92 results on '"Michelle Cheng"'
Search Results
2. Arginine-linked HPV-associated E7 displaying bacteria-derived outer membrane vesicles as a potent antigen-specific cancer vaccine
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Suyang Wang, Chao-Cheng Chen, Ming-Hung Hu, Michelle Cheng, Hsin-Fang Tu, Ya-Chea Tsai, Jr-Ming Yang, T. C. Wu, Chuan-Hsiang Huang, and Chien-Fu Hung
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Bacteria outer membrane vesicle ,Antigen display ,Cancer vaccine ,Tumor antigen-specific T cell ,Tumor infiltrating lymphocytes ,Medicine - Abstract
Abstract Background Bacteria-based cancer therapy have demonstrated innovative strategies to combat tumors. Recent studies have focused on gram-negative bacterial outer membrane vesicles (OMVs) as a novel cancer immunotherapy strategy due to its intrinsic properties as a versatile carrier. Method Here, we developed an Human Papillomavirus (HPV)-associated E7 antigen displaying Salmonella-derived OMV vaccine, utilizing a Poly(L-arginine) cell penetrating peptide (CPP) to enhance HPV16 E7 (aa49-67) H-2 Db and OMV affinity, termed SOMV-9RE7. Results Due to OMV’s intrinsic immunogenic properties, SOMV-9RE7 effectively activates adaptive immunity through antigen-presenting cell uptake and antigen cross-presentation. Vaccination of engineered OMVs shows immediate tumor suppression and recruitment of infiltrating tumor-reactive immune cells. Conclusion The simplicity of the arginine coating strategy boasts the versatility of immuno-stimulating OMVs that can be broadly implemented to personalized bacterial immunotherapeutic applications.
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- 2024
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3. FLT3L-induced virtual memory CD8 T cells engage the immune system against tumors
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Hsin-Fang Tu, Yu-Jui Kung, Ling Lim, Julia Tao, Ming-Hung Hu, Michelle Cheng, Deyin Xing, T. C. Wu, and Chien-Fu Hung
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CD44high CD8 T cells ,Virtual memory CD8 T cells ,Alb-FLT3L ,Medicine - Abstract
Abstract Background Previous research in FMS-like tyrosine kinase 3 ligands (FLT3L) has primarily focused on their potential to generate dendritic cells (DCs) from bone marrow progenitors, with a limited understanding of how these cells affect CD8 T cell function. In this study, we further investigated the in vivo role of FLT3L for the immunomodulatory capabilities of CD8 T cells. Methods Albumin-conjugated FLT3L (Alb-FLT3L) was generated and applied for translational medicine purposes; here it was used to treat naïve C57BL/6 and OT1 mice for CD8 T cell response analysis. Syngeneic B16ova and E.G7ova mouse models were employed for adoptive cell transfer to evaluate the effects of Alb-FLT3L preconditioning of CD8 T cells on tumor progression. To uncover the underlying mechanisms of Alb-FLT3L modulation, we conducted bulk RNA-seq analysis of the CD44high CD8 T cells. STAT1-deficient mice were used to elucidate the functional roles of Alb-FLT3L in the modulation of T cells. Finally, antibody blockade of type one interferon signaling and in vitro coculture of plasmacytoid DCs (pDCs) with naive CD8 T cells was performed to determine the role of pDCs in mediating regulation of CD44high CD8 T cells. Results CD44high CD8 T cells were enhanced in C57BL/6 mice administrated with Alb-FLT3L. These CD8 T cells exhibited virtual memory features and had greater proliferative and effective functions. Notably, the adoptive transfer of CD44high naïve CD8 T cells into C57BL/6 mice with B16ova tumors led to significant tumor regression. RNA-seq analysis of the CD44high naïve CD8 T cells revealed FLT3L to induce CD44high CD8 T cells in a JAK-STAT1 signaling pathway-dependent manner, as supported by results indicating a decreased ability of FLT3L to enhance CD8 T cell proliferation in STAT1-deficient mice as compared to wild-type control mice. Moreover, antibody blockade of type one interferon signaling restricted the generation of FLT3L-induced CD44high CD8 T cells, while CD44 expression was able to be induced in naïve CD8 T cells cocultured with pDCs derived from FLT3L-treated mice. This suggests the crucial role of pDCs in mediating FLT3L regulation of CD44high CD8 T cells. Conclusions These findings provide critical insight and support the therapeutic potential of Alb-FLT3L as an immune modulator in preconditioning of naïve CD8 T cells for cancer immunotherapy.
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- 2024
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4. Immune responses, therapeutic anti-tumor effects, and tolerability upon therapeutic HPV16/18 E6/E7 DNA vaccination via needle-free biojector
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Shiwen Peng, Hsin-Fang Tu, Michelle Cheng, Ming-Hung Hu, Hua-Ling Tsai, Ya-Chea Tsai, Chelsea Koenig, Cory Brayton, Hao Wang, Yung-Nien Chang, Rebecca C. Arend, Kimberly Levinson, Richard B. S. Roden, T. C. Wu, and Chien-Fu Hung
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human papillomavirus ,HPV16 ,HPV18 ,E6 ,E7 ,DNA vaccine ,Microbiology ,QR1-502 - Abstract
ABSTRACT Intramuscular vaccination of mice with the naked pBI-11 DNA plasmid targeting E6 and E7 of HPV16 and HPV18 via a conventional syringe and needle generates human papillomavirus (HPV) antigen-specific CD8+ T cell-mediated immune responses and therapeutic effects against the TC-1 tumor model. However, delivery of DNA vaccines by this method is less effective in patients, likely due to poor transduction of host tissues. Needle-free biojectors show great promise for DNA vaccination because of their simplicity of administration and high patient acceptability and also, we hypothesize, because of greater efficiency of cell transduction in host tissues. Here, we compared the kinetics of transgene expression from a plasmid DNA using intramuscular injection with a conventional needle administration to intradermal or intramuscular delivery with a customized Tropis biojector. Delivery using the customized Tropis biojector leads to enhanced transgene expression compared to intramuscular needle injection. In addition, we characterized the HPV antigen-specific CD8+ T cell-mediated immune responses and anti-tumor effects generated by pBI-11 DNA vaccination by each route of administration, as well as by split-dose multi-site injection. Intradermal, but not intramuscular, vaccination with pBI-11 DNA vaccine via customized Tropis biojector enhanced HPV antigen-specific CD8+ T cell-mediated immune responses over needle injection. Intradermal, but not intramuscular, vaccination via customized needle-free Tropis biojector elicited greater HPV antigen-specific CD8+ T cell-mediated immune responses as well as anti-tumor effects compared to intramuscular injection of pBI-11 with a needle. Good manufacturing practices (GMP) grade pBI-11 DNA vaccine delivered intradermally or intramuscularly via customized Tropis biojector was well tolerated by mice. IMPORTANCE Respectively, HPV16 and HPV18 cause 50% and 20% of cervical cancer cases globally. Viral proteins E6 and E7 are obligate drivers of oncogenic transformation. We recently developed a candidate therapeutic DNA vaccine, pBI-11, that targets HPV16 and HPV18 E6 and E7. Single-site intramuscular delivery of pBI-11 via a needle elicited therapeutic anti-tumor effects in mice and is now being tested in high-risk human papillomavirus+ head and neck cancer patients (NCT05799144). Needle-free biojectors such as the Tropis device show promise due to ease of administration, high patient acceptability, and the possibility of improved delivery. For example, vaccination of patients with the ZyCoV-D DNA vaccine using the Tropis device is effective against COVID19, well tolerated, and licensed. Here we show that split-dose, multi-site administration and intradermal delivery via the Tropis biojector increase the delivery of pBI-11 DNA vaccine, enhance HPV antigen-specific CD8+ T-cell responses, and improve anti-tumor therapeutic effects, suggesting its translational potential to treat HPV16/18 infection and disease.
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- 2023
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5. STAT1-Deficient HPV E6/E7-Associated Cancers Maintain Host Immunocompetency against Therapeutic Intervention
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Ling Lim, Ming-Hung Hu, Darrell Fan, Hsin-Fang Tu, Ya-Chea Tsai, Michelle Cheng, Suyang Wang, Chih-Long Chang, Tzyy-Choou Wu, and Chien-Fu Hung
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STAT1 ,human papillomavirus ,E6/E7 ,T cells ,immunity ,Medicine - Abstract
Human papillomavirus (HPV) remains a global health concern because it contributes to the initiation of various HPV-associated cancers such as anal, cervical, oropharyngeal, penile, vaginal, and vulvar cancer. In HPV-associated cancers, oncogenesis begins with an HPV infection, which is linked to the activation of the Janus protein tyrosine kinase (JAK)/STAT signaling pathway. Various STAT signaling pathways, such as STAT3 activation, have been well documented for their tumorigenic role, yet the role of STAT1 in tumor formation remains unclear. In the current study, STAT1−/− mice were used to investigate the role of STAT1 in the tumorigenesis of a spontaneous HPV E6/E7-expressing oral tumor model. Subsequently, our candidate HPV DNA vaccine CRT/E7 was administered to determine whether the STAT1−/− host preserves a therapeutic-responsive tumor microenvironment. The results indicated that STAT1−/− induces robust tumorigenesis, yet a controlled tumor response was attained upon CRT/E7 vaccination. Characterizing this treatment effect, immunological analysis found a higher percentage of circulating CD4+ and CD8+ T cells and tumor-specific cytotoxic T cells. In addition, a reduction in exhaustive lymphocyte activity was observed. Further analysis of a whole-cell tumor challenge affirmed these findings, as spontaneous tumor growth was more rapid in STAT1−/− mice. In conclusion, STAT1 deletion accelerates tumorigenesis, but STAT1−/− mice maintains immunocompetency in CRT/E7 treatments.
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- 2024
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6. Why are the batteries in the microwave?: Use of semantic information under uncertainty in a search task
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Gwendolyn L. Rehrig, Michelle Cheng, Brian C. McMahan, and Rahul Shome
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Scene semantics ,Visual search ,Decision-making ,Learning ,Prior knowledge ,Belief updating ,Consciousness. Cognition ,BF309-499 - Abstract
Abstract A major problem in human cognition is to understand how newly acquired information and long-standing beliefs about the environment combine to make decisions and plan behaviors. Over-dependence on long-standing beliefs may be a significant source of suboptimal decision-making in unusual circumstances. While the contribution of long-standing beliefs about the environment to search in real-world scenes is well-studied, less is known about how new evidence informs search decisions, and it is unclear whether the two sources of information are used together optimally to guide search. The present study expanded on the literature on semantic guidance in visual search by modeling a Bayesian ideal observer’s use of long-standing semantic beliefs and recent experience in an active search task. The ability to adjust expectations to the task environment was simulated using the Bayesian ideal observer, and subjects’ performance was compared to ideal observers that depended on prior knowledge and recent experience to varying degrees. Target locations were either congruent with scene semantics, incongruent with what would be expected from scene semantics, or random. Half of the subjects were able to learn to search for the target in incongruent locations over repeated experimental sessions when it was optimal to do so. These results suggest that searchers can learn to prioritize recent experience over knowledge of scenes in a near-optimal fashion when it is beneficial to do so, as long as the evidence from recent experience was learnable.
