54 results on '"Dean KR"'
Search Results
2. Steamship DisenchantmentChronotopes of Sea Adventure in Nordahl Grieg’s Skibet gaar videre
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Dean Krouk
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Nordahl Grieg ,maritime literature ,chronotopes ,the sea in literature ,Norwegian literature ,Literature (General) ,PN1-6790 - Abstract
This article analyzes Nordahl Grieg’s Skibet gaar videre (1924) as a maritime novel from the age of steamships. It explains the novel’s “maritime world picture” (Søren Frank) as a kind of disenchantment connected to the steamship. In addition, it analyzes the novel’s moments of re-enchantment that are connected to sailing ships and sea animals. The article is structured around several genre-typical chronotopes of sea adventure narrative, which help to explain the young Grieg’s aesthetic and ideological relations to the novel of the sea.
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- 2024
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3. On-farm testing of dairy calves’ avoidance response to human approach: Effects of sex, age and test order
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Ellingsen-Dalskau, K, primary, Dean, KR, additional, and Rousing, T, additional
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- 2020
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4. Database quality assessment in research in paramedicine: a scoping review
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Neil McDonald, Nicola Little, Dean Kriellaars, Malcolm B. Doupe, Gordon Giesbrecht, and Rob T. Pryce
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Paramedicine ,Prehospital ,Data ,Data quality ,Emergency medical services ,Data collection ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Research in paramedicine faces challenges in developing research capacity, including access to high-quality data. A variety of unique factors in the paramedic work environment influence data quality. In other fields of healthcare, data quality assessment (DQA) frameworks provide common methods of quality assessment as well as standards of transparent reporting. No similar DQA frameworks exist for paramedicine, and practices related to DQA are sporadically reported. This scoping review aims to describe the range, extent, and nature of DQA practices within research in paramedicine. Methods This review followed a registered and published protocol. In consultation with a professional librarian, a search strategy was developed and applied to MEDLINE (National Library of Medicine), EMBASE (Elsevier), Scopus (Elsevier), and CINAHL (EBSCO) to identify studies published from 2011 through 2021 that assess paramedic data quality as a stated goal. Studies that reported quantitative results of DQA using data that relate primarily to the paramedic practice environment were included. Protocols, commentaries, and similar study types were excluded. Title/abstract screening was conducted by two reviewers; full-text screening was conducted by two, with a third participating to resolve disagreements. Data were extracted using a piloted data-charting form. Results Searching yielded 10,105 unique articles. After title and abstract screening, 199 remained for full-text review; 97 were included in the analysis. Included studies varied widely in many characteristics. Majorities were conducted in the United States (51%), assessed data containing between 100 and 9,999 records (61%), or assessed one of three topic areas: data, trauma, or out-of-hospital cardiac arrest (61%). All data-quality domains assessed could be grouped under 5 summary domains: completeness, linkage, accuracy, reliability, and representativeness. Conclusions There are few common standards in terms of variables, domains, methods, or quality thresholds for DQA in paramedic research. Terminology used to describe quality domains varied among included studies and frequently overlapped. The included studies showed no evidence of assessing some domains and emerging topics seen in other areas of healthcare. Research in paramedicine would benefit from a standardized framework for DQA that allows for local variation while establishing common methods, terminology, and reporting standards.
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- 2023
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5. Development of a Global Physical Literacy (GloPL) Action Framework: Study protocol for a consensus process.
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Johannes Carl, Emiliano Mazzoli, Alexandre Mouton, Raymond Kim-Wai Sum, Amika Singh, Marlen Niederberger, João Martins, Dean Kriellaars, Nigel Green, Peter Elsborg, Dean A Dudley, John Cairney, Jaime Barratt, and Lisa M Barnett
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Medicine ,Science - Abstract
BackgroundThe holistic concept of physical literacy (PL) has gained growing attention in recent research, policy, and practice. Many important policy documents of the physical activity and educational fields (e.g., Global Action Plan on Physical Activity 2018-2030 by the World Health Organization, UNESCO's Quality Physical Education guidelines for policymakers) have specified PL. However, a clear framework for action is needed, as most initiatives across the world are fragmented, lack a prospective orientation, can benefit from conceptual clarification, and are not linked to effective translation into practice. Therefore, we aim to consensually develop a Global Physical Literacy (GloPL) Action Framework to define goals and principles (asking what is needed) as well as actions and ways (asking how these can be achieved) to move PL forward.Materials and methodsWe apply a three-stage group Delphi technique involving three representation groups: (a) geographical representatives to achieve global coverage of perspectives; (b) representatives of special thematic interest reflecting prominent gaps of current PL activities; and (c) representatives of societies from the broad field of physical activity and health to facilitate dissemination. The process will begin with an individual pre-Delphi exercise, in which experts generate initial ideas for the framework, followed by a four-eye document analysis to derive themes for the discussion. Subsequently, the experts will meet face-to-face in three online rounds to discuss and prioritize the themes. Interspersed formal voting with pre-defined agreement thresholds (via descriptive statistics) will inform the inclusion of themes within the final framework.ConclusionsA global consensus on goals, principles, actions, and ways for the development of PL has the potential to provide a largely accepted roadmap for future activities in research, policy, and practice. The co-production approach will help disseminate the GloPL Action Framework and benefit work in relevant application fields of physical activity and health worldwide.
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- 2024
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6. Paramedic attitudes towards prehospital spinal care: a cross-sectional survey
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Neil McDonald, Dean Kriellaars, and Rob T. Pryce
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Emergency medical services ,Paramedic ,Prehospital ,Spinal injuries ,Survey ,Special situations and conditions ,RC952-1245 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background The optimal application of spinal motion restriction (SMR) in the prehospital setting continues to be debated. Few studies have examined how changing guidelines have been received and interpreted by emergency medical services (EMS) personnel. This study surveys paramedics’ attitudes, observations, and self-reported practices around the treatment of potential spine injuries in the prehospital setting. Methods This was a cross-sectional survey of a North American EMS agency. After development and piloting, the final version of the survey contained four sections covering attitudes towards 1) general practice, 2) specific techniques, 3) assessment protocols, and 4) mechanisms of injury (MOI). Questions used Likert-scale, multiple-choice, yes/no, and free-text responses. Exploratory factor analysis (EFA) was used to identify latent constructs within responses, and factor scores were analyzed by ordinal logistic regression for associations with demographic characteristics (including qualification level, gender, and years of experience). MOI evaluations were assessed for inter-rater reliability (Fleiss’ kappa). Inductive qualitative content analysis, following Elo & Kyngäs (2008), was used to examine free-text responses. Results Two hundred twenty responses were received (36% of staff). Raw results indicated that respondents felt that SMR was seen as less important than in the past, that they were treating fewer patients than previously, and that they follow protocol in most situations. The EFA identified two factors: one (Judging MOIs) captured paramedics’ estimation that the presented MOI could potentially cause a spine injury, and another (Treatment Value) reflected respondents’ composite view of the effectiveness, importance, and applicability of SMR. Respondents with advanced life support (ALS) qualification were more likely to be skeptical of the value of SMR compared to those at the basic life support (BLS) level (OR: 2.40, 95%CI: 1.21–4.76, p = 0.01). Overall, respondents showed fair agreement in the evaluation of MOIs (k = 0.31, 95%CI: 0.09–0.49). Content analysis identified tension expressed by respondents between SMR-as-directed and SMR-as-applied. Conclusion Results of this survey show that EMS personnel are skeptical of many elements of SMR but use various strategies to balance protocol adherence with optimizing patient care. While identifying several areas for future research, these findings argue for incorporating provider feedback and judgement into future guideline revision.
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- 2022
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7. 'Where was this when I was in Physical Education?' Physical literacy enriched pedagogy in a quality physical education context
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Natalie Houser and Dean Kriellaars
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schools ,children and youth ,teachers ,students ,physical activity ,Sports ,GV557-1198.995 - Abstract
IntroductionIn recent years, there has been a call to restructure physical education (PE) practices and outcomes. A physical literacy enriched pedagogy approach would support this change by more intentional design of lesson planning that includes concurrent development of competence & confidence and inclusion of students of all levels of ability, leading to holistic development of the student. Despite this potential, there is little research to date that outlines PE pedagogical practices with physical literacy as a foundation. The purpose was to explore pedagogical practices and perspectives from elementary PE teachers through a physical literacy enriched pedagogy lens in a high-quality PE context.MethodsOne-on-one semi-structured interviews were conducted with a convenience sample of elementary PE teachers within one school division. Interviews with all participants focused on questions related to PE and physical literacy. Thematic analysis was used to analyze the data collected from the audio-recorded interviews.ResultsFour themes were generated based on the semi-structured interviews from six elementary PE teachers from one school division. The results identified key physical literacy enriched pedagogical practices based on four themes: supporting a holistic PE experience based upon physical literacy as an outcome; movement within and beyond PE; inclusive and individualized experiences; and physical literacy practices bringing the school community together. The findings were then connected to the physical literacy cycle and UNESCO components of quality PE.ConclusionsAll participants spoke to how their pedagogy focused on the holistic development and inclusion of their students based upon activation of various feedback pathways of the physical literacy cycle. The themes that emerged and subsequent insight gained from teachers went beyond existing physical literacy cycles, in particular by discussing development of students from cognitive, affective, social and creative (problem solving) perspectives, supporting an expansion to the existing physical literacy cycle as presented.
