Publications by authors named "Lisa Walters"

16 Publications

  • Page 1 of 1

Diagnostic yield of targeted next generation sequencing in 2002 Dutch cardiomyopathy patients.

Int J Cardiol 2021 Mar 1. Epub 2021 Mar 1.

University of Groningen, University Medical Center Groningen, Department of Genetics, Hanzeplein 1, 9713 GZ Groningen, the Netherlands.

Background: Next-generation sequencing (NGS) is increasingly used for clinical evaluation of cardiomyopathy patients as it allows for simultaneous screening of multiple cardiomyopathy-associated genes. Adding copy number variant (CNV) analysis of NGS data is not routine yet and may contribute to the diagnostic yield.

Objectives: Determine the diagnostic yield of our targeted NGS gene panel in routine clinical diagnostics of Dutch cardiomyopathy patients and explore the impact of exon CNVs on diagnostic yield.

Methods: Patients (N = 2002) referred for clinical genetic analysis underwent diagnostic testing of 55-61 genes associated with cardiomyopathies. Samples were analyzed and evaluated for single nucleotide variants (SNVs), indels and CNVs. CNVs identified in the NGS data and suspected of being pathogenic based on type, size and location were confirmed by additional molecular tests.

Results: A (likely) pathogenic (L)P variant was detected in 22.7% of patients, including 3 with CNVs and 25 where a variant was identified in a gene currently not associated with the patient's cardiomyopathy subtype. Only 15 out of 2002 patients (0.8%) were found to carry two (L)P variants.

Conclusion: The yield of routine clinical diagnostics of cardiomyopathies was relatively low when compared to literature. This is likely due to the fact that our study reports the outcome of patients in daily routine diagnostics, therefore also including patients not fully fulfilling (subtype specific) cardiomyopathy criteria. This may also explain why (L)P variants were identified in genes not associated with the reported subtype. The added value of CNV analysis was shown to be limited but not negligible.
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http://dx.doi.org/10.1016/j.ijcard.2021.02.069DOI Listing
March 2021

Podocyte stress and detachment measured in urine are related to mean arterial pressure in healthy humans.

Kidney Int 2020 09 28;98(3):699-707. Epub 2020 Apr 28.

Department of Internal Medicine, Nephrology Division, University of Michigan, Ann Arbor, Michigan, USA. Electronic address:

Hypertension-associated progressive glomerulosclerosis is a significant driver of both de novo and all-cause chronic kidney disease leading to end-stage kidney failure. The progression of glomerular disease proceeds via continuing depletion of podocytes from the glomeruli into the ultrafiltrate. To non-invasively assess injury patterns associated with mean arterial pressure (MAP), we conducted an observational study of 87 healthy normotensive individuals who were cleared for living kidney donation. Urine pellet podocin and aquaporin2 mRNAs normalized to the urine creatinine concentration (UPod:Creat ratio and UAqp2:Creat ratio) were used as markers of podocyte detachment and tubular injury, respectively. The ratio of two podocyte mRNA markers, podocin to nephrin (UPod:Neph) as well as the ratio of podocin to the tubular marker aquaporin2 (UPod:Aqp2) estimated the relative rates of podocyte stress and glomerular vs. tubular injury. The MAP was positively correlated with the UPod:Neph and UPod:Aqp2, thereby confirming the relationship of MAP with podocyte stress and the preferential targeting of the glomerulus by higher MAP. In multivariable linear regression analysis, both UPod:Neph and UPod:Creat, but not UAqp2:Creat or proteinuria, were both significantly related to a range of normal MAP (70 to 110 mm Hg). Systolic, as opposed to diastolic or pulse pressure was associated with UPod:Creat. Thus, higher podocyte stress and detachment into the urine are associated with MAP even in a relatively "normal" range of MAP. Hence, urine pellet mRNA monitoring can potentially identify progression risk before the onset of overt hypertension, proteinuria or chronic kidney disease.
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http://dx.doi.org/10.1016/j.kint.2020.03.038DOI Listing
September 2020

A narrative review: current upper limb prosthetic options and design.

