570 results on '"K. Hogan"'
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2. New gravity-derived bathymetry for the Thwaites, Crosson, and Dotson ice shelves revealing two ice shelf populations
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T. A. Jordan, D. Porter, K. Tinto, R. Millan, A. Muto, K. Hogan, R. D. Larter, A. G. C. Graham, and J. D. Paden
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Environmental sciences ,GE1-350 ,Geology ,QE1-996.5 - Abstract
Ice shelves play a critical role in the long-term stability of ice sheets through their buttressing effect. The underlying bathymetry and cavity thickness are key inputs for modelling future ice sheet evolution. However, direct observation of sub-ice-shelf bathymetry is time-consuming, logistically risky, and in some areas simply not possible. Here we use new compilations of airborne and marine gravity, radar depth sounding, and swath bathymetry to provide new estimates of sub-ice-shelf bathymetry outboard of the rapidly changing West Antarctic Thwaites Glacier and beneath the adjacent Dotson and Crosson ice shelves. This region is of special interest, as the low-lying inland reverse slope of the Thwaites Glacier system makes it vulnerable to marine ice sheet instability, with rapid grounding line retreat observed since 1993 suggesting this process may be underway. Our results confirm a major marine channel >800 m deep extends tens of kilometres to the front of Thwaites Glacier, while the adjacent ice shelves are underlain by more complex bathymetry. Comparison of our new bathymetry with ice shelf draft reveals that ice shelves formed since 1993 comprise a distinct population where the draft conforms closely to the underlying bathymetry, unlike the older ice shelves, which show a more uniform depth of the ice base. This indicates that despite rapid basal melting in some areas, these recently floated parts of the ice shelf are not yet in dynamic equilibrium with their retreated grounding line positions and the underlying ocean system, a factor which must be included in future models of this region's evolution. more...
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- 2020
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3. Deglaciation and future stability of the Coats Land ice margin, Antarctica
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D. A. Hodgson, K. Hogan, J. M. Smith, J. A. Smith, C.-D. Hillenbrand, A. G. C. Graham, P. Fretwell, C. Allen, V. Peck, J.-E. Arndt, B. Dorschel, C. Hübscher, A. M. Smith, and R. Larter
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Environmental sciences ,GE1-350 ,Geology ,QE1-996.5 - Abstract
The East Antarctic Ice Sheet discharges into the Weddell Sea via the Coats Land ice margin. We have used geophysical data to determine the changing ice-sheet configuration in this region through its last glacial advance and Holocene retreat and to identify constraints on its future stability. Methods included high-resolution multibeam bathymetry, sub-bottom profiles, seismic-reflection profiles, sediment core analysis and satellite altimetry. These provide evidence that Coats Land glaciers and ice streams merged with the palaeo-Filchner Ice Stream during the last glacial advance. Retreat of this ice stream from 12 848 to 8351 cal. yr BP resulted in its progressive southwards decoupling from Coats Land outlet glaciers. Moraines and grounding-zone wedges document the subsequent retreat and thinning of these glaciers, their loss of contact with the bed and the formation of ice shelves, which re-advanced to pinning points on topographic highs at the distal end of the troughs. Once fully detached from the bed, these ice shelves were predisposed to rapid retreat back to coastal grounding lines. This was due to reverse-bed slopes, the consequent absence of further pinning points in the troughs and potentially to the loss of structural integrity resulting from weaknesses inherited at the grounding line. These processes explain why there are no large ice shelves in the eastern Weddell Sea between 75.5 and 77° S. more...
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- 2018
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4. McClusky's Theory of Margin: A Constructivist Grounded Theory Review for the 21st Century
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Garrett K. Hogan
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In 1963, Howard Y. McClusky wrote the theory of margin, defining the personal ratio of power to load. Margin theory has been used to predict success; however, more research is needed to redevelop how this sixty-year-old theory is situated in the current environment. This grounded theory study examined the changes to margin by hybridization. Initial findings suggest that tasking is not the simple internal review of power and load, as suggested in the theory of margin. Instead, the hybridized environment adds additional factors of intensification and motivation drain brought on by omnipresent tasking and dynamic environments. These factors combine to create an additional environment-based term to the decades-old, one-dimensional theory. [For the full proceedings, see ED648717.] more...
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- 2023
5. Electrokinetic convection-enhanced delivery for infusion into the brain from a hydrogel reservoir
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Jesus G. Cruz-Garza, Lokeshwar S. Bhenderu, Khaled M. Taghlabi, Kendall P. Frazee, Jaime R. Guerrero, Matthew K. Hogan, Frances Humes, Robert C. Rostomily, Philip J. Horner, and Amir H. Faraji
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Biology (General) ,QH301-705.5 - Abstract
Abstract Electrokinetic convection-enhanced delivery (ECED) utilizes an external electric field to drive the delivery of molecules and bioactive substances to local regions of the brain through electroosmosis and electrophoresis, without the need for an applied pressure. We characterize the implementation of ECED to direct a neutrally charged fluorophore (3 kDa) from a doped biocompatible acrylic acid/acrylamide hydrogel placed on the cortical surface. We compare fluorophore infusion profiles using ECED (time = 30 min, current = 50 µA) and diffusion-only control trials, for ex vivo (N = 18) and in vivo (N = 12) experiments. The linear intensity profile of infusion to the brain is significantly higher in ECED compared to control trials, both for in vivo and ex vivo. The linear distance of infusion, area of infusion, and the displacement of peak fluorescence intensity along the direction of infusion in ECED trials compared to control trials are significantly larger for in vivo trials, but not for ex vivo trials. These results demonstrate the effectiveness of ECED to direct a solute from a surface hydrogel towards inside the brain parenchyma based predominantly on the electroosmotic vector. more...
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- 2024
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6. Engineering and public health: An interdisciplinary approach to addressing water quality in Compone, Peru
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E. Maring, G. Raspanti, G. Jaschek, K. Hogan, C. Farmer, D. Lovell, S. Grutzmacher, P. Parikh, and S. Olcese
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Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Published
- 2014
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7. The Impact of Blood Flow Restriction Training on Tibial Bone Stress Injury Rehabilitation: An Exploratory Case Series
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Andrew P Golden, Kathleen K Hogan, Jamie B Morris, and Bryan B Pickens
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Sports medicine ,RC1200-1245 - Abstract
# Background Lower extremity bone stress injuries (BSI) are common injuries among athletes and military members. Typical management involves a period of restricted weightbearing which can have rapid detrimental effects upon both muscle and bone physiology. Few studies have investigated the effect of blood flow restriction (BFR) training on bone in the rehabilitative setting. # Purpose The purpose of this study was to investigate the effects of lower extremity exercise with the addition of BFR upon bone mineral density, bone mineral content, and lean body mass in military members with tibial BSIs. # Study Design Case series # Methods Twenty military members with MRI-confirmed tibial BSI were recruited to complete lower extremity exercise with the addition of BFR twice per week for four weeks. The BFR cuff was applied proximally to the participant’s involved limb while they performed gluteal, thigh, and leg resistance exercises. Outcomes were assessed at baseline and four weeks. The primary outcomes were whole leg bone mineral density (BMD), bone mineral content (BMC), and lean body mass (LM) as measured by dual-energy x-ray absorptiometry. Secondary outcomes included thigh and leg circumference measures and patient-reported outcomes, including the Lower Extremity Functional Scale (LEFS), Patient-Reported Outcomes Measurement Information System 57 (PROMIS-57), and Global Rating of Change (GROC). # Results No significant differences were found in BMD (p=0.720) or BMC (p=0.749) between limbs or within limbs over time. LM was generally less in the involved limb (p=0.019), however there were no significant differences between or within limbs over time (p=0.404). For thigh circumference, significant main effects were found for time (p=0.012) and limb (p=0.015), however there was no significant interaction effect (p=0.510). No significant differences were found for leg circumference (p=0.738). Participants showed significant mean changes in LEFS (15.15 points), PROMIS physical function (8.98 points), PROMIS social participation (7.60 points), PROMIS anxiety (3.26 points), and PROMIS pain interference (8.39 points) at four weeks. # Conclusion The utilization of BFR in the early rehabilitative management of tibial BSI may help mitigate decrements in both bone and muscle tissue during periods of decreased physical loading. # Level of Evidence 4 more...
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- 2024
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8. Development and validation of a pulmonary function test data extraction tool for the US department of veterans affairs electronic health record
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Alexander S. Rabin, Julien B. Weinstein, Sarah M. Seelye, Taylor N. Whittington, Cainnear K. Hogan, and Hallie C. Prescott
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Pulmonary function test ,Electronic health record ,Veterans ,Forced expiratory volume ,Forced vital capacity ,Obstruction ,Medicine ,Biology (General) ,QH301-705.5 ,Science (General) ,Q1-390 - Abstract
Abstract Objective Pulmonary function test (PFT) results are recorded variably across hospitals in the Department of Veterans Affairs (VA) electronic health record (EHR), using both unstructured and semi-structured notes. We developed and validated a hospital-specific code to extract pre-bronchodilator measures of obstruction (ratio of forced expiratory volume in one second [FEV1] to forced vital capacity [FVC]) and severity of obstruction (percent predicted of FEV1). Results Among 36 VA facilities with the most PFTs completed between 2018 and 2022 from a parent cohort of veterans receiving long-acting controller inhalers, 12 had a consistent syntactical convention or template for reporting PFT data in the EHR. Of the 42,718 PFTs identified from these 12 facilities, the hospital-specific text processing pipeline yielded 24,860 values for the FEV1:FVC ratio and 23,729 values for FEV1. A ratio of FEV1:FVC less than 0.7 was identified in 17,615 of 24,922 studies (70.7%); 8864 of 24,922 (35.6%) had a severe or very severe reduction in FEV1 ( more...
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- 2024
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9. A novel minimally invasive and versatile kyphoplasty balloon-based model of porcine spinal cord injury
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Sean M. Barber, Tatiana Wolfe, Alexander G. Steele, Kris Hoffman, Matthew K. Hogan, Allison Frazier, Xiufeng Tang, Dimitry G. Sayenko, and Philip J. Horner
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spinal cord injury ,animal model ,minimally invasive surgery ,kyphoplasty ,spinal cord contusion injury ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
IntroductionSpinal cord injury (SCI) animal models often utilize an open surgical laminectomy, which results in animal morbidity and also leads to changes in spinal canal diameter, spinal cord perfusion, cerebrospinal fluid flow dynamics, and spinal stability which may confound SCI research. Moreover, the use of open surgical laminectomy for injury creation lacks realism when considering human SCI scenarios.MethodsWe developed a novel, image-guided, minimally invasive, large animal model of SCI which utilizes a kyphoplasty balloon inserted into the epidural space via an interlaminar approach without the need for open surgery.ResultsThe model was validated in 5 Yucatán pigs with imaging, neurofunctional, histologic, and electrophysiologic findings consistent with a mild compression injury.DiscussionFew large animal models exist that have the potential to reproduce the mechanisms of spinal cord injury (SCI) commonly seen in humans, which in turn limits the relevance and applicability of SCI translational research. SCI research relies heavily on animal models, which typically involve an open surgical, dorsal laminectomy which is inherently invasive and may have untoward consequences on animal morbidity and spinal physiology that limit translational impact. We developed a minimally invasive, large animal model of spinal cord injury which utilizes a kyphoplasty balloon inserted percutaneously into the spinal epidural space. Balloon inflation results in a targeted, compressive spinal cord injury with histological and electrophysiological features directly relevant to human spinal cord injury cases without the need for invasive surgery. Balloon inflation pressure, length of time that balloon remains inflated, and speed of inflation may be modified to achieve variations in injury severity and subtype. more...
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- 2024
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10. Patriarchy’s Remains: An Autopsy of Iberian Cinematic Dark Humour
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Erin K. Hogan
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- 2024
11. Use of a Candida albicans SC5314 PacBio HiFi reads dataset to close gaps in the reference genome assembly, reveal a subtelomeric gene family, and produce accurate phased allelic sequences
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Lois L. Hoyer, Brian A. Freeman, Elizabeth K. Hogan, and Alvaro G. Hernandez
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genome sequence ,Candida albicans ,pathogenic yeast genomes ,PacBio sequence data ,allelic sequences ,telomere-to-telomere ,Microbiology ,QR1-502 - Abstract
Candida albicans SC5314 is the most-often used strain for molecular manipulation of the species. The SC5314 reference genome sequence is the result of considerable effort from many scientists and has advanced research into fungal biology and pathogenesis. Although the resource is highly developed and presented in a phased diploid format, the sequence includes gaps and does not extend to the telomeres on its eight chromosome pairs. Accurate SC5314 genome assembly is complicated by the presence of extensive repeated sequences and considerable allelic length variation at some loci. Advances in genome sequencing technology provide the tools to obtain highly accurate long-read data that span even the most-difficult-to-assemble genome regions. Here, we describe derivation of a PacBio HiFi data set and creation of a collapsed haploid telomere-to-telomere assembly of the SC5314 genome (ASM3268872v1) that revealed previously unknown features of the strain. ASM3268872v1 subtelomeric distances were up to 19 kb larger than in the reference genome and revealed a family of highly conserved DNA helicase-encoding genes at 10 of the 16 chromosome ends. We also describe alignments of individual HiFi reads to deduce accurate diploid sequences for the most notoriously difficult-to-assemble C. albicans genes: the agglutinin-like sequence (ALS) gene family. We provide a tutorial that demonstrates how the HiFi reads can be visualized to explore any region of interest. Availability of the HiFi reads data set and the ASM3268872v1 comparative guide assembly will streamline research efforts because accurate diploid sequences can be derived using simple in silico methods rather than time-consuming laboratory-bench approaches. more...
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- 2024
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12. The Healthy Web--Access to Online Health Information for Individuals with Disabilities
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Geiger, Brian, Evans, R. R., Cellitti, M. A., Smith, K. Hogan, O'Neal, Marcia R., Firsing, S. L., III, and Chandan, P.
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Background: The Internet can be an invaluable resource for obtaining health information by people with disabilities. Although valid and reliable information is available, previous research revealed barriers to accessing health information online. Health education specialists have the responsibilities to insure that it is accessible to all users. IDEA and ADA mandate full participation in society by people with disabilities of all ages. Healthy People 2020 also includes objectives aimed at improving health information delivery, comprehension and application in daily life. Methods: This paper summarizes legal requirements and standards to present health information using technology and offers practical guidelines for accessible health education programs. Accessibility of online information was determined for representative consumer health web sites using an evaluation tool developed by Web Accessibility In Mind (Web AIM). Web sites were evaluated according to four accessibility principles: Perceivable, Operable, Understandable and Robust. Results: Despite available standards to design web sites without barriers, online health information is not accessible to all users. WAVE revealed accessibility errors on representative consumer health web sites, ranging from zero errors (autism information hosted by the National Library of Medicine) to 15 errors (sleep information from CNN Health). These errors may limit access to users with disabilities. Conclusions: Implementing guidelines for universal design for learning will diminish the digital divide. Health education specialists may direct consumers to web sites designed with accessibility in mind according to Web Content Accessibility Guidelines. more...
