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Namasivayam S, Tilves C, Ding H, Wu S, Domingue JC, Ruiz-Bedoya C, Shah A, Bohrnsen E, Schwarz B, Bacorn M, Chen Q, Levy S, Dominguez Bello MG, Jain SK, Sears CL, Mueller NT, Hourigan SK. Fecal transplant from vaginally seeded infants decreases intraabdominal adiposity in mice. Gut Microbes 2024; 16:2353394. [PMID: 38743047 PMCID: PMC11095576 DOI: 10.1080/19490976.2024.2353394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 05/06/2024] [Indexed: 05/16/2024] Open
Abstract
Exposing C-section infants to the maternal vaginal microbiome, coined "vaginal seeding", partially restores microbial colonization. However, whether vaginal seeding decreases metabolic disease risk is unknown. Therefore, we assessed the effect of vaginal seeding of human infants on adiposity in a murine model. Germ-free mice were colonized with transitional stool from human infants who received vaginal seeding or control (placebo) seeding in a double-blind randomized trial. There was a reduction in intraabdominal adipose tissue (IAAT) volume in male mice that received stool from vaginally seeded infants compared to control infants. Higher levels of isoleucine and lower levels of nucleic acid metabolites were observed in controls and correlated with increased IAAT. This suggests that early changes in the gut microbiome and metabolome caused by vaginal seeding have a positive impact on metabolic health.
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Affiliation(s)
- Sivaranjani Namasivayam
- Clinical Microbiome Unit (CMU), Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Curtis Tilves
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA
| | - Hua Ding
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shaoguang Wu
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jada C Domingue
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Camilo Ruiz-Bedoya
- Center for Infection and Inflammation Imaging Research, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ankit Shah
- Inova Health System, Inova Women’s Hospital, Falls Church, VA, USA
| | - Eric Bohrnsen
- Research Technologies Branch, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases; National Institutes of Health, Hamilton, MT, USA
| | - Benjamin Schwarz
- Research Technologies Branch, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases; National Institutes of Health, Hamilton, MT, USA
| | - Mickayla Bacorn
- Clinical Microbiome Unit (CMU), Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Qing Chen
- Clinical Microbiome Unit (CMU), Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Shira Levy
- Clinical Microbiome Unit (CMU), Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Maria Gloria Dominguez Bello
- Departments of Biochemistry and Microbiology, Rutgers University, New Brunswick, NJ, USA
- Humans and the microbiome program, Canadian Institute for Advanced Research (CIFAR), Toronto, ON, Canada
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Cynthia L Sears
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Noel T Mueller
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA
| | - Suchitra K Hourigan
- Clinical Microbiome Unit (CMU), Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Division of Pediatric Gastroenterology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Miller HE, Montemayor D, Levy S, Sharma K, Frost B, Bishop AJR. RLSuite: An Integrative R-Loop Bioinformatics Framework. J Bioinform Syst Biol 2023; 6:364-378. [PMID: 38292828 PMCID: PMC10827345 DOI: 10.26502/jbsb.5107071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
We recently described the development of a database of 810 R-loop mapping datasets and used this data to conduct a meta-analysis of R-loops. R-loops are three-stranded nucleic acid structures containing RNA:DNA hybrids and we were able to verify that 30% of expressed genes have an associated R-loop in a location conserved manner.. Moreover, intergenic R-loops map to enhancers, super enhancers and with TAD domain boundaries. This work demonstrated that R-loop mapping via high-throughput sequencing can reveal novel insight into R-loop biology, however the analysis and quality control of these data is a non-trivial task for which few bioinformatic tools exist. Herein we describe RLSuite, an integrative R-loop bioinformatics framework for pre-processing, quality control, and downstream analysis of R-loop mapping data. RLSuite enables users to compare their data to hundreds of public datasets and generate a user-friendly analysis report for sharing with non-bioinformatician colleagues. Taken together, RLSuite is a novel analysis framework that should greatly benefit the emerging R-loop bioinformatics community in a rapidly expanding aspect of epigenetic control that is still poorly understood.
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Affiliation(s)
- H E Miller
- Department of Cell Systems and Anatomy, UT Health San Antonio, San Antonio, TX, USA
- Greehey Children's Cancer Research Institute, UT Health San Antonio, San Antonio, TX, USA
- Bioinformatics Research Network, Atlanta, GA, USA
| | - D Montemayor
- Department of Medicine, UT Health San Antonio, San Antonio, TX, USA
- Center for Precision Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - S Levy
- Department of Cell Systems and Anatomy, UT Health San Antonio, San Antonio, TX, USA
- Bioinformatics Research Network, Atlanta, GA, USA
- Sam & Ann Barshop Institute for Longevity & Aging Studies, UT Health San Antonio, San Antonio, TX, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
| | - K Sharma
- Department of Medicine, UT Health San Antonio, San Antonio, TX, USA
- Center for Precision Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - B Frost
- Department of Cell Systems and Anatomy, UT Health San Antonio, San Antonio, TX, USA
- Sam & Ann Barshop Institute for Longevity & Aging Studies, UT Health San Antonio, San Antonio, TX, USA
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
| | - A J R Bishop
- Department of Cell Systems and Anatomy, UT Health San Antonio, San Antonio, TX, USA
- Greehey Children's Cancer Research Institute, UT Health San Antonio, San Antonio, TX, USA
- May's Cancer Center, UT Health San Antonio, San Antonio, TX, USA
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Chaudhary PP, O'Laughlin B, Kumar PS, Dabdoub SM, Levy S, Myles IA, Hourigan SK. Vaginal delivery provides skin colonization resistance from environmental microbes in the NICU. Clin Transl Med 2023; 13:e1506. [PMID: 38058267 PMCID: PMC10701179 DOI: 10.1002/ctm2.1506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 12/08/2023] Open
Affiliation(s)
- Prem Prashant Chaudhary
- Epithelial Therapeutics UnitNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | - Brynn O'Laughlin
- Clinical Microbiome UnitNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | - Purnima S. Kumar
- Department of Periodontics and Oral MedicineUniversity of Michigan School of DentistryAnn ArborMichiganUSA
| | - Shareef M. Dabdoub
- Division of Biostatistics and Computational BiologyCollege of DentistryUniversity of IowaIowa CityIowaUSA
| | - Shira Levy
- Clinical Microbiome UnitNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | - Ian A. Myles
- Epithelial Therapeutics UnitNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
| | - Suchitra K. Hourigan
- Clinical Microbiome UnitNational Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
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Subramanian P, Romero-Soto HN, Stern DB, Maxwell GL, Levy S, Hourigan SK. Delivery mode impacts gut bacteriophage colonization during infancy. medRxiv 2023:2023.11.13.23298307. [PMID: 38014162 PMCID: PMC10680904 DOI: 10.1101/2023.11.13.23298307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background Cesarean section delivery is associated with altered early-life bacterial colonization and later adverse inflammatory and immune health outcomes. Although gut bacteriophages can alter gut microbiome composition and impact host immune responses, little is known about how delivery mode impacts bacteriophage colonization over time. To begin to address this we examined how delivery mode affected bacteriophage colonization over the first two years of life. Results Shotgun metagenomic sequencing was conducted on 272 serial stool samples from 55 infants, collected at 1-2 days of life and 2, 6, 12 and 24 months. 33/55 (60%) infants were born by vaginal delivery. DNA viruses were identified, and by host inference, 94% of the viral sequences were found to be bacteriophages. Alpha diversity of the virome was increased in vaginally delivered infants compared to cesarean section delivered infants at 2 months (Shannon index, p=0.022). Beta diversity significantly differed by delivery mode at 2, 6, and 12 months when stratified by peripartum antibiotic use (Bray-Curtis dissimilarity, all p<0.05). Significant differentially abundant predicted bacteriophage hosts by delivery mode were seen at all time points. Moreover, there were differences in predicted bacteriophage functional gene abundances up to 24 months by delivery mode. Many of the functions considered to play a role in host response were increased in vaginal delivery. Conclusions Clear differences in bacteriophage composition and function were seen by delivery mode over the first two years of life. Given that phages are known to affect host immune response, our results suggest that future investigation into how delivery mode may lead to adverse inflammatory outcomes should not only include bacterial microbial colonization but also the potential role of bacteriophages and transkingdom interactions.
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Affiliation(s)
- Poorani Subramanian
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States
| | - Hector N Romero-Soto
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States
| | - David B Stern
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States
| | - George L Maxwell
- Women's Service Line, Inova Health System, Falls Church, Virginia, United States
| | - Shira Levy
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States
| | - Suchitra K Hourigan
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States
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Chaudhary PP, Myles IA, Zeldin J, Dabdoub S, Deopujari V, Baveja R, Baker R, Bengtson S, Sutton A, Levy S, Hourigan SK. Shotgun metagenomic sequencing on skin microbiome indicates dysbiosis exists prior to the onset of atopic dermatitis. Allergy 2023; 78:2724-2731. [PMID: 37422700 PMCID: PMC10543534 DOI: 10.1111/all.15806] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/01/2023] [Accepted: 05/14/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND While the microbiome is increasingly seen as a targetable contributor to atopic dermatitis (AD), questions remain as to whether the dysbiosis is secondary to diseased skin or if it predates symptom onset. Previous work has evaluated how the skin microbiome changes with age and established the influence of factors like delivery mode and breastfeeding on global microbiome diversity. However, these studies were unable to identify taxa which predict subsequent AD. METHODS Skin swab samples were collected from the first week of life for 72 children in the neonatal intensive care unit (NICU) at a single site hospital. Participants were followed for 3 years to determine their health status. We applied shotgun metagenomic sequencing to assess the microbiome differences between 31 children who went on to develop AD and 41 controls. RESULTS We identified that subsequent development of AD was associated with differential abundance of several bacterial and fungal taxa as well as several metabolic pathways, each of which have been previously associated with active AD. CONCLUSIONS Our work provides evidence of reproducibility for the previously reported dysbiotic signatures predating AD onset while also expanding prior findings through the first use of metagenomic assessment prior to AD onset. While extrapolation of our findings beyond the pre-term, NICU cohort is limited, our findings add to the evidence that the dysbiosis associated with AD pre-dates disease onset rather than reflect a secondary consequence of skin inflammation.