Disabil Rehabil Assist Technol 2020 08 11;15(6):604-613. Epub 2019 Apr 11.

Arm Dynamics, Redondo Beach, CA, USA.

This review was conducted to provide an overview of current literature as it relates to upper limb difference, available componentry, and prosthetic options and design. Emerging technologies combined with an increased awareness of the limb difference community have contributed to recent advancements in upper extremity prosthetics. A search of five major clinical databases utilizing keywords relating to upper limb prostheses, componenty and limb difference levels resulted in over 1200 articles. These articles were subjected to inclusion and exclusion criteria in order to identify current peer reviewed research relevant to this topic. Fifty-five applicable articles and sources of standards were reviewed based on the inclusion and exclusion criteria, presenting five general options for prosthetic intervention. This information was assimilated and categorized in this article, which provides an overview of the aforementioned options. While a noteworthy amount of research focuses on technological advancements, the five options for prosthetic intervention are inherently represented in the current literature. For individuals with upper limb difference, as well as their care team, successful rehabilitation hinges on awareness of new components, the functional efficacy of these components, and the evolved techniques used in prosthetic design and fabrication. It is noted that the rapid evolution of upper limb prosthetics consistently outpaces research and publication of information.Implications for rehabilitationTo provide an overview of prosthetic design considerations and options to help create a more informed rehabilitation team, leading to improved outcomes in prescription and management of upper limb prosthetics.To bring awareness of current research in the field of upper limb prosthetics in order to provoke further exploration of the efficacy of prosthetic options and design considerations.
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http://dx.doi.org/10.1080/17483107.2019.1594403DOI Listing
August 2020

Escape Room Recruitment Event: Description and Lessons Learned.

J Nurs Educ 2018 Mar;57(3):184-187

Background: The U.S. nursing workforce is facing a severe shortage of professionals due to an anticipated retirement of more than 500,000 RNs in the next 5 years.

Method: An Escape to Nursing event was created and delivered in a rural medical center college of nursing in the spring of 2017. This faculty team developed four distinct rooms that were designed with key nursing concepts and patient health conditions. Recruits worked in teams to solve the patient health care puzzle, which then enabled them to proceed to the next room.

Results: Feedback was positive from the recruits, including comments about expanding the game to more health care scenarios and reaching out to more recruits. Additional recruitment may lead to better turnout of recruits.

Conclusion: Linear, sequential formatting for the escape room game design is recommended for use with recruits into nursing. The use of escape rooms for recruitment is a positive activity. [J Nurs Educ. 2018;57(3):184-187.].
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http://dx.doi.org/10.3928/01484834-20180221-12DOI Listing
March 2018

A Randomized, Controlled Trial of Mirror Therapy for Upper Extremity Phantom Limb Pain in Male Amputees.

Front Neurol 2017 7;8:267. Epub 2017 Jul 7.

Walter Reed National Military Medical Center, Bethesda, MD, United States.

Objective: Phantom limb pain (PLP) is prevalent in patients post-amputation and is difficult to treat. We assessed the efficacy of mirror therapy in relieving PLP in unilateral, upper extremity male amputees.

Methods: Fifteen participants from Walter Reed and Brooke Army Medical Centers were randomly assigned to one of two groups: mirror therapy ( = 9) or control ( = 6, covered mirror or mental visualization therapy). Participants were asked to perform 15 min of their assigned therapy daily for 5 days/week for 4 weeks. The primary outcome was pain as measured using a 100-mm Visual Analog Scale.

Results: Subjects in the mirror therapy group had a significant decrease in pain scores, from a mean of 44.1 (SD = 17.0) to 27.5 (SD = 17.2) mm ( = 0.002). In addition, there was a significant decrease in daily time experiencing pain, from a mean of 1,022 (SD = 673) to 448 (SD = 565) minutes ( = 0.003). By contrast, the control group had neither diminished pain ( = 0.65) nor decreased overall time experiencing pain ( = 0.49). A pain decrement response seen by the 10th treatment session was predictive of final efficacy.