- Published
- 2011
13. Association between functional disability type and suicide-related outcomes among U.S. adults with disabilities in the National Survey on Drug Use and Health, 2015–2019
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Nicole M. Marlow, Zhigang Xie, Rebecca Tanner, Molly Jacobs, Michaela K. Hogan, Thomas E. Joiner, and Anne V. Kirby
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Adult ,Male ,Psychiatry and Mental health ,Cross-Sectional Studies ,Risk Factors ,Substance-Related Disorders ,Humans ,Disabled Persons ,Female ,Suicide, Attempted ,Biological Psychiatry ,Suicidal Ideation - Abstract
While research on suicidal behavior for people with disability (PWD) suggests they experience higher risk than people without disability, less is known about variations among individuals with different disability types. This nationally representative, cross-sectional study compared differences in suicide-related outcomes (ideation, planning, attempts) among PWD by functional disability type (hearing, vision, cognitive, mobility, complex activity) and number. Secondary analysis of adult PWD in the 2015-2019 National Survey on Drug Use and Health (unweighted N = 35,544; representing 47,723,378 PWD, weighted) was used to estimate relationships between suicide-related outcomes and disability type and number. Most respondents were female (55.9%), and 36.0% were aged ≥65 years. Adjusted odds ratios (AORs) from multivariable logistic regression indicated that suicidal ideation and suicide attempt, respectively, were significantly more likely among individuals with cognitive (AOR = 1.71, 95% CI = 1.24-2.35; AOR = 2.54, 95% CI = 1.31-4.91), complex activity (AOR = 1.96, 95% CI = 1.37-2.81; AOR = 2.67, 95% CI = 1.32-5.41), and ≥2 limitations (AOR = 2.02, 95% CI = 1.52-2.69; AOR = 3.46, 95% CI = 1.84-6.50) than hearing limitation. Also, relative to other disability types, suicide-related outcomes were significantly more likely among individuals with cognitive limitation and complex activity limitation (p 0.001). Additionally, suicide-related outcomes elevated in likelihood as the number of limitations increased, with the largest associations among those with ≥5 limitations for suicidal ideation (AOR = 2.31, 95% CI = 1.46-3.66), suicide planning (AOR = 3.34, 95% CI = 1.97-5.68), and suicide attempt (AOR = 6.37, 95% CI = 3.76-10.79). Subgroup analyses showed that presence of cognitive limitation and multiple limitations differentiated between suicidal ideators and suicide attempters. Further research is needed to identify causes of these risks and develop suicide prevention efforts for these particularly vulnerable groups. more...
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- 2022
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14. A Chromosome-Level Genome Assembly for Yamadazyma tenuis ATCC 10573
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Lois L. Hoyer, Elizabeth K. Hogan, Soon-Hwan Oh, Brian A. Freeman, Kimberly K. O. Walden, and Alvaro G. Hernandez
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Immunology and Microbiology (miscellaneous) ,Genetics ,Molecular Biology - Abstract
Pacific Biosciences (PacBio) long-read sequencing was used to generate a chromosome-level genome assembly for Yamadazyma tenuis strain ATCC 10573. The assembly featured 7 chromosomes that matched the electrophoretic karyotype and a 26.5-kb circular mitochondrial genome. The nuclear genome was 10.8 Mb, with a GC content of 43%, and 5,340 predicted genes. more...
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- 2023
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15. Comparison of Administrative vs Electronic Health Record-based Methods for Identifying Sepsis Hospitalizations
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Kevin J Karlic, Tori L Clouse, Cainnear K Hogan, Allan Garland, Sarah Seelye, Jeremy B Sussman, and Hallie C Prescott
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Pulmonary and Respiratory Medicine - Published
- 2023
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16. VCSEL based, wearable, continuously monitoring pulse oximeter.
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Daniel T. Kollmann, William K. Hogan, Charles Steidl, Mary K. Hibbs-Brenner, Daniel S. Hedin, and Patrick A. Lichter
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- 2013
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17. Interpretability, credibility, and usability of hospital-specific template matching versus regression-based hospital performance assessments; a multiple methods study
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Brenda M. McGrath, Linda Takamine, Cainnear K. Hogan, Timothy P. Hofer, Amy K. Rosen, Jeremy B. Sussman, Wyndy L. Wiitala, Andrew M. Ryan, and Hallie C. Prescott
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Surveys and Questionnaires ,Health Policy ,Humans ,Hospital Mortality ,Delivery of Health Care ,Diagnosis-Related Groups ,Hospitals - Abstract
Background Hospital-specific template matching (HS-TM) is a newer method of hospital performance assessment. Objective To assess the interpretability, credibility, and usability of HS-TM-based vs. regression-based performance assessments. Research design We surveyed hospital leaders (January-May 2021) and completed follow-up semi-structured interviews. Surveys included four hypothetical performance assessment vignettes, with method (HS-TM, regression) and hospital mortality randomized. Subjects Nationwide Veterans Affairs Chiefs of Staff, Medicine, and Hospital Medicine. Measures Correct interpretation; self-rated confidence in interpretation; and self-rated trust in assessment (via survey). Concerns about credibility and main uses (via thematic analysis of interview transcripts). Results In total, 84 participants completed 295 survey vignettes. Respondents correctly interpreted 81.8% HS-TM vs. 56.5% regression assessments, p p = 0.03. Nine concerns about credibility were identified: inadequate capture of case-mix and/or illness severity; inability to account for specialized programs (e.g., transplant center); comparison to geographically disparate hospitals; equating mortality with quality; lack of criterion standards; low power; comparison to dissimilar hospitals; generation of rankings; and lack of transparency. Five concerns were equally relevant to both methods, one more pertinent to HS-TM, and three more pertinent to regression. Assessments were mainly used to trigger further quality evaluation (a “check oil light”) and motivate behavior change. Conclusions HS-TM-based performance assessments were more interpretable and more credible to VA hospital leaders than regression-based assessments. However, leaders had a similar set of concerns related to credibility for both methods and felt both were best used as a screen for further evaluation. more...
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- 2022
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18. BedMachine v3: Complete Bed Topography and Ocean Bathymetry Mapping of Greenland From Multibeam Echo Sounding Combined With Mass Conservation
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M. Morlighem, C. N. Williams, E. Rignot, L. An, J. E. Arndt, J. L. Bamber, G. Catania, N. Chauché, J. A. Dowdeswell, B. Dorschel, I. Fenty, K. Hogan, I. Howat, A. Hubbard, M. Jakobsson, T. M. Jordan, K. K. Kjeldsen, R. Millan, L. Mayer, J. Mouginot, B. P. Y. Noël, C. O'Cofaigh, S. Palmer, S. Rysgaard, H. Seroussi, M. J. Siegert, P. Slabon, F. Straneo, M. R. van den Broeke, W. Weinrebe, M. Wood, and K. B. Zinglersen more...
- Published
- 2017
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19. Proyectando las luces y sombras de la industria audiovisual peninsular posCIMA: diálogos con mujeres cineastas emergentes
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García-Puente, Maria, primary and K. Hogan, Erin, additional
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- 2022
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20. A Tertiary Care-based Complex Care Program
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Annique K. Hogan, Matthew Dye, Kathryn F. Leach, Meghan M. Galligan, Rachel English, Brenna L. Aredas, David T. Rubin, and Noelle J. Stack
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medicine.medical_specialty ,MEDLINE ,Tertiary care ,03 medical and health sciences ,0302 clinical medicine ,Patient satisfaction ,Health care ,Humans ,Medicine ,Multiple Chronic Conditions ,030212 general & internal medicine ,Child ,Patient Care Team ,Tertiary Healthcare ,business.industry ,030503 health policy & services ,Stressor ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Emergency department ,Length of Stay ,Patient Acceptance of Health Care ,Quality Improvement ,Hospitalization ,Caregivers ,Patient Satisfaction ,Child, Preschool ,Family medicine ,Emergency Service, Hospital ,0305 other medical science ,business ,Care program ,Case Management ,Psychosocial - Abstract
OBJECTIVE Children with medical complexity (CMC) have significant health care costs, but they also experience substantial unmet health care needs, hospitalizations, and medical errors. Their parents often report psychosocial stressors and poor care satisfaction. Complex care programs can improve the care for CMC. At our tertiary care institution, we developed a consultative complex care program to improve the quality and cost of care for CMC and to improve the experience of care for patients and families. METHODS To address the needs of CMC at our institution, we developed the Compass Care Program, a consultative complex care program across inpatient and outpatient settings. Utilization data [hospital admissions per patient month; length of stay per admission; hospital days per patient month; emergency department (ED) visits per patient month; and institutional charges per patient month] and caregiver satisfaction data (obtained via paper survey at outpatient visits) were tracked over the period of participation in the program and compared preenrollment and postenrollment for program participants. RESULTS Participants had significant decreases in hospital admissions per patient month, length of stay per admission, hospital days per patient month, and charges per patient month following enrollment (P more...
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- 2020
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21. Preparing to Implement Evidence-Based Literacy Practices in the Co-taught Classroom
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Devin M. Kearns, Erin Clancy, Alexandra Shelton, Jade Wexler, and Erin K. Hogan
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Medical education ,Evidence-based practice ,Literacy education ,media_common.quotation_subject ,05 social sciences ,Professional development ,050401 social sciences methods ,050301 education ,Special education ,Literacy ,Education ,Clinical Psychology ,Team teaching ,0504 sociology ,ComputingMilieux_COMPUTERSANDEDUCATION ,Developmental and Educational Psychology ,Educational planning ,Psychology ,0503 education ,media_common - Abstract
It is essential that middle school content-area and special education co-teachers adopt evidence-based literacy practices that they can integrate into their content-area instruction to address the needs of all of the students in their classes. This article provides co-teachers with four planning tips to improve implementation of the practices they adopt. The planning tips are organized using the acronym FIRST: (a) monitor Fidelity of implementation of the adopted practices, (b) Integrate the practices into daily content-area instruction and across the year, (c) determine the Roles of each co-teacher when planning for and implementing instruction in the adopted practices, and (d) consider specific guidelines to Select Texts for each literacy-focused lesson. The planning tips are illustrated using examples related to the content-area literacy instruction (CALI) instructional framework, which is a set of evidence-based literacy practices and procedures designed to improve the literacy instruction middle school coteachers implement in their content-area classes. more...
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- 2020
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22. Individualizing Literacy Instruction in Co-Taught Classrooms Through a Station Teaching Model
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Cheryl P. Lyon, Erin K. Hogan, and Devin M. Kearns
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Content area ,media_common.quotation_subject ,05 social sciences ,Individualized instruction ,050301 education ,Literacy ,Education ,Clinical Psychology ,Team teaching ,Reading comprehension ,ComputingMilieux_COMPUTERSANDEDUCATION ,Developmental and Educational Psychology ,Mathematics education ,0501 psychology and cognitive sciences ,Co-teaching ,Psychology ,0503 education ,050104 developmental & child psychology ,media_common - Abstract
The Project CALI (Content Area Literacy Instruction) instructional framework is designed to enhance reading comprehension for all students, those with disabilities as well as their typically developing peers, in inclusive co-taught middle school content-area classrooms. For students with and at-risk for disabilities, even well-designed, research-based, and whole-class instruction often leads to inadequate improvement in reading comprehension and thus learning of content material. In CALI, teachers use student data to determine which students need more support and targeted, individualized instruction, and by contrast, which students may benefit from opportunities to extend their learning with more challenging texts and student-managed work. This article provides guidance for designing and implementing customizable lessons using station-teaching to individualize instruction. The Project CALI student support model is the final instructional piece of the CALI instructional framework. more...
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- 2020
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23. Engineering the ABIO-BIO interface of neurostimulation electrodes using polypyrrole and bioactive hydrogels
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Alexa R. Graham, Ankita Bhat, Philip J. Horner, Hemang Trivedi, Anthony Guiseppi-Elie, and Matthew K. Hogan
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Bio interface ,General Chemical Engineering ,Nanotechnology ,02 engineering and technology ,General Chemistry ,021001 nanoscience & nanotechnology ,Polypyrrole ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,Electrode ,Self-healing hydrogels ,0210 nano-technology ,Biosensor ,030217 neurology & neurosurgery - Abstract
Following spinal cord injury, the use of electrodes for neurostimulation in animal models has been shown to stimulate muscle movement, however, the efficacy of such treatment is impaired by increased interfacial impedance caused by fibrous encapsulation of the electrode. Sputter-deposited gold-on-polyimide electrodes were modified by potentiostatic electrodeposition of poly(pyrrole-co-3-pyrrolylbutyrate-conj-aminoethylmethacrylate): sulfopropyl methacrylate [P(Py-co-PyBA-conj-AEMA):SPMA] to various charge densities (0–100 mC/cm2) to address interfacial impedance and coated with a phosphoryl choline containing bioactive hydrogel to address biocompatibility at the ABIO-BIO interface. Electrodes were characterized with scanning electron microscopy (surface morphology), multiple-scan rate cyclic voltammetry (peak current and electroactive area), and electrochemical impedance spectroscopy (charge transfer resistance and membrane resistance). SEM analysis and electroactive area calculations identified films fabricated with a charge density of 50 mC/cm2 as well suited for neurostimulation electrodes. Charge transfer resistance demonstrated a strong inverse correlation (−0.83) with charge density of electrodeposition. On average, the addition of polypyrrole and hydrogel to neurostimulation electrodes decreased charge transfer resistance by 82 %. These results support the use of interfacial engineering techniques to mitigate high interfacial impedance and combat the foreign body response towards epidurally implanted neurostimulation electrodes. more...