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Affiliation(s)
- Prem Prashant Chaudhary
- Epithelial Therapeutics Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Ian A Myles
- Epithelial Therapeutics Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jordan Zeldin
- Epithelial Therapeutics Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Shareef Dabdoub
- Division of Biostatistics and Computational Biology, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | | | - Rajiv Baveja
- Fairfax Neonatal Associates, Fairfax, Virginia, USA
| | - Robin Baker
- Fairfax Neonatal Associates, Fairfax, Virginia, USA
| | - Sarah Bengtson
- College of William and Mary, Williamsburg, Virginia, USA
- Clinical Microbiome Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Ashleigh Sutton
- Clinical Microbiome Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Shira Levy
- Clinical Microbiome Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Suchitra K Hourigan
- Clinical Microbiome Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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Gamliel A, Lee YN, Lev A, AbuZaitun O, Rechavi E, Levy S, Simon AJ, Somech R. Immunologic Heterogeneity in 2 Cartilage-Hair Hypoplasia Patients With a Distinct Clinical Course. J Investig Allergol Clin Immunol 2023; 33:263-270. [PMID: 35166674 DOI: 10.18176/jiaci.0792] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Cartilage-hair hypoplasia (CHH) syndrome is a rare autosomal recessive syndrome associated with skeletal dysplasia, varying degrees of combined immunodeficiency (CID), short stature, hair hypoplasia, macrocytic anemia, increased risk of malignancies, and Hirschsprung disease. To provide clinical and immunological insights obtained from 2 unrelated patients who displayed clinical characteristics of CHH. METHODS Two patients with suspected CHH syndrome due to skeletal dysplasia and immunodeficiency underwent an immunological and genetic work-up using flow cytometry, next-generation sequencing (NGS) of the immune repertoire, and Sanger sequencing to identify the underlying defects. RESULTS Patient 1 presented with low birth weight and skeletal dysplasia. Newborn screening was suggestive of T-cell immunodeficiency, as T-cell receptor excision circle levels were undetectable. Both the T-cell receptor (TCR) Vß and TCR-g (TRG) repertoires were restricted, with evidence of clonal expansion. Genetic analysis identified compound heterozygous RMRP variants inherited from both parents. Patient 2 presented with recurrent lung and gastrointestinal infections, skeletal dysplasia, failure to thrive, and hepatomegaly. The polyclonal pattern of the TCRß repertoire was normal, with only slight overexpression of TCR-ßV20 and restricted expression of Vßs. TRG expressed a normal diverse repertoire, similar to that of the healthy control sample. Genetic analysis identified biallelic novel regulatory variants in RMRP. Both parents are carriers of this mutation. CONCLUSION Our findings demonstrate how the immunological work-up, supported by genetic findings, can dramatically change treatment and future outcome in patients with the same clinical syndrome.
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Affiliation(s)
- A Gamliel
- Pediatric Department A and Immunology Service, Jeffrey Modell Foundation Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y N Lee
- Pediatric Department A and Immunology Service, Jeffrey Modell Foundation Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Lev
- Pediatric Department A and Immunology Service, Jeffrey Modell Foundation Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - O AbuZaitun
- Ambulatory Pediatrics, Nablus, Palestinian Authority
| | - E Rechavi
- Pediatric Department A and Immunology Service, Jeffrey Modell Foundation Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Levy
- Pediatric Department A and Immunology Service, Jeffrey Modell Foundation Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - A J Simon
- Pediatric Department A and Immunology Service, Jeffrey Modell Foundation Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Hematology Laboratory, Hemato-Immunology Unit, and Sheba Cancer Research Center, Sheba Medical Center, Tel Hashomer, Israel
| | - R Somech
- Pediatric Department A and Immunology Service, Jeffrey Modell Foundation Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Mueller NT, Differding MK, Sun H, Wang J, Levy S, Deopujari V, Appel LJ, Blaser MJ, Kundu T, Shah AA, Dominguez Bello MG, Hourigan SK. Maternal Bacterial Engraftment in Multiple Body Sites of Cesarean Section Born Neonates after Vaginal Seeding-a Randomized Controlled Trial. mBio 2023; 14:e0049123. [PMID: 37074174 PMCID: PMC10294643 DOI: 10.1128/mbio.00491-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/20/2023] Open
Abstract
Children delivered by elective, prelabor Cesarean section (C-section) are not exposed to the birth canal microbiota and, in relation to vaginally delivered children, show altered microbiota development. Perturbed microbial colonization during critical early-life windows of development alters metabolic and immune programming and is associated with an increased risk of immune and metabolic diseases. In nonrandomized studies, vaginal seeding of C-section-born neonates partially restores their microbiota colonization to that of their vaginally delivered counterparts, but without randomization, confounding factors cannot be excluded. In a double-blind, randomized, placebo-controlled trial, we determined the effect of vaginal seeding versus placebo seeding (control arm) on the skin and stool microbiota of elective, prelabor C-section-born neonates (n = 20) at 1 day and 1 month after birth. We also examined whether there were between-arm differences in engraftment of maternal microbes in the neonatal microbiota. In relation to the control arm, vaginal seeding increased mother-to-neonate microbiota transmission and caused compositional changes and a reduction in alpha diversity (Shannon Index) of the skin and stool microbiota. The neonatal skin and stool microbiota alpha diversity when maternal vaginal microbiota is provided is intriguing and highlights the need of larger randomized studies to determine the ecological mechanisms and effects of vaginal seeding on clinical outcomes. IMPORTANCE Children delivered by elective C-section are not exposed to the birth canal and show altered microbiota development. Impairing microbial colonization during early life alters metabolic and immune programming and is associated with an increased risk of immune and metabolic diseases. In a double-blind, randomized, placebo-controlled trial, we determined the effect of vaginal seeding on the skin and stool microbiota of elective C-section born neonates and found that vaginal seeding increased mother-to-neonate microbiota transmission and caused compositional changes and a reduction in the skin and stool microbiota diversity. The reduction of neonatal skin and stool microbiota diversity when maternal vaginal microbiota is provided is intriguing and highlights the need of larger randomized studies to determine the ecological mechanisms and effects of vaginal seeding on clinical outcomes.
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Affiliation(s)
- Noel T. Mueller
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland, USA
| | - Moira K. Differding
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland, USA
| | - Haipeng Sun
- Department of Biochemistry and Microbiology, Rutgers University, New Brunswick, New Jersey, USA
| | - Jincheng Wang
- Department of Biochemistry and Microbiology, Rutgers University, New Brunswick, New Jersey, USA
| | - Shira Levy
- Clinical Microbiome Unit (CMU), Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Inova Children’s Hospital, Inova Health System, Falls Church, Virginia, USA
| | - Varsha Deopujari
- Inova Children’s Hospital, Inova Health System, Falls Church, Virginia, USA
| | - Lawrence J. Appel
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland, USA
| | - Martin J. Blaser
- Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, New Jersey, USA
| | - Tanima Kundu
- Center for Advanced Biotechnology and Medicine, Rutgers University, New Brunswick, New Jersey, USA
| | - Ankit A. Shah
- Inova Women’s Hospital, Inova Health System, Falls Church, Virginia, USA
| | - Maria Gloria Dominguez Bello
- Department of Biochemistry and Microbiology, Rutgers University, New Brunswick, New Jersey, USA
- Clinical Microbiome Unit (CMU), Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Department of Anthropology, Rutgers University, New Brunswick, New Jersey, USA
- Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey, USA
- Canadian Institute for Advanced Research (CIFAR), Toronto, Ontario, Canada
| | - Suchitra K. Hourigan
- Clinical Microbiome Unit (CMU), Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Inova Children’s Hospital, Inova Health System, Falls Church, Virginia, USA
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Mani J, Levy S, Angelova A, Hazrati S, Fassnacht R, Subramanian P, Richards T, Niederhuber JE, Maxwell GL, Hourigan SK. Epidemiological and microbiome associations of Clostridioides difficile carriage in infancy and early childhood. Gut Microbes 2023; 15:2203969. [PMID: 37096914 PMCID: PMC10132246 DOI: 10.1080/19490976.2023.2203969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
There has been an increase in the prevalence of Clostridioides difficile (C. diff) causing significant economic impact on the health care system. Although toxigenic C. diff carriage is recognized in infancy, there is limited data regarding its longitudinal trends, associated epidemiolocal risk factors and intestinal microbiome characteristics. The objectives of our longitudinal cohort study were to investigate temporal changes in the prevalence of toxigenic C.diff colonization in children up to 2 years, associated epidemiological and intestinal microbiome characteristics. Pregnant mothers were enrolled prenatally, and serial stool samples were collected from their children for 2 years. 2608 serial stool samples were collected from 817 children. 411/817 (50%) were males, and 738/817 (90%) were born full term. Toxigenic C.diff was detected in 7/569 (1%) of meconium samples, 116/624 (19%) of 2 m (month), 221/606 (37%) of 6 m, 227/574 (40%) of 12 m and 18/235 (8%) of 24 m samples. Infants receiving any breast milk at 6 m were less likely to be carriers at 2 m, 6 m and 12 m than those not receiving it. (p = 0.002 at 2 m, p < 0.0001 at 6 m, p = 0.022 at 12 m). There were no robust differences in the underlying alpha or beta diversity between those with and without toxigenic C. diff carriage at any timepoint, although small differences in the relative abundance of certain taxa were found. In this largest longitudinal cohort study to date, a high prevalence of toxigenic C. diff carrier state was noted. Toxigenic C. diff carrier state in children is most likely a transient component of the dynamic infant microbiome.
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Affiliation(s)
- Jyoti Mani
- Department of Pediatrics, Children's National Medical Center, Washington, DC, USA
| | - Shira Levy
- National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA
| | - Angelina Angelova
- National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA
| | - Sahel Hazrati
- Women's Service Line, Inova Health System, Falls Church, VA, USA
| | - Ryan Fassnacht
- Inova Children's Hospital, Inova Health System, Falls Church, VA, USA
| | - Poorani Subramanian
- National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA
- Inova Children's Hospital, Inova Health System, Falls Church, VA, USA
| | - Tiana Richards
- Inova Children's Hospital, Inova Health System, Falls Church, VA, USA
| | - John E Niederhuber
- Inova Children's Hospital, Inova Health System, Falls Church, VA, USA
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - George L Maxwell
- Women's Service Line, Inova Health System, Falls Church, VA, USA
| | - Suchitra K Hourigan
- National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA
- Inova Children's Hospital, Inova Health System, Falls Church, VA, USA
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Bacorn M, Romero-Soto HN, Levy S, Chen Q, Hourigan SK. The Gut Microbiome of Children during the COVID-19 Pandemic. Microorganisms 2022; 10:microorganisms10122460. [PMID: 36557713 PMCID: PMC9783902 DOI: 10.3390/microorganisms10122460] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
The gut microbiome has been shown to play a critical role in maintaining a healthy state. Dysbiosis of the gut microbiome is involved in modulating disease severity and potentially contributes to long-term outcomes in adults with COVID-19. Due to children having a significantly lower risk of severe illness and limited sample availability, much less is known about the role of the gut microbiome in children with COVID-19. It is well recognized that the developing gut microbiome of children differs from that of adults, but it is unclear if this difference contributes to the different clinical presentations and complications. In this review, we discuss the current knowledge of the gut microbiome in children with COVID-19, with gut microbiome dysbiosis being found in pediatric COVID-19 but specific taxa change often differing from those described in adults. Additionally, we discuss possible mechanisms of how the gut microbiome may mediate the presentation and complications of COVID-19 in children and the potential role for microbial therapeutics.
