Medicine and Health Sciences Commons^™

Evolution Of Telehealth-Its Impact On Palliative Care And Medication Management, Syed N Imam, Ursula K Braun, Mary A Garcia, Leanne K Jackson

Center for Medical Ethics and Health Policy Staff Publications

Palliative care plays a crucial role in enhancing the quality of life for individuals facing serious illnesses, aiming to alleviate suffering and provide holistic support. With the advent of telehealth, there is a growing interest in leveraging technology to extend the reach and effectiveness of palliative care services. This article provides a comprehensive review of the evolution of telehealth, the current state of telemedicine in palliative care, and the role of telepharmacy and medication management. Herein we highlight the potential benefits, challenges, and future directions of palliative telemedicine. As the field continues to advance, the article proposes key considerations for …

Identification Of Colorectal Cancer Cell Stemness From Single-Cell Rna Sequencing, Kangyu Lin, Saikat Chowdhury, Mohammad A Zeineddine, Fadl A Zeineddine, Nicholas J Hornstein, Dipen M Maru, Jean-Nicolas Vauthey, George J Chang, Elena Bogatenkova, David Menter, Scott Kopetz, John Paul Shen

Faculty, Staff and Student Publications

UNLABELLED: Cancer stem cells (CSC) play a critical role in metastasis, relapse, and therapy resistance in colorectal cancer. While characterization of the normal lineage of cell development in the intestine has led to the identification of many genes involved in the induction and maintenance of pluripotency, recent studies suggest significant heterogeneity in CSC populations. Moreover, while many canonical colorectal cancer CSC marker genes have been identified, the ability to use these classical markers to annotate stemness at the single-cell level is limited. In this study, we performed single-cell RNA sequencing on a cohort of 6 primary colon, 9 liver metastatic …

Targeting Branched N-Glycans And Fucosylation Sensitizes Ovarian Tumors To Immune Checkpoint Blockade, Hao Nie, Pratima Saini, Taito Miyamoto, Liping Liao, Rafal J Zielinski, Wei Zhou, Brennah Murphy, Martina Towers, Tyler Yang, Yuan Qi, Toshitha Kannan, Andrew Kossenkov, Hiroaki Tateno, Daniel T Claiborne, Nan Zhang, Mohamed Abdel-Mohsen, Rugang Zhang

Faculty, Staff and Student Publications

Aberrant glycosylation is a crucial strategy employed by cancer cells to evade cellular immunity. However, it's unclear whether homologous recombination (HR) status-dependent glycosylation can be therapeutically explored. Here, we show that the inhibition of branched N-glycans sensitizes HR-proficient, but not HR-deficient, epithelial ovarian cancers (EOCs) to immune checkpoint blockade (ICB). In contrast to fucosylation whose inhibition sensitizes EOCs to anti-PD-L1 immunotherapy regardless of HR-status, we observe an enrichment of branched N-glycans on HR-proficient compared to HR-deficient EOCs. Mechanistically, BRCA1/2 transcriptionally promotes the expression of MGAT5, the enzyme responsible for catalyzing branched N-glycans. The branched N-glycans on HR-proficient tumors augment their …

Ai Is A Viable Alternative To High Throughput Screening: A 318-Target Study, The Atomwise Aims Program

Faculty, Staff and Student Publications

High throughput screening (HTS) is routinely used to identify bioactive small molecules. This requires physical compounds, which limits coverage of accessible chemical space. Computational approaches combined with vast on-demand chemical libraries can access far greater chemical space, provided that the predictive accuracy is sufficient to identify useful molecules. Through the largest and most diverse virtual HTS campaign reported to date, comprising 318 individual projects, we demonstrate that our AtomNet® convolutional neural network successfully finds novel hits across every major therapeutic area and protein class. We address historical limitations of computational screening by demonstrating success for target proteins without known binders, …

Peritoneal Microenvironment Promotes Appendiceal Adenocarcinoma Growth: A Multi-Omics Approach Using Patient-Derived Xenografts, Vinay K Pattalachinti, Ichiaki Ito, Saikat Chowdhury, Abdelrahman Yousef, Yue Gu, Emma R Salle, Keith Fournier, Natalie W Fowlkes, John Paul Shen