- Published
- 2020
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24. Musculoskeletal injuries in US Air Force Tactical Air Control Party trainees: an 11-year longitudinal retrospective cohort study and presentation of a musculoskeletal injury classification matrix
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Ben R Hando, J Bryant, V Pav, L Haydu, K Hogan, J Mata, and C Butler
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General Medicine - Abstract
IntroductionLittle is known of the epidemiology of musculoskeletal injuries (MSKIs) in US Air Force Special Warfare (AFSPECWAR) Tactical Air Control Party trainees. The purpose of this longitudinal retrospective cohort study was to (1) report the incidence and type of MSKI sustained by AFSPECWAR trainees during and up to 1 year following training, (2) identify factors associated with MSKI, and (3) develop and present the MSKI classification matrix used to identify and categorise injuries in this study.MethodsTrainees in the Tactical Air Control Party Apprentice Course between fiscal years 2010–2020 were included. Diagnosis codes were classified as MSKI or non-MSKI using a classification matrix. Incidence rates and incidence proportion for injury types and regions were calculated. Measures were compared for differences between those who did and did not sustain an MSKI during training. A Cox proportional hazards model was used to identify factors associated with MSKI.ResultsOf the 3242 trainees, 1588 (49%) sustained an MSKI during training and the cohort sustained MSKIs at a rate of 16 MSKI per 100 person-months. Overuse/non-specific lower extremity injuries predominated. Differences were seen in some baseline measures between those who did and did not sustain an MSKI. Factors retained in the final Cox regression model were age, 1.5-mile run times and prior MSKI.ConclusionSlower run times and higher age were associated with an increased likelihood of MSKI. Prior MSKI was the strongest predictor of MSKI during training. Trainees sustained MSKIs at a higher rate than graduates in their first year in the career field. The MSKI matrix was effective in identifying and categorising MSKI over a prolonged (12-year) surveillance period and could be useful for future injury surveillance efforts in the military or civilian settings. Findings from this study could inform future injury mitigation efforts in military training environments. more...
- Published
- 2023
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25. Pathogen monitoring for early disease detection using oral fluid and air samples
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C. Goodell, A. Witt, J. Rudy, K. Hogan, C. Alonso, and D. Polson
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- 2022
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26. Diagnostic monitoring using oral fluids and sound: Complementing detection technologies
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C. Goodell, A. Witt, J. Rudy, K. Hogan, C. Alonso, and D. Polson
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- 2022
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27. The Goldilocks problem: Healthcare delivery models for children with medical complexity
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Meghan M Galligan and Annique K Hogan
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Patient-Centered Care ,Pediatrics, Perinatology and Child Health ,Humans ,General Medicine ,Child ,Delivery of Health Care ,Quality of Health Care - Abstract
Health systems have increasingly adapted elements of the medical home model in designing complex care programs for children with medical complexity (CMC). In recent years, several key complex care program designs have emerged. These programs have been shown to be effective in improving the quality and cost of care for CMC. In designing and implementing a complex care model, there are many variables a health system must consider to ensure program viability. To address CMC across the continuum of care, tertiary care systems should implement a portfolio of complex care models to accommodate the population's diverse needs. Further study is needed to establish 'gold standards' for complex care delivery models, but a major factor affecting program innovation is reimbursement, as the fee for service model does not adequately support the enhanced services required to ensure high value, high quality care for CMC. It is thus critical that stakeholders from health systems and payers align to engage in innovation in complex care delivery design and implementation. Without this partnership, advances in care delivery for CMC will be limited. more...
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- 2022
28. Variation in U.S. Hospital Practices for Bronchoscopy in the Intensive Care Unit
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Douglas A. Arenberg, Thomas S. Valley, Jose De Cardenas, Hallie C. Prescott, Max T Wayne, Sarah Seelye, Cainnear K Hogan, and Daniel Molling
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Hospitals ,Intensive Care Units ,Variation (linguistics) ,Bronchoscopy ,Emergency medicine ,medicine ,Humans ,business ,Retrospective Studies - Published
- 2021
29. Rigor and reproducibility in analysis of rodent behavior utilizing the forelimb reaching task following a cervical spinal cord injury
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Betsy H, Salazar, Kristopher A, Hoffman, Allison M, Fraizer, Frances, Humes, Matthew K, Hogan, Maddalena A, Horner, Timothy, Yadegar, Sarah, Trusler, Gillian F, Hamilton, and Philip J, Horner
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Behavioral Neuroscience - Abstract
Spinal cord injury (SCI) research with animals aims to understand the neurophysiological responses resultant of injury and to identify effective interventions that can translate into clinical treatments in the future. Consistent and reliable assessments to properly measure outcomes are essential to achieve this aim and avoid issues with reproducibility. The objective of this study was to establish a baseline for implementing the forelimb reaching task (FRT) assessment and analysis that increased reproducibility of our studies. For this study, we implemented a weekly FRT training program for six weeks. During this time the language of the scoring rubric for movement elements that comprise a reaching task was simplified and expanded. We calculated intra- and inter-rater variability among participants of the study both before and after training to determine the effect changes made had on rigor and reproducibility of this behavioral assessment in a cervical SCI rodent model. All animals (n = 19) utilized for FRT behavioral assessments received moderate contusion injuries using the Ohio State University device and were tested for a period of 5 weeks post-SCI. Videos used for scoring were edited and shared with all participants of this study to test FRT score variability and the effect simplification of the scoring rubric had on overall inter-rater reliability. From our results we determined training for a minimum of three weeks in FRT analysis is necessary for rigor and reproducibility of our behavioral studies, as well as the need for two raters to be assigned per animal to ensure accuracy of results. more...
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- 2023
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30. Evolution of optical subassemblies in IBM data communication transceivers.
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Jean M. Trewhella, Glen W. Johnson, William K. Hogan, and Dennis L. Karst
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- 2003
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31. UBR7 acts as a histone chaperone for post‐nucleosomal histone H3
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Alexander S. Lee, Ali Shilatifard, Daniel R. Foltz, Kyle P. Eagen, Justin Bodner, Alexander B. Willis, Celeste Rosencrance, Matthew N Gaynes, Ann K. Hogan, Shashank Srivastava, Aaron O. Bailey, Marc A. Morgan, Kizhakke M Sathyan, Jiehuan Huang, Sakshi Khurana, Ewelina Zasadzinska, and Kelvin A. Wong more...
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Ubiquitin-Protein Ligases ,Nucleosomal histone ,Autoantigens ,General Biochemistry, Genetics and Molecular Biology ,Cell Line ,Histones ,chemistry.chemical_compound ,Protein Domains ,Transcription (biology) ,Humans ,Molecular Biology ,General Immunology and Microbiology ,biology ,General Neuroscience ,Nuclear Proteins ,Articles ,Chromatin ,Cell biology ,Nucleosomes ,Histone Code ,Histone ,HEK293 Cells ,chemistry ,NASP ,Chaperone (protein) ,biology.protein ,H3K4me3 ,DNA ,HeLa Cells - Abstract
Histone chaperones modulate the stability of histones beginning from histone synthesis, through incorporation into DNA, and during recycling during transcription and replication. Following histone removal from DNA, chaperones regulate histone storage and degradation. Here, we demonstrate that UBR7 is a histone H3.1 chaperone that modulates the supply of pre-existing post-nucleosomal histone complexes. We demonstrate that UBR7 binds to post-nucleosomal H3K4me3 and H3K9me3 histones via its UBR box and PHD. UBR7 binds to the non-nucleosomal histone chaperone NASP. In the absence of UBR7, the pool of NASP-bound post-nucleosomal histones accumulate and chromatin is depleted of H3K4me3-modified histones. We propose that the interaction of UBR7 with NASP and histones opposes the histone storage functions of NASP and that UBR7 promotes reincorporation of post-nucleosomal H3 complexes. more...
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- 2021
32. Temporal Trends and Hospital Variation in Time-to-Antibiotics Among Veterans Hospitalized With Sepsis
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Daniel Molling, Xiao Qing Wang, Theodore J. Iwashyna, Sarah Seelye, John P. Donnelly, Makoto Jones, Vincent X. Liu, Max T Wayne, Cainnear K Hogan, and Hallie C. Prescott
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Male ,medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,Drug Administration Schedule ,Time-to-Treatment ,Sepsis ,Cohort Studies ,Critical Care Medicine ,Interquartile range ,Internal medicine ,Medicine ,Humans ,Veterans Affairs ,Aged ,Veterans ,Original Investigation ,business.industry ,Research ,Organ dysfunction ,General Medicine ,Emergency department ,Middle Aged ,medicine.disease ,humanities ,United States ,Anti-Bacterial Agents ,Hospitalization ,United States Department of Veterans Affairs ,Online Only ,Blood pressure ,Female ,medicine.symptom ,business ,Emergency Service, Hospital ,Cohort study - Abstract
Key Points Question How has timing of antibiotics for sepsis changed over time in US Department of Veterans Affairs Hospitals? Findings In this cohort of 111 385 veterans hospitalized with sepsis from 2013 to 2018, median time to antibiotics declined by 9 minutes per year. However, there was significant variation in time to antibiotics across hospitals, even after adjustment for patient characteristics. Meaning These findings suggest that there is potential for performance improvement for sepsis hospitalizations, but efforts to further accelerate time-to-antibiotics must be weighed against the risks of overtreatment., This cohort study examines temporal trends and variations in time-to-antibiotics for sepsis in the US Department of Veterans Affairs health care system., Importance It is unclear whether antimicrobial timing for sepsis has changed outside of performance incentive initiatives. Objective To examine temporal trends and variation in time-to-antibiotics for sepsis in the US Department of Veterans Affairs (VA) health care system. Design, Setting, and Participants This observational cohort study included 130 VA hospitals from 2013 to 2018. Participants included all patients admitted to the hospital via the emergency department with sepsis from 2013 to 2018, using a definition adapted from the Centers for Disease Control and Prevention Adult Sepsis Event definition, which requires evidence of suspected infection, acute organ dysfunction, and systemic antimicrobial therapy within 12 hours of presentation. Data were analyzed from October 6, 2020, to July 1, 2021. Exposures Time from presentation to antibiotic administration. Main Outcomes and Measures The main outcome was differences in time-to-antibiotics across study periods, hospitals, and patient subgroups defined by presenting temperature and blood pressure. Temporal trends in time-to-antibiotics were measured overall and by subgroups. Hospital-level variation in time-to-antibiotics was quantified after adjusting for differences in patient characteristics using multilevel linear regression models. Results A total of 111 385 hospitalizations for sepsis were identified, including 107 547 men (96.6%) men and 3838 women (3.4%) with a median (interquartile range [IQR]) age of 68 (62-77) years. A total of 7574 patients (6.8%) died in the hospital, and 13 855 patients (12.4%) died within 30 days. Median (IQR) time-to-antibiotics was 3.9 (2.4-6.5) hours but differed by presenting characteristics. Unadjusted median (IQR) time-to-antibiotics decreased over time, from 4.5 (2.7-7.1) hours during 2013 to 2014 to 3.5 (2.2-5.9) hours during 2017 to 2018 (P more...
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- 2021
33. Receipt of Recovery-Oriented Care Practices During Hospitalization for Sepsis
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Megan A. Watson, Clare Anderson, Kevin J. Karlic, Cainnear K. Hogan, Sarah Seelye, Stephanie P. Taylor, and Hallie C. Prescott
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General Medicine ,Original Clinical Report - Abstract
Survivors of sepsis hospitalization are at high risk for postsepsis morbidity, readmission, and death, but these negative outcomes can be mitigated by receipt of recommended care practices. We sought to assess factors associated with the receipt of recommended recovery-oriented care practices during hospitalization for sepsis. We hypothesized that patients treated in the ICU may be more likely than ward-treated patients to receive recommended care practices given the increasing focus on survivorship in the critical care field. DESIGN: Observational cohort study. SETTING: Michigan Medicine, a tertiary academic medical center. PATIENTS: Adult patients discharged alive from a hospitalization with a primary diagnosis of sepsis or septic shock in 2019. We further limited our cohort to patients receiving longitudinal care viewable in the Michigan Medicine electronic health record to ensure ability to capture posthospital care and outcomes. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Three-hundred sixty-five sepsis hospitalizations met study inclusion criteria. Using structured chart review, we determined receipt of the following recovery-based care practices during hospitalization: medication optimization, functional status evaluation at discharge, sepsis education, and scheduled follow-up within 2 weeks. The cohort was 46.6% female, 81.1% White, with a median age of 64 years. 51.2% were treated in the ICU. Medication optimization occurred in 93.7%, functional status evaluation in 82.7%, sepsis education in 20.0%, and scheduled follow-up within 2 weeks in 54.5%. ICU-treated patients had lower receipt of medication optimization and follow-up scheduling but greater receipt of functional and mental health status evaluations. In multivariable models, ICU treatment was associated with lower odds of receiving medication optimization (adjusted odds ratio, 0.72; 95% CI, 0.03–0.69) and not associated with receipt of other care practices. CONCLUSIONS: Our study shows incomplete receipt of recommended recovery-based care practices during sepsis hospitalization in both ward and ICU-treated patients. Sepsis education and mental health evaluation were particularly uncommon. more...
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- 2022
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34. Assessing Gq-GPCR-induced human astrocyte reactivity using bioengineered neural organoids
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Caroline Cvetkovic, Rajan Patel, Arya Shetty, Matthew K. Hogan, Morgan Anderson, Nupur Basu, Samira Aghlara-Fotovat, Srivathsan Ramesh, Debosmita Sardar, Omid Veiseh, Michael E. Ward, Benjamin Deneen, Philip J. Horner, and Robert Krencik more...
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Inflammation ,Neurons ,Pluripotent Stem Cells ,Synaptophysin ,Reproducibility of Results ,Bioengineering ,Cell Biology ,Cell Line ,Receptors, G-Protein-Coupled ,Organoids ,Adenosine Triphosphate ,Neural Stem Cells ,Astrocytes ,Spheroids, Cellular ,Glial Fibrillary Acidic Protein ,GTP-Binding Protein alpha Subunits, Gq-G11 ,Humans ,Calcium - Abstract
Astrocyte reactivity can directly modulate nervous system function and immune responses during disease and injury. However, the consequence of human astrocyte reactivity in response to specific contexts and within neural networks is obscure. Here, we devised a straightforward bioengineered neural organoid culture approach entailing transcription factor–driven direct differentiation of neurons and astrocytes from human pluripotent stem cells combined with genetically encoded tools for dual cell-selective activation. This strategy revealed that Gq-GPCR activation via chemogenetics in astrocytes promotes a rise in intracellular calcium followed by induction of immediate early genes and thrombospondin 1. However, astrocytes also undergo NF-κB nuclear translocation and secretion of inflammatory proteins, correlating with a decreased evoked firing rate of cocultured optogenetic neurons in suboptimal conditions, without overt neurotoxicity. Altogether, this study clarifies the intrinsic reactivity of human astrocytes in response to targeting GPCRs and delivers a bioengineered approach for organoid-based disease modeling and preclinical drug testing. more...
