Digital Commons Network^™

A Pragmatic Machine Learning Model To Predict Carbapenem Resistance, Ryan J Mcguire, Sean C Yu, Philip R O Payne, Albert M Lai, M Cristina Vazquez-Guillamet, Marin H Kollef, Andrew P Michelson

Open Access Publications

Infection caused by carbapenem-resistant (CR) organisms is a rising problem in the United States. While the risk factors for antibiotic resistance are well known, there remains a large need for the early identification of antibiotic-resistant infections. Using machine learning (ML), we sought to develop a prediction model for carbapenem resistance. All patients >18 years of age admitted to a tertiary-care academic medical center between 1 January 2012 and 10 October 2017 with ≥1 bacterial culture were eligible for inclusion. All demographic, medication, vital sign, procedure, laboratory, and culture/sensitivity data were extracted from the electronic health record. Organisms were considered CR …

A Phase 2a Randomized Clinical Trial Of Intravenous Vedolizumab For The Treatment Of Steroid-Refractory Intestinal Acute Graft-Versus-Host Disease, Yngvar Fløisand, Mark A Schroeder, Patrice Chevallier, Dominik Selleslag, Steven Devine, Anne S Renteria, Mohamad Mohty, Ibrahim Yakoub-Agha, Chunlin Chen, Andrejus Parfionovas, Syed Quadri, Johan Jansson, Mona Akbari, Yi-Bin Chen

Open Access Publications

Steroid-refractory (SR) acute graft-versus-host disease (aGvHD) remains a significant complication after allogeneic hematopoietic cell transplantation. Systemic corticosteroids are first-line therapy for aGvHD, but apart from ruxolitinib, there are no approved treatments for SR aGvHD. Vedolizumab is approved for treatment of ulcerative colitis and Crohn's disease, and may be effective for treatment of SR intestinal aGvHD. We conducted a phase 2a trial (NCT02993783) to evaluate the clinical efficacy, tolerability, and safety of vedolizumab 300 and 600 mg for SR intestinal aGvHD. This study was terminated before full enrollment was completed because early results failed to demonstrate positive proof-of-concept in efficacy. Before …

Longitudinal Data Reveal Strong Genetic And Weak Non-Genetic Components Of Ethnicity-Dependent Blood Dna Methylation Levels, Chris Mckennan, Katherine Naughton, Catherine Stanhope, Meyer Kattan, George T O'Connor, Megan T Sandel, Cynthia M Visness, Robert A Wood, Leonard B Bacharier, Avraham Beigelman, Stephanie Lovinsky-Desir, Alkis Togias, James E Gern, Dan Nicolae, Carole Ober

Open Access Publications

Epigenetic architecture is influenced by genetic and environmental factors, but little is known about their relative contributions or longitudinal dynamics. Here, we studied DNA methylation (DNAm) at over 750,000 CpG sites in mononuclear blood cells collected at birth and age 7 from 196 children of primarily self-reported Black and Hispanic ethnicities to study race-associated DNAm patterns. We developed a novel Bayesian method for high-dimensional longitudinal data and showed that race-associated DNAm patterns at birth and age 7 are nearly identical. Additionally, we estimated that up to 51% of all self-reported race-associated CpGs had race-dependent DNAm levels that were mediated through …

A Cardiac Rehabilitation Program For Breast Cancer Survivors: A Feasibility Study, Filadelfiya Zvinovski, Julie A Stephens, Bhuvaneswari Ramaswamy, Raquel E Reinbolt, Anne M Noonan, Jeffrey Bryan Vandeusen, Robert Wesolowski, Daniel G Stover, Nicole Olivia Williams, Sagar D Sardesai, Laxmi Mehta, Randi Foraker, Martha Gulati, Maryam Lustberg, Allison M Quick

Open Access Publications

Purpose: The purpose of this study was to determine the feasibility and preliminary efficacy of a cardiac rehabilitation (CR) intervention in the breast cancer population.

