Last data update: Jun 24, 2024. (Total: 47078 publications since 2009)
Records 1-10 (of 10 Records) |
Query Trace: Flanigan D [original query] |
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An optimized cell-based assay to assess influenza virus replication by measuring neuraminidase activity and its applications for virological surveillance
Patel MC , Flanigan D , Feng C , Chesnokov A , Nguyen HT , Elal AA , Steel J , Kondor RJ , Wentworth DE , Gubareva LV , Mishin VP . Antiviral Res 2022 208 105457 Year-round virological characterization of circulating epidemic influenza viruses is conducted worldwide to detect the emergence of viruses that may escape pre-existing immunity or acquire resistance to antivirals. High throughput phenotypic assays are needed to complement the sequence-based analysis of circulating viruses and improve pandemic preparedness. The recent entry of a polymerase inhibitor, baloxavir, into the global market further highlighted this need. Here, we optimized a cell-based assay that considerably streamlines antiviral and antigenic testing by replacing lengthy immunostaining and imaging procedures used in current assay with measuring the enzymatic activity of nascent neuraminidase (NA) molecules expressed on the surface of virus-infected cells. For convenience, this new assay was named IRINA (Influenza Replication Inhibition Neuraminidase-based Assay). IRINA was successfully validated to assess inhibitory activity of baloxavir on virus replication by testing a large set (>150) of influenza A and B viruses, including drug resistant strains and viruses collected during 2017-2022. To test its versatility, IRINA was utilized to evaluate neutralization activity of a broadly reactive human anti-HA monoclonal antibody, FI6, and post-infection ferret antisera, as well as the inhibition of NA enzyme activity by NA inhibitors. Performance of IRINA was tested in parallel using respective conventional assays. IRINA offers an attractive alternative to current phenotypic assays, while maintaining reproducibility and high throughput capacity. Additionally, the improved turnaround time may prove to be advantageous when conducting time sensitive studies, such as investigating a new virus outbreak. This assay can meet the needs of surveillance laboratories by providing a streamlined and cost-effective approach for virus characterization. |
Utility of linking survey and registry data to evaluate interventions and policies to address disparities in breast cancer survivorship among young women
Subramanian S , Jones M , Tangka FKL , Edwards P , Flanigan T , Kaganova J , Smith K , Fairley T , Hawkins NA , Rodriguez JL , Guy GP Jr , Thomas CC . Eval Program Plann 2021 88 101967 PURPOSE: There is limited research linking data sources to evaluate the multifactorial impacts on the quality of treatment received and financial burden among young women with breast cancer. To address this gap and support future evaluation efforts, we examined the utility of combining patient survey and cancer registry data. PATIENT AND METHODS: We administered a survey to women, aged 18-39 years, with breast cancer from four U.S. states. We conducted a systematic response-rate analysis and evaluated differences between racial groups. Survey responses were linked with cancer registry data to assess whether surveys could reliably supplement registry data. RESULTS: A total of 830 women completed the survey for a response rate of 28.4 %. Blacks and Asian/Pacific Islanders were half as likely to respond as white women. Concordance between survey and registry data was high for demographic variables (Cohen's kappa [k]: 0.879 to 0.949), moderate to high for treatments received (k: 0.467 to 0.854), and low for hormone receptor status (k: 0.167 to 0.553). Survey items related to insurance status, employment, and symptoms revealed racial differences. CONCLUSION: Cancer registry data, supplemented by patient surveys, can provide a broader understanding of the quality of care and financial impacts of breast cancer among young women. |
Treatment cost and access to care: experiences of young women diagnosed with breast cancer
