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Crowdsourced Assessment of Ureteroscopy with Laser Lithotripsy Video Feed Does Not Correlate with Trainee Experience.
Conti SL, Brubaker W, Chung BI, Sofer M, Hsi RS, Shinghal R, Elliott CS, Caruso T, Leppert JT
(2019) J Endourol 33: 42-49
MeSH Terms: Academic Medical Centers, California, Clinical Competence, Crowdsourcing, Hospitals, Veterans, Humans, Kidney Calculi, Lithotripsy, Laser, Reproducibility of Results, Ureteroscopy, Urology, Video Recording
Show Abstract · Added February 26, 2019
OBJECTIVES - We sought to validate the use of crowdsourced surgical video assessment in the evaluation of urology residents performing flexible ureteroscopic laser lithotripsy.
METHODS - We collected video feeds from 30 intrarenal ureteroscopic laser lithotripsy cases where residents, postgraduate year (PGY) two through six, handled the ureteroscope. The video feeds were annotated to represent overall performance and to contain parts of the procedure being scored. Videos were submitted to a commercially available surgical video evaluation platform (Crowd-Sourced Assessment of Technical Skills). We used a validated ureteroscopic laser lithotripsy global assessment tool that was modified to include only those domains that could be evaluated on the captured video. Videos were evaluated by crowd workers recruited using Amazon's Mechanical Turk platform as well as five endourology-trained experts. Mean scores were calculated and intraclass correlation coefficients (ICCs) were computed for the expert domain and total scores. ICCs were estimated using a linear mixed-effects model. Spearman rank correlation coefficients were calculated as a measure of the strength of the relationships between the crowd mean and expert average scores.
RESULTS - A total of 30 videos were reviewed 2488 times by 487 crowd workers and five expert endourologists. ICCs between expert raters were all below accepted levels of correlation (0.30), with the overall score having an ICC of <0.001. For individual domains, the crowd scores did not correlate with expert scores, except for the stone retrieval domain (0.60 p = 0.015). In addition, crowdsourced scores had a negative correlation with the PGY level (0.44, p = 0.019).
CONCLUSIONS - There is poor agreement between experts and poor correlation between expert and crowd scores when evaluating video feeds of ureteroscopic laser lithotripsy. The use of an intraoperative video of ureteroscopy with laser lithotripsy for assessment of resident trainee skills does not appear reliable. This is further supported by the lack of correlation between crowd scores and advancing PGY level.
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12 MeSH Terms
Sequence-based HLA-A, B, C, DP, DQ, and DR typing of 496 adults from San Diego, California, USA.
Moore E, Grifoni A, Weiskopf D, Schulten V, Arlehamn CSL, Angelo M, Pham J, Leary S, Sidney J, Broide D, Frazier A, Phillips E, Mallal S, Mack SJ, Sette A
(2018) Hum Immunol 79: 821-822
MeSH Terms: Adolescent, Adult, Alleles, California, Female, Gene Frequency, Genotype, Genotyping Techniques, HLA-A Antigens, HLA-B Antigens, HLA-C Antigens, HLA-DP Antigens, HLA-DQ Antigens, HLA-DR Antigens, Histocompatibility Testing, Humans, Linkage Disequilibrium, Male, Middle Aged, Sequence Analysis, DNA, T-Lymphocytes, Young Adult
Show Abstract · Added March 30, 2020
DNA sequence-based typing at the HLA-A, -B, -C, -DPB1, -DQA1, -DQB1, and -DRB1 loci was performed on 496 healthy adult donors from San Diego, California, to characterize allele frequencies in support of studies of T cell responses to common allergens. Deviations from Hardy Weinberg proportions were detected at each locus except A and C. Several alleles were found in more than 15% of individuals, including the class II alleles DPB1∗02:01, DPB1∗04:01, DQA1∗01:02, DQA1∗05:01, DQB1∗03:01, and the class I allele A∗02:01. Genotype data will be available in the Allele Frequencies Net Database (AFND 3562).
Copyright © 2018. Published by Elsevier Inc.
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MeSH Terms
Inverse Relationship between Soluble RAGE and Risk for Bronchopulmonary Dysplasia.
