Medicine and Health Sciences Commons^™

Il-12 Reprograms Car-Expressing Natural Killer T Cells To Long-Lived Th1-Polarized Cells With Potent Antitumor Activity, Elisa Landoni, Mark G Woodcock, Gabriel Barragan, Gabriele Casirati, Vincenzo Cinella, Simone Stucchi, Leah M Flick, Tracy A Withers, Hanna Hudson, Giulia Casorati, Paolo Dellabona, Pietro Genovese, Barbara Savoldo, Leonid S Metelitsa, Gianpietro Dotti

Faculty, Staff and Students Publications

Human natural killer T cells (NKTs) are innate-like T lymphocytes increasingly used for cancer immunotherapy. Here we show that human NKTs expressing the pro-inflammatory cytokine interleukin-12 (IL-12) undergo extensive and sustained molecular and functional reprogramming. Specifically, IL-12 instructs and maintains a Th1-polarization program in NKTs in vivo without causing their functional exhaustion. Furthermore, using CD62L as a marker of memory cells in human NKTs, we observe that IL-12 maintains long-term CD62L-expressing memory NKTs in vivo. Notably, IL-12 initiates a de novo programming of memory NKTs in CD62L-negative NKTs indicating that human NKTs circulating in the peripheral blood possess an intrinsic …

Navigating The Observation Zone: Do Risk Scores Help Stratify Patients With Indeterminate High-Sensitivity Cardiac Troponins?, Nicklaus P Ashburn, James K Mccord, Anna C Snavely, Robert H Christenson, Fred S Apple, Richard M Nowak, William F Peacock, Christopher R Defilippi, Simon A Mahler

Faculty, Staff and Students Publications

No abstract provided.

Combinatorial Effects Of Ion Channel Mis-Splicing As A Cause Of Myopathy In Myotonic Dystrophy, Larissa Nitschke, Thomas A Cooper

Faculty, Staff and Students Publications

Myotonic dystrophy type 1 (DM1) is an autosomal dominant disorder caused by an unstable expanded CTG repeat located in the 3'-UTR of the DM1 protein kinase (DMPK) gene. The pathogenic mechanism results in misregulated alternative splicing of hundreds of genes, creating the dilemma of establishing which genes contribute to the mechanism of DM1 skeletal muscle pathology. In this issue of the JCI, Cisco and colleagues systematically tested the combinatorial effects of DM1-relevant mis-splicing patterns in vivo and identified the synergistic effects of mis-spliced calcium and chloride channels as a major contributor to DM1 skeletal muscle impairment. The authors further demonstrated …

Short-Stay Units Vs Routine Admission From The Emergency Department In Patients With Acute Heart Failure: The Ssu-Ahf Randomized Clinical Trial, Peter S Pang, Douglas Char, Et Al.

2020-Current year OA Pubs

IMPORTANCE: More than 80% of patients who present to the emergency department (ED) with acute heart failure (AHF) are hospitalized. With more than 1 million annual hospitalizations for AHF in the US, safe and effective alternatives are needed. Care for AHF in short-stay units (SSUs) may be safe and more efficient than hospitalization, especially for lower-risk patients, but randomized clinical trial data are lacking.

OBJECTIVE: To compare the effectiveness of SSU care vs hospitalization in lower-risk patients with AHF.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter randomized clinical trial randomly assigned low-risk patients with AHF 1:1 to SSU or hospital admission …

Cost-Effectiveness Of Icosapent Ethyl In Reduce-It Usa: Results From Patients Randomized In The United States, William S Weintraub, Deepak L Bhatt, Zugui Zhang, Sarahfaye Dolman, William E Boden, Adam P Bress, Brandon K Bellows, Catherine G Derington, Sephy Philip, Gabriel Steg, Michael Miller, Eliot A Brinton, Terry A Jacobson, Jean-Claude Tardif, Christie M Ballantyne, Paul Kolm

Faculty, Staff and Students Publications

Background: In 3146 REDUCE-IT USA (Reduction of Cardiovascular Events With Icosapent Ethyl Intervention Trial USA) participants, icosapent ethyl (IPE) reduced first and total cardiovascular events by 31% and 36%, respectively, over 4.9 years of follow-up.