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- 2021
35. A wireless spinal stimulation system for ventral activation of the rat cervical spinal cord
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Cunjiang Yu, William J. Steele, Zhoulyu Rao, Philip J. Horner, Sean M. Barber, Matthew K. Hogan, Meng Huang, and Bethany R. Kondiles
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Science ,0206 medical engineering ,Electric Stimulation Therapy ,Stimulation ,Spinal cord injury ,02 engineering and technology ,Stimulus (physiology) ,Article ,03 medical and health sciences ,0302 clinical medicine ,Forelimb ,medicine ,Electrode array ,Animals ,Muscle, Skeletal ,Regeneration and repair in the nervous system ,Spinal Cord Injuries ,Multidisciplinary ,Electromyography ,business.industry ,medicine.disease ,Spinal cord ,020601 biomedical engineering ,Electric Stimulation ,Electrodes, Implanted ,Rats ,Electrophysiology ,medicine.anatomical_structure ,Gliosis ,Regenerative medicine ,Cervical Vertebrae ,Medicine ,medicine.symptom ,business ,Wireless Technology ,Biomedical engineering ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Electrical stimulation of the cervical spinal cord is gaining traction as a therapy following spinal cord injury; however, it is difficult to target the cervical motor region in a rodent using a non-penetrating stimulus compared with direct placement of intraspinal wire electrodes. Penetrating wire electrodes have been explored in rodent and pig models and, while they have proven beneficial in the injured spinal cord, the negative aspects of spinal parenchymal penetration (e.g., gliosis, neural tissue damage, and obdurate inflammation) are of concern when considering therapeutic potential. We therefore designed a novel approach for epidural stimulation of the rat spinal cord using a wireless stimulation system and ventral electrode array. Our approach allowed for preservation of mobility following surgery and was suitable for long term stimulation strategies in awake, freely functioning animals. Further, electrophysiology mapping of the ventral spinal cord revealed the ventral approach was suitable to target muscle groups of the rat forelimb and, at a single electrode lead position, different stimulation protocols could be applied to achieve unique activation patterns of the muscles of the forelimb. more...
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- 2021
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36. UBR7 Promotes Accumulation of NASP‐Bound Pre‐Existing Histone H3
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Ann K. Hogan, Kelvin A. Wong, Daniel R. Foltz, Ali Shilatifard, Jiehuan Huang, Matthew N Gaynes, Shashank Srivastava, Alexander B. Willis, Marc A. Morgan, Aaron Bailey, Kizhakke Mattada Sathyan, and Ewelina Zasadińzska more...
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Histone H3 ,NASP ,Chemistry ,Genetics ,Molecular Biology ,Biochemistry ,Biotechnology ,Cell biology - Published
- 2021
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37. Temporal Trends and Hospital Variation in Time to Antibiotics for Sepsis
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Vincent X. Liu, Hallie C. Prescott, Max T Wayne, Sarah Seelye, Daniel Molling, Cainnear K Hogan, Xiao Qing Wang, and John P. Donnelly
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Sepsis ,medicine.medical_specialty ,Variation (linguistics) ,business.industry ,medicine.drug_class ,Internal medicine ,Antibiotics ,medicine ,business ,medicine.disease - Published
- 2021
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38. Reduce, Retain, Recycle: Mechanisms for Promoting Histone Protein Degradation versus Stability and Retention
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Ann K. Hogan and Daniel R. Foltz
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DNA Replication ,Histones ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Transcription (biology) ,Nucleosome ,Animals ,Humans ,Histone Chaperones ,Histone octamer ,Molecular Biology ,Cellular Senescence ,030304 developmental biology ,0303 health sciences ,biology ,Protein Stability ,DNA replication ,Cell Differentiation ,Cell Biology ,Cell biology ,Chromatin ,Histone ,chemistry ,Chaperone (protein) ,Proteolysis ,biology.protein ,Minireview ,030217 neurology & neurosurgery ,DNA - Abstract
The eukaryotic genome is packaged into chromatin. The nucleosome, the basic unit of chromatin, is composed of DNA coiled around a histone octamer. Histones are among the longest-lived protein species in mammalian cells due to their thermodynamic stability and their associations with DNA and histone chaperones. Histone metabolism plays an integral role in homeostasis. While histones are largely stable, the degradation of histone proteins is necessary under specific conditions. Here, we review the physiological and cellular contexts that promote histone degradation. We describe specific known mechanisms that drive histone proteolysis. Finally, we discuss the importance of histone degradation and regulation of histone supply for organismal and cellular fitness. more...
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- 2021
39. Temporal Trends in Antimicrobial Prescribing During Hospitalization for Potential Infection and Sepsis
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Hallie C. Prescott, Sarah Seelye, Xiao Qing Wang, Cainnear K. Hogan, Joshua T. Smith, Patricia Kipnis, Fernando Barreda, John P. Donnelly, Jason M. Pogue, Theodore J. Iwashyna, Makoto M. Jones, and Vincent X. Liu more...
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Cohort Studies ,Hospitalization ,Male ,Sepsis ,Internal Medicine ,Humans ,Hospital Mortality ,Emergency Service, Hospital ,Systemic Inflammatory Response Syndrome ,Original Investigation ,Aged ,Anti-Bacterial Agents ,Retrospective Studies - Abstract
IMPORTANCE: Some experts have cautioned that national and health system emphasis on rapid administration of antimicrobials for sepsis may increase overall antimicrobial use even among patients without sepsis. OBJECTIVE: To assess whether temporal changes in antimicrobial timing for sepsis are associated with increasing antimicrobial use, days of therapy, or broadness of antimicrobial coverage among all hospitalized patients at risk for sepsis. DESIGN, SETTING, AND PARTICIPANTS: This is an observational cohort study of hospitalized patients at 152 hospitals in 2 health care systems during 2013 to 2018, admitted via the emergency department with 2 or more systemic inflammatory response syndrome (SIRS) criteria. Data analysis was performed from June 10, 2021, to March 22, 2022. EXPOSURES: Hospital-level temporal trends in time to first antimicrobial administration. OUTCOMES: Antimicrobial outcomes included antimicrobial use, days of therapy, and broadness of antibacterial coverage. Clinical outcomes included in-hospital mortality, 30-day mortality, length of hospitalization, and new multidrug-resistant (MDR) organism culture positivity. RESULTS: Among 1 559 523 patients admitted to the hospital via the emergency department with 2 or more SIRS criteria (1 269 998 male patients [81.4%]; median [IQR] age, 67 [59-77] years), 273 255 (17.5%) met objective criteria for sepsis. In multivariable models adjusted for patient characteristics, the adjusted median (IQR) time to first antimicrobial administration to patients with sepsis decreased by 37 minutes, from 4.7 (4.1-5.3) hours in 2013 to 3.9 (3.6-4.4) hours in 2018, although the slope of decrease varied across hospitals. During the same period, antimicrobial use within 48 hours, days of antimicrobial therapy, and receipt of broad-spectrum coverage decreased among the broader cohort of patients with SIRS. In-hospital mortality, 30-day mortality, length of hospitalization, new MDR culture positivity, and new MDR blood culture positivity decreased over the study period among both patients with sepsis and those with SIRS. When examining hospital-specific trends, decreases in antimicrobial use, days of therapy, and broadness of antibacterial coverage for patients with SIRS did not differ by hospital antimicrobial timing trend for sepsis. Overall, there was no evidence that accelerating antimicrobial timing for sepsis was associated with increasing antimicrobial use or impaired antimicrobial stewardship. CONCLUSIONS AND RELEVANCE: In this multihospital cohort study, the time to first antimicrobial for sepsis decreased over time, but this trend was not associated with increasing antimicrobial use, days of therapy, or broadness of antimicrobial coverage among the broader population at-risk for sepsis, which suggests that shortening the time to antibiotics for sepsis is feasible without leading to indiscriminate antimicrobial use. more...
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- 2022
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40. Intravenous alteplase for stroke with unknown time of onset guided by advanced imaging: systematic review and meta-analysis of individual patient data
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Götz Thomalla, Florent Boutitie, Henry Ma, Masatoshi Koga, Peter Ringleb, Lee H Schwamm, Ona Wu, Martin Bendszus, Christopher F Bladin, Bruce C V Campbell, Bastian Cheng, Leonid Churilov, Martin Ebinger, Matthias Endres, Jochen B Fiebach, Mayumi Fukuda-Doi, Manabu Inoue, Timothy J Kleinig, Lawrence L Latour, Robin Lemmens, Christopher R Levi, Didier Leys, Kaori Miwa, Carlos A Molina, Keith W Muir, Norbert Nighoghossian, Mark W Parsons, Salvador Pedraza, Peter D Schellinger, Stefan Schwab, Claus Z Simonsen, Shlee S Song, Vincent Thijs, Danilo Toni, Chung Y Hsu, Nils Wahlgren, Haruko Yamamoto, Nawaf Yassi, Sohei Yoshimura, Steven Warach, Werner Hacke, Kazunori Toyoda, Geoffrey A Donnan, Stephen M Davis, Christian Gerloff, Boris Raul Acosta, Karen Aegidius, Christian Albiker, Anna Alegiani, Miriam Almendrote, Angelika Alonso, Katharina Althaus, Pierre Amarenco, Hemasse Amiri, Bettina Anders, Adriana Aniculaesei, Jason Appleton, Juan Arenillas, Christina Back, Christian Bähr, Jürgen Bardutzky, Flore Baronnet-Chauvet, Rouven Bathe-Peters, Anna Bayer-Karpinska, Juan L. Becerra, Christoph Beck, Olga Belchí Guillamon, Amandine Benoit, Nadia Berhoune, Daniela Bindila, Julia Birchenall, Karine Blanc-Lasserre, Miguel Blanco Gonzales, Tobias Bobinger, Ulf Bodechtel, Eric Bodiguel, Urszula Bojaryn, Louise Bonnet, Benjamin Bouamra, Paul Bourgeois, Lorenz Breuer, Ludovic Breynaert, David Broughton, Raf Brouns, Sébastian Brugirard, Bart Bruneel, Florian Buggle, Serkan Cakmak, Ana Calleja, David Calvet, David Carrera, Hsin-Chieh Chen, Bharath Cheripelli, Tae-Hee Cho, Chi-un Choe, Lillian Choy, Hanne Christensen, Mareva Ciatipis, Geoffrey Cloud, Julien Cogez, Elisa Cortijo, Sophie Crozier, Dorte Damgaard, Krishna Dani, Beatrijs De Coene, Isabel De Hollander, Jacques De Keyser, Nina De Klippel, Charlotte De Maeseneire, Ann De Smedt, Maria del Mar Castellanos Rodrigo, Sandrine Deltour, Jelle Demeestere, Laurent Derex, Philippe Desfontaines, Ralf Dittrich, Anand Dixit, Laurens Dobbels, Valérie Domigo, Laura Dorado, Charlotte Druart, Kristina Hougaard Dupont, Anne Dusart, Rainer Dziewas, Matthias Ebner, Myriam Edjali-Goujon, Philipp Eisele, Salwa El Tawil, Ahmed Elhfnawy, Ana Etexberria, Nicholas Evans, Simon Fandler, Franz Fazekas, Sandra Felix, Jochen B. Fiebach, Jens Fiehler, Alexandra Filipov, Katharina Filipski, Robert Fleischmann, Christian Foerch, Ian Ford, Alexandra Gaenslen, Ivana Galinovic, Elena Meseguer