Digital Commons Network^™

Bintrafusp Alfa With Ccrt Followed By Bintrafusp Alfa Versus Placebo With Ccrt Followed By Durvalumab In Patients With Unresectable Stage Iii Nsclc: A Phase 2 Randomized Study, Everett E Vokes, Clifford G Robinson, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Preclinical evaluation of bintrafusp alfa (BA) combined with radiotherapy revealed greater antitumor effects than BA or radiotherapy alone. In a phase 1 study, BA exhibited encouraging clinical activity in patients with stage IIIB or IV NSCLC who had received previous treatment.

METHODS: This multicenter, double-blind, controlled phase 2 study (NCT03840902) evaluated the safety and efficacy of BA with concurrent chemoradiotherapy (cCRT) followed by BA (BA group) versus placebo with cCRT followed by durvalumab (durvalumab group) in patients with unresectable stage III NSCLC. The primary end point was progression-free survival according to Response Evaluation Criteria in Solid Tumors version 1.1 …

Serological Assays For Differentiating Natural Covid-19 Infection From Vaccine Induced Immunity, Samuel M S Cheng, Gaya K Amarasinghe, Et Al.

2020-Current year OA Pubs

BACKGROUND: Natural SARS-CoV-2 infection may elicit antibodies to a range of viral proteins including non-structural protein ORF8. RNA, adenovirus vectored and sub-unit vaccines expressing SARS-CoV-2 spike would be only expected to elicit S-antibodies and antibodies to distinct domains of nucleocapsid (N) protein may reliably differentiate infection from vaccine-elicited antibody. However, inactivated whole virus vaccines may potentially elicit antibody to wider range of viral proteins, including N protein. We hypothesized that antibody to ORF8 protein will discriminate natural infection from vaccination irrespective of vaccine type.

METHODS: We optimized and validated the anti-ORF8 and anti-N C-terminal domain (NCTD) ELISA assays using sera …

Primary Non-Function Of Hepatic Allograft With Preexisting Microvesicular Steatosis/Foamy Degeneration And Mild Large-Droplet Macrovesicular Steatosis, Melissa E Limia, Xiu Li Liu, Jennifer Yu, Kathleen Byrnes

2020-Current year OA Pubs

It has been established that more than mild large-droplet macrovesicular steatosis (LD-MAS) is associated with increased risk of graft non-function. In contrast, even severe small-droplet macrovesicular steatosis (SD-MAS) has been found to be less prognostically significant. It remains unclear if a donor liver with diffuse microvesicular steatosis is associated with an increased risk of graft dysfunction. A 56-year-old male with alcoholic cirrhosis was transplanted with a liver from a 42-year-old overweight male donor after brain death. The frozen section of the donor liver biopsy taken at harvest showed diffusely enlarged clear/foamy hepatocytes and mild LD-MAS (about 5-10% of total tissue). …

Calorie Restriction Reduces Biomarkers Of Cellular Senescence In Humans, Zaira Aversa, Susan B Racette, Et Al.

2020-Current year OA Pubs

Calorie restriction (CR) with adequate nutrient intake is a potential geroprotective intervention. To advance this concept in humans, we tested the hypothesis that moderate CR in healthy young-to-middle-aged individuals would reduce circulating biomarkers of cellular senescence, a fundamental mechanism of aging and aging-related conditions. Using plasma specimens from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE™) phase 2 study, we found that CR significantly reduced the concentrations of several senescence biomarkers at 12 and 24 months compared to an ad libitum diet. Using machine learning, changes in biomarker concentrations emerged as important predictors of the change …

Disease Characteristics, Treatments, And Outcomes Of Patients With Pulmonary Arterial Hypertension Treated With Selexipag In Real-World Settings From The Sphere Registry (Selexipag: The Users Drug Registry), Vallerie Mclaughlin, Harrison W Farber, Kristin B Highland, Anna R Hemnes, Murali M Chakinala, Kelly M Chin, Michelle Han, Michelle Cho, Tobore Tobore, Mohammad Rahman, Nick H Kim

2020-Current year OA Pubs

BACKGROUND: Selexipag is an oral prostacyclin receptor agonist, indicated for pulmonary arterial hypertension to delay disease progression and reduce the risk of pulmonary arterial hypertension-related hospitalization. SelexiPag: tHe usErs dRug rEgistry (NCT03278002) was a US-based, prospective, real-world registry of selexipag-treated patients.

