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Washington University School of Medicine

2021

Humans

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Women And Ethnoracial Minorities With Poor Cardiovascular Health Measures Associated With A Higher Risk Of Developing Mood Disorder, Aixia Guo, Kari A Stephens, Yosef M Khan, James R Langabeer, Randi E Foraker Dec 2021

Women And Ethnoracial Minorities With Poor Cardiovascular Health Measures Associated With A Higher Risk Of Developing Mood Disorder, Aixia Guo, Kari A Stephens, Yosef M Khan, James R Langabeer, Randi E Foraker

2020-Current year OA Pubs

BACKGROUND: Mood disorders (MDS) are a type of mental health illness that effects millions of people in the United States. Early prediction of MDS can give providers greater opportunity to treat these disorders. We hypothesized that longitudinal cardiovascular health (CVH) measurements would be informative for MDS prediction.

METHODS: To test this hypothesis, the American Heart Association's Guideline Advantage (TGA) dataset was used, which contained longitudinal EHR from 70 outpatient clinics. The statistical analysis and machine learning models were employed to identify the associations of the MDS and the longitudinal CVH metrics and other confounding factors.

RESULTS: Patients diagnosed with MDS …


A Next Generation Sequencing-Based Protocol For Screening Of Variants Of Concern In Autism Spectrum Disorder, Jie Huang, Jun Liu, Ruiyi Tian, Kevin Liu, Patrick Zhuang, Hannah Tayla Sherman, Christoph Budjan, Michelle Fong, Min-Seo Jeong, Xue-Jun Kong Dec 2021

A Next Generation Sequencing-Based Protocol For Screening Of Variants Of Concern In Autism Spectrum Disorder, Jie Huang, Jun Liu, Ruiyi Tian, Kevin Liu, Patrick Zhuang, Hannah Tayla Sherman, Christoph Budjan, Michelle Fong, Min-Seo Jeong, Xue-Jun Kong

2020-Current year OA Pubs

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with strong genetic influences. There is an increasing demand for ASD genetic testing beyond the traditionally recommended microarray and syndromic autism testing; however, the current whole genome sequencing (WGS) and whole exome sequencing (WES) methods are lacking an academic standard for WGS variant annotation, reporting, and interpretation, tailored towards patients with ASD and offer very limited interpretation for clinical significance. Using WGS data from six family trios, we demonstrate the clinical feasibility and technical implementation of an evidence-based, fully transparent bioinformatics pipeline and report framework for an ASD-focused WGS genetic report. We …


Emerging Themes In The Molecular Pathogenesis Of Enterotoxigenic Escherichia Coli, James M Fleckenstein, Alaullah Sheikh Dec 2021

Emerging Themes In The Molecular Pathogenesis Of Enterotoxigenic Escherichia Coli, James M Fleckenstein, Alaullah Sheikh

2020-Current year OA Pubs

Enterotoxigenic Escherichia coli (ETEC) are ubiquitous diarrheal pathogens that thrive in areas lacking basic human needs of clean water and sanitation. These genetically plastic organisms cause tremendous morbidity among disadvantaged young children, in the form of both acute diarrheal illness and sequelae of malnutrition and growth impairment. The recent discovery of additional plasmid-encoded virulence factors and elucidation of their critical role in the molecular pathogenesis of ETEC may inform new approaches to the development of broadly protective vaccines. Although the pathogens have been closely linked epidemiologically with nondiarrheal sequelae, these conditions remain very poorly understood. Similarly, while canonical effects of …


Stat3 Inhibitor Mitigates Cerebral Amyloid Angiopathy And Parenchymal Amyloid Plaques While Improving Cognitive Functions And Brain Networks, Jogender Mehla, Itender Singh, Deepti Diwan, James W Nelson, Molly Lawrence, Eunjae Lee, Adam Q Bauer, David M Holtzman, Gregory J Zipfel Dec 2021

Stat3 Inhibitor Mitigates Cerebral Amyloid Angiopathy And Parenchymal Amyloid Plaques While Improving Cognitive Functions And Brain Networks, Jogender Mehla, Itender Singh, Deepti Diwan, James W Nelson, Molly Lawrence, Eunjae Lee, Adam Q Bauer, David M Holtzman, Gregory J Zipfel

