Medicine and Health Sciences Commons^™

High Concordance Of Physician-Attestation With Manual Data Abstraction For Sickle Cell Type: An Ash Rc Data Hub Study, Alexis A Thompson, Ashima Singh, Donna S Neuberg, Amanda M Brandow, Allison A King, Sophie Lanzkron, Emily A Semmel, Sam Walters, Susan Rogers, Kathleen Torres, William A Wood

2020-Current year OA Pubs

Sickle cell disease (SCD) is the most common inherited blood disorder in the United States. The American Society of Hematology Research Collaborative (ASH RC) has built an SCD Data Hub (DH) to facilitate research and quality improvement using real-world data. To our knowledge, we report here the first analyses from the DH, focusing on cohort demographics and accurate identification of SCD diagnosis type. DH sites have data use agreements with ASH RC to extract and transfer electronic health record (EHR) data at least quarterly. Principal investigators (PI) provided additional attestation of SCD diagnosis based on existing local data sources deemed …

How Survivors Of Exploitation Who Use Drugs Navigate Systems Of Care: An Analysis Of Survivor Insights Using The Intersectional Risk Environment, Theresa Anasti, Hilary Thibodeau, Nathaniel A Dell, Kathleen Preble, Lauren Grimes, Lindsay B Gezinski

2020-Current year OA Pubs

BACKGROUND: Drug-related risks such as adverse health outcomes, overdose, and violent victimization vary across populations due to the marginalization of identities, structural inequities, and differing environments. Discrimination and criminalization exacerbate drug-related risks specifically for survivors of sexual exploitation who use drugs. This study aims to understand how survivors who are not currently utilizing intensive treatment services perceive their risk environment, including available resources, and identify possible mechanisms to address health equity. Emphasizing the role of harm reduction and the expertise of lived experience, this paper encourages innovative approaches to supporting survivors.

METHODS: A research team conducted seventeen semi-structured interviews with …

B Cell Expression Of An Enzymatic Intermediary In Ether Lipid Biosynthesis Promotes Antibody Responses And Germinal Center Size, Sung Hoon Cho, Marissa A Jones, Kaylor Meyer, David M Anderson, Sergiy Chetyrkin, M Wade Calcutt, Richard M Caprioli, Clay F Semenkovich, Mark R Boothby

2020-Current year OA Pubs

The qualities of antibody (Ab) responses provided by B lymphocytes and their plasma cell (PC) descendants are crucial facets of responses to vaccines and microbes. Metabolic processes and products regulate aspects of B cell proliferation and differentiation into germinal center (GC) and PC states along with Ab diversification. However, there is little information about lymphoid-cell-intrinsic functions of enzymes that mediate ether lipid biosynthesis. Imaging mass spectrometry (IMS) results had indicated that concentrations of a number of these phospholipids were substantially enhanced in GC compared to the background average in spleens, but it was unclear if biosynthesis in B cells was …

The Polymerized Protein Response (Ppr) Is Activated By Genetic Variants That Polymerize In The Er And Is Mediated By Nfκbp50, Admire Munanairi, David A Rudnick, Jiansheng Huang, David H Perlmutter

2020-Current year OA Pubs

In previous studies we have shown that accumulation of the polymerogenic variant ATZ that causes α1-antitrypsin deficiency (ATD) activates NFκB DNA binding. Here we discovered that this response, which we are naming the polymerized protein response (PPR), is characterized by NFκB p50 homodimers, distinct from the p50/p65 heterodimers in the canonical NFκB inflammatory response and the unfolded protein response (UPR). The PPR is also activated by other disease associated variants that polymerize in the ER whereas disease-associated variants that do not form polymers activate p50/p65 heterodimers and UPR. The PPR elicits a unique gene expression profile, including changes that stabilize …

Sex-Aware Genome-Wide Assessment Of De Novo Variants In Autism Across Coding And Noncoding Regions, Tychele N Turner

2020-Current year OA Pubs

BACKGROUND: Autism spectrum disorder (ASD) shows a consistent sex bias, yet how sex shapes de novo variant (DNV) risk across coding and noncoding sequence remains unclear. I analyzed DNVs in > 41,000 parent–child sequenced trios from three ASD family-based cohorts and compared DNV characteristics and enrichment patterns in males and females. Notably, these trios included individuals with ASD as well as those without ASD. I developed a new sex-aware DNV caller (HAT-FLEX) and thoroughly evaluated each candidate DNV using an additional tool introduced in this study, SNOW, to generate a high-confidence callset. RESULTS: I identified enrichment of missense and loss-of-function (LOF) …

