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1. Common data elements for clinical research in mitochondrial disease: a National Institute for Neurological Disorders and Stroke project

Author

Karaa, Amel, Rahman, Shamima, Lombès, Anne, Yu‐Wai‐Man, Patrick, Sheikh, Muniza K, Alai‐Hansen, Sherita, Cohen, Bruce H, Dimmock, David, Emrick, Lisa, Falk, Marni J, McCormack, Shana, Mirsky, David, Moore, Tony, Parikh, Sumit, Shoffner, John, Taivassalo, Tanja, Tarnopolsky, Mark, Tein, Ingrid, Odenkirchen, Joanne C, Goldstein, Amy, and Participants:, on behalf of the Mito Working Group Member

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Brain Disorders, Neurosciences, Biomedical Research, Common Data Elements, Data Collection, Humans, Mitochondrial Diseases, National Institute of Neurological Disorders and Stroke (U.S.), Nervous System Diseases, Research Design, Stroke, United States, Mito Working Group Member Participants:, Genetics & Heredity, Genetics, Clinical sciences
Abstract

ObjectivesThe common data elements (CDE) project was developed by the National Institute of Neurological Disorders and Stroke (NINDS) to provide clinical researchers with tools to improve data quality and allow for harmonization of data collected in different research studies. CDEs have been created for several neurological diseases; the aim of this project was to develop CDEs specifically curated for mitochondrial disease (Mito) to enhance clinical research.MethodsNine working groups (WGs), composed of international mitochondrial disease experts, provided recommendations for Mito clinical research. They initially reviewed existing NINDS CDEs and instruments, and developed new data elements or instruments when needed. Recommendations were organized, internally reviewed by the Mito WGs, and posted online for external public comment for a period of eight weeks. The final version was again reviewed by all WGs and the NINDS CDE team prior to posting for public use.ResultsThe NINDS Mito CDEs and supporting documents are publicly available on the NINDS CDE website ( https://commondataelements.ninds.nih.gov/ ), organized into domain categories such as Participant/Subject Characteristics, Assessments, and Examinations.ConclusionWe developed a comprehensive set of CDE recommendations, data definitions, case report forms (CRFs), and guidelines for use in Mito clinical research. The widespread use of CDEs is intended to enhance Mito clinical research endeavors, including natural history studies, clinical trial design, and data sharing. Ongoing international collaboration will facilitate regular review, updates and online publication of Mito CDEs, and support improved consistency of data collection and reporting.

Published
2017

2. The DGCR8 RNA-binding heme domain recognizes primary microRNAs by clamping the hairpin.

Author

Quick-Cleveland, Jen, Jacob, Jose, Weitz, Sara, Shoffner, Grant, Senturia, Rachel, and Guo, Feng

Subjects
Binding Sites, Heme, Humans, MicroRNAs, Nucleic Acid Conformation, Protein Binding, Protein Conformation, Protein Structure, Tertiary, RNA-Binding Proteins
Abstract

Canonical primary microRNA transcripts (pri-miRNAs) are characterized by a ∼30 bp hairpin flanked by single-stranded regions. These pri-miRNAs are recognized and cleaved by the Microprocessor complex consisting of the Drosha nuclease and its obligate RNA-binding partner DGCR8. It is not well understood how the Microprocessor specifically recognizes pri-miRNA substrates. Here, we show that in addition to the well-known double-stranded RNA-binding domains, DGCR8 uses a dimeric heme-binding domain to directly contact pri-miRNAs. This RNA-binding heme domain (Rhed) directs two DGCR8 dimers to bind each pri-miRNA hairpin. The two Rhed-binding sites are located at both ends of the hairpin. The Rhed and its RNA-binding surface are important for pri-miRNA processing activity. Additionally, the heme cofactor is required for formation of processing-competent DGCR8-pri-miRNA complexes. Our study reveals a unique protein-RNA interaction central to pri-miRNA recognition. We propose a unifying model in which two DGCR8 dimers clamp a pri-miRNA hairpin using their Rheds.

Published
2014

3. Ortholog identification in the presence of domain architecture rearrangement

Author

Sjölander, Kimmen, Datta, Ruchira S, Shen, Yaoqing, and Shoffner, Grant M

Subjects
Biological Sciences, Bioinformatics and Computational Biology, Genetics, Generic health relevance, Animals, Computational Biology, Databases, Factual, Evolution, Molecular, Genome, Humans, Phylogeny, Proteins, phylogenomics, orthology, promiscuous domains, multi-domain architecture, function prediction, super-ortholog, Biochemistry and Cell Biology, Computation Theory and Mathematics, Other Information and Computing Sciences, Bioinformatics, Biochemistry and cell biology, Bioinformatics and computational biology
Abstract

Ortholog identification is used in gene functional annotation, species phylogeny estimation, phylogenetic profile construction and many other analyses. Bioinformatics methods for ortholog identification are commonly based on pairwise protein sequence comparisons between whole genomes. Phylogenetic methods of ortholog identification have also been developed; these methods can be applied to protein data sets sharing a common domain architecture or which share a single functional domain but differ outside this region of homology. While promiscuous domains represent a challenge to all orthology prediction methods, overall structural similarity is highly correlated with proximity in a phylogenetic tree, conferring a degree of robustness to phylogenetic methods. In this article, we review the issues involved in orthology prediction when data sets include sequences with structurally heterogeneous domain architectures, with particular attention to automated methods designed for high-throughput application, and present a case study to illustrate the challenges in this area.

Published
2011

4. Systems serology detects functionally distinct coronavirus antibody features in children and elderly

Author

Allen C. Cheng, Francesca L Mordant, Katherine Kedzierska, Keith J. Chappell, Daniel Watterson, Brendon Y. Chua, Hannah G. Kelly, Suzanne K. Shoffner, Jane Crowe, Carolien E. van de Sandt, Melissa M. Lemke, Naphak Modhiran, Bruce D. Wines, Fatima Amanat, Thi H. O. Nguyen, Adam K. Wheatley, Marios Koutsakos, Wen Shi Lee, Hyon-Xhi Tan, Luca Hensen, Kelly B. Arnold, David C. Jackson, Paul R. Young, Amy W. Chung, Paul V. Licciardi, Katie L. Flanagan, Shidan Tosif, Samantha K Davis, Louise C. Rowntree, Chinn Yi Wong, Jennifer A Juno, Stephen J. Kent, Nigel W Crawford, P. Mark Hogarth, Philip Sutton, Melanie R Neeland, Robyn Esterbauer, Kevin J. Selva, Florian Krammer, Denise L. Doolan, Christina Lee, and Landsteiner Laboratory

Subjects
0301 basic medicine, Immunoglobulin A, Antibody Formation/immunology, viruses, Antibodies, SARS-CoV-2, COVID-19, Infection, Viral infection, General Physics and Astronomy, Antibodies, Viral, medicine.disease_cause, Viral/blood, Immunoglobulin G, Serology, Antibodies, Viral/blood, 0302 clinical medicine, Immunoglobulin A/blood, Receptors, 80 and over, Medicine, Child, skin and connective tissue diseases, Coronavirus, Aged, 80 and over, Multidisciplinary, biology, virus diseases, Middle Aged, Spike Glycoprotein, 3. Good health, Vaccination, COVID-19/immunology, Child, Preschool, 030220 oncology & carcinogenesis, Spike Glycoprotein, Coronavirus, Antibody, Adult, COVID-19 Vaccines, Adolescent, Science, Cross Reactions, Article, General Biochemistry, Genetics and Molecular Biology, SARS-CoV-2/immunology, 03 medical and health sciences, Young Adult, Humans, Preschool, Aged, business.industry, Receptors, IgG, fungi, Coronavirus/immunology, General Chemistry, biochemical phenomena, metabolism, and nutrition, Receptors, IgG/immunology, Immunoglobulin M/blood, body regions, 030104 developmental biology, Immunoglobulin M, Immunoglobulin G/blood, Antibody Formation, Humoral immunity, Immunology, biology.protein, IgG/immunology, Spike Glycoprotein, Coronavirus/immunology, COVID-19 Vaccines/immunology, Cross Reactions/immunology, business
Abstract

The hallmarks of COVID-19 are higher pathogenicity and mortality in the elderly compared to children. Examining baseline SARS-CoV-2 cross-reactive immunological responses, induced by circulating human coronaviruses (hCoVs), is needed to understand such divergent clinical outcomes. Here we show analysis of coronavirus antibody responses of pre-pandemic healthy children (n = 89), adults (n = 98), elderly (n = 57), and COVID-19 patients (n = 50) by systems serology. Moderate levels of cross-reactive, but non-neutralizing, SARS-CoV-2 antibodies are detected in pre-pandemic healthy individuals. SARS-CoV-2 antigen-specific Fcγ receptor binding accurately distinguishes COVID-19 patients from healthy individuals, suggesting that SARS-CoV-2 infection induces qualitative changes to antibody Fc, enhancing Fcγ receptor engagement. Higher cross-reactive SARS-CoV-2 IgA and IgG are observed in healthy elderly, while healthy children display elevated SARS-CoV-2 IgM, suggesting that children have fewer hCoV exposures, resulting in less-experienced but more polyreactive humoral immunity. Age-dependent analysis of COVID-19 patients, confirms elevated class-switched antibodies in elderly, while children have stronger Fc responses which we demonstrate are functionally different. These insights will inform COVID-19 vaccination strategies, improved serological diagnostics and therapeutics., Antibody responses to SARS-CoV-2 are critical in the immune response to infection, but the potential cross-reactivity to other human corona viruses is poorly appreciated. Here the authors apply a systems based approach to characterise the antibody response in pre-pandemic cohorts and assess heterotypic reactivity to SARS-CoV-2.

Published
2021

5. Uncovering Racial Bias

Author

Kathy Schoonover-Shoffner

Subjects
Black or African American, Racism, Humans, General Medicine
Published
2022

6. Impact of Surveillance After Lobectomy for Lung Cancer on Disease Detection and Survival

Author

Nicholas R. Mayne, Mark F. Berry, Mohan K. Mallipeddi, Walid R. Eltaraboulsi, Chi-Fu Jeffrey Yang, Ibtehaj A. Naqvi, Adam R. Shoffner, Thomas A. D'Amico, and Alice J. Darling

Subjects
Male, 0301 basic medicine, Pulmonary and Respiratory Medicine, Cancer Research, medicine.medical_specialty, Lung Neoplasms, Disease detection, Adenocarcinoma of Lung, Subgroup analysis, Single Center, Complete resection, 03 medical and health sciences, 0302 clinical medicine, Carcinoma, Non-Small-Cell Lung, Recurrent disease, Humans, Medicine, Prospective Studies, Stage (cooking), Pneumonectomy, Lung cancer, Aged, Retrospective Studies, business.industry, Incidence (epidemiology), Middle Aged, Prognosis, medicine.disease, Survival Rate, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Female, Radiology, Neoplasm Recurrence, Local, Tomography, X-Ray Computed, business, Follow-Up Studies, SEER Program
Abstract

Existing guidelines for surveillance after non-small-cell lung cancer (NSCLC) treatment are inconsistent and have relatively sparse supporting literature. This study characterizes detection rates of metachronous and recurrent disease during surveillance with computed tomography scans after definitive treatment of early stage NSCLC.The incidence of metachronous and recurrent disease in patients who previously underwent complete resection via lobectomy for stage IA NSCLC at a single center from 1996 to 2010 were evaluated. A subgroup analysis was used to compare survival of patients whose initial surveillance scan was 6 ± 3 months (early) versus 12 ± 3 months (late) after lobectomy.Of 294 eligible patients, 49 (17%) developed recurrent disease (14 local only, 35 distant), and 45 (15%) developed new NSCLC. Recurrent disease was found at a mean of 22 ± 19 months, and new primaries were found at a mean of 52 ± 31 months after lobectomy (P .01). Five-year survival after diagnosis of recurrent disease was significantly lower than after diagnosis of second primaries (2.3% vs. 57.5%; P .001). In the subgroup analysis of 187 patients, both disease detection on the initial scan (2% [2/94] vs. 4% [4/93]; P = .44) and 5-year survival (early, 80.8% vs. late, 86.7%; P = .61) were not significantly different between the early (n = 94) and the late (n = 93) groups.Surveillance after lobectomy for stage IA NSCLC is useful for identifying both new primary as well as recurrent disease, but waiting to start surveillance until 12 ± 3 months after surgery is unlikely to miss clinically important findings.

Published
2020
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7. SARS-CoV-2 infection results in immune responses in the respiratory tract and peripheral blood that suggest mechanisms of disease severity

Author

Wuji Zhang, Brendon Y. Chua, Kevin J. Selva, Lukasz Kedzierski, Thomas M. Ashhurst, Ebene R. Haycroft, Suzanne K. Shoffner-Beck, Luca Hensen, David F. Boyd, Fiona James, Effie Mouhtouris, Jason C. Kwong, Kyra Y. L. Chua, George Drewett, Ana Copaescu, Julie E. Dobson, Louise C. Rowntree, Jennifer R. Habel, Lilith F. Allen, Hui-Fern Koay, Jessica A. Neil, Matthew J. Gartner, Christina Y. Lee, Patiyan Andersson, Sadid F. Khan, Luke Blakeway, Jessica Wisniewski, James H. McMahon, Erica E. Vine, Anthony L. Cunningham, Jennifer Audsley, Irani Thevarajan, Torsten Seemann, Norelle L. Sherry, Fatima Amanat, Florian Krammer, Sarah L. Londrigan, Linda M. Wakim, Nicholas J. C. King, Dale I. Godfrey, Laura K. Mackay, Paul G. Thomas, Suellen Nicholson, Kelly B. Arnold, Amy W. Chung, Natasha E. Holmes, Olivia C. Smibert, Jason A. Trubiano, Claire L. Gordon, Thi H. O. Nguyen, and Katherine Kedzierska

Subjects
Multidisciplinary, SARS-CoV-2, Respiratory System, Immunity, General Physics and Astronomy, COVID-19, General Chemistry, Antibodies, Viral, Severity of Illness Index, General Biochemistry, Genetics and Molecular Biology, Article, Coronavirus, Immunoglobulin M, Immunoglobulin G, Spike Glycoprotein, Coronavirus, Humans
Abstract

Although the respiratory tract is the primary site of SARS-CoV-2 infection and the ensuing immunopathology, respiratory immune responses are understudied and urgently needed to understand mechanisms underlying COVID-19 disease pathogenesis. We collected paired longitudinal blood and respiratory tract samples (endotracheal aspirate, sputum or pleural fluid) from hospitalized COVID-19 patients and non-COVID-19 controls. Cellular, humoral and cytokine responses were analysed and correlated with clinical data. SARS-CoV-2-specific IgM, IgG and IgA antibodies were detected using ELISA and multiplex assay in both the respiratory tract and blood of COVID-19 patients, although a higher receptor binding domain (RBD)-specific IgM and IgG seroconversion level was found in respiratory specimens. SARS-CoV-2 neutralization activity in respiratory samples was detected only when high levels of RBD-specific antibodies were present. Strikingly, cytokine/chemokine levels and profiles greatly differed between respiratory samples and plasma, indicating that inflammation needs to be assessed in respiratory specimens for the accurate assessment of SARS-CoV-2 immunopathology. Diverse immune cell subsets were detected in respiratory samples, albeit dominated by neutrophils. Importantly, we also showed that dexamethasone and/or remdesivir treatment did not affect humoral responses in blood of COVID-19 patients. Overall, our study unveils stark differences in innate and adaptive immune responses between respiratory samples and blood and provides important insights into effect of drug therapy on immune responses in COVID-19 patients.

Published
2022

8. Fall 2021 Update: Navigating COVID Vaccination in Tumultuous Times

Author

Kathy Schoonover-Shoffner

Subjects
emergency use authorization (EUA), COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), layered prevention strategies, SARS-CoV-2, Vaccination, COVID-19, General Medicine, Research findings, Nursing, nursing, Political science, Pandemic, Humans, herd immunity, COVID vaccination, JCN Online Exclusive: NCPD Connection: for continuing education, Pandemics
Abstract

The COVID-19 pandemic and subsequent development of COVID vaccines have resulted in unique challenges for nurses. Nurses are being asked to make recommendations about vaccinations that have only been available since December 2020 even as vaccine information evolves on an almost daily basis. Standards of professional care and a Christian perspective on nursing to help guide nurses' practice in the current climate are discussed in this article. An overview of information and research findings published up to October 31, 2021 about COVID-19 vaccination is given to assist nurses in answering vaccination questions.

Published
2021

10. The Pain of Infertility

Author

Kathy Schoonover-Shoffner

Subjects
Infertility, Male, Psychotherapist, medicine, Humans, Pain, Female, General Medicine, Bible, Psychology, medicine.disease, Insider
Abstract

Infertility, the inability to conceive and/or carry a baby to term, is an agonizing experience for many. Both the experience and pain of infertility are ancient, shared by women and men of the Bible and by couples today. An insider's look into infertility can help nurses understand the suffering that occurs, suggest what can be said and done that can be helpful as well as hurtful, and offer insight into what can be gained personally and spiritually through the experience of infertility.

Published
2021

11. Spiritual Care at the Bedside

Author

Kathy Schoonover-Shoffner, Chintan K. Somaiya, Elizabeth Johnston Taylor, Carla Gober-Park, Khaled Bahjri, and Iris Mamier

Subjects
Point-of-Care Systems, media_common.quotation_subject, MEDLINE, Religiosity, Faith, 03 medical and health sciences, 0302 clinical medicine, Nursing, Surveys and Questionnaires, Spirituality, Humans, Conversation, 030212 general & internal medicine, media_common, Internet, Practice Patterns, Nurses', 030504 nursing, Parish Nursing, General Medicine, United States, humanities, Prayer, Spiritual care, 0305 other medical science, Psychology
Abstract

Little is known about how nurses' personal spirituality and religious (S/R) beliefs impact their spiritual care of patients. An online survey was used to collect data from 445 nurses, assessing facets of religiosity, their opinions about introducing S/R during patient care, demographic, and work-related variables. Findings indicated that even in a sample of Christian nurses who scored high on religiousness measures, spiritual care is infrequent. Nurses' opinions about whether it was appropriate to initiate S/R conversation, self-disclosure, and prayer were associated with aspects of nurse religiosity. Nurses working in a faith-based organization were more likely to believe they could initiate S/R conversation and offer prayer.

