Digital Commons Network^™

Population Pharmacokinetic Modelling And Simulation Of Tranexamic Acid In Adult Trauma Patients, Gideon Stitt, Philip C Spinella, Grant V Bochicchio, Ian Roberts, Kevin J Downes, Athena F Zuppa

2020-Current year OA Pubs

AIMS: The aim of this study is to describe the disposition of tranexamic acid (TXA) in adult trauma patients and derive a dosing regimen that optimizes exposure based on a predefined exposure target.

METHODS: We performed a population pharmacokinetic (popPK) analysis of participants enrolled in the Tranexamic Acid Mechanisms and Pharmacokinetics in Traumatic Injury (TAMPITI) trial (≥18 years with traumatic injury, given ≥1 blood product and/or requiring immediate transfer to the operating room) who were randomized to a single dose of either 2 or 4 g of TXA ≤2 h from time of injury. PopPK analysis was conducted using nonlinear …

Advances In Blood Biomarkers For Alzheimer Disease (Ad): A Review, Araya Dimtsu Assfaw, Suzanne E Schindler, John C Morris

2020-Current year OA Pubs

Alzheimer disease (AD) and Alzheimer Disease and Related Dementias (AD/ADRD) are growing public health challenges globally affecting millions of older adults, necessitating concerted efforts to advance our understanding and management of these conditions. AD is a progressive neurodegenerative disorder characterized pathologically by amyloid plaques and tau neurofibrillary tangles that are the primary cause of dementia in older individuals. Early and accurate diagnosis of AD dementia is crucial for effective intervention and treatment but has proven challenging to accomplish. Although testing for AD brain pathology with cerebrospinal fluid (CSF) or positron emission tomography (PET) has been available for over 2 decades, …

Risks And Benefits Of Intermittent Fasting For The Aging Cardiovascular System, Mualla Ozcan, Mahmoud Abdellatif, Ali Javaheri, Simon Sedej

2020-Current year OA Pubs

Population aging and the associated increase in cardiovascular disease rates pose serious threats to global public health. Different forms of fasting have become an increasingly attractive strategy to directly address aging and potentially limit or delay the onset of cardiovascular diseases. A growing number of experimental studies and clinical trials indicate that the amount and timing of food intake as well as the daily time window during which food is consumed, are crucial determinants of cardiovascular health. Indeed, intermittent fasting counteracts the molecular hallmarks of cardiovascular aging and promotes different aspects of cardiometabolic health, including blood pressure and glycemic control, …

Immune-Mediated Myositis Following Gene Therapy For Duchenne Muscular Dystrophy: A Case Report, Susan T Iannaccone, Chunyu Cai, Brittney Rhem, Kaitlin Batley, Veena Rajaram, Benjamin M Greenberg, Sachi Dharia, Craig M Zaidman

2020-Current year OA Pubs

No abstract provided.

Customization Of Computed Tomography Radio-Opacity In 3d-Printed Contrast-Injectable Tumor Phantoms, Yuktesh Kalidindi, Aravinda Krishna Ganapathy, Liam Cunningham, Adriene Lovato, Brian Albers, Anup S Shetty, David H Ballard

2020-Current year OA Pubs

Medical Imaging Phantoms (MIPs) calibrate imaging devices, train medical professionals, and can help procedural planning. Traditional MIPs are costly and limited in customization. Additive manufacturing allows for customizable, patient-specific phantoms. This study examines the CT attenuation characteristics of contrast-injectable, chambered 3D-printed phantoms to optimize tissue-mimicking capabilities. A MIP was constructed from a CT of a complex pelvic tumor near the iliac bifurcation. A 3D reconstruction of these structures composed of three chambers (aorta, inferior vena cava, tumor) with ports for contrast injection was 3D printed. Desired attenuations were 200 HU (arterial I), 150 HU (venous I), 40 HU (tumor I), …

Treatment Response With Potassium-Competitive Acid Blockers Based On Clinical Phenotypes Of Gastroesophageal Reflux Disease: A Systematic Literature Review And Meta-Analysis, Seungyeon Seo, Hye-Kyung Jung, C Prakash Gyawali, Hye Ah Lee, Hyung Seok Lim, Eui Sun Jeong, Seong Eun Kim, Chang Mo Moon

2020-Current year OA Pubs

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) is typically managed based on the clinical phenotype. We evaluated the efficacy and safety of potassium-competitive acid blockers (PCABs) in patients with various clinical GERD phenotypes.