2020-Current year OA Pubs

Previous reports indicate a potential role for signal transducer and activator of transcription 3 (STAT3) in amyloid-β (Aβ) processing and neuritic plaque pathogenesis. In the present study, the impact of STAT3 inhibition on cognition, cerebrovascular function, amyloid pathology, oxidative stress, and neuroinflammation was studied using in vitro and in vivo models of Alzheimer's disease (AD)-related pathology. For in vitro experiments, human brain vascular smooth muscle cells (HBVSMC) and human brain microvascular endothelial cells (HBMEC) were used, and these cultured cells were exposed to Aβ peptides followed by measurement of activated forms of STAT3 expression and reactive oxygen species (ROS) generation. …


Utility Of Facebook's Social Connectedness Index In Modeling Covid-19 Spread: Exponential Random Graph Modeling Study, Beth Prusaczyk, Kathryn Pietka, Joshua M Landman, Douglas A Luke Dec 2021

Utility Of Facebook's Social Connectedness Index In Modeling Covid-19 Spread: Exponential Random Graph Modeling Study, Beth Prusaczyk, Kathryn Pietka, Joshua M Landman, Douglas A Luke

Open Access Publications

BACKGROUND: The COVID-19 (the disease caused by the SARS-CoV-2 virus) pandemic has underscored the need for additional data, tools, and methods that can be used to combat emerging and existing public health concerns. Since March 2020, there has been substantial interest in using social media data to both understand and intervene in the pandemic. Researchers from many disciplines have recently found a relationship between COVID-19 and a new data set from Facebook called the Social Connectedness Index (SCI).

OBJECTIVE: Building off this work, we seek to use the SCI to examine how social similarity of Missouri counties could explain similarities …


Transcriptional Reprogramming Differentiates Active From Inactive Esr1 Fusions In Endocrine Therapy-Refractory Metastatic Breast Cancer, Xuxu Gou, Shunqiang Li, Et Al. Dec 2021

Transcriptional Reprogramming Differentiates Active From Inactive Esr1 Fusions In Endocrine Therapy-Refractory Metastatic Breast Cancer, Xuxu Gou, Shunqiang Li, Et Al.

2020-Current year OA Pubs

Genomic analysis has recently identified multiple


Minimally Invasive Postmortem Intestinal Tissue Sampling In Malnourished And Acutely Ill Children Is Feasible And Informative, Erika Feutz, Wieger Voskuijl, Peter J Finch, Ta-Chiang Liu, Robert H J Bandsma, Phillip I Tarr, Christopher Alan Moxon, Kelley Vanbuskirk, Sarah Lawrence, Grace Umutesi, Kirkby D Tickell, James A Berkley, Judd L Walson, Steve Kamiza, Donna M Denno Dec 2021

Minimally Invasive Postmortem Intestinal Tissue Sampling In Malnourished And Acutely Ill Children Is Feasible And Informative, Erika Feutz, Wieger Voskuijl, Peter J Finch, Ta-Chiang Liu, Robert H J Bandsma, Phillip I Tarr, Christopher Alan Moxon, Kelley Vanbuskirk, Sarah Lawrence, Grace Umutesi, Kirkby D Tickell, James A Berkley, Judd L Walson, Steve Kamiza, Donna M Denno

2020-Current year OA Pubs

BACKGROUND: Intestinal disorders such as environmental enteric dysfunction (EED) are prevalent in low- and middle-income countries (LMICs) and important contributors to childhood undernutrition and mortality. Autopsies are rarely performed in LMICs but minimally invasive tissue sampling is increasingly deployed as a more feasible and acceptable procedure, although protocols have been devoid of intestinal sampling to date. We sought to determine (1) the feasibility of postmortem intestinal sampling, (2) whether autolysis precludes enteric biopsies' utility, and (3) histopathologic features among children who died during hospitalization with acute illness or undernutrition.

METHODS: Transabdominal needle and endoscopic forceps upper and lower intestinal sampling …


Peroxisomal Β-Oxidation Acts As A Sensor For Intracellular Fatty Acids And Regulates Lipolysis, Lianggong Ding, Wenfei Sun, Miroslav Balaz, Anyuan He, Manuel Klug, Stefan Wieland, Robert Caiazzo, Violeta Raverdy, Francois Pattou, Philippe Lefebvre, Irfan J Lodhi, Bart Staels, Markus Heim, Christian Wolfrum Dec 2021

Peroxisomal Β-Oxidation Acts As A Sensor For Intracellular Fatty Acids And Regulates Lipolysis, Lianggong Ding, Wenfei Sun, Miroslav Balaz, Anyuan He, Manuel Klug, Stefan Wieland, Robert Caiazzo, Violeta Raverdy, Francois Pattou, Philippe Lefebvre, Irfan J Lodhi, Bart Staels, Markus Heim, Christian Wolfrum

