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Cost-effectiveness of Crohn's disease post-operative care

World journal of Gastroenterology 2016年第14期22卷 3860-3868页

作者： Emily K Wright Michael A Kamm Peter Dr Cruz Amy L Hamilton kathryn j ritchie Sally j Bell Steven j Brown William R Connell Paul V Desmond Danny Liew Department of Gastroenterology St Vincent's Hospital University of Melbourne Fitzroy VIC 3065 Melbourne Australia Imperial College London SW7 2AZ United Kingdom Melbourne EpiCentre University of Melbourne and Melbourne Health Parkville VIC 3010 Melbourne Australia

AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn's disease following intestinal resection.METHODS: In the "POCER" study patients undergoing intestinal resection were treated with post-operative drug therapy. Two thirds were randomized to active care(6 mo colonoscopy and drug intensification for endoscopic recurrence) and one third to drug therapy without early endoscopy. Colonoscopy at 18 mo and faecal calprotectin(FC) measurement were used to assess disease recurrence. Administrative data, chart review and patient questionnaires were collected prospectively over 18 mo.RESULTS: Sixty patients(active care n = 43, standardcare n = 17) were included from one health service. Median total health care cost was $6440 per patient. Active care cost $4824 more than standard care over 18 mo. Medication accounted for 78% of total cost, of which 90% was for adalimumab. Median health care cost was higher for those with endoscopic recurrence compared to those inremission [ $ 26347( IQR 25045-27485) vs $2729(IQR 1182-5215), P < 0.001]. FC to select patients for colonoscopy could reduce cost by $1010 per patient over 18 mo. Active care was associated with 18% decreased endoscopic recurrence, costing $861 for each recurrence prevented. CONCLUSION: Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated.

关键词： Crohn’s disease Post-operative Health economics Health care cost Biologics

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Estradiol increases cortical and trabecular bone accrual and bone strength in an adolescent male-to-female mouse model of gender-affirming hormone therapy

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Bone Research 2024年第1期12卷 95-106页

作者： Tian Nie Varun S.Venkatesh Suzanne Golub kathryn S.Stok Haniyeh Hemmatian Reena Desai David j.Handelsman jeffrey D.Zajac Mathis Grossmann Rachel A.Davey Department of Medicine Austin HealthUniversity of MelbourneHeidelbergVIC 3084Australia Department of Biomedical Engineering University of MelbourneParkvilleVIC 3010Australia ANZAC Research Institute University of Sydney and AndrologyConcord Repatriation General HospitalConcordNSW 2137Australia

The effects of gender-affirming hormone therapy on the skeletal integrity and fracture risk in transitioning adolescent trans girls are unknown.To address this knowledge gap,we developed a mouse model to simulate male-to-female transition in human adolescents in whom puberty is first arrested by using gonadotrophin-releasing hormone analogs with subsequent estradiol treatment.Puberty was suppressed by orchidectomy in male mice at 5 weeks of age.At 3 weeks post-surgery,male-to-female mice were treated with a high dose of estradiol(~0.85 mg)by intraperitoneal silastic implantation for 12 weeks.Controls included intact and orchidectomized males at 3 weeks post-surgery,vehicle-treated intact males,intact females and orchidectomized males at 12 weeks post-treatment.Compared to male controls,orchidectomized males exhibited decreased peak bone mass accrual and a decreased maximal force the bone could withstand prior to fracture.Estradiol treatment in orchidectomized male-to-female mice compared to mice in all control groups was associated with an increased cortical thickness in the mid-diaphysis,while the periosteal circumference increased to a level that was intermediate between intact male and female controls,resulting in increased maximal force and stiffness.In trabecular bone,estradiol treatment increased newly formed trabeculae arising from the growth plate as well as mineralizing surface/bone surface and bone formation rate,consistent with the anabolic action of estradiol on osteoblast proliferation.These data support the concept that skeletal integrity can be preserved and that long-term fractures may be prevented in trans girls treated with GnRHa and a sufficiently high dose of GAHT.Further study is needed to identify an optimal dose of estradiol that protects the bone without adverse side effects.