METHODS: Core databases were searched for studies comparing PCABs and proton pump inhibitors (PPIs) in clinical GERD phenotypes of erosive reflux disease (ERD), non-erosive reflux disease (NERD), PPI-resistant GERD and night-time heartburn. Additional analysis was performed based on disease severity and drug dosage, and pooled efficacy was calculated.

RESULTS: In 9 randomized controlled trials (RCTs) evaluating the initial treatment of ERD, the risk ratio for healing with PCABs versus …

Impact Of Esophageal Motility On Microbiome Alterations In Symptomatic Gastroesophageal Reflux Disease Patients With Negative Endoscopy: Exploring The Role Of Ineffective Esophageal Motility And Contraction Reserve, Ming-Wun Wong, I-Hsuan Lo, Wei-Kai Wu, Po-Yu Liu, Yu-Tang Yang, Chun-Yao Chen, Ming-Shiang Wu, Sunny H Wong, Wei-Yi Lei, Chih-Hsun Yi, Tso-Tsai Liu, Jui-Sheng Hung, Shu-Wei Liang, C Prakash Gyawali, Chien-Lin Chen

2020-Current year OA Pubs

BACKGROUND/AIMS: Ineffective esophageal motility (IEM) is common in patients with gastroesophageal reflux disease (GERD) and can be associated with poor esophageal contraction reserve on multiple rapid swallows. Alterations in the esophageal microbiome have been reported in GERD, but the relationship to presence or absence of contraction reserve in IEM patients has not been evaluated. We aim to investigate whether contraction reserve influences esophageal microbiome alterations in patients with GERD and IEM.

METHODS: We prospectively enrolled GERD patients with normal endoscopy and evaluated esophageal motility and contraction reserve with multiple rapid swallows during high-resolution manometry. The esophageal mucosa was biopsied for …

Phase Ii Basket Trial Of Dual Anti-Ctla-4 And Anti-Pd-1 Blockade In Rare Tumors (Dart) Swog S1609: Adrenocortical Carcinoma Cohort, Sandip P Patel, Megan Othus, Young Kwang Chae, Tridu Huynh, Benjamin Tan, Timothy Kuzel, Christine Mcleod, Gabby Lopez, Helen X Chen, Elad Sharon, Howard Streicher, Christopher W Ryan, Charles Blanke, Razelle Kurzrock

2020-Current year OA Pubs

OBJECTIVES: Multiple common cancers benefit from immunotherapy; however, less is known about efficacy in rare tumors. We report the results of the adrenocortical carcinoma cohort of NCI/SWOG S1609 Dual Anti-CTLA-4 and Anti-PD-1 blockade in Rare Tumors.

DESIGN/SETTING: A prospective, phase 2 clinical trial of ipilimumab plus nivolumab was conducted by the SWOG Early Therapeutics and Rare Cancers Committee for multiple rare tumor cohorts across >1,000 National Clinical Trial Network sites.

PARTICIPANTS: 21 eligible patients were registered. Median age was 53 years (range 26-69); 16 (76%) were women.

INTERVENTIONS: Ipilimumab 1 mg/kg intravenously every 6 weeks with nivolumab 240 mg intravenously …

Penetrating Posterior Urethral Injuries: Case Report And Management Strategies, Seyed Sajjad Tabei, Brandon Lippold, Wesley Baas, Gregory Murphy

2020-Current year OA Pubs

Penetrating posterior urethral trauma from gunshot wounds (GSW) is rare and requires prompt treatment to minimize complications. Data regarding the management of such cases is scarce in the literature and poorly addressed in the guidelines. Different management approaches exist, including urinary diversion with immediate versus delayed urethroplasty/fistula repair. We present our case series to add to our experience to the literature. Three patients aged 18-44 presented with ballistic posterior urethra injuries from GSW. Initial management involved urethral catheter placement, with one patient requiring operative placement of urethral and suprapubic catheters (SPTs). Complications included recurrent membranous stricture, urinary retention, rectourethral fistula, …

