Medicine and Health Sciences Commons^™

Country Reports On Practical Aspects Of Conducting Large-Scale Community Studies Of The Tolerability Of Mass Drug Administration With Ivermectin/Diethylcarbamazine/Albendazole For Lymphatic Filariasis, Purushothaman Jambulingam, Swaminathan Subramanian, Kaliannagounder Krishnamoorthy, Taniawati Supali, Peter Fischer, Christine Dubray, Carl Fayette, Jean Frantz Lemoine, Moses Laman, Christopher King, Josaia Samuela, Myra Hardy, Gary J Weil

2020-Current year OA Pubs

This article is a compilation of summaries prepared by lead investigators for large-scale safety and efficacy studies on mass drug administration of IDA (ivermectin, diethylcarbamazine, and albendazole) for lymphatic filariasis. The summaries highlight the experiences of study teams that assessed the safety and efficacy of IDA in five countries: India, Indonesia, Haiti, Papua New Guinea, and Fiji. They also highlight significant challenges encountered during these community studies and responses to those challenges that contributed to success.

Development And Introduction Of The Filariasis Test Strip: A New Diagnostic Test For The Global Program To Eliminate Lymphatic Filariasis, Anastasia Pantelias, Jonathan D King, Patrick Lammie, Gary J Weil

2020-Current year OA Pubs

A key component to achieving the global goal of elimination of lymphatic filariasis (LF) is the availability of appropriate tools for disease mapping, monitoring, and surveillance. However, the development of these tools for a neglected disease such as LF can be a challenge. The lack of a commercial market and low familiarity with these diseases leave little incentive for diagnostic manufacturers to invest in this space. The Filarial Test Strip (FTS) development story provides a case study on how a multi-stakeholder, public-private partnership model facilitated the development, evaluation, and introduction of a new monitoring and surveillance tool for LF. This …

Lessons From Large-Scale Tolerability And Acceptability Studies Of Triple Drug Mass Drug Administration Performed To Support Policy Change And Accelerate Elimination Of Lymphatic Filariasis, Gary J Weil, Peter U Fischer, Alison Krentel

2020-Current year OA Pubs

Early clinical trials clearly demonstrated the superior efficacy of triple drug therapy with ivermectin plus DEC and albendazole (IDA) for clearing microfilaremia (Mf) in individuals with lymphatic filariasis (LF). Although these initial pharmacokinetic and efficacy studies were necessary first steps in the clinical development of IDA, they were not sufficient to justify policy changes necessary for widespread use of this new regimen by national filariasis elimination programs. Processes and procedures that led to the World Health Organization's (WHO) endorsement of IDA as a mass drug administration (MDA) regimen for LF are reviewed elsewhere in this Supplement. However, the "guideline review …

Transmission Risk Of Covid-19 In High School And College Water Polo, Raymond J Kreienkamp, Christopher J Kreienkamp, Cindy Terrill, Mark E Halstead, Jason G Newland

2020-Current year OA Pubs

BACKGROUND: Concerns that athletes may be at a higher risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has led to reduced participation in sports during the COVID-19 pandemic. We aimed to assess COVID-19 incidence and transmission during the spring 2021 high school and college water polo seasons across the United States.

METHODS: This prospective observational study enrolled 1825 water polo athletes from 54 high schools and 36 colleges. Surveys were sent to coaches throughout the season, and survey data were collected and analyzed.

RESULTS: We identified 17 COVID-19 cases among 1223 high school water polo athletes (1.4%) and …

Nasally Delivered Interferon-Λ Protects Mice Against Infection By Sars-Cov-2 Variants Including Omicron, Zhenlu Chong, Courtney E Karl, Peter J Halfmann, Yoshihiro Kawaoka, Emma S Winkler, Shamus P Keeler, Michael J Holtzman, Jinsheng Yu, Michael S Diamond

