The application of electron paramagnetic resonance (EPR) spectroscopy to the detection of irradia... more The application of electron paramagnetic resonance (EPR) spectroscopy to the detection of irradiation treatment of bones of chicken, pork, beef, lamb, fish and mollusk shells was described. Induced radicals in irradiated samples gave distinguishable EPR patterns for differentiation from the unirradiated samples. The EPR signals were found to be relatively stable in mammalian bones and mollusk shells; but significant loss was observed in fish samples. Dose-response relationships of the samples were found to be linear at 0-5 kGy range (r 2 >0.95). Using calibration curve method, the irradiation status of all the 64 blind samples (14 unirradiated and 50 irradiated) was correctly identified. The estimation of irradiation doses was satisfactory with mean values ranging from 86 to 116% of those of the nominal values, and precision (%RSD) ranged from 15 to 29%. The validated analytical procedure was applied in the surveillance monitoring of about 400 food samples during the period of 2001-2004.
A sensitive and reliable method for detection of irradiated chicken, pork and mangoes is describe... more A sensitive and reliable method for detection of irradiated chicken, pork and mangoes is described. The method involved a derivatisation treatment of irradiation markers-2-dodecylcyclobutanone (2-dDCB) and 2tetradecylcyclobutanone (2-tDCB) with pentafluorophenyl hydrazine (PFPH) and detection by gas chromatographymass spectrometry (GC-MS). Samples were first subjected to Soxhlet extraction with n-hexane and purified by passing through Florisil columns according to EN1785 method. Then, the extracted 2-dDCB and 2-tDCB were derivatised with PFPH in acidic buffer for 60 min at ambient temperature (∼25 • C). Identification of the derivatives was confirmed by the presence of two characteristic and dominant ion fragments at m/z 249 and [M-54], each within the specified retention time windows, and matching of the relative intensities of these ions with those of the standards under SIM mode. The relative standard deviation (%RSD) of the ion ratios of m/z 249 to that of [M-54] for all the food matrices under study (2.96-3.06 for PFPH-dDCB; and 2.69-2.83 for PFPH-tDCB, respectively) were ≤10%. Mean spike recovery of the derivatisation process, with %RSD ≤ 20%, ranged from 68.6% to 71.4% and 57.9% to 70.8% for PFPH-dDCB and PFPH-tDCB respectively. The limits of detection (LODs) were estimated to be 0.01 µg/g. The present method was applicable to detect food samples that had received irradiation doses at 1-5 kGy. The quantity of equivalent 2-dDCB and 2-tDCB in the concerned foods was found to be proportional to the irradiated dose received.
The purpose of the present trial was to determine the feasibility of the daily topical applicatio... more The purpose of the present trial was to determine the feasibility of the daily topical application of the piperidine nitroxide, MTS-01, combined with chemoradiotherapy in the treatment of patients with anal carcinoma. The secondary study endpoints were the description of the effects of this agent on skin toxicity and rectal-associated lymphoid tissue. The participants received radiotherapy concurrent with mitomycin-C and 5-fluorouracil for carcinoma of the anal canal. MTS-01 was applied to the bilateral inguinal area and the gluteal cleft. Dermatologic and non-dermatologic toxicity was graded throughout the treatment period. Circulating lymphocytes were serially collected for phenotyping. Rectal mucosal snag biopsies were collected at baseline and at 1 year of follow-up. A total of 5 patients received topical MTS-01. Adverse events attributed to MTS-01 included asymptomatic grade 1 hypoglycemia and grade 1-2 diarrhea. Dermatitis within untreated, radiated skin was not more severe than dermatitis in MTS-01-treated, unirradiated skin. Circulating CD4 + lymphocyte suppression was noted at >1 year following treatment in human immunodeficiency virus-negative participants. CD4 + lymphocytes remained suppressed in the irradiated rectal mucosa at 1 year, whereas the CD8 + lymphocyte numbers recovered or increased. On the whole, the present study demonstrates that the MTS-01 topical application was tolerable with minimal toxicity. Chemoradiation for anal cancer led to prolonged CD4 + lymphocytopenia in the circulation and gut mucosa.