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- 2023
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8. A cross-sectional study of Canadian children's valuation of literacies across social contexts
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Emily Bremer, Philip Jefferies, John Cairney, and Dean Kriellaars
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physical literacy ,subjective task value ,movement ,physical activity ,education ,Sports ,GV557-1198.995 - Abstract
BackgroundChildren, on average, do not engage in sufficient physical activity to reap the physical, mental, and social health benefits. Understanding the value that children place on movement across social contexts, and the relative ranking of this valuation, may help us to understand and intervene on activity levels.MethodThis exploratory study examined the valuation of reading/writing, math, and movement across three social contexts (school, home, with friends) among children 6–13 years of age (N = 7,845; 51.3% male). Subjective task values across contexts were assessed with the valuing literacies subscale of the PLAYself. One-way Kruskal-Wallis ANOVAs were performed to test for differences between contexts and between literacies, respectively.ResultsSex differences and age-related variation were explored. Valuations of reading/writing (d = 1.16) and math (d = 1.33) decreased across context (school > family > friend), while the valuation of movement was relatively stable (d = 0.26). Valuations differed substantially with friends (p
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- 2023
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9. Running Against the Tide: Educating Future Public Relations and Communications Professionals In the Age of Neoliberalism
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Marina VUJNOVIC and Dean KRUCKEBERG
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public relations education ,neoliberalism ,higher education ,public discourse ,Communication. Mass media ,P87-96 - Abstract
This article examines public relations education in the context of neoliberalism and argues that, if we want public relations practitioners to have an important role in public discourse, we must first educate public relations students for public life. Neoliberalism, however, stands in the way because the growing emphasis in public relations education is on vocational skills and training, rather than on comprehensive liberal arts education. The authors discuss the tensions between theory and practice that is reflected in part in those who teach public relations courses, as well as in the current state of public relations education. The article concludes that public relations education must undergo a paradigmatic shift away from vocational training and toward a more comprehensive liberal arts education.
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- 2021
10. Database quality assessment in research in paramedicine: a scoping review protocol
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Dean Kriellaars, Gordon Giesbrecht, Neil McDonald, Malcolm Doupe, and Rob T Pryce
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Medicine - Abstract
Introduction The paramedic practice environment presents unique challenges to data documentation and access, as well as linkage to other parts of the healthcare system. Variable or unknown data quality can influence the validity of research in paramedicine. A number of database quality assessment (DQA) frameworks have been developed and used to evaluate data quality in other areas of healthcare. The extent these or other DQA practices have been applied to paramedic research is not known. Accordingly, this scoping review aims to describe the range, extent and nature of DQA practices within research in paramedicine.Methods and analysis This scoping review will follow established methods for the conduct (Johanna Briggs Institute; Arksey and O’Malley) and reporting (Preferred Reporting Items in Systematic Reviews and Meta-Analyses extension for scoping reviews) of scoping reviews. In consultation with a professional librarian, a search strategy was developed representing the applicable population, concept and context. This strategy will be applied to MEDLINE (National Library of Medicine), Embase (Elsevier), Scopus (Elsevier) and CINAHL (EBSCO) to identify studies published from 2011 through 2021 that assess paramedic data quality as a stated goal. Studies will be included if they report quantitative results of DQA using data that relate primarily to the paramedic practice environment. Protocols, commentaries, case studies, interviews, simulations and experimental data-processing techniques will be excluded. No restrictions will be placed on language. Study selection will be performed by two reviewers, with a third available to resolve conflicts. Data will be extracted from included studies using a data-charting form piloted and iteratively revised based on studies known to be relevant. Results will be summarised in a chart of study characteristics, DQA-specific outcomes and key findings.Ethics and dissemination Ethical approval is not required. Results will be submitted to relevant conferences and peer-reviewed journals.Trial registration 10.17605/OSF.IO/Z287T.
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- 2022
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11. Supporting Holistic Wellbeing for Performing Artists During the COVID-19 Pandemic and Recovery: Study Protocol
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Melanie Stuckey, Véronique Richard, Adam Decker, Patrice Aubertin, and Dean Kriellaars
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circus arts ,human performance ,psychological distress ,resilience ,physical literacy ,Psychology ,BF1-990 - Abstract
The COVID-19 pandemic resulted in the abrupt closure of circus schools, venues, and companies, introducing a myriad of novel stressors. Performers and students must now attempt to maintain their technical, physical, artistic, creative, and cognitive abilities without in-person support from their coaches and must manage the isolation from their training and performing spaces. For circus artists, the transposition of the work space to a home environment is not possible, which creates novel stressors that could lead to the exacerbation and escalation of mental health issues. The purpose of this study is to develop, implement and evaluate a holistic interventional program based on the socio-ecological model of resilience and operationalized through physical literacy. This will be a prospective longitudinal study with a retrospective comparison to data from a similar student cohort pre-pandemic. Interventions were designed using a population-specific, participant-based developmental model within a knowledge translation framework. The interventional program includes group webinars, small group information sessions, and one-on-one Zoom meetings, in addition to the distribution of electronic educational materials. The interventions will holistically provide psychological, physical, social, technical, artistic, and creative supports. Resources will be deployed throughout the closure period and through recovery, as transitions to return to training after prolonged hiatus will magnify known psychological and physical difficulties. Repeated, longitudinal assessment of students will be utilized to track changes over time at key transitions in the pandemic and school year and will be compared to a pre-pandemic school year. The framework for this program will be translatable to other performing arts and high-performance contexts. The program has implications for the mental health and overall wellbeing of artists and for cultural and economic recovery of the industry.
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- 2021
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12. Editorial: Brain-Computer Interfaces and Augmented/Virtual Reality
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Felix Putze, Athanasios Vourvopoulos, Anatole Lécuyer, Dean Krusienski, Sergi Bermúdez i Badia, Timothy Mullen, and Christian Herff
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BCI ,EEG ,fNIRS ,virtual reality ,augmented reality ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Published
- 2020
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13. Going forward with Pokemon Go
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Yvette Chong, Dean Krishen Sethi, Charmaine Hui Yun Loh, and Fatimah Lateef
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Augmented reality ,gameplay ,gaming ,mental wellness ,physical exercise ,Pokemon Go ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Pokemon Go is an augmented reality (AR) game which combines the use of smart mobile technology with physical exploration in the real world. It was a global phenomenon that rocked the world since 2016. Across boundaries and nations, the young and seniors were actively downloading and playing, joining the intrend gaming community. Was it a fleeting fad or a more sustainable activity? This paper discusses the literature currently available on this interesting phenomenon: its effect on physical and mental health as well as some documented hazards and distractions. From the review, Pokemon Go demonstrates that cleverly implemented AR games can reach millions of people and trigger substantial behavioral changes. AR games can help increase physical activities and exercise provided people's interest can be sustained.
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- 2018
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14. Falling Silent
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Dean Krouk
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Contemporary Literature ,Postmemory ,Silence ,Trauma ,Holocaust Studies ,ContemporaryLiterature ,Literature (General) ,PN1-6790 - Abstract
Abstract This article argues that Merethe Lindstrøm’s 2011 novel Dager i stillhetens historie portrays a collapse of the familial memory transmission structures that are normally involved in the making of postmemory, as defined by Marianne Hirsch. My analysis of the novel describes how it represents traumatic memories related to the Holocaust and how it portrays the struggle of listening to traumatic memories. Further, I describe the character Simon’s retreat into the isolation of silence as an engagement with traumatic loss and an attempt to reconnect with his former identity and lost family. Lastly, I draw on Hirsch’s analysis of the role of photographs in familial memory transfer to analyze passages in the novel that show what I call the breakdown of postmemory.
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- 2017
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15. Physical Literacy and Resilience in Children and Youth
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Philip Jefferies, Michael Ungar, Patrice Aubertin, and Dean Kriellaars
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resilience ,physical literacy ,physical activity ,physical education ,children ,youth ,Public aspects of medicine ,RA1-1270 - Abstract
Background: There is growing interest in the relationship between physical and psychosocial factors related to resilience to better understand the antecedents of health and successful adaptation to challenges in and out of school, and across the lifespan. To further this understanding, a trans-disciplinary approach was used to investigate the association between the multidimensional constructs of physical literacy and resilience in children at a key stage in their development.Methods: Cross-sectional data were collected from 227 school children aged 9-12 years old from five schools in Winnipeg, Manitoba, Canada. Resilience was measured using the Child and Youth Resilience Measure, and physical literacy through the Physical Literacy Assessment for Youth tools. Data were provided by self-report, surrogate assessors of the child (physical education teachers and parents), and trained assessors for movement skills. These data were analyzed using correlation and logistic regression.Results: Resilience was significantly correlated with numerous indicators of physical literacy, including movement capacity, confidence, and competence, environmental engagement, and overall perceptions of physical literacy. Regressions indicated that resilience could be predicted by movement confidence and competence, environmental engagement, and overall physical literacy.Conclusions: The findings of this study, using a constellation of sources, provide foundational evidence for the link between resilience and physical literacy among children, encouraging the importance of physical literacy development in schools. Longitudinal studies are required to further examine this relationship and how these previously unrelated fields may work together for a richer understanding of the interplay between the physical and psychological determinants of well-being.
