1,870 results on '"J. Cooper"'
Search Results
2. All SNPs are not created equal: genome-wide association studies reveal a consistent pattern of enrichment among functionally annotated SNPs.
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Schork, Andrew J, Thompson, Wesley K, Pham, Phillip, Torkamani, Ali, Roddey, J Cooper, Sullivan, Patrick F, Kelsoe, John R, O'Donovan, Michael C, Furberg, Helena, Tobacco and Genetics Consortium, Bipolar Disorder Psychiatric Genomics Consortium, Schizophrenia Psychiatric Genomics Consortium, Schork, Nicholas J, Andreassen, Ole A, and Dale, Anders M
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Tobacco and Genetics Consortium ,Bipolar Disorder Psychiatric Genomics Consortium ,Schizophrenia Psychiatric Genomics Consortium ,Humans ,Genetic Predisposition to Disease ,Schizophrenia ,Linkage Disequilibrium ,Phenotype ,Polymorphism ,Single Nucleotide ,Genome-Wide Association Study ,Polymorphism ,Single Nucleotide ,Clinical Research ,Human Genome ,Genetics ,2.1 Biological and endogenous factors ,Developmental Biology - Abstract
Recent results indicate that genome-wide association studies (GWAS) have the potential to explain much of the heritability of common complex phenotypes, but methods are lacking to reliably identify the remaining associated single nucleotide polymorphisms (SNPs). We applied stratified False Discovery Rate (sFDR) methods to leverage genic enrichment in GWAS summary statistics data to uncover new loci likely to replicate in independent samples. Specifically, we use linkage disequilibrium-weighted annotations for each SNP in combination with nominal p-values to estimate the True Discovery Rate (TDR = 1-FDR) for strata determined by different genic categories. We show a consistent pattern of enrichment of polygenic effects in specific annotation categories across diverse phenotypes, with the greatest enrichment for SNPs tagging regulatory and coding genic elements, little enrichment in introns, and negative enrichment for intergenic SNPs. Stratified enrichment directly leads to increased TDR for a given p-value, mirrored by increased replication rates in independent samples. We show this in independent Crohn's disease GWAS, where we find a hundredfold variation in replication rate across genic categories. Applying a well-established sFDR methodology we demonstrate the utility of stratification for improving power of GWAS in complex phenotypes, with increased rejection rates from 20% in height to 300% in schizophrenia with traditional FDR and sFDR both fixed at 0.05. Our analyses demonstrate an inherent stratification among GWAS SNPs with important conceptual implications that can be leveraged by statistical methods to improve the discovery of loci.
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- 2013
3. Improved detection of common variants associated with schizophrenia and bipolar disorder using pleiotropy-informed conditional false discovery rate.
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Andreassen, Ole A, Thompson, Wesley K, Schork, Andrew J, Ripke, Stephan, Mattingsdal, Morten, Kelsoe, John R, Kendler, Kenneth S, O'Donovan, Michael C, Rujescu, Dan, Werge, Thomas, Sklar, Pamela, Psychiatric Genomics Consortium (PGC), Bipolar Disorder and Schizophrenia Working Groups, Roddey, J Cooper, Chen, Chi-Hua, McEvoy, Linda, Desikan, Rahul S, Djurovic, Srdjan, and Dale, Anders M
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Psychiatric Genomics Consortium ,Bipolar Disorder and Schizophrenia Working Groups ,Humans ,Genetic Predisposition to Disease ,Bipolar Disorder ,Schizophrenia ,Polymorphism ,Single Nucleotide ,Genome-Wide Association Study ,Developmental Biology ,Genetics - Abstract
Several lines of evidence suggest that genome-wide association studies (GWAS) have the potential to explain more of the "missing heritability" of common complex phenotypes. However, reliable methods to identify a larger proportion of single nucleotide polymorphisms (SNPs) that impact disease risk are currently lacking. Here, we use a genetic pleiotropy-informed conditional false discovery rate (FDR) method on GWAS summary statistics data to identify new loci associated with schizophrenia (SCZ) and bipolar disorders (BD), two highly heritable disorders with significant missing heritability. Epidemiological and clinical evidence suggest similar disease characteristics and overlapping genes between SCZ and BD. Here, we computed conditional Q-Q curves of data from the Psychiatric Genome Consortium (SCZ; n = 9,379 cases and n = 7,736 controls; BD: n = 6,990 cases and n = 4,820 controls) to show enrichment of SNPs associated with SCZ as a function of association with BD and vice versa with a corresponding reduction in FDR. Applying the conditional FDR method, we identified 58 loci associated with SCZ and 35 loci associated with BD below the conditional FDR level of 0.05. Of these, 14 loci were associated with both SCZ and BD (conjunction FDR). Together, these findings show the feasibility of genetic pleiotropy-informed methods to improve gene discovery in SCZ and BD and indicate overlapping genetic mechanisms between these two disorders.
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- 2013
4. Multimodal imaging of the self-regulating developing brain
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Fjell, Anders M, Walhovd, Kristine Beate, Brown, Timothy T, Kuperman, Joshua M, Chung, Yoonho, Hagler, Donald J, Venkatraman, Vijay, Roddey, J Cooper, Erhart, Matthew, McCabe, Connor, Akshoomoff, Natacha, Amaral, David G, Bloss, Cinnamon S, Libiger, Ondrej, Darst, Burcu F, Schork, Nicholas J, Casey, BJ, Chang, Linda, Ernst, Thomas M, Gruen, Jeffrey R, Kaufmann, Walter E, Kenet, Tal, Frazier, Jean, Murray, Sarah S, Sowell, Elizabeth R, van Zijl, Peter, Mostofsky, Stewart, Jernigan, Terry L, Dale, Anders M, Newman, Erik, Ernst, Thomas, Van Zijl, Peter, Kuperman, Joshua, Murray, Sarah, Bloss, Cinnamon, Appelbaum, Mark, Gamst, Anthony, Thompson, Wesley, Bartsch, Hauke, Keating, Brian, Amaral, David, Sowell, Elizabeth, Kaufmann, Walter, Ruberry, Erika J, Powers, Alisa, Rosen, Bruce, Kennedy, David, and Gruen, Jeffrey
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Biomedical Imaging ,Basic Behavioral and Social Science ,Mental Health ,Brain Disorders ,Neurosciences ,Clinical Research ,Behavioral and Social Science ,Mental health ,Neurological ,Adolescent ,Adult ,Brain ,Child ,Child ,Preschool ,Humans ,Magnetic Resonance Imaging ,Young Adult ,executive function ,cognitive conflict ,inhibition ,morphometry ,Pediatric Imaging ,Neurocognition ,and Genetics Study - Abstract
Self-regulation refers to the ability to control behavior, cognition, and emotions, and self-regulation failure is related to a range of neuropsychiatric problems. It is poorly understood how structural maturation of the brain brings about the gradual improvement in self-regulation during childhood. In a large-scale multicenter effort, 735 children (4-21 y) underwent structural MRI for quantification of cortical thickness and surface area and diffusion tensor imaging for quantification of the quality of major fiber connections. Brain development was related to a standardized measure of cognitive control (the flanker task from the National Institutes of Health Toolbox), a critical component of self-regulation. Ability to inhibit responses and impose cognitive control increased rapidly during preteen years. Surface area of the anterior cingulate cortex accounted for a significant proportion of the variance in cognitive performance. This finding is intriguing, because characteristics of the anterior cingulum are shown to be related to impulse, attention, and executive problems in neurodevelopmental disorders, indicating a neural foundation for self-regulation abilities along a continuum from normality to pathology. The relationship was strongest in the younger children. Properties of large-fiber connections added to the picture by explaining additional variance in cognitive control. Although cognitive control was related to surface area of the anterior cingulate independently of basic processes of mental speed, the relationship between white matter quality and cognitive control could be fully accounted for by speed. The results underscore the need for integration of different aspects of brain maturation to understand the foundations of cognitive development.
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- 2012
5. Association of common genetic variants in GPCPD1 with scaling of visual cortical surface area in humans.
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Bakken, Trygve E, Roddey, J Cooper, Djurovic, Srdjan, Akshoomoff, Natacha, Amaral, David G, Bloss, Cinnamon S, Casey, B J, Chang, Linda, Ernst, Thomas M, Gruen, Jeffrey R, Jernigan, Terry L, Kaufmann, Walter E, Kenet, Tal, Kennedy, David N, Kuperman, Joshua M, Murray, Sarah S, Sowell, Elizabeth R, Rimol, Lars M, Mattingsdal, Morten, Melle, Ingrid, Agartz, Ingrid, Andreassen, Ole A, Schork, Nicholas J, Dale, Anders M, Weiner, Michael, Aisen, Paul, Petersen, Ronald, Jack, Clifford R, Jr, Jagust, William, Trojanowki, John Q, Toga, Arthur W, Beckett, Laurel, Green, Robert C, Saykin, Andrew J, Morris, John, Liu, Enchi, Montine, Tom, Gamst, Anthony, Thomas, Ronald G, Donohue, Michael, Walter, Sarah, Gessert, Devon, Sather, Tamie, Harvey, Danielle, Kornak, John, Dale, Anders, Bernstein, Matthew, Felmlee, Joel, Fox, Nick, Thompson, Paul, Schuff, Norbert, Alexander, Gene, DeCarli, Charles, Bandy, Dan, Koeppe, Robert A, Foster, Norm, Reiman, Eric M, Chen, Kewei, Mathis, Chet, Cairns, Nigel J, Taylor-Reinwald, Lisa, Trojanowki, J Q, Shaw, Les, Lee, Virginia M Y, Korecka, Magdalena, Crawford, Karen, Neu, Scott, Foroud, Tatiana M, Potkin, Steven, Shen, Li, Kachaturian, Zaven, Frank, Richard, Snyder, Peter J, Molchan, Susan, Kaye, Jeffrey, Quinn, Joseph, Lind, Betty, Dolen, Sara, Schneider, Lon S, Pawluczyk, Sonia, Spann, Bryan M, Brewer, James, Vanderswag, Helen, Heidebrink, Judith L, Lord, Joanne L, Johnson, Kris, Doody, Rachelle S, Villanueva-Meyer, Javier, Chowdhury, Munir, Stern, Yaakov, Honig, Lawrence S, Bell, Karen L, Morris, John C, Ances, Beau, Carroll, Maria, Leon, Sue, Mintun, Mark A, Schneider, Stacy, Marson, Daniel, and Griffith, Randall
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Adolescent ,Adult ,Aged ,Brain: pathology ,Brain Mapping: methods ,Cohort Studies ,Diagnostic Imaging: methods ,Female ,Genetic Variation ,Genome-Wide Association Study ,Genomics ,Genotype ,Humans ,Male ,Middle Aged ,Models ,Genetic ,Phosphoric Diester Hydrolases: genetics ,Polymorphism ,Single Nucleotide ,Saccharomyces cerevisiae: metabolism ,Visual Cortex: anatomy & histology ,pathology - Abstract
Visual cortical surface area varies two- to threefold between human individuals, is highly heritable, and has been correlated with visual acuity and visual perception. However, it is still largely unknown what specific genetic and environmental factors contribute to normal variation in the area of visual cortex. To identify SNPs associated with the proportional surface area of visual cortex, we performed a genome-wide association study followed by replication in two independent cohorts. We identified one SNP (rs6116869) that replicated in both cohorts and had genome-wide significant association (P(combined) = 3.2 × 10(-8)). Furthermore, a metaanalysis of imputed SNPs in this genomic region identified a more significantly associated SNP (rs238295; P = 6.5 × 10(-9)) that was in strong linkage disequilibrium with rs6116869. These SNPs are located within 4 kb of the 5' UTR of GPCPD1, glycerophosphocholine phosphodiesterase GDE1 homolog (Saccharomyces cerevisiae), which in humans, is more highly expressed in occipital cortex compared with the remainder of cortex than 99.9% of genes genome-wide. Based on these findings, we conclude that this common genetic variation contributes to the proportional area of human visual cortex. We suggest that identifying genes that contribute to normal cortical architecture provides a first step to understanding genetic mechanisms that underlie visual perception.
