Medical Specialties Commons^™

Dna Methylation At A Nutritionally Sensitive Region Of The Pax8 Gene Is Associated With Thyroid Volume And Function In Gambian Children, Toby Candler, Noah J Kessler, Chathura J Gunasekara, Kate A Ward, Philip James, Eleonora Laritsky, Maria S Baker, Roger Dyer, Rajavel Elango, David Jeffries, Robert A Waterland, Sophie E Moore, Marian Ludgate, Andrew M Prentice, Matt J Silver

Children’s Nutrition Research Center Staff Publications

PAX8 is a key thyroid transcription factor implicated in thyroid gland differentiation and function, and PAX8 gene methylation is reported to be sensitive to the periconceptional environment. Using a novel recall-by-epigenotype study in Gambian children, we found that PAX8 hypomethylation at age 2 years is associated with a 21% increase in thyroid volume and an increase in free thyroxine (T4) at 5 to 8 years, the latter equivalent to 8.4% of the normal range. Free T4 was associated with a decrease in DXA-derived body fat and bone mineral density. Furthermore, offspring PAX8 methylation was associated with periconceptional maternal nutrition, and …

Impact Of Cannabis Use On Least Pain Scores Among African American And White Patients With Cancer Pain: A Moderation Analysis, Salimah H Meghani, Ryan Quinn, Rebecca Ashare, Kristin Levoy, Brooke Worster, Mary Naylor, Jesse Chittams, Martin Cheatle

Department of Medical Oncology Faculty Papers

Introduction: Based on many published reports, African American patients with cancer experience higher pain severity scores and lower pain relief than White patients. This disparity results from undertreatment of pain and is compounded by low adherence to prescribed non-opioid and opioid analgesics among African American patients with cancer. While nearly one in four patients use cannabis to manage cancer-related symptoms, less is known about how cannabis use influences pain relief in this patient population.

Methods: This study is based on preliminary data from an ongoing study of longitudinal outcomes of opioid therapy among African American and White patients with cancer. …

Demographic Characteristics Among Members Of Patient Family Advisory Councils At A Pediatric Health System., Amanda Montalbano, Sheryl Chadwick, Deejo Miller, Kathryn Taff, Evelyn Donis De Miranda, Kimberly Pina, Andrea Bradley-Ewing

Manuscripts, Articles, Book Chapters and Other Papers

Patient Family Advisory Councils (PFACs) are groups of patients, families, and clinical health system leaders collaborating to improve the quality, safety, and experience of care. Best practices encourage PFAC membership to reflect the diversity of the communities served. A cross-sectional survey was conducted from September 2019 to January 2020 collecting demographic characteristics of the members of a pediatric health system's 17 PFACs. Of the 93 respondents (71.5%), notable inequities were racial (4.8% adult PFAC members vs. 17.4% patients were Black) and financial (adult PFAC median annual income was >$100,000 compared to the community median $77,589). The governing family advisory board …

Dextromethorphan-Quinidine Is Helpful For Pseudobulbar Affect Disorder In Stroke Patients, Michael Francis, Mira Hamame, Md, Mariam Nasrallah, Md, Alison Nesbitt, Do, James Peter Meza, Md, Phd

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent article using

Hammond FM, Alexander DN, Cutler AJ, et al. PRISM II: an open-label study to assess effectiveness of dextromethorphan/quinidine for pseudobulbar affect in patients with dementia, stroke or traumatic brain injury. BMC Neurology. 2016;16:89. https://doi.org/10.1186/s12883-016-0609-0

for a patient with pseudobulbar affect following stroke

"More Accessible And Easier To Deal With": A Qualitative Inquiry Of Leaders' Perceptions Of The Evolving Roles And Responsibilities Of Advanced Practice Providers At Texas Medical Center, Athena Krasnosky Msn, Aprn, Cpnp, Jessie Marcet-Gonzalez Msn, Aprn, Cpnp, Jordan Rodriguez Bs, Natalie Cormier Smith Msn, Aprn, Np-C, Brenda Chesley Msn, Aprn, Cpnp-Ac/Pc, Linda Brock Msn, Aprn, Cpnp, Heena Narsi Prasla Msn, Aprn, Cpnp, Geran Barton

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background. With over 10 million patient encounters a year at Texas Medical Center (TMC), Advanced Practice Providers (APPs) are being incorporated into health care delivery models. Moving beyond the narrow “scope of practice” debates that frequently surface when talking about APPs, this inquiry instead seeks to broaden the discussion and take a more comprehensive view of how APPs are being incorporated into health care delivery models that span across several TMC institutions.

