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Zeraouli G, Marconi M, Sullivan B, Wang S, Anaraki SZ, Hollinger R, Shlyaptsev S, Mariscal D, Rocca JJ. Multichannel Doppler fiber-imager spectrometer for spatiotemporal characterization of high-intensity laser-driven plasmas. Rev Sci Instrum 2024; 95:043506. [PMID: 38619372 DOI: 10.1063/5.0200285] [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: 01/25/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024]
Abstract
We demonstrate a flexible multichannel fiber-based imaging Doppler spectrometer to characterize plasmas in high intensity (≥1 × 1018 W/cm2) laser-plasma experiments at high repetition rates. This instrument collects data from ×21 different plasma locations combining optical fibers and a single imaging spectrometer. This diagnostic maps the plasma velocity evolution as a function of time with sub-pico-second resolution. Experimental results showing 2D velocity measurements of plasma with 20 μm spatial resolution are presented. Intensities of the order of 1018 W/cm2 were used to generate a plasma, while a much less intense, frequency doubled (400 nm), probe beam (1011 W/cm2) was used to measure the Doppler shift from the plasma critical surface. The instrument can be scaled to a larger number of channels (e.g., 100) still using a single spectrometer.
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Affiliation(s)
- G Zeraouli
- Colorado State University, Fort Collins, Colorado 80523, USA
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M Marconi
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - B Sullivan
- Colorado State University, Fort Collins, Colorado 80523, USA
- XUV Lasers, Fort Collins, Colorado 80523, USA
| | - S Wang
- Colorado State University, Fort Collins, Colorado 80523, USA
| | | | - R Hollinger
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - S Shlyaptsev
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - D Mariscal
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J J Rocca
- Colorado State University, Fort Collins, Colorado 80523, USA
- XUV Lasers, Fort Collins, Colorado 80523, USA
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2
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Zeraouli G, Mariscal DA, Hollinger R, Anaraki SZ, Folsom EN, Grace E, Rusby D, Hill MP, Williams GJ, Scott GG, Sullivan B, Wang S, King J, Swanson KK, Simpson RA, Djordjevic BZ, Andrews S, Costa R, Cauble B, Albert F, Rocca JJ, Ma T. Flexible tape-drive target system for secondary high-intensity laser-driven sources. Rev Sci Instrum 2023; 94:123306. [PMID: 38117203 DOI: 10.1063/5.0180715] [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: 10/11/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
We present the development of a flexible tape-drive target system to generate and control secondary high-intensity laser-plasma sources. Its adjustable design permits the generation of relativistic MeV particles and x rays at high-intensity (i.e., ≥1 × 1018 W cm-2) laser facilities, at high repetition rates (>1 Hz). The compact and robust structure shows good mechanical stability and a high target placement accuracy (<4 μm RMS). Its compact and flexible design allows for mounting in both the horizontal and vertical planes, which makes it practical for use in cluttered laser-plasma experimental setups. The design permits ∼170° of access on the laser-driver side and 120° of diagnostic access at the rear. A range of adapted apertures have been designed and tested to be easily implemented to the targetry system. The design and performance testing of the tape-drive system in the context of two experiments performed at the COMET laser facility at the Lawrence Livermore National Laboratory and at the Advanced Lasers and Extreme Photonics (ALEPH) facility at Colorado State University are discussed. Experimental data showing that the designed prototype is also able to both generate and focus high-intensity laser-driven protons at high repetition rates are also presented.
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Affiliation(s)
- G Zeraouli
- Colorado State University, Fort Collins, Colorado 80523, USA
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D A Mariscal
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Hollinger
- Colorado State University, Fort Collins, Colorado 80523, USA
| | | | - E N Folsom
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - E Grace
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D Rusby
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M P Hill
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G J Williams
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G G Scott
- Colorado State University, Fort Collins, Colorado 80523, USA
- STFC Central Laser Facility, Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 OQX, United Kingdom
| | - B Sullivan
- Colorado State University, Fort Collins, Colorado 80523, USA
- XUV Lasers, Fort Collins, Colorado 80523, USA
| | - S Wang
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J King
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - K K Swanson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R A Simpson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Z Djordjevic
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Andrews
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Costa
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Cauble
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - F Albert
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J J Rocca
- Colorado State University, Fort Collins, Colorado 80523, USA
- XUV Lasers, Fort Collins, Colorado 80523, USA
| | - T Ma
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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Sullivan B, Carroll E, Soares N. The ethical perspectives of using animals in pediatric health. Curr Probl Pediatr Adolesc Health Care 2023; 53:101489. [PMID: 38040613 DOI: 10.1016/j.cppeds.2023.101489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
While there are ethical standards for human biomedical research, animals have historically not benefitted from the same levels of protection. Cultural shifts in response to studies demonstrating animal capacity to suffer have resulted in laws defining minimum ethical standards for the treatment of various animal populations. However, none of these pertain to service or therapy animals nor do they define ethical considerations regarding training, placement, environment, and duty limitations specific to this population. The potential for harm and inability to provide consent should raise ethical questions of animal assisted interventions (AAI), including how to best balance the risk: benefit ratio for both animal and human participants. While service animals have specific definitions, therapy and emotional support animals are much less clearly defined and therefore have far less standardized practices regarding their training, certification, and process for matching to handlers. This can lead to animals being inadequately trained to cope with the stresses of their jobs or being placed in incompatible environments. Meanwhile, service animals' duties are constant, and the animal has little ability to consent to or withdraw from participation, leading to overwork, without the opportunity to engage in activities that align with the animals' natural preferences. Emotional support animals are the least defined of these populations, receive no formal training, and are at increased risk of inadequate care, unstable housing, and abuse from handlers who may also be poorly prepared to properly handle their needs. To uphold our moral obligations to the animals that serve to improve our own mental wellness and physical independence, urgent actions are needed to improve the protections in place for these populations.
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Affiliation(s)
- Brittany Sullivan
- Western Michigan University Homer Stryker MD School of Medicine (WMed), Kalamazoo, MI, United States
| | - Emily Carroll
- Cincinnati Children's Hospital, Cincinnati, OH, United States
| | - Neelkamal Soares
- Western Michigan University Homer Stryker MD School of Medicine (WMed), Kalamazoo, MI, United States.
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Kohler RE, Hemler J, Wagner RB, Sullivan B, Macenat M, Tagai EK, Miller SM, Wen KY, Ayers C, Einstein MH, Hudson SV. Confusion and anxiety in between abnormal cervical cancer screening results and colposcopy: "The land of the unknown". Patient Educ Couns 2023; 114:107810. [PMID: 37244133 PMCID: PMC10527466 DOI: 10.1016/j.pec.2023.107810] [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] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Attendance to colposcopy after abnormal cervical cancer screening is essential to cervical cancer prevention. This qualitative study explored patients' understanding of screening results, their experiences of the time leading up to the colposcopy appointment, and colposcopy. METHODS We recruited women referred for colposcopy from two urban practices in an academic health system. Individual interviews (N = 15) with participants were conducted after colposcopy appointments about their cervical cancer screening histories, current results, and colposcopy experiences. A team analyzed and summarized interviews and coded transcripts in Atlas.ti. RESULTS We found that most women were confused about their screening results, did not know what a colposcopy was before being referred for one, and experienced anxiety in the interval between receiving their results and having their colposcopy. Most women searched for information online, but found "misinformation," "worst-case scenarios" and generic information that did not resolve their confusion. CONCLUSION Women had little understanding of their cervical cancer risk and experienced anxiety looking for information and waiting for the colposcopy. Educating patients about cervical precancer and colposcopy, providing tailored information about their abnormal screening test results and potential next steps, and helping women manage distress may alleviate uncertainty while waiting for follow-up appointments. PRACTICE IMPLICATIONS Interventions to manage uncertainty and distress in the interval between receiving an abnormal screening test result and attending colposcopy are needed, even among highly adherent patients.
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Affiliation(s)
- Racquel E Kohler
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, 120 Albany St, New Brunswick, NJ 08901, USA.
| | - Jennifer Hemler
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 303 George St, New Brunswick, NJ 08901, USA
| | - Rachel B Wagner
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, 120 Albany St, New Brunswick, NJ 08901, USA
| | - Brittany Sullivan
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 303 George St, New Brunswick, NJ 08901, USA
| | - Myneka Macenat
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, 120 Albany St, New Brunswick, NJ 08901, USA
| | - Erin K Tagai
- Cancer Prevention and Control, Fox Chase Cancer Center/Temple University Health System, 333 Cottman Avenue, Philadelphia, PA 19111, USA
| | - Suzanne M Miller
- Cancer Prevention and Control, Fox Chase Cancer Center/Temple University Health System, 333 Cottman Avenue, Philadelphia, PA 19111, USA
| | - Kuang-Yi Wen
- Department of Medical Oncology, Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA 19107, USA
| | - Charletta Ayers
- Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, 125 Paterson St, New Brunswick, NJ 08901, USA
| | - Mark H Einstein
- Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, 185 South Orange Avenue, Newark, NJ 07103, USA
| | - Shawna V Hudson
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, 120 Albany St, New Brunswick, NJ 08901, USA; Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 303 George St, New Brunswick, NJ 08901, USA
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Ruhi-Williams P, Manasa M, Fazl Alizadeh R, Sullivan B, Kirby KA, Amin A, Nguyen NT. Impact of COVID-19 Pandemic on Management and Outcomes of Acute Cholecystitis at US Academic Centers. J Am Coll Surg 2023; 237:87-93. [PMID: 37318137 DOI: 10.1097/xcs.0000000000000668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND The COVID-19 pandemic has had wide-ranging effects on management of medical conditions. Many hospitals encountered staffing shortages, limited operating room availability, and shortage of hospital beds. There was increased psychological stress and fear of contracting COVID-19 infection, leading to delay in medical care for various disease processes. The objective of this study was to examine changes in management and outcomes attributed to the COVID-19 pandemic in patients presenting with acute calculus cholecystitis at US academic centers. STUDY DESIGN Using the Vizient database, patients with the diagnosis of acute calculus cholecystitis who underwent intervention during the 15 months before the pandemic (prepandemic, October 2018 to December 2019) were compared with 15 months during the pandemic (pandemic, March 2020 to May 2021). Outcomes measures included demographics, characteristics, type of intervention, length of stay, in-hospital mortality, and direct cost. RESULTS There were 146,459 patients with acute calculus cholecystitis identified (prepandemic: 74,605 vs pandemic: 71,854). Patients in the pandemic group were more likely to undergo medical management (29.4% vs 31.8%; p < 0.001) or percutaneous cholecystostomy tube placement (21.5% vs 18%; p < 0.001) and less likely to undergo laparoscopic cholecystectomy (69.8% vs 73.0%; p < 0.001). Patients in the pandemic group who underwent procedural intervention had longer length of stay (6.5 days vs 5.9 days; p < 0.001), higher in-hospital death (3.1% vs 2.3%; p < 0.001), and higher cost ($14,609 vs $12,570; p < 0.001). CONCLUSIONS In this analysis of patients with acute calculus cholecystitis, there were distinct changes in the management and outcomes of patients due to the COVID-19 pandemic. Changes in the type of intervention and outcomes are likely related to delayed presentation with increases in the severity and complexity of the disease.
