Medicine and Health Sciences Commons^™

Genome-Wide Association Studies And Mendelian Randomization Analyses Provide Insights Into The Causes Of Early-Onset Colorectal Cancer, R S Laskar, Y Cao, Et Al.

2020-Current year OA Pubs

BACKGROUND: The incidence of early-onset colorectal cancer (EOCRC; diagnosed < 50 years of age) is rising globally; however, the causes underlying this trend are largely unknown. CRC has strong genetic and environmental determinants, yet common genetic variants and causal modifiable risk factors underlying EOCRC are unknown. We conducted the first EOCRC-specific genome-wide association study (GWAS) and Mendelian randomization (MR) analyses to explore germline genetic and causal modifiable risk factors associated with EOCRC.

PATIENTS AND METHODS: We conducted a GWAS meta-analysis of 6176 EOCRC cases and 65 829 controls from the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), the Colorectal Transdisciplinary Study (CORECT), the Colon Cancer Family Registry (CCFR), and the UK Biobank. We then used the EOCRC GWAS to investigate 28 modifiable risk factors using two-sample MR.

RESULTS: We found two novel risk loci for EOCRC at 1p34.1 and 4p15.33, which were not previously associated with CRC risk. We identified a deleterious coding variant (rs36053993, G396D) at polyposis-associated DNA repair gene MUTYH …

Real-World Experience With Avacopan In Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis, Reza Zonozi, Aisha Shaikh, Colin Diffie, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Postmarketing data on outcomes of avacopan use in antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) are lacking.

METHODS: We performed a multicenter retrospective analysis of 92 patients with newly diagnosed or relapsing AAV who received therapy with avacopan. The coprimary outcome measures were clinical remission at 26 and 52 weeks. We use descriptive statistics and univariate logistic regression to assess outcomes and predictors of remission, respectively.

RESULTS: Of the 92 patients, 23% (n = 21) had a baseline estimated glomerular filtration rate (eGFR) < 15 ml/min per 1.73 m

CONCLUSION: A high rate of remission and an acceptable safety profile were observed with the use of …

Bcar4 Expression As A Predictive Biomarker For Endocrine Therapy Resistance In Breast Cancer, Muheng Liao, Jace Webster, Emily M Coonrod, Katherine N Weilbaecher, Christopher A Maher, Nicole M White

2020-Current year OA Pubs

BACKGROUND: Breast cancer, particularly the estrogen receptor positive (ER+) subtype, remains a leading cause of cancer-related death among women. Endocrine therapy is the most effective treatment for ER+ breast cancer; however, the development of resistance presents a significant challenge. This study explored the role of the breast cancer antiestrogen resistance 4 (BCAR4) gene as a potential driver of resistance and a pivotal biomarker in breast cancer.

PATIENTS AND METHODS: The researchers undertook a comprehensive analysis of 1743 patients spanning 6 independent cohorts. They examined the association of BCAR4 expression with patient outcomes across all breast cancer types and the PAM50 …

Transient Cortical Weakness Following Cerebral Angiography: A New Syndrome, Akash P Kansagra, Richard Pham, Arindam R Chatterjee, Christopher J Moran

2020-Current year OA Pubs

Transient cortical blindness is a known complication of iodinated contrast administration and is believed to reflect osmotic injury or autoregulatory dysfunction of the posterior circulation. Here, we report 2 cases of postangiography transient cortical

Changes In Online Marketing And Sales Practices Among Non-Medical Cannabis Retailers In 5 Us Cities, 2022 To 2023, Yuxian Cui, Zongshuan Duan, Cassidy R Loparco, Katie Vinson, Katelyn F Romm, Yan Wang, Patricia A Cavazos-Rehg, Erin Kasson, Y Tony Yang, Carla J Berg

2020-Current year OA Pubs

OBJECTIVES: Given the evolving cannabis marketplace (e.g., products, marketing strategies), this study examined online cannabis marketing practices over time.

METHODS: In 2022 and 2023, researchers assessed website content (e.g., age verification, sales, delivery, warnings, ad content, promotional strategies) among 175 randomly-selected cannabis retailers' websites across 5 US cities (Denver, Colorado; Seattle, Washington; Portland, Oregon; Las Vegas, Nevada; Los Angeles [LA], California, n=∼35/city). Analyses compared data from 2022 vs. 2023 and considered regulatory factors across cities.

