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Real-World Comparative Effectiveness Of Tocilizumab Monotherapy Vs. Tumor Necrosis Factor Inhibitors With Methotrexate In Patients With Rheumatoid Arthritis, Leslie R. Harrold, George W. Reed, Jennie Best, Steve Zlotnick, Joel M. Kremer 2018 University of Massachusetts Medical School

Real-World Comparative Effectiveness Of Tocilizumab Monotherapy Vs. Tumor Necrosis Factor Inhibitors With Methotrexate In Patients With Rheumatoid Arthritis, Leslie R. Harrold, George W. Reed, Jennie Best, Steve Zlotnick, Joel M. Kremer

Open Access Articles

INTRODUCTION: Controlled clinical studies have shown that the efficacy of tocilizumab (TCZ) monotherapy is superior to that of tumor necrosis factor inhibitor (TNFi) monotherapy and comparable to that of TCZ plus methotrexate (MTX) for the treatment of rheumatoid arthritis (RA). This study compared the real-world effectiveness of TCZ monotherapy vs. TNFis plus MTX in US patients with RA.

METHODS: TCZ-naive patients from the Corrona RA registry with prior exposure to > /= 1 TNFi who initiated TCZ monotherapy or TNFi + MTX were included. Outcomes included mean change in Clinical Disease Activity Index (CDAI), achievement of low disease activity (LDA; CDAI < /= 10), achievement of modified American College of Rheumatology (mACR) 20/50 responses, and mean change in modified Health Assessment Questionnaire (mHAQ) at 6 months. Patients initiating TNFi + MTX were grouped by MTX dose ( < /= 10 mg; > 10 to ...


How To Translate Self-Management Support Tools Into Clinical Practice, Matthew J. Simpson, Jeanette M. Daly, Douglas H. Fernald, John M. Westfall, LeAnn C. Michaels, Barcey T. Levy, David L. Hahn, Lyle J. Fagnan, Donald E. Nease Jr. 2018 University of Colorado School of Medicine

How To Translate Self-Management Support Tools Into Clinical Practice, Matthew J. Simpson, Jeanette M. Daly, Douglas H. Fernald, John M. Westfall, Leann C. Michaels, Barcey T. Levy, David L. Hahn, Lyle J. Fagnan, Donald E. Nease Jr.

Journal of Patient-Centered Research and Reviews

Purpose: Patient self-management is an inevitable part of the work of being a patient, and self-management support (SMS) has become increasingly important in chronic disease management. However, the majority of SMS resources available in the Agency for Healthcare Research and Quality SMS Resource Library were developed without explicit collaboration between clinicians and patients.

Methods: Translation of SMS tools derived from the library into primary care practices occurred utilizing boot camp translation in four different practice-based research networks (PBRNs). The typical model of boot camp translation was adapted for the purpose of the Implementing Networks’ Self-management Tools Through Engaging Patients and ...


The Wilbarger Protocol, Brittany Hatlestad 2018 Augustana College, Rock Island Illinois

The Wilbarger Protocol, Brittany Hatlestad

Biology: Student Scholarship & Creative Works

Sensory processing disorder (SPD) is ever-increasing in children with and without disabilities. The prevalence of such a diagnosis has given rise to many different therapeutic practices. The most prescriptive, the Wilbarger protocol, will be the topic of this technique and literature review with discussions of what sensory problems are, the Wilbarger protocol, the deep pressure and proprioceptive portion of the protocol, oral tactile techniques, mechanisms of the protocol, the limitations, other options for treatment, and will conclude by looking to future research.


Comparison Of Prescribing Practices For Older Adults Treated By Female Versus Male Physicians: A Retrospective Cohort Study, Paula A. Rochon, Jerry H. Gurwitz 2018 University of Toronto

Comparison Of Prescribing Practices For Older Adults Treated By Female Versus Male Physicians: A Retrospective Cohort Study, Paula A. Rochon, Jerry H. Gurwitz

Open Access Articles

IMPORTANCE: Subtle but important differences have been described in the way that male and female physicians care for their patients, with some evidence suggesting women are more likely to adhere to best practice recommendations.

OBJECTIVE: To determine if male and female physicians differ in their prescribing practices as measured by the initiation of lower-than-recommended dose cholinesterase inhibitor (ChEI) drug therapy for dementia management.

DESIGN, SETTING, AND PARTICIPANTS: All community-dwelling Ontario residents aged 66 years and older with dementia and newly dispensed an oral ChEI drug (donepezil, galantamine, or rivastigmine) between April 1, 2010 and June 30, 2016 were included.

MAIN ...