Gancedo, Ramanan Ganeshan, Carlos García Esperón, Alicia Garrido, Thomas Gattringer, Olivia Geraghty, Rohat Geran, Stefan Gerner, Sylvie Godon-Hardy, Jos Göhler, Amir Golsari, Meritxell Gomis, David Gorriz, Verena Gramse, Laia Grau, Martin Griebe, Cristina Guerrero, Damla Guerzoglu, Sophie Guettier, Vincent Guiraud, Christoph Gumbinger, Ignaz Gunreben, Florian Haertig, Christian Hametner, Bernard Hanseeuw, Andreas Hansen, Jakob Hansen, Thomas Harbo, Andreas Harloff, Peter Harmel, Karl Georg Häusler, Florian Heinen, Valentin Held, Simon Hellwig, Dimitri Hemelsoet, Michael Hennerici, Juliane Herm, Sylvia Hermans, María Hernández, Jose Hervas Vicente, Niels Hjort, Cristina Hobeanu, Carsten Hobohm, Elmar Höfner, Katharina Hohenbichler, Marc Hommel, Julia Hoppe, Eva Hornberger, Carolin Hoyer, Xuya Huang, Nils Ipsen, Irina Isern, Lourdes Ispierto, Helle Iversen, Lise Jeppesen, Marta Jimenez, Jan Jungehülsing, Eric Jüttler, Dheeraj Kalladka, Bernd Kallmünzer, Arindam Kar, Lars Kellert, André Kemmling, Tobias Kessler, Usman Khan, Matthias Klein, Christoph Kleinschnitz, Matti Klockziem, Michael Knops, Luzie Koehler, Martin Koehrmann, Heinz Kohlfürst, Rainer Kollmar, Peter Kraft, Thomas Krause, Bo Kristensen, Jan M. Kröber, Natalia Kurka, Alexandre Ladoux, Patrice Laloux, Catherine Lamy, Emmanuelle Landrault, Arne Lauer, Claire Lebely, Jonathan Leempoel, Kennedy Lees, Anne Leger, Laurence Legrand, Lin Li, Anna-Mareike Löbbe, Frederic London, Elena Lopez-cancio, Matthias Lorenz, Stephen Louw, Caroline Lovelock, Manuel Lozano Sánchez, Giuseppe Lucente, Janos Lückl, Alain Luna, Kosmas Macha, Alexandre Machet, Daniel Mackenrodt, Dominik Madzar, Charles Majoie, Anika Männer, Vicky Maqueda, Jacob Marstrand, Alicia Martinez, Annika Marzina, Laura Mechthouff, Per Meden, Guy Meersman, Julia Meier, Charles Mellerio, Oliver Menn, Nadja Meyer, Dominik Michalski, Peter Michels, Lene Michelsen, Monica Millán Torne, Jens Minnerup, Boris Modrau, Sebastian Moeller, Anette Møller, Nathalie Morel, Fiona Moreton, Ludovic Morin, Thierry Moulin, Barry Moynihan, Anne K. Mueller, Keith W. Muir, Patricia Mulero, Sibu Mundiyanapurath, Johannes Mutzenbach, Simon Nagel, Oliver Naggara, Arumugam Nallasivan, Irene Navalpotro, Alexander H. Nave, Paul Nederkoorn, Lars Neeb, Hermann Neugebauer, Tobias Neumann-Haefelin, Stefan Oberndorfer, Christian Opherk, Lorenz Oppel, Catherine Oppenheim, Johannes Orthgieß, Leif Ostergaard, Perrine Paindeville, Ernest Palomeras, Verena Panitz, Bhavni Patel, Andre Peeters, Dirk Peeters, Anna Pellisé, Johann Pelz, Anthony Pereira, Natalia Pérez de la Ossa, Richard Perry, Salvador Petraza, Stéphane Peysson, Waltraud Pfeilschifter, Alexander Pichler, Alexandra Pierskalla, Hans-Werner Pledl, Sven Poli, Katrin Pomrehn, Marika Poulsen, Luis Prats, Silvia Presas, Elisabeth Prohaska, Volker Puetz, Josep Puig, Josep Puig Alcántara, Jan Purrucker, Veronique Quenardelle, Sankaranarayanan Ramachandran, Soulliard Raphaelle, Nicolas Raposo, Tilman Reiff, Michel Remmers, Pauline Renou, Martin Ribitsch, Hardy Richter, Martin Ritter, Thomas Ritzenthaler, Gilles Rodier, Christine Rodriguez-Regent, Manuel Rodríguez-Yáñez, Maria Roennefarth, Christine Roffe, Sverre Rosenbaum, Charlotte Rosso, Joachim Röther, Michal Rozanski, Noelia Ruiz de Morales, Francesca Russo, Matthieu Rutgers, Sharmilla Sagnier, Yves Samson, Josep Sánchez, Tamara Sauer, Jan H. Schäfer, Simon Schieber, Josef Schill, Dennis Schlak, Ludwig Schlemm, Sein Schmidt, Wouter Schonewille, Julian Schröder, Andreas Schulz, Johannes Schurig, Sönke Schwarting, Alexander Schwarz, Christopher Schwarzbach, Matthias Seidel, Alexander Seiler, Jochen Sembill, Joaquin Serena Leal, Ashit Shetty, Igor Sibon, Claus Z. Simonsen, Oliver Singer, Aravinth Sivagnanaratham, Ide Smets, Craig Smith, Peter Soors, Nikola Sprigg, Maximilian Spruegel, David Stark, Susanne Steinert, Sebastian Stösser, Markus Stuermlinger, Bart Swinnen, Ruben Tamazyan, Jose Tembl, Mikel Terceno Izaga, Emmanuel Touze, Thomas Truelsen, Guillaume Turc, Gaetane Turine, Serdar Tütüncü, Pippa Tyrell, Xavier Ustrell, Wilfried Vadot, Anne-Evelyne Vallet, Pauline Vallet, Lucie van den Berg, Sophie van den Berg, Cecile van Eendenburg, Robbert-Jan Van Hooff, Isabelle van Sloten, Peter Vanacker, Evelien Vancaester, Patrick Vanderdonckt, Yves Vandermeeren, Frederik Vanhee, Roland Veltkamp, Karsten Vestergaard, Alain Viguier, Dolores Vilas, Kersten Villringer, Dieke Voget, Jörg von Schrader, Paul von Weitzel, Elisabeth Warburton, Claudia Weber, Jörg Weber, Karl Wegscheider, Mirko Wegscheider, Christian Weimar, Karin Weinstich, Christopher Weise, Gesa Weise, Chris Willems, Klemens Winder, Matthias Wittayer, Marc Wolf, Martin Wolf, Valerie Wolff, Christian Wollboldt, Frank Wollenweber, Anke Wouters, Bertrand Yalo, Marion Yger, Nadia Younan, Laetita Yperzeele, Vesna Zegarac, Pia Zeiner, Ulf Ziemann, Thomas Zonneveld, Mathieu Zuber, Tsugio Akutsu, Junya Aoki, Shuji Arakawa, Ryosuke Doijiri, Yusuke Egashira, Yukiko Enomoto, Eisuke Furui, Konosuke Furuta, Seiji Gotoh, Toshimitsu Hamasaki, Yasuhiro Hasegawa, Teryuki Hirano, Kazunari Homma, Masahiko Ichijyo, Toshihiro Ide, Shuichi Igarashi, Yasuyuki Iguchi, Masafumi Ihara, Hajime Ikenouchi, Tsuyoshi Inoue, Ryo Itabashi, Yasuhiro Ito, Toru Iwama, Kenji Kamiyama, Shoko Kamiyoshi, Haruka Kanai, Yasuhisa Kanematsu, Takao Kanzawa, Kazumi Kimura, Jiro Kitayama, Takanari Kitazono, Rei Kondo, Kohsuke Kudo, Masayoshi Kusumi, Ken Kuwahara, Shoji Matsumoto, Hideki Matsuoka, Ban Mihara, Kazuo Minematsu, Ken Miura, Naomi Morita, Wataru Mouri, Kayo Murata, Yoshinari Nagakane, Taizen Nakase, Hiromi Ohara, Nobuyuki Ohara, Hideyuki Ohnishi, Hajime Ohta, Masafumi Ohtaki, Ryo Ohtani, Toshiho Ohtsuki, Hideo Ohyama, Takashi Okada, Yasushi Okada, Masato Osaki, Nobuyuki Sakai, Yoshiki Sanbongi, Naoshi Sasaki, Makoto Sasaki, Shoichiro Sato, Kenta Seki, Wataru Shimizu, Yoshiaki Shiokawa, Takashi Sozu, Junichiro Suzuki, Rieko Suzuki, Yasushi Takagi, Shunya Takizawa, Norio Tanahashi, Eijiro Tanaka, Ryota Tanaka, Yohei Tateishi, Tomoaki Terada, Tadashi Terasaki, Kenichi Todo, Azusa Tokunaga, Akira Tsujino, Toshihiro Ueda, Yoshikazu Uesaka, Mihoko Uotani, Takao Urabe, Masao Watanabe, Yoshiki Yagita, Yusuke Yakushiji, Keizo Yasui, Toshiro Yonehara, Shinichi Yoshimura, K. Aarnio, F. Alemseged, C. Anderson, T. Ang, M.L. Archer, J. Attia, P. Bailey, A. Balabanski, A. Barber, P.A. Barber, J. Bernhardt, A. Bivard, D. Blacker, C.F. Bladin, A. Brodtmann, D. Cadilhac, B.C.V. Campbell, L. Carey, S. Celestino, L. Chan, W.H. Chang, A. ChangI, C.H. Chen, C.-I. Chen, H.F. Chen, T.C. Chen, W.H. Chen, Y.Y. Chen, C.A. Cheng, E. Cheong, Y.W. Chiou, P.M. Choi, H.J. Chu, C.S. Chuang, T.C. Chung, L. Churilov, B. Clissold, A. Connelly, S. Coote, B. Coulton, E. Cowley, J. Cranefield, S. Curtze, C. D'Este, S.M. Davis, S. Day, P.M. Desmond, H.M. Dewey, C. Ding, G.A. Donnan, R. Drew, S. Eirola, D. Field, T. Frost, C. Garcia-Esperon, K. George, R. Gerraty, R. Grimley, Y.C. Guo, G. Hankey, J. Harvey, S.C. Ho, K. Hogan, D. Howells, P.M. Hsiao, C.H. Hsu, C.T. Hsu, C.-S. Hsu, J.P. Hsu, Y.D. Hsu, Y.T. Hsu, C.J. Hu, C.C. Huang, H.Y. Huang, M.Y. Huang, S.C. Huang, W.S. Huang, D. Jackson, J.S. Jeng, S.K. Jiang, L. Kaauwai, O. Kasari, J. King, T.J. Kleinig, M. Koivu, J. Kolbe, M. Krause, C.W. Kuan, W.L. Kung, C. Kyndt, C.L. Lau, A. Lee, C.Y. Lee, J.T. Lee, Y. Lee, Y.C. Lee, C. Levi, C.R. Levi, L.M. Lien, J.C. Lim, C.C. Lin, C.H. Lin, C.M. Lin, D. Lin, C.H. Liu, J. Liu, Y.C. Lo, P.S. Loh, E. Low, C.H. Lu, C.J. Lu, M.K. Lu, J. Ly, H. Ma, L. Macaulay, R. Macdonnell, E. Mackey, M. Macleod, J. Mahadevan, V. Maxwell, R. McCoy, A. McDonald, S. McModie, A. Meretoja, S. Mishra, P.J. Mitchell, F. Miteff, A. Moore, C. Muller, F. Ng, F.C. Ng, J-L. Ng, W. O'Brian, V. O'Collins, T.J. Oxley, M.W. Parsons, S. Patel, G.S. Peng, L. Pesavento, T. Phan, E. Rodrigues, Z. Ross, A. Sabet, M. Sallaberger, P. Salvaris, D. Shah, G. Sharma, G. Sibolt, M. Simpson, S. Singhal, B. Snow, N. Spratt, R. Stark, J. Sturm, M.C. Sun, Y. Sun, P.S. Sung, Y.F. Sung, M. Suzuki, M. Tan, S.C. Tang, T. Tatlisumak, V. Thijs, M. Tiainen, C.H. Tsai, C.K. Tsai, C.L. Tsai, H.T. Tsai, L.K. Tsai, C.H. Tseng, L.T. Tseng, J. Tsoleridis, H. Tu, H.T-H. Tu, W. Vallat, J. Virta, W.C. Wang, Y.T. Wang, M. Waters, L. Weir, T. Wijeratne, C. Williams, W. Wilson, A.A. Wong, K. Wong, T.Y. Wu, Y.H. Wu, B. Yan, F.C. Yang, Y.W. Yang, N. Yassi, H.L. Yeh, J.H. Yeh, S.J. Yeh, C.H. Yen, D. Young, C.L. Ysai, W.W. Zhang, H. Zhao, L. Zhao, Katharina Althaus-Knaurer, Jörg Berrouschot, Erich Bluhmki, Paolo Bovi, Gilles Chatellier, Lynda Cove, Stephen Davis, A. Dixit, Geoffrey Donnan, Christina Ehrenkrona, Christoph Eschenfelder, Marc Fatar, Juan Francisco Arenillas, Franz Gruber, Lalit Kala, Peter Kapeller, Markku Kaste, Christof Kessler, Martin Köhrmann, Rico Laage, Kennedy R. Lees, Alain Luna Rodriguez, Jean-Louis Mas, Robert Mikulik, Carlos Molina, Girish Muddegowda, Keith Muir, Kurt Niederkorn, Xavier Nuñez, Peter Schellinger, Joaquin Serena, Jan Sobesky, Thorsten Steiner, Ann-Sofie Svenson, Rüdiger von Kummer, Joanna Wardlaw, Rebecca A. Betensky, Gregoire Boulouis, Raphael A. Carandang, William A. Copen, Pedro Cougo, Shawna Cutting, Kendra Drake, Andria L. Ford, John Hallenbeck, Gordon J. Harris, Robert Hoesch, Amie Hsia, Carlos Kase, Lawrence Latour, Michael H. Lev, Alona Muzikansky, Nandakumar Nagaraja, Lee H. Schwamm, Eric Searls, Shlee S. Song, Sidney Starkman, Albert J. Yoo, Ramin Zand, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Hospices Civils de Lyon (HCL), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon, Monash University [Melbourne], National Cerebral and Cardiovascular Center (NCCC - OSAKA), Osaka University [Osaka], University of Heidelberg, Medical Faculty, Massachusetts General Hospital [Boston], University of Melbourne, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Royal Adelaide Hospital [Adelaide Australia], National Institute of Neurological Disorders and Stroke [Bethesda] (NINDS), National Institutes of Health [Bethesda] (NIH), University Hospitals Leuven [Leuven], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Flanders Make [Leuven], Flanders Make, University of Newcastle [Australia] (UoN), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Vall d'Hebron University Hospital [Barcelona], University of Glasgow, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Girona Biomedical Research Institute [Girona, Spain] (IDIBGI), Ruhr-Universität Bochum [Bochum], Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Aarhus University Hospital, Cedars-Sinai Medical Center, Florey Institute of Neuroscience and Mental Health [Melbourne, Victoria, Australia], Austin Health, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], China Medical University Hospital [Taichung], Karolinska Institutet [Stockholm], The Walter and Eliza Hall Institute of Medical Research (WEHI), University of Texas at Austin [Austin], Collaborators Evaluation of unknown Onset Stroke thrombolysis trials (EOS) investigators: Boris Raul Acosta, Karen Aegidius, Christian Albiker, Anna Alegiani, Miriam Almendrote, Angelika Alonso, Katharina Althaus, Pierre Amarenco, Hemasse Amiri, Bettina Anders, Adriana Aniculaesei, Jason Appleton, Juan Arenillas, Christina Back, Christian Bähr, Jürgen Bardutzky, Flore Baronnet-Chauvet, Rouven Bathe-Peters, Anna Bayer-Karpinska, Juan L Becerra, Christoph Beck, Olga Belchí Guillamon, Amandine Benoit, Nadia Berhoune, Daniela Bindila, Julia Birchenall, Karine Blanc-Lasserre, Miguel Blanco Gonzales, Tobias Bobinger, Ulf Bodechtel, Eric