Benjamin JT, van der Meer R, Slaughter JC, Steele S, Plosa EJ, Sucre JM, Moore PE, Aschner JL, Blackwell TS, Young LR
(2018) Am J Respir Crit Care Med 197: 1083-1086
MeSH Terms: Biomarkers, Bronchopulmonary Dysplasia, California, Female, Gestational Age, Humans, Infant, Low Birth Weight, Infant, Newborn, Infant, Premature, Male, Receptor for Advanced Glycation End Products, Risk Factors
Added March 21, 2018
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12 MeSH Terms
Stephen Elledge and the DNA damage response.
Cortez D, Zhou Z, Sanchez Y
(2015) DNA Repair (Amst) 35: 156-7
MeSH Terms: Awards and Prizes, Biomedical Research, California, DNA Repair, Eukaryota, History, 21st Century, Massachusetts, Texas
Added February 4, 2016
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8 MeSH Terms
Correlates of virulence in a frog-killing fungal pathogen: evidence from a California amphibian decline.
Piovia-Scott J, Pope K, Worth SJ, Rosenblum EB, Poorten T, Refsnider J, Rollins-Smith LA, Reinert LK, Wells HL, Rejmanek D, Lawler S, Foley J
(2015) ISME J 9: 1570-8
MeSH Terms: Animals, California, Chytridiomycota, Mycoses, Population Dynamics, Ranidae, Virulence
Show Abstract · Added February 12, 2015
The fungal pathogen Batrachochytrium dendrobatidis (Bd) has caused declines and extinctions in amphibians worldwide, and there is increasing evidence that some strains of this pathogen are more virulent than others. While a number of putative virulence factors have been identified, few studies link these factors to specific epizootic events. We documented a dramatic decline in juvenile frogs in a Bd-infected population of Cascades frogs (Rana cascadae) in the mountains of northern California and used a laboratory experiment to show that Bd isolated in the midst of this decline induced higher mortality than Bd isolated from a more stable population of the same species of frog. This highly virulent Bd isolate was more toxic to immune cells and attained higher density in liquid culture than comparable isolates. Genomic analyses revealed that this isolate is nested within the global panzootic lineage and exhibited unusual genomic patterns, including increased copy numbers of many chromosomal segments. This study integrates data from multiple sources to suggest specific phenotypic and genomic characteristics of the pathogen that may be linked to disease-related declines.
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7 MeSH Terms
When to call it a day: incremental risk of amputation and death after multiple revascularization.
Hawkins AT, Schaumeier MJ, Smith AD, Hevelone ND, Nguyen LL
(2014) Ann Vasc Surg 28: 35-47
MeSH Terms: Aged, Aged, 80 and over, Amputation, Angioplasty, Balloon, California, Chi-Square Distribution, Comorbidity, Critical Illness, Decision Support Techniques, Female, Humans, Ischemia, Kaplan-Meier Estimate, Lower Extremity, Male, Middle Aged, Multivariate Analysis, Patient Selection, Proportional Hazards Models, Reoperation, Retrospective Studies, Risk Assessment, Risk Factors, Smoking, Time Factors, Treatment Outcome, Vascular Surgical Procedures
Show Abstract · Added September 27, 2016
BACKGROUND - Patients with critical limb ischemia (CLI) often undergo revascularization before amputation. The exact relationship between multiple procedures and increased risk of amputation is unclear. We sought to determine the increased risk of amputation for each additional revascularization.
METHODS - The 2007-2009 California State Inpatient Database (SID) was used to identify a cohort of CLI patients undergoing revascularization and conduct a time-to-event analysis for patients undergoing one or more revascularization procedures. One-year estimates were generated with Kaplan-Meier curves and compared with the log-rank test. The Wei-Lin-Weissfeld (WLW) marginal proportional hazards model was used to assess independent effects of number of revascularization procedures on amputation and death.
RESULTS - A total of 11,190 patients with CLI underwent revascularization between July 2007 and December 2009. Their mean age was 71.0 years (interquartile range 62-80 years) and 6255 (55.9%) were male. Over half the subjects (55.2%) were smokers and there was a high burden of comorbidities in the cohort. One-year estimates of amputation by number of revascularizations (1: 23.3%; 2: 27.1%; 3: 30.3%; 4: 26.7%; 5(+): 28.6%; P < 0.001) and death (1: 18.7%; 2: 21.1%; 3: 26.3%; 4: 23.6%; 5+: 32.1%; P = 0.012) increased significantly as procedures increased. In the WLW model for amputation, the hazard increased significantly for patients with 2 revascularization versus 1 (HR = 1.22; 95% CI 1.09-1.37; P = 0.001) and 3 revascularizations versus 2 (HR = 1.33; 95% CI 1.10-1.62; P = 0.004). In the multivariable WLW models for death, the increase in revascularization procedures for 2 compared with 1 (HR = 1.18; 95% CI 1.04-1.34; P = 0.010) was significant.
