Medicine and Health Sciences Commons^™

Development And Evaluation Of A Wearable Peripheral Vascular Compensation Sensor In A Swine Model Of Hemorrhage, Francesca Bonetta-Misteli, Toi Collins, Todd Pavek, Madison Carlgren, Derek Bashe, Antonina Frolova, Leonid Shmuylovich, Christine M O'Brien

2020-Current year OA Pubs

Postpartum hemorrhage (PPH) is the leading and most preventable cause of maternal mortality, particularly in low-resource settings. PPH is currently diagnosed through visual estimation of blood loss or monitoring of vital signs. Visual assessment routinely underestimates blood loss beyond the point of pharmaceutical intervention. Quantitative monitoring of hemorrhage-induced compensatory processes, such as the constriction of peripheral vessels, may provide an early alert for PPH. To this end, we developed a low-cost, wearable optical device that continuously monitors peripheral perfusion via laser speckle flow index (LSFI) to detect hemorrhage-induced peripheral vasoconstriction. The measured LSFI signal produced a linear response in phantom …

Social And Psychological Adversity Are Associated With Distinct Mother And Infant Gut Microbiome Variations, Barbara B Warner, Bruce A Rosa, I Malick Ndao, Phillip I Tarr, J Philip Miller, Sarah K England, Joan L Luby, Cynthia E Rogers, Carla Hall-Moore, Renay E Bryant, Jacqueline D Wang, Laura A Linneman, Tara A Smyser, Christopher D Smyser, Deanna M Barch, John Martin, Makedonka Mitreva, Et Al.

2020-Current year OA Pubs

Health disparities are driven by underlying social disadvantage and psychosocial stressors. However, how social disadvantage and psychosocial stressors lead to adverse health outcomes is unclear, particularly when exposure begins prenatally. Variations in the gut microbiome and circulating proinflammatory cytokines offer potential mechanistic pathways. Here, we interrogate the gut microbiome of mother-child dyads to compare high-versus-low prenatal social disadvantage, psychosocial stressors and maternal circulating cytokine cohorts (prospective case-control study design using gut microbiomes from 121 dyads profiled with 16 S rRNA sequencing and 89 dyads with shotgun metagenomic sequencing). Gut microbiome characteristics significantly predictive of social disadvantage and psychosocial stressors in …

Effects Of Computer-Based Cognitive Training Combined With Physical Training For Older Adults With Cognitive Impairment: A Four-Arm Randomized Controlled Trial, I-Ching Chuang, Hui-Yan Chiau, Wan-Wen Liao, Yih-Ru Wu, Chih-Hung Chang, Ching-Yi Wu

2020-Current year OA Pubs

OBJECTIVE: Combined physical (PHY) and cognitive (COG) training in sequential (SEQ) and simultaneous (SIMUL) sessions may delay the progression of cognitive impairment. To date, no study has directly compared in older adults with cognitive impairment the effects of COG training, PHY training, SEQ motor-cognitive training and SIMUL motor-cognitve training on specific indices of cognitive performance and activities of daily living (ADL). The purpose of this study was to determine whether SEQ and SIMUL motor-cognitive training can improve treatment outcomes compared with PHY or COG training alone. We also aimed to compare the effects of SEQ versus SIMUL motor-cognitive training on …

Disentangling Age, Gender, And Racial/Ethnic Disparities In Multiple Myeloma Burden: A Modeling Study, John H Huber, Mengmeng Ji, Yi-Hsuan Shih, Mei Wang, Graham Colditz, Su-Hsin Chang

2020-Current year OA Pubs

Multiple myeloma (MM) is a hematological malignancy that is consistently preceded by an asymptomatic condition, monoclonal gammopathy of undetermined significance (MGUS). Disparities by age, gender, and race/ethnicity in both MGUS and MM are well-established. However, it remains unclear whether these disparities can be explained by increased incidence of MGUS and/or accelerated progression from MGUS to MM. Here, we fit a mathematical model to nationally representative data from the United States and showed that the difference in MM incidence can be explained by an increased incidence of MGUS among male and non-Hispanic Black populations. We did not find evidence showing differences …

