emotional Problems compared to Team Clinic participants, including higher levels of Negative Mood/Physical Symptoms (p = 0.02). Team Clinic participants reported reduced family conflict surrounding diabetes at study end, compared to control group participants (p = 0.03). Caregivers did not report change in depressive symptoms or family conflict during the study. Hemoglobin A1C levels did not change over time in either group. Participation in Team Clinic was associated with improved psychosocial outcomes in middle school-aged participants with T1D.
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Affiliation(s)
- Shideh Majidi
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Mark W Reid
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Jennifer Fogel
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Barbara Anderson
- Baylor College of Medicine/Texas Children's Hospital, Houston, Texas, USA
| | - Georgeanna J Klingensmith
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Cindy Cain
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Cari Berget
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jennifer K Raymond
- Center for Endocrinology, Diabetes, and Metabolism, Children's Hospital Los Angeles, Los Angeles, California, USA
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15
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Abstract
OBJECTIVE A growing number of studies have associated various measures of social integration, the diversity of social roles in which one participates, with alterations in hypothalamic-pituitary-adrenocortical (HPA) functioning. The pathways through which social integration may be linked to HPA functioning, however, are as yet unknown. The present study examined whether daily social interactions, affective responses, health behaviors, and personality help explain the association between social integration and diurnal cortisol slope. METHODS A sample of 456 healthy, employed adults (53.9% female, 82.0% white, 72.2% bachelor's degree or greater, mean age of 42.86 years) completed a 4-day ecological momentary assessment protocol that measured cortisol, social interactions, affect, sleep, and physical activity at frequent intervals throughout the day. Social integration was measured at baseline. RESULTS Regression results controlling for age, sex, race, and education indicated that more socially integrated individuals showed steeper cortisol slopes (B = -0.00253, p = .006). Exploratory analyses suggested that the consistency (i.e., reduced variability) in nightly sleep midpoint partially explained this association (B = -0.00042, 95% confidence interval = -0.00095 to -0.00001). Personality, mood, social interaction patterns, and nonsleep health behavior differences did not account for the association between social integration and HPA activity. CONCLUSION This study replicates previous findings linking social integration and HPA functioning, and it examines patterns of nightly sleep as possible pathways through which the association may operate. Results have implications for understanding mechanisms for health risk and for development of future interventions.
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16
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Chen C, Tinsley L, Volkening L, Anderson B, Laffel LM. Characteristics Associated With Diabetes Device Use Among Youth With Type 1 Diabetes. J Endocr Soc 2021. [PMCID: PMC8090416 DOI: 10.1210/jendso/bvab048.1373] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Type 1 diabetes (T1D) is a common illness of childhood, requiring lifelong, daily complex management to prevent acute and chronic complications. Studies have shown that use of insulin pumps and continuous glucose monitors (CGM) offers benefit for glycemic control. However, such device use is not universal in adolescents. We aimed to compare baseline socio-demographic and diabetes characteristics associated with diabetes technology (pump and CGM) uptake and continued use in 13-17 year old teens with T1D. Data were derived from a multicenter clinical trial aimed at optimizing self-care and glycemic control in teens with T1D. Socio-demographic and diabetes data were collected quarterly by parent-youth interview and electronic medical record review prospectively over 18 months. Chi-square and t-tests compared characteristics of device and non-device users (pump vs no pump; CGM vs no CGM). The study sample comprised 301 teens (41% male) with mean±SD age 15.0±1.3 years, T1D duration 6.5±3.7 years, and A1c 8.5±1.1%. Most (65%) used a pump at entry or initiated pump therapy during the study; 35% used injection therapy at entry or stopped pump therapy. In contrast, 27% used a CGM at entry or started a CGM during the study, while 73% never used or stopped using CGM. Device users at entry and those who began use had similar characteristics, as did those who never used and those who discontinued device use. Pump users were more likely to use CGM than non-pump users (36% vs 10%, p<.0001). Neither age, sex, nor T1D duration was related to pump or CGM use. Pump users (vs non-pump users) were less likely to have another medical condition (44% vs 59%, p=.01) and more likely to be non-Hispanic white (83% vs 61%, p=.0001); have family annual household income ≥$150,000 (34% vs 19%, p=.0003), private health insurance (92% vs 74%, p<.0001), a parent with college education or higher (67% vs 46%, p=.0005), and a 2-parent household (88% vs 78%, p=.03). Pump users also had lower z-BMI (0.73±0.80 vs 0.97±0.79, p=.01), performed more frequent daily BG monitoring (4.8±1.8 vs 3.9±2.0, p<.0001), and were less likely to have HbA1c ≥9% at initial and last visits (25% vs 43%, p=.005; 31% vs 49%, p=.01). CGM users (vs non-CGM users) were more likely to be non-Hispanic white (88% vs 70%, p=.009); have family annual household income ≥$150,000 (44% vs 23%, p=.0001), a parent with college education or higher (78% vs 53%, p=.0004), and private health insurance (95% vs 82%, p=.005). CGM users also performed more frequent daily BG monitoring (5.2±1.9 vs 4.2±1.9, p=.0002) and were less likely to have HbA1c ≥9% after 18 months (27% vs 42%, p=.03). In summary, we found distinct socio-demographic and diabetes-specific factors associated with device use in adolescents with T1D. These findings provide an opportunity to address barriers associated with device non-use in order to expand device implementation, especially in underserved adolescents with T1D.
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17
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Lukyanova VV, Pellegrini J, Greenier E, Anderson B, Morgan B. Point-of-Care Ultrasound in Anesthesia Care: New AANA Practice Document Adopted by AANA Board of Directors. AANA J 2021; 89:9-11. [PMID: 33543708] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The American Association of Nurse Anesthetists recently released a practice considerations document titled, "Point-of-Care Ultrasound in Anesthesia Care," that clinicians, administrators, and other stakeholders are encouraged to download and read in their entirety, available at aana.com/PracticeManual.