A Correctable Immune Niche For Epithelial Stem Cell Reprogramming And Post-Viral Lung Diseases, Kangyun Wu, Yong Zhang, Huiqing Yin-Declue, Kelly Sun, Dailing Mao, Kuangying Yang, Stephen R. Austin, Erika C. Crouch, Steven L. Brody, Derek E. Byers, Christy M. Hoffmann, Michael E. Hughes, Michael J. Holtzman

2020-Current year OA Pubs

Epithelial barriers are programmed for defense and repair but are also the site of long-term structural remodeling and disease. In general, this paradigm features epithelial stem cells (ESCs) that are called on to regenerate damaged tissues but can also be reprogrammed for detrimental remodeling. Here we identified a Wfdc21-dependent monocyte-derived dendritic cell (moDC) population that functioned as an early sentinel niche for basal ESC reprogramming in mouse models of epithelial injury after respiratory viral infection. Niche function depended on moDC delivery of ligand GPNMB to the basal ESC receptor CD44 so that properly timed antibody blockade of ligand or receptor …

Blinatumomab For Mrd-Negative Acute Lymphoblastic Leukemia In Adults, Mark R Litzow, Geoffrey L Uy, Et Al.

2020-Current year OA Pubs

BACKGROUND: Many older adults with B-cell precursor acute lymphoblastic leukemia (BCP-ALL) have a relapse despite having a measurable residual disease (MRD)-negative complete remission with combination chemotherapy. The addition of blinatumomab, a bispecific T-cell engager molecule that is approved for the treatment of relapsed, refractory, and MRD-positive BCP-ALL, may have efficacy in patients with MRD-negative remission.

METHODS: In a phase 3 trial, we randomly assigned patients 30 to 70 years of age with

RESULTS: The data and safety monitoring committee reviewed the results from the third efficacy interim analysis and recommended that they be reported. Complete remission with or without full …

Review Of The Impact And Burden Of Urinary Urgency On Adults With Overactive Bladder, Adrian Wagg, A Lenore Ackerman, H Henry Lai, Diane K. Newman

2020-Current year OA Pubs

No abstract provided.

Instrumentation Failure In Adult Spinal Deformity Patients, David P Falk, Ravi Agrawal, Bijan Dehghani, Rohit Bhan, Sachin Gupta, Munish C Gupta

2020-Current year OA Pubs

In recent years, advances in the surgical treatment of adult spinal deformity (ASD) have led to improved outcomes. Although these advances have helped drive the development of deformity surgery to meet the rising volume of patients seeking surgical treatment, many challenges have yet to be solved. Instrumentation failure remains one of the most common major complications following deformity surgery, associated with significant morbidity due to elevated re-operation rates among those experiencing mechanical complications. The two most frequently encountered subtypes of instrumentation failure are rod fracture (RF) and proximal junctional kyphosis/proximal junctional failure (PJK/PJF). While RF and PJK/PJF are both modes …

A Comparative Analysis Of Sars-Cov-2 Variants Of Concern (Voc) Spike Proteins Interacting With Hace2 Enzyme, Jiawei Chen, Lingtao Chen, Heng Quan, Soongoo Lee, Kaniz Fatama Khan, Ying Xie, Qiaomu Li, Maria Valero, Zhiyu Dai, Yixin Xie

2020-Current year OA Pubs

In late 2019, the emergence of a novel coronavirus led to its identification as SARS-CoV-2, precipitating the onset of the COVID-19 pandemic. Many experimental and computational studies were performed on SARS-CoV-2 to understand its behavior and patterns. In this research, Molecular Dynamic (MD) simulation is utilized to compare the behaviors of SARS-CoV-2 and its Variants of Concern (VOC)-Alpha, Beta, Gamma, Delta, and Omicron-with the hACE2 protein. Protein structures from the Protein Data Bank (PDB) were aligned and trimmed for consistency using Chimera, focusing on the receptor-binding domain (RBD) responsible for ACE2 interaction. MD simulations were performed using Visual Molecular Dynamics …

Implantable And Semi-Implantable Biosensors For Minimally Invasive Disease Diagnosis, Yameng Xu, Jingyuan Zhang, Wilson Z. Ray, Matthew R. Macewan

2020-Current year OA Pubs

No abstract provided.