Faculty, Staff and Student Publications

Appendiceal adenocarcinoma (AA) is unique from other gastrointestinal malignancies in that it almost exclusively metastasizes to the peritoneal cavity. However, few studies have investigated the molecular interaction of the peritoneal microenvironment and AA. Here, we use a multi-omics approach with orthotopic and flank-implanted patient-derived xenografts (PDX) to study the effect of the peritoneal microenvironment on AA. AA tumors implanted in the peritoneal microenvironment tended to grow faster and displayed greater nuclear expression of Ki-67 relative to the same tumors implanted in the flank. Comparing the tumor-specific transcriptome (excluding stromal transcription), the peritoneal microenvironment relatively upregulated genes related to proliferation, including …

Antigen-Clustered Nanovaccine Achieves Long-Term Tumor Remission By Promoting B/Cd 4 T Cell Crosstalk, Chengyi Li, Ryan Clauson, Luke F Bugada, Fang Ke, Bing He, Hongwei Chen, Hongxiang Hu, Polina Chuikov, Brett Dallas Hill, Syed M Rizvi, Yudong Song, Kai Sun, Pasieka Axenov, Daniel Huynh, Xinyi Wang, Lana Garmire, Yu Leo Lei, Irina Grigorova, Fei Wen, Marilia Cascalho, Wei Gao, Duxin Sun

Faculty, Staff and Student Publications

Current cancer vaccines using T cell epitopes activate antitumor T cell immunity through dendritic cell/macrophage-mediated antigen presentation, but they lack the ability to promote B/CD4 T cell crosstalk, limiting their anticancer efficacy. We developed antigen-clustered nanovaccine (ACNVax) to achieve long-term tumor remission by promoting B/CD4 T cell crosstalk. The topographic features of ACNVax were achieved using an iron nanoparticle core attached with an optimal number of gold nanoparticles, where the clusters of HER2 B/CD4 T cell epitopes were conjugated on the gold surface with an optimal intercluster distance of 5-10 nm. ACNVax effectively trafficked to lymph nodes and cross-linked with …

Neonatal Outcomes In The Surgical Management Of Placenta Accreta Spectrum Disorders: A Retrospective Single-Center Observational Study From 468 Vietnamese Pregnancies Beyond 28 Weeks Of Gestation

Faculty, Staff and Student Publications

BACKGROUND: Placenta accreta spectrum disorders (PASDs) increase the mortality rate for mothers and newborns over a decade. Thus, the purpose of the study is to evaluate the neonatal outcomes in emergency cesarean section (CS) and planned surgery as well as in Cesarean hysterectomy and the modified one-step conservative uterine surgery (MOSCUS). The secondary aim is to reveal the factors relating to poor neonatal outcomes.

METHODS: This was a single-center retrospective study conducted between 2019 and 2020 at Tu Du Hospital, in the southern region of Vietnam. A total of 497 pregnant women involved in PASDs beyond 28 weeks of gestation …

Neutrophil Elastase Remodels Mammary Tumors To Facilitate Lung Metastasis, Amriti R Lulla, Said Akli, Cansu Karakas, Joseph A Caruso, Lucas D Warma, Xiayu Rao, Kelly K Hunt, Stephanie S Watowich, Khandan Keyomarsi

Faculty, Staff and Student Publications

Metastatic disease remains the leading cause of death due to cancer, yet the mechanism(s) of metastasis and its timely detection remain to be elucidated. Neutrophil elastase (NE), a serine protease secreted by neutrophils, is a crucial mediator of chronic inflammation and tumor progression. In this study, we used the PyMT model (NE+/+ and NE-/-) of breast cancer to interrogate the tumor-intrinsic and -extrinsic mechanisms by which NE can promote metastasis. Our results showed that genetic ablation of NE significantly reduced lung metastasis and improved metastasis-free survival. RNA-sequencing analysis of primary tumors indicated differential regulation of tumor-intrinsic actin cytoskeleton signaling pathways …

Author Correction: Automating Data Analysis For Hydrogen/Deuterium Exchange Mass Spectrometry Using Data-Independent Acquisition Methodology, Frantisek Filandr, Vladimir Sarpe, Shaunak Raval, D Alex Crowder, Morgan F Khan, Stephen Coales, Aleem Syed, John A Tainer, Susan P Lees-Miller, David C Schriemer

Faculty, Staff and Student Publications

No abstract provided.

We Are Not Okay: Moral Injury And A World On Fire, Keisha S Ray

Faculty and Staff Publications

No abstract provided.