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Affiliation(s)
| | - Joseph Pellegrini
- is currently the program director for the University of Maryland Nurse Anesthesia Program and the current chair of the AANA Practice Committee. Dr Pellegrini is a retired United States Navy captain and has been active in nurse anesthesia academia and clinical practice for 31 years
| | - Ewa Greenier
- is the director of professional practice for the American Association of Nurse Anesthetists
| | - Barbara Anderson
- is the assistant director, accreditation and practice affairs for the American Association of Nurse Anesthetists
| | - Brett Morgan
- is the senior director of education and practice for the American Association of Nurse Anesthetists
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18
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Monteith H, Anderson B, Williams PL. Capacity building and personal empowerment: participatory food costing in Nova Scotia, Canada. Health Promot Int 2020; 35:321-330. [PMID: 30793732 DOI: 10.1093/heapro/daz004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Food insecurity impacts millions of people globally. It has been recognized as a priority and a human right by the United Nations where empowerment of women is identified as a significant goal in addressing food insecurity. In the Maritime Province of Nova Scotia (NS), Canada, more than one in five children live in food insecure households. Since 2002, participatory action research (PAR) has been an integral component of food costing in NS with an aim to support capacity building for food security. Building on earlier research that examined short-term outcomes, and recognizing a lack of research examining outcomes of PAR processes, this study aimed to explore the medium-term individual capacity building processes and outcomes of women involved in Participatory Food Costing (PFC). Findings revealed that capacities were built with respect to interrelated themes of 'awareness, participation, personal development, readiness to change, political impact, influence on others, self-esteem, project growth and project continuity'. In addition, the involvement of these women in PFC resulted in both personal empowerment and food security-related policy change. Involving vulnerable populations through PAR is valuable in influencing health-related policy.
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19
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von Witt CG, Anderson B, Durbach IN, Johnson SD. Breeding systems of floral colour forms in the Drosera cistiflora species complex. Plant Biol (Stuttg) 2020; 22:992-1001. [PMID: 33448582 DOI: 10.1111/plb.13159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 06/02/2020] [Accepted: 07/02/2020] [Indexed: 06/12/2023]
Abstract
Variation in plant breeding systems has implications for pollinator-mediated selection on floral traits and the ecology of populations. Here we evaluate pollinator contribution to seed production, self-compatibility and pollen limitation in different floral colour forms of Drosera cistiflora sensu lato (Droseraceae). These insectivorous perennial plants are endemic to fynbos and renosterveld vegetation in the Cape Floristic Region of South Africa, and the species complex includes five floral colour forms (pink, purple, red, white and yellow), some of which are known to be pollinated by beetles. Controlled hand-pollination experiments were conducted in 15 populations of D. cistiflora s.l. (two to four populations per floral colour form) to test whether the colour forms vary in their degree of self-compatibility and their ability to produce seeds through autonomous self-fertilization. Yellow-flowered forms were highly self-incompatible, while other floral colour forms exhibited partial self-compatibility. Seed set resulting from autonomous selfing was very low, and pollinator dependence indices were high in all populations. Since hand cross-pollination resulted in greater seed set than open pollination in 13 of the 15 populations, we inferred that seed production is generally pollen-limited. Drosera cistiflora s.l. typically exhibits high levels of pollinator dependence and pollen limitation. This is unusual among Drosera species worldwide and suggests that pollinators are likely to mediate strong selection on attractive traits such as floral colour and size in D. cistiflora s.l. These results also suggest that the floral colour forms of D. cistiflora s.l. which are rare and threatened are likely to be vulnerable to local extinction if mutualisms were to collapse indefinitely.
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Affiliation(s)
- C G von Witt
- Centre for Functional Biodiversity, School of Life Sciences, University of KwaZulu-Natal, Scottsville, Pietermaritzburg, South Africa
| | - B Anderson
- Department of Botany and Zoology, Stellenbosch University, Matieland, South Africa
| | - I N Durbach
- Centre for Research into Ecological and Environmental Modelling, University of St Andrews, St Andrews, Scotland
- Centre for Statistics in Ecology, the Environment, and Conservation, Department of Statistical Sciences, University of Cape Town, Rondebosch, South Africa
| | - S D Johnson
- Centre for Functional Biodiversity, School of Life Sciences, University of KwaZulu-Natal, Scottsville, Pietermaritzburg, South Africa
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20
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Liu H, Luo J, Guillory B, Chen JA, Zang P, Yoeli JK, Hernandez Y, Lee IIG, Anderson B, Storie M, Tewnion A, Garcia JM. Ghrelin ameliorates tumor-induced adipose tissue atrophy and inflammation via Ghrelin receptor-dependent and -independent pathways. Oncotarget 2020; 11:3286-3302. [PMID: 32934774 PMCID: PMC7476735 DOI: 10.18632/oncotarget.27705] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/21/2020] [Indexed: 12/13/2022] Open
Abstract
Adipose tissue (AT) atrophy is a hallmark of cancer cachexia contributing to increased morbidity/mortality. Ghrelin has been proposed as a treatment for cancer cachexia partly by preventing AT atrophy. However, the mechanisms mediating ghrelin's effects are incompletely understood, including the extent to which its only known receptor, GHSR-1a, is required for these effects. This study characterizes the pathways involved in AT atrophy in the Lewis Lung Carcinoma (LLC)-induced cachexia model and those mediating the effects of ghrelin in Ghsr +/+ and Ghsr -/- mice. We show that LLC causes AT atrophy by inducing anorexia, and increasing lipolysis, AT inflammation, thermogenesis and energy expenditure. These changes were greater in Ghsr -/-. Ghrelin administration prevented LLC-induced anorexia only in Ghsr +/+, but prevented WAT lipolysis, inflammation and atrophy in both genotypes, although its effects were greater in Ghsr +/+. LLC-induced increases in BAT inflammation, WAT and BAT thermogenesis, and energy expenditure were not affected by ghrelin. In conclusion, ghrelin ameliorates WAT inflammation, fat atrophy and anorexia in LLC-induced cachexia. GHSR-1a is required for ghrelin's orexigenic effect but not for its anti-inflammatory or fat-sparing effects.