Trackins (Trk-Targeting Drugs): A Novel Therapy For Different Diseases, George N Chaldakov, Luigi Aloe, Stanislav G Yanev, Marco Fiore, Anton B Tonchev, Manlio Vinciguerra, Nikolai T Evtimov, Peter Ghenev, Krikor Dikranian

2020-Current year OA Pubs

Many routes may lead to the transition from a healthy to a diseased phenotype. However, there are not so many routes to travel in the opposite direction; that is, therapy for different diseases. The following pressing question thus remains: what are the pathogenic routes and how can be they counteracted for therapeutic purposes? Human cells contain >500 protein kinases and nearly 200 protein phosphatases, acting on thousands of proteins, including cell growth factors. We herein discuss neurotrophins with pathogenic or metabotrophic abilities, particularly brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), pro-NGF, neurotrophin-3 (NT-3), and their receptor Trk (tyrosine receptor …

A Randomized Controlled Trial Testing The Effects Of A Social Needs Navigation Intervention On Health Outcomes And Healthcare Utilization Among Medicaid Members With Type 2 Diabetes, Amy Mcqueen, David Von Nordheim, Charlene Caburnay, Linda Li, Cynthia Herrick, Lauren Grimes, Darrell Broussard, Rachel E Smith, Dana Lawson, Yan Yan, Matthew Kreuter

2020-Current year OA Pubs

Health systems are increasingly assessing and addressing social needs with referrals to community resources. The objective of this randomized controlled trial was to randomize adult Medicaid members with type 2 diabetes to receive usual care (

A Reinterpretation Of The Relationship Between Persistent And Resurgent Sodium Currents, Samuel P Brown, Ryan J Lawson, Jonathan D Moreno, Joseph L Ransdell

2020-Current year OA Pubs

The resurgent sodium current (I

Chimeric Viruses Enable Study Of Antibody Responses To Human Rotaviruses In Mice, Sarah Woodyear, Tawny L Chandler, Takahiro Kawagishi, Tom M Lonergan, Vanshika A Patel, Caitlin A Williams, Sallie R Permar, Siyuan Ding, Sarah L Caddy

2020-Current year OA Pubs

The leading cause of gastroenteritis in children under the age of five is rotavirus infection, accounting for 37% of diarrhoeal deaths in infants and young children globally. Oral rotavirus vaccines have been widely incorporated into national immunisation programs, but whilst these vaccines have excellent efficacy in high-income countries, they protect less than 50% of vaccinated individuals in low- and middle-income countries. In order to facilitate the development of improved vaccine strategies, a greater understanding of the immune response to existing vaccines is urgently needed. However, the use of mouse models to study immune responses to human rotavirus strains is currently …

Mapping The Contribution Of The C-Linker Domain To Gating Polarity In Cnbd Channels, Jenna L Lin, Yongchang Chang, Debanjan Tewari, John Cowgill, Baron Chanda

2020-Current year OA Pubs

Ion channels of the cyclic nucleotide-binding domain (CNBD) family play a crucial role in the regulation of key biological processes, such as photoreception and pacemaking activity in the heart. These channels exhibit high sequence and structural similarity but differ greatly in their functional responses to membrane potential. The CNBD family includes hyperpolarization-activated ion channels and depolarization-activated ether-à-go-go channels. Structural and functional studies show that the differences in the coupling interface between these two subfamilies' voltage-sensing domain and pore domain may underlie their differential response to membrane polarity. However, other structural components may also contribute to defining the polarity differences in …

Exploring Lipin1 As A Promising Therapeutic Target For The Treatment Of Duchenne Muscular Dystrophy, Abdulrahman Jama, Abdullah A Alshudukhi, Steve Burke, Lixin Dong, John Karanja Kamau, Brooklyn Morris, Ibrahim A Alkhomsi, Brian N Finck, Andrew Alvin Voss, Hongmei Ren

2020-Current year OA Pubs

BACKGROUND: Duchenne muscular dystrophy (DMD) is a progressive and devastating muscle disease, resulting from the absence of dystrophin. This leads to cell membrane instability, susceptibility to contraction-induced muscle damage, subsequent muscle degeneration, and eventually disability and early death of patients. Currently, there is no cure for DMD. Our recent studies identified that lipin1 plays a critical role in maintaining myofiber stability and integrity. However, lipin1 gene expression levels are dramatically reduced in the skeletal muscles of DMD patients and mdx mice.

