Publications by authors named "J David McDonald"

4,172 Publications

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Chromatin-Associated Protein Complexes Link DNA Base J and Transcription Termination in .

mSphere 2021 Feb 24;6(1). Epub 2021 Feb 24.

Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, Washington, USA

Unlike most other eukaryotes, and other trypanosomatid protozoa have largely eschewed transcriptional control of gene expression, relying instead on posttranscriptional regulation of mRNAs derived from polycistronic transcription units (PTUs). In these parasites, a novel modified nucleotide base (β-d-glucopyranosyloxymethyluracil) known as J plays a critical role in ensuring that transcription termination occurs only at the end of each PTU, rather than at the polyadenylation sites of individual genes. To further understand the biology of J-associated processes, we used tandem affinity purification (TAP) tagging and mass spectrometry to reveal proteins that interact with the glucosyltransferase performing the final step in J synthesis. These studies identified four proteins reminiscent of subunits in the PTW/PP1 complex that controls transcription termination in higher eukaryotes. Moreover, bioinformatic analyses identified the DNA-binding subunit of PTW/PP1 as a novel J-binding protein (JBP3), which is also part of another complex containing proteins with domains suggestive of a role in chromatin modification/remodeling. Additionally, JBP3 associates (albeit transiently and/or indirectly) with the trypanosomatid equivalent of the PAF1 complex involved in the regulation of transcription in other eukaryotes. The downregulation of JBP3 expression levels in resulted in a substantial increase in transcriptional readthrough at the 3' end of most PTUs. We propose that JBP3 recruits one or more of these complexes to the J-containing regions at the end of PTUs, where they halt the progression of the RNA polymerase. This decoupling of transcription termination from the splicing of individual genes enables the parasites' unique reliance on polycistronic transcription and posttranscriptional regulation of gene expression. parasites cause a variety of serious human diseases, with no effective vaccine and emerging resistance to current drug therapy. We have previously shown that a novel DNA base called J is critical for transcription termination at the ends of the polycistronic gene clusters that are a hallmark of and related trypanosomatids. Here, we describe a new J-binding protein (JBP3) associated with three different protein complexes that are reminiscent of those involved in the control of transcription in other eukaryotes. However, the parasite complexes have been reprogrammed to regulate transcription and gene expression in trypanosomatids differently than in the mammalian hosts, providing new opportunities to develop novel chemotherapeutic treatments against these important pathogens.
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http://dx.doi.org/10.1128/mSphere.01204-20DOI Listing
February 2021

Selected Abbreviations Used in This Supplement.

Acad Med 2020 Sep;95(9S A Snapshot of Medical Student Education in the United States and Canada: Reports From 145 Schools):S605

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http://dx.doi.org/10.1097/ACM.0000000000003565DOI Listing
September 2020

Electrocortical Effects of Acetaminophen during Emotional Picture Viewing, Cognitive Control, and Negative Feedback.

Cogn Affect Behav Neurosci 2021 Feb 19. Epub 2021 Feb 19.

Texas A&M University, College Station, TX, 77843, USA.

Acetaminophen, the active ingredient in Tylenol, may have psychological effects, such as reducing social and emotional pain. The current study (N = 173) used electroencephalography (EEG) to extend past research on acetaminophen. Healthy undergraduate students (64.7% women, age M = 18.15, SD = 3.33) were randomly assigned to ingest 1,000 mg of acetaminophen or placebo before completing emotional picture viewing (n = 143), a flanker task (n = 69), and a probabilistic learning task (n = 143) while EEG was recorded. (Sample sizes used for the analyses of each task differ from the total N due to data loss.) We observed standard event-related potentials (ERPs), including emotion-modulated late positive potentials during picture viewing and feedback-related negativity during feedback on the probabilistic learning task. We also observed standard error-related and conflict-related ERPs in the flanker task but could not adequately assess acetaminophen's effect on flanker ERPs due to excessive data loss. Acetaminophen did not alter any of the ERPs, in contrast to predictions based on prior research. Exploratory analyses revealed that acetaminophen reduced the relationship between trait behavioral inhibition system sensitivity and emotion-modulated late positive potentials. Together these findings suggest that a standard dose of acetaminophen did not reliably alter neural indicators of emotional or feedback processing. Instead, preliminary findings from our study suggested that a more nuanced relationship may exist between acetaminophen and individual differences in emotional processing, although this latter finding calls for further replication.
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http://dx.doi.org/10.3758/s13415-021-00866-0DOI Listing
February 2021

Seroprevalence of SARS-CoV-2 Antibodies in Rhode Island From a Statewide Random Sample.

Am J Public Health 2021 Feb 18:e1-e4. Epub 2021 Feb 18.

Philip A. Chan, Ewa King, Leanne Lasher, Matt Vargas, Ken Brindamour, Richard Huard, Ailis Clyne, James McDonald, Utpala Bandy, Laura Chambers, and Nicole Alexander-Scott are with the Rhode Island Department of Health, Providence. Yizhen Xu is with the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. William Goedel, Michelle L. Rogers, and Joseph W. Hogan are with the Brown University School of Public Health, Providence. David Yokum is with The Policy Lab, Brown University, Providence. Siena C. Napoleon is with the Brown University Warren Alpert School of Medicine, Providence.

To characterize statewide seroprevalence and point prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Rhode Island. We conducted a cross-sectional survey of randomly selected households across Rhode Island in May 2020. Antibody-based and polymerase chain reaction (PCR)-based tests for SARS-CoV-2 were offered. Hispanics/Latinos and African Americans/Blacks were oversampled to ensure adequate representation. Seroprevalence estimations accounted for test sensitivity and specificity and were compared according to age, race/ethnicity, gender, housing environment, and transportation mode. Overall, 1043 individuals from 554 households were tested (1032 antibody tests, 988 PCR tests). The estimated seroprevalence of SARS-CoV-2 antibodies was 2.1% (95% credible interval [CI] = 0.6, 4.1). Seroprevalence was 7.5% (95% CI = 1.3, 17.5) among Hispanics/Latinos, 3.8% (95% CI = 0.0, 15.0) among African Americans/Blacks, and 0.8% (95% CI = 0.0, 2.4) among non-Hispanic Whites. Overall PCR-based prevalence was 1.5% (95% CI = 0.5, 3.1). Rhode Island had low seroprevalence relative to other settings, but seroprevalence was substantially higher among African Americans/Blacks and Hispanics/Latinos. Rhode Island sits along the highly populated northeast corridor, making our findings broadly relevant to this region of the country. Continued monitoring via population-based sampling is needed to quantify these impacts going forward. (. Published online ahead of print February 18, 2021: e1-e4. https://doi.org/10.2105/AJPH.2020.306115).
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http://dx.doi.org/10.2105/AJPH.2020.306115DOI Listing
February 2021

Traffic generated emissions alter the lung microbiota by promoting the expansion of Proteobacteria in C57Bl/6 mice placed on a high-fat diet.