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Affiliation(s)
- Perisa Ruhi-Williams
- From the University of California Irvine Medical Center, Department of Surgery, Orange, CA (Ruhi-Williams, Manasa, Alizadeh, Sullivan, Nguyen)
| | - Morgan Manasa
- From the University of California Irvine Medical Center, Department of Surgery, Orange, CA (Ruhi-Williams, Manasa, Alizadeh, Sullivan, Nguyen)
| | - Reza Fazl Alizadeh
- From the University of California Irvine Medical Center, Department of Surgery, Orange, CA (Ruhi-Williams, Manasa, Alizadeh, Sullivan, Nguyen)
| | - Brittany Sullivan
- From the University of California Irvine Medical Center, Department of Surgery, Orange, CA (Ruhi-Williams, Manasa, Alizadeh, Sullivan, Nguyen)
| | - Katharine A Kirby
- University of California Irvine, Center for Statistical Consulting, Department of Statistics, Irvine, CA (Kirby)
| | - Alpesh Amin
- University of California Irvine Medical Center, Department of Medicine, Orange, CA (Amin)
| | - Ninh T Nguyen
- From the University of California Irvine Medical Center, Department of Surgery, Orange, CA (Ruhi-Williams, Manasa, Alizadeh, Sullivan, Nguyen)
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Aulakh A, Parker B, Sullivan B, Recsky M, Oliveira C, Richardson W, Hirschkorn P, Perini R, Bak A. A111 CLINICAL AND PATHOLOGICAL OUTCOMES BETWEEN WATER EXCHANGE AND AIR INSUFFLATION USING NON-SEDATED EXTENDED FLEXIBLE SIGMOIDOSCOPY FOR AVERAGE RISK COLORECTAL CANCER SCREENING: PRELIMINARY FINDINGS FROM A RANDOMIZED CONTROL TRIAL. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991151 DOI: 10.1093/jcag/gwac036.111] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Colorectal cancer (CRC) is Canada's third most common cancer type and represents approximately 11% of all cancer deaths. While sedated colonoscopy or flexible sigmoidoscopy (FS) continues to be considered for CRC screening, these modalities have limitations and risks. Another unevaluated screening modality, known as an extended FS (EFS), attempts to capitalize on the benefits of a FS while minimizing the risks involved with a sedated colonoscopy. EFS provides a scope-based examination up to the splenic flexure and then attempts to examine beyond, often to the point of the caecum. Providing the option for EFS may produce improvements in the patient experience and performance, which may improve the feasibility of using scope-based screening more broadly in screening programs. Purpose To determine the extent non-sedated EFS using the water exchange method (WE) is associated with a complete colon examination compared to the traditional air insufflation (AI) method using CO2 in an average-risk screening population. Method This randomized control trial included 90 non-sedated participants, screened by trained general surgery and gastroenterology clinicians at Kelowna General Hospital, British Columbia, Canada, using two different scope insufflation techniques, WE and AI. The primary outcome of interest was the cecal intubation rates (CIR), while secondary outcomes included the adenoma detection rate (ADR) and reported pain scores. Other metrics, such as patient satisfaction rates, sessile serrated adenoma detection rates (SSADR), and serrated lesion detection rates (SLDR) were also recorded. Result(s) The demographic characteristics between the WE and AI groups were statistically similar, with the mean age of participants being 58 and 57, respectively. During the study period, four endoscopists performed the EFS. There were higher initial satisfaction rates in the WE group vs the AI (95% vs 77%, satisfaction of ≥ 9/10 p = 0.028). CIR and ADR were similar between the WE and AI group (CIR = 93% vs 91%, p = 0.710), (ADR = 40% vs 34%, p = 0.660). The SSADR and SLDR were also similar between the WE and AI group (SSADR = 21% vs 14%, p = 0.408), (SLDR = 42% vs 36%, p = 0.528). Conclusion(s) EFS without sedation using either technique exceeds quality benchmarks recommended for sedated screening colonoscopy while maintaining adequate patient safety and comfort. The WE method optimizes a patient's overall experience making a strategy of average risk colorectal cancer screening with non-sedated WE EFS feasible. Please acknowledge all funding agencies by checking the applicable boxes below CAG, Other Please indicate your source of funding; Kelowna General Hospital, Interior Health Disclosure of Interest None Declared
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Affiliation(s)
- A Aulakh
- Faculty of Medicine , University of British Columbia
| | - B Parker
- Medicine , The Kelowna General Hospital , Kelowna,Provincial Health Services Authority, Vancouver
| | - B Sullivan
- Faculty of Medicine , University of British Columbia,Division of General Surgery, The Kelowna General Hospital , Kelowna
| | - M Recsky
- Faculty of Medicine , University of British Columbia,Division of General Surgery, The Kelowna General Hospital , Kelowna
| | - C Oliveira
- Medicine , The Kelowna General Hospital , Kelowna
| | - W Richardson
- Faculty of Medicine , University of British Columbia , Victoria
| | | | - R Perini
- Faculty of Medicine , University of British Columbia,Division of Gastroenterology, The Kelowna General Hospital , Kelowna, Canada
| | - A Bak
- Faculty of Medicine , University of British Columbia,Division of Gastroenterology, The Kelowna General Hospital , Kelowna, Canada
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Mariscal DA, Djordjević BZ, Anirudh R, Bremer T, Campbell PC, Feister S, Folsom E, Grace ES, Hollinger R, Jacobs SA, Kailkhura B, Kalantar D, Kemp AJ, Kim J, Kur E, Liu S, Ludwig J, Morrison J, Nedbailo R, Ose N, Park J, Rocca JJ, Scott GG, Simpson RA, Song H, Spears B, Sullivan B, Swanson KK, Thiagarajan J, Wang S, Williams GJ, Wilks SC, Wyatt M, Van Essen B, Zacharias R, Zeraouli G, Zhang J, Ma T. A flexible proton beam imaging energy spectrometer (PROBIES) for high repetition rate or single-shot high energy density (HED) experiments (invited). Rev Sci Instrum 2023; 94:023507. [PMID: 36859040 DOI: 10.1063/5.0101845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 12/28/2022] [Indexed: 06/18/2023]
Abstract
The PROBIES diagnostic is a new, highly flexible, imaging and energy spectrometer designed for laser-accelerated protons. The diagnostic can detect low-mode spatial variations in the proton beam profile while resolving multiple energies on a single detector or more. When a radiochromic film stack is employed for "single-shot mode," the energy resolution of the stack can be greatly increased while reducing the need for large numbers of films; for example, a recently deployed version allowed for 180 unique energy measurements spanning ∼3 to 75 MeV with <0.4 MeV resolution using just 20 films vs 180 for a comparable traditional film and filter stack. When utilized with a scintillator, the diagnostic can be run in high-rep-rate (>Hz rate) mode to recover nine proton energy bins. We also demonstrate a deep learning-based method to analyze data from synthetic PROBIES images with greater than 95% accuracy on sub-millisecond timescales and retrained with experimental data to analyze real-world images on sub-millisecond time-scales with comparable accuracy.
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Affiliation(s)
- D A Mariscal
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Z Djordjević
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Anirudh
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - T Bremer
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - P C Campbell
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Feister
- Department of Computer Science, California State University Channel Islands, Camarillo, California 93012, USA
| | - E Folsom
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - E S Grace
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Hollinger
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - S A Jacobs
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Kailkhura
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D Kalantar
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A J Kemp
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Kim
- Center for Energy Research, University of California San Diego, La Jolla, California 92093, USA
| | - E Kur
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Liu
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Ludwig
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Morrison
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - R Nedbailo
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - N Ose
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Park
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J J Rocca
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - G G Scott
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R A Simpson
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - H Song
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - B Spears
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Sullivan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - K K Swanson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Thiagarajan
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S Wang
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - G J Williams
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - S C Wilks
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - M Wyatt
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Van Essen
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Zacharias
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G Zeraouli
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - J Zhang
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - T Ma
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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8
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Pellerano MB, Hill D, Jimenez ME, Gordon M, Macenat M, Ferrante JM, Rivera-Núñez Z, Devance D, Lima D, Sullivan B, Crabtree BF, Georgopoulos P, Barrett ES, Reed DJ, Pernell CT, Dawkins MR, Lynn B, Dixon F, Castañeda M, Garcia H, Blaser MJ, Panettieri RA, Hudson SV. Connect: Cultivating Academic-Community Partnerships to Address Our Communities' Complex Needs During Public Health Crises. Prog Community Health Partnersh 2023; 17:447-464. [PMID: 37934443 PMCID: PMC11041973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
BACKGROUND Black and Latino communities have been disproportionately impacted by coronavirus disease 2019 and we sought to understand perceptions and attitudes in four heavily impacted New Jersey counties to develop and evaluate engagement strategies to enhance access to testing. OBJECTIVE To establish a successful academic/community partnership team during a public health emergency by building upon longstanding relationships and using principles from community engaged research. METHODS We present a case study illustrating multiple levels of engagement, showing how we successfully aligned expectations, developed a commitment of cooperation, and implemented a research study, with community-based and health care organizations at the center of community engagement and recruitment. LESSONS LEARNED This paper describes successful approaches to relationship building including information sharing and feedback to foster reciprocity, diverse dissemination strategies to enhance engagement, and intergenerational interaction to ensure sustainability. CONCLUSIONS This model demonstrates how academic/community partnerships can work together during public health emergencies to develop sustainable relationships.
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Bala-Kerr R, Sullivan B, Martin S. The Five-4-Life Quality Improvement Program: Improving Frontline Nurses' Cardiopulmonary Resuscitation Leadership and Team Management Skills. J Nurs Care Qual 2023; 38:40-46. [PMID: 36084315 DOI: 10.1097/ncq.0000000000000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Poor leadership and teamwork in cardiopulmonary resuscitation (CPR) are associated with poor patient outcomes. PROBLEM Frontline nursing staff frequently identify patients in cardiac arrest but may not have the initial leadership and teamwork skills to organize their initial rescue response. APPROACH The Five-4-Life Quality Improvement (QI) program was pilot tested in a pediatric unit within a 510-bed acute care hospital in 2 phases: first, an educational program focused on leadership, team dynamics, and CPR skills, followed by sustaining interventions in the unit. Video recordings of 12 mock codes (4 pre-, 4 post-, 4 follow-up) were analyzed by trained observers. OUTCOMES Descriptive statistical tests indicated a significant improvement in leadership, teamwork, and task management scores pre- and post-program, and sustained after the program. CONCLUSION Implementing the Five-4-Life QI program is feasible in improving leadership, teamwork, and task management of first responding frontline nurses.