关键词： treatment treatment strength

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In vivo measurement of NADH fluorescence lifetime in skeletal muscle via -ber-coupled time-correlated single photon counting

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journal of Innovative Optical Health Sciences 2024年第1期17卷 121-134页

作者： kathryn M.Priest jacob V.Schluns Nathania Nischal Colton L.Gattis jeffrey C.Wolchok Timothy j.Muldoon Department of Biomedical Engineering University of Arkansas FayettevilleARUSA

Nicotinamide adenine dinucleotide(NADH)is a cofactor that serves to shuttle electrons during metabolic processes such as glycolysis,the tricarboxylic acid cycle,and oxidative phosphorylation(OXPHOS).NADH is autofluorescent,and itsfluorescence lifetime can be used to infer metabolic dynamics in living cells.Fiber-coupled time-correlated single photon counting(TCSPC)equipped with an implantable needle probe can be used to measure NADH lifetime in vivo,enabling investigation of changing metabolic demand during muscle contraction or tissue regeneration.This study illustrates a proof of concept for point-based,minimally-invasive NADHfluorescence lifetime measurement in vivo.Volumetric muscle loss(VML)injuries were created in the left tibialis anterior(TA)muscle of male Sprague Dawley rats.NADH lifetime measurements were collected before,during,and after a 30 s tetanic contraction in the injured and uninjured TA muscles,which was subsequently-t to a biexponential decay model to yield a metric of NADH utilization(cytoplasmic vs protein-bound NADH,the A11/A22 ratio).On average,this ratio was higher during and after contraction in uninjured muscle compared to muscle at rest,suggesting higher levels of free NADH in contracting and recovering muscle,indicating increased rates of glycolysis.In injured muscle,this ratio was higher than uninjured muscle overall but decreased over time,which is consistent with current knowledge of inflammatory response to injury,suggesting tissue regeneration has occurred.These data suggest that-ber-coupled TCSPC has the potential to measure changes in NADH binding in vivo in a minimally invasive manner that requires further investigation.

关键词： Glycolysis oxidative phosphorylation energy metabolism volumetric muscle loss

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Does MgSO_(4) protect the preterm brain?Dissecting its role in the pathophysiology of hypoxic ischemic encephalopathy

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Neural Regeneration Research 2024年第9期19卷 1861-1862页

作者： Robert Galinsky Laura Bennet Alistair j.Gunn The ritchie Centre Hudson Institute of Medical ResearchMelbourneVICAustralia Department of Obstetrics and Gynaecology Monash UniversityMelbourneVICAustralia Department of Physiology The University of AucklandAucklandNew Zealand

Mitigating preterm encephalopathy continues to be one of the greatest challenges in perinatal medicine.Preterm encephalopathy is associated with high mortality,serious morbidity,and significant socio-economic impacts on the individuals,their families,and public health sectors and welfare systems that last a lifetime.The cost of disability associated with preterm brain injury continues to rise.Prevention of this injury,and disability,would significantly reduce this socioeconomic burden.

关键词： encephalopathy mortality hypoxic

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Psychological, social, and sexual challenges affecting men receiving male infertility treatment: a systematic review and implications for clinical care

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Asian journal of Andrology 2023年第4期25卷 448-453页

作者： Winston Wu justin La kathryn M Schubach Daniel Lantsberg Darren j Katz Department of Urology Western HealthSt AlbansVIC 3021Australia Department of Urology Kaiser Permanente San Rafael Medical CenterSan RafaelCA 94903USA Men’s Health Melbourne MelbourneVIC 3000Australia Reproductive Services Unit The Royal Women’s HospitalParkvilleVIC 3052Australia Melbourne IVF East MelbourneVIC 3002Australia Department of Surgery Western PrecinctUniversity of MelbourneParkvilleVIC 3010Australia

In recent years, social research surrounding the consequences of infertility has increasingly focused on the male perspective;however, a gap exists in the understanding of men’s experiences of male infertility treatment. This review aims to synthesize theexisting evidence concerning the psychological, social, and sexual burden of male infertility treatment on men, as well as patientneeds during clinical care. A systematic search identified 12 studies that are diverse in design, setting, and methods. Psychologicalevaluations have found that urological surgery may have a lasting impact on infertility-specific stress, and treatment failure canlead to feelings of depression, grief, and inadequacy. Men tended to have an avoidant coping mechanism throughout fertilitytreatment, and their self-esteem, relationship quality, and sexual functions can be tied to outcomes of treatment. Partner bonds canbe strengthened by mutual support and enhanced communication;couple separation, however, has been noted as a predominantreason for discontinuing male infertility treatment and may be associated with difficult circumstances surrounding severe maleinfertility. Surgical treatments can affect the sexual functioning of infertile men;however, the impact of testicular sperm extractionoutcomes appears to be psychologically driven whereas the improvements after microsurgical varicocelectomy are only evident inhypogonadal men. Clinically, there is a need for better inclusion, communication, education, and resource provision, to addressreported issues of marginalization and uncertainty in men. Routine psychosocial screening in cases of severe male infertility andfollow-up in cases of surgical treatment failure are likely beneficial.

