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Rambousek V, Friedrich L, Lang D, Horner A, Kaiser B, Lamprecht B. EP08.01-108 Real-Life Costs and Benefit of First-Line Pembrolizumab for Advanced NSCLC - A Propensity-Score Matched Case-Control Study. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.680] [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: 10/14/2022]
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Rouhani S, Peñataro Yori P, Paredes Olortegui M, Lima AA, Ahmed T, Mduma ER, George A, Samie A, Svensen E, Lima I, Mondal D, Mason CJ, Kalam A, Guerrant RL, Lang D, Zaidi A, Kang G, Houpt E, Kosek MN. The Epidemiology of Sapovirus in the Etiology, Risk Factors, and Interactions of Enteric Infection and Malnutrition and the Consequences for Child Health and Development (MAL-ED) Study: Evidence of Protection Following Natural Infection. Clin Infect Dis 2022; 75:1334-1341. [PMID: 36094137 PMCID: PMC9555839 DOI: 10.1093/cid/ciac165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sapovirus is one of the principal agents of acute viral enteritis in children. Because it has not been routinely included in diagnostic evaluations, the epidemiology and natural history remain poorly described. METHODS A birth cohort of 1715 children from 8 countries contributed surveillance samples (n = 35 620) and diarrheal specimens (n = 6868) from 0 to 24 months of age. Sapovirus was detected by quantitative polymerase chain reaction concurrently to other enteropathogens using multiarray cards. Logistic regression was used to identify risk factors, and longitudinal models were employed to estimate incidence rates and evaluate evidence of protective immunity. RESULTS Sapovirus was detected in 24.7% (n = 1665) of diarrheal stools and 12.8% (n = 4429) of monthly surveillance samples. More than 90% of children were infected and 60% experienced sapovirus diarrhea in the first 2 years of life. Breastfeeding and higher socioeconomic status were associated with reduced incidence of infection and illness. Specimens with sapovirus detected had an increased odds of coinfection with rotavirus (odds ratio [OR], 1.6 [95% confidence interval {CI}, 1.3-2.0]), astrovirus (OR, 1.5 [95% CI, 1.3-1.7]), adenovirus (OR, 1.3 [95% CI, 1.1-1.5]), and Shigella (OR, 1.4 [95% CI, 1.3-1.6]). Prior infection with sapovirus conferred a risk reduction of 22% for subsequent infection (hazard ratio [HR], 0.78 [95% CI, .74-.85]) and 24% for subsequent diarrhea (95% CI, 11.0%-35.0%; HR, 0.76). CONCLUSIONS Sapovirus is a common cause of early childhood diarrhea. Further research on coinfections is warranted. Evidence of acquired immunity was observed even in the absence of genotype-specific analysis for this pathogen of known genetic diversity.
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Affiliation(s)
- Saba Rouhani
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA.,Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Pablo Peñataro Yori
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | | | - Aldo A Lima
- Federal University of Ceará, Fortaleza, Brazil
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | | | | | | | - Ila Lima
- Federal University of Ceará, Fortaleza, Brazil
| | - Dinesh Mondal
- Nutrition Infection Interaction Research Group, Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Carl J Mason
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Richard L Guerrant
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | - Dennis Lang
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USAand
| | - Anita Zaidi
- Enteric and Diarrheal Diseases Programme, Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | | | - Eric Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | - Margaret N Kosek
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
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Mirza M, Escudero Siosi A, Lang D, Paddon K, Shine B, Soni A, Luqmani R. POS1549-HPR IMPROVING EFFICACY AND SAFETY OF BLOOD MONITORING IN RHEUMATOLOGY PATIENTS ON DISEASE MODIFYING ANTI-RHEUMATIC DRUGS (DMARDs) USING A NEW AUTOMATED ALGORITHM. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2471] [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: 11/04/2022]
Abstract
BackgroundMost patients in Rheumatology require early management with DMARDs to control their disease. In our department, around two hundred patients start a DMARD therapy every month and monitoring their blood test results whilst on DMARDs play an essential role to detect toxicity and the need for further action. This process has been done manually, which has been prone to error. Over the past six months, a minimum of three patients have had abnormalities which were missed, consequently identifying the need to improve the quality of the blood monitoring.ObjectivesThe aim of the project was to develop, test and implement an automated algorithm to review multiple blood test results and highlight any changes, trends or abnormalities in patients starting DMARD therapy efficiently.MethodsWe designed a system to automatically review blood tests from patients newly started on DMARD therapy, following the recommended British Society for Rheumatology (BSR) schedule for blood monitoring. Results are processed in our local laboratory, subsequently uploaded to our unique database and analysed automatically using an algorithm against BSR guided threshold values for each blood test. According to the value, each blood result is identified as normal, mildly abnormal, missing, trending, or abnormal. A trained clinician or pharmacist will review the data and endorse the results after taking any appropriate action. Based on the results, if any actions are needed, patients are contacted either by phone or via a letter automatically generated by this software, recommending them to have a repeat test or temporarily stop the medication as required.ResultsThe system was tested on two cohorts, comprised of 100 and 227 blood tests. It was faster and more efficient than the manual alternative. Following this test, each record was compared manually, based on the data stored on a spreadsheet.This new system led to the identification of more abnormalities versus the manual inspection (29% vs 10%, Chi square P<0.001). Additionally, it took less than a minute compared to the manual method, which took three hours to complete. Follow up manual inspection confirmed that the new system had correctly identified every abnormality, based on test records.To date, we have analysed 3568 blood results using this technique. 1564 (44%) results have been normal and endorsed within seconds. 374 (10%) were mildly abnormal, 17 (0.5%) results have been abnormal requiring action and 311 (9%) were abnormal requiring no action. 265 (7%) results showed a trend within the blood results. Trending results were defined as being out of range and worsening on two consecutive occasions but not reaching the limits for stoppig a drug. 1032 (29%) results contained missing results, a consequence of the different timings of results uploaded by various laboratory sections.ConclusionWe have developed an efficient and safe blood monitoring system for Rheumatology patients starting on a DMARD, proven to be more accurate compared to previous manual alternatives and able to process up to 10,000 results at a time.Disclosure of InterestsNone declared
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Willen B, Krauss D, Nandalur S, Ye H, Marvin K, Lang D. High Dose Rate Brachytherapy as Monotherapy vs. External Beam With HDR Boost in Unfavorable Intermediate Risk Localized Prostate Cancer: A Matched-Pair Analysis. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Napiwocki B, Stempien A, Lang D, Kruepke R, Kim G, Zhang J, Eckhardt L, Glukhov A, Kamp T, Crone W. Micropattern platform promotes extracellular matrix remodeling by human PSC-derived cardiac fibroblasts and enhances contractility of co-cultured cardiomyocytes. Physiol Rep 2021; 9:e15045. [PMID: 34617673 PMCID: PMC8496154 DOI: 10.14814/phy2.15045] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 08/20/2021] [Accepted: 08/31/2021] [Indexed: 02/02/2023] Open
Abstract
In native heart tissue, cardiac fibroblasts provide the structural framework of extracellular matrix (ECM) while also influencing the electrical and mechanical properties of cardiomyocytes. Recent advances in the field of stem cell differentiation have led to the availability of human pluripotent stem cell-derived cardiac fibroblasts (iPSC-CFs) in addition to cardiomyocytes (iPSC-CMs). Here we use a novel 2D in vitro micropatterned platform that provides control over ECM geometry and substrate stiffness. When cultured alone on soft micropatterned substrates, iPSC-CFs are confined to the micropatterned features and remodel the ECM into anisotropic fibers. Similar remodeling and ECM production occurs when cultured with iPSC-CMs in a co-culture model. In addition to modifications in the ECM, our results show that iPSC-CFs influence iPSC-CM function with accelerated Ca2+ transient rise-up time and greater contractile strains in the co-culture conditions compared to when iPSC-CMs are cultured alone. These combined observations highlight the important role cardiac fibroblasts play in vivo and the need for co-culture models like the one presented here to provide more representative in vitro cardiac constructs.
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Affiliation(s)
- B.N. Napiwocki
- Department of Biomedical EngineeringUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Wisconsin Institute for DiscoveryUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - A. Stempien
- Department of Biomedical EngineeringUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Wisconsin Institute for DiscoveryUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - D. Lang
- Department of MedicineDivision of Cardiovascular MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - R.A. Kruepke
- Engineering Mechanics ProgramUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - G. Kim
- Department of MedicineDivision of Cardiovascular MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - J. Zhang
- Department of MedicineDivision of Cardiovascular MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - L.L. Eckhardt
- Department of MedicineDivision of Cardiovascular MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - A.V. Glukhov
- Department of MedicineDivision of Cardiovascular MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - T.J. Kamp
- Department of MedicineDivision of Cardiovascular MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of Cell and Regenerative BiologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - W.C. Crone
- Department of Biomedical EngineeringUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Wisconsin Institute for DiscoveryUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Engineering Mechanics ProgramUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of Engineering PhysicsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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Lang D, Peeken J, Spraker M, Nyflot M, Combs S, Wilkens J, Bartzsch S. PO-1579: Deep learning based gross tumor volume definition on planning CTs of soft tissue sarcoma. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01597-8] [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: 11/16/2022]
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7
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Napiwocki BN, Lang D, Stempien A, Zhang J, Vaidyanathan R, Makielski JC, Eckhardt LL, Glukhov AV, Kamp TJ, Crone WC. Aligned human cardiac syncytium for in vitro analysis of electrical, structural, and mechanical readouts. Biotechnol Bioeng 2020; 118:442-452. [PMID: 32990953 DOI: 10.1002/bit.27582] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/30/2020] [Accepted: 09/11/2020] [Indexed: 11/06/2022]
Abstract
Human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) have emerged as an exciting new tool for cardiac research and can serve as a preclinical platform for drug development and disease modeling studies. However, these aspirations are limited by current culture methods in which hPSC-CMs resemble fetal human cardiomyocytes in terms of structure and function. Herein we provide a novel in vitro platform that includes patterned extracellular matrix with physiological substrate stiffness and is amenable to both mechanical and electrical analysis. Micropatterned lanes promote the cellular and myofibril alignment of hPSC-CMs while the addition of micropatterned bridges enable formation of a functional cardiac syncytium that beats synchronously over a large two-dimensional area. We investigated the electrophysiological properties of the patterned cardiac constructs and showed they have anisotropic electrical impulse propagation, as occurs in the native myocardium, with speeds 2x faster in the primary direction of the pattern as compared to the transverse direction. Lastly, we interrogated the mechanical function of the pattern constructs and demonstrated the utility of this platform in recording the strength of cardiomyocyte contractions. This biomimetic platform with electrical and mechanical readout capabilities will enable the study of cardiac disease and the influence of pharmaceuticals and toxins on cardiomyocyte function. The platform also holds potential for high throughput evaluation of drug safety and efficacy, thus furthering our understanding of cardiovascular disease and increasing the translational use of hPSC-CMs.