Methods and results: We used participant-level data from REDUCE-IT USA, 2021 US costs, and IPE costs ranging from $4.59 to $11.48 per day, allowing us to examine a range of possible medication costs. The in-trial analysis was participant-level, whereas the lifetime analysis used a Markov model. Both analyses considered value from a US health sector perspective. The incremental cost-effectiveness ratio (incremental costs divided by incremental …

Novel Techniques In Imaging Congenital Heart Disease: Jacc Scientific Statement, Ritu Sachdeva, Aimee K Armstrong, Rima Arnaout, Lars Grosse-Wortmann, B Kelly Han, Luc Mertens, Ryan A Moore, Laura J Olivieri, Anitha Parthiban, Andrew J Powell

Faculty, Staff and Students Publications

Recent years have witnessed exponential growth in cardiac imaging technologies, allowing better visualization of complex cardiac anatomy and improved assessment of physiology. These advances have become increasingly important as more complex surgical and catheter-based procedures are evolving to address the needs of a growing congenital heart disease population. This state-of-the-art review presents advances in echocardiography, cardiac magnetic resonance, cardiac computed tomography, invasive angiography, 3-dimensional modeling, and digital twin technology. The paper also highlights the integration of artificial intelligence with imaging technology. While some techniques are in their infancy and need further refinement, others have found their way into clinical workflow …

Gene Regulation And Speciation In A Migratory Divide Between Songbirds, Matthew I M Louder, Hannah Justen, Abigail A Kimmitt, Koedi S Lawley, Leslie M Turner, J David Dickman, Kira E Delmore

Faculty, Staff and Students Publications

Behavioral variation abounds in nature. This variation is important for adaptation and speciation, but its molecular basis remains elusive. Here, we use a hybrid zone between two subspecies of songbirds that differ in migration - an ecologically important and taxonomically widespread behavior---to gain insight into this topic. We measure gene expression in five brain regions. Differential expression between migratory states was dominated by circadian genes in all brain regions. The remaining patterns were largely brain-region specific. For example, expression differences between the subspecies that interact with migratory state likely help maintain reproductive isolation in this system and were documented in …

Clonal Hematopoiesis Risk Score And All-Cause And Cardiovascular Mortality In Older Adults, Seyedmohammad Saadatagah, Md Mesbah Uddin, Lachelle D Weeks, Abhishek Niroula, Meng Ru, Koichi Takahashi, Lukasz Gondek, Bing Yu, Alexander G Bick, Benjamin L Ebert, Elizabeth A Platz, Pradeep Natarajan, Christie M Ballantyne

Faculty, Staff and Student Publications

IMPORTANCE: Clonal hematopoiesis (CH) with acquired pathogenic variants in myeloid leukemia driver genes is common in older adults but of unknown prognostic value.

OBJECTIVE: To investigate the prevalence of CH and the utility of the CH risk score (CHRS) in estimating all-cause and disease-specific mortality in older adults with CH.

DESIGN, SETTING, AND PARTICIPANTS: This population-based prospective cohort study involved community-dwelling older adults (aged 67-90 years) without hematologic malignant neoplasms (HMs) who were participants in the Atherosclerosis Risk in Communities Visit 5 at 4 US centers: Forsyth County, North Carolina; Jackson, Mississippi; Minneapolis, Minnesota; and Washington County, Maryland. Samples were …

Microbial Co-Occurrences On Catheters From Long-Term Catheterized Patients, Taylor M Nye, Zongsen Zou, Chloe L P Obernuefemann, Jerome S Pinkner, Erin Lowry, Kent Kleinschmidt, Karla Bergeron, Aleksandra Klim, Karen W Dodson, Ana L Flores-Mireles, Jennifer N Walker, Daniel Garrett Wong, Alana Desai, Michael G Caparon, Scott J Hultgren

2020-Current year OA Pubs

Catheter-associated urinary tract infections (CAUTIs), a common cause of healthcare-associated infections, are caused by a diverse array of pathogens that are increasingly becoming antibiotic resistant. We analyze the microbial occurrences in catheter and urine samples from 55 human long-term catheterized patients collected over one year. Although most of these patients were prescribed antibiotics over several collection periods, their catheter samples remain colonized by one or more bacterial species. Examination of a total of 366 catheter and urine samples identify 13 positive and 13 negative genus co-occurrences over 12 collection periods, representing associations that occur more or less frequently than expected …