Association Of Antimicrobial Perioperative Prophylaxis With Cefuroxime Plus Metronidazole Or Amoxicillin/Clavulanic Acid And Surgical Site Infections In Colorectal Surgery, Elisavet Stavropoulou, Andrew Atkinson, Marie-Christine Eisenring, Christoph A Fux, Jonas Marschall, Laurence Senn, Nicolas Troillet

2020-Current year OA Pubs

OBJECTIVE: To compare intravenous (IV) amoxicillin/clavulanic acid (A/CA) to IV cefuroxime plus metronidazole (C + M) for preventing surgical site infections (SSI) in colorectal surgery.

BACKGROUND: Given their spectra that include most Enterobacterales and anaerobes, C + M is commonly recommended as prophylaxis of SSI in colorectal surgery. A/CA offers good coverage of Enterobacterales and anaerobes as well, but, in contrast to C + M, it also includes Enterococcus faecalis which is also isolated from patients with SSI and could trigger anastomotic leakage.

METHODS: Data from a Swiss SSI surveillance program were used to compare SSI rates after class II …

Virtual Blebbistatin: A Robust And Rapid Software Approach To Motion Artifact Removal In Optical Mapping Of Cardiomyocytes, Louis G Woodhams, Jingxuan Guo, David Schuftan, John J Boyle, Kenneth M Pryse, Elliot L Elson, Nathaniel Huebsch, Guy M Genin

2020-Current year OA Pubs

Fluorescent reporters of cardiac electrophysiology provide valuable information on heart cell and tissue function. However, motion artifacts caused by cardiac muscle contraction interfere with accurate measurement of fluorescence signals. Although drugs such as blebbistatin can be applied to stop cardiac tissue from contracting by uncoupling calcium-contraction, their usage prevents the study of excitation-contraction coupling and, as we show, impacts cellular structure. We therefore developed a robust method to remove motion computationally from images of contracting cardiac muscle and to map fluorescent reporters of cardiac electrophysiological activity onto images of undeformed tissue. When validated on cardiomyocytes derived from human induced pluripotent …

First-In-Human Prospective Trial Of Sonobiopsy In High-Grade Glioma Patients Using Neuronavigation-Guided Focused Ultrasound, Jinyun Yuan, Lu Xu, Chih-Yen Chien, Yaoheng Yang, Yimei Yue, Siaka Fadera, Andrew H Stark, Katherine E Schwetye, Arash Nazeri, Rupen Desai, Umeshkumar Athiraman, Aadel A Chaudhuri, Hong Chen, Eric C Leuthardt

2020-Current year OA Pubs

Sonobiopsy is an emerging technology that combines focused ultrasound (FUS) with microbubbles to enrich circulating brain disease-specific biomarkers for noninvasive molecular diagnosis of brain diseases. Here, we report the first-in-human prospective trial of sonobiopsy in high-grade glioma patients to evaluate its feasibility and safety in enriching plasma circulating tumor biomarkers. A nimble FUS device integrated with a clinical neuronavigation system was used to perform sonobiopsy following an established clinical workflow for neuronavigation. Analysis of blood samples collected before and after FUS sonication showed that sonobiopsy enriched plasma circulating tumor DNA (ctDNA), including a maximum increase of 1.6-fold for the mononucleosome …

Adding Pharmacist-Led Home Blood Pressure Telemonitoring To Usual Care For Blood Pressure Control: A Systematic Review And Meta-Analysis, Nischit Baral, Annabelle Santos Volgman, Amith Seri, Vijaya Chelikani, Sakiru Isa, Sri L P Javvadi, Timir K Paul, Joshua D Mitchell