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Affiliation(s)
- Ruth Bala-Kerr
- Department of Nursing, Harbor-UCLA Medical Center, Torrance, California
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10
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Swanson KK, Mariscal DA, Djordjevic BZ, Zeraouli G, Scott GG, Hollinger R, Wang S, Song H, Sullivan B, Nedbailo R, Rocca JJ, Ma T. Applications of machine learning to a compact magnetic spectrometer for high repetition rate, laser-driven particle acceleration. Rev Sci Instrum 2022; 93:103547. [PMID: 36319355 DOI: 10.1063/5.0101857] [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: 06/03/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Accurately and rapidly diagnosing laser-plasma interactions is often difficult due to the time-intensive nature of the analysis and will only become more so with the rise of high repetition rate lasers and the desire to implement feedback on a commensurate timescale. Diagnostic analysis employing machine learning techniques can help address this problem while maintaining a high degree of accuracy. We report on the application of machine learning to the analysis of a scintillator-based electron spectrometer for experiments on high intensity, laser-plasma interactions at the Colorado State University Advanced Lasers and Extreme Photonics facility. Our approach utilizes a neural network trained on synthetic data and tested on experiments to extract the accelerated electron temperature. By leveraging transfer learning, we demonstrate an improvement in the neural network accuracy, decreasing the network error by 50%.
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Affiliation(s)
- K K Swanson
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - D A Mariscal
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Z Djordjevic
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G Zeraouli
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - G G Scott
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - R Hollinger
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - S Wang
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - H Song
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - B Sullivan
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - R Nedbailo
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - J J Rocca
- Colorado State University, Fort Collins, Colorado 80523, USA
| | - T Ma
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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11
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O'Malley DM, Davis SN, Amare R, Sanabria B, Sullivan B, Devine KA, Ferrante JM, Findley PA, Miller SM, Hudson SV. User-Centered Development and Patient Acceptability Testing of a Health-Coaching Intervention to Enhance Cancer Survivorship Follow-up in Primary Care. J Cancer Educ 2022; 37:788-797. [PMID: 33025453 PMCID: PMC8024404 DOI: 10.1007/s13187-020-01883-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/18/2020] [Indexed: 05/07/2023]
Abstract
We describe an iterative three-phase approach used to develop a cancer survivorship health-coaching intervention to guide self-management and follow-up care for post-treatment breast, colorectal, and prostate cancer survivors. Informed by theory (e.g., Cognitive-Social Health Information Processing Model (C-SHIP)), relevant literature, and clinical guidelines, we engaged in a user-centered design process. In phase I, we conducted depth interviews with survivors of breast (n = 34), prostate (n = 4), and colorectal (n = 6) cancers to develop a health coaching prototype. In phase II, we utilized user-testing interviews (n = 9) to test and refine the health coaching prototype. For both phases, we used a template analysis independently coding each interview. In phase I, majority (n = 34, 81%) of survivors were positive about the utility of health coaching. Among these survivors (n = 34), the top areas of identified need were emotional support (44%), general health information (35.3%), changes in diet and exercise (29.3%), accountability and motivation (23.5%), and information about treatment effects (17.7%). The prototype was developed and user-tested and refined in phase III to address the following concerns: (1) the amount of time for calls, (2) density of reading materials, (3) clarity about health coaches' role, (4) customization. Collectively, this resulted in the development of the Extended Cancer Educational for Long-Term Cancer Survivors health-coaching (EXCELSHC) program, which represents the first cancer survivorship follow-up program to support follow-up care designed-for-dissemination in primary care settings. EXCELSHC is being tested in a clinical efficacy trial. Future research will focus on program refinement and testing for effectiveness in primary care.
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Affiliation(s)
- Denalee M O'Malley
- Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA.
- Rutgers Biomedical and Health Sciences, New Brunswick, USA.
- Rutgers Cancer Institute of New Jersey, New Brunswick, USA.
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA.
| | - Stacy N Davis
- Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
- Rutgers Biomedical and Health Sciences, New Brunswick, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, USA
- Rutgers, School of Public Health, Department of Health Behavior, Society, and Policy, New Brunswick, USA
| | - Rahwana Amare
- Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
- Rutgers Biomedical and Health Sciences, New Brunswick, USA
| | - Bianca Sanabria
- Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
- Rutgers Biomedical and Health Sciences, New Brunswick, USA
| | - Brittany Sullivan
- Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
- Rutgers Biomedical and Health Sciences, New Brunswick, USA
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Katie A Devine
- Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, USA
| | - Jeanne M Ferrante
- Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
- Rutgers Biomedical and Health Sciences, New Brunswick, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, USA
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Patricia A Findley
- Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, USA
- Rutgers School of Social Work, New Brunswick, USA
| | | | - Shawna V Hudson
- Rutgers, The State University of New Jersey, New Brunswick, NJ, 08901, USA
- Rutgers Biomedical and Health Sciences, New Brunswick, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, USA
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
- Rutgers, School of Public Health, Department of Health Behavior, Society, and Policy, New Brunswick, USA
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12
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Friefeld A, Higgins M, Branch-Elliman W, Sturgeon D, Bart N, Hederstedt K, Foster M, Seren A, Lamkin R, Sullivan B, Mull H. Abstract No. 605 An algorithm to flag totally implantable venous access port infections for the administration of chemotherapy using unstructured and structured data in the Veterans Health Administration’s electronic medical record. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.587] [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: 10/18/2022] Open
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13
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Al-Khouja F, Nyam A, Sheehan B, Sullivan B, Kabutey NK, Stamos MJ, Pigazzi A, Jafari MD. Conflict of Interest Disclosure Among the Highest Earning Physicians Receiving Compensation From Vascular Device Companies. Am Surg 2022; 88:2538-2543. [PMID: 35607273 DOI: 10.1177/00031348221103650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To characterize the association between payments made by vascular device companies to clinicians, and the conflict of interest (COI) declarations on relevant publications. SUMMARY BACKGROUND DATA Close association between medical device companies and clinicians is essential in the advancement of surgical technology. When evaluating the efficacy of novel equipment, identification of these relationships can minimize the risk of bias in relevant studies. METHODS Using the Open Payments Database (OPD), the 10 highest compensated clinicians from 10 vascular device companies were identified. In the population based bibliometric analysis, general payments, number of payments, h-index, and academic rank were identified. PubMed and Scopus were queried to identify author publications. Relevance to payment received and COI disclosures were identified for each article. RESULTS The physicians identified earned $33,442,266.74 with a median of $92,500 in 2017. The authors published an average of 6.46+/-9.08 articles in 2018. Relevant COI was identified in 74%. In 50.5% of the relevant publications was a COI declared. The median h index of authors was 18+/-23. Community based physicians had a higher rate of COI disclosure (65.6%) compared to academic physicians (47.6%) (P = .008). Low h-index authors had a higher rate of COI declaration (71.4%) compared to high h-index (43.6%) (P = .001). CONCLUSION A high degree of inconsistency was found between self-declared COI and relevant articles published by the highest compensated physicians. We propose a policy of full disclosure and the addition of a link to each author's OPD page on all publications to increase access to potential COI.
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Affiliation(s)
- Fares Al-Khouja
- Department of Surgery, 8788University of California, Irvine, Orange, CA, USA
| | - Amanda Nyam
- Department of Surgery, 8788University of California, Irvine, Orange, CA, USA
| | - Brian Sheehan
- Department of Surgery, 8788University of California, Irvine, Orange, CA, USA
| | - Brittany Sullivan
- Department of Surgery, 8788University of California, Irvine, Orange, CA, USA
| | - Nii-Kabu Kabutey
- Department of Surgery, 8788University of California, Irvine, Orange, CA, USA
| | - Michael J Stamos
- Department of Surgery, 8788University of California, Irvine, Orange, CA, USA
| | - Alessio Pigazzi
- Department of Surgery, 12295Weill Cornell Medicine, New York, NY, USA
| | - Mehraneh D Jafari
- Department of Surgery, 12295Weill Cornell Medicine, New York, NY, USA
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14
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Fazl Alizadeh R, Li S, Sullivan B, Manasa M, Ruhi-Williams P, Nahmias J, Carmichael J, Nguyen NT, Stamos MJ. Surgical Outcome in Laparoscopic Abdominal Surgical Operations with Clostridium Difficile Infection. Am Surg 2022; 88:2519-2524. [DOI: 10.1177/00031348221103644] [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: 11/16/2022]
Abstract
Introduction: Postoperative Clostridium difficile infection (CDI) has associated morbidity, but it is unknown how it impacts different operations. We sought to determine the incidence and postoperative morbidity following abdominal surgery. Method: The National Surgical Quality Improvement Program database (2015-2019) was utilized to evaluate adult (≥18 years-old) patients who developed CDI following laparoscopic abdominal operations. Univariate and multivariate analysis were performed to evaluate outcomes. Results: A total of 973 338 patients were studied and the overall incidence of CDI was .3% within 30 days of operation. Colorectal surgery had the highest incidence of CDI (1601/167 949,1.0%) with significantly longer mean length of stay (LOS) (8.0 days± 9.0, P < .01) compared to other surgical procedures. CDI patients also had a longer mean length of stay (6.6± 8.0 vs 2.1 ± 3.6 days, P < .01) and increased mortality (1.8% vs .2%, AOR: 4.64, CI: 3.45-5.67, P < .01) compared to patients without CDI. Conclusions: This national analysis demonstrates that CDI is a significant complication following abdominal surgery and is associated with increased LOS and mortality. Furthermore, laparoscopic colorectal surgery appears to have the greatest risk of CDI. Future research is needed to determine the exact cause in order to decrease the incidence of CDI by reconsidering the protocol of antibiotic use within the high-risk population.