Methods. This study uses a thematic analysis study design to analyze structured interviews collected from a small convenience sample of Advance Practice Provider Program Directors at Texas Medical …

Using Design-Thinking To Investigate And Improve Patient Experience, Jennifer Smiechowski, Megan Mercia, Kyle Kemp, Elizabeth Oddone Paolucci, Maria Santana, Rahim Kachra

Patient Experience Journal

Understanding and enhancing the patient experience can lead to improved healthcare outcomes. The purpose of this study was to capture a comprehensive and nuanced understanding of the patient experience on an inpatient medical teaching unit in order to identify key deficiencies and unmet needs. We then aim to implement a design-thinking methodology to find innovative ways to solve these deficiencies. Here we present the first two phases of this four-phased study. We retrospectively and prospectively collected quantitative data about patient experience with the Canadian Patient Experiences Survey-Inpatient Care. We then used this data to guide patient interviews. We identified several …

Impact Of Forensic Medical Evaluations On Immigration Relief Grant Rates And Correlates Of Outcomes In The United States., Holly G. Atkinson, Katarzyna Wyka, Kathryn Hampton, Christian Seno, Elizabeth Yim, Deborah Ottenheimer, Nermeen Arastu

Publications and Research

The purpose of this study was to investigate the impact of forensic medical evaluations on grant rates for applicants seeking immigration relief in the United States (U.S.) and to identify significant correlates of grant success. We conducted a retrospective analysis of 2584 cases initiated by Physicians for Human Rights between 2008-2018 that included forensic medical evaluations, and found that 81.6% of applicants for various forms of immigration relief were granted relief, as compared to the national asylum grant rate of 42.4%. Among the study’s cohort, the majority (73.7%) of positive outcomes were grants of asylum. A multivariable regression analysis revealed …

Gender Differences In Urothelial Bladder Cancer: Effects Of Natural Killer Lymphocyte Immunity, Charles T. Lutz, Lydia Livas, Steven R. Presnell, Morgan Sexton, Peng Wang

Pathology and Laboratory Medicine Faculty Publications

Men are more likely to develop cancer than women. In fact, male predominance is one of the most consistent cancer epidemiology findings. Additionally, men have a poorer prognosis and an increased risk of secondary malignancies compared to women. These differences have been investigated in order to better understand cancer and to better treat both men and women. In this review, we discuss factors that may cause this gender difference, focusing on urothelial bladder cancer (UBC) pathogenesis. We consider physiological factors that may cause higher male cancer rates, including differences in X chromosome gene expression. We discuss how androgens may promote …

Efficacy Of The Mrna-1273 Sars-Cov-2 Vaccine At Completion Of Blinded Phase, Hana M El Sahly, Lindsey R Baden, Brandon Essink, Susanne Doblecki-Lewis, Judith M Martin, Evan J Anderson, Thomas B Campbell, Jesse Clark, Lisa A Jackson, Carl J Fichtenbaum, Marcus Zervos, Bruce Rankin, Frank Eder, Gregory Feldman, Christina Kennelly, Laurie Han-Conrad, Michael Levin, Kathleen M Neuzil, Lawrence Corey, Peter Gilbert, Holly Janes, Dean Follmann, Mary Marovich, Laura Polakowski, John R Mascola, Julie E Ledgerwood, Barney S Graham, Allison August, Heather Clouting, Weiping Deng, Shu Han, Brett Leav, Deb Manzo, Rolando Pajon, Florian Schödel, Joanne E Tomassini, Honghong Zhou, Jacqueline Miller

Faculty, Staff and Students Publications

BACKGROUND: At interim analysis in a phase 3, observer-blinded, placebo-controlled clinical trial, the mRNA-1273 vaccine showed 94.1% efficacy in preventing coronavirus disease 2019 (Covid-19). After emergency use of the vaccine was authorized, the protocol was amended to include an open-label phase. Final analyses of efficacy and safety data from the blinded phase of the trial are reported.