disease defined as Mayo endoscopic subscore $2. Next-generation single-end sequencing was perform... more disease defined as Mayo endoscopic subscore $2. Next-generation single-end sequencing was performed using the Illumina HiSeq 4000 NGS platform. One sample was removed from analysis due to suboptimal read counts. Differential expression analysis was performed using DESeq. Results One-fourth of UC patients had active colonic disease at the time the biopsy was taken. Comparative analyses of gene expression levels between active UC patients and controls identified seven genes with significant different expression (false discovery rate (FDR) #0.1 and fold change (FC) $2). The top signals were seen for MUC4 which was significantly upregulated (FC=3.89, FDR=0.01), and FAM21B which was significantly downregulated (FC=0.06, FDR=0.05) in ileum of active UC compared to controls. All other significant genes were upregulated (CEACAM20, CASP10, LRG1, PDZK1IP1 and GRAMD2). Pathway analysis showed association with antiviral innate immunity and apoptosis signalling. When comparing ileal samples from inactive UC patients with controls, however, we did not observe any differentially expressed genes after adjustment for multiple testing. Also among UC patients, no differentially expressed genes were seen for those with active colonic disease versus those without. Conclusion Our study showed that-while no overt inflammation is generally seen in ileum of UC patients-subtle ileal gene expression changes do occur in patients depending on disease activity of the colon. The identified genes are involved in a range of UC-associated biological processes including barrier function, cell trafficking, apoptosis, angiogenesis and immune signalling. Whether ileal changes in these processes should be seen as a driving factor in UC or secondary epiphenomenon remains to be confirmed with functional studies.
Background/Aims: Emerging data shows a rise in colorectal cancer (CRC) incidence in young men and... more Background/Aims: Emerging data shows a rise in colorectal cancer (CRC) incidence in young men and women that is often chemoresistant, with potential new risk factors including alterations in the microbiome that remain understudied. We have recently observed altered microbiome with modulation of the gut immune response through crosstalk between sensors, microbes, and the TGF-β signaling pathway. Interestingly, we observed that human CRC cell lines with disruption of TGF-β had increased sensitivity to cisplatin and other DNA cross-linking agents. Yet at the same time, human CRC with loss of Smad4 portends poor prognosis and resistance to chemotherapy. Therefore, it was unclear whether the epithelial loss of Smad4 or stromal loss of Smad4 expression could be responsible for chemoresistance. Here, we investigated the role of chemotherapy with disruption of TGF-β signaling and an altered intestinal microbiome in colorectal carcinogenesis. Methods: CRCs induced by azoxymethane (AOM)/dextr...
Background: Short-term medical missions prevail as the most common form of international medical ... more Background: Short-term medical missions prevail as the most common form of international medical volunteerism, but they are ill-suited for medical education and training local providers in resource-limited settings. Objective: The purpose of this study is to evaluate the effectiveness of a longitudinal educational program in training clinicians how to perform point-of-care ultrasound (POCUS) in resource-limited clinics. Design: A retrospective study of a four-month POCUS training program was conducted with clinicians from a rural hospital in Haiti. The model included one-on-one, in-person POCUS teaching sessions by volunteer instructors from the United States and Europe. The Haitian trainees were assessed at the start of the program and at its conclusion by a direct objective structured clinical examination (OSCE), administered by the visiting instructors, with similar pre- and post- program ultrasound competency assessments. Results: Post-intervention, a significant improvement in ...