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- 2019
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16. The Preschool Physical Literacy Assessment Tool: Testing a New Physical Literacy Tool for the Early Years
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John Cairney, Heather J. Clark, Maeghan E. James, Drew Mitchell, Dean A. Dudley, and Dean Kriellaars
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physical literacy ,preschool ,physical activity promotion ,psychometric properties ,psychometric ,validity ,Pediatrics ,RJ1-570 - Abstract
Background: Physical literacy is essential to physical activity across the lifespan. While there is an emerging body of research on physical literacy in school-aged children, the preschool years have largely been ignored. We tested the psychometric properties of the new tool, the Preschool Physical Literacy Assessment Tool (Pre-PLAy) designed to address this gap.Methods: We recruted 78 children (aged 19–49 months) across 5 childcare centers in Hamilton, Ontario. Two Early Childhood Educators (ECE) completed the Pre-PLAy for each child at two points in time to assess inter-rater reliability and test-retest reliability. We assessed the agreement between the Pre-PLAy tool with gross motor skills and the ability of the PPLAy to predict physical activity.Results: Results indicated Pre-PLAy is related to gross motor skills and predictive of physical activity for females, but not males. Inter-rater and intra-rater reliability was at least adequate for all but the coordinated movements items and scale for females, but ECEs showed poor agreement for males.Conclusions: These results suggest initial support for the Pre-PLAy tool as a measure of physical literacy during the early years. However, some modification to the items and training are required to address the gender-specific effects found in this sample.
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- 2018
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17. Ellen Rees. Ibsen's Peer Gynt and the Production of Meaning.
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Dean Krouk
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History of Northern Europe. Scandinavia ,DL1-1180 ,Language and Literature - Published
- 2016
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18. The Montage Rhetoric of Nordahl Grieg’s Interwar Drama
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Dean Krouk
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theater ,modernism ,avant-garde ,Norwegian literature ,History of scholarship and learning. The humanities ,AZ20-999 - Abstract
This essay explains the modernist montage rhetoric of Nordahl Grieg’s 1935 drama Vår ære og vår makt in the context of the playwright’s interest in Soviet theater and his Communist sympathies. After considering the historical background for the play’s depiction of war profiteers in Bergen, Norway, during the First World War, the article analyzes Grieg’s use of a montage rhetoric consisting of grotesque juxtapositions and abrupt scenic shifts. Attention is also given to the play’s use of incongruous musical styles and its revolutionary political message. In the second part, the article discusses Grieg’s writings on Soviet theater from the mid-1930s. Grieg embraced innovative aspects of Soviet theater at a time when the greatest period of experimentation in post-revolutionary theater was already ending, and Socialist Realism was being imposed. The article briefly discusses Grieg’s controversial pro-Stalinist, anti-fascist position, before concluding that Vår ære og vår makt represents an important instance of Norwegian appropriation of international modernist and avant-garde theater.
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- 2018
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19. Monika Žagar. Knut Hamsun: The Dark Side of Literary Brilliance.
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Dean Krouk
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History of Northern Europe. Scandinavia ,DL1-1180 ,Language and Literature - Published
- 2011
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20. Prophet of regeneration: On two fascist readings of Knut Hamsun
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Dean Krouk
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Hamsun ,fascisme ,Norwegian literature ,PT8301-9155 - Published
- 2010
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21. Odds of Influenza in Patients Receiving Intra-articular Corticosteroid Injections: A Cohort Study.
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Sytsma TT, McCoy RG, Fischer KM, Dean KR, and Greenlund LS
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- Humans, Injections, Intra-Articular, Female, Male, Middle Aged, Aged, Cohort Studies, Case-Control Studies, Influenza Vaccines administration & dosage, Odds Ratio, Adult, Influenza, Human prevention & control, Adrenal Cortex Hormones administration & dosage, Adrenal Cortex Hormones adverse effects
- Abstract
Objective: Although intra-articular corticosteroid (IACS) is injected locally, some systemic absorption occurs, potentially causing immunosuppression in recipients. This study examined the odds of influenza in patients who received IACS compared with matched controls., Design: Adults in the authors' health system who received IACS from May 2012 through April 2018 were 1:1 matched to adults without IACS. The primary outcome was overall odds of influenza. Secondary analyses examined influenza odds by timing of IACS, joint size, and vaccination status., Results: A total of 23,368 adults (mean age, 63.5 yrs, 62.5% female) received IACS and were matched to a control. Although there was no difference in influenza odds by IACS status overall (odds ratio, 1.13; 95% confidence interval, 0.97-1.32), patients receiving IACS during influenza season had higher odds of influenza than matched controls (odds ratio, 1.34; 95% confidence interval, 1.03-1.74). Furthermore, unvaccinated patients who received IACS during influenza season had higher influenza odds compared with matched controls (odds ratio, 1.41; 95% confidence interval, 1.04-1.91]), whereas there was no difference among vaccinated patients., Conclusion: Patients receiving IACS injections during influenza season had higher odds of influenza. However, vaccination seemed to mitigate this risk. Patients receiving IACS injections should be counseled on infection risk and importance of vaccinations. Further research is needed to examine IACS effects on other viral illnesses., To Claim Cme Credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME., Cme Objectives: Upon completion of this article, the reader should be able to: (1) Identify potential adverse effects of intra-articular corticosteroids; (2) Recognize risk factors for influenza diagnosis; and (3) Describe importance of influenza vaccination., Level: Advanced., Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should only claim credit commensurate with the extent of their participation in the activity., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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22. The Impact of Antithrombotic Medications on Postoperative Bleeding Events Following Hemorrhoidectomy.
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Dean KR, Pavuluri H, Fox S, Tan X, Watson B, Wallenborn JG, and Blestel GA
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- Male, Female, Humans, Fibrinolytic Agents adverse effects, Retrospective Studies, Postoperative Hemorrhage chemically induced, Postoperative Hemorrhage epidemiology, Anticoagulants adverse effects, Hemorrhoids surgery, Hemorrhoidectomy adverse effects
- Abstract
Background: Bleeding complications are a risk associated with hemorrhoid procedures. Despite the prevalence of anticoagulant and antiplatelet therapies, including newer direct oral anticoagulants (DOACs) in the aging patient population there is a paucity of data regarding the impact of the use of antithrombotic therapy (AT) especially DOACs, on bleeding complications of hemorrhoid procedures., Methods: We retrospectively reviewed charts of patients who had undergone a total of 1152 procedures, including hemorrhoid excision and ligation, at a single institution in the years 2016-2018. We noted whether they were prescribed AT, the indication for therapy, perioperative medication management, whether a PBE occurred, and how the PBE was managed., Results: PBE's were noted in 5.92% of patients on ATs, as opposed to 2.66% of patients not on ATs ( P = .014.) The odds ratio of having a PBE when on ATs vs not on ATs is 2.3 (95% CI 1.21 to 4.38, P = .011). Seven out of 40 (17.5%) total PBE's required hospital admission or repeat procedure, and this was not associated with AT use. Surprisingly, although males represented most of the patients on ATs, females were statistically more likely to have a PBE following a hemorrhoidectomy if on ATs., Discussion: Patients on AT have an elevated risk of PBE compared to patients not on AT. No significant difference was found between the two groups when considering only those PBE's severe enough to require hospital admission or repeat procedure. Further research is required to establish clear guidelines regarding the perioperative management of AT for hemorrhoid procedures., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2023
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23. A case report of disseminated Streptococcus pneumoniae infection complicated by infective endocarditis, septic arthritis and epidural abscess in an immunocompetent patient.
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Dean KR, Koirala A, and Samarasekara H
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Streptococcus pneumoniae is a highly virulent, vaccine-preventable pathogen which can cause disease on a spectrum from benign to fatal. Apart from pneumonia, it commonly causes septicaemia and meningitis. This case report describes an unusual range of complications in a 53-year-old Caucasian female presenting to a regional hospital, without any risk known factors for severe disease (such as extremes of age, immunodeficiency or co-morbidities). Progressing from an episode of otitis media, her condition rapidly progressed to mastoid sinusitis, septic arthritis, infective endocarditis, epidural abscesses and multiple subcutaneous abscesses. Following quick identification of S. pneumoniae from a positive blood culture, the patient was treated with high-dose benzylpenicillin and ceftriaxone and aggressive source control by surgery, enabling a good clinical recovery., Competing Interests: No conflicts of interest to declare., (© 2023 The Authors.)