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- 2012
6. The Impact of Perioperative and Operative Variables on Early Postoperative Complications Following Primary Hypospadias Repair
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Douglas W. Storm, Gina M. Lockwood, Megan A. Bonnett, Benjamin J. Cooper, Logan M. Harris, and Christopher S. Cooper
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Male ,Hypospadias ,Urologic Surgical Procedures, Male ,Postoperative Complications ,Treatment Outcome ,Urethra ,Urology ,Humans ,Infant ,Retrospective Studies - Abstract
To evaluate possible risk factors for complications following primary hypospadias repair relative to factors associated with timing of hypospadias repair in terms of case order, morning or afternoon scheduling, perioperative delays, and surgeon's daily work schedule as well as individual operative techniques.We retrospectively reviewed charts of 422 boys undergoing primary hypospadias repair with a sutured urethroplasty by 1 of 3 surgeons over a 10-year period and the surgeon's daily schedule.The median age and IQR of the patients at time of operation was 0.79 (0.57) years, and median follow-up was 259 (664) days. A significant increase in the rate of any complication was noted with morning vs afternoon cases for the group overall with morning cases having a hazard 2.3 times higher than afternoon cases (P =.012). Additionally, there was a significant increase in hazard of complication with increasing difference in time between actual procedure duration vs scheduled duration, with hazard of complication increasing 5% for each increase of 15 minutes of surgical time (P =.043).A variety of previously identified potential risk factors for hypospadias complications were identified. Our analysis also demonstrated variability in level of risk of different factors between surgeons, reinforcing the utility of surgeons monitoring their own results in response to changes in technique. Novel potential risk factors for some surgeons identified in our study included an increased risk of complications when the hypospadias was done in the morning rather than the afternoon and when the procedure lasted longer than scheduled.
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- 2022
7. Social Needs Identified by Diagnostic Codes in Privately Insured U.S. Adults
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David T. Liss, Manisha Cherupally, Raymond H. Kang, Cassandra Aikman, Andrew J. Cooper, and Matthew J. O'Brien
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Adult ,Male ,Alcoholism ,Insurance, Health ,Food ,Research Design ,Epidemiology ,Case-Control Studies ,Public Health, Environmental and Occupational Health ,Humans ,Female ,Article - Abstract
INTRODUCTION: The relationships between healthcare use and social needs are not fully understood. In 2015, International Classification of Diseases, Tenth Revision coding introduced voluntary Z codes for social needs–related healthcare encounters. This study evaluated early national patterns of Z codes in privately insured adults. METHODS: In 2021, the authors conducted a case-control analysis of national commercial health payer claims from 2016 to 2019. Among adults with ≥6 months of continuous enrollment and ≥1 medical claims, patients with any assigned Z codes were defined as cases. Controls were selected through stratified random sampling. Z codes were organized under 3 categories: socioeconomic, community/social, and environmental. RESULTS: Of 29.5 million adults, 521,334 patients (1.8%) had any assigned Z codes. Among all the Z codes, 53.5% identified community/social issues, 30.3% identified environmental issues, and 16.2% identified socioeconomic issues. Among socioeconomic Z codes, housing needs were frequently identified, but needs for food, utility bills, and transportation were very rarely identified. In multivariable regression analysis, females had higher odds of Z code assignment than males. Depression and chronic pulmonary disease were the 2 common comorbidities (≥5% prevalence in cases and controls) that were highly associated with Z code assignment. Less common comorbidities strongly associated with Z code assignment were drug abuse, alcohol abuse, psychoses, and AIDS/HIV. CONCLUSIONS: In this national study of privately insured patients, many Z codes identified healthcare encounters caused by social stressors, whereas few identified food- or transportation-related causes. Depression and chronic pulmonary disease were highly associated with Z code assignment.
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- 2022
8. Post‐Roe emergency medicine: Policy, clinical, training, and individual implications for emergency clinicians
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Margaret E. Samuels‐Kalow, Pooja Agrawal, Giovanni Rodriguez, Amy Zeidan, Jennifer S. Love, Derek Monette, Michelle Lin, Richelle J. Cooper, Tracy E. Madsen, and Valerie Dobiesz
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Policy ,Pregnancy ,Abortion, Legal ,Emergency Medicine ,Humans ,Female ,General Medicine ,Supreme Court Decisions ,United States - Abstract
In June 2022, the United States Supreme Court decision Dobbs v. Jackson Women's Health Organization overturned Roe v. Wade, removing almost 50 years of precedent and enabling the imposition of a wide range of state-level restrictions on abortion access. Historical data from the United States and internationally demonstrate that the removal of safe abortion options will increase complications and the health risks to pregnant patients. Because the emergency department is a critical access point for reproductive health care, emergency clinicians must be prepared for the policy, clinical, educational, and legal implications of this change. The goal of this paper, therefore, is to describe the impact of the reversal of Roe v. Wade on health equity and reproductive justice, the provision of emergency care education and training, and the specific legal and reproductive consequences for emergency clinicians. Finally, we conclude with specific recommended policy and advocacy responses for emergency medicine clinicians.
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- 2022
9. A prospective study of risk factors associated with seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a large UK teaching hospital
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Daniel J Cooper, Sara Lear, Laura Watson, Ashley Shaw, Mark Ferris, Rainer Doffinger, Rachel Bousfield, Katherine Sharrocks, Michael P. Weekes, Ben Warne, Dominic Sparkes, Nick K Jones, Lucy Rivett, Matthew Routledge, Afzal Chaudhry, Katherine Dempsey, Montgomery Matson, Adil Lakha, George Gathercole, Olivia O'Connor, Emily Wilson, Orthi Shahzad, Kieran Toms, Rachel Thompson, Ian Halsall, David Halsall, Sally Houghton, Sofia Papadia, Nathalie Kingston, Kathleen E Stirrups, Barbara Graves, Paul Townsend, Neil Walker, Hannah Stark, Daniela De Angelis, Shaun Seaman, Gordon Dougan, John R Bradley, M. Estée Török, Ian Goodfellow, and Stephen Baker
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Microbiology (medical) ,Infectious Diseases ,Risk Factors ,SARS-CoV-2 ,Seroepidemiologic Studies ,Health Personnel ,COVID-19 ,Humans ,Prospective Studies ,Antibodies, Viral ,Hospitals, Teaching ,United Kingdom - Abstract
To describe the risk factors for SARS-CoV-2 infection in UK healthcare workers (HCWs).We conducted a prospective sero-epidemiological study of HCWs at a major UK teaching hospital using a SARS-CoV-2 immunoassay. Risk factors for seropositivity were analysed using multivariate logistic regression.410/5,698 (7·2%) staff tested positive for SARS-CoV-2 antibodies. Seroprevalence was higher in those working in designated COVID-19 areas compared with other areas (9·47% versus 6·16%) Healthcare assistants (aOR 2·06 [95%CI 1·14-3·71]; p=0·016) and domestic and portering staff (aOR 3·45 [95% CI 1·07-11·42]; p=0·039) had significantly higher seroprevalence than other staff groups after adjusting for age, sex, ethnicity and COVID-19 working location. Staff working in acute medicine and medical sub-specialities were also at higher risk (aOR 2·07 [95% CI 1·31-3·25]; p0·002). Staff from Black, Asian and minority ethnic (BAME) backgrounds had an aOR of 1·65 (95% CI 1·32 - 2·07; p0·001) compared to white staff; this increased risk was independent of COVID-19 area working. The only symptoms significantly associated with seropositivity in a multivariable model were loss of sense of taste or smell, fever, and myalgia; 31% of staff testing positive reported no prior symptoms.Risk of SARS-CoV-2 infection amongst HCWs is highly heterogeneous and influenced by COVID-19 working location, role, age and ethnicity. Increased risk amongst BAME staff cannot be accounted for solely by occupational factors.
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- 2022
10. Factors in childhood associated with lung function decline to adolescence in cystic fibrosis
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Nelufa Begum, Catherine A Byrnes, Joyce Cheney, Peter J Cooper, Emmanuelle Fantino, Nicholas Gailer, Keith Grimwood, Diana GutierrezCardenas, John Massie, Colin F Robertson, Peter D Sly, Harm AWM Tiddens, Claire E Wainwright, Robert S Ware, Radiology & Nuclear Medicine, and Pediatrics
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Adult ,Pulmonary and Respiratory Medicine ,Adolescent ,Cystic Fibrosis ,Vital Capacity ,SDG 3 - Good Health and Well-being ,Spirometry ,Child, Preschool ,Forced Expiratory Volume ,Pediatrics, Perinatology and Child Health ,Humans ,Longitudinal Studies ,Child ,Lung - Abstract
Background: Despite improvements in general health and life expectancy in people with cystic fibrosis (CF), lung function decline continues unabated during adolescence and early adult life. Methods: We examined factors present at age 5-years that predicted lung function decline from childhood to adolescence in a longitudinal study of Australasian children with CF followed from 1999 to 2017. Results: Lung function trajectories were calculated for 119 children with CF from childhood (median 5.0 [25%-75%=5.0–5.1]) years) to early adolescence (median 12.5 [25%-75%=11.4–13.8] years). Lung function fell progressively, with mean (standard deviation) annual change -0.105 (0.049) for forced vital capacity (FVC) Z-score (p1) Z-score (p1/FVC% (p1/FVC p = 0.001, FEF25–75 p = 0.01) and bronchoalveolar lavage neutrophil elastase activity (FEV1/FVC% p = 0.001, FEV1 p = 0.05, FEF25–75 p = 0.02). No examined factor predicted a decline in the FVC Z-score. Conclusions: Action in the first 5-years of life to prevent and/or treat respiratory exacerbations and counteract neutrophilic inflammation in the lower airways may reduce lung function decline in children with CF, and these should be targets of future research.
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- 2022
11. Bachelor of Science in Nursing students' perceptions of being a nurse: A scoping review
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Louise M, Allen, Simon J, Cooper, and Karen, Missen
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Humans ,Education, Nursing, Baccalaureate ,Students, Nursing ,Curriculum ,General Nursing - Abstract
High attrition rates in new graduate nurses maybe attributed to unrealistic perceptions of being a nurse. It is therefore important to identify nursing students' perceptions and the factors that influence them.The present study was conducted to identify and describe the literature relating to nursing students' perceptions of being a nurse. Research questions guiding the review were: (1) What are nursing students' perceptions of nursing? (2) What factors influence nursing students' perceptions of nursing?A scoping literature review was conducted between the years 2008 and March 2022 to capture nursing student perceptions from multiple countries, and year levels of study to note the changes in perceptions overtime. The data sources consisted of five electronic data bases; CINAHL, Medline, PsychINFO, Scopus, and Web of Science and search engine Google Scholar revealed 39 relevant sources. A scoping review methodology informed by the Joanna Briggs Institute and a published Scoping Review Checklist guided this review. An inductive thematic analysis identified five key themes.Key themes: Attributes and characteristics of nurses; Nursing as a profession; Skills required for nursing; Gender perceptions; and Influence of time and previous health work experience. Findings provide insight for future research to ensure the adequacy of curricula experiences in preparing new graduates for having realistic perceptions for practice.For nursing students to be prepared for the role of a nurse they must have realistic perceptions of what it means to be a nurse. Whilst it is evident that perceptions can be influenced by a variety of sources, this review highlights a lack of research pertaining to perceptions related to the physical, emotional, and social effects on an individual from being a nurse.
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- 2022
12. Contextual factors influencing patients' experiences of acute deterioration and medical emergency team ( <scp>MET</scp> ) encounter: A grounded theory study
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Catherine Chung, Lisa McKenna, and Simon J. Cooper
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Victoria ,Health Personnel ,Grounded Theory ,Humans ,Delivery of Health Care ,Qualitative Research ,General Nursing ,Quality of Health Care - Abstract
This paper explores the personal, social and structural factors that influence patients' experiences of acute deterioration and medical emergency team (MET) encounter.Patient experience is recognized as a means of assessing healthcare delivery with a positive experience being linked to high-quality healthcare, improved patient safety and reduced length of stay. The experience of acute deterioration is unique, extensive and complex. However, little is known about this experience from the patient's perspective.Constructivist grounded theory, informed by Kathy Charmaz, was used to explore the personal, social and structural factors that influence patients' experiences of acute deterioration and MET encounter.Using a semi-structured interview guide, in-depth individual interviews were conducted with 27 patients from three healthcare services in Victoria, Australia. Data were collected over a 12-month period from 2018 to 2019. Interview data were analysed using grounded theory processes.Contextual factors exert a powerful influence on patients' experiences of acute deterioration and MET encounter. The most significant factors identified include patients' expectations and illness perception, relationship with healthcare professionals during MET call and past experiences of acute illness. The expectations and perceptions patients had about their disease can condition their overall experience. Healthcare professional-patient interactions can significantly impact quality of care, patient experience and recovery. Patients' experiences of illness and healthcare can impact a person's future health-seeking behaviour and health status.Patients' actions and processes about their experiences of acute deterioration and MET encounter are the result of the complex interface of contextual factors.The findings from this study have highlighted the need for revised protocols for screening and management of patients who experience acute deterioration.
