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Ouellet M, Kim JZ, Guillaume H, Shaffer SM, Bassett LC, Bassett DS. Breaking reflection symmetry: evolving long dynamical cycles in Boolean systems. New J Phys 2024; 26:023006. [PMID: 38327877 PMCID: PMC10845163 DOI: 10.1088/1367-2630/ad1bdd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 11/29/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024]
Abstract
In interacting dynamical systems, specific local interaction rules for system components give rise to diverse and complex global dynamics. Long dynamical cycles are a key feature of many natural interacting systems, especially in biology. Examples of dynamical cycles range from circadian rhythms regulating sleep to cell cycles regulating reproductive behavior. Despite the crucial role of cycles in nature, the properties of network structure that give rise to cycles still need to be better understood. Here, we use a Boolean interaction network model to study the relationships between network structure and cyclic dynamics. We identify particular structural motifs that support cycles, and other motifs that suppress them. More generally, we show that the presence of dynamical reflection symmetry in the interaction network enhances cyclic behavior. In simulating an artificial evolutionary process, we find that motifs that break reflection symmetry are discarded. We further show that dynamical reflection symmetries are over-represented in Boolean models of natural biological systems. Altogether, our results demonstrate a link between symmetry and functionality for interacting dynamical systems, and they provide evidence for symmetry's causal role in evolving dynamical functionality.
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Affiliation(s)
- Mathieu Ouellet
- Department of Electrical & Systems Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Jason Z Kim
- Department of Bioengineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Harmange Guillaume
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- Cell and Molecular Biology Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Sydney M Shaffer
- Cell and Molecular Biology Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
- Department of Biological Engineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA 19104, United States of America
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Lee C Bassett
- Department of Electrical & Systems Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA 19104, United States of America
| | - Dani S Bassett
- Department of Electrical & Systems Engineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA 19104, United States of America
- Department of Biological Engineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA 19104, United States of America
- Department of Physics & Astronomy, College of Arts & Sciences, University of Pennsylvania, Philadelphia, PA 19104, United States of America
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States of America
- Santa Fe Institute, Santa Fe, NM 87501, United States of America
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Terman SW, Slinger G, Koek A, Skvarce J, Springer MV, Ziobro JM, Burke JF, Otte WM, Thijs RD, Lossius MI, Marson AG, Bonnett LJ, Braun KPJ. Variation in seizure risk increases from antiseizure medication withdrawal among patients with well-controlled epilepsy: A pooled analysis. Epilepsia Open 2024; 9:333-344. [PMID: 38071463 PMCID: PMC10839298 DOI: 10.1002/epi4.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE Guidelines suggest considering antiseizure medication (ASM) discontinuation in seizure-free patients with epilepsy. Past work has poorly explored how discontinuation effects vary between patients. We evaluated (1) what factors modify the influence of discontinuation on seizure risk; and (2) the range of seizure risk increase due to discontinuation across low- versus high-risk patients. METHODS We pooled three datasets including seizure-free patients who did and did not discontinue ASMs. We conducted time-to-first-seizure analyses. First, we evaluated what individual patient factors modified the relative effect of ASM discontinuation on seizure risk via interaction terms. Then, we assessed the distribution of 2-year risk increase as predicted by our adjusted logistic regressions. RESULTS We included 1626 patients, of whom 678 (42%) planned to discontinue all ASMs. The mean predicted 2-year seizure risk was 43% [95% confidence interval (CI) 39%-46%] for discontinuation versus 21% (95% CI 19%-24%) for continuation. The mean 2-year absolute seizure risk increase was 21% (95% CI 18%-26%). No individual interaction term was significant after correcting for multiple comparisons. The median [interquartile range (IQR)] risk increase across patients was 19% (IQR 14%-24%; range 7%-37%). Results were unchanged when restricting analyses to only the two RCTs. SIGNIFICANCE No single patient factor significantly modified the influence of discontinuation on seizure risk, although we captured how absolute risk increases change for patients that are at low versus high risk. Patients should likely continue ASMs if even a 7% 2-year increase in the chance of any more seizures would be too much and should likely discontinue ASMs if even a 37% risk increase would be too little. In between these extremes, individualized risk calculation and a careful understanding of patient preferences are critical. Future work will further develop a two-armed individualized seizure risk calculator and contextualize seizure risk thresholds below which to consider discontinuation. PLAIN LANGUAGE SUMMARY Understanding how much antiseizure medications (ASMs) decrease seizure risk is an important part of determining which patients with epilepsy should be treated, especially for patients who have not had a seizure in a while. We found that there was a wide range in the amount that ASM discontinuation increases seizure risk-between 7% and 37%. We found that no single patient factor modified that amount. Understanding what a patient's seizure risk might be if they discontinued versus continued ASM treatment is critical to making informed decisions about whether the benefit of treatment outweighs the downsides.
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Affiliation(s)
- Samuel W. Terman
- Department of NeurologyUniversity of MichiganAnn ArborMichiganUSA
| | - Geertruida Slinger
- Department of Child Neurology, UMC Utrecht Brain Center, Wilhelmina Children's HospitalUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Adriana Koek
- Department of NeurologyUniversity of MichiganAnn ArborMichiganUSA
- Department of NeurologyUniversity of California San FranciscoSan FransiscoCaliforniaUSA
| | - Jeremy Skvarce
- University of Michigan Medical SchoolAnn ArborMichiganUSA
| | | | - Julie M. Ziobro
- Department of PediatricsUniversity of MichiganAnn ArborMichiganUSA
| | - James F. Burke
- Department of NeurologyThe Ohio State UniversityColumbusOhioUSA
| | - Willem M. Otte
- Department of Child Neurology, UMC Utrecht Brain Center, Wilhelmina Children's HospitalUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Roland D. Thijs
- Stichting Epilepsie Instellingen Nederland (SEIN)HeemstedeThe Netherlands
- Department of NeurologyLeiden University Medical Centre (LUMC)LeidenThe Netherlands
- Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Morten I. Lossius
- Oslo University Hospital National Center for EpilepsyOsloNorway
- Institute of Clinical Medicine, University of OsloOsloNorway
| | - Anthony G. Marson
- Department of Pharmacology and TherapeuticsUniversity of LiverpoolLiverpoolUK
| | - Laura J. Bonnett
- Department of Health Data ScienceUniversity of LiverpoolLiverpoolUK
| | - Kees P. J. Braun
- Department of Child Neurology, UMC Utrecht Brain Center, Wilhelmina Children's HospitalUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
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Beatty C, Richardson KP, Tran PMH, Satter KB, Hopkins D, Gardiner M, Sharma A, Purohit S. Multiplex analysis of inflammatory proteins associated with risk of coronary artery disease in type-1 diabetes patients. Clin Cardiol 2024; 47:e24143. [PMID: 37822049 PMCID: PMC10768730 DOI: 10.1002/clc.24143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Chronic uncontrolled hyperglycemia, a precursor to chronic low-grade inflammation, is a leading cause of coronary artery disease (CAD) due to plaque buildup in type-1 diabetes (T1D) patients. We evaluated levels of 22 inflammatory markers in cross-sectional serum samples from 1222 subjects to evaluate their potential as risk factors for CAD in T1D patients. HYPOTHESIS Circulating levels of markers of inflammation may be the risk factors for incident CAD. METHODS The T1D subjects were divided into two groups: those without CAD (n = 1107) and with CAD (n = 115). Serum levels of proteins were assayed using multiplex immunoassays on a Luminex Platform. Differences between the two groups were made by univariate analysis. Multivariate logistic regression was used to ascertain the potential of proteins as risk factors for CAD. Influence of age, duration of diabetes, sex, hypertension, and dyslipidemia was determined in a stepwise manner. Serum levels of 22 proteins were combined into a composite score using Ridge regression for risk-based stratification. RESULTS Mean levels of CRP, IGFBP1, IGFBP2, insulin-like growth factors binding protein-6 (IGFBP6), MMP1, SAA, sTNFRI, and sTNFRII were elevated in CAD patients (n = 115) compared to T1D patients without CAD (nCAD, n = 1107). After adjusting for age, duration of diabetes, sex, hypertension, and dyslipidemia, higher levels of sTNFRI (odds ratio [OR] = 2.18, 1.1 × 10-3 ), sTNFRII (OR = 1.52, 1 × 10-2 ), and IGFBP6 (OR = 3.62, 1.8 × 10-3 ) were significantly associated with CAD. The composite score based on Ridge regression, was able to stratify CAD patients into low, medium, and high-risk groups. CONCLUSIONS The results show activation of the TNF pathway in CAD patients. Evaluating these markers in serum can be a potential tool for identifying high-risk T1D patients for intensive anti-inflammatory therapeutic interventions.
