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4196 MICROBIAL COMPOSITION DEFINES PELVIC PAIN PHENOTYPES IN REPRODUCTIVE-AGE WOMEN
- A. Lenore Ackerman, Muhammed Umair Khalique, James E. Ackerman, Zhi Cheng, Karyn S. Eilber, Jennifer T. Anger, David M. Underhill
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- Journal:
- Journal of Clinical and Translational Science / Volume 4 / Issue s1 / June 2020
- Published online by Cambridge University Press:
- 29 July 2020, pp. 12-13
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- Article
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OBJECTIVES/GOALS: In young women, there is significant symptomatic overlap among lower urinary tract conditions, including bladder and pelvic pain, leading to misdiagnosis and delayed care. The epidemiology of pelvic pain suggests a microbial involvement, but previous studies have not definitively identified specific bacteria associated with pain diagnoses. METHODS/STUDY POPULATION: We examined urinary bacterial associations with specific symptom clusters, not diagnoses. Catheterized urinary samples were obtained from 78 pre-menopausal controls and cases with bladder and pelvic pain. 16S next-generation sequencing (NGS) characterized urinary microbial populations; validated questionnaires quantified symptom type and severity. K means unsupervised clustering analysis of NGS data assigned subjects to urotypes based on the urinary bacterial community state types. Quantitative PCR (qPCR) confirmed the NGS results and provided objective concentrations for critical taxa. Linear regression analysis confirmed the associations of bacterial concentrations and specific symptoms. RESULTS/ANTICIPATED RESULTS: In a pilot study of 35 reproductive-age women with a variety of complaints NGS revealed four urotypes that correlated with symptomatology. Isolated urgency incontinence was rare; the majority of subjects with symptoms complained of genitourinary pain. Bladder-specific pain (worse with filling, relieved by voiding) was associated with Lactobacillus iners. Asymptomatic patients almost universally had a non-iners, Lactobacillus-predominant microbiota. Vaginal and urethral pain unrelated to voiding correlated with increasing Enterobacteriaceae, primarily Escherichia coli. Detection of these species by qPCR in a validation population (n = 43) was highly predictive of each phenotype (P < 0.00001). Pathologic bacteria were associated with the severity of specific pain symptoms. DISCUSSION/SIGNIFICANCE OF IMPACT: Our results implicate a microbial role in genitourinary pain. We describe clinically-useful bacterial biomarkers for specific pelvic and bladder pain phenotypes. This objective, rapid, and inexpensive testing to classify bladder and pelvic pain would allow more accurate diagnosis and improve treatment. CONFLICT OF INTEREST DESCRIPTION: Dr. Anger is an expert witness for Boston Scientific. Dr. Eilber is an investigator and expert witness for Boston Scientific, an investigator for Aquinox, and a consultant for Boston Scientific and Allergan. Dr. Ackerman is an expert witness for Cynosure.
Rethinking Human Responses to Sea-level Rise: The Mesolithic Occupation of the Channel Islands
- Chantal Conneller, Martin Bates, Richard Bates, Tim Schadla-Hall, Edward Blinkhorn, James Cole, Matt Pope, Beccy Scott, Andy Shaw, David Underhill
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- Journal:
- Proceedings of the Prehistoric Society / Volume 82 / December 2016
- Published online by Cambridge University Press:
- 03 March 2016, pp. 27-71
- Print publication:
- December 2016
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This work provides new insights into human responses to and perceptions of sea-level rise at a time when the landscapes of north-west Europe were radically changing. These issues are investigated through a case study focused on the Channel Islands. We report on the excavation of two sites, Canal du Squez in Jersey and Lihou (GU582) in Guernsey, and the study of museum collections across the Channel Islands. We argue that people were drawn to this area as a result of the dynamic environmental processes occurring and the opportunities these created. The evidence suggests that the area was a particular focus during the Middle Mesolithic, when Guernsey and Alderney were already islands and while Jersey was a peninsula of northern France. Insularisation does not appear to have created a barrier to occupation during either the Middle or Final Mesolithic, indicating the appearance of lifeways increasingly focused on maritime voyaging and marine resources from the second half of the 9th millennium BC onwards.