Pediatric Thyroid Cancer Lung Metastases And Rai: Long-Term Results, Ryan C Mueller, Nikhil Rammohan, Anthony J Apicelli, Ana Maria Arbelaez, Farrokh Dehdashti, Barry A Siegel, Vikas Prasad, Perry W Grigsby, Stephanie Markovina

2020-Current year OA Pubs

OBJECTIVES: Children with differentiated thyroid cancer (DTC) often present with lung metastases but historically have good outcomes. Radioactive iodine (RAI) is commonly used to treat these children. Given the rarity of this condition, little evidence detailing long-term outcomes and risk of radiation pneumonitis exists.

METHODS: We conducted a retrospective analysis of patients < 20 years old who received RAI for DTC lung metastases between 1973 and 2018. Disease-free survival (DFS) was calculated from diagnosis to last follow-up. Overall survival and rates of acute and late radiation pneumonitis were determined by chart review and obituary searches.

RESULTS: Sixteen patients met eligibility criteria. Fourteen presented with thyroid, nodal, and lung disease; one presented with thyroid and nodal disease with nodal and lung recurrence; and one presented with thyroid-only disease with nodal and lung recurrence. All patients underwent thyroidectomy, 10 underwent neck dissection, and four underwent …

Dual Membrane-Spanning Anti-Sigma 2 Controls Omv Biogenesis And Colonization Fitness In Bacteroides Thetaiotaomicron, Evan J Pardue, Tengfei Zhong, Nichollas E Scott, Biswanath Jana, Wandy Beatty, Juan C Ortiz-Marquez, Mohammed Kaplan, Clay Jackson-Litteken, Mario F Feldman

2020-Current year OA Pubs

UNLABELLED:

IMPORTANCE: Dual membrane-spanning anti-sigma factors (Dma) are a novel class of regulatory proteins found solely among Bacteroidota. Previous studies demonstrated the importance of Dma1 in vesiculation, but the overall role of the Dma family in Bacteroides physiology remains poorly understood. Here, we show that Dma2 modulates vesiculation and the expression of select polysaccharide utilization loci (PULs) that target host-associated glycans

Delivering Safe Sleep And Breastfeeding Education To Pregnant And New Mothers Through Private Facebook Groups: Study Protocol For A 4-Armed Randomized Controlled Trial, Rebecca F Carlin, Margaret G Parker, Ann L Kellams, Fern R Hauck, Stephen Kerr, Benjamin T Cornwell, Marc T Kiviniemi, Nicole Geller, Katherine E Boguszewski, Michael J Corwin, Eve R Colson, Rachel Y Moon

2020-Current year OA Pubs

BACKGROUND: Annually, more than 3500 US infants die suddenly and unexpectedly. Many sudden unexpected infant deaths (SUID) are preventable with greater adherence to safe infant sleep guidelines. There are racial and economic disparities in guideline adherence and SUID rates. Education alone has proven ineffective at altering behavior for many parents, and social networks and social norms regarding infant care have been found to influence rates of unsafe sleep. Using the power of social networks to shape social norms by delivering education through moderated online social media groups provides a unique opportunity to influence these practices in large groups of parents. …

Enhancing Inference Of Differential Gene Expression In Metatranscriptomes From Human Microbial Communities, Evan M Lee, Nathan P Mcnulty, Matthew C Hibberd, Jiye Cheng, Kazi Ahsan, Hao-Wei Chang, Barak A Cohen, Jeffrey I Gordon

2020-Current year OA Pubs

Metatranscriptomic (MTX) sequencing quantifies gene expression from the collective genomes of microbial communities (microbiomes), enabling assessment of functional activity rather than functional potential. While differential expression testing is essential for RNA-sequencing analysis, current metatranscriptomic approaches have only been benchmarked on simulated data, resulting in a lack of standard practices for analysis of real datasets. Here, we use mock communities (defined mixtures of microbial cells with known properties) to quantitatively assess robustness and susceptibility of current approaches to various confounders including organisms' low relative abundance, differential abundance, low prevalence, global transcriptional output changes, and compositional effects. We show that no current …