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Affiliation(s)
- Carol Beatty
- School of MedicineMedical College of GeorgiaAugustaGeorgiaUSA
| | - Katherine P. Richardson
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
| | - Paul M. H. Tran
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
- Department of Internal MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Khaled B. Satter
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
- Department of PathologyNational Institutes of HealthBethesdaMarylandUSA
| | - Diane Hopkins
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
| | - Melissa Gardiner
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
| | - Ashok Sharma
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
| | - Sharad Purohit
- School of MedicineCenter for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
- Department of Obstetrics and GynecologyMedical College of Georgia, Augusta UniversityAugustaGeorgiaUSA
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Avitabile CM, Krishnan US, Yung D, Handler SS, Varghese N, Bates A, Fineman J, Sullivan R, Friere G, Austin E, Mullen MP, Pereira C, Christensen EJ, Yenokyan G, Collaco JM, Abman SH, Romer L, Dunbar Ivy D, Rosenzweig EB. Actigraphy methodology in the Kids Mod PAH trial: Physical activity as a functional endpoint in pediatric clinical trials. Pulm Circ 2024; 14:e12339. [PMID: 38464344 PMCID: PMC10923039 DOI: 10.1002/pul2.12339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/27/2023] [Accepted: 01/10/2024] [Indexed: 03/12/2024] Open
Abstract
Pulmonary vasodilator treatment can improve hemodynamics, right ventricular function, symptoms, and survival in pediatric pulmonary hypertension (PH). However, clinical trial data are lacking due to many constraints. One major limitation is the lack of relevant trial endpoints reflective of hemodynamics or functional status in patients in whom standard exercise testing is impractical, unreliable, or not reproducible. The Kids Mod PAH trial (Mono- vs. Duo Therapy for Pediatric Pulmonary Arterial Hypertension) is an ongoing multicenter, Phase III, randomized, open-label, pragmatic trial to compare the safety and efficacy of first-line combination therapy (sildenafil and bosentan) to first-line monotherapy (sildenafil alone) in 100 pediatric patients with PH across North America. Investigators will measure participants' physical activity with a research-grade, wrist-worn actigraphy device at multiple time points as an exploratory secondary outcome. Vector magnitude counts per minute and activity intensity will be compared between the treatment arms. By directly and noninvasively measuring physical activity in the ambulatory setting, we aim to identify a novel, simple, inexpensive, and highly reproducible approach for quantitative assessment of exercise tolerance in pediatric PH. These data will increase the field's understanding of the effect of pulmonary vasodilator treatment on daily activity - a quantitative measure of functional status and wellbeing in pediatric PH and a potential primary outcome for future clinical trials in children with cardiopulmonary disorders.
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Affiliation(s)
- Catherine M. Avitabile
- Division of CardiologyUniversity of Pennsylvania Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Usha S. Krishnan
- Section of Pediatric Cardiology, Morgan Stanley Children's Hospital of NY Presbyterian, Vagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | - Delphine Yung
- Department of PediatricsUniversity of Washington School of MedicineSeattleWashingtonUSA
| | | | - Nidhy Varghese
- Department of Pediatrics, Baylor College of MedicineTexas Children's HospitalHoustonTexasUSA
| | - Angela Bates
- Division of Cardiology, Department of PediatricsStollery Children's Hospital and University of AlbertaEdmontonAlbertaCanada
| | - Jeff Fineman
- Division of Critical Care, Department of PediatricsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Rachel Sullivan
- Department of Pediatrics, Monroe Carell Jr. Children's HospitalVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Grace Friere
- Department of PediatricsJohns Hopkins All Children's HospitalSt. PetersburgFloridaUSA
| | - Eric Austin
- Department of Pediatrics, Monroe Carell Jr. Children's HospitalVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Mary P. Mullen
- Department of PediatricsBoston Children's HospitalBostonMassachusettsUSA
| | - Carol Pereira
- Duke Clinical Research InstituteDurhamNorth CarolinaUSA
| | - Eric J. Christensen
- Depertment of PediatricsJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Gayane Yenokyan
- Depertment of PediatricsJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Joseph M. Collaco
- Depertment of PediatricsJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Steven H. Abman
- Department of PediatricsChildren's Hospital ColoradoAuroraColoradoUSA
| | - Lew Romer
- Depertment of PediatricsJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - D. Dunbar Ivy
- Department of PediatricsChildren's Hospital ColoradoAuroraColoradoUSA
| | - Erika B. Rosenzweig
- Section of Pediatric Cardiology, Morgan Stanley Children's Hospital of NY Presbyterian, Vagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
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Nguyen Y, Blanchet B, Urowitz MB, Hanly JG, Gordon C, Bae S, Romero‐Diaz J, Sanchez‐Guerrero J, Clarke AE, Bernatsky S, Wallace DJ, Isenberg DA, Rahman A, Merrill JT, Fortin PR, Gladman DD, Bruce IN, Petri M, Ginzler EM, Dooley MA, Ramsey‐Goldman R, Manzi S, Jönsen A, Alarcón GS, Van Vollenhoven RF, Aranow C, Le Guern V, Mackay M, Ruiz‐Irastorza G, Lim SS, Inanc M, Kalunian KC, Jacobsen S, Peschken CA, Kamen DL, Askanase A, Buyon J, Costedoat‐Chalumeau N. Association Between Severe Nonadherence to Hydroxychloroquine and Systemic Lupus Erythematosus Flares, Damage, and Mortality in 660 Patients From the SLICC Inception Cohort. Arthritis Rheumatol 2023; 75:2195-2206. [PMID: 37459273 PMCID: PMC10792124 DOI: 10.1002/art.42645] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/05/2023] [Accepted: 06/29/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE The goals of this study were to assess the associations of severe nonadherence to hydroxychloroquine (HCQ), objectively assessed by HCQ serum levels, and risks of systemic lupus erythematosus (SLE) flares, damage, and mortality rates over five years of follow-up. METHODS The Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort is an international multicenter initiative (33 centers throughout 11 countries). The serum of patients prescribed HCQ for at least three months at enrollment were analyzed. Severe nonadherence was defined by a serum HCQ level <106 ng/mL or <53 ng/mL for HCQ doses of 400 or 200 mg/day, respectively. Associations with the risk of a flare (defined as a Systemic Lupus Erythematosus Disease Activity Index 2000 increase ≥4 points, initiation of prednisone or immunosuppressive drugs, or new renal involvement) were studied with logistic regression, and associations with damage (first SLICC/American College of Rheumatology Damage Index [SDI] increase ≥1 point) and mortality with separate Cox proportional hazard models. RESULTS Of the 1,849 cohort participants, 660 patients (88% women) were included. Median (interquartile range) serum HCQ was 388 ng/mL (244-566); 48 patients (7.3%) had severe HCQ nonadherence. No covariates were clearly associated with severe nonadherence, which was, however, independently associated with both flare (odds ratio 3.38; 95% confidence interval [CI] 1.80-6.42) and an increase in the SDI within each of the first three years (hazard ratio [HR] 1.92 at three years; 95% CI 1.05-3.50). Eleven patients died within five years, including 3 with severe nonadherence (crude HR 5.41; 95% CI 1.43-20.39). CONCLUSION Severe nonadherence was independently associated with the risks of an SLE flare in the following year, early damage, and five-year mortality.