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Affiliation(s)
- Reza Fazl Alizadeh
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Shiri Li
- Department of Surgery, New York Presbyterian Hospital, Weill Cornell College of Medicine, New York, NY, USA
| | - Brittany Sullivan
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Morgan Manasa
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Perisa Ruhi-Williams
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Jeffery Nahmias
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Joseph Carmichael
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Ninh T. Nguyen
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
| | - Michael J. Stamos
- Department of Surgery, School of Medicine, University of California, Irvine, CA, USA
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15
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Rivera-Núñez Z, Jimenez ME, Crabtree BF, Hill D, Pellerano MB, Devance D, Macenat M, Lima D, Gordon M, Sullivan B, Rosati RJ, Ferrante JM, Barrett ES, Blaser MJ, Panettieri RA, Hudson SV. Experiences of Black and Latinx health care workers in support roles during the COVID-19 pandemic: A qualitative study. PLoS One 2022; 17:e0262606. [PMID: 35041702 PMCID: PMC8765643 DOI: 10.1371/journal.pone.0262606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
Black and Latinx individuals, and in particular women, comprise an essential health care workforce often serving in support roles such as nursing assistants and dietary service staff. Compared to physicians and nurses, they are underpaid and potentially undervalued, yet play a critical role in health systems. This study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic from the perspective of Black and Latinx health care workers in support roles (referred to here as HCWs). From December 2020 to February 2021, we conducted 2 group interviews (n = 9, 1 group in English and 1 group in Spanish language) and 8 individual interviews (1 in Spanish and 7 in English) with HCWs. Participants were members of a high-risk workforce as well as of communities that suffered disproportionately during the pandemic. Overall, they described disruptive changes in responsibilities and roles at work. These disruptions were intensified by the constant fear of contracting COVID-19 themselves and infecting their family members. HCWs with direct patient care responsibilities reported reduced opportunities for personal connection with patients. Perspectives on vaccines reportedly changed over time, and were influenced by peers' vaccination and information from trusted sources. The pandemic has exposed the stress endured by an essential workforce that plays a critical role in healthcare. As such, healthcare systems need to dedicate resources to improve the work conditions for this marginalized workforce including offering resources that support resilience. Overall working conditions and, wages must be largely improved to ensure their wellbeing and retain them in their roles to manage the next public health emergency. The role of HCWs serving as ambassadors to provide accurate information on COVID-19 and vaccination among their coworkers and communities also warrants further study.
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Affiliation(s)
- Zorimar Rivera-Núñez
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey, United States of America
| | - Manuel E. Jimenez
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Benjamin F. Crabtree
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Diane Hill
- University-Community Partnerships, Rutgers School of Public Affairs and Administration, Rutgers University, Newark, New Jersey, United States of America
| | - Maria B. Pellerano
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Donita Devance
- University-Community Partnerships, Rutgers University, Newark, New Jersey, United States of America
| | - Myneka Macenat
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Daniel Lima
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Marsha Gordon
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Brittany Sullivan
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Robert J. Rosati
- Connected Health Institute, VNA Health Group, Holmdel, New Jersey, United States of America
| | - Jeanne M. Ferrante
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, New Jersey, United States of America
| | - Martin J. Blaser
- Departments of Medicine and Pathology, Rutgers Robert Wood Johnson Medical School, Rutgers Center for Advance Biotechnology and Medicine, New Brunswick, New Jersey, United States of America
| | - Reynold A. Panettieri
- Rutgers Institute for Translational Medicine and Science, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
| | - Shawna V. Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America
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16
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Sullivan B, Ahmad SM, Slevin CC, Sinkin RA, Nagraj VP, Fairchild KD. Major cardiorespiratory events do not increase after immunizations, eye exams, and other stressors in most very low birth weight infants. J Neonatal Perinatal Med 2021; 15:275-282. [PMID: 34459417 DOI: 10.3233/npm-210744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Increased cardiorespiratory events with bradycardia and oxygen desaturation have been reported in very low birthweight (VLBW) infants following stressors such as immunizations. These events are difficult to quantify and may be mild. Our group developed an automated algorithm to analyze bedside monitor data from NICU patients for events with bradycardia and prolonged oxygen desaturation (BDs) and used this to compare BDs 24 hours before and after potentially stressful interventions. METHODS We included VLBW infants from 2012-2017 with data available around at least one of four interventions: two-month immunizations, retinopathy of prematurity (ROP) examinations, ROP therapy, and inguinal hernia surgery. We used a validated algorithm to analyze electrocardiogram heart rate and pulse oximeter saturation data (HR, SpO2) to quantify BD events of HR < 100 beats/minute for≥4 seconds with oxygen desaturation < 80%SpO2 for≥10 seconds. BDs were analyzed 24 hours before and after interventions using Wilcoxon rank-sum tests. RESULTS In 354 of 493 (72%) interventions, BD frequency stayed the same or decreased in the 24 hours after the event. An increase of at least five BD's occurred in 17/146 (12%) after immunizations, 85/290 (29%) after ROP examinations, 4/33 (12%) after ROP therapy, and 3/25 (12%) after hernia surgery. Infants with an increase in BDs after interventions had similar demographics compared to those without. More infants with an increase in BDs following immunizations were on CPAP or caffeine than those without. CONCLUSIONS Most VLBW infants in our cohort had no increase in significant cardiorespiratory events in the 24 hours following potentially stressful interventions.
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Affiliation(s)
- B Sullivan
- Department of Pediatrics, Division of Neonatology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - S M Ahmad
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - C C Slevin
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - R A Sinkin
- Department of Pediatrics, Division of Neonatology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - V P Nagraj
- Signature Science, LLC, Charlottesville, VA, USA
| | - K D Fairchild
- Department of Pediatrics, Division of Neonatology, University of Virginia School of Medicine, Charlottesville, VA, USA
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17
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Nguyen NT, Sullivan B, Sagebin F, Hohmann SF, Amin A, Nahmias J. Analysis of COVID-19 Patients With Acute Respiratory Distress Syndrome Managed With Extracorporeal Membrane Oxygenation at US Academic Centers. Ann Surg 2021; 274:40-44. [PMID: 33843791 PMCID: PMC8189255 DOI: 10.1097/sla.0000000000004870] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study analyzed the outcomes of COVID-19 patients with ARDS who were managed with extracorporeal membrane oxygenation (ECMO) across 155 US academic centers. SUMMARY BACKGROUND DATA ECMO has been utilized in COVID-19 patients with acute respiratory distress syndrome (ARDS) and refractory hypoxemia. Early case series with the use of ECMO in these patients reported high mortality exceeding 90%. METHODS Using ICD-10 codes, data of patients with COVID-19 with ARDS, managed with ECMO between April and September 2020, were analyzed using the Vizient clinical database. Outcomes measured included in-hospital mortality, hospital and ICU length of stay, and direct cost. For comparative purposes, the outcome of a subset of COVID-19 patients aged between 18 and 64 years and managed with versus without ECMO were examined. RESULTS 1,182 patients with COVID-19 and ARDS received ECMO. In-hospital mortality was 45.9%, mean length of stay was 36.8 ± 24.9 days, and mean ICU stay was 29.1 ± 17.3 days. In-hospital mortality according to age group was 25.2% for 1 to 30 years; 42.2% for 31 to 50 years; 53.2% for 51 to 64 years; and 73.7% for ≥65 years. A subset analysis of COVID-19 patients, aged 18 to 64 years with ARDS requiring mechanical ventilation and managed with (n = 1113) vs without (n = 16,343) ECMO, showed relatively high in-hospital mortality for both groups (44.6% with ECMO vs 37.9% without ECMO). CONCLUSIONS In this large US study of patients with COVID-19 and ARDS managed with ECMO, the in-hospital mortality is high but much lower than initial reports. Future research is needed to evaluate which patients with COVID-19 and ARDS would benefit from ECMO.
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Affiliation(s)
- Ninh T Nguyen
- Department of Surgery, University of California, Irvine Medical Center, Orange, CA
| | - Brittany Sullivan
- Department of Surgery, University of California, Irvine Medical Center, Orange, CA
| | - Fabio Sagebin
- Department of Surgery, University of California, Irvine Medical Center, Orange, CA
| | - Samuel F Hohmann
- Vizient, Centers for Advanced Analytics and Informatics, Chicago, IL
| | - Alpesh Amin
- Department of Medicine, University of California, Irvine Medical Center, Orange, CA
| | - Jeffry Nahmias
- Department of Surgery, University of California, Irvine Medical Center, Orange, CA
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18
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Yeates EO, Nahmias J, Chinn J, Sullivan B, Stopenski S, Amin AN, Nguyen NT. Improved outcomes over time for adult COVID-19 patients with acute respiratory distress syndrome or acute respiratory failure. PLoS One 2021; 16:e0253767. [PMID: 34170950 PMCID: PMC8232521 DOI: 10.1371/journal.pone.0253767] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background COVID-19’s pulmonary manifestations are broad, ranging from pneumonia with no supplemental oxygen requirements to acute respiratory distress syndrome (ARDS) with acute respiratory failure (ARF). In response, new oxygenation strategies and therapeutics have been developed, but their large-scale effects on outcomes in severe COVID-19 patients remain unknown. Therefore, we aimed to examine the trends in mortality, mechanical ventilation, and cost over the first six months of the pandemic for adult COVID-19 patients in the US who developed ARDS or ARF. Methods and findings The Vizient Clinical Data Base, a national database comprised of administrative, clinical, and financial data from academic medical centers, was queried for patients ≥ 18-years-old with COVID-19 and either ARDS or ARF admitted between 3/2020-8/2020. Demographics, mechanical ventilation, length of stay, total cost, mortality, and discharge status were collected. Mann-Kendall tests were used to assess for significant monotonic trends in total cost, mechanical ventilation, and mortality over time. Chi-square tests were used to compare mortality rates between March-May and June-August. 110,223 adult patients with COVID-19 ARDS or ARF were identified. Mean length of stay was 12.1±13.3 days and mean total cost was $35,991±32,496. Mechanical ventilation rates were 34.1% and in-hospital mortality was 22.5%. Mean cost trended downward over time (p = 0.02) from $55,275 (March) to $18,211 (August). Mechanical ventilation rates trended down (p<0.01) from 53.8% (March) to 20.3% (August). Overall mortality rates also decreased (p<0.01) from 28.4% (March) to 13.7% (August). Mortality rates in mechanically ventilated patients were similar over time (p = 0.45), but mortality in patients not requiring mechanical ventilation decreased from March-May compared to June-July (13.5% vs 4.6%, p<0.01). Conclusions This study describes the outcomes of a large cohort with COVID-19 ARDS or ARF and the subsequent decrease in cost, mechanical ventilation, and mortality over the first 6 months of the pandemic in the US.