Ecotoxicol Environ Saf 2021 Feb 11;213:112035. Epub 2021 Feb 11.

Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX 76201, USA. Electronic address:

Air pollution has been documented to contribute to severe respiratory diseases like asthma and chronic obstructive pulmonary disorder (COPD). Although these diseases demonstrate a shift in the lung microbiota towards Proteobacteria, the effects of traffic generated emissions on lung microbiota profiles have not been well-characterized. Thus, we investigated the hypothesis that exposure to traffic-generated emissions can alter lung microbiota and immune defenses. Since a large population of the Western world consumes a diet rich in fats, we sought to investigate the synergistic effects of mixed vehicle emissions and high-fat diet consumption. We exposed 3-month-old male C57Bl/6 mice placed either on regular chow (LF) or a high-fat (HF: 45% kcal fat) diet to mixed emissions (ME: 30 µg PM/m gasoline engine emissions+70 µg PM/m diesel engine emissions) or filtered air (FA) for 6 h/d, 7 d/wk for 30 days. Levels of pulmonary immunoglobulins IgA, IgG, and IgM were analyzed by ELISA, and lung microbial profiling was done using qPCR and Illumina 16 S sequencing. We observed a significant decrease in lung IgA in the ME-exposed animals, compared to the FA-exposed animals, both fed a HF diet. Our results also revealed a significant decrease in lung IgG in the ME-exposed animals both on the LF diet and HF diet, in comparison to the FA-exposed animals. We also observed an expansion of Enterobacteriaceae belonging to the Proteobacteria phylum in the ME-exposed groups on the HF diet. Collectively, we show that the combined effects of ME and HF diet result in decreased immune surveillance and lung bacterial dysbiosis, which is of significance in lung diseases.
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http://dx.doi.org/10.1016/j.ecoenv.2021.112035DOI Listing
February 2021

Results of the Behavioral Health Readiness Evaluation and Decision-Making Instrument Study.

Mil Med 2021 01;186(Suppl 1):142-152

Department of Military Psychiatry, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA.

Introduction: Recent reports have demonstrated behavioral health (BH) system and individual provider challenges to BH readiness success. These pose a risk to winning on the battlefield and present a significant safety issue for the Army. One of the most promising areas for achieving better BH readiness results lies in improving readiness decision-making support for BH providers. The Walter Reed Army Institute of Research (WRAIR) has taken the lead in addressing this challenge by developing and empirically testing such tools. The results of the Behavioral Health Readiness Evaluation and Decision-Making Instrument (B-REDI) field study are herein described.

Methods: The B-REDI study received WRAIR Institutional Review Board approval, and BH providers across five U.S. Army Forces Command installations completed surveys from September 2018 to March 2019. The B-REDI tools/training were disseminated to 307 providers through random clinic assignments. Of these, 250 (81%) providers consented to participate and 149 (60%) completed both initial and 3-month follow-up surveys. Survey items included a wide range of satisfaction, utilization, and proficiency-level outcome measures. Analyses included examinations of descriptive statistics, McNemar's tests pre-/post-B-REDI exposure, Z-tests with subgroup populations, and chi-square tests with demographic comparisons.

Results: The B-REDI resulted in broad, statistically significant improvements across the measured range of provider proficiency-level outcomes. Net gains in each domain ranged from 16.5% to 22.9% for knowledge/awareness (P = .000), from 11.1% to 15.8% for personal confidence (P = .001-.000), and from 6.2% to 15.1% for decision-making/documentation (P = .035-.002) 3 months following B-REDI initiation, and only one (knowledge) failed to maintain a statistically significant improvement in all of its subcategories. The B-REDI also received high favorability ratings (79%-97% positive) across a wide array of end-user satisfaction measures.

Conclusions: The B-REDI directly addresses several critical Army BH readiness challenges by providing tangible decision-making support solutions for BH providers. Providers reported high degrees of end-user B-REDI satisfaction and significant improvements in all measured provider proficiency-level domains. By effectively addressing the readiness decision-making challenges Army BH providers encounter, B-REDI provides the Army BH health care system with a successful blueprint to set the conditions necessary for providers to make more accurate and timely readiness determinations. This may ultimately reduce safety and mission failure risks enterprise-wide, and policymakers should consider formalizing and integrating the B-REDI model into current Army BH practice.
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http://dx.doi.org/10.1093/milmed/usaa401DOI Listing
January 2021

Completeness of Medication Reconciliation Performed by Pediatric Resident Physicians at Hospital Admission for Asthma.

Can J Hosp Pharm 2021 1;74(1):30-35. Epub 2021 Jan 1.

, MD, FRCPC, is Assistant Professor in the Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia.

Background: Medication errors at hospital admission, though preventable, continue to be common. The process of medication reconciliation has been identified as an important tool in reducing medication errors. The first step in medication reconciliation involves documenting a patient's best possible medication history (BPMH); at the authors' tertiary pediatric hospital, this step is completed at time of admission by resident physicians.

Objectives: To describe and quantify the completeness of admission BPMH by resident physicians for pediatric inpatients with asthma.

Methods: This single-centre, retrospective chart review evaluated documentation of admission medication reconciliation for pediatric inpatients with asthma who were admitted between January 2016 and December 2017. Medication reconciliation forms were deemed incomplete if records for asthma medications were missing drug name, inhaler strength or oral drug dose, directions for use, or evidence of reconciliation.

Results: A total of 241 charts were evaluated, of which 97 (40%) had incomplete documentation for at least 1 medication; in particular, 48 (37%) of the 130 inhaled corticosteroid orders were missing inhaler strength. For most of the charts with incomplete medication history (68% [66/97]), no reason was documented; however, review of the medication reconciliation forms and physician notes revealed that families might have been unsure of a patient's home medications or physicians might have left it to the pharmacy to clarify medication doses.