Background: Inflammatory bowel disease (IBD) is well known to adversely affect quality of life (Q... more Background: Inflammatory bowel disease (IBD) is well known to adversely affect quality of life (QOL). Although we know that sexual health is important for physical, mental and emotional well-being, this has not been well defined in IBD patients. Aims: We assessed for 1) prevalence of sexual dysfunction in male veterans with IBD, 2) association between sexual dysfunction with overall QOL and 3) risk factors for sexual dysfunction. Methods: Subjects were prospectively enrolled from 9/2016-10/ 2017 at 3 VA medical centers. We collected demographics, IBD characteristics, comorbidities and medications known to affect sexual function at time of enrollment. All subjects completed a Short Inflammatory Bowel Disease Questionnaire (SIBDQ), a disease activity questionnaire [Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis (UC) or Harvey-Bradshaw Index (HBI) for Crohn's (CD)], and an International Index of Erectile Function (IIEF) survey. Results: 128 patients enrolled (71 CD, 56 UC, 1 Indeterminate colitis), mean SIBDQ 4.4 (1.1-6.6), mean age 50.9 years (25-82), 85% married or with a partner and 66% sexually active. Based on the IIEF (Table 1), 81.1% had moderate or severe erectile dysfunction (EF), 67.2% had moderate or severe orgasmic dysfunction (OF), 24.2% had moderate or severely low sexual desire (SD), 65.6% had moderate or severely low intercourse satisfaction (IS), and 36% had moderate or severely low overall satisfaction (OS). More severe sexual dysfunction (specifically EF, SD, IS, and OS) was associated with lower QOL scores. Looking at predictors for sexual dysfunction (Table 2), patients on biologics were 2.9 times more likely to have moderate or severe dysfunction on the EF scale (aOR 2.91, 95% CI 1.11-7.62; p=.03). Those with hypertension (HTN) were 4.3 times as likely to have moderate or severe dysfunction on the SD scale (aOR 4.27, 95% CI 1.79-10.12; p=.001). For overall satisfaction, anxiety (aOR 2.8, 95% CI 1.21-6.53; p=.017) and HTN (aOR 3.2, 1.45-7.03; p=0.004) increased the likelihood for moderate or severe dysfunction; having a partner was associated with a decreased likelihood (aOR 0.273, 95% CI 0.09-0.79; p=0.018). Disease activity (HBI or SCCAI) was not significantly associated with sexual dysfunction. Conclusion: In this prospective, multicenter study, sexual dysfunction was highly prevalent in male veterans with IBD. Moreover, more severe sexual dysfunction was associated with poorer QOL. Interestingly, while higher disease activity was not associated with sexual dysfunction, other more traditional risk factors, like HTN and anxiety, were associated with sexual dysfunction. The association between higher incidence of erectile dysfunction and biologic use has not previously been described and warrants further investigation.
Pediatric diabetes clinics around the world rapidly adapted care in response to COVID‐19. We expl... more Pediatric diabetes clinics around the world rapidly adapted care in response to COVID‐19. We explored provider perceptions of care delivery adaptations and challenges for providers and patients across nine international pediatric diabetes clinics.
Background: Population-based data assessing adverse outcomes during pregnancy in patients with In... more Background: Population-based data assessing adverse outcomes during pregnancy in patients with Inflammatory Bowel Disease (IBD) are limited. The aim of our study was to determine whether the odds of ectopic pregnancy are higher in women with Ulcerative Colitis (UC) and Crohn's disease (CD) compared to those without IBD. Methods: We performed a population-based retrospective cohort study using the Healthcare Cost and Utilization Project (HCUP)'s Nationwide Inpatient Sample (NIS) between 2004 and 2014. The NIS is the largest all-payer inpatient health care database in the United States. Among adult women (ages 18-50), unique pregnancies were identified using ICD-9-CM diagnosis codes (normal delivery, forceps delivery, liveborn, outcome of delivery, ectopic pregnancy, spontaneous abortion, induced abortion, intrauterine death and maternal death) as well as procedure codes (cesarean delivery, forceps, vacuum and breech delivery, other procedures inducing or assisting with delivery, removal of tubal and extratubal ectopic pregnancy, and abortion). Among the cohort of women with a pregnancy, multivariable logistic regression was used to evaluate the association of UC and CD with ectopic pregnancy while adjusting for age, race, income (defined as quartile of median household income by zip code), and primary insurance. Results: The NIS contains data from more than 7 million hospital stays annually. Over the 11-year period assessed (2004-2014) we identified 7,453,582 unique pregnancies, including 3673 in women with UC and 5927 in women with CD. Among these were 44,073 (0.59%)
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
