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Search Results: 1 - 10 of 198065 matches for " Caitlyn N. Ellerbe "
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Quantifying the Impact of Gestational Diabetes Mellitus, Maternal Weight and Race on Birthweight via Quantile Regression
Caitlyn N. Ellerbe, Mulugeta Gebregziabher, Jeffrey E. Korte, Jill Mauldin, Kelly J. Hunt
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0065017
Abstract: Background Quantile regression, a robust semi-parametric approach, was used to examine the impact of gestational diabetes mellitus (GDM) across birthweight quantiles with a focus on maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG). Methods Using linked birth certificate, inpatient hospital and prenatal claims data we examined live singleton births to non-Hispanic white (NHW, 135,119) and non-Hispanic black (NHB, 76,675) women in South Carolina who delivered 28–44 weeks gestation in 2004–2008. Results At a maternal BMI of 30 kg/m2 at the 90th quantile of birthweight, exposure to GDM was associated with birthweights 84 grams (95% CI 57, 112) higher in NHW and 132 grams (95% CI: 104, 161) higher in NHB. Results at the 50th quantile were 34 grams (95% CI: 17, 51) and 78 grams (95% CI: 56, 100), respectively. At a maternal GWG of 13.5 kg at the 90th quantile of birthweight, exposure to GDM was associated with birthweights 83 grams (95% CI: 57, 109) higher in NHW and 135 grams (95% CI: 103, 167) higher in NHB. Results at the 50th quantile were 55 grams (95% CI: 40, 71) and 69 grams (95% CI: 46, 92), respectively. Summary Our findings indicate that GDM, maternal prepregnancy BMI and GWG increase birthweight more in NHW and NHB infants who are already at the greatest risk of macrosomia or being large for gestational age (LGA), that is those at the 90th rather than the median of the birthweight distribution.
Validation of the treatment identification strategy of the HEDIS addiction quality measures: concordance with medical record review
Alex HS Harris, Rachelle N Reeder, Laura S Ellerbe, Thomas R Bowe
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-73
Abstract: Four type of records were randomly sampled from VHA electronic medical data: (a) Outpatient records from a substance use disorder (SUD) specialty clinic with a HEDIS-qualified substance use disorder (SUD) diagnosis/CPT code combination (n = 700), (b) Outpatient records from a non-SUD setting with a HEDIS-qualified SUD diagnosis/CPT code combination (n = 592), (c) Specialty SUD Inpatient/residential records that included a SUD diagnosis (n = 700), and (d) Non-SUD specialty Inpatient/residential records that included a SUD diagnosis (n = 700). Clinical progress notes for the sampled records were extracted and two raters classified each as documenting or not documenting addiction treatment. Rates of concordance between the HEDIS addiction treatment identification strategy and the raters' judgments were calculated for each record type.Within SUD outpatient clinics and SUD inpatient specialty units, 92% and 98% of sampled records had chart evidence of addiction treatment. Of outpatient encounters with a qualifying diagnosis/procedure code combination outside of SUD clinics, 63% had chart evidence of addiction treatment. Within non-SUD specialty inpatient units, only 46% of sampled records had chart evidence of addiction treatment.For records generated in SUD specialty settings, the HEDIS strategy of identifying SUD treatment with diagnosis and procedure codes has a high concordance with chart review. The concordance rate outside of SUD specialty settings is much lower and highly variable between facilities. Therefore, some patients may be counted as meeting the 2006 HEDIS Initiation and Engagement criteria without having received the specified amount (or any) addiction treatment.The ability to accurately identify the occurrence of specific health care events, such as episodes of behavioral health treatment, is central to many quality improvement and research efforts. Is the patient who screens positive for alcohol misuse given a brief intervention or referred to specialt
Are VHA administrative location codes valid indicators of specialty substance use disorder treatment?
