Publications by authors named "Allison White"

21 Publications

  • Page 1 of 1

Use of Selected Recommended Clinical Preventive Services - Behavioral Risk Factor Surveillance System, United States, 2018.

MMWR Morb Mortal Wkly Rep 2021 Apr 2;70(13):461-466. Epub 2021 Apr 2.

Clinical preventive services play an important role in preventing deaths, and Healthy People 2020 has set national goals for using clinical preventive services to improve population health (1). The Patient Protection and Affordable Care Act (ACA) requires many health plans to cover certain recommended clinical preventive services without cost-sharing when provided in-network (covered clinical preventive services).* To ascertain prevalence of the use of selected recommended clinical preventive services among persons aged ≥18 years, CDC analyzed data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), a state-based annual nationwide survey conducted via landline and mobile phones in the United States, for 10 clinical preventive services covered in-network with no cost-sharing pursuant to the ACA. The weighted prevalence of colon, cervical, and breast cancer screening, pneumococcal and tetanus vaccination, and diabetes screening ranged from 66.0% to 79.2%; the prevalence of the other four clinical preventive services were <50%: 16.5% for human papillomavirus (HPV) vaccination, 26.6% for zoster (shingles) vaccination, 33.2% for influenza vaccination, and 45.8% for HIV testing. Prevalence of HIV testing had the widest variation (3.1-fold differences) across states among the 10 services included in this report. The prevalence of use of clinical preventive services varied by insurance status, income level, and rurality, findings that are consistent with previous studies (2-6). The use of nine of the 10 services examined was lower among the uninsured, those with lower income, and those living in rural communities. Among those factors examined, insurance status was the dominant factor strongly associated with use of clinical preventive services, followed by income-level and rurality. Understanding factors influencing use of recommended clinical preventive services can potentially help decision makers better identify policies to increase their use including strategies to increase insurance coverage.
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http://dx.doi.org/10.15585/mmwr.mm7013a1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8022875PMC
April 2021

Potential for Kappa-Opioid Receptor Agonists to Engineer Nonaddictive Analgesics: A Narrative Review.

Anesth Analg 2021 02;132(2):406-419

Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas.

A serious adverse effect of prescription opioid analgesics is addiction, both to these analgesics and to illicit drugs like heroin that also activate the µ-opioid receptor (MOR). Opioid use disorder (OUD) and opioid overdose deaths represent a current American health crisis, and the prescription of opioid analgesics has contributed significantly to this crisis. While prescription opioids are highly effective analgesics, there currently exists no facile way to use them for extended periods without the risk of addiction. If addiction caused by MOR-targeting analgesics could be blocked by blending in a new "antiaddiction" ingredient that does not diminish analgesia and does not introduce its own therapeutically limiting side effects, then continued clinical use of prescription opioids for treating pain could be maintained (or even enhanced) instead of curtailed. In this narrative review, we contextualize this hypothesis, first with a brief overview of the current American opioid addiction crisis. The neurobiology of 2 key receptors in OUD development, MOR and the κ-opioid receptor (KOR), is then discussed to highlight the neuroanatomical features and circuitry in which signal transduction from these receptors lie in opposition-creating opportunities for pharmacological intervention in curtailing the addictive potential of MOR agonism. Prior findings with mixed MOR/KOR agonists are considered before exploring new potential avenues such as biased KOR agonists. New preclinical data are highlighted, demonstrating that the G protein-biased KOR agonist nalfurafine reduces the rewarding properties of MOR-targeting analgesics and enhances MOR-targeting analgesic-induced antinociception. Finally, we discuss the recent discovery that a regulator of G protein signaling (namely, RGS12) is a key component of signaling bias at KOR, presenting another drug discovery target toward identifying a single agent or adjuvant to be added to traditional opioid analgesics that could reduce or eliminate the addictive potential of the latter drug.
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http://dx.doi.org/10.1213/ANE.0000000000005309DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992303PMC
February 2021

A replication of preference displacement research in children with autism spectrum disorder.

J Appl Behav Anal 2021 Jan 28;54(1):403-416. Epub 2020 Sep 28.

Department of Counseling, Educational Psychology, and Special Education, Michigan State University.