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- 2021
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7. Computer vision applied to dual-energy computed tomography images for precise calcinosis cutis quantification in patients with systemic sclerosis
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Anita C. Chandrasekaran, Zhicheng Fu, Reid Kraniski, F. Perry Wilson, Shannon Teaw, Michelle Cheng, Annie Wang, Shangping Ren, Imran M. Omar, and Monique E. Hinchcliff
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Systemic sclerosis ,Scleroderma ,Calcinosis cutis ,Computer vision ,Convolutional neural networks (CNN) ,Dystrophic calcifications ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Although treatments have been proposed for calcinosis cutis (CC) in patients with systemic sclerosis (SSc), a standardized and validated method for CC burden quantification is necessary to enable valid clinical trials. We tested the hypothesis that computer vision applied to dual-energy computed tomography (DECT) finger images is a useful approach for precise and accurate CC quantification in SSc patients. Methods De-identified 2-dimensional (2D) DECT images from SSc patients with clinically evident lesser finger CC lesions were obtained. An expert musculoskeletal radiologist confirmed accurate manual segmentation (subtraction) of the phalanges for each image as a gold standard, and a U-Net Convolutional Neural Network (CNN) computer vision model for segmentation of healthy phalanges was developed and tested. A validation study was performed in an independent dataset whereby two independent radiologists manually measured the longest length and perpendicular short axis of each lesion and then calculated an estimated area by assuming the lesion was elliptical using the formula long axis/2 × short axis/2 × π, and a computer scientist used a region growing technique to calculate the area of CC lesions. Spearman’s correlation coefficient, Lin’s concordance correlation coefficient with 95% confidence intervals (CI), and a Bland-Altman plot (Stata V 15.1, College Station, TX) were used to test for equivalence between the radiologists’ and the CNN algorithm-generated area estimates. Results Forty de-identified 2D DECT images from SSc patients with clinically evident finger CC lesions were obtained and divided into training (N = 30 with image rotation × 3 to expand the set to N = 120) and test sets (N = 10). In the training set, five hundred epochs (iterations) were required to train the CNN algorithm to segment phalanges from adjacent CC, and accurate segmentation was evaluated using the ten held-out images. To test model performance, CC lesional area estimates calculated by two independent radiologists and a computer scientist were compared (radiologist 1 vs. radiologist 2 and radiologist 1 vs. computer vision approach) using an independent test dataset comprised of 31 images (8 index finger and 23 other fingers). For the two radiologists’, and the radiologist vs. computer vision measurements, Spearman’s rho was 0.91 and 0.94, respectively, both p
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- 2021
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8. High-throughput quantitative histology in systemic sclerosis skin disease using computer vision
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Chase Correia, Seamus Mawe, Shane Lofgren, Roberta G. Marangoni, Jungwha Lee, Rana Saber, Kathleen Aren, Michelle Cheng, Shannon Teaw, Aileen Hoffmann, Isaac Goldberg, Shawn E. Cowper, Purvesh Khatri, Monique Hinchcliff, and J. Matthew Mahoney
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Computer vision ,Systemic sclerosis ,Scleroderma ,Histology ,Modified Rodnan skin score ,Outcomes ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Skin fibrosis is the clinical hallmark of systemic sclerosis (SSc), where collagen deposition and remodeling of the dermis occur over time. The most widely used outcome measure in SSc clinical trials is the modified Rodnan skin score (mRSS), which is a semi-quantitative assessment of skin stiffness at seventeen body sites. However, the mRSS is confounded by obesity, edema, and high inter-rater variability. In order to develop a new histopathological outcome measure for SSc, we applied a computer vision technology called a deep neural network (DNN) to stained sections of SSc skin. We tested the hypotheses that DNN analysis could reliably assess mRSS and discriminate SSc from normal skin. Methods We analyzed biopsies from two independent (primary and secondary) cohorts. One investigator performed mRSS assessments and forearm biopsies, and trichrome-stained biopsy sections were photomicrographed. We used the AlexNet DNN to generate a numerical signature of 4096 quantitative image features (QIFs) for 100 randomly selected dermal image patches/biopsy. In the primary cohort, we used principal components analysis (PCA) to summarize the QIFs into a Biopsy Score for comparison with mRSS. In the secondary cohort, using QIF signatures as the input, we fit a logistic regression model to discriminate between SSc vs. control biopsy, and a linear regression model to estimate mRSS, yielding Diagnostic Scores and Fibrosis Scores, respectively. We determined the correlation between Fibrosis Scores and the published Scleroderma Skin Severity Score (4S) and between Fibrosis Scores and longitudinal changes in mRSS on a per patient basis. Results In the primary cohort (n = 6, 26 SSc biopsies), Biopsy Scores significantly correlated with mRSS (R = 0.55, p = 0.01). In the secondary cohort (n = 60 SSc and 16 controls, 164 biopsies; divided into 70% training and 30% test sets), the Diagnostic Score was significantly associated with SSc-status (misclassification rate = 1.9% [training], 6.6% [test]), and the Fibrosis Score significantly correlated with mRSS (R = 0.70 [training], 0.55 [test]). The DNN-derived Fibrosis Score significantly correlated with 4S (R = 0.69, p = 3 × 10− 17). Conclusions DNN analysis of SSc biopsies is an unbiased, quantitative, and reproducible outcome that is associated with validated SSc outcomes.
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- 2020
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9. Brain-wide neural dynamics of post-stroke recovery induced by optogenetic stimulation
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Shahabeddin Vahdat, Arjun Pendharkar, Terrance Chiang, Sean Harvey, Anika Kim, Zhijuan Cao, Hansen Chen, Michelle Cheng, Jin Hyung Jin Hyung, and Gary Steinberg
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Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Published
- 2021
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10. Cathelicidin Suppresses Colon Cancer Metastasis via a P2RX7-Dependent Mechanism
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Jiani Wang, Michelle Cheng, Ivy K.M. Law, Christina Ortiz, Mingjun Sun, and Hon Wai Koon
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
The antimicrobial peptide cathelicidin inhibits development of colitis-associated colon cancer. However, the role of cathelicidin in colon cancer metastasis remains unknown. We hypothesized that cathelicidin is effective in inhibiting colon cancer metastasis. Human colon cancer HT-29 cells were injected intravenously into nude mice. Control HA-tagged adeno-associated virus (HA-AAV) or cathelicidin-overexpressing AAV (CAMP-HA-AAV) were injected intravenously into nude mice on the same day. Four weeks later, the nude mice were assessed for lung and liver metastases. Human colon cancer SW620 cells were used to study the effect of cathelicidin on cell migration and cytoskeleton. Incubation of SW620 cells with cathelicidin dose-dependently reduced cell migration, disrupted cytoskeletal structure, and reduced βIII-tubulin (TUBB3) mRNA expression. The addition of the P2RX7 antagonist KN62, but not the FPRL1 antagonist WRW4, prevented the LL-37-mediated inhibition of cell migration and TUBB3 mRNA expression. The CAMP-HA-AAV-overexpressing group showed significantly reduced human CK20 protein (by 60%) and TUBB3 mRNA expression (by 40%) in the lungs and liver of the HT-29-loaded nude mice, compared to the HA-AAV control group. Intraperitoneal injection of KN62 reversed the CAMP-HA-AAV-mediated inhibition of human CK20 and TUBB3 expression in the lungs and liver of HT-29-loaded nude mice. In conclusion, cathelicidin inhibits colon cancer metastasis via a P2RX7-dependent pathway. Keywords: colon cancer, metastasis, antimicrobial peptide
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- 2019
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11. Circulating cathelicidin levels correlate with mucosal disease activity in ulcerative colitis, risk of intestinal stricture in Crohn’s disease, and clinical prognosis in inflammatory bowel disease
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Diana Hoang-Ngoc Tran, Jiani Wang, Christina Ha, Wendy Ho, S. Anjani Mattai, Angelos Oikonomopoulos, Guy Weiss, Precious Lacey, Michelle Cheng, Christine Shieh, Caroline C. Mussatto, Samantha Ho, Daniel Hommes, and Hon Wai Koon
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Biomarkers ,Complications of IBD ,Serologic testing ,Prognosis ,Mucosal disease activity ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background Cathelicidin (LL-37) is an antimicrobial peptide known to be associated with various autoimmune diseases. We attempt to determine if cathelicidin can accurately reflect IBD disease activity. We hypothesize that serum cathelicidin correlates with mucosal disease activity, stricture, and clinical prognosis of IBD patients. Methods Serum samples were collected from two separate cohorts of patients at the University of California, Los Angeles. Cohort 1 consisted of 50 control, 23 UC, and 28 CD patients. Cohort 2 consisted of 20 control, 57 UC, and 67 CD patients. LL-37 levels were determined by ELISA. Data from both cohorts were combined for calculation of accuracies in indicating mucosal disease activity, relative risks of stricture, and odds ratios of predicting disease development. Results Serum cathelicidin levels were inversely correlated with Partial Mayo Scores of UC patients and Harvey-Bradshaw Indices of CD patients. Among IBD patients with moderate or severe initial disease activity, the patients with high initial LL-37 levels had significantly better recovery than the patients with low initial LL-37 levels after 6–18 months, suggesting that high LL-37 levels correlate with good prognosis. Co-evaluation of LL-37 and CRP levels was more accurate than CRP alone or LL-37 alone in the correlation with Mayo Endoscopic Score of UC patients. Low LL-37 levels indicated a significantly elevated risk of intestinal stricture in CD patients. Conclusion Co-evaluation of LL-37 and CRP can indicate mucosal disease activity in UC patients. LL-37 can predict future clinical activity in IBD patients and indicate risk of intestinal stricture in CD patients.
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- 2017
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12. She Thinks in English, But She Wants in Mandarin: Differences in Singaporean Bilingual English–Mandarin Maternal Mental-State-Talk
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Michelle Cheng, Peipei Setoh, Marc H. Bornstein, and Gianluca Esposito
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bilingualism ,mental-state-talk ,socialization ,Psychology ,BF1-990 - Abstract
Chinese-speaking parents are believed to use less cognitive mental-state-talk than their English-speaking counterparts on account of their cultural goals in socializing their children to follow an interdependence script. Here, we investigated bilingual English–Mandarin Singaporean mothers who associate different functions for each language as prescribed by their government: English for school and Mandarin for in-group contexts. English and Mandarin maternal mental-state-talk from bilingual English–Mandarin mothers with their toddlers was examined. Mothers produced more ‘’cognitive’’ terms in English than in Mandarin and more ‘’desire’’ terms in Mandarin than in English. We show that mental-state-talk differs between bilingual parents’ languages, suggesting that mothers adjust their mental-state-talk to reflect the functions of each language.