Alex H. S. Harris, PhD,Rachelle N. Reeder, BA,Laura Ellerbe, MS,Thomas Bowe, PhD
Journal of Rehabilitation Research and Development , 2010,
Abstract: Healthcare quality managers and researchers often need to identify specific healthcare events from administrative data. In this study, we examined whether Veterans Health Administration (VHA) clinic stop and bed section codes are reliable indicators of substance use disorder (SUD) treatment as documented in clinical progress notes. For outpatient records with a progress note, SUD clinic stop code, SUD diagnosis code, and mental health procedure code, we found chart documentation of SUD care in 92.0% of 601 records: 82.5% of 372 records with a SUD clinic stop code and SUD diagnosis code but no mental health procedure code, 21.9% of 379 records with a SUD clinic stop code and mental health procedure code but no SUD diagnosis code, and 55.3% of 318 records with a SUD clinic stop code but no SUD diagnosis or mental health procedure code. For inpatient stays with a SUD bed section code and a progress note, we found chart documentation of SUD care in 99.0% of 699 records accompanied by a SUD diagnosis but 0% of 39 records without a SUD diagnosis. These results provide validity evidence and caveats to researchers and VHA quality managers who might use SUD specialty location codes as indicators of SUD specialty care.
Phosphatidylinositol 3'-kinase, mTOR, and Glycogen synthase kinase-3β mediated regulation of p21 in human urothelial carcinoma cells
Nicole L Yohn, Caitlyn N Bingaman, Ashley L DuMont, Lina I Yoo
BMC Urology , 2011, DOI: 10.1186/1471-2490-11-19
Abstract: Cells were treated with a combination of PI3-kinase stimulating growth factors and kinase inhibitors, or transfected with exogenous genes in order to identify the signaling events that are necessary for p21 induction. Mice with conditional deletion of Pten in bladder urothelium were also examined for evidence of PI3-kinase pathway signaling events that affect p21 expression.When cells were treated with PI3-kinase activating growth factors EGF or PDGF, we found that p21 levels increased, in a manner similar to that observed in mice. We used the inhibitors LY294002, Akti-1/2, and rapamycin, to show that p21 induction is dependent upon PI3-kinase and AKT activity, and partially dependent on mTOR. We treated the cells with proteasome inhibitor MG-132 and found that p21 may be degraded in the proteasome to regulate protein levels. Importantly, our findings show that GSK-3β plays a role in diminishing p21 levels in cells. Treatment of cells with the GSK-3β inhibitor SB-216763 increased p21 levels, while exogenous expression of GSK-3β caused a decrease in p21, indicating that GSK-3β actively reduces p21 levels. We found that a combined treatment of LY294002 and SB-216763 improved the cytotoxic effect against UMUC-3 and UMUC-14 carcinoma cells over LY294002 alone, suggesting potential therapeutic uses for GSK-3β inhibitors. Immunohistochemical staining in bladders from wild-type and Pten-deleted mice indicated that GSK-3β inhibitory phosphorylation increases when Pten is deleted.PI3-kinase and AKT cause an upregulation of p21 by suppressing GSK-3β activity and activating mTOR in both cultured human urothelial carcinoma cells and mouse urothelial cells in vivo.It has been well established that the phosphatase and tensin homologue deleted on chromosome 10 (PTEN) gene plays an important role in suppressing tumor development in multiple human cell types and organs such as the endometrium, brain, skin, and prostate [1]. Studies in the last few years have shown that PTEN mutation
Bayesian Analysis of Epidemics - Zombies, Influenza, and other Diseases
Caitlyn Witkowski,Brian Blais
Quantitative Biology , 2013,
Abstract: Mathematical models of epidemic dynamics offer significant insight into predicting and controlling infectious diseases. The dynamics of a disease model generally follow a susceptible, infected, and recovered (SIR) model, with some standard modifications. In this paper, we extend the work of Munz et.al (2009) on the application of disease dynamics to the so-called "zombie apocalypse", and then apply the identical methods to influenza dynamics. Unlike Munz et.al (2009), we include data taken from specific depictions of zombies in popular culture films and apply Markov Chain Monte Carlo (MCMC) methods on improved dynamical representations of the system. To demonstrate the usefulness of this approach, beyond the entertaining example, we apply the identical methodology to Google Trend data on influenza to establish infection and recovery rates. Finally, we discuss the use of the methods to explore hypothetical intervention policies regarding disease outbreaks.
