Digital Commons Network^™

Companion-002 A Clinical Trial Of Investigational Drug Ctx-009 Plus Paclitaxel Vs Paclitaxel In Second Line Advanced Btc, Nilofer Azad, Olivia Aranha, Et Al.

2020-Current year OA Pubs

Treatment options for patients with biliary tract cancer are limited, and the prognosis is poor. CTX-009, a novel bispecific antibody targeting both DLL4 and VEGF-A, has demonstrated antitumor activity in patients with advanced cancers as both a monotherapy and in combination with chemotherapy. In a phase II study of patients with advanced biliary tract cancer who had received one or two prior therapies, CTX-009 with paclitaxel demonstrated a 37.5% overall response rate (ORR). Described here is the design of and rationale for COMPANION-002, a randomized phase II/III study, which will evaluate the safety and efficacy of CTX-009 in combination with …

Neutrophils And Galectin-3 Defend Mice From Lethal Bacterial Infection And Humans From Acute Respiratory Failure, Sudipta Das, Janet S Lee, Et Al.

2020-Current year OA Pubs

Respiratory infection by Pseudomonas aeruginosa, common in hospitalized immunocompromised and immunocompetent ventilated patients, can be life-threatening because of antibiotic resistance. This raises the question of whether the host's immune system can be educated to combat this bacterium. Here we show that prior exposure to a single low dose of lipopolysaccharide (LPS) protects mice from a lethal infection by P. aeruginosa. LPS exposure trained the innate immune system by promoting expansion of neutrophil and interstitial macrophage populations distinguishable from other immune cells with enrichment of gene sets for phagocytosis- and cell-killing-associated genes. The cell-killing gene set in the neutrophil population uniquely …

Phantasus, A Web Application For Visual And Interactive Gene Expression Analysis, Maksim Kleverov, Daria Zenkova, Vladislav Kamenev, Margarita Sablina, Maxim N Artyomov, Alexey A Sergushichev

2020-Current year OA Pubs

Transcriptomic profiling became a standard approach to quantify a cell state, which led to the accumulation of huge amount of public gene expression datasets. However, both reuse of these datasets or analysis of newly generated ones requires significant technical expertise. Here, we present Phantasus: a user-friendly web application for interactive gene expression analysis which provides a streamlined access to more than 96,000 public gene expression datasets, as well as allows analysis of user-uploaded datasets. Phantasus integrates an intuitive and highly interactive JavaScript-based heatmap interface with an ability to run sophisticated R-based analysis methods. Overall Phantasus allows users to go all …

Generalized Genetic Liability To Substance Use Disorders, Alex P. Miller, Ryan Bogdan, Arpana Agrawal, Alexander S. Hatoum

2020-Current year OA Pubs

Lifetime and temporal co-occurrence of substance use disorders (SUDs) is common and compared with individual SUDs is characterized by greater severity, additional psychiatric comorbidities, and worse outcomes. Here, we review evidence for the role of generalized genetic liability to various SUDs. Coaggregation of SUDs has familial contributions, with twin studies suggesting a strong contribution of additive genetic influences undergirding use disorders for a variety of substances (including alcohol, nicotine, cannabis, and others). GWAS have documented similarly large genetic correlations between alcohol, cannabis, and opioid use disorders. Extending these findings, recent studies have identified multiple genomic loci that contribute to common …

Hexamerization: Explaining The Original Sin Of Igg-Mediated Complement Activation In Acute Lung Injury, Hrishikesh S. Kulkarni

2020-Current year OA Pubs

Although antibody-mediated lung damage is a major factor in transfusion-related acute lung injury (ALI), autoimmune lung disease (for example, coatomer subunit α [COPA] syndrome), and primary graft dysfunction following lung transplantation, the mechanism by which antigen-antibody complexes activate complement to induce lung damage remains unclear. In this issue of the JCI, Cleary and colleagues utilized several approaches to demonstrate that IgG forms hexamers with MHC class I alloantibodies. This hexamerization served as a key pathophysiological mechanism in alloimmune lung injury models and was mediated through the classical pathway of complement activation. Additionally, the authors provided avenues for exploring therapeutics for …

Secure Messaging And Telephone Use For Clinician-To-Clinician Communication, Sunny S Lou, Daphne Lew, Laura R Baratta, Elise Eiden, Christine A Sinsky, Thomas Kannampallil

2020-Current year OA Pubs

No abstract provided.