RESULTS: Similar to 2022, in 2023, 76.6 % required age verification for site entry, 85.1 % used social media promotion, and 90.9 % offered online …

Spatially Resolved Metabolomic Dataset Of Distinct Human Kidney Anatomic Regions, Haikuo Li, Benjamin D Humphreys

2020-Current year OA Pubs

Cortex, medulla and papilla are three major human kidney anatomic structures and they harbour unique metabolic functions, but the underlying metabolomic profiles are largely unknown at spatial resolution. Here, we generated a spatially resolved metabolomics dataset on human kidney cortex, medulla and papilla tissues dissected from the same donor. Matrix-Assisted Laser Desorption/Ionization-Imaging Mass Spectrometry (MALDI-IMS) was used to detect metabolite species over mass-to-charge ratios of 50 -1500 for each section at a resolution of 10 × 10 µm

Factitious Disorder Presenting As Sickle Cell Disease: A Case Report, Jeremy W Jacobs, Brenda J Grossman, Et Al.

2020-Current year OA Pubs

No abstract provided.

Predictors Of Non-Variceal Hemorrhage In A National Cohort Of Patients With Chronic Liver Disease, Amber Afzal, Preethi Kesavan, Luo Suhong, Brian F Gage, Kevin Korenblat, Martin Schoen, Kristen Sanfilippo

2020-Current year OA Pubs

BACKGROUND: Non-variceal hemorrhage in patients with chronic liver disease (CLD) increases morbidity, mortality, and healthcare costs. There are limited data on risk factors for non-variceal hemorrhage in the CLD population. The aim of this study was to assess the predictive value of various clinical and laboratory parameters for non-variceal hemorrhage in CLD patients.

METHODS: We conducted a retrospective cohort study of US veterans diagnosed with CLD between 2002 and 2018 within the Veterans Health Administration database. We derived candidate variables from existing risk prediction models for hemorrhage, risk calculators for severity of liver disease, Charlson index of prognostic comorbidities, and …

Plasma Extracellular Vesicle Tau And Tdp-43 As Diagnostic Biomarkers In Ftd And Als, Madhurima Chatterjee, Nicolas R Barthélemy, Randall J Bateman, Et Al.

2020-Current year OA Pubs

Minimally invasive biomarkers are urgently needed to detect molecular pathology in frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS). Here, we show that plasma extracellular vesicles (EVs) contain quantifiable amounts of TDP-43 and full-length tau, which allow the quantification of 3-repeat (3R) and 4-repeat (4R) tau isoforms. Plasma EV TDP-43 levels and EV 3R/4R tau ratios were determined in a cohort of 704 patients, including 37 genetically and 31 neuropathologically proven cases. Diagnostic groups comprised patients with TDP-43 proteinopathy ALS, 4R tauopathy progressive supranuclear palsy, behavior variant FTD (bvFTD) as a group with either tau or TDP-43 pathology, and healthy …

Late-Season Influenza Vaccine Effectiveness Against Medically Attended Outpatient Illness, United States, December 2022-April 2023, Jessie R Chung, Stacey L House, Tara Curley, Et Al.

2020-Current year OA Pubs

BACKGROUND: The 2022-23 US influenza season peaked early in fall 2022.

METHODS: Late-season influenza vaccine effectiveness (VE) against outpatient, laboratory-confirmed influenza was calculated among participants of the US Influenza VE Network using a test-negative design.

RESULTS: Of 2561 participants enrolled from December 12, 2022 to April 30, 2023, 91 laboratory-confirmed influenza cases primarily had A(H1N1)pdm09 (6B.1A.5a.2a.1) or A(H3N2) (3C.2a1b.2a.2b). Overall, VE was 30% (95% confidence interval -9%, 54%); low late-season activity precluded estimation for most subgroups.

CONCLUSIONS: 2022-23 late-season outpatient influenza VE was not statistically significant. Genomic characterization may improve the identification of influenza viruses that circulate postinfluenza peak.