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Affiliation(s)
- Yann Nguyen
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, AP‐HP Centre and Université Paris Cité and Centre de Recherche en Epidémiologie et Statistiques (CRESS), Unité Inserm 1153, Université de Paris CitéParisFrance
| | - Benoît Blanchet
- Biologie du médicament‐Toxicologie, AP‐HP Centre–Hôpital Cochin, Université Paris Cité, and UMR8038 CNRS, U1268 INSERM, Université Paris Cité, PRES Sorbonne Paris Cité, CARPEMParisFrance
| | | | - John G. Hanly
- Queen Elizabeth II Health Sciences Centre and Dalhousie UniversityHalifaxNova ScotiaCanada
| | - Caroline Gordon
- Institute of Inflammation and Ageing, University of BirminghamBirminghamUnited Kingdom
| | - Sang‐Cheol Bae
- Hanyang University Hospital for Rheumatic Diseases, Hanyang University Institute for Rheumatology, and Hanyang University Institute of Bioscience and BiotechnologySeoulKorea
| | | | | | - Ann E. Clarke
- Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | | | | | | | | | | | | | - Dafna D. Gladman
- Toronto Western Hospital, University of TorontoTorontoOntarioCanada
| | - Ian N. Bruce
- NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Center and Centre for Epidemiology Versus Arthritis, The University of ManchesterManchesterUK
| | - Michelle Petri
- Johns Hopkins University School of MedicineBaltimoreMaryland
| | | | - Mary Anne Dooley
- Thurston Arthritis Research Center, University of North CarolinaChapel Hill
| | | | - Susan Manzi
- Allegheny Health NetworkPittsburghPennsylvania
| | | | | | | | - Cynthia Aranow
- Feinstein Institute for Medical ResearchManhassetNew York
| | - Véronique Le Guern
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, AP‐HP Centre, Université Paris CitéParisFrance
| | - Meggan Mackay
- Feinstein Institute for Medical ResearchManhassetNew York
| | | | - S. Sam Lim
- Emory University School of MedicineAtlantaGeorgia
| | | | | | - Søren Jacobsen
- Rigshospitalet, Copenhagen University HospitalCopenhagenDenmark
| | | | | | - Anca Askanase
- Hospital for Joint Diseases and, Seligman Centre for Advanced Therapeutics, New York UniversityNew York City
| | - Jill Buyon
- New York University School of MedicineNew York City
| | - Nathalie Costedoat‐Chalumeau
- National Referral Centre for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, AP‐HP Centre and Université Paris Cité and Centre de Recherche en Epidémiologie et Statistiques (CRESS), Unité Inserm 1153, Université de Paris CitéParisFrance
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Chan H, Rodriguez Betancourt A, Liu CC, Chiang Y, Schmidlin PR. A conceptual review on reconstructive peri-implantitis therapy: Challenges and opportunities. Clin Exp Dent Res 2023; 9:735-745. [PMID: 37735844 PMCID: PMC10582225 DOI: 10.1002/cre2.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVES The current strategies to reconstruct lost peri-implant tissues due to the disease have been largely unpredictable. The aim of this conceptual review is to discuss relevant biological and biomechanical challenges of applying reconstructive means to treat peri-implantitis. Additionally, opportunities to improve treatment predictability are presented. MATERIAL AND METHODS A narrative review was conducted to fulfill the aim. RESULTS The four interrelated negative conditions hampering effective reconstruction are: inferior tissue perfusion, unfavorable bone topography, ineffective surface treatment, and unstable wound. First, peri-implant tissues resemble scars with reduced cellularity and vascularity, coupled with the absence of the periodontal ligament plexuses and the avascular implant and biomaterials, maintaining primary closure is a challenge, which is critical for regeneration. Second, defect morphology and bone topography surrounding implants determine the reconstructive potential. Unfortunately, noncontained defects are frequently encountered, with a combination of suprabony (horizontal bone loss) and infrabony (vertical usually involving circumferential bone loss) defects. Third, current attempts for implant surface decontamination are insufficient due to inaccessible macrostructure and rough surfaces in the micro-scale. Histologic evaluation has shown bacteria aggregation and calcified deposits around implants. Lastly, wound stability is difficult to achieve due to inherent soft tissue biomechanical quality and quantity deficiencies and mobile bone particulates. Opportunities to tackle the abovementioned challenges include the use of novel imaging technologies, such as high-frequency dental ultrasound and laser speckle imaging to evaluate tissue perfusion, soft tissue quality/quantity, and bone topography pre-surgically. The use of the operating microscope could allow better visualization and removal of etiologic factors. Strategies to improve soft tissue quality may include preoperative control of soft tissue inflammation and the potential use of biologics. Methods such as fixation to stabilize the biomaterials could be beneficial. CONCLUSIONS A more nuanced understanding of the current challenges and opportunities can lead to more effective preoperative and postoperative care protocols, ultimately improving the success rate of reconstructive procedures.
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Affiliation(s)
- Hsun‐Liang Chan
- Department of Periodontics and Oral MedicineThe University of Michigan School of DentistryAnn ArborMichiganUSA
| | - Amanda Rodriguez Betancourt
- Department of Periodontics and Oral MedicineThe University of Michigan School of DentistryAnn ArborMichiganUSA
| | - Chun Ching Liu
- Center of Dental Medicine, Division of Periodontology and Peri‐implant diseases, Clinic of Conservative and Preventive DentistryUniversity of ZurichZurichSwitzerland
| | - Yi‐Chen Chiang
- Department of Periodontics and Oral MedicineThe University of Michigan School of DentistryAnn ArborMichiganUSA
| | - Patrick R. Schmidlin
- Center of Dental Medicine, Division of Periodontology and Peri‐implant diseases, Clinic of Conservative and Preventive DentistryUniversity of ZurichZurichSwitzerland
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Eckhardt CA, Sun H, Malik P, Quadri S, Santana Firme M, Jones DK, van Sleuwen M, Jain A, Fan Z, Jing J, Ge W, Danish HH, Jacobson CA, Rubin DB, Kimchi EY, Cash SS, Frigault MJ, Lee JW, Dietrich J, Westover MB. Automated detection of immune effector cell-associated neurotoxicity syndrome via quantitative EEG. Ann Clin Transl Neurol 2023; 10:1776-1789. [PMID: 37545104 PMCID: PMC10578889 DOI: 10.1002/acn3.51866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 07/22/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE To develop an automated, physiologic metric of immune effector cell-associated neurotoxicity syndrome among patients undergoing chimeric antigen receptor-T cell therapy. METHODS We conducted a retrospective observational cohort study from 2016 to 2020 at two tertiary care centers among patients receiving chimeric antigen receptor-T cell therapy with a CD19 or B-cell maturation antigen ligand. We determined the daily neurotoxicity grade for each patient during EEG monitoring via chart review and extracted clinical variables and outcomes from the electronic health records. Using quantitative EEG features, we developed a machine learning model to detect the presence and severity of neurotoxicity, known as the EEG immune effector cell-associated neurotoxicity syndrome score. RESULTS The EEG immune effector cell-associated neurotoxicity syndrome score significantly correlated with the grade of neurotoxicity with a median Spearman's R2 of 0.69 (95% CI of 0.59-0.77). The mean area under receiving operator curve was greater than 0.85 for each binary discrimination level. The score also showed significant correlations with maximum ferritin (R2 0.24, p = 0.008), minimum platelets (R2 -0.29, p = 0.001), and dexamethasone usage (R2 0.42, p < 0.0001). The score significantly correlated with duration of neurotoxicity (R2 0.31, p < 0.0001). INTERPRETATION The EEG immune effector cell-associated neurotoxicity syndrome score possesses high criterion, construct, and predictive validity, which substantiates its use as a physiologic method to detect the presence and severity of neurotoxicity among patients undergoing chimeric antigen receptor T-cell therapy.