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Affiliation(s)
- Eric O. Yeates
- Department of Surgery, University of California Irvine, Orange, California, United States of America
- * E-mail:
| | - Jeffry Nahmias
- Department of Surgery, University of California Irvine, Orange, California, United States of America
| | - Justine Chinn
- Department of Surgery, University of California Irvine, Orange, California, United States of America
| | - Brittany Sullivan
- Department of Surgery, University of California Irvine, Orange, California, United States of America
| | - Stephen Stopenski
- Department of Surgery, University of California Irvine, Orange, California, United States of America
| | - Alpesh N. Amin
- Department of Medicine, University of California Irvine, Orange, California, United States of America
| | - Ninh T. Nguyen
- Department of Surgery, University of California Irvine, Orange, California, United States of America
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19
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Farzaneh C, Schomberg J, Sullivan B, Yu PT, Loudon W, Duong WQ, Gibbs D, Guner YS. Analysis of Unintentional Falls in Pediatric Population and Predictors of Morbidity. J Surg Res 2021; 267:48-55. [PMID: 34130238 DOI: 10.1016/j.jss.2021.04.036] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Unintentional falls are a leading cause of pediatric traumatic injury. This study evaluates clinical outcomes of fall-related injuries in children under the age of 10. METHODS The National Trauma Database was queried for children who experienced an unintentional fall. Patients were stratified by age in two groups: 1-5 and 6-10 years old. The primary outcome was post discharge extension of care, defined as transfer to skilled nursing facility or rehabilitation center after discharge from the hospital. Descriptive statistics and a multivariable logistic regression analysis were used to compare the two groups. RESULTS From 2009 to 2016, a total of 8,277 pediatric patients experienced an unintentional fall, with 93.6% of patients being discharged home. Falls were more common in younger children, with greater odds of post discharge extension of care. Predictors of increased associated risk of extended medical care included intracranial hemorrhage (OR 1.05, 95% CI 1.03-1.06) and thoracic injuries (OR 1.03, 95% CI 1.00-1.1.05) (P< 0.05). Mortality in pediatric patients suffering unintentional falls was a rare event occurring in 0.7% of cases in children 1-5 years old and 0.4% of children 6-10 years old. CONCLUSION The majority of children experiencing an unintentional fall are discharged home, with mortality being very rare. However, younger age is prone to more severe and serious injury patterns. Intracranial hemorrhage and thoracic injury were a predictor of need for extended medical care.
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Affiliation(s)
- Cyrus Farzaneh
- Department of Surgery, Division of Trauma, Burns, and Surgical Critical Care, University of California Irvine, Orange, California.
| | - John Schomberg
- Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, California
| | - Brittany Sullivan
- Department of Surgery, Division of Trauma, Burns, and Surgical Critical Care, University of California Irvine, Orange, California
| | - Peter T Yu
- Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, California
| | - William Loudon
- Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, California
| | - William Q Duong
- Department of Surgery, Division of Trauma, Burns, and Surgical Critical Care, University of California Irvine, Orange, California
| | - David Gibbs
- Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, California
| | - Yigit S Guner
- Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, California
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Milanak M, Sullivan B. Utilizing a novel digital affect mirror, morphii, to assess affective determinants of health. Eur Psychiatry 2021. [PMCID: PMC9470465 DOI: 10.1192/j.eurpsy.2021.354] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Decades of research have shown that affect, emotions and moods, significantly impact all aspects of health behaviors. This research utilized a novel digital analogue technology (Morphii) to assess eight affective domains: stress, anxiety, loneliness, irritability, depression, pain, energy and overall feelings of wellness. Objectives To demonstrate the feasibility of use and strength of relationship/comparison to validated measures. Methods A U.S. census-based sample of adults ages 18-80 (n=985) completed online assessments including the 8 Morphii’s and additional comparative mental/behavioral health assessments (PSS-4, GAD-7, UCLA Loneliness Scale V3, BITe, PHQ-8 & PHQ-2, P4 Pain Scale, WHO-5, CFQ-11, ESS, and Vitality Subscale SF-36) via the Prolific Academic online platform and were compensated nominally for their participation. The resulting sample was 51.6% female and 74.2% White. Results Each Morphii was compared with the common corresponding industry assessment (e.g., Depression Morphii with PHQ) resulting in Pearson correlations ranging from -.519 to .761, with 6 of the 8 showing correlations above .700. Pearson correlations between dysfunction and each of the 8 Morphiis were significant at the p < .000 level, ranging from a low of .421 (Loneliness) to a high of .607 (Depression). Internal reliability was very good (Cronbach’s Alpha = .862). Respondents who expressed an assessment modality preference (55.2%) chose the Morphii type over traditional assessment format at a 2.5:1 ratio. Conclusions Morphii provides a reliable and valid assessment option with the ability to obtain a comprehensive (8 domains at once), efficient (less than 60 second administration), assessment with increased patient/client preference and engagement. Disclosure Milanak - submitting author - I serve on the advisory board for ADoH Scientific to consult on scientific research of Morphii development. To date, I have not been paid any money for this advisory role.
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Abuqayyas L, Cheng L, Mitragotri D, Smith S, Teixeira Dos Santos M, Zhou Y, Chindalore V, Cohen S, Kivitz A, Posch M, Sullivan B, Parnes J. FRI0084 SAFETY, PHARMACOKINETICS, PHARMACODYNAMICS, IMMUNOGENICITY, AND PRELIMINARY EFFICACY OF ROZIBAFUSP ALFA IN SUBJECTS WITH RHEUMATOID ARTHRITIS: INTERIM ANALYSIS OF A PHASE 1B RANDOMIZED, PLACEBO-CONTROLLED, MULTIPLE ASCENDING DOSE CLINICAL TRIAL. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4744] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Autoimmune diseases, including systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), are associated with autoantibody production and dysregulated T- and B-cell responses. Rozibafusp alfa (AMG 570) is a first-in-class bispecific antibody-peptide conjugate targeting T- and B-cell activity through inhibition of ICOSL and BAFF and is currently in phase 2 clinical development for the treatment of SLE.Objectives:This interim analysis of a phase 1b study (NCT03156023) reports the safety, pharmacokinetics (PK), pharmacodynamics (PD), immunogenicity, and preliminary efficacy of rozibafusp alfa in subjects with RA.Methods:Subjects (N~34; age 18–75 years) with active RA, defined as a disease activity score (DAS28-CRP) >2.6, were randomized 3:1 to receive rozibafusp alfa or placebo subcutaneously every 2 weeks for 10 weeks (6 doses), with 24 weeks of follow-up. Subjects were divided into 4 cohorts to study 4 ascending doses of rozibafusp alfa. All subjects were maintained on a stable dose of methotrexate. The primary endpoint was the subject incidence of treatment-emergent adverse events (TEAEs). Additional assessments included serum PK profiles, PD (eg, ICOSL receptor occupancy [RO], changes in peripheral blood B cells), incidence of anti-rozibafusp alfa antibodies, and Patient and Physician Global Assessments (PtGA and PhGA) of disease activity.Results:As of June 5, 2019, 34 subjects were enrolled and included in this interim analysis. Rozibafusp alfa was generally well tolerated. TEAEs occurred in 92.3% and 87.5% of subjects receiving rozibafusp alfa and placebo, respectively. Most of these events were of grade ≤2 severity. The most common TEAE was upper respiratory infection (23.1%) for subjects receiving rozibafusp alfa and nasopharyngitis (37.5%) for subjects receiving placebo. No treatment-related AEs were of grade ≥3 severity and occurred in >2 subjects. Rozibafusp alfa demonstrated a nonlinear PK profile with greater than a dose-proportional increase in concentration across evaluated doses. The terminal half-life of rozibafusp alfa ranged from 5 to 11 days, with longer half-lives at higher dose levels. ICOSL RO on circulating B-cells was dose-related and reversible; upon multiple dosing, >90% mean RO was observed in cohorts 3 and 4. Treatment with rozibafusp alfa reduced the percentage of naïve B-cells and increased the percentage of memory B-cells in all cohorts. As of March 22, 2019, 2 of 18 (11.1%) rozibafusp alfa-treated subjects developed anti-rozibafusp alfa antibodies with no correlation to safety or AEs. Preliminary analysis of disease-related activity showed a trend for greater numerical improvement from baseline in PtGA and PhGA with rozibafusp alfa vs. placebo in cohorts 3 and 4.Conclusion:This interim analysis is the first to report the safety and tolerability of multiple ascending doses of rozibafusp alfa in RA subjects, with preliminary efficacy findings observed in the highest dose cohorts. PK/PD analysis demonstrated nonlinear, target-mediated disposition consistent with cell surface target interaction and PD activity consistent with dual ICOSL/BAFF neutralization. These findings informed the design and dose selection of an ongoing phase 2, randomized, placebo-controlled study to assess the efficacy and safety of rozibafusp alfa in subjects with active SLE and inadequate responses to standard of care therapy.Acknowledgments:Amgen Inc. and AstraZeneca sponsored this phase 1b studyDisclosure of Interests:Lubna Abuqayyas Shareholder of: Stockholder of Amgen Inc., Employee of: Employee of Amgen Inc., Laurence Cheng Shareholder of: Stockholder of Amgen Inc., Employee of: Former employee of Amgen Inc., Deepali Mitragotri Shareholder of: Stockholder of Amgen Inc., Employee of: Employee of Amgen Inc., Shawna Smith Shareholder of: Stockholder of Amgen Inc., Employee of: Employee of Amgen Inc., Marcia Teixeira dos Santos Shareholder of: Stockholder of Amgen Inc., Employee of: Employee of Amgen Inc., Yanchen Zhou Shareholder of: Stockholder of Amgen Inc., Employee of: Employee of Amgen Inc., Vishala Chindalore Grant/research support from: Nektar Therapeutics for conducted studies, Speakers bureau: > 5 years ago, Stanley Cohen Grant/research support from: Grant and research support from Amgen, AbbVie, Pfizer, Genentech, and Lilly, Consultant of: Consultant for Amgen, AbbVie, Pfizer, Genentech and Lilly, Alan Kivitz Shareholder of: AbbVie, Amgen, Gilead, GSK, Pfizer Inc, Sanofi, Consultant of: AbbVie, Boehringer Ingelheim,,Flexion, Genzyme, Gilead, Janssen, Novartis, Pfizer Inc, Regeneron, Sanofi, SUN Pharma Advanced Research, UCB, Paid instructor for: Celgene, Genzyme, Horizon, Merck, Novartis, Pfizer, Regeneron, Sanofi, Speakers bureau: AbbVie, Celgene, Flexion, Genzyme, Horizon, Merck, Novartis, Pfizer Inc, Regeneron, Sanofi, Maximilian Posch: None declared, Barbara Sullivan Shareholder of: Shareholder of Amgen Inc., Employee of: Former employee of Amgen Inc. Current employee of Ultragenyx, Jane Parnes Shareholder of: Stockholder of Amgen Inc., Employee of: Employee of Amgen Inc.
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Juckes SM, Sullivan B, Kostylev I, Price RB, Labrie D. Three-dimensional beam profiling used to characterize dental light-curing units. Appl Opt 2019; 58:9540-9547. [PMID: 31873552 DOI: 10.1364/ao.58.009540] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/30/2019] [Indexed: 06/10/2023]
Abstract
Two-dimensional (2D) beam profiling is an emerging technique used to characterize the beam homogeneity in dental light-curing units (LCUs). This project developed a method to combine multiple 2D beam profiles that had been measured along the beam path to create a 3D profile of the beam. This allowed a quantitative investigation of beam divergence and homogeneity at different distances from the source. To illustrate the use of this technique, four representative dental LCUs were measured. In addition, the selected dental LCUs demonstrated the effects of LCU design, particularly that of fiber optic light guides, on beam quality. The results show the value of a program that can recombine multiple beam profile images made at different distances from the source to create a 3D beam profile of a light beam.
