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Articles 2341 - 2370 of 77144
Full-Text Articles in Entire DC Network
Wdr4 Regulates Ribosome Biogenesis And Intestinal Homeostasis Via Let-7, Kreeti Kajal, Elham Rastegari, Wen-Der Wang, Jian-Chiuan Li, Chun-Hong Chen, Wan Hsuan Chou, Wei Chiao Chang, Tzu-Yang Lin, Kevin Tsai, Tsai Ming Lu, Kartik Venkatachalam, Hwei-Jan Hsu
Wdr4 Regulates Ribosome Biogenesis And Intestinal Homeostasis Via Let-7, Kreeti Kajal, Elham Rastegari, Wen-Der Wang, Jian-Chiuan Li, Chun-Hong Chen, Wan Hsuan Chou, Wei Chiao Chang, Tzu-Yang Lin, Kevin Tsai, Tsai Ming Lu, Kartik Venkatachalam, Hwei-Jan Hsu
Faculty, Staff and Student Publications
Proper regulation of ribosome biogenesis is essential for stem cell function and tissue homeostasis, yet its upstream control in adult intestinal stem cells (ISCs) remains unclear. Here, we identify the WD repeat protein Wdr4 as a key regulator of ISC homeostasis in the Drosophila midgut. Wdr4 cooperates with the methyltransferase Mettl1 to catalyze N⁷-methylguanosine (m⁷G) modification of let-7 miRNA. Wdr4 or Mettl1 depletion disrupts this modification, reducing let-7 levels and aberrantly activating TOR-JNK-dMyc signaling. This drives elevated ribosome biogenesis, ISC overproliferation, misdifferentiation, and intestinal dysplasia. Overexpression of let-7, inhibition of TOR, or suppression of JNK rescues these defects. Importantly, expression …
Prevalence Of Her2-Low Status And Outcomes In Early-Stage Her2-Negative Breast Cancer, Akshara Singareeka Raghavendra, Diane D Liu, Sarah Pasyar, Senthil Damodaran, Yu Shen, Jason A Mouabbi, Carlos H Barcenas, Debu Tripathy
Prevalence Of Her2-Low Status And Outcomes In Early-Stage Her2-Negative Breast Cancer, Akshara Singareeka Raghavendra, Diane D Liu, Sarah Pasyar, Senthil Damodaran, Yu Shen, Jason A Mouabbi, Carlos H Barcenas, Debu Tripathy
Faculty, Staff and Student Publications
HER2-low breast cancer (IHC 1+ or 2+ without HER2 gene amplification) is a distinct and understudied subtype. In a cohort of 14,593 early-stage breast cancer patients treated at MD Anderson from 2006 to 2019, 60.4% were HER2-low. Multivariable analysis showed HER2-low status was independently associated with race, histologic subtype, higher nuclear grade and stage, and estrogen receptor (ER) positivity. Among 2464 patients receiving neoadjuvant chemotherapy, HER2-low status was not linked to pathologic complete response (pCR), overall survival (OS), or disease-free survival (DFS) compared to HER2-0 tumors. Factors predicting pCR included nuclear grade III, stage I, invasive ductal carcinoma, lower ER/PR …
High-Throughput Multi-Organ Proteomics Workflow For Drug Efficacy And Toxicity Analysis, Yun Xiong, Lin Tan, Wai-Kin Chan, Dandan Zhu, Huimin Zhang, Eric S Yin, Sri Ramya Donepudi, Jibin Ding, Bo Wei, Bao Tran, Sara Martinez, Iqbal Mahmud, Faiza Hanif Waghu, Hamish I Stewart, Daniel J Hermanson, Rehan Akbani, John N Weinstein, Junjie Chen, Philip L Lorenzi
High-Throughput Multi-Organ Proteomics Workflow For Drug Efficacy And Toxicity Analysis, Yun Xiong, Lin Tan, Wai-Kin Chan, Dandan Zhu, Huimin Zhang, Eric S Yin, Sri Ramya Donepudi, Jibin Ding, Bo Wei, Bao Tran, Sara Martinez, Iqbal Mahmud, Faiza Hanif Waghu, Hamish I Stewart, Daniel J Hermanson, Rehan Akbani, John N Weinstein, Junjie Chen, Philip L Lorenzi
Faculty, Staff and Student Publications
Rapid and comprehensive analysis of complex proteomes across large sample sets is vital for unlocking the potential of systems biology. We present a high-throughput mass spectrometry (MS) proteomics method that integrates narrow-window data-independent acquisition (nDIA) with short-gradient micro-flow chromatography, enabling profiling of >240 samples per day. This optimized MS approach identifies 6,201 and 7,466 human proteins with 1- and 2-min gradients, respectively. As a practical application, we analyzed 507 samples composed of 13 different tissues from mice treated with the enzyme-drug L-asparaginase (ASNase) or its glutaminase-free Q59L mutant, generating a quantitative profile of 11,472 proteins following drug treatment. The MS …
Multimodal Spatial-Omics Reveal Co-Evolution Of Alveolar Progenitors And Proinflammatory Niches In Progression Of Lung Precursor Lesions, Fuduan Peng, Ansam Sinjab, Yibo Dai, Warapen Treekitkarnmongkol, Sujuan Yang, Lorena I Gomez Bolanos, Tieling Zhou, Minyue Chen, Alejandra G Serrano, Avantika Krishna, Nastaran Karimi, Manvi Sharma, Akshay Basi, Guangsheng Pei, Jianlong Liao, Yunhe Liu, Jiping Feng, Zahraa Rahal, Yang Liu, Jiahui Jiang, Kai Yu, Tala Noun, Yuejiang Liu, Khaja Khan, Kyung Serk Cho, Jichao Chen, Luisa M Solis, Sarah Mazzilli, Steven Dubinett, Tina Cascone, Avrum E Spira, Stephen Swisher, Naoe Jimbo, Takuo Hayashi, Satsuki Kishikawa, Kazuya Takamochi, Tomoo Itoh, Takashi Yao, Kenji Suzuki, Neda Kalhor, Ignacio I Wistuba, Mingyao Li, Seyed Javad Moghaddam, Junya Fujimoto, Jared Burks, Jeffrey Myers, Kadir Akdemir, Linghua Wang, Humam Kadara