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- 2022
13. Helminth infections and allergic diseases: Systematic review and meta-analysis of the global literature
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Margarete Arrais, Tiago Maricoto, Bright I. Nwaru, Philip J. Cooper, Jorge M.R. Gama, Miguel Brito, and Luis Taborda-Barata
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Adult ,Hypersensitivity, Immediate ,Atopy ,Immunology ,Helminthiasis ,Rhinitis, Allergic ,Asthma ,Cross-Sectional Studies ,Helminths ,Allergic disease ,Animals ,Humans ,Immunology and Allergy ,Risk factor ,Bronchial Hyperreactivity ,Child - Abstract
INTRODUCTION: There is considerable research interest in the role of helminth infections in the development of allergic diseases. However, findings from previous studies are mixed. Existing systematic reviews of these studies are outdated. We performed a systematic review of the global literature on the association between helminth infections and development and clinical outcomes of allergic diseases. METHODS: We searched Cochrane Library, MEDLINE, EMBASE, ISI Web of Science, PubMed, Global Index Medicus, Scielo, KoreaMed, Google Scholar, and Lilacs for studies published up to January 2020. We included observational epidemiological studies (cohort, case-control and cross-sectional studies) of children and adults reporting associations between helminth infections and asthma, allergic rhinitis, eczema and atopy. We performed random-effects meta-analysis to summarize the effect estimates. RESULTS: We included 80 studies with 99,967 participants. In the meta-analyses, we did not observe an overall association between helminth infections and allergic diseases. There was, however, evidence that A. lumbricoides infections was associated with an increased risk of bronchial hyperreactivity in children (RR:1.41, 95%CI: 1.17-1.70; I2=50, p for I2=0.09), and was associated with an increased risk of atopy among helminth-infected adults (RR:1.37, 95%CI: 1.18-1.61; I2=52, p for I2=0.02). We found no study that addressed the association between helminth infection and clinical outcomes of allergic diseases. The overall strength of the underlying evidence was low to moderate. CONCLUSION: Helminth infections may increase the risk of bronchial hyperreactivity in children and atopy in adults. Well-designed longitudinal cohorts may help clarify potential causal associations between chronic helminth infections and allergic diseases.
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- 2022
14. Third-generation EGFR and ALK inhibitors: mechanisms of resistance and management
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Alissa J. Cooper, Lecia V. Sequist, and Jessica J. Lin
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ErbB Receptors ,Lung Neoplasms ,Oncology ,Drug Resistance, Neoplasm ,Carcinoma, Non-Small-Cell Lung ,Mutation ,Humans ,Anaplastic Lymphoma Kinase ,Protein Kinase Inhibitors ,Article - Abstract
The discoveries of EGFR mutations and ALK rearrangements as actionable oncogenic drivers in non-small-cell lung cancer (NSCLC) has propelled a biomarker-directed treatment paradigm for patients with advanced-stage disease. Numerous EGFR and ALK tyrosine kinase inhibitors (TKIs) with demonstrated efficacy in patients with EGFR-mutant and ALK-rearranged NSCLCs have been developed, culminating in the availability of the highly effective third-generation TKIs osimertinib and lorlatinib, respectively. Despite their marked efficacy, resistance to these agents remains an unsolved fundamental challenge. Both 'on-target' mechanisms (largely mediated by acquired resistance mutations in the kinase domains of EGFR or ALK) and 'off-target' mechanisms of resistance (mediated by non-target kinase alterations such as bypass signalling activation or phenotypic transformation) have been identified in patients with disease progression on osimertinib or lorlatinib. A growing understanding of the biology and spectrum of these mechanisms of resistance has already begun to inform the development of more effective therapeutic strategies. In this Review, we discuss the development of third-generation EGFR and ALK inhibitors, predominant mechanisms of resistance, and approaches to tackling resistance in the clinic, ranging from novel fourth-generation TKIs to combination regimens and other investigational therapies.
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- 2022
15. Discovery, validation, and diagnostic ability of multiple protein‐based biomarkers in saliva and gingival crevicular fluid to distinguish between health and periodontal diseases
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Melissa M. Grant, John J. Taylor, Katrin Jaedicke, Andrew Creese, Catherine Gowland, Bernard Burke, Khawla Doudin, Upen Patel, Paul Weston, Michael Milward, Susan M. Bissett, Helen J. Cooper, Gerben Kooijman, Amir Rmaile, Marko de Jager, Philip M. Preshaw, and Iain L. C. Chapple
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Matrix Metalloproteinase 9 ,Chronic Periodontitis ,Pyruvate Kinase ,Humans ,Periodontics ,Gingival Crevicular Fluid ,Saliva ,Gingivitis ,Biomarkers - Abstract
To discover and validate differential protein biomarker expression in saliva and gingival crevicular fluid (GCF) to discriminate objectively between periodontal health and plaque-induced periodontal disease states.One-hundred and ninety participants were recruited from two centres (Birmingham and Newcastle upon Tyne, UK) comprising healthy, gingivitis, periodontitis, and edentulous donors. Samples from the Birmingham cohort were analysed by quantitative mass spectrometry proteomics for biomarker discovery. Shortlisted candidate proteins were then verified by enzyme-linked immunosorbent assay in both cohorts. Leave-one-out cross validation logistic regression analysis was used to identify the best performing biomarker panels.Ninety-five proteins were identified in both GCF and saliva samples, and 15 candidate proteins were selected based upon differences discovered between the donor groups. The best performing panels to distinguish between: health or gingivitis and periodontitis contained matrix metalloproteinase-9 (MMP9), S100A8, alpha-1-acid glycoprotein (A1AGP), pyruvate kinase, and age (area under the curve [AUC] 0.970); health and gingivitis contained MMP9, S100A8, A1AGP, and pyruvate kinase, but not age (AUC 0.768); and mild to moderate and advanced periodontitis contained MMP9, S100A8, A1AGP, pyruvate kinase, and age (AUC 0.789).Biomarker panels containing four proteins with and without age as a further parameter can distinguish between periodontal health and disease states.
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- 2022
16. Development of a Care Pathway for Atrial Fibrillation Patients in the Emergency Department
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Duc H, Do, Breno, Bernardes-Souza, Michael, Merjanian, Brandan, Lombardo, David M, Donaldson, Lynnell B, McCullough, Noel G, Boyle, and Richelle J, Cooper
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Hospitalization ,Atrial Fibrillation ,Critical Pathways ,Anticoagulants ,Humans ,Emergency Service, Hospital ,Cardiology and Cardiovascular Medicine ,United States - Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia and its prevalence is continuously increasing in the United States, leading to a progressive rise in the number of disease-related emergency department (ED) visits and hospitalizations. Although optimal long-term outpatient management for AF is well defined, the guidelines for optimal ED management of acute AF episodes is less clear. Studies have demonstrated that discharging patients with AF from the ED after acute stabilization is both safe and cost effective; however, the majority of these patients in the United States and in our institution are admitted to the hospital. To improve care of these patients, we established a multidisciplinary collaboration to develop an evidence-based systematic approach for the treatment and management of AF in the ED, that led to the creation of the University of California-Cardioversion, Anticoagulation, Rate Control, Expedited Follow-up/Education Atrial Fibrillation Pathway. Our pathway focuses on the acute stabilization of AF, adherence to best practices for anticoagulation, and reduction in unnecessary admissions through discharge from the ED with expedited outpatient follow-up whenever safe. A novel aspect of our pathway is that it is primarily driven by the ED physicians, while other published protocols primarily involve consulting cardiologists to guide management in the ED. Our protocol is very pertinent considering the current trend toward increased AF prevalence in the United States, coupled with a need for widespread implementation of strategies aimed at improving management of these patients while safely reducing hospital admissions and the economic burden of AF.
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- 2022
17. Quantification of parasite clearance in Plasmodium knowlesi infections
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Jeyamalar T. Thurai Rathnam, Matthew J. Grigg, Saber Dini, Timothy William, Sitti Saimah Sakam, Daniel J. Cooper, Giri S. Rajahram, Bridget E. Barber, Nicholas M. Anstey, Ali Haghiri, Megha Rajasekhar, Julie A. Simpson, and Apollo - University of Cambridge Repository
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Plasmodium falciparum ,Bayes Theorem ,Chloroquine ,Parasitemia ,Parasite clearance rate ,Artemisinins ,Malaria ,Antimalarials ,Infectious Diseases ,Zoonoses ,Bayesian hierarchical modelling ,Animals ,Humans ,Parasitology ,Plasmodium knowlesi ,Parasites - Abstract
Funder: University of Melbourne's Research Scholarship, BACKGROUND: The incidence of zoonotic Plasmodium knowlesi infections in humans is rising in Southeast Asia, leading to clinical studies to monitor the efficacy of anti-malarial treatments for knowlesi malaria. One of the key outcomes of anti-malarial drug efficacy is parasite clearance. For Plasmodium falciparum, parasite clearance is typically estimated using a two-stage method, that involves estimating parasite clearance for individual patients followed by pooling of individual estimates to derive population estimates. An alternative approach is Bayesian hierarchical modelling which simultaneously analyses all parasite-time patient profiles to determine parasite clearance. This study compared these methods for estimating parasite clearance in P. knowlesi treatment efficacy studies, with typically fewer parasite measurements per patient due to high susceptibility to anti-malarials. METHODS: Using parasite clearance data from 714 patients with knowlesi malaria and enrolled in three trials, the Worldwide Antimalarial Resistance Network (WWARN) Parasite Clearance Estimator (PCE) standard two-stage approach and Bayesian hierarchical modelling were compared. Both methods estimate the parasite clearance rate from a model that incorporates a lag phase, slope, and tail phase for the parasitaemia profiles. RESULTS: The standard two-stage approach successfully estimated the parasite clearance rate for 678 patients, with 36 (5%) patients excluded due to an insufficient number of available parasitaemia measurements. The Bayesian hierarchical estimation method was applied to the parasitaemia data of all 714 patients. Overall, the Bayesian method estimated a faster population mean parasite clearance (0.36/h, 95% credible interval [0.18, 0.65]) compared to the standard two-stage method (0.26/h, 95% confidence interval [0.11, 0.46]), with better model fits (compared visually). Artemisinin-based combination therapy (ACT) is more effective in treating P. knowlesi than chloroquine, as confirmed by both methods, with a mean estimated parasite clearance half-life of 2.5 and 3.6 h, respectively using the standard two-stage method, and 1.8 and 2.9 h using the Bayesian method. CONCLUSION: For clinical studies of P. knowlesi with frequent parasite measurements, the standard two-stage approach (WWARN's PCE) is recommended as this method is straightforward to implement. For studies with fewer parasite measurements per patient, the Bayesian approach should be considered. Regardless of method used, ACT is more efficacious than chloroquine, confirming the findings of the original trials.
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- 2023
18. Reply to ‘Particular challenges in the use of pulmonary vasodilating therapy for patients with pulmonary hypertension secondary to left heart disease’
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Trond J. Cooper, Pierpaolo Pellicori, Anastasia Ushakova, and Kenneth Dickstein
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Heart Failure ,Heart Diseases ,Hypertension, Pulmonary ,Humans ,Heart ,Cardiology and Cardiovascular Medicine ,Lung - Published
- 2022
19. Zoonotic Ancylostoma ceylanicum Hookworm Infections, Ecuador
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William J, Sears, Jorge, Cardenas, Joseph, Kubofcik, Thomas B, Nutman, and Philip J, Cooper
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Ancylostomatoidea ,Microbiology (medical) ,Hookworm Infections ,Ancylostoma ,Infectious Diseases ,Epidemiology ,Zoonoses ,Animals ,Humans ,Ecuador ,Ancylostomiasis - Abstract
Ancylostoma ceylanicum hookworms are zoonotic parasites that can infect humans. To detect autochthonous transmission, we analyzed human fecal samples collected in 2000. Multiparallel quantitative PCR detected infection in persons who had never traveled outside Ecuador. These data indicate human transmission of A. ceylanicum in the Americas, although endemicity remains unknown.