Conclusion: These results confirm that mirror therapy is an effective therapy for PLP in unilateral, upper extremity male amputees, reducing both severity and duration of daily episodes.

Registration: NCT0030144 ClinicalTrials.gov.
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http://dx.doi.org/10.3389/fneur.2017.00267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5500638PMC
July 2017

Range of Motion Requirements for Upper-Limb Activities of Daily Living.

Am J Occup Ther 2016 Jan-Feb;70(1):7001350010p1-7001350010p10

Linda Resnik, PT, PhD, is Research Career Scientist, Providence VA, and Professor (Research), Health Services, Policy and Practice, Brown University, Providence, RI.

Objective: We quantified the range of motion (ROM) required for eight upper-extremity activities of daily living (ADLs) in healthy participants.

Method: Fifteen right-handed participants completed several bimanual and unilateral basic ADLs while joint kinematics were monitored using a motion capture system. Peak motions of the pelvis, trunk, shoulder, elbow, and wrist were quantified for each task.

Results: To complete all activities tested, participants needed a minimum ROM of -65°/0°/105° for humeral plane angle (horizontal abduction-adduction), 0°-108° for humeral elevation, -55°/0°/79° for humeral rotation, 0°-121° for elbow flexion, -53°/0°/13° for forearm rotation, -40°/0°/38° for wrist flexion-extension, and -28°/0°/38° for wrist ulnar-radial deviation. Peak trunk ROM was 23° lean, 32° axial rotation, and 59° flexion-extension.

Conclusion: Full upper-limb kinematics were calculated for several ADLs. This methodology can be used in future studies as a basis for developing normative databases of upper-extremity motions and evaluating pathology in populations.
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http://dx.doi.org/10.5014/ajot.2016.015487DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4690598PMC
June 2016

Do users want to receive a DEKA Arm and why? Overall findings from the Veterans Affairs Study to optimize the DEKA Arm.

Prosthet Orthot Int 2014 Dec 28;38(6):456-66. Epub 2013 Nov 28.

Department of Orthopedics and Rehabilitation, Center for the Intrepid, San Antonio, TX, USA.

Background: The purposes of this article are (1) to report on the overall desirability of the DEKA Arm by prototype and by level of prosthesis, (2) to report on user-perceived benefits of the DEKA Arm as compared to their current prostheses, and (3) to summarize user concerns about taking the device home.

Study Design: Qualitative content analysis of data from a multiple case study design.

Methods: This study utilized data from 24 upper-limb amputees fit with a Gen 2 DEKA Arm and 13 fit with a Gen 3 DEKA Arm. Surveys were administered after fitting the DEKA Arm and at the end of training. Subjects recorded audiotaped comments about their experiences. All study sessions were videotaped.

Results: In all, 79% of Gen 2 and 85% of Gen 3 users indicated that either they wanted to receive or might want to receive a DEKA Arm. In total, 95% of Gen 2 and 91% of Gen 3 prior prosthesis users reported that they were able to perform new activities that they were unable to perform with their own device.

Conclusions: A large majority of subjects wanted a DEKA Arm, although desirability varied by amputation level.

Clinical Relevance: The majority of amputees in this study expressed a desire to receive the DEKA Arm, a device which provides multiple powered degrees of freedom and is operated predominantly by foot controls. The majority reported functional advantages of the DEKA Arm over their existing prostheses.
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http://dx.doi.org/10.1177/0309364613506914DOI Listing
December 2014

Development and evaluation of the activities measure for upper limb amputees.

Arch Phys Med Rehabil 2013 Mar 17;94(3):488-494.e4. Epub 2012 Oct 17.

Providence Veterans Administration Medical Center, Providence, RI, USA.

