Publications by authors named "Scott Robinson"

106 Publications

Risk assessment of preterm birth through identification and stratification of pregnancies using a real-time scoring algorithm.

SAGE Open Med 2021 12;9:2050312120986729. Epub 2021 Jan 12.

Norton Neuroscience Institute, Norton Healthcare, Louisville, KY, USA.

Introduction: Preterm birth poses a significant challenge. This study evaluated a real-time scoring algorithm to identify and stratify pregnancies to indicate preterm birth.

Methods: All claims data of pregnant women were reviewed between 1 January 2014 and 31 October 2018 in Kentucky.

Results: A total of 29,166 unique women who were matched to a live newborn were documented, with the pregnancy identified during the first trimester in 54.1% of women. Negative predictive values, sensitivity, and positive likelihood ratios increased from the first to third trimesters as pregnant women who were matched to a live newborn had more visits with their physicians. The area under the receiving-operating characteristics curve on test data classifying preterm birth was 0.59 for pregnancies identified during the first trimester, 0.62 for pregnancies identified in the second trimester, and 0.73 for pregnancies identified in the third trimester.

Conclusions: This study presents a real-time scoring algorithm of indicating preterm birth in the first trimester of gestation which permits stratification of pregnancies to provide more efficient early care management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/2050312120986729DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7809631PMC
January 2021

The SuperCam Instrument Suite on the NASA Mars 2020 Rover: Body Unit and Combined System Tests.

Authors:
Roger C Wiens Sylvestre Maurice Scott H Robinson Anthony E Nelson Philippe Cais Pernelle Bernardi Raymond T Newell Sam Clegg Shiv K Sharma Steven Storms Jonathan Deming Darrel Beckman Ann M Ollila Olivier Gasnault Ryan B Anderson Yves André S Michael Angel Gorka Arana Elizabeth Auden Pierre Beck Joseph Becker Karim Benzerara Sylvain Bernard Olivier Beyssac Louis Borges Bruno Bousquet Kerry Boyd Michael Caffrey Jeffrey Carlson Kepa Castro Jorden Celis Baptiste Chide Kevin Clark Edward Cloutis Elizabeth C Cordoba Agnes Cousin Magdalena Dale Lauren Deflores Dorothea Delapp Muriel Deleuze Matthew Dirmyer Christophe Donny Gilles Dromart M George Duran Miles Egan Joan Ervin Cecile Fabre Amaury Fau Woodward Fischer Olivier Forni Thierry Fouchet Reuben Fresquez Jens Frydenvang Denine Gasway Ivair Gontijo John Grotzinger Xavier Jacob Sophie Jacquinod Jeffrey R Johnson Roberta A Klisiewicz James Lake Nina Lanza Javier Laserna Jeremie Lasue Stéphane Le Mouélic Carey Legett Richard Leveille Eric Lewin Guillermo Lopez-Reyes Ralph Lorenz Eric Lorigny Steven P Love Briana Lucero Juan Manuel Madariaga Morten Madsen Soren Madsen Nicolas Mangold Jose Antonio Manrique J P Martinez Jesus Martinez-Frias Kevin P McCabe Timothy H McConnochie Justin M McGlown Scott M McLennan Noureddine Melikechi Pierre-Yves Meslin John M Michel David Mimoun Anupam Misra Gilles Montagnac Franck Montmessin Valerie Mousset Naomi Murdoch Horton Newsom Logan A Ott Zachary R Ousnamer Laurent Pares Yann Parot Rafal Pawluczyk C Glen Peterson Paolo Pilleri Patrick Pinet Gabriel Pont Francois Poulet Cheryl Provost Benjamin Quertier Heather Quinn William Rapin Jean-Michel Reess Amy H Regan Adriana L Reyes-Newell Philip J Romano Clement Royer Fernando Rull Benigno Sandoval Joseph H Sarrao Violaine Sautter Marcel J Schoppers Susanne Schröder Daniel Seitz Terra Shepherd Pablo Sobron Bruno Dubois Vishnu Sridhar Michael J Toplis Imanol Torre-Fdez Ian A Trettel Mark Underwood Andres Valdez Jacob Valdez Dawn Venhaus Peter Willis

Space Sci Rev 2021 21;217(1). Epub 2020 Dec 21.

Jet Propulsion Laboratory/Caltech, Pasadena, CA USA.

The SuperCam instrument suite provides the Mars 2020 rover, Perseverance, with a number of versatile remote-sensing techniques that can be used at long distance as well as within the robotic-arm workspace. These include laser-induced breakdown spectroscopy (LIBS), remote time-resolved Raman and luminescence spectroscopies, and visible and infrared (VISIR; separately referred to as VIS and IR) reflectance spectroscopy. A remote micro-imager (RMI) provides high-resolution color context imaging, and a microphone can be used as a stand-alone tool for environmental studies or to determine physical properties of rocks and soils from shock waves of laser-produced plasmas. SuperCam is built in three parts: The mast unit (MU), consisting of the laser, telescope, RMI, IR spectrometer, and associated electronics, is described in a companion paper. The on-board calibration targets are described in another companion paper. Here we describe SuperCam's body unit (BU) and testing of the integrated instrument. The BU, mounted inside the rover body, receives light from the MU via a 5.8 m optical fiber. The light is split into three wavelength bands by a demultiplexer, and is routed via fiber bundles to three optical spectrometers, two of which (UV and violet; 245-340 and 385-465 nm) are crossed Czerny-Turner reflection spectrometers, nearly identical to their counterparts on ChemCam. The third is a high-efficiency transmission spectrometer containing an optical intensifier capable of gating exposures to 100 ns or longer, with variable delay times relative to the laser pulse. This spectrometer covers 535-853 nm ( Raman shift relative to the 532 nm green laser beam) with full-width at half-maximum peak resolution in the Raman fingerprint region. The BU electronics boards interface with the rover and control the instrument, returning data to the rover. Thermal systems maintain a warm temperature during cruise to Mars to avoid contamination on the optics, and cool the detectors during operations on Mars. Results obtained with the integrated instrument demonstrate its capabilities for LIBS, for which a library of 332 standards was developed. Examples of Raman and VISIR spectroscopy are shown, demonstrating clear mineral identification with both techniques. Luminescence spectra demonstrate the utility of having both spectral and temporal dimensions. Finally, RMI and microphone tests on the rover demonstrate the capabilities of these subsystems as well.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11214-020-00777-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752893PMC
December 2020

A retrospective study of in-hospital mortality in patients with idiopathic pulmonary fibrosis between 2015 and 2018.