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Affiliation(s)
- B N Napiwocki
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - D Lang
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - A Stempien
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - J Zhang
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - R Vaidyanathan
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - J C Makielski
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - L L Eckhardt
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - A V Glukhov
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - T J Kamp
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Cell and Regenerative Biology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - W C Crone
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Wisconsin Institute for Discovery, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Engineering Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Haque MA, Platts-Mills JA, Mduma E, Bodhidatta L, Bessong P, Shakoor S, Kang G, Kosek MN, Lima AAM, Shrestha SK, Alam MA, Havt A, Samie A, Guerrant RL, Lang D, Mahfuz M, Bhutta ZA, Houpt ER, Ahmed T. Determinants of Campylobacter infection and association with growth and enteric inflammation in children under 2 years of age in low-resource settings. Sci Rep 2019; 9:17124. [PMID: 31748573 PMCID: PMC6868199 DOI: 10.1038/s41598-019-53533-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/31/2019] [Indexed: 12/11/2022] Open
Abstract
Campylobacter species infections have been associated with malnutrition and intestinal inflammation among children in low-resource settings. However, it remains unclear whether that association is specific to Campylobacter jejuni/coli. The aim of this study was to assess the association between both all Campylobacter species infections and Campylobacter jejuni/coli infections on growth and enteric inflammation in children aged 1-24 months. We analyzed data from 1715 children followed from birth until 24 months of age in the MAL-ED birth cohort study, including detection of Campylobacter species by enzyme immunoassay and Campylobacter jejuni/coli by quantitative PCR in stool samples. Myeloperoxidase (MPO) concentration in stool, used as a quantitative index of enteric inflammation, was measured. The incidence rate per 100 child-months of infections with Campylobacter jejuni/coli and Campylobacter species during 1-24 month follow up were 17.7 and 29.6 respectively. Female sex of child, shorter duration of exclusive breastfeeding, lower maternal age, mother having less than 3 living children, maternal educational level of <6 years, lack of routine treatment of drinking water, and unimproved sanitation were associated with Campylobacter jejuni/coli infection. The cumulative burden of both Campylobacter jejuni/coli infections and Campylobacter species were associated with poor growth and increased intestinal inflammation.
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Affiliation(s)
- Md Ahshanul Haque
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh.
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, USA
| | | | | | | | | | | | - Margaret N Kosek
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, USA
- Asociación Benéfica PRISMA, Iquitos, Peru
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Aldo A M Lima
- Clinical Research Unit and Institute of Biomedicine, Federal University of Ceara, Fortaleza, Brazil
| | | | - Md Ashraful Alam
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Alexandre Havt
- Clinical Research Unit and Institute of Biomedicine, Federal University of Ceara, Fortaleza, Brazil
| | | | - Richard L Guerrant
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, USA
| | - Dennis Lang
- Foundation for the National Institutes of Health, Bethesda, MD, USA
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | | | - Eric R Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, USA
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
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Korpe PS, Valencia C, Haque R, Mahfuz M, McGrath M, Houpt E, Kosek M, McCormick BJJ, Penataro Yori P, Babji S, Kang G, Lang D, Gottlieb M, Samie A, Bessong P, Faruque ASG, Mduma E, Nshama R, Havt A, Lima IFN, Lima AAM, Bodhidatta L, Shreshtha A, Petri WA, Ahmed T, Duggal P. Epidemiology and Risk Factors for Cryptosporidiosis in Children From 8 Low-income Sites: Results From the MAL-ED Study. Clin Infect Dis 2019; 67:1660-1669. [PMID: 29701852 PMCID: PMC6233690 DOI: 10.1093/cid/ciy355] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/24/2018] [Indexed: 12/20/2022] Open
Abstract
Background Cryptosporidium species are enteric protozoa that cause significant morbidity and mortality in children worldwide. We characterized the epidemiology of Cryptosporidium in children from 8 resource-limited sites in Africa, Asia, and South America. Methods Children were enrolled within 17 days of birth and followed twice weekly for 24 months. Diarrheal and monthly surveillance stool samples were tested for Cryptosporidium by enzyme-linked immunosorbent assay. Socioeconomic data were collected by survey, and anthropometry was measured monthly. Results Sixty-five percent (962/1486) of children had a Cryptosporidium infection and 54% (802/1486) had at least 1 Cryptosporidium-associated diarrheal episode. Cryptosporidium diarrhea was more likely to be associated with dehydration (16.5% vs 8.3%, P < .01). Rates of Cryptosporidium diarrhea were highest in the Peru (10.9%) and Pakistan (9.2%) sites. In multivariable regression analysis, overcrowding at home was a significant risk factor for infection in the Bangladesh site (odds ratio, 2.3 [95% confidence interval {CI}, 1.2-4.6]). Multiple linear regression demonstrated a decreased length-for-age z score at 24 months in Cryptosporidium-positive children in the India (β = -.26 [95% CI, -.51 to -.01]) and Bangladesh (β = -.20 [95% CI, -.44 to .05]) sites. Conclusions This multicountry cohort study confirmed the association of Cryptosporidium infection with stunting in 2 South Asian sites, highlighting the significance of cryptosporidiosis as a risk factor for poor growth. We observed that the rate, age of onset, and number of repeat infections varied per site; future interventions should be targeted per region to maximize success.
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Affiliation(s)
- Poonum S Korpe
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Cristian Valencia
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka
| | - Mustafa Mahfuz
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka
| | - Monica McGrath
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.,Fogarty International Center, Bethesda, Maryland
| | - Eric Houpt
- University of Virginia School of Medicine, Charlottesville
| | - Margaret Kosek
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Pablo Penataro Yori
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | | | - Dennis Lang
- Foundation for the National Institutes of Health, Bethesda, Maryland
| | - Michael Gottlieb
- Foundation for the National Institutes of Health, Bethesda, Maryland
| | | | | | - A S G Faruque
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka
| | - Esto Mduma
- Haydom Global Health Institute, Tanzania
| | | | - Alexandre Havt
- Clinical Research Unit and Institute of Biomedicine, Universidade Federal do Ceara, Fortaleza, Brazil
| | - Ila F N Lima
- Clinical Research Unit and Institute of Biomedicine, Universidade Federal do Ceara, Fortaleza, Brazil
| | - Aldo A M Lima
- Clinical Research Unit and Institute of Biomedicine, Universidade Federal do Ceara, Fortaleza, Brazil
| | | | | | | | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka
| | - Priya Duggal
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Kuder M, Hsieh F, Pien L, Lang D. M305 MULTIPLE FOOD ALLERGIES IN A SEPTUAGENARIAN. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Lang D, Horner A, Brehm E, Akbari K, Hergan B, Langer K, Asel C, Scala M, Kaiser B, Lamprecht B. Initial serum tumor marker dynamics predict progression-free and overall survival in single PD-1/PD-L1 inhibitor treated advanced NSCLC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.057] [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: 11/13/2022] Open
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13
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Huemer F, Rinnerthaler G, Lang D, Hackl H, Lamprecht B, Greil R. Association between antibiotics use and outcome in patients with NSCLC treated with immunotherapeutics. Ann Oncol 2019; 30:652-653. [PMID: 30689705 PMCID: PMC6879001 DOI: 10.1093/annonc/mdz021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- F Huemer
- Department of Internal Medicine III, Paracelsus Medical University Salzburg, Salzburg; Salzburg Cancer Research Institute, Salzburg
| | - G Rinnerthaler
- Department of Internal Medicine III, Paracelsus Medical University Salzburg, Salzburg; Salzburg Cancer Research Institute, Salzburg; Cancer Cluster Salzburg, Salzburg
| | - D Lang
- Department of Pulmonology, Kepler University Hospital, Linz
| | - H Hackl
- Division of Bioinformatics, Biocenter, Medical University of Innsbruck, Innsbruck, Austria
| | - B Lamprecht
- Department of Pulmonology, Kepler University Hospital, Linz
| | - R Greil
- Department of Internal Medicine III, Paracelsus Medical University Salzburg, Salzburg; Salzburg Cancer Research Institute, Salzburg; Cancer Cluster Salzburg, Salzburg.