Severe Pediatric Neurological Manifestations With Sars-Cov-2 Or Mis-C Hospitalization And New Morbidity, Conall Francoeur, Kristin P Guilliams, Shannon C Agner, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Neurological manifestations during acute SARS-CoV-2-related multisystem inflammatory syndrome in children (MIS-C) are common in hospitalized patients younger than 18 years and may increase risk of new neurocognitive or functional morbidity.

OBJECTIVE: To assess the association of severe neurological manifestations during a SARS-CoV-2-related hospital admission with new neurocognitive or functional morbidities at discharge.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study from 46 centers in 10 countries included patients younger than 18 years who were hospitalized for acute SARS-CoV-2 or MIS-C between January 2, 2020, and July 31, 2021.

EXPOSURE: Severe neurological manifestations, which included acute encephalopathy, seizures or status …

Glutamatergic Supramammillary Nucleus Neurons Respond To Threatening Stressors And Promote Active Coping, Abraham Escobedo, Salli-Ann Holloway, Megan Votoupal, Aaron L Cone, Hannah Skelton, Alex A Legaria, Imeh Ndiokho, Tasheia Floyd, Alexxai V Kravitz, Michael R Bruchas, Aaron J Norris

2020-Current year OA Pubs

Threat-response neural circuits are conserved across species and play roles in normal behavior and psychiatric diseases. Maladaptive changes in these neural circuits contribute to stress, mood, and anxiety disorders. Active coping in response to stressors is a psychosocial factor associated with resilience against stress-induced mood and anxiety disorders. The neural circuitry underlying active coping is poorly understood, but the functioning of these circuits could be key for overcoming anxiety and related disorders. The supramammillary nucleus (SuM) has been suggested to be engaged by threat. SuM has many projections and a poorly understood diversity of neural populations. In studies using mice, …

Cannabis, Tobacco Use, And Covid-19 Outcomes, Nicholas B Griffith, Timothy B Baker, Brendan T Heiden, Nina Smock, Giang Pham, Jingling Chen, Justin Yu, James Reddy, Albert M Lai, Eric Hogue, Laura J Bierut, Li-Shiun Chen

2020-Current year OA Pubs

IMPORTANCE: It is unclear whether cannabis use is associated with adverse health outcomes in patients with COVID-19 when accounting for known risk factors, including tobacco use.

OBJECTIVE: To examine whether cannabis and tobacco use are associated with adverse health outcomes from COVID-19 in the context of other known risk factors.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used electronic health record data from February 1, 2020, to January 31, 2022. This study included patients who were identified as having COVID-19 during at least 1 medical visit at a large academic medical center in the Midwest US.

EXPOSURES: Current cannabis …

An Evaluation Of The Outcomes Associated With Peritoneal Catheter Use In Neonates Undergoing Cardiac Surgery: A Multicenter Study, David M Kwiatkowski, Tara M Neumayr, Et Al.

2020-Current year OA Pubs

OBJECTIVE: The study objective was to determine if intraoperative peritoneal catheter placement is associated with improved outcomes in neonates undergoing high-risk cardiac surgery with cardiopulmonary bypass.

METHODS: This propensity score-matched retrospective study used data from 22 academic pediatric cardiac intensive care units. Consecutive neonates undergoing Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery category 3 to 5 cardiac surgery with cardiopulmonary bypass at centers participating in the NEonatal and Pediatric Heart Renal Outcomes Network collaborative were studied to determine the association of the use of an intraoperative placed peritoneal catheter for dialysis or passive drainage with clinical outcomes, including the …

Validated Clinical Score To Predict Gastroesophageal Reflux In Patients With Chronic Laryngeal Symptoms: Cough Reflux, Amanda J Krause, Alexander M Kaizer, Dustin A Carlson, Walter W Chan, Chien-Lin Chen, C Prakash Gyawali, Andrew Jenkins, John E Pandolfino, Vinathi Polamraju, Ming-Wun Wong, Madeline Greytak, Rena Yadlapati

2020-Current year OA Pubs

BACKGROUND & AIMS: Discerning whether laryngeal symptoms result from gastroesophageal reflux is clinically challenging and a reliable tool to stratify patients is needed. We aimed to develop and validate a model to predict the likelihood of gastroesophageal reflux disease (GERD) among patients with chronic laryngeal symptoms.

