Digital Commons Network^™

Dcs At The Center Of Help: Origins And Evolution Of The Three-Cell-Type Hypothesis, Renee Wu, Kenneth M Murphy

2020-Current year OA Pubs

Last year was the 10th anniversary of Ralph Steinman's Nobel Prize awarded for his discovery of dendritic cells (DCs), while next year brings the 50th anniversary of that discovery. Current models of anti-viral and anti-tumor immunity rest solidly on Steinman's discovery of DCs, but also rely on two seemingly unrelated phenomena, also reported in the mid-1970s: the discoveries of "help" for cytolytic T cell responses by Cantor and Boyse in 1974 and "cross-priming" by Bevan in 1976. Decades of subsequent work, controversy, and conceptual changes have gradually merged these three discoveries into current models of cell-mediated immunity against viruses and …

Activation Of Autophagic Flux Maintains Mitochondrial Homeostasis During Cardiac Ischemia/Reperfusion Injury, Lihao He, Sumanth D Prabhu, Et Al

2020-Current year OA Pubs

Reperfusion injury after extended ischemia accounts for approximately 50% of myocardial infarct size, and there is no standard therapy. HDAC inhibition reduces infarct size and enhances cardiomyocyte autophagy and PGC1α-mediated mitochondrial biogenesis when administered at the time of reperfusion. Furthermore, a specific autophagy-inducing peptide, Tat-Beclin 1 (TB), reduces infarct size when administered at the time of reperfusion. However, since SAHA affects multiple pathways in addition to inducing autophagy, whether autophagic flux induced by TB maintains mitochondrial homeostasis during ischemia/reperfusion (I/R) injury is unknown. We tested whether the augmentation of autophagic flux by TB has cardioprotection by preserving mitochondrial homeostasis both …

High-Resolution Label-Free Mapping Of Murine Kidney Vasculature By Raster-Scanning Optoacoustic Mesoscopy: An Ex Vivo Study, Colin A Goebel, Emma Brown, Fabian B Fahlbusch, Alexandra L Wagner, Adrian Buehler, Thomas Raupach, Martin Hohmann, Moritz Späth, Neal Burton, Joachim Woelfle, Michael Schmidt, Andrea Hartner, Adrian P Regensburger, Ferdinand Knieling

2020-Current year OA Pubs

BACKGROUND: Chronic kidney disease (CKD) is a global burden affecting both children and adults. Novel imaging modalities hold great promise to visualize and quantify structural, functional, and molecular organ damage. The aim of the study was to visualize and quantify murine renal vasculature using label-free raster scanning optoacoustic mesoscopy (RSOM) in explanted organs from mice with renal injury.

MATERIAL AND METHODS: For the experiments, freshly bisected kidneys of alpha 8 integrin knock-out (KO) and wildtype mice (WT) were used. A total of n=7 female (n=4 KO, n=3 WT) and n=6 male animals (n=2 KO, n=4 WT) aged 6 weeks were …

Etiology Of Persistent Microalbuminuria In Nigeria (P_Micro Study): Protocol And Study Design, C William Wester, Philip J Budge, Et Al.

2020-Current year OA Pubs

BACKGROUND: Microalbuminuria is an independent risk factor for cardiovascular and kidney disease and a predictor of end organ damage, both in the general population and in persons with HIV (PWH). Microalbuminuria is also an important risk factor for mortality in PWH treated with antiretroviral therapy (ART). In the ongoing Renal Risk Reduction (R3) study in Nigeria, we identified a high prevalence of microalbuminuria confirmed by two measurements 4-8 weeks apart in ART-experienced, virologically suppressed PWH. Although Stage 1 or 2 hypertension and exposure to potentially nephrotoxic antiretroviral medications were common in R3 participants, other traditional risk factors for albuminuria and …

Effects Of Chronic Cannabidiol In A Mouse Model Of Naturally Occurring Neuroinflammation, Neurodegeneration, And Spontaneous Seizures, Joshua T Dearborn, Hemanth R Nelvagal, Nicholas R Rensing, Keigo Takahashi, Stephanie M Hughes, Thomas M Wishart, Jonathan D Cooper, Michael Wong, Mark S Sands