Microrna-96 Promotes Schistosomiasis Hepatic Fibrosis In Mice By Suppressing Smad7, Xufeng Luo, Dongmei Zhang, Jun Xie, Qin Su, Xing He, Ruipu Bai, Guangping Gao, Weiqing Pan 2018 Second Military Medical University (China)

Microrna-96 Promotes Schistosomiasis Hepatic Fibrosis In Mice By Suppressing Smad7, Xufeng Luo, Dongmei Zhang, Jun Xie, Qin Su, Xing He, Ruipu Bai, Guangping Gao, Weiqing Pan

Open Access Articles

Infection with Schistosoma causes aberrant expression of host microRNAs (miRNAs), and normalizing the levels of dysregulated miRNAs can attenuate pathology. Here, we show that the host miRNA, miR-96, is markedly upregulated during the progression of hepatic schistosomiasis. We demonstrate that elevation of miR-96 induces hepatic fibrosis in infected mice by suppressing the expression of its target gene, Smad7. We show that infection with Schistosoma induces the expression of transforming growth factor beta1 (TGF-beta1), which in turn upregulates the expression of miR-96 through SMAD2/3-DROSHA-mediated post-transcriptional regulation. Furthermore, inhibition of miR-96 with recombinant adeno-associated virus 8 (rAAV8)-mediated delivery of Tough ...


Protection Induced By A Francisella Tularensis Subunit Vaccine Delivered By Glucan Particles, Adam O. Whelan, Helen C. Flick-Smith, Jane Homan, Zu T. Shen, Zoe Carpenter, Payam Khoshkenar, Ambily Abraham, Nicola J. Walker, Stuart M. Levitz, Gary R. Ostroff, Petra C. F. Oyston 2018 Dstl Porton Down

Protection Induced By A Francisella Tularensis Subunit Vaccine Delivered By Glucan Particles, Adam O. Whelan, Helen C. Flick-Smith, Jane Homan, Zu T. Shen, Zoe Carpenter, Payam Khoshkenar, Ambily Abraham, Nicola J. Walker, Stuart M. Levitz, Gary R. Ostroff, Petra C. F. Oyston

Open Access Articles

Francisella tularensis is an intracellular pathogen causing the disease tularemia, and an organism of concern to biodefence. There is no licensed vaccine available. Subunit approaches have failed to induce protection, which requires both humoral and cellular immune memory responses, and have been hampered by a lack of understanding as to which antigens are immunoprotective. We undertook a preliminary in silico analysis to identify candidate protein antigens. These antigens were then recombinantly expressed and encapsulated into glucan particles (GPs), purified Saccharomyces cerevisiae cell walls composed primarily of beta-1,3-glucans. Immunological profiling in the mouse was used to down-selection to seven lead ...


Adeno-Associated Virus Neutralizing Antibodies In Large Animals And Their Impact On Brain Intraparenchymal Gene Transfer, Dan Wang, Li Zhong, Mengxin Li, Jia Li, Karen Tran, Lingzhi Ren, Ran He, Jun Xie, Richard P. Moser, Cara Fraser, Tim Kuchel, Miguel Sena-Esteves, Terence R. Flotte, Neil Aronin, Guangping Gao 2018 University of Massachusetts Medical School

Adeno-Associated Virus Neutralizing Antibodies In Large Animals And Their Impact On Brain Intraparenchymal Gene Transfer, Dan Wang, Li Zhong, Mengxin Li, Jia Li, Karen Tran, Lingzhi Ren, Ran He, Jun Xie, Richard P. Moser, Cara Fraser, Tim Kuchel, Miguel Sena-Esteves, Terence R. Flotte, Neil Aronin, Guangping Gao

Open Access Articles

Pre-existing neutralizing antibody (NAb) against adeno-associated virus (AAV) commonly found in primates is a major host barrier that can severely compromise in vivo gene transfer by AAV vectors. To achieve proof-of-concept success in clinical development of recombinant AAV (rAAV)-based in vivo gene therapy, it is crucial to consider the potential interference of NAb and to enroll serologically compatible study subjects. In this study, we report a large AAV NAb dataset comprising multiple large animal species and AAV serotypes and compare two NAb assays based on in vitro or in vivo transduction inhibition, respectively. Together with previously published AAV seroepidemiology ...