Medicine (Baltimore) 2020 Nov;99(47):e23143

Duke Clinical Research Institute.

Hospitalizations are common in patients with idiopathic pulmonary fibrosis (IPF) and are associated with high mortality. We used data from the Premier Healthcare Database to determine in-hospital mortality rates and the factors associated with in-hospital mortality in patients with IPF in the era of approved antifibrotic drugs.The Premier Healthcare Database is a detailed and broadly representative database of hospital admissions and discharges in the US. Patients with IPF who were hospitalized between 1 January 2015 and 28 February 2018 were identified using a diagnostic algorithm comprising International Classification of Diseases -9 and International Classification of Diseases -10 diagnostic codes and billing data. Associations between patient-, hospital- and treatment-related factors and a composite outcome of death during the index visit, lung transplant during the index visit but >1 day after admission, or death during a readmission within 90 days of the index visit were analyzed using logistic regression.The cohort comprised 9667 hospitalized patients with IPF. In total, 1414 patients (14.6%) met the composite outcome: 1036 (10.7%) died during the index visit, 371 (3.8%) died during a readmission within 90 days; 7 (0.1%) underwent lung transplant >1 day after admission. Factors significantly associated with a higher risk of the composite outcome included mechanical ventilation (odds ratio 6.41 [95% CI: 5.24, 7.84]), admission to the intensive care unit (1.73 [1.49, 2.00]), attendance by a critical care physician (2.12 [1.33, 3.38]), older age (1.20 [1.12, 1.28] per 10-year increase), and use of intravenous steroids (1.16 [1.00, 1.34]), intravenous antibiotics (1.49 [1.22, 1.83]) and opioids (3.41 [2.95, 3.93]). Factors significantly associated with a lower risk of the composite outcome included female sex (0.70 [0.61, 0.80]), comorbid chronic obstructive pulmonary disease (0.69 [0.60, 0.78]), attendance by a family medicine physician (0.67 [0.48, 0.94]) or internal medicine physician (0.59 [0.46, 0.75]), and use of oral steroids (0.62 [0.51, 0.77]), statins (0.76 [0.67, 0.87]) and proton pump inhibitors (0.80 [0.70, 0.92]).In conclusion, patients with IPF are at risk of mortality during a hospital stay or readmission within 90 days, particularly those who receive mechanical ventilation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000023143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676591PMC
November 2020

Adaptations to light predict the foraging niche and disassembly of avian communities in tropical countrysides.

Ecology 2021 Jan 3;102(1):e03213. Epub 2020 Nov 3.

Florida Museum of Natural History and Department of Biology, University of Florida, Gainesville, Florida, 32611, USA.

The role of light in partitioning ecological niche space remains a frontier in understanding the assembly of terrestrial vertebrate communities and their response to global change. Leveraging recent advances in biologging technology and intensive field surveys of cloud forest bird communities across an agricultural land use gradient in the Peruvian Andes, we demonstrate that eye size predicts (1) the ambient light microenvironment used by free-ranging birds, (2) their foraging niche, and (3) species-specific sensitivity to agricultural land use change. For 15 species carrying light sensors (N = 71 individuals), light intensity levels were best explained by eye size and foraging behavior, with larger-eyed species using darker microenvironments. Across the cloud forest bird community (N = 240 species), hyperopic ("far-sighted") foragers, (e.g., flycatchers), had larger eyes compared to myopic ("near-sighted") species (e.g., gleaners and frugivores); eye size was also larger for myopic insectivores that foraged in the forest understory. Eye size strongly predicted sensitivity to brightly lit habitats across an agricultural land use gradient. Species that increased in abundance in mixed intensity agriculture, including fencerows, silvopasture, and pasture, had smaller eyes, suggesting that light acts as an environmental filter when communities disassemble in a human-disturbed landscape. We suggest that eye size represents a novel functional trait contributing to terrestrial vertebrate community assembly and sensitivity to habitat disturbance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ecy.3213DOI Listing
January 2021

Epigenetic regulation of the PGE2 pathway modulates macrophage phenotype in normal and pathologic wound repair.

JCI Insight 2020 09 3;5(17). Epub 2020 Sep 3.

Section of Vascular Surgery, Department of Surgery.

Macrophages are a primary immune cell involved in inflammation, and their cell plasticity allows for transition from an inflammatory to a reparative phenotype and is critical for normal tissue repair following injury. Evidence suggests that epigenetic alterations play a critical role in establishing macrophage phenotype and function during normal and pathologic wound repair. Here, we find in human and murine wound macrophages that cyclooxygenase 2/prostaglandin E2 (COX-2/PGE2) is elevated in diabetes and regulates downstream macrophage-mediated inflammation and host defense. Using single-cell RNA sequencing of human wound tissue, we identify increased NF-κB-mediated inflammation in diabetic wounds and show increased COX-2/PGE2 in diabetic macrophages. Further, we identify that COX-2/PGE2 production in wound macrophages requires epigenetic regulation of 2 key enzymes in the cytosolic phospholipase A2/COX-2/PGE2 (cPLA2/COX-2/PGE2) pathway. We demonstrate that TGF-β-induced miRNA29b increases COX-2/PGE2 production via inhibition of DNA methyltransferase 3b-mediated hypermethylation of the Cox-2 promoter. Further, we find mixed-lineage leukemia 1 (MLL1) upregulates cPLA2 expression and drives COX-2/PGE2. Inhibition of the COX-2/PGE2 pathway genetically (Cox2fl/fl Lyz2Cre+) or with a macrophage-specific nanotherapy targeting COX-2 in tissue macrophages reverses the inflammatory macrophage phenotype and improves diabetic tissue repair. Our results indicate the epigenetically regulated PGE2 pathway controls wound macrophage function, and cell-targeted manipulation of this pathway is feasible to improve diabetic wound repair.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1172/jci.insight.138443DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526451PMC
September 2020

Viewpoint: Connecting with New Partners in COVID-19 Response.

Public Adm Rev 2020 May 26. Epub 2020 May 26.

