Digital Commons Network^™

Evolution Of Genetic Networks For Human Creativity, I Zwir, C Del-Val, C R Cloninger, Et Al

Open Access Publications

The genetic basis for the emergence of creativity in modern humans remains a mystery despite sequencing the genomes of chimpanzees and Neanderthals, our closest hominid relatives. Data-driven methods allowed us to uncover networks of genes distinguishing the three major systems of modern human personality and adaptability: emotional reactivity, self-control, and self-awareness. Now we have identified which of these genes are present in chimpanzees and Neanderthals. We replicated our findings in separate analyses of three high-coverage genomes of Neanderthals. We found that Neanderthals had nearly the same genes for emotional reactivity as chimpanzees, and they were intermediate between modern humans and …

Psychosocial Syndemics And Multimorbidity In Patients With Heart Failure, Kenneth E Freedland, Judith A Skala, Robert M Carney, Brian C Steinmeyer, Michael W Rich

Open Access Publications

Heart failure (HF) is a common cause of hospitalization and mortality in older adults. HF is almost always embedded within a larger pattern of multimorbidity, yet many studies exclude patients with complex psychiatric and medical comorbidities or cognitive impairment. This has left significant gaps in research on the problems and treatment of patients with HF. In addition, HF is only one of multiple challenges facing patients with multimorbidity, stressful socioeconomic circumstances, and psychosocial problems. The purpose of this study is to identify combinations of comorbidities and health disparities that may affect HF outcomes and require different mixtures of medical, psychological, …

Shock In The Setting Of Diamond-Blackfan Anemia Relapse, Metri Haddaden, Samir Husami, Modar Alom, Yifan Pang, Zaid Imam, Daniel Keena

Open Access Publications

Adult intensivists have increasing exposure to individuals with congenital diseases surviving into adulthood. Solid knowledge bases and early recognition of the possible sequelae of congenital disorders are crucial in caring for these patients. We present a challenging case of shock and relapse of Diamond-Blackfan anemia in a 42-year-old man lost to follow-up for 18 years and highlighted the importance of healthcare transitions into adulthood and the challenges faced by health care systems to develop new strategies successfully transitioning complex pediatric patients to adult care.

Evidence For Dissociable Cognitive And Neural Pathways From Poverty Versus Maltreatment To Deficits In Emotion Regulation, Nourhan M Elsayed, Brent I Rappaport, Joan L. Luby, Deanna M Barch

Open Access Publications

Poverty and threat exposure (TE) predict deficits in emotion regulation (ER). Effective cognitive ER (i.e., reappraisal) may be supported by: (1) cognitive processes implicated in generating and implementing cognitive reappraisal, supported by activation in brain regions involved in cognitive control (e.g., frontal, insular, and parietal cortices) and (2) emotion processing and reactivity, involving identification, encoding, and maintenance of emotional states and related variation in brain activity of regions involved in emotional reactivity (i.e., amygdala). Poverty is associated with deficits in cognitive control, and TE with alterations in emotion processing and reactivity. Our goal was to identify dissociable emotional and cognitive …

Membrane Transporter Dimerization Driven By Differential Lipid Solvation Energetics Of Dissociated And Associated States, Rahul Chadda, Nathan Bernhardt, Elizabeth G. Kelley, Susana C.M. Teixeira, Kacie Griffith, Alejandro Gil-Ley, Tuğba N. Öztürk, Lauren E. Hughes, Ana Forsythe, Venkatramanan Krishnamani, José D. Faraldo-Gómez, Janice L. Robertson

Open Access Publications

Over two-thirds of integral membrane proteins of known structure assemble into oligomers. Yet, the forces that drive the association of these proteins remain to be delineated, as the lipid bilayer is a solvent environment that is both structurally and chemically complex. In this study, we reveal how the lipid solvent defines the dimerization equilibrium of the CLC-ec1 Cl

Genomic Context Differs Between Human Dilated Cardiomyopathy And Hypertrophic Cardiomyopathy, Megan J Puckelwartz, Gerald W Dorn Ii, Et Al