Methods: This single-arm feasibility study evaluated a 14-week CR intervention program in breast cancer survivors. Feasibility was defined as completion of at least 30/36 sessions of the program without serious adverse events (SAE) in 80% of patients. Secondary endpoints included the change in VO2 max, cardiovascular disease (CVD) risk factors, Duke Activity Secondary Index (DASI), Brief Fatigue Inventory (BFI), and QLQ-C30. All outcomes were reported as mean change and compared using paired

Results: A total …

Perilipin 2 Downregulation In Β Cells Impairs Insulin Secretion Under Nutritional Stress And Damages Mitochondria, Akansha Mishra, Chen Kang, Rajan Sah, Et Al.

Open Access Publications

Perilipin 2 (PLIN2) is a lipid droplet (LD) protein in β cells that increases under nutritional stress. Downregulation of PLIN2 is often sufficient to reduce LD accumulation. To determine whether PLIN2 positively or negatively affects β cell function under nutritional stress, PLIN2 was downregulated in mouse β cells, INS1 cells, and human islet cells. β Cell-specific deletion of PLIN2 in mice on a high-fat diet reduced glucose-stimulated insulin secretion (GSIS) in vivo and in vitro. Downregulation of PLIN2 in INS1 cells blunted GSIS after 24-hour incubation with 0.2 mM palmitic acid. Downregulation of PLIN2 in human pseudoislets cultured at 5.6 …

A Microbiota-Directed Food Intervention For Undernourished Children, Robert Y Chen, Matthew C Hibberd, Arjun S Raman, Daniel Webber, Cyrus Zhou, Vinaik Sundaresan, Kazi Ahsan, Martin F Meier, Michael J Barratt, Jeffrey I Gordon, Et Al

Open Access Publications

BACKGROUND: More than 30 million children worldwide have moderate acute malnutrition. Current treatments have limited effectiveness, and much remains unknown about the pathogenesis of this condition. Children with moderate acute malnutrition have perturbed development of their gut microbiota.

METHODS: In this study, we provided a microbiota-directed complementary food prototype (MDCF-2) or a ready-to-use supplementary food (RUSF) to 123 slum-dwelling Bangladeshi children with moderate acute malnutrition between the ages of 12 months and 18 months. The supplementation was given twice daily for 3 months, followed by 1 month of monitoring. We obtained weight-for-length, weight-for-age, and length-for-age z scores and mid-upper-arm circumference …

Adversity Is Linked With Decreased Parent-Child Behavioral And Neural Synchrony, Caroline P Hoyniak, Laura E Quiñones-Camacho, M Catalina Camacho, Jenna H Chin, Elizabeth M Williams, Lauren S Wakschlag, Susan B Perlman

Open Access Publications

Parent-child synchrony-parent-child interaction patterns characterized by contingent social responding, mutual responsivity, and co-regulation-has been robustly associated with adaptive child outcomes. Synchrony has been investigated in both behavioral and biological frameworks. While it has been demonstrated that adversity can influence behavioral parent-child synchrony, the neural mechanisms by which this disruption occurs are understudied. The current study examined the association between adversity, parent-child behavioral synchrony, and parent-child neural synchrony across lateral prefrontal cortical regions using functional near-infrared spectroscopy hyperscanning during a parent-child interaction task that included a mild stress induction followed by a recovery period. Participants included 115 children (ages 4-5) and …

The Epidemiology And Biology Of Pulmonary Metastases, William D Gerull, Varun Puri, Benjamin D Kozower

Open Access Publications

Our goal in this chapter is to explore the complex processes of metastasis and why there is a predisposition for this to occur in the lung. In addition, we aim to describe the incidence of pulmonary metastases in various contexts and based on the origin of the primary tumor. There are unique characteristics of the pulmonary system that make metastases more likely to occur in the lung than anywhere else in the body. Some of these characteristics include receiving the entire cardiac output every minute, having the densest capillary bed in the body, and being the first reservoir of most …