Objectives: (1) To develop a measure of activities for adults with upper limb amputation: the Activities Measure for Upper Limb Amputees (AM-ULA); and (2) to conduct initial psychometric evaluation of the measure.

Design: This was a cohort study where the prototype measure was administered twice within 1 week. Tests were videotaped and graded by 2 independent raters. Interrater reliability, test-retest reliability, internal consistency, and minimal detectable change were estimated. Known group validity was examined using analyses of variance comparing scores of transradial, transhumeral, and shoulder level amputees. Convergent validity was examined by correlating AM-ULA scores with dexterity tests and self-reported function.

Setting: Hospital outpatient.

Participants: Subjects (N=52) with upper limb amputation.

Interventions: Not applicable.

Main Outcome Measures: Not applicable.

Results: Intraclass correlation coefficients (ICCs) for test-retest reliability were .88 to .91. ICCs for interrater reliability were .84 to .89. Cronbach alphas were .89 to .91. The minimal detectable change at the 90% confidence interval was 3.7 points. Subjects with more distal levels of limb loss had better scores than those with more proximal levels (P<.01). The AM-ULA was moderately correlated with most dexterity tests and self-reported function.

Conclusions: The AM-ULA is a new measure of activity performance for adults with upper limb amputation that considers task completion, speed, movement quality, skillfulness of prosthetic use, and independence in its rating system. It has good interrater reliability, test-retest reliability, and demonstrated known group validity.
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http://dx.doi.org/10.1016/j.apmr.2012.10.004DOI Listing
March 2013

Employee engagement vital to ISO 15189 success.

Authors:
Lisa M Walters

MLO Med Lab Obs 2011 May;43(5):54

Healthy Solutions Quality Consulting, USA.

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May 2011

"[N]ot subject to our sense” : Margaret Cavendish's fusion of Renaissance science, magic and fairy lore.

Authors:
Lisa Walters

Womens Writ 2010 ;17(3):413-31

Saint Joseph's University, Philadelphia.

This article explores Margaret Cavendish's depictions of alchemy, witchcraft and fairy lore in her scientific treatise Philosophical Letters and in fictional texts from Natures Pictures and Poems and Fancies. Though Cavendish was a dedicated materialist, she appropriates theories of magic from early modern science and folklore into her materialist epistemology. As Cavendish draws upon a fusion of early modern conceptions of magic, she creates a radical theory of matter which not only challenges patriarchy and binary oppositions, but also explores the plurality and mystery that can exist within an infinitely complex material world.
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http://dx.doi.org/10.1080/09699080903162039DOI Listing
March 2011

Human immunodeficiency virus type 1 pathobiology studied in humanized BALB/c-Rag2-/-gammac-/- mice.

J Virol 2007 Mar 20;81(6):2700-12. Epub 2006 Dec 20.

Centere for Neurovirology and Neurodegenerative Disorders, Department of Pharmacology, University of Nebraska Medical Center, 985880 Nebraska Medical Center, Omaha, NE 68198-5880, USA.

The specificity of human immunodeficiency virus type 1 (HIV-1) for human cells precludes virus infection in most mammalian species and limits the utility of small animal models for studies of disease pathogenesis, therapy, and vaccine development. One way to overcome this limitation is by human cell xenotransplantation in immune-deficient mice. However, this has proved inadequate, as engraftment of human immune cells is limited (both functionally and quantitatively) following transplantation of mature human lymphocytes or fetal thymus/liver. To this end, a human immune system was generated from umbilical cord blood-derived CD34(+) hematopoietic stem cells in BALB/c-Rag2(-/-)gamma(c)(-/-) mice. Intrapartum busulfan administration followed by irradiation of newborn pups resulted in uniform engraftment characterized by human T-cell development in thymus, B-cell maturation in bone marrow, lymph node development, immunoglobulin M (IgM)/IgG production, and humoral immune responses following ActHIB vaccination. Infection of reconstituted mice by CCR5-coreceptor utilizing HIV-1(ADA) and subtype C 1157 viral strains elicited productive viral replication and lymphadenopathy in a dose-dependent fashion. We conclude that humanized BALB/c-Rag2(-/-)gamma(c)(-/-) mice represent a unique and valuable resource for HIV-1 pathobiology studies.
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http://dx.doi.org/10.1128/JVI.02010-06DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1865995PMC
March 2007

Experimental comparison of excision and swabbing microbiological sampling methods for carcasses.