Multimodal Spatial-Omics Reveal Co-Evolution Of Alveolar Progenitors And Proinflammatory Niches In Progression Of Lung Precursor Lesions, Fuduan Peng, Ansam Sinjab, Yibo Dai, Warapen Treekitkarnmongkol, Sujuan Yang, Lorena I Gomez Bolanos, Tieling Zhou, Minyue Chen, Alejandra G Serrano, Avantika Krishna, Nastaran Karimi, Manvi Sharma, Akshay Basi, Guangsheng Pei, Jianlong Liao, Yunhe Liu, Jiping Feng, Zahraa Rahal, Yang Liu, Jiahui Jiang, Kai Yu, Tala Noun, Yuejiang Liu, Khaja Khan, Kyung Serk Cho, Jichao Chen, Luisa M Solis, Sarah Mazzilli, Steven Dubinett, Tina Cascone, Avrum E Spira, Stephen Swisher, Naoe Jimbo, Takuo Hayashi, Satsuki Kishikawa, Kazuya Takamochi, Tomoo Itoh, Takashi Yao, Kenji Suzuki, Neda Kalhor, Ignacio I Wistuba, Mingyao Li, Seyed Javad Moghaddam, Junya Fujimoto, Jared Burks, Jeffrey Myers, Kadir Akdemir, Linghua Wang, Humam Kadara
Faculty, Staff and Student Publications
The co-evolution of different cell subsets in the progression of precursor lesions to lung adenocarcinoma (LUAD) is incompletely understood. We generated spatial transcriptomic maps of 56 human precursor lesions and LUADs from 25 patients and of an independent cohort of 36 lesions from 19 patients, analyzing a total of 486,519 spots and 5.4 million cells. We identify region-specific programs that distinguish precursors from LUADs. Spatially resolved clonal architectures reveal patient-specific heterogeneity in evolution of precursors to LUADs. We find epithelial alveolar progenitors expressing tumor-associated meta-programs and residing in niches enriched with proinflammatory subsets including IL1B high macrophages. Epithelial-proinflammatory niches are …
Fractionated Radiotherapy Adjuvant To Surgery Of Who-2 Meningioma With And Without Gross Total Resection: A Multicenter, Retrospective Cohort Study Of 1,452 Patients, Christian Mirian, Lasse Rehné Jensen, Adam Gorm Hoffmann, Tareq A Juratli, Andrea Daniela Maier, Pernilla Lindner, Anders Broechner, Sverre H Torp, Helen A Shih, Ramin A Morshed, Jacob S Young, Stephen T Magill, Walter Stummer, Dorothee Cäcilia Spille, Benjamin Brokinkel, Martin Proescholdt, Yasuhiro Kuroi, Konstantinos Gousias, Matthias Simon, Ricardo Prat-Acin, Stéphane Goutagny, Johannes Wach, Erdem Güresir, Junkoh Yamamoto, Young Zoon Kim, Joo Ho Lee, Daniel W Kim, Matthew Koshy, Donald M Cannon, Dennis C Shrieve, Chang-Ok Suh, Jong Hee Chang, Maria Kamenova, Sven Straumann, Jehuda Soleman, Ilker Y Eyüpoglu, Tony Catalan, Austin Lui, Philip V Theodosopoulos, Michael W Mcdermott, Pedro Góes, Fang Wang, Luis Souhami, Marie-Christine Guiot, Tamás Csonka, Toshiki Endo, Tejpal Gupta, Akash J Patel, Tiemo J Klisch, Jun Won Kim, Francesco Maiuri, Valeria Barresi, María Dolores Tabernero, Simon Skyrman, Mechthild Krause, Ian Law, Bjarne Winther Kristensen, Tina Nørgaard Munch, Torstein Meling, Kåre Fugleholm, Paul Blanche, Tiit Mathiesen
Fractionated Radiotherapy Adjuvant To Surgery Of Who-2 Meningioma With And Without Gross Total Resection: A Multicenter, Retrospective Cohort Study Of 1,452 Patients, Christian Mirian, Lasse Rehné Jensen, Adam Gorm Hoffmann, Tareq A Juratli, Andrea Daniela Maier, Pernilla Lindner, Anders Broechner, Sverre H Torp, Helen A Shih, Ramin A Morshed, Jacob S Young, Stephen T Magill, Walter Stummer, Dorothee Cäcilia Spille, Benjamin Brokinkel, Martin Proescholdt, Yasuhiro Kuroi, Konstantinos Gousias, Matthias Simon, Ricardo Prat-Acin, Stéphane Goutagny, Johannes Wach, Erdem Güresir, Junkoh Yamamoto, Young Zoon Kim, Joo Ho Lee, Daniel W Kim, Matthew Koshy, Donald M Cannon, Dennis C Shrieve, Chang-Ok Suh, Jong Hee Chang, Maria Kamenova, Sven Straumann, Jehuda Soleman, Ilker Y Eyüpoglu, Tony Catalan, Austin Lui, Philip V Theodosopoulos, Michael W Mcdermott, Pedro Góes, Fang Wang, Luis Souhami, Marie-Christine Guiot, Tamás Csonka, Toshiki Endo, Tejpal Gupta, Akash J Patel, Tiemo J Klisch, Jun Won Kim, Francesco Maiuri, Valeria Barresi, María Dolores Tabernero, Simon Skyrman, Mechthild Krause, Ian Law, Bjarne Winther Kristensen, Tina Nørgaard Munch, Torstein Meling, Kåre Fugleholm, Paul Blanche, Tiit Mathiesen
Faculty, Staff and Students Publications
Purpose
The role of adjuvant fractionated radiotherapy (aFRT) after gross total resection (GTR) of WHO-2 meningiomas remains unclear. We aimed to estimate the effect of aFRT on recurrence risk and survival following GTR and subtotal resection (STR).
