Digital Commons Network^™

Propofol Enhancement Of Slow Wave Sleep To Target The Nexus Of Geriatric Depression And Cognitive Dysfunction: Protocol For A Phase I Open Label Trial, Rachel Lynn Rios, Michael Green, S Kendall Smith, Mohammadmehdi Kafashan, Shinung Ching, Nuri B Farber, Nan Lin, Brendan P Lucey, Charles F Reynolds, Eric J Lenze, Ben Julian Agustin Palanca, Swiped Study Team

2020-Current year OA Pubs

INTRODUCTION: Late-life treatment-resistant depression (LL-TRD) is common and increases risk for accelerated ageing and cognitive decline. Impaired sleep is common in LL-TRD and is a risk factor for cognitive decline. Slow wave sleep (SWS) has been implicated in key processes including synaptic plasticity and memory. A deficiency in SWS may be a core component of depression pathophysiology. The anaesthetic propofol can induce electroencephalographic (EEG) slow waves that resemble SWS. Propofol may enhance SWS and oral antidepressant therapy, but relationships are unclear. We hypothesise that propofol infusions will enhance SWS and improve depression in older adults with LL-TRD. This hypothesis has …

Safety And Efficacy Of Metabolic Modulation With Ninerafaxstat In Patients With Nonobstructive Hypertrophic Cardiomyopathy, Martin S Maron, Sharon Cresci, Et Al.

2020-Current year OA Pubs

BACKGROUND: In nonobstructive hypertrophic cardiomyopathy (nHCM), there are no approved medical therapies. Impaired myocardial energetics is a potential cause of symptoms and exercise limitation. Ninerafaxstat, a novel cardiac mitotrope, enhances cardiac energetics.

OBJECTIVES: This study sought to evaluate the safety and efficacy of ninerafaxstat in nHCM.

METHODS: Patients with hypertrophic cardiomyopathy and left ventricular outflow tract gradient < 30 mm Hg, ejection fraction ≥50%, and peak oxygen consumption < 80% predicted were randomized to ninerafaxstat 200 mg twice daily or placebo (1:1) for 12 weeks. The primary endpoint was safety and tolerability, with efficacy outcomes also assessed as secondary endpoints.

RESULTS: A total of 67 patients with nHCM were enrolled at 12 centers (57 ± 11.8 years of age; 55% women). Serious adverse events occurred in 11.8% (n = 4 of 34) in the ninerafaxstat group and 6.1% (n = 2 of 33) …

Metabolic Regulation Of Single Synaptic Vesicle Exo- And Endocytosis In Hippocampal Synapses, Jongyun Myeong, Marion I Stunault, Vitaly A Klyachko, Ghazaleh Ashrafi

2020-Current year OA Pubs

Glucose has long been considered a primary energy source for synaptic function. However, it remains unclear to what extent alternative fuels, such as lactate/pyruvate, contribute to powering synaptic transmission. By detecting individual release events in hippocampal synapses, we find that mitochondrial ATP production regulates basal vesicle release probability and release location within the active zone (AZ), evoked by single action potentials. Mitochondrial inhibition shifts vesicle release closer to the AZ center and alters the efficiency of vesicle retrieval by increasing the occurrence of ultrafast endocytosis. Furthermore, we uncover that terminals can use oxidative fuels to maintain the vesicle cycle during …

Lxr/Cd38 Activation Drives Cholesterol-Induced Macrophage Senescence And Neurodegeneration Via Nad+ Depletion, Ryo Terao, Tae Jun Lee, Jason Colasanti, Charles W Pfeifer, Joseph B Lin, Andrea Santeford, Keitaro Hase, Shinobu Yamaguchi, Daniel Du, Brian S Sohn, Yo Sasaki, Mitsukuni Yoshida, Rajendra S Apte

2020-Current year OA Pubs

Although dysregulated cholesterol metabolism predisposes aging tissues to inflammation and a plethora of diseases, the underlying molecular mechanism remains poorly defined. Here, we show that metabolic and genotoxic stresses, convergently acting through liver X nuclear receptor, upregulate CD38 to promote lysosomal cholesterol efflux, leading to nicotinamide adenine dinucleotide (NAD

Retrospective Study On The Efficacy And Safety Of Dulaglutide In Patients With Diabetes And Moderate-Advanced Chronic Kidney Disease, Sriya Kosaraju, Rong M Zhang

2020-Current year OA Pubs

No abstract provided.