Monoallelic deletion of the microRNA biogenesis gene Dgcr8 produces deficits in the development of excitatory synaptic transmission in the prefrontal cortex
Claude M Schofield, Ruby Hsu, Alison J Barker, Caitlyn C Gertz, Robert Blelloch, Erik M Ullian
Neural Development , 2011, DOI: 10.1186/1749-8104-6-11
Abstract: In this study, we show that Dgcr8+/- mice display reduced expression of a subset of microRNAs in the prefrontal cortex, a deficit that emerges over postnatal development. Layer V pyramidal neurons in the medial prefrontal cortex of Dgcr8+/- mice have altered electrical properties, decreased complexity of basal dendrites, and reduced excitatory synaptic transmission.These findings demonstrate that precise microRNA expression is critical for the postnatal development of prefrontal cortical circuitry. Similar defects in neuronal maturation resulting from microRNA deficiency could represent endophenotypes of certain neuropsychiatric diseases of developmental onset.The cerebral cortex is the region in the mammalian brain associated with higher order cognitive and sensory processing. Integral to cortical function are interconnected networks of excitatory and inhibitory neurons, whose activity and connectivity emerge and strengthen through embryonic and postnatal development. Cortical neuron development requires the coordinated expression of specific genes that shape important physiological and structural properties, including dendritic arborization and the formation of GABAergic and glutamatergic synapses. Misregulation of these developmental processes has the potential to alter neuronal function and disrupt cortical circuitry, which may produce cognitive deficits that are a hallmark of certain mental disorders, including autism and schizophrenia. Accordingly, fully understanding the total complement of biological pathways that regulate the functional development of cortical neurons is of paramount importance.microRNAs (miRNAs) are a recently described class of small (approximately 22-nucleotide) non-coding RNAs that function in a regulatory capacity. miRNAs can powerfully control gene expression by binding to complementary sequences within the 3' untranslated region of target messenger RNAs, where they lead to the suppression of translation or mRNA degradation [1,2]. miR
Cost of Treatment in a US Commercially Insured, HIV-1–Infected Population
Caitlyn T. Solem, Sonya J. Snedecor, Alexandra Khachatryan, Katherine Nedrow, Margaret Tawadrous, Richard Chambers, Seema Haider, Kit Simpson
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0098152
Abstract: Objective Recent treatment patterns and cost data associated with HIV in the United States are limited. This study assessed first-line persistence and healthcare costs of HIV-1 in patients by treatment line and CD4 cell count. Methods MarketScan Commercial Claims and Encounters Database (2007–2011) and Lab Database (2007–2010) were used to construct two HIV-1 cohorts: 1) newly treated HIV-1–infected patients with ≥6 months' continuous enrollment prior to first third-agent drug claim (Newly Treated Cohort) and 2) CD4 cell count test results (CD4 Measurements Cohort). All patients were ≥18 years old and without hepatitis co-infection. The Kaplan-Meier method was used to measure treatment switch rates. Generalized linear models (gamma distribution, log link) were used to compare healthcare costs by treatment line and CD4 cell count controlling for potential confounders. Results Newly treated patients (n = 8,617) had mean age of 41, 82% were male, and 20% had experienced AIDS-defining events at baseline. Over 20% of newly treated patients switched initial treatment regimen within 2 years. Average unadjusted (and covariate-adjusted) total healthcare cost/year was $33,674 ($28,861) for first-line, $39,191 ($35,805) for second-line, and $39,882 ($40,804) for third-line treatment. Covariate-adjusted costs of care on second- and third-line treatments were significantly more expensive than first-line treatment (24% [p<0.001] and 41% [p = 0.006] higher, respectively). The CD4 Measurements Cohort included 803 CD4 measurements (mean age 49, 76% male, 8% experienced an AIDS-defining event). Costs associated with CD4 measurements <100 cells/μL were 92% higher than those with >350 cells/μL (p<0.001). For higher CD4 cell counts, the majority of expenditures were for antiretrovirals (64% of total for CD4 >350 cells/μL). Conclusions Despite modern advances in antiretroviral therapy and medical care, direct medical costs of HIV-1–infected patients increase after treatment switch and with lower CD4 counts, consistent with previous costing studies.
Learning-Induced Changes in Attentional Allocation during Categorization: A Sizable Catalog of Attention Change as Measured by Eye Movements
Caitlyn M. McColeman, Jordan I. Barnes, Lihan Chen, Kimberly M. Meier, R. Calen Walshe, Mark R. Blair
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0083302
Abstract: Learning how to allocate attention properly is essential for success at many categorization tasks. Advances in our understanding of learned attention are stymied by a chicken-and-egg problem: there are no theoretical accounts of learned attention that predict patterns of eye movements, making data collection difficult to justify, and there are not enough datasets to support the development of a rich theory of learned attention. The present work addresses this by reporting five measures relating to the overt allocation of attention across 10 category learning experiments: accuracy, probability of fixating irrelevant information, number of fixations to category features, the amount of change in the allocation of attention (using a new measure called Time Proportion Shift - TIPS), and a measure of the relationship between attention change and erroneous responses. Using these measures, the data suggest that eye-movements are not substantially connected to error in most cases and that aggregate trial-by-trial attention change is generally stable across a number of changing task variables. The data presented here provide a target for computational models that aim to account for changes in overt attentional behaviors across learning.