The COVID-19 crisis has called for the mobilization of diverse resources and coordination through administrative networks. This mobilization has brought to light the challenges involved in the recruiting and retention of diverse administrative networks. This article reviews the importance of and difficulties in maintaining diverse administrative networks. The review is followed by concrete strategies for building and maintaining diverse networks in Norman, OK. The lessons emphasize the role of active and imaginative recruitment and a realistic assessment of the challenges facing members of the network that can interfere with their participation. This article is protected by copyright. All rights reserved.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/puar.13247DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283865PMC
May 2020

Risk factors, resource use, and cost of postoperative low cardiac output syndrome.

J Thorac Cardiovasc Surg 2020 Jul 16. Epub 2020 Jul 16.

Tenax Therapeutics, Morrisville, NC.

Objective: Low cardiac output syndrome complicates recovery after cardiac surgery. We examined the incidence and risk factors for low cardiac output syndrome and its association with postoperative mortality, morbidity, resource use, and cost.

Methods: This cross-sectional retrospective observational study examined patients having cardiac surgery captured in the Premier Healthcare Database. Low cardiac output syndrome was defined as the requirement for postoperative mechanical circulatory support and/or hemodynamic instability requiring prolonged inotropic support. Incidence, risk factors, and association of low cardiac output syndrome with postoperative outcomes, including mortality, hospital and intensive care unit length of stay, hospital readmission, and cost at 30 days, 90 days, and 6 months, were examined.

Results: Among 59,810 patients from 164 hospitals having cardiac surgery between July 1, 2012, and June 30, 2014, low cardiac output syndrome developed in 6067 (10.1%) patients. Patients presenting in cardiogenic shock or systolic (± diastolic) heart failure were at greatest risk. Risk-adjusted in-hospital mortality was 12-fold greater with low cardiac output syndrome (odds ratio, 12.0; 95% confidence interval, 10.6-13.5). Risk-adjusted hospital costs (2019$; median [Q1, Q3]) were $64,041 [21,439] in patients who developed low cardiac output syndrome versus $48,086 [16,098] without; P < .001. Increased costs were driven by longer risk-adjusted hospital stay (10.1 [4.5] vs 8.5 [3.8] days); P < .001, intensive care unit (5.5 [2.5] vs 3.3 [1.5] days; P < .001) stay, and all-cause 30-day adjusted hospital readmission rates (mean [SD] 16.6 [8.2]% vs 13.9 [7.2]%; P < .001).

Conclusions: Cardiac surgical patients who develop postoperative low cardiac output syndrome suffer greater mortality and have greater resource use, health care costs, and all-cause readmission, which informs perioperative decision making, and impacts hospital performance metrics and federal priority to reduce health care costs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jtcvs.2020.06.125DOI Listing
July 2020

Pressurized DNA state inside herpes capsids-A novel antiviral target.

PLoS Pathog 2020 07 23;16(7):e1008604. Epub 2020 Jul 23.

Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America.

Drug resistance in viruses represents one of the major challenges of healthcare. As part of an effort to provide a treatment that avoids the possibility of drug resistance, we discovered a novel mechanism of action (MOA) and specific compounds to treat all nine human herpesviruses and animal herpesviruses. The novel MOA targets the pressurized genome state in a viral capsid, "turns off" capsid pressure, and blocks viral genome ejection into a cell nucleus, preventing viral replication. This work serves as a proof-of-concept to demonstrate the feasibility of a new antiviral target-suppressing pressure-driven viral genome ejection-that is likely impervious to developing drug resistance. This pivotal finding presents a platform for discovery of a new class of broad-spectrum treatments for herpesviruses and other viral infections with genome-pressure-dependent replication. A biophysical approach to antiviral treatment such as this is also a vital strategy to prevent the spread of emerging viruses where vaccine development is challenged by high mutation rates or other evasion mechanisms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1371/journal.ppat.1008604DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377361PMC
July 2020

Implantable Therapeutic Reservoir Systems for Diverse Clinical Applications in Large Animal Models.

Adv Healthc Mater 2020 06 27;9(11):e2000305. Epub 2020 Apr 27.

Anatomy & Regenerative Medicine Institute (REMEDI), School of Medicine, College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, H91 W5P7, Ireland.

Regenerative medicine approaches, specifically stem cell technologies, have demonstrated significant potential to treat a diverse array of pathologies. However, such approaches have resulted in a modest clinical benefit, which may be attributed to poor cell retention/survival at the disease site. A delivery system that facilitates regional and repeated delivery to target tissues can provide enhanced clinical efficacy of cell therapies when localized delivery of high doses of cells is required. In this study, a new regenerative reservoir platform (Regenervoir) is described for use in large animal models, with relevance to cardiac, abdominal, and soft tissue pathologies. Regenervoir incorporates multiple novel design features essential for clinical translation, with a focus on scalability, mechanism of delivery, fixation to target tissue, and filling/refilling with a therapeutic cargo, and is demonstrated in an array of clinical applications that are easily translated to human studies. Regenervoir consists of a porous reservoir fabricated from a single material, a flexible thermoplastic polymer, capable of delivering cargo via fill lines to target tissues. A radiopaque shear thinning hydrogel can be delivered to the therapy reservoir and multiple fixation methods (laparoscopic tacks and cyanoacrylate bioadhesive) can be used to secure Regenervoir to target tissues through a minimally invasive approach.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/adhm.202000305DOI Listing
June 2020

Clinical agreement and interchangeability of TEG5000 and TEG6s during cardiac surgery.

Anaesth Intensive Care 2020 Jan 23;48(1):43-52. Epub 2020 Jan 23.

Department of Anaesthesia and Pain Medicine, Waikato District Health Board, Hamilton, New Zealand.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0310057X19897657DOI Listing
January 2020

Lipid Metabolism Links Nutrient-Exercise Timing to Insulin Sensitivity in Men Classified as Overweight or Obese.

J Clin Endocrinol Metab 2020 03;105(3)

Department for Health, University of Bath, Bath, United Kingdom.

Context: Pre-exercise nutrient availability alters acute metabolic responses to exercise, which could modulate training responsiveness.

Objective: To assess acute and chronic effects of exercise performed before versus after nutrient ingestion on whole-body and intramuscular lipid utilization and postprandial glucose metabolism.

Design: (1) Acute, randomized, crossover design (Acute Study); (2) 6-week, randomized, controlled design (Training Study).

Setting: General community.

Participants: Men with overweight/obesity (mean ± standard deviation, body mass index: 30.2 ± 3.5 kg⋅m-2 for Acute Study, 30.9 ± 4.5 kg⋅m-2 for Training Study).