A comprehensive knowledge of the types and ratios of microbes that inhabit the healthy human gut ... more A comprehensive knowledge of the types and ratios of microbes that inhabit the healthy human gut is necessary before any kind of pre-clinical or clinical study can be performed that attempts to alter the microbiome to treat a condition or improve therapy outcome. To address this need we present an innovative scalable comprehensive analysis workflow, a healthy human reference microbiome list and abundance profile (GutFeelingKB), and a novel Fecal Biome Population Report (FecalBiome) with clinical applicability. GutFeelingKB provides a list of 157 organisms (8 phyla, 18 classes, 23 orders, 38 families, 59 genera and 109 species) that forms the baseline biome and therefore can be used as healthy controls for studies related to dysbiosis. This list can be expanded to 863 organisms if closely related proteomes are considered. The incorporation of microbiome science into routine clinical practice necessitates a standard report for comparison of an individual's microbiome to the growing knowledgebase of "normal" microbiome data. The FecalBiome and the underlying technology of GutFeelingKB address this need. The knowledgebase can be useful to regulatory agencies for the assessment of fecal transplant and other microbiome products, as it PLOS ONE |
Action potentials are the end product of synaptic integration, a process influenced by resting an... more Action potentials are the end product of synaptic integration, a process influenced by resting and active neuronal membrane properties. Diversity in these properties contributes to specialized mechanisms of synaptic integration and action potential firing, which are likely to be of functional significance within neural circuits. In the hippocampus, the majority of subicular pyramidal neurons fire high-frequency bursts of action potentials, whereas CA1 pyramidal neurons exhibit regular spiking behavior when subjected to direct somatic current injection. Using patch-clamp recordings from morphologically identified neurons in hippocampal slices, we analyzed and compared the resting and active membrane properties of pyramidal neurons in the subiculum and CA1 regions of the hippocampus. In response to direct somatic current injection, three subicular firing types were identified (regular spiking, weak bursting, and strong bursting), while all CA1 neurons were regular spiking. Within subi...
is characterized by exceeding low mucosal iga levels and interferon-driven inflammation possibly ... more is characterized by exceeding low mucosal iga levels and interferon-driven inflammation possibly related to the presence of a pathobiont. Yclim (2018),
The application of electron paramagnetic resonance (EPR) spectroscopy to the detection of irradia... more The application of electron paramagnetic resonance (EPR) spectroscopy to the detection of irradiation treatment of bones of chicken, pork, beef, lamb, fish and mollusk shells was described. Induced radicals in irradiated samples gave distinguishable EPR patterns for differentiation from the unirradiated samples. The EPR signals were found to be relatively stable in mammalian bones and mollusk shells; but significant loss was observed in fish samples. Dose-response relationships of the samples were found to be linear at 0-5 kGy range (r 2 >0.95). Using calibration curve method, the irradiation status of all the 64 blind samples (14 unirradiated and 50 irradiated) was correctly identified. The estimation of irradiation doses was satisfactory with mean values ranging from 86 to 116% of those of the nominal values, and precision (%RSD) ranged from 15 to 29%. The validated analytical procedure was applied in the surveillance monitoring of about 400 food samples during the period of 2001-2004.
A sensitive and reliable method for detection of irradiated chicken, pork and mangoes is describe... more A sensitive and reliable method for detection of irradiated chicken, pork and mangoes is described. The method involved a derivatisation treatment of irradiation markers-2-dodecylcyclobutanone (2-dDCB) and 2tetradecylcyclobutanone (2-tDCB) with pentafluorophenyl hydrazine (PFPH) and detection by gas chromatographymass spectrometry (GC-MS). Samples were first subjected to Soxhlet extraction with n-hexane and purified by passing through Florisil columns according to EN1785 method. Then, the extracted 2-dDCB and 2-tDCB were derivatised with PFPH in acidic buffer for 60 min at ambient temperature (∼25 • C). Identification of the derivatives was confirmed by the presence of two characteristic and dominant ion fragments at m/z 249 and [M-54], each within the specified retention time windows, and matching of the relative intensities of these ions with those of the standards under SIM mode. The relative standard deviation (%RSD) of the ion ratios of m/z 249 to that of [M-54] for all the food matrices under study (2.96-3.06 for PFPH-dDCB; and 2.69-2.83 for PFPH-tDCB, respectively) were ≤10%. Mean spike recovery of the derivatisation process, with %RSD ≤ 20%, ranged from 68.6% to 71.4% and 57.9% to 70.8% for PFPH-dDCB and PFPH-tDCB respectively. The limits of detection (LODs) were estimated to be 0.01 µg/g. The present method was applicable to detect food samples that had received irradiation doses at 1-5 kGy. The quantity of equivalent 2-dDCB and 2-tDCB in the concerned foods was found to be proportional to the irradiated dose received.