CONCLUSIONS - The risk of amputation increases with each additional revascularization procedure. These findings hold true for both percutaneous transluminal angioplasty only and lower extremity bypass only subsets. In addition, increased revascularization procedures appear to result in an increased risk of death. We advocate for continued communication between clinicians and patients on the true risks and benefits of additional revascularization procedures.
Copyright © 2014 Elsevier Inc. All rights reserved.
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27 MeSH Terms
Socioeconomic status and lung cancer: unraveling the contribution of genetic admixture.
Aldrich MC, Selvin S, Wrensch MR, Sison JD, Hansen HM, Quesenberry CP, Seldin MF, Barcellos LF, Buffler PA, Wiencke JK
(2013) Am J Public Health 103: e73-80
MeSH Terms: Adult, African Americans, Aged, California, Confidence Intervals, Female, Genetic Predisposition to Disease, Genotyping Techniques, Hispanic Americans, Humans, Logistic Models, Lung Neoplasms, Male, Middle Aged, Odds Ratio, Smoking, Social Class
Show Abstract · Added February 26, 2014
OBJECTIVES - We examined the relationship between genetic ancestry, socioeconomic status (SES), and lung cancer among African Americans and Latinos.
METHODS - We evaluated SES and genetic ancestry in a Northern California lung cancer case-control study (1998-2003) of African Americans and Latinos. Lung cancer case and control participants were frequency matched on age, gender, and race/ethnicity. We assessed case-control differences in individual admixture proportions using the 2-sample t test and analysis of covariance. Logistic regression models examined associations among genetic ancestry, socioeconomic characteristics, and lung cancer.
RESULTS - Decreased Amerindian ancestry was associated with higher education among Latino control participants and greater African ancestry was associated with decreased education among African lung cancer case participants. Education was associated with lung cancer among both Latinos and African Americans, independent of smoking, ancestry, age, and gender. Genetic ancestry was not associated with lung cancer among African Americans.
CONCLUSIONS - Findings suggest that socioeconomic factors may have a greater impact than genetic ancestry on lung cancer among African Americans. The genetic heterogeneity and recent dynamic migration and acculturation of Latinos complicate recruitment; thus, epidemiological analyses and findings should be interpreted cautiously.
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17 MeSH Terms
Risk factors for anal HPV infection and anal precancer in HIV-infected men who have sex with men.
Schwartz LM, Castle PE, Follansbee S, Borgonovo S, Fetterman B, Tokugawa D, Lorey TS, Sahasrabuddhe VV, Luhn P, Gage JC, Darragh TM, Wentzensen N
(2013) J Infect Dis 208: 1768-75
MeSH Terms: Adolescent, Adult, Anal Canal, Anus Neoplasms, CD4 Lymphocyte Count, California, Chlamydia Infections, Confidence Intervals, Demography, HIV Infections, HIV Seropositivity, Homosexuality, Male, Humans, Logistic Models, Male, Middle Aged, Papillomaviridae, Papillomavirus Infections, Precancerous Conditions, Risk Factors, Sexual Behavior, Smoking, Young Adult
Show Abstract · Added March 5, 2014
BACKGROUND - Carcinogenic human papillomaviruses (HPVs) cause a large proportion of anal cancers. Human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) are at increased risk of HPV infection and anal cancer compared with HIV-negative men. We evaluated risk factors for HPV infection and anal precancer in a population of HIV-infected MSM.
METHODS - Our study included 305 MSM at an HIV/AIDS clinic in the Kaiser Permanente Northern California Health Maintenance Organization. Logistic regression was used to estimate associations of risk factors comparing men without anal HPV infection; men with anal HPV infection, but no precancer; and men with anal precancer.
RESULTS - Low CD4 count (<350 cells/mm(3)) and previous chlamydia infection were associated with an increased risk of carcinogenic HPV infection (odds ratio [OR], 3.65; 95% confidence interval [CI], 1.28-10.40 and OR, 4.24; 95% CI, 1.16-15.51, respectively). History of smoking (OR, 2.71 95% CI, 1.43-5.14), duration, recency, and dose of smoking increased the risk of anal precancer among carcinogenic HPV-positive men but had no association with HPV infection.