Implementing A New Clinical Note Template To Reduce Documentation Burden At A Pediatric Organization, Nikki Blaze

Translational Projects (Open Access)

Clinical notes of a patient’s visit to a healthcare provider are necessary for patient care, reimbursement, and regulatory compliance with federal and state laws. Over time, non-standardized processes within the EHR have led to the increasing use of copy-paste to complete clinical notes, leading to irrelevant information being captured in the notes. Sinsky et al. (2020) shared that 49% of physicians' time is spent within the EHR, completing their documentation, placing orders, and reviewing the patient's chart. The documentation requirements for billing and coding created tension as clinicians sought ways to reduce the documentation burden. To reduce the documentation burden …

Prevalence Of Adverse Childhood Experiences And Its Dose-Response Association With Anxiety-Related Stress Symptoms In Young Adults Ages 18 To 44 Years Old In The United States, Kenechukwu O. Nwosu

Dissertations and Theses (Open Access)

Introduction: Adverse childhood experiences are common in the United States with about 64% of the population affected. Adverse childhood experiences are predictors of many chronic diseases including mental illnesses like anxiety. Though non-Hispanic whites are mostly afflicted by anxiety compared to their racial counterparts, minority races like non- Hispanic Black/African Americans disproportionately suffer more dire consequences due to the chronicity of untreated conditions which often result from lack of access to care among other barriers. Methods: This is a retrospective cross-sectional study. BRFSS 2022 data set was used to identify 56,598 respondents, ages 18 to 44 years old for analysis. …

Decoding Disease Mechanisms: Unraveling Large-Scale Biological Data For Novel Therapeutic Target Discovery, Yuntao Yang

Dissertations and Theses (Open Access)

This dissertation leverages large biological datasets and data-driven research to enhance our understanding of complex human diseases, deploying a unified narrative across three interconnected bioinformatics studies. Each study targets a different biological level, including genes, proteins, cells, and tissues, to uncover disease mechanisms and speed up the discovery of potential therapeutic targets.

The first study addresses gene-level analysis in the context of bladder cancer. It integrates gene expression data from lab models with clinical survival data to identify new therapeutic targets. This research pinpoints the IL6/JAK/STAT3 signaling pathway as a promising target for treating SMARCB1-deficient bladder cancer, demonstrating how combining …

Data Stewardship In Ftld Research: Investigator And Research Participant Views, Jalayne J Arias, Ana M Tyler, Laura M Beskow, Maria C Carillo, Susan Dickinson, Jill Goldman, Mary A Majumder, Michelle M Mello, Heather M Snyder, Jennifer S Yokoyama

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Federal policies and guidelines have expanded the return of individual results to participants and expectations for data sharing between investigators and through repositories. Here, we report investigators' and study participants' views and experiences with data stewardship practices within frontotemporal lobal degeneration (FTLD) research, which reveal unique ethical challenges.

Methods: Semi-structured interviews with (1) investigators conducting FTLD research that includes genetic data collection and/or analysis and (2) participants enrolled in a single site longitudinal FTLD study.

Results: Analysis of the interviews identified three meta themes: perspectives on data sharing, experiences with enrollment and participation, and data management and security as …

Lac-Phe Mediates The Effects Of Metformin On Food Intake And Body Weight, Shuke Xiao, Veronica L Li, Xuchao Lyu, Xudong Chen, Wei Wei, Fahim Abbasi, Joshua W Knowles, Alan Sheng-Hwa Tung, Shuliang Deng, Gaurav Tiwari, Xu Shi, Shuning Zheng, Laurie Farrell, Zsu-Zsu Chen, Kent D Taylor, Xiuqing Guo, Mark O Goodarzi, Alexis C Wood, Yii-Der Ida Chen, Leslie A Lange, Stephen S Rich, Jerome I Rotter, Clary B Clish, Usman A Tahir, Robert E Gerszten, Mark D Benson, Jonathan Z Long

Children’s Nutrition Research Center Staff Publications

Metformin is a widely prescribed anti-diabetic medicine that also reduces body weight. There is ongoing debate about the mechanisms that mediate metformin’s effects on energy balance. Here, we show that metformin is a powerful pharmacological inducer of the anorexigenic metabolite N-lactoyl-phenylalanine (Lac-Phe) in cells, in mice and two independent human cohorts. Metformin drives Lac-Phe biosynthesis through the inhibition of complex I, increased glycolytic flux and intracellular lactate mass action. Intestinal epithelial CNDP2+ cells, not macrophages, are the principal in vivo source of basal and metformin-inducible Lac-Phe. Genetic ablation of Lac-Phe biosynthesis in male mice renders animals resistant to the …