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Affiliation(s)
- Haiming Liu
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Gerontology and Geriatric Medicine, University of Washington Department of Medicine, Seattle, WA, USA.,These authors contributed equally to this work
| | - Jiaohua Luo
- Division of Endocrinology, Diabetes and Metabolism, MCL, Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.,Department of Environmental Hygiene, College of Preventive Medicine, Army Medical University, Chongqing, China.,These authors contributed equally to this work
| | - Bobby Guillory
- Division of Endocrinology, Diabetes and Metabolism, MCL, Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Ji-An Chen
- Division of Endocrinology, Diabetes and Metabolism, MCL, Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.,Department of Health Education, College of Preventive Medicine, Army Medical University, Chongqing, China
| | - Pu Zang
- Division of Endocrinology, Diabetes and Metabolism, MCL, Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.,Department of Endocrinology, Nanjing Jinling Hospital, Nanjing, China
| | - Jordan K Yoeli
- Division of Endocrinology, Diabetes and Metabolism, MCL, Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Yamileth Hernandez
- Division of Endocrinology, Diabetes and Metabolism, MCL, Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Ian In-Gi Lee
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Gerontology and Geriatric Medicine, University of Washington Department of Medicine, Seattle, WA, USA
| | - Barbara Anderson
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Gerontology and Geriatric Medicine, University of Washington Department of Medicine, Seattle, WA, USA
| | - Mackenzie Storie
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Gerontology and Geriatric Medicine, University of Washington Department of Medicine, Seattle, WA, USA
| | - Alison Tewnion
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Jose M Garcia
- Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Gerontology and Geriatric Medicine, University of Washington Department of Medicine, Seattle, WA, USA.,Division of Endocrinology, Diabetes and Metabolism, MCL, Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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21
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Nieman K, Anderson B, Cifelli C. The Effects of Dairy Product and Dairy Protein Intake on Inflammation: A Systematic Review of the Literature. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa060_009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Chronic inflammation is associated with obesity and chronic disease risk. Intake of dairy foods is associated with reduced risk of type 2 diabetes and cardiovascular disease; however, the impact of dairy intake on inflammation is not well established. The objective of this study was to conduct a systematic review of the literature to evaluate the effect of dairy product and dairy protein consumption on low-grade systemic inflammation in adults without severe inflammatory disorders.
Methods
This systematic review was conducted in accordance with the PRISMA statement and registered on PROSPERO (CRD42019129639). A literature search was completed in December 2018 and updated September 2019 using PubMed, CENTRAL, and review of reference lists from relevant review articles. The search resulted in identification and inclusion of 27 randomized controlled trials in this analysis, 19 trials which evaluated dairy products and 8 trials which evaluated dairy proteins.
Results
In the 19 trials which evaluated dairy products, 10 reported no inflammatory effect of the intervention, 8 reported a reduction in at least one biomarker of inflammation, and 1 reported a greater anti-inflammatory effect in the control as compared to the dairy product intervention. All 8 trials that investigated dairy protein intake on markers of inflammation reported no effect of the intervention. In the 17 trials which evaluated CRP following dairy product interventions, 12 studies reported no change, 4 studies in overweight and obese populations reported a decrease, and 1 study reported an increase in overweight and obese populations. In the 12 trials which evaluated an inflammatory-related cytokine (IL-6, TNF-α and receptors, IL-1β, and/or MCP-1), 7 studies reported no change in markers assessed, and 5 studies (4 of which were in overweight and obese populations) reported a decrease in at least one pro-inflammatory cytokine. A majority of the trials received neutral or positive quality ratings.
Conclusions
The available literature suggests dairy products and dairy proteins have neutral to beneficial effects on biomarkers of inflammation. Additional clinical studies designed using an inflammatory biomarker as the primary outcome, are needed to fully elucidate the effects of dairy intake on inflammation.
Funding Sources
National Dairy Council.
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22
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Lopez-Avila V, Jones TL, Anderson B, Behymer T, Christensen R, Dougherty T, Getek T, Ilnicki L, Richards D, Shalaby L, Vestal C. Interlaboratory Study of a Thermospray-Liquid Chromatographic/Mass Spectrometric Method for Selected N-Methyl Carbamates, N-Methyl Carbamoyloximes, and Substituted Urea Pesticides. J AOAC Int 2020. [DOI: 10.1093/jaoac/76.6.1329] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A thermospray-liquid chromatographic/mass spectrometric (TS-LC/MS) method was evaluated in an interlaboratory study for determining 3 N-methyl carbamates (bendiocarb, carbaryl, and carbofuran), 3 N-methyl carbamoyloximes (aldicarb, methomyl, and oxamyl), 2 substituted urea pesticides (diuron and linuron), and 1 ester of a substituted carbamic acid (carbendazim). The purpose of this study was to establish whether these 9 compounds can be reliably detected and quantitated with this method, and to establish the interlaboratory precision and accuracy of the method with currently available instrumentation. The study design was based on AOAC INTERNATIONAL’S blind replicate design with balanced replicates. The samples consisted of solutions of the 9 test compounds in methanol at 3 concentrations that were unknown to the participating laboratories and that covered the linear range of the method. Nine volunteer laboratories participated in the study. Linear regression equations are presented that calculate the accuracy of the method, i.e., the percent recovery of each of the 9 compounds at any concentration within the range of concentrations tested (5–90 (μg/mL for each compound, except carbendazim, for which the range was 1.25–22.5 μg/mL). The intra laboratory precisions of the TS-LC/MS method ranged from 6.5 to 33.1 % relative standard deviation, depending on the compound. The interlaboratory method precisions ranged from 29.8 to 98.2% relative standard deviation over the concentration range tested. Analysis of variance indicates that for all compounds tested, the variation from laboratory to laboratory is greater than that attributed to analytical error displayed within laboratories. There are many operational parameters that could contribute to interlaboratory variability; one of them, the thermospray tip temperature, can play a major role in adduct formation and ion fragmentation in the case of thermally labile carbamate pesticides and, therefore, needs to be monitored and controlled carefully. The correlation of mass spectral data with the thermospray tip temperature was attempted using principal component analysis.