Natural History Of 15 Patients With Autosomal Dominant Wfs1 Pathogenic Variants Associated With Sensorineural Hearing Loss And Optic Atrophy, Jessica P Roberts, Abby F Tang, Daniela Hernandez, Brianna Carman, Liam Oiknine, Cris Brown, Stacy Hurst, Yunshuo Tang, Fumihiko Urano

2020-Current year OA Pubs

OBJECTIVE: Autosomal dominant pathogenic variants in WFS1 cause a spectrum of disorders with phenotypic manifestations including low-frequency sensorineural hearing loss, optic nerve atrophy accompanied by low- to mid-frequency sensorineural hearing loss, non-syndromic diabetes mellitus, and early-onset cataracts. These conditions are generally milder than autosomal recessive Wolfram syndrome, except for Hattersley-Urano syndrome. Despite growing recognition of these disorders, data on clinical progression and long-term outcomes remain limited. This study aims to expand knowledge on disease severity and progression in autosomal dominant WFS1-related disorders. APPROACH: Clinical data were obtained from the Washington University International Registry and Clinical Study for Wolfram Syndrome and …

Herpes Simplex Virus Type 1 R-Loops Are Targets For Apobec-Mediated Mutagenesis, Márton Miskei, Dóra Varga, Lilla Hornyák, Éva Sipos, Éva Nagy, Qiuzhen Li, Zsolt Karányi, Zoltán Szabó, Rachel Deweerd, Abby M Green, Dávid Szüts, Eszter Csoma, Lóránt Székvölgyi

2020-Current year OA Pubs

APOBEC3 enzymes are key effectors of antiviral immunity that introduce mutations into viral genomes. We show that viral R-loops serve as preferred substrates for APOBEC3-mediated mutagenesis during herpes simplex virus type 1 (HSV-1) infection. APOBEC3 enzymes are recruited to viral R-loops, generating clustered C-to-T mutations in genes critical for viral assembly. Importantly, R-loops alone are not mutagenic, and APOBEC3 enzymes do not edit HSV-1 without an R-loop; mutagenesis occurs when R-loops and APOBEC3 enzymes interact. These findings identify endogenous R-loops formed during the HSV-1 life cycle as focal vulnerabilities and highlight R-loop-APOBEC3 coupling as a mechanism for antiviral mutagenesis.

Synthetic Lethality Of Decitabine Plus Atr Inhibition For Tp53-Mutated Aml, Jeremy T Baeten, Sumedha Agashe, Imene Tabet, Jack T Wooldridge, Amber Carter, Jamie N Butler, Christopher A Miller, Nicole Helton, Annabel Quinet, Kimberly B Johansson, Yichan Yang, Geoffrey L Uy, Alessandro Vindigni, Daniel C Link

2020-Current year OA Pubs

TP53 mutations are found in 10% to 15% of myeloid neoplasms and are associated with a dismal prognosis. Although hypomethylating agents (HMAs), such as decitabine, are active in TP53-mutated myeloid neoplasms (TP53-MN), mutation clearance is rarely complete and nearly all patients relapse. Molecular determinants of response to HMAs in TP53-MN are poorly understood. Here, we show that decitabine induces replicative stress with decreased replication fork progression, induction of single-strand DNA breaks, and activation of the ataxia telangiectasia mutated-Rad3-related (ATR) pathway. Resolution of decitabine-induced replication stress is impaired in TP53-mutated acute myeloid leukemia (AML) cells, representing a potential therapeutic vulnerability. Indeed, …

Enhanced Dietary Monitoring Using Fecal Genomics For Childhood Malnutrition Interventions, Ammara Aqeel, Najeeha T Iqbal, Sanam Iram Soomro, Sheraz Ahmed, Teresa K Mcdonald, Olivia Osborne, Sharon Jiang, Nolan Ives, Kazi Ahsan, Fayaz Umrani, Michael J Barratt, Jeffrey I Gordon, Syed Asad Ali, Lawrence A David