Subramanian S , Tangka FKL , Edwards P , Jones M , Flanigan T , Kaganova J , Smith K , Thomas CC , Hawkins NA , Rodriguez JL , Guy GP Jr , Fairley T . Cancer Causes Control 2020 31 (11) 1001-1009 PURPOSE: Breast cancer is the leading cause of cancer-related deaths in women younger than 40 years. We aim to evaluate cost as a barrier to care among female breast cancer patients diagnosed between 18 to 39 years. METHODS: In early 2017, we distributed a survey to women diagnosed with breast cancer between the ages of 18 and 39 years, as identified by the central cancer registries of California, Georgia, North Carolina, and Florida. We used multivariable statistics to explore cost-related barriers to receiving breast cancer care for the 830 women that completed the survey. RESULTS: About half of the women (47.4%) reported spending more on breast cancer care than expected, and almost two-thirds (65.3%) had not discussed costs with their care team. A third of the patients (31.8%) indicated forgoing care due to cost. Factors associated with not receiving anticipated care due to cost included age less than35 years at diagnosis, self-insurance, comorbid conditions, and late-stage diagnosis. CONCLUSION: Previous studies using breast cancer registry data have not included detailed insurance information and care received by young women. Young women with breast cancer frequently forgo breast cancer care due to cost. Our results highlight the potential for policies that facilitate optimal care for young breast cancer patients which could include the provision of comprehensive insurance coverage. |
Modified Antiretroviral Treatment Access Study (MARTAS): A randomized controlled trial of the efficacy of a linkage-to-care intervention among HIV-positive patients in Ukraine
Neduzhko O , Postnov O , Sereda Y , Kulchynska R , Bingham T , Myers JJ , Flanigan T , Kiriazova T . AIDS Behav 2020 24 (11) 3142-3154 Between October 2015 and March 2018, we conducted the Modified Antiretroviral Treatment Access Study (MARTAS), a nurse-delivered case management intervention to improve linkage-to-care for persons recently tested HIV positive. Adult participants from nine urban clinics in three regions of Ukraine were randomized to either MARTAS or standard of care (SOC) using individual, parallel, two-arm design. The main study outcome was linkage-to-care (defined as registration at an HIV clinic) within a 3-month period from enrollment in the study. Intention-to-treat analysis of MARTAS (n = 135) versus SOC (n = 139) showed intervention efficacy in linkage to HIV care (84.4% vs. 33.8%; adjusted RR 2.45; 95% CI 1.72, 3.47; p < 0.001). MARTAS is recommended for implementation in Ukraine and may be helpful in other countries with similar gaps in linkage-to-care. Clinicaltrials.gov registration number: NCT02338024. |
Insurance coverage, employment status, and financial well-being of young women diagnosed with breast cancer
Tangka FKL , Subramanian S , Jones M , Edwards P , Flanigan T , Kaganova Y , Smith KW , Thomas CC , Hawkins NA , Rodriguez J , Fairley T , Guy GP . Cancer Epidemiol Biomarkers Prev 2020 29 (3) 616-624 BACKGROUND: The economic cost of breast cancer is a major personal and public health problem in the United States. This study aims to evaluate the insurance, employment, and financial experiences of young female breast cancer survivors and to assess factors associated with financial decline. METHODS: We recruited 830 women under 40 years of age diagnosed with breast cancer between January 2013 and December 2014. The study population was identified through California, Florida, Georgia, and North Carolina population-based cancer registries. The cross-sectional survey was fielded in 2017 and included questions on demographics, insurance, employment, out-of-pocket costs, and financial well-being. We present descriptive statistics and multivariate analysis to assess factors associated with financial decline. RESULTS: Although 92.5% of the respondents were continuously insured over the past 12 months, 9.5% paid a "higher price than expected" for coverage. Common concerns among the 73.4% of respondents who were employed at diagnosis included increased paid (55.1%) or unpaid (47.3%) time off, suffering job performance (23.2%), and staying at (30.2%) or avoiding changing (23.5%) jobs for health insurance purposes. Overall, 47.0% experienced financial decline due to treatment-related costs. Patients with some college education, multiple comorbidities, late stage diagnoses, and self-funded insurance were most vulnerable. CONCLUSIONS: The breast cancer diagnosis created financial hardship for half the respondents and led to myriad challenges in maintaining employment. Employment decisions were heavily influenced by the need to maintain health insurance coverage. IMPACT: This study finds that a breast cancer diagnosis in young women can result in employment disruption and financial decline. |
Feasibility and acceptability of the Modified Antiretroviral Treatment Access Study (MARTAS) intervention based on a pilot study in Ukraine