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10
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Nashed L, Mani J, Hazrati S, Stern DB, Subramanian P, Mattei L, Bittinger K, Hu W, Levy S, Maxwell GL, Hourigan SK. Gut microbiota changes are detected in asymptomatic very young children with SARS-CoV-2 infection. Gut 2022; 71:2371-2373. [PMID: 35135843 PMCID: PMC9357857 DOI: 10.1136/gutjnl-2021-326599] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/28/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Lydia Nashed
- Inova Children’s Hospital, Inova Health System, Falls Church, Virginia, USA
| | - Jyoti Mani
- Pediatric Gastroenterology, Children's National Health System, Washington, District of Columbia, USA
| | - Sahel Hazrati
- Women’s Service Line, Inova Health System, Falls Church, Virginia, USA
| | - David B Stern
- Bioinformatics and Computational Biosciences Branch, NIAID, Bethesda, Maryland, USA
| | - Poorani Subramanian
- Bioinformatics and Computational Biosciences Branch, NIAID, Bethesda, Maryland, USA
| | - Lisa Mattei
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia Pediatrics Residency Program, Philadelphia, Pennsylvania, USA
| | - Kyle Bittinger
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia Pediatrics Residency Program, Philadelphia, Pennsylvania, USA
| | - Weiming Hu
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia Pediatrics Residency Program, Philadelphia, Pennsylvania, USA
| | - Shira Levy
- Inova Children’s Hospital, Inova Health System, Falls Church, Virginia, USA,Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - George L Maxwell
- Women’s Service Line, Inova Health System, Falls Church, Virginia, USA
| | - Suchitra K Hourigan
- Inova Children's Hospital, Inova Health System, Falls Church, Virginia, USA .,Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
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11
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Moutinho TJ, Powers DA, Hanson GF, Levy S, Baveja R, Hefner I, Mohamed M, Abdelghani A, Baker RL, Papin JA, Moore SR, Hourigan SK. Fecal sphingolipids predict parenteral nutrition-associated cholestasis in the neonatal intensive care unit. JPEN J Parenter Enteral Nutr 2022; 46:1903-1913. [PMID: 35285019 PMCID: PMC9468188 DOI: 10.1002/jpen.2374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Parenteral nutrition-associated cholestasis (PNAC) in the neonatal intensive care unit (NICU) causes significant morbidity and associated healthcare costs. Laboratory detection of PNAC currently relies on elevated serum conjugated bilirubin levels in the aftermath of impaired bile flow. Here, we sought to identify fecal biomarkers, which when integrated with clinical data, would better predict risk for developing PNAC. METHODS Using untargeted metabolomics in 200 serial stool samples from 60 infants, we applied statistical and machine learning approaches to identify clinical features and metabolic biomarkers with the greatest associative potential for risk of developing PNAC. Stools were collected prospectively from infants receiving PN with soybean oil-based lipid emulsion at a level IV NICU. RESULTS Low birth weight, extreme prematurity, longer duration of PN, and greater number of antibiotic courses were all risk factors for PNAC (P < 0.05). We identified 78 stool biomarkers with early predictive potential (P < 0.05). From these 78 biomarkers, we further identified 12 sphingomyelin lipids with high association for the development of PNAC in precholestasis stool samples when combined with birth anthropometry. CONCLUSION We demonstrate the potential for stool metabolomics to enhance early identification of PNAC risk. Earlier detection of high-risk infants would empower proactive mitigation with alterations to PN for at-risk infants and optimization of energy nutrition with PN for infants at lower risk.
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Affiliation(s)
- Thomas J. Moutinho
- Department of Biomedical EngineeringUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Deborah A. Powers
- Department of Biomedical EngineeringUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Gabriel F. Hanson
- Department of Biomedical EngineeringUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Shira Levy
- Inova Children's HospitalFalls ChurchVirginiaUSA
| | - Rajiv Baveja
- Fairfax Neonatal AssociatesFalls ChurchVirginiaUSA
| | | | | | | | | | - Jason A. Papin
- Department of Biomedical EngineeringUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Sean R. Moore
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of PediatricsUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Suchitra K. Hourigan
- Inova Children's HospitalFalls ChurchVirginiaUSA,Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of PediatricsUniversity of VirginiaCharlottesvilleVirginiaUSA,Division of Pediatric GastroenterologyPediatric Specialists of VirginiaFairfaxVirginiaUSA,Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA
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12
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Feng F, Ning Y, Xue Y, Friedl V, Hann D, Gibb B, Bergamaschi A, Guler G, Hazen K, Scott A, Phillips T, McCarthy E, Ellison C, Malta R, Nguyen A, Lopez V, Cavet R, Chowdhury S, Volkmuth W, Levy S. 69MO 5-Hydroxymethycytosine analysis reveals stable epigenetic changes in tumor tissue that enable cfDNA cancer predictions. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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13
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Garcia E, Sanchez-Rodriguez D, Levy S, Claessens M, Van Hauwermeiren C, Taliha M, Benoit F, Surquin M. [Factors associated with intrahospital mortality in older patients with COVID-19 in Belgium : The COVID-AgeBru study]. Rev Med Liege 2022; 77:146-152. [PMID: 35258862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE We aimed at assessing the association between demographical and clinical data and the intrahospital mortality in older patients with COVID-19 in Belgium. METHODS Descriptive, retrospective study of consecutive patients admitted to Brugmann university hospital, Brussels (Belgium) due to COVID-19 (Mars-September-2020). INCLUSION CRITERIA Patients aged ≥ 70 years admitted to acute care with a positive PCR-RT test, or a highly indicative computed tomography scan. EXCLUSION CRITERIA Patients transferred to another institution during hospitalization. OUTCOME MEASURE All-cause intrahospital mortality. Demographic, clinical data, presence of comordibidties and comprehensive geriatric assessment were collected. Adjusted and unadjusted logistic regression were performed. RESULTS From the 226 eligible patients, 160 (82.7 ± 6.5-year-old; 57.5 % females) met inclusion criteria, from which 67 (42 %) died during hospital stay. The adjusted logistic regression showed an association between intrahospital mortality and increasing age [OR = 1.09 per every year increase (95 % CI 1.02-1.16); p <0.001], type 2 diabetes [OR = 2.75 ( 1.17-6.46); p = 0.021], and acute respiratory distress syndrome (ARDS) [OR = 8.67 ( 3.48-21.61); p < 0.01]. CONCLUSIONS A higher positive association between intrahospital mortality and increasing age, type 2 diabetes, and ARDS was found. The prognosis value of the comprehensive geriatric assessment in older people with COVID-19 in Belgium requires further studies.
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Affiliation(s)
- E Garcia
- Faculté de Médecine, ULB, Bruxelles, Belgique
| | - D Sanchez-Rodriguez
- Faculté de Médecine, ULB, Bruxelles, Belgique
- Unité de Recherche Clinique, CHU Brugmann, Bruxelles, Belgique
- Centre Collaborateur de l'OMS pour l'étude de la santé et du vieillissement de l'Appareil musculosquelettique. Division de Santé publique, Épidémiologie et Économie de la Santé, ULiège, Belgique
- Département de Gériatrie, Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelone, Espagne
| | - S Levy
- Département de Gériatrie, CHU Brugmann, Bruxelles, Belgique
| | - M Claessens
- Département de Gériatrie, CHU Brugmann, Bruxelles, Belgique
| | | | - M Taliha
- Département de Gériatrie, CHU Brugmann, Bruxelles, Belgique
| | - F Benoit
- Faculté de Médecine, ULB, Bruxelles, Belgique
- Département de Gériatrie, CHU Brugmann, Bruxelles, Belgique
| | - M Surquin
- Faculté de Médecine, ULB, Bruxelles, Belgique
- Département de Gériatrie, CHU Brugmann, Bruxelles, Belgique
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14
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Nashed LM, Mani J, Hazrati S, Richards T, Nerikar N, Ravi S, Mattei L, Levy S, Maxwell G, Hourigan S. 482. SARS-CoV-2 Prevalence in Feces of Very Young Children, A Longitudinal Study. Open Forum Infect Dis 2021. [PMCID: PMC8644872 DOI: 10.1093/ofid/ofab466.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Understanding the disease burden of SARS- CoV-2 in young children has been challenging as the majority are asymptomatic or experience mild symptoms and were rarely tested. SARS-CoV-2 is traditionally detected through respiratory secretions but has also been reported in feces where shedding may continue for weeks after respiratory samples show resolution. We examined the prevalence of SARS-CoV-2 in already collected fecal samples from young children through the pandemic as well as associated demographic factors. Methods As part of an ongoing longitudinal microbiome study in Northern Virginia, serial stools samples were collected from infants before and throughout the Covid-19 pandemic. Reverse transcription quantitative-PCR detecting SARS-CoV-2 nucleocapsid gene in the N1 and N2 regions was performed. Penalized logistic regression models were developed to evaluate the association between fecal positivity and potential risk factors. Results The overall prevalence of SARS-CoV-2 in infant feces was 1.69 % (13 samples) with a prevalence at delivery, 2, 6, 12 and 24 months of 0, 0, 2.56, 1.96, and 0.85 % respectively. Fecal positivity was first detected 31 days before the reported first case of Covid-19 in Northern Virginia; prevalence rates peaked in September at 4.5% (Figure 1). Only one infant who tested positive was symptomatic with COVID-19 21 days before his stool was collected. Of the 13 positive samples, 8 reported Hispanic ethnicity and 7 reported an essential worker (Table 1). Penalized logistic regression model showed association between Hispanic ethnicity and testing positive (OR 5.04 (95% CI 1.7 – 15.0)) that remained after controlling for the presences of an essential worker (OR 4.7 (95% CI 1.6 – 14.0)). ![]()
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Conclusion Prevalence of SARS- CoV-2 in infant stool correlated with the prevalence of COVID-19 during the pandemic, with higher rates in those of Hispanic ethnicity corelating with regional trends. Fecal positivity in asymptomatic infants even before quarantine restrictions supports the early but silent transmission of SARS-CoV-2. This study likely underestimates true prevalence rates as stool samples were stored without viral preservative. There are many socioeconomic factors that predispose to disease while ethnicity may be a mediating or confounding factor Disclosures All Authors: No reported disclosures
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Affiliation(s)
| | - Jyoti Mani
- Inova Children’s Hospital, Annandale, Virginia
| | | | | | | | | | | | - Shira Levy
- Inova Children’s Hospital, Annandale, Virginia
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15
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Levorson RE, Christian E, Hunter B, Sayal J, Sun J, Bruce SA, Garofalo S, Southerland M, Ho S, Levy S, Defillipi C, Peake L, Place FC, Hourigan SK. A cross-sectional investigation of SARS-CoV-2 seroprevalence and associated risk factors in children and adolescents in the United States. PLoS One 2021; 16:e0259823. [PMID: 34748615 PMCID: PMC8575286 DOI: 10.1371/journal.pone.0259823] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/23/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pediatric SARS-CoV-2 data remain limited and seropositivity rates in children were reported as <1% early in the pandemic. Seroepidemiologic evaluation of SARS-CoV-2 in children in a major metropolitan region of the US was performed. METHODS Children and adolescents ≤19 years were enrolled in a cross-sectional, observational study of SARS-CoV-2 seroprevalence from July-October 2020 in Northern Virginia, US. Demographic, health, and COVID-19 exposure information was collected, and blood analyzed for SARS-CoV-2 spike protein total antibody. Risk factors associated with SARS-CoV-2 seropositivity were analyzed. Orthogonal antibody testing was performed, and samples were evaluated for responses to different antigens. RESULTS In 1038 children, the anti-SARS-CoV-2 total antibody positivity rate was 8.5%. After multivariate logistic regression, significant risk factors included Hispanic ethnicity, public or absent insurance, a history of COVID-19 symptoms, exposure to person with COVID-19, a household member positive for SARS-CoV-2 and multi-family or apartment dwelling without a private entrance. 66% of seropositive children had no symptoms of COVID-19. Secondary analysis included orthogonal antibody testing with assays for 1) a receptor binding domain specific antigen and 2) a nucleocapsid specific antigen had concordance rates of 80.5% and 79.3% respectively. CONCLUSIONS A much higher burden of SARS-CoV-2 infection, as determined by seropositivity, was found in children than previously reported; this was also higher compared to adults in the same region at a similar time. Contrary to prior reports, we determined children shoulder a significant burden of COVID-19 infection. The role of children's disease transmission must be considered in COVID-19 mitigation strategies including vaccination.