CONCLUSIONS - We found distinct risk factors for anal HPV infection and anal precancer. Risk factors for HPV infection and anal precancer are similar to established risk factors for cervical cancer progression.
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23 MeSH Terms
Tobacco smoke exposure and the risk of childhood acute lymphoblastic and myeloid leukemias by cytogenetic subtype.
Metayer C, Zhang L, Wiemels JL, Bartley K, Schiffman J, Ma X, Aldrich MC, Chang JS, Selvin S, Fu CH, Ducore J, Smith MT, Buffler PA
(2013) Cancer Epidemiol Biomarkers Prev 22: 1600-11
MeSH Terms: Adolescent, California, Case-Control Studies, Child, Child, Preschool, Cytogenetics, Female, Humans, Infant, Infant, Newborn, Leukemia, Myeloid, Male, Multivariate Analysis, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Pregnancy, Prenatal Exposure Delayed Effects, Risk Factors, Tobacco Smoke Pollution
Show Abstract · Added February 26, 2014
BACKGROUND - Tobacco smoke contains carcinogens known to damage somatic and germ cells. We investigated the effect of tobacco smoke on the risk of childhood acute lymphoblastic leukemia (ALL) and myeloid leukemia (AML), especially subtypes of prenatal origin such as ALL with translocation t(12;21) or high-hyperdiploidy (51-67 chromosomes).
METHODS - We collected information on exposures to tobacco smoking before conception, during pregnancy, and after birth in 767 ALL cases, 135 AML cases, and 1,139 controls (1996-2008). Among cases, chromosome translocations, deletions, or aneuploidy were identified by conventional karyotype and fluorescence in situ hybridization.
RESULTS - Multivariable regression analyses for ALL and AML overall showed no definite evidence of associations with self-reported (yes/no) parental prenatal active smoking and child's passive smoking. However, children with history of paternal prenatal smoking combined with postnatal passive smoking had a 1.5-fold increased risk of ALL [95% confidence interval (CI), 1.01-2.23], compared to those without smoking history (ORs for pre- or postnatal smoking only were close to one). This joint effect was seen for B-cell precursor ALL with t(12;21) (OR = 2.08; 95% CI, 1.04-4.16), but not high hyperdiploid B-cell ALL. Similarly, child's passive smoking was associated with an elevated risk of AML with chromosome structural changes (OR = 2.76; 95% CI, 1.01-7.58), but not aneuploidy.
CONCLUSIONS - Our data suggest that exposure to tobacco smoking was associated with increased risks of childhood ALL and AML; and risks varied by timing of exposure (before and/or after birth) and cytogenetic subtype, based on imprecise estimates.
IMPACT - Parents should limit exposures to tobacco smoke before and after the child's birth.
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18 MeSH Terms
Human monoclonal antibodies derived from memory B cells following live attenuated dengue virus vaccination or natural infection exhibit similar characteristics.
Smith SA, de Alwis R, Kose N, Durbin AP, Whitehead SS, de Silva AM, Crowe JE
(2013) J Infect Dis 207: 1898-908
MeSH Terms: Antibodies, Monoclonal, Antibodies, Neutralizing, Antibodies, Viral, Antibody-Dependent Enhancement, Antigens, Viral, B-Lymphocytes, California, Cell Line, Cross Reactions, Dengue, Dengue Vaccines, Dengue Virus, Herpesvirus 4, Human, Humans, Hybridomas, Neutralization Tests, North Carolina, Recombinant Proteins, Vaccination, Vaccines, Attenuated
Show Abstract · Added March 7, 2014
The immunopathogenesis of severe dengue is poorly understood, but there is concern that induction of cross-reactive nonneutralizing antibodies by infection or vaccination may increase the likelihood of severe disease during a subsequent infection. We generated a total of 63 new human monoclonal antibodies to compare the B-cell response of subjects who received the National Institutes of Health live attenuated dengue vaccine rDEN1Δ30 to that of subjects following symptomatic primary infection with DENV1. Both infection and vaccination induced serum neutralizing antibodies and DENV1-reactive peripheral blood B cells, but the magnitude of induction was lower in vaccinated individuals. Serotype cross-reactive weakly neutralizing antibodies dominated the response in both vaccinated and naturally infected subjects. Antigen specificities were very similar, with a slightly greater percentage of antibodies targeting E protein domain I/II than domain III. These data shed light on the similarity of human B-cell response to live attenuated DENV vaccine or natural infection.
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20 MeSH Terms