Published
2019
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12. Immune responses to SARS-CoV-2 in three children of parents with symptomatic COVID-19

Author

Richard Saffery, Kevin J. Selva, Rachel A Higgins, Daniel G. Pellicci, Celeste M. Donato, Nigel Curtis, David Burgner, Shidan Tosif, Sohinee Sarkar, Amy W. Chung, Katie L. Flanagan, Christina Lee, Katherine Kedzierska, Sarah McNab, Suzanne K. Shoffner, Kanta Subbarao, Melissa M. Lemke, Andrew C Steer, Kim Mulholland, Nigel W Crawford, Francesca L Mordant, Julie E Bines, Kelly B. Arnold, Carolien E. van de Sandt, Kate Dohle, Melanie R Neeland, Paul V. Licciardi, Zheng Quan Toh, Lien Anh Ha Do, Philip Sutton, and Landsteiner Laboratory

Subjects
CD4-Positive T-Lymphocytes, Male, Parents, 0301 basic medicine, Immunoglobulin A, viruses, General Physics and Astronomy, CD8-Positive T-Lymphocytes, Antibodies, Viral, medicine.disease_cause, Viral/blood, Monocytes, Immunoglobulin G, Serology, Antibodies, Viral/blood, 0302 clinical medicine, Immunoglobulin A/blood, Medicine, 030212 general & internal medicine, lcsh:Science, skin and connective tissue diseases, Child, Viral/immunology, Coronavirus, Multidisciplinary, biology, Middle Aged, Spike Glycoprotein, 3. Good health, Child, Preschool, Spike Glycoprotein, Coronavirus, CD4-Positive T-Lymphocytes/immunology, Cytokines, Female, Antibody, medicine.symptom, Coronavirus Infections, Adult, Science, Immunology, Pneumonia, Viral, Enzyme-Linked Immunosorbent Assay, Paediatric research, CD8-Positive T-Lymphocytes/immunology, Cytokines/blood, Pneumonia, Viral/immunology, Asymptomatic, Article, Antibodies, General Biochemistry, Genetics and Molecular Biology, Betacoronavirus, Coronavirus Infections/immunology, 03 medical and health sciences, Immune system, Saliva/immunology, Immunity, Humans, Serologic Tests, Saliva, Preschool, Pandemics, Betacoronavirus/immunology, SARS-CoV-2, business.industry, fungi, Australia, COVID-19, Monocytes/immunology, Coronavirus/immunology, Pneumonia, General Chemistry, biochemical phenomena, metabolism, and nutrition, body regions, 030104 developmental biology, Immunoglobulin G/blood, biology.protein, lcsh:Q, Spike Glycoprotein, Coronavirus/immunology, business
Abstract

Compared to adults, children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have predominantly mild or asymptomatic infections, but the underlying immunological differences remain unclear. Here, we describe clinical features, virology, longitudinal cellular, and cytokine immune profile, SARS-CoV-2-specific serology and salivary antibody responses in a family of two parents with PCR-confirmed symptomatic SARS-CoV-2 infection and their three children, who tested repeatedly SARS-CoV-2 PCR negative. Cellular immune profiles and cytokine responses of all children are similar to their parents at all timepoints. All family members have salivary anti-SARS-CoV-2 antibodies detected, predominantly IgA, that coincide with symptom resolution in 3 of 4 symptomatic members. Plasma from both parents and one child have IgG antibody against the S1 protein and virus-neutralizing activity detected. Using a systems serology approach, we demonstrate higher levels of SARS-CoV-2-specific antibody features of these family members compared to healthy controls. These data indicate that children can mount an immune response to SARS-CoV-2 without virological confirmation of infection, raising the possibility that immunity in children can prevent the establishment of SARS-CoV-2 infection. Relying on routine virological and serological testing may not identify exposed children, with implications for epidemiological and clinical studies across the life-span., Children with SARS-CoV-2 infection are more likely to have mild symptoms and may be asymptomatic, but underlying reasons remain unclear. Here, the authors show cellular, cytokine and antibody response to SARS-CoV-2 infection in three children who repeatedly tested negative for the virus by PCR, despite high exposure in the household.

Published
2020

13. The Difference Rehabilitation Makes

Author

Tami Rudder and Kathy Schoonover-Shoffner

Subjects
Male, medicine.medical_specialty, Rehabilitation, Traumatic brain injury, business.industry, medicine.medical_treatment, Cognition, General Medicine, medicine.disease, Medical care, medicine, Physical therapy, Humans, Female, business
Abstract

Physical medicine and rehabilitation, or physiatry, is comprehensive medical care that helps a person get back, keep, or improve his or her physical, mental, or cognitive abilities needed for daily life. Six hallmarks of rehabilitation were discovered by this nurse author after her husband suffered a severe traumatic brain injury and was cared for at Madonna Rehabilitation Hospitals.

Published
2020

14. Approaches to interdisciplinary mixed methods research in land-change science and environmental management

Author

Elizabeth Shoffner, Megan Mills-Novoa, Katherine J. Siegel, Aldo Farah-Pérez, and Eva Kinnebrew

Subjects
0106 biological sciences, Research design, Typology, Vocabulary, Conservation of Natural Resources, Ecology, Computer science, business.industry, 010604 marine biology & hydrobiology, Multimethodology, media_common.quotation_subject, Environmental resource management, 010603 evolutionary biology, 01 natural sciences, Research Personnel, Variety (cybernetics), Exchange of information, Humans, business, Discipline, Ecology, Evolution, Behavior and Systematics, Nature and Landscape Conservation, media_common, Coding (social sciences)
Abstract

Combining qualitative and quantitative methods and data is crucial to understanding the complex dynamics and often interdisciplinary nature of conservation. Many conservation scientists use mixed methods, but there are a variety of mixed methods approaches, a lack of shared vocabulary, and few methodological frameworks. We reviewed articles from 2 conservation-related fields that often incorporate qualitative and quantitative methods: land-change science (n = 16) and environmental management (n = 16). We examined how authors of these studies approached mixed methods research by coding key methodological characteristics, including relationships between method objectives, extent of integration, iterative interactions between methods, and justification for use of mixed methods. Using these characteristics, we created a typology with the goal of improving understanding of how researchers studying land-change science and environmental management approach interdisciplinary mixed methods research. We identified 5 types of mixed methods approaches, which we termed simple nested, informed nested, simple parallel, unidirectional synthesis, and bidirectional synthesis. Methods and data sources were often used to address different research questions within a project, and only around half of the reviewed papers methodologically integrated different forms of data. Most authors used one method to inform the other, rather than both informing one another. Very few articles used methodological iteration. Each methodological type has certain epistemological implications, such as the disciplinary reach of the research and the capacity for knowledge creation through the exchange of information between distinct methodologies. To exemplify a research design that can lead to multidimensional knowledge production, we provide a methodological framework that bidirectionally integrates and iterates qualitative and quantitative methods.Estrategias para la Investigación Interdisciplinaria con Métodos Mixtos en las Ciencias del Cambio de Suelo y el Manejo Ambiental Resumen La combinación entre los métodos cualitativos y cuantitativos y los datos es crucial para el entendimiento de las dinámicas complejas y con frecuencia, de la naturaleza interdisciplinaria de la conservación. Muchos científicos de la conservación usan métodos mixtos, aunque existe una variedad de estrategias de métodos mixtos, una falta de vocabulario común y pocos marcos de trabajo metodológicos. Revisamos los artículos publicados en dos campos relacionados con la conservación, los cuales con frecuencia incorporan métodos cualitativos y cuantitativos: las ciencias del cambio de suelo (n = 16) y el manejo ambiental (n = 16). Examinamos cómo los autores de estos estudios abordaron la investigación de métodos mixtos al codificar las características metodológicas importantes, incluyendo las relaciones entre los objetivos de los métodos, la extensión de la integración, las interacciones iterativas entre los métodos y la justificación para el uso de los métodos mixtos. Con estas características creamos una tipología con el objetivo de mejorar el entendimiento de cómo los investigadores que estudian las ciencias del cambio de suelo y el manejo ambiental abordan la investigación interdisciplinaria de métodos mixtos. Identificamos cinco tipos de estrategias de métodos mixtos, que denominamos anidadas, anidadas informadas, paralelas simples, de síntesis unidireccional y de síntesis bidireccional. Con frecuencia se utilizaron métodos y fuentes de datos para responder a diferentes preguntas de investigación dentro de un proyecto y sólo alrededor de la mitad de los artículos revisados integraron de manera metodológica diferentes presentaciones de los datos. La mayoría de los autores usaron un método para orientar al otro método, en lugar de que ambos métodos se orientaran mutuamente. Fueron muy pocos los artículos que usaron la iteración metodológica. Cada estilo metodológico tiene ciertas implicaciones epistemológicas, como el alcance disciplinario de la investigación y la capacidad de creación de conocimiento por medio del intercambio de información entre las distintas metodologías. Proporcionamos un marco de trabajo metodológico que integre de manera bidireccional y reitere los métodos cualitativos y cuantitativos para ejemplificar un diseño de investigación que pueda derivar en la producción multidimensional del conocimiento.

Published
2020

15. Nurse opinions about initiating spiritual conversation and prayer in patient care

Author

Carla Gober-Park, Kathy Schoonover-Shoffner, Khaled Bahjri, Elizabeth Johnston Taylor, Chintan K. Somaiya, and Iris Mamier

Subjects
Adult, Male, Adolescent, Attitude of Health Personnel, media_common.quotation_subject, Christianity, Religiosity, Faith, Young Adult, 03 medical and health sciences, Survey methodology, 0302 clinical medicine, Nursing, Spirituality, Humans, Conversation, 030212 general & internal medicine, General Nursing, media_common, 030504 nursing, Middle Aged, humanities, Prayer, Religion, Cross-Sectional Studies, Self-disclosure, Female, Nursing Staff, Patient Care, Spiritual care, 0305 other medical science, Psychology
Abstract

Aim The aim of this study was to understand nurses' opinions about initiating spiritual or religious conversation during patient care and to measure how these perspectives are associated with demographic, religious and work-related characteristics. Background Nurses are expected to provide spiritual care and do so in diverse ways. Little is known about how nurses think about initiating spiritual or religious discourse. Design Cross-sectional, quantitative. Methods Online survey methods allowed data collection from 445 nurses. The survey, accessed from the homepage of the Journal of Christian Nursing for 6 months beginning June 2015, included scales measuring various facets of religiosity, and items assessing nurse opinions about introducing spirituality or religion during patient care and demographic and work-related variables. Variables showing significant associations with Nurse Opinion items in bivariate analyses were examined using binary logistic regression. Results About 90% of participants believed it appropriate to initiate conversation about spirituality/religion and nearly three-quarters thought it appropriate to self-disclose spirituality/religion or offer prayer under certain circumstances or anytime. All personal religiosity indicators except tentativeness of belief were found to be associated with responses to Nurse Opinion items. That is, higher religiosity was associated with opinion one could initiate such conversations, whereas lower religiosity was associated with waiting for patients to initiate. Nurses working in a faith-based organization were 276% more likely to believe they could initiate such conversation and 153% more likely to think they could initiate an offer of prayer. Conclusion Nurse religiosity and work environment were associated with nurse opinions about initiating spiritual/religious discourse with patients.

Published
2018
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16. Transfusion practice patterns in patients with anemia receiving myelosuppressive chemotherapy for nonmyeloid cancer: results from a prospective observational study

Author

Cisio De Oliveira Brandao, Kaye Shoffner, Sejal Badre, James Granfortuna, S. Depasquale, and Chet Bohac

Subjects
Adult, Male, medicine.medical_specialty, Blood transfusion, Anemia, medicine.medical_treatment, Comorbidities, 03 medical and health sciences, Packed red blood cell, 0302 clinical medicine, Internal medicine, Neoplasms, Medicine, Humans, Medical history, Blood Transfusion, 030212 general & internal medicine, Hemoglobin, Prospective Studies, Prospective cohort study, Chemotherapy-induced anemia, Fatigue, Aged, Retrospective Studies, Aged, 80 and over, Myelosuppressive Chemotherapy, business.industry, Medical record, Cancer, Retrospective cohort study, Middle Aged, medicine.disease, Oncology, 030220 oncology & carcinogenesis, Original Article, Female, business
Abstract

Purpose The decision to prescribe packed red blood cell (PRBC) transfusions in patients with chemotherapy-induced anemia (CIA) includes assessment of clinical features such as the patient’s cancer type and treatment regimen, severity of anemia symptoms, and presence of comorbidities. We examined contemporary transfusion practices in patients with nonmyeloid cancer and CIA. Methods Key inclusion criteria were age ≥ 18 years with nonmyeloid cancer, receiving first/second-line myelosuppressive chemotherapy, baseline hemoglobin (Hb) ≤ 10.0 g/dL, and planned to receive ≥ 1 PRBC transfusions. Exclusion criteria were receipt of erythropoiesis-stimulating agents within 8 weeks of screening and/or chronic renal insufficiency. Data were collected from patients’ medical records, laboratory values, and physician/provider questionnaires. Proportion of patients for each clinical consideration leading to a decision to prescribe a PRBC transfusion and 95% exact binomial confidence intervals were determined. Results The study enrolled 154 patients at 18 sites in USA; 147 (95.5%) received a PRBC transfusion. Fatigue was the most common symptom affecting the decision to prescribe a PRBC transfusion (101 [69.2%] patients). Of the three reasons selected as primary considerations for prescribing a PRBC transfusion, anemia symptoms (106 [72.1%] patients) was the most frequently reported, followed by Hb value (37 [25.2%] patients) and medical history (4 [2.7%] patients). Conclusions In this study, the primary consideration for prescribing a PRBC transfusion was anemia symptoms in 72.1% of patients, with only 25.2% of patients prescribed a transfusion based exclusively on Hb value. Results indicate that clinical judgment and patient symptoms, not just Hb value, were used in decisions to prescribe PRBC transfusions. Electronic supplementary material The online version of this article (10.1007/s00520-017-4035-7) contains supplementary material, which is available to authorized users.

Published
2018

17. Experiencing God in Nursing

Author

Ryan M Hodges, Elizabeth B. Simon, and Kathy Schoonover-Shoffner

Subjects
Nursing practice, Religion and Psychology, Practice Patterns, Nurses', 030504 nursing, Practice patterns, 05 social sciences, Christian faith, MEDLINE, Media studies, 050109 social psychology, General Medicine, Nurse's Role, Christianity, 03 medical and health sciences, Work (electrical), Join (sigma algebra), Humans, 0501 psychology and cognitive sciences, Sociology, 0305 other medical science, Nurse-Patient Relations
Abstract

Christian faith supports the idea that God is always at work in the world. God invites people into relationship with him and then to join in his work. Three nurses relay supernatural events where God worked in and through their nursing practice, reinforcing the understanding of what author Henry Blackaby calls experiencing God. Christian nurses are called to enter deeply into relationship with God.

Published
2019

18. Concerning 'Triheptanoin vs trioctanoin for long‐chain fatty acid oxidation disorders: A double blinded, randomized controlled trial' by Gillingham et al

Author

John M. Shoffner

Subjects
business.industry, Double blinded, Fatty Acids, Oxidation reduction, Lipid metabolism, Pharmacology, Lipid Metabolism, Inborn Errors, Triheptanoin, law.invention, chemistry.chemical_compound, chemistry, Randomized controlled trial, law, Genetics, Humans, Medicine, Caprylates, Long chain fatty acid, business, Oxidation-Reduction, Triglycerides, Genetics (clinical)
Published
2019
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19. Common data elements for clinical research in mitochondrial disease: a National Institute for Neurological Disorders and Stroke project

Author

Karaa, A., Rahman, S., Lombes, A., Yu-Wai-Man, P., Sheikh, M.K., Alai-Hansen, S., Cohen, B.H., Dimmock, D., Emrick, L., Falk, M.J., McCormack, S., Mirsky, D., Moore, T., Parikh, S., Shoffner, J., Taivassalo, T., Tarnopolsky, M., Tein, I., Odenkirchen, J.C., Goldstein, A., Koene, S., Smeitink, J.A.M., Karaa, Amel, Rahman, Shamima, Lombès, Anne, Yu-Wai-Man, Patrick, Sheikh, Muniza K., Alai-Hansen, Sherita, Cohen, Bruce H., Dimmock, David, Emrick, Lisa, Falk, Marni J., Mccormack, Shana, Mirsky, David, Moore, Tony, Parikh, Sumit, Shoffner, John, Taivassalo, Tanja, Tarnopolsky, Mark, Tein, Ingrid, Odenkirchen, Joanne C., Goldstein, Amy, Mito Working Group, and Carelli Valerio

Subjects
0301 basic medicine, Gerontology, Research design, medicine.medical_specialty, Mitochondrial Diseases, Biomedical Research, Mitochondrial disease, Clinical Sciences, MEDLINE, 03 medical and health sciences, 0302 clinical medicine, Genetic, Genetics, medicine, Humans, National Institute of Neurological Disorders and Stroke (U.S.), Stroke, Genetics (clinical), Genetics & Heredity, Common Data Elements, Extramural, business.industry, Data Collection, Metabolic Disorders Radboud Institute for Health Sciences [Radboudumc 6], Neurosciences, Metabolic Disorders Radboud Institute for Molecular Life Sciences [Radboudumc 6], medicine.disease, United States, Brain Disorders, 030104 developmental biology, Clinical research, Research Design, Family medicine, Data quality, Research studies, [Mito Working Group Member Participants], Nervous System Diseases, business, 030217 neurology & neurosurgery
Abstract

Contains fulltext : 174061.pdf (Publisher’s version ) (Closed access) OBJECTIVES: The common data elements (CDE) project was developed by the National Institute of Neurological Disorders and Stroke (NINDS) to provide clinical researchers with tools to improve data quality and allow for harmonization of data collected in different research studies. CDEs have been created for several neurological diseases; the aim of this project was to develop CDEs specifically curated for mitochondrial disease (Mito) to enhance clinical research. METHODS: Nine working groups (WGs), composed of international mitochondrial disease experts, provided recommendations for Mito clinical research. They initially reviewed existing NINDS CDEs and instruments, and developed new data elements or instruments when needed. Recommendations were organized, internally reviewed by the Mito WGs, and posted online for external public comment for a period of eight weeks. The final version was again reviewed by all WGs and the NINDS CDE team prior to posting for public use. RESULTS: The NINDS Mito CDEs and supporting documents are publicly available on the NINDS CDE website ( https://commondataelements.ninds.nih.gov/ ), organized into domain categories such as Participant/Subject Characteristics, Assessments, and Examinations. CONCLUSION: We developed a comprehensive set of CDE recommendations, data definitions, case report forms (CRFs), and guidelines for use in Mito clinical research. The widespread use of CDEs is intended to enhance Mito clinical research endeavors, including natural history studies, clinical trial design, and data sharing. Ongoing international collaboration will facilitate regular review, updates and online publication of Mito CDEs, and support improved consistency of data collection and reporting.