Signaling Mechanisms Underlying Activity-Dependent Integration Of Adult-Born Neurons In The Mouse Olfactory Bulb, Suyang Bao, Juan M Romero, Benjamin D W Belfort, Benjamin R Arenkiel

Duncan NRI Faculty and Staff Publications

Adult neurogenesis has fascinated the field of neuroscience for decades given the prospects of harnessing mechanisms that facilitate the rewiring and/or replacement of adult brain tissue. The subgranular zone of the hippocampus and the subventricular zone of the lateral ventricle are the two main areas in the brain that exhibit ongoing neurogenesis. Of these, adult-born neurons within the olfactory bulb have proven to be a powerful model for studying circuit plasticity, providing a broad and accessible avenue into neuron development, migration, and continued circuit integration within adult brain tissue. This review focuses on some of the recognized molecular and signaling …

Glial Lipid Droplets Resolve Ros During Sleep, Lindsey D Goodman, Matthew J Moulton, Hugo J Bellen

Duncan NRI Faculty and Staff Publications

The Sehgal lab presents data showing that the non-cell autonomous pathway of glial lipid droplet formation occurs during sleep and helps to resolve neuronal reactive oxygen species (ROS). This promotes neuronal function after an active day. Hence, this pathway has an important physiological function beyond its previously described role in ROS-associated diseases, including Alzheimer’s disease.

Improving Data Accuracy, Completeness, And Efficiency In The Pediatric Congenital Heart Surgery Registry, Kelly Brown

Translational Projects (Open Access)

Clinical patient registries, such as the pediatric congenital heart surgery registry, are designed to collect large amounts of varied clinical, administrative, and demographic data on specific patient populations. Data from these registries are used for multiple purposes, such as reporting, national benchmarking, research, quality improvement activities, and accreditation. Therefore, organizations must have accurate, complete, and timely data to meet these demands. However, manual data abstraction is the predominant method for populating a clinical patient registry. This method utilizes paid data abstractors, clinicians, and administrative staff and can be inefficient, incomplete, inaccurate, and costly.

The aim of this project was to …

Use Of A Shared Decision-Making Approach To Improve Blood Pressure Readings In A Hispanic Population With Hypertension, Narayani Koirala

Doctor of Nursing Practice Final Project Abstract

Background: Hypertension is a major risk factor for cardiovascular disease morbidity and mortality with over half of all cardiovascular deaths attributed to it (CDC, 2022). “It is estimated that one-third of adults are hypertensive worldwide. Predictions indicate that one billion individuals will be hypertensive by 2025” (Eghbali et al., 2022). Non-adherence to prescription medication and lifestyle changes is a significant problem and prevalent in the Hispanic population due to various factors related to social determinants of health.

Aim: This project aimed to increase patient adherence to hypertension treatment therapy in Hispanic adults with hypertension for improved blood pressure control and …

Total Syntheses Of Hosieines A-C, Jiayang Zhang, Xu Yan, Qing-Bao Zhang, Fang Wang, Bin Yang, Yang Yang

Children’s Nutrition Research Center Staff Publications

The collective total syntheses of (±)-hosieines A-C with a cage-like tetracyclic framework have been realized, which includes the first syntheses of hosieines B-C. The key strategy of the synthesis employs a one-pot domino reaction that involves Cu-catalyzed [3+2] cycloaddition, 1,6-enone formation, and 1,6-aza-Michael addition forming the 5/6/6-aza-tricyclic skeleton. Other salient synthetic tactics comprise a challenging double bond migration and a 1,4-aza-Michael addition reaction to afford the tetracyclic framework.

Reducing Hemoglobin A1c Using Diabetes Self-Management Education And Support (Dsmes) For Hispanic Adults In A Primary Care Setting, Gita Gyawali Sedai

Doctor of Nursing Practice Final Project Abstract

Background: Members of the Hispanic population have a 50% or higher chance of developing diabetes and often do so at a younger age than other adults in the United States (CDC, 2022a). Diabetes complications also impact the Hispanic population harder, with higher rates of kidney failure caused by diabetes, along with diabetes-related vision loss and blindness (CDC, 2022a). DSMES programs have shown significant improvements in A1C and blood sugar control in different settings (Powers et al., 2020). However, it has not been implemented in many primary care settings.