Open Access Publications

To liberate fatty acids (FAs) from intracellular stores, lipolysis is regulated by the activity of the lipases adipose triglyceride lipase (ATGL), hormone-sensitive lipase and monoacylglycerol lipase. Excessive FA release as a result of uncontrolled lipolysis results in lipotoxicity, which can in turn promote the progression of metabolic disorders. However, whether cells can directly sense FAs to maintain cellular lipid homeostasis is unknown. Here we report a sensing mechanism for cellular FAs based on peroxisomal degradation of FAs and coupled with reactive oxygen species (ROS) production, which in turn regulates FA release by modulating lipolysis. Changes in ROS levels are sensed …


Activation Of The Α1Β2Γ2l Gaba Receptor By Physiological Agonists, Spencer R Pierce, Allison L Germann, Gustav Akk Dec 2021

Activation Of The Α1Β2Γ2l Gaba Receptor By Physiological Agonists, Spencer R Pierce, Allison L Germann, Gustav Akk

Open Access Publications

The Cl


Overexpression Screen Of Interferon-Stimulated Genes Identifies Rarres3 As A Restrictor Of Toxoplasma Gondii Infection, Nicholas Rinkenberger, Michael E Abrams, Sumit K Matta, John W Schoggins, Neal M Alto, L David Sibley Dec 2021

Overexpression Screen Of Interferon-Stimulated Genes Identifies Rarres3 As A Restrictor Of Toxoplasma Gondii Infection, Nicholas Rinkenberger, Michael E Abrams, Sumit K Matta, John W Schoggins, Neal M Alto, L David Sibley

2020-Current year OA Pubs

No abstract provided.


Electronically Available Patient Claims Data Improve Models For Comparing Antibiotic Use Across Hospitals: Results From 576 Us Facilities, Katherine E Goodman, Lisa Pineles, Laurence S Magder, Deverick J Anderson, Elizabeth Dodds Ashley, Ronald E Polk, Hude Quan, William E Trick, Keith F Woeltje, Surbhi Leekha, Sara E Cosgrove, Anthony D Harris Dec 2021

Electronically Available Patient Claims Data Improve Models For Comparing Antibiotic Use Across Hospitals: Results From 576 Us Facilities, Katherine E Goodman, Lisa Pineles, Laurence S Magder, Deverick J Anderson, Elizabeth Dodds Ashley, Ronald E Polk, Hude Quan, William E Trick, Keith F Woeltje, Surbhi Leekha, Sara E Cosgrove, Anthony D Harris

2020-Current year OA Pubs

BACKGROUND: The Centers for Disease Control and Prevention (CDC) uses standardized antimicrobial administration ratios (SAARs)-that is, observed-to-predicted ratios-to compare antibiotic use across facilities. CDC models adjust for facility characteristics when predicting antibiotic use but do not include patient diagnoses and comorbidities that may also affect utilization. This study aimed to identify comorbidities causally related to appropriate antibiotic use and to compare models that include these comorbidities and other patient-level claims variables to a facility model for risk-adjusting inpatient antibiotic utilization.

METHODS: The study included adults discharged from Premier Database hospitals in 2016-2017. For each admission, we extracted facility, claims, and …


High-Throughput Functional Analysis Of Cftr And Other Apically Localized Proteins In Ipsc-Derived Human Intestinal Organoids, Sunny Xia, Zoltán Bozóky, Michelle Di Paola, Onofrio Laselva, Saumel Ahmadi, Jia Xin Jiang, Amy L Pitstick, Chong Jiang, Daniela Rotin, Christopher N Mayhew, Nicola L Jones, Christine E Bear Dec 2021

High-Throughput Functional Analysis Of Cftr And Other Apically Localized Proteins In Ipsc-Derived Human Intestinal Organoids, Sunny Xia, Zoltán Bozóky, Michelle Di Paola, Onofrio Laselva, Saumel Ahmadi, Jia Xin Jiang, Amy L Pitstick, Chong Jiang, Daniela Rotin, Christopher N Mayhew, Nicola L Jones, Christine E Bear

Open Access Publications

Induced Pluripotent Stem Cells (iPSCs) can be differentiated into epithelial organoids that recapitulate the relevant context for CFTR and enable testing of therapies targeting Cystic Fibrosis (CF)-causing mutant proteins. However, to date, CF-iPSC-derived organoids have only been used to study pharmacological modulation of mutant CFTR channel activity and not the activity of other disease-relevant membrane protein constituents. In the current work, we describe a high-throughput, fluorescence-based assay of CFTR channel activity in iPSC-derived intestinal organoids and describe how this method can be adapted to study other apical membrane proteins. Specifically, we show how this assay can be employed to study …