METHODS: Adults with pulmonary hypertension (enrolled 2016-2020) prescribed selexipag were followed for ≤18 months, with data collected at routine clinic visits. Patients were defined as newly or previously initiated if they had started selexipag ≤60 days or >60 days, respectively, before enrollment.

RESULTS: The registry included 829 patients (430 newly initiated, 399 previously initiated; 759 with pulmonary arterial hypertension), …

Feasibility Of Interleukin-6 Receptor Blockade In Cardiac Antibody-Mediated Rejection, April A Pottebaum, Spenser E. January, Chang Liu, Steven Lavine, Joel D. Schilling, Kory J. Lavine

2020-Current year OA Pubs

BACKGROUND: Antibody-mediated rejection (AMR) remains a significant cause of heart transplant mortality with few effective therapies.

METHODS: This study aimed to describe initial experience of using interleukin-6 receptor blockade with tocilizumab in the treatment of acute cardiac AMR at Barnes-Jewish Hospital/Washington University Transplant Center from July 2017 to May 2021 (n = 7). Clinical, echocardiographic, and serum alloantibody data were analyzed before and after treatment.

RESULTS: All participants demonstrated marked improvement in functional status. Echocardiographic data following 4-6 mo of tocilizumab revealed significant improvements in biventricular systolic function for all participants. Consistent reductions in donor-specific HLA or angiotensin type I …

Aapm Medical Physics Practice Guideline 14.A: Yttrium-90 Microsphere Radioembolization, Nathan C Busse, Nichole M Maughan, Et Al.

2020-Current year OA Pubs

Radioembolization using Yttrium-90 (

Top 50 Most-Cited Studies About Osteochondritis Dissecans, Nicholas D Thomas, Raegan Mahler, Kylie Krombholz, Brendan Williams, Ted Ganley, Jeffrey J Nepple, Kevin Shea

2020-Current year OA Pubs

PURPOSE: To determine the 50 most frequently cited studies on osteochondritis dissecans (OCD) and to conduct a bibliometric analysis of these studies.

METHODS: We performed a search within the Clarivate Web of Science database, identifying articles published before December 2022 that encompass topics related to OCD. The search was conducted using the keywords "Osteochondritis Dissecans OR Osteochondritis OR Dissecans."Search results were then filtered using predetermined guidelines and criteria, and the 50 most-cited articles were selected for analysis. Extracted data included title, journal, design, main topic, joint, citations, year, country of origin, and level of evidence.

RESULTS: The search yielded 3,865 …

Concurrent Administration Of Serotonergic Antidepressants And Ozanimod In Participants With Relapsing Multiple Sclerosis From The Open-Label Extension Daybreak Trial, Robert T Naismith, Jeffrey A Cohen, Amit Bar-Or, Giancarlo Comi, Krzysztof W Selmaj, Hans-Peter Hartung, James K Sheffield, Anthony Krakovich, Daniel Tatosian, Chun-Yen Cheng, Jennifer Reardon, Vadim Khaychuk, Jon V Riolo, Diego Silva, Bruce Ac Cree

2020-Current year OA Pubs

BACKGROUND: Monoamine oxidase (MAO) inhibitors can interact with selective serotonin reuptake inhibitors (SSRIs)/serotonin-norepinephrine reuptake inhibitors (SNRIs). There is clinical interest surrounding use of ozanimod with SSRIs/SNRIs because the major metabolites of ozanimod are weak inhibitors of MAO-B in vitro.

OBJECTIVE: To evaluate the incidence of treatment-emergent adverse events (TEAEs) potentially related to serotonin accumulation (SA) during concomitant ozanimod and SSRI/SNRI use by performing analyses of data from an open-label, oral ozanimod 0.92 mg trial (DAYBREAK; NCT02576717).

METHODS: SA narrow (serotonin syndrome, neuroleptic malignant syndrome, and hyperthermia malignant) and broad (terms potentially associated with SA) MedDRA v24.0 searches were performed using …

Angptl3 Deficiency Impairs Lipoprotein Production And Produces Adaptive Changes In Hepatic Lipid Metabolism, Kendall H Burks, Yan Xie, In-Hyuk Jung, Sandip Mukherjee, Paul Lee, Upasana Pudupakkam, Ryan Wagoner, Ved Patel, Katherine Santana, Arturo Alisio, Brian N Finck, Nicholas O Davidson, Nathan O Stitziel, Et Al.