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- 2023
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24. A molecular epidemiological study on Escherichia coli in young chicks with colibacillosis identified two possible outbreaks across farms.
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Kravik IH, Kaspersen H, Sjurseth SK, Dean KR, David B, Aspholm M, and Sekse C
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- Animals, Escherichia coli genetics, Chickens, Phylogeny, Farms, Disease Outbreaks veterinary, Poultry Diseases epidemiology, Escherichia coli Infections epidemiology, Escherichia coli Infections veterinary
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Avian pathogenic Escherichia coli (APEC) is the cause of colibacillosis outbreaks in young poultry chicks, resulting in acute to peracute death. The high morbidity and mortality caused by colibacillosis results in poor animal welfare, reduced sustainability and economical loss worldwide. To advance the understanding of the molecular epidemiology, genomic relatedness and virulence traits of APEC, we performed systematic sampling from 45 confirmed colibacillosis broiler flocks with high first week mortality (FWM) during 2018-2021. From these flocks, 219 APEC isolates were whole genome sequenced (WGS) and bioinformatic analyses were performed. The bioinformatic analyses included sequence typing (ST), serotyping, detection of virulence-associated genes (VAGs) and phylogenetic analysis. Our results showed a high prevalence of ST23, ST429 and ST95 among APEC isolates from Norwegian broiler flocks, and identified ST23, ST429, ST117 and ST371 to cause disease more often alone, compared to ST95, ST69 and ST10. Phylogenetic analyses, together with associated metadata, identified two distinct outbreaks of colibacillosis across farms caused by ST429 and ST23 and gave insight into expected SNP distances within and between flocks identified with the same ST. Further, our results highlighted the need for combining two typing methods, such as serotyping and sequence typing, to better discriminate strains of APEC. Ultimately, systematic sampling of APEC from multiple birds in a flock, together with WGS as a diagnostic tool is important to identify the disease-causing APEC within a flock and to detect outbreaks of colibacillosis across farms., (© 2023. The Author(s).)
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- 2023
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25. Sensitivity and specificity of bacterial culture, qPCR, and somatic cell count for detection of goats with Staphylococcus aureus intramammary infection using Bayesian latent class models.
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Smistad M, Vatne MK, Sølverød L, and Dean KR
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- Animals, Female, Goats, Staphylococcus aureus, Latent Class Analysis, Bayes Theorem, Retrospective Studies, Cell Count veterinary, Staphylococcal Infections diagnosis, Staphylococcal Infections veterinary, Mastitis diagnosis, Mastitis epidemiology, Mastitis veterinary, Goat Diseases diagnosis, Goat Diseases epidemiology
- Abstract
Staphylococcus aureus (S. aureus) is an important udder pathogen affecting goat milk production. The ability to detect goats with subclinical mastitis caused by S. aureus is essential in udder health control programs. In Norway, the industry recommends using somatic cell count (SCC) as a screening tool, and conventional bacterial culture (BC) as a confirmatory test for goat milk samples, but a commercial qPCR, Mastitis 4 qPCR (DNA Diagnostics, Risskov, Denmark) is also available. However, few studies have validated the use of these methods for the detection of goats with S. aureus intramammary infection (IMI). Therefore, the objective of this retrospective study was to estimate the diagnostic sensitivity and specificity of BC, qPCR, and SCC for the detection of goats with IMI caused by S. aureus using Bayesian latent class analysis. We analyzed the BC and qPCR results of aseptically collected milk samples and SCC results from milk recording samples from 319 goats from three herds using different SCC cut-offs. At a SCC cut-off of 2000,000 cells/mL, the estimated median prevalence in each herd was 12.7% (95% highest posterior density credible interval [CI] 6.5-19.8), 15.7% (95% CI 9.3-23.0), and 1.5% (95% CI 0.0-4.3). The median sensitivity was 93.0% (95% CI 80.2-100), 93.6% (95% CI 82.3-100) and 78.2% (95% CI 62.3-91.2) for BC, qPCR, and SCC, respectively. The estimated median specificity of BC was 99.5% (99% CI 98.4-100), for qPCR, 98.9% (95% CI 97.5-100), and for SCC 61.5% (95% CI 56.0-67.1). The results show that BC, which is today's standard method for diagnosing IMI, has a high accuracy for detection of goats with S. aureus IMI, but qPCR had a sensitivity and specificity similar to BC, and may act as an alternative., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors MS, MKV and LS are affiliated with the TINE mastitis laboratory. MKV was involved in the analyses of the milk samples, but was not involved in the statistical analyses., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2022
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26. Evaluation of three commercial ELISA tests for serological detection of maedi-visna virus using Bayesian latent class analysis.
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Jerre A, Nordstoga AB, Dean KR, and Holmøy IH
- Subjects
- Sheep, Animals, Latent Class Analysis, Bayes Theorem, Retrospective Studies, Enzyme-Linked Immunosorbent Assay veterinary, Visna-maedi virus, Pneumonia, Progressive Interstitial, of Sheep diagnosis, Pneumonia, Progressive Interstitial, of Sheep epidemiology, Sheep Diseases diagnosis, Sheep Diseases epidemiology
- Abstract
Early and accurate diagnosis is fundamental for successful surveillance and control of maedi-visna virus (MVV). MVV was detected in Norway in 2019, almost 14 years after the previous outbreak. Genetic analysis indicates persistence of the virus in the sheep population since 2005. The virus was not detected despite continuous serological surveillance. This emphasises the need for improved surveillance, which relies on an understanding of both diagnostic test performance, sampling strategy and the prevalence of the disease. This study therefore aims to evaluate three commercial ELISA tests for MVV antibodies. We conducted a retrospective study using 615 samples from six flocks diagnosed with MVV in 2019. We ran all samples with the following three tests: ID Screen® MVV/CAEV Indirect (IDvet, Grabels, France), IDEXX MVV/CAEV p28 Ab Verification Test (IDEXX Laboratories, Maine, USA) and Elitest MVV/CAEV (Hyphen Biomed, Neuville-sur-Oise, France), hereinafter referred to as ID Screen, IDEXXp28 and Elitest respectively. Without a perfect reference test, we used Bayesian latent class analysis, including conditional dependence between tests, to estimate diagnostic accuracy and true prevalence in the flocks. Using recommended cut-off values, we found that ID Screen and Elitest had significantly higher sensitivity (Se) estimates (99.3 % [97.4-100.0, 95 % Posterior Credible Interval] and 97.4 % [94.1-99.7 %], respectively) than IDEXXp28 (79.5 % [72.3-86.0 %]), while IDEXXp28 and ID Screen had significantly higher specificity (Sp) estimates than Elitest (99.7 % [99.1-100.0], 99.1 % [98.0-99.8 %] and 93.7 % [91.4-95.7 %], respectively). The estimated true prevalence in the six flocks ranged from a median of 0.8-93.5 %. Combining ID Screen and Elitest in serial interpretation showed the highest median Se and Sp (96.7 % [92.0-99.1] and 100.0 % [99.9-100.0], respectively), as well as the highest median positive predictive value (PPV) for the population with the lowest prevalence. Our study supports the use of ID Screen for screening. Further verification with Elitest in serial interpretation will enhance the PPV., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2022
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27. Complexation of Lignin Dimers with β-Cyclodextrin and Binding Stability Analysis by ESI-MS, Isothermal Titration Calorimetry, and Molecular Dynamics Simulations.
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Dean KR, Novak B, Moradipour M, Tong X, Moldovan D, Knutson BL, Rankin SE, and Lynn BC
- Subjects
- Calorimetry, Lignin, Molecular Dynamics Simulation, Polymers, Cyclodextrins chemistry, beta-Cyclodextrins chemistry
- Abstract
Lignin derived from lignocellulosic biomass is the largest source of renewable bioaromatics present on earth and requires environmentally sustainable separation strategies to selectively obtain high-value degradation products. Applications of supramolecular interactions have the potential to isolate lignin compounds from biomass degradation fractions by the formation of variable inclusion complexes with cyclodextrins (CDs). CDs are commonly used as selective adsorbents for many applications and can capture guest molecules in their internal hydrophobic cavity. The strength of supramolecular interactions between CDs and lignin model compounds that represent potential lignocellulosic biomass degradation products can be characterized by assessing the thermodynamics of binding stability. Consequently, the inclusion interactions of β-CD and lignin model compounds G-(β-O-4')-G, G-(β-O-4')- trunc G (guaiacylglycerol-β-guaiacyl ether), and G-(β-β')-G (pinoresinol) were investigated empirically by electrospray ionization mass spectrometry and isothermal titration calorimetry, complemented by molecular dynamics (MD) simulations. Empirical results indicate that there are substantial differences in binding stability dependent on the linkage type. The lignin model β-β' dimer showed more potential bound states including 1:1, 2:1, and 1:2 (guest:host) complexation and, based on binding stability determinations, was consistently the most energetically favorable guest. Empirical results are supported by MD simulations that reveal that the capture of G-(β-β')-G by β-CD is promising with a 66% probability of being bound for G-(β-O-4')- trunc G compared to 88% for G-(β-β')-G (unbiased distance trajectory and explicit counting of bound states). These outcomes indicate CDs as a promising material to assist in separations of lignin oligomers from heterogeneous mixtures for the development of environmentally sustainable isolations of lignin compounds from biomass fractions.
