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Article ; Online: Enteral Feeding and Antibiotic Treatment Do Not Influence Increased Coefficient of Variation of Total Fecal Bile Acids in Necrotizing Enterocolitis.

Rothers, Janet L / Calton, Christine M / Stepp, Jennifer Mb / Halpern, Melissa D

Newborn (Clarksville, Md.)

2023 Volume 2, Issue 2, Page(s) 128–132

Abstract: Introduction: Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in preterm infants. In animal models, the accumulation of ileal bile acids (BAs) is a crucial component of NEC pathophysiology. Recently, we showed that the ... ...

Abstract	Introduction: Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in preterm infants. In animal models, the accumulation of ileal bile acids (BAs) is a crucial component of NEC pathophysiology. Recently, we showed that the coefficient of variation of total fecal BAs (CV-TBA) was elevated in infants who develop NEC compared to matched controls. However, neither the type of enteral nutrition nor antibiotic treatments-parameters that could potentially influence BA levels-were used to match pairs. Thus, we assessed the relationships between exposure to enteral feeding types and antibiotic treatments with NEC status and CV-TBA. Materials and methods: Serial fecal samples were collected from 79 infants born with birth weight (BW) ≤1800 gm and estimated gestational age (EGA) ≤32 weeks; eighteen of these infants developed NEC. Total fecal BA levels (TBA) were determined using a commercially available enzyme cycling kit. Relationships between CV-TBA and dichotomous variables (NEC status, demographics, early exposure variables) were assessed by independent samples t-tests. Fisher's exact tests were used to assess relationships between NEC status and categorical variables. Results: High values for CV-TBA levels perfectly predicted NEC status among infants in this study. However, feeding type and antibiotic usage did not drive this relationship. Conclusions: As in previous studies, high values for the CV-TBA levels in the first weeks of life perfectly predicted NEC status among infants. Importantly, feeding type and antibiotic usage-previously identified risk factors for NEC-did not drive this relationship.
Language	English
Publishing date	2023-05-07
Publishing country	United States
Document type	Journal Article
ISSN	2769-514X
ISSN (online)	2769-514X
DOI	10.5005/jp-journals-11002-0063
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Clostridium scindens

Calton, Christine M / Carothers, Katelyn / Ramamurthy, Shylaja / Jagadish, Neha / Phanindra, Bhumika / Garcia, Anett / Viswanathan, V K / Halpern, Melissa D

American journal of physiology. Gastrointestinal and liver physiology

2023 Volume 326, Issue 1, Page(s) G25–G37

Abstract: Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in premature infants. Evidence indicates that bile acid homeostasis is disrupted during NEC: ileal bile acid levels are elevated in animals with experimental NEC, as is ... ...

Abstract	Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in premature infants. Evidence indicates that bile acid homeostasis is disrupted during NEC: ileal bile acid levels are elevated in animals with experimental NEC, as is expression of the apical sodium-dependent bile acid transporter (Asbt). In addition, bile acids, which are synthesized in the liver, are extensively modified by the gut microbiome, including via the conversion of primary bile acids to more cytotoxic secondary forms. We hypothesized that the addition of bile acid-modifying bacteria would increase susceptibility to NEC in a neonatal rat model of the disease. The secondary bile acid-producing species
MeSH term(s)	Animals ; Humans ; Infant, Newborn ; Rats ; Bile Acids and Salts/metabolism ; Enterocolitis, Necrotizing/metabolism ; Organic Anion Transporters, Sodium-Dependent/metabolism ; Up-Regulation ; Clostridiales ; Disease Progression
Chemical Substances	Bile Acids and Salts ; Organic Anion Transporters, Sodium-Dependent ; sodium-bile acid cotransporter (145420-23-1)
Language	English
Publishing date	2023-11-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	603840-2
ISSN	1522-1547 ; 0193-1857
ISSN (online)	1522-1547
ISSN	0193-1857
DOI	10.1152/ajpgi.00102.2023
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Article ; Online: The Quality of End-of-Life Care among ICU versus Ward Decedents.

Rolnick, Joshua A / Ersek, Mary / Wachterman, Melissa W / Halpern, Scott D

American journal of respiratory and critical care medicine

2020 Volume 201, Issue 7, Page(s) 832–839

Abstract: Rationale: ...