METHODS: To identify whether increased lipin1 expression could prevent dystrophic pathology, we employed unique muscle-specific mdx:lipin1 transgenic (mdx:lipin1

RESULTS: …

Electroencephalogram Alpha Oscillations In Stroke Recovery: Insights Into Neural Mechanisms From Combined Transcranial Direct Current Stimulation And Mirror Therapy In Relation To Activities Of Daily Life, Chia-Lun Liu, Ya-Wen Tu, Ming-Wei Li, Ku-Chou Chang, Chih-Hung Chang, Chih-Kuang Chen, Ching-Yi Wu

2020-Current year OA Pubs

The goal of stroke rehabilitation is to establish a robust protocol for patients to live independently in community. Firstly, we examined the impact of 3 hybridized transcranial direct current stimulation (tDCS)-mirror therapy interventions on activities of daily life (ADL) in stroke patients. Secondly, we explored the underlying therapeutic mechanisms with theory-driven electroencephalography (EEG) indexes in the alpha band. This was achieved by identifying the unique contributions of alpha power in motor production to ADL in relation to the premotor cortex (PMC), primary cortex (M1), and Sham tDCS with mirror therapy. The results showed that, although post-intervention ADL improvement was comparable …

Early Depletion Of Gut Microbiota Shape Oligodendrocyte Response After Traumatic Brain Injury, Kirill Shumilov, Allen Ni, Maria Garcia-Bonilla, Marta Celorrio, Stuart H Friess

2020-Current year OA Pubs

BACKGROUND: This study is a cost-effectiveness study of two implementation strategies designed to train therapists in college and university counseling centers to deliver interpersonal psychotherapy. Costs of implementing a train-the-trainer (TTT) strategy versus an expert consultation strategy were estimated, and their relative effects upon therapist outcomes were calculated and compared.

METHODS: Twenty four counseling centers were recruited across the United States. These centers were randomized to either a TTT (experimental) condition, in which an in-house therapist trained other center therapists, or an expert consultation condition, in which center therapists participated in a workshop and received 12 months of ongoing supervision. …

Complications And Health-Related Quality Of Life In Children With Various Etiologies Of Early-Onset Scoliosis Treated With Magnetically Controlled Growing Rods- A Multicenter Study, Pawel Glowka, Pawel Grabala, Munish C Gupta, Daniel E Pereira, Michal Latalski, Anna Danielewicz, Michal Grabala, Marek Tomaszewski, Tomasz Kotwicki

2020-Current year OA Pubs

No abstract provided.

Combination Of Dual Jak/Hdac Inhibitor With Regorafenib Synergistically Reduces Tumor Growth, Metastasis, And Regorafenib-Induced Toxicity In Colorectal Cancer, Prachi Bajpai, Moh'd Khushman, Et Al.

2020-Current year OA Pubs

BACKGROUND: Treatment with regorafenib, a multiple-kinase inhibitor, to manage metastatic colorectal cancers (mCRCs) shows a modest improvement in overall survival but is associated with severe toxicities. Thus, to reduce regorafenib-induced toxicity, we used regorafenib at low concentration along with a dual JAK/HDAC small-molecule inhibitor (JAK/HDACi) to leverage the advantages of both JAK and HDAC inhibition to enhance antitumor activity. The therapeutic efficacy and safety of the combination treatment was evaluated with CRC models.

METHODS: The cytotoxicity of JAK/HDACi, regorafenib, and their combination were tested with normal colonic and CRC cells exhibiting various genetic backgrounds. Kinomic, ATAC-seq, RNA-seq, cell cycle, and …

The Impact Of Clinical Genome Sequencing In A Global Population With Suspected Rare Genetic Disease, Erin Thorpe, Marwan Shinawi, Et Al.