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Affiliation(s)
- Rebecca E. Levorson
- Division of Pediatric Infectious Diseases, Inova Children’s Hospital, Falls Church, Virginia, United States of America
- Division of Pediatric Infectious Diseases, Pediatric Specialists of Virginia, Fairfax, Virginia, United States of America
| | - Erica Christian
- Division of Pediatric Research, Inova Children’s Hospital, Falls Church, Virginia, United States of America
| | - Brett Hunter
- Department of Statistics, George Mason University, Fairfax, Virginia, United States of America
| | - Jasdeep Sayal
- Division of Pediatric Research, Inova Children’s Hospital, Falls Church, Virginia, United States of America
| | - Jiayang Sun
- Department of Statistics, George Mason University, Fairfax, Virginia, United States of America
| | - Scott A. Bruce
- Department of Statistics, George Mason University, Fairfax, Virginia, United States of America
| | - Stephanie Garofalo
- Inova Heart and Vascular Institute, Inova Health System, Falls Church, Virginia, United States of America
| | - Matthew Southerland
- Inova Heart and Vascular Institute, Inova Health System, Falls Church, Virginia, United States of America
| | - Svetlana Ho
- Division of Pediatric Research, Inova Children’s Hospital, Falls Church, Virginia, United States of America
| | - Shira Levy
- Division of Pediatric Research, Inova Children’s Hospital, Falls Church, Virginia, United States of America
| | - Christopher Defillipi
- Inova Heart and Vascular Institute, Inova Health System, Falls Church, Virginia, United States of America
| | - Lilian Peake
- Division of Epidemiology, Virginia Department of Health, Richmond, Virginia, United States of America
| | - Frederick C. Place
- Division of Pediatric Emergency Medicine, Inova Children’s Hospital, Falls Church, Virginia, United States of America
| | - Suchitra K. Hourigan
- Division of Pediatric Research, Inova Children’s Hospital, Falls Church, Virginia, United States of America
- Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
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16
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Mukherjee S, O'Connor H, Harman R, O'Donovan M, Debiram-Beecham I, Alias B, Bailey A, Bateman A, de Caestecker J, Crosby T, Falk S, Gollins S, Hawkins M, Levy S, Radhakrishna G, Roy R, Sripadam R, Fitzgerald R. P-109 CYTOFLOC: Evaluation of a non-endoscopic immunocytological device (Cytosponge™) for post-chemo-radiotherapy surveillance in patients with oesophageal cancer – a feasibility study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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17
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Baucher G, Rasoanandrianina H, Levy S, Pini L, Troude L, Roche PH, Callot V. T1 Mapping for Microstructural Assessment of the Cervical Spinal Cord in the Evaluation of Patients with Degenerative Cervical Myelopathy. AJNR Am J Neuroradiol 2021; 42:1348-1357. [PMID: 33985954 DOI: 10.3174/ajnr.a7157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 02/07/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Although current radiologic evaluation of degenerative cervical myelopathy by conventional MR imaging accurately demonstrates spondylosis or degenerative disc disease causing spinal cord dysfunction, conventional MR imaging still fails to provide satisfactory anatomic and clinical correlations. In this context, we assessed the potential value of quantitative cervical spinal cord T1 mapping regarding the evaluation of patients with degenerative cervical myelopathy. MATERIALS AND METHODS Twenty patients diagnosed with mild and moderate-to-severe degenerative cervical myelopathy and 10 healthy subjects were enrolled in a multiparametric MR imaging protocol. Cervical spinal cord T1 mapping was performed with the MP2RAGE sequence procedure. Retrieved data were processed and analyzed regarding the global spinal cord and white and anterior gray matter on the basis of the clinical severity and the spinal canal stenosis grading. RESULTS Noncompressed levels in healthy controls demonstrated significantly lower T1 values than noncompressed, mild, moderate, and severe stenotic levels in patients. Concerning the entire spinal cord T1 mapping, patients with moderate-to-severe degenerative cervical myelopathy had higher T1 values compared with healthy controls. Regarding the specific levels, patients with moderate-to-severe degenerative cervical myelopathy demonstrated a T1 value increase at C1, C7, and the level of maximal compression compared with healthy controls. Patients with mild degenerative cervical myelopathy had lower T1 values than those with moderate-to-severe degenerative cervical myelopathy at the level of maximal compression. Analyses of white and anterior gray matter confirmed similar results. Strong negative correlations between individual modified Japanese Orthopaedic Association scores and T1 values were also observed. CONCLUSIONS In this preliminary study, 3D-MP2RAGE T1 mapping demonstrated increased T1 values in the pathology tissue samples, with diffuse medullary alterations in all patients with degenerative cervical myelopathy, especially relevant at C1 (nonstenotic level) and at the maximal compression level. Encouraging correlations observed with the modified Japanese Orthopaedic Association score make this novel approach a potential quantitative biomarker related to clinical severity in degenerative cervical myelopathy. Nevertheless, patients with mild degenerative cervical myelopathy demonstrated nonsignificant results compared with healthy controls and should now be studied in multicenter studies with larger patient populations.
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Affiliation(s)
- G Baucher
- From the Neurochirurgie adulte (G.B., L.T., P.-H.R.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Nord, Marseille, France
- Center for Magnetic Resonance in Biology and Medicine (G.B., H.R., L.P., S.L., V.C.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
- iLab-Spine International Associated Laboratory (G.B., H.R., S.L., P.-H.R., V.C.), Marseille-Montreal, France-Canada
| | - H Rasoanandrianina
- Center for Magnetic Resonance in Biology and Medicine (G.B., H.R., L.P., S.L., V.C.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
- Center for Magnetic Resonance in Biology and Medicine (H.R., L.P., S.L., V.C.), Aix-Marseille Université, Center National de la Recherche Scientifique, Marseille, France
- iLab-Spine International Associated Laboratory (G.B., H.R., S.L., P.-H.R., V.C.), Marseille-Montreal, France-Canada
| | - S Levy
- Center for Magnetic Resonance in Biology and Medicine (G.B., H.R., L.P., S.L., V.C.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
- Center for Magnetic Resonance in Biology and Medicine (H.R., L.P., S.L., V.C.), Aix-Marseille Université, Center National de la Recherche Scientifique, Marseille, France
- iLab-Spine International Associated Laboratory (G.B., H.R., S.L., P.-H.R., V.C.), Marseille-Montreal, France-Canada
| | - L Pini
- Center for Magnetic Resonance in Biology and Medicine (G.B., H.R., L.P., S.L., V.C.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
- Center for Magnetic Resonance in Biology and Medicine (H.R., L.P., S.L., V.C.), Aix-Marseille Université, Center National de la Recherche Scientifique, Marseille, France
| | - L Troude
- From the Neurochirurgie adulte (G.B., L.T., P.-H.R.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Nord, Marseille, France
| | - P-H Roche
- From the Neurochirurgie adulte (G.B., L.T., P.-H.R.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Nord, Marseille, France
- iLab-Spine International Associated Laboratory (G.B., H.R., S.L., P.-H.R., V.C.), Marseille-Montreal, France-Canada
| | - V Callot
- Center for Magnetic Resonance in Biology and Medicine (G.B., H.R., L.P., S.L., V.C.), Assistance Publique-Hôpitaux de Marseille, Hôpital Universitaire Timone, Marseille, France
- Center for Magnetic Resonance in Biology and Medicine (H.R., L.P., S.L., V.C.), Aix-Marseille Université, Center National de la Recherche Scientifique, Marseille, France
- iLab-Spine International Associated Laboratory (G.B., H.R., S.L., P.-H.R., V.C.), Marseille-Montreal, France-Canada
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18
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Leung MHY, Tong X, Bøifot KO, Bezdan D, Butler DJ, Danko DC, Gohli J, Green DC, Hernandez MT, Kelly FJ, Levy S, Mason-Buck G, Nieto-Caballero M, Syndercombe-Court D, Udekwu K, Young BG, Mason CE, Dybwad M, Lee PKH. Characterization of the public transit air microbiome and resistome reveals geographical specificity. Microbiome 2021; 9:112. [PMID: 34039416 PMCID: PMC8157753 DOI: 10.1186/s40168-021-01044-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/09/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND The public transit is a built environment with high occupant density across the globe, and identifying factors shaping public transit air microbiomes will help design strategies to minimize the transmission of pathogens. However, the majority of microbiome works dedicated to the public transit air are limited to amplicon sequencing, and our knowledge regarding the functional potentials and the repertoire of resistance genes (i.e. resistome) is limited. Furthermore, current air microbiome investigations on public transit systems are focused on single cities, and a multi-city assessment of the public transit air microbiome will allow a greater understanding of whether and how broad environmental, building, and anthropogenic factors shape the public transit air microbiome in an international scale. Therefore, in this study, the public transit air microbiomes and resistomes of six cities across three continents (Denver, Hong Kong, London, New York City, Oslo, Stockholm) were characterized. RESULTS City was the sole factor associated with public transit air microbiome differences, with diverse taxa identified as drivers for geography-associated functional potentials, concomitant with geographical differences in species- and strain-level inferred growth profiles. Related bacterial strains differed among cities in genes encoding resistance, transposase, and other functions. Sourcetracking estimated that human skin, soil, and wastewater were major presumptive resistome sources of public transit air, and adjacent public transit surfaces may also be considered presumptive sources. Large proportions of detected resistance genes were co-located with mobile genetic elements including plasmids. Biosynthetic gene clusters and city-unique coding sequences were found in the metagenome-assembled genomes. CONCLUSIONS Overall, geographical specificity transcends multiple aspects of the public transit air microbiome, and future efforts on a global scale are warranted to increase our understanding of factors shaping the microbiome of this unique built environment.
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Affiliation(s)
- M H Y Leung
- School of Energy and Environment, City University of Hong Kong, Hong Kong SAR, China
| | - X Tong
- School of Energy and Environment, City University of Hong Kong, Hong Kong SAR, China
| | - K O Bøifot
- Comprehensive Defence Division, Norwegian Defence Research Establishment FFI, Kjeller, Norway
- Department of Analytical, Environmental & Forensic Sciences, King's College London, London, UK
| | - D Bezdan
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - D J Butler
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - D C Danko
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - J Gohli
- Comprehensive Defence Division, Norwegian Defence Research Establishment FFI, Kjeller, Norway
| | - D C Green
- Department of Analytical, Environmental & Forensic Sciences, King's College London, London, UK
| | - M T Hernandez
- Environmental Engineering Program, College of Engineering and Applied Science, University of Colorado, Boulder, CO, USA
| | - F J Kelly
- Department of Analytical, Environmental & Forensic Sciences, King's College London, London, UK
| | - S Levy
- HudsonAlpha Institute of Biotechnology, Huntsville, AL, USA
| | - G Mason-Buck
- Department of Analytical, Environmental & Forensic Sciences, King's College London, London, UK
| | - M Nieto-Caballero
- Environmental Engineering Program, College of Engineering and Applied Science, University of Colorado, Boulder, CO, USA
| | - D Syndercombe-Court
- Department of Analytical, Environmental & Forensic Sciences, King's College London, London, UK
| | - K Udekwu
- Department of Aquatic Sciences & Assessment, Swedish University of Agriculture, Uppsala, Sweden
| | - B G Young
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
| | - C E Mason
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA.
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA.
- The WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY, USA.