2020-Current year OA Pubs

Ready-to-use therapeutic and supplementary foods (RUTF/RUSF) are a primary treatment for childhood malnutrition in Community Management of Acute Malnutrition (CMAM) programs. However, measuring intervention compliance is labor intensive and unreliable. We applied FoodSeq, a fecal genomic dietary assessment biomarker, in malnourished infants (3-15 months) from Matiari, Pakistan. FoodSeq identified a significant increase in the abundance of DNA from chickpea, a primary RUSF ingredient, during RUSF administration and captured region-specific complementary feeding practices, including age-inappropriate feeding practices such as wide-spread tea consumption. Our findings highlight the potential of dietary genomics as an empirical and scalable tool for compliance monitoring and dietary …

Adipocytes Signal To Recruit Specific Mrnas From Surrounding Cells To Restore Expression Deficits, Clair Crewe, Snigdha Tiash, Yun-Ling Pai, Marjori Russo, Saket Awadhesbhai Patel, Yi-Cian Zheng, Alex Larkin, Chun-Kan Chen, Et Al.

2020-Current year OA Pubs

Extracellular vesicles (EVs) are nano-sized, membrane-delimited, particles released by cells that carry signaling macromolecules. A major pathway of EV production is potentiated by neutral sphingomyelinase 2 (SMPD3/nSMAse2), an enzyme that generates ceramide from sphingomyelin. In our attempt to study this pathway in adipocytes of male mice, we discover that the elimination of SMPD3 from adipocytes in vivo triggers a signal to surrounding immune cell-like preadipocytes to release EVs that carry SMPD3 mRNA. This results in a widespread increase in SMPD3 mRNA in purified null adipocytes without a change in the transcripts of other enzymes involved in ceramide metabolism. These results …

Etalanetug (E2814) In Dominantly Inherited Alzheimer's Disease: An Open-Label Phase 1b/2 Study To Assess Safety And Target Engagement In Participants With Mild To Moderate Cognitive Impairment, Erica Andreozzi, Kanta Horie, Nicolas R Barthélemy, Brian A Gordon, Shaney Flores, Tammie L S Benzinger, Eric Mcdade, Randall J Bateman, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Etalanetug (E2814) is designed to delay the clinical progression of Alzheimer's disease (AD) by binding to the microtubule binding region (MTBR) of tau implicated in seeding and spreading of tau pathology. Dominantly inherited Alzheimer's disease (DIAD) is a rare form of the disease (<  1%), having similar changes in the tau distribution and pathology to sporadic AD. Herein, we report the safety, pharmacology and biomarker results of the etalanetug Study 103 in DIAD patients.

METHODS: Study 103 enrolled participants with mild-to-moderate cognitive impairment due to DIAD who received etalanetug intravenously every 4 weeks escalating from 750 mg, 1500 mg, 3000 mg, to 4500 mg. After ascending to 4500 mg, patients received 4500 mg for up to 108 weeks. Tau pathology biomarkers, ptau217 and MTBR-tau243 were measured in CSF. Additional …

Trajectories Of Plasma And Csf Mtbr-Tau243 And Phosphorylated-Tau Species Across The Alzheimer's Disease Continuum, Lyduine E Collij, Gemma Salvadó, Kanta Horie, Nicolas R Barthélemy, Tobey J Betthauser, Olof Strandberg, Ruben Smith, Sebastian Palmqvist, Suzanne E Schindler, Rik Ossenkoppele, Shorena Janelidze, Niklas Mattsson-Carlgren, Randall J Bateman, Oskar Hansson

2020-Current year OA Pubs

To efficiently implement plasma and cerebrospinal fluid (CSF) biomarkers for staging and prognosis of Alzheimer disease (AD), we must understand their dynamics across disease progression. We analyzed participants from the Swedish BioFINDER-2 study with mass spectrometry measurements of plasma and CSF tau species, including eMTBR-tau243/MTBR-tau243 and phosphorylation occupancies (%p-tau). Disease duration was estimated using Aβ-PET and tau-PET with the SILA algorithm. Bootstrapped LOESS models showed that %p-tau217 changes earliest, increasing just before Aβ-PET positivity. Other p-tau species changed later, with smaller dynamic ranges and earlier ceiling effects. %p-tau205 and MTBR-tau243 changes aligned with tau-PET positivity onset, while MTBR-tau243-especially plasma eMTBR-tau243-tracked …

What Are The Top 10 Global Research Priorities For Perianal Crohn's Disease? The Global Perianal Crohn's Disease Priority Setting Partnership, Theo Pelly, Parakkal Deepak, Et Al.