2020-Current year OA Pubs

Cannabidiol (CBD) has gained attention as a therapeutic agent and is purported to have immunomodulatory, neuroprotective, and anti-seizure effects. Here, we determined the effects of chronic CBD administration in a mouse model of CLN1 disease (Cln1

Single Cell Rna-Sequence Analyses Reveal Uniquely Expressed Genes And Heterogeneous Immune Cell Involvement In The Rat Model Of Intervertebral Disc Degeneration, Milad Rohanifar, Sade W. Clayton, Garret W.D. Easson, Deepanjali S. Patil, Frank Lee, Luifang Jing, Marcos N. Barcellona, Julie E. Speer, Jordan J. Stivers, Simon Y. Tang, Lori A. Setton

2020-Current year OA Pubs

No abstract provided.

Resilience Of S309 And Azd7442 Monoclonal Antibody Treatments Against Infection By Sars-Cov-2 Omicron Lineage Strains, James Brett Case, Samantha Mackin, John M Errico, Zhenlu Chong, Emily A Madden, Bradley Whitener, Ana Jung, Lindsay Droit, Scott A Handley, Daved H Fremont, Herbert W Virgin, Michael S Diamond, Et Al

2020-Current year OA Pubs

Omicron variant strains encode large numbers of changes in the spike protein compared to historical SARS-CoV-2 isolates. Although in vitro studies have suggested that several monoclonal antibody therapies lose neutralizing activity against Omicron variants, the effects in vivo remain largely unknown. Here, we report on the protective efficacy against three SARS-CoV-2 Omicron lineage strains (BA.1, BA.1.1, and BA.2) of two monoclonal antibody therapeutics (S309 [Vir Biotechnology] monotherapy and AZD7442 [AstraZeneca] combination), which correspond to ones used to treat or prevent SARS-CoV-2 infections in humans. Despite losses in neutralization potency in cell culture, S309 or AZD7442 treatments reduced BA.1, BA.1.1, and …

Retrospective Analysis Of Pacritinib In Patients With Myelofibrosis And Severe Thrombocytopenia, Srdan Verstovsek, Ruben Mesa, Moshe Talpaz, Jean-Jacques Kiladjian, Claire N. Harrison, Stephen T. Oh, Alessandro M. Vannucchi, Raajit Rampal, Bart L. Scott, Sarah A. Buckley, Adam R. Craig, Karisse Roman-Torres, John O. Mascarenhas

2020-Current year OA Pubs

Thrombocytopenia is common in patients with myelofibrosis (MF) and is a well-established adverse prognostic factor. Both of the approved Janus kinase (JAK) inhibitors, ruxolitinib and fedratinib, can worsen thrombocytopenia and have not been evaluated in patients with severe thrombocytopenia (platelet counts <50×109/L). Pacritinib, a novel JAK2/interleukin-1 receptor-associated kinase 1 inhibitor, has been studied in two phase III trials (PERSIST-1 and PERSIST- 2), both of which enrolled patients with MF and severe thrombocytopenia. In order to better characterize treatment outcomes for this population with advanced disease, we present a retrospective analysis of efficacy and safety data in the 189 patients with severe thrombocytopenia treated in the PERSIST studies. The proportion of patients in the pacritinib group meeting efficacy endpoints was greater than in the BAT group for ≥35% spleen volume reduction (23% vs. 2%, P=0.0007), ≥50% modified Total Symptom Score reduction (25% vs. 8%, P=0.044), and self-reported symptom benefit ("much" or "very much" improved; 25% vs. 8%, P=0.016) at the primary analysis time point (week 24). The adverse event profile of pacritinib was manageable, and dose modification was rarely required. There was no excess in bleeding or death in pacritinib-treated patients. These results indicate that pacritinib is a promising treatment for patients with MF who lack safe and effective therapeutic options due to severe thrombocytopenia.

Association Between The Covid-19 Pandemic And Insurance-Based Disparities In Mortality After Major Surgery Among Us Adults, Laurent G Glance, Andrew W Dick, Ernie Shippey, Patrick J Mccormick, Richard Dutton, Patricia W Stone, Jingjing Shang, Stewart J Lustik, Heather L Lander, Igor Gosev, Karen E Joynt Maddox

2020-Current year OA Pubs

Importance: The COVID-19 pandemic caused significant disruptions in surgical care. Whether these disruptions disproportionately impacted economically disadvantaged individuals is unknown.