2020-Current year OA Pubs

Although vaccines and monoclonal antibody countermeasures have reduced the morbidity and mortality associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, variants with constellations of mutations in the spike gene jeopardize their efficacy. Accordingly, antiviral interventions that are resistant to further virus evolution are needed. The host-derived cytokine interferon lambda (IFN-λ) has been proposed as a possible treatment based on studies in human coronavirus 2019 (COVID-19) patients. Here, we show that IFN-λ protects against SARS-CoV-2 B.1.351 (Beta) and B.1.1.529 (Omicron) variants in three strains of conventional and human ACE2 transgenic mice. Prophylaxis or therapy with nasally delivered IFN-λ2 limits …

A Genome-Wide Crispr-Cas9 Knockout Screen Identifies Essential And Growth-Restricting Genes In Human Trophoblast Stem Cells, Chen Dong, Shuhua Fu, Rowan M Karvas, Brian Chew, Laura A Fischer, Xiaoyun Xing, Jessica K Harrison, Pooja Popli, Ramakrishna Kommagani, Ting Wang, Bo Zhang, Thorold W Theunissen

2020-Current year OA Pubs

The recent derivation of human trophoblast stem cells (hTSCs) provides a scalable in vitro model system of human placental development, but the molecular regulators of hTSC identity have not been systematically explored thus far. Here, we utilize a genome-wide CRISPR-Cas9 knockout screen to comprehensively identify essential and growth-restricting genes in hTSCs. By cross-referencing our data to those from similar genetic screens performed in other cell types, as well as gene expression data from early human embryos, we define hTSC-specific and -enriched regulators. These include both well-established and previously uncharacterized trophoblast regulators, such as ARID3A, GATA2, and TEAD1 (essential), and GCM1, …

Single-Cell Profiling Of Human Dura And Meningioma Reveals Cellular Meningeal Landscape And Insights Into Meningioma Immune Response, Anthony Z Wang, Jay A Bowman-Kirigin, Rupen Desai, Liang-I Kang, Pujan R Patel, Bhuvic Patel, Saad M Khan, Diane Bender, M Caleb Marlin, Jingxian Liu, Joshua W Osbun, Eric C Leuthardt, Michael R Chicoine, Ralph G Dacey, Gregory J Zipfel, Albert H Kim, David G Denardo, Allegra A Petti, Gavin P Dunn

2020-Current year OA Pubs

BACKGROUND: Recent investigations of the meninges have highlighted the importance of the dura layer in central nervous system immune surveillance beyond a purely structural role. However, our understanding of the meninges largely stems from the use of pre-clinical models rather than human samples.

METHODS: Single-cell RNA sequencing of seven non-tumor-associated human dura samples and six primary meningioma tumor samples (4 matched and 2 non-matched) was performed. Cell type identities, gene expression profiles, and T cell receptor expression were analyzed. Copy number variant (CNV) analysis was performed to identify putative tumor cells and analyze intratumoral CNV heterogeneity. Immunohistochemistry and imaging mass …

Machine Learning Derivation Of Four Computable 24-H Pediatric Sepsis Phenotypes To Facilitate Enrollment In Early Personalized Anti-Inflammatory Clinical Trials, Yidi Qin, John C Lin, Allan Doctor, Et Al.

2020-Current year OA Pubs

BACKGROUND: Thrombotic microangiopathy-induced thrombocytopenia-associated multiple organ failure and hyperinflammatory macrophage activation syndrome are important causes of late pediatric sepsis mortality that are often missed or have delayed diagnosis. The National Institutes of General Medical Science sepsis research working group recommendations call for application of new research approaches in extant clinical data sets to improve efficiency of early trials of new sepsis therapies. Our objective is to apply machine learning approaches to derive computable 24-h sepsis phenotypes to facilitate personalized enrollment in early anti-inflammatory trials targeting these conditions.