Adolescent Brain Cognitive Development (Abcd) Study Linked External Data (Led): Protocol And Practices For Geocoding And Assignment Of Environmental Data, Chun Chieh Fan, Andrew Marshall, Harry Smolker, Marybel R Gonzalez, Susan F Tapert, Deanna M Barch, Elizabeth Sowell, Gayathri J Dowling, Carlos Cardenas-Iniguez, Jessica Ross, Wesley K Thompson, Megan M Herting Dec 2021

Adolescent Brain Cognitive Development (Abcd) Study Linked External Data (Led): Protocol And Practices For Geocoding And Assignment Of Environmental Data, Chun Chieh Fan, Andrew Marshall, Harry Smolker, Marybel R Gonzalez, Susan F Tapert, Deanna M Barch, Elizabeth Sowell, Gayathri J Dowling, Carlos Cardenas-Iniguez, Jessica Ross, Wesley K Thompson, Megan M Herting

Open Access Publications

Our brain is constantly shaped by our immediate environments, and while some effects are transient, some have long-term consequences. Therefore, it is critical to identify which environmental risks have evident and long-term impact on brain development. To expand our understanding of the environmental context of each child, the Adolescent Brain Cognitive Development (ABCD) Study® incorporates the use of geospatial location data to capture a range of individual, neighborhood, and state level data based on the child's residential location in order to elucidate the physical environmental contexts in which today's youth are growing up. We review the major considerations and types …


Efficacy And Safety Of Avapritinib In Advanced Systemic Mastocytosis: Interim Analysis Of The Phase 2 Pathfinder Trial, Jason Gotlib, Andreas Reiter, Stephen T Oh, Et Al Dec 2021

Efficacy And Safety Of Avapritinib In Advanced Systemic Mastocytosis: Interim Analysis Of The Phase 2 Pathfinder Trial, Jason Gotlib, Andreas Reiter, Stephen T Oh, Et Al

Open Access Publications

Advanced systemic mastocytosis (AdvSM) is a rare, KIT D816V-driven hematologic neoplasm characterized by mast cell infiltration and shortened survival. We report the results of a prespecified interim analysis of an ongoing pivotal single-arm phase 2 trial (no. NCT03580655 ) of avapritinib, a potent, selective KIT D816V inhibitor administered primarily at a once-daily starting dose of 200 mg in patients with AdvSM (n = 62). The primary endpoint was overall response rate (ORR). Secondary endpoints included mean baseline change in AdvSM-Symptom Assessment Form Total Symptom Score and quality of life, time to response, duration of response, progression-free survival, overall survival, changes …


Comparison Of Machine Learning Clustering Algorithms For Detecting Heterogeneity Of Treatment Effect In Acute Respiratory Distress Syndrome: A Secondary Analysis Of Three Randomised Controlled Trials, Pratik Sinha, Alexandra Spicer, Kevin L Delucchi, Daniel F Mcauley, Carolyn S Calfee, Matthew M Churpek Dec 2021

Comparison Of Machine Learning Clustering Algorithms For Detecting Heterogeneity Of Treatment Effect In Acute Respiratory Distress Syndrome: A Secondary Analysis Of Three Randomised Controlled Trials, Pratik Sinha, Alexandra Spicer, Kevin L Delucchi, Daniel F Mcauley, Carolyn S Calfee, Matthew M Churpek

Open Access Publications

BACKGROUND: Heterogeneity in Acute Respiratory Distress Syndrome (ARDS), as a consequence of its non-specific definition, has led to a multitude of negative randomised controlled trials (RCTs). Investigators have sought to identify heterogeneity of treatment effect (HTE) in RCTs using clustering algorithms. We evaluated the proficiency of several commonly-used machine-learning algorithms to identify clusters where HTE may be detected.