The purpose of this paper was to replicate previous research on preference displacement with edible and leisure stimuli. In the present study, the experimenters evaluated preference displacement in 25 children with autism spectrum disorder using combined multiple stimulus without replacement preference assessments that consisted of highly preferred edible and leisure stimuli. In addition, the experimenters used a block randomization procedure to evaluate if assessment order influenced displacement outcomes. The experimenters observed patterns of complete displacement by edible stimuli for four participants and complete displacement by leisure stimuli for two participants; assessment order did not influence outcomes. The results and implications are discussed.
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http://dx.doi.org/10.1002/jaba.775DOI Listing
January 2021

Virtual Trauma-Focused Therapy for Military Members, Veterans, and Public Safety Personnel With Posttraumatic Stress Injury: Systematic Scoping Review.

JMIR Mhealth Uhealth 2020 09 21;8(9):e22079. Epub 2020 Sep 21.

Heroes in Mind Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.

Background: A necessary shift from in-person to remote delivery of psychotherapy (eg, teletherapy, eHealth, videoconferencing) has occurred because of the COVID-19 pandemic. A corollary benefit is a potential fit in terms of the need for equitable and timely access to mental health services in remote and rural locations. Owing to COVID-19, there may be an increase in the demand for timely, virtual delivery of services among trauma-affected populations, including public safety personnel (PSP; eg, paramedics, police, fire, correctional officers), military members, and veterans. There is a lack of evidence on the question of whether digital delivery of trauma-therapies for military members, veterans, and PSP leads to similar outcomes to in-person delivery. Information on barriers and facilitators and recommendations regarding digital-delivery is also scarce.

Objective: This study aims to evaluate the scope and quality of peer-reviewed literature on psychotherapeutic digital health interventions delivered remotely to military members, veterans, and PSP and synthesize the knowledge of needs, gaps, barriers to, and facilitators for virtual assessment of and virtual interventions for posttraumatic stress injury.

Methods: Relevant studies were identified using MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica dataBASE), APA (American Psychological Association) PsycINFO, CINAHL (Cumulative Index of Nursing and Allied Health Literature) Plus with Full Text, and Military & Government Collection. For collation, analysis, summarizing, and reporting of results, we used the CASP (Critical Skills Appraisal Program) qualitative checklist, PEDro (Physiotherapy Evidence Database) scale, level of evidence hierarchy, PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), and narrative synthesis.

Results: A total of 38 studies were included in this review. Evidence for the effectiveness of digital delivery of prolonged exposure therapy, cognitive processing therapy, behavioral activation treatment with therapeutic exposure to military members, veterans, and PSP was rated level 1a, whereas evidence for cognitive behavioral therapy was conflicting. The narrative synthesis indicated that virtual delivery of these therapies can be as effective as in-person delivery but may reduce stigma and cost while increasing access to therapy. Issues of risk, safety, potential harm (ie, suicidality, enabling avoidance), privacy, security, and the match among the therapist, modality, and patient warrant further consideration. There is a lack of studies on the influences of gender, racial, and cultural factors that may result in differential outcomes, preferences, and/or needs. An investigation into other therapies that may be suitable for digital delivery is needed.

Conclusions: Digital delivery of trauma therapies for military members, veterans, and PSP is a critical area for further research. Although promising evidence exists regarding the effectiveness of digital health within these populations, many questions remain, and a cautious approach to more widespread implementation is warranted.
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http://dx.doi.org/10.2196/22079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536597PMC
September 2020

Genetic deletion of in mice affects serotonin transporter expression and function and .

J Psychopharmacol 2020 12 25;34(12):1393-1407. Epub 2020 Aug 25.

Department of Neuroscience, West Virginia University, Morgantown, USA.

Background: Regulator of G protein Signaling (RGS) proteins inhibit G protein-coupled receptor (GPCR) signaling, including the signals that arise from neurotransmitter release. We have shown that RGS12 loss diminishes locomotor responses of C57BL/6J mice to dopamine transporter (DAT)-targeting psychostimulants. This diminution resulted from a brain region-specific upregulation of DAT expression and function in RGS12-null mice. This effect on DAT prompted us to investigate whether the serotonin transporter (SERT) exhibits similar alterations upon RGS12 loss in C57BL/6J mice.

Aims: Does RGS12 loss affect (a) hyperlocomotion to the preferentially SERT-targeting psychostimulant 3,4-methylenedioxymethamphetamine (MDMA), (b) SERT expression and function in relevant brain regions, and/or (c) serotonergically modulated behaviors?