Nivolumab Plus Brentuximab Vedotin For Relapsed/Refractory Peripheral T-Cell Lymphoma And Cutaneous T-Cell Lymphoma, Pier Luigi Zinzani, Neha Mehta-Shah, Et Al.

2020-Current year OA Pubs

No abstract provided.

Using Structured Problem Solving To Promote Fluid Consumption In The Prevention Of Urinary Stones With Hydration (Push) Trial, Peter P Reese, H Henry Lai, Alana C Desai, Et Al.

2020-Current year OA Pubs

BACKGROUND: Structured Problem Solving (SPS) is a patient-centered approach to promoting behavior change that relies on productive collaboration between coaches and participants and reinforces participant autonomy. We aimed to describe the design, implementation, and assessment of SPS in the multicenter Prevention of Urinary Stones with Hydration (PUSH) randomized trial.

METHODS: In the PUSH trial, individuals with a history of urinary stone disease and low urine output were randomized to control versus a multicomponent intervention including SPS that was designed to promote fluid consumption and thereby prevent recurrent stones. We provide details specifically about training and fidelity assessment of the SPS …

Quantifying The Effects Of Sleep On Sensor-Derived Variables From Upper Limb Accelerometry In People With And Without Upper Limb Impairment, Allison E Miller, Catherine E Lang, Marghuretta D Bland, Keith R Lohse

2020-Current year OA Pubs

BACKGROUND: Despite the promise of wearable sensors for both rehabilitation research and clinical care, these technologies pose significant burden on data collectors and analysts. Investigations of factors that may influence the wearable sensor data processing pipeline are needed to support continued use of these technologies in rehabilitation research and integration into clinical care settings. The purpose of this study was to investigate the effect of one such factor, sleep, on sensor-derived variables from upper limb accelerometry in people with and without upper limb impairment and across a two-day wearing period.

METHODS: This was a secondary analysis of data collected during …

Induced Cd8Α Identifies Human Nk Cells With Enhanced Proliferative Fitness And Modulates Nk Cell Activation, Celia C. Cubitt, Pamela Wong, Hannah K. Dorando, Jennifer A. Foltz, Jennifer Tran, Lynne Marsala, Nancy D. Marin, Mark Foster, Timothy Schappe, Hijab Fatima, Michelle Becker-Hapak, Alice Y. Zhou, Kimberly Hwang, Miriam T. Jacobs, David A. Russler-Germain, Emily M. Mace, Melissa M. Berrien-Elliott, Jacqueline E. Payton, Todd A. Fehniger

2020-Current year OA Pubs

The surface receptor CD8α is present on 20%-80% of human (but not mouse) NK cells, yet its function on NK cells remains poorly understood. CD8α expression on donor NK cells was associated with a lack of therapeutic responses in patients with leukemia in prior studies, thus, we hypothesized that CD8α may affect critical NK cell functions. Here, we discovered that CD8α- NK cells had improved control of leukemia in xenograft models compared with CD8α+ NK cells, likely due to an enhanced capacity for proliferation. Unexpectedly, we found that CD8α expression was induced on approximately 30% of previously CD8α- NK cells …

Intrapartum Exposure To Synthetic Oxytocin, Maternal Bmi, And Neurodevelopmental Outcomes In Children Within The Echo Consortium, Lisa Kurth, T Michael O'Shea, Irina Burd, Anne L Dunlop, Lisa Croen, Greta Wilkening, Ting-Ju Hsu, Stephan Ehrhardt, Arvind Palanisamy, Monica Mcgrath, Marie L Churchill, Daniel Weinberger, Marco Grados, Dana Dabelea

2020-Current year OA Pubs

BACKGROUND: Synthetic oxytocin (sOT) is frequently administered during parturition. Studies have raised concerns that fetal exposure to sOT may be associated with altered brain development and risk of neurodevelopmental disorders. In a large and diverse sample of children with data about intrapartum sOT exposure and subsequent diagnoses of two prevalent neurodevelopmental disorders, i.e., attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), we tested the following hypotheses: (1) Intrapartum sOT exposure is associated with increased odds of child ADHD or ASD; (2) associations differ across sex; (3) associations between intrapartum sOT exposure and ADHD or ASD are accentuated in …

Radiotherapy Plan Quality Assurance In Nrg Oncology Trials For Brain And Head/Neck Cancers: An Ai-Enhanced Knowledge-Based Approach, Du Wang, Jeff M Michalski, Jiayi Huang, Et Al.