- The Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
| | - M Dybwad
- Comprehensive Defence Division, Norwegian Defence Research Establishment FFI, Kjeller, Norway.
- Department of Analytical, Environmental & Forensic Sciences, King's College London, London, UK.
| | - P K H Lee
- School of Energy and Environment, City University of Hong Kong, Hong Kong SAR, China.
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Abstract
OBJECTIVES To determine if maternal confidence affects emergency department (ED) utilization in the first year of life. METHODS This retrospective cohort study examined the Maternal Confidence Questionnaire responses from a longitudinal birth cohort study and ED visits for these subjects across all Inova hospitals from January 2012 to July 2017 for full-term children 12 months or younger at the time of visit. Using logistic regression, maternal confidence, maternal race/ethnicity, age, education, parity, and insurance were evaluated against Emergency Severity Index acuity levels and ED visit frequency. RESULTS Of 2429 participants in the longitudinal study, 316 subjects visited the ED and met inclusion criteria. Medicaid status was the main factor associated with any ED visit. Low maternal confidence did not correlate with more frequent or nonurgent ED visits. Higher maternal confidence scores were seen in Hispanic or Latino mothers and mothers with parity greater than 1. Hispanic or Latino mothers were more likely to have Medicaid and more likely to bring their child to the ED. Mothers with college education had lower maternal confidence scores, were less likely to visit the ED, but had higher acuity level visits. CONCLUSIONS Low maternal confidence did not correlate with frequent ED visits or nonurgent visits. Medicaid status was the main factor associated with any ED visit. Hispanic or Latino mothers had higher maternal confidence scores, were more likely to have Medicaid and more likely to bring their child to the ED.
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Affiliation(s)
- Jina Giusto
- From the Department of Pediatrics, Inova Children's Hospital
| | - Megan Anton
- From the Department of Pediatrics, Inova Children's Hospital
| | - Sabrina Gaiazov
- Inova Translational Medicine Institute (ITMI), Inova Health Systems, Falls Church
| | - Kathi Huddleston
- College of Health and Human Services, George Mason University, Fairfax
| | - Shira Levy
- Inova Translational Medicine Institute (ITMI), Inova Health Systems, Falls Church
| | - Alma Fuller
- College of Health and Human Services, George Mason University, Fairfax
| | - Suchitra Hourigan
- Inova Translational Medicine Institute (ITMI), Inova Health Systems, Falls Church
| | - John Niederhuber
- Inova Translational Medicine Institute (ITMI), Inova Health Systems, Falls Church
| | - Vivian Hwang
- Department of Emergency Medicine, Inova Fairfax Hospital, Falls Church, VA
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Cox-Smith A, Cooper T, Punjabi P, Barton C, Levy S, Plymen C, Cole G. 95 Lack of Evidence for Reduced Efficacy of Medical Therapy for Heart Failure in Older Adults. Age Ageing 2021. [DOI: 10.1093/ageing/afab030.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
There are almost a million people with heart failure (HF) in the UK; the incidence increases sharply with age. Older adults receive less evidence-based therapy with few trials specifically examining therapeutic efficacy in older age groups representative of a contemporary UK HF population. Concern that efficacy is less in older adults may underlie under-prescription. With important recent advances in HF therapy, we reviewed the contemporary evidence base for any signal of different efficacy in older adults.
Methods
We reviewed recent RCTs of medical therapy for heart failure alongside meta-analyses updated with recent therapies including Angiotensin-Neprilysin inhibitors and SGLT2 inhibitors. For those trials in which effect size was presented for age subgroups we compared the effect size.
Results
Of 68 randomised controlled trials, 10 presented effect sizes for different age groups. The median average cut-off between younger and older age groups was 66 years (IQR 65 to 72.5 years) and the highest cut-off used was 75 years. The median hazard ratio was 0.77 (IQR 0.67 to 0.80) for the younger age group and 0.76 (IQR 0.73 to 0.88) for the older age group. In 8 of the 10 trials, the effect size in the oldest age group was statistically significant on its own including Sacubitril-Valsartan and Dapagliflozin.
Conclusion
When considering the medical therapeutic armamentarium for heart failure as a totality, there is no evidence it is any less effective in older adults than younger adults. The recent Zannad et al cross-trial analysis supported this showing significant additional life years in the patients over 80 years on HF therapy. Whilst there may be practical and frailty-related reasons for not prescribing life-prolonging therapy, the proportional survival benefits of these medications is similar in older adults. This should be utilised where practically possible and discussed with patients when making an informed choice.
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Affiliation(s)
- A Cox-Smith
- Hammersmith Hospital, Imperial College Healthcare NHS Trust
| | - T Cooper
- Hammersmith Hospital, Imperial College Healthcare NHS Trust
| | - P Punjabi
- Hammersmith Hospital, Imperial College Healthcare NHS Trust
| | - C Barton
- Hammersmith Hospital, Imperial College Healthcare NHS Trust
| | - S Levy
- Hammersmith Hospital, Imperial College Healthcare NHS Trust
| | - C Plymen
- Hammersmith Hospital, Imperial College Healthcare NHS Trust
| | - G Cole
- Hammersmith Hospital, Imperial College Healthcare NHS Trust
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21
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Alcala N, Dayton T, Mangiante L, Den Hartigh L, Levy S, Van Den Berg J, Moonen L, Derks J, Buikhuisen W, Speel E, Valk G, Tesselaar M, Vriens M, Clevers H, Foll M, Fernandez-Cuesta L. P47.03 Understanding Lung Neuroendocrine Tumor Progression Combining Organoid Models and Multi-Omic Analyses. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.859] [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: 12/01/2022]
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22
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Ramamoorthy S, Levy S, Mohamed M, Abdelghani A, Evans AM, Miller LAD, Mehta L, Moore S, Freinkman E, Hourigan SK. An ambient-temperature storage and stabilization device performs comparably to flash-frozen collection for stool metabolomics in infants. BMC Microbiol 2021; 21:59. [PMID: 33618670 PMCID: PMC7901118 DOI: 10.1186/s12866-021-02104-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/02/2021] [Indexed: 02/08/2023] Open
Abstract
Background Stool metabolites provide essential insights into the function of the gut microbiome. The current gold standard for storage of stool samples for metabolomics is flash-freezing at − 80 °C which can be inconvenient and expensive. Ambient temperature storage of stool is more practical, however no available methodologies adequately preserve the metabolomic profile of stool. A novel sampling kit (OMNImet.GUT; DNA Genotek, Inc.) was introduced for ambient temperature storage and stabilization of feces for metabolomics; we aimed to test the performance of this kit vs. flash-freezing. To do this stool was collected from an infant’s diaper was divided into two aliquots: 1) flash-frozen and 2) stored in an OMNImet.GUT tube at ambient temperature for 3–4 days. Samples from the same infant were collected at 2 different time points to assess metabolite changes over time. Subsequently, all samples underwent metabolomic analysis by liquid chromatography – tandem mass spectrometry (LC-MS/MS). Results Paired fecal samples (flash-frozen and ambient temperature) from 16 infants were collected at 2 time points (32 individual samples, 64 aliquots). Similar numbers of metabolites were detected in both the frozen and ambient temperature samples (1126 in frozen, 1107 in ambient temperature, 1064 shared between sample types). Metabolite abundances were strongly correlated between storage methods (median Spearman correlation Rs = 0.785 across metabolites). Hierarchical clustering analysis and principal component analysis showed that samples from the same individuals at a given time point clustered closely, regardless of the storage method. Repeat samples from the same individual were compared by paired t-test, separately for the frozen and OMNImet.GUT. The number of metabolites in each biochemical class that significantly changed (p < 0.05) at timepoint 2 relative to timepoint 1 was similar in flash-frozen versus ambient temperature storage. Changes in microbiota modified metabolites over time were also consistent across both methodologies. Conclusion Ambient temperature storage and stabilization of stool in the OMNImet.GUT device yielded comparable metabolomic results to flash freezing in terms of 1) the identity and abundance of detected biochemicals 2) the distinct metabolomic profiles of subjects and 3) changes in metabolites over time that are plausibly microbiota-induced. This method potentially provides a more convenient, less expensive home collection and storage option for stool metabolomic analysis. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02104-6.
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Affiliation(s)
| | - Shira Levy
- Inova Children's Hospital, 3300 Gallows Rd, Falls Church, VA, 22042, USA
| | - Masouma Mohamed
- Inova Children's Hospital, 3300 Gallows Rd, Falls Church, VA, 22042, USA
| | - Alaa Abdelghani
- Inova Children's Hospital, 3300 Gallows Rd, Falls Church, VA, 22042, USA
| | - Anne M Evans
- Metabolon, 617 Davis Dr UNIT 100, Morrisville, NC, 27560, USA
| | - Luke A D Miller
- Metabolon, 617 Davis Dr UNIT 100, Morrisville, NC, 27560, USA
| | - Lopa Mehta
- Inova Health System, 3300 Gallows Rd, Falls Church, VA, 22042, USA
| | - Sean Moore
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Virginia, 200 Jeanette Lancaster Way, Charlottesville, VA, 22903, USA
| | | | - Suchitra K Hourigan
- Inova Children's Hospital, 3300 Gallows Rd, Falls Church, VA, 22042, USA. .,Pediatric Specialists of Virginia, 3023 Hamaker Ct, Fairfax, VA, 22031, USA.
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23
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Gilad O, Rabinowich L, Levy S, Gotlieb N, Lubezky N, Goykhman Y, Nachmany I, Katz P, Shibolet O, Katchman H. Metabolic and Renal Effects of Mammalian Target of Rapamycin Inhibitors Treatment After Liver Transplantation: Real-Life Single-Center Experience. Transplant Proc 2020; 53:221-227. [PMID: 32650991 DOI: 10.1016/j.transproceed.2020.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/12/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mammalian target of rapamycin (mTOR) inhibitors following liver transplantation (LT) are used to minimize calcineurin inhibitor (CNI)-related nephrotoxicity. Data about metabolic effects of mTOR inhibitors are still limited. AIM This study aims to determine the renal and metabolic effects of different mTOR inhibitor-based protocols in real-life LT patients. METHODS This is a retrospective cohort study of patients treated with mTOR inhibitors after LT. Demographics, treatment protocols, glomerular filtration rate (GFR), and metabolic parameters were collected over a period of 4 years. Initiation of blood pressure (BP), diabetes mellitus, and lipid medications was also noted. RESULTS Fifty-two LT recipients received mTOR inhibitors. GFR improved significantly (by 1.96 mL/min/year), with greater improvement in patients with baseline renal dysfunction (+13.3 mL/min vs +4.5 mL/min at 3 years). Conversion to an mTOR inhibitor during the first post-transplant year resulted in a more durable improvement in GFR (for 4 years vs only 1 year for later conversion).No significant weight gain or new-onset diabetes mellitus was observed. However, there was some increase in total cholesterol (+7 mg/dL) and blood pressure (+2 mm Hg during the third year and +8 mm Hg in the fourth years), followed by initiation of lipid-lowering and BP medications in 25% and 13% of patients, respectively. CONCLUSIONS Treatment with an mTOR inhibitor following LT resulted in improved kidney functions without significant negative metabolic effects such as weight gain or new-onset diabetes mellitus. This makes mTOR inhibitors a valuable immunosuppressive option in the face of the growing incidence of nonalcoholic steatohepatitis as a leading cause for LT.