2020-Current year OA Pubs

Angiopoietin-like protein 3 (ANGPTL3) is a hepatically secreted protein and therapeutic target for reducing plasma triglyceride-rich lipoproteins and low-density lipoprotein (LDL) cholesterol. Although ANGPTL3 modulates the metabolism of circulating lipoproteins, its role in triglyceride-rich lipoprotein assembly and secretion remains unknown. CRISPR-associated protein 9 (CRISPR/Cas9) was used to target ANGPTL3 in HepG2 cells (ANGPTL3

Changes In Bone Marrow Fibrosis During Momelotinib Or Ruxolitinib Therapy Do Not Correlate With Efficacy Outcomes In Patients With Myelofibrosis, Stephen T Oh, Et Al.

2020-Current year OA Pubs

Bone marrow fibrosis (BMF) is a pathological feature of myelofibrosis, with higher grades associated with poor prognosis. Limited data exist on the association between outcomes and BMF changes. We present BMF data from Janus kinase (JAK) inhibitor-naive patients from SIMPLIFY-1 (NCT01969838), a double-blind, randomized, phase 3 study of momelotinib vs ruxolitinib. Baseline and week 24 bone marrow biopsies were graded from 0 to 3 as per World Health Organization criteria. Other assessments included Total Symptom Score, spleen volume, transfusion independence status, and hemoglobin levels. Paired samples were available from 144 and 160 patients randomized to momelotinib and ruxolitinib. With momelotinib …

Longitudinal Predictors Of Health-Related Quality Of Life In Isolated Dystonia, Johanna Junker, Joel S Perlmutter, Et Al.

2020-Current year OA Pubs

OBJECTIVE: To determine longitudinal predictors of health-related quality of life (HR-QoL) in an international multicenter cohort of patients with isolated dystonia.

METHODS: Out of 603 dystonia patients prospectively enrolled in the Natural History Dystonia Coalition study, 155 were assessed three times within 2 years for HR-QoL, symptoms of depression, generalized anxiety disorder (GAD), and social anxiety disorder (SAD), as well as dystonia severity and dystonic tremor. In addition, the impact of botulinum neurotoxin (BoNT) injections on HR-QoL was evaluated after 1 year.

RESULTS: Depressive symptoms at baseline predicted lower HR-QoL on all subscales after 2 years (all p ≤ 0.001). …

Screening For Problematic Opioid Use In The Emergency Department: Comparison Of Two Screening Measures, Brittany E Punches, Caroline E Freiermuth, Jon E Sprague, Jennifer L Brown, Elizabeth Hutzel-Dunham, Joshua Lambert, Robert Braun, Andrew Littlefield, Jennifer A Frey, Daniel J Bachmann, Jason J Bischof, Michael V Pantalon, Rachel M Ancona, David F Kisor, Michael S Lyons

2020-Current year OA Pubs

STUDY OBJECTIVE: Earlier intervention for opioid use disorder (OUD) may reduce long-term health implications. Emergency departments (EDs) in the United States treat millions with OUD annually who may not seek care elsewhere. Our objectives were (1) to compare two screening measures for OUD characterization in the ED and (2) to determine the proportion of ED patients screening positive for OUD and those who endorse other substance use to guide future screening programs.

METHODS: A cross-sectional study of randomly selected adult patients presenting to three Midwestern US EDs were enrolled, with duplicate patients excluded. Surveys were administered via research assistant and …

Creation Of A National Emergency Medicine Medical Education Journal Club, Jessica Pelletier, James Ahn, Andrew Golden, Caroline Astemborski, Michelle D. Lall, Albert Kim, Sara Dimeo

2020-Current year OA Pubs

Background There are a relatively limited number of emergency medicine (EM) medical education (MedEd) fellowships with few trainees at each program, creating barriers to local collaboration and networking. While best practices for developing MedEd journal clubs exist, there has not been an established national EM MedEd journal club. To address this need, we created a national journal club, the Council of Residency Directors (CORD) MedEd Journal Club (MEJC), to facilitate collaboration and networking opportunities by providing a synchronous online journal club. Objectives Our primary objective was to create a network for collaboration across geographical barriers to form a virtual community …