METHODS: We enrolled volunteers who were at high risk for Covid-19 or its complications; participants were randomly assigned in a 1:1 ratio to receive two intramuscular injections of mRNA-1273 (100 μg) or placebo, 28 days apart, at 99 centers across the United States. …

Baseline Mmp Expression In Periapical Granuloma And Its Relationship With Periapical Wound Healing After Surgical Endodontic Treatment, Muhammad Adeel Ahmed, Muhammad Faraz Anwar, Khalid Ahmed, Marziya Aftab, Fizza Nazim, Muhammad Furqan Bari, Mohammed Mustafa, Fahim Vohra, Ali Alrahlah, Muhammad Nouman Mughal, Syed Hani Abidi

Department of Biological & Biomedical Sciences

Background: Matrix metalloproteinases (MMPs) catalyzes the degradation of the extracellular matrix components and have a major role in many physiological processes including wound healing. In the current study, we examined the correlation of baseline MMPs 1, 2, 7, and 9 expressions with periapical wound healing after surgical endodontic treatment.
Methods: 27 patients aged between 15 and 57 years presenting with chronic apical periodontitis or chronic apical abscess of an anterior tooth with previously attempted or failed root canal treatment were included in this study. During surgical endodontic treatment, tissue from the periapical lesion sample was collected and used for gross …

Losses, Gains, And Changes To The Food Environment In A Rural Kentucky County During The Covid-19 Pandemic, Makenzie L. Barr, Courtney Martin, Courtney T. Luecking, Kathryn M. Cardarelli

Dietetics and Human Nutrition Faculty Publications

The COVID-19 pandemic has caused alterations to be made in the way many people access, prepare, and consume food. Rural communities are particularly impacted due to pre-existing structural vulnerabilities, i.e., poverty, lack of infrastructure, and limited fresh food options. This study aimed to characterize experiences of one rural Appalachian community’s changes to the food environment during the pandemic. In April 2021, six focus groups were conducted with residents of Laurel County, Kentucky. Using grounded theory, we identified losses, gains, and overall changes to the community food environment since the onset of COVID-19. Seventeen Laurel Countians (17 female; ages 30–74) participated …

3 Cases Of Superior Vena Cava Syndrome Following Percutaneous Right Ventricular Assist Device Placement, John R Vaile, J. Eduardo Rame, René J Alvarez, H. Todd Massey, Vakhtang Tchantchaleishvili, Alec Vishnevsky, Indranee Rajapreyar, Yevgeniy Brailovsky, Mahek Shah

Division of Cardiology Faculty Papers

We present 3 cases of superior vena cava (SVC) syndrome following percutaneous right ventricular assist device (RVAD) placement. Each case underscores the importance of early recognition of SVC syndrome in patients with percutaneous RVAD insertion via the internal jugular vein and calls for heightened awareness of device-associated complications. (Level of Difficulty: Advanced.).

Stent Or Shunt, What Could Be Better For Children With Duct Dependent Pulmonary Circulation?, Ghassan A. Shaath, Abdulraouf Mz Jijeh, Mohammed Fararjeh, Fahad Alhabshan, Mansour B. Almutairi, Ahmed Alomrani, Omar Tamimi

Journal of the Saudi Heart Association

Background: Systemic to pulmonary shunt (Shunt) is offered for children with duct dependent pulmonary circulation to augment pulmonary flow. Recently patent ductus arteriosus (PDA) stent (Stent) is widely used as an alternative method. We aimed to compare post intervention outcomes in children underwent either procedure. Methods: Infants under 3 months who had an initial palliation by Shunt or Stent were retrospectively reviewed between 2008-2016, then followed till the second intervention or 1 year whichever earlier. Results: 187 patients (110 Shunt and 77 Stent) were included. Initial weight and pulmonary artery (PA) branches size were similar between the groups. Shunt patients …

Hypothalamic Hamartomas: Evolving Understanding And Management., Nathan T. Cohen, J Helen Cross, Alexis Arzimanoglou, Samuel F Berkovic, John F Kerrigan, Ilene Penn Miller, Erica Webster, Lisa Soeby, Arthur Cukiert, Dale K Hesdorffer, Barbara L Kroner, Clifford B Saper, Andreas Schulze-Bonhage, William D. Gaillard

Neurology Faculty Publications

No abstract provided.