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Camacho A, Salah F, Bay CP, Waring J, Umeton R, Hirsch MS, Cole AP, Kibel AS, Loda M, Tempany CM, Fennessy FM. PI-RADS 3 score: A retrospective experience of clinically significant prostate cancer detection. BJUI Compass 2023; 4:473-481. [PMID: 37334024 PMCID: PMC10268585 DOI: 10.1002/bco2.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/30/2023] [Accepted: 02/20/2023] [Indexed: 06/20/2023] Open
Abstract
Rationale and objectives The study aims to propose an optimal workflow in patients with a PI-RADS 3 (PR-3) assessment category (AC) through determining the timing and type of pathology interrogation used for the detection of clinically significant prostate cancer (csPCa) in these men based upon a 5-year retrospective review in a large academic medical center. Materials and methods This United States Health Insurance Probability and Accountability Act (HIPAA)-compliant, institutional review board-approved retrospective study included men without prior csPCa diagnosis who received PR-3 AC on magnetic resonance (MR) imaging (MRI). Subsequent incidence and time to csPCa diagnosis and number/type of prostate interventions was recorded. Categorical data were compared using Fisher's exact test and continuous data using ANOVA omnibus F-test. Results Our cohort of 3238 men identified 332 who received PR-3 as their highest AC on MRI, 240 (72.3%) of whom had pathology follow-up within 5 years. csPCa was detected in 76/240 (32%) and non-csPCa in 109/240 (45%) within 9.0 ± 10.6 months. Using a non-targeted trans-rectal ultrasound biopsy as the initial approach (n = 55), another diagnostic procedure was required to diagnose csPCa in 42/55 (76.4%) of men, compared with 3/21(14.3%) men with an initial MR targeted-biopsy approach (n = 21); (p < 0.0001). Those with csPCa had higher median serum prostate-specific antigen (PSA) and PSA density, and lower median prostate volume (p < 0.003) compared with non-csPCa/no PCa. Conclusion Most patients with PR-3 AC underwent prostate pathology exams within 5 years, 32% of whom were found to have csPCa within 1 year of MRI, most often with a higher PSA density and a prior non-csPCa diagnosis. Addition of a targeted biopsy approach initially reduced the need for a second biopsy to reach a for csPCa diagnosis. Thus, a combination of systematic and targeted biopsy is advised in men with PR-3 and a co-existing abnormal PSA and PSA density.
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Affiliation(s)
- Andrés Camacho
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Fatima Salah
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Camden P. Bay
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Jonathan Waring
- Department of Informatics and Analytics, Dana‐Farber Cancer InstituteHarvard Medical SchoolBostonMassachusettsUSA
| | - Renato Umeton
- Department of Informatics and Analytics, Dana‐Farber Cancer InstituteHarvard Medical SchoolBostonMassachusettsUSA
| | - Michelle S. Hirsch
- Department of Pathology, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Alexander P. Cole
- Department of Urology, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Adam S. Kibel
- Department of Urology, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Massimo Loda
- Department of Pathology, Weill Cornell MedicineNew York‐Presbyterian HospitalNew YorkNew YorkUSA
| | - Clare M. Tempany
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Fiona M. Fennessy
- Department of RadiologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
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9
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Scarpato BM, Locke BW, Bledsoe J, Knox DB, Conner K, Stoddard GJ, Cirulis MM, Elliott CG, Dodson MW. The association between pulmonary artery enlargement and mortality in an Emergency Department population undergoing computed tomography pulmonary angiography. Pulm Circ 2023; 13:e12225. [PMID: 37063745 PMCID: PMC10090800 DOI: 10.1002/pul2.12225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/16/2023] [Accepted: 04/03/2023] [Indexed: 04/18/2023] Open
Abstract
Findings of an enlarged pulmonary artery diameter (PAd) and increased pulmonary artery to ascending aorta ratio (PA:AA) on contrast-enhanced computed tomography pulmonary angiography (CTPA) are associated with increased mortality in particular groups of patients with cardiopulmonary disease. However, the frequency and prognostic significance of these incidental findings has not been studied in unselected patients evaluated in the Emergency Department (ED). This study aims to determine the prevalence and associated prognosis of enlarged pulmonary artery measurements in an ED cohort. We measured PA and AA diameters on 990 CTPA studies performed in the ED. An enlarged PA diameter was defined as >27 mm in females and >29 mm in males, while an increased PA:AA was defined as >0.9. Poisson regression was performed to calculate prevalence ratios for relevant comorbidities, and multivariable Cox regression was performed to calculate hazard ratios (HR) for mortality of patients with enlarged pulmonary artery measurements. An enlarged PAd was observed in 27.9% of 990 patients and was more commonly observed in older patients and in patients with obesity or heart failure. Conversely, PA:AA was increased in 34.2% of subjects, and was more common in younger patients and those with peripheral vascular disease or obesity. After controlling for age, sex, and comorbidities, both enlarged PAd (HR 1.29, 95% CI 1.00-1.68, p = 0.05) and PA:AA (HR 1.70, 95% CI 1.31-2.22 p < 0.01) were independently associated with mortality. In sum, enlarged PAd and increased PA:AA are common in patients undergoing CTPAs in the ED setting and both are independently associated with mortality.
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Affiliation(s)
- Brittany M. Scarpato
- Division of Pulmonary and Critical Care MedicineUniversity of UtahSalt Lake CityUtahUSA
- Department of Pulmonary and Critical Care MedicineIntermountain Medical CenterMurrayUtahUSA
| | - Brian W. Locke
- Division of Pulmonary and Critical Care MedicineUniversity of UtahSalt Lake CityUtahUSA
- Department of Pulmonary and Critical Care MedicineIntermountain Medical CenterMurrayUtahUSA
| | - Joseph Bledsoe
- Division of Emergency MedicineIntermountain Medical CenterMurrayUtahUSA
- Department of Emergency MedicineStanford MedicineStanfordCaliforniaUSA
| | - Daniel B. Knox
- Department of Pulmonary and Critical Care MedicineIntermountain Medical CenterMurrayUtahUSA
| | - Karen Conner
- Division of RadiologyIntermountain Medical CenterMurrayUtahUSA
| | | | - Meghan M. Cirulis
- Division of Pulmonary and Critical Care MedicineUniversity of UtahSalt Lake CityUtahUSA
- Department of Pulmonary and Critical Care MedicineIntermountain Medical CenterMurrayUtahUSA
- Department of Pulmonary and Critical Care MedicinePulmonary Hypertension Care Center, Intermountain Medical CenterUtahMurrayUSA
| | - Charles Gregory Elliott
- Department of Pulmonary and Critical Care MedicineIntermountain Medical CenterMurrayUtahUSA
- Department of Pulmonary and Critical Care MedicinePulmonary Hypertension Care Center, Intermountain Medical CenterUtahMurrayUSA
| | - Mark W. Dodson
- Department of Pulmonary and Critical Care MedicineIntermountain Medical CenterMurrayUtahUSA
- Department of Pulmonary and Critical Care MedicinePulmonary Hypertension Care Center, Intermountain Medical CenterUtahMurrayUSA
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10
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Lehrer S, Rheinstein PH. Shingles vaccination reduces the risk of Parkinson's disease. Chronic Dis Transl Med 2023; 9:54-57. [PMID: 36926254 PMCID: PMC10011661 DOI: 10.1002/cdt3.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/15/2022] [Accepted: 10/18/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Steven Lehrer
- Department of Radiation OncologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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11
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Filon MJ, Gillette AA, Yang B, Khemees TA, Skala MC, Jarrard DF. Prostate cancer cells demonstrate unique metabolism and substrate adaptability acutely after androgen deprivation therapy. Prostate 2022; 82:1547-1557. [PMID: 35980831 PMCID: PMC9804183 DOI: 10.1002/pros.24428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/04/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Androgen deprivation therapy (ADT) has been the standard of care for advanced hormone-sensitive prostate cancer (PC), yet tumors invariably develop resistance resulting in castrate-resistant PC. The acute response of cancer cells to ADT includes apoptosis and cell death, but a large fraction remains arrested but viable. In this study, we focused on intensively characterizing the early metabolic changes that result after ADT to define potential metabolic targets for treatment. METHODS A combination of mass spectrometry, optical metabolic imaging which noninvasively measures drug responses in cells, oxygen consumption rate, and protein expression analysis was used to characterize and block metabolic pathways over several days in multiple PC cell lines with variable hormone response status including ADT sensitive lines LNCaP and VCaP, and resistant C4-2 and DU145. RESULTS Mass spectrometry analysis of LNCaP pre- and postexposure to ADT revealed an abundance of glycolytic intermediates after ADT. In LNCaP and VCaP, a reduction in the optical redox ratio [NAD(P)H/FAD], extracellular acidification rate, and a downregulation of key regulatory enzymes for fatty acid and glutamine utilization was acutely observed after ADT. Screening several metabolic inhibitors revealed that blocking fatty acid oxidation and synthesis reversed this stress response in the optical redox ratio seen with ADT alone in LNCaP and VCaP. In contrast, both cell lines demonstrated increased sensitivity to the glycolytic inhibitor 2-Deoxy- d-glucose(2-DG) and maintained sensitivity to electron transport chain inhibitor Malonate after ADT exposure. ADT followed by 2-DG results in synergistic cell death, a result not seen with simultaneous administration. CONCLUSIONS Hormone-sensitive PC cells displayed altered metabolic profiles early after ADT including an overall depression in energy metabolism, induction of a quiescent/senescent phenotype, and sensitivity to selected metabolic inhibitors. Glycolytic blocking agents (e.g., 2-DG) as a sequential treatment after ADT may be promising.