Patterns Of Self-Care Decision-Making And Associated Factors: A Cross-Sectional Observational Study, Christopher S Lee, Kenneth E Freedland, Tiny Jaarsma, Anna Strömberg, Ercole Vellone, Shayleigh Dickson Page, Heleen Westland, Sara Pettersson, Michelle Van Rijn, Subhash Aryal, Andrew Belfiglio, Douglas Wiebe, Barbara Riegel

2020-Current year OA Pubs

OBJECTIVE: The aim of this study was to identify for the first time patterns of self-care decision-making (i.e. the extent to which participants viewed contextual factors influencing decisions about symptoms) and associated factors among community-dwelling adults with chronic illness.

METHODS: This was a secondary analysis of data collected during the development and psychometric evaluation of the 27-item Self-Care Decisions Inventory that is based on Naturalistic Decision-Making (n = 430, average age = 54.9 ± 16.2 years, 70.2 % female, 87.0 % Caucasian, average number of chronic conditions = 3.6 ± 2.8). Latent class mixture modeling was used to identify patterns …

Spatial And Amplitude Dynamics Of Neurostimulation: Insights From The Acute Intrahippocampal Kainate Seizure Mouse Model, Thomas J Foutz, Nicholas Rensing, Lirong Han, Dominique M Durand, Michael Wong

2020-Current year OA Pubs

OBJECTIVE: Neurostimulation is an emerging treatment for patients with drug-resistant epilepsy, which is used to suppress, prevent, and terminate seizure activity. Unfortunately, after implantation and despite best clinical practice, most patients continue to have persistent seizures even after years of empirical optimization. The objective of this study is to determine optimal spatial and amplitude properties of neurostimulation in inhibiting epileptiform activity in an acute hippocampal seizure model.

METHODS: We performed high-throughput testing of high-frequency focal brain stimulation in the acute intrahippocampal kainic acid mouse model of status epilepticus. We evaluated combinations of six anatomic targets and three stimulus amplitudes.

RESULTS: …

A 3'Utr Insertion Is A Candidate Causal Variant At The Tmem106b Locus Associated With Increased Risk For Ftld-Tdp, Augustine Chemparathy, Chengran Yang, Carlos Cruchaga, Et Al.

2020-Current year OA Pubs

BACKGROUND AND OBJECTIVES: Single-nucleotide variants near

METHODS: An exploratory analysis identified structural variants on neurodegeneration-related genes. Subsequent analyses focused on an

RESULTS: The primary analysis included 432 participants (52.5% female, age range 45-92 years). We identified a 316 bp

DISCUSSION: We identified a novel

Semaglutide Improves Metabolic Dysfunction-Associated Steatohepatitis: A 10-Year Retrospective Study, Parth Shah, Megan White, Alex Sievert, Alexander Conway, Adam Kneepkens, Gregory Sayuk, Mauricio Lisker-Melman, Jill Elwing

2020-Current year OA Pubs

BACKGROUND AND AIMS: Semaglutide has been studied in patients with metabolic dysfunction-associated steatohepatitis (MASH) due to potential benefit from weight loss on liver inflammation. However, preclinical studies suggest that MASH improvement may be independent of weight loss. We aim to assess the impact of semaglutide on MASH in relation to weight loss.

METHODS: This retrospective study included 420 patients with diabetes on semaglutide for at least 12 months between 2011 and 2022. Exclusion criteria were liver disease other than MASH, decompensated cirrhosis, malignancy, and bariatric surgery. Primary endpoints were clinically significant improvements in AST or ALT (mean difference > 6.3 U/L …

Quantification Of Enteric Dysfunction In Cystic Fibrosis: Inter- And Intraindividual Variability, Laura A Duckworth, Kimberly A Sutton, Nurmohammad Shaikh, Jinli Wang, Carla Hall-Moore, Lori R Holtz, Phillip I Tarr, Ronald C Rubenstein

2020-Current year OA Pubs

OBJECTIVES: To test the utility of various biomarkers as indicators of gut dysfunction in cystic fibrosis (CF) and determine whether intraindividual variations in these measures are repeatable over short intervals and whether interindividual variations correlate with clinical outcomes.