Conclusions: Documentation of inhaler medications on admission medication reconciliation forms completed by resident physicians for pediatric patients with asthma was often incomplete. Future quality improvement interventions, including resident and patient education, are required at the study institution. Collaboration with pharmacy services is also likely to improve completeness of the medication reconciliation process.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801341PMC
January 2021

Relationship between cytokines and symptoms in people with incurable cancer: A systematic review.

Crit Rev Oncol Hematol 2021 Jan 19;159:103222. Epub 2021 Jan 19.

St Columba's Hospice, Edinburgh, UK; Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.

Background: Development and spread of cancer is linked to the inflammatory response, in which cytokines serve a key role. The inflammatory response may also form the basis for symptoms of cancer. This systematic review examines the relationship between cytokines and symptoms in incurable cancer.

Methods: MEDLINE, EMBASE, Cochrane Library, CINAHL, Web of Science and PsycINFO databases were searched for studies from January 2004 to January 2020.

Results: Twenty studies were selected (n = 1806 patients, 119 controls). Symptoms studied included depression, fatigue, pain, and loss of appetite. Nine studies examined patients with a specified tumour type, the remainder included patients with a mix of tumour types. Thirty-one cytokines were examined; multiple associations between cytokines and symptoms were described, supporting the hypothesis that cytokines may have a key role in symptom generation.

Conclusion: Symptoms of incurable cancer are associated with circulating cytokines. Further study is required to characterise these relationships, and to explore their therapeutic potential.
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http://dx.doi.org/10.1016/j.critrevonc.2021.103222DOI Listing
January 2021

Reliable, scalable functional genetics in bloodstream-form Trypanosoma congolense in vitro and in vivo.

PLoS Pathog 2021 Jan 22;17(1):e1009224. Epub 2021 Jan 22.

School of Life Sciences, University of Nottingham, Nottingham, United Kingdom.

Animal African trypanosomiasis (AAT) is a severe, wasting disease of domestic livestock and diverse wildlife species. The disease in cattle kills millions of animals each year and inflicts a major economic cost on agriculture in sub-Saharan Africa. Cattle AAT is caused predominantly by the protozoan parasites Trypanosoma congolense and T. vivax, but laboratory research on the pathogenic stages of these organisms is severely inhibited by difficulties in making even minor genetic modifications. As a result, many of the important basic questions about the biology of these parasites cannot be addressed. Here we demonstrate that an in vitro culture of the T. congolense genomic reference strain can be modified directly in the bloodstream form reliably and at high efficiency. We describe a parental single marker line that expresses T. congolense-optimized T7 RNA polymerase and Tet repressor and show that minichromosome loci can be used as sites for stable, regulatable transgene expression with low background in non-induced cells. Using these tools, we describe organism-specific constructs for inducible RNA-interference (RNAi) and demonstrate knockdown of multiple essential and non-essential genes. We also show that a minichromosomal site can be exploited to create a stable bloodstream-form line that robustly provides >40,000 independent stable clones per transfection-enabling the production of high-complexity libraries of genome-scale. Finally, we show that modified forms of T. congolense are still infectious, create stable high-bioluminescence lines that can be used in models of AAT, and follow the course of infections in mice by in vivo imaging. These experiments establish a base set of tools to change T. congolense from a technically challenging organism to a routine model for functional genetics and allow us to begin to address some of the fundamental questions about the biology of this important parasite.
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http://dx.doi.org/10.1371/journal.ppat.1009224DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870057PMC
January 2021

Marking of Tense and Agreement in Language Samples by Children With and Without Specific Language Impairment in African American English and Southern White English: Evaluation of Scoring Approaches and Cut Scores Across Structures.

J Speech Lang Hear Res 2021 Feb 20;64(2):491-509. Epub 2021 Jan 20.

Department of Psychology, Louisiana State University, Baton Rouge.

Purpose As follow-up to a previous study of probes, we evaluated the marking of tense and agreement (T/A) in language samples by children with specific language impairment (SLI) and typically developing controls in African American English (AAE) and Southern White English (SWE) while also examining the clinical utility of different scoring approaches and cut scores across structures. Method The samples came from 70 AAE- and 36 SWE-speaking kindergartners, evenly divided between the SLI and typically developing groups. The structures were past tense, verbal - auxiliary BE present, and auxiliary BE past. The scoring approaches were unmodified, modified, and strategic; these approaches varied in the scoring of forms classified as nonmainstream and other. The cut scores were dialect-universal and dialect-specific. Results Although low numbers of some forms limited the analyses, the results generally supported those previously found for the probes. The children produced a large and diverse inventory of mainstream and nonmainstream T/A forms within the samples; strategic scoring led to the greatest differences between the clinical groups while reducing effects of the children's dialects; and dialect-specific cut scores resulted in better clinical classification accuracies, with measures of past tense leading to the highest levels of classification accuracy. Conclusions For children with SLI, the findings contribute to studies that call for a paradigm shift in how children's T/A deficits are assessed and treated across dialects. A comparison of findings from the samples and probes indicates that probes may be the better task for identifying T/A deficits in children with SLI in AAE and SWE. Supplemental Material https://doi.org/10.23641/asha.13564709.
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http://dx.doi.org/10.1044/2020_JSLHR-20-00243DOI Listing
February 2021

The Association Between Patient-Reported Outcome Measurement Scores and Preference for Specific Interventions.

J Patient Exp 2020 Dec 23;7(6):1595-1601. Epub 2020 Jan 23.

Austin Regional Clinic, Austin, TX, USA.

To determine whether greater patient-reported symptom intensity and functional limitation influence expressed preferences for discretionary diagnostic and treatment interventions, we studied the association of patient factors and several Patient Reported Outcome Measure (PROM) scores with patient preferences for diagnostic and treatment interventions before and after the visit, a cross-sectional cohort study. One hundred and forty-three adult patients who completed several PROMs were asked their preferences for diagnostic and treatment interventions before and after a visit with an orthopedic surgeon. Patients with better physical function had fewer preferences for specific diagnostic interventions after the visit ( = .02), but PROM scores had no association with preferences for treatment interventions before or after the visit. A greater percentage of patients expressed the preference for no diagnostic or treatment intervention after the visit with a physician than before (diagnostic intervention; 2.1% before vs 30% after the visit; ≤ .001 and treatment intervention; 2.1% before vs 17% after the visit; ≤ .001). This study suggests that physician expertise may be more reassuring to people with more adaptive mind sets.
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http://dx.doi.org/10.1177/2374373519897761DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7786652PMC
December 2020

The future of ocean governance.