2020-Current year OA Pubs

BACKGROUND AND AIMS: Perianal Crohn's disease (pCD) is a debilitating condition with a prevalence of approximately 20% in patients within 10 years of diagnosis of CD. The condition significantly impacts patient quality of life, and there remain a number of unmet needs relating to its optimal management. A global Priority Setting Partnership (PSP) was established to identify the top 10 research priorities for pCD.

METHODS: The PSP followed standard James Lind Alliance (JLA) methodology. An initial survey was circulated to gather unanswered research questions from key stakeholders. From these responses, a longlist of summary questions was formed. These questions were …

Validate-Perianal: An International Real-World Multi-Centre Exploratory Validation Of The Topclass Definition Of A Radiologically Healed Fistula In Perianal Fistulising Crohn's Disease, Easan Anand, Thirza J Van Croonenburg, Sami Samaan, Phil Tozer, Ailsa Hart, Parakkal Deepak, David H Ballard, Jaap Stoker, Phillip Lung

2020-Current year OA Pubs

OBJECTIVES: Radiological healing on MRI is the ultimate therapeutic goal in Class 2a perianal fistulising Crohn's disease (pfCD). The TOpClass consortium recently defined radiological healing (TOpClass-RH) by the absence of T2 hyperintensity, a completely fibrotic fistula tract, and the absence of contrast enhancement when used. This study aimed to validate TOpClass-RH in real-world clinical practice.

MATERIALS AND METHODS: VALIDATE-PERIANAL was a retrospective, multi-centre international study. Patients with pfCD with a baseline MRI scan showing active disease and follow-up MRI evidence of radiological fistula healing between 2021 and 2023 were identified. Paired scans were independently reviewed by three gastrointestinal radiologists using …

Phip Suppresses Nurd To Enable The Growth Of Swi/Snf-Mutant Cancers, Hayden A Malone, Francisca N De Luna Vitorino, Benjamin A Garcia, Et Al.

2020-Current year OA Pubs

SWI/SNF chromatin remodeling complexes are perturbed in 20% of all cancers and in several developmental disorders, yet the mechanisms by which these mutations dysregulate transcription and drive disease are poorly understood. To both elucidate these mechanisms and identify vulnerabilities caused by these mutations, we leverage genome-wide CRISPR-Cas9 screening in hundreds of cancer cell lines and identify the chromatin reader protein PHIP as a specific dependency in cancers with broadly disrupted SWI/SNF function. Mechanistically, we reveal that PHIP cooperates with SWI/SNF to facilitate transcriptional activation by ubiquitinating and suppressing subunits of the repressive Nucleosome Remodeling and Deacetylase (NuRD) complex. We demonstrate …

Ex Vivo Effect Of Apixaban On Hemostatic Biomarkers In Children With Heart Disease: A Saxophone Trial Substudy, Ghada A Aborkhees, Amy J Barr, Kevin Dietrich, Christoph Male, Zhaoqing Wang, Chen Yao, R Mark Payne, Andrew C Glatz, Paul Monagle, Kristin M Burns, Alison M Reedy, Joshua L Dyme, Peter H Schafer, Antoinette Ajavon-Hartmann, Lesley G Mitchell

2020-Current year OA Pubs

BACKGROUND: The SAXOPHONE (Safety of Apixaban on Pediatric Heart Disease on the Prevention of Embolism) trial demonstrated the safety of apixaban for thromboprophylaxis in children with heart disease. Included a priori in the trial design was an exploratory biomarker substudy to evaluate the effects of apixaban on surrogate biomarkers of efficacy, thrombin generation capacity, and hemostatic proteins. The study assessed changes in d-dimer, thrombin generation assay parameters, factor VIII, fibrinogen, protein C, and protein S in children receiving apixaban compared with standard-of-care vitamin K antagonists (VKAs) or low-molecular-weight heparin.

METHODS: SAXOPHONE participants aged >1 year (n=182) had blood samples for …

Reference Proteins To Improve Core 1 And Core 2 Alzheimer's Disease Csf And Plasma Biomarkers, Linda Karlsson, Nicolas R Barthélemy, Kanta Horie, Suzanne E Schindler, Brian A Gordon, Cyrus A Raji, Tammie L S Benzinger, John C Morris, Randall J Bateman, Et Al.