STUDY DESIGN: We performed a cross-sectional, limited longitudinal study of children with CF aged 1-21 years who provided blood and stool samples at 2 or 3 visits, 2 weeks and 3 months apart, which were assayed for markers of intestinal inflammation (fecal calprotectin [fCal], lipocalin-2 [fLcn2], neopterin), and permeability (plasma lipopolysaccharide [LPS] antibodies, LPS-binding protein) by enzyme immunoassays. Control specimens were obtained …

A Cataract-Causing Mutation In The Trpm3 Cation Channel Disrupts Calcium Dynamics In The Lens, Yuefang Zhou, Thomas M Bennett, Philip A Ruzycki, Zhaohua Guo, Yu-Qing Cao, Mohammad Shahidullah, Nicholas A Delamere, Alan Shiels

2020-Current year OA Pubs

TRPM3 belongs to the melastatin sub-family of transient receptor potential (TRPM) cation channels and has been shown to function as a steroid-activated, heat-sensitive calcium ion (Ca

A Quick Recap: Discovering Cryptococcus Neoformans Capsule Mutants, Daphne Boodwa-Ko, Tamara L Doering

2020-Current year OA Pubs

No abstract provided.

Inter- And Intra-Observer Variability Of Radial-Endobronchial Ultrasound Image Interpretation For Peripheral Pulmonary Lesions, Nathaniel Moulton, Daniel B. Abbasi, Danish Ahmad, Nikki E. Burks, Praveen Chenna, Kevin Haas, Andrea Loiselle, Essam Mekhaiel, Mayank R. Pilli, Ali Sadoughi, Brandt Lydon, Tej Patel, Alexander C. Chen

2020-Current year OA Pubs

BACKGROUND: Radial probe endobronchial ultrasound (R-EBUS) is often utilized in guided bronchoscopy for the diagnosis of peripheral pulmonary lesions. R-EBUS probe positioning has been shown to correlate with diagnostic yield, but overall diagnostic yield with this technology has been inconsistent across the published literature. Currently there is no standardization for R-EBUS image interpretation, which may result in variability in grading concentricity of lesions and subsequently procedure performance. This was a survey-based study evaluating variability among practicing pulmonologists in R-EBUS image interpretation.

METHODS: R-EBUS images from peripheral bronchoscopy cases were sent to 10 practicing Interventional Pulmonologists at two different time points …

Venovenous Extracorporeal Membrane Oxygenation After Cardiac Arrest For Acute Respiratory Distress Syndrome Caused By Legionella: A Case Report, John C Grotberg, Linda Schulte, Erin Schumer, Mary Sullivan, Kunal Kotkar, Mohammad F Masood, Amit Pawale

2020-Current year OA Pubs

BACKGROUND: Legionella remains underdiagnosed in the intensive care unit and can progress to acute respiratory distress syndrome (ARDS), multiorgan failure and death. In severe cases, venovenous extracorporeal membrane oxygenation (VV-ECMO) allows time for resolution of disease with Legionella-targeted therapy. VV-ECMO outcomes for Legionella are favorable with reported survival greater than 70%. Rapid molecular polymerase chain reaction (PCR) testing of the lower respiratory tract aids in diagnosing Legionella with high sensitivity and specificity. We present a unique case of a patient with a positive COVID-19 test and ARDS who suffered a cardiac arrest. The patient was subsequently cannulated for VV-ECMO, and …

Reviewing The Clostridioides Difficile Mouse Model: Insights Into Infection Mechanisms, José L Fachi, Marco A R Vinolo, Marco Colonna

2020-Current year OA Pubs

No abstract provided.

Synergistic Protection Of Retinal Ganglion Cells (Rgcs) By Sarm1 Inactivation With Cntf In A Rodent Model Of Nonarteritic Anterior Ischemic Optic Neuropathy, Yan Guo, Zara Mehrabian, Jeffrey Milbrandt, Aaron Diantonio, Steven L Bernstein

2020-Current year OA Pubs

We evaluated whether inhibiting sterile alpha and (Toll/interleukin receptor (TIR)) motif-containing 1 (SARM1) activity protects retinal ganglion cells (RGCs) following ischemic axonopathy (rodent nonarteritic anterior ischemic optic neuropathy: rNAION) by itself and combined with ciliary neurotrophic factor (CNTF). Genetically modified SARM1(-) rats were rNAION-induced in one eye and compared against equivalently induced wild-type animals of the same background. Optic nerve (ON) diameters were quantified using optical coherence tomography (SD-OCT). RGCs were quantified 30 d post-induction using retinal stereology for Brn3a(+) nuclei. ON sections were analyzed by TEM and immunohistochemistry. SARM1(-)(-) and WT animals were then bilaterally sequentially rNAION-induced. One eye …