Abstract	Rationale:
MeSH term(s)	Aged ; Aged, 80 and over ; Female ; Hospital Mortality ; Hospital Units ; Hospitalization ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Quality of Health Care ; Terminal Care/standards
Language	English
Publishing date	2020-01-15
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.201907-1423OC
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Article ; Online: Clinical Outcomes in Adult Patients With an Anomalous Right Coronary Artery from the Left Sinus of Valsalva.

Warner, Eric D / Gulati, Aishwarya / Halpern, Ethan / Fischman, David L / Ruggiero, Nicholas J / Keith, Scott W / Layser, Robert B / McCarey, Melissa / Savage, Michael P

The American journal of cardiology

2023 Volume 204, Page(s) 122–129

Abstract: An anomalous origin of the right coronary artery from the opposite sinus of Valsalva with an intramural course (R-ACAOS-IM) may cause sudden cardiac death in children and adolescents. However, the natural history and management of patients in whom this ... ...

Abstract	An anomalous origin of the right coronary artery from the opposite sinus of Valsalva with an intramural course (R-ACAOS-IM) may cause sudden cardiac death in children and adolescents. However, the natural history and management of patients in whom this anomaly is detected later during adulthood remains uncertain. The goals of this study were to assess the impact of an R-ACAOS-IM on the clinical outcomes in an adult population and to determine if adult patients with this anomaly who do not have significant coronary artery disease (CAD) can be managed safely without surgical intervention. A database review identified patients aged >35 years with anomalous coronary arteries diagnosed by cardiac catheterization or coronary computed tomography angiography. The outcomes of patients with R-ACAOS-IM were compared with patients with anomalous left circumflex coronary arteries with retroaortic course (LCx-RA) (an anomaly not associated with ischemic events). The primary outcome was all-cause mortality. The study population consisted of 185 patients aged 59 ± 12 years. Clinical characteristics were similar in the R-ACAOS-IM (n = 88) and LCx-RA (n = 97) groups. At a follow-up of 6.6 ± 4.5 years, there was no difference in mortality (hazard ratio 0.64, 95% confidence interval 0.32 to 1.28, p = 0.20) when adjusted for gender, age, and CAD. A subgroup analysis of 88 patients with no obstructive CAD managed nonoperatively found no difference between the LCx and R-ACAOS-IM groups in mortality (hazard ratio 2.45, 95% confidence interval 0.45 to 13.40, p = 0.30). There was no significant difference between the 2 groups in the composite outcome of death, nonfatal myocardial infarction, or survived cardiac arrest. The outcome of adult patients who have anomalous R-ACAOS-IM are similar to patients who have anomalous LCx-RA with a known benign course. In conclusion, these results suggest that most patients who survive this anomaly into adulthood may be managed conservatively without intervention.
MeSH term(s)	Child ; Adolescent ; Humans ; Adult ; Sinus of Valsalva/diagnostic imaging ; Sinus of Valsalva/abnormalities ; Retrospective Studies ; Coronary Angiography/methods ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/surgery ; Coronary Vessel Anomalies/diagnostic imaging ; Coronary Vessel Anomalies/complications
Language	English
Publishing date	2023-08-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2023.07.066
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Article: The role of intestinal epithelial barrier function in the development of NEC.

Halpern, Melissa D / Denning, Patricia W

Tissue barriers

2015 Volume 3, Issue 1-2, Page(s) e1000707

Abstract: The intestinal epithelial barrier plays an important role in maintaining host health. Breakdown of intestinal barrier function is known to play a role in many diseases such as infectious enteritis, idiopathic inflammatory bowel disease, and neonatal ... ...

Abstract	The intestinal epithelial barrier plays an important role in maintaining host health. Breakdown of intestinal barrier function is known to play a role in many diseases such as infectious enteritis, idiopathic inflammatory bowel disease, and neonatal inflammatory bowel diseases. Recently, increasing research has demonstrated the importance of understanding how intestinal epithelial barrier function develops in the premature neonate in order to develop strategies to promote its maturation. Optimizing intestinal barrier function is thought to be key to preventing neonatal inflammatory bowel diseases such as necrotizing enterocolitis. In this review, we will first summarize the key components of the intestinal epithelial barrier, what is known about its development, and how this may explain NEC pathogenesis. Finally, we will review what therapeutic strategies may be used to promote optimal development of neonatal intestinal barrier function in order to reduce the incidence and severity of NEC.
Language	English
Publishing date	2015
Publishing country	United States
Document type	Journal Article
ISSN	2168-8362
ISSN	2168-8362
DOI	10.1080/21688370.2014.1000707
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Article ; Online: Elevated Coefficient of Variation in Total Fecal Bile Acids Precedes Diagnosis of Necrotizing Enterocolitis.