An Open-Source Device For Measuring Food Intake And Operant Behavior In Rodent Home-Cages, Bridget A. Matikainen-Ankney, Thomas Earnest, Eric Casey, Justin G. Wang, Alex A. Legaria, Kia M. Barclay, Makenzie R. Norris, Yu-Hsuan Chang, Eric Lin, Sineadh M. Conway, Ream Al-Hasani, Jordan G. Mccall, Meaghan C. Creed, Alexxai V. Kravitz, Et Al

Open Access Publications

Feeding is critical for survival, and disruption in the mechanisms that govern food intake underlies disorders such as obesity and anorexia nervosa. It is important to understand both food intake and food motivation to reveal mechanisms underlying feeding disorders. Operant behavioral testing can be used to measure the motivational component to feeding, but most food intake monitoring systems do not measure operant behavior. Here, we present a new solution for monitoring both food intake and motivation in rodent home-cages: the Feeding Experimentation Device version 3 (FED3). FED3 measures food intake and operant behavior in rodent home-cages, enabling longitudinal studies of …

Capsule Carbohydrate Structure Determines Virulence In Acinetobacter Baumannii, Yuli Talyansky, Travis B. Nielsen, Jun Yan, Ulrike Carlino-Macdonald, Gisela Di Venanzio, Somnath Chakravorty, Amber Ulhaq, Mario F. Feldman, Thomas A. Russo, Evgeny Vinogradov, Brian Luna, Meredith S. Wright, Mark D. Adams, Brad Spellberg

Open Access Publications

Acinetobacter baumannii is a highly antibiotic-resistant bacterial pathogen for which novel therapeutic approaches are needed. Unfortunately, the drivers of virulence in A. baumannii remain uncertain. By comparing genomes among a panel of A. baumannii strains we identified a specific gene variation in the capsule locus that correlated with altered virulence. While less virulent strains possessed the intact gene gtr6, a hypervirulent clinical isolate contained a spontaneous transposon insertion in the same gene, resulting in the loss of a branchpoint in capsular carbohydrate structure. By constructing isogenic gtr6 mutants, we confirmed that gtr6-disrupted strains were protected from phagocytosis in vitro and …

Designing And Undertaking Randomised Implementation Trials: Guide For Researchers, Luke Wolfenden, Robbie Foy, Justin Presseau, Jeremy Grimshaw, Noah Ivers, Byron Powell, Monica Taljaard, John Wiggers, Rachel Sutherland, Nicole Nathan, Christopher Williams, Melanie Kingsland, Andrew Milat, Rebecca Hodder, Sze Lin Yoong

Open Access Publications

No abstract provided.

Parental Factors Associated With The Decision To Participate In A Neonatal Clinical Trial, Elliott Mark Weiss, Rakesh Rao, Et Al

Open Access Publications

Importance: It remains poorly understood how parents decide whether to enroll a child in a neonatal clinical trial. This is particularly true for parents from racial or ethnic minority populations. Understanding factors associated with enrollment decisions may improve recruitment processes for families, increase enrollment rates, and decrease disparities in research participation.

Objective: To assess differences in parental factors between parents who enrolled their infant and those who declined enrollment for a neonatal randomized clinical trial.

Design, Setting, and Participants: This survey study conducted from July 2017 to October 2019 in 12 US level 3 and 4 neonatal intensive care units …

Tissue Biodistribution And Tumor Targeting Of Near-Infrared Labelled Anti-Cd38 Antibody-Drug Conjugate In Preclinical Multiple Myeloma, Nicholas Cho, Sooah Ko, Monica Shokeen