Methods
We analyzed 1452 patients with WHO-2 from our international, multicenter database (followed between 1989 and 2019). Outcomes were recurrence (10-year follow-up) and death (5-year follow-up). Risk estimates were obtained using competing risks and survival analysis. Average treatment effects were estimated by G-computation, adjusted for potential confounding by age, sex, Simpson grade, Ki-67 proliferation index, location, country group (universal healthcare or not), …
Artificial Intelligence In Medical Ethics Education: A Descriptive Study Of Eight Models In Multiple Choice Question Generation, John Obeid, Christopher Bobier, Alex Gillham, Adam Omelianchuk, Daniel Hurst
Artificial Intelligence In Medical Ethics Education: A Descriptive Study Of Eight Models In Multiple Choice Question Generation, John Obeid, Christopher Bobier, Alex Gillham, Adam Omelianchuk, Daniel Hurst
Center for Medical Ethics and Health Policy Staff Publications
Introduction: Integrating artificial intelligence (AI) into medical education poses barriers and opportunities for medical educators. One of those opportunities is content creation for medical ethics assessment. Assessing the performance of AI in generating multiple choice questions (MCQs) in ethics that aligns with United States Medical Licensing Examination (USMLE) is important. The present study evaluates the performance of eight AI models-GPT-4 Turbo, GPT-3.5 Turbo 0125, o1 Mini, o1 Preview, GPT-4, Claude 3.5 Sonnet, Claude 3 Opus, and Gemini-in regard to the relevance, clarity, and accuracy of generated ethics-based MCQs.
Methods: Each of the eight models was tasked with generating two sets …
Impaired Arginine, Citrulline And Glutamine Metabolism In Type 2 Diabetes: Insights From A Stable Isotope Study, Mustafa Tosur, Raven A Wierzchowska-Mcnew, Nicolaas E P Deutz, Mariëlle P K J Engelen
Impaired Arginine, Citrulline And Glutamine Metabolism In Type 2 Diabetes: Insights From A Stable Isotope Study, Mustafa Tosur, Raven A Wierzchowska-Mcnew, Nicolaas E P Deutz, Mariëlle P K J Engelen
Children’s Nutrition Research Center Staff Publications
Context: Arginine (Arg) is an important amino acid in T2D as a potent insulin secretagogue and precursor for nitric oxide (NO). Citrulline (Cit), the substrate for de novo Arg synthesis, is mostly produced from glutamine (Gln).
Objective: We aimed to investigate their metabolism in T2D using novel stable isotope tracer approach.
Methods: We studied 42 individuals (21 with T2D, 21 controls). After overnight fasting, blood samples were collected following pulse administration of stable amino acid tracers. Plasma concentrations and isotopic enrichments were measured by LC-MS/MS, and compartmental analyses were performed to calculate their whole-body production (WBP) rates and kinetics.
Results: …
Dupilumab Beyond The Airway: Decreased Morbidity In A Real-World Analysis, Emma J. Anisman, Spencer Short, Emma Tam, Benjamin F. Bitner, Abdulghafoor Alani, Marc Rosen, Mindy Rabinowitz, Damaris Pena Evertz, Elina Toskala, Gurston G. Nyquist
Dupilumab Beyond The Airway: Decreased Morbidity In A Real-World Analysis, Emma J. Anisman, Spencer Short, Emma Tam, Benjamin F. Bitner, Abdulghafoor Alani, Marc Rosen, Mindy Rabinowitz, Damaris Pena Evertz, Elina Toskala, Gurston G. Nyquist
Department of Otolaryngology - Head and Neck Surgery Faculty Papers
Background: Post hoc analyses of clinical trials have characterized dupilumab's adverse effects, yet the real-world impact in chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma is not well described. This study aims to characterize the risks of lymphoma, cardiovascular events, eosinophilia, joint pain, inflammatory arthritis, and sleep apnea in dupilumab-treated CRSwNP and/or asthma patients compared to those not taking dupilumab, and to other biologics.
Methods: This retrospective cohort study used TriNetX, a de-identified database containing over 100 million patient records. Demographics and adverse effects associated with immunotherapy use were collected.
Results: We identified 21,249 dupilumab-treated CRSwNP and/or asthma patients. After …
Shoulder Strength And Total Arc Range Of Motion: Associations With Upper-Extremity Joint Kinetics And Ball Velocity In Adolescent Baseball Pitchers, Tomohiro Ide, Stephen J. Thomas, Takato Ogasawara, Adam B. Rosen, Brian A. Knarr, Kazuma Akehi, Samuel J. Wilkins
Shoulder Strength And Total Arc Range Of Motion: Associations With Upper-Extremity Joint Kinetics And Ball Velocity In Adolescent Baseball Pitchers, Tomohiro Ide, Stephen J. Thomas, Takato Ogasawara, Adam B. Rosen, Brian A. Knarr, Kazuma Akehi, Samuel J. Wilkins
Department of Exercise Science Faculty Papers
BACKGROUND: Adolescent baseball pitchers are vulnerable to upper-extremity injuries because of the repetitive, high-stress nature of throwing movements. While shoulder strength and range of motion (ROM) are commonly measured, they are often interpreted in isolation during injury prevention assessments.
PURPOSE: To determine the relationship between clinical measures (shoulder ROM and strength) and throwing arm joint kinetics in adolescent baseball pitchers.
STUDY DESIGN: Descriptive laboratory study.
METHODS: This study was conducted in a laboratory setting. A total of 43 adolescent baseball pitchers (age, 15-18 years) were recruited through convenience sampling. Participants underwent clinical assessments of shoulder ROM and isokinetic concentric strength …
Improving Prediction Accuracy Of Radiation-Induced Temporal Lobe Injury In Nasopharyngeal Carcinoma Using Adc-Based Deep Learning And Dosiomics, Li Wang, Yang Li, Ting Qiu, Junyi Liu, Jiawei Zhou, Han Gao, Hongliang Yu, Yinsu Zhu, Baozhou Sun, Guanyu Yang, Shengfu Huang, Lirong Wu, Li Sun, Xia He
Improving Prediction Accuracy Of Radiation-Induced Temporal Lobe Injury In Nasopharyngeal Carcinoma Using Adc-Based Deep Learning And Dosiomics, Li Wang, Yang Li, Ting Qiu, Junyi Liu, Jiawei Zhou, Han Gao, Hongliang Yu, Yinsu Zhu, Baozhou Sun, Guanyu Yang, Shengfu Huang, Lirong Wu, Li Sun, Xia He
Faculty, Staff and Students Publications
Background: To investigate the potential of apparent diffusion coefficient (ADC) map-based deep learning and dose distribution-based dosiomics in predicting radiation-induced temporal lobe injury (RTLI) in nasopharyngeal carcinoma (NPC).