2020-Current year OA Pubs

Health systems have been quickly adopting telemedicine throughout the United States, especially since the onset of the COVID-19 pandemic. However, there are limited data on whether adding pharmacist-led home blood pressure (BP) telemonitoring to office-based usual care improves BP. We searched PubMed/MEDLINE and Embase for randomized controlled trials from January 2000 until April 2022, comparing studies on pharmacist-led home BP telemonitoring with usual care. Six randomized controlled trials, including 1,550 participants, satisfied the inclusion criteria. There were 774 participants in the pharmacist-led telemonitoring group and 776 in the usual care group. The addition of pharmacist-led telemonitoring to usual care was …

Tangent Functional Connectomes Uncover More Unique Phenotypic Traits, Kausar Abbas, Mintao Liu, Michael Wang, Duy Duong-Tran, Uttara Tipnis, Enrico Amico, Alan D Kaplan, Mario Dzemidzic, David Kareken, Beau M Ances, Jaroslaw Harezlak, Joaquín Goñi

2020-Current year OA Pubs

Functional connectomes (FCs) containing pairwise estimations of functional couplings between pairs of brain regions are commonly represented by correlation matrices. As symmetric positive definite matrices, FCs can be transformed via tangent space projections, resulting into tangent-FCs. Tangent-FCs have led to more accurate models predicting brain conditions or aging. Motivated by the fact that tangent-FCs seem to be better biomarkers than FCs, we hypothesized that tangent-FCs have also a higher fingerprint. We explored the effects of six factors: fMRI condition, scan length, parcellation granularity, reference matrix, main-diagonal regularization, and distance metric. Our results showed that identification rates are systematically higher when …

Ifn-Λ Derived From Nonsusceptible Enterocytes Acts On Tuft Cells To Limit Persistent Norovirus, Harshad Ingle, Heyde Makimaa, Somya Aggarwal, Hongju Deng, Lynne Foster, Yuhao Li, Elizabeth A Kennedy, Stefan T Peterson, Craig B Wilen, Sanghyun Lee, Mehul S Suthar, Megan T Baldridge

2020-Current year OA Pubs

Norovirus is a leading cause of epidemic viral gastroenteritis, with no currently approved vaccines or antivirals. Murine norovirus (MNoV) is a well-characterized model of norovirus pathogenesis in vivo, and persistent strains exhibit lifelong intestinal infection. Interferon-λ (IFN-λ) is a potent antiviral that rapidly cures MNoV. We previously demonstrated that IFN-λ signaling in intestinal epithelial cells (IECs) controls persistent MNoV, and here demonstrate that IFN-λ acts on tuft cells, the exclusive site of MNoV persistence, to limit infection. While interrogating the source of IFN-λ to regulate MNoV, we confirmed that MDA5-MAVS signaling, required for IFN-λ induction to MNoV in vitro, controls …

Procedure For Handling And Storage Of Onchocerca Volvulus Microfilariae Obtained From Skin Snips For Downstream Genetic Work, Shannon M Hedtke, Anusha Kode, Tony O Ukety, Jöel L Mande, Germain M Abhafule, Anuarite A Raciu, Claude B Uvon, Stephen R Jada, An Hotterbeekx, Joseph Nelson Siewe Fodjo, Makedonka Mitreva, Wilson Sebit, Robert Colebunders, Warwick N Grant, Annette C Kuesel

2020-Current year OA Pubs

WHO and endemic countries target elimination of transmission of

Picobirnaviruses Encode Proteins That Are Functional Bacterial Lysins, Tianyu Gan, David Wang

2020-Current year OA Pubs

Picobirnaviruses (PBVs) are double-stranded RNA viruses frequently detected in human and animal enteric viromes. Associations of PBVs with enteric graft-versus-host disease and type I diabetes during pregnancy have been established. Since their discovery in 1988, PBVs have been generally assumed to be animal-infecting viruses despite the lack of culture system, animal model, or detection in animal cells or tissues. Recent studies have proposed that bacteria or fungi could be the hosts of PBVs based on genomic analysis. Here, we functionally demonstrate that multiple PBVs of different genome organizations encode bacterial lysins that lyse

Proteogenomic Insights Suggest Druggable Pathways In Endometrial Carcinoma, Yongchao Dou, Rita Jui-Hsien Lu, Yige Wu, Matthew A Wyczalkowski, David Mutch, Li Ding, Et Al.