METHODS: We applied consensus, k-means clustering analysis to our extant PHENOtyping sepsis-induced Multiple …

Stimulating Tam-Mediated Anti-Tumor Immunity With Mannose-Decorated Nanoparticles In Ovarian Cancer, Evan B Glass, Alyssa A Hoover, Kennady K Bullock, Matthew Z Madden, Bradley I Reinfeld, Whitney Harris, Dominique Parker, Demetra H Hufnagel, Marta A Crispens, Dineo Khabele, W Kimryn Rathmell, Jeffrey C Rathmell, Andrew J Wilson, Todd D Giorgio, Fiona E Yull

2020-Current year OA Pubs

BACKGROUND: Current cancer immunotherapies have made tremendous impacts but generally lack high response rates, especially in ovarian cancer. New therapies are needed to provide increased benefits. One understudied approach is to target the large population of immunosuppressive tumor-associated macrophages (TAMs). Using inducible transgenic mice, we recently reported that upregulating nuclear factor-kappaB (NF-κB) signaling in TAMs promotes the M1, anti-tumor phenotype and limits ovarian cancer progression. We also developed a mannose-decorated polymeric nanoparticle system (MnNPs) to preferentially deliver siRNA payloads to M2, pro-tumor macrophages in vitro. In this study, we tested a translational strategy to repolarize ovarian TAMs via MnNPs loaded …

Structural Basis Of Sarm1 Activation, Substrate Recognition, And Inhibition By Small Molecules, Yun Shi, Yo Sasaki, Xianrong Mao, Aaron Diantonio, Jeffrey Milbrandt, Et Al.

2020-Current year OA Pubs

The NADase SARM1 (sterile alpha and TIR motif containing 1) is a key executioner of axon degeneration and a therapeutic target for several neurodegenerative conditions. We show that a potent SARM1 inhibitor undergoes base exchange with the nicotinamide moiety of nicotinamide adenine dinucleotide (NAD

Iv Sotalol Use In Pediatric And Congenital Heart Patients: A Multicenter Registry Study, Lindsey E Malloy-Walton, Nicholas H Von Bergen, Seshadri Balaji, Peter S Fischbach, Jason M Garnreiter, S Yukiko Asaki, Jeffrey P Moak, Luis A Ochoa, Philip M Chang, Hoang H Nguyen, Akash R Patel, Christa Kirk, Ashley K Sherman, Jennifer N Avari Silva, J Philip Saul

2020-Current year OA Pubs

Background There is limited information regarding the clinical use and effectiveness of IV sotalol in pediatric patients and patients with congenital heart disease, including those with severe myocardial dysfunction. A multicenter registry study was designed to evaluate the safety, efficacy, and dosing of IV sotalol. Methods and Results A total of 85 patients (age 1 day-36 years) received IV sotalol, of whom 45 (53%) had additional congenital cardiac diagnoses and 4 (5%) were greater than 18 years of age. In 79 patients (93%), IV sotalol was used to treat supraventricular tachycardia and 4 (5%) received it to treat ventricular arrhythmias. …

Pacing Therapy For Atrioventricular Dromotropathy: A Combined Computational-Experimental-Clinical Study, Floor C W M Salden, Peter R Huntjens, Et Al.

2020-Current year OA Pubs

AIMS: Investigate haemodynamic effects, and their mechanisms, of restoring atrioventricular (AV)-coupling using pacemaker therapy in normal and failing hearts in a combined computational-experimental-clinical study.

METHODS AND RESULTS: Computer simulations were performed in the CircAdapt model of the normal and failing human heart and circulation. Experiments were performed in a porcine model of AV dromotropathy. In a proof-of-principle clinical study, left ventricular (LV) pressure and volume were measured in 22 heart failure (HF) patients (LV ejection fraction <35%) with prolonged PR interval (>230 ms) and narrow or non-left bundle branch block QRS complex. Computer simulations and animal studies in normal hearts showed that restoring of AV-coupling …

Heart Failure And Patient-Reported Outcomes In Adults With Congenital Heart Disease From 15 Countries, Chun-Wei Lu, Kamila White, Et Al

2020-Current year OA Pubs

Background Heart failure (HF) is the leading cause of mortality and associated with significant morbidity in adults with congenital heart disease. We sought to assess the association between HF and patient-report outcomes in adults with congenital heart disease. Methods and Results As part of the APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study), we collected data on HF status and patient-reported outcomes in 3959 patients from 15 countries across 5 continents. Patient-report outcomes were: perceived health status (12-item Short Form Health Survey), quality of life (Linear Analogue Scale and Satisfaction with Life Scale), sense …