2020-Current year OA Pubs

There is mounting evidence of the value of clinical genome sequencing (cGS) in individuals with suspected rare genetic disease (RGD), but cGS performance and impact on clinical care in a diverse population drawn from both high-income countries (HICs) and low- and middle-income countries (LMICs) has not been investigated. The iHope program, a philanthropic cGS initiative, established a network of 24 clinical sites in eight countries through which it provided cGS to individuals with signs or symptoms of an RGD and constrained access to molecular testing. A total of 1,004 individuals (median age, 6.5 years; 53.5% male) with diverse ancestral backgrounds …

Genome-Wide Analyses Reveal A Potential Role For The Mapt, Mobp, And Apoe Loci In Sporadic Frontotemporal Dementia, Claudia Manzoni, Carlos Cruchaga, Et Al.

2020-Current year OA Pubs

Frontotemporal dementia (FTD) is the second most common cause of early-onset dementia after Alzheimer disease (AD). Efforts in the field mainly focus on familial forms of disease (fFTDs), while studies of the genetic etiology of sporadic FTD (sFTD) have been less common. In the current work, we analyzed 4,685 sFTD cases and 15,308 controls looking for common genetic determinants for sFTD. We found a cluster of variants at the MAPT (rs199443; p = 2.5 × 10

Hemodynamics Regulate Spatiotemporal Artery Muscularization In The Developing Circle Of Willis, Siyuan Cheng, Ivan Fan Xia, Renate Wanner, Javier Abello, Amber N Stratman, Stefania Nicoli

2020-Current year OA Pubs

Vascular smooth muscle cells (VSMCs) envelop vertebrate brain arteries and play a crucial role in regulating cerebral blood flow and neurovascular coupling. The dedifferentiation of VSMCs is implicated in cerebrovascular disease and neurodegeneration. Despite its importance, the process of VSMC differentiation on brain arteries during development remains inadequately characterized. Understanding this process could aid in reprogramming and regenerating dedifferentiated VSMCs in cerebrovascular diseases. In this study, we investigated VSMC differentiation on zebrafish circle of Willis (CoW), comprising major arteries that supply blood to the vertebrate brain. We observed that arterial specification of CoW endothelial cells (ECs) occurs after their migration …

Phase Ib Study Of Unesbulin (Ptc596) Plus Dacarbazine For The Treatment Of Locally Recurrent, Unresectable Or Metastatic, Relapsed Or Refractory Leiomyosarcoma, Brian A Van Tine, Matthew A Ingham, Steven Attia, Christian F Meyer, John D Baird, Esther Brooks-Asplund, Dhiren D'Silva, Ronald Kong, Anthony Mwatha, Kylie O'Keefe, Marla Weetall, Robert Spiegel, Gary K Schwartz

2020-Current year OA Pubs

PURPOSE: This multicenter, single-arm, open-label, phase Ib study was designed to determine the recommended phase II dose (RP2D) and to evaluate the safety and preliminary efficacy of unesbulin plus dacarbazine (DTIC) in patients with advanced leiomyosarcoma (LMS).

PATIENTS AND METHODS: Adult subjects with locally advanced, unresectable or metastatic, relapsed or refractory LMS were treated with escalating doses of unesbulin orally twice per week in combination with DTIC 1,000 mg/m

RESULTS: Unesbulin 300 mg administered orally twice per week in combination with DTIC 1,000 mg/m

CONCLUSION: Unesbulin 300 mg twice per week plus DTIC 1,000 mg/m

Where Are We Now With Oncolytic Viruses In Melanoma And Nonmelanoma Skin Malignancies?, George Nassief, Angela Anaeme, Karen Moussa, David Chen, George Ansstas

2020-Current year OA Pubs

Skin cancer prognosis has greatly improved recently due to the introduction of immune checkpoint inhibitors (ICIs). However, many patients with advanced skin cancer still experience immunotherapy resistance and disease progression during ICI treatment, thus calling for novel therapeutics which address this treatment gap. Talimogene laherparepvec (T-VEC) has gained popularity in recent years as a viable treatment option for patients with skin cancer. In preclinical studies, T-VEC demonstrated both a direct anti-tumor effect in injected lesions as well as a systemic immune-mediated effect in non-injected lesions, which could pose additional benefits when combined with ICI therapy. Following promising results from the …