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- 2020
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13. PRAS40 plays a pivotal role in protecting against stroke by linking the Akt and mTOR pathways
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Xiaoxing Xiong, Rong Xie, Hongfei Zhang, Lijuan Gu, Weiying Xie, Michelle Cheng, Zhihong Jian, Kristina Kovacina, and Heng Zhao
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Focal cerebral ischemia ,Akt ,Stroke ,mTOR ,PRAS40 ,PTEN ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
The proline-rich Akt substrate of 40 kDa (PRAS40) protein is not only a substrate of the protein kinase Akt but also a component of the mTOR complex 1 (mTORC1), thus it links the Akt and the mTOR pathways. We investigated the potential protective role of PRAS40 in cerebral ischemia and its underlying mechanisms by using rats with lentiviral over-expression of PRAS40 and mice with PRAS40 gene knockout (PRAS40 KO). Our results show that gene transfer of PRAS40 reduced infarction size in rats by promoting phosphorylation of Akt, FKHR (FOXO1), PRAS40, and mTOR. In contrast, PRAS40 KO increased infarction size. Although the PRAS40 KO under normal condition did not alter baseline levels of phosphorylated proteins in the Akt and mTOR pathways, PRAS40 KO that underwent stroke exhibited reduced protein levels of p-S6K and p-S6 in the mTOR pathway but not p-Akt, or p-PTEN in the Akt pathway. Furthermore, co-immunoprecipitation suggests that there were less interactive effects between Akt and mTOR in the PRAS40 KO. In conclusion, PRAS40 appears to reduce brain injury by converting cell signaling from Akt to mTOR.
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- 2014
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14. Chronic Constipation and Its Complications
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Michelle Cheng MD, Shahnaz Ghahremani MD, Antoinette Roth MD, and Soni C. Chawla MD
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Pediatrics ,RJ1-570 - Abstract
Background . Fecalomas are hard dense masses separate from surrounding fecal material or bowel contents. This case report intends to provide a brief review of the literature and differential diagnosis for a pelvic mass in a pediatric patient. Case Presentation . The patient is a 5-year-old male presenting with worsening constipation and stool leakage over several months, found to have a rare calcified pelvic mass on abdominal X-ray consistent with a fecaloma. Conclusion . Fecalomas should be considered on the differential diagnosis of pediatric patients who present with chronic constipation and a calcified pelvic mass.
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- 2016
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15. Antifibrogenic Effects of the Antimicrobial Peptide Cathelicidin in Murine Colitis-Associated FibrosisSummary
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Jun Hwan Yoo, Samantha Ho, Deanna Hoang-Yen Tran, Michelle Cheng, Kyriaki Bakirtzi, Yuzu Kubota, Ryan Ichikawa, Bowei Su, Diana Hoang-Ngoc Tran, Tressia C. Hing, Irene Chang, David Q. Shih, Richard E. Issacson, Richard L. Gallo, Claudio Fiocchi, Charalabos Pothoulakis, and Hon Wai Koon
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background & Aims: Cathelicidin (LL-37 in human and mCRAMP in mice) represents a family of endogenous antimicrobial peptides with anti-inflammatory effects. LL-37 also suppresses collagen synthesis, an important fibrotic response, in dermal fibroblasts. Here, we determined whether exogenous cathelicidin administration modulates intestinal fibrosis in two animal models of intestinal inflammation and in human colonic fibroblasts. Methods: C57BL/6J mice (n = 6 per group) were administered intracolonically with a trinitrobenzene sulphonic acid (TNBS) enema to induce chronic (6â7 weeks) colitis with fibrosis. We administered mCRAMP peptide (5 mg/kg every 3 day, week 5â7) or cathelicidin gene (Camp)-expressing lentivirus (107 infectious units week 4) intracolonically or intravenously, respectively. We then infected 129Sv/J mice with Salmonella typhimurium orally to induce cecal inflammation with fibrosis. Camp-expressing lentivirus (107 infectious units day 11) was administered intravenously. Results: TNBS-induced chronic colitis was associated with increased colonic collagen (col1a2) mRNA expression. Intracolonic cathelicidin (mCRAMP peptide) administration or intravenous delivery of lentivirus-overexpressing cathelicidin gene significantly reduced colonic col1a2 mRNA expression in TNBS-exposed mice compared with vehicle administration. Salmonella infection also caused increased cecal inflammation associated with collagen (col1a2) mRNA expression that was prevented by intravenous delivery of Camp-expressing lentivirus. Exposure of human primary intestinal fibroblasts and human colonic CCD-18Co fibroblasts to transforming growth factor-β1 (TGF-β1) and/or insulin-like growth factor 1 induced collagen protein and mRNA expression, which was reduced by LL-37 (3â5 μM) through a MAP kinase-dependent mechanism. Conclusions: Cathelicidin can reverse intestinal fibrosis by directly inhibiting collagen synthesis in colonic fibroblasts. Keywords: Antimicrobial Peptide, Collagen, Inflammatory Bowel Disease
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- 2015
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16. Managing the work-life balance when working from home: the experience of Flemish parents
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Jean-Paul Van Belle, Guidance Mthwazi, Minerva Ablay, Michelle Cheng, Sarah Cottriau, Nerine Couckhuyt, Gilles Termont, and Jan Claes
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The COVID-19 pandemic forced many people to work from home. Even after pandemic restrictions have been lifted, many parents continue to work from home. This poses several challenges and has led to a number of issues related to sharing rooms and equipment, dealing with distractions, and dealing with feelings. This paper examines the issues that arose for parents working from home in Flanders within these three categories, and recommends potential solutions. Data were collected through a survey. The target population of the survey was a group of Flemish parents with children under the age of 18 and working from home during the lockdown. The main findings of the research are summarized as follows. Most respondents did not have a separate workspace at home. This means that parents experienced different distractions at home than while working from the office. Children were the number one distraction for parents working from home. The care of children and the lack of work-life balance were also the main sources of conflict. However, the feelings when working from home are not only negative. Parents felt frustration and powerlessness, as well as motivation and happiness. Based on the analysis of the responses, recommendations are formulated from parents to parents on how to organise working from home with children.
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- 2023
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17. Investing in Community Organizations That Serve Marginalized Populations
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Margarita Alegria, Lauren Cohen, Ziqiang Lin, Michelle Cheng, and Sheri Lapatin Markle
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Minoritized racial and ethnic groups experience mental health issues yet persistently encounter systemic barriers to accessing mental health care. Disparities in mental health services are linked to structural racism, discrimination, and stigma. Social determinants of health also impact the risk of experiencing mental health issues and contribute to mental healthcare access. Community-based organizations (CBOs) can serve as vital linkages for delivering much-needed support across many domains (e.g., physical and mental health, housing, food, recreation, etc.) and provide opportunities for fostering connections with members of underserved communities. There is untapped potential in leveraging the skills and expertise offered by CBOs and their staff. Designing programs and interventions that incorporate the goals and ideals of the community served may facilitate sustainability and contribute to a reconceptualization of care delivery based on equity. Ensuring that community-informed initiatives are set up for success will require advocacy for multisector collaboration and innovative approaches and policies that facilitate community collaborations to improve mental health and well-being for communities of color to flourish.
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- 2023
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18. Confidential Deep Learning: Executing Proprietary Models on Untrusted Devices.
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Peter M. VanNostrand, Ioannis Kyriazis, Michelle Cheng, Tian Guo 0001, and Robert J. Walls
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- 2019
19. Contrasting lexical biases in bilingual English–Mandarin speech: Verb-biased mothers, but noun-biased toddlers
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Marc H. Bornstein, Peipei Setoh, Michelle Cheng, Gianluca Esposito, School of Social Sciences, and Lee Kong Chian School of Medicine (LKCMedicine)
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Linguistics and Language ,Vocabulary ,Bilingualism ,media_common.quotation_subject ,Mothers ,Experimental and Cognitive Psychology ,Verb ,Context (language use) ,Mandarin Chinese ,050105 experimental psychology ,Language and Linguistics ,Bias ,Psychology [Social sciences] ,Noun ,Noun Bias ,Developmental and Educational Psychology ,Humans ,Speech ,0501 psychology and cognitive sciences ,Neuroscience of multilingualism ,General Psychology ,Language ,media_common ,05 social sciences ,Contrast (statistics) ,Linguistics ,language.human_language ,Dominance (ethology) ,Child, Preschool ,language ,Female ,Psychology ,050104 developmental & child psychology - Abstract
Is noun dominance in early lexical acquisition a widespread or a language-specific phenomenon? Thirty Singaporean bilingual English–Mandarin learning toddlers and their mothers were observed in a mother-child play interaction. For both English and Mandarin, toddlers’ speech and reported vocabulary contained more nouns than verbs across book reading and toy playing. In contrast, their mothers’ speech contained more verbs than nouns in both English and Mandarin but differed depending on the context of the interaction. Although toddlers demonstrated a noun bias for both languages, the noun bias was more pronounced in English than in Mandarin. Together, these findings support early noun dominance as a widespread phenomenon in the lexical acquisition debate but also provide evidence that language specificity also plays a minor role in children’s early lexical development. Ministry of Education (MOE) Published version This research was supported by Singapore Ministry of Education’s Academic Research Fund Tier 1 and Social Science Research Thematic Grant (MOE2016-SSRTG-017) to Peipei Setoh.