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Affiliation(s)
- O Gilad
- Liver Unit, Department of Gastroenterology, Tel Aviv Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - L Rabinowich
- Liver Unit, Department of Gastroenterology, Tel Aviv Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Levy
- Liver Unit, Department of Gastroenterology, Tel Aviv Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - N Gotlieb
- Liver Unit, Department of Gastroenterology, Tel Aviv Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - N Lubezky
- Devision of Surgery, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y Goykhman
- Devision of Surgery, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - I Nachmany
- Devision of Surgery, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - P Katz
- Devision of Surgery, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - O Shibolet
- Liver Unit, Department of Gastroenterology, Tel Aviv Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H Katchman
- Liver Unit, Department of Gastroenterology, Tel Aviv Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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24
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Rodav O, Levy S, Hamdan S. Clinical characteristics and functions of non-suicide self-injury in youth. Eur Psychiatry 2020; 29:503-8. [DOI: 10.1016/j.eurpsy.2014.02.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 02/16/2014] [Accepted: 02/19/2014] [Indexed: 10/25/2022] Open
Abstract
AbstractPurposeLittle is known about the clinical characteristics and motivations for engaging in non-suicide self-injury (NSSI) behaviors in adolescence. The aim of this study was to examine the prevalence, characteristics and functions of NSSI among adolescents in community settings, and to explore risk factors related to this behavior.Subjects and methodsTwo hundred and seventy-five adolescents aged 12 to 17 were recruited randomly from different High Schools in Israel. They completed self-report questionnaires assessing NSSI (Ottawa Self-Injury Inventory), depression (Children's Depression Inventory – CDI) and impulsivity (Barratt Impulsiveness Scale – BIS-II).ResultsIn the past year, 20.7% of the participants reported engaging NSSI at least once. Among them, 42.1% declared they are still engaging in NSSI at the present. Motives for NSSI were internal emotion regulation reasons, external emotion regulation reasons for social influences. In addition, the NSSI group reported significantly higher levels of depressive, impulsivity and suicidal ideations. Depressive symptoms were found as significant predictors of NSSI in the future.Discussion and conclusionsHigh rates of NSSI among community adolescents were found. Depression, impulsivity and suicidal ideation were found significantly related to NSSI. Mental health professionals in schools and in primary care should routinely assess NSSI among adolescents.
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25
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Wong WS, Sabu P, Deopujari V, Levy S, Shah AA, Clemency N, Provenzano M, Saadoon R, Munagala A, Baker R, Baveja R, Mueller NT, Dominguez-Bello MG, Huddleston K, Niederhuber JE, Hourigan SK. Prenatal and Peripartum Exposure to Antibiotics and Cesarean Section Delivery Are Associated with Differences in Diversity and Composition of the Infant Meconium Microbiome. Microorganisms 2020; 8:E179. [PMID: 32012716 PMCID: PMC7074690 DOI: 10.3390/microorganisms8020179] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/11/2020] [Accepted: 01/19/2020] [Indexed: 12/16/2022] Open
Abstract
The meconium microbiome may provide insight into intrauterine and peripartum exposures and the very earliest intestinal pioneering microbes. Prenatal antibiotics have been associated with later obesity in children, which is thought to be driven by microbiome dependent mechanisms. However, there is little data regarding associations of prenatal or peripartum antibiotic exposure, with or without cesarean section (CS), with the features of the meconium microbiome. In this study, 16S ribosomal RNA gene sequencing was performed on bacterial DNA of meconium samples from 105 infants in a birth cohort study. After multivariable adjustment, delivery mode (p = 0.044), prenatal antibiotic use (p = 0.005) and peripartum antibiotic use (p < 0.001) were associated with beta diversity of the infant meconium microbiome. CS (vs. vaginal delivery) and peripartum antibiotics were also associated with greater alpha diversity of the meconium microbiome (Shannon and Simpson, p < 0.05). Meconium from infants born by CS (vs. vaginal delivery) had lower relative abundance of the genus Escherichia (p < 0.001). Prenatal antibiotic use and peripartum antibiotic use (both in the overall analytic sample and when restricting to vaginally delivered infants) were associated with differential abundance of several bacterial taxa in the meconium. Bacterial taxa in the meconium microbiome were also differentially associated with infant excess weight at 12 months of age, however, sample size was limited for this comparison. In conclusion, prenatal and peripartum antibiotic use along with CS delivery were associated with differences in the diversity and composition of the meconium microbiome. Whether or not these differences in the meconium microbiome portend risk for long-term health outcomes warrants further exploration.
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Affiliation(s)
- Wendy S.W. Wong
- Inova Translational Medicine Institute, Falls Church, Inova Fairfax Hospital, Falls Church, VA 22042, USA (V.D.); (S.L.); (N.C.); (M.P.); (R.S.); (A.M.); (K.H.); (J.E.N.)
| | - Priya Sabu
- School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA;
| | - Varsha Deopujari
- Inova Translational Medicine Institute, Falls Church, Inova Fairfax Hospital, Falls Church, VA 22042, USA (V.D.); (S.L.); (N.C.); (M.P.); (R.S.); (A.M.); (K.H.); (J.E.N.)
| | - Shira Levy
- Inova Translational Medicine Institute, Falls Church, Inova Fairfax Hospital, Falls Church, VA 22042, USA (V.D.); (S.L.); (N.C.); (M.P.); (R.S.); (A.M.); (K.H.); (J.E.N.)
| | - Ankit A. Shah
- Division of Maternal Fetal Medicine, Department of Ob/Gyn, Inova Fairfax Hospital, Falls Church, VA 22042, USA;
| | - Nicole Clemency
- Inova Translational Medicine Institute, Falls Church, Inova Fairfax Hospital, Falls Church, VA 22042, USA (V.D.); (S.L.); (N.C.); (M.P.); (R.S.); (A.M.); (K.H.); (J.E.N.)
| | - Marina Provenzano
- Inova Translational Medicine Institute, Falls Church, Inova Fairfax Hospital, Falls Church, VA 22042, USA (V.D.); (S.L.); (N.C.); (M.P.); (R.S.); (A.M.); (K.H.); (J.E.N.)
| | - Reem Saadoon
- Inova Translational Medicine Institute, Falls Church, Inova Fairfax Hospital, Falls Church, VA 22042, USA (V.D.); (S.L.); (N.C.); (M.P.); (R.S.); (A.M.); (K.H.); (J.E.N.)
| | - Akhil Munagala
- Inova Translational Medicine Institute, Falls Church, Inova Fairfax Hospital, Falls Church, VA 22042, USA (V.D.); (S.L.); (N.C.); (M.P.); (R.S.); (A.M.); (K.H.); (J.E.N.)
| | - Robin Baker
- Fairfax Neonatal Associates, Falls Church, VA 22042, USA; (R.B.); (R.B.)
| | - Rajiv Baveja
- Fairfax Neonatal Associates, Falls Church, VA 22042, USA; (R.B.); (R.B.)
| | - Noel T. Mueller
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA;
| | | | - Kathi Huddleston
- Inova Translational Medicine Institute, Falls Church, Inova Fairfax Hospital, Falls Church, VA 22042, USA (V.D.); (S.L.); (N.C.); (M.P.); (R.S.); (A.M.); (K.H.); (J.E.N.)
- College of Health and Human Services, George Mason University, Fairfax, VA 22030, USA
| | - John E. Niederhuber
- Inova Translational Medicine Institute, Falls Church, Inova Fairfax Hospital, Falls Church, VA 22042, USA (V.D.); (S.L.); (N.C.); (M.P.); (R.S.); (A.M.); (K.H.); (J.E.N.)
- Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA
- Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Suchitra K. Hourigan
- Inova Children’s Hospital, Inova Fairfax Hospital, Falls Church, VA 22042, USA
- Pediatric Specialists of Virginia, Fairfax, VA 22031, USA
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Domanovits H, Carbajosa Dalamau J, Hartikainen J, Juhlin T, Ritz B, Levy S. P4775Efficacy and safety of vernakalant for cardioversion of recent-onset atrial fibrillation in real-world clinical practice: the SPECTRUM post-approval safety study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Vernakalant is an antiarrhythmic agent designed for pharmacological conversion of recent onset of atrial fibrillation (AF) with combined action on cardiac potassium and sodium currents mainly concentrated in the atria.
Purpose
SPECTRUM was a post-authorisation safety study of vernakalant, conducted to collect information about real-life conditions of use and appropriate dosing, and to quantify possible medically significant risks associated with the use of vernakalant in real-world clinical practice.
Methods
This prospective and retrospective registry was conducted from Sep 2011 to Apr 2018 in 53 hospitals in EU countries including Austria, Denmark, Finland, Germany, Spain and Sweden. A total of 1,778 patients with 2,009 episodes of recent-onset AF received vernakalant and were followed up for 24 hours after the last infusion or until hospital discharge/end of medical encounter to obtain information on medically significant health outcomes of interest (HOIs, defined as significant hypotension, significant ventricular arrhythmia, significant atrial flutter, significant bradycardia), and serious adverse events (SAEs).
Results
In more than 99% of treatments, vernakalant was used in accordance to the labelled indication for conversion of AF for non-surgery (94.7%) or post-cardiac surgery patients (5.2%). Vernakalant was administered in the emergency department in 64.2% of cases, with a median stay of 7.5 hours and successfully converted 70.2% (95% CI: 68.1–72.2) of patients in the effectiveness analysis population with a median time to conversion of 11 minutes (95% CI: 8.0–27.0). A total of 19 HOIs were reported in 17 patients (0.8%, 95% CI: 0.5– .4%) with individual HOIs ranging from <0.1% to 0.7% suggesting these HOIs are uncommon. Significant bradycardia was the most common HOI observed in 15 patients (0.8%, 95% CI: 0.4–1.2%), with all events occurring within the first two hours (0.8%, 95% CI: 0.4–1.2%). The incidence of significant hypotension was 0.1% (2/2,009), significant atrial flutter (with 1:1 conduction) was 0.1% (2/2,009), and significant ventricular arrhythmia (sustained ventricular tachycardia) was <0.1% (1/2,009). A total of 28 SAEs, including all HOIs, were observed (1.3%, 95% CI: 0.8–1.9%); all patients fully recovered, except one who recovered with sequelae after an SAE of pericardial effusion definitely not related to vernakalant. There were no cases of torsades de pointes, ventricular fibrillation, or deaths reported in the SPECTRUM study.
Conclusion(s)
SPECTRUM is, to our knowledge, the largest drug registry conducted on the cardioversion of recent onset AF. The cumulative data from 2,009 vernakalant treatment episodes demonstrate an incidence of HOIs and SAEs similar or lower to what has been reported in earlier vernakalant IV clinical trials. The observed conversion rate was higher than reported in pivotal trials supporting vernakalant's efficacy and allowing early discharge.