Methods: Open-field and spontaneous home-cage locomotor activities were quantified. 5-HT, 5-HIAA, and SERT levels in brain-region homogenates, as well as SERT expression and function in brain-region tissue preparations, were measured using appropriate biochemical assays. Serotonergically modulated behaviors were assessed using forced swim and tail suspension paradigms, elevated plus and elevated zero maze tests, and social interaction assays.

Results: RGS12-null mice displayed no hyperlocomotion to 10 mg/kg MDMA. There were brain region-specific alterations in SERT expression and function associated with RGS12 loss. Drug-naïve RGS12-null mice displayed increases in both anxiety-like and anti-depressive-like behaviors.

Conclusion: RGS12 is a critical modulator of serotonergic neurotransmission and serotonergically modulated behavior in mice; lack of hyperlocomotion to low dose MDMA in RGS12-null mice is related to an alteration of steady-state SERT expression and 5-HT uptake.
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http://dx.doi.org/10.1177/0269881120944160DOI Listing
December 2020

Putative role of GPR139 on sleep modulation using pharmacological and genetic rodent models.

Eur J Pharmacol 2020 Sep 9;882:173256. Epub 2020 Jun 9.

Department of Neuroscience, Janssen Research & Development, L.L.C, San Diego, CA, USA. Electronic address:

GPR139 is a G-protein coupled receptor expressed in circumventricular regions of the habenula and septum. Amino acids L-tryptophan and L-phenylalanine have been shown to activate GPR139 at physiologically relevant concentrations. The aim of the present study was to investigate the role of GPR139 on sleep modulation using pharmacological and genetic (GPR139 knockout mice, KO) rodent models. To evaluate the effects of GPR139 pharmacological activation on sleep, rats were orally dosed with the selective GPR139 agonist JNJ-63533054 (3-30 mg/kg). When acutely administered at the beginning of the light phase, the GPR139 agonist dose-dependently reduced non-rapid eye movement (NREM) latency and increased NREM sleep duration without altering rapid eye movement (REM) sleep. This effect progressively dissipated upon 7-day repeated dosing, suggesting functional desensitization. Under baseline conditions, GPR139 KO mice spent less time in REM sleep compared to their wild type littermates during the dark phase, whereas NREM sleep was not altered. Under conditions of pharmacologically enhanced monoamine endogenous tone, GPR139 KO mice showed a blunted response to citalopram or fluoxetine induced REM sleep suppression and an attenuated response to the wake promoting effect of amphetamine. These findings indicate an emerging role of GPR139 in the modulation of sleep states.
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http://dx.doi.org/10.1016/j.ejphar.2020.173256DOI Listing
September 2020

Shifting from survival to supporting resilience in children and families in the COVID-19 pandemic: Lessons for informing U.S. mental health priorities.

Psychol Trauma 2020 Aug 11;12(S1):S133-S135. Epub 2020 Jun 11.

Department of Psychiatry, Massachusetts General Hospital.

This commentary contextualizes potential mental health outcomes for children during and after the COVID-19 pandemic within the risk and resilience literature. Individual, familial, and community-level factors that may increase risk for mental health challenges for children as well as factors associated with positive adaptation in the face of adversity are considered. We highlight the value of considering children's resilience within a systemic perspective by considering family-centered approaches including both short-term and long-term evidence-informed mental health practices. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0000781DOI Listing
August 2020

Quantified biomechanical properties of lower lumbar myofascia in younger adults with chronic idiopathic low back pain and matched healthy controls.

Clin Biomech (Bristol, Avon) 2020 03 2;73:78-85. Epub 2020 Jan 2.

Mechanical Engineering, Bradley University, 1501 West Bradley Ave., Peoria, IL 61625, USA. Electronic address:

Background: Non-specific chronic low back pain (LBP) is a prevalent condition that is poorly understood with respect to possible altered physical properties. Five biomechanical properties of stiffness, frequency, decrement, creep, and stress relaxation time of the L3-L4 myofascial tissue were quantified using the MyotonPro® in chronic idiopathic LBP and matched normal control subjects.

Methods: Measurements were obtained in the resting prone position on the left and right sides (initially and after 10 min rest) in 25 chronic LBP participants (16 female, 9 male) and 25 age- and sex-matched control subjects. Surface electromyography measurements were simultaneously conducted to ensure a resting state.