Open Access Publications

Background Inherited cardiomyopathies display variable penetrance and expression, and a component of phenotypic variation is genetically determined. To evaluate the genetic contribution to this variable expression, we compared protein coding variation in the genomes of those with hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM). Methods and Results Nonsynonymous single-nucleotide variants (nsSNVs) were ascertained using whole genome sequencing from familial cases of HCM (n=56) or DCM (n=70) and correlated with echocardiographic information. Focusing on nsSNVs in 102 genes linked to inherited cardiomyopathies, we correlated the number of nsSNVs per person with left ventricular measurements. Principal component analysis and generalized linear models …

Sex And Race-Ethnic Disparities In Door-To-Ct Time In Acute Ischemic Stroke: The Florida Stroke Registry, Sai P Polineni, Enmanuel J Perez, Kefeng Wang, Carolina M Gutierrez, Jeffrey Walker, Dianne Foster, Chuanhui Dong, Negar Asdaghi, Jose G Romano, Ralph L Sacco, Tatjana Rundek, Florida Stroke Registry

Open Access Publications

Background Less than 40% of acute stroke patients have computed tomography (CT) imaging performed within 25 minutes of hospital arrival. We aimed to examine the race-ethnic and sex differences in door-to-CT (DTCT) ≤25 minutes in the FSR (Florida Stroke Registry). Methods and Results Data were collected from 2010 to 2018 for 63 265 patients with acute ischemic stroke from the FSR and secondary analysis was performed on 15 877 patients with intravenous tissue plasminogen activator-treated ischemic stroke. Generalized estimating equation models were used to determine predictors of DTCT ≤25. DTCT ≤25 was achieved in 56% of cases of suspected acute …

Idiopathic Non-Cirrhotic Portal Hypertension And Porto-Sinusoidal Vascular Disease: Review Of Current Data, Michel Kmeid, Xiuli Liu, Samuel Ballentine, Hwajeong Lee

Open Access Publications

Idiopathic non-cirrhotic portal hypertension (INCPH) is a clinicopathologic disease entity characterized by the presence of clinical signs and symptoms of portal hypertension (PH) in the absence of liver cirrhosis or known risk factors accountable for PH. Multiple hematologic, immune-related, infectious, hereditary and metabolic risk factors have been associated with this disorder. Still, the exact etiopathogenesis is largely unknown. The recently proposed porto-sinusoidal vascular disease (PSVD) scheme broadens the spectrum of the disease by also including patients without clinical PH who are found to have similar histopathologic findings on core liver biopsies. Three histomorphologic lesions have been identified as specific for …

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 …

A Clinician’S Guide For Navigating The World Of Attention Deficit Hyperactivity Disorder Medications, Gregory W. Mattingly, Joel Young

Open Access Publications

No abstract provided.

Ambient Fine Particulate Matter Air Pollution And Risk Of Weight Gain And Obesity In United States Veterans: An Observational Cohort Study, Benjamin Bowe, Andrew K. Gibson, Yan Xie, Yan Yan, Aaron Van Donkelaar, Randall V. Martin, Ziyad Al-Aly

Open Access Publications

BACKGROUND: Experimental evidence and studies of children and adolescents suggest that ambient fine particulate matter [particulate matter

OBJECTIVES: Our goal was to characterize the association between

METHODS: We followed 3,902,440 U.S. Veterans from 2010 to 2018 (median 8.1 y, interquartile range: 7.3-8.4) and assigned time-updated

RESULTS: A

DISCUSSION:

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 …

Multimodal Examination Of Emotion Processing Systems Associated With Negative Affectivity Across Early Childhood, M Catalina Camacho, Elizabeth M Williams, Keya Ding, Susan B Perlman

Open Access Publications

High Temperamental Negative Affectivity in early childhood has been found to predict later emotion dysregulation. While much work has been conducted to separately probe bio-behavioral systems associated with Negative Affectivity, very little work has examined the relations among multiple systems across age. In this study, we use multi-modal methods to index neurobiological systems associated with Negative Affectivity in 53 4-7-year-old children. Prefrontal activation during emotion regulation was measured using functional near-infrared spectroscopy over the lateral prefrontal cortex (PFC) while children played a game designed to elicit frustration in Social (Happy and Angry faces) and Nonsocial contexts. Gaze behaviors while free-viewing …

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 …

Evaluating The Rapid Emergence Of Daptomycin Resistance In Corynebacterium: A Multicenter Study, Kaitlin F Mitchell, Erin Mcelvania, Meghan A Wallace, Lauren E Droske, Amy E Robertson, Lars F Westblade, Carey-Ann D. Burnham

