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Haocheng Li, Sarah Kozey-Keadle, Victor Kipnis, Raymond J Carroll
Motivated by physical activity data obtained from the BodyMedia FIT device (, we take a functional data approach for longitudinal studies with continuous proportional outcomes. The functional structure depends on three factors. In our three-factor model, the regression structures are specified as curves measured at various factor-points with random effects that have a correlation structure. The random curve for the continuous factor is summarized using a few important principal components...
2016: Stat: the ISI's Journal for Rapid Dissemination of Statistics Research
Eric Kipnis, Francesco Garzotto, Claudio Ronco
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Disease
Vincent X Liu, John W Morehouse, Jennifer M Baker, John D Greene, Patricia Kipnis, Gabriel J Escobar
The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture to drive improvements in the quality of health care. The inpatient setting, one of the most costly and impactful domains of healthcare, is an ideal setting in which to use data and information technology to foster continuous learning and quality improvement. The rapid digitization of inpatient medicine offers incredible new opportunities to use data from routine care to generate new discovery and thus close the virtuous cycle of learning...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Gabriel J Escobar, Benjamin J Turk, Arona Ragins, Jason Ha, Brian Hoberman, Steven M LeVine, Manuel A Ballesca, Vincent Liu, Patricia Kipnis
Patients who deteriorate in the hospital outside the intensive care unit (ICU) have higher mortality and morbidity than those admitted directly to the ICU. As more hospitals deploy comprehensive inpatient electronic medical records (EMRs), attempts to support rapid response teams with automated early detection systems are becoming more frequent. We aimed to describe some of the technical and operational challenges involved in the deployment of an early detection system. This 2-hospital pilot, set within an integrated healthcare delivery system with 21 hospitals, had 2 objectives...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
A Godier, M Bacus, E Kipnis, B Tavernier, A Guidat, A Rauch, E Drumez, S Susen, D Garrigue-Huet
BACKGROUND: In 2007, the multidisciplinary European Task Force for Advanced Bleeding Care in Trauma published guidelines for the management of the bleeding trauma patient. The present study aimed to assess compliance with the European guidelines during the first 24 h in a level I trauma centre and to determine whether compliance impacts mortality. METHODS: This was a retrospective study of consecutive bleeding trauma patients referred to a university hospital in France between 2010 and 2014...
November 2016: British Journal of Anaesthesia
Jennifer L Kuntz, Jennifer M Baker, Patricia Kipnis, Sherian Xu Li, Vincent Liu, Yang Xie, Stephen Marcella, Gabriel J Escobar
BACKGROUND Considerable efforts have been dedicated to developing strategies to prevent and treat recurrent Clostridium difficile infection (rCDI); however, evidence of the impact of rCDI on patient healthcare utilization and outcomes is limited. OBJECTIVE To compare healthcare utilization and 1-year mortality among adults who had rCDI, nonrecurrent CDI, or no CDI. METHODS We performed a nested case-control study among adult Kaiser Foundation Health Plan members from September 1, 2001, through December 31, 2013...
October 20, 2016: Infection Control and Hospital Epidemiology
Emmanuel Faure, Eric Kipnis, Perrine Bortolotti
No abstract text is available yet for this article.
September 29, 2016: New England Journal of Medicine
Patricia Kipnis, Benjamin J Turk, David A Wulf, Juan Carlos LaGuardia, Vincent Liu, Matthew M Churpek, Santiago Romero-Brufau, Gabriel J Escobar
BACKGROUND: Patients in general medical-surgical wards who experience unplanned transfer to the intensive care unit (ICU) show evidence of physiologic derangement 6-24h prior to their deterioration. With increasing availability of electronic medical records (EMRs), automated early warning scores (EWSs) are becoming feasible. OBJECTIVE: To describe the development and performance of an automated EWS based on EMR data. MATERIALS AND METHODS: We used a discrete-time logistic regression model to obtain an hourly risk score to predict unplanned transfer to the ICU within the next 12h...