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- 2021
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20. High-throughput quantitative histology in systemic sclerosis skin disease using computer vision
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Monique Hinchcliff, Rana Saber, Kathleen Aren, Roberta Goncalves Marangoni, Purvesh Khatri, Shane Lofgren, Aileen Hoffmann, J. Matthew Mahoney, Isaac Goldberg, Shannon Teaw, Jungwha Lee, Michelle Cheng, Seamus Mawe, Chase Correia, and Shawn E. Cowper
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Male ,0301 basic medicine ,lcsh:Diseases of the musculoskeletal system ,Biopsy ,Deep neural network ,Logistic regression ,Severity of Illness Index ,Outcome measures ,AlexNet ,Scleroderma ,Cohort Studies ,Correlation ,Scleroderma, Localized ,0302 clinical medicine ,Fibrosis ,Computer vision ,skin and connective tissue diseases ,Skin ,Principal Component Analysis ,Quantitative image features ,medicine.diagnostic_test ,integumentary system ,Middle Aged ,3. Good health ,Cohort ,Eosine Yellowish-(YS) ,Systemic sclerosis ,Female ,Algorithms ,Research Article ,Adult ,medicine.medical_specialty ,Histology ,Outcomes ,03 medical and health sciences ,Deep Learning ,Methyl Green ,Internal medicine ,Linear regression ,medicine ,Humans ,030203 arthritis & rheumatology ,Scleroderma, Systemic ,business.industry ,Modified Rodnan skin score ,medicine.disease ,Rheumatology ,Clinical trial ,030104 developmental biology ,Neural Networks, Computer ,Artificial intelligence ,lcsh:RC925-935 ,business ,Azo Compounds - Abstract
Background Skin fibrosis is the clinical hallmark of systemic sclerosis (SSc), where collagen deposition and remodeling of the dermis occur over time. The most widely used outcome measure in SSc clinical trials is the modified Rodnan skin score (mRSS), which is a semi-quantitative assessment of skin stiffness at seventeen body sites. However, the mRSS is confounded by obesity, edema, and high inter-rater variability. In order to develop a new histopathological outcome measure for SSc, we applied a computer vision technology called a deep neural network (DNN) to stained sections of SSc skin. We tested the hypotheses that DNN analysis could reliably assess mRSS and discriminate SSc from normal skin. Methods We analyzed biopsies from two independent (primary and secondary) cohorts. One investigator performed mRSS assessments and forearm biopsies, and trichrome-stained biopsy sections were photomicrographed. We used the AlexNet DNN to generate a numerical signature of 4096 quantitative image features (QIFs) for 100 randomly selected dermal image patches/biopsy. In the primary cohort, we used principal components analysis (PCA) to summarize the QIFs into a Biopsy Score for comparison with mRSS. In the secondary cohort, using QIF signatures as the input, we fit a logistic regression model to discriminate between SSc vs. control biopsy, and a linear regression model to estimate mRSS, yielding Diagnostic Scores and Fibrosis Scores, respectively. We determined the correlation between Fibrosis Scores and the published Scleroderma Skin Severity Score (4S) and between Fibrosis Scores and longitudinal changes in mRSS on a per patient basis. Results In the primary cohort (n = 6, 26 SSc biopsies), Biopsy Scores significantly correlated with mRSS (R = 0.55, p = 0.01). In the secondary cohort (n = 60 SSc and 16 controls, 164 biopsies; divided into 70% training and 30% test sets), the Diagnostic Score was significantly associated with SSc-status (misclassification rate = 1.9% [training], 6.6% [test]), and the Fibrosis Score significantly correlated with mRSS (R = 0.70 [training], 0.55 [test]). The DNN-derived Fibrosis Score significantly correlated with 4S (R = 0.69, p = 3 × 10− 17). Conclusions DNN analysis of SSc biopsies is an unbiased, quantitative, and reproducible outcome that is associated with validated SSc outcomes.
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- 2020
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21. Genotype shift of Malaysian porcine circovirus 2 (PCV2) from PCV2b to PCV2d within a decade
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Tan, Chew Yee, Thanawongnuwech, Roongroje, Arshad, Siti Suri, Hassan, Latiffah, Wai, Michelle Cheng Fong, Ooi, Peck Toung, Tan, Chew Yee, Thanawongnuwech, Roongroje, Arshad, Siti Suri, Hassan, Latiffah, Wai, Michelle Cheng Fong, and Ooi, Peck Toung
- Abstract
This paper aims to update the molecular status of porcine circovirus 2 (PCV2) in Malaysia. Firstly, the molecular detection rate of PCV2 in farm and sampled pig population were reported to be 83.78% (31/37 farms) and 83.54% (66/79 pigs) positive for PCV2, respectively. PCV2 was detected across all age groups, from fetuses, porkers to sows. Co-detection of PCV2 and PCV3 antigens was also reported at a rate of 28.77% (21/73). Secondly, PCV2 antigen was also detected in Malaysian abattoir lung samples: 18 out of 19 (94.74%) samples originating from clinically healthy finishers were tested positive. Further, this is the first study to confirm the circulation of PCV2 in the wild boar population roaming Peninsular Malaysia, where 28 out of 28 (100%) wild boar lung samples were found positive. One decade earlier, only genotype PCV2b was reported in Malaysia. This most recent update revealed that genotypes PCV2a, PCV2b and PCV2d were present, with PCV2d being the predominant circulating genotype. PCV2 cap gene nucleotide sequences in this study were found to be under negative selection pressure, with an estimated substitution rate of 1.102 × 10−3 substitutions/site/year (ssy).
- Published
- 2022
22. Development and Validation of an Instrument Measuring Postgraduates' Holistic Development
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Michelle CHENG
- Published
- 2022
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23. Cathelicidin Suppresses Colon Cancer Metastasis via a P2RX7-Dependent Mechanism
- Author
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Mingjun Sun, Jiani Wang, Michelle Cheng, Christina Ortiz, Ivy Ka Man Law, and Hon Wai Koon
- Subjects
0301 basic medicine ,Cancer Research ,antimicrobial peptide ,Colorectal cancer ,medicine.medical_treatment ,Intraperitoneal injection ,lcsh:RC254-282 ,Article ,Cathelicidin ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,medicine ,metastasis ,Pharmacology (medical) ,TUBB3 ,Lung ,Chemistry ,Antagonist ,Cell migration ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,3. Good health ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,colon cancer ,030220 oncology & carcinogenesis ,Cancer research ,Molecular Medicine ,lipids (amino acids, peptides, and proteins) - Abstract
The antimicrobial peptide cathelicidin inhibits development of colitis-associated colon cancer. However, the role of cathelicidin in colon cancer metastasis remains unknown. We hypothesized that cathelicidin is effective in inhibiting colon cancer metastasis. Human colon cancer HT-29 cells were injected intravenously into nude mice. Control HA-tagged adeno-associated virus (HA-AAV) or cathelicidin-overexpressing AAV (CAMP-HA-AAV) were injected intravenously into nude mice on the same day. Four weeks later, the nude mice were assessed for lung and liver metastases. Human colon cancer SW620 cells were used to study the effect of cathelicidin on cell migration and cytoskeleton. Incubation of SW620 cells with cathelicidin dose-dependently reduced cell migration, disrupted cytoskeletal structure, and reduced βIII-tubulin (TUBB3) mRNA expression. The addition of the P2RX7 antagonist KN62, but not the FPRL1 antagonist WRW4, prevented the LL-37-mediated inhibition of cell migration and TUBB3 mRNA expression. The CAMP-HA-AAV-overexpressing group showed significantly reduced human CK20 protein (by 60%) and TUBB3 mRNA expression (by 40%) in the lungs and liver of the HT-29-loaded nude mice, compared to the HA-AAV control group. Intraperitoneal injection of KN62 reversed the CAMP-HA-AAV-mediated inhibition of human CK20 and TUBB3 expression in the lungs and liver of HT-29-loaded nude mice. In conclusion, cathelicidin inhibits colon cancer metastasis via a P2RX7-dependent pathway. Keywords: colon cancer, metastasis, antimicrobial peptide
- Published
- 2019
24. Localized hypertrichosis following tacrolimus therapy: A case report and brief review
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Layal Antoury, Michelle Cheng, and Carol E. Cheng
- Subjects
Hypertrichosis ,medicine.medical_specialty ,business.industry ,Dermatology ,General Medicine ,medicine.disease ,Tacrolimus ,Hair growth ,Calcineurin ,Tacrolimus therapy ,medicine ,business ,Localized hypertrichosis - Published
- 2021
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25. A review and roadmap of the skin, lung and gut microbiota in systemic sclerosis
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Monique Hinchcliff, Michelle Cheng, and Shannon Teaw
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Microbial diversity ,Gut flora ,Scleroderma ,Immune system ,Rheumatology ,Medicine ,Humans ,Pharmacology (medical) ,Microbiome ,skin and connective tissue diseases ,Lung ,Review Articles ,Skin ,Gastrointestinal tract ,Scleroderma, Systemic ,biology ,integumentary system ,business.industry ,medicine.disease ,biology.organism_classification ,Gastrointestinal Microbiome ,Gastrointestinal Tract ,medicine.anatomical_structure ,Immunology ,business - Abstract
As our understanding of the genetic underpinnings of SSc increases, questions regarding the environmental trigger(s) that induce and propagate SSc in the genetically predisposed individual emerge. The interplay between the environment, the immune system, and the microbial species that inhabit the patient’s skin and gastrointestinal tract is a pathobiological frontier that is largely unexplored in SSc. The purpose of this review is to provide an overview of the methodologies, experimental study results and future roadmap for elucidating the relationship between the SSc host and his/her microbiome.
- Published
- 2020
26. TEMPI Syndrome With Progressive Telangiectasias Associated With Pulmonary Deterioration
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Michelle Cheng, Carol E. Cheng, Michael Lor, and Brannen Liang
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Male ,medicine.medical_specialty ,MEDLINE ,Paraproteinemias ,Angiogenesis Inhibitors ,Dermatology ,Polycythemia ,Bortezomib ,Text mining ,Internal medicine ,medicine ,Humans ,Telangiectasis ,Lenalidomide ,Lung ,business.industry ,Antibodies, Monoclonal ,Syndrome ,Middle Aged ,medicine.disease ,TEMPI syndrome ,medicine.anatomical_structure ,Cardiology ,Drug Therapy, Combination ,business ,Respiratory Insufficiency - Published
- 2020
27. Why are the batteries in the microwave?: Use of semantic information under uncertainty in a search task
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Brian McMahan, Michelle Cheng, Gwendolyn Rehrig, and Rahul Shome
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Consciousness. Cognition ,Observer (quantum physics) ,Experimental psychology ,Computer science ,Cognitive Neuroscience ,Bayesian probability ,Visuomotor behavior ,Experimental and Cognitive Psychology ,Plan (drawing) ,Semantics ,050105 experimental psychology ,Task (project management) ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Learning ,0501 psychology and cognitive sciences ,Attention ,Belief updating ,Microwaves ,Visual search ,Ideal (set theory) ,05 social sciences ,Uncertainty ,Cognition ,Bayes Theorem ,Sensory Systems ,Prior knowledge ,Ophthalmology ,Bayesian decision-making ,Original Article ,030217 neurology & neurosurgery ,Scene semantics ,Cognitive psychology ,BF309-499 ,Decision-making - Abstract
A major problem in human cognition is to understand how newly acquired information and long-standing beliefs about the environment combine to make decisions and plan behaviors. Over-dependence on long-standing beliefs may be a significant source of suboptimal decision-making in unusual circumstances. While the contribution of long-standing beliefs about the environment to search in real-world scenes is well-studied, less is known about how new evidence informs search decisions, and it is unclear whether the two sources of information are used together optimally to guide search. The present study expanded on the literature on semantic guidance in visual search by modeling a Bayesian ideal observer’s use of long-standing semantic beliefs and recent experience in an active search task. The ability to adjust expectations to the task environment was simulated using the Bayesian ideal observer, and subjects’ performance was compared to ideal observers that depended on prior knowledge and recent experience to varying degrees. Target locations were either congruent with scene semantics, incongruent with what would be expected from scene semantics, or random. Half of the subjects were able to learn to search for the target in incongruent locations over repeated experimental sessions when it was optimal to do so. These results suggest that searchers can learn to prioritize recent experience over knowledge of scenes in a near-optimal fashion when it is beneficial to do so, as long as the evidence from recent experience was learnable.