Mortality In Pulmonary Arterial Hypertension In The Modern Era: Early Insights From The Pulmonary Hypertension Association Registry, Kevin Y Chang, Sue Duval, David B Badesch, Todd M Bull, Murali M Chakinala, Teresa De Marco, Robert P Frantz, Anna Hemnes, Stephen C Mathai, Erika Berman Rosenzweig, John J Ryan, Thenappan Thenappan, Phar Investigators

2020-Current year OA Pubs

Background Current mortality data for pulmonary arterial hypertension (PAH) in the United States are based on registries that enrolled patients prior to 2010. We sought to determine mortality in PAH in the modern era using the PHAR (Pulmonary Hypertension Association Registry). Methods and Results We identified all adult patients with PAH enrolled in the PHAR between September 2015 and September 2020 (N=935). We used Kaplan-Meier survival analysis and Cox proportional hazards models to assess mortality at 1, 2, and 3 years. Patients were stratified based on disease severity by 3 validated risk scores. In treatment-naïve patients, we compared survival based …

Comparative Effectiveness Associated With Buprenorphine And Naltrexone In Opioid Use Disorder And Cooccurring Polysubstance Use, Kevin Y Xu, Carrie M Mintz, Ned Presnall, Laura J Bierut, Richard A Grucza

2020-Current year OA Pubs

Importance: Despite prevalent polysubstance use, treatment patterns and outcomes for individuals with opioid use disorder (OUD) and cooccurring substance use disorders (SUD) are understudied.

Objective: To evaluate the distribution of buprenorphine and naltrexone initiation among individuals with OUD with vs without cooccurring SUD and to assess the comparative effectiveness associated with buprenorphine and naltrexone against drug-related poisonings.

Design, Setting, and Participants: This observational comparative effectiveness study used insurance claims from 2011 to 2016 from the US IBM MarketScan databases to study initiation of medications for OUD (MOUD) among treatment-seeking individuals aged 12 to 64 years with a primary diagnosis of …

Analysis Of Stimulant Prescriptions And Drug-Related Poisoning Risk Among Persons Receiving Buprenorphine Treatment For Opioid Use Disorder, Carrie M Mintz, Kevin Y Xu, Ned J Presnall, Sarah M Hartz, Frances R Levin, Jeffrey F Scherrer, Laura J Bierut, Richard A Grucza

2020-Current year OA Pubs

Importance: Stimulant medication use is common among individuals receiving buprenorphine for opioid use disorder (OUD). Associations between prescription stimulant use and treatment outcomes in this population have been understudied.

Objectives: To investigate whether use of prescription stimulants was associated with (1) drug-related poisoning and (2) buprenorphine treatment retention.

Design, Setting, and Participants: This retrospective, recurrent-event cohort study with a case-crossover design used a secondary analysis of administrative claims data from IBM MarketScan Commercial and Multi-State Medicaid databases from January 1, 2006, to December 31, 2016. Primary analyses were conducted from March 1 through August 31, 2021. Individuals aged 12 to …

Racial And Ethnic Differences In Rural-Urban Trends In 5-Year Survival Of Patients With Lung, Prostate, Breast, And Colorectal Cancers: 1975-2011 Surveillance, Epidemiology, And End Results (Seer), Marquita W Lewis-Thames, Marvin E Langston, Saira Khan, Yunan Han, Lindsay Fuzzell, Shuai Xu, Justin Xavier Moore

2020-Current year OA Pubs

Importance: Considering reported rural-urban cancer incidence and mortality trends, rural-urban cancer survival trends are important for providing a comprehensive description of cancer burden. Furthermore, little is known about rural-urban differences in survival trends by racial and ethnic groups.

Objective: To examine national rural-urban trends in 5-year cancer-specific survival probabilities for lung, prostate, breast, and colorectal cancers in a diverse sample of racial and ethnic groups.

Design, Setting, and Participants: This cross-sectional study used an epidemiologic assessment with 1975 to 2016 Surveillance, Epidemiology, and End Results (SEER) data to analyze patients diagnosed no later than 2011. Patients were classified as living …

Timing Of Medicaid Enrollment, Late-Stage Breast Cancer Diagnosis, Treatment Delays, And Mortality, Evaline Xie, Graham A Colditz, Min Lian, Tracy Greever-Rice, Chester Schmaltz, Jill Lucht, Ying Liu

2020-Current year OA Pubs

BACKGROUND: Disrupted and delayed Medicaid coverage has been consistently associated with lower rates of cancer screening and early-stage cancer diagnosis compared with continuous coverage. However, the relationships between Medicaid coverage timing, breast cancer treatment delays, and survival are less clear.