Findings: Female LBP had significantly greater median decrement (p < 0.001) and stiffness (p < 0.010) than female controls. In female LBP patients, BMI correlated with decrement (p < 0.010) and creep (p < 0.050); creep also correlated with decrement (p < 0.050). Significant male versus female differences were found in all five properties in both LBP and control subgroups, except decrement in control males versus females.

Interpretation: This study showed that greater median decrement was found in LBP female subjects suggesting decrease in elasticity in the lumbar myofascia. Most of the biomechanical properties differed significantly by gender. This study further documented that right-handed dominance might correlate with greater right-sided lumbar myofascial stiffness.
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http://dx.doi.org/10.1016/j.clinbiomech.2019.12.026DOI Listing
March 2020

United States wildlife and wildlife product imports from 2000-2014.

Sci Data 2020 01 16;7(1):22. Epub 2020 Jan 16.

EcoHealth Alliance, 460 West 34th Street - Suite 1701, New York, New York, 10001, USA.

The global wildlife trade network is a massive system that has been shown to threaten biodiversity, introduce non-native species and pathogens, and cause chronic animal welfare concerns. Despite its scale and impact, comprehensive characterization of the global wildlife trade is hampered by data that are limited in their temporal or taxonomic scope and detail. To help fill this gap, we present data on 15 years of the importation of wildlife and their derived products into the United States (2000-2014), originally collected by the United States Fish and Wildlife Service. We curated and cleaned the data and added taxonomic information to improve data usability. These data include >2 million wildlife or wildlife product shipments, representing >60 biological classes and >3.2 billion live organisms. Further, the majority of species in the dataset are not currently reported on by CITES parties. These data will be broadly useful to both scientists and policymakers seeking to better understand the volume, sources, biological composition, and potential risks of the global wildlife trade.
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http://dx.doi.org/10.1038/s41597-020-0354-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6965094PMC
January 2020

Pharmacologic Characterization of JNJ-42226314, [1-(4-Fluorophenyl)indol-5-yl]-[3-[4-(thiazole-2-carbonyl)piperazin-1-yl]azetidin-1-yl]methanone, a Reversible, Selective, and Potent Monoacylglycerol Lipase Inhibitor.

J Pharmacol Exp Ther 2020 03 9;372(3):339-353. Epub 2019 Dec 9.

Janssen Research & Development, LLC, San Diego, California.

The serine hydrolase monoacylglycerol lipase (MAGL) is the rate-limiting enzyme responsible for the degradation of the endocannabinoid 2-arachidonoylglycerol (2-AG) into arachidonic acid and glycerol. Inhibition of 2-AG degradation leads to elevation of 2-AG, the most abundant endogenous agonist of the cannabinoid receptors (CBs) CB1 and CB2. Activation of these receptors has demonstrated beneficial effects on mood, appetite, pain, and inflammation. Therefore, MAGL inhibitors have the potential to produce therapeutic effects in a vast array of complex human diseases. The present report describes the pharmacologic characterization of [1-(4-fluorophenyl)indol-5-yl]-[3-[4-(thiazole-2-carbonyl)piperazin-1-yl]azetidin-1-yl]methanone (JNJ-42226314), a reversible and highly selective MAGL inhibitor. JNJ-42226314 inhibits MAGL in a competitive mode with respect to the 2-AG substrate. In rodent brain, the compound time- and dose-dependently bound to MAGL, indirectly led to CB1 occupancy by raising 2-AG levels, and raised norepinephrine levels in cortex. In vivo, the compound exhibited antinociceptive efficacy in both the rat complete Freund's adjuvant-induced radiant heat hypersensitivity and chronic constriction injury-induced cold hypersensitivity models of inflammatory and neuropathic pain, respectively. Though 30 mg/kg induced hippocampal synaptic depression, altered sleep onset, and decreased electroencephalogram gamma power, 3 mg/kg still provided approximately 80% enzyme occupancy, significantly increased 2-AG and norepinephrine levels, and produced neuropathic antinociception without synaptic depression or decreased gamma power. Thus, it is anticipated that the profile exhibited by this compound will allow for precise modulation of 2-AG levels in vivo, supporting potential therapeutic application in several central nervous system disorders. SIGNIFICANCE STATEMENT: Potentiation of endocannabinoid signaling activity via inhibition of the serine hydrolase monoacylglycerol lipase (MAGL) is an appealing strategy in the development of treatments for several disorders, including ones related to mood, pain, and inflammation. [1-(4-Fluorophenyl)indol-5-yl]-[3-[4-(thiazole-2-carbonyl)piperazin-1-yl]azetidin-1-yl]methanone is presented in this report to be a novel, potent, selective, and reversible noncovalent MAGL inhibitor that demonstrates dose-dependent enhancement of the major endocannabinoid 2-arachidonoylglycerol as well as efficacy in models of neuropathic and inflammatory pain.
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http://dx.doi.org/10.1124/jpet.119.262139DOI Listing
March 2020

Metabolic networks of the human gut microbiota.