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O'Malley DM, Davis SN, Devine KA, Sullivan B, Bator A, Clemow L, Ferrante JM, Findley PA, Miller SM, Hudson SV. Development and usability testing of the e-EXCELS tool to guide cancer survivorship follow-up care. Psychooncology 2019; 29:123-131. [PMID: 31626397 DOI: 10.1002/pon.5222] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/21/2019] [Accepted: 08/31/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study is to describe a user-centered (e.g., cancer survivors and clinicians) development process of an eHealth tool designed to facilitate self-management of cancer survivorship follow-up care. METHODS Guided by Cognitive-Social Health Information Processing (C-SHIP) model and informed by core self-management skills, we engaged in a user-centered design process. In phase I, we conducted in-depth interviews with survivors of breast (n = 33), prostate (n = 4), and colorectal (n = 6) cancers, and (n = 9) primary care providers to develop content and design of the web tool. Phase II utilized iterative user testing interviews (n = 9) to test the web-based tool prototype. Data from both phases were independently coded using a template/content analytic approach. RESULTS The top 5 functions identified in phase I for the web-based platform included: (a) educational materials to learn and prepare for health encounters (80%); (b) questions for health providers (74%); (c) ability to track contact information of providers (67%); (d) provide general information (64%); and, (e) support information (62%). Users of the prototype reported patient burden, tool fatigue, introduction timing of the tool, relevance, and security/privacy as concerns in phase II. CONCLUSIONS This study demonstrates the value of using a theoretically informed and user-centered design process to develop relevant and patient-centered eHealth resources to support cancer survivorship. A larger study is needed to establish the efficacy of this eHealth tool as an intervention to improve adherence to follow-up care guidelines.
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Affiliation(s)
- Denalee M O'Malley
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Stacy N Davis
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,School of Public Health, Health Behavior, Society, and Policy, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Katie A Devine
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Brittany Sullivan
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Alicja Bator
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Lynn Clemow
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Jeanne M Ferrante
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Patricia A Findley
- Rutgers School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Suzanne M Miller
- Fox Chase Cancer Center/Temple Health, Philadelphia, Pennsylvania
| | - Shawna V Hudson
- Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,School of Public Health, Health Behavior, Society, and Policy, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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Jafarikia M, Sullivan B, McSween P, Maignel L, Sullivan B. 299 Validation of genomic evaluation on some economically important traits of Canadian purebred pigs. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.248] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Jafarikia
- Canadian Centre for Swine improvement Inc.,Ottawa, ON, Canada
| | - B Sullivan
- Canadian Centre for Swine improvement Inc.,Ottawa, ON, Canada
| | - P McSween
- Canadian Centre for Swine improvement Inc.,Ottawa, ON, Canada
| | - L Maignel
- Canadian Centre for Swine improvement Inc.,Ottawa, ON, Canada
| | - B Sullivan
- Canadian Centre for Swine improvement Inc.,Ottawa, ON, Canada
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Shimokawa C, Sullivan B, Turbino ML, Soares CJ, Price RB. Influence of Emission Spectrum and Irradiance on Light Curing of Resin-Based Composites. Oper Dent 2017; 42:537-547. [PMID: 28581917 DOI: 10.2341/16-349-l] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE This study examined the influence of different emission spectra (single-peak and broad-spectrum) light-curing units (LCUs) delivering the same radiant exposures at irradiance values of 1200 or 3600 mW/cm2 on the polymerization and light transmission of four resin-based composites (RBCs). METHODS AND MATERIALS Two prototype LCUs that used the same light tip, but were either a single-peak blue or a broad-spectrum LED, were used to deliver the same radiant exposures to the top surfaces of the RBCs using either standard (1200 mW/cm2) or high irradiance (3600 mW/cm2) settings. The emission spectrum and radiant power from the LCUs were measured with a laboratory-grade integrating sphere coupled to a spectrometer, and the light beam was assessed with a beam profiler camera. Four RBCs (Filtek Supreme Ultra A2, Tetric EvoCeram A2, Tetric EvoCeram T, and TPH Spectra High Viscosity A2) were photoactivated using four different light conditions: single-peak blue/standard irradiance, single-peak blue/high irradiance, broad-spectrum/standard irradiance, and broad-spectrum/high irradiance. The degree of conversion (N=5) and microhardness at the top and bottom of 2.3-mm-diameter by 2.5-mm-thick specimens (N=5) were analyzed with analysis of variance and Tukey tests. The real-time light transmission through the RBCs was also measured. RESULTS For all light conditions, the 2.3-mm-diameter specimens received a homogeneous irradiance and spectral distribution. Although similar radiant exposures were delivered to the top surfaces of the RBCs, the amount of light energy emitted from the bottom surfaces was different among the four RBCs, and was also greater for the single-peak lights. Very little violet light (wavelengths below 420 nm) reached the bottom of the 2.5-mm-thick specimens. The degree of conversion and microhardness results varied according to the RBC (p<0.05). The RBCs that included alternative photoinitiators had greater microhardness values at the top when cured with broad-spectrum lights, while at the bottom, where little violet light was observed, the results were equal or higher when they were photoactivated with single-peak blue lights. With the exception of the microhardness at the top of TPH, equivalent or higher microhardness and degree-of-conversion values were achieved at the bottom surface when the standard (1200 mW/cm2) irradiance levels were used compared to when high irradiance levels were used. CONCLUSIONS Considering the different behaviors of the tested RBCs, the emission spectrum and irradiance level influenced the polymerization of some RBCs. The RBCs that included alternative photoinitiators produced greater values at the top when cured with broad-spectrum lights, while at the bottom, results were equal or higher for the RBCs photoactivated with single-peak blue lights.
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Laing L, Burns D, MacNeil I, Rich B, Huang Y, Myhre S, Soltani S, Sullivan B. Abstract P6-07-14: New method to measure functional HER2-driven signaling activity in primary tumor cells identifies HER2-negative breast cancers with abnormal HER2 signaling activity: New group of patients may benefit from anti-HER2 therapy. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-07-14] [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: 11/16/2022]
Abstract
Abstract
Background: Clinical trials have indicated a weak correlation between HER2 expression levels and HER2 targeted therapy benefit. Other biological factors, such as HER2 signaling activity, may be important to measure, in addition to expression and amplification of HER2, when identifying patients eligible for HER2 therapies. To measure the HER2-driven signaling activity of a patient's tumor cells, a new assay using an impedance biosensor, the CELx HER2 Signaling Profile (CELx HSP) Test, was developed. This study set out to provide an initial assessment of the CELx HSP Test, specifically to: 1) quantify HER2-driven signaling activity (HER2S) in cell lines and primary epithelial cells; 2) assess the correlation between HER2 expression levels and HER2 signaling activity; 3) define a preliminary cut-point between normal and abnormal HER2 signaling; and 4) estimate the proportion of HER2- primary breast cancer tumors with abnormal HER2 signaling.
Methods: A training set of de-identified fresh breast tissue specimens was obtained from 50 patients, 34 with HER2- breast cancer (IHC 0 or 1+) and 16 healthy patients. Cell samples were comprised of epithelial cells extracted and cultured from each specimen. Reference human breast cancer cell lines (9 HER2+, 10 HER2-) were also tested, including two cell lines used as controls in IHC HER2 tests. Real time live cell response to specific HER2 agonists (NRG1b or EGF) and with or without an antagonist (pertuzumab, an FDA-approved HER2 dimerization inhibitor) was measured and quantified using an xCELLigence RTCA impedance biosensor (ACEA Biosciences, San Diego, CA). From these responses, the net amount of HER2 participation in HER2 signaling initiated by the HER2 agonists (“HER2S”) was determined. Fluorescence cytometry was used to measure HER2 expression levels of each cell sample.
Results: Of the HER2– breast tumor cell samples tested, 7 of 34 patients (20.5%; 95% CI=10%-37%) had net HER2 signaling activity that was greater than the median HER2S of the HER2+ cell lines. There was no categorical correlation between HER2 IHC status (+ or -) and HER2 signaling activity (abnormal or normal) (Pearson's Chi-Square = 3.68; Phi Max = -0.78, Contingency Coefficient 0.28). The median HER2S, or net HER2 signaling activity, was comparable for the HER2- tumor, HER2- cell line, and the healthy patient samples (Md = 100, 117, 77, respectively). The median HER2S in HER2+ cell lines (Md = 248) is approximately 2.5-3.0 fold greater than the median of the other groups. A HER2S above 250 was considered abnormal or test positive, and was defined as the cut-point. The HER2S for the two IHC HER2 test control cell lines, SKBR3 for HER2+ and MDA-MB231 for HER2-, was 544 and 0.
Conclusions: These findings provide strong evidence that measurement of HER2 signaling activity may provide clinically relevant information, particularly for HER2- breast cancer patients. These results suggest a new group of HER2- breast cancer patients with abnormal HER2-driven signaling may benefit from anti-HER2 therapy. Additional studies are underway to confirm these findings and to analytically validate the CELx HSP test.
Citation Format: Laing L, Burns D, MacNeil I, Rich B, Huang Y, Myhre S, Soltani S, Sullivan B. New method to measure functional HER2-driven signaling activity in primary tumor cells identifies HER2-negative breast cancers with abnormal HER2 signaling activity: New group of patients may benefit from anti-HER2 therapy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-07-14.
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Affiliation(s)
| | | | | | - B Rich
- Celcuity, Minneapolis, MN
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Laing L, Burns D, Huang Y, MacNeil I, Rich B, Myhre S, Soltani S, Sullivan B. Abstract P4-12-06: Quantification of HER2-driven signaling (HER2S) inhibition of four different anti-HER2 drugs tested ex vivo in live primary HER2-negative breast cancer cell samples with abnormal HER2 signaling activity. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-12-06] [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: 11/16/2022]
Abstract
Abstract
Background: A new functional cellular analysis platform, the CELx HER2 Signaling Profile (CELx HSP) Test, uses a label-free impedance biosensor to measure HER2 signaling activity in live tumor cells. A recently completed study quantified HER2-driven signaling activity in epithelial cell samples extracted and cultured from fresh breast tissue specimens obtained from 34 patients with HER2-negative breast cancer (DAKO 0 or 1+). Of the cell samples tested, 7 of 34 HER2-negative breast tumor patients (20.5%; 95% CI=10%-37%) were found to have abnormal HER2 signaling activity (HER2S+). The current study set out to: 1) evaluate the primary cells with abnormal HER2-driven signaling with four HER2 signal inhibitors - pertuzumab, lapatinib, neratinib, afatinib; and 2) evaluate the same four HER2 signal inhibitors with 9 HER2-positive cell lines. The objective was to quantify the percentage of HER2-driven signaling activity each drug could inhibit ex vivo in the primary cell samples and cell lines. Comparing the results between the HER2-negative primary cells and the HER2-positive cell lines was also of interest. The anti-HER2 drug, trastuzumab, was not studied because its primary mechanism of action does not appear to be direct mediation of HER2-driven signaling.