Open Access Publications

Members of the genus

Parabrachial Opioidergic Projections To Preoptic Hypothalamus Mediate Behavioral And Physiological Thermal Defenses, Aaron J. Norris, Jordan R. Shaker, Aaron L. Cone, Imeh B. Ndiokho, Michael R. Bruchas

Open Access Publications

Maintaining stable body temperature through environmental thermal stressors requires detection of temperature changes, relay of information, and coordination of physiological and behavioral responses. Studies have implicated areas in the preoptic area of the hypothalamus (POA) and the parabrachial nucleus (PBN) as nodes in the thermosensory neural circuitry and indicate that the opioid system within the POA is vital in regulating body temperature. In the present study we identify neurons projecting to the POA from PBN expressing the opioid peptides dynorphin and enkephalin. Using mouse models, we determine that warm-activated PBN neuronal populations overlap with both prodynorphin (Pdyn) and proenkephalin (Penk) …

Coding Of Sexual Assault By Emergency Physicians: A Nationally Representative Study, Vithya Murugan, Katherine J Holzer, Michael G Vaughn, Jason T Carbone, Dylan B Jackson, Cindy C Bitter

Open Access Publications

INTRODUCTION: Sexual assault is a public health problem that affects many Americans and has multiple long-lasting effects on victims. Medical evaluation after sexual assault frequently occurs in the emergency department, and documentation of the visit plays a significant role in decisions regarding prosecution and outcomes of legal cases against perpetrators. The American College of Emergency Physicians recommends coding such visits as sexual assault rather than adding modifiers such as "alleged."

METHODS: This study reviews factors associated with coding of visits as sexual assault compared to suspected sexual assault using the 2016 Nationwide Emergency Department Sample.

RESULTS: Younger age, female gender, …

Bidirectional Regulation Of Glial Potassium Buffering - Glioprotection Versus Neuroprotection, Hailun Li, Lorenzo Lones, Aaron Diantonio

Open Access Publications

Glia modulate neuronal excitability and seizure sensitivity by maintaining potassium and water homeostasis. A salt inducible kinase 3 (SIK3)-regulated gene expression program controls the glial capacity to buffer K

Norovirus Evolution In Immunodeficient Mice Reveals Potentiated Pathogenicity Via A Single Nucleotide Change In The Viral Capsid, Forrest C Walker, Ebrahim Hassan, Stefan T. Peterson, Rachel Rodgers, Lawrence A. Schriefer, Cassandra E. Thompson, Yuhao Li, Gowri Kalugotla, Carla Blum-Johnston, Dylan Lawrence, Broc T. Mccune, Vincent R. Graziano, Larissa Lushniak, Sanghyun Lee, Alexa N. Roth, Stephanie M. Karst, Timothy J. Nice, Jonathan J. Miner, Craig B. Wilen, Megan T. Baldridge

Open Access Publications

Interferons (IFNs) are key controllers of viral replication, with intact IFN responses suppressing virus growth and spread. Using the murine norovirus (MNoV) system, we show that IFNs exert selective pressure to limit the pathogenic evolutionary potential of this enteric virus. In animals lacking type I IFN signaling, the nonlethal MNoV strain CR6 rapidly acquired enhanced virulence via conversion of a single nucleotide. This nucleotide change resulted in amino acid substitution F514I in the viral capsid, which led to >10,000-fold higher replication in systemic organs including the brain. Pathogenicity was mediated by enhanced recruitment and infection of intestinal myeloid cells and …

Association Of Early Versus Delayed Normalisation Of Left Ventricular Ejection Fraction With Mortality In Ischemic Cardiomyopathy, Walter B Schiffer, Andrew Perry, Elena Deych, David L Brown, Luigi Adamo

Open Access Publications

OBJECTIVE: In patients with non-ischaemic cardiomyopathy and reduced left ventricular ejection fraction (LVEF), normalisation of LVEF is associated with improved outcomes. However, data on patients with ischaemic cardiomyopathy and recovered LVEF are lacking. The goal of this study was to assess the prognostic significance of normalisation of the LVEF in patients with ischaemic cardiomyopathy.