Interventions: Moderate-intensity cycling performed before versus after mixed-macronutrient breakfast (Acute Study) or carbohydrate (Training Study) ingestion.

Results: Acute Study-exercise before versus after breakfast consumption increased net intramuscular lipid utilization in type I (net change: -3.44 ± 2.63% versus 1.44 ± 4.18% area lipid staining, P < 0.01) and type II fibers (-1.89 ± 2.48% versus 1.83 ± 1.92% area lipid staining, P < 0.05). Training Study-postprandial glycemia was not differentially affected by 6 weeks of exercise training performed before versus after carbohydrate intake (P > 0.05). However, postprandial insulinemia was reduced with exercise training performed before but not after carbohydrate ingestion (P = 0.03). This resulted in increased oral glucose insulin sensitivity (25 ± 38 vs -21 ± 32 mL⋅min-1⋅m-2; P = 0.01), associated with increased lipid utilization during exercise (r = 0.50, P = 0.02). Regular exercise before nutrient provision also augmented remodeling of skeletal muscle phospholipids and protein content of the glucose transport protein GLUT4 (P < 0.05).

Conclusions: Experiments investigating exercise training and metabolic health should consider nutrient-exercise timing, and exercise performed before versus after nutrient intake (ie, in the fasted state) may exert beneficial effects on lipid utilization and reduce postprandial insulinemia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1210/clinem/dgz104DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7112968PMC
March 2020

In-Hospital Mortality in Patients with Idiopathic Pulmonary Fibrosis: A US Cohort Study.

Lung 2019 12 20;197(6):699-707. Epub 2019 Sep 20.

Duke Clinical Research Institute, Durham, NC, USA.

Purpose: In patients with idiopathic pulmonary fibrosis (IPF), hospitalizations are associated with high mortality. We sought to determine in-hospital mortality rates and factors associated with in-hospital mortality in patients with IPF.

Methods: Patients with IPF were identified from the Premier Healthcare Database, a representative administrative dataset that includes > 20% of hospital discharges in the US, using an algorithm based on diagnostic codes and billing data. We used logistic regression to analyze associations between patient-, hospital-, and treatment-related characteristics and a composite primary outcome of death during the index visit, lung transplant during the index visit and > 1 day after admission, or death during a readmission within 90 days.

Results: The cohort comprised 6665 patients with IPF hospitalized between October 2011 and October 2014. A total of 963 (14.4%) met the primary outcome. Factors significantly associated with a higher risk of the primary outcome included mechanical ventilation [odds ratio 4.65 (95% CI 3.73, 5.80)], admission to the intensive care unit [1.83 (1.52, 2.21)], treatment with opioids (3.06 [2.57, 3.65]), and a diagnosis of pneumonia [1.44 (1.21, 1.71)]. Factors significantly associated with a lower risk included concurrent chronic obstructive pulmonary disease [0.65 (0.55, 0.77)] and female sex [0.67 (0.57, 0.79)].

Conclusions: Patients with IPF, particularly those receiving mechanical ventilation or intensive care, are at substantial risk of death or lung transplant during hospitalization or death during a readmission within 90 days.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00408-019-00270-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861436PMC
December 2019

The Histone Methyltransferase Setdb2 Modulates Macrophage Phenotype and Uric Acid Production in Diabetic Wound Repair.

Immunity 2019 08 23;51(2):258-271.e5. Epub 2019 Jul 23.

Department of Surgery, University of Michigan, Ann Arbor, MI, USA; Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA. Electronic address:

Macrophage plasticity is critical for normal tissue repair to ensure transition from the inflammatory to the proliferative phase of healing. We examined macrophages isolated from wounds of patients afflicted with diabetes and of healthy controls and found differential expression of the methyltransferase Setdb2. Myeloid-specific deletion of Setdb2 impaired the transition of macrophages from an inflammatory phenotype to a reparative one in normal wound healing. Mechanistically, Setdb2 trimethylated histone 3 at NF-κB binding sites on inflammatory cytokine gene promoters to suppress transcription. Setdb2 expression in wound macrophages was regulated by interferon (IFN) β, and under diabetic conditions, this IFNβ-Setdb2 axis was impaired, leading to a persistent inflammatory macrophage phenotype in diabetic wounds. Setdb2 regulated the expression of xanthine oxidase and thereby the uric acid (UA) pathway of purine catabolism in macrophages, and pharmacologic targeting of Setdb2 or the UA pathway improved healing. Thus, Setdb2 regulates macrophage plasticity during normal and pathologic wound repair and is a target for therapeutic manipulation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.immuni.2019.06.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703945PMC
August 2019

SIRT3 Regulates Macrophage-Mediated Inflammation in Diabetic Wound Repair.

J Invest Dermatol 2019 12 15;139(12):2528-2537.e2. Epub 2019 Jun 15.

Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA; Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA. Electronic address:

Control of inflammation is critical for the treatment of nonhealing wounds, but a delicate balance exists between early inflammation that is essential for normal tissue repair and the pathologic inflammation that can occur later in the repair process. This necessitates the development of novel therapies that can target inflammation at the appropriate time during repair. Here, we found that SIRT3 is essential for normal healing and regulates inflammation in wound macrophages after injury. Under prediabetic conditions, SIRT3 was decreased in wound macrophages and resulted in dysregulated inflammation. In addition, we found that FABP4 regulates SIRT3 in human blood monocytes, and inhibition of FABP4 in wound macrophages decreases inflammatory cytokine expression, making FABP4 a viable target for the regulation of excess inflammation and wound repair in diabetes. Using a series of ex vivo and in vivo studies with genetically engineered mouse models and diabetic human monocytes, we showed that FABP4 expression is epigenetically upregulated in diabetic wound macrophages and, in turn, diminishes SIRT3 expression, thereby promoting inflammation. These findings have significant implications for controlling inflammation and promoting tissue repair in diabetic wounds.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jid.2019.05.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185380PMC
December 2019

Bird niches in human culture and why they matter.

Authors:
Scott K Robinson

Proc Natl Acad Sci U S A 2019 05 20;116(22):10620-10622. Epub 2019 May 20.

Florida Museum, University of Florida, Gainesville, FL 32611

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1073/pnas.1905901116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561215PMC
May 2019

A New Mobile-responsive Solution to Increase Patient Adherence: Instant Personalized Product Handouts.

Wounds 2019 Apr;31(4):E21-E24

Federal University of São Paulo, São Paulo, Brazil.