METHODS: Using the linked Missouri Cancer Registry-Medicaid claims data, we identified 4583 women diagnosed with breast cancer between 2007 and 2016. We used logistic regression to estimate odds ratios (ORs) of late-stage diagnosis and treatment delays for prediagnosis (>30 days, >90 days, and >1 year before diagnosis) vs peridiagnosis enrollment. Cox proportional hazards models were used to estimate the …

Factors Associated With Endowed Chair Allocation In Medical Oncology In The United States, Lena Jia, Michael Kevin Rooney, Clare E Jacobson, Kent A Griffith, Christina Mangurian, Reshma Jagsi, Merry Jennifer Markham

2020-Current year OA Pubs

To explore persisting gender disparities across leadership roles in medicine, we examined factors associated with holding endowed chairs in US oncology divisions. In 2019, we identified 95 academic oncology divisions, using the Oncology Division Chiefs and Department Chairs listing in the American Society of Clinical Oncology myConnection forum. We collected public information on gender, degree, total National Institutes of Health funding as principal investigator, H-indices, publication and citation numbers, and graduation year and constructed a multivariable logistic regression model. All statistical tests were 2-sided. We identified 1087 oncology full professors. Of these, 287 (26.4%) held endowed chairs: 60 of 269 …

Demographic And Clinical Characteristics Associated With The Failure Of Nonoperative Management Of Uncomplicated Appendicitis In Children: Secondary Analysis Of A Nonrandomized Clinical Trial, Peter C Minneci, Jacqueline M Saito, Et Al.

2020-Current year OA Pubs

Importance: The factors associated with the failure of nonoperative management of appendicitis and the differences in patient-reported outcomes between successful and unsuccessful nonoperative management remain unknown.

Objectives: To investigate factors associated with the failure of nonoperative management of appendicitis and compare patient-reported outcomes between patients whose treatment succeeded and those whose treatment failed.

Design, Setting, and Participants: This study was a planned subgroup secondary analysis conducted in 10 children's hospitals that included 370 children aged 7 to 17 years with uncomplicated appendicitis enrolled in a prospective, nonrandomized clinical trial between May 1, 2015, and October 31, 2018, with 1-year follow-up …

Association Of Inappropriate Outpatient Pediatric Antibiotic Prescriptions With Adverse Drug Events And Health Care Expenditures, Anne M Butler, Derek S Brown, Michael J Durkin, John M Sahrmann, Katelin B Nickel, Caroline A O'Neil, Margaret A Olsen, David Y Hyun, Rachel M Zetts, Jason G Newland

2020-Current year OA Pubs

Importance: Nonguideline antibiotic prescribing for the treatment of pediatric infections is common, but the consequences of inappropriate antibiotics are not well described.

Objective: To evaluate the comparative safety and health care expenditures of inappropriate vs appropriate oral antibiotic prescriptions for common outpatient pediatric infections.

Design, Setting, and Participants: This cohort study included children aged 6 months to 17 years diagnosed with a bacterial infection (suppurative otitis media [OM], pharyngitis, sinusitis) or viral infection (influenza, viral upper respiratory infection [URI], bronchiolitis, bronchitis, nonsuppurative OM) as an outpatient from April 1, 2016, to September 30, 2018, in the IBM MarketScan Commercial Database. …

Cd19 + Cd21lo/Neg Cells Are Increased In Systemic Sclerosis-Associated Interstitial Lung Disease, Erin M Wilfong, Katherine N Vowell, Kaitlyn E Bunn, Elise Rizzi, Narender Annapureddy, Rosemarie B Dudenhofer, April Barnado, Rachel H Bonami, Joyce E Johnson, Leslie J Crofford, Peggy L Kendall