METHODS: This multicenter international study collected data from adults with chronic laryngeal symptoms who underwent objective testing (upper gastrointestinal endoscopy and/or ambulatory reflux monitoring) between March 2018 and May 2023. The training phase identified a model with optimal receiver operating characteristic curves, and β coefficients informed a weighted model. The validation phase assessed performance …

Skeletal Abnormalities In Mice With Dnmt3a Missense Mutations, Austin Bell-Hensley, Diana C Beard, Kathryn Feeney, Hongjun Zheng, Yunhao Jiang, Xiyun Zhang, Jin Liu, Harrison Gabel, Audrey Mcalinden

2020-Current year OA Pubs

Overgrowth and intellectual disability disorders in humans are typified by length/height and/or head circumference ≥ 2 standard deviations above the mean as well as intellectual disability and behavioral comorbidities, including autism and anxiety. Tatton-Brown-Rahman Syndrome is one type of overgrowth and intellectual disability disorder caused by heterozygous missense mutations in the DNA methyltransferase 3A (DNMT3A) gene. Numerous DNMT3A mutations have been identified in Tatton-Brown-Rahman Syndrome patients and may be associated with varying phenotype severities of clinical presentation. Two such mutations are the R882H and P904L mutations which result in severe and mild phenotypes, respectively. Mice with paralogous mutations (Dnmt3a

Metastasectomy For Extracalvarial Renal Cell Carcinoma, Rahim Abo Kasem, Karan Joseph, Adnan Shaik, Angela Downes, M Burhan Janjua

2020-Current year OA Pubs

KEY CLINICAL MESSAGE: Palliative surgical resection of extra-calvarial metastatic lesions from renal cell tumors is crucial for controlling metastatic spread, improving quality of life, and preventing associated morbidity. Careful surgical planning, including selective preoperative embolization and controlled resection around critical structures such as the sagittal sinus, is essential for successful outcomes. Cranioplasty with Titanium mesh and bone cement post-resection can provide symptomatic relief, better cosmesis, and overall improved quality of life.

ABSTRACT: Renal cell carcinomas are aggressive tumors with distant systemic disease. The calvarium appears to be an unusual and rare site for distant metastasis. The treatment modalities are challenging …

Real-World Experience With Avacopan In Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis, Reza Zonozi, Aisha Shaikh, Colin Diffie, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Postmarketing data on outcomes of avacopan use in antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) are lacking.

METHODS: We performed a multicenter retrospective analysis of 92 patients with newly diagnosed or relapsing AAV who received therapy with avacopan. The coprimary outcome measures were clinical remission at 26 and 52 weeks. We use descriptive statistics and univariate logistic regression to assess outcomes and predictors of remission, respectively.

RESULTS: Of the 92 patients, 23% (n = 21) had a baseline estimated glomerular filtration rate (eGFR) < 15 ml/min per 1.73 m

CONCLUSION: A high rate of remission and an acceptable safety profile were observed with the use of …

Ethological Computational Psychiatry: Challenges And Opportunities, Ilya E Monosov, Jan Zimmermann, Michael J Frank, Mackenzie W Mathis, Justin T Baker

2020-Current year OA Pubs

Studying the intricacies of individual subjects' moods and cognitive processing over extended periods of time presents a formidable challenge in medicine. While much of systems neuroscience appropriately focuses on the link between neural circuit functions and well-constrained behaviors over short timescales (e.g., trials, hours), many mental health conditions involve complex interactions of mood and cognition that are non-stationary across behavioral contexts and evolve over extended timescales. Here, we discuss opportunities, challenges, and possible future directions in computational psychiatry to quantify non-stationary continuously monitored behaviors. We suggest that this exploratory effort may contribute to a more precision-based approach to treating mental …