Published
2017

20. Surviving (Even Thriving?) in a Toxic Workplace

Author

Paul E. White and Kathy Schoonover-Shoffner

Subjects
030504 nursing, business.industry, Interprofessional Relations, Nurses, Toxic workplace, Dysfunctional family, 06 humanities and the arts, General Medicine, Public relations, 0603 philosophy, ethics and religion, 03 medical and health sciences, Work (electrical), Thriving, Humans, 060301 applied ethics, Business, Workplace, 0305 other medical science
Abstract

Anything toxic is poisonous and harmful-including a toxic workplace. Surveys of hundreds of individuals and organizations reveal three primary areas that are common in unhealthy work environments: sick systems, toxic leaders, and dysfunctional colleagues. This article draws from research and offers practical steps on how to survive, if not change and thrive, in toxic workplaces.

Published
2016
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21. The Potential Effects of Obesity on Social Security Claiming Behavior and Retirement Benefits

Author

Melissa A. Z. Knoll, Dave Shoffner, and Samantha O'Leary

Subjects
Male, Social Psychology, National Health and Nutrition Examination Survey, Ethnic group, Affect (psychology), Social class, Social Security, Pensions, 03 medical and health sciences, Life Expectancy, 0302 clinical medicine, 0502 economics and business, Humans, Obesity, 030212 general & internal medicine, Economic impact analysis, 050207 economics, Socioeconomics, Poverty, Socioeconomic status, Aged, 05 social sciences, United States, Social security, Clinical Psychology, Social Class, Life expectancy, Female, Demographic economics, Geriatrics and Gerontology, Psychology, Gerontology
Abstract

Objectives Obesity prevalence among Americans has increased for nearly three decades. We explore the relationship between the rise in obesity and Social Security retirement benefit claiming, a decision impacting nearly all aging Americans. Specifically, we investigate whether obesity can affect individuals' decision to claim benefits early, a choice that has important implications for financial security in retirement, particularly for those with lower socioeconomic status (SES). Method We use a microsimulation model called MINT6 (Modeling Income in the Near Term, version 6) to demonstrate the potential effects of obesity on subjective life expectancy and claiming behavior. We impute obesity status using data from the National Health and Nutrition Examination Survey (NHANES), which describes the distribution of obesity prevalence within the United States by gender, poverty status, and race/ethnicity. Results We find that the rise in obesity and the consequent incidence of obesity-related diseases may lead some individuals to make claiming decisions that lead to lower monthly and lifetime Social Security retirement benefits. Further, we find that the potential economic impact of this decision is larger for those with lower SES. Discussion We present a behavioral perspective by addressing the potential effects that obesity can have on individuals' retirement decisions and their resulting Social Security retirement benefits.

Published
2016
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22. Estimation of the lag time in a subsequent monomer addition model for fibril elongation

Author

Suzanne K. Shoffner and Santiago Schnell

Subjects
0301 basic medicine, Amyloid, Protein Folding, Time Factors, Polymers, Lag, Nucleation, General Physics and Astronomy, macromolecular substances, Fibril, 03 medical and health sciences, Phase (matter), Elementary reaction, medicine, Animals, Humans, Proteostasis Deficiencies, Physical and Theoretical Chemistry, Fibrillation, Chemistry, Fibrillogenesis, Rate equation, Kinetics, Crystallography, 030104 developmental biology, Biophysics, Protein folding, medicine.symptom
Abstract

Fibrillogenesis, the production or development of protein fibers, has been linked to protein folding diseases. The progress curve of fibrils or aggregates typically takes on a sigmoidal shape witha lag phase, a rapid growth phase, and a final plateau regime. The study of the lag phase and the estimation of its critical timescale provide insight into the factors regulating the fibrillation process. However, methods to estimate a quantitative expression for the lag time rely on empirical expressions, which cannot connect the lag time to kinetic parameters associated with the reaction mechanisms of protein fibrillation. Here we introduce an approach for the estimation of the lag time using the governing rate equations of the elementary reactions of a subsequent monomer addition model for protein fibrillation as a case study. We show that the lag time is given by the sum of the critical timescales for each fibril intermediate in the subsequent monomer addition mechanism and therefore reveals causal connectivity between intermediate species. Furthermore, we find that single-molecule assays of protein fibrillation can exhibit a lag phase without a nucleation process, while dyes and extrinsic fluorescent probe bulk assays of protein fibrillation do not exhibit an observable lag time phase during template-dependent elongation. Our approach could be valuable for investigating the effects of intrinsic and extrinsic factors to the protein fibrillation reaction mechanism and provides physicochemical insights into parameters regulating the lag phase.

Published
2016
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23. Trauma

Author

Kathy Schoonover-Shoffner

Subjects
Religion and Psychology, Psychoanalysis, Brain Injuries, Adaptation, Psychological, Emotions, Religion and Medicine, Quality of Life, Humans, Spirituality, General Medicine, Sociology, Cognitive reframing, Attitude to Health
Published
2020
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24. The traits that predict the magnitude and spatial scale of forest bird responses to urbanization intensity

Author

Grant D. Paton, Alexandra V. Shoffner, Andrew M. Wilson, and Sara A. Gagné

Subjects
0106 biological sciences, Avian clutch size, Adaptation, Biological, Social Sciences, Predation, Forests, 01 natural sciences, Geographical locations, Trees, Habits, Body Size, Wings, Animal, Psychology, Geographic Areas, Multidisciplinary, Ecology, Animal Behavior, Geography, Population Forecast, Eukaryota, Agriculture, Biodiversity, Plants, Terrestrial Environments, Trophic Interactions, Habitat, Community Ecology, Vertebrates, Medicine, Research Article, Urban Areas, Science, Wildlife, 010603 evolutionary biology, Ecosystems, Birds, Nesting Habits, Frugivore, Atlases as Topic, Quantitative Trait, Heritable, Urbanization, Animals, Humans, Bird conservation, Ecosystem, Demography, Behavior, 010604 marine biology & hydrobiology, Ecology and Environmental Sciences, Organisms, Biology and Life Sciences, Feeding Behavior, Pennsylvania, Clutch Size, United States, Amniotes, North America, Spatial ecology, Earth Sciences, Animal Migration, People and places, Zoology
Abstract

As humans continue moving to urban areas, there is a growing need to understand the effects of urban intensification on native wildlife populations. Forest species in remnant habitat are particularly vulnerable to urban intensification, but the mechanisms behind these effects are poorly understood. An understanding of how species traits, as proxies for mechanisms, mediate the effects of urban intensification on forest species can help fill this knowledge gap. Using a large point count dataset from the Second Pennsylvania Breeding Bird Atlas, we tested for the effects of species traits on the magnitude and spatial scale of the responses of 58 forest bird species to urbanization intensity in landscapes surrounding count locations. Average urbanization intensity effect size across species was -0.36 ± 0.49 (SE) and average scale of effect of urbanization intensity was 4.87 ± 5.95 km. Resident forest bird species that are granivorous or frugivorous, cavity-nesting, and have larger clutch sizes and more fledglings per clutch had more positive associations with increasing urbanization intensity in landscapes. In addition, the effect of urbanization intensity on forest birds manifested most strongly at larger spatial scales for granivorous, frugivorous, or omnivorous species that are cavity-nesting, have larger clutch sizes and longer wingspans, and flock in larger numbers. To our knowledge, the present study represents the first direct tests of the effects of species traits on both the magnitude and spatial scale of the effect of urbanization on forest birds, as well as the first evidence that migratory status, clutch size, wingspan, and fledglings per clutch are important determinants of the responses of forest birds to urbanization. We discuss the possible mechanisms underlying our results and their implications for forest bird conservation in urbanizing landscapes.

Published
2018

25. Next-Generation Sequencing to Diagnose Muscular Dystrophy, Rhabdomyolysis, and HyperCKemia

Author

Mark A. Tarnopolsky, Lauren Brady, John M. Shoffner, and Lily Wu

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Canada, Adolescent, Disease, DNA sequencing, Muscular Dystrophies, Rhabdomyolysis, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Muscle pathology, Internal medicine, medicine, Humans, In patient, Genetic Predisposition to Disease, Genetic Testing, Muscular dystrophy, Child, Creatine Kinase, Aged, Aged, 80 and over, business.industry, Infant, Newborn, Muscle weakness, Infant, General Medicine, Neuromuscular Diseases, Middle Aged, medicine.disease, Congenital myopathy, 030104 developmental biology, Phenotype, Neurology, Child, Preschool, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Background:Neuromuscular disorders are a phenotypically and genotypically diverse group of diseases that can be difficult to diagnose accurately because of overlapping clinical features and nonspecific muscle pathology. Next-generation sequencing (NGS) is a high-throughput technology that can be used as a more time- and cost-effective tool for identifying molecular diagnoses for complex genetic conditions, such as neuromuscular disorders.Methods:One hundred and sixty-nine patients referred to a Canadian neuromuscular clinic for evaluation of possible muscle disease were screened with an NGS panel of muscular dystrophy–associated genes. Patients were categorized by the reason of referral (1) muscle weakness (n=135), (2) recurrent episodes of rhabdomyolysis (n=18), or (3) idiopathic hyperCKemia (n=16).Results:Pathogenic and likely pathogenic variants were identified in 36.09% of patients (61/169). The detection rate was 37.04% (50/135) in patients with muscle weakness, 33.33% (6/18) with rhabdomyolysis, and 31.25% (5/16) in those with idiopathic hyperCKemia.Conclusions:This study shows that NGS can be a useful tool in the molecular workup of patients seen in a neuromuscular clinic. Evaluating the utility of large panels of a muscle disease-specific NGS panel to investigate the genetic susceptibilities of rhabdomyolysis and/or idiopathic hyperCKemia is a relatively new field. Twenty-eight of the pathogenic and likely pathogenic variants reported here are novel and have not previously been associated with disease.

Published
2018

26. Erratum to: Common data elements for clinical research in mitochondrial disease: a National Institute for Neurological Disorders and Stroke project

Author

Amel, Karaa, Shamima, Rahman, Anne, Lombès, Patrick, Yu-Wai-Man, Muniza K, Sheikh, Sherita, Alai-Hansen, Bruce H, Cohen, David, Dimmock, Lisa, Emrick, Marni J, Falk, Shana, McCormack, David, Mirsky, Tony, Moore, Sumit, Parikh, John, Shoffner, Tanja, Taivassalo, Mark, Tarnopolsky, Ingrid, Tein, Joanne C, Odenkirchen, and Amy, Goldstein

Subjects
Stroke, Biomedical Research, Common Data Elements, Mitochondrial Diseases, Research Design, Data Collection, Genetics, Humans, National Institute of Neurological Disorders and Stroke (U.S.), Nervous System Diseases, Genetics (clinical), United States, Article
Abstract

OBJECTIVES: The common data elements (CDE) project was developed by the National Institute of Neurological Disorders and Stroke (NINDS) to provide clinical researchers with tools to improve data quality and allow for harmonization of data collected in different research studies. CDEs have been created for several neurological diseases; the aim of this project was to develop CDEs specifically curated for mitochondrial disease (Mito) to enhance clinical research. METHODS: Nine working groups (WGs), composed of international mitochondrial disease experts, provided recommendations for Mito clinical research. They initially reviewed existing NINDS CDEs and instruments, and developed new data elements or instruments when needed. Recommendations were organized, internally reviewed by the Mito WGs, and posted online for external public comment for a period of eight weeks. The final version was again reviewed by all WGs and the NINDS CDE team prior to posting for public use. RESULTS: The NINDS Mito CDEs and supporting documents are publicly available on the NINDS CDE website (https://commondataelements.ninds.nih.gov/), organized into domain categories such as Participant/Subject Characteristics, Assessments, and Examinations. CONCLUSION: We developed a comprehensive set of CDE recommendations, data definitions, case report forms (CRFs), and guidelines for use in Mito clinical research. The widespread use of CDEs is intended to enhance Mito clinical research endeavors, including natural history studies, clinical trial design, and data sharing. Ongoing international collaboration will facilitate regular review, updates and online publication of Mito CDEs, and support improved consistency of data collection and reporting.

Published
2017

27. Need a Quick Ethics Refresher?

Author

Kathy Schoonover-Shoffner

Subjects
Adult, Male, Medical education, MEDLINE, General Medicine, Middle Aged, Christianity, Education, Nursing, Continuing, Humans, Engineering ethics, Female, Nursing Care, Nursing Staff, Curriculum, Psychology
Published
2017