Rev Fish Biol Fish 2021 Jan 12:1-18. Epub 2021 Jan 12.

Institute for Marine and Antarctic Studies, Private Bag 129, Hobart, TAS 7001 Australia.

Ocean governance is complex and influenced by multiple drivers and actors with different worldviews and goals. While governance encompasses many elements, in this paper we focus on the processes that operate within and between states, civil society and local communities, and the market, including industry. Specifically, in this paper, we address the question of how to move towards more sustainable ocean governance aligning with the sustainable development goals (SDGs) and the UN Ocean Decade. We address three major risks to oceans that arise from governance-related issues: (1) the impacts of the overexploitation of marine resources; (2) inequitable distribution of access to and benefits from marine ecosystem services, and (3) inadequate or inappropriate adaptation to changing ocean conditions. The SDGs have been used as an underlying framework to develop these risks. We identify five drivers that may determine how ocean governance evolves, namely formal rules and institutions, evidence and knowledge-based decision-making, legitimacy of decision-making institutions, stakeholder engagement and participation, and empowering communities. These drivers were used to define two alternative futures by 2030: (a) 'Business as Usual'-a continuation of current trajectories and (b) 'More Sustainable Future'-optimistic, transformational, but technically achievable. We then identify what actions, as structured processes, can reduce the three major governance-related risks and lead to the More Sustainable Future. These actions relate to the process of co-creation and implementation of improved, comprehensive, and integrated management plans, enhancement of decision-making processes, and better anticipation and consideration of ambiguity and uncertainty.

Supplementary Information: The online version of this article (10.1007/s11160-020-09631-x) contains supplementary material, which is available to authorized users.
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http://dx.doi.org/10.1007/s11160-020-09631-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7802408PMC
January 2021

Phytol, not propylene glycol, causes severe pulmonary injury after inhalation dosing in Sprague-Dawley rats.

Inhal Toxicol 2021 Jan 13:1-8. Epub 2021 Jan 13.

Lovelace Biomedical, Albuquerque, NM, USA.

The use of vaping pens for inhalation of cannabinoid derived products is rising and has become a popular alternative to smoking combustible products. For efficient product delivery, additives are sometimes added and vaping pens often may include compounds like Phytol or Propylene Glycol as thinning agents. This study aimed at comparing Phytol and Propylene Glycol with respect to potential toxicity and safe use in vaping products. Male and female Sprague Dawley rats were exposed to 5 mg/L of Phytol or Propylene Glycol for up to 6 hours over up to 14 days and monitored for clinical signs and changes in body weight. Gross necropsy and histopathology of respiratory tissue was performed to assess potential adverse effects. Phytol exposed animals expressed severe clinical signs, body weight loss and mortality after one or two exposure days, leading to termination of all dose groups for this compound. Lung weights were increased and respiratory tissue was severely affected, demonstrating dose-responsive tissue degeneration, necrosis, edema, hemorrhage and inflammation. Propylene Glycol exposed animals did not show any adverse reactions after 14 days of high dose exposure. For Phytol, a low observed adverse effect level (LOAEL) was determined at ≤109.0/10.9 mg/kg/day presented/deposited dose and therefore its use as excipient in vaping product is not recommend; a safe exposure range was not established for Phytol. Propylene Glycol, in contrast, is considered safe with a no observed adverse effect level (NOAEL) at 1151.7/115.2 mg/kg/day presented/deposited dose in rats.
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http://dx.doi.org/10.1080/08958378.2020.1867260DOI Listing
January 2021

Comprehensive assessment of quality of life, functioning and mental health in children with juvenile idiopathic arthritis and non-infectious uveitis.

Arthritis Care Res (Hoboken) 2021 Jan 9. Epub 2021 Jan 9.

Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, OH, United States.

Objective: Pediatric uveitis can lead to sight-threatening complications and impact quality of life (QOL) and functioning. We aim to examine health-related QOL (HRQOL), mental health, physical disability, vision-related functioning (VRF), and vision-related QOL (VRQOL) in children with juvenile idiopathic arthritis (JIA), JIA-associated uveitis (JIA-U), and other non-infectious uveitis. We hypothesize that there will be differences based on the presence of eye disease.

Methods: A multicenter cross-sectional study was conducted at four sites. Patients with JIA, JIA-U, or non-infectious uveitis were enrolled. Patients and parents completed the PedsQL (HRQOL), RCADS (anxiety/depression), CHAQ (physical disability), and EYE-Q (VRF/VRQOL). Clinical characteristics and patient-reported outcome measures (PROMs) were compared by diagnosis.

Results: Of 549 patients, 332 had JIA, 124 JIA-U, and 93 other uveitis. Children with JIA-U had worse EYE-Q scores compared to JIA only. In children with uveitis, those with anterior uveitis (JIA-U and uveitis only) had less ocular complications, better EYE-Q scores, and worse CHAQ and PedsQL physical summary scores compared to those with non-anterior disease. In children with anterior uveitis, those with JIA-U had worse PedsQL physical summary and CHAQ scores than anterior uveitis only. Further, EYE-Q scores were worse in children with bilateral uveitis and more visual impairment. There were no differences in RCADS scores among groups.

Conclusion: We provide a comprehensive outcome assessment of children with JIA, JIA-U, and other uveitis diagnoses. Differences in QOL and function were noted based on underlying disease. Our results support the addition of a vision-specific measure to better understand the impact of uveitis.
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http://dx.doi.org/10.1002/acr.24551DOI Listing
January 2021

Circulating 27-hydroxycholesterol and Risk of Colorectal Adenomas and Serrated Polyps.

Cancer Prev Res (Phila) 2021 Jan 6. Epub 2021 Jan 6.

Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.