- Published
- 2020
28. Comparing Online Care with In-Person Care for Patients With Psoriasis
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Emanual Michael Maverakis, April Armstrong, Josefina Torres, Cesar Rivas-Sanchez, Brittany M. Gibbons, Nazanin Ehsani-Chimeh, Cindy J Chambers, Caitlin Clark, Sanminder Singh, Chelsea Ma, Paulina Young, David J. Wong, Andrea Steel, Caitlin M. Gibbons, Cory A. Dunnick, Eric R. Carlson, Laura C. Serna, Aleksandra G Florek, Sucharita Boddu, Reason Wilken, Joel Gelfand, Christianne J. Lane, Michelle Cheng, Adam R. Ford, Brenda I. Cornejo, Mary-Margaret Chren, Mayumi Fujita, Heather Kornmehl, and Elizabeth A. Wang
- Subjects
medicine.medical_specialty ,business.industry ,Psoriasis ,Family medicine ,medicine ,medicine.disease ,business - Published
- 2020
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29. She Thinks in English, But She Wants in Mandarin: Differences in Singaporean Bilingual English-Mandarin Maternal Mental-State-Talk
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Peipei Setoh, Gianluca Esposito, Marc H. Bornstein, Michelle Cheng, School of Social Sciences, and Lee Kong Chian School of Medicine (LKCMedicine)
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Bilingualism ,lcsh:BF1-990 ,Mental-state-talk ,Socialization ,Development ,mental-state-talk ,Mandarin Chinese ,050105 experimental psychology ,Article ,Developmental psychology ,Behavioral Neuroscience ,Psychology [Social sciences] ,Genetics ,0501 psychology and cognitive sciences ,Neuroscience of multilingualism ,General Psychology ,Ecology, Evolution, Behavior and Systematics ,Government ,4. Education ,05 social sciences ,socialization ,developmental_psychology ,Cognition ,bilingualism ,language.human_language ,lcsh:Psychology ,Mental state ,language ,Psychology ,050104 developmental & child psychology - Abstract
Chinese-speaking parents are believed to use less cognitive mental-state-talk than their English-speaking counterparts on account of their cultural goals in socializing their children to follow an interdependence script. Here, we investigated bilingual English&ndash, Mandarin Singaporean mothers who associate different functions for each language as prescribed by their government: English for school and Mandarin for in-group contexts. English and Mandarin maternal mental-state-talk from bilingual English&ndash, Mandarin mothers with their toddlers was examined. Mothers produced more &lsquo, &rsquo, cognitive&rsquo, terms in English than in Mandarin and more &lsquo, desire&rsquo, terms in Mandarin than in English. We show that mental-state-talk differs between bilingual parents&rsquo, languages, suggesting that mothers adjust their mental-state-talk to reflect the functions of each language.
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- 2020
30. Clinical Relevance of Home Monitoring of Vital Signs and Blood Glucose Levels: A Narrative Review
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Jessica P Lee, Michelle Cheng, Georgina Freeman, John Conly, Lauren Brown, and Hector De la Hoz Siegler
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medicine.medical_specialty ,Vital signs ,MEDLINE ,Monitoring, Ambulatory ,01 natural sciences ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Narrative ,030212 general & internal medicine ,Reliability (statistics) ,Aged ,Aged, 80 and over ,Vital Signs ,010405 organic chemistry ,business.industry ,Blood Glucose Self-Monitoring ,Health Policy ,Reproducibility of Results ,Health technology ,Middle Aged ,Data Accuracy ,0104 chemical sciences ,Data extraction ,Family medicine ,Citation ,business ,Independent living - Abstract
ObjectivesWe sought to assess the presence and reporting quality of peer-reviewed literature concerning the accuracy, precision, and reliability of home monitoring technologies for vital signs and glucose determinations in older adult populations.MethodsA narrative literature review was undertaken searching the databases Medline, Embase, and Compendex. Peer-reviewed publications with keywords related to vital signs, monitoring devices and technologies, independent living, and older adults were searched. Publications between the years 2012 and 2018 were included. Two reviewers independently conducted title and abstract screening, and four reviewers independently undertook full-text screening and data extraction with all disagreements resolved through discussion and consensus.ResultsTwo hundred nine articles were included. Our review showed limited assessment and low-quality reporting of evidence concerning the accuracy, precision, and reliability of home monitoring technologies. Of 209 articles describing a relevant device, only 45 percent (n = 95) provided a citation or some evidence to support their validation claim. Of forty-eight articles that described the use of a comparator device, 65 percent (n = 31) used low-quality statistical methods, 23 percent (n = 11) used moderate-quality statistical methods, and only 12 percent (n = 6) used high-quality statistical methods.ConclusionsOur review found that current validity claims were based on low-quality assessments that do not provide the necessary confidence needed by clinicians for medical decision-making purposes. This narrative review highlights the need for standardized health technology reporting to increase health practitioner confidence in these devices, support the appropriate adoption of such devices within the healthcare system, and improve health outcomes.
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- 2019
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31. Prevalence and Characteristics of Myopic Degeneration in an Adult Chinese American Population: The Chinese American Eye Study
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Farzana Choudhury, Stacy M. Meuer, Ronald Klein, Dandan Wang, Mina Torres, Xuejuan Jiang, Roberta McKean-Cowdin, Rohit Varma, Stanley P. Azen, Chunyi Hsu, David Dinh, Ruzhang Jiang, Jie Sun, YuPing Wang, Justine Wong, Shuang Wu, Rucha Desai, Lisa V. John, and Michelle Cheng
- Subjects
Male ,China ,Refractive error ,genetic structures ,Cross-sectional study ,Population ,California ,Article ,03 medical and health sciences ,Age Distribution ,0302 clinical medicine ,Prevalence ,medicine ,Humans ,Severe Myopia ,Sex Distribution ,education ,Aged ,Chinese americans ,Aged, 80 and over ,education.field_of_study ,Asian ,medicine.diagnostic_test ,business.industry ,Fundus photography ,Staphyloma ,Middle Aged ,medicine.disease ,eye diseases ,Ophthalmology ,Cross-Sectional Studies ,Myopia, Degenerative ,Cohort ,030221 ophthalmology & optometry ,Female ,business ,030217 neurology & neurosurgery ,Demography - Abstract
Purpose To characterize and provide population-based prevalence estimates of myopic degeneration (MD) among Chinese Americans, the fastest-growing minority population in the United States in the last decade. Design Population-based, cross-sectional study. Methods A total of 1523 Chinese-American adults with myopia, aged 50 years and older, residing in the city of Monterey Park, California, underwent an interview and comprehensive eye examination, including subjective and objective refraction and stereoscopic fundus photography. For each participant, the eye with the worse myopic refractive error was included in this analysis. MD was assessed in a masked manner by an expert grader. Results The prevalence of any MD was 44.9% among myopic subjects, based on the presence of any degenerative lesion secondary to myopia. The prevalence was 32.2% when MD was defined by a modified version of the Meta-Analysis for Pathologic Myopia. The prevalence of specific lesions included tessellation (31.7%), tilted disc (28.1%), peripapillary atrophy (7.0%), staphyloma (5.7%), diffuse atrophy (6.4%), lacquer cracks (2.6%), intrachoroidal cavitation (2.2%), patchy atrophy (0.9%), and end-stage MD (0.2%). The prevalence of MD was higher among older myopic subjects and among participants with more severe myopia and longer axial length ( P Conclusions These data provide the first population-based estimates of MD in Chinese Americans and indicate that a high proportion of Chinese Americans might be at risk for MD and associated visual complications. Prevalence of MD in this cohort of Chinese Americans was higher than that observed in other East Asian populations and in people of other ethnicities.
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- 2018
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32. Eosinophilic fasciitis presenting as a unilateral, solitary plaque
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Claire, Alexanian, Michelle, Cheng, Maija, Kiuru, Jenny Z, Wang, Stephanie T, Le, and Danielle M, Tartar
- Subjects
Clobetasol ,Adolescent ,Thigh ,Eosinophilia ,Administration, Oral ,Humans ,Prednisone ,Female ,Fasciitis ,Administration, Cutaneous ,Glucocorticoids - Abstract
Eosinophilic fasciitis is a rare connective tissue disorder characterized by inflammation of the fascia that leads to painful, indurated skin. Because of its variable clinical presentation and overlap with conditions, such as morphea, the diagnosis of eosinophilic fasciitis can be challenging and relies on clinical presentation, histopathologic and laboratory analysis, and response to therapy. Herein, we present an unusual, solitary, isolated plaque with pathologic features and response to therapy most consistent with eosinophilic fasciitis.
- Published
- 2019
33. Brain Metastasis From Renal-Cell Carcinoma: An Institutional Study
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Jamil Syed, Kamyar Ghabili, Michael E. Hurwitz, Sandy T. Liu, Kevin A. Nguyen, Alfredo Suarez-Sarmiento, Veronica Chiang, Michelle Cheng, Harriet M. Kluger, Brian Shuch, and Adam Nolte
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,urologic and male genital diseases ,Systemic therapy ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Internal medicine ,medicine ,Carcinoma ,Humans ,Cumulative incidence ,Carcinoma, Renal Cell ,Aged ,Retrospective Studies ,business.industry ,Brain Neoplasms ,Middle Aged ,medicine.disease ,Prognosis ,Survival Analysis ,female genital diseases and pregnancy complications ,Kidney Neoplasms ,Clinical trial ,030220 oncology & carcinogenesis ,Clear cell carcinoma ,Female ,medicine.symptom ,business ,Brain metastasis - Abstract
Background Brain metastases (BM) are frequently observed in advanced renal-cell carcinoma (RCC). Historically these individuals have been excluded from clinical trials, but recently, with better local control, many can receive aggressive therapy after treatment. We evaluate our single-institution experience over various treatment eras. Patients and Methods Patients undergoing evaluation for RCC BM from 2001 to 2018 were identified from our institutional database. Clinical notes, demographics, comorbidities, histology, central nervous system (CNS) treatments, systemic therapy, and outcomes were reviewed. Overall survival (OS) and CNS recurrence-free survival (RFS) were evaluated by the Kaplan-Meier method. Cumulative incidence was evaluated using a competing risk model. Results We identified 158 patients with RCC BM, of whom 94.4% had clear-cell RCC, and 90.6% had extracranial metastases at diagnosis. Of these patients, 94 (60%) developed RCC BM over time, while 46 (29.1%) had RCC BM at initial presentation. Clinical symptoms were noted in 81.9% of patients. The median OS after diagnosis of RCC BM was 8.4 months, with a 3-year OS of 28.2%. The median CNS RFS was 8.5 months overall; however, those with one and more than one lesion had median CNS RFS of 12.4 and 6 months, respectively (P Conclusion The majority of RCC patients with BM are symptomatic and had prior metastatic disease that progressed to the brain. Those with a solitary RCC BM are less likely to develop CNS recurrence after local therapy and are ideal candidates for enrollment onto clinical trials.