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- 2022
20. Human Epidermal Growth Factor Receptor 2–Mutant Non–Small-Cell Lung Cancer: Continued Progress But Challenges Remain
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Alissa J. Cooper and Justin F. Gainor
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Cancer Research ,Lung Neoplasms ,Oncology ,Receptor, ErbB-2 ,Carcinoma, Non-Small-Cell Lung ,Humans - Published
- 2022
21. Back squat mechanics in persons with a unilateral transtibial amputation: A case study
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AuraLea Fain, Walter Lee Childers, and Kinyata J. Cooper
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Adult ,musculoskeletal diseases ,Knee Joint ,business.industry ,Rehabilitation ,Work (physics) ,Artificial Limbs ,Squat ,Mechanics ,Case description ,Health Professions (miscellaneous) ,Amputation, Surgical ,Biomechanical Phenomena ,medicine.anatomical_structure ,Amputees ,Transtibial amputation ,Humans ,Medicine ,Ankle ,business ,human activities ,Ankle Joint ,Foot (unit) - Abstract
CASE DESCRIPTION A 30-year-old person with a unilateral transtibial amputation (TTAmp) was assessed performing an Olympic-style back squat with an energy storage and return prosthetic foot. OBJECTIVE Determine joint-level movement strategies of an individual with TTAmp while performing an Olympic-style back squat. STUDY DESIGN Case study design. TREATMENT Back squat mechanics are evaluated in an individual with TTAmp by comparing the contribution of the ankle, knee, and hip joint to total positive and negative amputated and sound limb work. OUTCOMES The hip joint was the greatest contributor to total positive limb work compared with the knee and ankle, respectively, in the amputated (55.0% hip vs. 30.8% knee, P < 0.001; vs. 14.2% ankle, P = 0.001) and sound limbs (52.2% hip vs. 38.9% knee, P < 0.001; vs. 8.9% ankle, P < 0.001). The hip joint was the greatest contributor to total negative limb work compared with the ankle in both the amputated (51.0% hip vs. 15.9% ankle, P < 0.001) and sound limbs (47.3% hip vs. 10.0% ankle, P < 0.001) and the knee in the amputated limb (51.0% hip vs. 32.5% knee, P < 0.001). Ankle joint power demonstrated an atypical bimodal negative/positive/negative/positive pattern. CONCLUSION The individual with TTAmp used a hip-dominant joint strategy in both the amputated and sound limbs while demonstrating more potential to optimize the prosthetic foot's energy storage and return capabilities when performing a back squat.
- Published
- 2021
22. T Cells Promote Metastasis by Regulating Extracellular Matrix Remodeling following Chemotherapy
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Mahesh Devarasetty, Yuval Shaked, Tim J Cooper, Michael Timaner, Shay Soker, Avital Vorontsova, Tamar Barenholz-Cohen, Ruth Scherz-Shouval, Oshrat Levi-Galibov, Daphne Weihs, Jozafina Haj-Shomaly, Ziv Raviv, and Peleg Hasson
- Subjects
Cancer Research ,Adoptive cell transfer ,Lung Neoplasms ,Paclitaxel ,Breast Neoplasms ,Lysyl oxidase ,Mice, SCID ,CD8-Positive T-Lymphocytes ,Metastasis ,Protein-Lysine 6-Oxidase ,Extracellular matrix ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,medicine ,Animals ,Humans ,030304 developmental biology ,Mice, Knockout ,Extracellular Matrix Proteins ,Mice, Inbred BALB C ,0303 health sciences ,Chemistry ,Mammary Neoplasms, Experimental ,Cancer ,medicine.disease ,Adoptive Transfer ,Antineoplastic Agents, Phytogenic ,Extracellular Matrix ,3. Good health ,Oncology ,030220 oncology & carcinogenesis ,Cancer cell ,MCF-7 Cells ,Cancer research ,Female ,CD8 - Abstract
Metastasis is the main cause of cancer-related mortality. Despite intense efforts to understand the mechanisms underlying the metastatic process, treatment of metastatic cancer is still challenging. Here we describe a chemotherapy-induced, host-mediated mechanism that promotes remodeling of the extracellular matrix (ECM), ultimately facilitating cancer cell seeding and metastasis. Paclitaxel (PTX) chemotherapy enhanced rapid ECM remodeling and mechanostructural changes in the lungs of tumor-free mice, and the protein expression and activity of the ECM remodeling enzyme lysyl oxidase (LOX) increased in response to PTX. A chimeric mouse model harboring genetic LOX depletion revealed chemotherapy-induced ECM remodeling was mediated by CD8+ T cells expressing LOX. Consistently, adoptive transfer of CD8+ T cells, but not CD4+ T cells or B cells, from PTX-treated mice to naïve immunodeprived mice induced pulmonary ECM remodeling. Lastly, in a clinically relevant metastatic breast carcinoma model, LOX inhibition counteracted the metastasis-promoting, ECM-related effects of PTX. This study highlights the role of immune cells in regulating ECM and metastasis following chemotherapy, suggesting that inhibiting chemotherapy-induced ECM remodeling represents a potential therapeutic strategy for metastatic cancer. Significance: Chemotherapy induces prometastatic pulmonary ECM remodeling by upregulating LOX in T cells, which can be targeted with LOX inhibitors to suppress metastasis. See related commentary by Kolonin and Woodward, p. 197
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- 2021
23. Pre-SMA activation and the perception of contagiousness and authenticity in laughter sounds
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Robert J. Cooper, Sophie K. Scott, and Addison Billing
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Volition ,Laughter ,Cognitive Neuroscience ,media_common.quotation_subject ,Experimental and Cognitive Psychology ,Empathy ,Social behaviour ,SMA ,Sound ,Neuropsychology and Physiological Psychology ,Perception ,Auditory Perception ,Humans ,Psychology ,media_common ,Cognitive psychology - Abstract
Functional near-infrared spectroscopy and behavioural methods were used to examine the neural basis of the behavioural contagion and authenticity of laughter. We demonstrate that the processing of laughter sounds recruits networks previously shown to be related to empathy and auditory-motor mirror networks. Additionally, we found that the differences in the levels of activation in response to volitional and spontaneous laughter could predict an individual's perception of how contagious they found the laughter to be.
- Published
- 2021
24. Multi-institutional Validation of Improved Vesicoureteral Reflux Assessment With Simple and Machine Learning Approaches
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Adree Khondker, Jethro C. C. Kwong, Priyank Yadav, Justin Y. H. Chan, Anuradha Singh, Marta Skreta, Lauren Erdman, Daniel T. Keefe, Katherine Fischer, Gregory Tasian, Jessica H. Hannick, Frank Papanikolaou, Benjamin J. Cooper, Christopher S. Cooper, Mandy Rickard, and Armando J. Lorenzo
- Subjects
Vesico-Ureteral Reflux ,Machine Learning ,Cystography ,Urology ,Humans ,Reproducibility of Results ,Ureter ,Child ,Retrospective Studies - Abstract
Vesicoureteral reflux grading from voiding cystourethrograms is highly subjective with low reliability. We aimed to demonstrate improved reliability for vesicoureteral reflux grading with simple and machine learning approaches using ureteral tortuosity and dilatation on voiding cystourethrograms.Voiding cystourethrograms were collected from our institution for training and 5 external data sets for validation. Each voiding cystourethrogram was graded by 5-7 raters to determine a consensus vesicoureteral reflux grade label and inter- and intra-rater reliability was assessed. Each voiding cystourethrogram was assessed for 4 features: ureteral tortuosity, proximal, distal, and maximum ureteral dilatation. The labels were then assigned to the combination of the 4 features. A machine learning-based model, qVUR, was trained to predict vesicoureteral reflux grade from these features and model performance was assessed by AUROC (area under the receiver-operator-characteristic).A total of 1,492 kidneys and ureters were collected from voiding cystourethrograms resulting in a total of 8,230 independent gradings. The internal inter-rater reliability for vesicoureteral reflux grading was 0.44 with a median percent agreement of 0.71 and low intra-rater reliability. Higher values for each feature were associated with higher vesicoureteral reflux grade. qVUR performed with an accuracy of 0.62 (AUROC=0.84) with stable performance across all external data sets. The model improved vesicoureteral reflux grade reliability by 3.6-fold compared to traditional grading (In a large pediatric population from multiple institutions, we show that machine learning-based assessment for vesicoureteral reflux improves reliability compared to current grading methods. qVUR is generalizable and robust with similar accuracy to clinicians but the added prognostic value of quantitative measures warrants further study.
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- 2022
25. Impacts of Decentralized Environmental Governance on Andean Bear Conservation in Colombia
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Nathan P. Nibbelink, Rhianna R. Hohbein, and Robert J. Cooper
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Conservation of Natural Resources ,Global and Planetary Change ,Ecology ,biology ,Corporate governance ,Wildlife ,Context (language use) ,Colombia ,biology.organism_classification ,Pollution ,Decentralization ,Environmental Policy ,Environmental governance ,Development economics ,Animals ,Humans ,Business ,Natural resource management ,Tremarctos ornatus ,Ecosystem ,Ursidae ,Wildlife conservation - Abstract
Decentralized environmental governance has become increasingly common across much of Latin America and in developing countries more generally, yet the impacts of decentralization on wildlife conservation remain unclear. Decentralized environmental governance is thought to improve efficiency, local compliance, and democratic potential of natural resource management. However, wildlife conservation, especially that of large mammals, poses unique challenges in the context of decentralized governance: wildlife conservation is often expensive, requires large expanses of contiguous habitat, and often offers few economic benefits. We analyzed Colombia's decentralized environmental governance and its performance in conserving a contentious and border-crossing wildlife species, the Andean bear (Tremarctos ornatus). We considered both decentralized institutions and nongovernmental organizations (NGOs). This analysis is informed by 67 semi-structured interviews with conservation practitioners in Colombia. We found inconsistent program implementation across the country and little information exchange among institutions. These issues quite likely contribute to exacerbated human-bear conflict and thus more Andean bear deaths suggesting that the successful coordination of large-scale wildlife conservation may yet require the leadership of strong central institutions. A few international NGOs were working to improve Andean bear conservation in Colombia, but we saw little involvement at the national level of Colombian NGOs-some of whom felt they were being unfairly outcompeted by international elites. We recommend a greater engagement with Colombian NGOs (by both donors and international NGOs) as a means through which to ensure the integrity of Andean bear conservation into the future.