The Implementation Process For Pharmacogenomic Testing For Cancer-Targeted Therapies, Ann Chen Wu, Kathleen M. Mazor, Rachel Ceccarelli, Stephanie Loomer, Christine Y. Lu 2018 Harvard Medical School

The Implementation Process For Pharmacogenomic Testing For Cancer-Targeted Therapies, Ann Chen Wu, Kathleen M. Mazor, Rachel Ceccarelli, Stephanie Loomer, Christine Y. Lu

Open Access Articles

Recent advances in genomic medicine have led to the availability of genomic tests that have the potential to improve population health, yet the process for obtaining these tests and getting them reimbursed by insurers has not been described. The objective of this study was to describe the process of ordering pharmacogenomic tests by interviewing providers, patients, and laboratories about cancer-related pharmacogenomic tests. We interviewed patients who were prescribed, providers who prescribed medications that should be guided by pharmacogenomic testing, and individuals from diagnostic laboratories. A total of 10 providers, 16 patients, and eight diagnostic laboratories described logistical and insurance issues ...


Reduced Incidence And Better Liver Disease Outcomes Among Chronic Hcv Infected Patients Who Consume Cannabis, Adeyinka Adejumo, Oluwole Muyiwa Adegbala, Kelechi Lauretta Adejumo, Terence N. Bukong 2018 University of Massachusetts Medical School

Reduced Incidence And Better Liver Disease Outcomes Among Chronic Hcv Infected Patients Who Consume Cannabis, Adeyinka Adejumo, Oluwole Muyiwa Adegbala, Kelechi Lauretta Adejumo, Terence N. Bukong

Open Access Articles

Background and Aim: The effect of cannabis use on chronic liver disease (CLD) from Hepatitis C Virus (HCV) infection, the most common cause of CLD, has been controversial. Here, we investigated the impact of cannabis use on the prevalence of CLD among HCV infected individuals.

Methods: We analyzed hospital discharge records of adults (age > /= 18 years) with a positive HCV diagnosis. We evaluated records from 2007 to 2014 of the Nationwide Inpatient Sample (NIS). We excluded records with other causes of chronic liver diseases (alcohol, hemochromatosis, NAFLD, PBC, HBV, etc.). Of the 188,333 records, we matched cannabis users to ...


All-In-One Adeno-Associated Virus Delivery And Genome Editing By Neisseria Meningitidis Cas9 In Vivo, Raed Ibraheim, Chun-Qing Song, Aamir Mir, Nadia Amrani, Wen Xue, Erik J. Sontheimer 2018 University of Massachusetts Medical School

All-In-One Adeno-Associated Virus Delivery And Genome Editing By Neisseria Meningitidis Cas9 In Vivo, Raed Ibraheim, Chun-Qing Song, Aamir Mir, Nadia Amrani, Wen Xue, Erik J. Sontheimer

RNA Therapeutics Institute Publications

BACKGROUND: Clustered, regularly interspaced, short palindromic repeats (CRISPR) and CRISPR-associated proteins (Cas) have recently opened a new avenue for gene therapy. Cas9 nuclease guided by a single-guide RNA (sgRNA) has been extensively used for genome editing. Currently, three Cas9 orthologs have been adapted for in vivo genome engineering applications: Streptococcus pyogenes Cas9 (SpyCas9), Staphylococcus aureus Cas9 (SauCas9), and Campylobacter jejuni (CjeCas9). However, additional in vivo editing platforms are needed, in part to enable a greater range of sequences to be accessed via viral vectors, especially those in which Cas9 and sgRNA are combined into a single vector genome.

RESULTS: Here ...


Macular Phototoxicity After Corneal Cross-Linking, Paulo Rodolfo Barbisan Tagliari, Marina Goncalves Viturino Monteiro, Fernanda Maria Souto Silveira, Bo Tian, Roberto Damian Pacheco Pinto, Lucas Barasnevicius Quagliato, Mauricio Abujamra Nascimento, Rosane Silvestre de Castro, Carlos Eduardo Arieta Leite 2018 State University of Campinas, Brazil

Macular Phototoxicity After Corneal Cross-Linking, Paulo Rodolfo Barbisan Tagliari, Marina Goncalves Viturino Monteiro, Fernanda Maria Souto Silveira, Bo Tian, Roberto Damian Pacheco Pinto, Lucas Barasnevicius Quagliato, Mauricio Abujamra Nascimento, Rosane Silvestre De Castro, Carlos Eduardo Arieta Leite

Open Access Articles

Purpose: To assess potential vascular, structural, and functional changes to the macula in patients with keratoconus that underwent ultraviolet A (UVA)-riboflavin-mediated corneal collagen cross-linking (CXL) therapy.

Patients and methods: Seventeen eyes from 17 patients of age 16 years or older with keratoconus undergoing CXL treatment were studied. The same eye served as its own control (before CXL vs after CXL). Eyes were evaluated in terms of best-corrected visual acuity (BCVA), refractive error, intraocular pressure, Amsler grid, retinography, fluorescein angiography, autofluorescence, and spectral domain optical coherence tomography (SD-OCT) prior to CXL and 7 and 30 days after treatment. Multifocal electroretinography ...


