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Abrantes AM, Browne J, Stein MD, Anderson B, Iacoi S, Barter S, Shah Z, Read J, Battle C. A lifestyle physical activity intervention for women in alcohol treatment: A pilot randomized controlled trial. J Subst Use Addict Treat 2024; 163:209406. [PMID: 38759733 DOI: 10.1016/j.josat.2024.209406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 03/20/2024] [Accepted: 05/14/2024] [Indexed: 05/19/2024]
Abstract
INTRODUCTION Compared to men, women with alcohol use disorder (AUD) are more likely to drink to manage stress and negative affect. Given women's risk for poor drinking outcomes, it is critical to develop and test interventions that target these affective factors. Physical activity improves negative affect and has emerged as a promising adjunct to AUD treatment and, thus, may be especially valuable for women. METHODS Fifty women with AUD (49.9 ± 12.0 years of age) participated in either a 12-week telephone-delivered lifestyle physical activity plus Fitbit (LPA + Fitbit) or a health education contact (HEC) control intervention following a partial hospital addictions treatment program. The study examined changes in drinking behaviors, mental health outcomes, and physical activity engagement post-intervention using both conventional test statistics and standard effect sizes. RESULTS Higher rates of continuous abstinence during the 12-week period were observed in the LPA + Fitbit condition (55.6 %) than in the HEC condition (33.6 %); odds ratio = 2.97. However, among women who drank any alcohol during the 12-weeks, slightly higher rates of heavy drinking and drinks/day were observed among women in the LPA + Fitbit condition. Significant differences for improved mental health outcomes (including depression, anxiety, negative affect, positive affect, perceived stress, and behavioral activation) and increased self-reported physical activity were consistently observed among participants in the LPA + Fitbit condition, relative to HEC. CONCLUSIONS The LPA + Fitbit program had a positive impact on alcohol abstinence, mental health, and physical activity in adult women receiving treatment for AUD. Future research should continue to investigate the optimal implementation strategies, duration, and intensity of LPA interventions in the context of a fully-powered RCT.
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Affiliation(s)
- Ana M Abrantes
- Butler Hospital, Providence, RI, United States of America; Alpert Medical School of Brown University, Providence, RI, United States of America.
| | - Julia Browne
- Alpert Medical School of Brown University, Providence, RI, United States of America; Research Service, VA Providence Healthcare System, Providence, RI, United States of America
| | - Michael D Stein
- Butler Hospital, Providence, RI, United States of America; Boston University School of Public Health, Boston, MA, United States of America
| | | | - Sydney Iacoi
- Butler Hospital, Providence, RI, United States of America
| | - Sarah Barter
- Butler Hospital, Providence, RI, United States of America
| | - Zainab Shah
- Butler Hospital, Providence, RI, United States of America
| | - Jennifer Read
- University of Buffalo, Buffalo, NY, United States of America
| | - Cynthia Battle
- Butler Hospital, Providence, RI, United States of America; Alpert Medical School of Brown University, Providence, RI, United States of America; Women & Infants' Hospital of Rhode Island, Providence, RI, United States of America
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Anderson B, Mozaffari K, Foster CH, Jaco AA, Rosner MK. The Ultrasonic Bone Scalpel does not Outperform the High-Speed Drill: A Single Academic Experience. World Neurosurg 2024; 185:e387-e396. [PMID: 38350596 DOI: 10.1016/j.wneu.2024.02.037] [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] [Received: 01/18/2024] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Spinal decompression and osteotomies are conventionally performed using high-speed drills (HSDs) and rongeurs. The ultrasonic bone scalpel (UBS) is a tissue-specific osteotome that preferentially cuts bone while sparing the surrounding soft tissues. There is ongoing investigation into its ability to optimize peri- and postoperative outcomes in spine surgery. The purpose of this study was to compare the intraoperative metrics and complications during a transition period from HSD to UBS. METHODS A single-institution, single-surgeon retrospective analysis was conducted of patients undergoing spine surgery from January 2020 to December 2021. Statistical analyses were performed to detect associations between the surgical technique and outcomes of interest. A P value < 0.05 was considered statistically significant. RESULTS A total of 193 patients met the inclusion criteria (HSD, n = 100; UBS, n = 93). Multivariate logistic regression revealed similar durotomy (P = 0.10), nerve injury (P = 0.20), and reoperation (P = 0.68) rates. Although the estimated blood loss (EBL) and length of stay were similar, the operative time was significantly longer with the UBS (192.81 vs. 204.72 minutes; P = 0.03). Each subsequent surgery using the UBS revealed a 3.1% decrease in the probability of nerve injury (P = 0.026) but had no significant effects on the operative time, EBL, or probability of durotomy or reoperation. CONCLUSIONS The UBS achieves outcomes on par with conventional tools, with a trend toward a lower incidence of neurologic injury. The expected reductions in EBL and durotomy were not realized in our cohort, perhaps because of a high proportion of revision surgeries, although these might be dependent on surgeon familiarity, among other operative factors. Future prospective studies are needed to validate our results and further refine the optimal application of this device in spine surgery.
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Affiliation(s)
- Bradley Anderson
- Department of Neurological Surgery, The George Washington University Hospital, Washington, District of Columbia, USA.
| | - Khashayar Mozaffari
- Department of Neurological Surgery, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Chase H Foster
- Department of Neurological Surgery, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Alejandro A Jaco
- Department of Neurological Surgery, The George Washington University Hospital, Washington, District of Columbia, USA
| | - Michael K Rosner
- Department of Neurological Surgery, The George Washington University Hospital, Washington, District of Columbia, USA
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Shahidi B, Anderson B, Ordaz A, Berry DB, Ruoss S, Zlomislic V, Allen RT, Garfin SR, Farshad M, Schenk S, Ward SR. Paraspinal muscles in individuals undergoing surgery for lumbar spine pathology lack a myogenic response to an acute bout of resistance exercise. JOR Spine 2024; 7:e1291. [PMID: 38222805 PMCID: PMC10782077 DOI: 10.1002/jsp2.1291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/28/2023] [Accepted: 09/06/2023] [Indexed: 01/16/2024] Open
Abstract
Background Lumbar spine pathology (LSP) is a common source of low back or leg pain, and paraspinal muscle in these patients demonstrates fatty and fibrotic infiltration, and cellular degeneration that do not reverse with exercise-based rehabilitation. However, it is unclear of this lack of response is due to insufficient exercise stimulus, or an inability to mount a growth response. The purpose of this study was to compare paraspinal muscle gene expression between individuals with LSP who do and do not undergo an acute bout of resistance exercise. Methods Paraspinal muscle biopsies were obtained from 64 individuals with LSP undergoing spinal surgery. Eight participants performed an acute bout of machine-based lumbar extension resistance exercise preoperatively. Gene expression for 42 genes associated with adipogenic/metabolic, atrophic, fibrogenic, inflammatory, and myogenic pathways was measured, and differential expression between exercised and non-exercised groups was evaluated for (a) the full cohort, and (b) an age, gender, acuity, and etiology matched sub-cohort. Principal components analyses were used to identify gene expression clustering across clinical phenotypes. Results The exercised cohort demonstrated upregulation of inflammatory gene IL1B, inhibition of extracellular matrix components (increased MMP3&9, decreased TIMP1&3, COL1A1) and metabolic/adipogenic genes (FABP4, PPARD, WNT10B), and downregulation of myogenic (MYOD, ANKRD2B) and atrophic (FOXO3) genes compared to the non-exercised cohort, with similar patterns in the matched sub-analysis. There were no clinical phenotypes significantly associated with gene expression profiles. Conclusion An acute bout of moderate-high intensity resistance exercise did not result in upregulation of myogenic genes in individuals with LSP. The response was characterized by mixed metabolic and fibrotic gene expression, upregulation of inflammation, and downregulation of myogenesis.