Objective: This study aims to develop a solution for clinicians to quickly generate customized product handouts with clinical, coverage, pricing, and supplier information for patients, with the goal of increasing patient adherence.

Methods: Using design thinking methodology, a digital solution was developed as a module within a clinical/reimbursement decision-support web application for wound care and hyperbaric clinicians. The module was tested at 4 wound clinics (beta-sites) located in the Midwest region of the United States following a 1-group posttest study design.

Results: Ten clinicians at the 4 beta-sites completed a survey upon evaluation. All respondents indicated they would use the module daily or weekly. Most users (80%) indicated it met their needs very well (vs. moderately or not as much). Nurses who shared handouts with patients found 7 of 8 handouts were useful or very useful in increasing patient adherence to the plan of care.

Conclusions: A digital point-of-care solution that generates customized product handouts with clinical, coverage, pricing, and supplier information may significantly improve patient adherence while saving clinicians time.
View Article and Find Full Text PDF

Download full-text PDF

Source
April 2019

Draft Opioid-Prescribing Guidelines for Uncomplicated Normal Spontaneous Vaginal Birth.

Obstet Gynecol 2019 01;133(1):81-90

University of Illinois at Chicago, Chicago, Illinois; Novartis Oncology, East Hanover, New Jersey; U.S. Department of Health and Human Services, Washington, DC; and Premier, Inc, Charlotte, North Carolina.

Women who experience an uncomplicated vaginal delivery have acute intrapartum pain and variable pain in the immediate postpartum period. Although the Centers for Disease Control and Prevention (CDC) has urged clinicians to improve opioid-prescribing behavior, there are no published clinical practice guidelines for prescribing opioids during labor and delivery and at discharge for patients with uncomplicated normal spontaneous vaginal delivery. To address the knowledge gap regarding guidelines for pain management in this population, we used the national Premiere Health Care Database for deliveries of uncomplicated vaginal births from January 1, 2014, to December 31, 2016, to determine the prevalence of opioid administration. Among the 49,133 women who met inclusion criteria, 78.2% were administered opioids during hospitalization and 29.8% were administered opioids on the day of discharge. Descriptive statistics were generated to document the characteristics of the patients receiving opioids as well as the characteristics of hospitals administering opioids during inpatient labor and delivery and on discharge. Patient-level variables included age group, marital status, race, ethnicity, payer type, and length of stay. Hospital-level variables included bed size, geographic region, teaching status, and urbanicity status. These data were then presented in an electronic Delphi survey to 14 participants. The survey participants were obstetrician-gynecologists identified by the American College of Obstetricians and Gynecologists as being thought leaders in the obstetrics field and who had also demonstrated an active interest in the opioid epidemic and its effect on women's health. After the panelists viewed the opioid administration data, they were presented with an adapted version of the CDC's guidelines for opioid prescribing for chronic pain management. The eight adapted guidelines were constructed to be more relevant and appropriate for the inpatient normal spontaneous vaginal delivery population. After three rounds of the surveying process, seven of the eight adapted guidelines were endorsed by the survey participants. These seven draft consensus guidelines could now be used as a starting point to develop more broadly endorsed and studied guidelines for appropriately managing pain control for women with uncomplicated spontaneous vaginal birth.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/AOG.0000000000002996DOI Listing
January 2019

Use it or lose it? Effects of age, experience, and disuse on crawling.

Dev Psychobiol 2019 01 16;61(1):29-42. Epub 2018 Nov 16.

Department of Psychology, New York University, New York City, New York.

What happens to early acquired but later abandoned motor skills? To investigate effects of disuse on early-developing motor skills, we examined crawling in two groups of habitual crawlers (34 6-12-month-old infants and five adults with Uner Tan Syndrome) and two groups of rusty crawlers (27 11-12-year-old children and 13 college-aged adults). Habitual crawlers showed striking similarities in gait patterns, limbs supporting the body, and crawling speed, despite dramatic differences in crawling practice, posture, and body size. Habitual crawlers trotted predominantly, whereas rusty crawlers showed a variety of gait patterns. Within sequences, habitual crawlers and children showed more switches in gait patterns than young adults. Children crawled faster and kept fewer limbs on the grounds than the other groups. Old crawling patterns were retained despite disuse, but new ones were also added. Surprisingly, results indicate that nothing was lost with disuse, but some features of crawling were gained or altered.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/dev.21802DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345180PMC
January 2019

Evaluation of Healthcare Use and Clinical Outcomes of Alvimopan in Patients Undergoing Bowel Resection: A Propensity Score-Matched Analysis.

Dis Colon Rectum 2018 12;61(12):1418-1425

Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio.

Background: Postoperative ileus is a significant complication after bowel resection surgeries. Alvimopan is the only US Food and Drug Administration-approved therapy for accelerating the return of bowel function after large- and small-bowel resection.

Objective: The purpose of this study was to estimate the healthcare use and in-hospital morbidities associated with on-label use of alvimopan in patients undergoing bowel resection surgeries.

Design: A retrospective observational propensity-matched cohort study was conducted using a large hospital administrative database.

Setting: The study included inpatient postsurgical patients.

Patients: Patients aged ≥18 years undergoing a primary large or small segmental bowel resection with discharge dates between January 2010 and December 2014 were included.

Interventions: Patients receiving 2 to 15 doses of alvimopan were defined as the treatment cohort, and those without any alvimopan use were included as control subjects.

Main Outcome Measures: The primary outcome was postoperative length of stay. Secondary outcomes included postoperative in-hospital morbidities, inpatient mortality, intensive care unit length of stay, discharge disposition, and 30-day readmission.

Results: Each propensity-score matched cohort included 18,559 patients. The mean (±SD) postoperative length of stay was 4.62 ± 2.45 days in alvimopan-treated patients compared with 5.24 ± 3.35 days in control subjects (p < 0.001). Alvimopan-treated patients had lower rates of postoperative GI complication (12.15% vs 16.50%; p < 0.001). The rates of urinary tract infections; other postoperative infections; and cardiovascular, pulmonary, thromboembolic, and cerebrovascular events were also lower compared with the control subjects.

Limitations: The study was limited by its inability to generalize to the US population, because the database included a convenience sample of hospital discharges. The identification of patients undergoing bowel resection and their clinical conditions relied on the accuracy and completeness of International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis and procedure coding. There may be a confounding effect by the use of enhanced recovery pathways associated with the use of alvimopan.