28. Efficacy and Safety of Degludec versus Glargine in Type 2 Diabetes

Author

Marso, Steven P., McGuire, Darren K., Zinman, Bernard, Poulter, Neil R., Emerson, Scott S., Pieber, Thomas R., Pratley, Richard E., Haahr, Poul-Martin, Lange, Martin, Brown-Frandsen, Kirstine, Moses, Alan, Skibsted, Simon, Kvist, Kajsa, Buse, John B., Hansen, Liliana, Rabol, Rasmus, Bethel, Angelyn, de Lemos, James A., Senn, Stephen, Schwamm, Lee, Timmis, Adam, Alshekhlee, Amer, Bach, Richard G., Bertram, Therese M., Chaitman, Bernard R., Cruz-Flores, Salvador, Eckstein, Jane F., Feen, Eliahu S., Fisher, Simon J., Gosselin, Gilbert, Lim, Michael J., Rosenzweig, James L., Sherwin, Robert S., Tobin, Garry S., Vetrovec, George, Ziemer, David C., Daugaard, Gedske, Ozlem, Er, Pollak, Michael, Sengelov, Lisa, Ahn, Yu-Bae, Amod, Aslam, Benroubi, Mariana, Boonyavarakul, Apussanee, Canecki-Varzic, Silvija, Consoli, Agostino, Eliaschewitz, Freddy G., Franek, Edward, Jinnouchi, Hideaki, Khokhlov, Alexander L., Mithal, Ambrish, Philis-Tsimikas, Athena, Ong, Tiong Kiam, Pop, Lavinia, Reyna, Leobardo Sauque, Rodbard, Helena W., Roula, Daoud, Saravanan, Ponnusamy, Sesti, Giorgio, Sorli, Christopher, Sposetti, Georgina, Tinahones-Madueno, Francisco-Jose, Woo, Vincent, Berard, Lori, Caballero Mateos, Irene, Cooper, Alison, DeLuca, Clarisa, Fillary, Julie, Gan, Diyana Gan Abdul Rahman, Goondiwala, Amina, Tapia, Jessica, Busch, Robert, Chaykin, Louis, Hollander, Priscilla, Karounos, Dennis, Lane, Wendy, Lingvay, Ildiko, Odugbesan, A. Ola, Ohlson-Elliott, Theresa, Ovalle, Fernando, Pantalone, Kevin M., Phelps, Spencer, Pop-Busui, Rodica, Robertson, David, Shlesinger, Yshay, Silver, Robert, Warren, Mark, Arrar, Mohammed, Belkheir, Hassani, Benabbas, Youcef, Benferhat, Schahrazed, Benoun, Fatima, Bensalem, Samia, Bourezane, Samia, Elaoufi, Selmane Rafik, Gourine, Mouna, Hadjhabib, Mohamed, Hadjhamou, Fouzia, Hakem, Jamila, Kaouache, Nadjib, Khensal, Sabrina, Kitouni, Yacine, Lakhal, Lamine, Lezzar, Al-Kassem, Meftah, Imane Aicha, Mehenni, Lahouaria, Nouri, Nassim, Oumerzouk, Fatma, Sakouhi, Mounia, Talha, Kheira, Zemri, Zouaouia, Caeiro, Gabriela, Calveyra, Martha, Cluigt, Natalia, Geronazzo, Veronica, Lema, Silvina, Monferran, Pablo Martinez, Oviedo, Alejandra, Pozzi, Jose, Sala, Jorgelina, Schindler, Ana, Sernia, Virginia, Sicer, Maximiliano, Solis, Silvana, Varela, Patricia, Waitman, Jorge, Augusto, Gustavo Akerman, Alves, Breno, Alves, Erica, Barbosa, Luciana, Bona, Renata, Borges, Joao, Bosco, Adriana, Canani, Luis, Castro, Denise, Cavalcante, Lilian, Cechin, Laura, Cercato, Cintia, Chrisman, Carlos, Chrisman, Carolina, Cintra, Rebecca, Costa, Giselle, Fontenele, Ana Paula, Forti, Adriana, Francisco, Beatriz, Franco, Denise, Genestreti, Paulo, Gross, Jorge, Haddad, Ludmila, Halpern, Alfredo, Hissa, Miguel, Leanca, Camila, Leao, Beatriz, Marinho, Ana Elisabeth, Miranda, Isabela, Nunes, Adriano, Palhares, Fabiana, Poco, Christiani, Salles, Joao, Sampaio, Celia, Santomauro Jr., Augusto, Sartori, Carla, Sena, Rita, da Silva, Marina, da Silva, Paula, Siqueira, Katia, Turatti, Luiz, Valenti, Adriana, Vasques, Enio, Vencio, Sergio, Visconti, Guilherme, Belanger, Andre, Chilvers, Martyn, Dumas, Richard, Hurd, Carmen, Lafleche, Francois, Lam, Paul, Martinho, Valdemar, Palardy, Jean, Peterson, Sean, Raff, Errol, Sinnaeve, Linda, Sullivan, David, Baraban, Vedrana, Blaslov, Kristina, Bulum, Tomislav, Varzic, Silvija Canecki, Berkovic, Maja Cigrovski, Balen, Marica Jandric, Kruljac, Ivan, Lesnjakovic, Silvija, Lucijanic, Tomo, Majic, Ana, Rahelic, Dario, Smircic-Duvnjak, Lea, Vrkljan, Milan, Zibar, Karin, Zukanovic, Sidbela, Athanasopoulou, Elpida, Benis, Apostolos, Benroubi, Marian, Diakoumopoulou, Evanthia, Doupis, John, Griva, Theodora, Kazakos, Kyriakos, Kypraios, Nikolaos, Liatis, Stavros, Makrilakis, Konstantinos, Markou, Athina, Pagkalos, Emmanouil, Papanastasiou, Labrini, Piaditis, George, Sampanis, Christos, Siami, Evangelia, Tentolouris, Nikolaos, Tsiama, Vasiliki, Zografou, Ioanna, Adling, Pravishal, Ali, Mazher, Anjana, R. M., Arora, Arpita, Ayyar, Vageesh, Banerjee, Suvro, Bantwal, Ganapathi, Bhagwat, Nikhil, Bhattacharyya, Arpandev, Bhawarlal, Anandakumar, Chakraborty, Rabin, Chatterjee, Sanjay, Chaudhury, Tirthankar, Chowdhury, Subhankar, Damelia, Priyal, Das, Mrinal, Das, Sambit, Desai, Ankush, Devru, Nandani, Farooqui, Khalid, Ganie, Mohd Ashraf, George, Belinda, Ghosh, Debasis, Girithara, Gopalakrishnan, Haribhai, Zinzuwadia, Jain, Nupur, Jassar, Amandeep, Joshi, Ameya, Kale, Dilip, Kale, Shailaja, Kelwade, Jayant, Khatri, Ashok, Kulshreshtha, Bindu, Majumder, Bikas, Manikath, Neeraj, Margekar, Shubhalaxmi, Marwah, Tiven, Mathew, Vivek, Moulick, N. D., Mutha, Abhay, Muthu, Ramuu, Nalawade, Asmitha, Narvencar, Kedareshwar, Pandit, Kaushik, Pangtey, Ghanshyam, Parthasarathy, B., Phatak, Sanjeev, Prakash, Anupam, Prusty, Pitambar, Radhakrishnan, Chandni, Raja, Indu, Ravikumar, Ranjani, Saboo, Banshi, Sachdeva, Isha, Sangeetha, S., Selvam, Kasthuri, Sethi, Bipin, Shah, Asha, Shah, Harshal K., Shah, Priyanshu, Shah, Rushit, Shaikh, Sajid, Shaikh, Shehla, Singh, K. P., Sivagnanam, Nallaperumal, Tandon, Nikhil, Thonangi, Rajesh, Thulaseedharan, N., Toraskar, Kedar, Varthakavi, Premalatha, Yadav, Sameer, Andreozz, Francesco, Arturi, Franco, Baldassarre, Maria Pompea Antonia, Barone, Milena, Bonura, Alice, Bucciarelli, Loredana, Buscemi, Chiara, Buscemi, Silvio, Carnovale, Anna, Caselli, Chiara, Ceci, Gloria, Cimino, Elena, Colella, Alessandra, Crippa, Valentina, Cufone, Sabrina, D'Erasmo, Laura, De Remigis, Alessandra, Di Bartolo, Paolo, Dionisio, Rosa, Disoteo, Olga, Fabietti, Marcella, Febo, Fabrizio, Filetti, Sebastiano, Genovese, Stefano, Ginestra, Federica, Grancini, Valeria, Grieco, Elvira, Magistro, Andrea, Maranghi, Marianna, Monti, Lucilla, Orsi, Emanuela, Pellicano, Francesca, Pergolini, Daniela, Perticone, Francesca, Piatti, PierMarco, Pizzi, Gianluigi, Rondinelli, Maurizio, Rossi, Margherita, Rubino, Mariangela, Setola, Emanuela, Succurro, Elena, Tarquini, Giovanna, Tiseo, Giusy, Tonolo, Giancarlo, Villa, Valentina, Hong, Stefania Vo, Amano, Kazushi, Hachiya, Remi, Hieshima, Kunio, Hirao, Koichi, Hisatake, Tomoko, Honda, Ritsuko, Ihana, Noriko, Inoue, Kaori, Iwamoto, Yasuhiko, Jinnouchi, Tomio, Kajiwara, Keizou, Kawazu, Shoji, Kikuchi, Masatoshi, Kikuchi, Takako, Koike, Yoko, Komatsu, Mitsuhisa, Kumakura, Atsushi, Kurinami, Noboru, Kushiyama, Akifumi, Maeda, Hajime, Matsuda, Toshihisa, Nakamura, Shuji, Nakayama, Koujin, Nishio, Shin-ichi, Onishi, Yukiko, Sato, Nobuyuki, Sato, Yoshihiko, Shirabe, Shinichiro, Sugiyama, Seigo, Suzuki, Tomoko, Tahara, Tazu, Takao, Toshiko, Takei, Masahiro, Takemoto, Ikutaka, Takeshige, Keiko, Tanaka, Kentaro, Taniguchi, Shotaro, Tsujimoto, Tetsuro, Tsukuda, Katsunori, Wakabayashi, Sayaka, Yamazaki, Masanori, Yoshida, Yoko, Yoshimoto, Ayako, Abidin, Imran Zainal, Abdullah, Shahrin Tarmizi Che, Adam, Noor Lita, Ahmad, Madihah, Ahmad, Nik Nur Fatnoon Nik, Amin, Nor Hanim Mohd, Aw, Cheng Yew, Cham, Yee Ling, Chong, Hui Min, Chua, Seng Keong, Fauzi, Sharifah Aisyah Shahabudin Syed Ahmad, Fong, Alan Yean Yip, Ghapar, Abd Kahar Abd, Hanafi, Norliza, Abu Hassan, Muhammad Radzi, Iberahim, Rahimah, Khiew, Ning Zan, Lee, Gary Chin Keong, Lingam, Rakesh, Long, Richard Chay Shien, Mahendran, Kauthaman A., Oon, Yen Yee, Said, Asri, Sothiratnam, Radhakrishna, Sridhar, Ganiga Srinivasiah, Suan, Mohd Azri Mohd, Tan, Sian Kong, Tey, Julian Hock Chuan, Undok, Abdul Wahab, Waid, Anuar, Vijayasingham, Shalini, Voon, Chi Yen, Yew, Kuan Leong, Yong, Lit Sin, Aguilar-Parra, Lilia, Aguirre, Karen, Alvarez-Carrillo, Rebeca, Arechavaleta-Granell, Maria, Baez-Campos, Aurelia, Bayram Llamas, Edmundo Alfredo, Calvo-Vargas, Cesar, Cedano-Limon, Marielena, Beltran Jaramillo, Teresita de Jesus, de Jesus Marin-Lopez, Jose, Ruiz Cornejo, Maria de Jesus, Juarez Cervantes, Maria del Carmen, Estevez de Alba, Isabel, Estrada Garcia, Raul, Estrada, Suellen, Garza-Vergara, Marisol, Gonzalez-Perez, Rosa, Gonzalez-Valencia, Carlos, Guerrero-Reyes, Rosalinda, Haro Ortiz, Jose Alfredo, Hernandez Salazar, Eduardo, Illescas Diaz, Iris, Illescas Diaz, Jesus, Loredo, Imelda, Jimenez-Ramos, Silvia, Larios-Mora, Diana, Lopez Garcia, Maria Elena, Lopez-Serrano, Julieta, Martinez-Nolasco, Bertha, Nunez Marquez, Ricardo, Pacheco Aranda, Elizabeth, Peralta-Cantu, Irving, Perez Chagollan, Ana, Ramirez, Maria, Robledo Duron, Israel, Rodriguez Briones, Ignacio, Rodriguez, Maria, Sauque Reyna, Leobardo, Vazquez-Ceja, Adriana, Vera-Bocanegra, Alejandro, Vidrio Velazquez, Maricela, Contreras Sandoval, Aleida Yael, Bartelik, Karol, Bilska, Aleksandra, Biniszkiewicz, Tomasz, Bogdanski, Pawel, Chamienia, Agnieszka, Cieslak-Puchalska, Anna, Czochra, Wojciech, Gajewski, Bogdan, Gromniak, Elwira, Holda, Ewa, Jaskulska-Gorzelewska, Barbara, Jedynasty, Krystyna, Kloda, Elzbieta, Kmak-Balawender, Beata, Kobielusz-Gembala, Iwona, Konieczny, Marek, Kramarczuk, Elzbieta, Kuleta, Jerzy, Lesniewski, Robert, Lominska, Teresa, Lukaszewicz, Monika, Majewska, Izabella, Mlynarski, Tomasz, Mostowy, Aleksandra, Rybak, Anna, Skrypnik, Damian, Wolny, Malgorzata, Zmuda, Witold, Buduru, Alina Nicoleta, Cif, Adriana, Cozma, Mihaela, Crisan, Carmen, Barbonta, Cristian Gelu, Barbonta, Diana, Mihalcea, Madalina, Mociran, Mihaela, Muresan, Sorina, Popescu, Alexandrina, Pruna, Luchiana, Sandu, Nadia Ramona, Suleac, Oana Andreea, Vincze, Eva Cornelia, Andreeva, Elena, Berns, Svetlana, Barykina, Irina, Bernitcyna, Angela, Bezdenezhnykh, Natalia, Chumachek, Elena, Demarina, Svetlana, Didenko, Anna, Dubinina, Nadezhda, Dzherieva, Irina, Elsukova, Olga, Esenyan, Lev, Filippova, Ekaterina, Gabova, Nadezhda, Garina, Irina, Glikman, Yulia, Glova, Svetlana, Goncharova, Ekaterina, Gorbatova, Elena, Gordeev, Ivan, Grigorian, Inessa, Gromova, Svetlana, Ipatko, Irina, Karaban, Elena, Katushkina, Yulia, Kaygorodtseva, Olga, Kerova, Irina, Khaisheva, Larisa, Khmelnitskiy, Oleg, Khokhlov, Alexander, Khokhlov, Mikhail, Khorolets, Ekaterina, Klyuenkova, Elena, Konovalova, Olga, Korneva, Ksenia, Kosmacheva, Elena, Kunitsyna, Marina, Kupriyanova, Tatiana, Kuznetsova, Natalia, Lantseva, Olga, Ledyaeva, Alla, Lileeva, Elena, Markovich, Alexander, Martirosian, Narine, Maslova, Alisa, Milyukova, Galina, Mokhova, Irina, Nagirniak, Olga, Nastina, Elena, Nedogoda, Sergei, Orlova, Valeriia, Svetlana, Otarova, Ostapenko, Marina, Papaskiri, Nino, Pavlikova, Elena, Peskov, Andrey, Petrik, Galina, Petrov, Alexander, Petunina, Nina, Platonov, Dmitry, Poliakova, Yulia, Potapova, Zhanna, Pribylova, Svetlana, Razumovsky, Igor, Redkin, Alexander, Rodionova, Tatyana, Rudenko, Evgenia, Rykalina, Natalia, Salasyuk, Alla, Semikina, Tatiana, Serebryakova, Inna, Shanina, Larisa, Shmidt, Evgenia, Sinitsina, Olga, Smetanina, Svetlana, Smirnova, Marya, Smirnova, Victoria, Smolentseva, Nadezhda, Sobolev, Alexander, Soldatenkova, Anna, Soldatova, Yulia, Speshilova, Svetlana, Startseva, Olga, Strezhova, Larisa, Strongin, Leonid, Suplotova, Lyudmila, Suvorova, Daria, Tepaeva, Alisa, Trukhina, Liubov, Tyugaeva, Alisa, Vasyutkova, Olga, Vinokurova, Valentina, Yukhno, Elena, Yuzhakova, Natalia, Zagrebelnaya, Olga, Zalevskaya, Alsu, Zhukova, Elena, Aomar Millan, Ismael, Beltran Romero, Luis M., Ignacio Fernandez Navarro, Jose, Carlos Ferrer Garcia, Juan, Garcia Blasco, Lourdes, Garcia Garcia, Clara, Garcia Puig, Juan, Girbes Borras, Juan, Inigo Zaera, Pilar, Lopez de la Torre, Mart-n, Martinez Alfaro, Baldomera, Morales Portillo, Cristobal, Romero Sanchez, Paloma, Sebastian Ochoa, Nerea, Serrano Olmedo, Isabel, Tinahones Madueno, Francisco, Torres Jimenez, Rosa, Adeyemo, A. O., Bassa, Ayesha, Bhorat, A., Bhorat, Qasim, Blacking, Laura, Burgess, Lesley, Coetzee, Kathleen, Conradie, Hillet, Cyster, Henry, Distiller, Larry, Ellis, G. C., Gani, Mashra, Gordon, Debra, Govender, Parimala, Govender, Thirumani, Govender, Vimladhevi, Jivan, Daksha, Joffe, Barry, Jooma, Yaseer, Kaplan, Hilton, Komati, Stephanus, Kramer, Brian, Kruger, Sieglinde, Landau, Stanley, Latiff, Gulam, Maritz, L., Matthews, Peter, Middlemost, S. J., Ngcakani, Nomangesi, Nortje, Hennie, Osman, Yasmin, Padayachee, Trevenesan, Podgorski, Gracjan, Potts, Jenny, Pretorius, Catharina, Prozesky, Hans, Snyman, Hans, Tayob, Mohammed, Urbach, Dorothea, van der Merwe, Maryke, Vorajee, Haroon, Wilson, Nadine, Wing, J. R., Lee, Jie Eun, Ahn, Chang Ho, Kim, Nam Hoon, Kim, Sun Hwa, Hwangbo, Yul, Ko, Sun Hye, An, Jee Hyun, Ko, Seung Hyun, Lee, Ji Hyun, Noh, Jung Hyun, Ji, Myeong Jin, Kim, Kyeong Jin, Jung, Chan-Hyeon, Kim, DongJun, Kim, Kyongyoung, Kim, Lee-Kyung, Kim, SinGon, Kim, Eun Ky, Lee, Dong-Hwa, Cho, Young Min, Moon, Shin-Je, Oh, Chang-Myung, Hong, A. Ram, Park, Kyeong Seon, Yun, Jae Seung, Hong, Jae Won, Kim, Hee Young, Buranapin, Supawan, Deerochanawong, Chaicharn, Hengjeerajarus, Natavuth, Kosachunhanun, Natapong, Kuanprasert, Srun, Kunavisarut, Tada, Laortanakul, Rungnapa, Mangklabruks, Ampica, Phornphutkul, Mattabhorn, Prasitdamrong, Hutsaya, Snabboon, Thiti, Sriwijitkamol, Apiradee, Suwanwalaikorn, Sompongse, Tantiwong, Puntip, Tejavanija, Sirakarn, Vorasettakarnkit, Yongkasem, Alasabbagh, Samer, Bagais, Christos, Bingley, Polly, Borthwick, Les, Brett, Barbara, Davidson, Sue, Ewing, Jane, Garesse, Robert, Gillani, Syed, Gkastaris, Konstantinos, Herring, Roselle, Illsley, Graham, Johnson, Andrew, Kaplan, Felicity, Lonnen, Kathryn, Malcolm, Ellen, McCrimmon, Rory, Mcknight, John, Nair, Rajiv, Patel, Vinod, Pearson, Ewan, Raghavan, Rajeev, Raj, Suchitra, Russell-Jones, David, Sampson, Mike, Singh, Baldev, Sukamer, Nithya, Turner, Jeremy, Venkataraman, Hema, Viljoen, Adie, Wake, Deborah, Barnes, Cassandra, Boyd, Gary, Childress, Gwen, Coleman, Debora, Combs, Judy, Davis, Leon, Davison, Kentress, DeAtkine, David, Dunaway, Linda, Duncan, Janet, Hibbard, Nina, Martin, Melissa, Nichols, Melissa, Painter, Karolynn, Perkins, Tammy, Quinney, Rosylen, Raymond, Katrina, Roney, Christopher, Sanchez, Gilberto, Sosnowchik, James, Sultan, Farah, Talley, Shellie, Trippe, Bruce, Tuck, Pamela, Vaughan, T., Warriner, Amy, Watts, Tamara, Williams, Hayes, Abidov, Aiden, Abidov, Yulia, Anderson, Corey, Avila, Vanessa, Baraniak, James, Berry, Barbara, Bessette, Lynn, Blackwell, Gina, Burrows, Jennifer, Caldron, Meghan, Chang, Chui-An, Collins, Elizabeth, Crawford, Meli'sa, Delfin, Katherine, De'Loera, Jessie, Dokken, Betsy, Feld, Lawrence, Gill, Ryan, Gordon, James, Gordon, Rachel, Gullick, Nicole, Gutierrez, Diane, Harrison, Larissa, Haught, Annamarie, Hemmila, Karin, Hendrickson, Darell, Horsley, Craig, Hsu, Connie, Jerrell, Maggie, Kertesz, Briana, Khananisho, Paulina, Lenzmeier, Sonia, Lenzmeier, Thomas, Lipschitz, Barbara, Lonquist, Mark, Mather, Dana, (Shelley) Miceli, Michelene, Norris, Gwenth, Padilla, Ann