METHODS: Five unsupervised: Latent class analysis (LCA), K-means, partition around medoids, hierarchical, and spectral clustering; and four supervised algorithms: model-based recursive partitioning, Causal Forest (CF), and X-learner with Random Forest (XL-RF) and Bayesian Additive Regression Trees were individually applied to three prior …


Identification Of Histone Deacetylase Inhibitors With (Arylidene)Aminoxy Scaffold Active In Uveal Melanoma Cell Lines, Susanna Nencetti, Doretta Cuffaro, Elisa Nuti, Lidia Ciccone, Armando Rossello, Marina Fabbi, Flavio Ballante, Gabriella Ortore, Grazia Carbotti, Francesco Campelli, Irene Banti, Rosaria Gangemi, Garland R Marshall, Elisabetta Orlandini Dec 2021

Identification Of Histone Deacetylase Inhibitors With (Arylidene)Aminoxy Scaffold Active In Uveal Melanoma Cell Lines, Susanna Nencetti, Doretta Cuffaro, Elisa Nuti, Lidia Ciccone, Armando Rossello, Marina Fabbi, Flavio Ballante, Gabriella Ortore, Grazia Carbotti, Francesco Campelli, Irene Banti, Rosaria Gangemi, Garland R Marshall, Elisabetta Orlandini

Open Access Publications

Uveal melanoma (UM) represents an aggressive type of cancer and currently, there is no effective treatment for this metastatic disease. In the last years, histone deacetylase inhibitors (HDACIs) have been studied as a possible therapeutic treatment for UM, alone or in association with other chemotherapeutic agents. Here we synthesised a series of new HDACIs based on the SAHA scaffold bearing an (arylidene)aminoxy moiety. Their HDAC inhibitory activity was evaluated on isolated human HDAC1, 3, 6, and 8 by fluorometric assay and their binding mode in the catalytic site of HDACs was studied by molecular docking. The most promising hit was …


The Human Connectome Project: A Retrospective, Jennifer Stine Elam, Matthew F. Glasser, Michael P. Harms, Gregory C. Burgess, Sandra W. Curtiss, Michael R. Hodge, Eileen A. Cler, Daniel M. Marcus, Deanna M. Barch, David C. Van Essen, Et Al. Dec 2021

The Human Connectome Project: A Retrospective, Jennifer Stine Elam, Matthew F. Glasser, Michael P. Harms, Gregory C. Burgess, Sandra W. Curtiss, Michael R. Hodge, Eileen A. Cler, Daniel M. Marcus, Deanna M. Barch, David C. Van Essen, Et Al.

2020-Current year OA Pubs

The Human Connectome Project (HCP) was launched in 2010 as an ambitious effort to accelerate advances in human neuroimaging, particularly for measures of brain connectivity; apply these advances to study a large number of healthy young adults; and freely share the data and tools with the scientific community. NIH awarded grants to two consortia; this retrospective focuses on the "WU-Minn-Ox" HCP consortium centered at Washington University, the University of Minnesota, and University of Oxford. In just over 6 years, the WU-Minn-Ox consortium succeeded in its core objectives by: 1) improving MR scanner hardware, pulse sequence design, and image reconstruction methods, …


Pharmacogenomics Insights Into Precision Pediatric Oncology, Kristie N. Ramos, David Gregornik, Kenneth S. Ramos Dec 2021

Pharmacogenomics Insights Into Precision Pediatric Oncology, Kristie N. Ramos, David Gregornik, Kenneth S. Ramos

2020-Current year OA Pubs

PURPOSE OF REVIEW: Pharmacogenomic insights provide an opportunity to optimize medication dosing regimens and patient outcomes. However, the potential for interindividual genomic variability to guide medication dosing and toxicity monitoring is not yet standard of care. In this review, we present advances for the thiopurines, anthracyclines and vincristine and provide perspectives on the actionability of pharmacogenomic guidance in the future.

RECENT FINDINGS: The current guideline on thiopurines recommends that those with normal predicted thiopurine methyltransferase and NUDT15 expression receive standard-of-care dosing, while 'poor metabolizer' haplotypes receive a decreased 6-mercaptopurine starting dose to avoid bone marrow toxicity. Emerging evidence established significant …


A Brief History Of Nearly Ev-Erything - The Rise And Rise Of Extracellular Vesicles, Yvonne Couch, Edit I Buzàs, Dolores Di Vizio, Yong Song Gho, Paul Harrison, Andrew F Hill, Jan Lötvall, Graça Raposo, Philip D Stahl, Clotilde Théry, Kenneth W Witwer, David R F Carter Dec 2021

A Brief History Of Nearly Ev-Erything - The Rise And Rise Of Extracellular Vesicles, Yvonne Couch, Edit I Buzàs, Dolores Di Vizio, Yong Song Gho, Paul Harrison, Andrew F Hill, Jan Lötvall, Graça Raposo, Philip D Stahl, Clotilde Théry, Kenneth W Witwer, David R F Carter