2020-Current year OA Pubs

Interstitial lung disease (ILD) represents a significant cause of morbidity and mortality in systemic sclerosis (SSc). The purpose of this study was to examine recirculating lymphocytes from SSc patients for potential biomarkers of interstitial lung disease (ILD). Peripheral blood mononuclear cells (PBMCs) were isolated from patients with SSc and healthy controls enrolled in the Vanderbilt University Myositis and Scleroderma Treatment Initiative Center cohort between 9/2017-6/2019. Clinical phenotyping was performed by chart abstraction. Immunophenotyping was performed using both mass cytometry and fluorescence cytometry combined with t-distributed stochastic neighbor embedding analysis and traditional biaxial gating. This study included 34 patients with SSc-ILD, …

Cardiac Mesenchymal Stem Cells Promote Fibrosis And Remodeling In Heart Failure: Role Of Pdgf Signaling, Tariq Hamid, Yuanyuan Xu, Mohamed Ameen Ismahil, Gregg Rokosh, Miki Jinno, Guihua Zhou, Qiongxin Wang, Sumanth D. Prabhu

2020-Current year OA Pubs

Heart failure (HF) is characterized by progressive fibrosis. Both fibroblasts and mesenchymal stem cells (MSCs) can differentiate into pro-fibrotic myofibroblasts. MSCs secrete and express platelet-derived growth factor (PDGF) and its receptors. We hypothesized that PDGF signaling in cardiac MSCs (cMSCs) promotes their myofibroblast differentiation and aggravates post-myocardial infarction left ventricular remodeling and fibrosis. We show that cMSCs from failing hearts post-myocardial infarction exhibit an altered phenotype. Inhibition of PDGF signaling in vitro inhibited cMSC-myofibroblast differentiation, whereas in vivo inhibition during established ischemic HF alleviated left ventricular remodeling and function, and decreased myocardial fibrosis, hypertrophy, and inflammation. Modulating cMSC PDGF receptor …

Efficacy And Safety Of Bempedoic Acid In Patients Not Receiving Statins In Phase 3 Clinical Trials, Ulrich Laufs, Christie M Ballantyne, Maciej Banach, Harold Bays, Alberico L Catapano, P Barton Duell, Anne C Goldberg, Antonio M Gotto, Lawrence A Leiter, Kausik K Ray, Leanne T Bloedon, Diane Macdougall, Yang Zhang, G B John Mancini

2020-Current year OA Pubs

BACKGROUND: Despite the high incidence of patients with statin tolerance problems, randomized evaluations of nonstatin oral treatment options for lowering of low-density lipoprotein cholesterol (LDL-C) in this population are sparse.

OBJECTIVE: To assess the LDL-C lowering effect of bempedoic acid in patients not taking statins.

METHODS: This was a pooled analysis of data from patients enrolled in four phase 3 bempedoic acid studies (12 to 52 weeks in duration) who were not taking concomitant statins (Phase 3 No Statin Cohort) and a phase 3 bempedoic acid plus ezetimibe fixed-dose combination study (BA+EZE FDC No Statin Cohort). The primary endpoint for …

American Society For Transplantation And Cellular Therapy Series: #5-Management Of Clostridioides Difficile Infection In Hematopoietic Cell Transplant Recipients, Carolyn D Alonso, Gabriela Maron, Mini Kamboj, Paul A Carpenter, Arun Gurunathan, Kathleen M Mullane, Erik R Dubberke

2020-Current year OA Pubs

The Practice Guidelines Committee of the American Society for Transplantation and Cellular Therapy partnered with its Transplant Infectious Disease Special Interest Group to update its 2009 compendium-style infectious disease guidelines for hematopoietic cell transplantation (HCT). A completely new approach was taken with the goal of better serving clinical providers by publishing each standalone topic in the infectious disease series as a concise format of frequently asked questions (FAQ), tables, and figures. Adult and pediatric infectious disease and HCT content experts developed and then answered FAQs and finalized topics with harmonized recommendations that were made by assigning an A through E …

Functional Analysis Of A Novel De Novo Variant In Ppp5c Associated With Microcephaly, Seizures, And Developmental Delay, Sara M Fielder, Jill A Rosenfeld, Lindsay C Burrage, Lisa Emrick, Seema Lalani, Ruben Attali, Joshua N Bembenek, Hieu Hoang, Dustin Baldridge, Gary A Silverman, Undiagnosed Diseases Network, Tim Schedl, Stephen C Pak