Contributors
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- By Zachary W. Adams, Margarita Alegría, Atalay Alem, Jordi Alonso, Victor Aparicio, Rifat Atun, Florence Baingana, Emily Baron, Marco Bertelli, Dinesh Bhugra, Sanchita Biswas, José Miguel Caldas de Almeida, Edwin Cameron, Somnath Chatterji, Erminia Colucci, Janice L. Cooper, Carla Kmett Danielson, Diego De Leo, Mary-Jo DelVecchio Good, Marten W. de Vries, Maureen S. Durkin, Xiangming Fang, Julia W. Felton, Sally Field, Andrea Fiorillo, Lance Gable, Teddy Gafna, Sandro Galea, Patrick Gatonga, Sofia Halperin-Goldstein, Yanling He, Grace A. Herbert, Sabrina Hermosilla, Simone Honikman, Takashi Izutsu, Ruwan M. Jayatunge, Janis H. Jenkins, Rachel Jenkins, Lynne Jones, Jayanthi Karunaratne, Ronald C. Kessler, Rob Keukens, Lincoln I. Khasakhala, Hanna Kienzler, Sarah Kippen Wood, M. Thomas Kishore, Robert Kohn, Natasja Koitzsch Jensen, Sheri Lapatin, Anna Lessios, Isabel Louro Bernal, Feijun Luo, Laura MacPherson, Matthew J. Maenner, Anne W. Mbwayo, David McDaid, Ingrid Meintjes, Victoria N. Mutiso, David M. Ndetei, Samuel O. Okpaku, Lijing Ouyang, Ramachandran Padmavati, Clare Pain, Duncan Pedersen, Jordan Pfau, Felipe Picon, Rodney D. Presley, Reima Pryor, Shoba Raja, Thara Rangaswamy, Jorge Rodriguez, Diana Rose, Moosa Salie, Norman Sartorius, Ester Shapiro, Manuela Silva, Daya Somasundaram, Katherine Sorsdahl, Dan J. Stein, Deborah M. Stone, Heather Stuart, Athula Sumathipala, Hema Tharoor, Rita Thom, Lay San Too, Atsuro Tsutsumi, Chris Underhill, Anne Valentine, Claire van der Westhuizen, Thandi van Heyningen, Robert van Voren, Inka Weissbecker, Gail Wyatt
- Edited by Samuel O. Okpaku
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- Book:
- Essentials of Global Mental Health
- Published online:
- 05 March 2014
- Print publication:
- 27 February 2014, pp x-xiv
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3 - Mapping and monitoring bird populations: their conservation uses
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- By Les Underhill, Avian Demography Unit, Department of Statistical Services, University of Cape Town, Rondebosch 7700, South Africa, David Gibbons, Conservation Science Department, RSPB, The Lodge, Sandy, Bedfordshire SG19 2DL UK
- Edited by Ken Norris, University of Reading, Deborah J. Pain, Royal Society for the Protection of Birds
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- Book:
- Conserving Bird Biodiversity
- Published online:
- 10 December 2009
- Print publication:
- 06 June 2002, pp 34-60
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Summary
INTRODUCTION
Accurate and up-to-date distribution maps and a good numerical insight into population sizes and trends are a prerequisite for effective conservation. The conservation status of a species hinges on three questions: ‘Where are they?’, ‘How many are there?’ and ‘What is their trend?’ This chapter focuses on providing answers to these questions. We cannot conserve what we do not understand.
This chapter provides a series of examples and case studies into conservation applications of bird inventories and bird monitoring. However, even the best inventories and perfect monitoring make no contribution to conservation on their own. This information simply allows an assessment of the status of a species or a site: it will not, for example, halt a species' decline. Explanations need to be found for trends, and management and action plans need to be compiled and implemented. Monitoring needs to be built into these actions, otherwise we have no measure of the impact of conservation interventions.
One of the most outstanding conservation successes of the twentieth century – the widespread removal of organochlorine insecticides from the environment – showed clearly the role that monitoring plays in bird conservation. These harmful chemicals caused direct mortality of adult birds of prey, most notably peregrines (Falco peregrinus), through accumulation in body tissues, and caused indirect mortality through thinning of their eggshells leading to reduced hatching success and poorer breeding performance. Consequently, peregrine populations declined worldwide, and only recovered when organochlorine usage was reduced.