Treatment Of Triple-Negative Breast Cancer Cells With The Canady Cold Plasma Conversion System: Preliminary Results, Xiaoqian Cheng, Warren Rowe, Lawan Ly, Alexey Shashurin, Taisen Zhuang, Shruti Wigh, Giacomo Basadonna, Barry Trink, Michael Keidar, Jerome Canady 2018 Jerome Canady Research Institute for Advanced Biological and Technological Sciences

Treatment Of Triple-Negative Breast Cancer Cells With The Canady Cold Plasma Conversion System: Preliminary Results, Xiaoqian Cheng, Warren Rowe, Lawan Ly, Alexey Shashurin, Taisen Zhuang, Shruti Wigh, Giacomo Basadonna, Barry Trink, Michael Keidar, Jerome Canady

Open Access Articles

Triple-negative breast cancer is a phenotype of breast cancer where the expression level of estrogen, progesterone and human epidermal growth factor receptor 2 (HER2) receptors are low or absent. It is more frequently diagnosed in younger and premenopausal women, among which African and Hispanic have a higher rate. Cold atmospheric plasma has revealed its promising ant-cancer capacity over the past two decades. In this study, we report the first cold plasma jet delivered by the Canady Cold Plasma Conversion Unit and characterization of its electric and thermal parameters. The unit effectively reduced the viability of triple-negative breast cancer up to ...


Pneumatic Balloon Dilation Versus Myotomy For The Treatment Of Achalsia, Benjamin E. Ueberroth 2018 Wayne State University School of Medicine

Pneumatic Balloon Dilation Versus Myotomy For The Treatment Of Achalsia, Benjamin E. Ueberroth

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Moonen A, Annese V, Belmans A, et al. Long-term results of the European achalasia trial: A multicentre randomised controlled trial comparing pneumatic dilation versus laparoscopic Heller myotomy. Gut. 2016 May;65(5):732-9. doi: 10.1136/gutjnl-2015-310602.


Prevalence And Management Of Iron Overload In Pyruvate Kinase Deficiency: Report From The Pyruvate Kinase Deficiency Natural History Study, Eduard J. van Beers, Peter E. Newburger, Rachael F. Grace 2018 University Medical Center Utrecht

Prevalence And Management Of Iron Overload In Pyruvate Kinase Deficiency: Report From The Pyruvate Kinase Deficiency Natural History Study, Eduard J. Van Beers, Peter E. Newburger, Rachael F. Grace

Open Access Articles

Pyruvate kinase (PK) deficiency is the most common red cell glycolytic enzyme defect causing hereditary non-spherocytic hemolytic anemia. Current treatments are mainly supportive and include red cell transfusions and splenectomy.11 Regular red cell transfusions are known to result in iron overload; however, the prevalence and spectrum of transfusion-independent iron overload in the overall PK deficient population has not been well defined. This analysis describes the prevalence and clinical characteristics of iron overload in patients enrolled in the PK Deficiency Natural History Study (NHS) with a focus on those patients who are not regularly transfused.2


Icatibant Is Not An Appropriate Treatment Option For Ace-Inhibitor Induced Angioedema Of The Head And Neck, Faiz Khaja 2018 Wayne State University School of Medicine

Icatibant Is Not An Appropriate Treatment Option For Ace-Inhibitor Induced Angioedema Of The Head And Neck, Faiz Khaja

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Sinert T, Levy P, Bernstein JA, et al. Randomized trial of icatibant for angiotensin-converting enzyme inhibitor-induced upper airway angioedema. J Allergy Clin Immunol Pract. 2017;5(5):1402-9. doi: 10.1016/j.jaip.2017.03.003


The Canady Helios Cold Plasma Scalpel Significantly Decreases Viability In Malignant Solid Tumor Cells In A Dose-Dependent Manner, Warren Rowe, Xiaoqian Cheng, Lawan Ly, Taisen Zhuang, Giacomo Basadonna, Barry Trink, Michael Keidar, Jerome Canady 2018 Jerome Canady Research Institute for Advanced Biological and Technological Sciences

The Canady Helios Cold Plasma Scalpel Significantly Decreases Viability In Malignant Solid Tumor Cells In A Dose-Dependent Manner, Warren Rowe, Xiaoqian Cheng, Lawan Ly, Taisen Zhuang, Giacomo Basadonna, Barry Trink, Michael Keidar, Jerome Canady

Open Access Articles

To determine appropriate treatment doses of cold atmospheric plasma (CAP), the Canady Helios Cold Plasma Scalpel was tested across numerous cancer cell types including renal adenocarcinoma, colorectal carcinoma, pancreatic adenocarcinoma, ovarian adenocarcinoma, and esophageal adenocarcinoma. Various CAP doses were tested consisting of both high (3 L/min) and low (1 L/min) helium flow rates, several power settings, and a range of treatment times up to 5 min. The impact of cold plasma on the reduction of viability was consistently dose-dependent; however, the anti-cancer capability varied significantly between cell lines. While the lowest effective dose varied from cell line to ...