Use Of A Blood Biomarker Test Improves Economic Utility In The Evaluation Of Older Patients Presenting With Cognitive Impairment, William J Canestaro, Randall J Bateman, David M Holtzman, Mark Monane, Joel B Braunstein

2020-Current year OA Pubs

More than 16 million Americans living with cognitive impairment warrant a diagnostic evaluation to determine the cause of this disorder. The recent availability of disease-modifying therapies for Alzheimer's disease (AD) is expected to significantly drive demand for such diagnostic testing. Accurate, accessible, and affordable methods are needed. Blood biomarkers (BBMs) offer advantages over usual care amyloid positron emission tomography (PET) and cerebrospinal fluid (CSF) biomarkers in these regards. This study used a budget impact model to assess the economic utility of the PrecivityAD

Paracrine Signaling By Pancreatic Islet Cilia, Samantha E Adamson, Jing W Hughes

2020-Current year OA Pubs

The primary cilium is a sensory and signaling organelle present on most pancreatic islet endocrine cells, where it receives and interprets a wide range of intra-islet chemical cues including hormones, peptides, and neurotransmitters. The ciliary membrane possesses a molecular composition distinct from the plasma membrane, with enrichment of signaling mediators including G protein-coupled receptors (GPCRs), tyrosine kinase family receptors, membrane transporters and others. When activated, these membrane proteins interact with ion channels and adenylyl cyclases to trigger local Ca

Takotsubo Syndrome In Patients With Covid-19: A Systematic Review, Xiaojia Lu, Catherine Teng, Peng Cai, Jing Liang, Yanxuan Wang, Hawa Abu, Yuan Jia Wang, John E Madias, Kan Liu, Qi Liu, Pengyang Li

2020-Current year OA Pubs

BACKGROUND: Respiratory conditions are major physical triggers of takotsubo syndrome (TTS) and portend worse outcomes. However, data on TTS in patients with coronavirus disease-2019 infection (COVID-19) are limited.

METHODS: We searched PubMed, Embase, and Cochrane Library databases for case reports for the period 2019-2022 describing TTS in patients with COVID-19 pneumonia (TTS-COVID). We summarized the clinical data and outcomes and compared them to those in patients with TTS with an acute respiratory disease other than COVID-19 as a trigger (TTS-acute respiratory disease) and those with TTS with no respiratory disease (TTS-no respiratory disease).

RESULTS: The mortality rate was higher in …

Anomalous Left Superior Vena Cava Predisposing To Recurrent Brain Abscesses: A Case Report And Review Of The Literature, Adnan Shaik, Karan Joseph, Rahim Abo Kasem, Angela Downes, Muhammed B. Janjua

2020-Current year OA Pubs

Brain abscess is a devastating illness, with a high risk of morbidity and mortality. Recurrent brain abscess poses a challenge to diagnosis while treatment options may differ. Right to left shunt is a lesser-explored etiology for recurrent brain abscesses. PubMed literature review was performed to study all published studies with reference to right to left cardiac shunt as a possible etiology for the recurrent brain abscesses. The authors also report a case of a young male who developed recurrent brain abscess after previous resection and treatment. Right to left cardiac shunting of deoxygenated blood is an etiology for recurrent brain …

A Microbiota-Directed Complementary Food Intervention In 12-18-Month-Old Bangladeshi Children Improves Linear Growth, Ishita Mostafa, Matthew C Hibberd, Steven J Hartman, Md Hasan Hafizur Rahman, Mustafa Mahfuz, S M Tafsir Hasan, Per Ashorn, Michael J Barratt, Tahmeed Ahmed, Jeffrey I Gordon

2020-Current year OA Pubs

BACKGROUND: Globally, stunting affects ∼150 million children under five, while wasting affects nearly 50 million. Current interventions have had limited effectiveness in ameliorating long-term sequelae of undernutrition including stunting, cognitive deficits and immune dysfunction. Disrupted development of the gut microbiota has been linked to the pathogenesis of undernutrition, providing potentially new treatment approaches.