Acknowledgement/Funding
Study funded by Correvio International Sarl, Geneva, Switzerland
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Affiliation(s)
- H Domanovits
- Medical University of Vienna, Department of Emergency Medicine, Vienna, Austria
| | | | | | - T Juhlin
- Skane University Hospital, Lund, Sweden
| | - B Ritz
- Correvio International Sarl, Geneva, Switzerland
| | - S Levy
- Aix-Marseille University, Marseille, France
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27
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Levy S, Aarts M, Eskens F, Keymeulen K, Been L, Grünhagen D, van Akkooi A, Jalving M, Tesselaar M. Avelumab for advanced Merkel cell carcinoma in the Netherlands: A nationwide survey. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Levy S, Hahner C, Carhart F. P1.07-07 An Interdisciplinary Collaborative Approach to Discharge Readiness on a Thoracic Surgery Specialty Unit. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1016] [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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29
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Levy S, Moschandreas J, Debiram-Beecham I, O’Donovan M, Brooks C, Bailey A, Hawkins M, Kadri S, de Caestecker J, Crosby T, Fitzgerald R, Mukherjee S. Cytosponge™ for post‐chemoradiation surveillance of oesophageal cancer: a feasibility study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.209] [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: 11/12/2022] Open
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30
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Scher N, Riet F, Janoray G, Debbi K, Levy S, Louisot P, Chajon E, Salame E, Barillot I, De Crevoisier R, Calais G, Chapet S. EP-1414 SBRT for the treatment of hepatocellular carcinoma: a retrospective multicenter study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31834-1] [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: 11/27/2022]
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31
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Mathieu J, Detraux D, Kuppers D, Wang Y, Cavanaugh C, Sidhu S, Levy S, Robitaille AM, Ferreccio A, Bottorff T, McAlister A, Somasundaram L, Artoni F, Battle S, Hawkins RD, Moon RT, Ware CB, Paddison PJ, Ruohola-Baker H. Folliculin regulates mTORC1/2 and WNT pathways in early human pluripotency. Nat Commun 2019; 10:632. [PMID: 30733432 PMCID: PMC6367455 DOI: 10.1038/s41467-018-08020-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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] [Received: 06/22/2017] [Accepted: 12/05/2018] [Indexed: 01/05/2023] Open
Abstract
To reveal how cells exit human pluripotency, we designed a CRISPR-Cas9 screen exploiting the metabolic and epigenetic differences between naïve and primed pluripotent cells. We identify the tumor suppressor, Folliculin(FLCN) as a critical gene required for the exit from human pluripotency. Here we show that FLCN Knock-out (KO) hESCs maintain the naïve pluripotent state but cannot exit the state since the critical transcription factor TFE3 remains active in the nucleus. TFE3 targets up-regulated in FLCN KO exit assay are members of Wnt pathway and ESRRB. Treatment of FLCN KO hESC with a Wnt inhibitor, but not ESRRB/FLCN double mutant, rescues the cells, allowing the exit from the naïve state. Using co-immunoprecipitation and mass spectrometry analysis we identify unique FLCN binding partners. The interactions of FLCN with components of the mTOR pathway (mTORC1 and mTORC2) reveal a mechanism of FLCN function during exit from naïve pluripotency. The pathways involved in exit from pluripotency in human embryonic stem cells are poorly understood. Here, the authors performed a CRISPR-based screen to identify genes that promote exit from naïve pluripotency and find a role for folliculin (FLCN) by regulating the mTOR and Wnt pathways.
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Affiliation(s)
- J Mathieu
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA.,Department of Comparative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - D Detraux
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA.,Laboratory of Cellular Biochemistry and Biology (URBC), University of Namur, Namur, 5000, Belgium
| | - D Kuppers
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA
| | - Y Wang
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA.,Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, WA, 98109, USA
| | - C Cavanaugh
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA.,Department of Comparative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - S Sidhu
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - S Levy
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - A M Robitaille
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA.,Department of Pharmacology, University of Washington, Seattle, WA, 98195, USA
| | - A Ferreccio
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - T Bottorff
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - A McAlister
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - L Somasundaram
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - F Artoni
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - S Battle
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA.,Department of Medical Genetics & Genome Sciences, University of Washington, Seattle, WA, 98195, USA
| | - R D Hawkins
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA.,Department of Medical Genetics & Genome Sciences, University of Washington, Seattle, WA, 98195, USA
| | - R T Moon
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA.,Department of Pharmacology, University of Washington, Seattle, WA, 98195, USA
| | - C B Ware
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA.,Department of Comparative Medicine, University of Washington, Seattle, WA, 98109, USA
| | - P J Paddison
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA. .,Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA.
| | - H Ruohola-Baker
- Department of Biochemistry, University of Washington, Seattle, WA, 98195, USA. .,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, 98109, USA.
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Bomzon Z, Naveh A, Levy S, Kirson E, Weinberg U. P01.048 A novel transducer array layout for delivering Tumor Treating Fields to the infratentorial brain at therapeutic levels. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.090] [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)
| | - A Naveh
- Novocure ltd., Haifa, Israel
| | - S Levy
- Novocure ltd., Haifa, Israel
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Urman N, Levy S, Frenkel A, Naveh A, Hershkovich HS, Kirson E, Wenger C, Lavy-Shahaf G, Manzur D, Yesharim O, Bomzon Z. P04.57 Creating patient-specific computational head models for the study of tissue-electric field interactions using deformable templates. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Urman
- Novocure ltd., Haifa, Israel
| | - S Levy
- Novocure ltd., Haifa, Israel
| | | | - A Naveh
- Novocure ltd., Haifa, Israel
| | | | | | - C Wenger
- Novocure Gmbh, root D4, Switzerland
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Urman N, Hershkovich HS, Naveh A, Levy S, Bomzon Z. P04.31 Defining Tumor Treating Fields (TTFields) dosimetry using Power Density Loss and related measures. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- N Urman
- Novocure ltd., Haifa, Israel
| | | | - A Naveh
- Novocure ltd., Haifa, Israel
| | - S Levy
- Novocure ltd., Haifa, Israel
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Cabello FC, Cohen SN, Curtiss R, Dougan G, van Embden J, Finlay BB, Heffron F, Helinski D, Hull R, Hull S, Isberg R, Kopecko DJ, Levy S, Mekalanos J, Ortiz JM, Rappuoli R, Roberts MC, So M, Timmis KN. Farewell Stan Stanley Falkow: 1934-2018. Environ Microbiol 2018; 20:2322-2333. [PMID: 30146753 DOI: 10.1111/1462-2920.14308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F C Cabello
- Department of Microbiology and Immunology, New York Medical College, Valhalla, NY, USA
| | - S N Cohen
- Department of Genetics, Stanford University, Stanford, CA, USA
| | - R Curtiss
- Departments of Infectious Diseases and Immunology and Comparative, Diagnostic and Population Medicine, University of Florida, Gainesville, FL, USA
| | - G Dougan
- Microbial Pathogenesis Group, Welcome Sanger Institute, Hinxton, UK
| | - J van Embden
- Division of Infectious Diseases, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - B B Finlay
- Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
| | - F Heffron
- Department of Molecular Microbiology and Immunology, Oregon Health and Science University, Portland, OR, USA
| | - D Helinski
- Biological Sciences, University of California San Diego, La Jolla, CA, USA
| | - R Hull
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - S Hull
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - R Isberg
- Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, MA, USA
| | | | - S Levy
- Department of Molecular Biology and Microbiology, Tufts University, Boston, MA, USA
| | - J Mekalanos
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA, USA
| | - J M Ortiz
- Departamento de Biologia Molecular, Universidad de Cantabria, Santander, Spain
| | | | - M C Roberts
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - M So
- Department of Immunobiology, University of Arizona, Tucson, AZ, USA
| | - K N Timmis
- Institute of Microbiology, Technical University of Braunschweig, Braunschweig, Germany
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Nossel HL, Lanzkowsky P, Levy S, Mibashan RS, Hansen JDL. A Study of Coagulation Factor Levels in Women during Labour and in Their Newborn Infants. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1655636] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Summary1. Coagulation factors levels were measured in 10 normal mothers and in their infants within 15 min of birth and at 48-96 hrs of age.2. In the mothers the levels of fibrinogen (532 mg/%), factors VIII (196%), IX (130%) and X (122%) were elevated; the levels of prothrombin (107%) and factor V (108%) were normal ; and the level of factor XI (69%) was reduced.3. The infants blood examined within 15 min of birth had a slightly elevated factor VIII level (138%), slightly reduced fibrinogen (195 mg/%) and factor V levels (79%), low levels of prothrombin (55%) and factors IX (27%), X (35%) and XI (32%).4. Blood from the infants at 48-96 hrs of age showed little change from the birth levels of factors V (89%), and VIII (116%) and a slight increase in factor XI level (39%). Four of the infants had received vitamin K1 and had higher levels of prothrombin and factors IX and X than the 7 who had not received vitamin K1.5. These results are compared with those of previous studies and the possible mechanisms underlying the changes is discussed.
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Hourigan SK, Subramanian P, Hasan NA, Ta A, Klein E, Chettout N, Huddleston K, Deopujari V, Levy S, Baveja R, Clemency NC, Baker RL, Niederhuber JE, Colwell RR. Comparison of Infant Gut and Skin Microbiota, Resistome and Virulome Between Neonatal Intensive Care Unit (NICU) Environments. Front Microbiol 2018; 9:1361. [PMID: 29988506 PMCID: PMC6026636 DOI: 10.3389/fmicb.2018.01361] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 06/05/2018] [Indexed: 01/08/2023] Open
Abstract
Background: There is a growing move to provide care for premature infants in a single family, private room neonatal intensive care unit (NICU) in place of the traditional shared space, open bay NICU. The resultant effect on the developing neonatal microbiota is unknown. Study Design: Stool and groin skin swabs were collected from infants in a shared-space NICU (old NICU) and a single-family room NICU (new NICU) on the same hospital campus. Metagenomic sequencing was performed and data analyzed by CosmosID bioinformatics software package. Results: There were no significant differences between the cohorts in gestational age, length of stay, and delivery mode; infants in the old NICU received significantly more antibiotics (p = 0.03). Differentially abundant antimicrobial resistance genes and virulence associated genes were found between the cohorts in stool and skin, with more differentially abundant antimicrobial resistance genes in the new NICU. The entire bacterial microbiota analyzed to the genus level significantly differed between cohorts in skin (p = 0.0001) but not in stool samples. There was no difference in alpha diversity between the two cohorts. DNA viruses and fungi were detected but did not differ between cohorts. Conclusion: Differences were seen in the resistome and virulome between the two cohorts with more differentially abundant antimicrobial resistance genes in the new NICU. This highlights the influence that different NICU environments can have on the neonatal microbiota. Whether the differences were due to the new NICU being a single-family NICU or located in a newly constructed building warrants exploration. Long term health outcomes from the differences observed must be followed longitudinally.