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Affiliation(s)
- Bahar Shahidi
- UC San Diego Department of Orthopaedic SurgeryLa JollaCaliforniaUSA
| | - Bradley Anderson
- UC San Diego Department of Orthopaedic SurgeryLa JollaCaliforniaUSA
| | - Angel Ordaz
- UC San Diego Department of Orthopaedic SurgeryLa JollaCaliforniaUSA
| | - David B. Berry
- UC San Diego Department of Orthopaedic SurgeryLa JollaCaliforniaUSA
- UC San Diego Department of RadiologyLa JollaCaliforniaUSA
| | - Severin Ruoss
- UC San Diego Department of Orthopaedic SurgeryLa JollaCaliforniaUSA
| | - Vinko Zlomislic
- UC San Diego Department of Orthopaedic SurgeryLa JollaCaliforniaUSA
| | - R. Todd Allen
- UC San Diego Department of Orthopaedic SurgeryLa JollaCaliforniaUSA
| | - Steven R. Garfin
- UC San Diego Department of Orthopaedic SurgeryLa JollaCaliforniaUSA
| | - Mazda Farshad
- Balgrist University HospitalUniversity of ZurichZürichSwitzerland
| | - Simon Schenk
- UC San Diego Department of Orthopaedic SurgeryLa JollaCaliforniaUSA
| | - Samuel R. Ward
- UC San Diego Department of Orthopaedic SurgeryLa JollaCaliforniaUSA
- UC San Diego Department of RadiologyLa JollaCaliforniaUSA
- UC San Diego Department of BioengineeringLa JollaCaliforniaUSA
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Hayaki J, Abrantes AM, Anderson B, Stein MD. Chronic Pain and Cannabis Use Frequency, Intensity, and Severity in Young Adults. Subst Use Misuse 2024; 59:576-582. [PMID: 38017655 PMCID: PMC10922830 DOI: 10.1080/10826084.2023.2287240] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Cannabis use is common among young adults and is associated with many physical and mental health problems. Persons with chronic pain may be particularly susceptible to using cannabis at high rates, including for analgesic purposes, thus exposing themselves to greater risk of cannabis-related problems. However, little research has examined connections between chronic pain and cannabis use in the young adult population. MATERIALS AND METHODS Participants were young adults from the community who were recruited for a larger health behaviors study. The present sample included 403 persons from this larger sample who reported cannabis use in the past 90 days. Participants completed measures of demographic characteristics, cannabis and alcohol use, and chronic pain. RESULTS This young adult sample reported using cannabis on an average of 47.1 of the past 90 days, and 20.1% reported chronic pain. Chronic pain was associated with greater cannabis use frequency (IRR = 1.35, 95%CI 1.15; 1.57, p < 0.001), intensity (IRR = 1.61, 95%CI 1.18; 2.21, p = 0.003), and negative consequences (IRR = 1.23, 95%CI 1.02; 1.48, p < 0.030). DISCUSSION In this sample of young adults who use cannabis, chronic pain was significantly associated with frequent, intense cannabis use, as well as more cannabis-related negative consequences. These findings suggest that chronic pain may be a marker for a particularly high-risk pattern of cannabis use in this age group, thus identifying an especially vulnerable subset of young adults who may require heightened research and clinical attention.
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Affiliation(s)
- Jumi Hayaki
- Department of Psychology, College of the Holy Cross, Worcester, MA, USA
| | - Ana M. Abrantes
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Behavioral Medicine and Addiction Research Unit, Butler Hospital, Providence, RI, USA
| | - Bradley Anderson
- Behavioral Medicine and Addiction Research Unit, Butler Hospital, Providence, RI, USA
| | - Michael D. Stein
- Department of Health Law, Policy & Management, School of Public Health, Boston University, Boston, MA, USA
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Uebelacker LA, Braun TD, Taylor LE, Saper R, Baldwi M, Abrantes A, Tremont G, Toribio A, Kirshy S, Koch R, Lorin L, Van Noppen D, Anderson B, Roseen EJ, Stein MD. Evaluation of intervention components to maximize yoga practice among people with chronic pain taking opioid agonist therapy: A factorial experiment using the multiphase optimization strategy framework. Contemp Clin Trials 2024; 137:107411. [PMID: 38103784 PMCID: PMC10922864 DOI: 10.1016/j.cct.2023.107411] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/01/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Chronic pain affects up to half of individuals taking opioid agonist therapy (OAT; i.e., methadone and buprenorphine) for opioid use disorder (OUD), and yoga-based interventions may be useful for decreasing pain-related disability. Whereas more yoga practice (i.e., higher "dosage") may improve pain-related outcomes, it can be challenging for people with chronic pain taking OAT to attend class regularly and sustain a regular personal yoga practice. Therefore, we plan to optimize a yoga-based intervention (YBI) package in order to support class attendance and personal practice, thus maximizing the yoga dose received. STUDY DESIGN Using the Multiphase Optimization Strategy (MOST) framework, we will conduct a factorial experiment to examine four intervention components that may be added to a weekly yoga class as part of a YBI. Components include: 1) personal practice videos featuring study yoga teachers, 2) two private sessions with a yoga teacher, 3) daily text messages to inspire personal practice, and 4) monetary incentives for class attendance. The primary outcome will be minutes per week engaged in yoga (including class attendance and personal practice). We plan to enroll 192 adults with chronic pain who are taking OAT for OUD in this 2x2x2x2 factorial experiment. CONCLUSION Results of the study will guide development of an optimized yoga-based intervention package that maximizes dosage of yoga received. The final treatment package can be tested in a multisite efficacy trial of yoga to reduce pain interference in daily functioning in people with chronic pain who are taking OAT. TRIAL REGISTRATION Pre-registration of the study was completed on ClinicalTrials.gov (identifier: NCT04641221).
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Affiliation(s)
- Lisa A Uebelacker
- Alpert Medical School of Brown University, Providence, RI, United States of America; Butler Hospital, Providence, RI, United States of America.
| | - Tosca D Braun
- Alpert Medical School of Brown University, Providence, RI, United States of America; Butler Hospital, Providence, RI, United States of America.
| | - Lynn E Taylor
- University of Rhode Island, Kingston, RI, United States of America
| | - Robert Saper
- Cleveland Clinic, Cleveland, OH, United States of America
| | - Marielle Baldwi
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
| | - Ana Abrantes
- Alpert Medical School of Brown University, Providence, RI, United States of America; Butler Hospital, Providence, RI, United States of America
| | - Geoffrey Tremont
- Alpert Medical School of Brown University, Providence, RI, United States of America; The Boston University School of Public Health, Boston, MA, United States of America
| | - Alisha Toribio
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
| | - Shannon Kirshy
- Butler Hospital, Providence, RI, United States of America
| | - Ryan Koch
- Butler Hospital, Providence, RI, United States of America
| | - Lucy Lorin
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
| | | | | | - Eric J Roseen
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
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Anderson B, Shahidi B. The Impact of Spine Pathology on Posterior Ligamentous Complex Structure and Function. Curr Rev Musculoskelet Med 2023; 16:616-626. [PMID: 37870725 PMCID: PMC10733250 DOI: 10.1007/s12178-023-09873-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE OF REVIEW Spinal ligament is an important component of the spinal column in mitigating biomechanical stress. Particularly the posterior ligamentous complex, which is composed of the ligamentum flavum, interspinous, and supraspinous ligaments. However, research characterizing the biomechanics and role of ligament health in spinal pathology and clinical context are scarce. This article provides a comprehensive review of the implications of spinal pathology on the structure, function, and biomechanical properties of the posterior ligamentous complex. RECENT FINDINGS Current research characterizing biomechanical properties of the posterior ligamentous complex is primarily composed of cadaveric studies and finite element modeling, and more recently incorporating patient-specific anatomy into finite element models. The ultimate goal of current research is to understand the relative contributions of these ligamentous structures in healthy and pathological spine, and whether preserving ligaments may play an important role in spinal surgical techniques. At baseline, posterior ligamentous complex structures account for 30-40% of spinal stability, which is highly dependent on the intrinsic biomechanical properties of each ligament. Biomechanics vary widely with pathology and following rigid surgical fixation techniques and are generally maladaptive. Often secondary to morphological changes in the setting of spinal pathology, but morphological changes in ligament may also serve as a primary pathology. Biomechanical maladaptations of the spinal ligament adversely influence overall spinal column integrity and ultimately predispose to increased risk for surgical failure and poor clinical outcomes. Future research is needed, particularly in living subjects, to better characterize adaptations in ligaments that can provide targets for improved treatment of spinal pathology.