Purpose: The purpose of this project was to implement and evaluate …

Radiation-Induced Lymphopenia: Understanding, Predictive Modelling And Developing Photon And Proton-Based Mitigation Strategies, Yan Chu

Dissertations and Theses (Open Access)

It is well recognized that the effectiveness of radiotherapy (RT) requires an intact adaptive immune system, while lymphocytes are highly radiosensitive and are prevalent in the “dose bath” of radiation surrounding the tumor volume. Furthermore, it has been shown that, for nearly all disease sites, radiation-induced lymphopenia (RIL) is associated with poor outcomes. Recently, we observed compelling evidence of significant differences in the lymphocyte-sparing effects of proton therapy (PT) vs. photon (or x-ray) therapy (XRT) attributable to the differences in magnitudes of the dose baths of the two modalities. In addition, previous work has further demonstrated that both patient-specific and …

An Informatics Framework For Representing, Detecting, And Measuring Citations Of Biomedical Datasets, Xu Zuo

Dissertations and Theses (Open Access)

Biomedical research is inherently data-intensive, emphasizing the necessity of making data findable, accessible, interoperable, and reusable (FAIR) to expedite scientific breakthroughs. Despite the importance, data creators often do not receive sufficient recognition and lack the motivation to publish datasets in accordance with FAIR principles, primarily due to inadequate incentives. Citations serve as a means to attribute credit for dataset creation, track dataset usage, and assess the impact of data. Implementing standardized data citations could significantly enhance the discoverability of data and foster the maintenance of high-quality datasets. Initiatives like DataCite and the FAIRsharing community have been instrumental in addressing this …

Emotional Distress Predicts Reduced Type 2 Diabetes Treatment Adherence In The Glycemia Reduction Approaches In Diabetes: A Comparative Effectiveness Study (Grade), Caroline A Presley, Sherita Hill Golden, Valerie L Arends, Janet Brown-Friday, Jonathan A Krakoff, Colleen E Suratt, Andrea H Waltje, Andrea L Cherrington, Jeffrey S Gonzalez

Faculty, Staff and Student Publications

Objective: We examined longitudinal associations between emotional distress (specifically, depressive symptoms and diabetes distress) and medication adherence in Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE), a large randomized controlled trial comparing four glucose-lowering medications added to metformin in adults with relatively recent-onset type 2 diabetes mellitus (T2DM).

Research design and methods: The Emotional Distress Substudy assessed medication adherence, depressive symptoms, and diabetes distress in 1,739 GRADE participants via self-completed questionnaires administered biannually up to 3 years. We examined baseline depressive symptoms and diabetes distress as predictors of medication adherence over 36 months. Bidirectional visit-to-visit relationships were also …

Scurvy In An Adolescent: A Case Report

Faculty, Staff and Students Publications

Scurvy is a rare condition characterized by a deficiency in dietary vitamin C. Historically a disease taught in the context of long ocean voyages with limited vitamin intake, it is now rare in developed nations. The classical physical exam findings include gingival bleeding, perifollicular hemorrhages, and corkscrew hairs. We discuss the case of a 15-year-old female with scurvy whose initial presentation suggested more common diagnoses seen in the emergency department setting. Her course was complicated by a prior history of anorexia nervosa and a restrictive diet that lacked necessary vitamins. Once the patient's dietary habits were identified, a detailed physical …

Cyclophilin A Supports Translation Of Intrinsically Disordered Proteins And Affects Haematopoietic Stem Cell Ageing, Shannon E Moree, Xuan Lu, Gandhar K Datar, Cedric T Hill, Eric Spooner, Jordon C K King, David B Sykes, Borja Saez, Bruno Di Stefano, Xi Chen, Daniela S Krause, Ergun Sahin, Francis T F Tsai, Margaret A Goodell, Bradford C Berk, David T Scadden, André Catic

Faculty, Staff and Students Publications

Loss of protein function is a driving force of ageing. We have identified peptidyl-prolyl isomerase A (PPIA or cyclophilin A) as a dominant chaperone in haematopoietic stem and progenitor cells. Depletion of PPIA accelerates stem cell ageing. We found that proteins with intrinsically disordered regions (IDRs) are frequent PPIA substrates. IDRs facilitate interactions with other proteins or nucleic acids and can trigger liquid-liquid phase separation. Over 20% of PPIA substrates are involved in the formation of supramolecular membrane-less organelles. PPIA affects regulators of stress granules (PABPC1), P-bodies (DDX6) and nucleoli (NPM1) to promote phase separation and increase cellular stress resistance. …

Hepatocellular Carcinoma Screening In A Contemporary Cohort Of At-Risk Patients, Nabihah Tayob, Vincent Merrill, Daniel Q Huang, Ju Dong Yang, Anand V Kulkarni, Fasiha Kanwal, Jorge Marrero, Neehar Parikh, Amit G Singal

Faculty, Staff and Students Publications

IMPORTANCE: Cohort studies demonstrating an association of hepatocellular carcinoma (HCC) screening with reduced mortality are prone to lead-time and length-time biases.