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Affiliation(s)
- Viorica Lopez-Avila
- Midwest Research Institute, California Operations, 625-B Clyde Ave, Mountain View, CA 94043
| | - Tammy L Jones
- U.S. Environmental Protection Agency, Environmental Monitoring Systems Laboratory, Las Vegas, NV 89119
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Tomlinson S, Burstow D, Chan J, Anderson B, Edwards N, Chamberlain R, Appadurai V, Scalia G. 359 Invasive Validation of ‘The Oh Factor’ – a Simple, One-step Algorithm for Determining Left Ventricular Filling Pressure in All Patients. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.366] [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: 10/23/2022]
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Badwe R, Pramesh C, Feldman N, Gupta S, D’Cruz A, Anderson B. Prospective comparison of travel burden, cost and time to obtain tumour board treatment plan through in-person visits vs an AI enabled health technology (N = 1803). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz272.008] [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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Anderson B, Smyrk TC, Graham RP, Lightner A, Sweetser S. Idiopathic myointimal hyperplasia is a distinct cause of chronic colon ischaemia. Colorectal Dis 2019; 21:1073-1078. [PMID: 31074117 DOI: 10.1111/codi.14685] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/12/2019] [Indexed: 02/08/2023]
Abstract
AIM Colon ischaemia (CI) is most commonly an acute and reversible manifestation of a transient, non-occlusive decrease of blood flow in the colonic microvasculature. Irreversible complications are uncommon and the progression to chronic CI remains controversial. Our objective was to identify cases of chronic CI and assess for distinct clinicopathological features. METHOD A retrospective review was performed of CI patients having symptom chronicity of ≥ 1 month and ischaemic histology at our institution from 1994 to 2015. Demographic, clinical, endoscopic, radiological, pathological and outcome variables were abstracted. Histological evaluation was performed by two gastrointestinal pathologists. RESULTS Fifteen patients (n = 9; 67% men) with a median age of 65 years (range 22-88) were identified. The most common presenting symptoms were diarrhoea and abdominal pain (n = 6, 86%; n = 5, 71%, respectively). The typical endoscopic appearance was segmental ulceration of the sigmoid colon (n = 6, 75%). Vascular imaging showed patent mesenteric vessels in all patients. Histopathological evaluation revealed venous intimal hyperplasia consistent with idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) in eight patients; the remainder showed non-specific ulceration and fibrosis. Surgical resection was performed in seven IMHMV patients, resulting in symptom resolution. On re-review of pre-resection biopsies, all IMHMV patients had characteristic changes of hyperplastic, thick-walled, hyalinized vessels in the lamina propria. CONCLUSIONS IMHMV is a unique histopathological entity causing chronic CI. The small vessel histological changes in IMHMV are distinctive in colonic resections and undetectable by routine vascular imaging. Preoperative diagnosis of IMHMV is possible with endoscopic biopsy and segmental colon resection is curative.
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Affiliation(s)
- B Anderson
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - T C Smyrk
- Division of Anatomic Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - R P Graham
- Division of Anatomic Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - A Lightner
- Division of Colon and Rectal Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - S Sweetser
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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Winters B, Krone T, Nieman K, Wopereis S, Bijlsma S, Broek TVD, Caspers MPM, Anderson B, Anthony J. A Unique Personalized Nutrition Program Facilitates Lifestyle Behavior Changes: Novel Insights from HABIT's Personalized Approach to Health (PATH) Study (P15-020-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz037.p15-020-19] [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: 11/15/2022] Open
Abstract
Abstract
Objectives
A key to a successful personalized nutrition (PN) strategy is tailoring the behavior intervention to achieve sustained behavior change consistent with desired health outcomes. The objective of this study was to evaluate the impact of a digitally-delivered, systems biology-based PN program (Habit, LLC, Oakland, CA), that included nutrition and behavior advice, and meals.
Methods
In this single-arm, multi-phase, open-label study (clinicaltrials.gov: NCT03424395), participants (n = 107; 67% female), 30–59 years of age, were provided a Fitbit® Activity Tracker and instructions to complete an at-home kit that included collection of DNA and capillary blood before and after (30 and 120 min) consuming a mixed macronutrient challenge beverage. Lifestyle behavior data and activity levels were collected at baseline. Participants completed a 10-week control phase and a 10-week PN program intervention phase that included tailored nutrition and behavior advice, and meals (2 meals/day, 5 days/week). Validated quality of life, perceived stress, diet self-efficacy, and eating behavior questionnaires were administered to assess behavior before and after the intervention. Data from 73 compliant participants (66% female) were included in the analysis. Anthropometric and biological results were used to categorize participants into subgroups including Protein Seekers (PS) and Range Seekers (RS).
Results
Participants reported feeling fuller faster after the intervention, relative to before (P = 0.002), which could be linked to the dietary recommendations and behavior advice. Analysis by gender showed men reported more control over their eating patterns during negative events at baseline, compared to women (P = 0.005). This difference was not evident at the end of the intervention with women reporting slightly more, and men slightly less control. PS entered the study with a higher weight and BMI (P < 0.001 for both) and reported eating more quickly than RS (P = 0.003). This difference diminished, and by the end of the intervention PS did not differ from RS which could reflect the tailored advice provided.
Conclusions
These and other data provide novel insights on how a tailored personalized intervention that targeted food behavior may help drive positive changes in health outcomes.
Funding Sources
Habit, LLC.
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Winters B, Wopereis S, Bijlsma S, Krone T, Broek TVD, Caspers MPM, Anderson B, Nieman K, Anthony J. A Novel Personalized Nutrition Program Improves Health and Lifestyle Behaviors: Subgroup Analysis Results from Habit's Personalized Approaches to Health (PATH) Study (P15-019-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz037.p15-019-19] [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: 11/14/2022] Open
Abstract
Abstract
Objectives
This study evaluates the impact of a digitally-delivered systems biology-based personalized nutrition (PN) program (Habit LLC, Oakland, CA), that included nutrition and behavior advice, and meals.
Methods
In this single-arm, multi-phase, open-label study (clinicaltrials.gov: NCT03424395), participants (n = 107; 67% female) were provided a Fitbit® Activity Tracker and completed an at-home kit that included collection of DNA and capillary blood before and after (30 and 120 min) consuming a mixed macronutrient challenge beverage. Participants completed a 10-week run-in and 10-week PN program intervention phase. The intervention included personalized nutrition and behavior advice and meals (2 meals/day; 5 days/week) tailored to dietary subgroups. Here we report on changes in diet, anthropometrics, and biomarkers of two subgroups (Range Seekers [RS] and Protein Seekers [PS]) that differed in anthropometrics and biological measures at baseline and were provided different dietary recommendations.
Results
At baseline, there were no differences between groups in nutrients assessed, however, compared to RS (n = 48), PS (n = 22) had higher BMI, weight, body fat %, waist and hip circumference (all P < 0.0001), HOMA-IR, age, (both P < 0.01), muscle mass, diastolic blood pressure, hepatic insulin resistance index and c-peptide (all P < 0.05). After the intervention, both groups reduced intakes of calories (P < 0.001) and % calories from saturated fat and monounsaturated fat (both P < 0.05). Intakes of total fat, saturated fat, and sodium (all P < 0.001) as well as carbohydrate and total sugars (both P < 0.05) were also reduced. RS and PS increased vitamin C and fiber intakes (P < 0.001). PS, but not RS, received advice to increase protein intake, accordingly % calories from protein increased in PS by 28% (P < 0.001). PS also increased intake of b-carotene and vitamin A (P < 0.01). BMI and weight decreased in both groups (P < 0.001) after the intervention, with greater extent of weight loss observed in PS. In addition to weight loss in PS, a reduction in total and LDL cholesterol (P < 0.001) was observed.