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Affiliation(s)
- Suchitra K Hourigan
- Department of Pediatrics, Inova Children's Hospital, Falls Church, VA, United States.,Inova Translational Medicine Institute, Falls Church, VA, United States.,Department of Pediatric Gastroenterology, Pediatric Specialists of Virginia, Fairfax, VA, United States
| | | | | | - Allison Ta
- Department of Pediatrics, Inova Children's Hospital, Falls Church, VA, United States
| | - Elisabeth Klein
- Inova Translational Medicine Institute, Falls Church, VA, United States
| | - Nassim Chettout
- Inova Translational Medicine Institute, Falls Church, VA, United States
| | - Kathi Huddleston
- Inova Translational Medicine Institute, Falls Church, VA, United States
| | - Varsha Deopujari
- Inova Translational Medicine Institute, Falls Church, VA, United States
| | - Shira Levy
- Inova Translational Medicine Institute, Falls Church, VA, United States
| | - Rajiv Baveja
- Fairfax Neonatal Associates PC, Falls Church, VA, United States
| | - Nicole C Clemency
- Inova Translational Medicine Institute, Falls Church, VA, United States
| | - Robin L Baker
- Fairfax Neonatal Associates PC, Falls Church, VA, United States
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Levy S, Chaouat M, Malca N, Serror K, Mimoun M, Boccara D. [Not Available]. Ann Burns Fire Disasters 2018; 31:4-9. [PMID: 30174563 PMCID: PMC6116657] [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] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
Chemical burns raise diagnostic and treatment issues because they have specific appearances and evolution. Our objective was to study the characteristics of chemical burns and to assess the quality of our treatment. This retrospective observational study examined the records of all patients admitted for chemical burns to the burn treatment center of Saint Louis Hospital in Paris from January 1, 1990, through December 31, 2015. During this period, 162 patients came to our center for chemical burn treatment. Most of them were men (67%). The majority of the burns were caused by alkalis (27%) and resulted from workplace accidents (29%). The average time before consultation was 5.36 days. The areas mainly damaged were the hands (36%) and the burn areas averaged 1.2% of the total body surface area (TBSA). Forty-eight patients had at least one deep patch. In total, 59 patients (36.4%) were hospitalized for an average duration of 4.18 days. Thirty-eight of them underwent surgery. Lastly, 92% of the operations had been anticipated from the first consultation. In our center, the population affected, the circumstances and the topography of our patients' burns were similar to the data from the literature. It appears that the principal specificity of our series is a very low body surface burned. This can be attributed to the prevention measures we have in France and underlines their importance. Only 8% of the patients who had surgery were underestimated or their burns became deeper secondarily. This number is lower than the data from other series.
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Affiliation(s)
- S. Levy
- Samuel Levy
Centre de Traitement des Brûlés, Hôpital St Louis1, avenue Claude Vellefaux, 75010 ParisFrance+33630212158
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Thakur U, Levy S, Sivaratnam D, Herath D, Nadesapillai S, Toh H, Westcott J, Lichtenstein M, Hepworth G, Better N. The Relationship Between Ischaemia on Myocardial Perfusion Imaging and Chest Pain or Electrocardiogram Changes During Exercise. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Levy S, Vences-Catalán F, Kuo C, Rajapaksa R, Duault C, Levy R, Levy S. EFFECTIVE THERAPY BY ANTI-CD81 AGAINST B CELL LYMPHOMAS ENGAGES BOTH DIRECT AND INDIRECT IMMUNE MECHANISMS. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S. Levy
- Medicine/Oncology, Stanford; Stanford USA
| | | | - C. Kuo
- Medicine/Oncology, Stanford; Stanford USA
| | | | - C. Duault
- Medicine/Oncology, Stanford; Stanford USA
| | - R. Levy
- Medicine/Oncology, Stanford; Stanford USA
| | - S. Levy
- Medicine/Oncology, Stanford; Stanford USA
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Levy S, Banerjee S, Theofanous TG, Hsu YY. Preface: Nuclear Reactor Thermal Hydraulics. NUCL SCI ENG 2017. [DOI: 10.13182/nse84-a18577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Levy
- S. Levy Incorporate, 3425 South Bascom Avenue Campbell, California 95008-70006
| | - S. Banerjee
- University of Californ, Department of Chemical and Nuclear Engineering, Santa Barbara, California 93106
| | - T. G. Theofanous
- Purdue University, Department of Nuclear ar Engineering, West Lafayette, Indiana 47907
| | - Y. Y. Hsu
- University of Marylan, Department of Chemical and Nuclear Engineering, College Park, Maryland 20742
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Cornelius T, Earnshaw VA, Menino D, Bogart LM, Levy S. Treatment motivation among caregivers and adolescents with substance use disorders. J Subst Abuse Treat 2017; 75:10-16. [PMID: 28237049 DOI: 10.1016/j.jsat.2017.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 01/09/2017] [Accepted: 01/12/2017] [Indexed: 10/20/2022]
Abstract
Substance use disorders (SUDs) in adolescence have negative long-term health effects, which can be mitigated through successful treatment. Caregivers play a central role in adolescent treatment involvement; however, studies have not examined treatment motivation and pressures to enter treatment in caregiver/adolescent dyads. Research suggests that internally motivated treatment (in contrast to coerced treatment) tends to lead to better outcomes. We used Self-determination theory (SDT) to examine intersecting motivational narratives among caregivers and adolescents in SUD treatment. Relationships between motivation, interpretation of caregiver pressures, adolescent autonomy, and relatedness were also explored. Adolescents in SUD treatment and their caregivers (NDyads=15) were interviewed about treatment experiences. Interviews were coded for treatment motivation, including extrinsic (e.g., motivated by punishment), introjected (e.g., motivated by guilt), and identified/integrated motivation (e.g., seeing a behavior as integral to the self). Internalization of treatment motivation, autonomy support/competence (e.g., caregiver support for adolescent decisions), and relatedness (e.g., acceptance and support) were also coded. Four dyadic categories were identified: agreement that treatment was motivated by the adolescent (intrinsic); agreement that treatment was motivated by the caregiver (extrinsic); agreement that treatment was motivated by both, or a shift towards adolescent control (mixed/transitional); and disagreement (adolescents and caregivers each claimed they motivated treatment; conflicting). Autonomy support and relatedness were most prominent in intrinsic dyads, and least prominent in extrinsic dyads. The mixed/transitional group was also high in autonomy support and relatedness. The extrinsic group characterized caregiver rules as an unwelcome mechanism for behavioral control; caregivers in the other groups saw rules as a way to build adolescent competence and repair relationships, and adolescents saw rules as indicating care rather than control. Adolescents with intrinsic motivations were the most engaged in treatment. Results suggest the importance of intrinsically motivated treatment, and highlight autonomy support and relatedness as mechanisms that might facilitate treatment engagement.
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Affiliation(s)
- T Cornelius
- University of Connecticut, Department of Psychological Sciences, 406 Babbidge Road, Unit 1020, Storrs, CT 06269, United States.
| | - V A Earnshaw
- University of Delaware, Department of Human Development and Family Studies, 111 Alison Hall West, Newark, DE 19716, United States; Boston Children's Hospital, Division of General Pediatrics, 300 Longwood Avenue, Boston, MA 02115, United States; Harvard Medical School, Department of Pediatrics, 25 Shattuck Street, Boston, MA 02115, United States
| | - D Menino
- Boston Children's Hospital, Division of General Pediatrics, 300 Longwood Avenue, Boston, MA 02115, United States
| | - L M Bogart
- Boston Children's Hospital, Division of General Pediatrics, 300 Longwood Avenue, Boston, MA 02115, United States; Harvard Medical School, Department of Pediatrics, 25 Shattuck Street, Boston, MA 02115, United States; RAND Corporation, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138, United States
| | - S Levy
- Harvard Medical School, Department of Pediatrics, 25 Shattuck Street, Boston, MA 02115, United States; Boston Children's Hospital, Division of Developmental Medicine, 300 Longwood Avenue, Boston, MA 02115, United States
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Kaabour M, Guerisse F, Mols P, Levy S. [Pseudotumor cerebri due to taking minocycline]. Rev Med Brux 2017; 38:169-172. [PMID: 28653520] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The cerebral pseudotumor (PTC) is defined by the increase in cerebrospinal fluid (CSF) pressure, a normal composition of the latter in the absence of identified intracranial structural abnormalities, in particular by neuroimaging. The pathophysiology of PTC is poorly understood although its diagnostic criteria are well established. Drugs such as minocycline, tetracycline and doxycycline have been repeatedly implicated as a causative factor in PTC. The prognosis of PTC related to minocycline, reported in the literature is quite variable. Some authors suggest a benign condition with spontaneous healing by stopping the antibiotic, while others report permanent loss of vision. A 12-year-old girl is admitted to the emergency room for progressively progressive pulsatile temporal headaches associated with diplopia. The patient reported the use of minocycline 50 mg / d for five months, prescribed by her attending physician as part of an acne treatment. PTC will be demonstrated by severe papillary edema and cerebral NMR will demonstrate an enlargement of the subarachnoid space around the optic nerves. After three lumbar punctures, the condition of the patient stabilized and there was a marked improvement in headache despite the persistence of bilateral papillary edema. This work describes a clinical case of PTC induced by the use of minocycline and reviews the physiopathology, the diagnosis and the management of this one.
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Affiliation(s)
- M Kaabour
- Service des Urgences Pédiatriques, H.U.D.E.R.F
| | - F Guerisse
- Service de Médecine Interne-Urgences, C.H.U. Tivoli, La Louvière
| | - P Mols
- Service des Urgences et du SMUR, C.H.U. Saint-Pierre
| | - S Levy
- Service de Médecine interne, Hôpital Erasme
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Marshall T, VanBuren J, Cavanaugh J, Warren J, Curtis A, Levy S. Beverage Clusters Have Limited Associations with Dental Caries During Adolescence. J Acad Nutr Diet 2016. [DOI: 10.1016/j.jand.2016.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
This paper summarizes a current study examining the availability, appropriateness and acceptability of a technologically dependable healthcare provision to both service users and staff. An interface between the Electronic Patient Record (EPR) and future home care technology (Telecare) is suggested in the form of a ‘technology prescription’. It is argued that appropriately prescribed technology will enable people to benefit from a modern, evidence-based service, which promotes a proactive means of addressing and preventing future health and care needs. The paper argues that technological innovations in care must not be perceived as a threat to the partnerships necessary in achieving maximum health gains, but rather be an aid to a patient centred clinical encounter.
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Affiliation(s)
- S. Levy
- School of Science and Engineering University of Abertay Dundee DD1 1HG, UK Tel: +44 (0)1382 308696
| | - D. A. Bradley
- School of Science and Engineering, University of Abertay, Dundee
| | - M. T. Swanston
- School of Social and Health Sciences, University of Abertay, Dundee
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Korecka J, Levy S, Isacson O. In vivo modeling of neuronal function, axonal impairment and connectivity in neurodegenerative and neuropsychiatric disorders using induced pluripotent stem cells. Mol Cell Neurosci 2016; 73:3-12. [DOI: 10.1016/j.mcn.2015.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 12/04/2015] [Accepted: 12/08/2015] [Indexed: 02/07/2023] Open
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Porter A, Kennard D, Lang SJ, Levy S, Wang Q, Djedovic N, Chua E. 65ARE TOO MANY PATIENTS GREATER THAN 80 YEARS OLD WITH NON-VALVULAR ATRIAL FIBRILLATION EXPOSED TO UNDUE BLEEDING RISK FROM WARFARIN? Age Ageing 2016. [DOI: 10.1093/ageing/afw034.02] [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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Levy S, Porter A, Desai A, Nallamuthu N, Shah N, Swart E, Thum LP, Chua E. 26ADMISSION AVOIDANCE USING GERIATRICIAN LED VIRTUAL WARD ROUNDS IN A RAPID RESPONSE SERVICE: THE HARROW STARRS MODEL. Age Ageing 2016. [DOI: 10.1093/ageing/afw024.26] [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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Affiliation(s)
- S Levy
- Royal Eye Infirmary, Derriford Hospital, Plymouth, Devon, UK
| | - A Booth
- Royal Eye Infirmary, Derriford Hospital, Plymouth, Devon, UK
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Cohen-Zubary N, Gingold-Belfer R, Levy S, Wasserberg N, Dickman R. Home electrical stimulation for women with fecal incontinence: a preliminary randomized controlled trial. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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