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- 2022
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28. Description of ISAV-HPRΔ-positive salmon farms in Norway in 2020.
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Dean KR, Oliveira VHS, Wolff C, Moldal T, and Jansen MD
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- Animals, Aquaculture, Salmon, Fish Diseases epidemiology, Isavirus, Orthomyxoviridae Infections, Salmo salar
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- 2022
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29. Realtime case study simulations of transmission of Pancreas Disease (PD) in Norwegian salmonid farming for disease control purposes.
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Bang Jensen B, Dean KR, Huseby RB, Aldrin M, and Qviller L
- Subjects
- Animals, Aquaculture, Norway epidemiology, Pancreas, Alphavirus Infections epidemiology, Alphavirus Infections prevention & control, Alphavirus Infections veterinary, Fish Diseases epidemiology, Pancreatic Diseases epidemiology, Pancreatic Diseases veterinary, Salmonidae
- Abstract
Pancreas Disease (PD) is a viral disease caused by Salmonid Alphavirus (SAV). It affects farmed salmonids in the North Atlantic, and leads to reduced feed intake and increased mortality with reduced production and welfare as a consequence. In 2013, the estimated cost of an outbreak on an average salmon farm was about 6.6 mil €. In Norway, PD has been notifiable since 2008, and regulations to mitigate disease spread are in place. However, despite the regulations, 140-170 farms are affected by PD every year. The aquaculture industry is growing continuously, introducing farms in new geographical areas, and fish are moved between hydrographically separated zones for trade and slaughter. All such movements and relocations need to be approved by the competent authorities. Thus, there is a demand for support to farmers and competent authorities when making decisions on disease management and especially on the effect of moving infected fish. We have used a disease-transmission model for outbreak-simulation in real time for assessing the probability of disease transmission from a farm that gets infected with PD. We have also simulated the effects of three different control-regimes: no stamping-out, delayed stamping-out or immediate stamping-out, on the transmission of PD to surrounding farms. Simulations showed that the immediate stamping out of an infected farm led to effective containment of an outbreak. No stamping out led to up to 32.1% of farms within 100 km of the index farm to become effected. We have used real production data for the model building and the scenario simulations, and the results illustrate that a risk assessment of horizontal disease transmission must be undertaken on a case-by-case basis, because the time and place of the outbreak has a large influence on the risk of transmission., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2021
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30. Simulated effects of increasing salmonid production on sea lice populations in Norway.
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Dean KR, Aldrin M, Qviller L, Helgesen KO, Jansen PA, and Bang Jensen B
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- Animals, Female, Norway epidemiology, Copepoda, Fish Diseases epidemiology, Fish Diseases parasitology, Lice Infestations, Salmonidae parasitology
- Abstract
Norway produces more than one million tonnes of salmonids every year, almost exclusively in open-water net pens. In 2014, the Norwegian government announced plans to increase salmonid production. However, increasing the number of farmed salmonids can have negative effects on the marine environment that threaten the industry's sustainability. In particular, production growth can lead to an increase in density-dependent diseases, including parasitic sea lice. The aim of this study was to simulate the effects of increased salmonid production on sea lice abundance using different scenarios for increasing the number of fish and for the management of sea lice. We used a previously developed, partly stage-structured model based on Norwegian production and environmental data to simulate the different scenarios. Our results show that increasing the marine farmed salmonid population at a national level by two or five times the current production leads to an increase in the sea lice abundance by 3.5% and 7.1%, respectively. We also found that by lowering the maximum allowable level of sea lice to an average of 0.049 adult females per fish, weekly treatments can be used to control sea lice population growth with a five times increase in production. However, this increases the number of farms treating per week by as much as 281.3%, which can lead to high costs and increased mortality among farmed salmonids. Overall, the results from our study shed light on the effects of increasing salmonid production in Norway with respect to the ongoing threat of sea lice infestations., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2021
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31. Epigenetic biotypes of post-traumatic stress disorder in war-zone exposed veteran and active duty males.
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Yang R, Gautam A, Getnet D, Daigle BJ, Miller S, Misganaw B, Dean KR, Kumar R, Muhie S, Wang K, Lee I, Abu-Amara D, Flory JD, Hood L, Wolkowitz OM, Mellon SH, Doyle FJ 3rd, Yehuda R, Marmar CR, Ressler KJ, Hammamieh R, and Jett M
- Subjects
- Epigenesis, Genetic genetics, Epigenome, Humans, Male, Military Personnel, Stress Disorders, Post-Traumatic genetics, Veterans
- Abstract
Post-traumatic stress disorder (PTSD) is a heterogeneous condition evidenced by the absence of objective physiological measurements applicable to all who meet the criteria for the disorder as well as divergent responses to treatments. This study capitalized on biological diversity observed within the PTSD group observed following epigenome-wide analysis of a well-characterized Discovery cohort (N = 166) consisting of 83 male combat exposed veterans with PTSD, and 83 combat veterans without PTSD in order to identify patterns that might distinguish subtypes. Computational analysis of DNA methylation (DNAm) profiles identified two PTSD biotypes within the PTSD+ group, G1 and G2, associated with 34 clinical features that are associated with PTSD and PTSD comorbidities. The G2 biotype was associated with an increased PTSD risk and had higher polygenic risk scores and a greater methylation compared to the G1 biotype and healthy controls. The findings were validated at a 3-year follow-up (N = 59) of the same individuals as well as in two independent, veteran cohorts (N = 54 and N = 38), and an active duty cohort (N = 133). In some cases, for example Dopamine-PKA-CREB and GABA-PKC-CREB signaling pathways, the biotypes were oppositely dysregulated, suggesting that the biotypes were not simply a function of a dimensional relationship with symptom severity, but may represent distinct biological risk profiles underpinning PTSD. The identification of two novel distinct epigenetic biotypes for PTSD may have future utility in understanding biological and clinical heterogeneity in PTSD and potential applications in risk assessment for active duty military personnel under non-clinician-administered settings, and improvement of PTSD diagnostic markers., (© 2020. The Author(s).)
- Published
- 2021
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32. Factors associated with baseline mortality in Norwegian Atlantic salmon farming.
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Oliveira VHS, Dean KR, Qviller L, Kirkeby C, and Bang Jensen B
- Subjects
- Animals, Cohort Studies, Environment, Norway epidemiology, Retrospective Studies, Risk Factors, Salinity, Seafood, Seasons, Temperature, Aquaculture methods, Aquaculture statistics & numerical data, Fish Diseases mortality, Salmo salar growth & development, Salmo salar parasitology
- Abstract
In 2019, it was estimated that more than 50 million captive Atlantic salmon in Norway died in the final stage of their production in marine cages. This mortality represents a significant economic loss for producers and a need to improve welfare for farmed salmon. Single adverse events, such as algal blooms or infectious disease outbreaks, can explain mass mortality in salmon cages. However, little is known about the production, health, or environmental factors that contribute to their baseline mortality during the sea phase. Here we conducted a retrospective study including 1627 Atlantic salmon cohorts put to sea in 2014-2019. We found that sea lice treatments were associated with Atlantic salmon mortality. In particular, the trend towards non-medicinal sea lice treatments, including thermal delousing, increases Atlantic salmon mortality in the same month the treatment is applied. There were differences in mortality among production zones. Stocking month and weight were other important factors, with the lowest mortality in smaller salmon stocked in August-October. Sea surface temperature and salinity also influenced Atlantic salmon mortality. Knowledge of what affects baseline mortality in Norwegian aquaculture can be used as part of syndromic surveillance and to inform salmon producers on farming practices that can reduce mortality., (© 2021. The Author(s).)
- Published
- 2021
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33. The influence of temperature on the seasonality of historical plague outbreaks.
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Krauer F, Viljugrein H, and Dean KR
- Subjects
- Disease Outbreaks, Europe, Humans, Pandemics, Temperature, Plague epidemiology, Yersinia pestis
- Abstract
Modern plague outbreaks exhibit a distinct seasonal pattern. By contrast, the seasonality of historical outbreaks and its drivers has not been studied systematically. Here, we investigate the seasonal pattern, the epidemic peak timing and growth rates, and the association with latitude, temperature, and precipitation using a large, novel dataset of plague- and all-cause mortality during the Second Pandemic in Europe and the Mediterranean. We show that epidemic peak timing followed a latitudinal gradient, with mean annual temperature negatively associated with peak timing. Based on modern temperature data, the predicted epidemic growth of all outbreaks was positive between 11.7°C and 21.5°C with a maximum around 17.3°C. Hence, our study provides evidence that the growth of plague epidemics across the whole study region depended on similar absolute temperature thresholds. Here, we present a systematic analysis of the seasonality of historical plague in the Northern Hemisphere, and we show consistent evidence for a temperature-related process influencing the epidemic peak timing and growth rates of plague epidemics.