Objective: To evaluate the association between the COVID-19 pandemic and mortality after major surgery among patients with Medicaid insurance or without insurance compared with patients with commercial insurance.

Design, Setting, and Participants: This cross-sectional study used data from the Vizient Clinical Database for patients who underwent major surgery at hospitals in the US between January 1, 2018, and May 31, 2020.

Exposures: The hospital proportion of patients with COVID-19 during the first wave of COVID-19 cases between March 1 and …

Long Covid After Breakthrough Sars-Cov-2 Infection, Ziyad Al-Aly, Benjamin Bowe, Yan Xie

2020-Current year OA Pubs

The post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-also referred to as Long COVID-have been described, but whether breakthrough SARS-CoV-2 infection (BTI) in vaccinated people results in post-acute sequelae is not clear. In this study, we used the US Department of Veterans Affairs national healthcare databases to build a cohort of 33,940 individuals with BTI and several controls of people without evidence of SARS-CoV-2 infection, including contemporary (n = 4,983,491), historical (n = 5,785,273) and vaccinated (n = 2,566,369) controls. At 6 months after infection, we show that, beyond the first 30 days of illness, compared to …

Comparison Of Perioperative Outcomes Among Non-Small Cell Lung Cancer Patients With Neoadjuvant Immune Checkpoint Inhibitor Plus Chemotherapy, Egfr-Tki, And Chemotherapy Alone: A Real-World Evidence Study, Deping Zhao, Long Xu, Junqi Wu, Yunlang She, Hang Su, Likun Hou, Haoran E., Lei Zhang, Francesco Grossi, Melanie P. Subramanian, Anthony W. Kim, Yuming Zhu, Chang Chen

2020-Current year OA Pubs

Background: The utilization of neoadjuvant immune checkpoint inhibitor (ICI) plus chemotherapy has increased significantly for resectable non-small cell lung cancer (NSCLC). It is still unclear whether such a treatment paradigm affects perioperative outcomes compared with other neoadjuvant treatment. We aimed to evaluate the perioperative outcomes of pulmonary resection after neoadjuvant ICI plus chemotherapy and to compare them with neoadjuvant epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKI) and neoadjuvant chemotherapy alone for resectable NSCLC.

Methods: A retrospective cohort including 194 stage IB-IIIB NSCLC underwent surgical resection after neoadjuvant treatment between 2018 and 2020 were reviewed. Perioperative complications were evaluated using the …

A Phase 2 Trial Of A Topical Antiseptic Bundle In Head And Neck Cancer Surgery: Effects On Surgical Site Infection And The Oral Microbiome, Joseph Zenga, Sidharth V Puram, Et Al.

2020-Current year OA Pubs

BACKGROUND: Head and neck cancer (HNC) surgery remains an important component of management but is associated with a high rate of surgical site infection (SSI). We aimed to assess the safety and efficacy of a topical mucosal antiseptic bundle in preventing SSI and evaluate microbial predictors of infection through a genomic sequencing approach.

METHODS: This study was an open-label, single-arm, single-center, phase 2 trial of a topical mucosal antiseptic bundle in patients with HNC undergoing aerodigestive tract resection and reconstruction. Patients underwent topical preparation of the oral mucosa with povidone-iodine (PI) and chlorhexidine gluconate (CHG) pre- and intra-operatively followed by …

Interim Outcomes Of Mechanical Thrombectomy For Deep Vein Thrombosis From The All-Comer Clout Registry, David J Dexter, Luis Sanchez, Et Al.

2020-Current year OA Pubs

OBJECTIVES: The multicenter, prospective, single arm CLOUT registry assesses the safety and effectiveness of the ClotTriever System (Inari Medical, Irvine, CA) for the treatment of acute and nonacute lower extremity deep vein thrombosis (DVT) in all-comer patients. Reported here are the outcomes of the first 250 patients.