The oxysterol 27-hydroxycholesterol (27-OHC) is an endogenous selective estrogen receptor modulator implicated in breast cancer etiology. It is unknown whether circulating 27-OHC is associated with colorectal neoplasia risk. Circulating 27-OHC was measured using LC/MS in fasting plasma collected at baseline from participants of the Vitamin D/Calcium Polyp Prevention Study, a completed randomized clinical trial. Participants were between 45 and 75 years old, recently diagnosed with ≥1 colorectal adenoma, and followed for new colorectal polyps during colonoscopic surveillance. Adjusted risk ratios (RR) with 95% confidence intervals (CI) of new colorectal polyps were estimated for quartiles of circulating 27-OHC using log-linear regression for repeated outcomes. Polyp phenotypes included any adenomas, advanced adenomas, hyperplastic polyps, and sessile serrated adenomas/polyps. Circulating 27-OHC was measured at baseline for 1,246 participants. Compared with participants with circulating 27-OHC below the first quartile (<138 ng/mL), those with circulating 27-OHC at or above the fourth quartile (≥201 ng/mL) had 24% higher risk of adenomas (RR, 1.24; 95% CI, 1.05-1.47) and 89% higher risk of advanced adenomas (RR, 1.89; 95% CI, 1.17-3.06). Stronger associations were observed among participants with advanced adenomas at baseline. Circulating 27-OHC was not associated with risk of hyperplastic polyps (RR, 0.90; 95% CI, 0.66-1.22) or sessile serrated adenomas/polyps (RR, 1.02; 95% CI, 0.50-2.07). Circulating 27-OHC may be a risk factor for colorectal adenomas but not serrated polyps. PREVENTION RELEVANCE: This study found that plasma concentration of 27-hydroxycholesterol, a metabolite of cholesterol that regulates lipid metabolism and acts as a selective estrogen receptor modulator, is associated with the risk of developing precursor lesions for colorectal cancer.
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http://dx.doi.org/10.1158/1940-6207.CAPR-20-0414DOI Listing
January 2021

Gadolinium retention within multiple rat organs after intra-articular administration of gadolinium-based contrast agents.

Skeletal Radiol 2021 Jan 6. Epub 2021 Jan 6.

Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

Objective: To characterize the extent of retention and biodistribution of gadolinium (Gd) following intra-articular (IA) injection of linear and macrocyclic gadolinium-based contrast agents (GBCAs) into the knee joint of a rat model.

Materials And Methods: Fifteen Wistar rats were divided into five groups and underwent fluoroscopically-guided injections of both knee joints of (1) clinical 1:200 dilution (low dose, LD) gadodiamide (linear GBCA), (2) LD gadobutrol (macrocyclic GBCA), (3) undiluted (high dose, HD) gadodiamide, (4) HD gadobutrol, and (5) saline. Gd concentrations were quantified by inductively coupled plasma mass spectrometry in (1) blood and urine samples obtained over a 72 h period and (2) knee joint tissues, brain, kidney, and bone marrow at 3 days post-injection.

Results: Both HD and LD gadodiamide and gadobutrol were rapidly absorbed from the joint with peak serum and urine concentration at 1 h post-injection, with relatively faster clearance of gadobutrol. All GBCA-exposed groups had detectable levels of Gd in the joint tissues, bone marrow, and/or kidneys (median tissue gadolinium range: 0.1-71 μg Gd/g tissue), with higher amounts observed with gadodiamide versus gadobutrol. Retention within brain tissues was only detected following HD gadodiamide administration but not LD gadodiamide nor HD or LD gadobutrol.

Conclusion: There was rapid systemic absorption, redistribution, and widespread multi-organ retention of Gd following IA injection of both linear and macrocyclic GBCAs, despite substantial amounts of urinary excretion. Higher concentrations of Gd were observed with administration of gadodiamide compared to gadobutrol in most tissues and biofluids.
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http://dx.doi.org/10.1007/s00256-020-03695-3DOI Listing
January 2021

Asymptomatic macrocephaly: to scan or not to scan.

Pediatr Radiol 2021 Jan 5. Epub 2021 Jan 5.

Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.

Background: Macrocephaly is a common finding in infants and is often idiopathic or familial. In the absence of clinical signs and symptoms, it can be difficult to determine when concern for underlying pathology is justified.

Objectives: The objectives of this study were to determine the utility of screening head ultrasound (US) in asymptomatic infants with macrocephaly and to identify clinical factors associated with significant US findings.

Materials And Methods: A 20-year retrospective review was performed of infants undergoing head US for macrocephaly or rapidly increasing head circumference. Data collected included age, gender, head circumference at birth and at the time of US, specialty of the ordering physician, US findings, computed tomography (CT) or magnetic resonance imaging (MRI) findings, and clinical course including interventions.

Results: Four hundred and forty infants met inclusion criteria. Two hundred and eighty studies (64%) were found to be normal, 137 (31%) had incidental findings, 17 (3.8%) had indeterminate but potentially significant findings, and 6 (1.4%) had significant findings. Twenty of the 23 infants with indeterminate or significant findings had subsequent CT or MRI. This confirmed significant findings in eight infants (1.8%): three subdural hematomas, two intracranial tumors, two aqueductal stenoses, and one middle fossa cyst. Five of the eight infants required surgical procedures. The only statistically significant association found with having a significant finding on head US was head circumference at birth.

Conclusion: Ultrasound is a useful initial study to evaluate infantile macrocephaly, identifying several treatable causes in our study and, when negative, effectively excluding significant pathology.
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http://dx.doi.org/10.1007/s00247-020-04907-7DOI Listing
January 2021

Exposure to traffic-generated air pollution promotes alterations in the integrity of the brain microvasculature and inflammation in female ApoE mice.

Toxicol Lett 2021 Mar 26;339:39-50. Epub 2020 Dec 26.

Advanced Environmental Research Institute, Department of Biological Sciences, University of North Texas, Denton, TX, 76201, USA. Electronic address:

Traffic-generated air pollutants have been correlated with alterations in blood-brain barrier (BBB) integrity, which is associated with pathologies in the central nervous system (CNS). Much of the existing literature investigating the effects of air pollution in the CNS has predominately been reported in males, with little known regarding the effects in females. As such, this study characterized the effects of inhalation exposure to mixed vehicle emissions (MVE), as well as the presence of female sex hormones, in the CNS of female ApoE mice, which included cohorts of both ovariectomized (ov-) and ovary-intact (ov+) mice. Ov + and ov- were placed on a high-fat diet and randomly grouped to be exposed to either filtered-air (FA) or MVE (200 PM/m: 50 μg PM/m gasoline engine + 150 μg PM/m from diesel engine emissions) for 6 h/d, 7d/wk, for 30d. MVE-exposure resulted in altered cerebral microvascular integrity and permeability, as determined by the decreased immunofluorescent expression of tight junction (TJ) proteins, occludin, and claudin-5, and increased IgG extravasation into the cerebral parenchyma, compared to FA controls, regardless of ovary status. Associated with the altered cerebral microvascular integrity, we also observed an increase in matrix metalloproteinases (MMPs) -2/9 activity in the MVE ov+, MVE ov-, and FA ov- groups, compared to FA ov+. There was also elevated expression of intracellular adhesion molecule (ICAM)-1, inflammatory interleukins (IL-1, IL-1β), and tumor necrosis factor (TNF-α) mRNA in the cerebrum of MVE ov + and MVE ov- animals. IκB kinase (IKK) subunits IKKα and IKKβ mRNA expressions were upregulated in the cerebrum of MVE ov- and FA ov- mice. Our findings indicate that MVE exposure mediates altered integrity of the cerebral microvasculature correlated with increased MMP-2/9 activity and inflammatory signaling, regardless of female hormones present.
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http://dx.doi.org/10.1016/j.toxlet.2020.12.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864563PMC
March 2021