METHODS: 124 Bangladeshi children with moderate acute malnutrition (MAM) enrolled (at 12-18 months) in a previously reported 3-month RCT of a microbiota-directed complementary food (MDCF-2) were followed for two years. Weight and length were monitored by anthropometry, the abundances of bacterial strains were assessed by quantifying metagenome-assembled …

Metastasectomy For Extracalvarial Renal Cell Carcinoma, Rahim Abo Kasem, Karan Joseph, Adnan Shaik, Angela Downes, M Burhan Janjua

2020-Current year OA Pubs

KEY CLINICAL MESSAGE: Palliative surgical resection of extra-calvarial metastatic lesions from renal cell tumors is crucial for controlling metastatic spread, improving quality of life, and preventing associated morbidity. Careful surgical planning, including selective preoperative embolization and controlled resection around critical structures such as the sagittal sinus, is essential for successful outcomes. Cranioplasty with Titanium mesh and bone cement post-resection can provide symptomatic relief, better cosmesis, and overall improved quality of life.

ABSTRACT: Renal cell carcinomas are aggressive tumors with distant systemic disease. The calvarium appears to be an unusual and rare site for distant metastasis. The treatment modalities are challenging …

Migraine Headache In Patients With Spontaneous Coronary Artery Dissection: A Report Of The Iscad Registry, Bryan J Wells, Kathryn Lindley, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic cause of myocardial infarction. Migraine headache has been reported to be common among patients with SCAD, but the degree of migraine-related disability has not been quantified.

METHODS: Clinical data and headache variables were obtained from the baseline assessment of the prospective, multicenter iSCAD Registry. Migraine-related disability was quantified using the self-reported Migraine Disability Assessment (MIDAS). Demographic, clinical, psychosocial, and medical characteristics from data entry forms were compared between patients with and without migraine.

RESULTS: Of the 773 patients with available data, 46% reported previous or current migraines. Those with migraines were …

Co-Aggregation With Apolipoprotein E Modulates The Function Of Amyloid-Β In Alzheimer's Disease, Zengjie Xia, Michael R Strickland, Hong Jiang, David M Holtzman, Et Al.

2020-Current year OA Pubs

Which isoforms of apolipoprotein E (apoE) we inherit determine our risk of developing late-onset Alzheimer's Disease (AD), but the mechanism underlying this link is poorly understood. In particular, the relevance of direct interactions between apoE and amyloid-β (Aβ) remains controversial. Here, single-molecule imaging shows that all isoforms of apoE associate with Aβ in the early stages of aggregation and then fall away as fibrillation happens. ApoE-Aβ co-aggregates account for ~50% of the mass of diffusible Aβ aggregates detected in the frontal cortices of homozygotes with the higher-risk APOE4 gene. We show how dynamic interactions between apoE and Aβ tune disease-related …

Factors Associated With Incomplete Resection For Large, Locally Invasive Non-Small Cell Lung Cancer, Whitney S. Brandt, Zhizhou Yang, Brendan T. Heiden, Pamela P. Samson, Daniel Morgensztern, Saiama N. Waqar, Bryan F. Meyers, Ruben G. Nava, G. Alexander Patterson, Benjamin D. Kozower, Varun Puri

2020-Current year OA Pubs

BACKGROUND: Large, node-negative but locally invasive non-small cell lung cancer (NSCLC) is associated with increased perioperative risk but improved survival if a complete resection is obtained. Factors associated with positive margins in this population are not well-studied.

METHODS: We performed a retrospective cohort study using National Cancer Database (NCDB) for adult patients with >5 cm, clinically node-negative NSCLC with evidence of invasion of nearby structures [2006-2015]. Patients were classified as having major structure involvement (azygous vein, pulmonary artery/vein, vena cava, carina/trachea, esophagus, recurrent laryngeal/vagus nerve, heart, aorta, vertebrae) or chest wall invasion (rib pleura, chest wall, diaphragm). Our primary outcome …

The Debranching Enzyme Dbr1 Regulates Lariat Turnover And Intron Splicing, Luke Buerer, Brittany A Townley, Nima Mosammaparast, Et Al.