2020-Current year OA Pubs

We characterized a prospective endometrial carcinoma (EC) cohort containing 138 tumors and 20 enriched normal tissues using 10 different omics platforms. Targeted quantitation of two peptides can predict antigen processing and presentation machinery activity, and may inform patient selection for immunotherapy. Association analysis between MYC activity and metformin treatment in both patients and cell lines suggests a potential role for metformin treatment in non-diabetic patients with elevated MYC activity. PIK3R1 in-frame indels are associated with elevated AKT phosphorylation and increased sensitivity to AKT inhibitors. CTNNB1 hotspot mutations are concentrated near phosphorylation sites mediating pS45-induced degradation of β-catenin, which may render …

Erg K+ Channels Mediate A Major Component Of Action Potential Repolarization In Lymphatic Muscle, Hae Jin Kim, Min Li, Emma C Erlich, Gwendalyn J Randolph, Michael J Davis

2020-Current year OA Pubs

Smooth muscle cells in the walls of collecting lymphatic vessels fire spontaneous action potentials (APs), which conduct rapidly over the muscle layer to initiate contractions that propel lymph. Several ion channels have been implicated in the currents underlying the AP spike and the preceding diastolic depolarization, but the molecular identities of K

Phase Separation Of Protein Mixtures Is Driven By The Interplay Of Homotypic And Heterotypic Interactions, Mina Farag, Wade M Borcherds, Anne Bremer, Tanja Mittag, Rohit V Pappu

2020-Current year OA Pubs

Prion-like low-complexity domains (PLCDs) are involved in the formation and regulation of distinct biomolecular condensates that form via phase separation coupled to percolation. Intracellular condensates often encompass numerous distinct proteins with PLCDs. Here, we combine simulations and experiments to study mixtures of PLCDs from two RNA-binding proteins, hnRNPA1 and FUS. Using simulations and experiments, we find that 1:1 mixtures of A1-LCD and FUS-LCD undergo phase separation more readily than either of the PLCDs on their own due to complementary electrostatic interactions. Tie line analysis reveals that stoichiometric ratios of different components and their sequence-encoded interactions contribute jointly to the driving …

3d-Cultured Blastoids Model Human Embryogenesis From Pre-Implantation To Early Gastrulation Stages, Rowan M Karvas, Joseph E Zemke, Syed Shahzaib Ali, Eric Upton, Eshan Sane, Laura A Fischer, Chen Dong, Kyoung-Mi Park, Brian Chew, Brittany Meyer, Chao Zhou, Sabine Dietmann, Thorold W Theunissen, Et Al.

2020-Current year OA Pubs

Naive human pluripotent stem cells have the remarkable ability to self-organize into blastocyst-like structures ("blastoids") that model lineage segregation in the pre-implantation embryo. However, the extent to which blastoids can recapitulate the defining features of human post-implantation development remains unexplored. Here, we report that blastoids cultured on thick three-dimensional (3D) extracellular matrices capture hallmarks of early post-implantation development, including epiblast lumenogenesis, rapid expansion and diversification of trophoblast lineages, and robust invasion of extravillous trophoblast cells by day 14. Extended blastoid culture results in the localized activation of primitive streak marker TBXT and the emergence of embryonic germ layers by day …

Atezolizumab For Advanced Alveolar Soft Part Sarcoma, Alice P Chen, Brian A Van Tine, Et Al.

2020-Current year OA Pubs

BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare soft-tissue sarcoma with a poor prognosis and no established therapy. Recently, encouraging responses to immune checkpoint inhibitors have been reported.

METHODS: We conducted an investigator-initiated, multicenter, single-group, phase 2 study of the anti-programmed death ligand 1 (PD-L1) agent atezolizumab in adult and pediatric patients with advanced ASPS. Atezolizumab was administered intravenously at a dose of 1200 mg (in patients ≥18 years of age) or 15 mg per kilogram of body weight with a 1200-mg cap (in patients <18 years of age) once every 21 days. Study end points included objective response, duration of response, and progression-free survival according to Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1, as well as pharmacodynamic biomarkers of multistep drug action.