Prospective Study To Characterize Adalimumab Exposure In Pediatric Patients With Rheumatic Diseases, Tatjana Welzel, Klervi Golhen, Andrew Atkinson, Verena Gotta, David Ternant, Jasmin B Kuemmerle-Deschner, Christine Michler, Gilbert Koch, Johannes N Van Den Anker, Marc Pfister, Andreas Woerner

2020-Current year OA Pubs

BACKGROUND: In pediatric rheumatic diseases (PRD), adalimumab is dosed using fixed weight-based bands irrespective of methotrexate co-treatment, disease activity (DA) or other factors that might influence adalimumab pharmacokinetics (PK). In rheumatoid arthritis (RA) adalimumab exposure between 2-8 mg/L is associated with clinical response. PRD data on adalimumab is scarce. Therefore, this study aimed to analyze adalimumab PK and its variability in PRD treated with/without methotrexate.

METHODS: A two-center prospective study in PRD patients aged 2-18 years treated with adalimumab and methotrexate (G

RESULTS: Twenty-eight patients (14 per group), diagnosed with juvenile idiopathic arthritis (71.4%), non-infectious uveitis (25%) or chronic recurrent …

Hat: De Novo Variant Calling For Highly Accurate Short-Read And Long-Read Sequencing Data, Jeffrey K Ng, Tychele N Turner

2020-Current year OA Pubs

MOTIVATION: de novo variants (DNVs) are variants that are present in offspring but not in their parents. DNVs are both important for examining mutation rates as well as in the identification of disease-related variation. While efforts have been made to call DNVs, calling of DNVs is still challenging from parent-child sequenced trio data. We developed Hare And Tortoise (HAT) as an automated DNV detection workflow for highly accurate short-read and long-read sequencing data. Reliable detection of DNVs is important for human genomics and HAT addresses this need.

RESULTS: HAT is a computational workflow that begins with aligned read data (i.e. …

Organ Preservation And Survival By Clinical Response Grade In Patients With Rectal Cancer Treated With Total Neoadjuvant Therapy: A Secondary Analysis Of The Opra Randomized Clinical Trial, Hannah M Thompson, Steven R Hunt, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Assessing clinical tumor response following completion of total neoadjuvant therapy (TNT) in patients with locally advanced rectal cancer is paramount to select patients for watch-and-wait treatment.

OBJECTIVE: To assess organ preservation (OP) and oncologic outcomes according to clinical tumor response grade.

DESIGN, SETTING, AND PARTICIPANTS: This was secondary analysis of the Organ Preservation in Patients with Rectal Adenocarcinoma trial, a phase 2, nonblinded, multicenter, randomized clinical trial. Randomization occurred between April 2014 and March 2020. Eligible participants included patients with stage II or III rectal adenocarcinoma. Data analysis occurred from March 2022 to July 2023.

INTERVENTION: Patients were randomized …

Breast Cancer Incidence Among Us Women Aged 20 To 49 Years By Race, Stage, And Hormone Receptor Status, Shuai Xu, Sara Murtagh, Yunan Han, Fei Wan, Adetunji T Toriola

2020-Current year OA Pubs

IMPORTANCE: Breast cancer in young women has a less favorable prognosis compared with older women. Yet, comprehensive data on recent trends and how period and cohort effects may affect these trends among young women are not well-known.

OBJECTIVE: To evaluate breast cancer incidence among young women in the US over a 20-year period by race and ethnicity, hormone receptor status (estrogen receptor [ER] and progesterone receptor [PR]), tumor stage, and age at diagnosis, as well as how period and cohort effects may affect these trends.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from Surveillance, Epidemiology, and End Results …

Implications Of Preoperative Depression For Lumbar Spine Surgery Outcomes: A Systematic Review And Meta-Analysis, Saad Javeed, Braeden Benedict, Salim Yakdan, Samia Saleem, Justin K Zhang, Kathleen Botterbush, Madelyn R Frumkin, Angela Hardi, Brian Neuman, Jay F Piccirillo, Burel R Goodin, Thomas L Rodebaugh, Wilson Z Ray, Jacob K Greenberg, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Comorbid depression is common among patients with degenerative lumbar spine disease. Although a well-researched topic, the evidence of the role of depression in spine surgery outcomes remains inconclusive.