Paracrine Signaling By Pancreatic Islet Cilia, Samantha E Adamson, Jing W Hughes

2020-Current year OA Pubs

The primary cilium is a sensory and signaling organelle present on most pancreatic islet endocrine cells, where it receives and interprets a wide range of intra-islet chemical cues including hormones, peptides, and neurotransmitters. The ciliary membrane possesses a molecular composition distinct from the plasma membrane, with enrichment of signaling mediators including G protein-coupled receptors (GPCRs), tyrosine kinase family receptors, membrane transporters and others. When activated, these membrane proteins interact with ion channels and adenylyl cyclases to trigger local Ca

Proteolysis Of The Pericellular Matrix: Pinpointing The Role And Involvement Of Matrix Metalloproteinases In Early Osteoarthritic Remodeling, Marina Danalache, Felix Umrath, Rosa Riester, Maik Schwitalle, Farshid Guilak, Ulf Krister Hoffmann

2020-Current year OA Pubs

The pericellular matrix (PCM) serves a critical role in signal transduction and mechanoprotection in chondrocytes. Osteoarthritis (OA) leads to a gradual deterioration of the cartilage, marked by a shift in the spatial arrangement of chondrocytes from initially isolated strands to large cell clusters in end-stage degeneration. These changes coincide with progressive enzymatic breakdown of the PCM. This study aims to assess the role and involvement of specific matrix metalloproteinases (MMPs) in PCM degradation during OA. We selected cartilage samples from 148 OA patients based on the predominant spatial chondrocyte patterns. The presence of various MMPs (-1,-2,-3,-7,-8,-9,-10,-12,-13) was identified by multiplexed …

Spatially Resolved Metabolomic Dataset Of Distinct Human Kidney Anatomic Regions, Haikuo Li, Benjamin D Humphreys

2020-Current year OA Pubs

Cortex, medulla and papilla are three major human kidney anatomic structures and they harbour unique metabolic functions, but the underlying metabolomic profiles are largely unknown at spatial resolution. Here, we generated a spatially resolved metabolomics dataset on human kidney cortex, medulla and papilla tissues dissected from the same donor. Matrix-Assisted Laser Desorption/Ionization-Imaging Mass Spectrometry (MALDI-IMS) was used to detect metabolite species over mass-to-charge ratios of 50 -1500 for each section at a resolution of 10 × 10 µm

Genetic Loci Regulate Sarbecovirus Pathogenesis: A Comparison Across Mice And Humans, Alexandra Schäfer, Laura A Vanblargan, Larissa B Thackray, Michael S Diamond, Et Al.

2020-Current year OA Pubs

Coronavirus (CoV) cause considerable morbidity and mortality in humans and other mammals, as evidenced by the emergence of Severe Acute Respiratory CoV (SARS-CoV) in 2003, Middle East Respiratory CoV (MERS-CoV) in 2012, and SARS-CoV-2 in 2019. Although poorly characterized, natural genetic variation in human and other mammals modulate virus pathogenesis, as reflected by the spectrum of clinical outcomes ranging from asymptomatic infections to lethal disease. Using multiple human epidemic and zoonotic Sarbecoviruses, coupled with murine Collaborative Cross genetic reference populations, we identify several dozen quantitative trait loci that regulate SARS-like group-2B CoV pathogenesis and replication. Under a Chr4 QTL, we …

Transient Cortical Weakness Following Cerebral Angiography: A New Syndrome, Akash P Kansagra, Richard Pham, Arindam R Chatterjee, Christopher J Moran

2020-Current year OA Pubs

Transient cortical blindness is a known complication of iodinated contrast administration and is believed to reflect osmotic injury or autoregulatory dysfunction of the posterior circulation. Here, we report 2 cases of postangiography transient cortical

Implementation And Prospective Performance Evaluation Of An Intraoperative Duration Prediction Model Using High Throughput Real-Time Data, York Jiao, Thomas Kannampallil

2020-Current year OA Pubs

BACKGROUND: Accurate real-time prediction of intraoperative duration can contribute to improved perioperative outcomes. We implemented a data pipeline for extraction of real-time data from nascent anaesthesia records and silently deployed a predictive machine learning (ML) algorithm.