RESULTS: A total of 52 patients were evaluated. An objective response was observed in …

Facilitators And Barriers To Optimal Home Blood Pressure Management In Patients With Hypertensive Disorders Of Pregnancy In A Tertiary Care Facility In Abuja, Nigeria: A Qualitative Research Study, Zainab Mahmoud, Adaego A Orji, Chukwuebuka F Okoye, Friday O Ameh, Erica Jamro-Comer, Aliyu Isah, Bissallah Ekele, Godwin Akaba, Dike B Ojji, Mark D Huffman

2020-Current year OA Pubs

BACKGROUND: Nigeria has one of the highest burdens of maternal deaths globally, and hypertensive disorders of pregnancy (HDP) are the leading cause of maternal morbidity and mortality in the country. There is a significant implementation gap in utilizing evidence-based practices for the management of HDP in Nigeria. This study evaluated facilitators and barriers to implementing a home blood pressure monitoring program to improve management of HDP.

METHODS: From August 2022 to September 2022, we conducted 15 semi-structured, key informant interviews and 4 focus group discussions among patients, health care workers, and administrators at University of Abuja Teaching Hospital (UATH), a …

Single Genomic Enhancers Drive Experience-Dependent Gabaergic Plasticity To Maintain Sensory Processing In The Adult Cortex, Ori Roethler, Eran Zohar, Katayun Cohen-Kashi Malina, Lidor Bitan, Harrison Wren Gabel, Ivo Spiegel

2020-Current year OA Pubs

Experience-dependent plasticity of synapses modulates information processing in neural circuits and is essential for cognitive functions. The genome, via non-coding enhancers, was proposed to control information processing and circuit plasticity by regulating experience-induced transcription of genes that modulate specific sets of synapses. To test this idea, we analyze here the cellular and circuit functions of the genomic mechanisms that control the experience-induced transcription of Igf1 (insulin-like growth factor 1) in vasoactive intestinal peptide (VIP) interneurons (INs) in the visual cortex of adult mice. We find that two sensory-induced enhancers selectively and cooperatively drive the activity-induced transcription of Igf1 to thereby …

Hyperferritinemic Sepsis, Macrophage Activation Syndrome, And Mortality In A Pediatric Research Network: A Causal Inference Analysis, Zhenziang Fan, John C Lin, Allan Doctor, Et Al.

2020-Current year OA Pubs

BACKGROUND: One of five global deaths are attributable to sepsis. Hyperferritinemic sepsis (> 500 ng/mL) is associated with increased mortality in single-center studies. Our pediatric research network's objective was to obtain rationale for designing anti-inflammatory clinical trials targeting hyperferritinemic sepsis.

METHODS: We assessed differences in 32 cytokines, immune depression (low whole blood ex vivo TNF response to endotoxin) and thrombotic microangiopathy (low ADAMTS13 activity) biomarkers, seven viral DNAemias, and macrophage activation syndrome (MAS) defined by combined hepatobiliary dysfunction and disseminated intravascular coagulation, and mortality in 117 children with hyperferritinemic sepsis (ferritin level > 500 ng/mL) compared to 280 children with sepsis …

Are Public Health Researchers Designing For Dissemination? Findings From A National Survey In China, Yiluan Hu, Xuejun Yin, Enying Gong, Jing Liu, Xia Liu, Ruitai Shao, Juan Zhang, Ross C Brownson

2020-Current year OA Pubs

BACKGROUND: Research findings are not always disseminated in ways preferred by audiences, and research dissemination is not always considered a priority by researchers. While designing for dissemination (D4D) provides an active process to facilitate effective dissemination, use of these practices in China is largely unknown. We aimed to describe the designing for dissemination activities and practices among public health researchers in China.

METHODS: In January 2022, we conducted a cross-sectional survey in 61 sub-committees of four national academic societies which include a wide range of health disciplines. The sample mainly involved researchers at universities or research institutions, the Centers for …

Lem2 Is Essential For Cardiac Development By Maintaining Nuclear Integrity, Jacob A Ross, Didier Hodzic, Et Al.