2020-Current year OA Pubs

The quality of radiation therapy (RT) treatment plans directly affects the outcomes of clinical trials. KBP solutions have been utilized in RT plan quality assurance (QA). In this study, we evaluated the quality of RT plans for brain and head/neck cancers enrolled in multi-institutional clinical trials utilizing a KBP approach. The evaluation was conducted on 203 glioblastoma (GBM) patients enrolled in NRG-BN001 and 70 nasopharyngeal carcinoma (NPC) patients enrolled in NRG-HN001. For each trial, fifty high-quality photon plans were utilized to build a KBP photon model. A KBP proton model was generated using intensity-modulated proton therapy (IMPT) plans generated on …

Effect Of Genomic And Cellular Environments On Gene Expression Noise, Clarice K Y Hong, Avinash Ramu, Siqi Zhao, Barak A Cohen

2020-Current year OA Pubs

BACKGROUND: Individual cells from isogenic populations often display large cell-to-cell differences in gene expression. This "noise" in expression derives from several sources, including the genomic and cellular environment in which a gene resides. Large-scale maps of genomic environments have revealed the effects of epigenetic modifications and transcription factor occupancy on mean expression levels, but leveraging such maps to explain expression noise will require new methods to assay how expression noise changes at locations across the genome.

RESULTS: To address this gap, we present Single-cell Analysis of Reporter Gene Expression Noise and Transcriptome (SARGENT), a method that simultaneously measures the noisiness …

Biobank-Wide Association Scan Identifies Risk Factors For Late-Onset Alzheimer's Disease And Endophenotypes, Donghui Yan, Carlos Cruchaga, Et Al.

2020-Current year OA Pubs

Rich data from large biobanks, coupled with increasingly accessible association statistics from genome-wide association studies (GWAS), provide great opportunities to dissect the complex relationships among human traits and diseases. We introduce BADGERS, a powerful method to perform polygenic score-based biobank-wide association scans. Compared to traditional approaches, BADGERS uses GWAS summary statistics as input and does not require multiple traits to be measured in the same cohort. We applied BADGERS to two independent datasets for late-onset Alzheimer's disease (AD; n=61,212). Among 1738 traits in the UK biobank, we identified 48 significant associations for AD. Family history, high cholesterol, and numerous traits …

Health Equity Engineering: Optimizing Hope For A New Generation Of Healthcare, Felicity T Enders, Joyce E Balls-Berry, Et Al.

2020-Current year OA Pubs

Medical researchers are increasingly prioritizing the inclusion of underserved communities in clinical studies. However, mere inclusion is not enough. People from underserved communities frequently experience chronic stress that may lead to accelerated biological aging and early morbidity and mortality. It is our hope and intent that the medical community come together to engineer improved health outcomes for vulnerable populations. Here, we introduce Health Equity Engineering (HEE), a comprehensive scientific framework to guide research on the development of tools to identify individuals at risk of poor health outcomes due to chronic stress, the integration of these tools within existing healthcare system …

Solutes Unmask Differences In Clustering Versus Phase Separation Of Fet Proteins, Mrityunjoy Kar, Laura T Vogel, Gaurav Chauhan, Suren Felekyan, Hannes Ausserwöger, Timothy J Welsh, Furqan Dar, Anjana R Kamath, Tuomas P J Knowles, Anthony A Hyman, Claus A M Seidel, Rohit V Pappu