Methods: This retrospective study included 3578 NPC patients from Jiangsu Cancer Hospital receiving intensity-modulated radiation therapy (IMRT). Ninety-four RTLI patients were recruited based on inclusion criteria and matched 1:1 with 97 control subjects using propensity scores. Patients were randomly assigned to the training cohort (n = 135) and the validation cohort (n = 59). Deep transfer learning (DTL) features and dosiomics features were extracted from ADC map and three-dimensional dose distribution, respectively. …
Human Papillomavirus Vaccine Perceptions Among Noncollege Young Adults And Tiktok Influencers: Qualitative Study, Amelia Burke-Garcia, Dasha Afanaseva, Erin Cutroneo, Kayla Madden, Angela Sustaita-Ruiz, Estefany Rivera Sanchez, Amy Leader
Human Papillomavirus Vaccine Perceptions Among Noncollege Young Adults And Tiktok Influencers: Qualitative Study, Amelia Burke-Garcia, Dasha Afanaseva, Erin Cutroneo, Kayla Madden, Angela Sustaita-Ruiz, Estefany Rivera Sanchez, Amy Leader
Department of Medical Oncology Faculty Papers
BACKGROUND: Human papillomavirus (HPV) vaccination is a proven and effective tool for preventing several types of cancers, yet vaccination rates among young adults remain suboptimal, particularly among those not enrolled in 4-year colleges. This population can be more difficult to reach due to fewer established institutional touchpoints, limited engagement with campus-based health services, and greater variability in access to preventive care. At the same time, social media has become a dominant source of information for young adults, with TikTok (ByteDance) emerging as one of the most widely used platforms. Approximately 41% of TikTok's users are between the ages of 16 …
Genome And Transcriptome-Wide Analyses Identify Multiple Candidate Genes And A Significant Polygenic Contribution In Bicuspid Aortic Valve, Sébastien Thériault, Jacob A Holdcraft, Dinara Sharipova, Adèle Faucherre, Radoslaw M Debiec, Gina M Peloso, Baravan Al-Kassou, Sary Aranki, Elena Ashikhmina Swan, Andrea Ballotta, Michele Bellino, Hanna M Björck, Anne Sophie Boureau, Peter S Braund, François Corriveau, François Dagenais, Lasse Folkersen, Amalia Forte, Michael D Francke, Alessandro Frigiola, Svetlana Gorbatov, Dongchuan Guo, Karam M Habchi, Mahyar Heydarpour, Eric M Isselbacher, Chris Jopling, Fabien Laporte, Solena Le Scouarnec, Zhonglin Li, Peter Lichtner, Carlo Maj, Hasanga D Manikpurage, Christopher P Nelson, Thy B Nguyen, Russell A Norris, Chin Siang Ong, Philippe Pibarot, Tanmoy Roychowdhury, Berardo Sarubbi, Floriane Simonet, Thoralf Sundt, Ida Surakka, Idit Tessler, Cristen J Willer, Susanne Wittmann, Bo Yang, Igor Berezovets, Stefanie A Doppler, Martina Dreßen, Katharina Knoll, Thomas Puehler, Heribert Schunkert, Jean-François Avierinos, Malenka M Bissell, Aidan P Bolger, Yohan Bossé, Eduardo Bossone, María Brion, Rodolfo Citro, Carlo De Vincentiis, G Michael Deeb, Alessandro Della Corte, Christian Dina, Ronen Durst, Stephan Ensminger, Per Eriksson, Arturo Evangelista, Anders Franco-Cereceda, Dan Gilon, Betti Giusti, Simon L Hetherington, Gordon S Huggins, Markus Krane, Thierry Le Tourneau, Giuseppe Limongelli, Patrick Mathieu, David Messika-Zeitoun, Hector I Michelena, Dianna Milewicz, Jochen D Muehlschlegel, David R Murdock, Georg Nickenig, Stefano Nistri, Markus M Nöthen, Francesca Pluchinotta, Siddharth K Prakash, Nilesh J Samani, Jean-Jacques Schott, Tom R Webb, Stéphane Zaffran, Salim Abdelilah-Seyfried, Kim Eagle, Johannes Schumacher, Teresa Trenkwalder, Simon Body
Genome And Transcriptome-Wide Analyses Identify Multiple Candidate Genes And A Significant Polygenic Contribution In Bicuspid Aortic Valve, Sébastien Thériault, Jacob A Holdcraft, Dinara Sharipova, Adèle Faucherre, Radoslaw M Debiec, Gina M Peloso, Baravan Al-Kassou, Sary Aranki, Elena Ashikhmina Swan, Andrea Ballotta, Michele Bellino, Hanna M Björck, Anne Sophie Boureau, Peter S Braund, François Corriveau, François Dagenais, Lasse Folkersen, Amalia Forte, Michael D Francke, Alessandro Frigiola, Svetlana Gorbatov, Dongchuan Guo, Karam M Habchi, Mahyar Heydarpour, Eric M Isselbacher, Chris Jopling, Fabien Laporte, Solena Le Scouarnec, Zhonglin Li, Peter Lichtner, Carlo Maj, Hasanga D Manikpurage, Christopher P Nelson, Thy B Nguyen, Russell A Norris, Chin Siang Ong, Philippe Pibarot, Tanmoy Roychowdhury, Berardo Sarubbi, Floriane Simonet, Thoralf Sundt, Ida Surakka, Idit Tessler, Cristen J Willer, Susanne Wittmann, Bo Yang, Igor Berezovets, Stefanie A Doppler, Martina Dreßen, Katharina Knoll, Thomas Puehler, Heribert Schunkert, Jean-François Avierinos, Malenka M Bissell, Aidan P Bolger, Yohan Bossé, Eduardo Bossone, María Brion, Rodolfo Citro, Carlo De Vincentiis, G Michael Deeb, Alessandro Della Corte, Christian Dina, Ronen Durst, Stephan Ensminger, Per Eriksson, Arturo Evangelista, Anders Franco-Cereceda, Dan Gilon, Betti Giusti, Simon L Hetherington, Gordon S Huggins, Markus Krane, Thierry Le Tourneau, Giuseppe Limongelli, Patrick Mathieu, David Messika-Zeitoun, Hector I Michelena, Dianna Milewicz, Jochen D Muehlschlegel, David R Murdock, Georg Nickenig, Stefano Nistri, Markus M Nöthen, Francesca Pluchinotta, Siddharth K Prakash, Nilesh J Samani, Jean-Jacques Schott, Tom R Webb, Stéphane Zaffran, Salim Abdelilah-Seyfried, Kim Eagle, Johannes Schumacher, Teresa Trenkwalder, Simon Body
Faculty, Staff and Student Publications
Background: Bicuspid aortic valve (BAV) is a frequent congenital heart defect with a high heritability. Despite this, only a limited number of genes have been associated with the disease, and the molecular mechanisms remain unexplained in most cases. This study aimed to further understand the genetic architecture of BAV.