2020-Current year OA Pubs

AIMS: Nuclear envelope integrity is essential for the compartmentalization of the nucleus and cytoplasm. Importantly, mutations in genes encoding nuclear envelope (NE) and associated proteins are the second highest cause of familial dilated cardiomyopathy. One such NE protein that causes cardiomyopathy in humans and affects mouse heart development is Lem2. However, its role in the heart remains poorly understood.

METHODS AND RESULTS: We generated mice in which Lem2 was specifically ablated either in embryonic cardiomyocytes (Lem2 cKO) or in adult cardiomyocytes (Lem2 iCKO) and carried out detailed physiological, tissue, and cellular analyses. High-resolution episcopic microscopy was used for three-dimensional reconstructions …

Medication And Road Test Performance Among Cognitively Healthy Older Adults, David B Carr, Kebede Beyene, Jason Doherty, Samantha A Murphy, Ann M Johnson, Hailee Domash, Noah Riley, Alexis Walker, Ashwin Sabapathy, John C Morris, Ganesh M Babulal

2020-Current year OA Pubs

IMPORTANCE: Older adults are increasingly prescribed medications that have adverse effects. Prior studies have found a higher risk of motor vehicle crashes to be associated with certain medication use.

OBJECTIVE: To determine whether specific medication classes were associated with performance decline as assessed by a standardized road test in a community sample of cognitively healthy older adults, to evaluate additional associations of poor road test performance with comorbid medical conditions and demographic characteristics, and to test the hypothesis that specific medication classes (ie, antidepressants, benzodiazepines, sedatives or hypnotics, anticholinergics, antihistamines, and nonsteroidal anti-inflammatory drugs or acetaminophen) would be associated with …

Evaluation Of The Electronic Clinical Dementia Rating For Dementia Screening, Rachel L Nosheny, Daniel Yen, Krista Moulder, Connie Mayo, Maureen Mcmillan, John C Morris, Yan Li, Et Al.

2020-Current year OA Pubs

IMPORTANCE: The Clinical Dementia Rating (CDR) is a well-validated instrument widely used to detect and stage dementia due to Alzheimer disease. The digital Electronic Clinical Dementia Rating (eCDR) can be remotely self-administered and automatically scored, with potential to facilitate efficient dementia screening and staging.

OBJECTIVE: To evaluate the association of the eCDR with the CDR and other in-clinic assessments for screening older adults for cognitive impairment.

DESIGN, SETTING, AND PARTICIPANTS: This multisite, cross-sectional study used baseline data from a longitudinal, observational study from 2020 to 2023, including up to 3 years of follow-up. Participants were enrolled from 3 Alzheimer Disease …

Acc/Aha Hypertension Guidelines And Cha2ds2-Vasc Up-Scoring In Patients With Atrial Fibrillation, Krishna Pundi, Kensey L Gosch, Alexander C Perino, Philip G Jones, Nihar R Desai, Thomas M Maddox, Mintu Turakhia

2020-Current year OA Pubs

No abstract provided.

State Public Assistance Spending And Survival Among Adults With Cancer, Justin M Barnes, Kenton J Johnston, Kimberly J Johnson, Fumiko Chino, Nosayaba Osazuwa-Peters

2020-Current year OA Pubs

IMPORTANCE: Social determinants of health contribute to disparities in cancer outcomes. State public assistance spending, including Medicaid and cash assistance programs for socioeconomically disadvantaged individuals, may improve access to care; address barriers, such as food and housing insecurity; and lead to improved cancer outcomes for marginalized populations.

OBJECTIVE: To determine whether state-level public assistance spending is associated with overall survival (OS) among individuals with cancer, overall and by race and ethnicity.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included US adults aged at least 18 years with a new cancer diagnosis from 2007 to 2013, with follow-up through 2019. Data …

Neighborhood Disadvantage And Neural Correlates Of Threat And Reward Processing In Survivors Of Recent Trauma, E Kate Webb, Stacey L House, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Differences in neighborhood socioeconomic characteristics are important considerations in understanding differences in risk vs resilience in mental health. Neighborhood disadvantage is associated with alterations in the function and structure of threat neurocircuitry.