关键词： male infertility male infertility treatment patient experience patient-centered care psychosocial sexual

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Characterization of colloidal arsenic at two abandoned gold mine sites in Nova Scotia, Canada, using asymmetric flow-field flow fractionation-inductively coupled plasma mass spectrometry

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journal of Environmental Sciences 2016年第11期28卷 189-196页

作者： kathryn j Tindale Pritesh j Patel Dirk Wallschlager Environmental and Life Sciences Graduate Program School of the Environment Department of Chemistry and Water Quality Centre Trent University Peterborough ON K9L 0G2 Canada Ore Pros Inc Beamsville ON LOR 1B2 Canada

Asymmetric flow-field flow fractionation-inductively-coupled plasma-mass spectrometry was used to determine whether colloidal arsenic（As） exists in soil pore water and soil extract samples at two arsenic-contaminated abandoned gold mines（Montague and Goldenville, Nova Scotia）. Colloidal arsenic was found in 12 out of the 80 collected samples（= 15%）, and was primarily associated with iron（Fe） in the encountered colloids. The molar Fe/As ratios indicate that the colloids in some samples appeared to be discrete iron–arsenic minerals, whereas in other samples, they were more consistent with As-rich iron（oxy）hydroxides. Up to three discrete size fractions of colloidal As were encountered in the samples, with mean colloid diameters between 6 and 14 nm. The pore water samples only contained one size fraction of As-bearing colloids（around 6 nm diameter）, while larger As-bearing colloids were only encountered in soil extracts.

关键词： Arsenic Colloids Gold mine tailings ICP-MS Nova Scotia Nanoparticles

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Strategies for practitioners to support patients in plant-based eating

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journal of Geriatric Cardiology 2017年第5期14卷 338-341页

作者： Micaela C Karlsen kathryn j Pollard Nutritional Epidemiology Program Tufts Friedman School of Nutrition Science and Policy Boston Massachusetts USA T. Colin Campbell Center for Nutrition Studies Ithaca NY 14851 USA

Successfully implementing a plant-based diet is attain-able for patients, but the likelihood of achieving long-term,dietary maintenance can be increased by follow-up andsupport from practitioners. Practitioners, in particular physi-cians, are seen as nutrition authorities,and are thereforewell-positioned to deliver dietary advice and nutritionalprescriptions.

关键词： Adherence Behavior change Dietary change Motivational interviewing Plant-based diet Vegetarian

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Divergence and correlated evolution of male wing spot and courtship display between Drosophila nepalensis and D.trilutea

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Insect Science 2022年第5期29卷 1445-1460页

作者： Wen-Zhou Mo Zhuo-Miao Li Xiang-Mei Deng Ai-Li Chen Michael G.ritchie De-jun Yang Zhuo-Bin He Masanori j.Toda Shuo-Yang Wen Department of Entomology College of Plant ProtectionSouth China Agricultural UniversityGuangzhouChina School of Biology University of St AndrewsSt AndrewsUK Acoustics Laboratory Guangdong Institute of MetrologySouth China National Centre of MetrologyGuangzhouChina The Hokkaido University Museum SapporoJapan