Microbiology (Reading) 2020 02;166(2):96-119

Biology Department, Concordia University, 7141 Sherbrooke St W, SP-375-09 Montreal, Quebec, H4B 1R6, Canada.

The human gut microbiota controls factors that relate to human metabolism with a reach far greater than originally expected. Microbial communities and human (or animal) hosts entertain reciprocal exchanges between various inputs that are largely controlled by the host via its genetic make-up, nutrition and lifestyle. The composition of these microbial communities is fundamental to supply metabolic capabilities beyond those encoded in the host genome, and contributes to hormone and cellular signalling that support the dynamic adaptation to changes in food availability, environment and organismal development. Poor functional exchange between the microbial communities and their human host is associated with dysbiosis, metabolic dysfunction and disease. This review examines the biology of the dynamic relationship between the reciprocal metabolic state of the microbiota-host entity in balance with its environment (i.e. in healthy states), the enzymatic and metabolic changes associated with its imbalance in three well-studied diseases states such as obesity, diabetes and atherosclerosis, and the effects of bariatric surgery and exercise.
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http://dx.doi.org/10.1099/mic.0.000853DOI Listing
February 2020

Preclinical Testing of Nalfurafine as an Opioid-sparing Adjuvant that Potentiates Analgesia by the Mu Opioid Receptor-targeting Agonist Morphine.

J Pharmacol Exp Ther 2019 11 6;371(2):487-499. Epub 2019 Sep 6.

Departments of Physiology and Pharmacology (S.W.K., A.N.W., J.D.G., K.W., D.P.S., V.S.), Neuroscience, and Behavioral Medicine and Psychiatry (V.S.), West Virginia University School of Medicine, Morgantown, West Virginia; Department of Psychology, West Virginia University Eberly College of Arts and Sciences, Morgantown, West Virginia (K.R.T., S.G.K.); Department of Medicinal Chemistry, The University of Kansas School of Pharmacy, Lawrence, Kansas (T.E.P.); Division of Chemical Biology and Medicinal Chemistry, The University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina (A.A.H., J.A.); and Department of Pharmacology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina (T.K.)

Mu opioid receptor (MOR)-targeting analgesics are efficacious pain treatments, but notorious for their abuse potential. In preclinical animal models, coadministration of traditional kappa opioid receptor (KOR)-targeting agonists with MOR-targeting analgesics can decrease reward and potentiate analgesia. However, traditional KOR-targeting agonists are well known for inducing antitherapeutic side effects (psychotomimesis, depression, anxiety, dysphoria). Recent data suggest that some functionally selective, or biased, KOR-targeting agonists might retain the therapeutic effects of KOR activation without inducing undesirable side effects. Nalfurafine, used safely in Japan since 2009 for uremic pruritus, is one such functionally selective KOR-targeting agonist. Here, we quantify the bias of nalfurafine and several other KOR agonists relative to an unbiased reference standard (U50,488) and show that nalfurafine and EOM-salvinorin-B demonstrate marked G protein-signaling bias. While nalfurafine (0.015 mg/kg) and EOM-salvinorin-B (1 mg/kg) produced spinal antinociception equivalent to 5 mg/kg U50,488, only nalfurafine significantly enhanced the supraspinal analgesic effect of 5 mg/kg morphine. In addition, 0.015 mg/kg nalfurafine did not produce significant conditioned place aversion, yet retained the ability to reduce morphine-induced conditioned place preference in C57BL/6J mice. Nalfurafine and EOM-salvinorin-B each produced robust inhibition of both spontaneous and morphine-stimulated locomotor behavior, suggesting a persistence of sedative effects when coadministered with morphine. Taken together, these findings suggest that nalfurafine produces analgesic augmentation, while also reducing opioid-induced reward with less risk of dysphoria. Thus, adjuvant administration of G protein-biased KOR agonists like nalfurafine may be beneficial in enhancing the therapeutic potential of MOR-targeting analgesics, such as morphine.
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http://dx.doi.org/10.1124/jpet.118.255661DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6863463PMC
November 2019

Critical Importance of a One Health Approach to Antimicrobial Resistance.