OBJECTIVE: To investigate associations of neighborhood disadvantage with white and gray matter and neural reactivity to positive and negative stimuli in the context of trauma exposure.

DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, survivors of trauma who completed sociodemographic and posttraumatic symptom assessments and neuroimaging were recruited as part of the Advancing Understanding of Recovery After Trauma (AURORA) study between September 2017 and June 2021. Data …

An Intraoperative Telemedicine Program To Improve Perioperative Quality Measures: The Actfast-3 Randomized Clinical Trial, Christopher R King, Stephen Gregory, Bradley A Fritz, Thaddeus P Budelier, Arbi Ben Abdallah, Alex Kronzer, Daniel L Helsten, Brian Torres, Sherry Mckinnon, Shreya Goswami, Divya Mehta, Omokhaye Higo, Paul Kerby, Bernadette Henrichs, Mary C Politi, Joanna Abraham, Michael S Avidan, Thomas Kannampallil, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Telemedicine for clinical decision support has been adopted in many health care settings, but its utility in improving intraoperative care has not been assessed.

OBJECTIVE: To pilot the implementation of a real-time intraoperative telemedicine decision support program and evaluate whether it reduces postoperative hypothermia and hyperglycemia as well as other quality of care measures.

DESIGN, SETTING, AND PARTICIPANTS: This single-center pilot randomized clinical trial (Anesthesiology Control Tower-Feedback Alerts to Supplement Treatments [ACTFAST-3]) was conducted from April 3, 2017, to June 30, 2019, at a large academic medical center in the US. A total of 26 254 adult surgical patients …

Development And Replication Of Objective Measurements Of Social Visual Engagement To Aid In Early Diagnosis And Assessment Of Autism, Warren Jones, Cheryl Klaiman, Shana Richardson, Meena Lambha, Morganne Reid, Taralee Hamner, Chloe Beacham, Peter Lewis, Jose Paredes, Laura Edwards, Natasha Marrus, John N Constantino, Sarah Shultz, Ami Klin

2020-Current year OA Pubs

IMPORTANCE: Autism spectrum disorder is a common and early-emerging neurodevelopmental condition. While 80% of parents report having had concerns for their child's development before age 2 years, many children are not diagnosed until ages 4 to 5 years or later.

OBJECTIVE: To develop an objective performance-based tool to aid in early diagnosis and assessment of autism in children younger than 3 years.

DESIGN, SETTING, AND PARTICIPANTS: In 2 prospective, consecutively enrolled, broad-spectrum, double-blind studies, we developed an objective eye-tracking-based index test for children aged 16 to 30 months, compared its performance with best-practice reference standard diagnosis of autism (discovery study), …

Acute Kidney Injury-Induced Circulating Tnfr1/2 Elevations Correlate With Persistent Kidney Injury And Progression To Fibrosis, Akshayakeerthi Arthanarisami, Yohei Komaru, Charikleia Katsouridi, Julian Schumacher, Deborah K Verges, Liang Ning, Mai M Abdelmageed, Andreas Herrlich, Eirini Kefaloyianni

2020-Current year OA Pubs

Elevated levels of circulating tumor necrosis factor receptors 1 and 2 (cTNFR1/2) predict chronic kidney disease (CKD) progression; however, the mechanisms of their release remain unknown. Whether acute kidney injury (AKI) drives cTNFR1/2 elevations and whether they predict disease outcomes after AKI remain unknown. In this study, we used AKI patient serum and urine samples, mouse models of kidney injury (ischemic, obstructive, and toxic), and progression to fibrosis, nephrectomy, and related single-cell RNA-sequencing datasets to experimentally test the role of kidney injury on cTNFR1/2 levels. We show that TNFR1/2 serum and urine levels are highly elevated in all of the …