Methods: A genome-wide association study meta-analysis including 9631 cases among 65 677 participants was performed. Genes were prioritized using transcriptomic analyses based on RNA sequencing in relevant tissues, including human fetal and adult aortic valves. The impact of the knockdown or knockout of 4 candidate genes on cardiac development was verified …
Tracking Focal Adhesion Turnover: A Novel Reporter For Fa-Phagy Flux, Kuizhi Qu, Mengjun Dai, Ying Jiang, Sophie Liu, John P Hagan, Louise D Mccullough, Zhen Xu, Yan-Ning Rui
Tracking Focal Adhesion Turnover: A Novel Reporter For Fa-Phagy Flux, Kuizhi Qu, Mengjun Dai, Ying Jiang, Sophie Liu, John P Hagan, Louise D Mccullough, Zhen Xu, Yan-Ning Rui
Faculty, Staff and Student Publications
Focal adhesions (FAs) are critical multi-protein complexes regulating cell adhesion, migration, and survival, and their dysregulation contributes to cancer metastasis and vascular diseases. Despite extensive research on FA formation, little is known about FA turnover, particularly its regulation by autophagy. This study introduces a novel tandem fluorescence reporter capable of tracking the entire FA-phagy flux, from autophagosome formation to lysosomal degradation. The reporter, based on a red–green fluorescence system with a lysosome-specific cleavage site, integrates seamlessly into endogenous focal adhesion complexes, demonstrating sensitivity and specificity to autophagy stimuli. Validated in multiple cell lines, the tool revealed dynamic FA-phagy responses to …
Defining Clinically Relevant Responses In Erectile Function: An Smsna Position Statement, Landon Trost, Faysal Yafi, Alan Shindel, Mohit Khera, Raymond C Rosen, Petar Bajic, Helen Bernie, Martin Gross, Johanna Hannan, Sevann Helo, Lawrence Jenkins Ii, Carol Podlasek, Daniel Watter, Matthew Ziegelmann, Tobias Köhler
Defining Clinically Relevant Responses In Erectile Function: An Smsna Position Statement, Landon Trost, Faysal Yafi, Alan Shindel, Mohit Khera, Raymond C Rosen, Petar Bajic, Helen Bernie, Martin Gross, Johanna Hannan, Sevann Helo, Lawrence Jenkins Ii, Carol Podlasek, Daniel Watter, Matthew Ziegelmann, Tobias Köhler
Faculty, Staff and Students Publications
Background: To date, no scoring system has adequately defined clinical efficacy of erectile dysfunction (ED) therapies when evaluating differences between cohorts or in meta-analytic studies.
Aim: To outline the minimal criteria required for any therapy to be considered clinically effective in the treatment of ED.
Methods: An analytic review was performed of standardized ED questionnaires, with a particular emphasis placed on the International Index of Erectile Function, Erectile Function Domain (IIEF-EFD), and the minimally clinically important difference (MCID) concept. The data were used to create a societal position statement and recommendations on best practices within clinical trials to determine treatment …
Commentary On “Ultrasound Evaluation Of Left Ventricular Function In Coronary Artery Ectasia: The Added Value Of 2d Speckle-Tracking Echocardiography”, Eman Aslam, Maryam Amjad
Commentary On “Ultrasound Evaluation Of Left Ventricular Function In Coronary Artery Ectasia: The Added Value Of 2d Speckle-Tracking Echocardiography”, Eman Aslam, Maryam Amjad
Journal of the Saudi Heart Association
No abstract provided.
A Glimpse Of Liver Resection Profile In An Indonesian Tertiary Hospital: A Retrospective Descriptive Study, Florencia V. Vaniara, Arnetta Nl Lalisang, Toar Jm Lalisang, Yarman Mazni, Agi S. Putranto, Wifanto S. Jeo, Febiansyah Ibrahim, Ridho A. Syaiful, Lam Sihardo, Vania Mg Marbun
A Glimpse Of Liver Resection Profile In An Indonesian Tertiary Hospital: A Retrospective Descriptive Study, Florencia V. Vaniara, Arnetta Nl Lalisang, Toar Jm Lalisang, Yarman Mazni, Agi S. Putranto, Wifanto S. Jeo, Febiansyah Ibrahim, Ridho A. Syaiful, Lam Sihardo, Vania Mg Marbun
The New Ropanasuri Journal of Surgery
Introduction. In-depth liver resection profile is needed for evaluation to improve the procedure’s outcome. This study aims to describe the clinical characteristics and outcomes of liver resection in HCC patients in Cipto Mangunkusumo Tertiary Hospital.
Methods. This study retrospectively analyzed the clinical data of 19 HCC patients who underwent liver resection in Cipto Mangunkusumo Tertiary Hospital from 2021 to 2024. Demographic, clinical, laboratory, operative, and pathological data were collected. Postoperative complications were assessed using the Clavien-Dindo classification system within 30- and 90-day postoperative periods.
Result. Nineteen patients were included, comprising 12 (63.2%) males and 7 (36.8%) females. Sixteen patients (84.2%) …
Management Of Gastrointestinal Tract Arteriovenous Malformations In Adults: A Literature Review, Febiansyah Ibrahim, Angie Beatrice
Management Of Gastrointestinal Tract Arteriovenous Malformations In Adults: A Literature Review, Febiansyah Ibrahim, Angie Beatrice
The New Ropanasuri Journal of Surgery
Introduction. Arteriovenous malformations (AVMs) of the gastrointestinal (GI) tract are rare vascular lesions that can cause significant GI bleeding, posing a diagnostic challenge in clinical practice. This literature review examines the management strategies for AVMs in adults, focusing on identifying optimal treatment approaches and minimizing recurrence, particularly in Indonesia where no standardized treatment guidelines are available.