J Food Prot 2005 Oct;68(10):2163-8

Department of Clinical Veterinary Science, Division of Farm Animal Science, University of Bristol, Langford, Bristol BS40 5DU, UK.

Bovine sides, ovine carcasses, and porcine carcasses were individually inoculated by dipping in various suspensions of a marker organism (Escherichia coli K-12 or Pseudomonas fluorescens), alone or in combination with two meat-derived bacterial strains, and were sampled by two standard methods: cotton wet-dry swabbing and excision. The samples were examined for bacterial counts on plate count agar (PCA plate counts) and on violet red brilliant green agar (VRBGA plate counts) by standard International Organization for Standardization methods. Average bacterial recoveries by swabbing, expressed as a percentage of the appropriate recoveries achieved by excision, varied widely (2 to 100%). Several factors that potentially contributed to relatively low and highly variable bacterial recoveries obtained by swabbing were investigated in separate experiments. Neither the difference in size of the swabbed area (10, 50, or 100 cm2 on beef carcasses) nor the difference in time of swabbing (20 or 60 min after inoculation of pig carcasses) had a significant effect on the swabbing recoveries of the marker organism used. In an experiment with swabs preinoculated with the marker organism and then used for carcass swabbing, on average, 12% of total bacterial load was transferred inversely (i.e., from the swab to the carcass during the standard swabbing procedure). In another experiment, on average, 14% of total bacterial load was not released from the swab into the diluent during standard swab homogenization. Use of custom-made swabs with abrasive butts, around which metal pieces of pan scourers were wound, markedly increased PCA plate count recoveries from noninoculated lamb carcasses at commercial abattoirs compared with cotton swabs. In spite of the observed inferiority of the cotton wet-dry swabbing method compared with the excision method for bacterial recovery, the former is clearly preferred by the meat industry because it does not damage the carcass. Therefore, further large-scale evaluation of the two carcass sampling methods has been undertaken under commercial conditions and reported separately.
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http://dx.doi.org/10.4315/0362-028x-68.10.2163DOI Listing
October 2005

A comparison of wet-dry swabbing and excision sampling methods for microbiological testing of bovine, porcine, and ovine carcasses at red meat slaughterhouses.

J Food Prot 2005 Oct;68(10):2155-62

Microbiology Department, Direct Laboratories Ltd., Wergs Road, Wolverhampton, West Midlands WV6 8QT, UK.

A comparison of wet-dry swabbing and surface tissue excision of carcasses by coring was undertaken. Samples from 1,352 bovine, 188 ovine, and 176 porcine carcasses were collected from 70 separate visits to commercial slaughterhouses operating under normal conditions. The mean total aerobic viable bacterial counts (TVCs) for all species sampled by excision was 5.36 log units, which was significantly greater than the 4.35 log units measured for swabbing. Poorly correlated linear relationships between swab- and excision-derived bacterial numbers from near-adjacent carcasses were observed for all three animal species. R2 values for least squares regressions for bovine, ovine, and porcine carcasses were 0.09, 0.27, and 0.21, respectively. The reasons why it was not possible to calculate a factor that allowed the interconversion of bacterial numbers between samples collected by each sampling method were investigated. Uncertainty associated with laboratory analyses was a contributing factor because the geometric relative standard deviations measured for TVCs were 0.174 and 0.414 for excision and swabbing, respectively. Uneven distribution of bacteria at identical sampling sites on near-adjacent carcasses on processing lines was also a contributory factor. The implications of these findings for process control verification were investigated by intensive sampling for 13 weeks in three commercial slaughterhouses. As many as 4 log units of difference in TVCs were observed in duplicate samples collected within a narrow timeframe from near-adjacent carcasses on the processing line. We conclude that it might not be appropriate to institute corrective actions in slaughterhouses on the basis of a single week's test results.
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http://dx.doi.org/10.4315/0362-028x-68.10.2155DOI Listing
October 2005

Macrophage-induced inflammation affects hippocampal plasticity and neuronal development in a murine model of HIV-1 encephalitis.