Conclusions: The use of alvimopan was associated with a reduction of 0.62 days in postsurgery length of stay and lower rates of postoperative GI complications, infections, and other in-hospital morbidities. See Video Abstract at http://links.lww.com/DCR/A703.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/DCR.0000000000001181DOI Listing
December 2018

Reversible secretome and signaling defects in diabetic mesenchymal stem cells from peripheral arterial disease patients.

J Vasc Surg 2018 12 10;68(6S):137S-151S.e2. Epub 2018 Aug 10.

Department of Surgery, Emory University School of Medicine, Atlanta, Ga; Parker H. Petit Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, Ga; Surgery and Research Services, Atlanta VA Medical Center, Atlanta, Ga. Electronic address:

Objective: Regenerative medicine seeks to stall or to reverse the pathologic consequences of chronic diseases. Many people with diabetes have peripheral arterial disease (PAD), which increases their already high risk of major amputation. Cellular therapies are a promising regenerative medicine approach to PAD that can be used to focally inject regenerative cells to endangered tissue beds. Mesenchymal stem cells (MSCs) are known to promote tissue regeneration through stromal support and paracrine stimulation of new blood vessels (angiogenesis). Whereas little is known about human diabetic MSCs (dMSCs), particularly those from patients with PAD, dMSCs have a limited expansion capacity but can be improved with human platelet lysate (PL) supplementation. PL is rich in many growth factors, including epidermal growth factor (EGF), which is known to be important to cell proliferation and survival signaling pathways. We hypothesize that dMSCs have a reversible defect in EGF receptor pathways. The objective of this work was to test this hypothesis using dMSCs from PAD patients.

Methods: The secretome expression of EGF and prominent angiogens was characterized from bone marrow (BM)-derived and adipose tissue-derived (ATD) dMSCs from five patients (six limbs) undergoing major amputation. Western blot was used to characterize the AKT and extracellular signal-regulated protein kinases 1 and 2 expression in dMSCs under standard culture (5% fetal bovine serum plus fibroblast growth factor 2 [FGF2]), 5% human PL, or 5% fetal bovine serum plus EGF. Healthy donor MSCs were control cells. The angiogenic activity of BM- and ATD-dMSCs was tested on human umbilical vein endothelial cells (ECs). Paired t-test, analysis of variance, and Kruskal-Wallis tests were used as appropriate.

Results: Both BM- and ATD-dMSCs had typical MSC surface marker expression and similar expansion profiles, and they did not express EGF in their secretome. PL supplementation of dMSCs improved AKT signaling, but they were resistant to FGF2 activation of extracellular signal-regulated protein kinases 1 and 2. EGF supplementation led to similar AKT expression as with PL, but PL had greater phosphorylation of AKT at 30 and 60 minutes. The conditioned media from both BM- and ATD-dMSCs had robust levels of prominent angiogens (vascular endothelial growth factor, monocyte chemoattractant protein 1, hepatocyte growth factor), which stimulated EC proliferation and migration, and the co-culture of dMSCs with ECs led to significantly longer EC sprouts in three-dimensional gel than EC-alone pellets.

Conclusions: PL and EGF supplementation improves AKT expression in dMSCs over that of FGF2, but PL improved pAKT over that of EGF. Thus, PL supplementation strategies may improve AKT signaling, which could be important to MSC survival in cellular therapies. Furthermore, BM- and ATD-dMSCs have similar secretomes and robust in vitro angiogenic activity, which supports pursuing dMSCs from both reservoirs in regenerative medicine strategies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jvs.2018.05.223DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252140PMC
December 2018

An efficient extension of N-mixture models for multi-species abundance estimation.

Methods Ecol Evol 2018 Feb 24;9(2):340-353. Epub 2017 Jul 24.

Department of Biology, University of Florida, Gainesville, Florida.

In this study we propose an extension of the N-mixture family of models that targets an improvement of the statistical properties of rare species abundance estimators when sample sizes are low, yet typical for tropical studies. The proposed method harnesses information from other species in an ecological community to correct each species' estimator. We provide guidance to determine the sample size required to estimate accurately the abundance of rare tropical species when attempting to estimate the abundance of single species.We evaluate the proposed methods using an assumption of 50 m radius plots and perform simulations comprising a broad range of sample sizes, true abundances and detectability values and a complex data generating process. The extension of the N-mixture model is achieved by assuming that the detection probabilities are drawn at random from a beta distribution in a multi-species fashion. This hierarchical model avoids having to specify a single detection probability parameter per species in the targeted community. Parameter estimation is done via Maximum Likelihood.We compared our multi-species approach with previously proposed multi-species N-mixture models, which we show are biased when the true densities of species in the community are less than seven individuals per 100 hectares. The beta N-mixture model proposed here outperforms the traditional Multi-species N-mixture model by allowing the estimation of organisms at lower densities and controlling the bias in the estimation.We illustrate how our methodology can be used to suggest sample sizes required to estimate the abundance of organisms, when these are either rare, common or abundant. When the interest is full communities, we show how the multi-species approaches, and in particular our beta model and estimation methodology, can be used as a practical solution to estimate organism densities from rapid inventory datasets. The statistical inferences done with our model via Maximum Likelihood can also be used to group species in a community according to their detectabilities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/2041-210X.12856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992910PMC
February 2018

Host species, and not environment, predicts variation in blood parasite prevalence, distribution, and diversity along a humidity gradient in northern South America.

Ecol Evol 2018 Apr 13;8(8):3800-3814. Epub 2018 Mar 13.

Laboratorio de Biología Evolutiva de Vertebrados Departamento de Ciencias Biológicas Universidad de Los Andes Bogotá Colombia.

Environmental factors strongly influence the ecology and evolution of vector-borne infectious diseases. However, our understanding of the influence of climatic variation on host-parasite interactions in tropical systems is rudimentary. We studied five species of birds and their haemosporidian parasites ( and ) at 16 sampling sites to understand how environmental heterogeneity influences patterns of parasite prevalence, distribution, and diversity across a marked gradient in water availability in northern South America. We used molecular methods to screen for parasite infections and to identify parasite lineages. To characterize spatial heterogeneity in water availability, we used weather-station and remotely sensed climate data. We estimated parasite prevalence while accounting for spatial autocorrelation, and used a model selection approach to determine the effect of variables related to water availability and host species on prevalence. The prevalence, distribution, and lineage diversity of haemosporidian parasites varied among localities and host species, but we found no support for the hypothesis that the prevalence and diversity of parasites increase with increasing water availability. Host species and host × climate interactions had stronger effects on infection prevalence, and parasite lineages were strongly associated with particular host species. Because climatic variables had little effect on the overall prevalence and lineage diversity of haemosporidian parasites across study sites, our results suggest that independent host-parasite dynamics may influence patterns in parasitism in environmentally heterogeneous landscapes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ece3.3785DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5916302PMC
April 2018

Clinical and economic benefits of advanced microplegia delivery system in cardiac surgery: evidence from 250 hospitals.