2020-Current year OA Pubs

Phase separation and percolation contribute to phase transitions of multivalent macromolecules. Contributions of percolation are evident through the viscoelasticity of condensates and through the formation of heterogeneous distributions of nano- and mesoscale pre-percolation clusters in sub-saturated solutions. Here, we show that clusters formed in sub-saturated solutions of FET (FUS-EWSR1-TAF15) proteins are affected differently by glutamate versus chloride. These differences on the nanoscale, gleaned using a suite of methods deployed across a wide range of protein concentrations, are prevalent and can be unmasked even though the driving forces for phase separation remain unchanged in glutamate versus chloride. Strikingly, differences in anion-mediated …

Accessibility, Relevance, And Impact Of A Symptom Monitoring Tool For Home Hospice Care: Theory Elaboration And Qualitative Assessment, Karla T Washington, Debra Parker Oliver, Allison K Donehower, Patrick White, Jacquelyn J Benson, Patrick G Lyons, George Demiris

2020-Current year OA Pubs

BACKGROUND: Early users found Engagement and Visualization to Improve Symptoms in Oncology Care (ENVISION), a web-based application designed to improve home management of hospice patients' symptoms and support patients' and family caregivers' well-being, to be generally useful and easy to use. However, they also raised concerns about potential challenges users with limited technological proficiency might experience.

OBJECTIVE: We sought to concurrently accomplish two interrelated study aims: (1) to develop a conceptual framework of digital inclusivity for health information systems and (2) to apply the framework in evaluating the digital inclusivity of the ENVISION application.

METHODS: We engaged ENVISION users (N=34) …

Quantification Of Visceral Fat At The L5 Vertebral Body Level In Patients With Crohn's Disease Using T2-Weighted Mri, Favour Garuba, Aravinda Ganapathy, Spencer Mckinley, Karan H Jani, Adriene Lovato, Satish E Viswanath, Scott Mchenry, Parakkal Deepak, David H Ballard

2020-Current year OA Pubs

The umbilical or L3 vertebral body level is often used for body fat quantification using computed tomography. To explore the feasibility of using clinically acquired pelvic magnetic resonance imaging (MRI) for visceral fat measurement, we examined the correlation of visceral fat parameters at the umbilical and L5 vertebral body levels. We retrospectively analyzed T2-weighted half-Fourier acquisition single-shot turbo spin echo (HASTE) MR axial images from Crohn's disease patients who underwent MRI enterography of the abdomen and pelvis over a three-year period. We determined the area/volume of subcutaneous and visceral fat from the umbilical and L5 levels and calculated the visceral …

Molecular Insights Into The Prototypical Single-Stranded Dna-Binding Protein From E. Coli, Nina J Bonde, Alexander G Kozlov, Michael M Cox, Timothy M Lohman, James L Keck

2020-Current year OA Pubs

The SSB protein of

A Fungal Protein Organizes Both Glycogen And Cell Wall Glucans, Liza Loza, Tamara L Doering

2020-Current year OA Pubs

Glycogen is a glucose storage molecule composed of branched α-1,4-glucan chains, best known as an energy reserve that can be broken down to fuel central metabolism. Because fungal cells have a specialized need for glucose in building cell wall glucans, we investigated whether glycogen is used for this process. For these studies, we focused on the pathogenic yeast

Graded Decisions In The Human Brain, Tao Xie, Markus Adamek, Hohyun Cho, Matthew A Adamo, Anthony L Ritaccio, Jon T Willie, Peter Brunner, Jan Kubanek

2020-Current year OA Pubs

Decision-makers objectively commit to a definitive choice, yet at the subjective level, human decisions appear to be associated with a degree of uncertainty. Whether decisions are definitive (i.e., concluding in all-or-none choices), or whether the underlying representations are graded, remains unclear. To answer this question, we recorded intracranial neural signals directly from the brain while human subjects made perceptual decisions. The recordings revealed that broadband gamma activity reflecting each individual's decision-making process, ramped up gradually while being graded by the accumulated decision evidence. Crucially, this grading effect persisted throughout the decision process without ever reaching a definite bound at the …

Comprehensive Proteogenomic Characterization Of Rare Kidney Tumors, Ginny Xiaohe Li, Yize Li, Nataly Naser Al Deen, Feng Chen, Wagma Caravan, Andrew Houston, Siqi Chen, Li Ding, Et Al.