Application of ecological and evolutionary theory to microbiome community dynamics across systems.

Proc Biol Sci 2020 12 23;287(1941):20202886. Epub 2020 Dec 23.

Department of Integrative Biology, University of California, Berkeley, CA 94720, USA.

A fundamental aim of microbiome research is to understand the factors that influence the assembly and stability of host-associated microbiomes, and their impact on host phenotype, ecology and evolution. However, ecological and evolutionary theories applied to predict microbiome community dynamics are largely based on macroorganisms and lack microbiome-centric hypotheses that account for unique features of the microbiome. This special feature sets out to drive advancements in the application of eco-evolutionary theory to microbiome community dynamics through the development of microbiome-specific theoretical and conceptual frameworks across plant, human and non-human animal systems. The feature comprises 11 research and review articles that address: (i) the effects of the microbiome on host phenotype, ecology and evolution; (ii) the application and development of ecological and evolutionary theories to investigate microbiome assembly, diversity and stability across broad taxonomic scales; and (iii) general principles that underlie microbiome diversity and dynamics. This cross-disciplinary synthesis of theoretical, conceptual, methodological and analytical approaches to characterizing host-microbiome ecology and evolution across systems addresses key research gaps in the field of microbiome research and highlights future research priorities.
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http://dx.doi.org/10.1098/rspb.2020.2886DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779500PMC
December 2020

Does prophylactic inferior vena cava filter reduce the hazard of pulmonary embolism and mortality in severe trauma? A single center retrospective comparative study.

Eur J Radiol Open 2021 10;8:100299. Epub 2020 Dec 10.

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.

Objectives: Use of inferior vena cava (IVC) filters in patients following severe trauma without recent history of venous thromboembolism (VTE) is controversial. Our objective was to determine if IVC filter placement in the setting of severe trauma effects the hazard of in-hospital pulmonary embolism (PE), deep venous thrombosis (DVT) and mortality.

Methods: This retrospective study recruited patients from a single Level I Trauma Center between 1/2008 and 12/2013. Inclusion criteria were age>15 years, Injury Severity Score (ISS)>15 and survival>24 h after hospital admission. Patients with VTE diagnosed prior to IVC filter placement were excluded. A Cox proportional hazards regression model was used, adjusting for immortal time bias with landmark analysis at predefined time after injury. Differences between IVC filter and non-IVC filter groups were adjusted using propensity score.

Results: In total 1451 patients were reviewed; 282 patients received an IVC filter and 1169 patients had no IVC filter placed. The mean age was 45.9 vs. 56.9 years and the mean ISS was 29.8 vs. 22.6 in the IVC filter and the non-IVC filter group, respectively. IVC filter placement was not associated with the hazard of PE (HR = 0.46; 95 % CI, 0.12,1.70; P = 0.24) or mortality (HR = 1.02; 95 % CI 0.60,1.75; P = 0.93). However, IVC filter placement was associated with the hazard of DVT (HR = 2.73; 95 % CI, 1.28,5.85; P = 0.01).

Conclusions: In patients with severe trauma, those with prophylactic IVC filter placement did not have a reduced hazard of PE or mortality, but an increased hazard of DVT was observed.
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http://dx.doi.org/10.1016/j.ejro.2020.100299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734225PMC
December 2020

Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of the current landscape of invasive meningococcal disease in children.

Can Commun Dis Rep 2020 Oct 1;46(10):339-343. Epub 2020 Oct 1.

Department of Paediatrics, Western University, London, ON.

Background: Immunizations have led to a decrease in the incidence of invasive meningococcal disease (IMD) in Canada, but this infection still leads to significant morbidity and mortality.

Objectives: The purpose of this study was to determine the burden of illness and management of IMD in paediatric hospitals.

Methods: Data were collected on all cases of IMD in eight paediatric hospitals from 2013 to 2017.

Results: There were 17 cases of IMD. Three of eight hospitals had no cases. Just over half of the cases were serogroup B (n=9); a quarter (n=4) were serogroup W; less than a quarter (n=3) were serogroup Y; and one was unknown. Two infected children were not started on antibiotics until day one and day five after the initial blood culture was collected, but had uneventful recoveries. Six cases required admission to intensive care units; two died. Six cases had probable or proven meningitis. Thrombocytopenia was documented in seven cases. All cases had elevated C-reactive protein levels. Seven children received more than seven days of antibiotics; of these seven, only two had complications that justified prolonged therapy (subdural empyema and septic knee). Six cases had a central line placed.

Conclusion: IMD is now rare in Canadian children, but about one-third of the cases in our study required treatment in the intensive care unit and two died. Clinicians appear to not always be aware that a five to seven-day course is adequate for uncomplicated cases of bacteremia or meningitis.
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http://dx.doi.org/10.14745/ccdr.v46i10a05DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723307PMC
October 2020

Correlation between urine ACR and 24-h proteinuria in a real-world cohort of systemic AL amyloidosis patients.

Blood Cancer J 2020 12 11;10(12):124. Epub 2020 Dec 11.

Division of Nephrology, Mayo Clinic, Rochester, MI, USA.