METHODS/RESULTS: We performed a non-prespecified post hoc analysis of the Surgical Treatment for Ischaemic Heart Failure (STICH) trial to determine the association between normalisation of LVEF (>50%) and mortality during follow-up. Of the 1212 patients with LVEF <35% enroled in the STICH trial, 932 underwent assessment of LVEF at 4 months and/or 2 years after enrolment. Among them, 18 patients experienced normalisation in LVEF at 4-month follow-up and 35 patients experienced recovery in LVEF at 2 years. Recovery of LVEF at 4 months and recovery of LVEF at 2 years were not correlated. Recovery of LVEF at 4 months was not associated with reduced all-cause mortality in unadjusted analysis (log-rank test p=0.54) or in Cox proportional hazards analysis (HR: 0.93; 95% CI: 0.48 to 1.80; p=0.82). Ejection fraction recovery at 2 years was associated with a reduction in all-cause mortality, both in unadjusted analysis (log-rank test p=0.004) and in the Cox proportional hazard model (HR: 0.41; 95% CI: 0.21 to 0.80; p=0.009).

CONCLUSIONS: In patients with ischaemic cardiomyopathy, delayed normalisation …

Not All Lymphoid Aggregates In Chronic Lymphocytic Leukemia (Cll) Patients Are Due To Cll!, Lily Mahapatra, Tianjiao Wang, Yi-Shan Lee, John L Frater

Open Access Publications

Infection is a common cause of morbidity and mortality in chronic lymphocytic leukemia and should be considered when examining bone marrow specimens to identify a potentially treatable pathogen.

Racial Residential Segregation And Colorectal Cancer Mortality In The Mississippi Delta Region, Aaron J Kruse-Diehr, Justin T Mcdaniel, Marquita W Lewis-Thames, Aimee S James, Musa Yahaya

Open Access Publications

INTRODUCTION: Few studies have examined the effects of racial segregation on colorectal cancer (CRC) outcomes, and none has determined whether rurality moderates the effect of racial segregation on CRC mortality. We examined whether the effect of segregation on CRC mortality varied by rurality in the Mississippi Delta Region, an economically distressed and historically segregated region of the United States.

METHODS: We used data from the US Census Bureau and the 1999-2018 Surveillance, Epidemiology, and End Results (SEER) program to estimate mixed linear regression models in which CRC mortality rates among Black and White residents in Delta Region counties (N = …

Evaluation Of Optimal Blood Culture Incubation Time To Maximize Clinically Relevant Results From A Contemporary Blood Culture Instrument And Media System, Eric M Ransom, Zahra Alipour, Meghan A Wallace, Carey-Ann D. Burnham

Open Access Publications

Timely diagnosis of microorganisms in blood cultures is necessary to optimize therapy. Although blood culture media and systems have evolved for decades, the standard interval for incubation prior to being discarded as negative has remained 5 days. Here, we evaluated the optimal incubation time for the BacT/Alert Virtuo blood culture detection system (bioMérieux) using FA Plus (aerobic) and FN Plus (anaerobic) resin culture bottles in routine clinical use. Following institutional review board (IRB) approval, a retrospective review evaluated the outcomes of 158,710 bottles collected between November 2018 and October 2019. The number of positive blood bottles was 13,592 (8.6%); 99% …

Transcriptomic And Functional Analyses Of Mitochondrial Dysfunction In Pressure Overload-Induced Right Ventricular Failure, Hyuntae V Hwang, Nefthi Sandeep, Ramesh V Nair, Dong-Qing Hu, Mingming Zhao, Ingrid S Lan, Giovanni Fajardo, Scot J Matkovich, Daniel Bernstein, Sushma Reddy

Open Access Publications

Background In complex congenital heart disease patients such as those with tetralogy of Fallot, the right ventricle (RV) is subject to pressure overload, leading to RV hypertrophy and eventually RV failure. The mechanisms that promote the transition from stable RV hypertrophy to RV failure are unknown. We evaluated the role of mitochondrial bioenergetics in the development of RV failure. Methods and Results We created a murine model of RV pressure overload by pulmonary artery banding and compared with sham-operated controls. Gene expression by RNA-sequencing, oxidative stress, mitochondrial respiration, dynamics, and structure were assessed in pressure overload-induced RV failure. RV failure …

Reg4 And Its Downstream Transcriptional Activator Cd44icd In Stage Ii And Iii Colorectal Cancer, Jared A. Sninsky, Kumar S. Bishnupuri, Iván González, Nikolaos A. Trikalinos, Ling Chen, Brian K. Dieckgraefe