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Affiliation(s)
- Bradley Anderson
- Department of Orthopaedic Surgery, The University of California San Diego, 9500 Gilman Dr., MC0863, La Jolla, San Diego, CA, 92093, USA
| | - Bahar Shahidi
- Department of Orthopaedic Surgery, The University of California San Diego, 9500 Gilman Dr., MC0863, La Jolla, San Diego, CA, 92093, USA.
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Anderson B, Harris P, Mozaffari K, Foster CH, Johnson M, Jaco AA, Rosner MK. Comparison of Perioperative and Long-term Outcomes Following PEEK and Autologous Cranioplasty: A Single Institution Experience and Review of the Literature. World Neurosurg 2023; 180:e127-e134. [PMID: 37683922 DOI: 10.1016/j.wneu.2023.09.005] [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] [Received: 05/31/2023] [Revised: 09/01/2023] [Accepted: 09/02/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE Three-dimensionally (3D) printed polyether-ether-ketone (PEEK) implants are a relatively novel option for cranioplasty that have recently gained popularity. However, there is ongoing debate with respect to material efficacy and safety compared to autologous bone grafts. The purpose of this study was to offer our institution's experience and add to the growing body of literature. METHODS A single-institution retrospective analysis of patients undergoing cranioplasties between 2016 and 2021. Patients were divided into PEEK and autologous cranioplasty cohorts. Parameters of interest included patient demographics as well as perioperative (<3 months postoperative) and long-term outcomes (>3 months postoperative). A P value < 0.05 was considered statistically significant. RESULTS A total of 31 patients met inclusion criteria (PEEK: 15, Autologous: 16). Mean age of total cohort was 48.9 years (range 19-82 years). Modified Frailty Index (mFI) revealed greater rate of comorbidities among the Autologous group (P = 0.073), which was accounted for in statistical analyses. Multiple logistic regression model revealed significantly higher rate of surgical site infection in the Autologous cohort (31.3% vs. 0%, P = 0.011). Minor complications were similar between groups, while the Autologous group experienced significantly more major postoperative complications (50%) versus PEEK (13.3%) (P = 0.0291). Otherwise perioperative and long term complication profiles were similar between groups. Additionally, generalized linear model demonstrated both cohorts had similar mean hospital length of stay (LoS) (Autologous: 16.1 vs. PEEK: 10.7 days). CONCLUSIONS PEEK cranioplasty implants may offer more favorable perioperative complication profiles with similar long-term complication rates and hospital LoS compared to autologous bone implants. Future studies are warranted to confirm our findings in larger series, and further examine the utility of PEEK in cranioplasty.
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Affiliation(s)
- Bradley Anderson
- Department of Neurological Surgery, The George Washington University Hospital, Washington DC, USA.
| | - Peter Harris
- Department of Neurological Surgery, The George Washington University Hospital, Washington DC, USA
| | - Khashayar Mozaffari
- Department of Neurological Surgery, The George Washington University Hospital, Washington DC, USA
| | - Chase H Foster
- Department of Neurological Surgery, The George Washington University Hospital, Washington DC, USA
| | - Michael Johnson
- Department of Neurological Surgery, The George Washington University Hospital, Washington DC, USA; Department of Physician Assistant Studies, The George Washington University, Washington DC, USA
| | - Alejandro A Jaco
- Department of Neurological Surgery, The George Washington University Hospital, Washington DC, USA
| | - Michael K Rosner
- Department of Neurological Surgery, The George Washington University Hospital, Washington DC, USA
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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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Uebelacker LA, Pinkston MM, Busch AM, Baker JV, Anderson B, Caviness CM, Herman DS, Weisberg RB, Abrantes AM, Stein MD. HIV-PASS (Pain and Sadness Support): Randomized Controlled Trial of a Behavioral Health Intervention for Interference Due to Pain in People Living With HIV, Chronic Pain, and Depression. Psychosom Med 2023; 85:250-259. [PMID: 36799731 PMCID: PMC10073275 DOI: 10.1097/psy.0000000000001172] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE This study aimed to determine whether HIV-Pain and Sadness Support (HIV-PASS), a collaborative behavioral health intervention based on behavioral activation, is associated with decreased pain-related interference with daily activities, depression, and other outcomes in people living with HIV. METHODS We conducted a three-site clinical trial ( n = 187) in which we randomly assigned participants to receive either HIV-PASS or health education control condition. In both conditions, participants received seven intervention sessions, comprising an initial in-person joint meeting with the participant, their HIV primary care provider and a behavioral health specialist, and six, primarily telephone-based, meetings with the behavioral health specialist and participant. The intervention period lasted 3 months, and follow-up assessments were conducted for an additional 9 months. RESULTS Compared with health education, HIV-PASS was associated with significantly lower pain-related interference with daily activities at the end of month 3 (our primary outcome; b = -1.31, 95% confidence interval = -2.28 to -0.34). We did not observe other differences between groups at 3 months in secondary outcomes that included worst or average pain in the past week, depression symptoms, anxiety, and perceived overall mental and physical health. There were no differences between groups on any outcomes at 12 months after enrollment. CONCLUSIONS A targeted intervention can have positive effects on pain interference. At the end of intervention, effects we found were in a clinically significant range. However, effects diminished once the intervention period ended. TRIAL REGISTRATION ClinicalTrials.gov NCT02766751.
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Affiliation(s)
- Lisa A Uebelacker
- From the Departments of Psychiatry and Human Behavior (Uebelacker, Pinkston, Caviness, Herman, Abrantes) and Family Medicine (Uebelacker, Weisberg), Alpert Medical School of Brown University; Behavioral Medicine and Addictions Research (Uebelacker, Anderson, Caviness, Herman, Abrantes, Stein), Butler Hospital; Department of Medicine (Pinkston), Alpert Medical School of Brown University; Lifespan Physicians Group (Pinkston), The Miriam Hospital, Providence, Rhode Island; Department of Medicine (Busch, Baker), Hennepin Healthcare; Department of Medicine (Busch, Baker), University of Minnesota, Minneapolis, Minnesota; VA Boston Healthcare System (Weisberg); Department of Psychiatry (Weisberg), Boston University School of Medicine; and Department of Health Law, Policy and Management(Stein), Boston University School of Public Health, Boston, Massachusetts
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Uebelacker LA, Epstein-Lubow G, Sillice MA, O'Keeffe B, Kraines M, Battle CL, Anderson B, Miller IW, Abrantes AM. Project MOVE: A randomized controlled trial of Interventions for initiating and maintaining physical activity in depressed individuals. Ment Health Phys Act 2023; 24:100508. [PMID: 36967813 PMCID: PMC10032365 DOI: 10.1016/j.mhpa.2023.100508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Objective To test interventions for increasing aerobic exercise in depressed individuals. Methods We conducted a 3-arm randomized controlled trial aimed at increasing minutes of moderate-to-vigorous physical activity (MVPA) in depressed adults (N = 242). Each successive arm included an added component that might serve to increase and maintain physical activity. Arms were: 1) Brief advice (BA) to aerobic exercise; 2) BA + supervised and home-based aerobic exercise (SHE) + health education (HE); and 3) BA + SHE +cognitive-behavioral sessions focused on increasing and maintaining aerobic exercise (CBEX). HE was intended to serve as a control for CBEX. Assessments were conducted at baseline, Month 1.5, end of intervention (Month 3), Month 6, and Month 9. The primary outcome of MVPA was assessed via accelerometry. Secondary outcomes included self-reported MVPA, depression severity, and other aspects of mood and affect. Results At 3 months (the pre-designated primary outcome timepoint), the simple effect of treatment was statistically significant (F2, 569.0 = 4.17, p = .016), with BA+SHE+CBEX being superior to BA. We did not observe differences between BA+SHE+HE and either of the other arms. There were no statistically significant differences between treatment groups at 6- or 9-months. Treatment effects were not statistically significant for secondary outcomes. Conclusions Supervised and home-based exercise, when combined with a cognitive-behavioral exercise intervention, is effective in increasing aerobic exercise in depressed adults in the short-term, although the impact diminishes post-intervention period.