J Comp Eff Res 2018 07 23;7(7):673-683. Epub 2018 Apr 23.

CTI Clinical Trial & Consulting Services Inc., Consulting Services 100 E. Rivercenter Blvd, Covington, KY 41011, USA.

Aim: Determine the impact of a second generation microplegia delivery system (MPS2) compared with traditional cardioplegia. Materials &  methods: Multivariable difference-in-differences analysis using fixed effects was performed for each outcome: adverse event (AE) composite, total visit cost, medication cost, length of stay (LOS) and  intensive care unit (ICU) days.

Results: A 2.25% absolute risk reduction in AE composite was found with MPS2 compared with traditional cardioplegia, which equates to relative risk reduction of 5.25%. Significant reductions in LOS and ICU days (0.1 α level). Per case reduction of US$1231 total visit and US$192 medication costs were found in MPS2 hospitals.

Conclusion: For hospitals with MPS2, significant reductions were seen in AEs, LOS and ICU days, which lead to reductions in total visit and medication costs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2217/cer-2018-0011DOI Listing
July 2018

Responsiveness of rat fetuses to sibling motor activity: Communication in utero?

Dev Psychobiol 2018 04 14;60(3):265-277. Epub 2018 Feb 14.

Pacific Ethological Laboratories, Olympia, Washington.

Previous research has revealed that fetuses detect and respond to extrauterine stimuli such as maternal movement and speech, but little attention has been cast on how fetuses may directly influence and respond to each other in the womb. This study investigated whether motor activity of E20 rat fetuses influenced the behavior of siblings in utero. Three experiments showed that; (a) contiguous siblings expressed a higher frequency of synchronized movement than noncontiguous siblings; (b) fetuses that lay between two siblings immobilized with curare showed less movement relative to fetuses between saline or uninjected controls; and (c) fetuses between two siblings behaviorally activated by the opioid agonist U50,488 also showed less activity and specific behavioral changes compared to controls. Our findings suggest that rat fetuses are directly impacted by sibling motor activity, and thus that a rudimentary form of communication between siblings may influence the development of fetuses in utero.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/dev.21615DOI Listing
April 2018

Response.

Chest 2017 07;152(1):219-220

Medical Affairs-Americas/East Asia and Global Health Economics and Outcomes, bioMérieux USA, Durham, NC; Medicine and International Relations, University of California San Diego, San Diego, CA; Health Policy and Management, University of North Carolina, Raleigh, NC.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2017.04.180DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026270PMC
July 2017

Burden of illness associated with sinusoidal obstruction syndrome/veno-occlusive disease in patients with hematopoietic stem cell transplantation.

J Med Econ 2017 Aug 14;20(8):871-883. Epub 2017 Jun 14.

d Benioff Children's Hospital, University of California San Francisco , San Francisco , CA , USA.

Aims: Sinusoidal obstruction syndrome (SOS) is a life-threatening complication of hematopoietic stem cell transplantation (HSCT) associated with significant morbidity and mortality. Healthcare utilization, costs, and mortality were assessed in HSCT patients diagnosed with SOS, with and without multi-organ dysfunction (MOD).

Materials And Methods: This retrospective observational study identified real-world patients undergoing HSCT between January 1, 2009 and May 31, 2014 using the Premier Healthcare Database. In absence of a formal ICD-9-CM diagnostic code, SOS patients were identified using a pre-specified definition adapted from Baltimore and Seattle criteria and clinical practice. Severe SOS (SOS/MOD) and non-severe SOS (SOS/no-MOD) were classified according to clinical evidence for MOD in the database.

Results: Of the 5,418 patients with a discharge diagnosis of HSCT, 291 had SOS, with 134 categorized as SOS/MOD and 157 as SOS/no-MOD. The remaining 5,127 patients had HSCT without SOS. Overall SOS incidence was 5.4%, with 46% having evidence of MOD. Distribution of age, gender, and race were similar between the SOS cohorts and non-SOS patients. After controlling for hospital profile and admission characteristics, demographics, and clinical characteristics, the adjusted mean LOS was 31.0 days in SOS/MOD compared to 23.9 days in the non-SOS cohort (medians = 26.9 days vs 20.8 days, p < .001). The adjusted mean cost of SOS/MOD patients was $140,653, which was $41,702 higher than the non-SOS cohort (medians = $105,749 vs $74,395, p < .001). An almost 6-fold increased odds of inpatient mortality was associated with SOS/MOD compared to the non-SOS cohort (odds ratio = 5.88; 95% CI = 3.45-10.33).

Limitations: Limitations of retrospective observational studies apply, since the study was not randomized. Definition for SOS was based on ICD-9 diagnosis codes from a hospital administrative database and reliant on completeness and accuracy of coding.

Conclusions: Analysis of real-world data shows that SOS/MOD is associated with significant increases in healthcare utilization, costs, and inpatient mortality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13696998.2017.1336623DOI Listing
August 2017

Dietary intake is independently associated with the maximal capacity for fat oxidation during exercise.

Am J Clin Nutr 2017 04 1;105(4):864-872. Epub 2017 Mar 1.