Glia 2005 Dec;52(4):344-53

Laboratory of Neuroregeneration, Department of Pharmacology and Experimental Neuroscience, Center for Neurovirology and Neurodegenerative Disorders, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA.

Cognitive, behavioral, and motor impairments, during progressive human immunodeficiency virus type 1 (HIV-1) infection, are linked to activation of brain mononuclear phagocytes (MP; perivascular macrophages and microglia). Activated MPs effect a giant cell encephalitis and neuroinflammatory responses that are mirrored in severe combined immunodeficient (SCID) mice injected with human monocyte-derived macrophages (MDM). Whether activated human MDMs positioned in the basal ganglia affect hippocampal neuronal plasticity, the brain subregion involved in learning and memory, is unknown. Thus, immunohistochemical techniques were used for detection of newborn neurons (polysialylated neuronal cell adhesion molecule [PSA-NCAM]) and cell proliferation (Ki-67) to assay MDM effects on neuronal development in mouse models of HIV-1 encephalitis. Immunodeficient (C.B.-17/SCID and nonobese diabetic/SCID, NOD/SCID) and immune competent (C.B.-17) mice were injected with uninfected or HIV-1-infected MDM. Sham-operated or unmanipulated mice served as controls. Neuronal plasticity was evaluated in the hippocampal dentate gyrus (DG) at days 7 and 28. By day 7, increased numbers of Ki-67+ cells, PSA-NCAM+ cells and dendrites in DG were observed in sham-operated animals. In contrast, significant reductions in neuronal precursors and altered neuronal morphology paralleled increased microglial activation in both HIV-1-infected and uninfected MDM-injected animals. DG cellular composition was restored at day 28. We posit that activated MDM induce inflammation and diminish DG neuronal plasticity. These data provide novel explanations for the cognitive impairments manifested during advanced HIV-1 infection.
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http://dx.doi.org/10.1002/glia.20253DOI Listing
December 2005

Fate of pathogens present in livestock wastes spread onto fescue plots.

Appl Environ Microbiol 2005 Feb;71(2):691-6

Direct Laboratories Ltd., Microbiological Research Division, Wergs Road, Wolverhampton, West Midlands WV6 8TQ, United Kingdom.

Fecal wastes from a variety of farmed livestock were inoculated with livestock isolates of Escherichia coli O157, Listeria monocytogenes, Salmonella, Campylobacter jejuni, and Cryptosporidium parvum oocysts at levels representative of the levels found in naturally contaminated wastes. The wastes were subsequently spread onto a grass pasture, and the decline of each of the zoonotic agents was monitored over time. There were no significant differences among the decimal reduction times for the bacterial pathogens. The mean bacterial decimal reduction time was 1.94 days. A range of times between 8 and 31 days for a 1-log reduction in C. parvum levels was obtained, demonstrating that the protozoans were significantly more hardy than the bacteria. Oocyst recovery was more efficient from wastes with lower dry matter contents. The levels of most of the zoonotic agents had declined to below detectable levels by 64 days. However, for some waste types, 128 days was required for the complete decline of L. monocytogenes levels. We were unable to find significant differences between the rates of pathogen decline in liquid (slurry) and solid (farmyard manure) wastes, although concerns have been raised that increased slurry generation as a consequence of more intensive farming practices could lead to increased survival of zoonotic agents in the environment.
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http://dx.doi.org/10.1128/AEM.71.2.691-696.2005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC546755PMC
February 2005