- Published
- 2021
26. Incidence and seasonality of respiratory viruses among medically attended children with acute respiratory infections in an Ecuador birth cohort, 2011–2014
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Eduardo Azziz-Baumgartner, Carmen S. Arriola, Meredith McMorrow, Michael Daugherty, Martha E. Chico, William W. Davis, Philip J. Cooper, Andrea Lopez, Alba Maria Ropero, Doménica de Mora, and Alfredo Bruno
- Subjects
Pulmonary and Respiratory Medicine ,Pediatrics ,medicine.medical_specialty ,Epidemiology ,respiratory syncytial virus ,Respiratory Syncytial Virus Infections ,Virus ,burden ,children ,Influenza, Human ,medicine ,Humans ,Respiratory system ,Child ,Respiratory Tract Infections ,Disease burden ,business.industry ,Incidence (epidemiology) ,Incidence ,Public Health, Environmental and Occupational Health ,Infant ,Original Articles ,Vaccination ,Infectious Diseases ,Child, Preschool ,Respiratory Syncytial Virus, Human ,Cohort ,Viruses ,Respiratory virus ,Original Article ,Birth Cohort ,Ecuador ,Seasons ,business ,Birth cohort ,influenza - Abstract
Background Ecuador annually has handwashing and respiratory hygiene campaigns and seasonal influenza vaccination to prevent respiratory virus illnesses but has yet to quantify disease burden and determine epidemic timing. Methods To identify respiratory virus burden and assess months with epidemic activity, we followed a birth cohort in northwest Ecuador during 2011–2014. Mothers brought children to the study clinic for routine checkups at ages 1, 2, 3, 5, and 8 years or if children experienced any acute respiratory illness symptoms (e.g., cough, fever, or difficulty breathing); clinical care was provided free of charge. Those with medically attended acute respiratory infections (MAARIs) were tested for common respiratory viruses via real‐time reverse‐transcription polymerase chain reaction (rRT‐PCR). Results In 2011, 2376 children aged 1–4 years (median 35 months) were enrolled in the respiratory cohort and monitored for 7017.5 child‐years (cy). The incidence of respiratory syncytial virus (RSV) was 23.9 (95% CI 17.3–30.5), influenza 10.6 (2.4–18.8), adenoviruses 6.7 (4.6–28.0), parainfluenzas 5.0 (2.3–10.5), and rhinoviruses, bocaviruses, human metapneumoviruses, seasonal coronaviruses, and enteroviruses
- Published
- 2021
27. Three dimensional modeling of biologically relevant fluid shear stress in human renal tubule cells mimics in vivo transcriptional profiles
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Nancy J. Cox, Roshan Darji, Emily J. Ross, Hanna Sothers, Emily R Gordon, Balabhaskar Prabhakarpandian, Oakley Baron, Sara J. Cooper, Dustin Haithcock, Richard M. Myers, and Kapil Pant
- Subjects
0301 basic medicine ,Science ,Kidney ,Endocytosis ,Cell morphology ,Models, Biological ,Article ,Kidney Tubules, Proximal ,Transcriptome ,03 medical and health sciences ,0302 clinical medicine ,Gene expression ,Genetics ,medicine ,Humans ,Biological models ,Genome ,Multidisciplinary ,Lab-on-a-chip ,Reabsorption ,Chemistry ,Gene Expression Profiling ,Cilium ,Computational Biology ,Biological Transport ,Epithelial Cells ,Cell biology ,Kidney Tubules ,030104 developmental biology ,medicine.anatomical_structure ,Gene Expression Regulation ,Cell culture ,030220 oncology & carcinogenesis ,Medicine ,Stress, Mechanical ,Shear Strength ,Biomarkers ,Signal Transduction - Abstract
The kidney proximal tubule is the primary site for solute reabsorption, secretion and where kidney diseases can originate, including drug-induced toxicity. Two-dimensional cell culture systems of the human proximal tubule cells (hPTCs) are often used to study these processes. However, these systems fail to model the interplay between filtrate flow, fluid shear stress (FSS), and functionality essential for understanding renal diseases and drug toxicity. The impact of FSS exposure on gene expression and effects of FSS at differing rates on gene expression in hPTCs has not been thoroughly investigated. Here, we performed RNA-sequencing of human RPTEC/TERT1 cells in a microfluidic chip-based 3D model to determine transcriptomic changes. We measured transcriptional changes following treatment of cells in this device at three different fluidic shear stress. We observed that FSS changes the expression of PTC-specific genes and impacted genes previously associated with renal diseases in genome-wide association studies (GWAS). At a physiological FSS level, we observed cell morphology, enhanced polarization, presence of cilia, and transport functions using albumin reabsorption via endocytosis and efflux transport. Here, we present a dynamic view of hPTCs response to FSS with increasing fluidic shear stress conditions and provide insight into hPTCs cellular function under biologically relevant conditions.
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- 2021
28. Revascularization for Renovascular Disease: A Scientific Statement From the American Heart Association
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Vivek, Bhalla, Stephen C, Textor, Joshua A, Beckman, Ana I, Casanegra, Christopher J, Cooper, Esther S H, Kim, James M, Luther, Sanjay, Misra, and Gustavo S, Oderich
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Hypertension, Renovascular ,Hypertension ,Internal Medicine ,Humans ,American Heart Association ,Prospective Studies ,Renal Artery Obstruction ,Vascular Surgical Procedures - Abstract
Renovascular disease is a major causal factor for secondary hypertension and renal ischemic disease. However, several prospective, randomized trials for atherosclerotic disease failed to demonstrate that renal revascularization is more effective than medical therapy for most patients. These results have greatly reduced the generalized diagnostic workup and use of renal revascularization. Most guidelines and review articles emphasize the limited average improvement and fail to identify those clinical populations that do benefit from revascularization. On the basis of the clinical experience of hypertension centers, specialists have continued selective revascularization, albeit without a summary statement by a major, multidisciplinary, national organization that identifies specific populations that may benefit. In this scientific statement for health care professionals and the public-at-large, we review the strengths and weaknesses of randomized trials in revascularization and highlight (1) when referral for consideration of diagnostic workup and therapy may be warranted, (2) the evidence/rationale for these selective scenarios, (3) interventional and surgical techniques for effective revascularization, and (4) areas of research with unmet need.
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- 2022
29. Potent and Selective Covalent Inhibition of the Papain-like Protease from SARS-CoV-2
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Brian C. Sanders, Suman Pokhrel, Audrey D. Labbe, Irimpan I. Mathews, Connor J. Cooper, Russell B. Davidson, Gwyndalyn Phillips, Kevin L. Weiss, Qiu Zhang, Hugh O’Neill, Manat Kaur, Jurgen G. Schmidt, Walter Reichard, Surekha Surendranathan, Jyothi Parvathareddy, Lexi Phillips, Christopher Rainville, David E. Sterner, Desigan Kumaran, Babak Andi, Gyorgy Babnigg, Nigel W. Moriarty, Paul D. Adams, Andrzej Joachimiak, Brett L. Hurst, Suresh Kumar, Tauseef R. Butt, Colleen B. Jonsson, Lori Ferrins, Soichi Wakatsuki, Stephanie Galanie, Martha S. Head, and Jerry M. Parks
- Subjects
Mammals ,Multidisciplinary ,SARS-CoV-2 ,Prevention ,General Physics and Astronomy ,COVID-19 ,General Chemistry ,Pneumonia ,Hepatitis C ,Antiviral Agents ,General Biochemistry, Genetics and Molecular Biology ,Vaccine Related ,Infectious Diseases ,Emerging Infectious Diseases ,Good Health and Well Being ,5.1 Pharmaceuticals ,Biodefense ,Papain ,Animals ,Humans ,Protease Inhibitors ,Chronic ,Development of treatments and therapeutic interventions ,Lung ,Peptide Hydrolases - Abstract
Direct-acting antivirals are needed to combat coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The papain-like protease (PLpro) domain of Nsp3 from SARS-CoV-2 is essential for viral replication. In addition, PLpro dysregulates the host immune response by cleaving ubiquitin and interferon-stimulated gene 15 protein (ISG15) from host proteins. As a result, PLpro is a promising target for inhibition by small-molecule therapeutics. Here we have designed a series of covalent inhibitors by introducing a peptidomimetic linker and reactive electrophile onto analogs of the noncovalent PLpro inhibitor GRL0617. The most potent compound inhibited PLpro with kinact/KI = 10,000 M− 1 s− 1, achieved sub-µM EC50 values against three SARS-CoV-2 variants in mammalian cell lines, and did not inhibit a panel of human deubiquitinases at > 30 µM concentrations of inhibitor. An X-ray co-crystal structure of the compound bound to PLpro validated our design strategy and established the molecular basis for covalent inhibition and selectivity against structurally similar human DUBs. These findings present an opportunity for further development of covalent PLpro inhibitors.
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- 2022
30. Anti-Restenotic Technologies in the SFA: Balloons and Stents
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Brent R. Keate and Kyle J. Cooper
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Femoral Artery ,Peripheral Arterial Disease ,Technology ,Treatment Outcome ,Coated Materials, Biocompatible ,Humans ,Radiology, Nuclear Medicine and imaging ,Popliteal Artery ,Stents ,Constriction, Pathologic ,Cardiology and Cardiovascular Medicine ,Angioplasty, Balloon - Abstract
Peripheral arterial disease (PAD) is a common condition, which significantly impacts the quality and length of life. In recent years, drug-eluting devices have demonstrated improved clinical effectiveness for treating peripheral arterial disease in the femoropopliteal arteries compared to traditional stents and angioplasty balloons. However, recent controversial studies have called the safety of this technology into question, leading to confusion as to if, when, and how these devices should be used. This article focuses on the underlying pathophysiology and pharmacology, the clinical benefits and potential harms, as well as expected future developments affecting the use of these drug-eluting technologies in treating peripheral arterial disease of the superficial femoral arteries.
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- 2022
31. LTK fusions: A new target emerges in non-small cell lung cancer
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Alissa J, Cooper, Lecia V, Sequist, Ted W, Johnson, and Jessica J, Lin
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Cancer Research ,Lung Neoplasms ,Oncology ,Carcinoma, Non-Small-Cell Lung ,Humans ,Receptor Protein-Tyrosine Kinases ,Anaplastic Lymphoma Kinase ,Gene Fusion ,Protein Kinase Inhibitors ,Article ,respiratory tract diseases - Abstract
Lung cancer is one of the most aggressive tumors. Targeted therapies stratified by oncogenic drivers has remarkably improved therapeutic outcomes in patients with non-small cell lung cancer (NSCLC) (1). However, such oncogenic drivers are not found in 25-40% of NSCLC cases (2). Here, we identified a novel fusion transcript of CLIP1 and LTK using whole transcriptome sequencing in a multi-institutional genome screening platform (LC-SCRUM-Asia, UMIN000036871). The CLIP1-LTK fusion was present in 0.4% of NSCLCs and was mutually exclusive with other known oncogenic drivers. We show that kinase activity of CLIP1-LTK fusion protein is constitutively activated and has transformation potential. Treatment of Ba/F3 cells expressing CLIP1-LTK with lorlatinib, an ALK inhibitor, inhibited CLIP1-LTK kinase activity, suppressed proliferation, and induced apoptosis. One NSCLC patient harboring the CLIP1-LTK fusion showed dramatic clinical responses to lorlatinib treatment. To our knowledge, this is the first description of LTK alterations with oncogenic activity in cancers. Our results demonstrate that the CLIP1-LTK fusion is a novel target in NSCLC, which could be treated with lorlatinib.
- Published
- 2022
32. Pooled CRISPR screening in pancreatic cancer cells implicates co-repressor complexes as a cause of multiple drug resistance via regulation of epithelial-to-mesenchymal transition
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Ryne C. Ramaker, Richard M. Myers, Emily R Gordon, Andrew A. Hardigan, Sara J. Cooper, and Carter A. Wright
- Subjects
0301 basic medicine ,Cancer Research ,Abcg2 ,Histone Deacetylase 1 ,Drug resistance ,0302 clinical medicine ,Cell Movement ,Gene expression ,CRISPR ,RNA-Seq ,RC254-282 ,0303 health sciences ,biology ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Precision oncology ,Phenotype ,Drug Resistance, Multiple ,Chromatin ,3. Good health ,Gene Expression Regulation, Neoplastic ,Oncology ,030220 oncology & carcinogenesis ,Gene Knockdown Techniques ,Chromatin Immunoprecipitation Sequencing ,Efflux ,Co-Repressor Proteins ,Carcinoma, Pancreatic Ductal ,Epithelial-Mesenchymal Transition ,ABCG2 ,Antineoplastic Agents ,03 medical and health sciences ,Pancreatic cancer ,Cell Line, Tumor ,Genetics ,medicine ,Humans ,Epithelial–mesenchymal transition ,Gene ,030304 developmental biology ,Genome-wide screen ,Research ,medicine.disease ,digestive system diseases ,HDAC1 ,Multiple drug resistance ,Pancreatic Neoplasms ,030104 developmental biology ,Drug Resistance, Neoplasm ,Cancer research ,biology.protein ,CRISPR-Cas Systems - Abstract
Background Pancreatic ductal adenocarcinoma (PDAC) patients suffer poor outcomes, including a five-year survival of below 10%. Poor outcomes result in part from therapeutic resistance that limits the impact of cytotoxic first-line therapy. Novel therapeutic approaches are needed, but currently no targeted therapies exist to treat PDAC. Methods To assess cellular resistance mechanisms common to four cytotoxic chemotherapies (gemcitabine, 5-fluorouracil, irinotecan, and oxaliplatin) used to treat PDAC patients, we performed four genome-wide CRISPR activation (CRISPRact) and CRISPR knock-out (CRISPRko) screens in two common PDAC cell lines (Panc-1 and BxPC3). We used pathway analysis to identify gene sets enriched among our hits and conducted RNA-sequencing and chromatin immunoprecipitation-sequencing (ChIP-seq) to characterize top hits from our screen. We used scratch assays to assess changes in cellular migration with HDAC1 overexpression. Results Our data revealed activation of ABCG2, a well-described efflux pump, as the most consistent mediator of resistance in each of our screens. CRISPR-mediated activation of genes involved in transcriptional co-repressor complexes also conferred resistance to multiple drugs. Expression of many of these genes, including HDAC1, is associated with reduced survival in PDAC patients. Up-regulation of HDAC1 in vitro increased promoter occupancy and expression of several genes involved in the epithelial-to-mesenchymal transition (EMT). These cells also displayed phenotypic changes in cellular migration consistent with activation of the EMT pathway. The expression changes resulting from HDAC1 activation were also observed with activation of several other co-repressor complex members. Finally, we developed a publicly available analysis tool, PancDS, which integrates gene expression profiles with our screen results to predict drug sensitivity in resected PDAC tumors and cell lines. Conclusion Our results provide a comprehensive resource for identifying cellular mechanisms of drug resistance in PDAC, mechanistically implicate HDAC1, and co-repressor complex members broadly, in multi-drug resistance, and provide an analytical tool for predicting treatment response in PDAC tumors and cell lines.