Neduzhko O , Postnov O , Bingham T , Myers JJ , Flanigan T , Kiriazova T . J Int Assoc Provid AIDS Care 2019 18 2325958218823257 We conducted a pilot of the Modified Antiretroviral Treatment Access Study (MARTAS), a linkage to HIV treatment intervention, prior to implementing a multisite randomized controlled trial (RCT) in Ukraine. The objectives of the pilot were to assess the feasibility and acceptability of the MARTAS intervention among a small sample of adults recently diagnosed with HIV at specialty clinics in the Mykolaiv region of Ukraine in 2015. The adapted intervention consisted of up to 6 individual-level sessions with a linkage coordinator (nurse) over a 90-day period. Overall, 22 persons participated in the pilot. On average, participants received 4.2 sessions and 14 participants linked to HIV care within 3 months of study enrollment. All 18 participants who completed the acceptability survey expressed high satisfaction with their interaction with their linkage coordinator. The results of the pilot demonstrated feasibility and acceptability of the MARTAS intervention in advance of a larger scale RCT in Ukraine. |
Patient and provider perspectives inform an intervention to improve linkage to care for HIV patients in Ukraine
Kiriazova T , Postnov O , Bingham T , Myers J , Flanigan T , Vitek C , Neduzhko O . BMC Health Serv Res 2018 18 (1) 58 BACKGROUND: Engagement with HIV medical care is critical to successful HIV treatment and prevention efforts. However, in Ukraine, delays in the timely initiation of HIV treatment hamper viral suppression. By January 01, 2016, only 126,604 (57.5%) of the estimated 220,000 people living with HIV (PLWH) had registered for HIV care, and most (55.1%) of those who registered for HIV care in 2015 did that at a late stage of infection. In the US, Anti-Retroviral Treatment and Access to Services (ARTAS) intervention successfully linked newly diagnosed PLWH to HIV services using strengths-based case management with a linkage coordinator. To tailor the ARTAS intervention for Ukraine, we conducted a qualitative study with patients and providers to understand barriers and facilitators that influence linkage to HIV care. METHODS: During September-October 2014, we conducted 20 in-depth interviews with HIV-positive patients and two focus groups with physicians in infectious disease, sexually transmitted infection (STI), and addiction clinics in Dnipropetrovsk Region of Ukraine. Interviews and focus groups were audio-recorded and transcribed verbatim. We translated illustrative quotes into English. We used thematic analysis for the data analysis. RESULTS: Participants (20 patients and 14 physicians) identified multiple, mostly individual-level factors influencing HIV care initiation. Key barriers included lack of HIV knowledge, non-acceptance of HIV diagnosis, fear of HIV disclosure, lack of psychological support from health providers, and HIV stigma in community. Responsibility for one's health, health deterioration, and supportive provider communication were reported as facilitators to linkage to care. Expected benefits from the case management intervention included psychological support, HIV education, and help with navigating the segmented health system. CONCLUSIONS: The findings from the study will be used to optimize the ARTAS for the Ukrainian context. Our findings can also support future linkage-to-care strategies in other countries of Eastern Europe and Central Asia. |
Risk factors for HCV infection among young adults in rural New York who inject prescription opioid analgesics
Zibbell JE , Hart-Malloy R , Barry J , Fan L , Flanigan C . Am J Public Health 2014 104 (11) e1-e7 OBJECTIVES: We investigated a cluster of new hepatitis C cases in rural New York among a cohort of young people who inject drugs (PWID) and misuse prescription opioid analgesics (POA). METHODS: We recruited a purposive sample of PWID from Cortland County for an in-person survey and HCV rapid antibody test (March-July 2012). We examined sociodemographics, drugs currently injected, and lifetime and recent injection behaviors to ascertain associations with HCV antibody (anti-HCV) positivity. RESULTS: Of 123 PWID, 76 (61.8%) were younger than 30 years, and 100 (81.3%) received HCV rapid testing. Of those tested, 34 (34.0%) were positive. Participants who reported injecting POA in the past 12 months were 5 times more likely to be anti-HCV positive than those who injected drugs other than POA, and participants who reported sharing injection equipment in the past 12 months were roughly 4 times more likely to be anti-HCV positive than those who did not. CONCLUSIONS: Our analysis suggests people injecting POA may be at higher risk for HCV infection than people who inject heroin or other drugs but not POA. |
Evidence-based path to newborn screening for Duchenne muscular dystrophy.