2020-Current year OA Pubs

Non-clear cell renal cell carcinomas (non-ccRCCs) encompass diverse malignant and benign tumors. Refinement of differential diagnosis biomarkers, markers for early prognosis of aggressive disease, and therapeutic targets to complement immunotherapy are current clinical needs. Multi-omics analyses of 48 non-ccRCCs compared with 103 ccRCCs reveal proteogenomic, phosphorylation, glycosylation, and metabolic aberrations in RCC subtypes. RCCs with high genome instability display overexpression of IGF2BP3 and PYCR1. Integration of single-cell and bulk transcriptome data predicts diverse cell-of-origin and clarifies RCC subtype-specific proteogenomic signatures. Expression of biomarkers MAPRE3, ADGRF5, and GPNMB differentiates renal oncocytoma from chromophobe RCC, and PIGR and SOSTDC1 distinguish papillary RCC …

Feasibility, Acceptability And Preliminary Effect Of A Community-Led Hiv Self-Testing Model Among Adolescent Girls And Young Women In Rural Northern Uganda: A Quasi-Experimental Study Protocol, Ronald Olum, Elvin H Geng, Freddy E Kitutu, Philippa M Musoke

2020-Current year OA Pubs

BACKGROUND: Adolescent girls and young women (AGYW) in sub-Saharan Africa face a disproportionately higher HIV/AIDS burden despite the global decline in incidence. Existing interventions often fail to adequately address their unique social, economic, and cultural challenges, limiting access to essential HIV/AIDS services, including HIV testing. Emerging evidence indicates that HIV self-testing, a user-friendly and confidential method, enhances HIV diagnosis and linkage to care by targeting these barriers. This study aims to assess the feasibility, acceptability, and preliminary impact of a peer-delivered, community-health worker (CHW)-facilitated HIV self-testing intervention for AGYW in Northern Uganda.

METHODS: This mixed-methods quasi-experimental implementation science study will …

Gilteritinib As Post-Transplant Maintenance For Aml With Internal Tandem Duplication Mutation Of Flt3, Mark J Levis, Geoffrey L Uy, Et Al.

2020-Current year OA Pubs

PURPOSE: Allogeneic hematopoietic cell transplantation (HCT) improves outcomes for patients with AML harboring an internal tandem duplication mutation of

METHODS: Adults with

RESULTS: Three hundred fifty-six participants were randomly assigned post-HCT to receive gilteritinib or placebo. Although RFS was higher in the gilteritinib arm, the difference was not statistically significant (hazard ratio [HR], 0.679 [95% CI, 0.459 to 1.005]; two-sided

CONCLUSION: Although the overall improvement in RFS was not statistically significant, RFS was higher for participants with detectable

Common Single-Base Insertions In The Vntr Of The Carboxyl Ester Lipase (Cel) Gene Are Benign And Also Likely To Arise Somatically In The Exocrine Pancreas, Ranveig S Brekke, Anny Gravdal, Khadija El Jellas, Grace E Curry, Jianguo Lin, Steven J Wilhelm, Solrun J Steine, Eric Mas, Stefan Johansson, Mark E Lowe, Bente B Johansson, Xunjun Xiao, Karianne Fjeld, Anders Molven

2020-Current year OA Pubs

The CEL gene encodes carboxyl ester lipase, a pancreatic digestive enzyme. CEL is extremely polymorphic due to a variable number tandem repeat (VNTR) located in the last exon. Single-base deletions within this VNTR cause the inherited disorder MODY8, whereas little is known about VNTR single-base insertions in pancreatic disease. We therefore mapped CEL insertion variants (CEL-INS) in 200 Norwegian patients with pancreatic neoplastic disorders. Twenty-eight samples (14.0%) carried CEL-INS alleles. Most common were insertions in repeat 9 (9.5%), which always associated with a VNTR length of 13 repeats. The combined INS allele frequency (0.078) was similar to that observed in …

The Impact Of Behavior Change Counseling Delivered Via A Digital Health Tool Versus Routine Care Among Adolescents With Obesity: Pilot Randomized Feasibility Study, Maura Kepper, Callie Walsh-Bailey, Zoe M Miller, Min Zhao, Kianna Zucker, Angeline Gacad, Cynthia Herrick, Neil H White, Ross C Brownson, Randi E Foraker

2020-Current year OA Pubs

BACKGROUND: Youth overweight and obesity is a public health crisis and increases the risk of poor cardiovascular health (CVH) and chronic disease. Health care providers play a key role in weight management, yet few tools exist to support providers in delivering tailored evidence-based behavior change interventions to patients.