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Lees KE, Lang D, Graham A, Burnett J, Olsen B, Sivers-Teixeira T, Rosen AE, Elman A. AN ENVIRONMENTAL SCAN OF EMPIRICAL AND PRACTICE-BASED EVIDENCE TO INFORM CARE MODEL DEVELOPMENT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.728] [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: 11/12/2022] Open
Affiliation(s)
- K E Lees
- Northeastern University, West Roxbury, Massachusetts, United States
| | - D Lang
- University of Massachusetts Medical School, Worcester, MA, USA
| | - A Graham
- Executive Office of Elder Affairs, Boston, MA, USA
| | - J Burnett
- University of Texas Health Science Center, Houston, TX, USA; Texas Elder Abuse and Mistreatment Institute, Houston, TX, USA
| | - B Olsen
- University of Texas Health Science Center, Houston, TX, USA; Texas Elder Abuse and Mistreatment Institute, Houston, TX, USA
| | - T Sivers-Teixeira
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A E Rosen
- Weill Cornell Medical College, New York, NY, USA; New York-Presbyterian Health Care System, New York, NY, USA
| | - A Elman
- Weill Cornell Medicine, New York, NY, USA
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Platts-Mills JA, Liu J, Rogawski ET, Kabir F, Lertsethtakarn P, Siguas M, Khan SS, Praharaj I, Murei A, Nshama R, Mujaga B, Havt A, Maciel IA, McMurry TL, Operario DJ, Taniuchi M, Gratz J, Stroup SE, Roberts JH, Kalam A, Aziz F, Qureshi S, Islam MO, Sakpaisal P, Silapong S, Yori PP, Rajendiran R, Benny B, McGrath M, McCormick BJJ, Seidman JC, Lang D, Gottlieb M, Guerrant RL, Lima AAM, Leite JP, Samie A, Bessong PO, Page N, Bodhidatta L, Mason C, Shrestha S, Kiwelu I, Mduma ER, Iqbal NT, Bhutta ZA, Ahmed T, Haque R, Kang G, Kosek MN, Houpt ER. Use of quantitative molecular diagnostic methods to assess the aetiology, burden, and clinical characteristics of diarrhoea in children in low-resource settings: a reanalysis of the MAL-ED cohort study. Lancet Glob Health 2018; 6:e1309-e1318. [PMID: 30287127 PMCID: PMC6227251 DOI: 10.1016/s2214-109x(18)30349-8] [Citation(s) in RCA: 215] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/28/2018] [Accepted: 07/11/2018] [Indexed: 12/17/2022]
Abstract
Background Optimum management of childhood diarrhoea in low-resource settings has been hampered by insufficient data on aetiology, burden, and associated clinical characteristics. We used quantitative diagnostic methods to reassess and refine estimates of diarrhoea aetiology from the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study. Methods We re-analysed stool specimens from the multisite MAL-ED cohort study of children aged 0–2 years done at eight locations (Dhaka, Bangladesh; Vellore, India; Bhaktapur, Nepal; Naushero Feroze, Pakistan; Venda, South Africa; Haydom, Tanzania; Fortaleza, Brazil; and Loreto, Peru), which included active surveillance for diarrhoea and routine non-diarrhoeal stool collection. We used quantitative PCR to test for 29 enteropathogens, calculated population-level pathogen-specific attributable burdens, derived stringent quantitative cutoffs to identify aetiology for individual episodes, and created aetiology prediction scores using clinical characteristics. Findings We analysed 6625 diarrhoeal and 30 968 non-diarrhoeal surveillance stools from 1715 children. Overall, 64·9% of diarrhoea episodes (95% CI 62·6–71·2) could be attributed to an aetiology by quantitative PCR compared with 32·8% (30·8–38·7) using the original study microbiology. Viral diarrhoea (36·4% of overall incidence, 95% CI 33·6–39·5) was more common than bacterial (25·0%, 23·4–28·4) and parasitic diarrhoea (3·5%, 3·0–5·2). Ten pathogens accounted for 95·7% of attributable diarrhoea: Shigella (26·1 attributable episodes per 100 child-years, 95% CI 23·8–29·9), sapovirus (22·8, 18·9–27·5), rotavirus (20·7, 18·8–23·0), adenovirus 40/41 (19·0, 16·8–23·0), enterotoxigenic Escherichia coli (18·8, 16·5–23·8), norovirus (15·4, 13·5–20·1), astrovirus (15·0, 12·0–19·5), Campylobacter jejuni or C coli (12·1, 8·5–17·2), Cryptosporidium (5·8, 4·3–8·3), and typical enteropathogenic E coli (5·4, 2·8–9·3). 86·2% of the attributable incidence for Shigella was non-dysenteric. A prediction score for shigellosis was more accurate (sensitivity 50·4% [95% CI 46·7–54·1], specificity 84·0% [83·0–84·9]) than current guidelines, which recommend treatment only of bloody diarrhoea to cover Shigella (sensitivity 14·5% [95% CI 12·1–17·3], specificity 96·5% [96·0–97·0]). Interpretation Quantitative molecular diagnostics improved estimates of pathogen-specific burdens of childhood diarrhoea in the community setting. Viral causes predominated, including a substantial burden of sapovirus; however, Shigella had the highest overall burden with a high incidence in the second year of life. These data could improve the management of diarrhoea in these low-resource settings. Funding Bill & Melinda Gates Foundation.
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Affiliation(s)
- James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.
| | - Jie Liu
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Elizabeth T Rogawski
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA; Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | | | | | | | - Shaila S Khan
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | | | - Buliga Mujaga
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | | | - Timothy L McMurry
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Darwin J Operario
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Mami Taniuchi
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Jean Gratz
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Suzanne E Stroup
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - James H Roberts
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | | | | | | | - M Ohedul Islam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Pimmada Sakpaisal
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Sasikorn Silapong
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Pablo P Yori
- Asociación Benéfica PRISMA, Iquitos, Peru; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Monica McGrath
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Jessica C Seidman
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Dennis Lang
- Foundation for the National Institutes of Health, Bethesda, MD, USA
| | - Michael Gottlieb
- Foundation for the National Institutes of Health, Bethesda, MD, USA
| | - Richard L Guerrant
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | | | | | | | | | - Nicola Page
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Ladaporn Bodhidatta
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Carl Mason
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Sanjaya Shrestha
- Walter Reed/AFRIMS Research Unit, Nepal, Kathmandu, Nepal; University of Bergen, Bergen, Norway
| | - Ireen Kiwelu
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | | | | | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Margaret N Kosek
- Asociación Benéfica PRISMA, Iquitos, Peru; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eric R Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
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Rogawski ET, Liu J, Platts-Mills JA, Kabir F, Lertsethtakarn P, Siguas M, Khan SS, Praharaj I, Murei A, Nshama R, Mujaga B, Havt A, Maciel IA, Operario DJ, Taniuchi M, Gratz J, Stroup SE, Roberts JH, Kalam A, Aziz F, Qureshi S, Islam MO, Sakpaisal P, Silapong S, Yori PP, Rajendiran R, Benny B, McGrath M, Seidman JC, Lang D, Gottlieb M, Guerrant RL, Lima AAM, Leite JP, Samie A, Bessong PO, Page N, Bodhidatta L, Mason C, Shrestha S, Kiwelu I, Mduma ER, Iqbal NT, Bhutta ZA, Ahmed T, Haque R, Kang G, Kosek MN, Houpt ER. Use of quantitative molecular diagnostic methods to investigate the effect of enteropathogen infections on linear growth in children in low-resource settings: longitudinal analysis of results from the MAL-ED cohort study. Lancet Glob Health 2018; 6:e1319-e1328. [PMID: 30287125 PMCID: PMC6227248 DOI: 10.1016/s2214-109x(18)30351-6] [Citation(s) in RCA: 213] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/28/2018] [Accepted: 07/11/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Enteropathogen infections in early childhood not only cause diarrhoea but contribute to poor growth. We used molecular diagnostics to assess whether particular enteropathogens were associated with linear growth across seven low-resource settings. METHODS We used quantitative PCR to detect 29 enteropathogens in diarrhoeal and non-diarrhoeal stools collected from children in the first 2 years of life obtained during the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) multisite cohort study. Length was measured monthly. We estimated associations between aetiology-specific diarrhoea and subclinical enteropathogen infection and quantity and attained length in 3 month intervals, at age 2 and 5 years, and used a longitudinal model to account for temporality and time-dependent confounding. FINDINGS Among 1469 children who completed 2 year follow-up, 35 622 stool samples were tested and yielded valid results. Diarrhoeal episodes attributed to bacteria and parasites, but not viruses, were associated with small decreases in length after 3 months and at age 2 years. Substantial decrements in length at 2 years were associated with subclinical, non-diarrhoeal, infection with Shigella (length-for-age Z score [LAZ] reduction -0·14, 95% CI -0·27 to -0·01), enteroaggregative Escherichia coli (-0·21, -0·37 to -0·05), Campylobacter (-0·17, -0·32 to -0·01), and Giardia (-0·17, -0·30 to -0·05). Norovirus, Cryptosporidium, typical enteropathogenic E coli, and Enterocytozoon bieneusi were also associated with small decrements in LAZ. Shigella and E bieneusi were associated with the largest decreases in LAZ per log increase in quantity per g of stool (-0·13 LAZ, 95% CI -0·22 to -0·03 for Shigella; -0·14, -0·26 to -0·02 for E bieneusi). Based on these models, interventions that successfully decrease exposure to Shigella, enteroaggregative E coli, Campylobacter, and Giardia could increase mean length of children by 0·12-0·37 LAZ (0·4-1·2 cm) at the MAL-ED sites. INTERPRETATION Subclinical infection and quantity of pathogens, particularly Shigella, enteroaggregative E coli, Campylobacter, and Giardia, had a substantial negative association with linear growth, which was sustained during the first 2 years of life, and in some cases, to 5 years. Successfully reducing exposure to certain pathogens might reduce global stunting. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Elizabeth T Rogawski
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA; Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Jie Liu
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | | | | | | | - Shaila S Khan
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | | | - Buliga Mujaga
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | | | - Darwin J Operario
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Mami Taniuchi
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Jean Gratz
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Suzanne E Stroup
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - James H Roberts
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | | | | | | | - M Ohedul Islam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Pimmada Sakpaisal
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Sasikorn Silapong
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Pablo P Yori
- Asociación Benéfica PRISMA, Iquitos, Peru; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Monica McGrath
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Jessica C Seidman
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Dennis Lang
- Foundation for the National Institutes of Health, Bethesda, MD, USA
| | - Michael Gottlieb
- Foundation for the National Institutes of Health, Bethesda, MD, USA
| | - Richard L Guerrant
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | | | | | | | | | - Nicola Page
- National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Ladaporn Bodhidatta
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Carl Mason
- Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Sanjaya Shrestha
- Walter Reed/AFRIMS Research Unit, Nepal, Kathmandu, Nepal; University of Bergen, Bergen, Norway
| | - Ireen Kiwelu
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | | | | | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Margaret N Kosek
- Asociación Benéfica PRISMA, Iquitos, Peru; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eric R Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.
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Ramírez-González RH, Borrill P, Lang D, Harrington SA, Brinton J, Venturini L, Davey M, Jacobs J, van Ex F, Pasha A, Khedikar Y, Robinson SJ, Cory AT, Florio T, Concia L, Juery C, Schoonbeek H, Steuernagel B, Xiang D, Ridout CJ, Chalhoub B, Mayer KFX, Benhamed M, Latrasse D, Bendahmane A, Wulff BBH, Appels R, Tiwari V, Datla R, Choulet F, Pozniak CJ, Provart NJ, Sharpe AG, Paux E, Spannagl M, Bräutigam A, Uauy C. The transcriptional landscape of polyploid wheat. Science 2018; 361:eaar6089. [PMID: 30115782 DOI: 10.1126/science.aar6089] [Citation(s) in RCA: 497] [Impact Index Per Article: 82.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 07/11/2018] [Indexed: 12/14/2022]
Abstract
The coordinated expression of highly related homoeologous genes in polyploid species underlies the phenotypes of many of the world's major crops. Here we combine extensive gene expression datasets to produce a comprehensive, genome-wide analysis of homoeolog expression patterns in hexaploid bread wheat. Bias in homoeolog expression varies between tissues, with ~30% of wheat homoeologs showing nonbalanced expression. We found expression asymmetries along wheat chromosomes, with homoeologs showing the largest inter-tissue, inter-cultivar, and coding sequence variation, most often located in high-recombination distal ends of chromosomes. These transcriptionally dynamic genes potentially represent the first steps toward neo- or subfunctionalization of wheat homoeologs. Coexpression networks reveal extensive coordination of homoeologs throughout development and, alongside a detailed expression atlas, provide a framework to target candidate genes underpinning agronomic traits in wheat.