2020-Current year OA Pubs

Extracellular vesicles (EVs) are small cargo-bearing vesicles released by cells into the extracellular space. The field of EVs has grown exponentially over the past two decades; this growth follows the realisation that EVs are not simply a waste disposal system as had originally been suggested by some, but also a complex cell-to-cell communication mechanism. Indeed, EVs have been shown to transfer functional cargo between cells and can influence several biological processes. These small biological particles are also deregulated in disease. As we approach the 75th anniversary of the first experiments in which EVs were unknowingly isolated, it seems right to …


A Reevaluation Of The Tolerability And Effects Of Single-Dose Ivermectin Treatment On Onchocerca Volvulus Microfilariae In The Skin And Eyes In Eastern Ghana, Nicholas O Opoku, Michael E Gyasi, Felix Doe, Daphne Lew, Augustine R Hong, Sithembele Chithenga, Peter U Fischer, Christopher L King, Gary J Weil Nov 2021

A Reevaluation Of The Tolerability And Effects Of Single-Dose Ivermectin Treatment On Onchocerca Volvulus Microfilariae In The Skin And Eyes In Eastern Ghana, Nicholas O Opoku, Michael E Gyasi, Felix Doe, Daphne Lew, Augustine R Hong, Sithembele Chithenga, Peter U Fischer, Christopher L King, Gary J Weil

Open Access Publications

Mass administration of ivermectin (IVM) has significantly reduced onchocerciasis prevalence, intensity, and morbidity in most endemic areas. Most IVM clinical trials were performed long ago in persons with high-intensity infections that are uncommon in West Africa today. This cohort treatment study recruited participants from a hypoendemic area in eastern Ghana to reevaluate the efficacy and tolerability of IVM with a special focus on the kinetics of microfilaria (Mf) clearance. Mf in the skin and anterior chambers (AC) were assessed by skin snip and slit lamp examinations at baseline and at 3 and 6 months after treatment with IVM 150 μg/kg. …


Sex Modifies Apoe Ε4 Dose Effect On Brain Tau Deposition In Cognitively Impaired Individuals, Shaozhen Yan, Chaojie Zheng, Manish D Paranjpe, Yanxiao Li, Weihua Li, Xiuying Wang, Tammie L S Benzinger, Jie Lu, Yun Zhou Nov 2021

Sex Modifies Apoe Ε4 Dose Effect On Brain Tau Deposition In Cognitively Impaired Individuals, Shaozhen Yan, Chaojie Zheng, Manish D Paranjpe, Yanxiao Li, Weihua Li, Xiuying Wang, Tammie L S Benzinger, Jie Lu, Yun Zhou

2020-Current year OA Pubs

Recent studies in cognitively unimpaired elderly individuals suggest that the APOE ε4 allele exerts a dosage-dependent effect on brain tau deposition. The aim of this study was to investigate sex differences in APOE ε4 gene dosage effects on brain tau deposition in cognitively impaired individuals using quantitative 18F-flortaucipir PET. Preprocessed 18F-flortaucipir tau PET images, T1-weighted structural MRI, demographic information, global cortical amyloid-β burden measured by 18F-florbetapir PET, CSF total tau and phosphorylated tau measurements were obtained from the Alzheimer's Disease Neuroimaging Initiative database. Two hundred and sixty-eight cognitively impaired individuals with 146 APOE ε4 non-carriers and 122 carriers (85 heterozygotes …


A Scoping Review Of De-Implementation Frameworks And Models, Callie Walsh-Bailey, Edward Tsai, Rachel G Tabak, Alexandra B Morshed, Wynne E Norton, Virginia R Mckay, Ross C Brownson, Sheyna Gifford Nov 2021

A Scoping Review Of De-Implementation Frameworks And Models, Callie Walsh-Bailey, Edward Tsai, Rachel G Tabak, Alexandra B Morshed, Wynne E Norton, Virginia R Mckay, Ross C Brownson, Sheyna Gifford

2020-Current year OA Pubs

BACKGROUND: Reduction or elimination of inappropriate, ineffective, or potentially harmful healthcare services and public health programs can help to ensure limited resources are used effectively. Frameworks and models (FM) are valuable tools in conceptualizing and guiding the study of de-implementation. This scoping review sought to identify and characterize FM that can be used to study de-implementation as a phenomenon and identify gaps in the literature to inform future model development and application for research.