Bodiguel, Urszula Bojaryn, Louise Bonnet, Benjamin Bouamra, Paul Bourgeois, Florent Boutitie, Lorenz Breuer, Ludovic Breynaert, David Broughton, Raf Brouns, Sébastian Brugirard, Bart Bruneel, Florian Buggle, Serkan Cakmak, Ana Calleja, David Calvet, David Carrera, Hsin-Chieh Chen, Bastian Cheng, Bharath Cheripelli, Tae-Hee Cho, Chi-Un Choe, Lillian Choy, Hanne Christensen, Mareva Ciatipis, Geoffrey Cloud, Julien Cogez, Elisa Cortijo, Sophie Crozier, Dorte Damgaard, Krishna Dani, Beatrijs De Coene, Isabel De Hollander, Jacques De Keyser, Nina De Klippel, Charlotte De Maeseneire, Ann De Smedt, Maria Del Mar Castellanos Rodrigo, Sandrine Deltour, Jelle Demeestere, Laurent Derex, Philippe Desfontaines, Ralf Dittrich, Anand Dixit, Laurens Dobbels, Valérie Domigo, Laura Dorado, Charlotte Druart, Kristina Hougaard Dupont, Anne Dusart, Rainer Dziewas, Martin Ebinger, Matthias Ebner, Myriam Edjali-Goujon, Philipp Eisele, Salwa El Tawil, Ahmed Elhfnawy, Matthias Endres, Ana Etexberria, Nicholas Evans, Simon Fandler, Franz Fazekas, Sandra Felix, Jochen B Fiebach, Jens Fiehler, Alexandra Filipov, Katharina Filipski, Robert Fleischmann, Christian Foerch, Ian Ford, Alexandra Gaenslen, Ivana Galinovic, Elena Meseguer Gancedo, Ramanan Ganeshan, Carlos García Esperón, Alicia Garrido, Thomas Gattringer, Olivia Geraghty, Rohat Geran, Christian Gerloff, Stefan Gerner, Sylvie Godon-Hardy, Jos Göhler, Amir Golsari, Meritxell Gomis, David Gorriz, Verena Gramse, Laia Grau, Martin Griebe, Cristina Guerrero, Damla Guerzoglu, Sophie Guettier, Vincent Guiraud, Christoph Gumbinger, Ignaz Gunreben, Florian Haertig, Christian Hametner, Bernard Hanseeuw, Andreas Hansen, Jakob Hansen, Thomas Harbo, Andreas Harloff, Peter Harmel, Karl Georg Häusler, Florian Heinen, Valentin Held, Simon Hellwig, Dimitri Hemelsoet, Michael Hennerici, Juliane Herm, Sylvia Hermans, María Hernández, Jose Hervas Vicente, Niels Hjort, Cristina Hobeanu, Carsten Hobohm, Elmar Höfner, Katharina Hohenbichler, Marc Hommel, Julia Hoppe, Eva Hornberger, Carolin Hoyer, Xuya Huang, Nils Ipsen, Irina Isern, Lourdes Ispierto, Helle Iversen, Lise Jeppesen, Marta Jimenez, Jan Jungehülsing, Eric Jüttler, Dheeraj Kalladka, Bernd Kallmünzer, Arindam Kar, Lars Kellert, André Kemmling, Tobias Kessler, Usman Khan, Matthias Klein, Christoph Kleinschnitz, Matti Klockziem, Michael Knops, Luzie Koehler, Martin Koehrmann, Heinz Kohlfürst, Rainer Kollmar, Peter Kraft, Thomas Krause, Bo Kristensen, Jan M Kröber, Natalia Kurka, Alexandre Ladoux, Patrice Laloux, Catherine Lamy, Emmanuelle Landrault, Arne Lauer, Claire Lebely, Jonathan Leempoel, Kennedy Lees, Anne Leger, Laurence Legrand, Robin Lemmens, Lin Li, Anna-Mareike Löbbe, Frederic London, Elena Lopez-Cancio, Matthias Lorenz, Stephen Louw, Caroline Lovelock, Manuel Lozano Sánchez, Giuseppe Lucente, Janos Lückl, Alain Luna, Kosmas Macha, Alexandre Machet, Daniel Mackenrodt, Dominik Madzar, Charles Majoie, Anika Männer, Vicky Maqueda, Jacob Marstrand, Alicia Martinez, Annika Marzina, Laura Mechthouff, Per Meden, Guy Meersman, Julia Meier, Charles Mellerio, Oliver Menn, Nadja Meyer, Dominik Michalski, Peter Michels, Lene Michelsen, Monica Millán Torne, Jens Minnerup, Boris Modrau, Sebastian Moeller, Anette Møller, Nathalie Morel, Fiona Moreton, Ludovic Morin, Thierry Moulin, Barry Moynihan, Anne K Mueller, Keith W Muir, Patricia Mulero, Sibu Mundiyanapurath, Johannes Mutzenbach, Simon Nagel, Oliver Naggara, Arumugam Nallasivan, Irene Navalpotro, Alexander H Nave, Paul Nederkoorn, Lars Neeb, Hermann Neugebauer, Tobias Neumann-Haefelin, Norbert Nighoghossian, Stefan Oberndorfer, Christian Opherk, Lorenz Oppel, Catherine Oppenheim, Johannes Orthgieß, Leif Ostergaard, Perrine Paindeville, Ernest Palomeras, Verena Panitz, Bhavni Patel, Andre Peeters, Dirk Peeters, Anna Pellisé, Johann Pelz, Anthony Pereira, Natalia Pérez de la Ossa, Richard Perry, Salvador Petraza, Stéphane Peysson, Waltraud Pfeilschifter, Alexander Pichler, Alexandra Pierskalla, Hans-Werner Pledl, Sven Poli, Katrin Pomrehn, Marika Poulsen, Luis Prats, Silvia Presas, Elisabeth Prohaska, Volker Puetz, Josep Puig, Josep Puig Alcántara, Jan Purrucker, Veronique Quenardelle, Sankaranarayanan Ramachandran, Soulliard Raphaelle, Nicolas Raposo, Tilman Reiff, Michel Remmers, Pauline Renou, Martin Ribitsch, Hardy Richter, Peter Ringleb, Martin Ritter, Thomas Ritzenthaler, Gilles Rodier, Christine Rodriguez-Regent, Manuel Rodríguez-Yáñez, Maria Roennefarth, Christine Roffe, Sverre Rosenbaum, Charlotte Rosso, Joachim Röther, Michal Rozanski, Noelia Ruiz de Morales, Francesca Russo, Matthieu Rutgers, Sharmilla Sagnier, Yves Samson, Josep Sánchez, Tamara Sauer, Jan H Schäfer, Simon Schieber, Josef Schill, Dennis Schlak, Ludwig Schlemm, Sein Schmidt, Wouter Schonewille, Julian Schröder, Andreas Schulz, Johannes Schurig, Sönke Schwarting, Alexander Schwarz, Christopher Schwarzbach, Matthias Seidel, Alexander Seiler, Jochen Sembill, Joaquin Serena Leal, Ashit Shetty, Igor Sibon, Claus Z Simonsen, Oliver Singer, Aravinth Sivagnanaratham, Ide Smets, Craig Smith, Peter Soors, Nikola Sprigg, Maximilian Spruegel, David Stark, Susanne Steinert, Sebastian Stösser, Markus Stuermlinger, Bart Swinnen, Ruben Tamazyan, Jose Tembl, Mikel Terceno Izaga, Vincent Thijs, Götz Thomalla, Emmanuel Touze, Thomas Truelsen, Guillaume Turc, Gaetane Turine, Serdar Tütüncü, Pippa Tyrell, Xavier Ustrell, Wilfried Vadot, Anne-Evelyne Vallet, Pauline Vallet, Lucie van den Berg, Sophie van den Berg, Cecile van Eendenburg, Robbert-Jan Van Hooff, Isabelle van Sloten, Peter Vanacker, Evelien Vancaester, Patrick Vanderdonckt, Yves Vandermeeren, Frederik Vanhee, Roland Veltkamp, Karsten Vestergaard, Alain Viguier, Dolores Vilas, Kersten Villringer, Dieke Voget, Jörg von Schrader, Paul von Weitzel, Elisabeth Warburton, Claudia Weber, Jörg Weber, Karl Wegscheider, Mirko Wegscheider, Christian Weimar, Karin Weinstich, Christopher Weise, Gesa Weise, Chris Willems, Klemens Winder, Matthias Wittayer, Marc Wolf, Martin Wolf, Valerie Wolff, Christian Wollboldt, Frank Wollenweber, Anke Wouters, Bertrand Yalo, Marion Yger, Nadia Younan, Laetita Yperzeele, Vesna Zegarac, Pia Zeiner, Ulf Ziemann, Thomas Zonneveld, Mathieu Zuber, Tsugio Akutsu, Junya Aoki, Junya Aoki, Shuji Arakawa, Ryosuke Doijiri, Yusuke Egashira, Yukiko Enomoto, Mayumi Fukuda-Doi, Eisuke Furui, Konosuke Furuta, Seiji Gotoh, Toshimitsu Hamasaki, Yasuhiro Hasegawa, Teryuki Hirano, Kazunari Homma, Masahiko Ichijyo, Toshihiro Ide, Shuichi Igarashi, Yasuyuki Iguchi, Masafumi Ihara, Hajime Ikenouchi, Manabu Inoue, Tsuyoshi Inoue, Ryo Itabashi, Yasuhiro Ito, Toru Iwama, Kenji Kamiyama, Shoko Kamiyoshi, Haruka Kanai, Yasuhisa Kanematsu, Takao Kanzawa, Kazumi Kimura, Jiro Kitayama, Takanari Kitazono, Masatoshi Koga, Rei Kondo, Kohsuke Kudo, Masayoshi Kusumi, Ken Kuwahara, Shoji Matsumoto, Hideki Matsuoka, Ban Mihara, Kazuo Minematsu, Ken Miura, Kaori Miwa, Naomi Morita, Wataru Mouri, Kayo Murata, Yoshinari Nagakane, Taizen Nakase, Hiromi Ohara, Nobuyuki Ohara, Hideyuki Ohnishi, Hajime Ohta, Masafumi Ohtaki, Ryo Ohtani, Toshiho Ohtsuki, Hideo Ohyama, Takashi Okada, Yasushi Okada, Masato Osaki, Nobuyuki Sakai, Yoshiki Sanbongi, Naoshi Sasaki, Makoto Sasaki, Shoichiro Sato, Kenta Seki, Wataru Shimizu, Yoshiaki Shiokawa, Takashi Sozu, Junichiro Suzuki, Rieko Suzuki, Yasushi Takagi, Shunya Takizawa, Norio Tanahashi, Eijiro Tanaka, Ryota Tanaka, Yohei Tateishi, Tomoaki Terada, Tadashi Terasaki, Kenichi Todo, Azusa Tokunaga, Kazunori Toyoda, Akira Tsujino, Toshihiro Ueda, Yoshikazu Uesaka, Mihoko Uotani, Takao Urabe, Masao Watanabe, Yoshiki Yagita, Yusuke Yakushiji, Haruko Yamamoto, Keizo Yasui, Toshiro Yonehara, Sohei Yoshimura, Shinichi Yoshimura, K Aarnio, F Alemseged, C Anderson, T Ang, M L Archer, J Attia, P Bailey, A Balabanski, A Barber, P A Barber, J Bernhardt, A Bivard, D Blacker, C F Bladin, A Brodtmann, D Cadilhac, B C V Campbell, L Carey, S Celestino, L Chan, W H Chang, A ChangI, C H Chen, C-I Chen, H F Chen, T C Chen, W H Chen, Y Y Chen, C A Cheng, E Cheong, Y W Chiou, P M Choi, H J Chu, C S Chuang, T C Chung, L Churilov, B Clissold, A Connelly, S Coote, B Coulton, E Cowley, J Cranefield, S Curtze, C D'Este, S M Davis, S Day, P M Desmond, H M Dewey, C Ding, G A Donnan, R Drew, S Eirola, D Field, T Frost, C Garcia-Esperon, K George, R Gerraty, R Grimley, Y C Guo, G Hankey, J Harvey, S C Ho, K Hogan, D Howells, P M Hsiao, C H Hsu, C T Hsu, C-S Hsu, J P Hsu, Y D Hsu, Y T Hsu, C J Hu, C C Huang, H Y Huang, M Y Huang, S C Huang, W S Huang, D Jackson, J S Jeng, S K Jiang, L Kaauwai, O Kasari, J King, T J Kleinig, M Koivu, J Kolbe, M Krause, C W Kuan, W L Kung, C Kyndt, C L Lau, A Lee, C Y Lee, J T Lee, Y Lee, Y C Lee, C Levi, C R Levi, L M Lien, J C Lim, C C Lin, C H Lin, C M Lin, D Lin, C H Liu, J Liu, Y C Lo, P S Loh, E Low, C H Lu, C J Lu, M K Lu, J Ly, H Ma, L Macaulay, R Macdonnell, E Mackey, M Macleod, J Mahadevan, V Maxwell, R McCoy, A McDonald, S McModie, A Meretoja, S Mishra, P J Mitchell, F Miteff, A Moore, C Muller, F Ng, F C Ng, J-L Ng, W O'Brian, V O'Collins, T J Oxley, M W Parsons, S Patel, G S Peng, L Pesavento, T Phan, E Rodrigues, Z Ross, A Sabet, M Sallaberger, P Salvaris, D Shah, G Sharma, G Sibolt, M Simpson, S Singhal, B Snow, N Spratt, R Stark, J Sturm, M C Sun, Y Sun, P S Sung, Y F Sung, M Suzuki, M Tan, S C Tang, T Tatlisumak, V Thijs, M Tiainen, C H Tsai, C K Tsai, C L Tsai, H T Tsai, L K Tsai, C H Tseng, L T Tseng, J Tsoleridis, H Tu, H T-H Tu, W Vallat, J Virta, W C Wang, Y T Wang, M Waters, L Weir, T Wijeratne, C Williams, W Wilson, A A Wong, K Wong, T Y Wu, Y H Wu, B Yan, F C Yang, Y W Yang, N Yassi, H L Yeh, J H Yeh, S J Yeh, C H Yen, D Young, C L Ysai, W W Zhang, H Zhao, L Zhao, Katharina Althaus-Knaurer, Martin Bendszus, Jörg Berrouschot, Erich Bluhmki, Paolo Bovi, Gilles Chatellier, Lynda Cove, Stephen Davis, A Dixit, Geoffrey Donnan, Rainer Dziewas, Christina Ehrenkrona, Christoph Eschenfelder, Marc Fatar, Juan Francisco Arenillas, Franz Gruber, Werner Hacke, Lalit Kala, Peter Kapeller, Markku Kaste, Christof Kessler, Martin Köhrmann, Rico Laage, Kennedy R Lees, Didier Leys, Alain Luna Rodriguez, Jean-Louis Mas, Robert Mikulik, Carlos Molina, Girish Muddegowda, Keith Muir, Kurt Niederkorn, Xavier Nuñez, Catherine Oppenheim, Sven Poli, Peter Ringleb, Peter Schellinger, Stefan Schwab, Joaquin Serena, Jan Sobesky, Thorsten Steiner, Ann-Sofie Svenson, Danilo Toni, Roland Veltkamp, Rüdiger von Kummer, Nils Wahlgren, Joanna Wardlaw, Rebecca A Betensky, Gregoire Boulouis, Raphael A Carandang, William A Copen, Pedro Cougo, Shawna Cutting, Kendra Drake, Andria L Ford, John Hallenbeck, Gordon J Harris, Robert Hoesch, Amie Hsia, Carlos Kase, Lawrence Latour, Arne Lauer, Michael H Lev, Alona Muzikansky, Nandakumar Nagaraja, Lee H Schwamm, Eric Searls, Shlee S Song, Sidney Starkman, Steven Warach, Ona Wu, Albert J Yoo, Ramin Zand, University of Newcastle [Callaghan, Australia] (UoN), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CarMeN, laboratoire, Yperzeele, Laetitia, Evaluation of Unknown Onset Stroke Thrombolysis trials (EOS) investigators, UCL - SSS/IONS - Institute of NeuroScience, UCL - (MGD) Service de neurologie, Supporting clinical sciences, UZB Other, Physical Medicine and Rehabilitation, Clinical sciences, Neuroprotection & Neuromodulation, Radiology and Nuclear Medicine, ANS - Neurovascular Disorders, Neurology, ACS - Atherosclerosis & ischemic syndromes, Graduate School, Center of Experimental and Molecular Medicine, ACS - Pulmonary hypertension & thrombosis, and ACS - Microcirculation more...