Conclusions
Together, these results support the efficacy of a digitally-delivered PN program, differentiated by subtype, in improving dietary patterns and health indicators.
Funding Sources
Habit, LLC.
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Seifert B, Sullivan M, Anderson B, Scott A, Sulym C, Bolanos A, Ferguson L, Sebastian S, Rapisardo S. 48. Identification of a novel CEBPA homozygous duplication by NGS and SNP microarray. Cancer Genet 2019. [DOI: 10.1016/j.cancergen.2019.04.054] [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: 11/24/2022]
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Irwin RS, Heffner JE, Maxwell L, French CL, Augustyn N, Frantsve-Hawley J, Barnes PJ, Brightling CE, Davidson BL, Gutterman DD, Hall JB, Hill NS, Johnson RG, Manaker S, Mehra R, Moss J, Murin S, O’Byrne PM, Rubin BK, Schwarz MI, Anderson B, Lipsey L, Miller C, Goorsky P, Musacchio R, de Hon FD, Poppalardo P, Adamitis K, Clark C, Fournier E, Nightlinger M, Nuttall S, Richardson M, Rolya N, Schottenfeld D, Segal-Isaacson A, Tomasheski M, Poppalardo P, Goorsky P, Rice J, Welch S. Spread the Word About CHEST in 2019. Chest 2019; 155:1-4. [DOI: 10.1016/j.chest.2018.11.003] [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] [Received: 11/13/2018] [Accepted: 11/13/2018] [Indexed: 12/01/2022] Open
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Bishry AE, Anderson B, Krebber H. Reduction Ascending Aortoplasty Suitability of Waist Coat Aortoplasty Egyptian Experience With Reference to the Gold Coast Experience. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.02.017] [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: 10/26/2022]
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Edwards N, Scalia G, Sabapathy S, Anderson B, Chamberlain R, Chan J. Resting Global Myocardial Work Derived from Non-Invasive LV Pressure-Strain Loops Discriminates between True Positive and False Positive Exercise Stress Echocardiography. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.316] [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: 11/25/2022]
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Anderson B, Scalia G, Burstow D. Utility of the Mitral Valve Doppler Velocity Index in Detecting Significant Mitral Regurgitation Post-Surgical Mitral Valve Repair. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.331] [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: 11/29/2022]
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Lawley C, Tanous D, Anderson B, Celermajer D, Wilson W, Shipton S, O’Donnell C, Roberts P. Percutaneous Pulmonary Valve Implantation (PPVI) in Australia and New Zealand (ANZ). Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.507] [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: 11/30/2022]
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Edwards NFA, Chan J, Sabapathy S, Anderson B, Chamberlain R, Scalia G. 4922Novel non-invasive left ventricular pressure-strain loop imaging demonstrates reduced myocardial work in cardiomyopathy with significant regional variation in non-ischemic cases. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.4922] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - J Chan
- The Prince Charles Hospital, Brisbane, Australia
| | | | - B Anderson
- The Prince Charles Hospital, Brisbane, Australia
| | | | - G Scalia
- The Prince Charles Hospital, Brisbane, Australia
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McClain MR, Klingensmith GJ, Anderson B, Berget C, Cain C, Shea J, Campbell K, Pyle L, Raymond JK. Team Clinic: Group Approach to Care of Early Adolescents With Type 1 Diabetes. Diabetes Spectr 2018; 31:273-278. [PMID: 30140144 PMCID: PMC6092886 DOI: 10.2337/ds17-0063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Georgeanna J. Klingensmith
- Barbara Davis Center for Diabetes, University of Colorado, Department of Pediatrics, Anschutz Medical Campus, Aurora, CO
| | - Barbara Anderson
- Baylor College of Medicine/Texas Children’s Hospital, Houston, TX
| | - Cari Berget
- Barbara Davis Center for Diabetes, University of Colorado, Department of Pediatrics, Anschutz Medical Campus, Aurora, CO
| | - Cindy Cain
- Barbara Davis Center for Diabetes, University of Colorado, Department of Pediatrics, Anschutz Medical Campus, Aurora, CO
| | - Jacqueline Shea
- Barbara Davis Center for Diabetes, University of Colorado, Department of Pediatrics, Anschutz Medical Campus, Aurora, CO
| | - Kristen Campbell
- Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO
| | - Jennifer K. Raymond
- Los Angeles Children’s Hospital, University of Southern California, Keck School of Medicine, Los Angeles, CA
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Edwards NFA, Chan J, Anderson B, Chamberlain R, Lwin M, Scalia G. 5019The apical strain index of the left ventricle. Surprising findings in a large non-amyloid population. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5019] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - J Chan
- The Prince Charles Hospital, Brisbane, Australia
| | - B Anderson
- The Prince Charles Hospital, Brisbane, Australia
| | | | - M Lwin
- The Prince Charles Hospital, Brisbane, Australia
| | - G Scalia
- The Prince Charles Hospital, Brisbane, Australia
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Friedemann-Sánchez G, Capistrant BD, Ron J, Novak L, Zuijdwijk C, Ogle GD, Anderson B, Moran A, Pendsey S. Caregiving for children with type 1 diabetes and clinical outcomes in central India: The IDREAM study. Pediatr Diabetes 2018; 19:527-533. [PMID: 28809093 DOI: 10.1111/pedi.12567] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 07/10/2017] [Accepted: 07/17/2017] [Indexed: 01/09/2023] Open
Abstract
AIMS Parental care influences outcomes for children's type 1 diabetes (T1D). There is little evidence about the impact of parental caregiving in developing countries, where fixed dose human insulin (conventional) therapy and limited self-monitoring of blood glucose are common. This article investigates whether performance of key T1D management tasks by children or their caregivers impacts hemoglobin A1c (HbA1c). METHODS We surveyed the caregivers of 179 children with T1D routinely treated in a specialized diabetes clinic in Maharashtra, India to determine who performs key diabetes care tasks: child or parent. We used linear regression to estimate the relationship between parental caregiving and HbA1c, and how this association varies by child age and time since diagnosis. RESULTS Caregivers of older children were less involved in care tasks, though caregivers of 11- to 18-year olds performed more care for children diagnosed for a longer duration. Parental involvement in key insulin delivery tasks was associated with lower HbA1c levels for all children. These reductions were greatest among children 11 to 14 years old and diagnosed for less than 2 years: mean HbA1c levels were 8.5% (69 mmol/mol) if the caregiver, and 14.4% (134 mmol/mol) if the child, performed the tasks (P < .05). CONCLUSION Parents of children diagnosed with T1D early in life remain involved in care throughout the child's adolescence. Parents of children diagnosed in late childhood and early adolescence are significantly less involved in care, and this is associated with worse glycemic control. Clinics must know who performs care tasks and tailor diabetes education appropriately.