METHODS: All-comer patients with lower extremity DVT were enrolled, including those with bilateral DVT, those with previously failed DVT treatment, and regardless of symptom duration. The primary effectiveness end point is complete or near-complete (≥75%) thrombus removal determined by independent core laboratory-adjudicated Marder scores. Safety outcomes include serious adverse events through 30 days …

Longitudinal Morphological And Functional Characterization Of Human Heart Organoids Using Optical Coherence Tomography, Yixuan Ming, Senyue Hao, Fei Wang, Yonatan R. Lewis-Israeli, Brett D. Volmert, Zhiyao Xu, Anna Goestenkors, Aitor Aguirre, Chao Zhou

2020-Current year OA Pubs

Organoids play an increasingly important role as in vitro models for studying organ development, disease mechanisms, and drug discovery. Organoids are self-organizing, organ-like three-dimensional (3D) cell cultures developing organ-specific cell types and functions. Recently, three groups independently developed self-assembling human heart organoids (hHOs) from human pluripotent stem cells (hPSCs). In this study, we utilized a customized spectral-domain optical coherence tomography (SD-OCT) system to characterize the growth of hHOs. Development of chamber structures and beating patterns of the hHOs were observed via OCT and calcium imaging. We demonstrated the capability of OCT to produce 3D images in a fast, label-free, and …

Accuracy And Reliability Of Diffusion Imaging Models, Nicole A. Seider, Babatunde Adeyemo, Ryland Miller, Dillan J. Newbold, Jacqueline M. Hampton, Kristen M. Scheidter, Jerrel Rutlin, Timothy O. Laumann, Jarod L. Roland, David F. Montez, Andrew N. Van, Annie Zheng, Scott Marek, Benjamin P. Kay, G. Larry Bretthorst, Yong Wang, Steven E. Petersen, Deanna M. Barch, Evan M. Gordon, Abraham Z. Snyder, Joshua S. Shimony, Nico U. F. Dosenbach

2020-Current year OA Pubs

Diffusion imaging aims to non-invasively characterize the anatomy and integrity of the brain's white matter fibers. We evaluated the accuracy and reliability of commonly used diffusion imaging methods as a function of data quantity and analysis method, using both simulations and highly sampled individual-specific data (927-1442 diffusion weighted images [DWIs] per individual). Diffusion imaging methods that allow for crossing fibers (FSL's BedpostX [BPX], DSI Studio's Constant Solid Angle Q-Ball Imaging [CSA-QBI], MRtrix3's Constrained Spherical Deconvolution [CSD]) estimated excess fibers when insufficient data were present and/or when the data did not match the model priors. To reduce such overfitting, we developed …

Changes In Adiposity Over The Life Course And Gene Expression In Postmenopausal Women, Yunan Han, Graham A Colditz, Adetunji T Toriola

2020-Current year OA Pubs

BACKGROUND: Early life adiposity and changes in adiposity over the life course are associated with mammographic breast density among postmenopausal women. However, the underlying mechanisms are unknown; therefore, we comprehensively examined the associations of early life body mass index (BMI) and changes in BMI from ages 10, 18 to age at mammogram with growth factor, RANK pathway, and sex hormone gene expression in 372 postmenopausal women.

METHODS: We estimated early life BMI at age 10 using the validated 9-level Stunkard pictogram. We calculated BMI at other ages (18, 30, and current age at mammogram) by dividing weight in kilograms at …

Motor Network Reorganization Induced In Chronic Stroke Patients With The Use Of A Contralesionally-Controlled Brain Computer Interface, Joseph B. Humphries, Daniela J S Mattos, Jerrel Rutlin, Andy G S Daniel, Kathleen Rybczynski, Theresa Notestine, Joshua S. Shimony, Harold Burton, Alexandre Carter, Eric C. Leuthardt

2020-Current year OA Pubs

No abstract provided.