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Affiliation(s)
- Lisa A Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
| | - Gary Epstein-Lubow
- Butler Hospital, Providence RI, USA
- Department of Health Services, Policy and Practice of Brown University, Providence RI, USA
| | - Marie A Sillice
- City University of New York School of Public & Health Policy, Department of Health Policy and Management, New York, NY, 10027
| | | | - Morganne Kraines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
- Center for Women's Behavioral Health, Women & Infants' Hospital of Rhode Island, Providence RI, USA
| | | | - Ivan W Miller
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University Providence RI, USA
- Butler Hospital, Providence RI, USA
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12
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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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13
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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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14
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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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15
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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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16
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Jawa R, Stein MD, Anderson B, Liebschutz JM, Stewart C, Phillips KT, Barocas JA. Behavioral Risk Factors for HIV Infection in Hospitalized Persons Who Co-use Stimulants and Opioids. AIDS Behav 2022; 26:1047-1055. [PMID: 34510289 PMCID: PMC8435119 DOI: 10.1007/s10461-021-03460-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 01/03/2023]
Abstract
We investigated the association of 90-day opioid and stimulant co-use and HIV risk behaviors in a cross-sectional analysis of hospitalized HIV-negative people who inject drugs (PWID). We compared those injecting opioids alone to two sub-groups who co-used opioids with (1) cocaine, (2) amphetamine-type stimulants (ATS), on sex and injection drug risk behaviors assessed via the Risk Assessment Battery (RAB), where a higher score indicates a higher risk. Of 197 participants who injected opioids, 53% co-used cocaine only, 5% co-used ATS only, 18% co-used both cocaine and ATS, 24% co-used neither stimulant. PWID who injected opioids alone had a mean RAB drug risk score of 5.98 points and sex risk score of 2.16 points. Compared to PWID who injected opioids alone, PWID who co-used stimulants had higher mean drug risk RAB scores: cocaine, b = 2.84 points [95% confidence interval (CI) 1.01; 4.67]; ATS, b = 3.43 points (95% CI 1.29; 5.57). Compared to PWID who injected opioids alone, cocaine co-use was associated with higher sex RAB scores b = 1.06 points (95% CI 0.32; 1.79). Overall, we found a significant association between stimulant co-use and higher HIV sex and drug risk scores.
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Affiliation(s)
- Raagini Jawa
- Section of Infectious Diseases, Boston Medical Center, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA.
- Boston University School of Medicine, Boston, MA, USA.
| | - Michael D Stein
- Boston University School of Public Health, Boston, MA, USA
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Bradley Anderson
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Jane M Liebschutz
- Division of General Internal Medicine, Center for Research On Health Care, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Kristina T Phillips
- Center for Integrated Health Care Research, Kaiser Permanente Honolulu, Honolulu, HI, USA
| | - Joshua A Barocas
- Section of Infectious Diseases, Boston Medical Center, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA
- Boston University School of Medicine, Boston, MA, USA
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17
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Narayanan SP, Anderson B, Bharucha AE. Sex- and Gender-Related Differences in Common Functional Gastroenterologic Disorders. Mayo Clin Proc 2021; 96:1071-1089. [PMID: 33814075 PMCID: PMC8075061 DOI: 10.1016/j.mayocp.2020.10.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/07/2020] [Accepted: 10/02/2020] [Indexed: 12/11/2022]
Abstract
Functional gastrointestinal (GI) disorders (FGIDs) result from central and peripheral mechanisms, cause chronic remitting-relapsing symptoms, and are associated with comorbid conditions and impaired quality of life. This article reviews sex- and gender-based differences in the prevalence, pathophysiologic factors, clinical characteristics, and management of functional dyspepsia (FD) and irritable bowel syndrome (IBS) that together affect approximately 1 in 4 people in the United States. These conditions are more common in women. Among patients with IBS, women are more likely to have severe symptoms and coexistent anxiety or depression; constipation or bloating and diarrhea are more common in women and men, respectively, perhaps partly because defecatory disorders, which cause constipation, are more common in women. Current concepts suggest that biological disturbances (eg, persistent mucosal inflammation after acute gastroenteritis) interact with other environmental factors (eg, abuse) and psychological stressors, which influence the brain and gut to alter GI tract motility or sensation, thereby causing symptoms. By comparison to a considerable understanding of sex-based differences in the pathogenesis of visceral hypersensitivity in animal models, we know less about the contribution of these differences to FGID in humans. Slow gastric emptying and colon transit are more common in healthy women than in men, but effects of gonadal hormones on colon transit are less important than in rodents. Although increased visceral sensation partly explains symptoms, the effects of sex on visceral sensation, colonic permeability, and the gut microbiome are less prominent in humans than rodents. Whether sex or gender affects response to medications or behavioral therapy in FD or IBS is unclear because most patients in these studies are women.
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Affiliation(s)
| | | | - Adil E Bharucha
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
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18
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Jawa R, Stein M, Anderson B, Liebschutz JM, Stewart C, Keosaian J, Barocas JA. 1549. Association of Skin Infections with Sharing of Injection Drug Preparation Equipment among People who Inject Drugs. Open Forum Infect Dis 2020. [PMCID: PMC7778059 DOI: 10.1093/ofid/ofaa439.1729] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Sharing needles and injection drug preparation equipment (IDPE) among people who inject drugs (PWID) are well-established risk factors for viral transmission. Shared needles and IDPE may be a reservoir for bacteria and serve as a nidus for skin and soft tissue infections (SSTI). Given the rising rates of SSTIs in PWID, we investigated the association of needle and IDPE sharing on history and incidence of SSTI in a cohort of PWID. Methods Active inpatient PWID were recruited to a randomized control trial of a risk reduction intervention aimed at reducing bacterial and viral infections. A subset of participants (N=252) who injected drugs were included in the analysis. The primary dependent variable in this cross-sectional cohort study was self-reported incidence of SSTI one year post-hospitalization. We assessed three self-reported independent variables from baseline enrollment: 1) sharing needles, 2) sharing IDPE, and 3) sharing needles or IDPE and compared these groups separately to persons who reported not sharing via univariate and multi-level Poisson regression model estimating the adjusted effect of baseline sharing on incidence of SSTI during follow up. Results Participant characteristics: 37.9 years [mean]; 58% male; 90% primarily inject opioids, 43% inject with others, 13% shared IDPE only, 50% shared needles or IDPE. In general, persons who shared IDPE only compared to those who did not share were younger, more likely female, more likely Caucasian, were less likely to primarily inject opioids, and had a higher mean on the knowledge scale. We found no significant differences of prior self-reported SSTI. Adjusted for those randomized in the behavioral intervention arm for skin cleaning, persons who shared needles only and needles or IDPE had a higher incidence of SSTI compared with persons who did not share (IRR 1.90, 95% CI1.03-3.51, p=0.04; IRR 2.14, 95% CI 1.23-3.72 p=0.007). Persons who shared IDPE only did not have a statistically significant higher incidence of SSTI compared with persons who did not share (IRR 1.3, 95%CI 0.89-1.95 p=0.157). Conclusion In this cohort of hospitalized active PWID, we found a significant association between baseline sharing of needles or IDPE but not IDPE only with incidence of self-reported SSTI. Disclosures All Authors: No reported disclosures
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Affiliation(s)
| | - Michael Stein
- Boston University School of Public Health, Boston, Massachusetts
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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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Timko C, Chatav Schonbrun Y, Anderson B, Johnson JE, Stein M. Perceived Substance Use Norms Among Jailed Women with Alcohol Use Disorders. Alcohol Clin Exp Res 2020; 44:1834-1841. [PMID: 32876998 DOI: 10.1111/acer.14403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Social norms regarding substance use predict substance use behaviors. In a sample of jailed women with alcohol use disorders (AUDs), we compared (i) jailed women's perceptions of the US women population's rates of substance use, with US women's actual rates of substance use; (ii) jailed women's perceived rates of substance use by US women, with their perceptions of use by their own friends; and (iii) US women's actual rates of substance use, with observed sample substance use rates. METHODS Participants were 205 jailed women who met criteria for an AUD. We used the 1-sample or dependent-samples t-test to make the comparisons. RESULTS Participants overestimated US women's rates of substance use and incarceration rates. They perceived their friends' substance use as less common than US women's. The jailed women reported higher rates of their own substance use than actual rates by US women. In addition, jailed women self-reported less cannabis use, but more alcohol and cocaine use and cigarette smoking, than they perceived their friends to have used. The more women perceived their friends as drinking, the less they had a goal to drink less or abstain from drinking postincarceration; in contrast, perceptions of US women's drinking were not related to personal goals for drinking. CONCLUSIONS Interventions that correct misperceptions about substance use norms may have utility for jailed women with AUDs.