A 24-h urine protein collection (24hUP), the gold standard for measuring albuminuria in systemic AL amyloidosis, is cumbersome and inaccurate. We retrospectively reviewed 575 patients with systemic AL amyloidosis to assess the correlation between a urine albumin to creatinine ratio (uACR) and the 24hUP. The uACR correlated strongly with 24hUP at diagnosis (Pearson's r = 0.87, 95% CI 0.83-0.90) and during the disease course (Pearson's r = 0.88, 95% CI 0.86-0.90). A uACR ≥300 mg/g estimated a 24hUP ≥ 500 mg with a sensitivity of 92% and specificity of 97% (area under the receiver operating curve = 0.938, 95% CI 0.919-0.957). A uACR cutoff of 3600 mg/g best predicted a 24hUP > 5000 g (sensitivity 93%, specificity 94%), and renal stage at diagnosis was strongly concordant using either 24hUP or uACR as the proteinuria measure (k = 0.823, 95% CI 0.728-0.919). In patients with serial urine collections, a > 30% decrease in uACR predicted a > 30% decrease in 24hUP with a sensitivity of 94%. In conclusion, the uACR is a reliable and convenient method for ruling out proteinuria >500 mg per day, prognosticating renal outcomes, and assessing renal response to therapy. Further studies are needed to validate the uACR cutoffs proposed in this study.
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http://dx.doi.org/10.1038/s41408-020-00391-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733489PMC
December 2020

Snx14 proximity labeling reveals a role in saturated fatty acid metabolism and ER homeostasis defective in SCAR20 disease.

Proc Natl Acad Sci U S A 2020 Dec 11. Epub 2020 Dec 11.

Department of Cell Biology, UT Southwestern Medical Center, Dallas, TX 75390;

Fatty acids (FAs) are central cellular metabolites that contribute to lipid synthesis, and can be stored or harvested for metabolic energy. Dysregulation in FA processing and storage causes toxic FA accumulation or altered membrane compositions and contributes to metabolic and neurological disorders. Saturated lipids are particularly detrimental to cells, but how lipid saturation levels are maintained remains poorly understood. Here, we identify the cerebellar ataxia spinocerebellar ataxia, autosomal recessive 20 (SCAR20)-associated protein Snx14, an endoplasmic reticulum (ER)-lipid droplet (LD) tethering protein, as a factor required to maintain the lipid saturation balance of cell membranes. We show that following saturated FA (SFA) treatment, the ER integrity of cells is compromised, and both cells and SCAR20 disease patient-derived cells are hypersensitive to SFA-mediated lipotoxic cell death. Using APEX2-based proximity labeling, we reveal the protein composition of Snx14-associated ER-LD contacts and define a functional interaction between Snx14 and Δ-9 FA desaturase SCD1. Lipidomic profiling reveals that cells increase membrane lipid saturation following exposure to palmitate, phenocopying cells with perturbed SCD1 activity. In line with this, cells manifest delayed FA processing and lipotoxicity, which can be rescued by SCD1 overexpression. Altogether, these mechanistic insights reveal a role for Snx14 in FA and ER homeostasis, defects in which may underlie the neuropathology of SCAR20.
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http://dx.doi.org/10.1073/pnas.2011124117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777019PMC
December 2020

A multivariate Bayesian network analysis of water quality factors influencing trihalomethanes formation in drinking water distribution systems.

Water Res 2021 Feb 30;190:116712. Epub 2020 Nov 30.

UNSW Water Research Centre, School of Civil & Environmental Engineering, University of New South Wales, NSW, 2052, Australia. Electronic address:

Controlling disinfection by-products formation while ensuring effective drinking water disinfection is important for protecting public health. However, understanding and predicting disinfection by-product formation under a variety of conditions in drinking water distribution systems remains challenging as disinfection by-product formation is a multifactorial phenomenon. This study aimed to assess the application of Bayesian Network models to predict the concentration of trihalomethanes, the dominant halogenated disinfection by-product class, using various water quality parameters. Naïve Bayesian and semi-naïve Bayesian models were constructed from Sydney and South East Queensland datasets across 15 drinking water distribution systems in Australia. The targeted variable, total trihalomethanes concentration, was discretised into 3 bins (<0.1 mg L, 0.1 - 0.2 mg L and >0.2 mg L). The Bayesian network structures were built using water quality parameters including concentrations of individual and total trihalomethanes, disinfectant species (free chlorine, monochloramine, dichloramine, total chlorine), nitrogen species (free ammonia, total ammonia, nitrate, nitrite), and other physical/chemical parameters (temperature, pH, dissolved organic carbon, total dissolved solids, conductivity and turbidity). Seven performance parameters, including predictive accuracy and the rates of true and false positive and negative results, were used to assess the accuracy and precision of the Bayesian network models. After evaluating the model performance, the optimum models were selected to be Bayesian network augmented naïve models. These were observed to have the highest predictive accuracies for Sydney (78%) and South East Queensland (94%). Although disinfectant residuals are among the key variables that lead to trihalomethanes formation, potential concentrations of trihalomethanes in distribution systems can be more confidently predicted, in terms of probability associated with a wider range of water quality variables, using Bayesian networks. The modelling procedure developed in this work can now be applied to develop system-specific Bayesian network models for trihalomethanes prediction in other drinking water distribution systems.
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http://dx.doi.org/10.1016/j.watres.2020.116712DOI Listing
February 2021

Integration is opening the door to a new journey toward oral health value-based care.

J Public Health Dent 2020 09;80 Suppl 2:S89-S91

Arizona Alliance for Community Health Centers, Phoenix, AZ, USA.

Oral health is a key component of overall health and there is a cost to not including it in the value-based transformation conversation. Health care needs to break down the silos that exist between dentistry and medicine so we can leverage integration to achieve value-based care.
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http://dx.doi.org/10.1111/jphd.12400DOI Listing
September 2020

A Subset of Roux-en-Y Gastric Bypass Bacterial Consortium Colonizes the Gut of Nonsurgical Rats without Inducing Host-Microbe Metabolic Changes.

mSystems 2020 Dec 8;5(6). Epub 2020 Dec 8.

Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, South Kensington Campus, London, United Kingdom

Roux-en-Y gastric bypass (RYGB) is an effective weight loss surgery, resulting in a characteristic increase of fecal The contribution of this compositional change to metabolic benefits of RYGB is currently debatable. Therefore, this study employed 16S rRNA gene sequencing and metabolic profiling to monitor the dynamic colonization of the RYGB microbial consortium and their metabolic impact on the host. Eleven Wistar rats received vancomycin and enrofloxacin, followed by fecal microbiota transplantation (FMT) of cecal slurry obtained from either RYGB- or sham-operated rats. Urine and feces from the microbiota recipients (RYGB microbiota recipients [RYGBr],  = 6; sham microbiota recipients [SHAMr],  = 5) were collected pre- and post-antibiotics and 1, 3, 6, 9, and 16 days post-FMT. No significant differences in body weight and food intake were observed between RYGBr and SHAMr. While neither group reached the community richness of that of their donors, by day 6, both groups reached the richness and diversity of that prior to antibiotic treatment. However, the typical signature of RYGB microbiome-increased -was not replicated in these recipients after two consecutive FMT, suggesting that the environmental changes induced by the anatomical rearrangements of RYGB could be key for sustaining such a consortium. The transplanted bacteria did not induce the same metabolic signature of urine and feces as those previously reported in RYGB-operated rats. Future work is required to explore environmental factors that shape the RYGB microbiota in order to further investigate the metabolic functions of the RYGB microbiota, thereby teasing out the mechanisms of the RYGB surgery. Roux-en-Y gastric bypass (RYGB) surgery results in a long-term gut bacterial shift toward in both patients and rodents. The contribution of this compositional shift, or the RYGB bacterial consortium, to the metabolic benefit of the surgery remains debatable. It is unclear how well these bacteria colonize in an anatomically normal gut. This is a fundamental question in both defining the function of the RYGB microbiota and evaluating its potential as a nonsurgical treatment for obesity. We monitored the dynamic colonization of the RYGB bacterial consortium and observed that while approximately one-third of the bacterial taxa from the RYGB donor colonized in the gut of the nonoperated recipients, were unable to colonize for longer than 3 days. The study highlighted that a successful long-term colonization of -rich RYGB microbiota in nonsurgical animals requires key environmental factors that may be dictated by the intestinal anatomical modification by the surgery itself.
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http://dx.doi.org/10.1128/mSystems.01047-20DOI Listing
December 2020

Tackling health inequity: a commentary on the potential of acupuncture to improve health outcomes of marginalised populations.

Acupunct Med 2020 Dec 6:964528420961404. Epub 2020 Dec 6.

Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.

Background: Health inequities or disparities challenge governments and public health systems, impacting health service delivery worldwide. Inherent disadvantage linked to the social determinants of health is intrinsic to the health outcomes among society's marginalised and most vulnerable members. It is acknowledged that marginalised individuals present with higher levels of chronic disease, multi-morbidities and adverse health behaviours than their non-disadvantaged peers. Marginalised individuals and communities present with complex health problems and often receive poor quality or inadequate health care that is unable to meet their needs, leading to stigmatisation and perpetuating the cycle of disadvantage.

Discussion: Emerging research indicates that there may be a role for acupuncture in managing the health needs of marginalised populations and that when historical barriers to accessing acupuncture treatment (such as awareness, availability and affordability of this therapy) are removed, certain marginalised populations are open to engaging with acupuncture treatment. Acupuncture has been used by low-income, refugee, veteran and ethnic minority groups to manage chronic pain, substance use disorders, stress and the impacts of trauma in conventional health settings such as community clinics and hospitals. There is the suggestion that integrative health settings and group treatment models may improve access and uptake of acupuncture among marginalised groups.

Conclusion: Evidence suggests that the sociodemographic profile of acupuncture users is diverse and acupuncture therapy holds potential value in the treatment of marginalised populations. Further research that investigates reframing and expanding the scope of practice for acupuncture is timely and may contribute to tackling health inequity.
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http://dx.doi.org/10.1177/0964528420961404DOI Listing
December 2020

Initial Opioid Prescription and Number Needed to Harm.

R I Med J (2013) 2020 Dec 1;103(10):44-46. Epub 2020 Dec 1.

Chief Administrative Officer, Board of Medical Licensure and Discipline, Rhode Island Department of Health.

Prescription opioids are an important step in the development of persistent opioid use. Our study estimates the change in long-term opioid use before and after a 2017 regulatory update on acute pain prescribing. Prescribing information was abstracted from the Rhode Island Prescription Drug Monitoring Program (PDMP). Using the changed rates of initial opioid prescriptions of 8 or more days, and a calculated Number Needed to Harm for prescriptions of that duration, the rates of long-term opioid use were estimated decrease by 111 long-term opioid users per month.
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December 2020

Use of Medical Cannabis to Treat Traumatic Brain Injury.

J Neurotrauma 2021 Jan 25. Epub 2021 Jan 25.

The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, Albuquerque, New Mexico, USA.

There is not a single pharmacological agent with demonstrated therapeutic efficacy for traumatic brain injury (TBI). With recent legalization efforts and the growing popularity of medical cannabis, patients with TBI will inevitably consider medical cannabis as a treatment option. Pre-clinical TBI research suggests that cannabinoids have neuroprotective and psychotherapeutic properties. In contrast, recreational cannabis use has consistently shown to have detrimental effects. Our review identified a paucity of high-quality studies examining the beneficial and adverse effects of medical cannabis on TBI, with only a single phase III randomized control trial. However, observational studies demonstrate that TBI patients are using medical and recreational cannabis to treat their symptoms, highlighting inconsistencies between public policy, perception of potential efficacy, and the dearth of empirical evidence. We conclude that randomized controlled trials and prospective studies with appropriate control groups are necessary to fully understand the efficacy and potential adverse effects of medical cannabis for TBI.
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http://dx.doi.org/10.1089/neu.2020.7148DOI Listing
January 2021

Examining Cultural Identification and Alcohol Use Among American Indian and Caucasian College Students.

Am Indian Alsk Native Ment Health Res 2020 ;27(2):23-36

Previous research consistently concludes American Indians (AI) demonstrate higher levels of alcohol use than Caucasians (CA); however, recent research suggests AIs may be drinking at similar or lower rates than CAs. Little research has examined cultural identification as a contributing factor to alcohol use. This study sought to examine cultural identification and its relationship to alcohol use between AI and CA college students. Participants consisted of 56 AI and 87 CA college students who selfreported on past 6-month alcohol consumption and how they culturally identified per the Orthogonal Theory of Biculturalism. CAs reported a significantly higher average daily alcohol consumption than AIs who identified as Marginal, Traditional, and Assimilated. This research represents a compelling anecdotal and empirical socio-cultural paradigm shift from the "AIs drink more" mindset among college students. Further, understanding the relationship between cultural identification and alcohol use enhances assessment, diagnostic, and intervention efforts for both AIs and CAs.
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http://dx.doi.org/10.5820/aian.2702.2020.23DOI Listing
January 2020