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Affiliation(s)
| | - Beatrix D Capistrant
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota.,Statistics and Data Science, Smith College, Northampton, Massachusetts
| | - James Ron
- Hubert H. Humphrey School of Public Affairs and Department of Political Science, University of Minnesota, Minneapolis, Minnesota.,Centro de Investigación y Docencia Económicas (CIDE), Mexico City, Mexico
| | - Lindsey Novak
- Department of Economics, Colby College, Waterville, Maine
| | - Caroline Zuijdwijk
- Division of Endocrinology and Metabolism, Children's Hospital of Eastern Ontario (CHEO), CHEO Research Institute, Ottawa, Canada
| | - Graham D Ogle
- International Diabetes Federation, Life for a Child Program, Glebe, Australia
| | - Barbara Anderson
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Antoinette Moran
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Sharad Pendsey
- Diabetes Research Education and Management Trust, Nagpur, India
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Sharp JR, Maguire JL, Carsley S, Abdullah K, Chen Y, Perrin EM, Parkin PC, Birken CS, Maguire JL, Lau E, Laupacis A, Parkin PC, Salter M, Szatmari P, Weir S, Abdullah K, Aglipay M, Ali Y, Anderson LN, Bayoumi I, Birken CS, Borkhoff CM, Carsley S, Chen S, Chen Y, Dai DW, Darmawikarta D, Dennis CL, Eny K, Erdle S, Furlong K, Kavikondala K, Koroshegyi C, Kowal C, Lee GJ, Maguire JL, Mason D, Omand J, Parkin PC, Persaud N, Plumptre L, van den Heuvel M, Vanderhout S, Wong P, Zabih W, Abdurrahman M, Anderson B, Anderson K, Arbess G, Baker J, Barozzino T, Bergeron S, Bhagat D, Blanchette N, Bloch G, Bonifacio J, Bowry A, Brown A, Bugera J, Calpin C, Campbell D, Cheema S, Cheng E, Chisamore B, Constantin E, Culbert E, Danayan K, Das P, Derocher MB, Do A, Dorey M, Doukas K, Egger A, Farber A, Freedman A, Freeman S, Fung K, Gazeley S, Goldenberg D, Guiang C, Ha D, Hafiz S, Handford C, Hanson L, Harrington L, Hatch H, Hughes T, Jacobson S, Jagiello L, Jansz G, Kadar P, Kiran T, Kitney L, Knowles H, Kwok B, Lakhoo S, Lam-Antoniades M, Lau E, Leung FH, Li A, Li P, Loo J, Louis J, Mahmoud S, Male R, Mascoll V, Moodie R, Morinis J, Nader M, Naymark S, Neelands P, Owen J, Parry J, Peer M, Pena K, Perlmutar M, Persaud N, Pinto A, Pitt T, Porepa M, Qi V, Ramji N, Ramji N, Rana J, Rosenthal A, Rouleau K, Saunderson J, Saxena R, Schiralli V, Sgro M, Shepherd S, Smiltnieks B, Srikanthan C, Taylor C, Turner S, Uddin F, Vaughan J, Weisdorf T, Wijayasinghe S, Wong P, Wormsbecker A, Ying E, Young E, Zajdman M, Bustos M, Camacho C, Dalwadi D, Jegathesan T, Malhi T, Thadani S, Thompson J, Thompson L, Allen C, Boodhoo B, Hall J, Juni P, Lebovic G, Pope K, Shim J, Thorpe K, Azad A. Temperament Is Associated With Outdoor Free Play in Young Children: A TARGet Kids! Study. Acad Pediatr 2018; 18:445-451. [PMID: 28842293 DOI: 10.1016/j.acap.2017.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 08/04/2017] [Accepted: 08/12/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Outdoor free play is important for preschoolers' physical activity, health, and development. Certain temperamental characteristics are associated with obesity, nutrition, and sedentary behaviors in preschoolers, but the relationship between temperament and outdoor play has not been examined. This study examined whether there is an association between temperament and outdoor play in young children. METHODS Healthy children aged 1 to 5 years recruited to The Applied Research Group for Kids (TARGet Kids!), a community-based primary care research network, from July 2008 to September 2013 were included. Parent-reported child temperament was assessed using the Childhood Behavior Questionnaire. Outdoor free play and other potential confounding variables were assessed through validated questionnaires. Multivariable linear regression was used to determine the association between temperament and outdoor play, adjusted for potential confounders. RESULTS There were 3393 children with data on outdoor play. The association between negative affectivity and outdoor play was moderated by sex; in boys, for every 1-point increase in negative affectivity score, mean outdoor play decreased by 4.7 minutes per day. There was no significant association in girls. Surgency was associated with outdoor play; for every 1-point increase in surgency/extraversion, outdoor play increased by 4.6 minutes per day. CONCLUSIONS Young children's temperamental characteristics were associated with their participation in outdoor free play. Consideration of temperament could enhance interventions and strategies to increase outdoor play in young children. Longitudinal studies are needed to elucidate the relationship between children's early temperament and physical activity.