2020-Current year OA Pubs

Concentration-based fluid biomarkers represent an informative and cost-effective way to detect and monitor Alzheimer's disease (AD) pathology. However, non-AD-related interindividual variation in biofluids can also affect biomarker concentrations. Here, we investigated whether normalization of CSF and plasma biomarkers to reference proteins, such as amyloid-β40 (Aβ40) and non-phosphorylated mid-region tau (np-tau), improves their robustness and reliability of representing AD pathology load. Using the Swedish BioFINDER-2 cohort [n = 1702, 50.7% male, mean (standard deviation) age 68.4 (12.2) years], we compared the associations between tau/Aβ-PET load and fluid biomarkers alone versus biomarkers in a ratio with a reference protein (Aβ40 or np-tau) …

Mitochondrial Presequences Harbor Variable Strengths To Maintain Organellar Function, Youmian Yan, Baigalmaa Erdenepurev, Thiago N Menezes, Ian Collinson, Natalie M Niemi

2020-Current year OA Pubs

Hundreds of mitochondrial proteins rely on N-terminal presequences for organellar targeting and import. While generally described as positively charged amphiphilic helices, presequences lack a consensus motif and thus likely promote protein import into mitochondria with variable efficiencies. Indeed, the concept of presequence strength underlies biological models such as stress sensing, yet a quantitative analysis of what dictates strong versus weak presequences is lacking. Furthermore, the extent to which presequence strength affects mitochondrial function and cellular fitness remains unclear. Here, we capitalize on the MitoLuc protein import assay to define multiple aspects of presequence strength. We find that select presequences, including …

Medicare Part D Formulary Coverage Of Disease-Modifying Therapies For Multiple Sclerosis, Pengxiang Li, Matthew J Klebanoff, John K Lin, Keya D Doshi, Salim Chahin, Jalpa A Doshi

2020-Current year OA Pubs

No abstract provided.

Eeg In Patients With Altered Mental Status In The Emergency Department, Mariama Runcie, Neal Nolan, Olivia Yoo, Robert Silbergleit, Fábio A Nascimento, Maura Kennedy, M Brandon Westover, Joshua N Goldstein

2020-Current year OA Pubs

BACKGROUND: Altered mental status is a common chief complaint in the emergency setting, and the initial evaluation often fails to find an etiology. Subclinical (electrographic) seizures and nonconvulsive status epilepticus (NCSE) are potential causes of delirium and altered mental status, but require electroencephalogram (EEG) for diagnosis. It is not clear how often subclinical seizure or NCSE is present in those with undifferentiated altered mental status, nor which patients are most likely to benefit from emergent EEG. METHODS: We performed a retrospective review of patients presenting to a single academic medical center emergency department (ED) over a one-year period with the …

Depolymerizing F-Actin Accelerates The Exit From Pluripotency To Enhance Stem Cell-Derived Islet Differentiation, Nathaniel J Hogrebe, Mason D Schmidt, Punn Augsornworawat, Sarah E Gale, Mira Shunkarova, Jeffrey R Millman

2020-Current year OA Pubs

In this study, we demonstrate that cytoskeletal state at the onset of directed differentiation impacts the exit of human pluripotent stem cells (hPSCs) from pluripotency and downstream lineage specification. In particular, depolymerizing F-actin with latrunculin A (latA) during the first 24 h of definitive endoderm formation facilitates efficient loss of pluripotency and alters Activin/Nodal, BMP, c-Jun, and WNT signaling dynamics. These signaling changes influence downstream patterning of the gut tube, leading to improved pancreatic progenitor identity and decreased expression of markers associated with other endodermal lineages. Continued differentiation generates islets containing a higher percentage of β cells that exhibit improved …

Two-Year Outcomes Following Delandistrogene Moxeparvovec Treatment In Ambulatory Patients With Duchenne Muscular Dystrophy: Phase 3 Embark Trial, Jerry R Mendell, Craig M Zaidman, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Delandistrogene moxeparvovec is a recombinant adeno-associated virus rhesus isolate serotype 74 vector-based gene therapy that addresses the absence of functional dystrophin in Duchenne muscular dystrophy (DMD). EMBARK is a phase 3, two-part, crossover, randomized, placebo-controlled trial assessing the safety and efficacy of delandistrogene moxeparvovec (single intravenous dose 1.33 × 10

METHODS: As a result of the crossover study design, 2-year functional outcomes of patients receiving delandistrogene moxeparvovec in part 1 of EMBARK were compared, by pre-specified analysis, with a matched propensity score-weighted external control (EC).