OBJECTIVE: To investigate the association between preoperative depression and patient-reported outcome measures (PROMs) after lumbar spine surgery.

DATA SOURCES: A systematic search of PubMed, Cochrane Database of Systematic Reviews, Embase, Scopus, PsychInfo, Web of Science, and ClinicalTrials.gov was performed from database inception to September 14, 2023.

STUDY SELECTION: Included studies involved adults undergoing lumbar spine surgery and compared PROMs in patients with vs those without depression. Studies evaluating the correlation between …

Lipid Nanodisc Scaffold And Size Alter The Structure Of A Pentameric Ligand-Gated Ion Channel, Vikram Dalal, Mark J Arcario, John T Petroff 2nd, Brandon K Tan, Noah M Dietzen, Michael J Rau, James A J Fitzpatrick, Grace Brannigan, Wayland W L Cheng

2020-Current year OA Pubs

Lipid nanodiscs have become a standard tool for studying membrane proteins, including using single particle cryo-electron microscopy (cryo-EM). We find that reconstituting the pentameric ligand-gated ion channel (pLGIC), Erwinia ligand-gated ion channel (ELIC), in different nanodiscs produces distinct structures by cryo-EM. The effect of the nanodisc on ELIC structure extends to the extracellular domain and agonist binding site. Additionally, molecular dynamic simulations indicate that nanodiscs of different size impact ELIC structure and that the nanodisc scaffold directly interacts with ELIC. These findings suggest that the nanodisc plays a crucial role in determining the structure of pLGICs, and that reconstitution of …

Fatty Acid Synthesis Suppresses Dietary Polyunsaturated Fatty Acid Use, Anna Worthmann, Sangeeta Adak, Clay F Semenkovich, Et Al.

2020-Current year OA Pubs

Dietary polyunsaturated fatty acids (PUFA) are increasingly recognized for their health benefits, whereas a high production of endogenous fatty acids - a process called de novo lipogenesis (DNL) - is closely linked to metabolic diseases. Determinants of PUFA incorporation into complex lipids are insufficiently understood and may influence the onset and progression of metabolic diseases. Here we show that fatty acid synthase (FASN), the key enzyme of DNL, critically determines the use of dietary PUFA in mice and humans. Moreover, the combination of FASN inhibition and PUFA-supplementation decreases liver triacylglycerols (TAG) in mice fed with high-fat diet. Mechanistically, FASN inhibition …

Genome-Wide And Targeted Crispr Screens Identify Rnf213 As A Mediator Of Interferon Gamma-Dependent Pathogen Restriction In Human Cells, Sumit K Matta, Hinissan P Kohio, Pallavi Chandra, Adam Brown, John G Doench, Jennifer A Philips, Siyuan Ding, L David Sibley

2020-Current year OA Pubs

To define cellular immunity to the intracellular pathogen

A Dataset Of Digital Holograms Of Normal And Thalassemic Cells, Vahid Abbasian, Arash Darafsheh

2020-Current year OA Pubs

Digital holographic microscopy (DHM) is an intriguing medical diagnostic tool due to its label-free and quantitative nature, providing high-contrast images of phase samples. By capturing both intensity and phase information, DHM enables the numerical reconstruction of quantitative phase images. However, the lateral resolution is limited by the diffraction limit, which prompted the recent suggestion of microsphere-assisted DHM to enhance the DHM resolution straightforwardly. The use of such a technique as a medical diagnostic tool requires testing and validation of the proposed assays to prove their feasibility and viability. This paper publishes 760 and 609 microsphere-assisted DHM images of normal and …

Contrast Response Function Estimation With Nonparametric Bayesian Active Learning, Dom C P Marticorena, Quinn Wai Wong, Jake Browning, Ken Wilbur, Samyukta Jayakumar, Pinakin Gunvant Davey, Aaron R Seitz, Jacob R Gardner, Dennis L Barbour