METHODS: We searched nine databases and eleven journals from a broad array of disciplines (e.g., healthcare, public health, public policy) for de-implementation studies published between 1990 …


Identifying Barriers To Evidence-Based Care For Sickle Cell Disease: Results From The Sickle Cell Disease Implementation Consortium Cross-Sectional Survey Of Healthcare Providers In The Usa, Matthew Smeltzer, Kristen Howell, Marsha Treadwell, Liliana Preiss, Allison King, Jeffrey Glassberg, Paula Tanabe, Sherif Badawy, Lisa Dimartino, Robert Gibson, Julie Kanter, Lisa Klesges, Jane Hankins, Sickle Cell Disease Implementation Consortium Nov 2021

Identifying Barriers To Evidence-Based Care For Sickle Cell Disease: Results From The Sickle Cell Disease Implementation Consortium Cross-Sectional Survey Of Healthcare Providers In The Usa, Matthew Smeltzer, Kristen Howell, Marsha Treadwell, Liliana Preiss, Allison King, Jeffrey Glassberg, Paula Tanabe, Sherif Badawy, Lisa Dimartino, Robert Gibson, Julie Kanter, Lisa Klesges, Jane Hankins, Sickle Cell Disease Implementation Consortium

Open Access Publications

OBJECTIVES: Sickle cell disease (SCD) leads to chronic and acute complications that require specialised care to manage symptoms and optimise clinical results. The National Heart Lung and Blood Institute (NHLBI) evidence-based guidelines assist providers in caring for individuals with SCD, but adoption of these guidelines by providers has not been optimal. The objective of this study was to identify barriers to treating individuals with SCD.

METHODS: The SCD Implementation Consortium aimed to investigate the perception and level of comfort of providers regarding evidence-based care by surveying providers in the regions of six clinical centres across the USA, focusing on non-emergency …


Predictors Of Coronary Artery Calcium And Long-Term Risks Of Death, Myocardial Infarction, And Stroke In Young Adults, Aamir Javaid, Joshua D Mitchell, Todd C Villines Nov 2021

Predictors Of Coronary Artery Calcium And Long-Term Risks Of Death, Myocardial Infarction, And Stroke In Young Adults, Aamir Javaid, Joshua D Mitchell, Todd C Villines

Open Access Publications

Background Coronary artery calcium (CAC) is well-validated for cardiovascular disease risk stratification in middle to older-aged adults; however, the 2019 American College of Cardiology/American Heart Association guidelines state that more data are needed regarding the performance of CAC in low-risk younger adults. Methods and Results We measured CAC in 13 397 patients aged 30 to 49 years without known cardiovascular disease or malignancy between 1997 and 2009. Outcomes of myocardial infarction (MI), stroke, major adverse cardiovascular events (MACE; MI, stroke, or cardiovascular death), and all-cause mortality were assessed using Cox proportional hazard models, controlling for baseline risk factors (including atrial …


Developing And Demonstrating The Viability And Availability Of The Multilevel Implementation Strategy For Syncope Optimal Care Through Engagement (Mission) Syncope App: Evidence-Based Clinical Decision Support Tool, Shiraz Amin, Vedant Gupta, Gaixin Du, Colleen Mcmullen, Matthew Sirrine, Mark V Williams, Susan S Smyth, Romil Chadha, Seth Stearley, Jing Li Nov 2021

Developing And Demonstrating The Viability And Availability Of The Multilevel Implementation Strategy For Syncope Optimal Care Through Engagement (Mission) Syncope App: Evidence-Based Clinical Decision Support Tool, Shiraz Amin, Vedant Gupta, Gaixin Du, Colleen Mcmullen, Matthew Sirrine, Mark V Williams, Susan S Smyth, Romil Chadha, Seth Stearley, Jing Li

2020-Current year OA Pubs

BACKGROUND: Syncope evaluation and management is associated with testing overuse and unnecessary hospitalizations. The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Syncope Guideline aims to standardize clinical practice and reduce unnecessary services. The use of clinical decision support (CDS) tools offers the potential to successfully implement evidence-based clinical guidelines. However, CDS tools that provide an evidence-based differential diagnosis (DDx) of syncope at the point of care are currently lacking.

OBJECTIVE: With input from diverse health systems, we developed and demonstrated the viability of a mobile app, the Multilevel Implementation Strategy for Syncope optImal care thrOugh eNgagement (MISSION) Syncope, as …


Enhancing Dopamine Tone Modulates Global And Local Cortical Perfusion As A Function Of Comt Val158met Genotype, Daniella J Furman, Ioannis Pappas, Robert L White 3rd, Andrew S Kayser, Mark D'Esposito Nov 2021

Enhancing Dopamine Tone Modulates Global And Local Cortical Perfusion As A Function Of Comt Val158met Genotype, Daniella J Furman, Ioannis Pappas, Robert L White 3rd, Andrew S Kayser, Mark D'Esposito