OBJECTIVE: The goal of this pilot randomized feasibility study was to determine the feasibility of implementing the Patient-Centered Real-Time Intervention (PREVENT) tool in clinical settings, generate implementation data to inform scale-up, and gather preliminary effectiveness data.

METHODS: A pilot randomized clinical trial was conducted to examine the feasibility, implementation, and preliminary impact …

Liver Acox1 Regulates Levels Of Circulating Lipids That Promote Metabolic Health Through Adipose Remodeling, Dongliang Lu, Anyuan He, Min Tan, Marguerite Mrad, Amal El Daibani, Donghua Hu, Xuejing Liu, Brian Kleiboeker, Tao Che, Fong-Fu Hsu, Monika Bambouskova, Clay F. Semenkovich, Irfan J. Lodhi

2020-Current year OA Pubs

No abstract provided.

Assessment Of Gait, Balance, And Falls In Individuals With Neurodegenerative Diseases, Lauren Tueth

WUSM Theses and Dissertations – All Programs

Neurodegenerative diseases are a group of disorders that impact the brain and lead to neuronal degeneration. This degeneration causes many different symptoms, which are often grouped into motor, cognitive, and psychiatric domains. Individuals with these disorders can experience symptoms from multiple domains at the same time, but little is known about how these distinct symptoms may impact each other.

In Chapter 2, we explored the intersection of balance and cognitive impairment in individuals with Alzheimer disease (AD). AD is traditionally discussed in the context of the dementia symptoms, but people with AD also experience motor deficits. Falls are a huge …

Measurement Of And Contributors To Developmental Coordination Impairment, Jeffrey D. Konrad

WUSM Theses and Dissertations – All Programs

Movement drives childhood development. As motor skills improve across development, a child becomes capable of greater interactions with their physical and social environment. Children with motor impairments miss out on these interaction opportunities and their development across a variety of domains can suffer. There is accumulating evidence that poor motor competence relates to an array of developmental outcomes such as educational achievement, reading skills, social development, and emotional regulation. Two developmentally important motor impairments are poor motor competence and hyperactivity which are associated with Autism Spectrum Disorder (ASD), Developmental Coordination Disorder (DCD), and/or Attention Deficit Hyperactivity Disorder (ADHD). Critical to …

Exploring Complex Daily Tasks In Preclinical Alzheimer Disease, Audrey A. Keleman

WUSM Theses and Dissertations – All Programs

Alzheimer disease (AD) is a slowly progressive neurodegenerative disorder marked by a gradual decline in cognitive functions and ability to perform daily activities. AD begins with a clinically silent period in which pathological abnormalities accumulate in the brain before cognitive impairments occur (i.e., while individuals remain cognitively normal [CN]). This stage is known as preclinical AD and can last up to two decades. It can be identified by measuring biomarkers of AD using neuroimaging or biofluid techniques. In the United States alone, it is estimated that nearly 46 million individuals are in the preclinical stage of AD and at risk …

Quantitative T2 Mapping-Based Longitudinal Assessment Of Brain Injury And Therapeutic Rescue In The Rat Following Acute Organophosphate Intoxication, Alita Jesal D Almeida, Brad A Hobson, Naomi Saito, Donald A Bruun, Valerie A Porter, Danielle J Harvey, Joel R Garbow, Abhijit J Chaudhari, Pamela J Lein

2020-Current year OA Pubs

Acute intoxication with organophosphate (OP) cholinesterase inhibitors poses a significant public health risk. While currently approved medical countermeasures can improve survival rates, they often fail to prevent chronic neurological damage. Therefore, there is need to develop effective therapies and quantitative metrics for assessing OP-induced brain injury and its rescue by these therapies. In this study we used a rat model of acute intoxication with the OP, diisopropylfluorophosphate (DFP), to test the hypothesis that T