RESULTS: At 2 years, EMBARK patients showed statistically significant benefit versus the EC cohort …

Promoting Community And Social Participation In Chronic Stroke: A Pilot Study Of The Engage Intervention, Elizabeth Skidmore, Carolyn Baum, Jessica Kersey, Emily Kringle, Kelsey Voltz-Poremba, Sular Gordon, Tina Harris, Heidi Fischer, Maureen Gecht, Michelle Furman, Joy Hammel

2020-Current year OA Pubs

BACKGROUND: Survivors of stroke report low levels of community and social participation, even years after stroke. ENGAGE is a community-based intervention that merges social learning, guided problem solving, and supervised practice to collaboratively identify, generate, and apply solutions to challenges with community and social participation after stroke.

OBJECTIVE: We examined the feasibility, acceptability, and safety of ENGAGE and characterized within group changes in community and social participation outcomes.

METHODS: Community-dwelling survivors of stroke, occupational therapy providers, and occupational therapy scientists partnered to co-design the essential and structural elements of ENGAGE, as well as to evaluate ENGAGE using a multi-site single-arm …

Exploring Nurses' Documentation Prioritization Strategies To Alleviate Ehr Documentation Burden: A Phenomenological Study, Rosemary Mugoya, Jennifer Thate, Fan Hao, Sarah C Rossetti, Po-Yin Yen

2020-Current year OA Pubs

OBJECTIVE: This study aims to understand how inpatient nurses determine and prioritize necessary documentation within the context of the Excessive Documentation Burden (ExDocBurden) in Electronic Health Records (EHRs).

METHODOLOGY: A phenomenological approach was used to explore inpatient nurses' lived experiences of prioritizing EHR documentation. Interpretive phenomenology guided the study design, focusing on how nurses prioritize documentation. Purposive sampling recruited 14 registered nurses (RNs) from acute and critical care settings. Data was collected through semi-structured interviews and analyzed using Colaizzi's 7-step and Smith's Interpretive Phenomenology Analysis.

RESULTS: Five themes emerged: (1) Advocating for Quality Patient Care Environment and Patient Needs, (2) …

Lyplal1 Rare Loss-Of-Function Variants In Humans And Deletion In Human Hepatoma Cells Protect Against Masld, Rawdat Hussain, Chinmay Raut, Ponnandy Prabhu, Akram Irshaid, Yash Hegde, Yue Chen, Asmita Pant, Antonino Oliveri, Xiaochao Wei, Lishi Yin, Tiffany L Russell, Brian Halligan, Clay F Semenkovich, Elizabeth K Speliotes

2020-Current year OA Pubs

Genetic variants near LYPLAL1 are associated with Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD) in humans, but their impact on LYPLAL1 function is unknown. We identified LYPLAL1 loss-of-function variants from UK BioBank (UKBB) whole-exome sequencing data that had AlphaMissense or GPN-MSA scores in the top 20% of LYPLAL1 variants for being disruptive. We aggregated these variants and carried out burden analysis for effects on MRI Proton Density-Fat Fraction (MRI-PDFF) and ICD-based MASLD in UKBB. Rare loss-of-function LYPLAL1 variants were associated with reduced MRI-PDFF and ICD diagnosed MASLD across sexes. We used CRISPR to knockout and overexpress LYPLAL1 in human hepatoma cells …

Mental Health Symptom Screening Among Adult Emergency Department Patients: A Cross-Sectional Study, Jacob Langkiet, Rachel M Ancona, Et Al.

2020-Current year OA Pubs

OBJECTIVES: Mental health symptoms profoundly influence healthcare outcomes and utilization. Although mental health conditions are common in emergency department (ED) patients, routine, noncrisis screening is not consistently implemented; thus, problems may go unrecognized outside of psychiatric crisis presentations. We aimed to estimate the prevalence of current symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) among ED patients using validated screening tools.

METHODS: We conducted a secondary analysis of cross-sectional data from 1305 randomly selected, adult patients from 3 urban, academic EDs. Validated survey instruments included (i) Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety Short Form 8a, (ii) Emotional Distress …