B Cells Mediate Lung Ischemia/Reperfusion Injury By Recruiting Classical Monocytes Via Synergistic B Cell Receptor/Tlr4 Signaling, Khashayar Farahnak, Yun Zhu Bai, Yuhei Yokoyama, Deniz B. Morkan, Zhiyi Liu, Junedh M. Amrute, Alejandro De Filippis Falcon, Yuriko Terada, Fuyi Liao, Wenjun Li, Hailey M. Shepherd, Ramsey R. Hachem, Varun Puri, Kory J. Lavine, Andrew E. Gelman, Ankit Bharat, Daniel Kreisel, Ruben G. Nava

2020-Current year OA Pubs

Ischemia/reperfusion injury-mediated (IRI-mediated) primary graft dysfunction (PGD) adversely affects both short- and long-term outcomes after lung transplantation, a procedure that remains the only treatment option for patients suffering from end-stage respiratory failure. While B cells are known to regulate adaptive immune responses, their role in lung IRI is not well understood. Here, we demonstrated by intravital imaging that B cells are rapidly recruited to injured lungs, where they extravasate into the parenchyma. Using hilar clamping and transplant models, we observed that lung-infiltrating B cells produce the monocyte chemokine CCL7 in a TLR4-TRIF-dependent fashion, a critical step contributing to classical monocyte …

Mypathway Human Epidermal Growth Factor Receptor 2 Basket Study: Pertuzumab + Trastuzumab Treatment Of A Tissue-Agnostic Cohort Of Patients With Human Epidermal Growth Factor Receptor 2-Altered Advanced Solid Tumors, Christopher J Sweeney, Ron Bose, Et Al.

2020-Current year OA Pubs

No abstract provided.

Comprehensive Workflow And Its Validation For Simulating Diffuse Speckle Statistics For Optical Blood Flow Measurements, Lisa Kobayashi Frisk, Manish Verma, Faruk Bešlija, Chen-Hao P Lin, Nishighanda Patil, Sumana Chetia, Jason W Trobaugh, Joseph P Culver, Turgut Durduran

2020-Current year OA Pubs

Diffuse optical methods including speckle contrast optical spectroscopy and tomography (SCOS and SCOT), use speckle contrast (

Drug Preparation, Injection-Related Infections, And Harm Reduction Practices Among A National Sample Of Individuals Entering Treatment For Opioid Use Disorder, Laura R Marks, Michael J Durkin, Kelly Ayres, Matthew Ellis

2020-Current year OA Pubs

BACKGROUND: The rise in injection drug use in the USA has led to an increase in injection site infections. We performed a national survey of people who use drugs to evaluate common drug use preparation, harm reduction practices, and experiences with injection site infections.

METHODS: A survey was disseminated to members of the Survey of Key Informants' Patients Program from 2021 to 2022 and distributed to patients 18 years or older newly entering one of 68 substance use disorder treatment programs across the USA with a primary diagnosis of an opioid use disorder. Participants were surveyed about practices when preparing …

Identification Of Molecular Subphenotypes In Two Cohorts Of Paediatric Ards, Nadir Yehya, Matt S Zinter, Jill M Thompson, Michelle J Lim, Mark R Hanudel, Mustafa F Alkhouli, Hector Wong, Matthew N Alder, Daniel J Mckeone, E Scott Halstead, Pratik Sinha, Anil Sapru

2020-Current year OA Pubs

BACKGROUND: Two subphenotypes of acute respiratory distress syndrome (ARDS), hypoinflammatory and hyperinflammatory, have been reported in adults and in a single paediatric cohort. The relevance of these subphenotypes in paediatrics requires further investigation. We aimed to identify subphenotypes in two large observational cohorts of paediatric ARDS and assess their congruence with prior descriptions.

METHODS: We performed latent class analysis (LCA) separately on two cohorts using biomarkers as inputs. Subphenotypes were compared on clinical characteristics and outcomes. Finally, we assessed overlap with adult cohorts using parsimonious classifiers.

FINDINGS: In two cohorts from the Children's Hospital of Philadelphia (n=333) and from a …