- Published
- 2019
34. Violaceous Nodules in an Annular Configuration Encircling an Orthotopic Liver Transplant Scar
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Michelle Cheng, David S. Cassarino, and Young Mike Choi
- Subjects
Liver Cirrhosis ,Male ,medicine.medical_specialty ,Fatal outcome ,Multiple Organ Failure ,Dermatology ,Cicatrix ,Fatal Outcome ,Biopsy ,medicine ,Humans ,Medical history ,medicine.diagnostic_test ,business.industry ,Disease progression ,Abdominal Wall ,Biopsy, Needle ,Orthotopic Liver Transplant ,Middle Aged ,Immunohistochemistry ,Lymphoproliferative Disorders ,Liver Transplantation ,medicine.anatomical_structure ,Disease Progression ,Abdomen ,Radiology ,business ,Immunosuppressive Agents - Published
- 2019
35. Phellinusspecies: An emerging cause of refractory fungal infections in patients with X-linked chronic granulomatous disease
- Author
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Adrian M. Zelazny, Kathleen R Sheridan, Christa S. Zerbe, Steven M. Holland, Ghady Haidar, and Michelle Cheng
- Subjects
Adult ,Male ,0301 basic medicine ,Antifungal Agents ,Phellinus ,Adolescent ,Pyridines ,030106 microbiology ,Dermatology ,Disease ,Granulomatous Disease, Chronic ,Microbiology ,Young Adult ,03 medical and health sciences ,Chronic granulomatous disease ,immune system diseases ,Amphotericin B ,hemic and lymphatic diseases ,DNA, Ribosomal Spacer ,Nitriles ,medicine ,Humans ,Lung ,Aspergillus ,biology ,Basidiomycota ,Hematopoietic Stem Cell Transplantation ,Brain ,General Medicine ,Triazoles ,medicine.disease ,Molecular diagnostics ,biology.organism_classification ,Transplantation ,Infectious Diseases ,Immunology ,Tomography, X-Ray Computed ,Invasive Fungal Infections ,Progressive disease ,medicine.drug - Abstract
Aspergillus spp. are a leading cause of mortality in chronic granulomatous disease (CGD), but other fungi have emerged in the era of mould prophylaxis. Of these, Phellinus spp. are an under-recognised cause of invasive fungal infections (IFIs) in CGD, and data on their presentation and management are scarce. We present a patient with CGD who developed disseminated IFI involving the lungs and brain. Surgical specimens grew a basidiomycete which was disregarded as a contaminant. After three months of progressive disease despite antifungals, he was diagnosed with Phellinus tropicalis by internal transcribed spacer (ITS) sequencing. He improved with amphotericin B and isavuconazole but required haematopoietic stem cell transplantation (HSCT). We review the literature on Phellinus infections in CGD and conclude that: (i) these infections emerge on mould-active prophylaxis and are indolent; (ii) they typically cause locally destructive disease but can disseminate; (iii) diagnosis is delayed and requires molecular methods; (iv) amphotericin B is most active in vitro; and (v) treatment is protracted and requires surgery and possibly HSCT. In conclusion, Phellinus spp. are emerging pathogens in CGD. Every effort should be made to establish the diagnosis of non-Aspergillus IFIs in patients with CGD by sending tissue specimens for molecular diagnostics.
- Published
- 2016
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36. 'You’re telling me!' The prevalence and predictors of pronoun reversals in children with autism spectrum disorders and typical development
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Michelle Cheng, Nan Xu Rattanasone, Saime Tek, Deborah Fein, Neha Khetrapal, Katherine Demuth, and Letitia R. Naigles
- Subjects
Pronoun ,Vocabulary ,Joint attention ,media_common.quotation_subject ,05 social sciences ,Psychological intervention ,medicine.disease ,Article ,Developmental psychology ,03 medical and health sciences ,Psychiatry and Mental health ,Clinical Psychology ,Typically developing ,0302 clinical medicine ,Developmental and Educational Psychology ,medicine ,Autism ,0501 psychology and cognitive sciences ,Psychology ,030217 neurology & neurosurgery ,Early language ,050104 developmental & child psychology ,media_common ,Spontaneous speech - Abstract
Social and linguistic explanations have been proposed for pronoun reversals in young typically developing (TD) children and those with autism spectrum disorders (ASD). The current study breaks new ground in investigating both explanations, comparing 18 TD toddlers and 15 children with ASD at similar language levels. Spontaneous speech was sampled every four months for six visits. Vocabulary and joint attention were also measured. Both groups produced pronoun reversals at low rates. The ASD group produced somewhat more reversals than the TD group, overall and at multiple visits. In the ASD group, early language and joint attention scores contributed significantly and independently to the incidence of reversal. Both linguistic and social factors seem implicated; moreover, reversals seem to occur when children’s language and social abilities develop asynchronously. These findings can help clinicians devise both linguistic and social interventions for the relevant children.
- Published
- 2016
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37. Cathelicidin suppresses lipid accumulation and hepatic steatosis by inhibition of the CD36 receptor
- Author
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Philip Fleshner, Zhaoping Li, D Hoang-Ngoc Tran, Michelle Vu, David Q. Shih, S A Mattai, Michelle Cheng, Bowei Su, Stephan R. Targan, D Hoang-Yen Tran, Christina Ortiz, Samantha Ho, Richard L. Gallo, Ivy Ka Man Law, Dermot P.B. McGovern, Jung Eun Lee, Hon Wai Koon, Tamer Sallam, E Fisseha, Iordanes Karagiannides, Kyriaki Bakirtzi, Tressia C. Hing, Elaine C. Lee, Lori Robbins, Christine Shieh, and Aristea Sideri
- Subjects
CD36 Antigens ,Male ,0301 basic medicine ,Endocrinology, Diabetes and Metabolism ,CD36 ,medicine.medical_treatment ,Medicine (miscellaneous) ,Inbred C57BL ,Medical and Health Sciences ,Cathelicidin ,Mice ,0302 clinical medicine ,Adipocytes ,Receptor ,2. Zero hunger ,Nutrition and Dietetics ,biology ,Chemistry ,Fatty liver ,Cell Differentiation ,hemic and immune systems ,Immunohistochemistry ,3. Good health ,Liver ,030220 oncology & carcinogenesis ,lipids (amino acids, peptides, and proteins) ,circulatory and respiratory physiology ,medicine.medical_specialty ,Diet, High-Fat ,Article ,Education ,Diabetes Mellitus, Experimental ,Prediabetic State ,Experimental ,Endocrinology & Metabolism ,03 medical and health sciences ,Cathelicidins ,3T3-L1 Cells ,Internal medicine ,parasitic diseases ,Diabetes Mellitus ,medicine ,Animals ,Humans ,Obesity ,Animal ,Lipid metabolism ,Metabolism ,Lipid Metabolism ,medicine.disease ,In vitro ,Diet ,Fatty Liver ,Mice, Inbred C57BL ,High-Fat ,Disease Models, Animal ,030104 developmental biology ,Endocrinology ,Gene Expression Regulation ,Disease Models ,Hepatocytes ,biology.protein ,Steatosis ,Antimicrobial Cationic Peptides - Abstract
Background and objectivesObesity is a global epidemic which increases the risk of the metabolic syndrome. Cathelicidin (LL-37 and mCRAMP) is an antimicrobial peptide with an unknown role in obesity. We hypothesize that cathelicidin expression correlates with obesity and modulates fat mass and hepatic steatosis.Materials and methodsMale C57BL/6 J mice were fed a high-fat diet. Streptozotocin was injected into mice to induce diabetes. Experimental groups were injected with cathelicidin and CD36 overexpressing lentiviruses. Human mesenteric fat adipocytes, mouse 3T3-L1 differentiated adipocytes and human HepG2 hepatocytes were used in the in vitro experiments. Cathelicidin levels in non-diabetic, prediabetic and type II diabetic patients were measured by enzyme-linked immunosorbent assay.ResultsLentiviral cathelicidin overexpression reduced hepatic steatosis and decreased the fat mass of high-fat diet-treated diabetic mice. Cathelicidin overexpression reduced mesenteric fat and hepatic fatty acid translocase (CD36) expression that was reversed by lentiviral CD36 overexpression. Exposure of adipocytes and hepatocytes to cathelicidin significantly inhibited CD36 expression and reduced lipid accumulation. Serum cathelicidin protein levels were significantly increased in non-diabetic and prediabetic patients with obesity, compared with non-diabetic patients with normal body mass index (BMI) values. Prediabetic patients had lower serum cathelicidin protein levels than non-diabetic subjects.ConclusionsCathelicidin inhibits the CD36 fat receptor and lipid accumulation in adipocytes and hepatocytes, leading to a reduction of fat mass and hepatic steatosis in vivo. Circulating cathelicidin levels are associated with increased BMI. Our results demonstrate that cathelicidin modulates the development of obesity.
- Published
- 2016
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38. MP66-01 BRAIN METASTASIS FROM RENAL CELL CARCINOMA: AN INSTITUTIONAL STUDY
- Author
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Adam Nolte, Kevin A. Nguyen, Michelle Cheng, Alfredo Suarez-Sarmiento, and Brian Shuch
- Subjects
Renal cell carcinoma ,business.industry ,Urology ,Cancer research ,medicine ,medicine.disease ,business ,Brain metastasis - Published
- 2018
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39. Complementary and alternative medicine mention and recommendations in inflammatory bowel disease guidelines: systematic review and assessment using AGREE II
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Jeremy Y. Ng, Henry Liu, and Michelle Chenghuazou Wang
- Subjects
AGREE II ,Clinical practice guideline ,Complementary and alternative medicine ,Crohn’s disease ,Inflammatory bowel disease ,Ulcerative colitis ,Other systems of medicine ,RZ201-999 - Abstract
Abstract Background Many patients with inflammatory bowel disease (IBD) use complementary and alternative medicine (CAM) for disease management. There is, however, a communication gap between patients and healthcare professionals regarding CAM use, where patients are hesitant to disclose CAM use to providers. The purpose of this study was to identify the quantity and assess the quality of CAM recommendations in IBD clinical practice guidelines (CPGs) using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Methods MEDLINE, EMBASE, and CINAHL were systematically searched from 2011 to 2022 to find CPGs for the treatment and/or management of IBD. The Guidelines International Network (GIN) and National Center for Complementary and Integrative Health (NCCIH) websites were also searched. Eligible CPGs were assessed using the AGREE II instrument. Results Nineteen CPGs made CAM recommendations for IBD and were included in this review. Average scaled domain percentages of CPGs were as follows (overall CPG, CAM section): scope and purpose (91.5%, 91.5%), clarity of presentation (90.3%, 64.0%), editorial independence (57.0%, 57.0%), stakeholder involvement (56.7%, 27.8%), rigour of development (54.7%, 45.9%), and applicability (14.6%, 2.1%). Conclusions The majority of CPGs with CAM recommendations were of low quality and their CAM sections scored substantially lower relative to other therapies in the overall CPG. In future updates, CPGs with low scaled-domain percentages could be improved in accordance with AGREE II and other guideline development resources. Further research investigating how CAM therapies can best be incorporated into IBD CPGs is warranted.