Marie, Petersen, Dena, Riffer, Ernie, Scott, Susan, Sheridan, Kathryn, Smith, Misty, Stump, Craig, Thomson, Stephen, Torok, Ernese, Vesely, Kelly, Vincent, Tom, Wilson, Christy, Wilson, Sandra, Agarwal, Monica, Appleberry, Kady, Barden, M. Gregg, Brickell, Lorrie, Bravo, Eric, Cassis, Cady, Covington, Becky, Devine, De'Andrea, Dishongh, Katherine, Dugger, Joseph, Evans, Lauren, Francis, Spencer, Johnson, David, Koneru, Kalyana, Kurck, Sheryl, Lingisetty, Chandra, Menke, Jennifer, Miller, Beatrice, Montgomery, Cristal, Nimmo, Teresa, Pace, Daniel, Pellegrino, Richard, Rose, Joseph, Straub, Karl, Stubbs, Amanda, Thomas, Leslie, Thrasher, James, Thrasher, Lesa, Wijewardane, Priyantha, Williamson, Kimberly, Acevedo, Lizeth, Ahmad, Aakif, Andresen, Teri, Anderson-Berman, Nancy, Ayele, Etsegenet, Baker, Janice, Banares, Arlene, Barsalou, Thea, Becker, Steven, Benavidez, JoAnn, Benitez, Guadalupe, Bernstein, Richard, Bhasker, Kala, Blain, Arthur, Blustin, Joy, Bughi, Stephanie, Carney, Kimberly, Castro, Gerardo, Catangay, Jennifer, Chambers, Joseph, Chan, Eve, Chang, Amy, Chang, Anna, Chavous Jr., Donald, Chen, Constance, Chiu, Ken, Chochinov, Ronald, Chu, James, Cleghorn, Monica, Cohen-Gadol, Shariar, Cokely, David, Collins, Michelle, Collins, Yolanda, Colomy, Carissa, Cruz-Corona, Yolanda, Cunnea, Virginia, Dailey, George, Dang, Andy, Dang, Trinh, De La Luz, Mabel, Delgadillo, Rico, Delgado, Michael, Desta, Taddese, Doriguzzi, David, Dulgeroff, Anthony, Einhorn, Daniel, Emery, Pamela, Figueroa, Martin, Fink, Raymond, Flowe, Chelsea, Flowers, Francesca, Fregosi, Julie, Garcia, Gabriel, Garcia, Maria, Gaudiani, Linda, Gawad, Michael, Ghattas, Sam, Gilroy, Christine, Gonzalez, Viviana, Gonzalez, Yadira, Guadron-Hernandez, Liliana, Ha, Thu, Haas, Terry, Harbison, Judy, Hernandez, Graciela, Hernandez, Robert, Herrera, Nancy, Ho, Vincent, Hsu, Kang, Humphries, Denise, Huynh, Vincent, Jacobs, Shahram, Jardula, Michael, Jarman, Cheryl, Kabongo, Martin, Kafri, Hassan, Kaplan, Roy, Kim, Grace, Kobayashi, Gary, Korff, Gary, Kowalick, Alexandra, Levin, Ellis, Lewis, Erin, Lisovskiy, Svetlana, Luu, Hieu, Malkhassian, Daniel, Maletz, Louis, Martinez, Geraldine, Martinez, Gilbert, Martinez-Miss, Salomon, McCallum, James, Melikian, George, Metcalf, Francine, Michlin, Bernard, Michlin, Shira, Mitchell, Anitha, Moattari, Ali Reza, Montano-Pereira, Cynthia, Moon, Mia, Naderi, Bahar, Nagata, Jenna, Nguyen, Christopher, Norwood, Paul, Garcia, Sagrario Olmos, Olsen, Sharon, Pardino, Aarika, Parkes, Kathleen, Pascal, Aileen, Patel, Mihir, Paulson, Carolyn, Pernia, Kay, Perez, Marisol, Pham, David, Presant, Larry, Preston, Krista, Reeves, Laurie, Richards, Jessica, Rios-Santiago, Jessica, Risser, Joseph, Rodriguez, Silvia, (Cherrie) Rosal, Rosario, Rosenblit, Paul, Rosero, Raquel, Sadler, Chris, Samoa, Raynald, Sanchez, Liliana, Schaeffer, Cynthia, Schwartz, Alan, Scott, Christopher, Scott, Courtney, Scott, Cranford, Shartel, Jo-Ann, Shaw, Sylvia, Sivalingam, Kanagaratnam, Sligh, Scott, Sligh, Teresa, Smith, Bradley, Soler, Daniel, Spencer, Torre, Stalters, Sophia, Stone, Jenine, Szlachcic, Yaga, Thorsell, Ashley, Tu, Zhongheng, Unger, Jeffrey, Vela, Teresa, Walton, Anita, Whittle, Jessica, Wilson, Lou Ellen, Wing, Zandra, Wright, Philippa, Wyman, Shannan, Yao, Ni, Zlock, Douglas, Baker, Chelsea, Bakkum, Robyn, Bird, C. David, Carangi, Gwen, Cohen, Kenneth, Daza-Taylor, Kristen, Diesburg-Stanwood, Amy, Douglass, Sara, Finck, Lani, Karaboitis, Krisoula, Kerstein, Howard, Lesh, Kurt, Loesch, Ryan, McClure, Lori, Nevarez, Max, Pavol, Bristol, Rasouli, Neda, Rockler, Briana, Sanagorski, Rebecca, Solano, Royce, Underkofler, Chantal, Van Winkle, Rebecca, Weiss, Sarah, White, Katherine, Wirtemburg, Patricia, Zarrabi, Lida, Zemel, Leonard, Barchini, George, Casagni, Kimberely, Cordisco, Marie Elena, Davis, Amanda, Duffy-Hidalgo, Bobbi, Huntley, Richard, McNicol, Donald, Miller, Neil, Mukwaya, Margaret, Northrup, Patricia, Platt, Jonathan, Rabideau, Diane, Randolph, Pamela, Rose, Suzanne, Samuel, James, Savino, Robert, Soufer, Joseph, Torello, Carole, Abinader, Azarel, Agosto, Milagos, Aguirre, Frank, Alexander, Lori, Almanza, Orlando, Alvarez, Dalia, Anees, Muhammad, Aqua, Keith, Arazo, Luz, Asberry, Claudia, Ashley, Alyssa, Balentine, Tracy, Barta, Melissa, Bertot, Ivan, Binns-Leon, Michelle, Borello, Nora, Bostick, Janette, Boucher, Loria, Braddy, Dalton, Breton, Cristian, Broxton, Bridgitte, Burke, Deborah, Cabielles, Tania, Calderon, Juan, Canaan, Yamil, Canelon, Gustavo, Cardona, Jose, Castillo-Gonzalez, Sheila, Castro, Kenia, Chacon, Jessica, Chehade, Joe, Church, Lara, Cohen, Lisa, Crews, Erin, Cromer, Carol, Cromer, Michael, Cuello, Jorge, Cusi, Kenneth, de Leon, Karel, Delgado, Edmund, Delima, Selma, Denson, Janneral, DeVries, Benjamin, Diaz, Maritza, Digon, Beningo, Dowell, Michelle, Dunn, Kelly, Ellington, Dickson, Emerick, George, Encarnacion, Frances, Ezell, Leslie, Fahmie, Ashley, Fernandez, Noel, Figueredo, Rommel, Flores, Patricia, Fonseca, Juan, Freeman, Alain, Freeman, Erica, Frias, Juan, Garcia, Lazaro, Geronilla, Giovanni, Hamilton, Maxine, Hanabergh, Rodolfo, Hanson, Lenita, Harris, Kim, Hasan, Syed, Hendrick, Mary, Hicks, Melissa, Hoffman, Lara, Holt, Antoniwa, Hutchinson, Rachel, Iparraguirre, Harold, Janicka, Ania, Janovitz, Richard, Jones, Dawn, Jones, Sarah, Kaplun, Polina, Kelijman, Mirtha, Kersey, Angela, Khan, Ashraf, Khan, Misal, Kirk, Gregory, Konwai, Ada, Kovar, Meghan, Kutner, Mark, Lafaille, Jimmy, Leach, Dana, Levenson, David, Lewy-Alterbaum, Lorena, Light, Timothy, Lo, Margaret, Loman, Lusiana, Long, Sarah, Love, Jeremy, Madera, Arelis, Magee, James, Mallitz, Michelle, Marquez, Farid, Marshall, Richard, Mary, James, Mateu, Janet, McKenzie, Leanna, McKenzie, Rona, McKenzie, Wilfred, Mendelson, Reina, Mendez, Janet, Merlos, Ledis, Mierau, Jennifer, Miller, Robert, Miranda-Palma, Bresta, Montoya, Carla, Navarro, Eduardo, Neller, Christian, Nossa, Janette, Osborn, Tracey, Patel, Bijal, Penabad, Jesus, Perez, Gilberto, Pineda, Daniel, Pinero-Pilona, Antonio, Platt, George, Prestwood, Elfrida, Quintero, Luis, Rengifo, Rodney, Reyes, Dannier, Rivas, Aolani, Rivero, Mileydis, Robinson, Sonya, Robison, Dawn, Rodriguez, Dalier, Rodriguez, Ivete, Rodriguez, Toni, Rosario, Cristobal, Rosenwasser, Rebecca, Roura, Miguel, Schramm, Erich, Schramm, Rashi, Schweppe, Laurie, Segel, Scott, Sepulveda, Maria, Sheets, Lori, Shields, Karen, Smith, Krystal, Smith, Meridith, Somerstein, Claudia, Solano, Maria, Suarez, Manuel, Suarez, Omar, Suarez, Rogelio, Suarez, Victor, Sultan, Senan, Sutton, David, Szilagyi, Istvan, Thorne, Margaret, Travaglini, Stefano, Trevino, Miguel, Uriarte, Oscar, Vizcaino, Luis, Wadud, Khurram, Wehmeier, Kent, Weinstein, Debra, Welch, Celeste, White, Alexander, White, Basil, Williams, Tammy, Williamson, Cathi, Zwick, Lisa, Adams, Cynthia, Arkin, David, Bode, Bruce, Bonner, Sheila, Bonner, Wes, Bowen, Danielle, Bradley, Brooke, Bradley, Paul, Brennan, Elizaebeth, Brown, Cynthia, Brown, De'Aira, Burgess, Elizabeth, Collett, Taryn, Cook, Jennifer, Corse, Steven, Dukes, Kaitlyn, Durrence, Jenna, Dutton, Robin, Estes, Susie, Falcone, Laura, Gaskin, Katherine, Goswami, Ketan, Hart, Mari, Jester, Donni, Kies, Staci, Leiker, Abigail, Lu, Peter, Mahakala, Aparna, Maher, Maxine, Miller, Alan, Miller, Todd, Munoz, Miguel, Musto, Michele, Odugbesan, Adeniyi, Olson, Darin, Osborn, Nicole, Pace, Kerri, Pajkovic, Gordana, Paulus, Carolyn, Phillips, Lawrence, Reddick, William, Reed, John, Rowe, Shasta, Sadler, Barney, Sapp, Tabby, Savoye, Louise, Shore, David, Shuman, Susan, Sittle, Jessica, Standard, Shana, Wardell, Karla, Workman, Amy, Carreira, Tabitha, Fitz-Patrick, David, Hean, Vutheary, Limcolioc, April, Nihei, Megan, Park, Youngmee, Pau, Cindy, Shannon, Lindsey, Trotter, Alanna, Williams, Sierra, Coughenour, Tiffany, Liljenquist, John, Vance, Carl, Williams, Jonathan, Agaiby, Eva, Agaiby, John, Argo, Kelly, Azad, Nasrin, Backus, Arnetta, Bartlett, Andrew, Bellucci-Jackson, Jennifer, Boncu, Otilia, Brodt, Pamela, Carlson, Hope, Collins, Kathleen, Delibasic, Maja, Dor, Isaac, Dukett, Mary, Emanuele, Nicholas, Gabel, Faith, Giardino, Alexandra, Hoelzer, David, Hsieh, Annming, Jayaramaiah, Poornima, Kearney, Tracy, Kelley, Kathleen, Kravarusic, Jelena, Lawless, Andrea, Maheshwari, Hiralal, Martin, Elonia, McCall, Linda, Mikell, Frank, Nallala, Deepika, Said, Sufyan, Sakla, Nadia, Schiferi, Joanna, Smith, Patricia, Stokes, John, Sugimoto, Danny, Sugimoto, Michael, Swan, Delores, Alfata, Sarab, Beavins, Jill, Bogardus, Christine, Bogardus, Donald, Calvert, Brittany, Calvin, Krystle, Carlton, Kristin, Condit, Jonathan, Cornett, George, Covert, Carissa, Dela Llana, Alexander, Dixon, Rosie, Felker, Dean, Fogle, Sara, Harris, Leslie, Hoebeke, Roberta E., Silva, Ricardo, Johnson, Tabitha, Johnston, Kelly, King, Jennifer, Lang, Amber, Maynard, Kenneth, McDaniel, Vickie, McGrath, Caitlin, Moretto, Thomas, Ndukwu, Ikeadi, O'Connor, Leo, O'Connor, Thomas, Oliver, Tonya, Overmars, Stephanie, Patel, Minesh, Patterson, Geraldine, Powell, Talessa, Raphael, Annmarie, Raphael, Rod, Reedy, Mark, Reyes, Hubert S., Ridge, Terry, Rutherford, Mary S., Sebastian, Mike, Shaeffer, Laura, Sheets, Michelle, Thomas, Karen, Trueblood, Nancy, Tucker, Tiffany, White, Adrian, Wooldridge, Evan, Wright, Alison, Zapinski, Dawn, Cieloha, Megan, Coker, Clarine, Fletcher, Cherisa, Kay, Jennifer, Larsen, Katelyn, Marar, Isam, Motz, Zachary, Paul, Jamie, Pokorski, Alan, Rabadi-Marar, Diana, Scheideler, Kylie, Sobczyk, Jill, Sweeney, Kolbie, Brink, Nathalie, Buth, Dennis, Grimes, Katlyn, Lakin, Gregory, Loewen, Barbara, Secrist, Neal, Simon, William, Steere, Diane, Talbot, Kimberly, Wheeler, Christina, Adams, Derick, Armour, Wilhelmina, Asher, Whitney, Bays, Harold, Behl, Noreen, Conn, Brittany, Dye, Lyndsey, Earl, Jennifer, Farris, Neil, Figueroa, Sergio, Fruit, Olivia, Hobbs, Coury, Howard, Kristen, Jackson, Tamara, Kain, Angela, Karounos, Chrisi, Keiran, Sarah, Kennedy, Ryan, King, Kara, Krishnasamy, Sathya, Lambdin, Winona, Micklewright, Gezina, Mokshagundam, Sri, Mooney, Stephen, Moore, Melanie, Morgan, Denise, Morley, Robert, Newsome, Stacy, Nichols, Jennifer, Nims, Diana, Nockerts, Nichole, Oremus, Ruth, Ritchey, Barbara Michelle, Shelton, Christina, Smith, Danielle, Walker, Debra, Weiter, Kathleen, Whitehead, Rebecca, Wood, Robert, Woodruff, Robin, Young, J. DeShay, Alper, Arnold, Berry, Martha, Gauthier, Nadine, Griffin, Catina, Haynes, Elvia, Lawrence, Jereta, McCormack, Teraina (Terry), Midyett, Catherine, Rangaraj, Uma, Smith, William, Stricker, Makenzie, Tandron, Ileana, Vargas, Ramon, Wagner, Michele, Albert, Marie, Baillargeon, Gail, Stephens, John, Aroda, Vanita, Dempsey, Michael, Junker, Herman, Lopez, Meyling, Shepard, Marc, Ciccarelli, Carol, Datu, Joycelyn, Gallagher-Dorval, Karen, Hartigan, Celia, Kowaloff, Edward, Lock, John-Paul, Rosano, Nina, Shaw, Bernadette, Thompson, Michael, Abbo, Camerin, Anton, Salwan, Baker, Lydia, Bhan, Arti, Blackmer, Karla, Boley, Bryon, Hyde, Desirae, Bonema, John, Carlin, Tamara, Curran, Nancy, Dandois, Bethani, Dermyer, Abigail, Dubeck, Janet, Elkins, Jennifer, Ferris, Pamela, Fraser, Neil, Kozma, Julia Gargan, Gasparovich, David, Grodman, Robert, Hampson, Jaison, Hewitt, Mitzie, Hiatt, Judy, Hopkins, Ashley, Howard, Jennifer, Joliat, John, Joliat, Jonathan, Kalt, Steven, Katzman, Steven, Kogelman, Jesse, Kruger, Davida, Kurkowski, April, Lambert, Jodi, Levcovici, Elisabeta, Lockwood, Karen, Lumberg, Michael, McMullen, Lindsay, Meyers, Peter, Minto, Carrie, Nelson, Tina, Neuner, Gregory, Nurmi, Kevin, Perkins, Judy, Plunkett, Cynthia, Ruoff, Gary, Samantray, Julie, Sawah, Ahmed, Secord, Samantha, Seyoum, Berhane, Sherman, Sarah, Simpson, Michael, Sinkoff, Mark, Skoney, Joseph, Small, Jami, Szerlong, Heidi, Tinetti, Timothy, Toomey, Adam, VanDerWerff, Holly, Whitehouse, Fred, Wilkins, Raechelle, Wolf, Stephanie, Yarows, Steven, Eldred, Edward, Hester, Kim, Huling, Randall, Moore, Kerry, Preslar, Kristina, Proge, Nakia, Smith, Lora, Young, Gerri, Bybee, Kevin, Carr, George, Case, Christopher, Forker, Alan, Goeke, Lindsay, Kocher, Darlene, Lin, Oscar, Littlefield, James, Mendoza, Robinson, Moore, Michelle, Oberhaus, Barbara, Reed, Larry, Rutherford, Cheryl, Windsor, Sheryl, Ackerman, Kim, Christensen, Reed, De Souza, Jose, Douglas, Kirsten, Hrncirik, Therese, Lefkowicz, Magen, McDonnell, Lindsey, Severa, Larry, Tjaden, Jeffrey, Ward, Laura, Addison, Shayla, Anderson, Robert, Baker, Claire, Baum, Robert, Belitz, Jenny, Boerner, Shannon, Desouza, Cyrus, Drincic, Andjela, Fitzgibbons, William, Francis, Jessica, Garvin, Maureen, Goldner, Whitney, Goodrich, Melissa, Grubbs, Lisa, Hatcher, Theresa, Hochstein, Renee, Hunter, Christine, Keuchel, Janet, Konigsberg, Sarah, Kuechenmeister, Lisa, Mack, Lynn, McKnight, Thomas, Mensik, Hanna, Mitchell, Jan, Moeller, Jennifer, Montanez, Edward, Montoya, Paul, Nemecek, Tiffany, Neumeister, Amy, Newcomb, Jefferey, Pracht, Shelby, Radke, Kaitlin, Rahman, Jennifer, Renter, Samantha, Reynolds, Jill, Grace Rodriguez, Maria, Satorie, Jessica, Schiermann, Lynnda, Severson, Megan, Shivaswamy, Vijay, Snyder, Janice, Tillson, Renee, Vasey, Andrew, Wahl, Timothy, Weeks, William, Wolf, Thomas, Springer, Brian, Mitchell, Janice, Woodruff, Mark, Alvarez, Isis, Bowers, Rachel, Cala-Anaya, Franklin, Castellanos-Rodriguez, Rudiber, Christopher, Janice, Concepcion, Gelvis, Fernandez, Dareana, Ghanem, Paula, Harmon, Nicolette, Kaiser, Heather, Kaplan, Westbrook, Klugh, Serena, Le, Nicholas, Lehrner, Stephanie, Lopez, Robert, Martin, Olga, Martinez, Tina, Martini, Nicole, Molin, Clifford, Nakhle, Samer, Newsome, Yvonne, Neylon, Ellen, Olsen, Jarvis, Palal, Betsy, Philander, Peter, Rosario, Adriana