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Affiliation(s)
- Christine Timko
- From the, Center for Innovation to Implementation (CT), VA Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California, USA
| | - Yael Chatav Schonbrun
- Department of Psychiatry and Human Behavior (YCS), Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Behavioral Medicine and Addictions Research (YCS, BA, MS), Butler Hospital, Providence, Rhode Island, USA
| | - Bradley Anderson
- Behavioral Medicine and Addictions Research (YCS, BA, MS), Butler Hospital, Providence, Rhode Island, USA
| | - Jennifer E Johnson
- Division of Public Health (JEJ), College of Human Medicine, Michigan State University, Flint, Michigan, USA
| | - Michael Stein
- Behavioral Medicine and Addictions Research (YCS, BA, MS), Butler Hospital, Providence, Rhode Island, USA.,Department of Health Law, Policy, & Management (MS), Boston University School of Public Health, Boston, Massachusetts, USA.,Boston University School of Public Health (MS), Boston, Massachusetts, USA
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21
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Dawson MA, Hennigar S, McClung J, Shankaran M, Nyangau E, Evans W, Hellerstein M, Field T, Kelley A, Anderson B, Pasiakos S, Berryman C. Energy Restriction Decreases Triglyceride Turnover in Subcutaneous and Visceral Adipose Tissue, but Has No Effect on Hepatic De Novo Lipogenesis in Obese Zucker Rats. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa049_013] [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: 11/13/2022] Open
Abstract
Abstract
Objectives
Obesity is associated with increased hepatic de novo lipogenesis (DNL) and altered triglyceride (TG) turnover. A previous trial in male Sprague Dawley rats demonstrated that both energy restriction and higher protein diets downregulate hepatic DNL. It is unknown whether energy restriction and higher protein diets alter kinetic measures of lipid metabolism in obese rodents. The present study examined the effects of energy restriction and dietary protein content on tissue-specific lipid kinetics in obese Zucker rats.
Methods
Six-week-old female obese Zucker rats (Leprfa+/fa+; n = 48) were randomized into one of four groups: ad libitum (AL) standard AIN-93 M diet (14% protein, 9% fat, 3 mg cholesterol/100 g feed), 60% energy-restricted (ER) diet, ad libitum high protein (AL + PRO) modified AIN-93 M diet (35% protein, 9% fat, 7.2 mg cholesterol/100 g feed), or a 60% energy-restricted high protein (ER + PRO) diet. Using 2H2O labeling and mass isotopomer distribution analysis, DNL, TG turnover, and de novo cholesterol synthesis were measured in hepatic, subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) after 10 weeks of feeding. Two-way ANOVA and post-hoc Tukey pair-wise comparisons were performed.
Results
Energy restriction, independent of protein content, resulted in less body mass gain (main effect, P < 0.05), although there were no differences in body fat % (ER: 50.8 ± 2.8%, ER + PRO: 50.5 ± 3.7%, AL: 47.3 ± 5.3%, AL + PRO: 50.0 ± 5.3%; P > 0.05). Energy restriction decreased TG turnover in SAT and VAT (main effect, P < 0.05), increased the contribution from DNL versus other sources to newly deposited TG in VAT (P < 0.01), did not change total DNL in VAT or liver (P > 0.05) but reduced DNL in SAT (P < 0.01), and increased hepatic, SAT, and VAT de novo cholesterol synthesis (P < 0.01). Dietary protein had no effect on lipid kinetics.
Conclusions
In obese Zucker rats, hepatic DNL was not altered by energy restriction or higher protein feeding. However, energy restriction did decrease TG turnover in SAT and VAT. In a leptin-deficient rodent model of obesity, energy restriction had differential effects on various measures of lipid metabolism.
Funding Sources
DMRP/USAMRDC. Views expressed are those of the authors and do not reflect the official policy of the Army, DoD, or U.S. Government.
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Affiliation(s)
| | | | - James McClung
- U.S. Army Research Institute of Environmental Medicine
| | | | | | | | | | | | - Alyssa Kelley
- U.S. Army Research Institute of Environmental Medicine
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22
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Christopher PP, Anderson B, Stein MD. Comparing views on civil commitment for drug misuse and for mental illness among persons with opioid use disorder. J Subst Abuse Treat 2020; 113:107998. [PMID: 32359671 PMCID: PMC7200755 DOI: 10.1016/j.jsat.2020.107998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/23/2020] [Accepted: 03/04/2020] [Indexed: 11/20/2022]
Abstract
Despite the growing use of civil commitment for drug use disorders, little is known about attitudes among individuals who might be subject to civil commitment. This study examined attitudes of persons with opioid use disorder toward civil commitment for drug misuse and for psychiatric illness. Consecutive persons entering a brief, inpatient opioid detoxification (n = 254) were surveyed regarding their attitudes about civil commitment for mental illness and for drug use, and responses were compared by commitment type and by individual history of being civilly committed for opioid misuse. Participants endorsed high support for civil commitment (both psychiatric and drug misuse-related) when used to address risk of harm to self, to others, and of criminal activity. Respondents were more likely to support civil commitment for psychiatric disorders than for drug misuse, expressing higher support for civil commitment in general, higher agreement with the criteria used to justify civil commitment, and greater perceived efficacy of commitment. Individuals previously committed for opioid misuse were less likely to support drug misuse-related commitment on the basis of its perceived efficacy. These results suggest individuals with opioid use disorder hold more favorable views toward civil commitment for mental health disorders than for drug misuse, and reinforce the need for more research on the procedures and outcomes related to civil commitment for drug misuse.