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Affiliation(s)
- Julia R Sharp
- Department of Post-Graduate Medical Education, The Hospital for Sick Children (SickKids), University of Toronto, Canada
| | - Jonathon L Maguire
- Paediatric Outcomes Research Team, The Hospital for Sick Children (SickKids), University of Toronto, Canada; Department of Paediatrics, The Hospital for Sick Children (SickKids), University of Toronto, Canada; The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada; Department of Paediatrics, St Michael's Hospital, Toronto, Canada
| | - Sarah Carsley
- Paediatric Outcomes Research Team, The Hospital for Sick Children (SickKids), University of Toronto, Canada
| | - Kawsari Abdullah
- Paediatric Outcomes Research Team, The Hospital for Sick Children (SickKids), University of Toronto, Canada
| | - Yang Chen
- The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
| | - Eliana M Perrin
- Department of Pediatrics, Division of Primary Care, Duke University, Durham, NC
| | - Patricia C Parkin
- Paediatric Outcomes Research Team, The Hospital for Sick Children (SickKids), University of Toronto, Canada; Department of Paediatrics, The Hospital for Sick Children (SickKids), University of Toronto, Canada
| | - Catherine S Birken
- Paediatric Outcomes Research Team, The Hospital for Sick Children (SickKids), University of Toronto, Canada; Department of Paediatrics, The Hospital for Sick Children (SickKids), University of Toronto, Canada; Child Health Evaluative Studies, SickKids Research Institute, Toronto, Canada; The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada.
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Guillory B, Jawanmardi N, Iakova P, Anderson B, Zang P, Timchenko NA, Garcia JM. Ghrelin deletion protects against age-associated hepatic steatosis by downregulating the C/EBPα-p300/DGAT1 pathway. Aging Cell 2018; 17. [PMID: 29024407 PMCID: PMC5771394 DOI: 10.1111/acel.12688] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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] [Accepted: 09/04/2017] [Indexed: 12/13/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. NAFLD usually begins as low‐grade hepatic steatosis which further progresses in an age‐dependent manner to nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma in some patients. Ghrelin is a hormone known to promote adiposity in rodents and humans, but its potential role in hepatic steatosis is unknown. We hypothesized that genetic ghrelin deletion will protect against the development of age‐related hepatic steatosis. To examine this hypothesis, we utilized ghrelin knockout (KO) mice. Although no different in young animals (3 months old), we found that at 20 months of age, ghrelin KO mice have significantly reduced hepatic steatosis compared to aged‐matched wild‐type (WT) mice. Examination of molecular pathways by which deletion of ghrelin reduces steatosis showed that the increase in expression of diacylglycerol O‐acyltransferase‐1 (DGAT1), one of the key enzymes of triglyceride (TG) synthesis, seen with age in WT mice, is not present in KO mice. This was due to the lack of activation of CCAAT/enhancer binding protein‐alpha (C/EBPα) protein and subsequent reduction of C/EBPα‐p300 complexes. These complexes were abundant in livers of old WT mice and were bound to and activated the DGAT1 promoter. However, the C/EBPα‐p300 complexes were not detected on the DGAT1 promoter in livers of old KO mice resulting in lower levels of the enzyme. In conclusion, these studies demonstrate the mechanism by which ghrelin deletion prevents age‐associated hepatic steatosis and suggest that targeting this pathway may offer therapeutic benefit for NAFLD.
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Affiliation(s)
- Bobby Guillory
- Department of Medicine; Baylor College of Medicine; Division of Endocrinology; Diabetes and Metabolism, MCL; Center for Translational Research in Inflammatory Diseases; Michael E. DeBakey Veterans Affairs Medical Center; Houston TX 77030 USA
- Huffington Center on Aging; Baylor College of Medicine; Houston TX 77030 USA
| | - Nicole Jawanmardi
- Huffington Center on Aging; Baylor College of Medicine; Houston TX 77030 USA
- Department of Pathology and Immunology; Baylor College of Medicine; Houston TX 77030 USA
| | - Polina Iakova
- Huffington Center on Aging; Baylor College of Medicine; Houston TX 77030 USA
- Department of Pathology and Immunology; Baylor College of Medicine; Houston TX 77030 USA
| | - Barbara Anderson
- GRECC; VA Puget Sound Health Care System; University of Washington; Seattle WA 98108 USA
| | - Pu Zang
- GRECC; VA Puget Sound Health Care System; University of Washington; Seattle WA 98108 USA
- Department of Endocrinology; Nanjing Jinling Hospital; Nanjing 210002 China
| | - Nikolai A. Timchenko
- Huffington Center on Aging; Baylor College of Medicine; Houston TX 77030 USA
- Department of Pathology and Immunology; Baylor College of Medicine; Houston TX 77030 USA
- Cincinnati Children's Hospital Medical Center; Cincinnati OH 45229 USA
| | - Jose M. Garcia
- Department of Medicine; Baylor College of Medicine; Division of Endocrinology; Diabetes and Metabolism, MCL; Center for Translational Research in Inflammatory Diseases; Michael E. DeBakey Veterans Affairs Medical Center; Houston TX 77030 USA
- Huffington Center on Aging; Baylor College of Medicine; Houston TX 77030 USA
- GRECC; VA Puget Sound Health Care System; University of Washington; Seattle WA 98108 USA
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Tucholka JL, Jacobson N, Steffens NM, Schumacher JR, Tevaarwerk AJ, Anderson B, Wilke LG, Greenberg CC, Neuman HB. Breast cancer survivor's perspectives on the role different providers play in follow-up care. Support Care Cancer 2018; 26:2015-2022. [PMID: 29332175 DOI: 10.1007/s00520-018-4042-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 01/03/2018] [Indexed: 01/06/2023]
Abstract
IMPORTANCE Significant variation in the number and types of oncologists that provide breast cancer follow-up exists. However, there is limited understanding regarding breast cancer survivors' preferences for who provides their follow-up. Our objective was to explore breast cancer survivors' perspectives on the goals of breast cancer follow-up, the preferred role for primary care providers, and the perceived roles of different types of oncologists during follow-up. METHODS A convenience sample of stage 0-III breast cancer survivors was identified and in-depth one-on-one interviews conducted. Data were analyzed using inductive content analysis. RESULTS Survivors cited a strong preference for oncology-based follow-up within the first 5 years after diagnosis, driven by their need for reassurance that cancer had not recurred. Survivors also thought that their primary care provider needed to be involved. Survivors assumed that oncology follow-up was directed by a standard protocol that included streamlining the follow-up team. Survivors recognized that patients with more complex cancers or challenging treatment courses may require more intensive follow-up and deviate from the standard protocol. Most survivors were comfortable deferring decisions regarding who participated in follow-up to the oncology team. CONCLUSIONS Most patients think a streamlined approach to oncology-based breast cancer follow-up already occurs, driven by a standard protocol. The use of a standard protocol to provide guidance for which types of oncology providers should participate in breast cancer follow-up will streamline care and represents a significant opportunity to reduce unnecessary variation. This approach is especially critical given patients' strong preferences for oncology-based follow-up.