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Lang D, Akbari K, Lamprecht B, Fellner F. Initial Patient Characteristics and Standardized Quantification of Radiological Findings in Nonspecific Interstitial Pneumonia. Pneumologie 2018. [DOI: 10.1055/s-0037-1619245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- D Lang
- Klinik für Lungenheilkunde, Kepler Universitätsklinikum Linz
| | - K Akbari
- Zentrales Radiologie Institut, Kepler Universitätsklinikum Linz
| | - B Lamprecht
- Klinik für Lungenheilkunde, Kepler Universitätsklinikum Linz
| | - F Fellner
- Zentrales Radiologie Institut, Kepler Universitätsklinikum Linz
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Olortegui MP, Rouhani S, Yori PP, Salas MS, Trigoso DR, Mondal D, Bodhidatta L, Platts-Mills J, Samie A, Kabir F, Lima A, Babji S, Shrestha SK, Mason CJ, Kalam A, Bessong P, Ahmed T, Mduma E, Bhutta ZA, Lima I, Ramdass R, Moulton LH, Lang D, George A, Zaidi AK, Kang G, Houpt ER, Kosek MN. Astrovirus Infection and Diarrhea in 8 Countries. Pediatrics 2018; 141:peds.2017-1326. [PMID: 29259078 PMCID: PMC9923568 DOI: 10.1542/peds.2017-1326] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [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] [Accepted: 10/12/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Astroviruses are important drivers of viral gastroenteritis but remain understudied in community settings and low- and middle-income countries. We present data from 8 countries with high prevalence of diarrhea and undernutrition to describe astrovirus epidemiology and assess evidence for protective immunity among children 0 to 2 years of age. METHODS We used 25 898 surveillance stools and 7077 diarrheal stools contributed by 2082 children for enteropathogen testing, and longitudinal statistical analysis to describe incidence, risk factors, and protective immunity. RESULTS Thirty-five percent of children experienced astrovirus infections. Prevalence in diarrheal stools was 5.6%, and severity exceeded all enteropathogens except rotavirus. Incidence of infection and diarrhea were 2.12 and 0.88 episodes per 100 child-months, respectively. Children with astrovirus infection had 2.30 times the odds of experiencing diarrhea after adjustment for covariates (95% confidence interval [CI], 2.01-2.62; P < .001). Undernutrition was a risk factor: odds of infection and diarrhea were reduced by 10% and 13%, respectively, per increase in length-for-age z score (infection: odds ratio, 0.90 [95% CI, 0.85-0.96]; P < .001; diarrhea: odds ratio, 0.87 [95% CI, 0.79-0.96]; P = .006). Some evidence of protective immunity to infection was detected (hazard ratio, 0.84 [95% CI, 0.71-1.00], P = .052), although this was heterogeneous between sites and significant in India and Peru. CONCLUSIONS Astrovirus is an overlooked cause of diarrhea among vulnerable children worldwide. With the evidence presented here, we highlight the need for future research as well as the potential for astrovirus to be a target for vaccine development.
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Affiliation(s)
| | - Saba Rouhani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pablo Peñataro Yori
- Asociación Benéfica PRISMA, Iquitos, Peru;,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | | | | | - James Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia
| | | | | | - Aldo Lima
- Universidade Federal do Ceará, Fortaleza, Brazil
| | | | - Sanjaya Kumar Shrestha
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand;,Centre for International Health, University of Bergen, Bergen, Norway
| | - Carl J. Mason
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Adil Kalam
- Aga Khan University, Naushahro Feroze, Pakistan
| | | | | | | | | | - Ila Lima
- Universidade Federal do Ceará, Fortaleza, Brazil
| | | | - Lawrence H. Moulton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Dennis Lang
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland; and,Foundation for the National Institutes of Health, Bethesda, Maryland
| | | | | | | | - Eric R. Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia
| | - Margaret N. Kosek
- Asociación Benéfica PRISMA, Iquitos, Peru;,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;,Address correspondence to Margaret N. Kosek, MD, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205. E-mail
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Lang D. P172 A rare subtype of urticaria. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.159] [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: 11/16/2022]
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Rogawski ET, Platts-Mills JA, Seidman JC, John S, Mahfuz M, Ulak M, Shrestha S, Soofi SB, Yori PP, Mduma E, Svensen E, Ahmed T, Lima AA, Bhutta Z, Kosek M, Lang D, Gottlieb M, Zaidi A, Kang G, Bessong P, Houpt ER, Guerrant RL. Early Antibiotic Exposure in Low-resource Settings Is Associated With Increased Weight in the First Two Years of Life. J Pediatr Gastroenterol Nutr 2017; 65:350-356. [PMID: 28604514 PMCID: PMC5559187 DOI: 10.1097/mpg.0000000000001640] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/30/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The potential growth-promoting effects of antibiotics are not well understood among undernourished children in environments with high pathogen exposure. We aimed to assess whether early antibiotic exposure duration and class were associated with growth to 2 years of age across 8 low-resource sites in the MAL-ED birth cohort study. METHODS We followed 1954 children twice per week from birth to 2 years to record maternally reported antibiotic exposures and measure anthropometry monthly. We estimated the associations between antibiotic exposure before 6 months of age and weight-for-age and length-for-age (LAZ) z scores to 2 years. We assessed the impact of class-specific exposures and duration, and compared these results to effects of antibiotic exposures after 6 months of age. RESULTS Antibiotic use before 6 months of age was associated with increased weight from 6 months to 2 years, whereas associations with length were less consistent across sites and antibiotic classes. Compared to unexposed children, 2 or more courses of metronidazole, macrolides, and cephalosporins were associated with adjusted increases in weight-for-age of 0.24 (95% confidence interval (CI): 0.04, 0.43), 0.23 (95% CI: 0.05, 0.42), and 0.19 (95% CI: 0.04, 0.35) from 6 months to 2 years, respectively. CONCLUSIONS Antibiotic use in low-resource settings was most associated with the ponderal growth of children who had multiple exposures to antibiotics with broad spectrum and anaerobic activity in early infancy. Opportunities for rational and targeted antibiotic therapy in low resource settings may also promote short-term weight gain in children, although longer-term physical growth and metabolic impacts are unknown.
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Affiliation(s)
- Elizabeth T. Rogawski
- Department of Public Health Sciences
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA
| | - James A. Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA
| | - Jessica C. Seidman
- Fogarty International Center, National Institutes of Health, Bethesda, MD
| | | | - Mustafa Mahfuz
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Sanjaya Shrestha
- Walter Reed/Armed Forces Research Institute of Medical Sciences Research Unit, Kathmandu, Nepal
- Center for International Health, University of Bergen, Bergen, Norway
| | | | - Pablo Penataro Yori
- Asociación Benéfica PRISMA, Iquitos, Peru
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | | | | | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Aldo A.M. Lima
- Clinical Research Unit and Institute of Biomedicine, Federal University of Ceara, Fortaleza, Brazil
| | | | - Margaret Kosek
- Asociación Benéfica PRISMA, Iquitos, Peru
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Dennis Lang
- Foundation for the National Institutes of Health, Bethesda, MD
| | | | | | | | | | - Eric R. Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA
| | - Richard L. Guerrant
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA
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Schott B, Lang D, Kulikovskaja L, van Ham M, Jänsch L, Gundelfinger E, Smalla K, Dunay I. Synaptic proteome alterations in chronic toxoplasma gondii-infected mice suggest interference with glutamatergic neurotransmission. PHARMACOPSYCHIATRY 2017. [DOI: 10.1055/s-0037-1606443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- B Schott
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - D Lang
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - L Kulikovskaja
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - M van Ham
- Cellular Proteome Research, HZI, Braunschweig, Germany
| | - L Jänsch
- Cellular Proteome Research, HZI, Braunschweig, Germany
| | - E Gundelfinger
- Department of Neurochemistry and Molecular Biology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - K Smalla
- Department of Neurochemistry and Molecular Biology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - I Dunay
- Institute for Inflammation and Neurodegeneration, Otto von Guericke University, Magdeburg, Germany
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Gahr M, Eller J, Hiemke C, Freudenmann R, Connemann B, Lang D, Schönfeldt-Lecuona C. Drug safety related to agents used for opioid maintenance therapy. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1746] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionThere is only little data regarding drug safety related to agents used for opioid maintenance therapy (OMT).Objectives/aimsTo study drug safety and the reporting behaviour of adverse drug reactions (ADR) related to OMT.MethodsA cross-sectional questionnaire-based telephone survey among physicians providing outpatient OMT in a federal state of Germany (n = 176; response rate = 55.7%) was conducted.ResultsMost of the respondents (n = 97/55.1%) reported that they observe ADR related to buprenorphine, [dihydro]codein and [levo]methdone rarely (n = 38/21.6%), very rarely (n = 39/22.2%) or never (n = 20/11.4%). Methadone was reported to be most frequently associated with the occurrence of ADR (n = 82/46.6%), followed by levomethadone (n = 33/18.8%), buprenorphine (n = 6/3.4%), and dihydrocodeine (n = 3/1.7%). Frequently observed ADR related to these agents were gastrointestinal, nervous system and psychiatric disorders, and hyperhidrosis. Methadone and levomethadone (not buprenorphine) were reported to be frequently associated with fatigue, weight gain, and sexual dysfunction. Only buprenorphine was reported to be frequently associated with withdrawal and rebound effects, and drug intolerance. Hundred twenty-nine participants (73.3%) stated that they never report ADR related to OMT, whereas n = 19 (10.8%) did so when referring to ADR related to their complete medical practice (Chi2 = 141.070; df = 1; P < 0.001).ConclusionsOur data revealed similar patterns of ADR related to outpatient OMT as those reported in the product information or in pain therapy. Motivation to report ADR related to agents used for OMT may be reduced compared to ADR related to the general medical practice.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Gahr M, Uzelac Z, Zeiss R, Connemann B, Lang D, Schönfeldt-Lecuona C. Web search query data and prescription volumes of antidepressants. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.376] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionPersons using the Internet generate large amounts of health-related data, which are increasingly used in modern health sciences.Objectives/aimsWe analysed the relation between annual prescription volumes (APV) of several antidepressants with marketing approval in Germany and corresponding web search query data generated in Google to test, if web search query volume may be a proxy for medical prescription practice.MethodsWe obtained APVs of several antidepressants related to corresponding prescriptions at the expense of the statutory health insurance in Germany from 2004–2013. Web search query data generated in Germany and related to defined search-terms (active substance or brand name) were obtained with Google Trends. We calculated correlations (Pearson's r) between the APVs of each substance and the respective annual “search share” values; coefficients of determination (R2) were computed to determine the amount of variability shared by the two variables.ResultsSignificant and strong correlations between substance-specific APVs and corresponding annual query volume were found for each substance during the observational interval: agomelatine (r = 0.968; R2 = 0.932; P = 0.01), bupropion (r = 0.962; R2 = 0.925; P = 0.01), citalopram (r = 0.970; R2 = 0.941; P = 0.01), escitalopram (r = 0.824; R2 = 0.682; P = 0.01), fluoxetine (r = 0.885; R2 = 0.783; P = 0.01), paroxetine (r = 0.801; R2 = 0.641; P = 0.01), and sertraline (r = 0.880; R2 = 0.689; P = 0.01).ConclusionsAlthough the used data did not allow to perform an analysis with a higher temporal resolution our results suggest that web search query volume may be a proxy for corresponding prescription behaviour. However, further studies analysing other pharmacologic agents and prescription data that facilitates an increased temporal resolution are needed to confirm this hypothesis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Gahr M, Zeiss R, Lang D, Connemann B, Schönfeldt-Lecuona C. Hepatotoxicity related to anti-depressive psychopharmacotherapy: Implications of quantitative signal detection. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1414] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionDrug-induced liver injury is a major problem of pharmacotherapy and is also frequent with anti-depressive psychopharmacotherapy.Objectives/aimsHowever, there are only few studies using a consistent methodologic approach to study hepatotoxicity of a larger group of antidepressants.MethodsWe performed a quantitative signal detection analysis using pharmacovigilance data from the Uppsala monitoring center from the WHO that records adverse drug reaction data from worldwide sources; we calculated reporting odds ratios (ROR) as measures for disproportionality within a case-/non-case approach for several frequently prescribed anti-depressants.ResultsBoth positive controls, amineptine (ROR 38.4 [95% CI: 33.8–43.6]) and nefazodone (ROR 3.2 [95% CI: 3.0–3.5]), were statistically associated with hepatotoxicity. Following amineptine, agomelatine (ROR 6.4 [95% CI: 5.7–7.2]) was associated with the second highest ROR, followed by tianeptine (ROR 4.4 [95% CI: 3.6–5.3]), mianserin (ROR 3.6 [95% CI: 3.3–3.4]) and nefazodone.ConclusionsIn line with previous studies our results support the hypothesis that agomelatine and several other anti-depressants may be associated with relevant hepatotoxicity. However, the used data and applied method do not allow a quantitative evaluation of hepatotoxicity or assessment of substance–specific differences regarding the extent of hepatotoxicity.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Lang D, Gatterer C, Purkarthofer W, Lamprecht B. Effects of Pulmonary Rehabilitation – a first year experience and evaluation of important outcome parameters. Pneumologie 2017. [DOI: 10.1055/s-0037-1598480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- D Lang
- Department of Pulmonary Medicine, Kepler University Clinic
| | - C Gatterer
- Department of Pulmonary Medicine, Kepler University Clinic; Rehabilitation Clinic Enns
| | | | - B Lamprecht
- Department of Pulmonary Medicine, Kepler University Clinic; Rehabilitation Clinic Enns
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Reddy K, Kearns M, Alvarez Arango S, Carrillo Martin I, Cuervo-Pardo N, Cuervo-Pardo L, Dimov V, Lang D, Lopez-Alvarez S, Schroer B, Dula M, Zheng S, Kozinetz C, Gonzalez-Estrada A. P275 Youtube and food allergy: an appraisal of the educational quality of information. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.288] [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: 11/16/2022]
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Ambikapathi R, Kosek MN, Lee GO, Mahopo C, Patil CL, Maciel BL, Turab A, Islam MM, Ulak M, Bose A, Paredes Olortegui M, Pendergast LL, Murray-Kolb LE, Lang D, McCormick BJJ, Caulfield LE. How multiple episodes of exclusive breastfeeding impact estimates of exclusive breastfeeding duration: report from the eight-site MAL-ED birth cohort study. Matern Child Nutr 2016; 12:740-56. [PMID: 27500709 PMCID: PMC5095788 DOI: 10.1111/mcn.12352] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 06/02/2016] [Accepted: 06/07/2016] [Indexed: 11/28/2022]
Abstract
The duration of exclusive breastfeeding (EBF) is often defined as the time from birth to the first non‐breast milk food/liquid fed (EBFLONG), or it is estimated by calculating the proportion of women at a given infant age who EBF in the previous 24 h (EBFDHS). Others have measured the total days or personal prevalence of EBF (EBFPREV), recognizing that although non‐EBF days may occur, EBF can be re‐initiated for extended periods. We compared breastfeeding metrics in the MAL‐ED study; infants' breastfeeding trajectories were characterized from enrollment (median 7 days, IQR: 4, 12) to 180 days at eight sites. During twice‐weekly surveillance, caretakers were queried about infant feeding the prior day. Overall, 101 833 visits and 356 764 child days of data were collected from 1957 infants. Median duration of EBFLONG was 33 days (95% CI: 32–36), compared to 49 days based on the EBFDHS. Median EBFPREV was 66 days (95% CI: 62–70). Differences were because of the return to EBF after a non‐EBF period. The median number of returns to EBF was 2 (IQR: 1, 3). When mothers re‐initiated EBF (second episode), infants gained an additional 18.8 days (SD: 25.1) of EBF, and gained 13.7 days (SD: 18.1) (third episode). In settings where women report short gaps in EBF, programmes should work with women to return to EBF. Interventions could positively influence the duration of these additional periods of EBF and their quantification should be considered in impact evaluation studies. © 2016 John Wiley & Sons Ltd
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Affiliation(s)
- Ramya Ambikapathi
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA.,Center for Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Margaret N Kosek
- Center for Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Gwenyth O Lee
- Center for Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Cloupas Mahopo
- Department of Nutrition, School of Health Sciences, University of Venda, Thohoyandou, Limpopo Province, South Africa
| | - Crystal L Patil
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Bruna L Maciel
- Department of Nutrition, State University of Ceará, Fortaleza, Ceará, Brazil
| | - Ali Turab
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - M Munirul Islam
- Centre for Nutrition and Food Security, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Manjeswori Ulak
- Department of Child Health and Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | | | | | - Laura L Pendergast
- School Psychology Program, Temple University, Philadelphia, Pennsylvania, USA
| | - Laura E Murray-Kolb
- Department of Nutritional Sciences, The Pennsylvania State University, State College, Pennsylvania, USA
| | - Dennis Lang
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Laura E Caulfield
- Center for Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
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Amour C, Gratz J, Mduma E, Svensen E, Rogawski ET, McGrath M, Seidman JC, McCormick BJJ, Shrestha S, Samie A, Mahfuz M, Qureshi S, Hotwani A, Babji S, Trigoso DR, Lima AAM, Bodhidatta L, Bessong P, Ahmed T, Shakoor S, Kang G, Kosek M, Guerrant RL, Lang D, Gottlieb M, Houpt ER, Platts-Mills JA. Epidemiology and Impact of Campylobacter Infection in Children in 8 Low-Resource Settings: Results From the MAL-ED Study. Clin Infect Dis 2016; 63:1171-1179. [PMID: 27501842 PMCID: PMC5064165 DOI: 10.1093/cid/ciw542] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/02/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Enteropathogen infections have been associated with enteric dysfunction and impaired growth in children in low-resource settings. In a multisite birth cohort study (MAL-ED), we describe the epidemiology and impact of Campylobacter infection in the first 2 years of life. METHODS Children were actively followed up until 24 months of age. Diarrheal and nondiarrheal stool samples were collected and tested by enzyme immunoassay for Campylobacter Stool and blood samples were assayed for markers of intestinal permeability and inflammation. RESULTS A total of 1892 children had 7601 diarrheal and 26 267 nondiarrheal stool samples tested for Campylobacter We describe a high prevalence of infection, with most children (n = 1606; 84.9%) having a Campylobacter-positive stool sample by 1 year of age. Factors associated with a reduced risk of Campylobacter detection included exclusive breastfeeding (risk ratio, 0.57; 95% confidence interval, .47-.67), treatment of drinking water (0.76; 0.70-0.83), access to an improved latrine (0.89; 0.82-0.97), and recent macrolide antibiotic use (0.68; 0.63-0.74). A high Campylobacter burden was associated with a lower length-for-age Z score at 24 months (-1.82; 95% confidence interval, -1.94 to -1.70) compared with a low burden (-1.49; -1.60 to -1.38). This association was robust to confounders and consistent across sites. Campylobacter infection was also associated with increased intestinal permeability and intestinal and systemic inflammation. CONCLUSIONS Campylobacter was prevalent across diverse settings and associated with growth shortfalls. Promotion of exclusive breastfeeding, drinking water treatment, improved latrines, and targeted antibiotic treatment may reduce the burden of Campylobacter infection and improve growth in children in these settings.
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Affiliation(s)
| | - Jean Gratz
- Haydom Lutheran Hospital, Haydom, Tanzania Division of Infectious Diseases and International Health, University of Virginia, Charlottesville
| | | | | | - Elizabeth T Rogawski
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville
| | - Monica McGrath
- Fogarty International Center, National Institutes of Health
| | | | | | - Sanjaya Shrestha
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | - Mustafa Mahfuz
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | | | | | - Aldo A M Lima
- Clinical Research Unit and Institute of Biomedicine, Federal University of Ceara, Fortaleza, Brazil
| | | | | | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | - Margaret Kosek
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland Asociación Benéfica PRISMA, Iquitos, Peru
| | - Richard L Guerrant
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville
| | - Dennis Lang
- Foundation for the National Institutes of Health, Bethesda
| | | | - Eric R Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville
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Lang D, Friedmann S, Paulus D. Adaptivity of conditional random field based outdoor point cloud classification. Pattern Recognit Image Anal 2016. [DOI: 10.1134/s1054661816020085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Davies R, Williams J, Sime K, Hughes E, Jordan L, Rawlings C, Lang D, Jones S, Rose-John S, Williams A, Choy E. FRI0045 Therapeutic Blockade of Interleukin-6 Trans-Signalling Restores Vascular Function in Murine Collagen Induced Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1480] [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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Rouhani S, Peñataro Yori P, Paredes Olortegui M, Siguas Salas M, Rengifo Trigoso D, Mondal D, Bodhidatta L, Platts-Mills J, Samie A, Kabir F, Lima A, Babji S, Mason CJ, Kalam A, Bessong P, Ahmed T, Mduma E, Bhutta ZA, Lima I, Ramdass R, Lang D, George A, Zaidi AKM, Kang G, Houpt E, Kosek MN. Norovirus Infection and Acquired Immunity in 8 Countries: Results From the MAL-ED Study. Clin Infect Dis 2016; 62:1210-7. [PMID: 27013692 PMCID: PMC4845786 DOI: 10.1093/cid/ciw072] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 12/22/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Norovirus is an important cause of childhood diarrhea. We present data from a longitudinal, multicountry study describing norovirus epidemiology during the first 2 years of life. METHODS A birth cohort of 1457 children across 8 countries contributed 7077 diarrheal stools for norovirus testing. A subset of 199 children contributed additional asymptomatic samples (2307) and diarrheal stools (770), which were used to derive incidence rates and evaluate evidence for acquired immunity. RESULTS Across sites, 89% of children experienced at least 1 norovirus infection before 24 months, and 22.7% of all diarrheal stools were norovirus positive. Severity of norovirus-positive diarrhea was comparable to other enteropathogens, with the exception of rotavirus. Incidence of genogroup II (GII) infection was higher than genogroup I and peaked at 6-11 months across sites. Undernutrition was a risk factor for symptomatic norovirus infection, with an increase in 1 standard deviation of length-for-age z score associated with a 17% reduction (odds ratio, 0.83 [95% confidence interval, .72-.97]; P = .011) in the odds of experiencing diarrhea when norovirus was present, after accounting for genogroup, rotavirus vaccine, and age. Evidence of acquired immunity was observed among GII infections only: Children with prior GII infection were found to have a 27% reduction in the hazard of subsequent infection (hazard ratio, 0.727; P = .010). CONCLUSIONS The high prevalence of norovirus across 8 sites in highly variable epidemiologic settings and demonstration of protective immunity for GII infections provide support for investment in vaccine development.