METHODS: Clinical variables were retrieved from the electronic health record via a third-party clinical decision support platform and contemporaneously ingested into a previously developed ML model. The model was trained using 3 months data, and performance was subsequently evaluated over 10 months using continuous ranked probability score.

RESULTS: The ML model made 6 173 435 predictions on 62 142 procedures. Mean continuous ranked probability …

The Impact Of An Advanced Practice Radiation Therapist Contouring For A Cbct-Based Adaptive Radiotherapy Program, Robbie Beckert, Joshua P Schiff, Eric Morris, Pamela Samson, Hyun Kim, Eric Laugeman

2020-Current year OA Pubs

We successfully implemented an APRT specializing in CBCT-guided online adaptive contouring. These data show statistical improvements in contouring time with APRT-led vs non-APRT led ART contouring, suggesting that an APRT specifically trained to manage the ART process may reduce physician workload and patient treatment time.

Symptom Characteristics, Perceived Causal Attributions, And Contextual Factors Influencing Self-Care Behaviors: An Ecological Daily Assessment Study Of Adults With Chronic Illness, Barbara Riegel, Shayleigh Dickson Page, Subhash Aryal, Christopher S Lee, Andrew Belfiglio, Kenneth E Freedland, Anna Stromberg, Ercole Vellone, Heleen Westland, Michelle M Van Rijn, Sara Pettersson, Douglas J Wiebe, Tiny Jaarsma

2020-Current year OA Pubs

OBJECTIVE: Insights into how symptoms influence self-care can guide patient education and improve symptom control. This study examined symptom characteristics, causal attributions, and contextual factors influencing self-care of adults with arthritis, asthma, chronic obstructive pulmonary disease, diabetes, or heart failure.

METHODS: Adults (n = 81) with a symptomatic chronic illness participated in a longitudinal observational study. Using Ecological Daily Assessment, participants described one symptom twice daily for two weeks, rating its frequency, severity, bothersomeness, duration, causes, and self-care.

RESULTS: The most frequent symptoms were fatigue and shortness of breath. Pain, fatigue, and joint stiffness were the most severe and bothersome. …

Co-Aggregation With Apolipoprotein E Modulates The Function Of Amyloid-Β In Alzheimer's Disease, Zengjie Xia, Michael R Strickland, Hong Jiang, David M Holtzman, Et Al.

2020-Current year OA Pubs

Which isoforms of apolipoprotein E (apoE) we inherit determine our risk of developing late-onset Alzheimer's Disease (AD), but the mechanism underlying this link is poorly understood. In particular, the relevance of direct interactions between apoE and amyloid-β (Aβ) remains controversial. Here, single-molecule imaging shows that all isoforms of apoE associate with Aβ in the early stages of aggregation and then fall away as fibrillation happens. ApoE-Aβ co-aggregates account for ~50% of the mass of diffusible Aβ aggregates detected in the frontal cortices of homozygotes with the higher-risk APOE4 gene. We show how dynamic interactions between apoE and Aβ tune disease-related …

Safety Of Non-Cuffed Tunneled Central Venous Catheters In Adults With Cystic Fibrosis, Arshan Dehbozorgi, Badr Jandali, Robert Turner, Aaron Rohr, Brandon Custer, Kate Young, Carissa Walter, Lauren Clark, Yanming Li, Deepika Polineni, Joel Mermis

2020-Current year OA Pubs

BACKGROUND: Peripherally inserted central catheters (PICCs) are the most common route of intravenous (I.V.) access for treatment of cystic fibrosis (CF) pulmonary exacerbations, but repeated PICC placement can result in upper extremity peripheral venous stenosis. Once peripheral stenosis develops, a non-cuffed tunneled central venous catheter (NcTCVC) is an alternative route for IV access. While these are regularly used at some CF centers, the safety and complication rate compared to PICCs in adults with CF has not been reported. This study aims to describe the safety of NcTCVCs in adults with CF.

METHODS: A retrospective cohort study was performed at a …

Predictors Of Non-Variceal Hemorrhage In A National Cohort Of Patients With Chronic Liver Disease, Amber Afzal, Preethi Kesavan, Luo Suhong, Brian F Gage, Kevin Korenblat, Martin Schoen, Kristen Sanfilippo

2020-Current year OA Pubs

BACKGROUND: Non-variceal hemorrhage in patients with chronic liver disease (CLD) increases morbidity, mortality, and healthcare costs. There are limited data on risk factors for non-variceal hemorrhage in the CLD population. The aim of this study was to assess the predictive value of various clinical and laboratory parameters for non-variceal hemorrhage in CLD patients.