2020-Current year OA Pubs

The cognitive effects of pharmacologically enhancing cortical dopamine (DA) tone are variable across healthy human adults. It has been postulated that individual differences in drug responses are linked to baseline cortical DA activity according to an inverted-U-shaped function. To better understand the effect of divergent starting points along this curve on DA drug responses, researchers have leveraged a common polymorphism (rs4680) in the gene encoding the enzyme catechol-O-methyltransferase (COMT) that gives rise to greater (Met allele) or lesser (Val allele) extracellular levels of cortical DA. Here we examined the extent to which changes in resting cortical perfusion following the administration …


Development And Immunogenicity Of A Prototype Multivalent Group B Streptococcus Bioconjugate Vaccine, Jeremy A Duke, Amy V Paschall, Lloyd S Robinson, Cory J Knoot, Evgeny Vinogradov, Nichollas E Scott, Mario F Feldman, Fikri Y Avci, Christian M Harding Nov 2021

Development And Immunogenicity Of A Prototype Multivalent Group B Streptococcus Bioconjugate Vaccine, Jeremy A Duke, Amy V Paschall, Lloyd S Robinson, Cory J Knoot, Evgeny Vinogradov, Nichollas E Scott, Mario F Feldman, Fikri Y Avci, Christian M Harding

2020-Current year OA Pubs

Group B


Angiotensin Receptor-Neprilysin Inhibition In Acute Myocardial Infarction, Marc A Pfeffer, Douglas L Mann, Et Al Nov 2021

Angiotensin Receptor-Neprilysin Inhibition In Acute Myocardial Infarction, Marc A Pfeffer, Douglas L Mann, Et Al

Open Access Publications

BACKGROUND: In patients with symptomatic heart failure, sacubitril-valsartan has been found to reduce the risk of hospitalization and death from cardiovascular causes more effectively than an angiotensin-converting-enzyme inhibitor. Trials comparing the effects of these drugs in patients with acute myocardial infarction have been lacking.

METHODS: We randomly assigned patients with myocardial infarction complicated by a reduced left ventricular ejection fraction, pulmonary congestion, or both to receive either sacubitril-valsartan (97 mg of sacubitril and 103 mg of valsartan twice daily) or ramipril (5 mg twice daily) in addition to recommended therapy. The primary outcome was death from cardiovascular causes or incident …


Storytelling To Improve Disease Outcomes In Gout (Stride-Go): A Multicenter, Randomized Controlled Trial In African American Veterans With Gout, Jasvinder A Singh, Amy Joseph, Joshua Baker, Joshua S Richman, Terrence Shaneyfelt, Kenneth G Saag, Seth Eisen Nov 2021

Storytelling To Improve Disease Outcomes In Gout (Stride-Go): A Multicenter, Randomized Controlled Trial In African American Veterans With Gout, Jasvinder A Singh, Amy Joseph, Joshua Baker, Joshua S Richman, Terrence Shaneyfelt, Kenneth G Saag, Seth Eisen

2020-Current year OA Pubs

BACKGROUND: Urate-lowering therapy (ULT) adherence is low in gout, and few, if any, effective, low-cost, interventions are available. Our objective was to assess if a culturally appropriate gout-storytelling intervention is superior to an attention control for improving gout outcomes in African-Americans (AAs).

METHODS: In a 1-year, multicenter, randomized controlled trial, AA veterans with gout were randomized to gout-storytelling intervention vs. a stress reduction video (attention control group; 1:1 ratio). The primary outcome was ULT adherence measured with MEMSCap™, an electronic monitoring system that objectively measured ULT medication adherence.

RESULTS: The 306 male AA veterans with gout who met the eligibility …


Physical Activity And Fat-Free Mass During Growth And In Later Life, Klaas R Westerterp, Susan B Racette, Et Al. Nov 2021

Physical Activity And Fat-Free Mass During Growth And In Later Life, Klaas R Westerterp, Susan B Racette, Et Al.

2020-Current year OA Pubs

BACKGROUND: Physical activity may be a way to increase and maintain fat-free mass (FFM) in later life, similar to the prevention of fractures by increasing peak bone mass.

OBJECTIVES: A study is presented of the association between FFM and physical activity in relation to age.

METHODS: In a cross-sectional study, FFM was analyzed in relation to physical activity in a large participant group as compiled in the International Atomic Energy Agency Doubly Labeled Water database. The database included 2000 participants, age 3-96 y, with measurements of total energy expenditure (TEE) and resting energy expenditure (REE) to allow calculation of physical …