- Published
- 2021
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34. First detection of highly pathogenic avian influenza virus in Norway.
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Madslien K, Moldal T, Gjerset B, Gudmundsson S, Follestad A, Whittard E, Tronerud OH, Dean KR, Åkerstedt J, Jørgensen HJ, das Neves CG, and Rømo G
- Subjects
- Animals, Animals, Wild virology, Charadriiformes, Ducks, Geese, Influenza in Birds virology, Norway epidemiology, Influenza A Virus, H5N8 Subtype isolation & purification, Influenza in Birds epidemiology
- Abstract
Background: Several outbreaks of highly pathogenic avian influenza (HPAI) caused by influenza A virus of subtype H5N8 have been reported in wild birds and poultry in Europe during autumn 2020. Norway is one of the few countries in Europe that had not previously detected HPAI virus, despite widespread active monitoring of both domestic and wild birds since 2005., Results: We report detection of HPAI virus subtype H5N8 in a wild pink-footed goose (Anser brachyrhynchus), and several other geese, ducks and a gull, from south-western Norway in November and December 2020. Despite previous reports of low pathogenic avian influenza (LPAI), this constitutes the first detections of HPAI in Norway., Conclusions: The mode of introduction is unclear, but a northward migration of infected geese or gulls from Denmark or the Netherlands during the autumn of 2020 is currently our main hypothesis for the introduction of HPAI to Norway. The presence of HPAI in wild birds constitutes a new, and ongoing, threat to the Norwegian poultry industry, and compliance with the improved biosecurity measures on poultry farms should therefore be ensured. [MK1]Finally, although HPAI of subtype H5N8 has been reported to have very low zoonotic potential, this is a reminder that HPAI with greater zoonotic potential in wild birds may pose a threat in the future. [MK1]Updated with a sentence emphasizing the risk HPAI pose to poultry farms, both in the Abstract and in the Conclusion-section in main text, as suggested by Reviewer 1 (#7).
- Published
- 2021
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35. The study of the chromatographic behavior and a mass spectrometric approach to differentiating the diastereomer pair of the β-O-4 lignin dimer series.
- Author
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Asare SO, Dean KR, and Lynn BC
- Subjects
- Dimerization, Stereoisomerism, Chromatography methods, Lignin chemistry, Tandem Mass Spectrometry methods
- Abstract
Lignin and lignans are natural products found in plant cell walls. Lignin research has historically focused on lignin degradation techniques in the hope of converting lignin into useful aromatic carbon feedstocks. In contrast, investigations of lignans existing as natural product dimers, have been focused on thier interesting biological activities. Many lignan compounds are chemically identical to dimers derived from lignin, and both lignin and lignan dimers can possess multiple chiral centers leading to observations of diastereomer pairs where one diastereomer exhibits the bulk of the activity. For example, the G-(β-O-4')-G dimer was reported to have a pro-angiogenic activity with one diastereomer of the pair showing enhanced pro-angiogenic activity. Traditional analytical techniques such as nuclear magnetic resonance (NMR) can differentiate the diastereomer pairs of β-O-4 compounds; however, isolation of a pure sample is often required for analysis. This work was aimed at exploring the potential use of tandem mass spectrometry to differentiate diastereomer pairs in the β-O-4 dimer series. Each diastereomer pair in the nine-dimer series was separated by HPLC and interrogated by tandem mass spectrometry. To understand the chromatographic behavior of the diastereomer pair in the β-O-4 dimer series, three commercially available reverse phase HPLC columns were evaluated. A temperature programming experiment using water/acetonitrile isocratic elution showed that the chromatographic retention mechanism of these diastereomers was hydrophobically driven with analytes having more methoxy groups exhibiting larger ΔH
0 and higher octanol-water partition coefficient values. Tandem mass spectrometry performed on each of the diastereomers produced fragment ions having different ion abundances. A mechanistic study based on the ion abundance of "sequence-specific ions" and "-48 ions" was used to assign a configuration to each of the pairs of diastereomers in the nine-dimer series.- Published
- 2021
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36. Utilization of machine learning for identifying symptom severity military-related PTSD subtypes and their biological correlates.
- Author
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Siegel CE, Laska EM, Lin Z, Xu M, Abu-Amara D, Jeffers MK, Qian M, Milton N, Flory JD, Hammamieh R, Daigle BJ Jr, Gautam A, Dean KR, Reus VI, Wolkowitz OM, Mellon SH, Ressler KJ, Yehuda R, Wang K, Hood L, Doyle FJ 3rd, Jett M, and Marmar CR
- Subjects
- Diagnostic and Statistical Manual of Mental Disorders, Humans, Machine Learning, Male, Military Personnel, Stress Disorders, Post-Traumatic diagnosis, Veterans
- Abstract
We sought to find clinical subtypes of posttraumatic stress disorder (PTSD) in veterans 6-10 years post-trauma exposure based on current symptom assessments and to examine whether blood biomarkers could differentiate them. Samples were males deployed to Iraq and Afghanistan studied by the PTSD Systems Biology Consortium: a discovery sample of 74 PTSD cases and 71 healthy controls (HC), and a validation sample of 26 PTSD cases and 36 HC. A machine learning method, random forests (RF), in conjunction with a clustering method, partitioning around medoids, were used to identify subtypes derived from 16 self-report and clinician assessment scales, including the clinician-administered PTSD scale for DSM-IV (CAPS). Two subtypes were identified, designated S1 and S2, differing on mean current CAPS total scores: S2 = 75.6 (sd 14.6) and S1 = 54.3 (sd 6.6). S2 had greater symptom severity scores than both S1 and HC on all scale items. The mean first principal component score derived from clinical summary scales was three times higher in S2 than in S1. Distinct RFs were grown to classify S1 and S2 vs. HCs and vs. each other on multi-omic blood markers feature classes of current medical comorbidities, neurocognitive functioning, demographics, pre-military trauma, and psychiatric history. Among these classes, in each RF intergroup comparison of S1, S2, and HC, multi-omic biomarkers yielded the highest AUC-ROCs (0.819-0.922); other classes added little to further discrimination of the subtypes. Among the top five biomarkers in each of these RFs were methylation, micro RNA, and lactate markers, suggesting their biological role in symptom severity.
- Published
- 2021
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37. Multi-omic biomarker identification and validation for diagnosing warzone-related post-traumatic stress disorder.
- Author
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Dean KR, Hammamieh R, Mellon SH, Abu-Amara D, Flory JD, Guffanti G, Wang K, Daigle BJ Jr, Gautam A, Lee I, Yang R, Almli LM, Bersani FS, Chakraborty N, Donohue D, Kerley K, Kim TK, Laska E, Young Lee M, Lindqvist D, Lori A, Lu L, Misganaw B, Muhie S, Newman J, Price ND, Qin S, Reus VI, Siegel C, Somvanshi PR, Thakur GS, Zhou Y, Hood L, Ressler KJ, Wolkowitz OM, Yehuda R, Jett M, Doyle FJ 3rd, and Marmar C
- Subjects
- Biomarkers, Brain, Humans, Male, Military Personnel, Stress Disorders, Post-Traumatic diagnosis, Stress Disorders, Post-Traumatic genetics, Veterans
- Abstract
Post-traumatic stress disorder (PTSD) impacts many veterans and active duty soldiers, but diagnosis can be problematic due to biases in self-disclosure of symptoms, stigma within military populations, and limitations identifying those at risk. Prior studies suggest that PTSD may be a systemic illness, affecting not just the brain, but the entire body. Therefore, disease signals likely span multiple biological domains, including genes, proteins, cells, tissues, and organism-level physiological changes. Identification of these signals could aid in diagnostics, treatment decision-making, and risk evaluation. In the search for PTSD diagnostic biomarkers, we ascertained over one million molecular, cellular, physiological, and clinical features from three cohorts of male veterans. In a discovery cohort of 83 warzone-related PTSD cases and 82 warzone-exposed controls, we identified a set of 343 candidate biomarkers. These candidate biomarkers were selected from an integrated approach using (1) data-driven methods, including Support Vector Machine with Recursive Feature Elimination and other standard or published methodologies, and (2) hypothesis-driven approaches, using previous genetic studies for polygenic risk, or other PTSD-related literature. After reassessment of ~30% of these participants, we refined this set of markers from 343 to 28, based on their performance and ability to track changes in phenotype over time. The final diagnostic panel of 28 features was validated in an independent cohort (26 cases, 26 controls) with good performance (AUC = 0.80, 81% accuracy, 85% sensitivity, and 77% specificity). The identification and validation of this diverse diagnostic panel represents a powerful and novel approach to improve accuracy and reduce bias in diagnosing combat-related PTSD.
- Published
- 2020
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38. Significant reduction of vancomycin resistant E. faecium in the Norwegian broiler population coincided with measures taken by the broiler industry to reduce antimicrobial resistant bacteria.