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Affiliation(s)
| | | | | | | | | | - Dinesh Mondal
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka
| | | | | | | | | | - Aldo Lima
- Universidade Federal do Ceará, Fortaleza, Brazil
| | | | - Carl J Mason
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - Adil Kalam
- Aga Khan University, Naushahro Feroze, Pakistan
| | | | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka
| | | | | | - Ila Lima
- Universidade Federal do Ceará, Fortaleza, Brazil
| | | | - Dennis Lang
- Foundation for the National Institutes of Health, Bethesda, Maryland
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Fietz D, Markmann M, Lang D, Konrad L, Geyer J, Kliesch S, Chakraborty T, Hossain H, Bergmann M. Transfection of Sertoli cells with androgen receptor alters gene expression without androgen stimulation. BMC Mol Biol 2015; 16:23. [PMID: 26715186 PMCID: PMC4696255 DOI: 10.1186/s12867-015-0051-7] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 12/09/2015] [Indexed: 12/14/2022] Open
Abstract
Background Androgens play an important role for the development of male fertility and gained interest as growth and survival factors for certain types of cancer. Androgens act via the androgen receptor (AR/Ar), which is involved in various cell biological processes such as sex differentiation. To study the functional mechanisms of androgen action, cell culture systems and AR-transfected cell lines are needed. Transfection of AR into cell lines and subsequent gene expression analysis after androgen treatment is well established to investigate the molecular biology of target cells. However, it remains unclear how the transfection with AR itself can modulate the gene expression even without androgen stimulation. Therefore, we transfected Ar-deficient rat Sertoli cells 93RS2 by electroporation using a full length human AR. Results Transfection success was confirmed by Western Blotting, immunofluorescence and RT-PCR. AR transfection-related gene expression alterations were detected with microarray-based genome-wide expression profiling of transfected and non-transfected 93RS2 cells without androgen stimulation. Microarray analysis revealed 672 differentially regulated genes with 200 up- and 472 down-regulated genes. These genes could be assigned to four major biological categories (development, hormone response, immune response and metabolism). Microarray results were confirmed by quantitative RT-PCR analysis for 22 candidate genes. Conclusion We conclude from our data, that the transfection of Ar-deficient Sertoli cells with AR has a measurable effect on gene expression even without androgen stimulation and cause Sertoli cell damage. Studies using AR-transfected cells, subsequently stimulated, should consider alterations in AR-dependent gene expression as off-target effects of the AR transfection itself. Electronic supplementary material The online version of this article (doi:10.1186/s12867-015-0051-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- D Fietz
- Institute of Veterinary Anatomy, Histology and Embryology, Justus Liebig University, Frankfurter Straße 98, 35392, Giessen, Germany.
| | - M Markmann
- Institute of Medical Microbiology, Justus Liebig University, Giessen, Germany.
| | - D Lang
- Institute of Veterinary Anatomy, Histology and Embryology, Justus Liebig University, Frankfurter Straße 98, 35392, Giessen, Germany.
| | - L Konrad
- Department of Gynecology and Obstetrics, Justus Liebig University, Giessen, Germany.
| | - J Geyer
- Institute of Veterinary Anatomy, Histology and Embryology, Justus Liebig University, Frankfurter Straße 98, 35392, Giessen, Germany.
| | - S Kliesch
- Department of Clinical Andrology, Centre for Reproductive Medicine and Andrology, University Clinic Münster, Münster, Germany.
| | - T Chakraborty
- Institute of Medical Microbiology, Justus Liebig University, Giessen, Germany.
| | - H Hossain
- Institute of Medical Microbiology, Justus Liebig University, Giessen, Germany.
| | - M Bergmann
- Institute of Veterinary Anatomy, Histology and Embryology, Justus Liebig University, Frankfurter Straße 98, 35392, Giessen, Germany.
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Sepehry AA, Lang D, Hsiung GY, Rauscher A. Prevalence of Brain Microbleeds in Alzheimer Disease: A Systematic Review and Meta-Analysis on the Influence of Neuroimaging Techniques. AJNR Am J Neuroradiol 2015; 37:215-22. [PMID: 26635284 DOI: 10.3174/ajnr.a4525] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 07/11/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE The literature on the prevalence of Alzheimer disease-associated cerebral microbleeds assessed with MR imaging shows considerable heterogeneity in terms of imaging techniques and parameters. Our aim was to perform a meta-analysis of the role of imaging techniques, including image acquisition, field strength and scanner type, and clinical and demographic factors on the reported prevalence of microbleeds in Alzheimer disease. MATERIALS AND METHODS The prevalence of microbleeds was examined with respect to a priori-selected moderating variables via meta-analytic tools of literature reports. RESULTS Fourteen unique studies providing 15 microbleed prevalence rates met the selection criteria for inclusion. The aggregate prevalence of microbleeds was 24% (95% CI, 19%-28%). Scan (SWI = 40%, gradient echo = 18%, EPI = 19%) and field strength (slope = 0.39; standard error = 15, P < .01) influenced the prevalence of microbleeds. The associations between microbleeds and age, sex, and global cognitive status were not significant. After updating the literature, the aggregate prevalence remained in the 95% CI range. CONCLUSIONS Imaging technique and field strength are strongly associated with the prevalence of microbleeds over the global aggregate. Standardized imaging protocols for identification of microbleeds are recommended to minimize confounds.
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Affiliation(s)
- A A Sepehry
- From the Division of Neurology (A.A.S., G.-Y.H.), Department of Medicine Departments of Paediatrics (A.A.S., A.R.)
| | - D Lang
- Radiology (D.L.); University of British Columbia, Vancouver, British Columbia, Canada
| | - G-Y Hsiung
- From the Division of Neurology (A.A.S., G.-Y.H.), Department of Medicine
| | - A Rauscher
- Departments of Paediatrics (A.A.S., A.R.)
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Platts-Mills JA, Babji S, Bodhidatta L, Gratz J, Haque R, Havt A, McCormick BJ, McGrath M, Olortegui MP, Samie A, Shakoor S, Mondal D, Lima IF, Hariraju D, Rayamajhi BB, Qureshi S, Kabir F, Yori PP, Mufamadi B, Amour C, Carreon JD, Richard SA, Lang D, Bessong P, Mduma E, Ahmed T, Lima AA, Mason CJ, Zaidi AK, Bhutta ZA, Kosek M, Guerrant RL, Gottlieb M, Miller M, Kang G, Houpt ER. Pathogen-specific burdens of community diarrhoea in developing countries: a multisite birth cohort study (MAL-ED). Lancet Glob Health 2015. [PMID: 26202075 DOI: 10.1016/s2214-109x(15)00151-5] [Citation(s) in RCA: 587] [Impact Index Per Article: 65.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Most studies of the causes of diarrhoea in low-income and middle-income countries have looked at severe disease in people presenting for care, and there are few estimates of pathogen-specific diarrhoea burdens in the community. METHODS We undertook a birth cohort study with not only intensive community surveillance for diarrhoea but also routine collection of non-diarrhoeal stools from eight sites in South America, Africa, and Asia. We enrolled children within 17 days of birth, and diarrhoeal episodes (defined as maternal report of three or more loose stools in 24 h, or one loose stool with visible blood) were identified through twice-weekly home visits by fieldworkers over a follow-up period of 24 months. Non-diarrhoeal stool specimens were also collected for surveillance for months 1-12, 15, 18, 21, and 24. Stools were analysed for a broad range of enteropathogens using culture, enzyme immunoassay, and PCR. We used the adjusted attributable fraction (AF) to estimate pathogen-specific burdens of diarrhoea. FINDINGS Between November 26, 2009, and February 25, 2014, we tested 7318 diarrhoeal and 24 310 non-diarrhoeal stools collected from 2145 children aged 0-24 months. Pathogen detection was common in non-diarrhoeal stools but was higher with diarrhoea. Norovirus GII (AF 5·2%, 95% CI 3·0-7·1), rotavirus (4·8%, 4·5-5·0), Campylobacter spp (3·5%, 0·4-6·3), astrovirus (2·7%, 2·2-3·1), and Cryptosporidium spp (2·0%, 1·3-2·6) exhibited the highest attributable burdens of diarrhoea in the first year of life. The major pathogens associated with diarrhoea in the second year of life were Campylobacter spp (7·9%, 3·1-12·1), norovirus GII (5·4%, 2·1-7·8), rotavirus (4·9%, 4·4-5·2), astrovirus (4·2%, 3·5-4·7), and Shigella spp (4·0%, 3·6-4·3). Rotavirus had the highest AF for sites without rotavirus vaccination and the fifth highest AF for sites with the vaccination. There was substantial variation in pathogens according to geography, diarrhoea severity, and season. Bloody diarrhoea was primarily associated with Campylobacter spp and Shigella spp, fever and vomiting with rotavirus, and vomiting with norovirus GII. INTERPRETATION There was substantial heterogeneity in pathogen-specific burdens of diarrhoea, with important determinants including age, geography, season, rotavirus vaccine usage, and symptoms. These findings suggest that although single-pathogen strategies have an important role in the reduction of the burden of severe diarrhoeal disease, the effect of such interventions on total diarrhoeal incidence at the community level might be limited.