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- 2021
33. Impact of early life geohelminths on wheeze, asthma and atopy in Ecuadorian children at 8 years
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Philip J. Cooper, David P. Strachan, Mauricio Lima Barreto, Thomas A.E. Platts-Mills, Maritza Vaca, Augusto Maldonado, Yisela Oviedo, Irina Chis Ster, and Martha E. Chico
- Subjects
Hypersensitivity, Immediate ,0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,medicine.drug_class ,Immunology ,atopy ,geohelminths ,Asthma and Lower Airway Disease ,Atopy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Wheeze ,Bronchodilator ,parasitic diseases ,medicine ,Humans ,Immunology and Allergy ,Eosinophilia ,Trichiura ,Child ,Respiratory Sounds ,Skin Tests ,Asthma ,biology ,business.industry ,Infant, Newborn ,asthma ,respiratory system ,medicine.disease ,biology.organism_classification ,Early life ,respiratory tract diseases ,030104 developmental biology ,030228 respiratory system ,wheeze ,Exhaled nitric oxide ,Original Article ,Female ,Ecuador ,ORIGINAL ARTICLES ,medicine.symptom ,Ascaris lumbricoides ,business - Abstract
Background Early‐life exposures to geohelminths may protect against development of wheeze/asthma and atopy. Objective To study the effect of maternal geohelminths and infections in children during the first 5 years on atopy, wheeze/asthma and airways reactivity/inflammation at 8 years. Methods Birth cohort of 2404 neonates followed to 8 years in rural Ecuador. Data on wheeze/asthma were collected by questionnaire and atopy by skin prick test (SPT) reactivity to 9 allergens. We measured airways reactivity to bronchodilator, fractional exhaled nitric oxide (FeNO) and nasal eosinophilia. Stool samples were examined for geohelminths by microscopy. Results 1933 (80.4%) children were evaluated at 8 years. Geohelminths were detected in 45.8% of mothers and 45.5% of children to 5 years. Frequencies of outcomes at 8 years were as follows: wheeze (6.6%), asthma between 5 and 8 years (7.9%), SPT (14.7%), airways reactivity (10%) and elevated FeNO (10.3%) and nasal eosinophilia (9.2%). Any maternal geohelminth was associated with reduced SPT prevalence (OR 0.72). Childhood Trichuris trichiura infections during the first 5 years were associated with reduced wheeze (OR 0.57) but greater parasite burdens with Ascaris lumbricoides at 5 years were associated with increased wheeze (OR 2.83) and asthma (OR 2.60). Associations between maternal geohelminths and wheeze/asthma were modified by atopy. Parasite‐specific effects on wheeze/asthma and airways reactivity and inflammation were observed in non‐atopic children. Conclusions Our data provide novel evidence for persistent effects of in utero geohelminth exposures on childhood atopy but highlight the complex nature of the relationship between geohelminths and the airways. Registered as an observational study (ISRCTN41239086)., Maternal geohelminths protect 8‐year‐old children from the development of allergen skin prick test reactivity with strongest effects observed in infected children of infected mothers. Early childhood infections with Trichuris trichiura protect against wheeze at 8 years. Effects of geohelminths on wheeze/asthma and airways reactivity and inflammation at 8 years vary by parasite species and atopy.
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- 2021
34. Prognostic Value of Computed Tomography Versus Echocardiography Derived Right to Left Ventricular Diameter Ratio in Acute Pulmonary Embolism
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Pinang Shastri, Mohammad Al-Sarie, Nikita Ashcherkin, Osama Dasa, Christopher J. Cooper, Zaid Ammari, Ali Hasnie, Rajesh Gupta, Mohammed Ruzieh, and Pamela S. Brewster
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.drug_class ,Heart Ventricles ,030204 cardiovascular system & hematology ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Ventricular Dysfunction ,Natriuretic peptide ,medicine ,Pulmonary angiography ,Humans ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Computed tomography angiography ,Aged, 80 and over ,medicine.diagnostic_test ,biology ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Troponin ,Pulmonary embolism ,medicine.anatomical_structure ,Respiratory failure ,Echocardiography ,Ventricle ,Acute Disease ,Cardiology ,biology.protein ,Female ,Pulmonary Embolism ,Tomography, X-Ray Computed ,business - Abstract
Computed Tomography (CT) Pulmonary Angiography is the most commonly used diagnostic study for acute pulmonary embolism (PE). Echocardiogram (ECHO) is also used for risk stratification in acute PE, however the diagnostic performance of CT versus ECHO for risk stratification remains unclear.CT and ECHO right ventricle (RV) and left ventricle (LV) diameters were measured in a retrospective cohort of patients with acute PE. RV:LV diameter ratios were calculated and correlation between CT and ECHO RV:LV ratio was assessed. Sensitivity and specificity for the composite adverse events endpoint of mortality, respiratory failure requiring intubation, cardiac arrest, or shock requiring vasopressors within 30 days of admission were assessed for CT or ECHO derived RV:LV ratio alone and in combination with biomarkers (troponin or B-type natriuretic peptide).A total of 74 subjects met the inclusion criteria and had a mean age of 62±18 years. The proportion of patients with RV:LV1 was similar when comparing CT (37.8%) versus ECHO (33.8%) (P = 0.61). A statistically significant correlation was found between CT derived and ECHO derived RV:LV diameter ratio (r = 0.832, P0.001). The sensitivity and specificity to predict 30-day composite adverse events for CT versus ECHO derived RV:LV diameter ratio1 together with positive biomarker status was similar with sensitivity and specificity of 87% and 41% versus 87% and 42%, respectively.In patients with acute PE, CT and ECHO RV:LV diameter ratio correlate well and identify similar proportion of PE patients at risk for early adverse events. These findings may streamline risk stratification of patients with acute PE.
- Published
- 2021
35. Smartphone-based photogrammetry provides improved localization and registration of scalp-mounted neuroimaging sensors
- Author
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Ilaria Mazzonetto, Marco Castellaro, Robert J. Cooper, and Sabrina Brigadoi
- Subjects
Electroencephalography ,Humans ,Neuroimaging ,Photogrammetry ,Scalp ,Smartphone ,Multidisciplinary ,Near-infrared spectroscopy ,Biomedical engineering ,Neuroscience - Abstract
Functional near infrared spectroscopy and electroencephalography are non-invasive techniques that rely on sensors placed over the scalp. The spatial localization of the measured brain activity requires the precise individuation of sensor positions and, when individual anatomical information is not available, the accurate registration of these sensor positions to a head atlas. Both these issues could be successfully addressed using a photogrammetry-based method. In this study we demonstrate that sensor positions can be accurately detected from a video recorded with a smartphone, with a median localization error of 0.7 mm, comparable if not lower, to that of conventional approaches. Furthermore, we demonstrate that the additional information of the shape of the participant’s head can be further exploited to improve the registration of the sensor’s positions to a head atlas, reducing the median sensor localization error of 31% compared to the standard registration approach.
- Published
- 2022
36. Plasmodium vivax malaria serological exposure markers: Assessing the degree and implications of cross-reactivity with P. knowlesi
- Author
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Rhea J. Longley, Matthew J. Grigg, Kael Schoffer, Thomas Obadia, Stephanie Hyslop, Kim A. Piera, Narimane Nekkab, Ramin Mazhari, Eizo Takashima, Takafumi Tsuboi, Matthias Harbers, Kevin Tetteh, Chris Drakeley, Chetan E. Chitnis, Julie Healer, Wai-Hong Tham, Jetsumon Sattabongkot, Michael T. White, Daniel J. Cooper, Giri S. Rajahram, Bridget E. Barber, Timothy William, Nicholas M. Anstey, Ivo Mueller, The Walter and Eliza Hall Institute of Medical Research (WEHI), University of Melbourne, Charles Darwin University [Australia], Hub Bioinformatique et Biostatistique - Bioinformatics and Biostatistics HUB, Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Epidémiologie et Analyse des Maladies Infectieuses - Infectious Disease Epidemiology and Analytics, Ehime University [Matsuyama, Japon], RIKEN Center for Integrative Medical Sciences [Yokohama] (RIKEN IMS), RIKEN - Institute of Physical and Chemical Research [Japon] (RIKEN), London School of Hygiene and Tropical Medicine (LSHTM), Biologie de Plasmodium et Vaccins - Malaria Parasite Biology and Vaccines, Mahidol University [Bangkok], University of Cambridge [UK] (CAM), Hospital Queen Elizabeth II [Kota Kinabalu, Sabah, Malaysia], Infectious Diseases Society Kota Kinabalu Sabah [Malaysia], Gleneagles Hospital [Kota Kinabalu, Sabah, Malaysia], WEHI Innovation Fund (R.L., I.M.). Clinical Trials Funding: Malaysian Ministry of Health (grant number BP00500420), the Asia Pacific Malaria Elimination Network (108-07), and the Australian National Health and Medical Research Council (NHMRC, 1037304, 1045156, 115680). NHMRC Fellowships to N.M.A. #1135820, M.J.G. #1138860, and R.L. #1173210. NHMRC grants #1092789, #1134989, #1132975 and #1043345 (I.M.). M.J.G. was also supported by the Australian Centre for International Agricultural Research (Grant# LS-2019-116)., Tham, Wai-Hong [0000-0001-7950-8699], and Apollo - University of Cambridge Repository
- Subjects
antibody cross-reactivity ,species cross-reactivity ,General Biochemistry, Genetics and Molecular Biology ,Article ,Malaria ,serosurveillance ,serological exposure markers ,Immunoglobulin G ,Malaria, Vivax ,antibodies ,Humans ,Plasmodium knowlesi ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Plasmodium vivax ,malaria elimination ,ComputingMilieux_MISCELLANEOUS - Abstract
Serological markers are a promising tool for surveillance and targeted interventions for Plasmodium vivax malaria. P. vivax is closely related to the zoonotic parasite P. knowlesi, which also infects humans. P. vivax and P. knowlesi are co-endemic across much of South East Asia, making it important to design serological markers that minimize cross-reactivity in this region. To determine the degree of IgG cross-reactivity against a panel of P. vivax serological markers, we assayed samples from human patients with P. knowlesi malaria. IgG antibody reactivity is high against P. vivax proteins with high sequence identity with their P. knowlesi ortholog. IgG reactivity peaks at 7 days post-P. knowlesi infection and is short-lived, with minimal responses 1 year post-infection. We designed a panel of eight P. vivax proteins with low levels of cross-reactivity with P. knowlesi. This panel can accurately classify recent P. vivax infections while reducing misclassification of recent P. knowlesi infections.
- Published
- 2022
37. Fertility preservation practices for female oncofertility differ significantly across the USA: results of a survey of SREI members
- Author
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Leah J. Cooper, Benjamin R. Emery, Kenneth Aston, Douglas Fair, Mitchell P. Rosen, Erica Johnstone, and Joseph M. Letourneau
- Subjects
Cryopreservation ,Male ,Obstetrics and Gynecology ,Fertility Preservation ,General Medicine ,Cross-Sectional Studies ,Reproductive Medicine ,Semen ,Neoplasms ,Surveys and Questionnaires ,Genetics ,Humans ,Female ,Genetics (clinical) ,Developmental Biology - Abstract
The field of oncofertility has maintained an important focus on improving access, yet standardized practices are lacking. To assess how female cancer patients are provided oncofertility care, we sought to determine provider-level differences and whether there are physician or practice characteristics that predict these variations.A cross-sectional survey was sent to SREI members. The survey included fifteen questions about physician practice characteristics and oncofertility cryopreservation protocols. Topics included ovarian stimulation protocols, fertilization techniques, stage of embryo cryopreservation, routine use of pre-implantation genetic testing for aneuploidy (PGT-A), and ovarian tissue cryopreservation (OTC). Statistical analyses assessed whether practice setting, geographic region, time in practice, and mandatory state insurance coverage had effects on cryopreservation protocols.A total of 141 (17%) from diverse REI practice backgrounds completed the survey. The median number of new female oncofertility consults per year was 30 (range 1 to 300). Providers in academic settings treated more patients (median 40 vs. 15, p 0.001). Providers in academic settings more often use gonadotropin-releasing hormone agonists (85% vs. 52%, p 0.001) and perform OTC (41% vs. 4%, p 0.001). Providers in academic practices were less likely to perform intracytoplasmic sperm injection in every cycle (37% vs. 55%, p = 0.032) and less likely to usually advise PGT-A (21% vs. 36%, p = 0.001). Mandated state insurance coverage had no effect on oncofertility practices.Oncofertility practices vary among providers. Factors such as practice setting and region may affect the services provided. We do not yet know the best practices in oncofertility patients, and future research is needed.