Ecohealth 2019 09 28;16(3):404-409. Epub 2019 Jun 28.

Emory Antibiotic Resistance Center, School of Medicine and Rollins School of Public Health, Emory University, Atlanta, GA, USA.

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http://dx.doi.org/10.1007/s10393-019-01415-5DOI Listing
September 2019

COMPARISON OF CLINICAL FATIGUE PROTOCOLS TO DECREASE SINGLE-LEG FORWARD HOP PERFORMANCE IN HEALTHY INDIVIDUALS.

Int J Sports Phys Ther 2018 Apr;13(2):143-151

Department of Physical Therapy, Creighton University, Omaha, NE, USA.

Background: Return to activity decisions after anterior cruciate ligament reconstruction (ACL-R) are limited by functional performance tests often performed in a non-fatigued state. Fatigue can improve test sensitivity, but current methods to induce fatigue are typically bilateral tasks or focus on the quadriceps muscle in isolation.

Hypothesis/purpose: To determine the effects of a two-minute lateral step-down fatigue test compared to a 30-second side-hop test on single-leg forward hop distance in healthy individuals. It was hypothesized that participants would demonstrate decreased hop distance with both tests, but the two-minute lateral step-down fatigue test would result in greater deficits in single-leg forward hop distance.

Study Design: Randomized crossover.

Methods: Twenty healthy participants (16 females, 4 males; age = 23.7±3.0 years, height = 153.8±36.2 cm; mass = 64.4±12.8 kg; Tegner = 6.8±1.2) were asked to perform single-leg forward hop for distance pre- and post-fatigue. Participants were randomly assigned to one of the two fatigue tests, 30-second side-hop or 2-minute lateral step-down test, during the first visit. They returned within a week and performed the same sequence of tests but underwent whichever fatigue test was not assigned at the prior visit.

Results: There was a significant decrease (p < 0.001) in single-leg forward hop distance following the 30-second side-hop test (pre = 134.1±23.7 cm, post = 126.2±24.4 cm) and the two-minute lateral step-down test (pre = 135.0±26.1 cm, post = 122.7±27.4 cm). The decrease in hop distance was significantly greater (p < 0.001) for the two-minute lateral step-down test compared to the 30-second side-hop test.

Conclusion: The two-minute lateral step-down test resulted in a greater decrease in hop performance compared to the 30-second side-hop test. The results establish a threshold for expected changes that occur in a healthy population and that can then be compared with an injured athlete population. The two-minute lateral step-down exercise may be an effective method of inducing fatigue to better mimic performance in a sports environment to inform return-to-sport decisions.

Level Of Evidence: Level 1b- Therapy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063070PMC
April 2018

Biomechanical properties of low back myofascial tissue in younger adult ankylosing spondylitis patients and matched healthy control subjects.

Clin Biomech (Bristol, Avon) 2018 08 6;57:67-73. Epub 2018 Jun 6.

Mechanical Engineering, Bradley University, Peoria, IL 61625, USA. Electronic address:

Background: Ankylosing spondylitis is a degenerative and inflammatory rheumatologic disorder that primarily affects the spine. Delayed diagnosis leads to debilitating spinal damage. This study examines biomechanical properties of non-contracting (resting) human lower lumbar myofascia in ankylosing spondylitis patients and matched healthy control subjects.

Methods: Biomechanical properties of stiffness, frequency, decrement, stress relaxation time, and creep were quantified from 24 ankylosing spondylitis patients (19 male, 5 female) and 24 age- and sex-matched control subjects in prone position on both sides initially and after 10 min rest. Concurrent surface electromyography measurements were performed to ensure resting state. Statistical analyses were conducted, and significance was set at p < 0.05.

Findings: Decreased lumbar muscle elasticity (inverse of decrement) was primarily correlated with disease duration in ankylosing spondylitis subjects, whereas BMI was the primary correlate in control subjects. In ankylosing spondylitis and control groups, significant positive correlations were observed between the linear elastic properties of stiffness and frequency as well as between the viscoelastic parameters of stress relaxation time and creep. The preceding groups also showed significant negative correlations between the linear elastic and viscoelastic properties.