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Affiliation(s)
- James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | | | | | - Jean Gratz
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA; Haydom Lutheran Hospital, Haydom, Tanzania
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Alexandre Havt
- Clinical Research Unit and Institute of Biomedicine, Federal University of Ceara, Fortaleza, Brazil
| | | | - Monica McGrath
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | - Dinesh Mondal
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ila Fn Lima
- Clinical Research Unit and Institute of Biomedicine, Federal University of Ceara, Fortaleza, Brazil
| | | | | | | | | | | | | | | | - J Daniel Carreon
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Stephanie A Richard
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Dennis Lang
- Foundation for the National Institutes of Health, Bethesda, MD, USA
| | | | - Esto Mduma
- Haydom Lutheran Hospital, Haydom, Tanzania
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Aldo Aam Lima
- Clinical Research Unit and Institute of Biomedicine, Federal University of Ceara, Fortaleza, Brazil
| | - Carl J Mason
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | - Margaret Kosek
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Asociación Benéfica PRISMA, Iquitos, Peru
| | - Richard L Guerrant
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Michael Gottlieb
- Foundation for the National Institutes of Health, Bethesda, MD, USA
| | - Mark Miller
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Eric R Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.
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Lang D. Opportunities to assess factors contributing to the development of the intestinal microbiota in infants living in developing countries. Microb Ecol Health Dis 2015; 26:28316. [PMID: 26031686 PMCID: PMC4451096 DOI: 10.3402/mehd.v26.28316] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Recent evidence suggests that establishment of a healthy gut microbiota shortly after birth is important to achieve optimal growth and development of children. Being born into a resource-poor environment presents challenges to the establishment of a healthy gut microbial flora in the newborn. Among these challenges are births that occur at home, traditional pre-lacteal feeding of newborns leading to failure to initiate lactation, poor sanitation and water quality, early environmental exposure to, and infection with, enteric or other pathogens, suboptimal breast feeding duration and intensity, deficiencies in weaning and childhood diets contributing to micro- and macro-nutrient deficiencies, and the frequent use of antibiotics. These factors should be considered in the design and implementation of preventive and therapeutic interventions aimed at improving the health and development of these children.
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Affiliation(s)
- Dennis Lang
- Foundation for the National Institutes of Health, Bethesda, MD, USA;
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Houpt E, Gratz J, Kosek M, Zaidi AKM, Qureshi S, Kang G, Babji S, Mason C, Bodhidatta L, Samie A, Bessong P, Barrett L, Lima A, Havt A, Haque R, Mondal D, Taniuchi M, Stroup S, McGrath M, Lang D. Microbiologic methods utilized in the MAL-ED cohort study. Clin Infect Dis 2015; 59 Suppl 4:S225-32. [PMID: 25305291 DOI: 10.1093/cid/ciu413] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
A central hypothesis of The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study is that enteropathogens contribute to growth faltering. To examine this question, the MAL-ED network of investigators set out to achieve 3 goals: (1) develop harmonized protocols to test for a diverse range of enteropathogens, (2) provide quality-assured and comparable results from 8 global sites, and (3) achieve maximum laboratory throughput and minimum cost. This paper describes the rationale for the microbiologic assays chosen and methodologies used to accomplish the 3 goals.
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Affiliation(s)
| | | | | | | | | | | | | | - Carl Mason
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | | | | | | | | | - Aldo Lima
- Universidade Federal do Ceara, Fortaleza, Brazil
| | | | | | | | | | | | - Monica McGrath
- Fogarty International Center, National Institutes of Health
| | - Dennis Lang
- Fogarty International Center, National Institutes of Health Foundation of the National Institutes of Health, Bethesda, Maryland
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Murray-Kolb LE, Rasmussen ZA, Scharf RJ, Rasheed MA, Svensen E, Seidman JC, Tofail F, Koshy B, Shrestha R, Maphula A, Vasquez AO, da Costa HP, Yousafzai AK, Oria RB, Roshan R, Bayyo EB, Kosek M, Shrestha S, Schaefer BA, Bessong P, Ahmed T, Lang D. The MAL-ED cohort study: methods and lessons learned when assessing early child development and caregiving mediators in infants and young children in 8 low- and middle-income countries. Clin Infect Dis 2015; 59 Suppl 4:S261-72. [PMID: 25305296 DOI: 10.1093/cid/ciu437] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
More epidemiological data are needed on risk and protective factors for child development. In The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study, we assessed child development in a harmonious manner across 8 sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa, and Tanzania. From birth to 24 months, development and language acquisition were assessed via the Bayley Scales of Infant and Toddler Development and a modified MacArthur Communicative Development Inventory. Other measures were infant temperament, the child's environment, maternal psychological adjustment, and maternal reasoning abilities. We developed standard operating procedures and used multiple techniques to ensure appropriate adaptation and quality assurance across the sites. Test adaptation required significant time and human resources but is essential for data quality; funders should support this step in future studies. At the end of this study, we will have a portfolio of culturally adapted instruments for child development studies with examination of psychometric properties of each tool used.
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Affiliation(s)
| | - Zeba A Rasmussen
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | | | | | - Erling Svensen
- University of Bergen, Norway Haydom Lutheran Hospital, Haydom, Tanzania
| | - Jessica C Seidman
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - Fahmida Tofail
- icddr,b (formerly the International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
| | | | - Rita Shrestha
- Institute of Medicine, Kathmandu, Nepal Royal Thai Army-Armed Forces Research Institute of Medical Sciences, Nepal and Thailand
| | | | - Angel Orbe Vasquez
- Asociacion Benefica PRISMA, Iquitos, Peru Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | | | | | | | - Margaret Kosek
- Asociacion Benefica PRISMA, Iquitos, Peru Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Sanjaya Shrestha
- Institute of Medicine, Kathmandu, Nepal Royal Thai Army-Armed Forces Research Institute of Medical Sciences, Nepal and Thailand
| | | | | | | | - Dennis Lang
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland The Foundation for the National Institutes of Health, Bethesda, Maryland
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Kosek M, Guerrant RL, Kang G, Bhutta Z, Yori PP, Gratz J, Gottlieb M, Lang D, Lee G, Haque R, Mason CJ, Ahmed T, Lima A, Petri WA, Houpt E, Olortegui MP, Seidman JC, Mduma E, Samie A, Babji S. Assessment of environmental enteropathy in the MAL-ED cohort study: theoretical and analytic framework. Clin Infect Dis 2015; 59 Suppl 4:S239-47. [PMID: 25305293 DOI: 10.1093/cid/ciu457] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [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: 01/05/2023] Open
Abstract
Individuals in the developing world live in conditions of intense exposure to enteric pathogens due to suboptimal water and sanitation. These environmental conditions lead to alterations in intestinal structure, function, and local and systemic immune activation that are collectively referred to as environmental enteropathy (EE). This condition, although poorly defined, is likely to be exacerbated by undernutrition as well as being responsible for permanent growth deficits acquired in early childhood, vaccine failure, and loss of human potential. This article addresses the underlying theoretical and analytical frameworks informing the methodology proposed by the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study to define and quantify the burden of disease caused by EE within a multisite cohort. Additionally, we will discuss efforts to improve, standardize, and harmonize laboratory practices within the MAL-ED Network. These efforts will address current limitations in the understanding of EE and its burden on children in the developing world.
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Affiliation(s)
- Margaret Kosek
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland Asociación Benéfica PRISMA, Iquitos, Peru
| | | | | | - Zulfiqar Bhutta
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Pablo Peñataro Yori
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland Asociación Benéfica PRISMA, Iquitos, Peru
| | - Jean Gratz
- Center for Global Health, University of Virginia, Charlottesville
| | | | - Dennis Lang
- Foundation of the National Institutes of Health Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - Gwenyth Lee
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland Asociación Benéfica PRISMA, Iquitos, Peru
| | | | - Carl J Mason
- Walter Reed/Armed Forces Research Institute of Medical Sciences Research Unit, Bangkok, Thailand
| | - Tahmeed Ahmed
- Center for Vaccine Sciences, iccdr,b, Dhaka, Bangladesh
| | - Aldo Lima
- Federal University of Ceará, Fortaleza, Brazil
| | - William A Petri
- Center for Global Health, University of Virginia, Charlottesville
| | - Eric Houpt
- Center for Global Health, University of Virginia, Charlottesville
| | - Maribel Paredes Olortegui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland Asociación Benéfica PRISMA, Iquitos, Peru
| | - Jessica C Seidman
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | | | - Amidou Samie
- University of Venda, Limpopo Province, South Africa
| | - Sudhir Babji
- Christian Medical College, Vellore, Tamil Nadu, India
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40
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Gahr M, Zeiss R, Lang D, Connemann B, Hiemke C, Freudenmann R, Schönfeldt-Lecuona C. Risk of Bleeding Related to Selective and Non-selective Serotonergic Antidepressants: A Case/Non-case Approach Using Data from Two Pharmacovigilance Databases. Pharmacopsychiatry 2014. [DOI: 10.1055/s-0032-1395594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- M. Gahr
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | - R. Zeiss
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | - D. Lang
- Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | - B. Connemann
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | - C. Hiemke
- Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany
| | - R. Freudenmann
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
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41
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Gahr M, Zeiss R, Lang D, Connemann BJ, Hiemke C, Freudenmann RW, Schönfeldt-Lecuona C. Risk of bleeding related to selective and non-selective serotonergic antidepressants: a case/non-case approach using data from two pharmacovigilance databases. Pharmacopsychiatry 2014; 48:19-24. [PMID: 25376976 DOI: 10.1055/s-0034-1394398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION There is increasing evidence for an association between treatment with selective serotonin reuptake inhibitors (SSRI) and an increased risk of bleeding events. The most important underlying mechanism appears to be inhibition of serotonin uptake in platelets, an effect that is also present in antidepressants with non-selective serotonin-reuptake inhibition (NSRI). Accordingly, also NSRI may be associated with an increased risk of bleeding. However, there is little data in this regard. METHODS Based on data (spontaneous reports of adverse drug reactions) from 2 pharmacovigilance databases (WHO-database/Vigibase™; BfArM/AkdÄ-database in Germany) we used a case/non-case approach and calculated reporting odds ratios (ROR) as measures for disproportionality regarding the association of treatment with an agent of the group SSRI/NSRI and haemorrhages. RESULTS Whereas both positive control agents (ASS and diclofenac) were statistically associated with haemorrhages in both databases (ASS: BfArM/AkdÄ, ROR 13.62 [95% CI 12.76-14.53]/WHO, ROR 12.96 [95% CI 12.75-13.16]; diclofenac: BfArM/AkdÄ, ROR 3.01 [95% CI 2.71-3.21]/WHO, ROR 2.11 [95% CI 2.05-2.16]), none of the agents of the group SSRI (ROR<1) was associated with haemorrhages. In group NSRI, only St. John's wort/hypericum was associated with haemorrhages (WHO-database, ROR 1.31 [95% CI 1.06-1.63]). DISCUSSION Signal detectioning in 2 pharmacovigilance databases suggest that serotonin reuptake inhibition is not associated with an increased risk of bleeding. However, underreporting may have accounted for the evaluated absent associations, particularly concerning SSRI. Regarding the detected increased risk of bleeding associated with hypericum, pharmacokinetic drug-drug interactions may be relevant independent of serotonin reuptake inhibition.