METHODS: We conducted a retrospective cohort study of US veterans diagnosed with CLD between 2002 and 2018 within the Veterans Health Administration database. We derived candidate variables from existing risk prediction models for hemorrhage, risk calculators for severity of liver disease, Charlson index of prognostic comorbidities, and …

Efficacy And Safety Of A Four-Drug, Quarter-Dose Treatment For Hypertension: The Quartet Usa Randomized Trial, Mark D Huffman, Et Al.

2020-Current year OA Pubs

New approaches are needed to lower blood pressure (BP) given persistently low control rates. QUARTET USA sought to evaluate the effect of four-drug, quarter-dose BP lowering combination in patients with hypertension. QUARTET USA was a randomized (1:1), double-blinded trial conducted in federally qualified health centers among adults with hypertension. Participants received either a quadpill of candesartan 2 mg, amlodipine 1.25 mg, indapamide 0.625 mg, and bisoprolol 2.5 mg or candesartan 8 mg for 12 weeks. If BP was >130/>80 mm Hg at 6 weeks in either arm, then participants received open label add-on amlodipine 5 mg. The primary outcome …

Plasma Extracellular Vesicle Tau And Tdp-43 As Diagnostic Biomarkers In Ftd And Als, Madhurima Chatterjee, Nicolas R Barthélemy, Randall J Bateman, Et Al.

2020-Current year OA Pubs

Minimally invasive biomarkers are urgently needed to detect molecular pathology in frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS). Here, we show that plasma extracellular vesicles (EVs) contain quantifiable amounts of TDP-43 and full-length tau, which allow the quantification of 3-repeat (3R) and 4-repeat (4R) tau isoforms. Plasma EV TDP-43 levels and EV 3R/4R tau ratios were determined in a cohort of 704 patients, including 37 genetically and 31 neuropathologically proven cases. Diagnostic groups comprised patients with TDP-43 proteinopathy ALS, 4R tauopathy progressive supranuclear palsy, behavior variant FTD (bvFTD) as a group with either tau or TDP-43 pathology, and healthy …

Scmr Expert Consensus Statement For Cardiovascular Magnetic Resonance Of Patients With A Cardiac Implantable Electronic Device, Daniel Kim, Pamela K Woodard, Et Al.

2020-Current year OA Pubs

Cardiovascular magnetic resonance (CMR) is a proven imaging modality for informing diagnosis and prognosis, guiding therapeutic decisions, and risk stratifying surgical intervention. Patients with a cardiac implantable electronic device (CIED) would be expected to derive particular benefit from CMR given high prevalence of cardiomyopathy and arrhythmia. While several guidelines have been published over the last 16 years, it is important to recognize that both the CIED and CMR technologies, as well as our knowledge in MR safety, have evolved rapidly during that period. Given increasing utilization of CIED over the past decades, there is an unmet need to establish a …

Naturalistic Assessment Of Reaction Time Variability In Older Adults At Risk For Alzheimer's Disease, Matthew S Welhaf, Hannah Wilks, Andrew J Aschenbrenner, David A Balota, Suzanne E Schindler, Tammie L S Benzinger, Brian A Gordon, Carlos Cruchaga, Chengjie Xiong, John C Morris, Jason Hassenstab

2020-Current year OA Pubs

OBJECTIVE: Maintaining attention underlies many aspects of cognition and becomes compromised early in neurodegenerative diseases like Alzheimer's disease (AD). The consistency of maintaining attention can be measured with reaction time (RT) variability. Previous work has focused on measuring such fluctuations during in-clinic testing, but recent developments in remote, smartphone-based cognitive assessments can allow one to test if these fluctuations in attention are evident in naturalistic settings and if they are sensitive to traditional clinical and cognitive markers of AD.

METHOD: Three hundred and seventy older adults (aged 75.8 +/- 5.8 years) completed a week of remote daily testing on the …