The purpose of the present trial was to determine the feasibility of the daily topical applicatio... more The purpose of the present trial was to determine the feasibility of the daily topical application of the piperidine nitroxide, MTS-01, combined with chemoradiotherapy in the treatment of patients with anal carcinoma. The secondary study endpoints were the description of the effects of this agent on skin toxicity and rectal-associated lymphoid tissue. The participants received radiotherapy concurrent with mitomycin-C and 5-fluorouracil for carcinoma of the anal canal. MTS-01 was applied to the bilateral inguinal area and the gluteal cleft. Dermatologic and non-dermatologic toxicity was graded throughout the treatment period. Circulating lymphocytes were serially collected for phenotyping. Rectal mucosal snag biopsies were collected at baseline and at 1 year of follow-up. A total of 5 patients received topical MTS-01. Adverse events attributed to MTS-01 included asymptomatic grade 1 hypoglycemia and grade 1-2 diarrhea. Dermatitis within untreated, radiated skin was not more severe than dermatitis in MTS-01-treated, unirradiated skin. Circulating CD4 + lymphocyte suppression was noted at >1 year following treatment in human immunodeficiency virus-negative participants. CD4 + lymphocytes remained suppressed in the irradiated rectal mucosa at 1 year, whereas the CD8 + lymphocyte numbers recovered or increased. On the whole, the present study demonstrates that the MTS-01 topical application was tolerable with minimal toxicity. Chemoradiation for anal cancer led to prolonged CD4 + lymphocytopenia in the circulation and gut mucosa.
disease defined as Mayo endoscopic subscore $2. Next-generation single-end sequencing was perform... more disease defined as Mayo endoscopic subscore $2. Next-generation single-end sequencing was performed using the Illumina HiSeq 4000 NGS platform. One sample was removed from analysis due to suboptimal read counts. Differential expression analysis was performed using DESeq. Results One-fourth of UC patients had active colonic disease at the time the biopsy was taken. Comparative analyses of gene expression levels between active UC patients and controls identified seven genes with significant different expression (false discovery rate (FDR) #0.1 and fold change (FC) $2). The top signals were seen for MUC4 which was significantly upregulated (FC=3.89, FDR=0.01), and FAM21B which was significantly downregulated (FC=0.06, FDR=0.05) in ileum of active UC compared to controls. All other significant genes were upregulated (CEACAM20, CASP10, LRG1, PDZK1IP1 and GRAMD2). Pathway analysis showed association with antiviral innate immunity and apoptosis signalling. When comparing ileal samples from inactive UC patients with controls, however, we did not observe any differentially expressed genes after adjustment for multiple testing. Also among UC patients, no differentially expressed genes were seen for those with active colonic disease versus those without. Conclusion Our study showed that-while no overt inflammation is generally seen in ileum of UC patients-subtle ileal gene expression changes do occur in patients depending on disease activity of the colon. The identified genes are involved in a range of UC-associated biological processes including barrier function, cell trafficking, apoptosis, angiogenesis and immune signalling. Whether ileal changes in these processes should be seen as a driving factor in UC or secondary epiphenomenon remains to be confirmed with functional studies.