- Author
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Simm R, Slettemeås JS, Norström M, Dean KR, Kaldhusdal M, and Urdahl AM
- Subjects
- Animals, Anti-Bacterial Agents pharmacology, Antimicrobial Stewardship organization & administration, Antimicrobial Stewardship standards, Food Industry standards, Food Industry trends, Gram-Positive Bacterial Infections microbiology, Gram-Positive Bacterial Infections prevention & control, Gram-Positive Bacterial Infections veterinary, Infection Control standards, Infection Control trends, Microbial Sensitivity Tests, Norway epidemiology, Poultry Diseases epidemiology, Poultry Diseases microbiology, Poultry Diseases prevention & control, Pyrans pharmacology, Vancomycin Resistance physiology, Chickens microbiology, Drug Resistance, Multiple, Bacterial, Enterococcus faecium isolation & purification, Food Industry organization & administration, Gram-Positive Bacterial Infections epidemiology, Infection Control organization & administration, Vancomycin-Resistant Enterococci isolation & purification
- Abstract
Vancomycin resistant enterococci (VRE) belong to the most common causes of nosocomial infections worldwide. It has been reported that use of the glycopeptide growth promoter avoparcin selected for a significant livestock-reservoir of VRE in many European countries, including Norway. However, although avoparcin was banned as a feed-additive in 1995, VRE have for unknown reasons consistently been reported in samples from Norwegian broilers. When avoparcin was banned, broiler-feed was supplemented with the polyether ionophore narasin in order to control the diseases coccidiosis and the frequent sequela necrotic enteritis. A potential link between transferrable vancomycin resistance and reduced susceptibility to narasin was recently reported. The use of narasin as a feed additive was abolished by the Norwegian broiler industry in 2016 and since then, broilers have been reared without in-feed antibacterial supplements. In this study, we demonstrate that all VRE isolates from Norwegian broilers collected in 2006-2014 displayed reduced susceptibility to narasin. Surveillance data collected two years after the narasin abolishment show a significant reduction in VRE, below the detection limit of the surveillance method, and a concurrent marked reduction in Enterococcus faecium with reduced susceptibility to narasin. The significant decline of E. faecium with reduced susceptibility to these antimicrobial compounds also coincided with an increased focus on cleaning and disinfection between broiler flocks. Furthermore, data from a controlled in vivo experiment using Ross 308 broilers indicate that the proportion of E. faecium with reduced susceptibility to narasin was heavily reduced in broilers fed a narasin-free diet compared to a diet supplemented with narasin. Our results are consistent with that the abolishment of this feed additive, possibly in combination with the increased focus on cleaning and disinfection, has had a substantial impact on the occurrence of VRE in the Norwegian broiler population., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2019
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39. Human plague system associated with rodent diversity and other environmental factors.
- Author
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Sun Z, Xu L, Schmid BV, Dean KR, Zhang Z, Xie Y, Fang X, Wang S, Liu Q, Lyu B, Wan X, Xu J, Stenseth NC, and Xu B
- Abstract
Plague remains a threat to public health and is considered as a re-emerging infectious disease today. Rodents play an important role as major hosts in plague persistence and driving plague outbreaks in natural foci; however, few studies have tested the association between host diversity in ecosystems and human plague risk. Here we use zero-inflated generalized additive models to examine the association of species richness with human plague presence (where plague outbreaks could occur) and intensity (the average number of annual human cases when they occurred) in China during the Third Pandemic. We also account for transportation network density, annual precipitation levels and human population size. We found rodent species richness, particularly of rodent plague hosts, is positively associated with the presence of human plague. Further investigation shows that species richness of both wild and commensal rodent plague hosts are positively correlated with the presence, but only the latter correlated with the intensity. Our results indicated a positive relationship between rodent diversity and human plague, which may provide suggestions for the plague surveillance system., Competing Interests: We have no competing interests.
- Published
- 2019
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40. Historical and genomic data reveal the influencing factors on global transmission velocity of plague during the Third Pandemic.
- Author
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Xu L, Stige LC, Leirs H, Neerinckx S, Gage KL, Yang R, Liu Q, Bramanti B, Dean KR, Tang H, Sun Z, Stenseth NC, and Zhang Z
- Subjects
- Animals, Climate Change, Databases, Factual, Genomics methods, Humans, Yersinia pestis genetics, Genome, Bacterial genetics, Pandemics statistics & numerical data, Plague genetics, Plague transmission, Virulence genetics
- Abstract
Quantitative knowledge about which natural and anthropogenic factors influence the global spread of plague remains sparse. We estimated the worldwide spreading velocity of plague during the Third Pandemic, using more than 200 years of extensive human plague case records and genomic data, and analyzed the association of spatiotemporal environmental factors with spreading velocity. Here, we show that two lineages, 2.MED and 1.ORI3, spread significantly faster than others, possibly reflecting differences among strains in transmission mechanisms and virulence. Plague spread fastest in regions with low population density and high proportion of pasture- or forestland, findings that should be taken into account for effective plague monitoring and control. Temperature exhibited a nonlinear, U-shaped association with spread speed, with a minimum around 20 °C, while precipitation showed a positive association. Our results suggest that global warming may accelerate plague spread in warm, tropical regions and that the projected increased precipitation in the Northern Hemisphere may increase plague spread in relevant regions., Competing Interests: The authors declare no conflict of interest., (Copyright © 2019 the Author(s). Published by PNAS.)
- Published
- 2019
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41. The Third Plague Pandemic in Europe.
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Bramanti B, Dean KR, Walløe L, and Chr Stenseth N
- Subjects
- Animals, Disease Vectors, Europe epidemiology, History, 20th Century, History, 21st Century, Humans, Plague epidemiology, Plague transmission, Rats, Yersinia pestis physiology, Pandemics history, Plague history
- Abstract
Plague has a long history on the European continent, with evidence of the disease dating back to the Stone Age. Plague epidemics in Europe during the First and Second Pandemics, including the Black Death, are infamous for their widespread mortality and lasting social and economic impact. Yet, Europe still experienced plague outbreaks during the Third Pandemic, which began in China and spread globally at the end of the nineteenth century. The digitization of international records of notifiable diseases, including plague, has enabled us to retrace the introductions of the disease to Europe from the earliest reported cases in 1899, to its disappearance in the 1940s. Using supplemental literature, we summarize the potential sources of plague in Europe and the transmission of the disease, including the role of rats. Finally, we discuss the international efforts aimed at prevention and intervention measures, namely improved hygiene and sanitation, that ultimately led to the disappearance of plague in Europe.
- Published
- 2019
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42. Reply to Barbieri et al.: Out of the Land of Darkness: Plague on the fur trade routes.
- Author
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Bramanti B, Namouchi A, Schmid BV, Dean KR, and Stenseth NC
- Subjects
- Disease Outbreaks, History, Medieval, Humans, Plague history, Plague epidemiology, Yersinia pestis
- Abstract
Competing Interests: The authors declare no conflict of interest.
- Published
- 2019
- Full Text
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43. Epidemiology of a bubonic plague outbreak in Glasgow, Scotland in 1900.
- Author
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Dean KR, Krauer F, and Schmid BV
- Abstract
On 3 August 1900, bubonic plague ( Yersinia pestis ) broke out in Glasgow for the first time during the Third Pandemic. The local sanitary authorities rigorously tracked the spread of the disease and they found that nearly all of the 35 cases could be linked by contact with a previous case. Despite trapping hundreds of rats in the area, there was no evidence of a rat epizootic and the investigators speculated that the outbreak could be due to human-to-human transmission of bubonic plague. Here we use a likelihood-based method to reconstruct transmission trees for the outbreak. From the description of the outbreak and the reconstructed trees, we infer several epidemiological parameters. We found that the estimated mean serial interval was 7.4-9.2 days and the mean effective reproduction number dropped below 1 after implementation of control measures. We also found a high rate of secondary transmissions within households and observations of transmissions from individuals who were not terminally septicaemic. Our results provide important insights into the epidemiology of a bubonic plague outbreak during the Third Pandemic in Europe., Competing Interests: The authors declare no competing interests.
- Published
- 2019
- Full Text
- View/download PDF
44. Reply to Park et al.: Human ectoparasite transmission of plague during the Second Pandemic is still plausible.
- Author
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Dean KR, Krauer F, Walløe L, Lingjærde OC, Bramanti B, Stenseth NC, and Schmid BV
- Subjects
- Disease Outbreaks, Humans, Yersinia pestis, Pandemics, Plague epidemiology
- Abstract
Competing Interests: The authors declare no conflict of interest.