A Rare Case Of Pontocerebellar Hypoplasia Type 1b With Literature Review, Ana C Spyridakis, Ying Cao, Florentina Litra

2020-Current year OA Pubs

A full-term female newborn was transferred to our neonatal intensive care unit (NICU) on day two of life for hypotonia. Physical examination was significant for overriding sutures, displaced small anterior fontanelle, axial hypotonia, extremity hypertonia, and slow deep tendon reflexes. She was also noted to have stridor with crying but had unlabored breathing without oxygen requirements and a normal heart examination. A brain magnetic resonance imaging (MRI) showed a large cisterna magna and cerebellar hypoplasia with the majority of the cerebellar vermis present, suggesting a possible Dandy-Walker variant (cerebellar vermis hypoplasia). Head computed tomography showed areas of close approximation of …

Performance Of A Multianalyte 'Rule-Out' Assay In Pregnant Individuals With Suspected Preeclampsia, Maged M Costantine, Georges Macones, Et Al

2020-Current year OA Pubs

BACKGROUND: The ability to diagnose preeclampsia clinically is suboptimal. Our objective was to validate a novel multianalyte assay and characterize its performance, when intended for use as an aid to rule-out preeclampsia.

METHODS: Prospective, multicenter cohort study of pregnant individuals presenting between 28

RESULTS: One thousand thirty-six pregnant individuals were enrolled in the study cohort with an incidence of preeclampsia of 30.3% (27.6%-33.2%). The time to develop preeclampsia was shorter for those with an at-risk compared with negative assay result (log-rank

CONCLUSIONS: We confirmed that a novel multianalyte assay was associated with the time to develop preeclampsia and has a …

Technical Note: Institutional Solution Of Clinical Cine Mri For Tumor Motion Evaluation In Radiotherapy, Taeho Kim, Yu Wu, Zhen Ji, H Michael Gach, Nels Knutson, Stacie Mackey, Matthew Schmidt

2020-Current year OA Pubs

PURPOSE: Since 4D-MRI is inadequate to capture dynamic respiratory variations, real-time cinematographic (cine) MRI is actively used in MR-guided radiotherapy (MRgRT) for tumor motion evaluation, delineation, and tracking. However, most radiotherapy imaging platforms do not support the format of cine MRI from clinical MRI systems. This study developed an institutional solution of clinical cine MRI for tumor motion evaluation in radiotherapy applications.

METHODS: Cine MRI manipulation software (called Cine Viewer) was developed within a commercial Treatment Planning System (TPS). It consists of (1) single/orthogonal viewers, (2) display controllers, (3) measurement grids/markers, and (4) manual contouring tools.

RESULTS: The institutional solution …

Antibiotics For Preventing Recurrent Urinary Tract Infection: Systematic Review And Meta-Analysis, Philipp Jent, Julia Berger, Annette Kuhn, Barbara W Trautner, Andrew Atkinson, Jonas Marschall

2020-Current year OA Pubs

Recurrent urinary tract infections are a common health problem. The only comprehensive synthesis on antibiotic prophylaxis in the last 15 years has been a guideline-embedded meta-analysis. We conducted a systematic review and meta-analysis of randomized controlled trials published up to October 13, 2020, evaluating patients age ≥12 years with either ≥2 episodes of lower urinary tract infection (UTI) within 6 months or ≥3 in the past year. Placebo or antibiotics were allowed as comparators. Study quality was low. In the 11 placebo-controlled trials, the risk for developing UTI was 85% lower with prophylaxis in comparison with placebo (risk ratio [RR], …

Safety Of Onasemnogene Abeparvovec For Patients With Spinal Muscular Atrophy 8.5 Kg Or Heavier In A Global Managed Access Program, Deepa H Chand, Susan Mitchell, Rui Sun, Nicole Lamarca, Sandra P Reyna, Thao Sutter

2020-Current year OA Pubs

BACKGROUND: Spinal muscular atrophy is a rare, neurodegenerative disorder caused by biallelic deletions in the survival motor neuron (SMN1) gene. Onasemnogene abeparvovec is a one-time, intravenous gene replacement therapy designed to deliver the SMN1 transgene. Although available in many geographies, it is not approved globally. The Global Managed Access Program (GMAP) expanded treatment access to patients in countries where treatment was not approved. Previous onasemnogene abeparvovec clinical trials included patients with body weight <8.5 kg. Through GMAP, children weighing ≥8.5 kg received onasemnogene abeparvovec. We describe safety data for heavier patients in GMAP.