Interpretation: Findings indicate that increased disease duration is associated with decreased tissue elasticity or myofascial degradation. Both ankylosing spondylitis and healthy subjects revealed similar correlations between the linear and viscoelastic properties which suggest that the disease does not directly alter their inherent interrelations. The novel results that stiffness is greater in AS than normal subjects, whereas decrement is significantly correlated with AS disease duration deserves further investigation of the biomechanical properties and their underlying mechanisms.
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http://dx.doi.org/10.1016/j.clinbiomech.2018.06.006DOI Listing
August 2018

Study protocol for Log2Lose: A feasibility randomized controlled trial to evaluate financial incentives for dietary self-monitoring and interim weight loss in adults with obesity.

Contemp Clin Trials 2018 02 28;65:116-122. Epub 2017 Dec 28.

Duke University School of Nursing, USA.

The obesity epidemic has negative physical, psychological, and financial consequences. Despite the existence of effective behavioral weight loss interventions, many individuals do not achieve adequate weight loss, and most regain lost weight in the year following intervention. We report the rationale and design for a 2×2 factorial study that involves financial incentives for dietary self-monitoring (yes vs. no) and/or interim weight loss (yes vs. no). Outpatients with obesity participate in a 24-week, group-based weight loss intervention. All participants are asked to record their daily dietary and liquid intake on a smartphone application (app) and to weigh themselves daily at home on a study-provided cellular scale. An innovative information technology (IT) solution collates dietary data from the app and weight from the scale. Using these data, an algorithm classifies participants weekly according to whether they met their group's criteria to receive a cash reward ranging from $0 to $30 for dietary self-monitoring and/or interim weight loss. Notice of the reward is provided via text message, and credit is uploaded to a gift card. This pilot study will provide information on the feasibility of using this novel IT solution to provide variable-ratio financial incentives in real time via its effects on recruitment, intervention adherence, retention, and cost. This study will provide the foundation for a comprehensive, adequately-powered, randomized controlled trial to promote short-term weight loss and long-term weight maintenance. If efficacious, this approach could reduce the prevalence, adverse outcomes, and costs of obesity for millions of Americans. Clinicaltrials.gov registration: NCT02691260.
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http://dx.doi.org/10.1016/j.cct.2017.12.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803330PMC
February 2018

Hotspots of canine leptospirosis in the United States of America.

Vet J 2017 Apr 2;222:29-35. Epub 2017 Mar 2.

EcoHealth Alliance, 460 West 34th Street, 17th Floor, New York, NY 10001, USA.

Leptospirosis is a widespread zoonotic disease that causes hepatic and renal disease in dogs and human beings. The incidence of leptospirosis in dogs in the USA appears to be increasing. This study used 14 years of canine leptospirosis testing data across 3109 counties in the USA to analyze environmental and socio-economic correlates with rates of infection and to produce a map of locations of increased risk for canine leptospirosis. Boosted regression trees were used to identify the probability of a dog testing positive for leptospirosis based on microscopic agglutination test (MAT) results, and environmental and socio-economic data. The Midwest, East and Southwest were more likely to yield positive tests for leptospirosis, although specific counties in Appalachia had some of the highest predicted probabilities. Location (suburban areas or areas with deciduous forest) and climate (precipitation and temperature) were predictors for positive MAT results for leptospirosis, although the precise direction and strength of the effects was difficult to interpret. Wide geographic variation in predicted risk was identified. This risk mapping approach may provide opportunities for improved diagnosis, control and prevention of leptospirosis in dogs.
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http://dx.doi.org/10.1016/j.tvjl.2017.02.009DOI Listing
April 2017

Environmental arsenic exposure and microbiota in induced sputum.

Int J Environ Res Public Health 2014 Feb 21;11(2):2299-313. Epub 2014 Feb 21.

Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson 85724, USA.