OBJECTIVE: To characterize the clinical benefits of HCC screening, adjusting for lead-time and length-time biases, in a diverse, contemporary cohort of at-risk patients.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study of patients with HCC was conducted between January 2008 and December 2022 at 2 large US health systems. Data analysis was performed from September to November 2023.

MAIN OUTCOMES AND MEASURES: The primary outcome was screen-detected HCC, defined by abnormal screening-intent abdominal imaging or α-fetoprotein level within 6 …

Virtual Multi-Institutional Tumor Board: A Strategy For Personalized Diagnoses And Management Of Rare Cns Tumors, Lisa Boris, Yeonju Kim, Kenneth Aldape, Martha M Quezado, John A Butman, James G Smirniotopoulos, Huma Chaudhry, Christina I Tsien, Prashant Chittiboina, Kareem Zaghloul, Orwa Aboud, Nicholas G Avgeropoulos, Eric C Burton, David M Cachia, Karan S Dixit, Jan Drappatz, Erin M Dunbar, Peter Forsyth, Edina Komlodi-Pasztor, Jacob Mandel, Byram H Ozer, Eudocia Q Lee, Surabhi Ranjan, Rimas V Lukas, Margarita Raygada, Michael E Salacz, Matthew A Smith-Cohn, James Snyder, Ariane Soldatos, Brett J Theeler, Brigitte C Widemann, Kevin A Camphausen, John D Heiss, Terri S Armstrong, Mark R Gilbert, Marta Penas-Prado

Faculty, Staff and Students Publications

PURPOSE: Multidisciplinary tumor boards (MTBs) integrate clinical, molecular, and radiological information and facilitate coordination of neuro-oncology care. During the COVID-19 pandemic, our MTB transitioned to a virtual and multi-institutional format. We hypothesized that this expansion would allow expert review of challenging neuro-oncology cases and contribute to the care of patients with limited access to specialized centers.

METHODS: We retrospectively reviewed records from virtual MTBs held between 04/2020-03/2021. Data collected included measures of potential clinical impact, including referrals to observational or therapeutic studies, referrals for specialized neuropathology analysis, and whether molecular findings led to a change in diagnosis and/or guided management …

An Evidence-Based Update On Anticholinergic Use For Drug-Induced Movement Disorders, Jovita Crasta, Roger S Mcintyre, Jonathan M Meyer, Amita Patel, J Michael Smith, Khody Farahmand, Rachel Manahan, Leslie Lundt, Samantha A Cicero

Faculty, Staff and Students Publications

Drug-induced movement disorders (DIMDs) are associated with use of dopamine receptor blocking agents (DRBAs), including antipsychotics. The most common forms are drug-induced parkinsonism (DIP), dystonia, akathisia, and tardive dyskinesia (TD). Although rare, neuroleptic malignant syndrome (NMS) is a potentially life-threatening consequence of DRBA exposure. Recommendations for anticholinergic use in patients with DIMDs were developed on the basis of a roundtable discussion with healthcare professionals with extensive expertise in DIMD management, along with a comprehensive literature review. The roundtable agreed that "extrapyramidal symptoms" is a non-specific term that encompasses a range of abnormal movements. As such, it contributes to a misconception …

Neural And Behavioural State Switching During Hippocampal Dentate Spikes, Ivan Soltesz

Faculty, Staff and Students Publications

Distinct brain and behavioural states are associated with organized neural population dynamics that are thought to serve specific cognitive functions^1–3. Memory replay events, for example, occur during synchronous population events called sharp-wave ripples in the hippocampus while mice are in an ‘offline’ behavioural state, enabling cognitive mechanisms such as memory consolidation and planning^4–11. But how does the brain re-engage with the external world during this behavioural state and permit access to current sensory information or promote new memory formation? Here we found that the hippocampal dentate spike, an understudied population event that …