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- 2023
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40. The Roles of Antimicrobial Peptides in the Regulation of Gastrointestinal Microbiota and Innate Immunity
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Michelle Cheng, Hon Wai Koon, Dermot P. McGovern, David Q. Shih, and Ivy Ka Man Law
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Gastrointestinal tract ,Innate immune system ,Mechanism (biology) ,Gastrointestinal microbiota ,Antimicrobial peptides ,Immunology ,medicine ,Inflammation ,medicine.symptom ,Biology ,Gut flora ,Antimicrobial ,biology.organism_classification - Abstract
Numerous antimicrobial peptides (AMPs) are expressed in the mucosa of the gastrointestinal tract where they are able to modulate innate immune responses and gut microbiota. Interestingly, the antimicrobial functions of AMPs are not necessarily the most important mechanism in the modulation of gastrointestinal diseases. Instead, AMPs may promote certain protective microbial species and modulate innate immune responses. The interactions of AMPs with innate immunity and gut microbiota reveal interesting drug targets. AMPs may serve as novel therapeutic approaches against gastrointestinal infection and inflammation, but the application of AMPs and their derivatives in treating gastrointestinal diseases remains at an early stage. AMPs may even directly modulate obesity and metabolic diseases. Additionally, AMPs may serve as biomarkers of gastrointestinal diseases, as expression of AMPs is often altered during the development of gastrointestinal diseases. This report summarizes the latest development of AMP-related gastrointestinal research with emphasis on innate immunity and gut microbiota.
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- 2018
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41. Generalized morphea in the setting of pembrolizumab
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Michelle Cheng, Laura Bernet, and Lisa D. Hisaw
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Male ,medicine.medical_specialty ,Lung Neoplasms ,Biopsy ,Treatment outcome ,MEDLINE ,Dermatology ,Pembrolizumab ,Antibodies, Monoclonal, Humanized ,030226 pharmacology & pharmacy ,Scleroderma ,03 medical and health sciences ,0302 clinical medicine ,Antineoplastic Agents, Immunological ,medicine ,Humans ,Skin pathology ,Melanoma ,Skin ,Scleroderma, Systemic ,medicine.diagnostic_test ,business.industry ,Choroid Neoplasms ,Middle Aged ,medicine.disease ,Treatment Outcome ,030220 oncology & carcinogenesis ,Monoclonal ,Prednisone ,business ,Generalized scleroderma - Published
- 2017
42. Fidaxomicin Inhibits Clostridium difficile Toxin A-Mediated Enteritis in the Mouse Ileum
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Tressia C. Hing, Yoshi Ichikawa, Charalabos Pothoulakis, Xinhua Chen, Michelle Cheng, Hon Wai Koon, Ciaran P. Kelly, and Samantha Ho
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Male ,Messenger ,Interleukin-1beta ,Anti-Inflammatory Agents ,Gene Expression ,Injections, Intralesional ,Inbred C57BL ,medicine.disease_cause ,Mice ,Enterotoxins ,Intestinal mucosa ,Edema ,Pharmacology (medical) ,Fidaxomicin ,Intestinal Mucosa ,Enterocolitis, Pseudomembranous ,Enterocolitis ,Pseudomembranous ,Pharmacology and Pharmaceutical Sciences ,Clostridium difficile ,Anti-Bacterial Agents ,Intralesional ,Infectious Diseases ,Neutrophil Infiltration ,Medical Microbiology ,Vancomycin ,medicine.symptom ,medicine.drug ,Bacterial Toxins ,Clostridium difficile toxin A ,Biology ,Microbiology ,Injections ,Ileum ,Metronidazole ,medicine ,Animals ,Experimental Therapeutics ,RNA, Messenger ,Pharmacology ,Clostridioides difficile ,Toxin ,Epithelial Cells ,Fibroblasts ,Mice, Inbred C57BL ,Aminoglycosides ,RNA - Abstract
Clostridium difficile infection (CDI) is a common, debilitating infection with high morbidity and mortality. C. difficile causes diarrhea and intestinal inflammation by releasing two toxins, toxin A and toxin B. The macrolide antibiotic fidaxomicin was recently shown to be effective in treating CDI, and its beneficial effect was associated with fewer recurrent infections in CDI patients. Since other macrolides possess anti-inflammatory properties, we examined the possibility that fidaxomicin alters C. difficile toxin A-induced ileal inflammation in mice. The ileal loops of anesthetized mice were injected with fidaxomicin (5, 10, or 20 μM), and after 30 min, the loops were injected with purified C. difficile toxin A or phosphate-buffered saline alone. Four hours after toxin A administration, ileal tissues were processed for histological evaluation (epithelial cell damage, neutrophil infiltration, congestion, and edema) and cytokine measurements. C. difficile toxin A caused histologic damage, evidenced by increased mean histologic score and ileal interleukin-1β (IL-1β) protein and mRNA expression. Treatment with fidaxomicin (20 μM) or its primary metabolite, OP-1118 (120 μM), significantly inhibited toxin A-mediated histologic damage and reduced the mean histology score and ileal IL-1β protein and mRNA expression. Both fidaxomicin and OP-1118 reduced toxin A-induced cell rounding in human colonic CCD-18Co fibroblasts. Treatment of ileal loops with vancomycin (20 μM) and metronidazole (20 μM) did not alter toxin A-induced histologic damage and IL-1β protein expression. In addition to its well known antibacterial effects against C. difficile , fidaxomicin may possess anti-inflammatory activity directed against the intestinal effects of C. difficile toxins.
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- 2014
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43. Initial Evidence for a Brief Measure of Buddhist Coping in the United States
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Carmen Oemig-Dworsky, Clara Michelle Cheng, and Russell E. Phillips
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Coping (psychology) ,Buddhism ,Religious studies ,Construct validity ,Psychology ,Social psychology ,Incremental validity ,Short scale ,General Psychology - Abstract
Although the field of spiritual coping has greatly expanded in recent years, there is no short scale of Buddhist coping as there is for the Abrahamic religions. The goal of the present study is to create the Brief BCOPE, a 15-item scale of Buddhist coping based on a study of 860 Buddhist participants across the United States. Exploratory and confirmatory factor analyses provide preliminary evidence of the construct validity of the Brief BCOPE, and data are presented suggesting potential convergent, discriminant, criterion, and incremental validity for the scale. Although there are limitations to the study, the present research suggests that the Brief BCOPE might provide an efficient means of assessing Buddhist coping in applied and research settings.
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- 2014
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44. Melanoma depth in patients with an established dermatologist
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Sean T. McGuire, Jonhan Ho, Michelle Cheng, Laura K. Ferris, and Jacqueline F. Moreau
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Adult ,Male ,medicine.medical_specialty ,Skin Neoplasms ,Waiting Lists ,Melanoma in situ ,Dermatology ,medicine ,Humans ,Neoplasm Invasiveness ,In patient ,skin and connective tissue diseases ,Melanoma ,Aged ,Retrospective Studies ,Physician-Patient Relations ,business.industry ,Dermatology department ,Middle Aged ,medicine.disease ,Wait time ,Cross-Sectional Studies ,Early Diagnosis ,Female ,Invasive Melanoma ,Skin cancer ,business - Abstract
Background The impact of having an established dermatologist on melanoma depth at diagnosis is incompletely understood. Objective We sought to determine whether having had a previous dermatologic examination (an established dermatologist), the recency of the last examination, and the wait time for the dermatology appointment are associated with melanoma invasiveness and depth. Methods This was a retrospective cross-sectional study of 388 patients with primary melanoma at an academic dermatology department. Results Patients with an established dermatologist were more likely than patients without an established dermatologist to be given a diagnosis of melanoma in situ (103/162 [63.6%] vs 69/155 [44.5%], P = .001) and to have thinner invasive melanoma (0.48 [0.30-0.71] mm vs 0.61 [0.40-1.10] mm, respectively, P = .003). These trends were observed for patients with self-detected, but not dermatologist-detected, melanoma. Patient-detected melanomas made up 184/361 (51.0%) of all melanomas, 83/199 (41.7%) of in situ melanomas, and 101/162 (62.4%) invasive melanomas. Self-detected melanomas were in situ in 36 of 61 (59.0%) patients with an established dermatologist versus 40 of 108 (37.0%) patients without an established dermatologist, P = .006. Neither time from last dermatologic examination nor wait time for an appointment was associated with melanoma invasiveness or depth. Limitations Data are retrospective and from 1 large academic health care system. Conclusion Education obtained at the dermatology appointment may improve early self-detection of melanoma, and having an established dermatologist may facilitate earlier evaluation of concerning lesions.
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- 2014
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45. VALUE-BASED HEALTHCARE AS A FRAMEWORK OF CARE FOR OLDER ADULTS AND THEIR FAMILY CAREGIVERS
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Deirdre McCaughey, Gwen McGhan, Michelle Cheng, Fiona Clement, Natalie C. Ludlow, and Jessica P Lee
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Gerontology ,Abstracts ,Health (social science) ,Session 880 (Poster) ,Family caregivers ,Value based healthcare ,Life-span and Life-course Studies ,Psychology ,Health Professions (miscellaneous) ,Family Caregiving Issues - Abstract
Value-based healthcare (VBHC) is a term synonymous with the pursuit of greater value in healthcare, however, the term “value” lacks conceptual clarity. Using Porter’s 2010 seminal VBHC shows promise for placing the older adult and their family caregiver at the center of care models, which is a central tenet in healthcare value. The purpose of our study is to conceptualize how Porter’s VBHC is defined, operationalized, and implemented to address the need for person-and-family centered care models that improve outcomes while being cost effective. A literature search in six academic databases was conducted to identify articles examining VBHC; specifically studies with a Porter-based patient-centric focus. 1,001 articles were retrieved for initial review. Using a consensus-based logic model for inclusion/exclusion, 802 met the inclusion criteria for full text review. Articles were examined using the following objectives: 1) conceptually map the VBHC literature, 2) identify application of Porter’s equation, and 3) identify the methodologies used to measure outcomes, costs, and value. Findings were cross-compared and emergent themes organized to Porter facets of value (outcomes, costs, and value). Our review found the three facets of Porter’s VBHC are established across the literature, however, most studies examine only one or two facets and fail to specify or define all three. Although applied in research, there is a lack of consistency in the actual use of Porter’s definition. Five recommendations for future research using Porter’s VBHC include: (1) pre-selection of outcomes/costs, (2) operationalizing outcomes/costs, (3) value framework creation, (4) data collection, and (5) value calculation.