- Published
- 2022
38. Long-Term Mortality in Obstructive Hypertrophic Cardiomyopathy: Looking Beyond the Assigned Treatment
- Author
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George V, Moukarbel and Christopher J, Cooper
- Subjects
Treatment Outcome ,Heart Septum ,Humans ,Cardiomyopathy, Hypertrophic - Published
- 2022
39. Telehealth in the Field of Developmental-Behavioral Pediatrics: Advantages, Challenges, and Future Perspectives
- Author
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Dianne McBrien, Marcio Leyser, Matthew J. O’Brien, Linda J. Cooper-Brown, Lane Strathearn, and Kelly M. Schieltz
- Subjects
2019-20 coronavirus outbreak ,Behavioral pediatrics ,Telemedicine ,Medical education ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Field (Bourdieu) ,Telehealth ,Pediatrics ,Health Services Accessibility ,Psychiatry and Mental health ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology ,Humans ,Child ,Psychology - Published
- 2021
40. Operative Duration and Short-Term Postoperative Complications after Unicompartmental Knee Arthroplasty
- Author
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Roshan P. Shah, Herbert J. Cooper, Nana O. Sarpong, Michael B. Held, Jeffrey A. Geller, and Venkat Boddapati
- Subjects
Reoperation ,musculoskeletal diseases ,medicine.medical_specialty ,Multivariate analysis ,Blood transfusion ,medicine.medical_treatment ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Blood Transfusion ,Orthopedics and Sports Medicine ,Postoperative Period ,Risk factor ,Arthroplasty, Replacement, Knee ,Unicompartmental knee arthroplasty ,Retrospective Studies ,030222 orthopedics ,business.industry ,Odds ratio ,Osteoarthritis, Knee ,Confidence interval ,Surgery ,Treatment Outcome ,Orthopedic Procedures ,business ,Complication - Abstract
Prolonged operative duration is an independent risk factor for postoperative complications in many orthopedic procedures ranging from shoulder arthroscopy to total hip and knee arthroplasties. It has not been well studied in unicompartmental knee arthroplasty (UKA). The purpose of this study is to assess the effect of operative duration on complications after UKA.Using the American College of Surgeons National Surgical Quality Improvement Program registry, we identified all primary unilateral UKAs from 2005 to 18. Patients were divided into three cohorts based on the operative duration:90 minutes, between 90 and 120 minutes, and120 minutes. Baseline patient and operative demographics (age, gender, etc.) and thirty-day complications were compared using bivariate analysis. Multivariate analysis was used to assess the independent effect of operative duration on postoperative outcomes after adjusting for differences in baseline characteristics.We identified 11,806 patients who underwent primary UKA from 2005 to 18. There was no difference in the "any complication" rate between cohorts. However, operative duration120 minutes was associated with a significantly higher likelihood of reoperation (odds ratio [OR] 2.02, 95% confidence interval [CI]: 1.15-3.57, P = .015), non-home discharge (OR: 2.14, CI: 1.65-2.77, P.001), surgical site infection (OR: 1.76, CI: 1.03-3.01, P = .038), and blood transfusions (OR: 3.23, CI: 1.44-7.22, P = .004) when compared with operative duration90 minutes. There was no difference in mortality rates.Increased operative duration greater than 2 hours in primary UKA is associated with an increased risk of non-home discharge, surgical site infection, reoperation, and blood transfusion.
- Published
- 2021
41. Liquid Extraction Surface Analysis Mass Spectrometry of ESKAPE Pathogens
- Author
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Helen J. Cooper, Iain B. Styles, Jana Havlikova, and Robin C. May
- Subjects
Acinetobacter baumannii ,Staphylococcus aureus ,food.ingredient ,Klebsiella pneumoniae ,Enterococcus faecium ,Chemical Fractionation ,010402 general chemistry ,Mass spectrometry ,medicine.disease_cause ,01 natural sciences ,Microbiology ,food ,Bacterial Proteins ,Structural Biology ,Tandem Mass Spectrometry ,Enterobacter cloacae ,medicine ,Agar ,Humans ,Databases, Protein ,Spectroscopy ,Bacteriological Techniques ,biology ,Chemistry ,Pseudomonas aeruginosa ,010401 analytical chemistry ,Bacterial Infections ,biology.organism_classification ,0104 chemical sciences ,Solvents ,Research Article - Abstract
The ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter cloacae) represent clinically important bacterial species that are responsible for most hospital-acquired drug-resistant infections; hence, the need for rapid identification is of high importance. Previous work has demonstrated the suitability of liquid extraction surface analysis mass spectrometry (LESA MS) for the direct analysis of colonies of two of the ESKAPE pathogens (Staphylococcus aureus and Pseudomonas aeruginosa) growing on agar. Here, we apply LESA MS to the remaining four ESKAPE species (E. faecium E745, K. pneumoniae KP257, A. baumannii AYE, and E. cloacae S11) as well as E. faecalis V583 (a close relative of E. faecium) and a clinical isolate of A. baumannii AC02 using an optimized solvent sampling system. In each case, top-down LESA MS/MS was employed for protein identification. In total, 24 proteins were identified from 37 MS/MS spectra by searching against protein databases for the individual species. The MS/MS spectra for the identified proteins were subsequently searched against multiple databases from multiple species in an automated data analysis workflow with a view to determining the accuracy of identification of unknowns. Out of 24 proteins, 19 were correctly assigned at the protein and species level, corresponding to an identification success rate of 79%.
- Published
- 2021
42. Emergency physician stressors, concerns, and behavioral changes during COVID‐19: A longitudinal study
- Author
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Elissa S. Epel, Stephen Lim, Remi Frazier, Anthony J. Medak, Brigitte M. Baumann, Robert M. Rodriguez, Brian W. Roberts, Brian Chinnock, Richelle J. Cooper, and Mycyk, Mark B
- Subjects
Male ,Longitudinal study ,physicians ,Cross-sectional study ,Original Contributions ,Clinical Sciences ,Logistic regression ,Basic Behavioral and Social Science ,stress ,03 medical and health sciences ,COVID-19 Testing ,0302 clinical medicine ,Clinical Research ,emergency medicine ,COVID‐19 ,Surveys and Questionnaires ,Behavioral and Social Science ,medicine ,Humans ,Longitudinal Studies ,COVID-emergency medicine ,Pandemics ,SARS-CoV-2 ,business.industry ,Prevention ,Stressor ,COVID-19 ,030208 emergency & critical care medicine ,Original Contribution ,General Medicine ,Odds ratio ,Post-Traumatic Stress Disorder (PTSD) ,Anxiety Disorders ,Emergency & Critical Care Medicine ,COVID‐ ,Confidence interval ,Brain Disorders ,Mental Health ,Cross-Sectional Studies ,Test score ,Public Health and Health Services ,Emergency Medicine ,Anxiety ,psychological ,Female ,medicine.symptom ,business ,Demography - Abstract
Author(s): Baumann, Brigitte M; Cooper, Richelle J; Medak, Anthony J; Lim, Stephen; Chinnock, Brian; Frazier, Remi; Roberts, Brian W; Epel, Elissa S; Rodriguez, Robert M | Abstract: ObjectivesThe objective was to provide a longitudinal assessment of anxiety levels and work and home concerns of U.S. emergency physicians during the COVID-19 pandemic.MethodsWe performed a longitudinal, cross-sectional email survey of clinically active emergency physicians (attending, fellow, and resident) at seven academic emergency departments. Follow-up surveys were sent 4 to 6nweeks after the initial survey and assessed the following: COVID-19 patient exposure, availability of COVID-19 testing, levels of home and workplace anxiety/stress, changes in behaviors, and performance on a primary care posttraumatic stress disorder screen (PC-PTSD-5). Logistic regression explored factors associated with a high PC-PTSD-5 scale score (≥3), indicating increased risk for PTSD.ResultsOf the 426 surveyed initial respondents, 262 (61.5%) completed the follow-up survey. While 97.3% (255/262) reported treating suspected COVID-19 patients, most physicians (162/262, 61.8%) had not received testing themselves. In follow-up, respondents were most concerned about the relaxing of social distancing leading to a second wave (median scoren= 6, IQRn= 4-7). Physicians reported a consistently high ability to order COVID-19 tests for patients (median scoren= 6, IQRn= 5-7) and access to personal protective equipment (median scoren= 6, IQRn= 5-6). Women physicians were more likely to score ≥ 3 than men on the PC-PTSD-5 screener on the initial survey (43.3% vs. 22.5%; Δ 20.8%, 95% confidence interval [CI]n= 9.3% to 31.5%), and despite decreases in overall proportions, this discrepancy remained in follow-up (34.7% vs. 16.8%; Δ 17.9%, 95% CIn= 7.1% to 28.1%). In examining the relationship between demographics, living situations, and institution location on having a PC-PTSD-5 score ≥ 3, only female sex was associated with a PC-PTSD-5 score ≥ 3 (adjusted odds ration= 2.48, 95% CIn= 1.28 to 4.79).ConclusionsWhile exposure to suspected COVID-19 patients was nearly universal, stress levels in emergency physicians decreased with time. At both initial and follow-up assessments, women were more likely to test positive on the PC-PTSD-5 screener compared to men.
- Published
- 2021
43. Translational control of enzyme scavenger expression with toxin-induced micro RNA switches
- Author
-
Justin J. Cooper-White, Nina M. Pollak, and Joanne Macdonald
- Subjects
0301 basic medicine ,Time Factors ,Computer science ,medicine.disease_cause ,Biochemistry ,Synthetic biology ,0302 clinical medicine ,Inducer ,chemistry.chemical_classification ,Regulation of gene expression ,Multidisciplinary ,biology ,Biological activity ,Enzymes ,030220 oncology & carcinogenesis ,Toxicity ,Medicine ,Science ,Computational biology ,Article ,03 medical and health sciences ,Theophylline ,Cytochrome P-450 CYP1A2 ,In vivo ,Detoxification ,microRNA ,medicine ,Humans ,Molecule ,Gene Silencing ,Biological computation ,Toxins, Biological ,Base Sequence ,business.industry ,Toxin ,Modular design ,Scavenger (chemistry) ,Enzyme assay ,Enzyme Activation ,MicroRNAs ,HEK293 Cells ,030104 developmental biology ,Enzyme ,chemistry ,Protein Biosynthesis ,biology.protein ,Nucleic Acid Conformation ,RNA ,business - Abstract
Biological computation requires in vivo control of molecular behavior to progress development of autonomous devices. miRNA switches represent excellent, easily engineerable synthetic biology tools to achieve user-defined gene regulation. Here we present the construction of a synthetic network to implement detoxification functionality. We employed a modular design strategy by engineering toxin-induced control of an enzyme scavenger. Our miRNA switch results show moderate synthetic expression control over a biologically active detoxification enzyme molecule, using an established design protocol. However, following a new design approach, we demonstrated an evolutionarily designed miRNA switch to more effectively activate enzyme activity than synthetically designed versions, allowing markedly improved extrinsic user-defined control with a toxin as inducer. Our straightforward new design approach is simple to implement and uses easily accessible web-based databases and prediction tools. The ability to exert control of toxicity demonstrates potential for modular detoxification systems that provide a pathway to new therapeutic and biocomputing applications.