2020-Current year OA Pubs

The majority of genic transcription is intronic. Introns are removed by splicing as branched lariat RNAs which require rapid recycling. The branch site is recognized during splicing catalysis and later debranched by Dbr1 in the rate-limiting step of lariat turnover. Through generation of a viable DBR1 knockout cell line, we find the predominantly nuclear Dbr1 enzyme to encode the sole debranching activity in human cells. Dbr1 preferentially debranches substrates that contain canonical U2 binding motifs, suggesting that branchsites discovered through sequencing do not necessarily represent those favored by the spliceosome. We find that Dbr1 also exhibits specificity for particular 5' …

Propofol Enhancement Of Slow Wave Sleep To Target The Nexus Of Geriatric Depression And Cognitive Dysfunction: Protocol For A Phase I Open Label Trial, Rachel Lynn Rios, Michael Green, S Kendall Smith, Mohammadmehdi Kafashan, Shinung Ching, Nuri B Farber, Nan Lin, Brendan P Lucey, Charles F Reynolds, Eric J Lenze, Ben Julian Agustin Palanca, Swiped Study Team

2020-Current year OA Pubs

INTRODUCTION: Late-life treatment-resistant depression (LL-TRD) is common and increases risk for accelerated ageing and cognitive decline. Impaired sleep is common in LL-TRD and is a risk factor for cognitive decline. Slow wave sleep (SWS) has been implicated in key processes including synaptic plasticity and memory. A deficiency in SWS may be a core component of depression pathophysiology. The anaesthetic propofol can induce electroencephalographic (EEG) slow waves that resemble SWS. Propofol may enhance SWS and oral antidepressant therapy, but relationships are unclear. We hypothesise that propofol infusions will enhance SWS and improve depression in older adults with LL-TRD. This hypothesis has …

Tcaf1 Promotes Trpv2-Mediated Ca2+ Release In Response To Cytosolic Dna To Protect Stressed Replication Forks, Lingzhen Kong, Chen Cheng, Abigael Cheruiyot, Jiayi Yuan, Yichan Yang, Sydney Hwang, Daniel Foust, Ning Tsao, Emily Wilkerson, Nima Mosammaparast, Michael B Major, David W Piston, Shan Li, Zhongsheng You

2020-Current year OA Pubs

The protection of the replication fork structure under stress conditions is essential for genome maintenance and cancer prevention. A key signaling pathway for fork protection involves TRPV2-mediated Ca

Retrospective Study On The Efficacy And Safety Of Dulaglutide In Patients With Diabetes And Moderate-Advanced Chronic Kidney Disease, Sriya Kosaraju, Rong M Zhang

2020-Current year OA Pubs

No abstract provided.

Induced Cd8Α Identifies Human Nk Cells With Enhanced Proliferative Fitness And Modulates Nk Cell Activation, Celia C. Cubitt, Pamela Wong, Hannah K. Dorando, Jennifer A. Foltz, Jennifer Tran, Lynne Marsala, Nancy D. Marin, Mark Foster, Timothy Schappe, Hijab Fatima, Michelle Becker-Hapak, Alice Y. Zhou, Kimberly Hwang, Miriam T. Jacobs, David A. Russler-Germain, Emily M. Mace, Melissa M. Berrien-Elliott, Jacqueline E. Payton, Todd A. Fehniger

2020-Current year OA Pubs

The surface receptor CD8α is present on 20%-80% of human (but not mouse) NK cells, yet its function on NK cells remains poorly understood. CD8α expression on donor NK cells was associated with a lack of therapeutic responses in patients with leukemia in prior studies, thus, we hypothesized that CD8α may affect critical NK cell functions. Here, we discovered that CD8α- NK cells had improved control of leukemia in xenograft models compared with CD8α+ NK cells, likely due to an enhanced capacity for proliferation. Unexpectedly, we found that CD8α expression was induced on approximately 30% of previously CD8α- NK cells …

Using Structured Problem Solving To Promote Fluid Consumption In The Prevention Of Urinary Stones With Hydration (Push) Trial, Peter P Reese, H Henry Lai, Alana C Desai, Et Al.

2020-Current year OA Pubs

BACKGROUND: Structured Problem Solving (SPS) is a patient-centered approach to promoting behavior change that relies on productive collaboration between coaches and participants and reinforces participant autonomy. We aimed to describe the design, implementation, and assessment of SPS in the multicenter Prevention of Urinary Stones with Hydration (PUSH) randomized trial.