2020-Current year OA Pubs

Multidimensional psychometric functions can typically be estimated nonparametrically for greater accuracy or parametrically for greater efficiency. By recasting the estimation problem from regression to classification, however, powerful machine learning tools can be leveraged to provide an adjustable balance between accuracy and efficiency. Contrast sensitivity functions (CSFs) are behaviorally estimated curves that provide insight into both peripheral and central visual function. Because estimation can be impractically long, current clinical workflows must make compromises such as limited sampling across spatial frequency or strong assumptions on CSF shape. This article describes the development of the machine learning contrast response function (MLCRF) estimator, which …

Hecatomb: An Integrated Software Platform For Viral Metagenomics, Michael J Roach, Sarah J Beecroft, Kathie A Mihindukulasuriya, Leran Wang, Anne Paredes, Luis Alberto Chica Cárdenas, Kara Henry-Cocks, Lais Farias Oliveira Lima, Elizabeth A Dinsdale, Robert A Edwards, Scott A Handley

2020-Current year OA Pubs

BACKGROUND: Modern sequencing technologies offer extraordinary opportunities for virus discovery and virome analysis. Annotation of viral sequences from metagenomic data requires a complex series of steps to ensure accurate annotation of individual reads and assembled contigs. In addition, varying study designs will require project-specific statistical analyses.

FINDINGS: Here we introduce Hecatomb, a bioinformatic platform coordinating commonly used tasks required for virome analysis. Hecatomb means "a great sacrifice." In this setting, Hecatomb is "sacrificing" false-positive viral annotations using extensive quality control and tiered-database searches. Hecatomb processes metagenomic data obtained from both short- and long-read sequencing technologies, providing annotations to individual sequences …

Process Evaluation Of A Double-Blind Randomized Controlled Trial To Assess The Efficacy And Safety Of A Quadruple Ultra-Low-Dose Treatment For Hypertension Within A Federally Qualified Health Center Network (Quartet Usa), Olutobi A Sanuade, Tyler A Jacobson, Adriana Quintana, Fallon M Flowers, Hiba Abbasi, My H Vu, Abigail S Baldridge, Jairo Mejia, Danielle Lazar, Jody D Ciolino, Mark D Huffman, Namratha R Kandula

2020-Current year OA Pubs

BACKGROUND: This convergent parallel-design mixed-methods process evaluation of the QUARTET USA (Quadruple Ultra-Low-Dose Treatment for Hypertension USA) clinical trial (NCT03640312) explores patient and health care professional perceptions about the use of low-dose quadruple therapy (LDQT) as a novel strategy for hypertension management.

METHODS AND RESULTS: A survey of all 62 patients enrolled in the QUARTET USA trial was conducted. A subsample of 13 patients and 11 health care professionals, recruited via purposive sampling, took part in semistructured interviews. At enrollment, 68% of participants (mean [SD] age, 51.7 [11.5] years; 56% self-identified as Hispanic: Mexican ethnicity, 16% as Hispanic: other ethnicity, …

On The Way To The Altar: An Illustration Of Transpersonal Psychoanalytic Psychotherapy, Willow Pearson Trimbach

International Journal of Transpersonal Studies Advance Publication Archive

This paper illustrates transpersonal psychoanalytic psychotherapy through a detailed clinical example. A creative synthesis of Voice Dialogue work and Dreamtending, applied through storytelling and active imagination, is presented with a patient who is about to be married. Areas such as the therapeutic relationship including skills, techniques, clinical decisions, goals, interventions and the therapeutic space and presence are explored and discussed throughout the paper as they relate to transpersonal psychoanalytic psychotherapy.

Measuring Paranormal Beliefs: Reconceptualization And Empirical Validation Of The Paranormal Belief Construct, Hugo Matas, Enric Munar, Lluis Ballester, Maria José Hernández-Lloreda

International Journal of Transpersonal Studies Advance Publication Archive

The Revised Paranormal Belief Scale (RPBS) is the most widely-used tool for measuring beliefs in paranormal phenomena, although it is not free from criticism. Lindeman and Aarnio (2006) proposed an extended version of the RPBS with some improvements and a second-order hierarchical model to explain the structure of the scale. Our objective was to analyze the goodness of fit of the model and measurement invariance by sex in a Spanish sample. A sample of 6,584 participants completed the extended RPBS. After reversed items were removed, the model demonstrated an adequate fit, significant factor loadings and invariance between sexes. The results …

Dreams, Synchrony, And Synchronicity, Terry Marks-Tarlow

International Journal of Transpersonal Studies Advance Publication Archive

No abstract provided.