METHODS: GMAP records were reviewed to identify patients weighing ≥8.5 kg at onasemnogene abeparvovec dosing. To obtain corresponding adverse event (AE) data, the Novartis ARGUS safety database …

Cd1d Expression Demarcates Cdx4+ Hemogenic Mesoderm With Definitive Hematopoietic Potential, J Philip Creamer, Stephanie A Luff, Hao Yu, Christopher M Sturgeon

2020-Current year OA Pubs

To achieve efficient, reproducible differentiation of human pluripotent stem cells (hPSCs) towards specific hematopoietic cell-types, a comprehensive understanding of the necessary cell signaling and developmental trajectories involved is required. Previous studies have identified the mesodermal progenitors of extra-embryonic-like and intra-embryonic-like hemogenic endothelium (HE), via stage-specific WNT and ACTIVIN/NODAL, with GYPA/GYPB (CD235a/b) expression serving as a positive selection marker for mesoderm harboring exclusively extra-embryonic-like hemogenic potential. However, a positive mesodermal cell-surface marker with exclusively intra-embryonic-like hemogenic potential has not been identified. Recently, we reported that early mesodermal expression of CDX4 critically regulates definitive HE specification, suggesting that CDX4 may act in …

Comparative Effectiveness Of Diversion Of Cerebrospinal Fluid For Children With Severe Traumatic Brain Injury, Michael J Bell, Jose Pineda, Et Al.

2020-Current year OA Pubs

Importance: Diversion of cerebrospinal fluid (CSF) has been used for decades as a treatment for children with severe traumatic brain injury (TBI) and is recommended by evidenced-based guidelines. However, these recommendations are based on limited studies.

Objective: To determine whether CSF diversion is associated with improved Glasgow Outcome Score-Extended for Pediatrics (GOS-EP) and decreased intracranial pressure (ICP) in children with severe TBI.

Design, Setting, and Participants: This observational comparative effectiveness study was performed at 51 clinical centers that routinely care for children with severe TBI in 8 countries (US, United Kingdom, Spain, the Netherlands, Australia, New Zealand, South Africa, and …

Unilateral Loss Of Maxillary Molars In Young Mice Leads To Bilateral Condylar Adaptation And Degenerative Disease., Christopher Phillip Chen, Jiehua Zhang, Bin Zhang, Mohamed G Hassan, Kyle Hane, Caroline C Chen, Ana Alejandra Navarro Palacios, Sunil Kapila, Andrew H Jheon, Alice F Goodwin

2020-Current year OA Pubs

The adaptive response of the mandible and temporomandibular joint (TMJ) to altered occlusion in juvenile patients is presently unclear. To address this question, we established a mouse model in which all molars were extracted from the maxillary right quadrant in prepubertal, 3-week-old mice and analyzed morphological, tissue, cellular, and molecular changes in the mandible and condyle 3 weeks later. Unilateral loss of maxillary molars led to significant, robust, bilateral changes, primarily in condylar morphology, including anteroposterior narrowing of the condylar head and neck and increased convexity at the condylar surface, as determined by geometric morphometric analysis. Furthermore, both condyles in …

Developing Shelf-Stable Microbiota Directed Complementary Food (Mdcf) Prototypes For Malnourished Children: Study Protocol For A Randomized, Single-Blinded, Clinical Study, Ishita Mostafa, Shah Mohammad Fahim, Subhasish Das, Md Amran Gazi, Md Mehedi Hasan, Kazi Nazmus Saqeeb, Mustafa Mahfuz, Hannah B Lynn, Michael J Barratt, Jeffrey I Gordon, Tahmeed Ahmed

2020-Current year OA Pubs

BACKGROUND: Childhood undernutrition is a major public health concern that needs special attention to achieve 2025 global nutrition targets. Moderate acute malnutrition (MAM), manifest as wasting (low weight-for-height), affects 33 million children under 5, yet there are currently no global guidelines for its treatment. We recently performed a randomized-controlled clinical study of a microbiota-directed complementary food formulation (MDCF-2) in 12-18-month-old Bangladeshi children with MAM. The results revealed that MDCF-2, freshly prepared each day, produced a significantly greater improvement in ponderal growth than a standard ready-to-use supplementary food (RUSF), an effect that is associated with repair of the disrupted gut microbial …

Risk Of Early Versus Later Rebleeding From Dural Arteriovenous Fistulas With Cortical Venous Drainage, Andrew J Durnford, Ridhima Guniganti, Akash P Kansagra, Gregory J Zipfel, Et Al

2020-Current year OA Pubs

BACKGROUND: Cranial dural arteriovenous fistulas with cortical venous drainage are rare lesions that can present with hemorrhage. A high rate of rebleeding in the early period following hemorrhage has been reported, but published long-term rates are much lower. No study has examined how risk of rebleeding changes over time. Our objective was to quantify the relative incidence of rebleeding in the early and later periods following hemorrhage.