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Affiliation(s)
- Mikolaj J. Filon
- Department of Urology, School of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - Amani A. Gillette
- Department of Biomedical EngineeringUniversity of WisconsinMadisonWisconsinUSA
- Morgridge Institute for ResearchMadisonWisconsinUSA
| | - Bing Yang
- Department of Urology, School of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - Tariq A. Khemees
- Department of Urology, School of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - Melissa C. Skala
- Department of Biomedical EngineeringUniversity of WisconsinMadisonWisconsinUSA
- Morgridge Institute for ResearchMadisonWisconsinUSA
- Carbone Comprehensive Cancer CenterUniversity of WisconsinMadisonWisconsinUSA
| | - David F. Jarrard
- Department of Urology, School of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
- Carbone Comprehensive Cancer CenterUniversity of WisconsinMadisonWisconsinUSA
- Molecular and Environmental Toxicology ProgramUniversity of WisconsinMadisonWisconsinUSA
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12
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Martinez-Orengo N, Tahmazian S, Lai J, Wang Z, Sinharay S, Schreiber-Stainthorp W, Basuli F, Maric D, Reid W, Shah S, Hammoud DA. Assessing organ-level immunoreactivity in a rat model of sepsis using TSPO PET imaging. Front Immunol 2022; 13:1010263. [PMID: 36439175 PMCID: PMC9685400 DOI: 10.3389/fimmu.2022.1010263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022] Open
Abstract
There is current need for new approaches to assess/measure organ-level immunoreactivity and ensuing dysfunction in systemic inflammatory response syndrome (SIRS) and sepsis, in order to protect or recover organ function. Using a rat model of systemic sterile inflammatory shock (intravenous LPS administration), we performed PET imaging with a translocator protein (TSPO) tracer, [18F]DPA-714, as a biomarker for reactive immunoreactive changes in the brain and peripheral organs. In vivo dynamic PET/CT scans showed increased [18F]DPA-714 binding in the brain, lungs, liver and bone marrow, 4 hours after LPS injection. Post-LPS mean standard uptake values (SUVmean) at equilibrium were significantly higher in those organs compared to baseline. Changes in spleen [18F]DPA-714 binding were variable but generally decreased after LPS. SUVmean values in all organs, except the spleen, positively correlated with several serum cytokines/chemokines. In vitro measures of TSPO expression and immunofluorescent staining validated the imaging results. Noninvasive molecular imaging with [18F]DPA-714 PET in a rat model of systemic sterile inflammatory shock, along with in vitro measures of TSPO expression, showed brain, liver and lung inflammation, spleen monocytic efflux/lymphocytic activation and suggested increased bone marrow hematopoiesis. TSPO PET imaging can potentially be used to quantify SIRS and sepsis-associated organ-level immunoreactivity and assess the effectiveness of therapeutic and preventative approaches for associated organ failures, in vivo.
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Affiliation(s)
- Neysha Martinez-Orengo
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Sarine Tahmazian
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Jianhao Lai
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Zeping Wang
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Sanhita Sinharay
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - William Schreiber-Stainthorp
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Falguni Basuli
- Chemistry and Synthesis Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, MD, United States
| | - Dragan Maric
- Flow and Imaging Cytometry Core Facility, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - William Reid
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Swati Shah
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Dima A. Hammoud
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States
- *Correspondence: Dima A. Hammoud,
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13
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Piper JD, Mazhanga C, Chidhanguro D, Prendergast AJ. Impact of COVID-19 on schooling in rural Zimbabwe. Child Care Health Dev 2022; 48:1134-1135. [PMID: 36224615 PMCID: PMC9577473 DOI: 10.1111/cch.12955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/06/2021] [Accepted: 12/20/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Joe D Piper
- Zvitambo Institute for Maternal and Child Health, Harare, Zimbabwe
- Blizard Institute, Queen Mary University of London, London, UK
| | - Clever Mazhanga
- Zvitambo Institute for Maternal and Child Health, Harare, Zimbabwe
| | | | - Andrew J Prendergast
- Zvitambo Institute for Maternal and Child Health, Harare, Zimbabwe
- Blizard Institute, Queen Mary University of London, London, UK
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14
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Motlaghian SM, Belger A, Bustillo JR, Ford JM, Iraji A, Lim K, Mathalon DH, Mueller BA, O'Leary D, Pearlson G, Potkin SG, Preda A, van Erp TGM, Calhoun VD. Nonlinear functional network connectivity in resting functional magnetic resonance imaging data. Hum Brain Mapp 2022; 43:4556-4566. [PMID: 35762454 PMCID: PMC9491296 DOI: 10.1002/hbm.25972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 05/06/2022] [Accepted: 05/18/2022] [Indexed: 11/06/2022] Open
Abstract
In this work, we focus on explicitly nonlinear relationships in functional networks. We introduce a technique using normalized mutual information (NMI) that calculates the nonlinear relationship between different brain regions. We demonstrate our proposed approach using simulated data and then apply it to a dataset previously studied by Damaraju et al. This resting-state fMRI data included 151 schizophrenia patients and 163 age- and gender-matched healthy controls. We first decomposed these data using group independent component analysis (ICA) and yielded 47 functionally relevant intrinsic connectivity networks. Our analysis showed a modularized nonlinear relationship among brain functional networks that was particularly noticeable in the sensory and visual cortex. Interestingly, the modularity appears both meaningful and distinct from that revealed by the linear approach. Group analysis identified significant differences in explicitly nonlinear functional network connectivity (FNC) between schizophrenia patients and healthy controls, particularly in the visual cortex, with controls showing more nonlinearity (i.e., higher normalized mutual information between time courses with linear relationships removed) in most cases. Certain domains, including subcortical and auditory, showed relatively less nonlinear FNC (i.e., lower normalized mutual information), whereas links between the visual and other domains showed evidence of substantial nonlinear and modular properties. Overall, these results suggest that quantifying nonlinear dependencies of functional connectivity may provide a complementary and potentially important tool for studying brain function by exposing relevant variation that is typically ignored. Beyond this, we propose a method that captures both linear and nonlinear effects in a "boosted" approach. This method increases the sensitivity to group differences compared to the standard linear approach, at the cost of being unable to separate linear and nonlinear effects.