Background/Aims: Emerging data shows a rise in colorectal cancer (CRC) incidence in young men and... more Background/Aims: Emerging data shows a rise in colorectal cancer (CRC) incidence in young men and women that is often chemoresistant, with potential new risk factors including alterations in the microbiome that remain understudied. We have recently observed altered microbiome with modulation of the gut immune response through crosstalk between sensors, microbes, and the TGF-β signaling pathway. Interestingly, we observed that human CRC cell lines with disruption of TGF-β had increased sensitivity to cisplatin and other DNA cross-linking agents. Yet at the same time, human CRC with loss of Smad4 portends poor prognosis and resistance to chemotherapy. Therefore, it was unclear whether the epithelial loss of Smad4 or stromal loss of Smad4 expression could be responsible for chemoresistance. Here, we investigated the role of chemotherapy with disruption of TGF-β signaling and an altered intestinal microbiome in colorectal carcinogenesis. Methods: CRCs induced by azoxymethane (AOM)/dextr...
Background: Short-term medical missions prevail as the most common form of international medical ... more Background: Short-term medical missions prevail as the most common form of international medical volunteerism, but they are ill-suited for medical education and training local providers in resource-limited settings. Objective: The purpose of this study is to evaluate the effectiveness of a longitudinal educational program in training clinicians how to perform point-of-care ultrasound (POCUS) in resource-limited clinics. Design: A retrospective study of a four-month POCUS training program was conducted with clinicians from a rural hospital in Haiti. The model included one-on-one, in-person POCUS teaching sessions by volunteer instructors from the United States and Europe. The Haitian trainees were assessed at the start of the program and at its conclusion by a direct objective structured clinical examination (OSCE), administered by the visiting instructors, with similar pre- and post- program ultrasound competency assessments. Results: Post-intervention, a significant improvement in ...
Background: Inflammatory bowel disease (IBD) is well known to adversely affect quality of life (Q... more Background: Inflammatory bowel disease (IBD) is well known to adversely affect quality of life (QOL). Although we know that sexual health is important for physical, mental and emotional well-being, this has not been well defined in IBD patients. Aims: We assessed for 1) prevalence of sexual dysfunction in male veterans with IBD, 2) association between sexual dysfunction with overall QOL and 3) risk factors for sexual dysfunction. Methods: Subjects were prospectively enrolled from 9/2016-10/ 2017 at 3 VA medical centers. We collected demographics, IBD characteristics, comorbidities and medications known to affect sexual function at time of enrollment. All subjects completed a Short Inflammatory Bowel Disease Questionnaire (SIBDQ), a disease activity questionnaire [Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis (UC) or Harvey-Bradshaw Index (HBI) for Crohn's (CD)], and an International Index of Erectile Function (IIEF) survey. Results: 128 patients enrolled (71 CD, 56 UC, 1 Indeterminate colitis), mean SIBDQ 4.4 (1.1-6.6), mean age 50.9 years (25-82), 85% married or with a partner and 66% sexually active. Based on the IIEF (Table 1), 81.1% had moderate or severe erectile dysfunction (EF), 67.2% had moderate or severe orgasmic dysfunction (OF), 24.2% had moderate or severely low sexual desire (SD), 65.6% had moderate or severely low intercourse satisfaction (IS), and 36% had moderate or severely low overall satisfaction (OS). More severe sexual dysfunction (specifically EF, SD, IS, and OS) was associated with lower QOL scores. Looking at predictors for sexual dysfunction (Table 2), patients on biologics were 2.9 times more likely to have moderate or severe dysfunction on the EF scale (aOR 2.91, 95% CI 1.11-7.62; p=.03). Those with hypertension (HTN) were 4.3 times as likely to have moderate or severe dysfunction on the SD scale (aOR 4.27, 95% CI 1.79-10.12; p=.001). For overall satisfaction, anxiety (aOR 2.8, 95% CI 1.21-6.53; p=.017) and HTN (aOR 3.2, 1.45-7.03; p=0.004) increased the likelihood for moderate or severe dysfunction; having a partner was associated with a decreased likelihood (aOR 0.273, 95% CI 0.09-0.79; p=0.018). Disease activity (HBI or SCCAI) was not significantly associated with sexual dysfunction. Conclusion: In this prospective, multicenter study, sexual dysfunction was highly prevalent in male veterans with IBD. Moreover, more severe sexual dysfunction was associated with poorer QOL. Interestingly, while higher disease activity was not associated with sexual dysfunction, other more traditional risk factors, like HTN and anxiety, were associated with sexual dysfunction. The association between higher incidence of erectile dysfunction and biologic use has not previously been described and warrants further investigation.