Arsenic exposure from drinking water is associated with adverse respiratory outcomes, but it is unknown whether arsenic affects pulmonary microbiota. This exploratory study assessed the effect of exposure to arsenic in drinking water on bacterial diversity in the respiratory tract of non-smokers. Induced sputum was collected from 10 subjects with moderate mean household water arsenic concentration (21.1 ± 6.4 ppb) and 10 subjects with low household water arsenic (2.4 ± 0.8 ppb). To assess microbiota in sputum, the V6 hypervariable region amplicons of bacterial 16s rRNA genes were sequenced using the Ion Torrent Personal Genome Machine. Microbial community differences between arsenic exposure groups were evaluated using QIIME and Metastats. A total of 3,920,441 sequence reads, ranging from 37,935 to 508,787 per sample for 316 chips after QIIME quality filtering, were taxonomically classified into 142 individual genera and five phyla. Firmicutes (22%), Proteobacteria (17%) and Bacteriodetes (12%) were the main phyla in all samples, with Neisseriaceae (15%), Prevotellaceae (12%) and Veillonellacea (7%) being most common at the genus level. Some genera, including Gemella, Lactobacillales, Streptococcus, Neisseria and Pasteurellaceae were elevated in the moderate arsenic exposure group, while Rothia, Prevotella, Prevotellaceae Fusobacterium and Neisseriaceae were decreased, although none of these differences was statistically significant. Future studies with more participants and a greater range of arsenic exposure are needed to further elucidate the effects of drinking water arsenic consumption on respiratory microbiota.
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http://dx.doi.org/10.3390/ijerph110202299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945600PMC
February 2014

Development and implementation of a clinical pharmacist training and assessment program.

Am J Health Syst Pharm 2012 Feb;69(4):278-81

Providence Sacred Heart Medical Center and Children’s Hospital,Spokane, WA 99204, USA.

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http://dx.doi.org/10.2146/ajhp110253DOI Listing
February 2012

Conceptual similarity promotes generalization of higher order fear learning.

Learn Mem 2011 17;18(3):156-60. Epub 2011 Feb 17.

Center for Cognitve Neuroscience and Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA.

We tested the hypothesis that conceptual similarity promotes generalization of conditioned fear. Using a sensory preconditioning procedure, three groups of subjects learned an association between two cues that were conceptually similar, unrelated, or mismatched. Next, one of the cues was paired with a shock. The other cue was then reintroduced to test for fear generalization, as measured by the skin conductance response. Results showed enhanced fear generalization that correlated with trait anxiety levels in the group that learned an association between conceptually similar stimuli. These findings suggest that conceptual representations of conditional stimuli influence human fear learning processes.
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http://dx.doi.org/10.1101/lm.2016411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056515PMC
June 2011

Improvement in orofacial granulomatosis on a cinnamon- and benzoate-free diet.

Inflamm Bowel Dis 2006 Jun;12(6):508-14

Department of Dietetics, Kings College London, Medical and Dental Schools, Guy's, Kings and St Thomas's Hospital, London, UK.

Background: Orofacial granulomatosis (OFG) is a chronic inflammatory disorder presenting characteristically with lip swelling but also affecting gingivae, buccal mucosa, floor of mouth, and a number of other sites in the oral cavity. Although the cause remains unknown, there is evidence for involvement of a dietary allergen. Patch testing has related responses to cinnamon and benzoate to the symptoms of OFG, with improvement obtained through exclusion diets. However, an objective assessment of the effect of a cinnamon- and benzoate-free diet (CB-free diet) as primary treatment for OFG has not previously been performed. Thus, this study was undertaken to investigate the benefits of a CB-free diet as first-line treatment of patients with OFG.

Materials And Methods: Thirty-two patients with a confirmed diagnosis of OFG were identified from a combined oral medicine/gastroenterology clinic. All had received a CB-free diet as primary treatment for a period of 8 weeks. Each patient underwent a standardized assessment of the oral cavity to characterize the number of sites affected and the type of inflammation involved before and after diet.

Results: There was a significant improvement in oral inflammation in patients on the diet after 8 weeks. Both global oral and lip inflammatory scores improved (P<0.001), and there was significant improvement in both lip and oral site and activity involvement. However, improvement in lip activity was less marked than oral activity. Response to a CB-free diet did not appear to be site specific. A history of OFG-associated gut involvement did not predict a response to the diet.

Conclusions: The impact of dietary manipulation in patients with OFG can be significant, particularly with regard to oral inflammation. With the disease most prevalent in the younger population, a CB-free diet can be recommended as primary treatment. Subsequent topical or systemic immunomodulatory therapy may then be avoided or used as second line.
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http://dx.doi.org/10.1097/00054725-200606000-00011DOI Listing
June 2006