December 2016: Journal of Biomedical Informatics
Antoine Louveau, Sandro Da Mesquita, Jonathan Kipnis
Lymphatic vasculature drains interstitial fluids, which contain the tissue's waste products, and ensures immune surveillance of the tissues, allowing immune cell recirculation. Until recently, the CNS was considered to be devoid of a conventional lymphatic vasculature. The recent discovery in the meninges of a lymphatic network that drains the CNS calls into question classic models for the drainage of macromolecules and immune cells from the CNS. In the context of neurological disorders, the presence of a lymphatic system draining the CNS potentially offers a new player and a new avenue for therapy...
September 7, 2016: Neuron
Janet A Tooze, Laurence S Freedman, Raymond J Carroll, Douglas Midthune, Victor Kipnis
The food frequency questionnaire (FFQ) is known to be prone to measurement error. Researchers have suggested excluding implausible energy reporters (IERs) of FFQ total energy when examining the relationship between a health outcome and FFQ-reported intake to obtain less biased estimates of the effect of the error-prone measure of exposure; however, the statistical properties of stratifying by IER status have not been studied. Under certain assumptions, including nondifferential error, we show that when stratifying by IER status, the attenuation of the estimated relative risk in the stratified models will be either greater or less in both strata (implausible and plausible reporters) than for the nonstratified model, contrary to the common belief that the attenuation will be less among plausible reporters and greater among IERs...
November 2016: Biometrical Journal. Biometrische Zeitschrift
Jonathan Kipnis
Neuroimmunologists seek to understand the interactions between the central nervous system (CNS) and the immune system, both under homeostatic conditions and in diseases. Unanswered questions include those relating to the diversity and specificity of the meningeal T cell repertoire; the routes taken by immune cells that patrol the meninges under healthy conditions and invade the parenchyma during pathology; the opposing effects (beneficial or detrimental) of these cells on CNS function; the role of immune cells after CNS injury; and the evolutionary link between the two systems, resulting in their tight interaction and interdependence...
August 19, 2016: Science
Rémi Coudroy, Didier Payen, Yoann Launey, Anne-Claire Lukaszewicz, Mahmoud Kaaki, Benoit Veber, Olivier Collange, Antoine Dewitte, Laurent Martin-Lefevre, Matthieu Jabaudon, Thomas Kerforne, Martine Ferrandière, Eric Kipnis, Carlos Vela, Stéphanie Chevalier, Jihad Mallat, Sandrine Charreau, Jean-Claude Lecron, René Robert
Conflicting results have been reported on the influence of Polymyxin-B hemoperfusion treatment on systemic inflammation markers. The aim of study was to assess in a randomized control trial the influence on plasma cytokine concentrations of Polymyxin-B hemoperfusion in septic shock due to peritonitis. A panel of 10 pro- or anti-inflammatory cytokines was measured in 213 patients with peritonitis-induced septic shock enrolled in the randomized trial ABDOMIX testing the impact of 2 Polymyxin-B hemoperfusion sessions with standard treatment...
August 8, 2016: Shock
Daniel Raper, Antoine Louveau, Jonathan Kipnis
The many interactions between the nervous and the immune systems, which are active in both physiological and pathological states, have recently become more clearly delineated with the discovery of a meningeal lymphatic system capable of carrying fluid, immune cells, and macromolecules from the central nervous system (CNS) to the draining deep cervical lymph nodes. However, the exact localization of the meningeal lymphatic vasculature and the path of drainage from the cerebrospinal fluid (CSF) to the lymphatics remain poorly understood...
September 2016: Trends in Neurosciences
Anthony J Filiano, Yang Xu, Nicholas J Tustison, Rachel L Marsh, Wendy Baker, Igor Smirnov, Christopher C Overall, Sachin P Gadani, Stephen D Turner, Zhiping Weng, Sayeda Najamussahar Peerzade, Hao Chen, Kevin S Lee, Michael M Scott, Mark P Beenhakker, Vladimir Litvak, Jonathan Kipnis
Immune dysfunction is commonly associated with several neurological and mental disorders. Although the mechanisms by which peripheral immunity may influence neuronal function are largely unknown, recent findings implicate meningeal immunity influencing behaviour, such as spatial learning and memory. Here we show that meningeal immunity is also critical for social behaviour; mice deficient in adaptive immunity exhibit social deficits and hyper-connectivity of fronto-cortical brain regions. Associations between rodent transcriptomes from brain and cellular transcriptomes in response to T-cell-derived cytokines suggest a strong interaction between social behaviour and interferon-γ (IFN-γ)-driven responses...