Simultaneous assessment of cytotoxic T lymphocyte responses against multiple viral infections by combined usage of optimal epitope matrices, anti- CD3 mAb T-cell expansion and "RecycleSpot"
Florian K Bihl, Elisabetta Loggi, John V Chisholm, Hannah S Hewitt, Leah M Henry, Caitlyn Linde, Todd J Suscovich, Johnson T Wong, Nicole Frahm, Pietro Andreone, Christian Brander
Journal of Translational Medicine , 2005, DOI: 10.1186/1479-5876-3-20
Abstract: Cell-mediated immunity is considered critical for the prevention and control of many viral infections [1-6]. The approaches developed to detect these responses in vitro have evolved over the years and have provided quantitative and qualitative information on virus-specific T cells for a number of viral infections. These assays include, besides others, lymphoproliferative assays using 3H-thymidine incorporation or CFSE staining, limiting dilution precursor-frequency assays for the enumeration of CTL precursor frequencies, intracellular cytokine staining (ICS) and enzyme-linked immunospot (ELISpot) assays [7-10]. Although these assays differ in their minimal cell requirements, the detailed, simultaneous analysis of anti-viral immunity against multiple viral infections is often limited by cell availability, regardless of the assay employed.The ELISpot assay has become widely used for rapidly assessing cellular immune responses to extensive numbers of antigens while using relatively few cells. A number of studies have also employed peptide matrix approaches, where every antigenic peptide is tested in two peptide pools, so that responses to reactive pools sharing a specific peptide can help to identify the targeted peptide [9,11]. This has reduced the required cell numbers significantly, so that for instance HIV-specific responses can generally be comprehensively assessed using less than 15 × l06 cells [9]. However, despite such advances, the simultaneous enumeration of virus-specific immunity to multiple viral infections still exceeds the required sample size that can routinely be obtained. Sample size may not be of great concern when assessing CTL mediated immune responses against single, small genome viruses such as HIV and HCV, which can be tested in a comprehensive manner using overlapping peptide sets spanning the entire expressed viral genome [9,12]. Nevertheless, such comprehensive approaches are not feasible for larger viruses, such as DNA-based herpesviruses li
Digging the New York City Skyline: Soil Fungal Communities in Green Roofs and City Parks
Krista L. McGuire, Sara G. Payne, Matthew I. Palmer, Caitlyn M. Gillikin, Dominique Keefe, Su Jin Kim, Seren M. Gedallovich, Julia Discenza, Ramya Rangamannar, Jennifer A. Koshner, Audrey L. Massmann, Giulia Orazi, Adam Essene, Jonathan W. Leff, Noah Fierer
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0058020
Abstract: In urban environments, green roofs provide a number of benefits, including decreased urban heat island effects and reduced energy costs for buildings. However, little research has been done on the non-plant biota associated with green roofs, which likely affect their functionality. For the current study, we evaluated whether or not green roofs planted with two native plant communities in New York City functioned as habitats for soil fungal communities, and compared fungal communities in green roof growing media to soil microbial composition in five city parks, including Central Park and the High Line. Ten replicate roofs were sampled one year after planting; three of these roofs were more intensively sampled and compared to nearby city parks. Using Illumina sequencing of the fungal ITS region we found that green roofs supported a diverse fungal community, with numerous taxa belonging to fungal groups capable of surviving in disturbed and polluted habitats. Across roofs, there was significant biogeographical clustering of fungal communities, indicating that community assembly of roof microbes across the greater New York City area is locally variable. Green roof fungal communities were compositionally distinct from city parks and only 54% of the green roof taxa were also found in the park soils. Phospholipid fatty acid analysis revealed that park soils had greater microbial biomass and higher bacterial to fungal ratios than green roof substrates. City park soils were also more enriched with heavy metals, had lower pH, and lower quantities of total bases (Ca, K, and Mg) compared to green roof substrates. While fungal communities were compositionally distinct across green roofs, they did not differentiate by plant community. Together, these results suggest that fungi living in the growing medium of green roofs may be an underestimated component of these biotic systems functioning to support some of the valued ecological services of green roofs.
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