Wildfire And Asylum: A Terrapsychological Approach To Backyard Pilgrimage, Jacob Kaminker

International Journal of Transpersonal Studies Advance Publication Archive

This paper offers a conceptual framework and embodied practice of finding ones’ psychological roots through mythological re-emplacement. The author utilizes the lenses of depth psychology, terrapsychology, ritual and pilgrimage. The method also focuses on experiences of awe in nature as a catalyst for transpersonal experience. This deeply personal account offers a model for the reader’s own symbolic engagement with the physical, natural and historically rich world around them.

Integrating Clinical Intuition For A Whole Person Approach To Empowerment, Jennifer Sousa

International Journal of Transpersonal Studies Advance Publication Archive

This paper is a summary of a study utilizing constructivist grounded theory to examine the process of accessing and applying clinical intuition in psychotherapy. Intensive interviews were conducted with 19 psychotherapists to explore their experiences with clinical intuition, including training on the topic, supportive conditions for accessing intuition, and decision making around its application in session. Engagement in an iterative process of data collection and analysis occurred to arrive at the constructed theory: integrating clinical intuition for a whole person approach to empowerment. The theory is comprised of the core categories (a) building trust and confidence to access and use …

The Role Of Personality In Moving Encounters With Sacred Art, Jacob Lang, Despina Stamatopoulou, Gerald C. Cupchik

International Journal of Transpersonal Studies Advance Publication Archive

In Roman Catholic and Eastern Orthodox traditions, the material world is understood to contain access points to the transcendent. An icon may move the awestruck believer to emotional engagement and reflection on moral and religious themes. Personality dispositions potentiating the experience of being moved in religious aesthetic contexts have not been thoroughly studied. The present article describes the development and testing of a cross-sectional study into potential belief and personality-related predictors of being moved by sacred art in a lab environment evocative of a holy site. Ninety (90) Christians in Canada and Greece completed personality measures and viewed and rated …

Empathy, Ethics, And Empowerment: Supervising The Transpersonal Therapist, John Elfers, Patty Hlava

International Journal of Transpersonal Studies Advance Publication Archive

This grounded theory study addressed the question What model explains the essential qualities, skills, and competencies of an effective supervisory relationship for transpersonal therapists in training? It emerged out of a recognition that current training models for supervisors were not inclusive of competencies to address the needs of therapist trainees who are oriented toward a transpersonal approach to psychotherapy. The results of 22 interviews with trainees and supervisors surfaced a fundamental tension within the supervisory relationship in the distinction among the primary responsibility of the supervisor for ensuring client welfare, and encouraging supervisees to develop their personal therapeutic orientation and …

Overexpression Of Wnt7a Enhances Radiosensitivity Of Non-Small Cell Lung Cancer Via The Wnt/Jnk Pathway, Loan Quynh Tran

VCU's Medical Journal Club: The Work of Future Health Professionals

Wnt7a serves an important role in slowing down the growth of non-small-cell lung cancer (NSCLC). However, little is known about the effect(s) of Wnt7a on the sensitivity of NSCLC to radiation. In the study, NSCLC cell proliferation and apoptosis in response to Wnt7a overexpression and/or radiation as one combination were determined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl-tertazolium bromide (MTT) assay and flow cytometry, respectively. The western blot technique was used to further examine the activation of Wnt/cJun N-terminal kinase (JNK) and Wnt/b-catenin signaling pathways in NSCLC cell lines H1650 and A549.

The results indicate that the overexpression of Wnt7a, in combination with radiation inhibits …

To Till And To Keep: Following The Ethical Imperative To Care For Creation Through Gender Exploration And Expression, Phoebe Carstens

Obsculta

In light of the recent USCCB document regarding 'the Moral Limits to Technological Manipulation of the Human Body,' this essay explores an alternative, transgender-affirming ethical framework drawn from Pope Francis's Laudato si’. Within this framework, gender-affirming care is presented as fulfilling the call to care for creation through exploration and cultivation of the self.