Knapp, Shannon / Kehring, Allysa / Stepp, Jennifer / Calton, Christine M / Gephart, Sheila M / Bandlamuri, Sruti / Boyle, Kate E / Dietz, Grey I / Johnson, Haeley / Romo, Ryan E / Spencer, Mackenzie / Bedrick, Alan D / Halpern, Melissa D

Scientific reports

2020 Volume 10, Issue 1, Page(s) 249

Abstract: Accumulation of bile acids (BAs) may mediate development of necrotizing enterocolitis (NEC). Serial fecal samples were collected from premature infants with birth weight (BW) ≤ 1800 g, estimated gestational age (EGA) ≤ 32 weeks, and <30 days old prior to ...

Abstract	Accumulation of bile acids (BAs) may mediate development of necrotizing enterocolitis (NEC). Serial fecal samples were collected from premature infants with birth weight (BW) ≤ 1800 g, estimated gestational age (EGA) ≤ 32 weeks, and <30 days old prior to initiation of enteral feeding. Nine infants that developed Bell's Stage ≥ II NEC were matched with control infants based on BW, EGA, day of life (DOL) enteral feeding was initiated and DOL of the first sample. From each subject, five samples matched by DOL collected were analyzed for BA levels and composition. Fifteen individual BA species were measured via LC-MS/MS and total BA levels were measured using the Diazyme Total Bile Acid Assay kit. No statistically significant differences in composition were observed between control and NEC at the level of individual species (p = 0.1133) or grouped BAs (p = 0.0742). However, there was a statistically significant difference (p = 0.000012) in the mean coefficient of variation (CV) between the two groups with infants developing NEC having more than four-fold higher mean CV than controls. Importantly, these variations occurred prior to NEC diagnosis. These data suggest fluctuations in total fecal BA levels could provide the basis for the first predictive clinical test for NEC.
MeSH term(s)	Bile Acids and Salts/chemistry ; Bile Acids and Salts/metabolism ; Enterocolitis, Necrotizing/diagnosis ; Enterocolitis, Necrotizing/metabolism ; Feces/chemistry ; Female ; Humans ; Infant ; Male
Chemical Substances	Bile Acids and Salts
Language	English
Publishing date	2020-01-14
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-019-57178-0
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Article ; Online: Biodiversity monitoring for a just planetary future.

Chapman, Melissa / Goldstein, Benjamin R / Schell, Christopher J / Brashares, Justin S / Carter, Neil H / Ellis-Soto, Diego / Faxon, Hilary Oliva / Goldstein, Jenny E / Halpern, Benjamin S / Longdon, Joycelyn / Norman, Kari E A / O'Rourke, Dara / Scoville, Caleb / Xu, Lily / Boettiger, Carl

Science (New York, N.Y.)

2024 Volume 383, Issue 6678, Page(s) 34–36

Abstract: Data that influence policy and major investment decisions risk entrenching social and political inequities. ...

Abstract	Data that influence policy and major investment decisions risk entrenching social and political inequities.
MeSH term(s)	Biodiversity ; Ecological Parameter Monitoring ; Socioeconomic Factors ; Humans ; Investments ; Decision Making
Language	English
Publishing date	2024-01-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	128410-1
ISSN	1095-9203 ; 0036-8075
ISSN (online)	1095-9203
ISSN	0036-8075
DOI	10.1126/science.adh8874
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Article: Does abnormal bile acid metabolism contribute to NEC?

Halpern, Melissa D / Dvorak, Bohuslav

Seminars in perinatology

2007 Volume 32, Issue 2, Page(s) 114–121

Abstract: Bile acids (BAs) facilitate emulsification, absorption, and transport of fats and sterols in the intestine and liver and are essential for normal digestion. However, accumulation of BAs in the intestine can result in damage to the intestinal epithelium. ... ...