- Subjects
medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Ischemic Stroke/*diagnostic imaging/*drug therapy ,Tomography, X-Ray Computed/methods ,Fibrinolytic Agents/adverse effects/*therapeutic use ,030204 cardiovascular system & hematology ,Ischemic Stroke/diagnostic imaging ,surgery ,0302 clinical medicine ,Modified Rankin Scale ,030212 general & internal medicine ,10. No inequality ,Infusions, Intravenous ,Stroke ,Tomography ,Time-to-Treatment ,General Medicine ,Thrombolysis ,X-Ray Computed/methods ,Tissue Plasminogen Activator/adverse effects ,3. Good health ,[SDV] Life Sciences [q-bio] ,Diffusion Magnetic Resonance Imaging/methods ,Treatment Outcome ,Meta-analysis ,Tissue Plasminogen Activator ,Intravenous ,medicine.medical_specialty ,Infusions ,Intravenous thrombolysis ,Neuroimaging ,Neuroscience(all) ,Placebo ,Tissue Plasminogen Activator/adverse effects/*therapeutic use ,03 medical and health sciences ,Fibrinolytic Agents ,Internal medicine ,medicine ,Humans ,ddc:610 ,Ischemic Stroke ,business.industry ,neurology ,Fibrinolytic Agents/adverse effects ,Odds ratio ,Recovery of Function ,medicine.disease ,Clinical research ,Diffusion Magnetic Resonance Imaging ,Human medicine ,business ,Tomography, X-Ray Computed ,Fibrinolytic agent - Abstract
International audience; BACKGROUND: Patients who have had a stroke with unknown time of onset have been previously excluded from thrombolysis. We aimed to establish whether intravenous alteplase is safe and effective in such patients when salvageable tissue has been identified with imaging biomarkers. METHODS: We did a systematic review and meta-analysis of individual patient data for trials published before Sept 21, 2020. Randomised trials of intravenous alteplase versus standard of care or placebo in adults with stroke with unknown time of onset with perfusion-diffusion MRI, perfusion CT, or MRI with diffusion weighted imaging-fluid attenuated inversion recovery (DWI-FLAIR) mismatch were eligible. The primary outcome was favourable functional outcome (score of 0-1 on the modified Rankin Scale [mRS]) at 90 days indicating no disability using an unconditional mixed-effect logistic-regression model fitted to estimate the treatment effect. Secondary outcomes were mRS shift towards a better functional outcome and independent outcome (mRS 0-2) at 90 days. Safety outcomes included death, severe disability or death (mRS score 4-6), and symptomatic intracranial haemorrhage. This study is registered with PROSPERO, CRD42020166903. FINDINGS: Of 249 identified abstracts, four trials met our eligibility criteria for inclusion: WAKE-UP, EXTEND, THAWS, and ECASS-4. The four trials provided individual patient data for 843 individuals, of whom 429 (51%) were assigned to alteplase and 414 (49%) to placebo or standard care. A favourable outcome occurred in 199 (47%) of 420 patients with alteplase and in 160 (39%) of 409 patients among controls (adjusted odds ratio [OR] 1·49 [95% CI 1·10-2·03]; p=0·011), with low heterogeneity across studies (I(2)=27%). Alteplase was associated with a significant shift towards better functional outcome (adjusted common OR 1·38 [95% CI 1·05-1·80]; p=0·019), and a higher odds of independent outcome (adjusted OR 1·50 [1·06-2·12]; p=0·022). In the alteplase group, 90 (21%) patients were severely disabled or died (mRS score 4-6), compared with 102 (25%) patients in the control group (adjusted OR 0·76 [0·52-1·11]; p=0·15). 27 (6%) patients died in the alteplase group and 14 (3%) patients died among controls (adjusted OR 2·06 [1·03-4·09]; p=0·040). The prevalence of symptomatic intracranial haemorrhage was higher in the alteplase group than among controls (11 [3%] vs two [\textless1%], adjusted OR 5·58 [1·22-25·50]; p=0·024). INTERPRETATION: In patients who have had a stroke with unknown time of onset with a DWI-FLAIR or perfusion mismatch, intravenous alteplase resulted in better functional outcome at 90 days than placebo or standard care. A net benefit was observed for all functional outcomes despite an increased risk of symptomatic intracranial haemorrhage. Although there were more deaths with alteplase than placebo, there were fewer cases of severe disability or death. FUNDING: None. more...
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- 2020
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41. Measurement of Sepsis in a National Cohort Using Three Different Methods to Define Baseline Organ Function
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Hallie C. Prescott, Max T Wayne, Daniel Molling, Vincent X. Liu, Xiao Qing Wang, Cainnear K Hogan, and Sarah Seelye
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Pulmonary and Respiratory Medicine ,Adult ,medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,Sepsis ,Cohort Studies ,chemistry.chemical_compound ,Internal medicine ,Epidemiology ,Medicine ,Humans ,Hospital Mortality ,Veterans Affairs ,Retrospective Studies ,Original Research ,Creatinine ,business.industry ,Organ dysfunction ,Emergency department ,medicine.disease ,Hospitalization ,chemistry ,Liver function ,medicine.symptom ,business ,Emergency Service, Hospital - Abstract
Rationale: In 2017, the U.S. Centers for Disease Control and Prevention (CDC) developed a new surveillance definition of sepsis, the adult sepsis event (ASE), to better track sepsis epidemiology. The ASE requires evidence of acute organ dysfunction and defines baseline organ function pragmatically as the best in-hospital value. This approach may undercount sepsis if new organ dysfunction does not resolve by discharge. Objectives: To understand how sepsis identification and outcomes differ when using the best laboratory values during hospitalization versus methods that use historical lookbacks to define baseline organ function. Methods: We identified all patients hospitalized at 138 Veterans Affairs hospitals (2013–2018) admitted via the emergency department with two or more systemic inflammatory response criteria, were treated with antibiotics within 48 hours (i.e., had potential infection), and completed 4+ days of antibiotics (i.e., had suspected infection). We considered the following three approaches to defining baseline renal, hematologic, and liver function: the best values during hospitalization (as in the Centers for Disease Control and Prevention’s ASE), the best values during hospitalization plus the prior 90 days (3-mo baseline), and the best values during hospitalization plus the prior 180 days (6-mo baseline). We determined how many patients met the criteria for sepsis by each approach, and then compared characteristics and outcomes of sepsis hospitalizations between the three approaches. Results: Among 608,128 hospitalizations with potential infection, 72.1%, 68.5%, and 58.4% had creatinine, platelet, and total bilirubin measured, respectively, in the prior 3 months. A total of 86.0%, 82.6%, and 74.8%, respectively, had these labs in the prior 6 months. Using the hospital baseline, 100,568 hospitalizations met criteria for community-acquired sepsis. By contrast, 111,983 and 117,435 met criteria for sepsis using the 3- and 6-month baselines, for a relative increase of 11% and 17%, respectively. Patient characteristics were similar across the three approaches. In-hospital mortality was 7.2%, 7.0%, and 6.8% for sepsis hospitalizations identified using the hospital, 3-month baseline, and 6-month baseline. The 30-day mortality was 12.5%, 12.7%, and 12.5%, respectively. Conclusions: Among veterans hospitalized with potential infection, the majority had laboratory values in the prior 6 months. Using 3- and 6-month lookbacks to define baseline organ function resulted in an 11% and 17% relative increase, respectively, in the number of sepsis hospitalizations identified. more...
- Published
- 2021
42. Una isla propia: hogares y sentimientos queer en 80 egunean
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María García Puente and Erin K. Hogan
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- 2020
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43. Appendiceal intussusception presenting as a caecal mass
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M, Alhamar, B, Ahsan, K, Hogan, and M, Raoufi
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Adult ,Cecal Diseases ,Humans ,Female ,Appendix ,Intussusception - Abstract
The differential diagnosis of caecal mass is broad and the inclusion of appendiceal pathologies is an important element.We report a 37-year-old woman with recurrent right iliac fossa pain. Computed tomography scan revealed a caecal mass suggesting complete inversion or intussusception of the appendix, which was confirmed by pathologic microscopic examination. This case report discusses appendiceal intussusception with emphasis on diagnosis and treatment options.Appendiceal intussusception is a rare entity and the complete type typically presents as a polypoid lesion located at the appendiceal orifice in the caecum. It is imperative to include this entity in the differential diagnosis of caecal mass, especially during colonoscopy, as the removal of this polypoid lesion can result in a devastating caecal perforation or haemorrhage. more...
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- 2020
44. Identifying and Improving the Active Ingredients in Pediatric Complex Care
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Annique K. Hogan and Chris Feudtner
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Active ingredient ,medicine.medical_specialty ,business.industry ,Pediatrics, Perinatology and Child Health ,MEDLINE ,Medicine ,Humans ,business ,Intensive care medicine ,Child ,Original Investigation - Abstract
IMPORTANCE: Children with medical complexity (CMC) frequently experience fragmented care. We have demonstrated that outpatient comprehensive care (CC) reduces serious illnesses, hospitalizations, and costs for high-risk CMC. Yet continuity of care for CMC is often disrupted with emergency department (ED) visits and hospitalizations. OBJECTIVE: To evaluate a hospital consultation (HC) service for CMC from their outpatient CC clinicians. DESIGN, SETTING, AND PARTICIPANTS: Randomized quality improvement trial at the University of Texas Health Science Center at Houston with an outpatient CC clinic and tertiary pediatric hospital (Children’s Memorial Hermann Hospital). Participants included high-risk CMC (≥2 hospitalizations or ≥1 pediatric intensive care unit [PICU] admission in the year before enrolling in our clinic) receiving CC. Data were analyzed between January 11, 2018, and December 20, 2019. INTERVENTIONS: The HC included serial discussions between CC clinicians, ED physicians, and hospitalists addressing need for admission, inpatient treatment, and transition back to outpatient care. Usual hospital care (UHC) involved routine pediatric hospitalist care. MAIN OUTCOMES AND MEASURES: Total hospital days (primary outcome), PICU days, hospitalizations, and health system costs in skeptical bayesian analyses (using a prior probability assuming no benefit). RESULTS: From October 3, 2016, through October 2, 2017, 342 CMC were randomized to either HC (n = 167) or UHC (n = 175) before meeting the predefined bayesian stopping guideline (>80% probability of reduced hospital days). In intention-to-treat analyses, the probability that HC reduced total hospital days was 91% (2.72 vs 6.01 per child-year; bayesian rate ratio [RR], 0.61; 95% credible interval [CrI], 0.30-1.26). The probability of a reduction with HC vs UHC was 98% for hospitalizations (0.60 vs 0.93 per child-year; RR, 0.68; 95% CrI, 0.48-0.97), 89% for PICU days (0.77 vs 1.89 per child-year; RR, 0.59; 95% CrI, 0.26-1.38), and 94% for mean total health system costs ($24 928 vs $42 276 per child-year; cost ratio, 0.67; 95% CrI, 0.41-1.10). In secondary analysis using a bayesian prior centered at RR of 0.78, reflecting the opinion of 7 experts knowledgeable about CMC, the probability that HC reduced hospital days was 96%. CONCLUSIONS AND RELEVANCE: Among CMC receiving comprehensive outpatient care, an HC service from outpatient clinicians likely reduced total hospital days, hospitalizations, PICU days, other outcomes, and health system costs. Additional trials of an HC service from outpatient CC clinicians are needed for CMC in other centers. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02870387 more...
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- 2020
45. Neural Stimulation and Molecular Mechanisms of Plasticity and Regeneration: A Review
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Matthew K. Hogan, Gillian F. Hamilton, and Philip J. Horner
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0301 basic medicine ,neurotrauma ,neuroplasticity ,Biology ,lcsh:RC321-571 ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Neurotrophic factors ,Neuroplasticity ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Brain-derived neurotrophic factor ,Regeneration (biology) ,Depolarization ,Neuromodulation (medicine) ,activity-dependent plasticity ,030104 developmental biology ,Cellular Neuroscience ,Molecular Response ,plasticity ,regeneration ,Activity-dependent plasticity ,neuromodulation ,Systematic Review ,Neuroscience ,030217 neurology & neurosurgery ,neurostimulation - Abstract
Neural stimulation modulates the depolarization of neurons, thereby triggering activity-associated mechanisms of neuronal plasticity. Activity-associated mechanisms in turn play a major role in post-mitotic structure and function of adult neurons. Our understanding of the interactions between neuronal behavior, patterns of neural activity, and the surrounding environment is evolving at a rapid pace. Brain derived neurotrophic factor is a critical mediator of activity-associated plasticity, while multiple immediate early genes mediate plasticity of neurons following bouts of neural activity. New research has uncovered genetic mechanisms that govern the expression of DNA following changes in neural activity patterns, including RNAPII pause-release and activity-associated double stranded breaks. Discovery of novel mechanisms governing activity-associated plasticity of neurons hints at a layered and complex molecular control of neuronal response to depolarization. Importantly, patterns of depolarization in neurons are shown to be important mediators of genetic expression patterns and molecular responses. More research is needed to fully uncover the molecular response of different types of neurons-to-activity patterns; however, known responses might be leveraged to facilitate recovery after neural damage. Physical rehabilitation through passive or active exercise modulates neurotrophic factor expression in the brain and spinal cord and can initiate cortical plasticity commensurate with functional recovery. Rehabilitation likely relies on activity-associated mechanisms; however, it may be limited in its application. Electrical and magnetic stimulation direct specific activity patterns not accessible through passive or active exercise and work synergistically to improve standing, walking, and forelimb use after injury. Here, we review emerging concepts in the molecular mechanisms of activity-derived plasticity in order to highlight opportunities that could add value to therapeutic protocols for promoting recovery of function after trauma, disease, or age-related functional decline. more...
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- 2020
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46. Quantification of Myelinated Nerve Fraction and Degeneration in Spinal Cord Neuropil by SHIFT MRI
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Xiufeng Tang, Caio C. Quini, Lesley Chaboub, Kristopher A. Hoffman, Zhong-Lin Lu, Philip J. Horner, Tatiana Wolfe, Matthew K. Hogan, Betsy H. Salazar, Houston Methodist Hospital, Universidade Estadual Paulista (Unesp), NYU Shanghai, NYU-ECNU Institute of Cognitive Neuroscience at NYU Shanghai, and New York University more...