The Kardashian Index Of Cardiologists: Do More Social Media Followers Mean More Citations Or Merely Celebrity Status In Academia?, Talal Almas, Maheera Farooqi, Vikneswaran Raj Nagarajan, Muhammad Ali Niaz, Absam Akbar, Yohan Porus Irani, Jung Hur, Josef Finsterer

Medical College Documents

No abstract provided.

Left Atrial Appendage Occlusion For Stroke Prevention In Nonvalvular Atrial Fibrillation, Fareed Moses S Collado, Claudia M Lama Von Buchwald, Christina K Anderson, Nidhi Madan, Hussam S Suradi, Henry D Huang, Hani Jneid, Clifford J Kavinsky

Faculty, Staff and Students Publications

The majority of embolic strokes in patients with nonvalvular atrial fibrillation are caused by thrombi in the left atrial appendage. It is projected that strokes related to atrial fibrillation will markedly increase in the future unless effective mitigation strategies are implemented. Systemic anticoagulation has been known to be highly effective in reducing stroke risk in patients with atrial fibrillation. However, bleeding complications and nonadherence are barriers to effective anticoagulation therapy. Surgical and percutaneous left atrial appendage occlusion devices are nonpharmacologic strategies to mitigate the challenges of drug therapy. We present a contemporary review of left atrial appendage occlusion for stroke …

Genetic Landscape And Emerging Therapies In Uveal Melanoma, Rino S Seedor, Marlana Orloff, Takami Sato

Department of Medical Oncology Faculty Papers

Despite successful treatment of primary uveal melanoma, up to 50% of patients will develop systemic metastasis. Metastatic disease portends a poor outcome, and no adjuvant or metastatic therapy has been FDA approved. The genetic landscape of uveal melanoma is unique, providing prognostic and potentially therapeutic insight. In this review, we discuss our current understanding of the molecular and cytogenetic mutations in uveal melanoma, and the importance of obtaining such information. Most of our knowledge is based on primary uveal melanoma and a better understanding of the mutational landscape in metastatic uveal melanoma is needed. Clinical trials targeting certain mutations such …

Mirna-30e Downregulation Increases Cancer Cell Proliferation, Invasion And Tumor Growth Through Targeting Rps6kb1, Lin Wang, Xiang-Bo Ji, Li-Hong Wang, Zhong-Kun Xia, Yun-Xia Xie, Wen-Jing Liu, Jian-Ge Qiu, Bing-Hua Jiang, Ling-Zhi Liu

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Human esophagus carcinoma (EC) is one of the most common malignant tumors, especially in Africa and Asia including China. In EC initiation and progression, genetic and epigenetic aberrations have been reported to play a major role, but the underlying molecular mechanisms are largely unknown. In this study, the miR-30e levels were analyzed in human EC tissues and TCGA databases, and the results demonstrated that miR-30e expression in EC tissues was significantly decreased compared to adjacent normal tissues. To further investigate the role of miR-30e in cancer cells, we found that forced expression of miR-30e dramatically inhibited cell proliferation, invasion, tube …

Infant Outcomes Following Maternal Infection With Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2): First Report From The Pregnancy Coronavirus Outcomes Registry (Priority) Study., Valerie J. Flaherman, Yalda Afshar, W. John Boscardin, Roberta L. Keller, Anne H. Mardy, Mary K. Prahl, Carolyn T. Phillips, Ifeyinwa V. Asiodu, Vincenzo Berghella, Brittany D. Chambers, Joia Crear-Perry, Denise J. Jamieson, Vanessa L. Jacoby, Stephanie L. Gaw

Department of Obstetrics and Gynecology Faculty Papers

Infant outcomes after maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not well described. In a prospective US registry of 263 infants, maternal SARS-CoV-2 status was not associated with birth weight, difficulty breathing, apnea, or upper or lower respiratory infection through 8 weeks of age.