Support-Af: Piloting A Multi-Faceted, Electronic Medical Record-Based Intervention To Improve Prescription Of Anticoagulation, Alok Kapoor, Azraa Amroze, Jessica G. Golden, Sybil L. Crawford, Kevin O'Day, Rasha Elhag, Ahmed Nagy, Steve A. Lubitz, Jane S. Saczynski, Jomol Mathew, David D. McManus 2018 Boston University School of Medicine

Support-Af: Piloting A Multi-Faceted, Electronic Medical Record-Based Intervention To Improve Prescription Of Anticoagulation, Alok Kapoor, Azraa Amroze, Jessica G. Golden, Sybil L. Crawford, Kevin O'Day, Rasha Elhag, Ahmed Nagy, Steve A. Lubitz, Jane S. Saczynski, Jomol Mathew, David D. Mcmanus

Open Access Articles

Background: Only 50% of eligible atrial fibrillation ( AF ) patients receive anticoagulation ( AC ). Feasibility and effectiveness of electronic medical record (EMR)-based interventions to profile and raise provider AC percentage is poorly understood. The SUPPORT-AF (Supporting Use of AC Through Provider Profiling of Oral AC Therapy for AF) study aims to improve rates of adherence to AC guidelines by developing and delivering supportive tools based on the EMR to providers treating patients with AF.

Methods and Results: We emailed cardiologists and community-based primary care providers affiliated with our institution reports of their AC percentage relative to peers. We also sent an ...


Relapsed Ovarian High-Grade Serous Carcinoma With Long-Term Survival Associated With Synchronous Primary Squamous Cell Carcinoma Of The Colon, Karla Sladoljev, Ena Perin, Ani Mihaljević Ferrari, Marko Klarić, Alemka Brnčić-Fischer, Senija Eminović, Danijela Vrdoljak-Mozetič, Emina Babarovic 2018 School of Medicine University of Rijeka, University of Rijeka, Croatia

Relapsed Ovarian High-Grade Serous Carcinoma With Long-Term Survival Associated With Synchronous Primary Squamous Cell Carcinoma Of The Colon, Karla Sladoljev, Ena Perin, Ani Mihaljević Ferrari, Marko Klarić, Alemka Brnčić-Fischer, Senija Eminović, Danijela Vrdoljak-Mozetič, Emina Babarovic

Proceedings in Obstetrics and Gynecology

High-grade serous ovarian cancer (HGSOC) is the most common and also the most aggressive subtype of ovarian cancer while squamous cell carcinoma (SCC) of the colon is an extremely rare histologic subtype of all colonic malignancies with poor prognosis.

Here we report a unique case of synchronous primary SCC of the colon and second recurrence of HGSOC in a patient with 15-years survival. Our patient developed two recurrent HGSOCs with disease-free survival time of five and nine years, respectively. The second recurrence of HGSOC was associated with the synchronous primary SCC of the ascending colon and was further complicated with ...


One Group's Historical Reflections On Dna Vaccine Development, Ellen F. Fynan, Shan Lu, Harriet L. Robinson 2018 Worcester State College

One Group's Historical Reflections On Dna Vaccine Development, Ellen F. Fynan, Shan Lu, Harriet L. Robinson

Open Access Articles

DNA vaccines were pioneered by several groups in the early 1990s. This article presents the reflections of one of these groups on their work with retroviral vectors in chickens that contributed to the discovery and early development of DNA vaccines. Although the findings were initially met with skepticism, the work presented here combined with that of others founded a new method of vaccination: the direct inoculation of purified DNA encoding the target antigen.


Coping With Chronic Fungal Rhinosinusitis: Diagnosis To Therapy, Veronica Corcino, Leslie Beavin, Shengli Lu, Ashley Ross, Carmen V. Sciortino Jr. 2018 University of Louisville

Coping With Chronic Fungal Rhinosinusitis: Diagnosis To Therapy, Veronica Corcino, Leslie Beavin, Shengli Lu, Ashley Ross, Carmen V. Sciortino Jr.

The University of Louisville Journal of Respiratory Infections

No abstract provided.


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