Ruiz, Sanchez, Mary, Sierra-Garcia, Miguel, Smith, Myesha, Trenche, Samuel, Trippi, Danna, Vernetti, Nicholas, Villegas, Laura, White, Briana, Wilcox, Simmon, Carmolli-Cornette, Lisa, Chuang, Ellie, Hoffman, Sheila, Laliberte, Alison, Marshall, Lisa, Meroski, Pamela, O'Neil, Christine, Shippey, Jeanette, Spector, Linda, Cam, Jenny, Chen, Tina, Damle, Jagadish, Holman, Rebecca, Liu, Jenny, Milazzo, Carmelo, Quach, Brenda, Yang, Bin, Ahmad, Basharat, Aro, Dominic, Azeem, Fouzal, Bonaccorso, Antoinette, Brancato, Lenore, Brautigam, Donald, Charatz, Seth, Chiarot, June, Cunningham, Linda, DiCerbo, Nancy, DiGiovanna, Michael, Dluge-Aungst, Dawn, Dolbeer, Traci, Donovan, Daniel, Duma, Carol, Ellwood, Rebecca, Freedman, Zachary, Gorman, Timothy, Gunther, David, Hogan, Eileen, Hoffman, Lisa, Kapoor, Anoop, Kelly, Michelle, Kitchen, Timothy, Lam, David, Levister, Camilla, Levy, Carol, Lopez, Carlos, Lyons-Patterson, Jane, Makam, Sashi, Mauceri, Diana, McClary, Carole, Murak, Daniel, Nolan, Kelly, Nunez, Carlos, Elliott, Theresa Ohlson, Ostrowski, Phillip, Pallai, Ajish, Porges, Andrew, Rodes, Alfredo, Rosenberg, Richard, Rubel, Lance, Serrano, Lelanie, Shannon, Daniel, Sinha, Rabi, Snyder, Brian, Sy, Claude, Tang, Rocky, Varavenkataraman, Raghupathy, Winterberger, Amy, Allen, Stacy, Anderson, Marshall, Asbill, Mark, Beasley, Amanda, Bennett, Chrisitian, Bergamo, Katherine, Bilbro, Scott, Brannock, Sarah, Brown, Laura, Bryant, Danielle, Buck, Genena, Burdette, Tara, Buse, John, Butler, Laura, Caldwell, Ronald, Cannon, Daniel, Cannon, Kevin, Carter, Casey, Cherry, Amanda, Comer, Zoe, Crittenden, Susan, Cuffee, Juanita, Culmer, Dawn, Daly-Barnes, Kristie, Evensen, Erick, Saavedra, Rubin, Dean, John, Dezube, Milana, Diner, Jaime, Dodis, Regina, Dostou, Jean, Duclos, Michelle, Elmore, Miles, Ferree, Kristin, Foster, Leslie, Fuller, Gail, Garner, Susan, Godwin, Sarah, Goley, April, Gore, Whitney, Green, Brenda, Harris, Elizabeth, Harris, Joy, Harris, Rebecca, Hatharasinghe, Roger, Herring, Charles, Hill, Chernessa, Holmes, Robert, Hutchens, Erin, Jennings, Stuart, Kaake, Ashley, Kaygun, Handan, Kirkman, Marian Sue, Kretzschmar, Heather, Lang, Jaqueline, Largay, Joseph, Lewis, Melissa, Long, Maria Ann, Lucas, Kathryn, McCall, Roshanda, McDaniel, Catrina, McGinnis, Lee Ann, Mogabgab, Edward, Montero, Manuel, Montgomery, Richard, Moran, Joseph, Morgan, Katie, Motley, Taylor, Narendran, Mahendra, Narron, Brooke, Newman, Walter, Nicholson, John, Norris, Stephanie, Norton, Jennifer, Nowell, Erin, O'Brien, Heather, Otero, Heydin, Perkins, Victoria, Quesada, Reyna, Raad, George, Raley, Rosalie, Raman, Sujatha, Rappaport, Jonathan, Ray, Robert, Ray, Shannon, Rice, Lucian, Roberts, Christine, Ross, Kaylee, Scanlon, Erica, Schroder, Derek, Schulte, Michelle, Schultzaberger, Richard, Shoffner, Sylvia, Skrzynski, Michael, Smith, Brian, Smith, Holly, Smith, Jennifer, Smith, Justin, Smith, Kendall, Smith, Leigh, Sparks, Jeffrey, Speece, Jessica, Spivey, Jessica, Stebich, Andrew, Temple, Karen, Tessena, Boryana, Thompson, Casey, Traylor, Henry, Turner, Juliana, Turner, Sh-Rhonda, Van Cleeff, Martin, Vukojicic, Katarina, Wanchick, Leslie, Weinrib, Stephen, Werner, Devorah, Wishon, Candace, Wilson, Jonathan, Wilson, Stephanie, Wright, Heather, Young, Laura, Brown, Jamie, Lillestol, Michael, Allen, Mary Jo, Barker, Bruce, Bedel, Gary, Beuerlein, Shawn, Bhati, Amar, Breslaw, Nicole, Brown, April, Burtch, Brian, Check, Ellen, Chiodi, Shawnie, Colosimo, Linda, Cope, Kathie, Coressel, Denise, Cramer, Bethany, Crowel, Amy, Daboul, Nizar, DeLong, Rebecca, Dirkes, William, Farooki, Zia, Fixler, Don, Friedhof, Linda, Griffen, Julie, Hagan, Anjani, Haney, Kevin, Harris, Kira, Hoffmann, Amanda, Hsieh, Ronald, Ismail-Beigi, Faramarz, Kelso, Kim, Khamousia, Nidaa, Kremer, Gerald, Krol, Adrienne, Kulow, Tanya, Kuttler, Mary, Lee, Andy, Leksan, Jane, McElroy-Marcus, Susan, McNeil, Donald, Mulligan, Guy, Pantalone, Kevin, Perrino, Frank, Peysha, Lori, Pickett, Alicia, Pritchard, James, Provanzana, Kathleen, Rancitelli, Philip, Raupp, Randa, Schnall, Adrian, Siddiqui, Jaweriah, Smith, Cynthia, Sood, Ajay, Sortor, Jennifer, Spinelli, Kristin, Taylor, Diana, Thornton, Aaron, Tiktin, Margaret, Twine, Melissa, Urbank, Ann, Voegele, Francis, Wang, Lawrence, Weiss, Daniel, Werner, Amanda, Williams, Daniel, Wilson, Charles, Aberle, Teresa, Arcon-Rios, Sirlys, Arodak, Bassam, Aziz, Ammara, Bixler, Lacey, Brisko, Carolann, Cannon, Melanie, Choe, James, Connery, Lisa, Elkosseifi, Myriam, George, Aja, Hummer, Kimberly, LaBryer, Lauren, Lane, James, Lim, Jonea, Mirza, Lubna, Mittadodla, Saritha, Priest, Diane, Rao, Veitla, Ricci, Cassie, Salazar, Jennifer, Shaw, Jessica, St John, Jennifer, Talsania, Mitali, Joarder, Farahnaz, Riddle, Matthew, Yuen, Kevin, Ahmed, Intekhab, Austin, Barry, Bagnata, Linda, Bartkowiak, Anthony, Batrus, Jennifer, Baumgarten, Thomas, Belejchak, Paula, Belucher, Christine, Benton, Julia, Berger, Peter, Biscoveanu, Mihaela, Blasick, Abbie, Blyler, Kay, Casey, Linda, Chandler, Bronell, Chapman, Kim, Chou, Brian, Cisar, Jennifer, Clatterbuck, Tabetha, Cook, Richard, Cook II, Richard, Dardi, Inderpreet, DeSalle, Dina, Edevane, Shari, Elliott, Kelsey, Everhart, Brian, Furlong, Kevin J., Geishauser, Jennifer, Goisse, Marcy, Goodman, Yvonne, Gordon, Murray, Gutowski, Catherine, Harris, Ronald, Hu, Ying, Hull, Jenny, Iachini, Kathleen, Iannamorelli, Anthony, Jabbour, Serge, Jackson, Timothy, Jameson, Brian, Janosov, Paula, Jordan, Terry, Kennedy, John, Kurtzer, Gayle, Labuda, Joseph, LaRochelle, Anne, Levinson, Lawrence, Madder, Robert, Marconnet, Kari, Mareda, Patricia, Michael, Donna, Michaels, Debra, Miller, Cathy, Miller, Jeffrey, Minnock, Ann, Mitchell, Michele, Moturi, Hemlata, Moyer, Heather, Nagelberg, Steven, Oliver, Michael, Pepe, Constance, Porter, Patricia, Posey, Dora, Purighalla, Raman, Redmond, Jessica, Reiling, Joseph, Reiling, Susan, Rine, Kathy, Rust, William, Sandutch, Jill, Shaffer, Anette, Shalongo, Annette, Shawley, Sarah, Shonk, Pamela, Singh, Vinay, Slucki, Andrea, Spiller, Kellie, Springer, Nina, Sprouse, Heidi, Sun, Albert, Taylor, Judith, Watine, Robert, Watkinson, Jean, Weaver, Nancy, Wenocur, Howard, Yeoman, Gary, Ackermann, Jeremy, Averill, Nathan, Ballard, Thomas, Byars, William, Carter, Caroline, Castay, Cathleen, Cheek, Shonda, Collins, Jessica, Collins-Jamison, Traci, Cooksey, Erin, Crockford, Nicole, Cutshall, Christopher, Dar, Moahad, Drake, Almond, Dugat, Kameron, Durham, John, Durham, Nancy, Eagerton, Donald, Edmonds, Nataish, Farmer III, Joseph, Fogarty, Charles, Gatlin, June, Geisberg, Harry, Grossman, Margaret, Harrell, Wendy, Harrison, John, Harrison, Kristina, Heincelman, Sarah, Holladay, Lauren, Huberty, Chad, Isakov, Ingrid, Jordan, Norma, Kunkel, Michael, Laserna, Susan, Lawrence, Amanda, Lawrence, Andrew, Livingston, Yolanda, Lloyd, Eric, Lopez, Lina, Manuel, Joyce, Mayfield, Ronald, McDonald, Margaret, Morgan, Caroleann, Munn, Joanie, Murphy, Lauren, Nicol, Brent, Nicol, Philip, Norris, Rebecca, Phillips, Bunny, Reeves, Angela, Roach, Jacqueline, Ross, Irene, Santi, Jeffrey, Saunders, Jacqueline, Shugart, Henry, Singleton, Monnieque, Slee, Erin, Smalley, Kathleen, Smith, Kristy, Sofley, Carl, Solheim, Vesna, Spell, Samantha, Tanenberg, Robert, Whitley, Chester, Widel, Michele, Wilhoit, Gordon, Wood, Ruth, Wright, Jaime, Wulf, Alissa, Zapkowski, Julie, Adams, Kristi, Adams, Roberta, Ananthula, Parvati, Bass, Caitlin, Bates, Chad, Baum, Howard, Bays, Anna, Beck, Teresa, Bilbrey, Brett, Brown, Ashley, Carlton, Anna, Carter, Jenny, Cheri, Laura, Childress, Richard, Cloud, Mark, Cohen, A. Jay, Coulter, Alice, Dotson, Kimberly, Green, Christopher, Helton, Ashley, Houstrup, Jody, Huffman, David, Hurst, Fred, Hurst, James, Jantzi, Curtis, Jerkins, Randy, Jerkins, Terri, Jones, Mandy, Kelley, Shane, Kroulek, Judy, Lawhun, Dennis, Lee, Marcus, Louthan, James, Manning, Rickey, May, Michael, Means, Katherine, Monroe, Jeanabe, Morawski, Emily, Morin, David, Morris, Barbara, Murray, John, Nichols, Robert, Olivi, Stacie, Pennington, Kristina, Poe, Jenny, Pour, Omid Rad, Reeves, Michael, Reeves, Pamela, Root, Connie, Rose, Karen, Rutledge, Lily, Ryan, Eugene, Schwartz, Patricia, Shafer, Jennifer, Singh, Chitra, Smith, Ashley, Snow, Rodney, Stamps, Henry, Staton, Peggy, Stevens, Jeffrey, Stovall, Cathy, Sturgeon, Rodney, Tapp, John, Tapp, Stacy, Warner, Carla, Weiss, Melissa, White, Judith, Wierum, Craig, Williams, Konya, Wright, Tiffanie, Abreu, Marconi, Agarwal, Vandana, Ahmad, Aftab, Ahmad, Asma, Ahmed, Faiz, Ahn, Lily, Alaoui, Rachid, Alarcon, Stephanie, Allison, Dale, Annamalai, Rajasekaran, Arain, Khadija, Arellano, Angelica, Arispe, Barbara, Aronoff, Stephen, Arroyo, Jesus, Bachand, Trista, Bailey, Becky, Bajaj, Chris, Banarer, Salomon, Barnella, Christine, Bartz, Mary, Bates, Jason, Becerra, Karen, Benavides, Melissa, Bhuchar, Subodh, Blevins, Thomas, Bonazzi, Amanda, Brinson, Cynthia, Brown, Timiki, Buckley, Brandee, Bunker, Christy, Burbano, Jose, Busch, Vickey, Bustamante, Rosibel, Calais, Natalee, Camacho, Allison, Camp, Shana, Canada, Nancy, Canchola, Daniel, Cano, Monica, Cardenas, Veronica, Carl, Leighton, Casaubon, Luis, Castaneda, Jessica, Castro, Cindy, Ceniceros, Diego, Chaicha-Brom, Tira, Chaudhuri, Sudipta, Chavez-Velazquez, Alberto, Chen, Jocelyn, Cheyne, Theresa, Chilka, Sapna, Chionh, Kristen, Chunawala, Imran, Cope, Pamela, Cotton, Sonja, Daudjee, Munib, Davidson, Tichina, De Loa, Geraldine, Deniega, Ann, Dillow, Naco, Dominguez, Michael, Dorfman, Steven, Doshi, Ankur, Dunnam, Theresa, Dutta, Papiya, Eiler-Prater, Megann, Eizensmits, Christina, Espinosa, Valerie, Evans, Charles, Frisinger, Cathy, Ganta, Shylesh, Galtney, Kirsten, Gammon, John, Garcia, Analisa Marie, Garcia, Ronald, Glaspie, Tina, Golici, Laura, Gonzalez, Julian, Grant, David, Green, Carrie, Groce, Lindsay, Guevara, Stephanie, Gutierrez, Mary, Hance, Cortney, Harden, Tiffany, Harrison, Lindsay, Herrera, Carlos, Hettler, Evelyn, Holcomb, Michelle, Hoste, Laura, Hudson, Tina, Huerta, Leticia, Jain, Mahendra, Jayaram, Preeth, Johnson, Monique, Johnson, Olivia, Jones, Laurie, Joseph, John, Juarez, Misty, Karimjee, Najmuddin, Kephart, Ashley, Khan, Armgan, Khan, Jalil, Killian, Michael, Kniffen, Wendy, Koops, Maureen, Kwan, Louise, La, John, Laabs, Jessica, Ledesma, Gilbert, Lee, Monica, Leuck, Kathryn, Livingston, Carrie, Llanas, Teresa, Longoria, Andy, Lorta, Jesse, Lothringer, Larry, MacAdams, Maria, MacAdams, Michael, MacGillivray, Brian, Mageno, Melissa, Malek, Megan, Manley, Meghan, Marler, Karen, Martinez, Cristina, Massie, Jodi, Mateos, Glenda, Mathew, Reena, Maya, Claudia, Mazour, Meg, Mbogua, Caroline, McClendon, Robert, McMullen, Deirdre, Meisner, Carl, Menchaca, Ethelina, Meyers, Linda, Miklius, Audrey, Milam, Alissa, Milam, Ronnie, Miller, Tracey, Mize, Lisa, Moczygemba, Roger, Nafegar, Alexandria, Naidu, Jayaram, Nair, Archana, Nguyen, Alison, Nielsen, Douglas, Nisnisan, Josier, Nisnisan, Maria, Oden, Wendy, Orsak, Jessica, Ozer, Kerem, Papacostea, Olivia, Panchal, Ravi, Parikh, Manish, Parthiban, Beneta, Perrin, Brittney, Perkins, Harvonya, Poduri, Madhuri, Pop, Laurentiu, Portales, Nancy, Porter-Tucci, Linda, Postell, Sharon, Pucillo, Ronald, Reddy, Madhavi, Reddy, Rajneesh, Almodovar, Ramon Gilberto Reyes, Richard, Timiki, Richardson, Michele, Riesch, Louie, Rivera-Flores, Samuel, Rizvi, Abid, Rizvi, Samana, Rodas, Kristen, Rodgers, Mark, Roe, Erin, Rogers, Rebecca, Romero, Reina, Rooker-Morris, Leslie, Rosenstock, Julio, Sachson, Richard, Salcedo, Alfredo, Schill, Joseph, Schuh, Kristy, Schuster, Randall, Scribner, Anita, Shah, Arunkumar, Shaw, Stephanie, Shirley, Jefferey, Shook, Mindy, Siddiqui, Muhammad, Sims, Jamie, Singh, Kamalpreet, Skero, Jennifer, Smejdir, Debra, Stacey, Amy, Strzinek, Robert, Tan, Anjanette, Tayabali, Khadija, Tercero, Almundena, Terry, Jessica, Tinney, Irene, Toe, Florence, Toler, Sara, Tripathy, Devjit, Tumyan, Anna, Ulrich, Michelle, Underwood, Krissandra, Valdez, Christina, Valdivieso, April, Vanderheiden, Anna, Vandre, Morgan, Vardeman, Megan, Vargas, Richard, Vilchis, Monica, Warne, Desiree, Wallace, Jeannine, Weindorff, Kathleen, Welch, Heather, Wellmon, Brandy, Werntz, Gary, White, Leta, Williams, Tearani, Wilson, Maria, Wilson, Robyn, Wilson, Ronald, Wood, John, Wright, David, Yeatts, Rhonda, Zahir, Rezwana, Crockett, Becky, Fawson, Ashlee, Graham, Timothy, Mitchell, Zachary, Quinn, Sally, Reddy, Deepika, Rhudy, Jackson, Rosen, Priscilla, Shakespear, Kaylynn, Simmons, Debra, Turner, Ashley, Vanderhoof, Erin, Wahl, Matthew, Zubair, Imran, Algus, Michael, Gilbert, Matthew, Gorson, David, Marney, Annis, Rodriguez, Juan Pablo Perdomo, Roth, Marilynn, Scofield, Sheilah, Thottan, Anna, Bittorf, Margaret, Botros, Emad, Carpenter, Jeanette, Dashiell, Carie, Dimascio-Johnson, Nancy, Fredrickson, Sonja, Gruenther, M., Hall, Lisa, Hartman, Aaron, Hiner, Janette, Kelley, Donna, Kimmel, Melissa, Larrick, Laura, Lawson, Marie, Levy, James, Lewis, Teneshia, Lovell, Charles, Newby, James, Nichols, Michelle, O'Donnell, Philip, Orengo, Sheyla, Pecsok, Thomas, Reiss, Lind, Tarkington, Phillip, Yeatts, Donald, Zieve, Franklin, Ahmed, Imtiaz, Ali, Sajid, Anwar, Sami, Cathcart, Harold, Dawson, Lucia, Floresca, Rolando, Galvan, Ashley, Gardner, Timothy, Halsey, Kami, Hashmi, Farrukh, Hegel, Jackie, Landon, Megan, Moulton, Katlynn, Nand, Cheta, Sakic, Amra, Sevey, Brandie, Wilson, Bruce, Ahl, Scott, Blank, Robert, Coly, Gerard, Hoenig, Jennifer, Jain, Rajeev, Joseph, Elizabeth, Kasprzak, Debra, Kisiel, Lalaine, Maaske, Maurene, Manadhar, Smriti, Patel, Shailendra, Sickler, Whitney, Grp, D.E.V.O.T.E. Study, Acibadem University Dspace, Marso S.P., Mcguire D.K., Zinman B., Poulter N.R., Emerson S.S., Pieber T.R., Pratley R.E., Haahr P.-M., Lange M., Brown-Frandsen K., Moses A., Skibsted S., Kvist K., Buse J.B., and Buscemi S