Unilateral Vocal Fold Paralysis In Adults: Etiological Factors In Yemen, Ali Obaid Muthanna

Hadhramout University Journal of Natural & Applied Sciences

Unilateral vocal fold paralysis is a common finding in otolaryngology practice. Various etiologies is known to cause this condition are neck surgery, cancer, neck trauma, neurological disorders and idiopathic The aim of this study was to determine the possible etiologies of unilateral vocal fold paralysis among adult patients. A prospective hospital based study was conducted at OtoLaryngology Department, at Al-Thawra Teaching Hospital, Sana'a, Yemen, during the period January 2015-June 2018.Patients have unilateral vocal fold paralysis were enrolling in this study. All patients underwent to history, clinical examination, laboratory investigations, and radiological studies. A total of 80 patients with unilateral vocal …

Risk Factors, Comorbidities And Outcomes Of Severe Acute Malnutrition Among Children In Mukalla Maternity And Child Hospital, Hadhramout, Yemen, Saleh Awad Bahwal, Mazin Ahmed Jawass, Faiza Salmeen Naji

Hadhramout University Journal of Natural & Applied Sciences

Severe acute malnutrition (SAM) is one of the major health problems in Yemen. The aim of this study is to determine the risk factors, comorbidities and outcomes of SAM in Mukalla Maternity and Child Hospital (MMCH) in AlMukalla city, Hadhramout Governorate, Yemen. We conducted a case-control study on 200 children aged 6 to 59 months (100 cases and 100 controls) who were admitted to the pediatric nutrition departments (MMCH) between September 2018 and August 2019. The risk factors for SAM were children age 6-24 months (OR 2.99; CI: 1.66 - 5.36), residing in rural areas (OR= 1.83; CI: 1.04 - …

Acute Kidney Injury: Analysis Of 175 Cases In Al-Mukalla, Hadhramout, Hussein Saeed Alghazali, Ahmed Mubark Daakik, Abdalrahim Abdulla Bahashwan, Mohammed Rasheed Bamekhlah

Hadhramout University Journal of Natural & Applied Sciences

This was a retrospective descriptive study of acute kidney injury patients admitted at Al-Mukalla Central Hospitals, Hadhramout, between January 2017 and April 2019. All cases were 175; divided to two groups, patients with age less than 40 years (Group I) 44.6%, and patients of age more than 40 years (Group II) were 55.4%. Age of male patients ranged between 18-39 years and age of female patients ranged between 18-38 years. Group I included 28 males (31.1%) and 50 females (58.8%), Group II included 62 males (68.9%) and 35 females (41.2%). Risk factors in relation to age groups were: diabetes mellitus …

Frequency Of Lower Ureteric Stones And Their Treatment By Tamsulosin, Aden, Ali Ahmed Salem Hatroom

Hadhramout University Journal of Natural & Applied Sciences

The aim of the study is to find out the frequency of lower ureteric stones related to sex, age, and the outcome of using tamsulosin in their treatment This was a retrospective study of all patients who suffer from lower ureteral stone and seen in our Private Urology Clinic from January 2014 to December 2017 in Aden. The total patients were 160. They were 98 (61.3%) males and 62 (38.7%) females) with ratio male to female 1.6 :1. The mean age of patients is (35.2 ± 11.2) years, range (15 to 56) years. The most involved side is left ureter …

Emergency Department Administration Of Covid-19 Antibody Therapies: Early Experience., Christopher Payette, Joseph T. Brooks, Robert Shesser

Emergency Medicine Faculty Publications

No abstract provided.

Acr Appropriateness Criteria® Parathyroid Adenoma., David Zander, Paul M Bunch, Bruno Policeni, Amy F Juliano, Denise Carneiro-Pla, Prachi Dubey, Maria K Gule-Monroe, Mari Hagiwara, Jenny K Hoang, Vikas Jain, Lawrence T Kim, Gul Moonis, Matthew S Parsons, Tanya J Rath, Carmen C Solórzano, Rathan M Subramaniam, M Reza Taheri, Kate Duchene Thoma, Andrew T Trout, Mark E Zafereo, Amanda S Corey

Radiology Faculty Publications

No abstract provided.