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Affiliation(s)
- J L Tucholka
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - N Jacobson
- School of Nursing, Institute for Clinical and Translational Research, University of Wisconsin-Madison, Madison, WI, USA
| | - N M Steffens
- Denver Public Health, Denver Health and Hospital Authority, Denver, CO, USA
| | - J R Schumacher
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - A J Tevaarwerk
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, H4/726 CSC, 600 Highland Ave., Madison, WI, 53792-7375, USA.,Department of Medicine, Division of Hematology and Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - B Anderson
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - L G Wilke
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, H4/726 CSC, 600 Highland Ave., Madison, WI, 53792-7375, USA
| | - C C Greenberg
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, H4/726 CSC, 600 Highland Ave., Madison, WI, 53792-7375, USA
| | - Heather B Neuman
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. .,University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, H4/726 CSC, 600 Highland Ave., Madison, WI, 53792-7375, USA.
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Anderson B, Scalia G. Estimation of Left Ventricular Outflow Tract Diameter by Nomogram From Body Surface Area: Providing a Safeguard for Cases with Difficult Echocardiographic Images. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.438] [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: 10/28/2022]
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Edwards N, Scalia G, Sabapathy S, Anderson B, Chamberlain R, Chan J. Non–Invasive Left Ventricular Pressure-Strain Loop Can Differentiate Global and Regional Wasted Work Between Ischaemic and Non–Ischaemic Cardiomyopathies. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.484] [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: 10/28/2022]
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Van Buren DJ, Wilfley DE, Marcus MD, Anderson B, Abramson NW, Berkowitz R, Ievers-Landis C, Trief P, Yasuda P, Hirst K. Depressive symptoms and glycemic control in youth with type 2 diabetes participating in the TODAY clinical trial. Diabetes Res Clin Pract 2018; 135:85-87. [PMID: 29146120 PMCID: PMC5801121 DOI: 10.1016/j.diabres.2017.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 07/06/2017] [Revised: 10/03/2017] [Accepted: 11/08/2017] [Indexed: 11/22/2022]
Abstract
The relationship between depressive symptoms and glycemic control in youth with type 2 diabetes was assessed at baseline (n = 682), 6, and/or 24 months (n = 576). Neither baseline nor persistence of depressive symptoms was significantly associated with maintenance of glycemic control. Nevertheless, depressive symptoms were common, suggesting the importance of repeated screening.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Kathryn Hirst
- George Washington University Biostatistics Center, USA.
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Jardine K, Lee-Tannock A, Auld B, Stanley F, Anderson B, Franco H, Eagleston K, Suna J, Johnson J, Ward C, Gooi A. Antenatal Detection of Dextro-Transposition of the Great Arteries and Impact of Standardised Fetal Heart Screening in Queensland Over a 10-Year Period. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.041] [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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Buxton M, Anderson B, Lord J. The secret service – analysis of the available knowledge on moths as pollinators in New Zealand. NEW ZEAL J ECOL 2018. [DOI: 10.20417/nzjecol.42.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
Objectives Capillary refill time (CRT) has been taught as a rapid indicator of circulatory status but to be a useful clinical test, CRT needs to be reproducible when performed by another health care worker. No inter-rater agreement studies have been reported for adult patients. The aim of this study was to determine the inter-observer reliability of CRT in a sample of adult emergency department (ED) patients. Methods This prospective observational study included clinically stable ED patients with a variety of conditions from two community EDs. A doctor and a nurse each measured CRT by estimation to the nearest half-second using a standard method on each patient. They were blinded to each other's measurements. The primary outcome of interest was inter-rater agreement. Secondary outcome was agreement in classification as normal or abnormal according to accepted definitions. Data was analysed using bias plot analysis, correlation, absolute percent agreement and kappa analysis. Results Totally, 209 patients were enrolled; 51% were female and 86% were Caucasian. Median CRT was 2 seconds (95% CI 2–2.35 seconds). The mean difference between measurements by the different observers was 0 second, however the 95% limits of agreement were very wide (–1.7 to +1.9 seconds). Agreement was 70% for classification of ‘normal’ or ‘abnormal’ using the 2-second definition of normal, with a kappa of 0.38. Conclusion Interobserver agreement in measurement of CRT was poor in adult subjects with wide limits of agreement. This is a serious threat to the appropriateness of this test for use in clinical practice.
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Affiliation(s)
- B Anderson
- Monash Institute of Health Services Research, Clayton, Australia
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50
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Butler AM, Weller BE, Yi-Frazier JP, Fegan-Bohm K, Anderson B, Pihoker C, Hilliard ME. Diabetes-Specific and General Life Stress and Glycemic Outcomes in Emerging Adults With Type 1 Diabetes: Is Race/Ethnicity a Moderator? J Pediatr Psychol 2017; 42:933-940. [PMID: 28645198 PMCID: PMC5896631 DOI: 10.1093/jpepsy/jsx092] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 05/08/2017] [Accepted: 05/25/2017] [Indexed: 11/14/2022] Open
Abstract
Objective This study examines whether race/ethnicity moderates relationships of (a) diabetes stress and general life stressors with (b) diabetes outcomes of glycemic control and diabetic ketoacidosis (DKA) among emerging adults (aged 18-25 years) with type 1 diabetes (T1D). Method Using a T1D Exchange Registry sample of non-Hispanic White, African American, and Hispanic emerging adults (N = 3,440), multiple group analyses were used to determine whether race/ethnicity moderates the relationships between stress and diabetes outcomes. Results The relationships between the two stress types and glycemic control did not differ between African American and non-Hispanic Whites. However, as compared with non-Hispanic Whites, the association between higher diabetes-specific stress and poorer glycemic control was significantly stronger for Hispanics, and Hispanics had poorer glycemic control when they experienced a relatively fewer number of general life stressors than non-Hispanic Whites. The relationships between the type of stress (diabetes-specific and general stress) and DKA did not differ across racial/ethnic groups. Conclusions Future research should evaluate possible mechanisms that contribute to the different relationships of stress with glycemic control among Hispanics compared with non-Hispanic Whites.
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Affiliation(s)
| | - Bridget E. Weller
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
| | - Joyce P. Yi-Frazier
- Center for Clinical and Translational Research, Seattle Children’s Research Institute
| | | | | | - Catherine Pihoker
- Center for Clinical and Translational Research, Seattle Children’s Research Institute
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