Open Access Publications

Reg4 is highly expressed in gastrointestinal malignancies and acts as a mitogenic and pro-invasive factor. Our recent works suggest that Reg4 binds with CD44 and induces its proteolytic cleavage to release intra-cytoplasmic domain of CD44 (CD44ICD). The goal of this study is to demonstrate clinical significance of the Reg4-CD44/CD44ICD pathway in stage II/III colon cancer and its association with clinical parameters of aggression. We constructed a tissue microarray (TMA) of 93 stage II/III matched colon adenocarcinoma patients, 23 with recurrent disease. The TMA was immunohistochemically stained for Reg4, CD44, and CD44ICD proteins and analyzed to identify associations with tumor characteristics, …

Hippocampus Guides Adaptive Learning During Dynamic Social Interactions, Oriel Feldmanhall, David F. Montez, Elizabeth A. Phelps, Lila Davachi, Vishnu P. Murty

Open Access Publications

How do we evaluate whether someone will make a good friend or collaborative peer? A hallmark of human cognition is the ability to make adaptive decisions based on information garnered from limited prior experiences. Using an interactive social task measuring adaptive choice (deciding who to reengage or avoid) in male and female participants, we find the hippocampus supports value-based social choices following single-shot learning. These adaptive choices elicited a suppression signal in the hippocampus, revealing sensitivity for the subjective perception of a person and how well they treat you during choice. The extent to which the hippocampus was suppressed was …

Treatment Of Patients With Chronic Pruritus Of Unknown Origin With Dupilumab, Jiehyun Jeon, Fang Wang, Asima Badic, Brian S Kim

Open Access Publications

BACKGROUND: Chronic pruritus of unknown origin (CPUO) is a highly debilitating disease that lacks effective treatments. This study explores a new therapeutic strategy with dupilumab.

OBJECTIVES: To examine whether patients with CPUO demonstrate clinical response to dupilumab.

PATIENTS AND METHODS: This is a retrospective case series examining all patients with CPUO who were treated with dupilumab from March 2017 to December 2019 at a tertiary referral clinic at Washington University School of Medicine in St. Louis, MO. Numerical rating scale (NRS) itch score changes over time were recorded and analyzed.

RESULTS: Fifteen patients (67% women; mean [SD] age, 68.7 [12.6] …

Controlling Opioid Receptor Functional Selectivity By Targeting Distinct Subpockets Of The Orthosteric Site, Rajendra Uprety, Tao Che, Balázs R. Varga, Abdelfattah Faouzi, Sarah M. Bernhard, Susruta Majumdar, Et Al

Open Access Publications

Controlling receptor functional selectivity profiles for opioid receptors is a promising approach for discovering safer analgesics; however, the structural determinants conferring functional selectivity are not well understood. Here, we used crystal structures of opioid receptors, including the recently solved active state kappa opioid complex with

Sympathetic Stimulation Increases Serum Lactate Concentrations In Patients Admitted With Sepsis: Implications For Resuscitation Strategies, Nikhil Jagan, Lee E Morrow, Ryan W Walters, Robert W Plambeck, Tej M Patel, Douglas R Moore, Mark A Malesker

Open Access Publications

BACKGROUND: Diametrically opposed positions exist regarding the deleterious effects of elevated lactate. There are data suggesting that it is a detrimental proxy for tissue hypoperfusion and anaerobic metabolism in sepsis and an alternative viewpoint is that some of the hyperlactatemia produced maybe adaptive. This study was conducted to explore the relationship between serum lactate levels, mean arterial blood pressure (MAP), and sympathetic stimulation in patients with sepsis.

METHODS: Retrospective analysis of prospectively collected clinical data from four community-based hospitals and one academic medical center. 8173 adults were included. Heart rate (HR) was used as a surrogate marker of sympathetic stimulation. …

Gut Helicobacter Presentation By Multiple Dendritic Cell Subsets Enables Context-Specific Regulatory T Cell Generation, Emilie V. Russler-Germain, Jaeu Yi, Shannon Young, Katherine Nutsch, Harikesh S. Wong, Teresa L. Ai, Jiani N. Chai, Vivek Durai, Daniel H. Kaplan, Ronald N. Germain, Kenneth M. Murphy, Chyi-Song Hsieh

Open Access Publications

Generation of tolerogenic peripheral regulatory T (pTreg) cells is commonly thought to involve CD103