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Affiliation(s)
- Paul P Christopher
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School, Brown University, United States of America.
| | - Bradley Anderson
- General Medicine Unit, Butler Hospital, Providence, RI, United States of America
| | - Michael D Stein
- Department of Health Law, Policy & Management, School of Public Health, Boston University, United States of America
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Varanoske A, Hennigar S, Margolis L, Berryman C, Shankaran M, Field T, Palacios H, Nyangau E, Mohammed H, Evans W, Hellerstein M, Kelley A, Anderson B, McClung J, Pasiakos S. Effects of Prolonged Energy Restriction and Dietary Protein on Muscle Protein Synthesis and Proteome Dynamics in Obese Zucker Rats. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa049_063] [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
High protein (HP) diets during short-term energy restriction (ER) attenuate energy-mediated reductions in muscle protein synthesis (MPS). MPS-adaptive responses to HP diets during prolonged ER are not well described. This study examined the effects of prolonged ER and HP on MPS and the synthesis rates of numerous individual muscle proteins.
Methods
Female 6-wk-old obese Zucker (leprfa+/fa+, n = 48) rats were randomized to one of four diet groups for 10 weeks: ad libitum-standard protein (AL-SP; 14% protein), AL-HP (35% protein), ER-SP, and ER-HP (both fed 60% of intake of AL-SP). At the start of week 10, D2O was administered by intraperitoneal injection and isotopic equilibrium was maintained daily by providing D2O in drinking water. Rats were euthanized after 1 week of labeling, and mixed-MPS (gastrocnemius), absolute mixed-MPS (mixed-MPS x muscle protein content), proteome dynamics, and protein half-lives [rate/d (k) = –ln(1-f)/d, where f is mixed-MPS and t is time in days; t1/2 (days) = ln(2)/k] were quantified.
Results
Mixed-MPS was not altered by energy status and protein intake. Gastrocnemius mass was lower (P < 0.001) in ER-fed rats than AL-fed rats and higher (P = 0.034) for AL-HP than AL-SP. As a result, absolute mixed-MPS was lower (P < 0.005) in ER than AL, regardless of dietary protein. Absolute synthesis in 24 of 26 myofibrillar, 32 of 61 mitochondrial, and 55 of 60 cytoplasmic measured proteins were lower in ER than AL (P < 0.05), regardless of dietary protein. The difference in absolute synthesis of myofibrillar, mitochondrial, and cytoplasmic proteins due to ER compared to AL was 28%, 16%, and 27%, respectively. Comparison of HP and SP within each energy state revealed lower turnover rates and prolonged half-lives for a majority of measured muscle proteins in HP than in SP in both ER and AL conditions (P < 0.001).
Conclusions
Prolonged ER in obese Zucker rats exerted a strong suppressive effect on myofibrillar, mitochondrial, and cytoplasmic MPS, suggesting reduced protein accretion contributed to lower gastrocnemius mass in ER-fed rats. Lower turnover rates of most muscle proteins in HP-fed rats without reductions in protein pool size (i.e., tissue mass) suggests prolonged HP intake, independent of energy, may prolong muscle protein lifespan of in obese Zucker rats.
Funding Sources
Supported by USAMRDC; authors’ views not official U.S. Army or DoD policy.
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Affiliation(s)
| | | | - Lee Margolis
- U.S. Army Research Institute of Environmental Medicine
| | | | | | | | | | | | | | | | | | - Alyssa Kelley
- U.S. Army Research Institute of Environmental Medicine
| | | | - James McClung
- U.S. Army Research Institute of Environmental Medicine
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Uebelacker LA, Sillice MA, Epstein-Lubow G, Battle CL, Anderson B, Caviness C, Miller IW, Abrantes AM. Combined intervention approaches for initiating and maintaining physical activity in depressed individuals: design and rationale of the Project MOVE randomized clinical trial. Contemp Clin Trials 2020; 91:105974. [PMID: 32151752 PMCID: PMC8017446 DOI: 10.1016/j.cct.2020.105974] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/25/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Regular engagement in physical activity decreases risks for many chronic conditions, and may also improve depression symptoms. However, rates of physical activity and adherence to exercise interventions remain low among depressed individuals relative to non-depressed individuals. METHODS This is a study protocol for Project MOVE. This study is a theoretically-driven, 3-arm randomized controlled trial for increasing physical activity with depressed adults. Each successive arm includes an added component that may serve to increase and maintain physical activity. The arms are: 1) Brief advice (BA) to exercise alone (minimal treatment control condition); 2) BA + supervised and home-based exercise (SHE) + health education (HE; serves as contact control for CBEX); and 3) BA + SHE +cognitive-behavioral sessions focused on increasing and maintaining exercise (CBEX). The target sample size is 240. Assessments are conducted at baseline, Month 1.5, end of intervention (month 3), and at 6 and 9 months. The primary outcome is minutes of moderate-to-vigorous physical activity, assessed via an accelerometer. Secondary outcomes include cardiorespiratory fitness, body composition, and depression, and maintenance of moderate-vigorous physical activity through 6 and 9 month follow-ups. Mediators and moderators derived from behavior change theories, including the Health Behavior Model, Self-Determination Theory, and Social Ecological Theory, will be examined. CONCLUSION Project MOVE is designed to test primarily whether both a structured exercise program (SHE) and a cognitive-behavioral group (CBEX) increase physical activity in depressed adults during both a 3-month intervention period, and during the 6-months that follow.
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Affiliation(s)
- Lisa A Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA
| | - Marie A Sillice
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA; Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA.
| | - Gary Epstein-Lubow
- Psychosocial Research Program, Butler Hospital, Providence, RI, USA; Department of Health Services, Policy and Practice of Brown University, Providence, RI, USA
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA; Center for Women's Behavioral Health, Women & Infants' Hospital of Rhode Island, Providence, RI, USA
| | - Bradley Anderson
- Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA
| | - Celeste Caviness
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA
| | - Ivan W Miller
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Psychosocial Research Program, Butler Hospital, Providence, RI, USA
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Behavioral Medicine & Addiction Research, Butler Hospital, Providen,ce, RI, USA
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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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Anderson B, Carlson P, Laurenti M, Vella A, Camilleri M, Desai A, Feuerhak K, Bharucha AE. Association between allelic variants in the glucagon-like peptide 1 and cholecystokinin receptor genes with gastric emptying and glucose tolerance. Neurogastroenterol Motil 2020; 32:e13724. [PMID: 31691451 PMCID: PMC6923543 DOI: 10.1111/nmo.13724] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/06/2019] [Accepted: 08/28/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Nutrient-mediated release of cholecystokinin and glucagon-like peptide-1 (GLP-1) regulates gastric emptying (GE) via duodenogastric feedback mechanisms; GLP-1 also regulates postprandial insulin secretion. Some patients with functional upper gastrointestinal symptoms have impaired glucose tolerance during enteral dextrose infusion. Our hypothesis was that variants in CCK, GLP-1, and TCF7L2 (transcription factor 7-like 2 locus), which is associated with greatest genetic risk for development of type 2 diabetes mellitus, are associated with GE and independently with glucose tolerance. Our aims were to evaluate the associations between these GE, glucose tolerance, and these single nucleotide polymorphisms (SNPs). METHODS Genetic variants, scintigraphic GE of solids, plasma glucose, insulin, and GLP-1 during enteral dextrose infusion (75gm over 2 hours) were measured. GE and enteral dextrose infusion were, respectively, evaluated in 44 (27 controls and 17 patients with functional dyspepsia or nausea) and 42 (28 controls, 14 patients) participants; of these, 51 participants consented to assessment of SNPs. Four functional SNPs were studied: rs6923761 and rs1042044 at GLP-1 receptor, rs7903146 (TCF7L2), and rs1800857 (CCK receptor). KEY RESULTS Gastric emptying was normal in 38, rapid in 4, and delayed in two participants; 38 had normal, and four had impaired glucose tolerance. The T allele at rs7903146 (TCF7L2) was non-significantly associated (P = .14) with faster GE. The associations between SNPs and demographic variables, GE thalf , glucose tolerance and plasma GLP1 levels were not significant. CONCLUSIONS & INFERENCES There is a trend toward an association between faster GE and the diabetes-associated allele at rs7903146 in TCF7L2. However, these SNPs were not associated with plasma glucose or GLP1 concentrations during enteral dextrose infusion.