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Affiliation(s)
- Sara M. Motlaghian
- Tri‐institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS)Georgia State, Georgia Tech, EmoryAtlantaGeorgiaUSA
| | - Aysenil Belger
- Department of PsychiatryUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Juan R. Bustillo
- Department of PsychiatryUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Judith M. Ford
- Department of PsychiatryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- San Francisco VA Medical CenterSan FranciscoCaliforniaUSA
| | - Armin Iraji
- Tri‐institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS)Georgia State, Georgia Tech, EmoryAtlantaGeorgiaUSA
| | - Kelvin Lim
- Department of PsychiatryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Daniel H. Mathalon
- Department of PsychiatryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- San Francisco VA Medical CenterSan FranciscoCaliforniaUSA
| | - Bryon A. Mueller
- Department of PsychiatryUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Daniel O'Leary
- Department of PsychiatryUniversity of IowaIowa CityIowaUSA
| | - Godfrey Pearlson
- Department of Psychiatry and NeurobiologyYale School of MedicineNew HavenConnecticutUSA
| | - Steven G. Potkin
- Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA
| | - Adrian Preda
- Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA
| | - Theo G. M. van Erp
- Department of Psychiatry and Human BehaviorUniversity of California IrvineIrvineCaliforniaUSA
| | - Vince D. Calhoun
- Tri‐institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS)Georgia State, Georgia Tech, EmoryAtlantaGeorgiaUSA
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15
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Vasquez‐Montes V, Tyagi V, Sikorski E, Kyrychenko A, Freites JA, Thévenin D, Tobias DJ, Ladokhin AS. Ca 2+ -dependent interactions between lipids and the tumor-targeting peptide pHLIP. Protein Sci 2022; 31:e4385. [PMID: 36040255 PMCID: PMC9366937 DOI: 10.1002/pro.4385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/31/2022] [Accepted: 06/24/2022] [Indexed: 11/08/2022]
Abstract
Cancerous tissues undergo extensive changes to their cellular environments that differentiate them from healthy tissues. These changes include changes in extracellular pH and Ca2+ concentrations, and the exposure of phosphatidylserine (PS) to the extracellular environment, which can modulate the interaction of peptides and proteins with the plasma membrane. Deciphering the molecular mechanisms of such interactions is critical for advancing the knowledge-based design of cancer-targeting molecular tools, such as pH-low insertion peptide (pHLIP). Here, we explore the effects of PS, Ca2+ , and peptide protonation state on the interactions of pHLIP with lipid membranes. Cellular studies demonstrate that exposed PS on the plasma membrane promotes pHLIP targeting. The magnitude of this effect is dependent on extracellular Ca2+ concentration, indicating that divalent cations play an important role in pHLIP targeting in vivo. The targeting mechanism is further explored with a combination of fluorescence and circular dichroism experiments in model membranes and microsecond-timescale all-atom molecular dynamics simulations. Our results demonstrate that Ca2+ is engaged in coupling peptide-lipid interactions in the unprotonated transmembrane conformation of pHLIP. The simulations reveal that while the pH-induced insertion leads to a strong depletion of PS around pHLIP, the Ca2+ -induced insertion has the opposite effect. Thus, extracellular levels of Ca2+ are crucial to linking cellular changes in membrane lipid composition with the selective targeting and insertion of pHLIP. The characterized Ca2+ -dependent coupling between pHLIP sidechains and PS provides atomistic insights into the general mechanism for lipid-coupled regulation of protein-membrane insertion by divalent cations.
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Affiliation(s)
- Victor Vasquez‐Montes
- Department of Biochemistry and Molecular BiologyThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Vivek Tyagi
- Department of ChemistryUniversity of CaliforniaIrvineCaliforniaUSA
| | - Eden Sikorski
- Department of ChemistryLehigh UniversityBethlehemPennsylvaniaUSA
| | - Alexander Kyrychenko
- Institute of Chemistry and School of Chemistry, V. N. Karazin Kharkiv National UniversityKharkivUkraine
| | | | - Damien Thévenin
- Department of ChemistryLehigh UniversityBethlehemPennsylvaniaUSA
| | | | - Alexey S. Ladokhin
- Department of Biochemistry and Molecular BiologyThe University of Kansas Medical CenterKansas CityKansasUSA
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16
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Lederle LI, Steinman MA, Jing B, Nguyen B, Lee SJ. Glycemic treatment deintensification practices in nursing home residents with type 2 diabetes. J Am Geriatr Soc 2022; 70:2019-2028. [PMID: 35318647 PMCID: PMC9283249 DOI: 10.1111/jgs.17735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/02/2022] [Accepted: 02/12/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Older nursing home (NH) residents with glycemic overtreatment are at significant risk of hypoglycemia and other harms and may benefit from deintensification. However, little is known about deintensification practices in this setting. METHODS We conducted a cohort study from January 1, 2013 to December 31, 2019 among Veterans Affairs (VA) NH residents. Participants were VA NH residents age ≥65 with type 2 diabetes with a NH length of stay (LOS) ≥ 30 days and an HbA1c result during their NH stay. We defined overtreatment as HbA1c <6.5 with any insulin use, and potential overtreatment as HbA1c <7.5 with any insulin use or HbA1c <6.5 on any glucose-lowering medication (GLM) other than metformin alone. Our primary outcome was continued glycemic overtreatment without deintensification 14 days after HbA1c. RESULTS Of the 7422 included residents, 17% of residents met criteria for overtreatment and an additional 23% met criteria for potential overtreatment. Among residents overtreated and potentially overtreated at baseline, 27% and 19%, respectively had medication regimens deintensified (73% and 81%, respectively, continued to be overtreated). Long-acting insulin use and hyperglycemia ≥300 mg/dL before index HbA1c were associated with increased odds of continued overtreatment (odds ratio [OR] 1.37, 95% confidence interval [CI] 1.14-1.65 and OR 1.35, 95% CI 1.10-1.66, respectively). Severe functional impairment (MDS-ADL score ≥ 19) was associated with decreased odds of continued overtreatment (OR 0.72, 95% CI 0.56-0.95). Hypoglycemia was not associated with decreased odds of overtreatment. CONCLUSIONS Overtreatment of diabetes in NH residents is common and a minority of residents have their medication regimens appropriately deintensified. Deprescribing initiatives targeting residents at high risk of harms and with low likelihood of benefit such as those with history of hypoglycemia, or high levels of cognitive or functional impairment are most likely to identify NH residents most likely to benefit from deintensification.
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Affiliation(s)
- Lauren I. Lederle
- Geriatrics and Extended Care ServiceSan Francisco Virginia Medical CenterSan FranciscoCaliforniaUSA
- Veterans Affairs Quality Scholars FellowshipSan Francisco Virginia Medical CenterSan FranciscoCaliforniaUSA
- Division of GeriatricsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Michael A. Steinman
- Geriatrics and Extended Care ServiceSan Francisco Virginia Medical CenterSan FranciscoCaliforniaUSA
- Division of GeriatricsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Bocheng Jing
- Division of GeriatricsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Brian Nguyen
- Division of GeriatricsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Sei J. Lee
- Geriatrics and Extended Care ServiceSan Francisco Virginia Medical CenterSan FranciscoCaliforniaUSA
- Veterans Affairs Quality Scholars FellowshipSan Francisco Virginia Medical CenterSan FranciscoCaliforniaUSA
- Division of GeriatricsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
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17
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Weinstock C, Flegel WA, Srivastava K, Kaiser S, Schrezenmeier H, Tsamadou C, Ludwig C, Jahrsdörfer B, Bovin NV, Henry SM. Erytra blood group analyser and kode technology testing of SARS-CoV-2 antibodies among convalescent patients and vaccinated individuals. EJHaem 2022; 3:72-79. [PMID: 35464155 PMCID: PMC9015314 DOI: 10.1002/jha2.352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 02/05/2023]
Abstract
Surveillance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic requires tests to monitor antibody formation and prevalence. We detected SARS-CoV-2 antibodies using red cells coated by Kode technology with short peptides derived from the SARS-CoV-2 spike protein (SP). Such modified red cells, called C19-kodecytes, can be used as reagent cells in any manual or automated column agglutination assay. We investigated the presence of SARS-CoV-2 antibodies in 130 samples from COVID-19 convalescent plasma donors using standard manual technique, two FDA-authorized enzyme-linked immunosorbent assay (ELISA) assays and a virus neutralisation assay. The sensitivity of the C19-kodecyte assay was 88%, comparable to the anti-SP and anti-nucleocapsid protein (NCP) ELISAs (86% and 83%) and the virus neutralisation assay (88%). The specificity of the C19-kodecyte assay was 90% (anti-SP 100% and anti-NCP 97%). Likewise, 231 samples from 73 vaccinated individuals were tested with an automated analyser, and we monitored the appearance and persistence of SARS-CoV-2 antibodies. The C19-kodecyte assay is a robust tool for SARS-CoV-2 antibody detection. Automated blood group analyser use enables large-scale SARS-CoV-2 antibody testing for vaccination monitoring in population surveys.