Open Access Publications

Daratumumab (DARA) is an FDA-approved high-affinity monoclonal antibody targeting CD38 that has shown promising therapeutic efficacy in double refractory multiple myeloma (MM) patients. Despite the well-established clinical efficacy of DARA, not all heavily pretreated patients respond to single-agent DARA, and the majority of patients who initially respond eventually progress. Antibody-drug conjugates (ADCs) combine the highly targeted tumor antigen recognition of antibodies with the cell killing properties of chemotherapy for effective internalization and processing of the drug. In this study, we evaluated the anti-tumor efficacy of DARA conjugated to the maytansine derivative, mertansine (DM1), linked via a non-cleavable bifunctional linker. The …

Disordered Eating, Food Insecurity, And Weight Status Among Transgender And Gender Nonbinary Youth And Young Adults: A Cross-Sectional Study Using A Nutrition Screening Protocol, Whitney R. Linsenmeyer, Ian M. Katz, Jamie L. Reed, Andrea M. Giedinghagen, Christopher B. Lewis, Sarah K. Garwood

Open Access Publications

No abstract provided.

The Utility Of Body Composition Assessment In Nutrition And Clinical Practice: An Overview Of Current Methodology, Clifton J Holmes, Susan B Racette

Open Access Publications

Body composition is a key component for maintaining good general health and longevity. It can be influenced by a variety of factors, including genetics, environment, and lifestyle choices. The assessment of body composition is an essential tool for nutrition specialists to effectively evaluate nutritional status and monitor progression during dietary interventions. As humans age, there is a natural increase in fat mass coupled with a gradual decline in lean mass, specifically in bone and muscle mass. Individuals with a high body fat percentage are at a greater risk of cardiovascular diseases, type 2 diabetes, several types of cancer, and early …

Combined Effect Of Lead Exposure And Allostatic Load On Cardiovascular Disease Mortality-A Preliminary Study, Emmanuel Obeng-Gyasi, Alesia C Ferguson, Katherine A Stamatakis, Michael A Province

Open Access Publications

This study explores the combined effect of lead (Pb) exposure and an index of chronic physiological stress on cardiovascular disease mortality using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2008 linked to 1999-2014 National Death Index data. Chronic physiological stress was measured using the allostatic load (AL) index, which was formed by analyzing markers from the cardiovascular, inflammatory, and metabolic systems, with Pb levels, assessed using blood lead levels (BLL). The dataset was analyzed with statistical techniques to explore (a) the relationship between Pb exposure and AL, and (b) the combined role of Pb and AL on …

Cd16+Cd163+ Monocytes Traffic To Sites Of Inflammation During Necrotizing Enterocolitis In Premature Infants, Oluwabunmi O. Olaloye, Misty Good, Et Al

Open Access Publications

Necrotizing enterocolitis (NEC) is a severe gastrointestinal complication of prematurity. Using suspension and imaging mass cytometry coupled with single-cell RNA sequencing, we demonstrate severe inflammation in patients with NEC. NEC mucosa could be subtyped by an influx of three distinct neutrophil phenotypes (immature, newly emigrated, and aged). Furthermore, CD16+CD163+ monocytes/Mϕ, correlated with newly emigrated neutrophils, were specifically enriched in NEC mucosa, found adjacent to the blood vessels, and increased in circulation of infants with surgical NEC, suggesting trafficking from the periphery to areas of inflammation. NEC-specific monocytes/Mϕ transcribed inflammatory genes, including TREM1, IL1A, IL1B, and calprotectin, and neutrophil recruitment genes …

Genetic Association Study Of Childhood Aggression Across Raters, Instruments, And Age, Hill F. Ip, Andrew C. Heath, Pamela Madden, Et Al.

Open Access Publications

No abstract provided.