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Affiliation(s)
| | | | - Marcello Laurenti
- Mayo School of Graduate Medical Education, Division of Internal Medicine
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27
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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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Stein M, Herman D, Conti M, Anderson B, Bailey G. Initiating buprenorphine treatment for opioid use disorder during short-term in-patient 'detoxification': a randomized clinical trial. Addiction 2020; 115:82-94. [PMID: 31430414 DOI: 10.1111/add.14737] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/21/2019] [Accepted: 07/01/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS The effectiveness of linking people from short-term in-patient managed withdrawal programs ('detoxification') to long-term, primary care-based buprenorphine is unknown. We tested whether buprenorphine initiation during an opioid withdrawal program and linkage to office-based buprenorphine (LINK) after discharge would increase engagement with office-based buprenorphine and decrease illicit opioid use during the ensuing 6 months compared with standard withdrawal management (WM). DESIGN Single-site randomized controlled trial. SETTING Short-term in-patient detoxification program in Massachusetts, USA. PARTICIPANTS People with opioid use disorder (n = 115) who averaged 32.4 years of age, 68.2% male, 79.1% white, using illicit opioids on 27.3 of the last 30 days, were randomly assigned to WM (n = 59) versus LINK (n = 56). INTERVENTION AND COMPARATOR Intervention was buprenorphine induction, in-patient dose stabilization and post-discharge transition to maintenance buprenorphine at an affiliated primary care clinic (LINK). Comparator was 5-day buprenorphine managed withdrawal protocol (WM). MEASUREMENTS Mean 30-day rate of use of illicit opioids (primary aim) and prescribed buprenorphine (secondary aim) at 1, 3 and 6 months. FINDINGS Compared with WM, participants in the LINK condition had lower illicit opioid use rates at days 12 [b = -6.81, 95% confidence interval (CI) = -9.69; -3.92, P < 0.001], 35 (b = -8.55, 95% CI - 11.63; -5.47, P < 0.001), 95 (b = -7.34, 95% CI = -10.59; -4.11, P < 0.001) and 185 (b = -3.52, 95% CI = -7.07; 0.27, P = 0.052). The LINK arm had higher prescription buprenorphine use rates (P < 0.001) at all assessments. CONCLUSIONS Among people with opioid use disorder, initiation of, and linkage to, office-based buprenorphine treatment post-discharge reduced illicit opioid use and increased days of buprenorphine treatment for up to 6 months post-discharge compared with an in-patient detoxification protocol.
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Affiliation(s)
- Michael Stein
- Boston University School of Public Health, Boston, MA, USA.,Department of General Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Debra Herman
- Department of General Medicine and Addictions Research, Butler Hospital, Providence, RI, USA.,Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Micah Conti
- Department of General Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Bradley Anderson
- Department of General Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Genie Bailey
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
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Affiliation(s)
- Bradley Anderson
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Karthik Ravi
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
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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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Anderson B, Johnson D, Sweetser S. An Unusual Cause of Gastric Outlet Obstruction. Clin Gastroenterol Hepatol 2019; 17:e34. [PMID: 29410053 DOI: 10.1016/j.cgh.2018.01.043] [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] [Received: 01/23/2018] [Accepted: 01/26/2018] [Indexed: 02/07/2023]
Affiliation(s)
- Bradley Anderson
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - David Johnson
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Seth Sweetser
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
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Bharucha AE, Anderson B, Bouchoucha M. More movement with evaluating colonic transit in humans. Neurogastroenterol Motil 2019; 31:e13541. [PMID: 30681255 PMCID: PMC6362846 DOI: 10.1111/nmo.13541] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Colonic functions (ie, absorption of fluids and electrolytes, digestion of selected nutrients, harbor for microbes, and elimination of excreta) necessitate complex patterns of storage and transit. Indeed, colonic transit accounts for a major part of the mouth-to-anus transit time. Colonic transit assessments are useful for understanding the pathophysiology of disease, the pharmacodynamic effects of new medications and to diagnose slow transit constipation. Currently, radiopaque markers, scintigraphy, and a colonic pH-pressure capsule are used to measure overall colonic transit. Radioopaque markers, scintigraphy, and the electromagnetic capsule, which is a newer technique, also evaluate regional colonic transit. The pH-pressure capsule also measures colonic pressures. Magnetic resonance imaging and a radio-frequency identification-based device are evolving methods for assessing colonic transit. PURPOSE This mini-review, which accompanies a study evaluating the assessment of colon transit with the electromagnetic capsule, evaluates and compares existing and evolving methods for evaluating colonic transit in humans (Neurogastroenterol Motil. 2018; in press). In addition to overall and regional colonic transit, the electromagnetic capsule evaluates colonic motor patterns without radiation exposure. These patterns are summarized by analyzing the characteristics (ie, distance and velocity) of discrete antegrade and retrograde capsule movements as they travel in the colon. However, the electromagnetic capsule does not measure pressure or colonic wall movement (ie, contractions). The motor patterns identified by this capsule should be compared with motor patterns identified with manometry. The next challenge is to harness different techniques to evaluate the relationships between colonic pressures and transit or, even better, the trifecta of colonic contractions, pressure events, and transit.
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Affiliation(s)
- Adil E. Bharucha
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Bradley Anderson
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Michel Bouchoucha
- Université Paris V René Descartes, Paris Cedex 06, France
- Hôpital Avicenne, Bobigny, France
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34
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Yang LH, Grivel MM, Anderson B, Bailey GL, Opler M, Wong LY, Stein MD. A new brief opioid stigma scale to assess perceived public attitudes and internalized stigma: Evidence for construct validity. J Subst Abuse Treat 2019; 99:44-51. [PMID: 30797393 DOI: 10.1016/j.jsat.2019.01.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 01/23/2023]
Abstract
One key strategy to improve treatment access for persons with opioid use disorder (OUD) is overcoming stigma that is internalized by such individuals. Because few theoretically-derived, multidimensional measures of substance abuse stigma exist, we contribute a brief, theoretically-based measure of opioid-related stigma (adapted from Corrigan's Self-Stigma of Mental Illness Scale) to assess perceived stigma and internalized stigma among individuals with OUD. This study presents initial validation of the newly-developed Brief Opioid Stigma Scale among 387 adults who entered an inpatient opioid managed-withdrawal program. The scale assesses: (1) Stereotype awareness ("Aware"), or the extent to which individuals who use opioids perceive community members to believe OUD-related stereotypes; (2) Stereotype agreement ("Agree"), or the endorsement of stigmatizing beliefs by individuals who use opioids; (3) Self-esteem decrement ("Harm"), or the diminution of self-esteem due to these negative stereotypes' impacts on self-worth. Psychosocial measures including self-esteem, depressive symptoms, mental and physical functioning, and desire for aftercare OUD medication treatment, were administered to assess construct validity. Results showed that greater endorsement of the "harm" stigma subscale was associated with greater depressive symptoms, lower self-esteem, and poorer mental and physical functioning. The "aware" stigma subscale displayed similar overall patterns of associations with self-esteem and depression but to a lesser magnitude. The "aware" stigma subscale was positively associated with desire for aftercare methadone and naltrexone treatment, and the "harm" subscale was positively associated with desire for aftercare buprenorphine treatment. Results indicated good initial construct validity. Tailored stigma interventions are recommended for specific aftercare OUD medication treatments.