Male-specific wing spots are usually associated with wing displays in the courtship behavior of Drosophila and may play important roles in sexual selection.Two closely related species,D.nepalensis and D.trilutea,differ in wing spots and scissoring behavior.Here,we compare male morphological characters,pigmentation intensity of male wing spots,wing-scissoring behavior,courtship songs,and reproductive isolation between 2 species.F1 fertile females and sterile males result from the cross between females of D.nepalensis and males of D.trilutea.The pigmentation of wing spots is significantly weaker in D.trilutea than in D.nepalensis and the F1 hybrid.Males scissor both wings in front of the female during courtship,with a posture spreading wings more widely,and at a faster frequency in D.nepalensis than in D.trilutea and the F1s.Males of D.trilutea vibrate wings to produce 2 types(A and B)of pulse songs,whereas D.nepalensis and the F1s sing only type B songs.The incidence of wing vibration and scissoring during courtship suggests that wing vibration is essential but scissoring is a facultative courtship element for successful mating in both species.The association between the darker wing spots with more elaborate scissoring might be the consequence of correlated evolution of these traits in D.nepalensis;however,D.trilutea retains wing scissoring during courtship despite having weaker pigmentation of wing spots.The genetic architecture of 2 traits differs in the F1s,consistent with maternal or sex-linked effects for spots but nonadditive effects for scissoring.

关键词： correlated evolution courtship song Drosophila nepalensis Drosophila trilutea wing display wing spot

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Photosynthesis of Submerged and Surface Leaves of the Dwarf Water Lily(Nymphoides aquatica)Using PAM Fluorometry

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journal of Botanical Research 2022年第3期4卷 25-43页

作者： Tharawit Wuthirak Raymond j.ritchie Department of Biology Faculty of SciencePrince of Songkla UniversityHat Yai90112Thailand Tropical Plant Biology Unit Faculty of Technology and EnvironmentPrince of Songkla UniversityPhuket83120Thailand

Dwarf Water Lilies Nymphoides aquatica(j.F.Gmel)Kuntze have floating and submerged leaves.Some submerged aquatic vascular plants have a form of CAM(Crassulacean Acid Metabolism)called Submerged Aquatic Macrophyte(SAM)metabolism.Blue-diode based PAM technology was used to measure the Photosynthetic Oxygen Evolution Rate(POER:1O_(2)≡4e^(-)).Optimum Irradiance(E_(opt)),maximum POER(POER_(max))and quantum efficiency(α_(0))all vary on a diurnal cycle.The shape of the POER vs.E curves is different in seedling,submerged and surface leaves.Both E_(opt) and POER_(max) are very low in seedling leaves(E_(opt)≈104μmol photon m^(-2) s^(-1),PPFD;POER_(max)≈4.95µmol O_(2) g^(-1) Chl a s^(-1)),intermediate in mature submerged leaves(E_(opt)≈419µmol photon m^(-2) s^(-1) PPFD,POER_(max)≈38.1µmol O_(2) g^(-1) Chl a s^(-1))and very high in surface leaves(E_(opt)≈923µmol photon m^(-2) s^(-1) PPFD,POER_(max)≈76.1µmol O_(2) g^(-1) Chl a s^(-1)).Leaf titratable acid(C4 acid pool)is too small(≈20 to 50 mol H+m^(-3))to support substantial SAM metabolism.Gross daily photosynthesis of surface leaves is≈3.71 g C m^(-2) d^(-1) in full sun and as much as 1.4 gC m^(-2) d^(-1) in shaded submerged leaves.There is midday inhibition of photosynthesis.

关键词： CAM photosynthesis SAM photosynthesis Submerged aquatic macrophyte Carbon fixation Diurnal cycle Photosynthetic oxygen evolution rate(POER) Light curves PAM fluorometry Photosynthetic photon fluence rate(PPFD) Primary productivity

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A tale of motor neurons and CD4＋ T cells： moving forward by looking back

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Neural Regeneration Research 2017年第4期12卷 562-565页

作者： Abhirami Kannan Iyer kathryn j.jones Department of Anatomy and Cell Biology Indiana University School of Medicine

Amyotrophic lateral sclerosis （ALS） is a fatal progressive disorder characterized by the selective degeneration of motor neurons （MN）. The impact of peripheral immune status on disease progression and MN survival is becoming increasingly recognized in the ALS research field. In this review, we briefly discuss findings from mouse models of peripheral nerve injury and immunodeficiency to understand how the immune system regulates MN survival. We extend these observations to similar studies in the widely used superoxide dismutase 1 （SOD1） mouse model of ALS. Last, we present future hypotheses to identify potential causative factors that lead to immune dysregulation in ALS. The lessons from preceding work in this area offer new exciting directions to bridge the gap in our current understanding of immune mediated neuroprotection in ALS.

关键词： amyotrophic lateral sclerosis （ALS） superoxide dismutase 1 （SOD1） immune system SOD1 mice motor neuron CD4＋ T cells neuroprotection

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