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Affiliation(s)
- Christof Weinstock
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Willy A. Flegel
- Department of Transfusion MedicineNIH Clinical Center, National Institutes of HealthBethesdaMarylandUSA
| | - Kshitij Srivastava
- Department of Transfusion MedicineNIH Clinical Center, National Institutes of HealthBethesdaMarylandUSA
| | - Sabine Kaiser
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Hubert Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Chrysanthi Tsamadou
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Carolin Ludwig
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Bernd Jahrsdörfer
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden‐Württemberg – Hessen; Department of Transfusion MedicineUlm UniversityUlmGermany
| | - Nicolai V. Bovin
- Centre for Kode Technology InnovationSchool of EngineeringComputer and Mathematical Sciences, Faculty of Design and Creative TechnologiesAuckland Stephen HenryAucklandNew Zealand
| | - Stephen M. Henry
- Centre for Kode Technology InnovationSchool of EngineeringComputer and Mathematical Sciences, Faculty of Design and Creative TechnologiesAuckland Stephen HenryAucklandNew Zealand
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18
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Cui X, Sun J, Minkove SJ, Li Y, Cooper D, Couse Z, Eichacker PQ, Torabi‐Parizi P. Effects of chloroquine or hydroxychloroquine treatment on non-SARS-CoV2 viral infections: A systematic review of clinical studies. Rev Med Virol 2021; 31:e2228. [PMID: 33694220 PMCID: PMC8209942 DOI: 10.1002/rmv.2228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 12/15/2022]
Abstract
Chloroquine (CQ) and hydroxychloroquine (HCQ) have been used as antiviral agents for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. We performed a systematic review to examine whether prior clinical studies that compared the effects of CQ and HCQ to a control for the treatment of non-SARS-CoV2 infection supported the use of these agents in the present SARS-CoV2 outbreak. PubMed, EMBASE, Scopus and Web of Science (PROSPERO CRD42020183429) were searched from inception through 2 April 2020 without language restrictions. Of 1766 retrieved reports, 18 studies met our inclusion criteria, including 17 prospective controlled studies and one retrospective study. CQ or HCQ were compared to control for the treatment of infectious mononucleosis (EBV, n = 4), warts (human papillomavirus, n = 2), chronic HIV infection (n = 6), acute chikungunya infection (n = 1), acute dengue virus infection (n = 2), chronic HCV (n = 2), and as preventive measures for influenza infection (n = 1). Survival was not evaluated in any study. For HIV, the virus that was most investigated, while two early studies suggested HCQ reduced viral levels, four subsequent ones did not, and in two of these CQ or HCQ increased viral levels and reduced CD4 counts. Overall, three studies concluded CQ or HCQ were effective; four concluded further research was needed to assess the treatments' effectiveness; and 11 concluded that treatment was ineffective or potentially harmful. Prior controlled clinical trials with CQ and HCQ for non-SARS-CoV2 viral infections do not support these agents' use for the SARS-CoV2 outbreak.
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Affiliation(s)
- Xizhong Cui
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
| | - Junfeng Sun
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
| | - Samuel J. Minkove
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
| | - Yan Li
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
| | - Diane Cooper
- NIH LibraryClinical CenterNational Institutes of HealthBethesdaMarylandUSA
| | - Zoe Couse
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
| | - Peter Q. Eichacker
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
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19
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Juarez JG, Chaves LF, Garcia‐Luna SM, Martin E, Badillo‐Vargas I, Medeiros MCI, Hamer GL. Variable coverage in an Autocidal Gravid Ovitrap intervention impacts efficacy of Aedes aegypti control. J Appl Ecol 2021; 58:2075-2086. [PMID: 34690360 PMCID: PMC8518497 DOI: 10.1111/1365-2664.13951] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 06/07/2021] [Indexed: 01/12/2023]
Abstract
Control of the arboviral disease vector Aedes aegypti has shown variable levels of efficacy around the globe. We evaluated an Autocidal Gravid Ovitrap (AGO) intervention as a stand-alone control tool for population suppression of A. aegypti in US communities bordering Mexico.We conducted a cluster randomized crossover trial with weekly mosquito surveillance of sentinel households from July 2017 to December 2018. The intervention took place from August to December of both years. Multilevel models (generalized linear and additive mixed models) were used to analyse the changes in population abundance of female A. aegypti.We observed that female populations were being suppressed 77% (2018) and four times lower outdoor female abundance when AGO coverage (number of intervention AGO traps that surrounded a sentinel home) was high (2.7 AGOs/house). However, we also observed that areas with low intervention AGO coverage resulted in no difference (2017) or slightly higher abundance compared to the control. These results suggest that coverage rate might play a critical role on how populations of female A. aegypti are being modulated in the field. The lack of larval source habitat reduction and the short duration of the intervention period might have limited the A. aegypti population suppression observed in this study. Synthesis and applications. The mosquito, A. aegypti, is a public health concern in most tropical and subtropical regions. With the rise of insecticide resistance, the evaluation of non-chemical tools has become pivotal in the fight against arboviral disease transmission. Our study shows that the AGO intervention, as a stand-alone control tool, is limited by its coverage in human settlements. Vector control programmes should consider, that if the target coverage rate is not achieved, measures will be ineffective unless coupled with other control approaches. Although our multilevel modelling was focused on A. aegypti and the AGO, the approach can be applied to other mosquito vector species.
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Affiliation(s)
- Jose G. Juarez
- Department of EntomologyTexas A&M UniversityCollege StationTXUSA
| | - Luis F. Chaves
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA)CartagoCosta Rica
| | | | - Estelle Martin
- Department of EntomologyTexas A&M UniversityCollege StationTXUSA
| | | | | | - Gabriel L. Hamer
- Department of EntomologyTexas A&M UniversityCollege StationTXUSA
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Sebro R, Ashok SS. Utility of absolute apparent diffusion coefficient and chemical-shift imaging versus CT attenuation for predicting malignancy from percutaneous bone biopsies. J Med Radiat Sci 2021; 68:220-227. [PMID: 33607698 PMCID: PMC8424316 DOI: 10.1002/jmrs.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/20/2020] [Accepted: 02/03/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Bone lesions are sometimes detected on computed tomography studies, and biopsies are performed to evaluate whether these are malignant. The aim of the study is to evaluate whether chemical-shift imaging (CSI) and diffusion-weighted imaging (DWI) magnetic resonance imaging (MRI) are more informative than the CT attenuation for predicting malignancy. METHODS Retrospective analysis of 86 patients who underwent both diagnostic CT, CSI MRI and DWI MRI within 6 weeks prior to bone biopsy at a tertiary care academic institution between 01/01/2010 and 03/01/2020. The CT attenuation, signal intensity on in-phase sequences (SIIP), signal intensity on out-of-phase sequences (SIOP), signal intensity ratio (SIR = SIOP/SIIP) and the apparent diffusion coefficient (ADC) of the lesions over the region of the biopsy tract were measured. RESULTS A threshold CT attenuation of 157 Hounsfield Units (HU) had a sensitivity of 47.7%, specificity of 83.3% and area under the curve (AUC) of 0.59. A threshold ADC of 793 × 10-6 mm2 /s had a sensitivity of 75.8%, specificity of 85.7% and AUC of 0.83 to predict whether a bone biopsy would detect malignancy. A threshold SIR of 0.949 had a sensitivity of 77.8%, specificity of 77.8% and AUC of 0.81 to predict whether a bone biopsy would detect malignancy. ADC (P = 0.029) and SIR (P = 0.009) were significantly better than CT attenuation. There was no predictive difference between SIR and ADC (P = 0.742). CONCLUSIONS The CT attenuation of a lesion is a poor predictor of malignancy in bone lesions. CSI and DWI are significantly better for predicting malignancy.
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Affiliation(s)
- Ronnie Sebro
- Department of RadiologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of Orthopaedic SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of Biostatistics, Epidemiology and InformaticsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of GeneticsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - S. Sharon Ashok
- Department of RadiologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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21
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Taylor KN, Joshi AA, Hirfanoglu T, Grinenko O, Liu P, Wang X, Gonzalez‐Martinez JA, Leahy RM, Mosher JC, Nair DR. Validation of semi-automated anatomically labeled SEEG contacts in a brain atlas for mapping connectivity in focal epilepsy. Epilepsia Open 2021; 6:493-503. [PMID: 34033267 PMCID: PMC8408609 DOI: 10.1002/epi4.12499] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/18/2021] [Accepted: 04/10/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Stereotactic electroencephalography (SEEG) has been widely used to explore the epileptic network and localize the epileptic zone in patients with medically intractable epilepsy. Accurate anatomical labeling of SEEG electrode contacts is critically important for correctly interpreting epileptic activity. We present a method for automatically assigning anatomical labels to SEEG electrode contacts using a 3D-segmented cortex and coregistered postoperative CT images. METHOD Stereotactic electroencephalography electrode contacts were spatially localized relative to the brain volume using a standard clinical procedure. Each contact was then assigned an anatomical label by clinical epilepsy fellows. Separately, each contact was automatically labeled by coregistering the subject's MRI to the USCBrain atlas using the BrainSuite software and assigning labels from the atlas based on contact locations. The results of both labeling methods were then compared, and a subsequent vetting of the anatomical labels was performed by expert review. RESULTS Anatomical labeling agreement between the two methods for over 17 000 SEEG contacts was 82%. This agreement was consistent in patients with and without previous surgery (P = .852). Expert review of contacts in disagreement between the two methods resulted in agreement with the atlas based over manual labels in 48% of cases, agreement with manual over atlas-based labels in 36% of cases, and disagreement with both methods in 16% of cases. Labels deemed incorrect by the expert review were then categorized as either in a region directly adjacent to the correct label or as a gross error, revealing a lower likelihood of gross error from the automated method. SIGNIFICANCE The method for semi-automated atlas-based anatomical labeling we describe here demonstrates potential to assist clinical workflow by reducing both analysis time and the likelihood of gross anatomical error. Additionally, it provides a convenient means of intersubject analysis by standardizing the anatomical labels applied to SEEG contact locations across subjects.