Method. A literature search was conducted from August 24, 2022, to September 11, 2023, using PUBMED®, Cochrane®, Proquest®, and Scopus® databases. The inclusion criteria were studies published in English or Indonesian within the last 25 years, including case series, cohort studies, or systematic reviews …
The Outcome Of Snare Loop Catheter For Foreign Body Removal In Superior Vena Cava: An Evidence-Based Case Report, Hutomo Rezky Noorsukma, Patrianef Darwis
The Outcome Of Snare Loop Catheter For Foreign Body Removal In Superior Vena Cava: An Evidence-Based Case Report, Hutomo Rezky Noorsukma, Patrianef Darwis
The New Ropanasuri Journal of Surgery
Introduction. In recent years, the utilization of central venous catheters (CVC) in medical practice has become increasingly common. One of the complications associated with central venous catheterization is embolization of catheter fragments, which arefound in 1% of cases. Currently, endovascular techniques, such as snare loop catheter, have been developed for the extraction of intravascular foreign bodies. However, there is no strong evidence regarding this method. Thisliterature review aims toevaluate the efficacy and safety of snare loop catheters for foreign body removal within the superior vena cava (SVC).
Method. We searched four databases, that is Cochrane, PubMed, EBSCO, and …
Roux-En-Y Duodenojejunostomy As Surgical Treatment For Congenital Duodenal Obstruction: A Case Report, Ahmad Yani, Albireza Ruhimat
Roux-En-Y Duodenojejunostomy As Surgical Treatment For Congenital Duodenal Obstruction: A Case Report, Ahmad Yani, Albireza Ruhimat
The New Ropanasuri Journal of Surgery
Introduction. Congenital duodenal obstruction is an anatomical abnormality in newborns. Various intrinsic and extrinsic etiologies can cause duodenal obstruction. The surgical treatment that is commonly performed on duodenal obstruction in neonates is duodenoduodenostomy. However, several etiological conditions, such as preduodenal portal vein (PDPV) and pancreatic annulare cause duodenoduodenostomy nearly impossible to perform, so an alternative surgery procedure with a good outcome is necessary.
Case Illustration. A female neonate had been suspected congenital duodenal obstruction since pregnancy due to polyhydramnios. An OGT was inserted with greenish yellow residue after the baby was born. Based on abdominal x-ray examination, a …
Whipple Procedure For High-Grade Pediatric Pancreatic Injury After Blunt Trauma: A Case Report, David C. El Gah, Tri H. Rahayatri, Asri D. Rachmawati, Adianto Nugroho
Whipple Procedure For High-Grade Pediatric Pancreatic Injury After Blunt Trauma: A Case Report, David C. El Gah, Tri H. Rahayatri, Asri D. Rachmawati, Adianto Nugroho
The New Ropanasuri Journal of Surgery
Introduction: Pediatric pancreatic injury isuncommon but carries significant morbidity. While non-operative management is standard for low-grade injuries, the optimal approach for high-grade trauma (AAST grade III–V) remains debated. Pancreaticoduodenectomy (Whipple procedure) is rarely performed due to high procedural risks and is typically reserved for severe pancreatic head injury with concomitant duodenal damage.
Case presentations: A 13-year-old boy presented three days after blunt abdominal trauma with epigastric pain and bilious vomiting. CT imaging revealed free fluid, a large retroperitoneal hematoma, and suspected pancreatic head injury. Despite initial stability and conservative management in the High Care Unit, worsening abdominal distension prompted an …
Locoregional Management In Breast Cancer With Brca1/2 Mutation: Evidence Based Case Report, Adlina Karisyah, Sonar S. Panigoro
Locoregional Management In Breast Cancer With Brca1/2 Mutation: Evidence Based Case Report, Adlina Karisyah, Sonar S. Panigoro
The New Ropanasuri Journal of Surgery
Introduction. Breast cancer is still one of the top health issues worldwide. Hereditary predisposition is linked with morbidity and mortality of breast cancer patients. BRCA 1/2 genetic mutation, one of mutations in breast cancer that has been extensively observed, has tremendous effects on the carrier. Studies showed that patients with BRCA1/2 mutation are often associated with poor pathological characteristics. Further research isyet to identify the effect of the mutation with prognosis including locoregional recurrences. This study aims to understand the risk of locoregional recurrences on the patients with breast cancer and BRCA 1/2 genetic mutation who had BCT or …
Transient Protein Structure Guides Surface Diffusion Pathways For Electron Transport In Membrane Supercomplexes, Chun Kit Chan, Jonathan Nguyen, Corey F Hryc, Chitrak Gupta, Kevin Redding, William Dowhan, Matthew L Baker, Alberto Perez, Eugenia Mileykovskaya, Abhishek Singharoy
Transient Protein Structure Guides Surface Diffusion Pathways For Electron Transport In Membrane Supercomplexes, Chun Kit Chan, Jonathan Nguyen, Corey F Hryc, Chitrak Gupta, Kevin Redding, William Dowhan, Matthew L Baker, Alberto Perez, Eugenia Mileykovskaya, Abhishek Singharoy
Faculty, Staff and Student Publications
The exact biological role of mitochondrial supercomplexes remains debated, particularly their role in guiding redox proteins across membranes during energy conversion. We integrate multiscale modeling and single particle cryo-electron microscopy (cryo-EM) to examine electron transfer in mitochondrial supercomplexes composed of complexes III and IV (CIII and CIV). Using bioinformatic and entropy-based methods, we generated structural ensembles capturing conformations of CIII's disordered QCR6 hinge within the yeast CIII2CIV2 supercomplex. Molecular and Brownian Dynamics simulations reveal that these negatively charged hinge states electrostatically couple with redox proteins, promoting their binding and directional diffusion across the membrane on millisecond timescales. Rather than hindering …