2020-Current year OA Pubs

We describe a proband evaluated through the Undiagnosed Diseases Network (UDN) who presented with microcephaly, developmental delay, and refractory epilepsy with a de novo p.Ala47Thr missense variant in the protein phosphatase gene, PPP5C. This gene has not previously been associated with a Mendelian disease, and based on the population database, gnomAD, the gene has a low tolerance for loss-of-function variants (pLI = 1, o/e = 0.07). We functionally evaluated the PPP5C variant in C. elegans by knocking the variant into the orthologous gene, pph-5, at the corresponding residue, Ala48Thr. We employed assays in three different biological processes where pph-5 was …

Bone Metastases In Non-Small Cell Lung Cancer: A Narrative Review, Brendan J. Knapp, Siddhartha Devarakonda, Ramaswamy Govindan

2020-Current year OA Pubs

Background and Objective: Bone metastases are common in patients with non-small cell lung cancer (NSCLC) and remain a significant source of morbidity, mortality, and diminished quality of life, despite the considerable progress made in the overall management of patients with metastatic NSCLC over the last decade. Understanding the molecular pathogenesis of bone metastases is critical to improving survival, preserving function, and managing symptoms in this patient population. The objective of our review is to provide a comprehensive review of the pathophysiology, clinical presentation, management, and factors predicting the development and prognosis of patients with NSCLC with bone metastases.

Methods: An …

Anxiety Symptoms Among Patients With Systemic Lupus Erythematosus Persist Over Time And Are Independent Of Sle Disease Activity, Daphne Lew, Xinliang Huang, Sara R Kellahan, Hong Xian, Seth Eisen, Alfred H J Kim

2020-Current year OA Pubs

OBJECTIVE: The objectives of this study are to identify patterns of anxiety symptomology over time among patients with systemic lupus erythematosus (SLE) and to assess the longitudinal relationship between SLE disease activity and anxiety symptomology.

METHODS: Longitudinal data from 139 patients with American College of Rheumatology or Systemic Lupus International Collborating Clinic (SLICC)-classified SLE were analyzed. Anxiety symptomology was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Emotional Distress: Anxiety Short Form 8a. SLE disease activity was measured using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2000 (S2K) and S2K Responder Index 50 (S2K RI-50). Group-based trajectory modeling (GBTM) …

Optimization Of Care For Patients With Hereditary Angioedema Living In Rural Areas, Marc A Riedl, Douglas T Johnston, John Anderson, J Allen Meadows, Daniel Soteres, Stephen B Leblanc, H James Wedner, David M Lang

2020-Current year OA Pubs

BACKGROUND: People living in rural areas of the United States experience greater health inequality than individuals residing in urban or suburban locations and encounter several barriers to obtaining optimal health care. Health disparities are compounded for patients with rare diseases such as hereditary angioedema (HAE), an autosomal dominant genetic disorder characterized by recurrent, severe abdominal pain and life-threatening oropharyngeal or laryngeal swelling.

OBJECTIVE: To explore the challenges of managing patients with HAE in rural areas and suggest possible improvements for optimizing care.

DATA SOURCES: PubMed was searched for articles on patient care management, treatment challenges, rural health, and HAE.

STUDY …

Poems Syndrome: Real World Experience In Diagnosis And Systemic Therapy - 108 Patients Multicenter Analysis, Artur Jurczyszyn, Mark Fiala, Ravi Vij, Et Al.

2020-Current year OA Pubs

POEMS syndrome, a rare plasma cell disorder, is challenging both in the diagnostic and therapeutic management. We present real word retrospective analysis of 108 cases analyzing clinical features and therapeutic modes. We compare our results with the available literature. This is the first description with such wide use of proteasome inhibitors in first line treatment. POEMS (Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes) syndrome is a rare and challenging plasma cell disorder, both in the diagnostic and therapeutic management of the disease. Currently, the literature on POEMS is sparse with most evidence being case reports and small case studies. We present …