Subjects
Insulin degludec, Blood Glucose, Male, medicine.medical_treatment, DEVOTE Study Group, Insulin Glargine, Type 2 diabetes, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, law.invention, diabetes, insulin, 0302 clinical medicine, Randomized controlled trial, law, Cardiovascular Disease, GLUCOSE CONTROL, 11 Medical and Health Sciences, RISK, COMPLICATIONS, OUTCOMES, Incidence, General Medicine, Middle Aged, Insulin, Long-Acting, VARIABILITY, Cardiovascular Diseases, diabetes mellitus, Female, Life Sciences & Biomedicine, Human, medicine.drug, medicine.medical_specialty, 030209 endocrinology & metabolism, Aged, Diabetes Mellitus, Type 2, Double-Blind Method, Humans, Hypoglycemia, Hypoglycemic Agents, Medicine (all), Bedtime, Article, EVENTS, 03 medical and health sciences, HYPOGLYCEMIA, Medicine, General & Internal, Internal medicine, Diabetes mellitus, General & Internal Medicine, medicine, Intensive care medicine, METAANALYSIS, Science & Technology, Hypoglycemic Agent, Insulin glargine, business.industry, Insulin, medicine.disease, business, BASAL INSULIN
Abstract

BACKGROUND Degludec is an ultralong-Acting, once-daily basal insulin that is approved for use in adults, adolescents, and children with diabetes. Previous open-label studies have shown lower day-To-day variability in the glucose-lowering effect and lower rates of hypoglycemia among patients who received degludec than among those who received basal insulin glargine. However, data are lacking on the cardiovascular safety of degludec. METHODS We randomly assigned 7637 patients with type 2 diabetes to receive either insulin degludec (3818 patients) or insulin glargine U100 (3819 patients) once daily between dinner and bedtime in a double-blind, treat-To-Target, event-driven cardiovascular outcomes trial. The primary composite outcome in the time-To-event analysis was the first occurrence of an adjudicated major cardiovascular event (death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke) with a prespecified noninferiority margin of 1.3. Adjudicated severe hypoglycemia, as defined by the American Diabetes Association, was the prespecified, multiplicity-Adjusted secondary outcome. RESULTS Of the patients who underwent randomization, 6509 (85.2%) had established cardiovascular disease, chronic kidney disease, or both. At baseline, the mean age was 65.0 years, the mean duration of diabetes was 16.4 years, and the mean (±SD) glycated hemoglobin level was 8.4±1.7%; 83.9% of the patients were receiving insulin. The primary outcome occurred in 325 patients (8.5%) in the degludec group and in 356 (9.3%) in the glargine group (hazard ratio, 0.91; 95% confidence interval, 0.78 to 1.06; P

Published
2017

29. MERRF Classification: Implications for Diagnosis and Clinical Trials

Author

John M. Shoffner, Sinda Zarrouk-Mahjoub, and Josef Finsterer

Subjects
0301 basic medicine, Phenocopy, business.industry, Clinical study design, Mitochondrial disease, Disease, medicine.disease, Bioinformatics, MERRF Syndrome, Clinical trial, 03 medical and health sciences, MT-TK, 030104 developmental biology, 0302 clinical medicine, Developmental Neuroscience, Neurology, Mitochondrial myopathy, Pediatrics, Perinatology and Child Health, medicine, Myoclonic epilepsy, Humans, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background Given the etiologic heterogeneity of disease classification using clinical phenomenology, we employed contemporary criteria to classify variants associated with myoclonic epilepsy with ragged-red fibers (MERRF) syndrome and to assess the strength of evidence of gene-disease associations. Standardized approaches are used to clarify the definition of MERRF, which is essential for patient diagnosis, patient classification, and clinical trial design. Methods Systematic literature and database search with application of standardized assessment of gene-disease relationships using modified Smith criteria and of variants reported to be associated with MERRF using modified Yarham criteria. Results Review of available evidence supports a gene-disease association for two MT-tRNAs and for POLG. Using modified Smith criteria, definitive evidence of a MERRF gene-disease association is identified for MT-TK. Strong gene-disease evidence is present for MT-TL1 and POLG. Functional assays that directly associate variants with oxidative phosphorylation impairment were critical to mtDNA variant classification. In silico analysis was of limited utility to the assessment of individual MT-tRNA variants. With the use of contemporary classification criteria, several mtDNA variants previously reported as pathogenic or possibly pathogenic are reclassified as neutral variants. Conclusions MERRF is primarily an MT-TK disease, with pathogenic variants in this gene accounting for ~90% of MERRF patients. Although MERRF is phenotypically and genotypically heterogeneous, myoclonic epilepsy is the clinical feature that distinguishes MERRF from other categories of mitochondrial disorders. Given its low frequency in mitochondrial disorders, myoclonic epilepsy is not explained simply by an impairment of cellular energetics. Although MERRF phenocopies can occur in other genes, additional data are needed to establish a MERRF disease-gene association. This approach to MERRF emphasizes standardized classification rather than clinical phenomenology, thus improving patient diagnosis and clinical trial design.

Published
2017

30. What About Moral Distress?

Author

Kathy Schoonover-Shoffner

Subjects
Moral distress, Ethics, Nursing, medicine, MEDLINE, Psychological stress, Humans, General Medicine, medicine.disease_cause, Psychology, Morals, Christianity, Stress, Psychological, Clinical psychology
Published
2017

31. Executive Summary: Transforming Moral Distress into Moral Resilience in Nursing

Author

Maureen Shawn Kennedy, Kathy Schoonover-Shoffner, and Cynda Hylton Rushton

Subjects
media_common.quotation_subject, education, MEDLINE, Nursing, 0603 philosophy, ethics and religion, Morals, Christianity, 03 medical and health sciences, 0302 clinical medicine, Moral distress, Ethics, Nursing, Humans, 030212 general & internal medicine, State of the science, health care economics and organizations, General Nursing, media_common, Executive summary, 030504 nursing, 06 humanities and the arts, General Medicine, American nurse association, Bioethics, Congresses as Topic, Resilience, Psychological, humanities, United States, Nurse clinicians, 060301 applied ethics, Psychological resilience, 0305 other medical science, Psychology, Stress, Psychological
Abstract

To examine practices for addressing moral distress, a collaborative project was developed by the Johns Hopkins Berman Institute of Bioethics, the Johns Hopkins School of Nursing, the American Journal of Nursing, and the Journal of Christian Nursing, along with the American Association of Critical-Care Nurses and the American Nurses Association. Its purpose was to identify strategies that individuals and systems can use to mitigate the detrimental effects of moral distress and foster moral resilience. On August 11 and 12, 2016, an invitational symposium, State of the Science: Transforming Moral Distress into Moral Resilience in Nursing, was held at the Johns Hopkins School of Nursing in Baltimore, Maryland. Forty-five nurse clinicians, researchers, ethicists, organization representatives, and other stakeholders took part. The result of the symposium was group consensus on recommendations for addressing moral distress and building moral resilience in four areas: practice, education, research, and policy. Participants and the organizations represented were energized and committed to moving this agenda forward. The full report is available online at http://journals.lww.com/ajnonline/Pages/Moral-Distress-Supplement.aspx.

Published
2017

32. A Collaborative State of the Science Initiative: Transforming Moral Distress into Moral Resilience in Nursing

Author

Cynda Hylton Rushton, Kathy Schoonover-Shoffner, and Maureen Shawn Kennedy

Subjects
media_common.quotation_subject, education, MEDLINE, Ethical practice, Nursing, 0603 philosophy, ethics and religion, Morals, 03 medical and health sciences, Moral distress, Humans, State of the science, health care economics and organizations, General Nursing, media_common, 030504 nursing, 06 humanities and the arts, General Medicine, Bioethics, American nurse association, Resilience, Psychological, humanities, Nurse clinicians, 060301 applied ethics, Psychological resilience, 0305 other medical science, Psychology, Stress, Psychological
Abstract

To examine practices for addressing moral distress, a collaborative project was developed by the Johns Hopkins Berman Institute of Bioethics, the Johns Hopkins School of Nursing, the American Journal of Nursing, and the Journal of Christian Nursing, along with the American Association of Critical-Care Nurses and the American Nurses Association. Its purpose was to identify strategies that individuals and systems can use to mitigate the detrimental effects of moral distress and foster moral resilience. On August 11 and 12, 2016, an invitational symposium, State of the Science: Transforming Moral Distress into Moral Resilience in Nursing, was held at the Johns Hopkins School of Nursing in Baltimore, Maryland. Forty-five nurse clinicians, researchers, ethicists, organization representatives, and other stakeholders took part. The result of the symposium was group consensus on recommendations for addressing moral distress and building moral resilience in four areas: practice, education, research, and policy. Participants and the organizations represented were energized and committed to moving this agenda forward.

Published
2017

33. Hard Faith

Author

Kathy, Schoonover-Shoffner

Subjects
Adult, Male, Adaptation, Psychological, Humans, Female, Nursing Care, Parish Nursing, General Medicine, Middle Aged, Nursing Staff, Hospital, Christianity, Stress, Psychological, United States
Published
2019
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34. Heterozygous mutations of the kinesin KIF21A in congenital fibrosis of the extraocular muscles type 1 (CFEOM1)

Author

Monte A. Del Monte, Berendina De Vries, Arnold London, Wai-Man Chan, Emin Cumhur Sener, Anat Loewenstein, Joseph L. Demer, Elizabeth C. Engle, Nakamichi Saito, Robert P. Cruse, Michael C. Brodsky, A. Nurten Akarsu, Roger H. Johnson, Mark S. Ruttum, Alina A. Zubcov, Alex V. Levin, Naomichi Matsumoto, Blaine L. Hart, Teresa de Berardinis, Lionel Kowal, Ravi Battu, Marlene C. Vogel, Michael O'Keefe, Thomas J. Carlow, Frank Hanisch, Banu T. Öztürk, Caroline Andrews, Robert D. Letson, Moshe Lazar, Eiichiro Uyama, Craig A. McKeown, James A. Katowitz, Scott M. Goldstein, Piergiorgio Franceschini, Richard M. Robb, Lisa Morris, Adriano Magli, Koki Yamada, Peter Roggenkäemper, Nicolas Krawiecki, Willem A. Houtman, John M. Shoffner, Anna Newlin, Elias I. Traboulsi, Irene Gottlob, Yamada, K, Andrews, C, Chan, Wm, Mckeown, Ca, Magli, A, DE BERARDINIS, Teresa, Loewenstein, A, Lazar, M, O'Keefe, M, Letson, R, London, A, Ruttum, M, Matsumoto, N, Saito, N, Morris, L, DEL MONTE, M, Johnson, Rh, Uyama, E, Houtman, Wa, DE VRIES, B, Carlow, Tj, Hart, Bl, Krawiecki, N, Shoffner, J, Vogel, Mc, Katowitz, J, Goldstein, Sm, Levin, Av, Sener, Ec, Ozturk, Bt, Akarsu, An, Brodsky, Mc, Hanisch, F, Cruse, Rp, Zubcov, Aa, Robb, Rm, Roggenkaemper, P, Gottlob, I, Kowal, L, Battu, R, Traboulsi, Ei, Franceschini, P, Newlin, A, Demer, Jl, and Engle, E. C.

Subjects
Proband, Male, Heterozygote, congenital, hereditary, and neonatal diseases and abnormalities, genetic structures, Genetic Linkage, Molecular Sequence Data, Kinesins, Nerve Tissue Proteins, Biology, REGION, Motor protein, Mutational hotspot, Congenital fibrosis of the extraocular muscles, MAPS, Genetics, medicine, Missense mutation, Humans, Amino Acid Sequence, Strabismus, Child, Ophthalmoplegia, Sequence Homology, Amino Acid, CHROMOSOME-12, REFINEMENT, Oculomotor nerve, Genetic Variation, EXTERNAL OPHTHALMOPLEGIA, medicine.disease, Fibrosis, eye diseases, Pedigree, Phenotype, Oculomotor Muscles, Mutation, Kinesin, Female
Abstract

Congenital fibrosis of the extraocular muscles type 1 (CFEOM1; OMIM #135700) is an autosomal dominant strabismus disorder associated with defects of the oculomotor nerve. We show that individuals with CFEOM1 harbor heterozygous missense mutations in a kinesin motor protein encoded by KIF21A. We identified six different mutations in 44 of 45 probands. The primary mutational hotspots are in the stalk domain, highlighting an important new role for KIF21A and its stalk in the formation of the oculomotor axis.

Published
2003

35. Author response: CSF concentrations of 5-methyltetrahydrofolate in a cohort of young children with autism

Author

John M. Shoffner

Subjects
Pediatrics, medicine.medical_specialty, 5-Methyltetrahydrofolate, Cohort Studies, 03 medical and health sciences, Folinic acid, 0302 clinical medicine, Folic Acid, medicine, Humans, 030212 general & internal medicine, Autistic Disorder, Child, Tetrahydrofolates, medicine.diagnostic_test, Lumbar puncture, Cognition, medicine.disease, Autism spectrum disorder, Cohort, Autism, Neurology (clinical), Psychology, 030217 neurology & neurosurgery, Decision limit, medicine.drug
Abstract

On behalf of my coauthors, I thank Dr. Barrett for the comment on our article.1 Dr. Barrett correctly recognizes that one of the central aspects of our study was to investigate whether a relationship of CSF 5-MTHF levels to symptoms in young children with autism exists. As addressed in the article, a major difficulty in diagnosing cerebral folate deficiency using CSF 5-MTHF levels was the lack of reference intervals from a normal population that would allow defining clinical decision limits.1 To gain insight into the relationship between CSF 5-MTHF levels and clinical decision limits for young children with autism, we assessed CSF 5-MTHF over time and correlated these levels with detailed clinical assessments. The CSF 5-MTHF levels varied significantly and were not associated with any measures of adaptive behavior, cognitive ability, or autism spectrum disorder symptom severity. As discussed in the article, pediatric CSF normative data that consider natural CSF 5-MTHF variability over time are essential to defining reference intervals as well as critical decision limits.1 In our cohort of young children with autism, a critical decision limit for CSF 5-MTHF levels was not identified. Further research in patients with autism is needed before CSF 5-MTHF levels can be used to justify lumbar puncture to diagnose cerebral folate deficiency or treatment of patients with compounds such as folinic acid or 5-MTHF.

Published
2016

36. Significant Moments

Author

Kathy Schoonover-Shoffner

Subjects
Practice Patterns, Nurses', Humans, General Medicine, Christianity
Published
2016

37. Coordination of signaling and tissue mechanics during morphogenesis of murine intestinal villi: a role for mitotic cell rounding

Author

Andrew M. Freddo, Kenichiro Taniguchi, Suzanne K. Shoffner, Shiva Rudraraju, Margaux N. Guysinger, Deborah L. Gumucio, Ann S. Grosse, Santiago Schnell, Benjamin Margolis, Yue Shao, Krishna Garikipati, and Sha Wang

Subjects
0301 basic medicine, Compressive Strength, Biophysics, Morphogenesis, Mitosis, Biology, Biochemistry, Mechanotransduction, Cellular, Models, Biological, Article, 03 medical and health sciences, Mice, medicine, Animals, Humans, Computer Simulation, Mechanotransduction, Intestinal Mucosa, Membrane invagination, Cell Size, Microvilli, Intestinal villus, Mesenchymal stem cell, Apical membrane, Epithelium, Cell biology, 030104 developmental biology, medicine.anatomical_structure, Stress, Mechanical
Abstract

Efficient digestion and absorption of nutrients by the intestine requires a very large apical surface area, a feature that is enhanced by the presence of villi, fingerlike epithelial projections that extend into the lumen. Prior to villus formation, the epithelium is a thick pseudostratified layer. In mice, villus formation begins at embryonic day (E)14.5, when clusters of mesenchymal cells form just beneath the thick epithelium. At this time, analysis of the flat lumenal surface reveals a regular pattern of short apical membrane invaginations that form in regions of the epithelium that lie in between the mesenchymal clusters. Apical invaginations begin in the proximal intestine and spread distally, deepening with time. Interestingly, mitotically rounded cells are frequently associated with these invaginations. These mitotic cells are located at the tips of the invaginating membrane (internalized within the epithelium), rather than adjacent to the apical surface. Further investigation of epithelial changes during membrane invagination reveals that epithelial cells located between mesenchymal clusters experience a circumferential compression, as epithelial cells above each cluster shorten and widen. Using a computational model, we examined whether such forces are sufficient to cause apical invaginations. Simulations and in vivo data reveal that proper apical membrane invagination involves intraepithelial compressive forces, mitotic cell rounding in the compressed regions and apico-basal contraction of the dividing cell. Together, these data establish a new model that explains how signaling events intersect with tissue forces to pattern apical membrane invaginations that define the villus boundaries.