The Setd2 L1609p Mutation Found In Leukemia Disrupts Methyltransferase Activity And Reduces Histone H3k36 Trimethylation, Christina Michail, Jérémy Berthelet, Ariel E Mechaly, Linh-Chi Bui, Haopeng Yang, Duo Cai, Amira Al Mahi, Aowei Xie, Valeria Bisio, Valentina Sirri, Jean-Marie Dupret, Fabien Guidez, Ximing Xu, Nicolas Joly, Leslie Regad, Mireille Viguier, Frédérique Deshayes, Nicolas Dulphy, Michael R Green, Ahmed Haouz, Fernando Rodrigues Lima
The Setd2 L1609p Mutation Found In Leukemia Disrupts Methyltransferase Activity And Reduces Histone H3k36 Trimethylation, Christina Michail, Jérémy Berthelet, Ariel E Mechaly, Linh-Chi Bui, Haopeng Yang, Duo Cai, Amira Al Mahi, Aowei Xie, Valeria Bisio, Valentina Sirri, Jean-Marie Dupret, Fabien Guidez, Ximing Xu, Nicolas Joly, Leslie Regad, Mireille Viguier, Frédérique Deshayes, Nicolas Dulphy, Michael R Green, Ahmed Haouz, Fernando Rodrigues Lima
Faculty, Staff and Student Publications
SETD2 is the primary methyltransferase responsible for generating H3K36me3, an epigenetic mark that is essential for transcriptional regulation and chromatin integrity. SETD2 mutations are frequently observed in various cancers and tend to cluster within its catalytic SET domain. Despite the clinical relevance of SETD2 missense mutations in cancer, their biochemical and structural consequences remain insufficiently characterized. Here, we present the enzymatic and structural characterization of the SETD2 L1609P mutant enzyme identified in leukemia. The L1609 residue is located in the SET domain within a conserved hydrophobic pocket that is involved in substrate H3K36 recognition. Interestingly, site-directed mutagenesis of residues within …
Phase I Study Of Bevacizumab And Temsirolimus Combination Therapy In Advanced Malignancies: Safety, Efficacy, And Ovarian Cancer Expansion, Sarina A Piha-Paul, Chieh Tseng, Emily Thompson, R Jason Stafford, Hung Le, Lei Kang, Siqing Fu, Apostolia Tsimberidou, George Blumenschein, Jordi Rodon Ahnert, John M Slopis, David Hong, Aung Naing, Funda Meric-Bernstam, Chaan S Ng, Shannon Westin, Anil K Sood
Phase I Study Of Bevacizumab And Temsirolimus Combination Therapy In Advanced Malignancies: Safety, Efficacy, And Ovarian Cancer Expansion, Sarina A Piha-Paul, Chieh Tseng, Emily Thompson, R Jason Stafford, Hung Le, Lei Kang, Siqing Fu, Apostolia Tsimberidou, George Blumenschein, Jordi Rodon Ahnert, John M Slopis, David Hong, Aung Naing, Funda Meric-Bernstam, Chaan S Ng, Shannon Westin, Anil K Sood
Faculty, Staff and Student Publications
Background: Bevacizumab and temsirolimus target angiogenic and mTOR pathways in cancer progression.
Methods: This phase I study enrolled 48 heavily pretreated patients with advanced solid tumors, including an ovarian cancer expansion cohort. Patients received bevacizumab biweekly plus temsirolimus weekly in a 3 + 3 design to assess safety, maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs). Exploratory analyses included tumor genomic profiling and dynamic contrast-enhanced MRI (DCE-MRI).
Results: Patients had a median age of 59 and median four prior therapies. Common tumor types were ovarian (27%) and head and neck (15%). Treatment-related adverse events occurred in 93.8%, with 31.3% ≥grade …
Zingiber Officinale-Mediated Zinc Oxide Nanoparticles: Antimicrobial Activity Against Multidrug-Resistant Bacteria, Maureen Bakor Tabe, Ovgu Isbilen, Jennifer N Walker, Ender Cinar
Zingiber Officinale-Mediated Zinc Oxide Nanoparticles: Antimicrobial Activity Against Multidrug-Resistant Bacteria, Maureen Bakor Tabe, Ovgu Isbilen, Jennifer N Walker, Ender Cinar
Faculty, Staff and Student Publications
Background: The fight against infectious diseases has transformed over the past century with the emergence of multidrug-resistant bacteria, where pathogens that exhibit resistance to multiple antibiotic classes leading to significant challenges to modern medicine. Zingiber officinale is well-documented to exhibit diverse biological activities, including strong antioxidant, antimicrobial, and anti-neuroinflammatory effects. Zinc oxide nanoparticles can be synthesized cost-effectively and are widely utilized in biomedical applications, including their use as anticancer agents and drug-delivery systems, as well as for their intrinsic antibacterial and anti-inflammatory properties. In this study, we aimed to take a combinatorial approach to investigate the antimicrobial effects of Z. …
Pain Prevalence And Pain Management At The End Of Life: Regional And Urban-Rural Differences From A National-Representative Survey Of Chinese Older Adults, Yaolin Pei, Xiang Qi, Zexi Zhou, Yifan Lou, Jing Wang, Yang Li, Bei Wu
Pain Prevalence And Pain Management At The End Of Life: Regional And Urban-Rural Differences From A National-Representative Survey Of Chinese Older Adults, Yaolin Pei, Xiang Qi, Zexi Zhou, Yifan Lou, Jing Wang, Yang Li, Bei Wu
Faculty, Staff and Student Publications
Background: Effective pain management is essential for improving quality of life at the end of life. However, challenges persist globally, particularly in China, where palliative care remains underdeveloped. This study investigates pain prevalence and the associations between pain severity, place of death, and the quality of pain management among older adults in China, with a focus on regional and urban-rural disparities.