Abstract	Bile acids (BAs) facilitate emulsification, absorption, and transport of fats and sterols in the intestine and liver and are essential for normal digestion. However, accumulation of BAs in the intestine can result in damage to the intestinal epithelium. Using the neonatal rat model of necrotizing enterocolitis (NEC), we have recently shown that BAs accumulate in both the ileal lumen and enterocytes of neonatal rats with NEC and the increased BA levels are positively correlated with disease severity. Importantly, when BAs are not allowed to accumulate, neonatal rat pups develop significantly less disease. In addition, BA transporters are altered during disease development. These data indicate that BAs play an important role in the development of experimental NEC, and suggest that the inability of neonatal rats to adequately regulate BA transporters may be a mechanism by which ileal damage occurs.
MeSH term(s)	Animals ; Bile Acids and Salts/adverse effects ; Bile Acids and Salts/metabolism ; Disease Models, Animal ; Enterocolitis, Necrotizing/etiology ; Enterocolitis, Necrotizing/pathology ; Humans ; Immunohistochemistry ; Infant, Newborn ; Infant, Premature ; Intestinal Mucosa/drug effects ; Intestinal Mucosa/injuries ; Intestinal Mucosa/pathology ; Portal System ; Rats ; Severity of Illness Index
Chemical Substances	Bile Acids and Salts
Language	English
Publishing date	2007-11-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	752403-1
ISSN	1558-075X ; 0146-0005
ISSN (online)	1558-075X
ISSN	0146-0005
DOI	10.1053/j.semperi.2008.01.005
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Article ; Online: Elevated Coefficient of Variation in Total Fecal Bile Acids Precedes Diagnosis of Necrotizing Enterocolitis

Shannon Knapp / Allysa Kehring / Jennifer Stepp / Christine M. Calton / Sheila M. Gephart / Sruti Bandlamuri / Kate E. Boyle / Grey I. Dietz / Haeley Johnson / Ryan E. Romo / Mackenzie Spencer / Alan D. Bedrick / Melissa D. Halpern

Scientific Reports, Vol 10, Iss 1, Pp 1-

2020 Volume 10

Abstract: Abstract Accumulation of bile acids (BAs) may mediate development of necrotizing enterocolitis (NEC). Serial fecal samples were collected from premature infants with birth weight (BW) ≤ 1800 g, estimated gestational age (EGA) ≤ 32 weeks, and <30 days old ...

Abstract	Abstract Accumulation of bile acids (BAs) may mediate development of necrotizing enterocolitis (NEC). Serial fecal samples were collected from premature infants with birth weight (BW) ≤ 1800 g, estimated gestational age (EGA) ≤ 32 weeks, and <30 days old prior to initiation of enteral feeding. Nine infants that developed Bell’s Stage ≥ II NEC were matched with control infants based on BW, EGA, day of life (DOL) enteral feeding was initiated and DOL of the first sample. From each subject, five samples matched by DOL collected were analyzed for BA levels and composition. Fifteen individual BA species were measured via LC-MS/MS and total BA levels were measured using the Diazyme Total Bile Acid Assay kit. No statistically significant differences in composition were observed between control and NEC at the level of individual species (p = 0.1133) or grouped BAs (p = 0.0742). However, there was a statistically significant difference (p = 0.000012) in the mean coefficient of variation (CV) between the two groups with infants developing NEC having more than four-fold higher mean CV than controls. Importantly, these variations occurred prior to NEC diagnosis. These data suggest fluctuations in total fecal BA levels could provide the basis for the first predictive clinical test for NEC.
Keywords	Medicine ; R ; Science ; Q
Subject code	690
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Nature Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Authors Respond.

Halpern-Felsher, Bonnie / Vallone, Donna / Hair, Elizabeth / Ling, Pamela / Song, Anna V / Bondy, Melissa L / Boykan, Rachel

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

2020 Volume 68, Issue 1, Page(s) 216–221

MeSH term(s)	Adolescent ; COVID-19 ; Electronic Nicotine Delivery Systems ; Humans ; SARS-CoV-2 ; Smoking ; Vaping
Language	English
Publishing date	2020-11-26
Publishing country	United States
Document type	Letter ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Comment
ZDB-ID	1063374-1
ISSN	1879-1972 ; 1054-139X
ISSN (online)	1879-1972
ISSN	1054-139X
DOI	10.1016/j.jadohealth.2020.10.017
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