METHODS: Patients with dural arteriovenous fistula and cortical venous drainage presenting with hemorrhage were identified from the multinational CONDOR (Consortium for Dural Fistula Outcomes Research) database. Natural history follow-up was defined as time …

Onasemnogene Abeparvovec For Presymptomatic Infants With Two Copies Of Smn2 At Risk For Spinal Muscular Atrophy Type 1: The Phase Iii Spr1nt Trial, Kevin A Strauss, Craig M Zaidman, Et Al

2020-Current year OA Pubs

SPR1NT ( NCT03505099 ) was a Phase III, multicenter, single-arm study to investigate the efficacy and safety of onasemnogene abeparvovec for presymptomatic children with biallelic SMN1 mutations treated at ≤6 weeks of life. Here, we report final results for 14 children with two copies of SMN2, expected to develop spinal muscular atrophy (SMA) type 1. Efficacy was compared with a matched Pediatric Neuromuscular Clinical Research natural-history cohort (n = 23). All 14 enrolled infants sat independently for ≥30 seconds at any visit ≤18 months (Bayley-III item #26; P < 0.001; 11 within the normal developmental window). All survived without permanent ventilation at 14 months as per protocol; 13 maintained body weight (≥3rd WHO percentile) through 18 months. No child used nutritional or respiratory support. No serious adverse events were considered related to treatment by the investigator. Onasemnogene abeparvovec was effective and well-tolerated for children expected to develop SMA type 1, highlighting the urgency for universal newborn screening.

Assessment Of Ethno-Racial And Insurance-Based Disparities In Pediatric Forearm And Tibial Fracture Care In The United States, Andrew J Landau, Afolayan K Oladeji, Pooya Hosseinzadeh

2020-Current year OA Pubs

INTRODUCTION: Despite growing attention to healthcare disparities and interventions to improve inequalities, additional identification of disparities is needed, particularly in the pediatric population. We used state and nationwide databases to identify factors associated with the surgical treatment of pediatric forearm and tibial fractures.

METHODS: The Healthcare Cost and Utilization Project State Inpatient, Emergency Department, and Ambulatory Surgery and Services Databases from four US states and the Nationwide Emergency Department Sample database were quarried using International Classification of Diseases codes to identify patients from 2006 to 2015. Multivariable regression models were used to determine factors associated with surgical treatment.

RESULTS: State …

Onasemnogene Abeparvovec For Presymptomatic Infants With Three Copies Of Smn2 At Risk For Spinal Muscular Atrophy: The Phase Iii Spr1nt Trial, Kevin A Strauss, Craig M Zaidman, Et Al

2020-Current year OA Pubs

Most children with biallelic SMN1 deletions and three SMN2 copies develop spinal muscular atrophy (SMA) type 2. SPR1NT ( NCT03505099 ), a Phase III, multicenter, single-arm trial, investigated the efficacy and safety of onasemnogene abeparvovec for presymptomatic children with biallelic SMN1 mutations treated within six postnatal weeks. Of 15 children with three SMN2 copies treated before symptom onset, all stood independently before 24 months (P < 0.0001; 14 within normal developmental window), and 14 walked independently (P < 0.0001; 11 within normal developmental window). All survived without permanent ventilation at 14 months; ten (67%) maintained body weight (≥3rd WHO percentile) without feeding support through 24 months; and none required nutritional or respiratory support. No serious adverse events were considered treatment-related by the investigator. Onasemnogene abeparvovec was effective and well-tolerated for presymptomatic infants at risk of SMA type 2, underscoring the urgency of early identification and intervention.