Paediatric Serum Sickness-Like Reaction: A 10-Year Retrospective Cohort Study, Blanca R. Del Pozzo-Magaña, Awatif Abuzgaia, Barbara Murray, Michael J. Rieder, Alejandro Lazo-Langner

Paediatrics Publications

Background: Serum sickness-like reaction (SSLR) is an acute inflammatory condition affecting predominantly children. The pathophysiology remains unclear, but drugs are considered the main trigger. Objective: The aim of this study was to describe the clinical and laboratory features, triggers, and treatment modalities in children diagnosed with SSLR. Methods: We conducted a 10-year retrospective cohort study including all paediatric patients (0 to 18 years old) with query SSLR referred to the Adverse Drug Reactions Clinic at the Children's Hospital of Western Ontario. Diagnostic criteria included acute skin rash plus joint inflammation with or without fever. Results: We included 83 patients (47 …

Proteinase 3 Contributes To Endothelial Dysfunction In An Experimental Model Of Sepsis, Eric K. Patterson, Carolina Gillio-Meina, Claudio M. Martin, Douglas D. Fraser, Logan R. Van Nynatten, Marat Slessarev, Gediminas Cepinskas

Paediatrics Publications

In sepsis-induced inflammation, polymorphonuclear neutrophils (PMNs) contribute to vascular dysfunction. The serine proteases proteinase 3 (PR3) and human leukocyte elastase (HLE) are abundant in PMNs and are released upon degranulation. While HLE’s role in inflammation-induced endothelial dysfunction is well studied, PR3’s role is largely uninvestigated. We hypothesized that PR3, similarly to HLE, contributes to vascular barrier dysfunction in sepsis. Plasma PR3 and HLE concentrations and their leukocyte mRNA levels were measured by ELISA and qPCR, respectively, in sepsis patients and controls. Exogenous PR3 or HLE was applied to human umbilical vein endothelial cells (HUVECs) and HUVEC dysfunction was assessed by …

In Vivo Magnetic Resonance Spectroscopy Of Hyperpolarized [1-, Lauren M Smith, Conrad B Pitts, Lanette J Friesen-Waldner, Neetin H Prabhu, Katherine E Mathers, Kevin J Sinclair, Trevor P Wade, Timothy Regnault, Charles A Mckenzie

Paediatrics Publications

BACKGROUND: Alterations in glycolysis are central to the increasing incidence of non-alcoholic fatty liver disease (NAFLD), highlighting a need for in vivo, non-invasive technologies to understand the development of hepatic metabolic aberrations.

PURPOSE: To use hyperpolarized magnetic resonance spectroscopy (MRS) and proton density fat fraction (PDFF) magnetic resonance imaging (MRI) techniques to investigate the effects of a chronic, life-long exposure to the Western diet (WD) in an animal model resulting in NAFLD; to investigate the hypothesis that exposure to the WD will result in NAFLD in association with altered pyruvate metabolism.

STUDY TYPE: Prospective.

ANIMAL MODEL: Twenty-eight male guinea pigs …

Effect Of Covid-19 Pandemic Lockdowns On Planned Cancer Surgery For 15 Tumour Types In 61 Countries: An International Prospective, Cohort Study, Covidsurg Collaborative

Department of Surgery Faculty Publications

Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national …

The Sulfur Microbial Diet Is Associated With Increased Risk Of Early-Onset Colorectal Cancer Precursors, Long H. Nguyen, Yin Cao, Jinhee Hur, Raaj S. Mehta, Daniel R. Sikavi, Yiqing Wang, Wenjie Ma, Kana Wu, Mingyang Song, Edward L. Giovannucci, Eric B. Rimm, Walter C. Willett, Wendy S. Garrett, Jacques Izard, Curtis Huttenhower, Andrew T. Chan

Food for Health: Publications

Background and aims: Diet may contribute to the increasing incidence of colorectal cancer (CRC) before age 50 (early-onset CRC). Microbial metabolism of dietary sulfur produces hydrogen sulfide (H₂S), a gastrointestinal carcinogen that cannot be easily measured at scale. As a result, evidence supporting its role in early neoplasia is lacking.

Methods: We evaluated long-term adherence to the sulfur microbial diet, a dietary index defined a priori based on increased abundance of 43 bacterial species involved with sulfur metabolism, with risk of CRC precursors among 59,013 individuals who underwent lower endoscopy in the Nurses’ Health Study II …