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Affiliation(s)
- M Gahr
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | - R Zeiss
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | - D Lang
- Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | - B J Connemann
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | - C Hiemke
- Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany
| | - R W Freudenmann
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
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Affiliation(s)
- J. Sauer
- Institut für Organische Chemie der Universität München
| | - D. Lang
- Institut für Organische Chemie der Universität München
| | - H. Wiest
- Institut für Organische Chemie der Universität München
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Sandhu KV, Lang D, Müller B, Nullmeier S, Yanagawa Y, Schwegler H, Stork O. Glutamic acid decarboxylase 67 haplodeficiency impairs social behavior in mice. Genes, Brain and Behavior 2014; 13:439-50. [DOI: 10.1111/gbb.12131] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 01/06/2014] [Accepted: 03/05/2014] [Indexed: 12/31/2022]
Affiliation(s)
- K. V. Sandhu
- Department of Genetics & Molecular Neurobiology; Institute of Biology; Magdeburg Germany
| | - D. Lang
- Department of Genetics & Molecular Neurobiology; Institute of Biology; Magdeburg Germany
| | - B. Müller
- Department of Genetics & Molecular Neurobiology; Institute of Biology; Magdeburg Germany
| | - S. Nullmeier
- Institute of Anatomy; Otto-von-Guericke University Magdeburg; Magdeburg Germany
| | - Y. Yanagawa
- Department of Genetic and Behavioral Neuroscience; Gunma University Graduate School of Medicine and JST, CREST; Maebashi Japan
| | - H. Schwegler
- Institute of Anatomy; Otto-von-Guericke University Magdeburg; Magdeburg Germany
- Center for Behavioral Brain Sciences; Magdeburg Germany
| | - O. Stork
- Department of Genetics & Molecular Neurobiology; Institute of Biology; Magdeburg Germany
- Center for Behavioral Brain Sciences; Magdeburg Germany
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McGrath M, Seidman J, Nelson M, Lang D, Gratz J, Knobler S, Platts-Mills J, Houpt E. The prevalence of norovirus in the MAL-ED cohort. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Thawer SG, Horsnell WGC, Darby M, Hoving JC, Dewals B, Cutler AJ, Lang D, Brombacher F. Lung-resident CD4⁺ T cells are sufficient for IL-4Rα-dependent recall immunity to Nippostrongylus brasiliensis infection. Mucosal Immunol 2014; 7:239-48. [PMID: 23778354 DOI: 10.1038/mi.2013.40] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 05/09/2013] [Indexed: 02/04/2023]
Abstract
Immunity to Nippostrongylus brasiliensis reinfection requires pulmonary CD4⁺ T-cell responses. We examined whether secondary lymphoid recruited or pre-existing lung CD4⁺ T-cell populations coordinated this immunity. To do this, we blocked T-cell egress from lymph nodes using Fingolimod (FTY720). This impaired host ability to resolve a primary infection but did not change effectiveness of recall immunity. Associated with this effective recall immunity was the expansion and T helper type 2 polarization of a pre-existing pulmonary CD4⁺ T-cell population. LTβR-Ig (lymphotoxin beta-receptor fusion protein)-mediated disruption of stromal cell organization of immune cells did not disrupt this recall immunity, suggesting that protection was mediated by a pulmonary interstitial residing CD4⁺ T-cell population. Adoptive transfer of N. brasiliensis-experienced pulmonary CD4⁺ T cells from FTY720-treated wild-type or T-cell interleukin (IL)-4Rα-deficient mice demonstrated protection to be IL-4Rα dependent. These results show that pre-existing CD4⁺ T cells can drive effective recall immunity to N. brasiliensis infection independently of T-cell recruitment from secondary lymphoid organs.
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Affiliation(s)
- S G Thawer
- International Centre for Genetic Engineering and Biotechnology/Institute of Infectious Diseases and Molecular Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa
| | - W G C Horsnell
- International Centre for Genetic Engineering and Biotechnology/Institute of Infectious Diseases and Molecular Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa
| | - M Darby
- International Centre for Genetic Engineering and Biotechnology/Institute of Infectious Diseases and Molecular Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa
| | - J C Hoving
- International Centre for Genetic Engineering and Biotechnology/Institute of Infectious Diseases and Molecular Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa
| | - B Dewals
- International Centre for Genetic Engineering and Biotechnology/Institute of Infectious Diseases and Molecular Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa
| | - A J Cutler
- International Centre for Genetic Engineering and Biotechnology/Institute of Infectious Diseases and Molecular Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa
| | - D Lang
- Department of Human Biology, Health Science Faculty, University of Cape Town, Cape Town, South Africa
| | - F Brombacher
- International Centre for Genetic Engineering and Biotechnology/Institute of Infectious Diseases and Molecular Medicine, Health Science Faculty, University of Cape Town, Cape Town, South Africa
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Hwang H, Lang D, Janardhan A, Ravikumar V, Holzem K, Choi B, Schuessler R, Efimov I. Partial Uncoupling of Impulse Source to Atrial Tissue by Ablation Triggers De Novo Ectopic Beats Through Paradoxical Improvement of Impulse Propagation. Heart Rhythm 2013. [DOI: 10.1016/j.hrthm.2013.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Humbert JP, Koppler P, Matter N, Lang D, Malviya AN. Le signal calcium dans la cellule: l'enveloppe nucléaire est-elle un réservoir à calcium ? ACTA ACUST UNITED AC 2013. [DOI: 10.4267/10608/2325] [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: 11/30/2022]
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Reynolds SL, Williams AS, Williams H, Smale S, Stephenson HJ, Amos N, George SJ, O'Donnell VB, Lang D. Contractile, but not endothelial, dysfunction in early inflammatory arthritis: a possible role for matrix metalloproteinase-9. Br J Pharmacol 2013; 167:505-14. [PMID: 22506619 PMCID: PMC3449256 DOI: 10.1111/j.1476-5381.2012.01988.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND PURPOSE Excess morbidity/mortality in rheumatoid arthritis (RA) is associated with increased incidence of cardiovascular disease. In this 'proof-of-concept' study, vascular function was characterized in the murine collagen-induced arthritis (mCIA) model, the benchmark choice for evaluation of the pathological processes and assessment of new therapies. EXPERIMENTAL APPROACH Mice in the very early stages of arthritis development [and appropriate naïve (non-immunized) age-matched controls] were used in the study. Blood pressure was measured using tail cuff plethysmography. Vascular function in rings of isolated aorta was studied with isometric tension myography. Levels of NO metabolites (NO(x)), MMP-9 protein and IL-1β in plasma and MMP-9 protein in aortic homogenates were quantified. KEY RESULTS Impaired vascular contractile responses in arthritis were unaffected by ex vivo inhibition of NOS (endothelial/neuronal and inducible) or COX activities. Endothelium-dependent and -independent relaxation, plasma NO(x) and blood pressure were unaffected by arthritis. Plasma and aortic homogenate MMP-9 protein levels were increased significantly in arthritis. Incubation of aortic tissues from naïve control animals with exogenous MMP-9 impaired subsequent contractile responses, mirroring that observed in arthritis. A role for IL-1β in perpetuating contractile dysfunction and increasing aortic MMP-9 was excluded. CONCLUSIONS AND IMPLICATIONS These data identify for the first time a relationship between early arthritis and contractile dysfunction and a possible role for MMP-9 therein, in the absence of overt endothelial dysfunction or increased NO production. As such, MMP-9 may constitute a significant target for early intervention in RA patients with a view to decreasing risk of cardiovascular disease.
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Affiliation(s)
- S l Reynolds
- Wales Heart Research Institute, School of Medicine, Cardiff University, Heath Park Campus, Cardiff, UK
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Kosek M, Haque R, Lima A, Babji S, Shrestha S, Qureshi S, Amidou S, Mduma E, Lee G, Yori PP, Guerrant RL, Bhutta Z, Mason C, Kang G, Kabir M, Amour C, Bessong P, Turab A, Seidman J, Olortegui MP, Quetz J, Lang D, Gratz J, Miller M, Gottlieb M. Fecal markers of intestinal inflammation and permeability associated with the subsequent acquisition of linear growth deficits in infants. Am J Trop Med Hyg 2012. [PMID: 23185075 PMCID: PMC3583335 DOI: 10.4269/ajtmh.2012.12-0549] [Citation(s) in RCA: 231] [Impact Index Per Article: 19.3] [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] [Indexed: 12/01/2022] Open
Abstract
Enteric infections are associated with linear growth failure in children. To quantify the association between intestinal inflammation and linear growth failure three commercially available enzyme-linked immunosorbent assays (neopterin [NEO], alpha-anti-trypsin [AAT], and myeloperoxidase [MPO]) were performed in a structured sampling of asymptomatic stool from children under longitudinal surveillance for diarrheal illness in eight countries. Samples from 537 children contributed 1,169 AAT, 916 MPO, and 954 NEO test results that were significantly associated with linear growth. When combined to form a disease activity score, children with the highest score grew 1.08 cm less than children with the lowest score over the 6-month period following the tests after controlling for the incidence of diarrheal disease. This set of affordable non-invasive tests delineates those at risk of linear growth failure and may be used for the improved assessments of interventions to optimize growth during a critical period of early childhood.
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Affiliation(s)
- Margaret Kosek
- *Address correspondence to Margaret Kosek, Johns Hopkins Bloomberg School of Public Health, Department of International Health, 615 N. Wolfe St E5545, Baltimore, MD 21205. E-mail:
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Kreutz C, Gehring JS, Lang D, Reski R, Timmer J, Rensing SA. TSSi—an R package for transcription start site identification from 5′ mRNA tag data. Bioinformatics 2012; 28:1641-2. [DOI: 10.1093/bioinformatics/bts189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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