Report From The 6th International Meeting On Bone Marrow Adiposity (Bma2020), Erica L Scheller, Meghan E Mcgee-Lawrence, Beata Lecka-Czernik

Open Access Publications

The 6

Sleep-Disordered Breathing In Pregnancy: A Developmental Origin Of Offspring Obesity?, Sarah S Farabi, Linda A Barbour, Teri L Hernandez

Open Access Publications

Sleep-disordered breathing (SDB) worsens over pregnancy, and obstructive sleep apnea is associated with serious maternal complications. Intrauterine exposures that provoke insulin resistance (IR), inflammation, or oxidative stress may have long-term offspring health consequences. In obesity, worsening maternal SDB appears to be an exposure that increases the risk for both small- or large-for-gestational-age (SGA, LGA, respectively), suggesting distinct outcomes linked to a common maternal phenotype. The aim of this paper is to systematically review and link data from both mechanistic rodent models and descriptive human studies to characterize the impact of maternal SDB on fetal development. A systematic review of the …

A Two-Hit Model Of Alcoholic Liver Disease That Exhibits Rapid, Severe Fibrosis, Monideepa Sengupta, Suomia Abuirqeba, Amina Kameric, Aurore Cecile-Valfort, Arindam Chatterjee, Kristine Griffett, Thomas P. Burris, Colin A. Flaveny

Open Access Publications

Alcoholic liver disease (ALD) is responsible for an average of 50.4% and 44.2%of liver disease deaths among males and females respectively. Driven by alcohol misuse, ALD is often reversible by cessation of consumption. However, abstinence programs can have limited success at curtailing abuse, and the loss of life. ALD, therefore, remains a significant clinical challenge. There is a need for effective treatments that prevent or reverse alcohol-induced liver damage to complement or supplant behavioral interventions. Metabolic syndrome, which is disproportionally prevalent in ALD patients, accelerates the progression of ALD and increases liver disease mortality. Current rodent models of ALD unfortunately …

Sex-Dimorphic Genetic Effects And Novel Loci For Fasting Glucose And Insulin Variability, Vasiliki Lagou, Ping An, Michael A. Province, Et Al.

Open Access Publications

No abstract provided.

Follow The Metaplasia: Characteristics And Oncogenic Implications Of Metaplasia's Pattern Of Spread Throughout The Stomach, José B Sáenz

Open Access Publications

The human stomach functions as both a digestive and innate immune organ. Its main product, acid, rapidly breaks down ingested products and equally serves as a highly effective microbial filter. The gastric epithelium has evolved mechanisms to appropriately handle the myriad of injurious substances, both exogenous and endogenous, to maintain the epithelial barrier and restore homeostasis. The most significant chronic insult that the stomach must face is

Harnessing The Potential Of Multiomics Studies For Precision Medicine In Infectious Disease, Rebecca A. Ward, Philip A. Mudd, Rachel M. Presti, Andrej Spec, Et Al

Open Access Publications

The field of infectious diseases currently takes a reactive approach and treats infections as they present in patients. Although certain populations are known to be at greater risk of developing infection (eg, immunocompromised), we lack a systems approach to define the true risk of future infection for a patient. Guided by impressive gains in "omics" technologies, future strategies to infectious diseases should take a precision approach to infection through identification of patients at intermediate and high-risk of infection and deploy targeted preventative measures (ie, prophylaxis). The advances of high-throughput immune profiling by multiomics approaches (ie, transcriptomics, epigenomics, metabolomics, proteomics) hold …

Monitoring The Variation In The Gut Microbiota Of Captive Woolly Monkeys Related To Changes In Diet During A Reintroduction Process, Camilo Quiroga-González, Luis Alberto Chica Cardenas, Mónica Ramírez, Alejandro Reyes, Camila González, Pablo R. Stevenson

Open Access Publications

No abstract provided.