- Published
- 2018
- Full Text
- View/download PDF
45. Human ectoparasites and the spread of plague in Europe during the Second Pandemic.
- Author
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Dean KR, Krauer F, Walløe L, Lingjærde OC, Bramanti B, Stenseth NC, and Schmid BV
- Subjects
- Animals, Bayes Theorem, Disease Vectors, Ectoparasitic Infestations, Epidemiologic Methods, Europe epidemiology, Humans, Markov Chains, Pandemics, Plague mortality, Plague parasitology, Rodentia, Yersinia pestis pathogenicity, Models, Statistical, Pediculus microbiology, Plague epidemiology, Plague transmission, Siphonaptera microbiology
- Abstract
Plague, caused by the bacterium Yersinia pestis , can spread through human populations by multiple transmission pathways. Today, most human plague cases are bubonic, caused by spillover of infected fleas from rodent epizootics, or pneumonic, caused by inhalation of infectious droplets. However, little is known about the historical spread of plague in Europe during the Second Pandemic (14-19th centuries), including the Black Death, which led to high mortality and recurrent epidemics for hundreds of years. Several studies have suggested that human ectoparasite vectors, such as human fleas ( Pulex irritans ) or body lice ( Pediculus humanus humanus ), caused the rapidly spreading epidemics. Here, we describe a compartmental model for plague transmission by a human ectoparasite vector. Using Bayesian inference, we found that this model fits mortality curves from nine outbreaks in Europe better than models for pneumonic or rodent transmission. Our results support that human ectoparasites were primary vectors for plague during the Second Pandemic, including the Black Death (1346-1353), ultimately challenging the assumption that plague in Europe was predominantly spread by rats., Competing Interests: The authors declare no conflict of interest., (Copyright © 2018 the Author(s). Published by PNAS.)
- Published
- 2018
- Full Text
- View/download PDF
46. Systems biology approach to understanding post-traumatic stress disorder.
- Author
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Thakur GS, Daigle BJ Jr, Dean KR, Zhang Y, Rodriguez-Fernandez M, Hammamieh R, Yang R, Jett M, Palma J, Petzold LR, and Doyle FJ 3rd
- Subjects
- Animals, Biomedical Research, Humans, Mice, United States, Stress Disorders, Post-Traumatic genetics, Stress Disorders, Post-Traumatic metabolism, Stress Disorders, Post-Traumatic physiopathology, Systems Biology
- Abstract
Post-traumatic stress disorder (PTSD) is a psychological disorder affecting individuals that have experienced life-changing traumatic events. The symptoms of PTSD experienced by these subjects-including acute anxiety, flashbacks, and hyper-arousal-disrupt their normal functioning. Although PTSD is still categorized as a psychological disorder, recent years have witnessed a multi-directional research effort attempting to understand the biomolecular origins of the disorder. This review begins by providing a brief overview of the known biological underpinnings of the disorder resulting from studies using structural and functional neuroimaging, endocrinology, and genetic and epigenetic assays. Next, we discuss the systems biology approach, which is often used to gain mechanistic insights from the wealth of available high-throughput experimental data. Finally, we provide an overview of the current computational tools used to decipher the heterogeneous types of molecular data collected in the study of PTSD.
- Published
- 2015
- Full Text
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47. Ion-water clusters, bulk medium effects, and ion hydration.
- Author
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Merchant S, Dixit PD, Dean KR, and Asthagiri D
- Subjects
- Ions chemistry, Thermodynamics, Water chemistry
- Abstract
Thermochemistry of gas-phase ion-water clusters together with estimates of the hydration free energy of the clusters and the water ligands are used to calculate the hydration free energy of the ion. Often the hydration calculations use a continuum model of the solvent. The primitive quasichemical approximation to the quasichemical theory provides a transparent framework to anchor such efforts. Here we evaluate the approximations inherent in the primitive quasichemical approach and elucidate the different roles of the bulk medium. We find that the bulk medium can stabilize configurations of the cluster that are usually not observed in the gas phase, while also simultaneously lowering the excess chemical potential of the ion. This effect is more pronounced for soft ions. Since the coordination number that minimizes the excess chemical potential of the ion is identified as the optimal or most probable coordination number, for such soft ions the optimum cluster size and the hydration thermodynamics obtained with and without account of the bulk medium on the ion-water clustering reaction can be different. The ideas presented in this work are expected to be relevant to experimental studies that translate thermochemistry of ion-water clusters to the thermodynamics of the hydrated ion and to evolving theoretical approaches that combine high-level calculations on clusters with coarse-grained models of the medium.
- Published
- 2011
- Full Text
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48. Serological characteristics of peanut allergy.
- Author
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Clarke MC, Kilburn SA, Hourihane JO, Dean KR, Warner JO, and Dean TP
- Subjects
- Adolescent, Adult, Blotting, Western, Child, Child, Preschool, Chromatography, Liquid, Electrophoresis, Polyacrylamide Gel, Humans, Immunoglobulin E blood, Infant, Radioallergosorbent Test, Allergens immunology, Arachis adverse effects, Arachis immunology, Food Hypersensitivity immunology, Immunoglobulin E immunology, Plant Proteins immunology
- Abstract
Background: Peanut is the most common cause of severe or fatal food-associated anaphylaxis. Studies indicate that peanut extracts contain many allergenic proteins. The identification of major and minor allergenic components is necessary for standardization of experimental and diagnostic extracts., Objective: To identify further major and minor allergenic components of peanut extract using a large population of peanut allergics, and to relate serological findings to clinical parameters., Methods: The crude peanut extract was fractionated by fast protein liquid chromatography and the IgE binding proteins identified by sodium dodecyl sulphate polyacrylamide gel electrophoresis followed by western blotting. Serum from 89 peanut allergics with a positive history of peanut allergy and elevated specific IgE and control serum from four atopic and four non-atopic, non-peanut allergics were used., Results: Nineteen peanut proteins were found to bind IgE from peanut allergic sera. Over 70% of subjects reacted to protein bands of 63 and 17 kDa (consistent with Ara h 1 and Ara h 2, respectively), confirming the importance of these two proteins as major allergens. A high proportion of patient sera also bound proteins at 15, 10, 30, 18 and 51 kDa in decreasing order. The percentage of cases with sensitivity to a 15 kDa protein was found to be higher in patient groups with severe reactions to peanut., Conclusion: This study highlights the diversity of peanut allergens. Diagnostic extracts containing a high proportion of the 15 kDa component may aid in diagnosis.
- Published
- 1998
- Full Text
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49. Recoverin inhibits the phosphorylation of dark-adapted rhodopsin more than it does that of bleached rhodopsin: a possible mechanism through which rhodopsin kinase is prevented from participation in a side reaction.
- Author
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Senin II, Dean KR, Zargarov AA, Akhtar M, and Philippov PP
- Subjects
- Calcium pharmacology, Darkness, G-Protein-Coupled Receptor Kinase 1, Hippocalcin, Phosphorylation drug effects, Protein Kinases metabolism, Recoverin, Rhodopsin physiology, Rod Cell Outer Segment metabolism, Signal Transduction drug effects, Urea, Calcium-Binding Proteins pharmacology, Eye Proteins, Light, Lipoproteins, Nerve Tissue Proteins, Protein Kinase Inhibitors, Rhodopsin metabolism
- Abstract
In its resting state rhodopsin kinase is present in an inactive from and is activated after interaction with light-activated rhodopsin (Rho*). The activated rhodopsin kinase then phosphorylates Rho* but is also able to catalyse the phosphorylation of dark-adapted rhodopsin. A consequence of the latter behaviour of the activated kinase is that at low levels of bleach a large number of phosphoryl groups are incorporated per mol of Rho*. Recoverin- and Ca2+-dependent inhibition of rhodopsin kinase was found to be inversely related to the extent of bleaching; the lower the fraction of rhodopsin bleached, the greater the inhibition. The IC50 of recoverin is approx. 1 microM at a 0.2% level of bleach and about 5 microM in a fully bleached sample. The inhibitory effect of recoverin was studied separately on the phosphorylation of rhodopsin and Rho*. The formation of phosphorylated rhodopsin was inhibited 4.5-fold more strongly than that of phosphorylated Rho*. These results are interpreted to suggest that one of the roles of the recoverin-dependent regulation of the activity of rhodopsin kinase is to prevent the enzyme from participating in the unwanted phosphorylation of dark-adapted rhodopsin, directing it to fulfil its 'correct' function of quenching the transduction activity of Rho*.
- Published
- 1997
- Full Text
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50. Application of an electrophoretic methodology for the identification of low molecular weight proteins in foods.
- Author
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Dean TP, Clarke MC, Hourihane JO, Dean KR, and Warner JO
- Subjects
- Arachis, Electrophoresis, Polyacrylamide Gel, Molecular Weight, Allergens analysis, Food Hypersensitivity etiology, Proteins analysis
- Abstract
Identification and characterisation of food proteins are core features of food allergy research. Current methods used to identify allergenic proteins in food have insufficient resolution and are unable to detect low molecular weight proteins. In this study we report the use of a simple SDS-PAGE method which allows resolution of small proteins. We have subsequently applied this method and reported presence of low molecular weight proteins in a range of hydrolysed milk formulae (Nutramigen, Pregistimil, Alfare, Pepti-Junior and Pregomin), and crude peanut protein extract. The molecular weight distribution for the peanut extract and the hydrolysates ranged between 5-200kDa and 2-17kDa respectively.
- Published
- 1996
- Full Text
- View/download PDF
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