Published
2016

38. Innate Immunity against Granulibacter bethesdensis, an Emerging Gram-Negative Bacterial Pathogen

Author

John I. Gallin, Larissa S. Rogge, Steven M. Holland, Jessica Chu, Frank R. DeLeo, Meggan Czapiga, Adeline R. Whitney, Helen H. Song, Harry L. Malech, Adam R. Shoffner, David E. Greenberg, Kunio Nagashima, Anna R. Cruz, Pamela A. Shaw, Michael E. Fenster, Kimberly R. Marshall-Batty, and Kol A. Zarember

Subjects
Blood Bactericidal Activity, Neutrophils, Phagocytosis, Immunology, Colony Count, Microbial, Host tropism, Biology, Granulomatous Disease, Chronic, medicine.disease_cause, Microbiology, Pathogenesis, Chronic granulomatous disease, Escherichia coli, medicine, Humans, Pathogen, Cellular Microbiology: Pathogen-Host Cell Molecular Interactions, Microbial Viability, Innate immune system, Complement System Proteins, medicine.disease, Immunity, Innate, Infectious Diseases, Acetobacteraceae, Granulibacter bethesdensis, Parasitology, Gram-Negative Bacterial Infections, Reactive Oxygen Species
Abstract

Acetic acid bacteria were previously considered nonpathogenic in humans. However, over the past decade, five genera of Acetobacteraceae have been isolated from patients with inborn or iatrogenic immunodeficiencies. Here, we describe the first studies of the interactions of the human innate immune system with a member of this bacterial family, Granulibacter bethesdensis , an emerging pathogen in patients with chronic granulomatous disease (CGD). Efficient phagocytosis of G. bethesdensis by normal and CGD polymorphonuclear leukocytes (CGD PMN) required heat-labile serum components (e.g., C3), and binding of C3 and C9 to G. bethesdensis was detected by immunoblotting. However, this organism survived in human serum concentrations of ≥90%, indicating a high degree of serum resistance. Consistent with the clinical host tropism of G. bethesdensis , CGD PMN were unable to kill this organism, while normal PMN, in the presence of serum, reduced the number of CFU by about 50% after a 24-h coculture. This finding, together with the observations that G. bethesdensis was sensitive to H 2 O 2 but resistant to LL-37, a human cationic antimicrobial peptide, suggests an inherent resistance to O 2 -independent killing. Interestingly, 10 to 100 times greater numbers of G. bethesdensis were required to achieve the same level of reactive oxygen species (ROS) production induced by Escherichia coli in normal PMN. In addition to the relative inability of the organism to elicit production of PMN ROS, G. bethesdensis inhibited both constitutive and FAS-induced PMN apoptosis. These properties of reduced PMN activation and resistance to nonoxidative killing mechanisms likely play an important role in G. bethesdensis pathogenesis.

Published
2012
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39. Ortholog identification in the presence of domain architecture rearrangement

Author

Grant M. Shoffner, Ruchira S. Datta, Yao-Qing Shen, and Kimmen Sjölander

Subjects
Databases, Factual, Architecture domain, Structural similarity, function prediction, Computational biology, Biology, Genome, Homology (biology), Evolution, Molecular, 03 medical and health sciences, 0302 clinical medicine, Protein sequencing, Phylogenetics, Animals, Humans, Molecular Biology, Phylogeny, 030304 developmental biology, Genetics, 0303 health sciences, Special Issue Papers, Phylogenetic tree, Computational Biology, Proteins, Robustness (evolution), phylogenomics, super-ortholog, multi-domain architecture, promiscuous domains, orthology, 030217 neurology & neurosurgery, Information Systems
Abstract

Ortholog identification is used in gene functional annotation, species phylogeny estimation, phylogenetic profile construction and many other analyses. Bioinformatics methods for ortholog identification are commonly based on pairwise protein sequence comparisons between whole genomes. Phylogenetic methods of ortholog identification have also been developed; these methods can be applied to protein data sets sharing a common domain architecture or which share a single functional domain but differ outside this region of homology. While promiscuous domains represent a challenge to all orthology prediction methods, overall structural similarity is highly correlated with proximity in a phylogenetic tree, conferring a degree of robustness to phylogenetic methods. In this article, we review the issues involved in orthology prediction when data sets include sequences with structurally heterogeneous domain architectures, with particular attention to automated methods designed for high-throughput application, and present a case study to illustrate the challenges in this area.

Published
2011
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40. Phosphorylation of histone H3(T118) alters nucleosome dynamics and remodeling

Author

Richard Fishel, Michael G. Poirier, Michelle B. Ferdinand, Sarah Javaid, Nilanjana Chatterjee, Matthew A. Shoffner, Justin A. North, Blaine Bartholomew, Jennifer J. Ottesen, Robin J. Nakkula, and Jonathan W. Picking

Subjects
Nucleosome disassembly, Gene Regulation, Chromatin and Epigenetics, Chromatin remodeling, Histones, 03 medical and health sciences, Histone methylation, Genetics, Histone code, Nucleosome, Humans, Phosphorylation, 030304 developmental biology, 0303 health sciences, biology, 030302 biochemistry & molecular biology, DNA, Chromatin Assembly and Disassembly, Linker DNA, Molecular biology, SWI/SNF, Cell biology, Nucleosomes, DNA-Binding Proteins, Histone, MutS Homolog 2 Protein, biology.protein, Protein Binding
Abstract

Nucleosomes, the fundamental units of chromatin structure, are regulators and barriers to transcription, replication and repair. Post-translational modifications (PTMs) of the histone proteins within nucleosomes regulate these DNA processes. Histone H3(T118) is a site of phosphorylation [H3(T118ph)] and is implicated in regulation of transcription and DNA repair. We prepared H3(T118ph) by expressed protein ligation and determined its influence on nucleosome dynamics. We find H3(T118ph) reduces DNA-histone binding by 2 kcal/mol, increases nucleosome mobility by 28-fold and increases DNA accessibility near the dyad region by 6-fold. Moreover, H3(T118ph) increases the rate of hMSH2-hMSH6 nucleosome disassembly and enables nucleosome disassembly by the SWI/SNF chromatin remodeler. These studies suggest that H3(T118ph) directly enhances and may reprogram chromatin remodeling reactions.

Published
2011

41. RecurrentGranulibacter bethesdensisInfections and Chronic Granulomatous Disease

Author

David E. Greenberg, Harry L. Malech, Li Ding, Michael E. Fenster, Adam R. Shoffner, Richard L. Wasserman, Steven M. Holland, Stephen F. Porcella, Kimberly R. Marshall-Batty, Kishore Kanakabandi, Patrick R. Murray, Frida Stock, Kimmo Virtaneva, Dan E. Sturdevant, Kol A. Zarember, Adrian M. Zelazny, and David F. Welch

Subjects
Adult, Male, Microbiology (medical), Adolescent, Epidemiology, comparative genomic hybridization, lcsh:Medicine, chronic granulomatous disease, Biology, Granulomatous Disease, Chronic, Communicable Diseases, Emerging, Genomic Instability, Article, lcsh:Infectious and parasitic diseases, Microbiology, Emerging pathogen, Chronic granulomatous disease, Recurrence, RNA, Ribosomal, 16S, lymphadenitis, CME, medicine, Humans, lcsh:RC109-216, In patient, Typing, DNA Primers, relapse, Base Sequence, Bacteria, lcsh:R, medicine.disease, Antimicrobial, Multiple drug resistance, RNA, Bacterial, Infectious Diseases, Granulibacter bethesdensis, Immunology, Synopsis, Acetobacteraceae, Ceftriaxone, Gram-Negative Bacterial Infections, Genome, Bacterial, medicine.drug
Abstract

Chronic granulomatous disease (CGD) is characterized by frequent infections, most of which are curable. Granulibacter bethesdensis is an emerging pathogen in patients with CGD that causes fever and necrotizing lymphadenitis. However, unlike typical CGD organisms, this organism can cause relapse after clinical quiescence. To better define whether infections were newly acquired or recrudesced, we use comparative bacterial genomic hybridization to characterize 11 isolates obtained from 5 patients with CGD from North and Central America. Genomic typing showed that 3 patients had recurrent infection months to years after apparent clinical cure. Two patients were infected with the same strain as previously isolated, and 1 was infected with a genetically distinct strain. This organism is multidrug resistant, and therapy required surgery and combination antimicrobial drugs, including long-term ceftriaxone. G. bethesdensis causes necrotizing lymphadenitis in CGD, which may recur or relapse.

Published
2010
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42. Cerebral folate deficiency

Author

Simon Heales, Keith Hyland, and John Shoffner

Subjects
medicine.medical_specialty, Leucovorin, Administration, Oral, Rett syndrome, Folic Acid Deficiency, Gastroenterology, Cerebrospinal fluid, Risk Factors, Internal medicine, Genetics, medicine, Humans, Folate Receptor 1, Genetic Predisposition to Disease, Tetrahydrofolates, Genetics (clinical), Autoantibodies, Brain Diseases, Psychomotor retardation, Cerebellar ataxia, business.industry, medicine.disease, Treatment Outcome, Endocrinology, Dyskinesia, Folate receptor, Dietary Supplements, Mutation, Sensorineural hearing loss, Folate receptor 1, medicine.symptom, business, Folic Acid Transporters
Abstract

Cerebral folate deficiency (CFD) is defined as any neurological syndrome associated with a low cerebrospinal fluid (CSF) concentration of 5-methyltetrahydrofolate (5MTHF) in the presence of normal peripheral folate status. CFD has a wide clinical presentation, with reported signs and symptoms generally beginning at around 4 months of age with irritability and sleep disturbances. These can be followed by psychomotor retardation, dyskinesia, cerebellar ataxia and spastic diplegia. Other signs may include deceleration of head growth, visual disturbances and sensorineural hearing loss. Identification of CFD is achieved by determining 5MTHF concentration in CSF. Once identified, CFD can in many cases be treated by administering oral folinic acid. Supplementation with folic acid is contraindicated and, if used, may exacerbate the CSF 5MTHF deficiency. Generation of autoantibodies against the folate receptor required to transport 5MTHF into CSF and mutations in the folate receptor 1 (FOLR1) gene have been reported to be causes of CFD. However, other mechanisms are probably also involved, as CFD has been reported in Aicardi-Goutiere's and Rett syndromes and in mitochondriopathies. Several metabolic conditions and a number of widely used drugs can also lead to a decrease in the concentration of CSF 5MTHF, and these should be considered in the differential diagnosis if a low concentration of 5MTHF is found following CSF analysis.

Published
2010
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43. 12-Hour Shifts

Author

Kathy Schoonover-Shoffner

Subjects
Medical education, 030504 nursing, business.industry, Personnel Staffing and Scheduling, MEDLINE, Shift Work Schedule, Nursing, General Medicine, 03 medical and health sciences, 0302 clinical medicine, Action (philosophy), Humans, Medicine, 0305 other medical science, business, 030217 neurology & neurosurgery
Published
2018
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44. Autosomal recessive inheritance of classic Bethlem myopathy

Author

Carsten G. Bönnemann, Alexandra B. Columbus, Diane M. Dunn, A. Reghan Foley, Robert B. Weiss, Yaqun Zou, John Shoffner, and Ying Hu

Subjects
Adult, Male, Heterozygote, Ullrich congenital muscular dystrophy, Molecular Sequence Data, Mutation, Missense, Genes, Recessive, Collagen Type VI, Biology, Compound heterozygosity, Article, Exon, Muscular Diseases, Collagen VI, medicine, Humans, Missense mutation, Amino Acid Sequence, Allele, Genetics (clinical), Sequence Deletion, Genetics, Sequence Homology, Amino Acid, Bethlem myopathy, Dermis, Exons, Fibroblasts, medicine.disease, Exon skipping, Pedigree, Phenotype, Neurology, Pediatrics, Perinatology and Child Health, Neurology (clinical)
Abstract

Mutations in the collagen VI genes (COL6A1, COL6A2 and COL6A3) result in Ullrich congenital muscular dystrophy (CMD), Bethlem myopathy or phenotypes intermediate between Ullrich CMD and Bethlem myopathy. While Ullrich CMD can be caused by either recessively or dominantly acting mutations, Bethlem myopathy has thus far been described as an exclusively autosomal dominant condition. We report two adult siblings with classic Bethlem myopathy who are compound heterozygous for a single nucleotide deletion (exon 23; c.1770delG), leading to in-frame skipping of exon 23 on the maternal allele, and a missense mutation p.R830W in exon 28 on the paternal allele. The parents are carriers of the respective mutations and are clinically unaffected. The exon skipping mutation in exon 23 results in a chain incapable of heterotrimeric assembly, while p.R830W likely ameliorates the phenotype into the Bethlem range. Thus, autosomal recessive inheritance can also underlie Bethlem myopathy, supporting the notion that Ullrich CMD and Bethlem myopathy are part of a common clinical and genetic spectrum.

Published
2009
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45. Fever Plus Mitochondrial Disease Could Be Risk Factors for Autistic Regression

Author

Stephanie Cossette, Lauren Hyams, Lisa Ollis, Audra Aliberti, Sara Kuoch, John M. Shoffner, Lauren Mylacraine, Kevin Bennett, Jeffrey Dale, Genevieve Niedziela Langley, and Keith Hyland

Subjects
Male, medicine.medical_specialty, Mitochondrial Diseases, Adolescent, Fever, Mitochondrial disease, Population, Comorbidity, Biology, Young Adult, Recurrence, Risk Factors, Stress, Physiological, Internal medicine, Prevalence, medicine, Humans, Young adult, Child, education, Psychiatry, Retrospective Studies, education.field_of_study, Incidence, Incidence (epidemiology), Brain, Infant, Retrospective cohort study, medicine.disease, Regression, Mitochondria, Regression, Psychology, Vaccination, Child Development Disorders, Pervasive, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Neurology (clinical), Energy Metabolism
Abstract

Autistic spectrum disorders encompass etiologically heterogeneous persons, with many genetic causes. A subgroup of these individuals has mitochondrial disease. Because a variety of metabolic disorders, including mitochondrial disease show regression with fever, a retrospective chart review was performed and identified 28 patients who met diagnostic criteria for autistic spectrum disorders and mitochondrial disease. Autistic regression occurred in 60.7% (17 of 28), a statistically significant increase over the general autistic spectrum disorder population (P < .0001). Of the 17 individuals with autistic regression, 70.6% (12 of 17) regressed with fever and 29.4% (5 of 17) regressed without identifiable linkage to fever or vaccinations. None showed regression with vaccination unless a febrile response was present. Although the study is small, a subgroup of patients with mitochondrial disease may be at risk of autistic regression with fever. Although recommended vaccinations schedules are appropriate in mitochondrial disease, fever management appears important for decreasing regression risk.

Published
2009
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46. Siblings With Leukoencephalopathy

Author

John Shoffner, Galen N. Breningstall, and Richard J. Patterson

Subjects
Male, Pathology, medicine.medical_specialty, NDUFV1, Leukoencephalopathy, medicine, Humans, Spasticity, Electron Transport Complex I, medicine.diagnostic_test, business.industry, Siblings, Leukoencephalopathy, Progressive Multifocal, Infant, NADH Dehydrogenase, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, Diffuse leukoencephalopathy, Mutation, Pediatrics, Perinatology and Child Health, Mutation (genetic algorithm), Female, Neurology (clinical), medicine.symptom, business, Developmental regression
Abstract

Two consanguineous siblings presented with developmental regression and emerging spasticity. Cranial magnetic resonance imaging in both showed diffuse leukoencephalopathy. Further investigation established the siblings as having complex 1 deficiency consequent to a novel homozygous mutation in NDUFV1, a nuclear-encoded subunit of complex 1. Diffuse leukoencephalopathy may be a presentation of complex 1 deficiency.

Published
2008
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47. Effect of a rapid response system for patients in shock on time to treatment and mortality during 5 years*

Author

Debbie Shoffner, David W. Johnson, Mark Eliason, Bruce Spurlock, Frank Sebat, Andrew A. Kramer, Kristen Henry, and Amjad A. Musthafa

Subjects
Male, Patient Care Team, medicine.medical_specialty, Time Factors, Patient care team, business.industry, Time to treatment, Sepsis syndrome, Shock, Middle Aged, Critical Care and Intensive Care Medicine, medicine.disease, Sepsis, Early Diagnosis, Intensive care, Shock (circulatory), Humans, Medicine, Female, Prospective Studies, medicine.symptom, business, Intensive care medicine, Healthcare providers, Rapid response system
Abstract

Treatment of nontraumatic shock is often delayed or inadequate due to insufficient knowledge or skills of front-line healthcare providers, limited hospital resources, and lack of institution-wide systems to ensure application of best practice. As a result, mortality from shock remains high. We designed a study to determine whether outcomes will be improved by a hospital-wide system that educates and empowers clinicians to rapidly identify and treat patients in shock with a multidisciplinary team using evidenced-based protocols.Single-center trial before and after implementation of a hospital-wide rapid response system for early identification and treatment of patients in shock.A 180-bed regional referral center in northern California.A total of 511 adult patients who met criteria for shock during a 7-yr period.We designed a rapid response system that included a comprehensive educational program for clinicians on earlier recognition of shock, empowerment of front-line providers using specific criteria to initiate therapy, mobilization of the rapid response team, protocol goal-directed therapy, and early transfer to the intensive care unit. Outcome feedback was provided to foster adoption.We measured times to key interventions and hospital mortality 2.5 yrs before and until 5 yrs after system initiation. Times to interventions and mortality decreased significantly over time before and after adjusting for confounding factors. Interventions times, including shock alert activation, infusion of 2 L of fluid, central venous catheter placement, and antibiotic administration, were significant predictors of mortality (p.05). Overall and septic subgroup mortality decreased from before system implementation through protocol year 5 from 40% to 11.8% and from 50% to 10%, respectively (p.001).Over time, a rapid response system for patients in shock continued to reduce time to treatment, resulting in a continued decrease in mortality. By year 5, only three patients needed to be treated to save one additional life.

Published
2007
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48. GrittingYour Teeth at Work?

Author

Kathy, Schoonover-Shoffner

Subjects
Attitude of Health Personnel, Adaptation, Psychological, Humans, Nursing Care, Christianity, Stress, Psychological
Published
2015

49. Alpha-sarcoglycanopathy presenting as exercise intolerance and rhabdomyolysis in two adults

Author

Mamta Giri, Lauren Brady, Mark A. Tarnopolsky, Eric P. Hoffman, and J Shoffner

Subjects
musculoskeletal diseases, Adult, Male, Pathology, medicine.medical_specialty, Exercise intolerance, Rhabdomyolysis, Sarcoglycans, medicine, Sarcoglycanopathies, Humans, Myopathy, Muscle, Skeletal, Genetics (clinical), SGCA, Muscle biopsy, Exercise Tolerance, medicine.diagnostic_test, business.industry, Myoglobinuria, Muscle weakness, Myalgia, medicine.disease, Sarcoglycanopathy, Neurology, Pediatrics, Perinatology and Child Health, Female, Neurology (clinical), medicine.symptom, business
Abstract

Two patients with exercise-induced myalgias and rhabdomyolysis with myoglobinuria were evaluated with muscle biopsy and comprehensive myopathy next generation sequencing (NGS) gene panels. Genetic analysis revealed homozygosity for two known pathogenic SGCA mutations (R284C in Patient 1 and V247M in Patient 2). Muscle biopsy showed minimal changes with normal immunohistochemistry for α-sarcoglycan. Western blotting showed 27% and 35% of normal α-sarcoglycan immunoreactivity when compared to age matched controls, confirming the diagnosis of α-sarcoglycanopathy in both patients. The sarcoglycan genes should be added to the differential diagnosis for cases that present with rhabdomyolysis, exercise intolerance, and hyperCKemia, even in the absence of muscle weakness or normal α-sarcoglycan immunohistochemistry. Work-up of patients with these types of non-specific presentation may be best facilitated through the use of non-specific NGS myopathy panels.

Published
2015

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