July 21, 2016: Nature
Anastasia Gaisinskaya-Kipnis, Jacob Klein
Highly efficient lubricating boundary layers at biosurfaces such as cartilage have been proposed to comprise phospholipids complexed with biomacromolecules exposed at the surfaces. To gain insight into this, a systematic study on the normal and frictional forces between surfaces bearing a sequentially deposited model alginate-on-chitosan bilayer, bearing different adsorbed phosphatidylcholine (PC) liposomes, was carried out using a surface force balance. Structures of the resulting surface complexes were determined using atomic force microscopy (AFM) and cryo-scanning electron microscopy (cryo-SEM)...
August 8, 2016: Biomacromolecules
Ioana A Marin, Jonathan Kipnis
The view of the nervous system being the victim of destructive inflammation during autoimmunity, degeneration, or injury has been rapidly changing. Recent studies are supporting the idea that the immune system provides support for the nervous system at various levels. Though cell patrolling through the nervous system parenchyma is limited compared with other tissues, immune cell presence within the central nervous system (CNS; microglia), as well as around it (in the meningeal spaces and choroid plexus) has been shown to be important for brain tissue maintenance and function...
January 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Perrine Bortolotti, Benjamin Hennart, Camille Thieffry, Guillaume Jausions, Emmanuel Faure, Teddy Grandjean, Marion Thepaut, Rodrigue Dessein, Delphine Allorge, Benoit P Guery, Karine Faure, Eric Kipnis, Bertrand Toussaint, Audrey Le Gouellec
BACKGROUND: Pseudomonas aeruginosa (Pa) is a Gram-negative bacteria frequently involved in healthcare-associated pneumonia with poor clinical outcome. To face the announced post-antibiotic era due to increasing resistance and lack of new antibiotics, new treatment strategies have to be developed. Immunomodulation of the host response involved in outcome could be an alternative therapeutic target in Pa-induced lung infection. Kynurenines are metabolites resulting from tryptophan catabolism and are known for their immunomodulatory properties...
2016: BMC Microbiology
Monalisa M Trentini, Fábio M de Oliveira, André Kipnis, Ana P Junqueira-Kipnis
Mycobacterium tuberculosis causes tuberculosis (TB), a disease that killed more than 1.5 million people worldwide in 2014, and the Bacillus Calmette Guérin (BCG) vaccine is the only currently available vaccine against TB. However, it does not protect adults. Th1 and Th17 cells are crucial for TB control, as well as the neutrophils that are directly involved in DC trafficking to the draining lymph nodes and the activation of T lymphocytes during infection. Although several studies have shown the importance of neutrophils during M...
2016: Frontiers in Microbiology
Joshua N Sampson, Charles E Matthews, Laurence Freedman, Raymond J Carroll, Victor Kipnis
Sedentary behavior has already been associated with mortality, cardiovascular disease, and cancer. Questionnaires are an affordable tool for measuring sedentary behavior in large epidemiological studies. Here, we introduce and evaluate two statistical methods for quantifying measurement error in questionnaires. Accurate estimates are needed for assessing questionnaire quality. The two methods would be applied to validation studies that measure a sedentary behavior by both questionnaire and accelerometer on multiple days...
2016: Journal of Applied Statistics
F Garzotto, M Ostermann, D Martín-Langerwerf, M Sánchez-Sánchez, J Teng, R Robert, A Marinho, M E Herrera-Gutierrez, H J Mao, D Benavente, E Kipnis, A Lorenzin, D Marcelli, C Tetta, C Ronco
BACKGROUND: The previously published "Dose Response Multicentre International Collaborative Initiative (DoReMi)" study concluded that the high mortality of critically ill patients with acute kidney injury (AKI) was unlikely to be related to an inadequate dose of renal replacement therapy (RRT) and other factors were contributing. This follow-up study aimed to investigate the impact of daily fluid balance and fluid accumulation on mortality of critically ill patients without AKI (N-AKI), with AKI (AKI) and with AKI on RRT (AKI-RRT) receiving an adequate dose of RRT...
June 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
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