School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom; and

Substantial interindividual variability exists in the maximal rate of fat oxidation (MFO) during exercise with potential implications for metabolic health. Although the diet can affect the metabolic response to exercise, the contribution of a self-selected diet to the interindividual variability in the MFO requires further clarification. We sought to identify whether recent, self-selected dietary intake independently predicts the MFO in healthy men and women. The MFO and maximal oxygen uptake ([Formula: see text]O max) were determined with the use of indirect calorimetry in 305 healthy volunteers [150 men and 155 women; mean ± SD age: 25 ± 6 y; body mass index (BMI; in kg/m): 23 ± 2]. Dual-energy X-ray absorptiometry was used to assess body composition with the self-reported physical activity level (SRPAL) and dietary intake determined in the 4 d before exercise testing. To minimize potential confounding with typically observed sex-related differences (e.g., body composition), predictor variables were mean-centered by sex. In the analyses, hierarchical multiple linear regressions were used to quantify each variable's influence on the MFO. The mean absolute MFO was 0.55 ± 0.19 g/min (range: 0.19-1.13 g/min). A total of 44.4% of the interindividual variability in the MFO was explained by the [Formula: see text]O max, sex, and SRPAL with dietary carbohydrate (carbohydrate; negative association with the MFO) and fat intake (positive association) associated with an additional 3.2% of the variance. When expressed relative to fat-free mass (FFM), the MFO was 10.8 ± 3.2 mg · kg FFM · min (range: 3.5-20.7 mg · kg FFM · min) with 16.6% of the variability explained by the [Formula: see text]O max, sex, and SRPAL; dietary carbohydrate and fat intakes together explained an additional 2.6% of the variability. Biological sex was an independent determinant of the MFO with women showing a higher MFO [men: 10.3 ± 3.1 mg · kg FFM · min (3.5-19.9 mg · kg FFM · min); women: 11.2 ± 3.3 mg · kg FFM · min (4.6-20.7 mg · kg FFM · min); < 0.05]. Considered alongside other robust determinants, dietary carbohydrate and fat intake make modest but independent contributions to the interindividual variability in the capacity to oxidize fat during exercise. This trial was registered at clinicaltrials.gov as NCT02070055.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3945/ajcn.116.133520DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5366043PMC
April 2017

Internal iliac venous aneurysm associated with pelvic venous insufficiency.

J Vasc Surg Venous Lymphat Disord 2017 03 25;5(2):257-260. Epub 2016 Jul 25.

Division of Vascular Surgery, University of Michigan, Ann Arbor, Mich. Electronic address:

Aneurysmal disease of the internal iliac vein is rare, with no standard indication for or accepted modality of treatment. Here we report an instance of unilateral, primary left internal iliac venous aneurysm and associated pelvic venous insufficiency. Following extensive workup for alternative causes, the aneurysm and left gonadal vein were coil embolized with good effect.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jvsv.2016.05.004DOI Listing
March 2017

HLA gene expression is altered in whole blood and placenta from women who later developed preeclampsia.

Physiol Genomics 2017 03 27;49(3):193-200. Epub 2017 Jan 27.

Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom; and.

Preeclampsia is a multisystem disease that significantly contributes to maternal and fetal morbidity and mortality. In this study, we used a non-biased microarray approach to identify dysregulated genes in maternal whole blood samples which may be associated with the development of preeclampsia. Whole blood samples were obtained at 28 wk of gestation from 5 women who later developed preeclampsia (cases) and 10 matched women with normotensive pregnancies (controls). Placenta samples were obtained from an independent cohort of 19 women with preeclampsia matched with 19 women with normotensive pregnancies. We studied gene expression profiles using Illumina microarray in blood and validated changes in gene expression in whole blood and placenta tissue by qPCR. We found a transcriptional profile differentiating cases from controls; 336 genes were significantly dysregulated in blood from women who developed preeclampsia. Functional annotation of microarray results indicated that most of the genes found to be dysregulated were involved in inflammatory pathways. While general trends were preserved, only was validated in whole blood samples from cases using qPCR (2.30- ± 0.9-fold change) whereas in placental tissue expression was found to be significantly increased in samples from women with preeclampsia (5.88- ± 2.24-fold change). We have identified that is upregulated in the circulation of women who went on to develop preeclampsia. In placenta of women with preeclampsia we identified that upregulated. Our data provide further evidence for involvement of the gene family in the pathogenesis of preeclampsia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1152/physiolgenomics.00106.2016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5374453PMC
March 2017

Effect of Procalcitonin Testing on Health-care Utilization and Costs in Critically Ill Patients in the United States.

Chest 2017 Jan 25;151(1):23-33. Epub 2016 Aug 25.

Medical Affairs-Americas/East Asia and Global Health Economics and Outcomes, bioMérieux USA, Durham, NC; Medicine and International Relations, University of California San Diego, San Diego, CA; Health Policy and Management, University of North Carolina, Raleigh, NC.

Background: There is a growing use of procalcitonin (PCT) to facilitate the diagnosis and management of severe sepsis. We investigated the impact of one to two PCT determinations on ICU day 1 on health-care utilization and cost in a large research database.

Methods: A retrospective, propensity score-matched multivariable analysis was performed on the Premier Healthcare Database for patients admitted to the ICU with one to two PCT evaluations on day 1 of ICU admission vs patients who did not have PCT testing.

Results: A total of 33,569 PCT-managed patients were compared with 98,543 propensity score-matched non-PCT patients. In multivariable regression analysis, PCT utilization was associated with significantly decreased total length of stay (11.6 days [95% CI, 11.4 to 11.7] vs 12.7 days [95% CI, 12.6 to 12.8]; 95% CI for difference, 1 to 1.3; P < .001) and ICU length of stay (5.1 days [95% CI, 5.1 to 5.2] vs 5.3 days [95% CI, 5.3 to 5.4]; 95% CI for difference, 0.1 to 0.3; P < .03), and lower hospital costs ($30,454 [95% CI, 29,968 to 31,033] vs $33,213 [95% CI, 32,964 to 33,556); 95% CI for difference, 2,159 to 3,321; P < .001). There was significantly less total antibiotic exposure (16.2 days [95% CI, 16.1 to 16.5] vs 16.9 days [95% CI, 16.8 to 17.1]; 95% CI for difference, -0.9 to 0.4; P = .006) in PCT-managed patients. Patients in the PCT group were more likely to be discharged to home (44.1% [95% CI, 43.7 to 44.6] vs 41.3% [95% CI, 41 to 41.6]; 95% CI for difference, 2.3 to 3.3; P = .006). Mortality was not different in an analysis including the 96% of patients who had an independent measure of mortality risk available (19.1% [95% CI, 18.7 to 19.4] vs 19.1% [95% CI, 18.9 to 19.3]; 95% CI for difference, -0.5 to 0.4; P = .93).

Conclusions: Use of PCT testing on the first day of ICU admission was associated with significantly lower hospital and ICU lengths of stay, as well as decreased total, ICU, and pharmacy cost of care. Further elucidation of clinical outcomes requires additional data.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.chest.2016.06.046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026224PMC
January 2017