- Published
- 2021
44. A role for GLUT3 in glioblastoma cell invasion that is not recapitulated by GLUT1
- Author
-
Corinne E. Augelli-Szafran, Sarah E Williford, Sara J. Cooper, Catherine J. Libby, Sajina Gc, Anita B. Hjelmeland, Anh Nhat Tran, Victor M. Darley-Usmar, Sixue Zhang, Kaysaw Tuy, Emily R Gordon, Juan Gordillo, Jennifer L. Fisher, William A. Flavahan, Ashlee Long, Brittany N. Lasseigne, Amber Jones, and Gloria A. Benavides
- Subjects
0301 basic medicine ,Nerve Tissue Proteins ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Circulating tumor cell ,Downregulation and upregulation ,Glioma ,medicine ,Humans ,RNA-Seq ,Osteopontin ,Glucose transporter ,Glucose Transporter Type 1 ,QH573-671 ,Glucose Transporter Type 3 ,biology ,Brain Neoplasms ,glioblastoma ,Cell Biology ,invasion ,medicine.disease ,Gene Expression Regulation, Neoplastic ,030104 developmental biology ,030220 oncology & carcinogenesis ,biology.protein ,Cancer research ,GLUT1 ,Cytology ,metabolism ,Research Article ,Research Paper ,GLUT3 ,Extracellular matrix organization - Abstract
The multifaceted roles of metabolism in invasion have been investigated across many cancers. The brain tumor glioblastoma (GBM) is a highly invasive and metabolically plastic tumor with an inevitable recurrence. The neuronal glucose transporter 3 (GLUT3) was previously reported to correlate with poor glioma patient survival and be upregulated in GBM cells to promote therapeutic resistance and survival under restricted glucose conditions. It has been suggested that the increased glucose uptake mediated by GLUT3 elevation promotes survival of circulating tumor cells to facilitate metastasis. Here we suggest a more direct role for GLUT3 in promoting invasion that is not dependent upon changes in cell survival or metabolism. Analysis of glioma datasets demonstrated that GLUT3, but not GLUT1, expression was elevated in invasive disease. In human xenograft derived GBM cells, GLUT3, but not GLUT1, elevation significantly increased invasion in transwell assays, but not growth or migration. Further, there were no changes in glycolytic metabolism that correlated with invasive phenotypes. We identified the GLUT3 C-terminus as mediating invasion: substituting the C-terminus of GLUT1 for that of GLUT3 reduced invasion. RNA-seq analysis indicated changes in extracellular matrix organization in GLUT3 overexpressing cells, including upregulation of osteopontin. Together, our data suggest a role for GLUT3 in increasing tumor cell invasion that is not recapitulated by GLUT1, is separate from its role in metabolism and survival as a glucose transporter, and is likely broadly applicable since GLUT3 expression correlates with metastasis in many solid tumors.
- Published
- 2021
45. What can we learn from measuring IgE to allergens and allergen components in tropical and subtropical settings in Brazil?
- Author
-
Philip J. Cooper
- Subjects
biology ,business.industry ,Subtropics ,Allergens ,Immunoglobulin E ,medicine.disease_cause ,Pediatrics ,RJ1-570 ,Allergen ,Pediatrics, Perinatology and Child Health ,Immunology ,biology.protein ,Humans ,Medicine ,business ,Brazil - Published
- 2021
46. Safety of Cefazolin for Perioperative Prophylaxis in Patients with Penicillin Allergy Labels
- Author
-
Jocelyn J. Cooper, Vidya L. Atluri, Rupali Jain, Paul S. Pottinger, and David T. Coleman
- Subjects
Pulmonary and Respiratory Medicine ,Drug Hypersensitivity ,Immunology ,Cefazolin ,Immunology and Allergy ,Humans ,Penicillins ,Antibiotic Prophylaxis ,Article ,Anti-Bacterial Agents - Published
- 2022
47. Reduced sister chromatid cohesion acts as a tumor penetrance modifier
- Author
-
Jun Wang, Holly R. Thomas, Yu Chen, Stefanie M. Percival, Stephanie C. Waldrep, Ryne C. Ramaker, Robert G. Thompson, Sara J. Cooper, Zechen Chong, and John M. Parant
- Subjects
Cancer Research ,Chromosomal Proteins, Non-Histone ,Cell Cycle Proteins ,Penetrance ,Chromatids ,Mice ,Acetyltransferases ,Chromosome Segregation ,Neoplasms ,Genetics ,Animals ,Humans ,Tumor Suppressor Protein p53 ,Molecular Biology ,Genetics (clinical) ,Ecology, Evolution, Behavior and Systematics ,Zebrafish - Abstract
Sister chromatid cohesion (SCC) is an important process in chromosome segregation. ESCO2 is essential for establishment of SCC and is often deleted/altered in human cancers. We demonstrate that esco2 haploinsufficiency results in reduced SCC and accelerates the timing of tumor onset in both zebrafish and mouse p53 heterozygous null models, but not in p53 homozygous mutant or wild-type animals. These data indicate that esco2 haploinsufficiency accelerates tumor onset in a loss of heterozygosity (LOH) sensitive background. Analysis of The Cancer Genome Atlas (TCGA) confirmed ESCO2 deficient tumors have elevated number of LOH events throughout the genome. Further, we demonstrated heterozygous loss of sgo1, important in maintaining SCC, also results in reduced SCC and accelerated tumor formation in a p53 heterozygous background. Surprisingly, while we did observe elevated levels of chromosome missegregation and micronuclei formation in esco2 heterozygous mutant animals, this chromosomal instability did not contribute to the accelerated tumor onset in a p53 heterozygous background. Interestingly, SCC also plays a role in homologous recombination, and we did observe elevated levels of mitotic recombination derived p53 LOH in tumors from esco2 haploinsufficient animals; as well as elevated levels of mitotic recombination throughout the genome of human ESCO2 deficient tumors. Together these data suggest that reduced SCC contributes to accelerated tumor penetrance through elevated mitotic recombination.
- Published
- 2022
48. Property space mapping of Pseudomonas aeruginosa permeability to small molecules
- Author
-
Inga V. Leus, Jon W. Weeks, Vincent Bonifay, Yue Shen, Liang Yang, Connor J. Cooper, Dinesh Nath, Adam S. Duerfeldt, Jeremy C. Smith, Jerry M. Parks, Valentin V. Rybenkov, and Helen I. Zgurskaya
- Subjects
Multidisciplinary ,Cell Membrane ,Gram-Negative Bacteria ,Pseudomonas aeruginosa ,Humans ,Microbial Sensitivity Tests ,Permeability ,Anti-Bacterial Agents - Abstract
Two membrane cell envelopes act as selective permeability barriers in Gram-negative bacteria, protecting cells against antibiotics and other small molecules. Significant efforts are being directed toward understanding how small molecules permeate these barriers. In this study, we developed an approach to analyze the permeation of compounds into Gram-negative bacteria and applied it to Pseudomonas aeruginosa, an important human pathogen notorious for resistance to multiple antibiotics. The approach uses mass spectrometric measurements of accumulation of a library of structurally diverse compounds in four isogenic strains of P. aeruginosa with varied permeability barriers. We further developed a machine learning algorithm that generates a deterministic classification model with minimal synonymity between the descriptors. This model predicted good permeators into P. aeruginosa with an accuracy of 89% and precision above 58%. The good permeators are broadly distributed in the property space and can be mapped to six distinct regions representing diverse chemical scaffolds. We posit that this approach can be used for more detailed mapping of the property space and for rational design of compounds with high Gram-negative permeability.
- Published
- 2022
49. Transcriptomic Analysis of Canine Osteosarcoma from a Precision Medicine Perspective Reveals Limitations of Differential Gene Expression Studies
- Author
-
Rebecca L. Nance, Sara J. Cooper, Dmytro Starenki, Xu Wang, Brad Matz, Stephanie Lindley, Annette N. Smith, Ashley A. Smith, Noelle Bergman, Maninder Sandey, Jey Koehler, Payal Agarwal, and Bruce F. Smith
- Subjects
Osteosarcoma ,Sleep Apnea, Obstructive ,Dogs ,Genetics ,Animals ,Humans ,osteosarcoma ,transcriptome ,sequencing ,cancer ,canine ,Bone Neoplasms ,Dog Diseases ,Precision Medicine ,Transcriptome ,Genetics (clinical) - Abstract
Despite significant advances in cancer diagnosis and treatment, osteosarcoma (OSA), an aggressive primary bone tumor, has eluded attempts at improving patient survival for many decades. The difficulty in managing OSA lies in its extreme genetic complexity, drug resistance, and heterogeneity, making it improbable that a single-target treatment would be beneficial for the majority of affected individuals. Precision medicine seeks to fill this gap by addressing the intra- and inter-tumoral heterogeneity to improve patient outcome and survival. The characterization of differentially expressed genes (DEGs) unique to the tumor provides insight into the phenotype and can be useful for informing appropriate therapies as well as the development of novel treatments. Traditional DEG analysis combines patient data to derive statistically inferred genes that are dysregulated in the group; however, the results from this approach are not necessarily consistent across individual patients, thus contradicting the basis of precision medicine. Spontaneously occurring OSA in the dog shares remarkably similar clinical, histological, and molecular characteristics to the human disease and therefore serves as an excellent model. In this study, we use transcriptomic sequencing of RNA isolated from primary OSA tumor and patient-matched normal bone from seven dogs prior to chemotherapy to identify DEGs in the group. We then evaluate the universality of these changes in transcript levels across patients to identify DEGs at the individual level. These results can be useful for reframing our perspective of transcriptomic analysis from a precision medicine perspective by identifying variations in DEGs among individuals.
- Published
- 2022
50. Single gene targeted nanopore sequencing enables simultaneous identification and antimicrobial resistance detection of sexually transmitted infections
- Author
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Natalia Romero Sandoval, Andrea A. Lopez Rodas, Luz Marina Llangarí, Sadiq Tariq Sadiq, Liqing Zhou, and Philip J. Cooper
- Subjects
Gene Sequencing ,Mycoplasma genitalium ,Artificial Gene Amplification and Extension ,medicine.disease_cause ,Polymerase Chain Reaction ,Biochemistry ,Medical Conditions ,Medicine and Health Sciences ,DNA sequencing ,Pathogen ,Trichomonas Vaginalis ,Multidisciplinary ,biology ,Database and informatics methods ,Sequence analysis ,Eukaryota ,Protists ,Anti-Bacterial Agents ,Nucleic acids ,RNA, Ribosomal, 23S ,Infectious Diseases ,Ribosomal RNA ,DNA Gyrase ,Vagina ,Trichomonas ,Medicine ,Female ,Ecuador ,Macrolides ,Fluoroquinolones ,Research Article ,Cell biology ,Cellular structures and organelles ,Bioinformatics ,Science ,Sexually Transmitted Diseases ,Real-Time Polymerase Chain Reaction ,Research and Analysis Methods ,Microbiology ,Antibiotic resistance ,Microbial Control ,Drug Resistance, Bacterial ,medicine ,Humans ,Molecular Biology Techniques ,Sequencing Techniques ,Non-coding RNA ,Molecular Biology ,BLAST algorithm ,Pharmacology ,Sex Workers ,Organisms ,Biology and Life Sciences ,biology.organism_classification ,Virology ,Neisseria gonorrhoeae ,Nanopore Sequencing ,RNA ,Trichomonas vaginalis ,Nanopore sequencing ,Antimicrobial Resistance ,Chlamydia trachomatis ,Ribosomes - Abstract
Objectives To develop a simple DNA sequencing test for simultaneous identification and antimicrobial resistance (AMR) detection of multiple sexually transmitted infections (STIs). Methods Real-time PCR (qPCR) was initially performed to identify Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) and Trichomonas vaginalis (TV) infections among a total of 200 vulvo-vaginal swab samples from female sex workers in Ecuador. qPCR positive samples plus qPCR negative controls for these STIs were subjected to single gene targeted PCR MinION-nanopore sequencing using the smartphone operated MinIT. Results Among 200 vulvo-vaginal swab samples 43 were qPCR positive for at least one of the STIs. Single gene targeted nanopore sequencing generally yielded higher pathogen specific read counts in qPCR positive samples than qPCR negative controls. Of the 26 CT, NG or MG infections identified by qPCR, 25 were clearly distinguishable from qPCR negative controls by read count. Discrimination of TV qPCR positives from qPCR negative controls was poorer as many had low pathogen loads (qPCR cycle threshold >35) which produced few specific reads. Real-time AMR profiling revealed that 3/3 NG samples identified had gyrA mutations associated with fluoroquinolone resistance, 2/10 of TV had mutations related to metronidazole resistance, while none of the MG samples possessed 23S rRNA gene mutations contributing to macrolide resistance. Conclusions Single gene targeted nanopore sequencing for diagnosing and simultaneously identifying key antimicrobial resistance markers for four common genital STIs shows promise. Further work to optimise accuracy, reduce costs and improve speed may allow sustainable approaches for managing STIs and emerging AMR in resource poor and laboratory limited settings.
- Published
- 2022
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