Pediatric diabetes clinics around the world rapidly adapted care in response to COVID‐19. We expl... more Pediatric diabetes clinics around the world rapidly adapted care in response to COVID‐19. We explored provider perceptions of care delivery adaptations and challenges for providers and patients across nine international pediatric diabetes clinics.
Background: Population-based data assessing adverse outcomes during pregnancy in patients with In... more Background: Population-based data assessing adverse outcomes during pregnancy in patients with Inflammatory Bowel Disease (IBD) are limited. The aim of our study was to determine whether the odds of ectopic pregnancy are higher in women with Ulcerative Colitis (UC) and Crohn's disease (CD) compared to those without IBD. Methods: We performed a population-based retrospective cohort study using the Healthcare Cost and Utilization Project (HCUP)'s Nationwide Inpatient Sample (NIS) between 2004 and 2014. The NIS is the largest all-payer inpatient health care database in the United States. Among adult women (ages 18-50), unique pregnancies were identified using ICD-9-CM diagnosis codes (normal delivery, forceps delivery, liveborn, outcome of delivery, ectopic pregnancy, spontaneous abortion, induced abortion, intrauterine death and maternal death) as well as procedure codes (cesarean delivery, forceps, vacuum and breech delivery, other procedures inducing or assisting with delivery, removal of tubal and extratubal ectopic pregnancy, and abortion). Among the cohort of women with a pregnancy, multivariable logistic regression was used to evaluate the association of UC and CD with ectopic pregnancy while adjusting for age, race, income (defined as quartile of median household income by zip code), and primary insurance. Results: The NIS contains data from more than 7 million hospital stays annually. Over the 11-year period assessed (2004-2014) we identified 7,453,582 unique pregnancies, including 3673 in women with UC and 5927 in women with CD. Among these were 44,073 (0.59%)
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
A comprehensive knowledge of the types and ratios of microbes that inhabit the healthy human gut ... more A comprehensive knowledge of the types and ratios of microbes that inhabit the healthy human gut is necessary before any kind of pre-clinical or clinical study can be performed that attempts to alter the microbiome to treat a condition or improve therapy outcome. To address this need we present an innovative scalable comprehensive analysis workflow, a healthy human reference microbiome list and abundance profile (GutFeelingKB), and a novel Fecal Biome Population Report (FecalBiome) with clinical applicability. GutFeelingKB provides a list of 157 organisms (8 phyla, 18 classes, 23 orders, 38 families, 59 genera and 109 species) that forms the baseline biome and therefore can be used as healthy controls for studies related to dysbiosis. This list can be expanded to 863 organisms if closely related proteomes are considered. The incorporation of microbiome science into routine clinical practice necessitates a standard report for comparison of an individual's microbiome to the growing knowledgebase of "normal" microbiome data. The FecalBiome and the underlying technology of GutFeelingKB address this need. The knowledgebase can be useful to regulatory agencies for the assessment of fecal transplant and other microbiome products, as it PLOS ONE |
Action potentials are the end product of synaptic integration, a process influenced by resting an... more Action potentials are the end product of synaptic integration, a process influenced by resting and active neuronal membrane properties. Diversity in these properties contributes to specialized mechanisms of synaptic integration and action potential firing, which are likely to be of functional significance within neural circuits. In the hippocampus, the majority of subicular pyramidal neurons fire high-frequency bursts of action potentials, whereas CA1 pyramidal neurons exhibit regular spiking behavior when subjected to direct somatic current injection. Using patch-clamp recordings from morphologically identified neurons in hippocampal slices, we analyzed and compared the resting and active membrane properties of pyramidal neurons in the subiculum and CA1 regions of the hippocampus. In response to direct somatic current injection, three subicular firing types were identified (regular spiking, weak bursting, and strong bursting), while all CA1 neurons were regular spiking. Within subi...
is characterized by exceeding low mucosal iga levels and interferon-driven inflammation possibly ... more is characterized by exceeding low mucosal iga levels and interferon-driven inflammation possibly related to the presence of a pathobiont. Yclim (2018),
Uploads
Papers by Michael Yao