Methods: Epithelial cells from the 7 HER2-negative tumor specimens with abnormal HER2-driven signaling (HER2S+) and the 9 HER2-positive cell lines were obtained. Real time live cell response to NRG1, a specific HER2/HER3 agonist, with or without a HER2 targeted drug (pertuzumab, lapatinib, neratinib, afatinib) was measured and quantified using an xCELLigence RTCA impedance biosensor (ACEA Biosciences, San Diego, CA). Clinically relevant concentrations of the HER2 drugs were used. From these responses, the percentage inhibition of the HER2-driven signaling initiated by NRG1 by the HER2 drugs was determined.
Results: Each of the HER2 drugs inhibited an average of at least 69% of the HER2-driven signaling activated by NRG1 stimulation in the HER2-negative primary cell samples; the highest level of inhibition was found with the two irreversible covalent dual RTKi's, afatinib and neratinib. All of the HER2 drugs inhibited a greater percentage of HER2-driven signaling in the HER2-negative primary tumor cells than in the HER2-positive cell lines.
table 1 Avg. % NRG1 Inhibition Cell LinesPrimariesHER2 DrugsMechanism of Action(HER2+)(HER2-)PertuzumabHER2 dimerization inhibitor46%78%LapatinibReversible Dual RTKi (HER2, EGF)15%69%AfatinibIrreversible Covalent Dual RTKi (HER2, EGF)47%93%NeratinibIrreversible Covalent Dual RTKi (HER2, EGF)95%100%
Conclusions: These findings provide strong evidence that HER2 signal inhibitors are effective in blocking abnormal levels of HER2-driven signaling (HER2S+) ex vivo in live primary cells from breast cancer patients with normal expression levels of HER2. These results suggest a new group of breast cancer patients, HER2-negative with abnormal HER2 signaling (HER2-/HER2S+), may benefit from the addition of HER2 signal inhibitors to current combination therapeutic regimens. Additional studies to confirm these findings are underway.
Citation Format: Laing L, Burns D, Huang Y, MacNeil I, Rich B, Myhre S, Soltani S, Sullivan B. Quantification of HER2-driven signaling (HER2S) inhibition of four different anti-HER2 drugs tested ex vivo in live primary HER2-negative breast cancer cell samples with abnormal HER2 signaling activity [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-12-06.
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Affiliation(s)
| | | | | | | | - B Rich
- Celcuity, Minneapolis, MN
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Harlow JE, Rueggeberg FA, Labrie D, Sullivan B, Price RB. Transmission of violet and blue light through conventional (layered) and bulk cured resin-based composites. J Dent 2016; 53:44-50. [PMID: 27373167 DOI: 10.1016/j.jdent.2016.06.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/08/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES This study measured the transmission of light in the 'violet' (350≤λ≤425nm) and 'blue' (425<λ≤550nm) spectral ranges from a polywave(®) LED curing light through different thicknesses of four commercial, resin-based composites (RBCs). MATERIAL AND METHODS Samples of conventional layered RBCs (Tetric EvoCeram A2, Filtek Supreme Ultra A2B), and bulk-curing resins (Tetric EvoCeram Bulk Fill IVA, and SureFil SDR Flow U) were prepared. Three samples of each RBC were made at thicknesses of 0.1, 0.7, 1, 2, and 4-mm. The uncured RBC specimens were affixed at the entrance aperture of a 6-inch integrating sphere and light-cured once for 20s using a polywave(®) LED curing light (Bluephase G2) on its high power setting. The spectral radiant power transmitted through each RBC in the 'violet' and 'blue' regions was measured using a fiberoptic spectrometer. RESULTS As RBC thickness increased, an exponential attenuation of transmitted light was measured (R(2)>0.98). Attenuation was greater for the 'violet' than for the 'blue' spectral regions. At the light tip, the violet light component represented 15.4% of the light output. After passing through 4-mm of RBC, the violet light represented only between 1.2-3.1% of the transmitted light depending on the RBC. Depending on RBC, approximately 100mW from the Bluephase G2 was transmitted through 0.1-mm of RBC in the 'violet' range, falling at most to 11mW after passing through 2-mm of RBC, and to only 2mW at 4-mm depth. CONCLUSIONS Increasing RBC thickness results in an exponential decrease in light transmission. This attenuation is RBC-dependent with shorter wavelengths (violet) attenuated to a greater extent than longer wavelengths (blue). CLINICAL RELEVANCE Despite the increased translucency of bulk curing RBCs, spectral radiant power shorter than 425nm from a curing light is unlikely to be effective at a depth of 4-mm or more.
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Affiliation(s)
- J E Harlow
- Dental Clinical Sciences, Dalhousie University, P.O. BOX 15000, Halifax (NS), B3H 4R2, Canada.
| | - F A Rueggeberg
- Department of Oral Rehabilitation, Section of Dental Materials, Dental College of Georgia, Augusta University, Augusta, GA, United States.
| | - D Labrie
- Department of Physics and Atmospheric Science, Dalhousie University, P.O. BOX 15000, Halifax (NS), B3H 4R2, Canada.
| | - B Sullivan
- Dental Clinical Sciences, Dalhousie University, P.O. BOX 15000, Halifax (NS), B3H 4R2, Canada.
| | - R B Price
- Dental Clinical Sciences, Dalhousie University, P.O. BOX 15000, Halifax (NS), B3H 4R2, Canada.
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Harlow JE, Sullivan B, Shortall AC, Labrie D, Price RB. Characterizing the output settings of dental curing lights. J Dent 2015; 44:20-6. [PMID: 26546716 DOI: 10.1016/j.jdent.2015.10.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 10/23/2015] [Accepted: 10/31/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES For improved inter-study reproducibility and ultimately improved patient care, researchers and dentists need to know what electromagnetic radiation (light) is emitted from the light-curing unit (LCU) they are using and what is received by the resin. This information cannot be obtained from a dental radiometer, even though many studies have used a dental radiometer. METHODS The light outputs from six LCUs (two QTH and four broad-spectrum LED units) were collected in real-time using an integrating sphere connected to a fiberoptic spectrometer during different light exposures. RESULTS It was found that the spectral emissions were unique to each LCU, and there was no standardization in what was emitted on the various ramp (soft-start) settings. Relative to the normal use setting, using the ramp setting reduced the radiant energy (J) delivered from each LCU. For one of the four broad-spectrum LED LCUs, the spectral emissions in the violet range did not increase when the overall radiant power output was increased. In addition, this broad-spectrum LED LCU emitted no light from the violet LED chip for the first 5s and only emitted violet light when the ramp phase finished. CONCLUSIONS A single irradiance value derived from a dental radiometer or from a laboratory grade power meter cannot adequately describe the output from the LCU. Manufacturers should provide more information about the light output from their LCUs. Ideally, future assessments and research publications that include resin photopolymerization should report the spectral radiant power delivered from the LCU throughout the entire exposure cycle.
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Affiliation(s)
- J E Harlow
- Dental Clinical Sciences, Dalhousie University, P.O. BOX 15000, Halifax, NS, B3H 4R2, Canada.
| | - B Sullivan
- Dental Clinical Sciences, Dalhousie University, P.O. BOX 15000, Halifax, NS, B3H 4R2, Canada.
| | - A C Shortall
- University of Birmingham, School of Dentistry, St. Chad's Queensway, Birmingham, West Midlands, England, UK.
| | - D Labrie
- Department of Physics and Atmospheric Science, Dalhousie University, P.O. BOX 15000, Halifax, NS, B3H 4R2, Canada.
| | - R B Price
- Dental Clinical Sciences, Dalhousie University, P.O. BOX 15000, Halifax, NS, B3H 4R2, Canada.
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AlQahtani MQ, Michaud PL, Sullivan B, Labrie D, AlShaafi MM, Price RB. Effect of High Irradiance on Depth of Cure of a Conventional and a Bulk Fill Resin-based Composite. Oper Dent 2015; 40:662-72. [PMID: 26237638 DOI: 10.2341/14-244-l] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study evaluated the effect of using three commercial light curing units (LCUs) delivering a range of irradiance values, but delivering similar radiant exposures on the depth of cure of two different resin-based composites (RBCs). METHODS A conventional hybrid RBC (Z100 shade A2, 3M ESPE) or a bulk fill RBC (Tetric EvoCeram Bulk Fill shade IVA, Ivoclar Vivadent) was packed into a 10-mm deep semicircular metal mold with a 2-mm internal radius. The RBC was exposed to light from a plasma-arc-curing (PAC) light (Sapphire Plus, DenMat) for five seconds, a quartz-tungsten-halogen (QTH) light (Optilux 501, Kerr) for 40 seconds, or a light-emitting-diode (LED) light (S10, 3M ESPE) for 20 seconds and 40 seconds (control). The Knoop microhardness was then measured as soon as possible at the top surface and at three points every 0.5 mm down from the surface. For each RBC, a repeated measures analysis of variance (ANOVA) model was used to predict the Knoop hardness in a manner analogous to a standard regression model. This predicted value was used to determine at what depth the RBC reached 80% of the mean hardness achieved at the top surface with any light. RESULTS The PAC light delivered an irradiance and radiant exposure of 7328 mW/cm(2) and 36.6 J/cm(2), respectively, to the RBCs; the QTH light delivered 936 mW/cm(2) and 37.4 J/cm(2) and in 20 seconds the LED light delivered 1825 mW/cm(2) and 36.5 J/cm(2). In 40 seconds, the control LED light delivered a radiant exposure of 73.0 J/cm(2). For Z100, using 80% of the maximum hardness at the top surface as the criteria for adequate curing, all light exposure conditions achieved the 2.0-mm depth of cure claimed by the manufacturer. The LED light used for 40 seconds achieved the greatest depth of cure (5.0 mm), and the PAC light used for five seconds, the least (2.5 mm). Tetric EvoCeram Bulk Fill achieved a 3.5-mm depth of cure when the broad-spectrum QTH light was used for 40 seconds delivering 37.4 J/cm(2). It required a 40-second exposure time with the narrow-spectrum LED, delivering approximately 73 J/cm(2) to reach a depth of cure of 4 mm. CONCLUSIONS When delivering a similar radiant exposure of 37 J/cm(2), the QTH (40 seconds) and LED (20 seconds) units achieved a greater depth of cure than the PAC (five seconds) light. For both resins, the greatest depth of cure was achieved when the LED light was used for 40 seconds delivering 73 J/cm(2) (p<0.05).