Methods: We used data from the 2014, 2016, 2018, and 2020 waves of the China Longitudinal Aging Social Survey. The final sample included 1,525 older adults who died during the study period. We conducted OLS regression analyses to examine …
Comparative Analysis Of Ctdna Monitoring Strategies In Advanced Nsclc With Met Exon 14 Skipping Mutations Treated With Ensartinib, Mo Zhou, Yin Zhu, Xuqi Sun, Ying Han, Rui Jin, Panwen Tian, Jun Zhao, Yang Jin, Zhiyuan Guo, Yongchang Zhang, Yiran Meng, Fei Liu, Wen Li, Xiuning Le, Haifeng Shen, Yang Xia
Comparative Analysis Of Ctdna Monitoring Strategies In Advanced Nsclc With Met Exon 14 Skipping Mutations Treated With Ensartinib, Mo Zhou, Yin Zhu, Xuqi Sun, Ying Han, Rui Jin, Panwen Tian, Jun Zhao, Yang Jin, Zhiyuan Guo, Yongchang Zhang, Yiran Meng, Fei Liu, Wen Li, Xiuning Le, Haifeng Shen, Yang Xia
Faculty, Staff and Student Publications
Mesenchymal-epithelial transition exon 14 skipping mutations (METex14) define a targetable molecular subset of non-small cell lung cancer (NSCLC), but optimal circulating tumor DNA (ctDNA) biomarkers to guide MET tyrosine kinase inhibitor therapy remain undefined. Within the EMBRACE trial of ensartinib, we conducted a prospective biomarker analysis with plasma collected at baseline (V0) and 4 weeks after treatment initiation (V1). ctDNA was profiled using a hybrid-capture next-generation sequencing panel covering 229 cancer-related genes, and mutations were classified into three monitoring paradigms: MET-specific alterations, canonical alterations (tier I/II), and pan-alterations (any variant in any gene on the panel). Baseline ctDNA positivity rates …
Recommendations From The Blue Ribbon Panel On Fluoroscopy Safety, Dustin A Gress, M Mahesh, Kevin W Dickey, John F Angle, D Duane Baldwin, Stephen Balter, Wayne Batchelor, Lisa Bruedigan, Christopher Davis, Deirdre Elder, R Paul Guillerman, Maged N Guirguis, David Hardwick, Carrie M Hayes, Jeremy J Heit, A Kyle Jones, Melissa Kirkwood, Andrew Kuhls-Gilcrist, Bonnie Martin-Harris, William W Mayo-Smith, Sarah E Mckenney, Richard Miguel, Donald L Miller, Eric Monroe, Kristi Moore, Thomas L Morgan, Kari J Nelson, Kathryn Petrovic, Shellie Pike, Carlos A Pino, Travis Prowant, Jonathan W Revels, Vinil Shah, Andrew Y Wang, David B Weiss, Darcy J Wolfman, Kevin A Wunderle, Jessica Zarzour, Michael E Zychowicz, Alan H Matsumoto
Recommendations From The Blue Ribbon Panel On Fluoroscopy Safety, Dustin A Gress, M Mahesh, Kevin W Dickey, John F Angle, D Duane Baldwin, Stephen Balter, Wayne Batchelor, Lisa Bruedigan, Christopher Davis, Deirdre Elder, R Paul Guillerman, Maged N Guirguis, David Hardwick, Carrie M Hayes, Jeremy J Heit, A Kyle Jones, Melissa Kirkwood, Andrew Kuhls-Gilcrist, Bonnie Martin-Harris, William W Mayo-Smith, Sarah E Mckenney, Richard Miguel, Donald L Miller, Eric Monroe, Kristi Moore, Thomas L Morgan, Kari J Nelson, Kathryn Petrovic, Shellie Pike, Carlos A Pino, Travis Prowant, Jonathan W Revels, Vinil Shah, Andrew Y Wang, David B Weiss, Darcy J Wolfman, Kevin A Wunderle, Jessica Zarzour, Michael E Zychowicz, Alan H Matsumoto
Faculty, Staff and Student Publications
There are many challenges associated with the safe use of fluoroscopy. These challenges include but are not limited to highly variable regulatory requirements, scope of practice concerns, inconsistent education and training, and lack of staff empowerment. Challenges are further compounded by the increasing use of fluoroscopy across a wide range of medical specialties. To facilitate consensus on how to address the issues, the ACR convened the multidisciplinary Blue Ribbon Panel on Fluoroscopy Safety (BRP-FS), with 32 organizations represented. The goal of the BRP-FS is to establish multi- and interspecialty consensus standards for the safe use of fluoroscopy in health care, …
Identification Of A Cytokine Biomarker For Prognostic Modeling Of Breast Cancer-Related Lymphedema, Alison J Wu, Neil Lin, Jie Su, Cherie Lin, Madison-Shira Hossack, Wei Shi, Farnoosh Abbas-Aghababazadeh, Wei Xu, Benjamin Haibe-Kains, Simona F Shaitelman, Melissa B Aldrich, Fei-Fei Liu, Jennifer Y Y Kwan
Identification Of A Cytokine Biomarker For Prognostic Modeling Of Breast Cancer-Related Lymphedema, Alison J Wu, Neil Lin, Jie Su, Cherie Lin, Madison-Shira Hossack, Wei Shi, Farnoosh Abbas-Aghababazadeh, Wei Xu, Benjamin Haibe-Kains, Simona F Shaitelman, Melissa B Aldrich, Fei-Fei Liu, Jennifer Y Y Kwan
Faculty, Staff and Student Publications
Lymphedema is a chronic complication of breast cancer treatment, and early intervention is crucial to reduce morbidity. This study evaluated the role of blood-based cytokine biomarkers in the prognostication of breast cancer-related lymphedema (BCRL) to improve risk prediction. A secondary analysis of inflammatory biomarkers for BCRL was performed using a previously published cohort of 147 breast cancer patients who had undergone serum cytokine profiling during their treatment at the Princess Margaret Cancer Centre from 2010-2014. Prognostic cytokine variables for lymphedema were selected by regression analysis and independence from known clinical risk factors. Regression-based modeling was employed to integrate prognostic variables …
Endothelial Oncogenic Kras Mutation Drives The Dynamics Of Microglia And Macrophages In Brain Arteriovenous Malformation, Hyejin Park, Jung-Eun Park, Bridger H Freeman, Bosco Seong Kyu Yang, Shun-Ming Ting, Alexander K Suh, Jude Pj Savarraj, Shuning Huang, Jakob Körbelin, Huimahn Alex Choi, Sean P Marrelli, Jaroslaw Aronowski, Peng Roc Chen, Eunhee Kim, Eun S Park
Endothelial Oncogenic Kras Mutation Drives The Dynamics Of Microglia And Macrophages In Brain Arteriovenous Malformation, Hyejin Park, Jung-Eun Park, Bridger H Freeman, Bosco Seong Kyu Yang, Shun-Ming Ting, Alexander K Suh, Jude Pj Savarraj, Shuning Huang, Jakob Körbelin, Huimahn Alex Choi, Sean P Marrelli, Jaroslaw Aronowski, Peng Roc Chen, Eunhee Kim, Eun S Park
Faculty, Staff and Student Publications
Mutation of KRAS in endothelial cells (KRAS-EC) leads to intracerebral hemorrhage (ICH) in brain arteriovenous malformations (bAVM), resulting in severe disabilities or even death. However, it is unclear what causes this hemorrhagic conversion of bAVM. Here, using a locally established, clinically-relevant sporadic bAVM mouse model, created by overexpressing mutant KRAS (KRASG12V) in the brain EC, we demonstrate that KRAS-EC act as trigger for microglia (MG) activation and infiltration of macrophages (Mϕ). Using three-dimensional immunostaining approach with cleared human and mouse bAVM tissues, we demonstrate an abundance of MG/Mϕ around the bAVM nidus. The presence of MG/Mϕ are correlated to the …