- Published
- 2019
46. Prevalence and Risk Factors for Refractive Error in Adult Chinese Americans: The Chinese American Eye Study
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Rohit Varma, Mina Torres, Roberta McKean-Cowdin, Fen Rong, Chunyi Hsu, Xuejuan Jiang, Stanley P. Azen, David Dinh, Ruzhang Jiang, Jie Sun, Dandan Wang, YuPing Wang, Justine Wong, Shuang Wu, Rucha Desai, Lisa V. John, and Michelle Cheng
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0301 basic medicine ,Male ,Refractive error ,medicine.medical_specialty ,China ,genetic structures ,Cross-sectional study ,Population ,Visual Acuity ,Astigmatism ,Risk Assessment ,California ,Article ,03 medical and health sciences ,High astigmatism ,0302 clinical medicine ,Age Distribution ,Risk Factors ,Ophthalmology ,medicine ,Myopia ,Humans ,Sex Distribution ,education ,Chinese americans ,Aged ,Aged, 80 and over ,education.field_of_study ,medicine.diagnostic_test ,Asian ,business.industry ,Middle Aged ,medicine.disease ,Subjective refraction ,eye diseases ,030104 developmental biology ,Cross-Sectional Studies ,Eye examination ,030221 ophthalmology & optometry ,Female ,sense organs ,business ,Demography - Abstract
To estimate the prevalence of refractive errors in adult Chinese Americans, and to evaluate factors associated with myopia and high myopia.A population-based, cross-sectional study.Chinese Americans 50 years and older residing in Monterey Park, California, were recruited. Noncycloplegic automated refraction with supplemental subjective refraction was performed. Myopia, high myopia, hyperopia, and high hyperopia were defined as a spherical equivalent of-0.5 diopter (D),-5.0 D,+0.5 D, and ≥+3.0 D, respectively. Astigmatism and high astigmatism were defined as a cylinder of0.5 D and2.25 D, respectively. Risk factor assessment was guided by a conceptual model.Data from 4144 participants were analyzed. The overall prevalence of myopia, high myopia, hyperopia, high hyperopia, astigmatism, and high astigmatism in the right eye was 35.1% (95% confidence interval, 33.6%-36.6%), 7.4% (6.6%-8.3%), 40.2% (38.7%-41.8%), 2.7% (2.2%-3.3%), 45.6% (44.1%-47.2%), and 3.7% (3.1%-4.3%), respectively. The prevalence of myopia and high myopia was lower among older individuals (P.05). Reversed age trends were observed for the other refractive errors (P.05). There was no sex difference in the prevalence of refractive errors, except for a higher prevalence of hyperopia among female subjects (P = .010). Age, acculturation, education, income, marital status, birth country, history of ocular disease, nonocular comorbidities, and recent eye examination were associated with prevalence of myopia. All of these factors, except for acculturation, were also associated with high myopia.Our data present the first population-based estimates of the prevalence of refractive errors among adult Chinese Americans. Compared with whites, Hispanics, and blacks, Chinese Americans have a higher burden of myopia, high myopia, and astigmatism.
- Published
- 2016
47. Simplified three-dimensional tissue clearing and incorporation of colorimetric phenotyping
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Yichen Ding, Michelle Cheng, Cindy F. Yang, Harrison Chen, Dino Di Carlo, Jocelyn T. Kim, Atsushi Nakano, Kevin Sung, Tzung K. Hsiai, Vincent Huang, Rajan P. Kulkarni, Daniel Eguchi, and Jianguo Ma
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0301 basic medicine ,Pathology ,medicine.medical_specialty ,Computer science ,Tissue imaging ,Bioengineering ,Horseradish peroxidase ,Article ,Imaging ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Microscopy ,medicine ,Animals ,Humans ,Colorimetry ,Histocytological Preparation Techniques ,Microscopy, Confocal ,Multidisciplinary ,Tissue clearing ,biology ,030104 developmental biology ,Phenotype ,Light sheet fluorescence microscopy ,Confocal ,Three-Dimensional ,biology.protein ,Microscopic imaging ,Biomedical Imaging ,Generic health relevance ,030217 neurology & neurosurgery ,Biomedical engineering - Abstract
Tissue clearing methods promise to provide exquisite three-dimensional imaging information; however, there is a need for simplified methods for lower resource settings and for non-fluorescence based phenotyping to enable light microscopic imaging modalities. Here we describe the simplified CLARITY method (SCM) for tissue clearing that preserves epitopes of interest. We imaged the resulting tissues using light sheet microscopy to generate rapid 3D reconstructions of entire tissues and organs. In addition, to enable clearing and 3D tissue imaging with light microscopy methods, we developed a colorimetric, non-fluorescent method for specifically labeling cleared tissues based on horseradish peroxidase conversion of diaminobenzidine to a colored insoluble product. The methods we describe here are portable and can be accomplished at low cost and can allow light microscopic imaging of cleared tissues, thus enabling tissue clearing and imaging in a wide variety of settings.
- Published
- 2016
48. Abstract 69: Cerebellar Dentate Nucleus is an Effective Brain Stimulation Target for Post-stroke Recovery
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Shunsuke Ishizaka, Michelle Cheng, Aatman Shah, Eric Wang, Alex Bautista, Guohua Sun, and Gary K Steinberg
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Advanced and Specialized Nursing ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Objective: Functional recovery after stroke has been observed in both human and animal studies. Post-stroke brain stimulations are promising neurorestorative techniques as they allow direct manipulation of the target area’s excitability. Previously we have demonstrated that optogenetic neuronal stimulation of the ipsilesional primary motor cortex (iM1) promotes functional recovery. To determine an optimal brain stimulation target, we test whether optogenetic neuronal stimulation of the contralesional cerebellar dentate nucleus (cLCN) can promote recovery. We hypothesize that stimulation of cLCN may be more effective, as it sends excitatory outputs to multiple motor and premotor areas. Methods: Thy-1-ChR2-YFP line-18 transgenic male mice were used. Mice underwent stereotaxic surgery to implant an optical fiber in cLCN or iM1, followed by an intraluminal middle cerebral artery suture occlusion. Three groups of mice were used: control non-stimulated stroke mice, short stimulated stroke mice (short-stim, day5-14 post-stroke) and long stimulated stroke mice (long-stim, day5-28 post-stroke). Sensorimotor behavior tests were used to assess their recovery. Results: Our data showed that cLCN-stimulated stroke mice recovered quickly, with significant improvement in distance traveled as early as day7 (p Conclusion: Our data suggest that cLCN stimulations post-stroke can promote persistent functional recovery. Furthermore, cLCN-stimulated mice recovered faster than iM1-stimulated mice, indicate that cLCN may be a more effective brain stimulation target. Current studies examine the brain activation patterns of cLCN-stimulated mice, as well as the mechanisms of cLCN-induced recovery.
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- 2016
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49. Abstract TP263: Whole Brain Screening of Cellular and Molecular Changes After Stroke
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Markus Aswendt, Brian Hsueh, Shunsuke Ishizaka, Guohua Sun, Michelle Cheng, Karl Deisseroth, and Gary K Steinberg
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Advanced and Specialized Nursing ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Objective: Recovery can occur after stroke in both human and animals, and this is attributed in part by rewiring of neural connections in areas adjacent to or remotely connected to the infarct. As stroke can cause brain-wide network changes, it is important to interrogate regenerative processes in the whole brain after stroke. In this study we use a high resolution 3D whole brain imaging technique called CLARITY to visualize the cellular and structural changes in stroke mice during recovery. Hypothesis: We hypothesize that the CLARITY procedure will provide a more detailed and complete visualization of post-stroke regenerative processes in the whole brain. Material/Methods: We used C57Bl6 WT mice with 10-12 weeks of age. Ischemic stroke was induced by transient middle cerebral artery occlusion using an intraluminal suture. Mice were sacrificed at different time points (Post-stroke day 1, 7, 14 and 28) and brains were processed with the CLARITY protocol. Brains were immunostained repeatedly with antibodies for neurons, glia, oligodendrocytes, microglia/macrophages and blood vessels. Results: Stroke brains collected at different post-stroke timepoints became optically transparent after the CLARITY process. Interestingly, the ischemic area turned transparent for all timepoints except post-stroke day 7 and 28. At this time point the ischemic area remains opaque after CLARITY process, suggesting that the cellular composition at this timepoint is resistant to the CLARITY treatment. Immunostaining with MAP2 demonstrates labeling of neuronal processes in the whole brain. Current studies investigate other cell types and cellular processes, such as glial scarring (GFAP), microglia/macrophage accumulation (CD68) and angiogenesis (Collagen IV) to map the reorganization at the cellular level with high resolution in 3D whole brain. Conclusion: Stroke brains can be made optically transparent after the CLARITY process. This allows high resolution whole brain 3D imaging to probe for the cellular and molecular mechanisms during stroke recovery.
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- 2016
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50. An Inkblot for the Implicit Assessment of Personality: The Semantic Misattribution Procedure
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Silvia Rusu, B. Keith Payne, Irina Macsinga, Delia Vîrgă, LaurenΤiu P. MaricuΤoiu, Florin A. Sava, and Clara Michelle Cheng
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Social Psychology ,media_common.quotation_subject ,05 social sciences ,Self-concept ,050109 social psychology ,050105 experimental psychology ,Rorschach test ,Measure personality ,Personality ,0501 psychology and cognitive sciences ,Misattribution of memory ,Implicit attitude ,Psychology ,Priming (psychology) ,Social psychology ,media_common ,Cognitive psychology - Abstract
Misattributions people make about their own reaction to ambiguous stimuli can be used to measure personality self–concepts implicitly. On the basis of a semantic misattribution priming paradigm [semantic misattribution procedure (SMP)], we assessed the implicit personality self–concept related to three dimensions included in the Big–Five model: conscientiousness, neuroticism, and extraversion. Across three studies (N1 = 98, N2 = 140, and N3 = 135), the SMP was robustly related, in the expected direction, to individual differences in self–reported personality questionnaires and managed to predict both self–reported and objectively measured behaviours. The main advantage of SMP over classical explicit measures of personality is its higher resistance to social desirability tendencies, although its psychometric properties are somewhat lower than those pertaining to explicit measures of personality. Finally, comparisons of our results with studies that used other implicit measures of personality self–concept indicate that the SMP has higher criterion validity. Copyright © 2012 John Wiley & Sons, Ltd.
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- 2012
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