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Paik J, Kwok F, Seamons A, Brabb T, Kim J, Sullivan B, Hsu C, O'Brien KD, Maggio-Price L. Effects of murine norovirus on atherosclerosis in ldlr(-/-) mice depends on the timing of infection. Comp Med 2015; 65:114-122. [PMID: 25926396 PMCID: PMC4408896] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/15/2014] [Accepted: 12/23/2014] [Indexed: 06/04/2023]
Abstract
We previously reported that murine norovirus (MNV), a virus prevalent in United States research institutions, increased atherosclerotic lesion size in Ldlr(-/-) mice when the mice were infected 8 wk after feeding an atherogenic diet. To determine whether the timing of MNV infection relative to atherosclerosis development altered the disease phenotype and to examine potential mechanisms by which MNV influences the disease process, we fed Ldlr(-/-) mice an atherogenic diet for 16 wk. Three days after initiating the atherogenic diet, half of the mice received MNV4 and the other half vehicle only (clarified cell-culture lysate; controls). Both groups of mice developed large aortic sinus lesions (control compared with MNV4: 133 ± 8 × 10³ μm² compared with 140 ± 7 × 10³ μm²) that were not significantly different in size. Because the timing of MNV infection relative to atherosclerosis development and hypercholesterolemia differed between our previous and the current studies, we examined whether hypercholesterolemia altered MNV4-induced changes in bone-marrow-derived macrophages. MNV4 infection increased the potential of macrophages to take up and store cholesterol by increasing CD36 expression while suppressing the ABCA1 transporter. Thus, the effects of MNV4 infection on atherosclerotic lesion size appear to be dependent on the timing of the infection: MNV4 infection promotes only established lesions. This effect may be due to MNV4's ability to increase cholesterol uptake and decrease efflux by regulating CD36 and ABCA1 protein expression.
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Affiliation(s)
- Jisun Paik
- The Department of Comparative Medicine, University of Washington, Seattle, Washington, USA.
| | - Fiona Kwok
- The Department of Comparative Medicine, University of Washington, Seattle, Washington, USA
| | - Audrey Seamons
- The Department of Comparative Medicine, University of Washington, Seattle, Washington, USA
| | - Thea Brabb
- The Department of Comparative Medicine, University of Washington, Seattle, Washington, USA
| | - Jinkyu Kim
- The Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Brittany Sullivan
- The Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Charlie Hsu
- The Department of Comparative Medicine, University of Washington, Seattle, Washington, USA
| | - Kevin D O'Brien
- The Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Lillian Maggio-Price
- The Department of Comparative Medicine, University of Washington, Seattle, Washington, USA
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Sullivan B, Bhatt A, Huang F, Atun R, Maruthappu M, Fitchett J, Head M. US and UK investments in global oncology research: A systematic
analysis. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.991] [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] Open
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Childress H, Sullivan B, Kaur J, Karthikeyan R. Effects of ultraviolet light disinfection on tetracycline-resistant bacteria in wastewater effluents. J Water Health 2014; 12:404-9. [PMID: 25252343 DOI: 10.2166/wh.2013.257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The ubiquitous use of antibiotics has led to an increasing number of antibiotic-resistant bacterial strains, including strains that are multidrug-resistant, pathogenic, or both. There is also evidence to suggest that antibiotic resistance genes (ARGs) spread to the environment, humans, and animals through wastewater effluents. The overall objective of this study was to investigate the effect of ultraviolet (UV) light disinfection on antibiotic-resistant bacteria. Wastewater effluent samples from a wastewater treatment plant (WWTP) in Texas were evaluated for differences in tetracycline-resistant bacteria before and after UV treatment. The effects of photoreactivation or dark repair on the reactivation of bacteria present in WWTP effluent after UV disinfection were also examined. Culture-based methods were used to characterize viable heterotrophic, tetracycline-resistant heterotrophic, Escherichia coli, and tetracycline-resistant E. coli bacteria present before and after UV treatment. UV disinfection was found to be as effective at reducing concentrations of resistant heterotrophs and E. coli, as it was at reducing total bacterial concentrations. The lowest survival ratio following UV disinfection was observed in tetracycline-resistant E. coli showing particular susceptibility to UV treatment. Photoreactivation and dark repair rates were found to be comparable to each other for all bacterial populations.
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Affiliation(s)
- H Childress
- Department of Biological and Agricultural Engineering, Texas A&M University, 2117 TAMU, College Station, TX 77843-2117, USA E-mail:
| | - B Sullivan
- Department of Biological and Agricultural Engineering, Texas A&M University, 2117 TAMU, College Station, TX 77843-2117, USA E-mail:
| | - J Kaur
- Department of Biological and Agricultural Engineering, Texas A&M University, 2117 TAMU, College Station, TX 77843-2117, USA E-mail:
| | - R Karthikeyan
- Department of Biological and Agricultural Engineering, Texas A&M University, 2117 TAMU, College Station, TX 77843-2117, USA E-mail:
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Sullivan B, Ghahghaei S, Walker L. Statistics of Eye Movements in Natural Tasks. J Vis 2014. [DOI: 10.1167/14.10.764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Johnson L, Sullivan B, Hayhoe M, Ballard D. A modular soft barrier model combines uncertainty and reward to predict human eye movements in a two-task driving environment. J Vis 2013. [DOI: 10.1167/13.9.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Willcox S, Butt P, Hakaraia-Tino T, Sullivan B, Hudson R. WAI wise: a fun, practical and effective water safety experience for young adults. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040590h.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mulcahy N, Sullivan B. EVIDENCE-BASED DROWNING AND INJURY PREVENTION: COASTAL PUBLIC SAFETY AT HOT WATER BEACH AND PAKIRI BEACH. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040580g.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Katz L, Kit D, Sullivan B, Snyder K, Hayhoe M. Searching for objects in a virtual apartment: the effect of experience on scene memory. J Vis 2012. [DOI: 10.1167/12.9.264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sullivan B, Johnson L, Rothkopf C, Ballard D, Hayhoe M. The effect of uncertainty and reward on fixation behavior in a driving task. J Vis 2012. [DOI: 10.1167/12.9.1259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Smith J, Romero J, Dahn T, Dunphy K, Sullivan B, Mallay M, Croll L, Reynolds J, Andress C, Dahn J. The effect of heating temperature and nitric acid treatments on the performance of Cu- and Zn-based broad spectrum respirator carbons. J Colloid Interface Sci 2011; 364:178-94. [DOI: 10.1016/j.jcis.2011.08.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 06/23/2011] [Accepted: 08/11/2011] [Indexed: 11/29/2022]
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Yoon J, Subramanian S, Ding Y, Wang S, Goodspeed L, Sullivan B, Kim J, O'Brien KD, Chait A. Chronic insulin therapy reduces adipose tissue macrophage content in LDL-receptor-deficient mice. Diabetologia 2011; 54:1252-60. [PMID: 21327868 PMCID: PMC3246423 DOI: 10.1007/s00125-011-2055-2] [Citation(s) in RCA: 7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 12/31/2010] [Indexed: 01/09/2023]
Abstract
AIMS/HYPOTHESIS Insulin has anti-inflammatory effects in short-term experiments. However, the effects of chronic insulin administration on inflammation are unknown. We hypothesised that chronic insulin administration would beneficially alter adipose tissue inflammation and several circulating inflammatory markers. METHODS We administered two forms of long-acting insulin, insulin glargine (A21Gly,B31Arg,B32Arg human insulin) and insulin detemir (B29Lys[ε-tetradecanoyl],desB30 human insulin), to LDL-receptor-deficient mice. After 8 weeks on a diet that causes obesity, hyperglycaemia, adipose tissue macrophage accumulation and atherosclerosis, the mice received subcutaneous glargine, detemir or NaCl (control) for 12 weeks. Serum amyloid A (SAA) and serum amyloid P (SAP), metabolic variables, adipose tissue macrophages and aortic atherosclerosis were evaluated. RESULTS Weight gain was equivalent in all groups. The glycated haemoglobin level fell equivalently in both insulin-treated groups. Plasma cholesterol and triacylglycerol levels, and hepatic triacylglycerol level significantly improved in the glargine compared with the detemir or control groups. Levels of mRNA expression for monocyte chemotactic protein-1 and F4/80, a macrophage marker, in adipose tissue were decreased only in the glargine group (p < 0.05). Visceral adipose tissue macrophage content decreased in both insulin groups (p < 0.05), whereas atherosclerosis decreased only in the glargine group. Circulating SAA and SAP did not decrease in either insulin-treated group, but IL-6 levels fell in the glargine-treated mice. CONCLUSIONS/INTERPRETATION While chronic insulin administration did not decrease SAA and SAP, administration of glargine but not detemir insulin improved dyslipidaemia, IL-6 levels and atherosclerosis, and both insulins reduced macrophage accumulation in visceral adipose tissue. Thus, chronic insulin therapy has beneficial tissue effects independent of circulating inflammatory markers in this murine model of diet-induced obesity and diabetes.
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Affiliation(s)
- J Yoon
- Diabetes Obesity Center for Excellence, Division of Metabolism, Endocrinology and Nutrition, University of Washington, 815 Mercer Street, Box 358055, Seattle, WA 98109, USA
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Kit D, Sullivan B, Snyder K. A computational model for change detection in familiar environments. J Vis 2010. [DOI: 10.1167/10.7.743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sullivan B, Rothkopf C, Hayhoe M, Ballard D. Modeling gaze priorities in driving. J Vis 2010. [DOI: 10.1167/10.7.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Jasper M, Care A, Sullivan B, Ingman W, Aplin J, Robertson S. Uterine epithelial cell fucosylated structures are regulated by macrophages during early pregnancy in mouse. J Reprod Immunol 2010. [DOI: 10.1016/j.jri.2010.06.071] [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: 10/19/2022]
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Sullivan B, Wenger M, Von Der Heide R, Bittner J. The crowding effect and perceptual and decisional holism in the visual processing of faces. J Vis 2010. [DOI: 10.1167/8.6.888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Bittner J, Wenger M, Von Der Heide R, Sullivan B. Common elements of perceptual organization: Illusory contours and dimensional consistency. J Vis 2010. [DOI: 10.1167/8.6.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sullivan B, Hayhoe M. The influence of prior experience and task-demands on visual search for a pop-out target. J Vis 2010. [DOI: 10.1167/9.8.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Snyder K, Sullivan B, Revia R, Hayhoe M. The effect of experience on visual capture in a virtual environment. J Vis 2010. [DOI: 10.1167/9.8.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Jovancevic J, Sullivan B, Hayhoe M. Avoiding collisions in real and virtual environments. J Vis 2010. [DOI: 10.1167/8.6.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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