METHODS: In the PUSH trial, individuals with a history of urinary stone disease and low urine output were randomized to control versus a multicomponent intervention including SPS that was designed to promote fluid consumption and thereby prevent recurrent stones. We provide details specifically about training and fidelity assessment of the SPS …

Nivolumab Plus Brentuximab Vedotin For Relapsed/Refractory Peripheral T-Cell Lymphoma And Cutaneous T-Cell Lymphoma, Pier Luigi Zinzani, Neha Mehta-Shah, Et Al.

2020-Current year OA Pubs

No abstract provided.

Safety And Efficacy Of Metabolic Modulation With Ninerafaxstat In Patients With Nonobstructive Hypertrophic Cardiomyopathy, Martin S Maron, Sharon Cresci, Et Al.

2020-Current year OA Pubs

BACKGROUND: In nonobstructive hypertrophic cardiomyopathy (nHCM), there are no approved medical therapies. Impaired myocardial energetics is a potential cause of symptoms and exercise limitation. Ninerafaxstat, a novel cardiac mitotrope, enhances cardiac energetics.

OBJECTIVES: This study sought to evaluate the safety and efficacy of ninerafaxstat in nHCM.

METHODS: Patients with hypertrophic cardiomyopathy and left ventricular outflow tract gradient < 30 mm Hg, ejection fraction ≥50%, and peak oxygen consumption < 80% predicted were randomized to ninerafaxstat 200 mg twice daily or placebo (1:1) for 12 weeks. The primary endpoint was safety and tolerability, with efficacy outcomes also assessed as secondary endpoints.

RESULTS: A total of 67 patients with nHCM were enrolled at 12 centers (57 ± 11.8 years of age; 55% women). Serious adverse events occurred in 11.8% (n = 4 of 34) in the ninerafaxstat group and 6.1% (n = 2 of 33) …

Quantifying The Effects Of Sleep On Sensor-Derived Variables From Upper Limb Accelerometry In People With And Without Upper Limb Impairment, Allison E Miller, Catherine E Lang, Marghuretta D Bland, Keith R Lohse

2020-Current year OA Pubs

BACKGROUND: Despite the promise of wearable sensors for both rehabilitation research and clinical care, these technologies pose significant burden on data collectors and analysts. Investigations of factors that may influence the wearable sensor data processing pipeline are needed to support continued use of these technologies in rehabilitation research and integration into clinical care settings. The purpose of this study was to investigate the effect of one such factor, sleep, on sensor-derived variables from upper limb accelerometry in people with and without upper limb impairment and across a two-day wearing period.

METHODS: This was a secondary analysis of data collected during …

Metabolic Regulation Of Single Synaptic Vesicle Exo- And Endocytosis In Hippocampal Synapses, Jongyun Myeong, Marion I Stunault, Vitaly A Klyachko, Ghazaleh Ashrafi

2020-Current year OA Pubs

Glucose has long been considered a primary energy source for synaptic function. However, it remains unclear to what extent alternative fuels, such as lactate/pyruvate, contribute to powering synaptic transmission. By detecting individual release events in hippocampal synapses, we find that mitochondrial ATP production regulates basal vesicle release probability and release location within the active zone (AZ), evoked by single action potentials. Mitochondrial inhibition shifts vesicle release closer to the AZ center and alters the efficiency of vesicle retrieval by increasing the occurrence of ultrafast endocytosis. Furthermore, we uncover that terminals can use oxidative fuels to maintain the vesicle cycle during …

Lxr/Cd38 Activation Drives Cholesterol-Induced Macrophage Senescence And Neurodegeneration Via Nad+ Depletion, Ryo Terao, Tae Jun Lee, Jason Colasanti, Charles W Pfeifer, Joseph B Lin, Andrea Santeford, Keitaro Hase, Shinobu Yamaguchi, Daniel Du, Brian S Sohn, Yo Sasaki, Mitsukuni Yoshida, Rajendra S Apte

2020-Current year OA Pubs

Although dysregulated cholesterol metabolism predisposes aging tissues to inflammation and a plethora of diseases, the underlying molecular mechanism remains poorly defined. Here, we show that metabolic and genotoxic stresses, convergently acting through liver X nuclear receptor, upregulate CD38 to promote lysosomal cholesterol efflux, leading to nicotinamide adenine dinucleotide (NAD