Mendell JR , Shilling C , Leslie ND , Flanigan KM , Al-Dahhak R , Gastier-Foster J , Kneile K , Dunn DM , Duval B , Aoyagi A , Hamil C , Mahmoud M , Roush K , Bird L , Rankin C , Lilly H , Street N , Chandrasekar R , Weiss RB . Ann Neurol 2012 71 (3) 304-13 OBJECTIVE: Creatine kinase (CK) levels are increased on dried blood spots in newborns related to the birthing process. As a marker for newborn screening, CK in Duchenne muscular dystrophy (DMD) results in false-positive testing. In this report, we introduce a 2-tier system using the dried blood spot to first assess CK with follow-up DMD gene testing. METHODS: A fluorometric assay based upon the enzymatic transphosphorylation of adenosine diphosphate to adenosine triphosphate was used to measure CK activity. Preliminary studies established a population-based range of CK in newborns using 30,547 deidentified anonymous dried blood spot samples. Mutation analysis used genomic DNA extracted from the dried blood spot followed by whole genome amplification with assessment of single-/multiexon deletions/duplications in the DMD gene using multiplex ligation-dependent probe amplification. RESULTS: DMD gene mutations (all exonic deletions) were found in 6 of 37,649 newborn male subjects, all of whom had CK levels >2,000U/l. In 3 newborns with CK >2,000U/l in whom DMD gene abnormalities were not found, we identified limb-girdle muscular dystrophy gene mutations affecting DYSF, SGCB, and FKRP. INTERPRETATION: A 2-tier system of analysis for newborn screening for DMD has been established. This path for newborn screening fits our health care system, minimizes false-positive testing, and uses predetermined levels of CK on dried blood spots to predict DMD gene mutations. |
Sexually transmitted infections and hepatitis in men with a history of incarceration
Sosman J , MacGowan R , Margolis A , Gaydos CA , Eldridge G , Moss S , Flanigan T , Iqbal K , Belcher L . Sex Transm Dis 2011 38 (7) 634-639 BACKGROUND: Men entering correctional facilities have high rates of human immunodeficiency virus, sexually transmitted infections (STI), and hepatitis. Many prisons offer screening, treatment, and vaccination services; however, little is known about the rates of these infections in men after release to the community. METHODS: Young men were recruited from prisons in Mississippi, Rhode Island, and Wisconsin as part of a human immunodeficiency virus/STI/hepatitis intervention study. Participants were offered screening for Neisseria gonorrhoeae (GC), Chlamydia trachomatis, trichomoniasis, syphilis, hepatitis B (HBV) and C (HCV) 6 months after release. Logistic regression was performed to identify associations with prevalent infections. RESULTS: Of 248 eligible men, 178 (71.8%) participated. Their mean age was 22.5 years, and 92% reported multiple lifetime incarcerations. At 6-month postrelease, 79% reported unprotected vaginal or anal sex, and 26% tested positive for 1 or more infections (GC, 1%; C. trachomatis, 12%; trichomoniasis, 8%; syphilis, 0%; HCV, 6%; HBV, 1%). Of all, 55% were susceptible to HBV infection. Active STI (GC, C. trachomatis, or trichomoniasis) was associated with less education (odds ratios [OR], 2.25; P < 0.05). HCV infection was associated with injection drug use (OR, 69.70; P < 0.05) and being white (OR, 7.54; P < 0.05). HBV susceptibility was associated with older age (OR, 3.02; P < 0.05), more education (OR, 2.39; P < 0.05), or incarceration in Mississippi (OR, 6.69; P < 0.05) or Rhode Island (OR, 2.84; P < 0.05). CONCLUSIONS: Effective screening and prevention programs are needed for this population before and after release from custody to prevent acquisition and further transmission of these infections. 2011 American Sexually Transmitted Diseases Association All rights reserved. |
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