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Affiliation(s)
- Lawrence H Yang
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, USA.
| | - Margaux M Grivel
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, NY, USA
| | | | - Genie L Bailey
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Stanley Street Treatment & Resources, Inc., Fall River, MA, USA
| | | | | | - Michael D Stein
- Butler Hospital, Providence, RI, USA; Boston University School of Public Health, Boston, MA, USA
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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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36
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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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37
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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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38
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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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Vijayvargiya P, Anderson B, Nehra V. A Rare Cause of Progressive Constipation, Abdominal Distension, and Weight Loss. Clin Gastroenterol Hepatol 2018; 16:e126-e127. [PMID: 29246700 DOI: 10.1016/j.cgh.2017.12.014] [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] [Received: 11/28/2017] [Accepted: 12/06/2017] [Indexed: 02/07/2023]
Affiliation(s)
- Priya Vijayvargiya
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Bradley Anderson
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Vandana Nehra
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
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Abstract
INTRODUCTION Civil commitment is an increasingly used policy intervention to combat the opioid epidemic. Yet little is known about persons who get committed and outcomes following commitment for opioid use. In the current cross-sectional study, we compared the characteristics of persons with and without a history of civil commitment, and the correlates of post-commitment abstinence. METHODS Between October 2017 and May 2018, we surveyed consecutive persons entering a brief, inpatient opioid detoxification (n = 292) regarding their lifetime experiences with civil commitment for opioid use. RESULTS Participants averaged 34.6 years of age, 27.1% were female, and 78.1% were White. Seventy-eight (26.7%) experienced civil commitment for opioid use at least once in their lifetime. Committed individuals had significantly higher rates of fentanyl, heroin, and injection drug use, drug overdoses, past incarceration, current criminal justice involvement, and past medication treatment for opioid use (p < .05). The average time to relapse following commitment was 72 days, although 33.8% relapsed on the same day of their release. Longer post-commitment abstinence was significantly associated with post-commitment medication treatment, higher perceived procedural justice (i.e., fairness) during the commitment hearing, positive attitude and higher motivation at the end of commitment, and improvement in attitude during commitment (p < .05). CONCLUSION Opioid users who experience civil commitment constitute an especially high risk group. A positive commitment experience and post-commitment medication treatment are associated with longer post-commitment abstinence.
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Affiliation(s)
- Paul P Christopher
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School, Brown University, Box G-BH, Providence RI 02912 United States.
| | - Bradley Anderson
- General Medicine Unit, Butler Hospital, Providence RI United States
| | - Michael D Stein
- Department of Health Law, Policy & Management, School of Public Health, Boston University, United States
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Anderson B, Andrews J, Poterucha J. Subcapsular Hepatic Hematoma Resulting From Hepatic Microaneurysms in a Patient With Systemic Amyloidosis. Clin Gastroenterol Hepatol 2018; 16:A40. [PMID: 29360509 DOI: 10.1016/j.cgh.2018.01.012] [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] [Received: 12/02/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 02/07/2023]
Affiliation(s)
- Bradley Anderson
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - James Andrews
- Department of Vascular and Interventional Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - John Poterucha
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
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Anderson B, Sweetser S. Acute Diarrhea in an Immunocompromised 55-Year-Old Man. Gastroenterology 2018; 155:623-624. [PMID: 29549045 DOI: 10.1053/j.gastro.2018.02.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 02/03/2018] [Accepted: 02/08/2018] [Indexed: 12/02/2022]
Affiliation(s)
- Bradley Anderson
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Seth Sweetser
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
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Anderson B, Sweetser S. Chronic Abdominal Pain in a 47-Year-Old Woman. Gastroenterology 2018; 155:627-628. [PMID: 29913135 DOI: 10.1053/j.gastro.2018.02.043] [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] [Received: 01/20/2018] [Accepted: 02/05/2018] [Indexed: 12/02/2022]
Affiliation(s)
- Bradley Anderson
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Seth Sweetser
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota
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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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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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Hailemariam M, Stein M, Anderson B, Schonbrun YC, Moore K, Kurth M, Richie F, Johnson JE. Correlates of alcoholics anonymous affiliation among justice-involved women. BMC Womens Health 2018; 18:125. [PMID: 29996829 PMCID: PMC6042328 DOI: 10.1186/s12905-018-0614-0] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 06/22/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) constitutes a major public health problem and is associated with a substantial amount of disability and premature death worldwide. Several treatment and self-help options including Alcoholics Anonymous (AA) meetings are available. Nevertheless, factors associated with AA affiliation in some disadvantaged groups such as justice-involved women are not well understood. The purpose of this study is to report on previously unexamined correlates of past year AA affiliation among women in pretrial jail detention. METHODS The current study used cross-sectional data from 168 women with DSM-5 diagnosis of AUD in pretrial jail detention. The study examined factors related to women's concept of self and others (i.e., disbelief that others are trustworthy, lack of autonomy to choose who they interact with, experience of violent victimization, low investment in self-care, higher stress levels, and homelessness) as correlates of past-year AA affiliation, controlling for severity of AUD and demographic factors. RESULTS Women who believe that others are inherently trustworthy, women who met less AUD criteria, and women who are older reported more past-year AA affiliation in both univariate and multivariate analyses. CONCLUSION Introducing AA outreach and alternative interventions for younger, less severely addicted women might improve AUD outcomes. Moreover, designing more individualized treatment plan for women who believe others are not trust worthy might help AUD treatment engagement in this population. TRIAL REGISTRATION NCT01970293 , 10/28/2013.
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Affiliation(s)
- Maji Hailemariam
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI USA
| | - Michael Stein
- Boston University School of Public Health, Health Law, Policy and Management, Boston, MA USA
- Butler Hospital, Providence, RI USA
| | | | | | - Kelly Moore
- Department of Psychiatry, Yale University, School of Medicine, New Haven, USA
| | | | - Fallon Richie
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI USA
| | - Jennifer E. Johnson
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI USA
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Moore KE, Santiago Rivera OJ, Anderson B, Johnson JE, Hahn JA, Kurth ME, Reddy MK, Schonbrun YC, Stein MD. Phosphatidylethanol Levels Among Incarcerated Women: The Influence of Pre-incarceration Alcohol Consumption and Length of Abstinence. Alcohol Clin Exp Res 2018; 42:500-507. [PMID: 29281858 DOI: 10.1111/acer.13587] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/18/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Phosphatidylethanol (PEth) is a direct biomarker for alcohol that is formed shortly after alcohol use and may remain detectable in blood for weeks after alcohol consumption. There is little research on alcohol use factors that influence PEth elimination, especially among women. METHODS Data were collected from 116 alcohol use-disordered women who were recently incarcerated. We used a 2-part model with logistic and linear components to examine whether alcohol consumption in the 2 weeks prior to incarceration and days since last alcoholic drink (operationalized as abstinence days prior to incarceration + days incarcerated) were associated with PEth detectability (>8 ng/ml) and level (ng/ml) in blood. RESULTS Participants reported drinking an average of 10 drinks per day in the 2 weeks prior to incarceration. Days since last drink was negatively associated with PEth level (odds ratio [OR] = 0.97, 95% confidence interval [CI] = 0.93; 0.99) and being PEth detectable (OR = 0.96, 95% CI = 0.91; 0.99). Quantity of alcohol consumed prior to jail admission was associated with PEth detection (OR = 1.08; 95% CI = 1.03; 1.16), but not PEth level. CONCLUSIONS Days since last alcoholic drink and drinks per day both influenced PEth detectability, but only days since last drink predicted PEth level among a large sample of women with alcohol use disorder in the criminal justice system.
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Affiliation(s)
- Kelly E Moore
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | | | - Bradley Anderson
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, Rhode Island
| | - Jennifer E Johnson
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, Michigan
| | - Judith A Hahn
- Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Megan E Kurth
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, Rhode Island
| | - Madhavi K Reddy
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Yael C Schonbrun
- Department of Psychiatry and Human Behavior, Brown University Medical School and Butler Hospital, Providence, Rhode Island
| | - Michael D Stein
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, Rhode Island.,Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, Massachusetts
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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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