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Neuropil ,quantitative MRI ,030218 nuclear medicine & medical imaging ,Lesion ,White matter ,03 medical and health sciences ,Myelin ,0302 clinical medicine ,Nuclear magnetic resonance ,medicine ,Animals ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Axon ,Spinal cord injury ,Myelin Sheath ,Spinal Cord Injuries ,rat spinal cord ,mild neuro injury ,Chemistry ,Penumbra ,neurodegeneration ,medicine.disease ,Spinal cord ,Magnetic Resonance Imaging ,spinal cord injury ,Axolemma ,medicine.anatomical_structure ,Spinal Cord ,T2 relaxation ,medicine.symptom - Abstract
Made available in DSpace on 2021-06-25T10:13:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-04-01 Background: Neurodegeneration is a complex cellular process linked to prompt changes in myelin integrity and gradual neuron loss. Current imaging techniques offer estimations of myelin volumes in lesions/remyelinated areas but are limited to detect subtle injury. Purpose: To investigate whether measurements detected by a signal hierarchically isolated as a function of time-to-echo (SHIFT) MRI technique can determine changes in myelin integrity and fiber axolemma. Study Type: Prospective animal model. Animal Model: Surgically demyelinated spinal cord (SC) injury model in rodents (n = 6). Field Strength/Sequence: Gradient-echo spin-echo at 3T. Assessment: Multicompartment T2 relaxations were computed by SHIFT MRI in 75-microns-resolution images of the SC injury penumbra region 2 weeks post-trauma. G-ratio and axolemma delamination were assessed by transmission electron microscopy (TEM) in intact and injured samples. SC myelinated nerve fraction was computed by SHIFT MRI prospectively and assessed histologically. Statistical Tests: Relations between SHIFT-isolated T2-components and TEM measurements were studied using linear regression and t-tests. Pearson's correlation and significance were computed to determine the SHIFT's sensitivity to detect myelinated fibers ratio in gray matter. Regularized least-squares-based ranking analysis was employed to determine SHIFT MRI's ability to discern intact and injured myelinated nerves. Results: Biexponential signals isolated by SHIFT MRI for intact vs. lesion penumbra exhibited changes in T2, shifting from intermediate components (25 ± 2 msec) to long (43 ± 11 msec) in white matter, and similarly in gray matter regions-of-interest (31 ± 2 to 46 ± 16 msec). These changes correlated highly with TEM g-ratio and axon delamination measurements (P < 0.05). Changes in short T2 components were observed but not statistically significant (8.5 ± 0.5 to 7 ± 3 msec, P = 0.445, and 4.0 ± 0.9 to 7 ± 3 msec, P = 0.075, respectively). SHIFT MRI's ability to detect myelinated fibers within gray matter was confirmed (P < 0.001). Data Conclusion: Changes detected by SHIFT MRI are associated with abnormal intermembrane spaces formed upon mild injury, directly correlated with early neuro integrity loss. Level of Evidence 1. Technical Efficacy Stage 2. Center for Neuroregneration Department of Neurosurgery Houston Methodist Research Institute Houston Methodist Hospital Department of Biological Physics Universidade Estadual Paulista UNESP Division of Arts and Sciences NYU Shanghai NYU-ECNU Institute of Cognitive Neuroscience at NYU Shanghai Center for Neural Science and Department of Psychology New York University Department of Biological Physics Universidade Estadual Paulista UNESP more...
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- 2020
47. Wnts regulate planar cell polarity via heterotrimeric G protein and PI3K signaling
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Andre Landin Malt, Maxwell S. Madani, Connor D. Smith, Arielle K. Hogan, and Xiaowei Lu
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Macromolecular Substances ,Biology ,Development ,GTP-Binding Protein alpha Subunits, Gi-Go ,Mechanotransduction, Cellular ,Microtubules ,03 medical and health sciences ,Mice ,Phosphatidylinositol 3-Kinases ,0302 clinical medicine ,GTP-binding protein regulators ,Heterotrimeric G protein ,Report ,Cell polarity ,Hair Cells, Auditory ,medicine ,Animals ,Mechanotransduction ,Wnt Signaling Pathway ,030304 developmental biology ,0303 health sciences ,Polarity ,Wnt signaling pathway ,Cell Polarity ,Cell Biology ,Kinocilium ,Heterotrimeric GTP-Binding Proteins ,Cell biology ,respiratory tract diseases ,Cochlea ,medicine.anatomical_structure ,sense organs ,Hair cell ,Signal transduction ,Carrier Proteins ,030217 neurology & neurosurgery - Abstract
The planar cell polarity (PCP) pathway is essential for tissue morphogenesis. However, the roles of Wnt ligands in the mammalian PCP pathway remain poorly understood. This study identifies a Wnt/heterotrimeric G protein/PI3K pathway that regulates cell-intrinsic and tissue-level PCP in the mouse cochlea., In the mammalian cochlea, the planar cell polarity (PCP) pathway aligns hair cell orientation along the plane of the sensory epithelium. Concurrently, multiple cell intrinsic planar polarity (referred to as iPCP) modules mediate planar polarization of the hair cell apical cytoskeleton, including the kinocilium and the V-shaped hair bundle essential for mechanotransduction. How PCP and iPCP are coordinated during development and the roles of Wnt ligands in this process remain unresolved. Here we show that genetic blockade of Wnt secretion in the cochlear epithelium resulted in a shortened cochlear duct and misoriented and misshapen hair bundles. Mechanistically, Wnts stimulate Gi activity by regulating the localization of Daple, a guanine nucleotide exchange factor (GEF) for Gαi. In turn, the Gβγ complex signals through phosphoinositide 3-kinase (PI3K) to regulate kinocilium positioning and asymmetric localizations of a subset of core PCP proteins, thereby coordinating PCP and iPCP. Thus, our results identify a putative Wnt/heterotrimeric G protein/PI3K pathway for PCP regulation. more...
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- 2020
48. NOTCH1-driven UBR7 stimulates nucleotide biosynthesis to promote T cell acute lymphoblastic leukemia
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Issam Ben-Sahra, Jeffrey N. Savas, Justin Bodner, Ann K. Hogan, Natalia Khalatyan, Kelvin A. Wong, Daniel R. Foltz, Umakant Sahu, Shashank Srivastava, Jiehuan Huang, Yalu Zhou, Panagiotis Ntziachristos, and Kizhakke Mattada Sathyan more...
- Subjects
Proteomics ,Enzyme complex ,T cell ,T-Lymphocytes ,Ubiquitin-Protein Ligases ,Regulator ,Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ,Biochemistry ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Ubiquitin ,hemic and lymphatic diseases ,medicine ,Medicine and Health Sciences ,Humans ,Receptor, Notch1 ,Research Articles ,030304 developmental biology ,Cancer ,chemistry.chemical_classification ,0303 health sciences ,Multidisciplinary ,biology ,Cell growth ,Nucleotides ,Phosphoribosyl pyrophosphate ,Ubiquitination ,SciAdv r-articles ,hemic and immune systems ,Cell biology ,Ubiquitin ligase ,Enzyme ,medicine.anatomical_structure ,chemistry ,030220 oncology & carcinogenesis ,embryonic structures ,biology.protein ,cardiovascular system ,biological phenomena, cell phenomena, and immunity ,Research Article - Abstract
UBR7 supports nucleotide biosynthesis and NOTCH1-driven T cell acute lymphoblastic leukemia through regulation of PRPS enzymes., Ubiquitin protein ligase E3 component N-recognin 7 (UBR7) is the most divergent member of UBR box–containing E3 ubiquitin ligases/recognins that mediate the proteasomal degradation of its substrates through the N-end rule. Here, we used a proteomic approach and found phosphoribosyl pyrophosphate synthetases (PRPSs), the essential enzymes for nucleotide biosynthesis, as strong interacting partners of UBR7. UBR7 stabilizes PRPS catalytic subunits by mediating the polyubiquitination-directed degradation of PRPS-associated protein (PRPSAP), the negative regulator of PRPS. Loss of UBR7 leads to nucleotide biosynthesis defects. We define UBR7 as a transcriptional target of NOTCH1 and show that UBR7 is overexpressed in NOTCH1-driven T cell acute lymphoblastic leukemia (T-ALL). Impaired nucleotide biosynthesis caused by UBR7 depletion was concomitant with the attenuated cell proliferation and oncogenic potential of T-ALL. Collectively, these results establish UBR7 as a critical regulator of nucleotide metabolism through the regulation of the PRPS enzyme complex and uncover a metabolic vulnerability in NOTCH1-driven T-ALL. more...
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- 2020
49. Trans-differentiation of outer hair cells into inner hair cells in the absence of INSM1
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Freddie Márquez, Jorge A. Cantu, Teerawat Wiwatpanit, Chuan Zhi Foo, Matthew J. Schipma, Anne Duggan, Sarah M. Lorenzen, Ann K. Hogan, Jaime García-Añoveros, Mary Ann Cheatham, and John C. Clancy
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Male ,0301 basic medicine ,Cell ,Biology ,Mice ,03 medical and health sciences ,Downregulation and upregulation ,otorhinolaryngologic diseases ,medicine ,Animals ,Cochlea ,Regulation of gene expression ,Hair Cells, Auditory, Inner ,Multidisciplinary ,Transdifferentiation ,Gene Expression Regulation, Developmental ,Embryo, Mammalian ,Embryonic stem cell ,Up-Regulation ,Cell biology ,DNA-Binding Proteins ,Mice, Inbred C57BL ,Repressor Proteins ,Hair Cells, Auditory, Outer ,030104 developmental biology ,medicine.anatomical_structure ,Organ Specificity ,Cell Transdifferentiation ,Female ,sense organs ,Hair cell ,Transcriptome ,Homeotic gene ,Transcription Factors - Abstract
The mammalian cochlea contains two types of mechanosensory hair cell that have different and critical functions in hearing. Inner hair cells (IHCs), which have an elaborate presynaptic apparatus, signal to cochlear neurons and communicate sound information to the brain. Outer hair cells (OHCs) mechanically amplify sound-induced vibrations, providing enhanced sensitivity to sound and sharp tuning. Cochlear hair cells are solely generated during development, and hair cell death—most often of OHCs—is the most common cause of deafness. OHCs and IHCs, together with supporting cells, originate in embryos from the prosensory region of the otocyst, but how hair cells differentiate into two different types is unknown1–3. Here we show that Insm1, which encodes a zinc finger protein that is transiently expressed in nascent OHCs, consolidates their fate by preventing trans-differentiation into IHCs. In the absence of INSM1, many hair cells that are born as OHCs switch fates to become mature IHCs. To identify the genetic mechanisms by which Insm1 operates, we compared the transcriptomes of immature IHCs and OHCs, and of OHCs with and without INSM1. In OHCs that lack INSM1, a set of genes is upregulated, most of which are normally preferentially expressed by IHCs. The homeotic cell transformation of OHCs without INSM1 into IHCs reveals a mechanism by which these neighbouring mechanosensory cells begin to differ: INSM1 represses a core set of early IHC-enriched genes in embryonic OHCs and makes them unresponsive to an IHC-inducing gradient, so that they proceed to mature as OHCs. Without INSM1, some of the OHCs in which these few IHC-enriched transcripts are upregulated trans-differentiate into IHCs, identifying candidate genes for IHC-specific differentiation. Conditional deletion of Insm1 in mice demonstrates that INSM1 is the key switch that causes the maturation of outer hair cells in the cochlea, with its absence resulting in an increase in inner hair cells instead. more...
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- 2018
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50. DNA methylation of imprinted genes at birth is associated with child weight status at birth, 1 year, and 3 years
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Sarah Gonzalez-Nahm, Cathrine Hoyo, Vijaya K. Hogan, Diane L. Rowley, Sara E. Benjamin-Neelon, Michelle A. Mendez, and Susan K. Murphy
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0301 basic medicine ,Male ,medicine.medical_specialty ,lcsh:QH426-470 ,Imprinted genes ,Birth weight ,lcsh:Medicine ,Gestational Age ,Umbilical cord ,Body Mass Index ,03 medical and health sciences ,Genomic Imprinting ,Pregnancy ,Genetics ,medicine ,Birth Weight ,Humans ,Obesity ,Molecular Biology ,Genetics (clinical) ,2. Zero hunger ,Child weight ,DNA methylation ,business.industry ,Obstetrics ,Research ,lcsh:R ,Infant, Newborn ,Gestational age ,Infant ,Anthropometry ,medicine.disease ,Fetal Blood ,lcsh:Genetics ,030104 developmental biology ,Differentially methylated regions ,medicine.anatomical_structure ,Child, Preschool ,Infant, Small for Gestational Age ,Small for gestational age ,Female ,business ,Body mass index ,Developmental Biology - Abstract
Background This study assessed the associations between nine differentially methylated regions (DMRs) of imprinted genes in DNA derived from umbilical cord blood leukocytes in males and females and (1) birth weight for gestational age z score, (2) weight-for-length (WFL) z score at 1 year, and (3) body mass index (BMI) z score at 3 years. Methods We conducted multiple linear regression in n = 567 infants at birth, n = 288 children at 1 year, and n = 294 children at 3 years from the Newborn Epigenetics Study (NEST). We stratified by sex and adjusted for race/ethnicity, maternal education, maternal pre-pregnancy BMI, prenatal smoking, maternal age, gestational age, and paternal race. We also conducted analysis restricting to infants not born small for gestational age. Results We found an association between higher methylation of the sequences regulating paternally expressed gene 10 (PEG10) and anthropometric z scores at 1 year (β = 0.84; 95% CI = 0.34, 1.33; p = 0.001) and 3 years (β = 1.03; 95% CI = 0.37, 1.69; p value = 0.003) in males only. Higher methylation of the DMR regulating mesoderm-specific transcript (MEST) was associated with lower anthropometric z scores in females at 1 year (β = − 1.03; 95% CI − 1.60, − 0.45; p value = 0.001) and 3 years (β = − 1.11; 95% CI − 1.98, − 0.24; p value = 0.01). These associations persisted when we restricted to infants not born small for gestational age. Conclusion Our data support a sex-specific association between altered methylation and weight status in early life. These methylation marks can contribute to the compendium of epigenetically regulated regions detectable at birth, influencing obesity in childhood. Larger studies are required to confirm these findings. Electronic supplementary material The online version of this article (10.1186/s13148-018-0521-0) contains supplementary material, which is available to authorized users. more...
- Published
- 2018
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