A Novel Precision Approach To Overcome The "Addiction Pandemic" By Incorporating Genetic Addiction Risk Severity (Gars) And Dopamine Homeostasis Restoration, Kenneth Blum, Shan Kazmi, Edward J Modestino, Bill William Downs, Debasis Bagchi, David Baron, Thomas Mclaughlin, Richard Green, Rehan Jalali, Panayotis K Thanos, Igor Elman, Rajendra D Badgaiyan, Abdalla Bowirrat, Mark S Gold

Open Access Publications

This article describes a unique therapeutic precision intervention, a formulation of enkephalinase inhibitors, enkephalin, and dopamine-releasing neuronutrients, to induce dopamine homeostasis for detoxification and treatment of individuals genetically predisposed to developing reward deficiency syndrome (RDS). The formulations are based on the results of the addiction risk severity (GARS) test. Based on both neurogenetic and epigenetic evidence, the test evaluates the presence of reward genes and risk alleles. Existing evidence demonstrates that the novel genetic risk testing system can successfully stratify the potential for developing opioid use disorder (OUD) related risks or before initiating opioid analgesic therapy and RDS risk for …

Universal School Meals And Associations With Student Participation, Attendance, Academic Performance, Diet Quality, Food Security, And Body Mass Index: A Systematic Review, Juliana F W Cohen, Amelie A Hecht, Gabriella M Mcloughlin, Lindsey Turner, Marlene B Schwartz

Open Access Publications

The school environment plays an important role in children's diets and overall health, and policies for universal free school meals have the potential to contribute to positive child health outcomes. This systematic review evaluates studies examining the association between universal free school meals and students' school meal participation rates, diets, attendance, academic performance, and Body Mass Index (BMI), as well as school finances. The search was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). A search for studies published in economically developed countries published through December 2020 was performed in PubMed, Education Resources Information …

Cannabis-Induced Hypodopaminergic Anhedonia And Cognitive Decline In Humans: Embracing Putative Induction Of Dopamine Homeostasis, Kenneth Blum, Jag Khalsa, Jean Lud Cadet, David Baron, Abdalla Bowirrat, Brent Boyett, Lisa Lott, Raymond Brewer, Marjorie Gondré-Lewis, Gregory Bunt, Shan Kazmi, Mark S Gold

Open Access Publications

Over years, the regular use of cannabis has substantially increased among young adults, as indicated by the rise in cannabis use disorder (CUD), with an estimated prevalence of 8. 3% in the United States. Research shows that exposure to cannabis is associated with hypodopaminergic anhedonia (depression), cognitive decline, poor memory, inattention, impaired learning performance, reduced dopamine brain response-associated emotionality, and increased addiction severity in young adults. The addiction medicine community is increasing concern because of the high content of delta-9-tetrahydrocannabinol (THC) currently found in oral and vaping cannabis products, the cognitive effects of cannabis may become more pronounced in young …

Predicting Outcomes In Patients Undergoing Pancreatectomy Using Wearable Technology And Machine Learning: Prospective Cohort Study, Heidy Cos, Dingwen Li, Gregory Williams, Jeffrey Chininis, Ruixuan Dai, Jingwen Zhang, Rohit Srivastava, Lacey Raper, Dominic Sanford, William Hawkins, Chenyang Lu, Chet W Hammill

Open Access Publications

BACKGROUND: Pancreatic cancer is the third leading cause of cancer-related deaths, and although pancreatectomy is currently the only curative treatment, it is associated with significant morbidity.

OBJECTIVE: The objective of this study was to evaluate the utility of wearable telemonitoring technologies to predict treatment outcomes using patient activity metrics and machine learning.

METHODS: In this prospective, single-center, single-cohort study, patients scheduled for pancreatectomy were provided with a wearable telemonitoring device to be worn prior to surgery. Patient clinical data were collected and all patients were evaluated using the American College of Surgeons National Surgical Quality Improvement Program surgical risk calculator …

Whipworm-Associated Intestinal Microbiome Members Consistent Across Both Human And Mouse Hosts, Bruce A Rosa, Caroline Snowden, John Martin, Kerstin Fischer, Jonah Kupritz, Ethiopia Beshah, Taniawati Supali, Lincoln Gankpala, Peter U Fischer, Joseph F Urban, Makedonka Mitreva

Open Access Publications

The human whipworm