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Affiliation(s)
| | - Anand A. Joshi
- Department of Electrical EngineeringUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Tugba Hirfanoglu
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOHUSA
- Department of Pediatric NeurologyGazi University School of MedicineAnkaraTurkey
| | | | - Ping Liu
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOHUSA
| | - Xiaofeng Wang
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOHUSA
| | - Jorge A. Gonzalez‐Martinez
- Department of Neurological Surgery and Epilepsy CenterUniversity of Pittsburgh Medical CenterPittsburghPAUSA
| | - Richard M. Leahy
- Department of Electrical EngineeringUniversity of Southern CaliforniaLos AngelesCAUSA
| | - John C. Mosher
- Department of NeurologyMcGovern Medical SchoolUniversity of Texas Health Science Center at HoustonHoustonTXUSA
| | - Dileep R. Nair
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOHUSA
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22
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Kaur RP, Izumchenko E, Blakaj DM, Mladkova N, Lechner M, Beaumont TL, Floudas CS, Gallia GL, London NR. The genomics and epigenetics of olfactory neuroblastoma: A systematic review. Laryngoscope Investig Otolaryngol 2021; 6:721-728. [PMID: 34401496 PMCID: PMC8356883 DOI: 10.1002/lio2.597] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 05/18/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Olfactory neuroblastoma (ONB) or esthesioneuroblastoma (ENB) is a rare malignancy of the nasal cavity believed to arise from the olfactory epithelium. The goal of this study was to systematically review the genomics, epigenetics, and cytogenetics of ONB and to understand the potential clinical implications of these studies. METHODS A systematic literature review was performed for articles published before May 2020 using Cochrane, Embase, Pubmed, and Scopus databases. Inclusion criteria included genomics, cytogenetics, and epigenetics studies on ONB. Exclusion criteria included studies not in English or systematic reviews. Articles and abstracts were reviewed by two independent reviewers to reduce bias during article selection and synthesis of results. Of the 36 studies included in this review, 24 were research articles and 12 were abstracts. RESULTS Although recurrent mutations among ONB tumors are uncommon, alterations in TP53, DMD, PIK3CA, NF1, CDKN2A, CDKN2C, CTNNB1, EGFR, APC, cKIT, cMET, PDGFRA, CDH1, FH, SMAD4, FGFR3 and IDH2 genes have been reported in several recent studies. In addition, cytogenetic studies revealed that the landscape of chromosomal aberrations varies widely amongst ONB tumors. CONCLUSIONS The rare character of ONB has limited the sample size available for cytogenetic, genomic, and epigenetic studies and contributes to the limitations of this systematic review. Comprehensive genomic and epigenomic studies with larger cohorts are warranted to validate the initial reports summarized in this review and to identify potential therapeutic targets for ONB.
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Affiliation(s)
- Raman Preet Kaur
- Department of Otolaryngology – Head and Neck SurgeryJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Evgeny Izumchenko
- Section of Hematology Oncology, Department of MedicineUniversity of Chicago MedicineChicagoIllinoisUSA
| | - Dukagjin M. Blakaj
- Department of Radiation OncologyThe Ohio State UniversityColumbusOhioUSA
| | - Nikol Mladkova
- Department of Radiation OncologyThe Ohio State UniversityColumbusOhioUSA
| | - Matt Lechner
- Department of Otolaryngology‐Head and Neck SurgeryStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Thomas L. Beaumont
- Department of NeurosurgeryUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Charalampos S. Floudas
- Genitourinary Malignancies Branch, Center for Cancer ResearchNational Cancer InstituteBethesdaMarylandUSA
| | - Gary L. Gallia
- Department of Otolaryngology – Head and Neck SurgeryJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of NeurosurgeryJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Nyall R. London
- Department of Otolaryngology – Head and Neck SurgeryJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of NeurosurgeryJohns Hopkins UniversityBaltimoreMarylandUSA
- Sinonasal and Skull Base Tumor ProgramNational Institute on Deafness and Other Communication Disorders, NIHBethesdaMarylandUSA
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23
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Janke AT, Jain S, Hwang U, Rosenberg M, Biese K, Schneider S, Goyal P, Venkatesh AK. Emergency department visits for emergent conditions among older adults during the COVID-19 pandemic. J Am Geriatr Soc 2021; 69:1713-1721. [PMID: 33955546 PMCID: PMC8242842 DOI: 10.1111/jgs.17227] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND/OBJECTIVE Emergency department (ED) visits have declined while excess mortality, not attributable to COVID-19, has grown. It is not known whether older adults are accessing emergency care differently from their younger counterparts. Our objective was to determine patterns of ED visit counts for emergent conditions during the COVID-19 pandemic for older adults. DESIGN Retrospective, observational study. SETTING Observational analysis of ED sites enrolled in a national clinical quality registry. PARTICIPANTS One hundred and sixty-four ED sites in 33 states from January 1, 2019 to November 15, 2020. MAIN OUTCOME AND MEASURES We measured daily ED visit counts for acute myocardial infarction (AMI), stroke, sepsis, fall, and hip fracture, as well as deaths in the ED, by age categories. We estimated Poisson regression models comparing early and post-early pandemic periods (defined by the Centers for Disease Control and Prevention) to the pre-pandemic period. We report incident rate ratios to summarize changes in visit incidence. RESULTS For AMI, stroke, and sepsis, the older (75-84) and oldest old (85+ years) had the greatest decline in visit counts initially and the smallest recovery in the post-early pandemic periods. For falls, visits declined early and partially recovered uniformly across age categories. In contrast, hip fractures exhibited less change in visit rates across time periods. Deaths in the ED increased during the early pandemic period, but then fell and were persistently lower than baseline, especially for the older (75-84) and oldest old (85+ years). CONCLUSIONS The decline in ED visits for emergent conditions among older adults has been more pronounced and persistent than for younger patients, with fewer deaths in the ED. This is concerning given the greater prevalence and risk of poor outcomes for emergent conditions in this age group that are amenable to time-sensitive ED diagnosis and treatment, and may in part explain excess mortality during the COVID-19 era among older adults.
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Affiliation(s)
- Alexander T. Janke
- Department of Emergency MedicineYale University School of MedicineNew HavenConnecticutUSA
| | - Snigdha Jain
- Section of Geriatrics and Section of Pulmonary, Critical Care and Sleep MedicineYale University School of MedicineNew HavenConnecticutUSA
| | - Ula Hwang
- Department of Emergency MedicineYale University School of MedicineNew HavenConnecticutUSA
- Geriatrics Research, Education and Clinical CenterJames J. Peters VAMCBronxNew YorkUSA
| | - Mark Rosenberg
- St. Joseph's HealthPatersonNew JerseyUSA
- American College of Emergency PhysiciansIrvingTexasUSA
| | - Kevin Biese
- Department of Emergency MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA
| | | | - Pawan Goyal
- American College of Emergency PhysiciansIrvingTexasUSA
| | - Arjun K. Venkatesh
- Department of Emergency MedicineYale University School of MedicineNew HavenConnecticutUSA
- Center for Outcomes Research and EvaluationYale University School of MedicineNew HavenConnecticutUSA
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24
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Lane JN, Ganguli I, Gaule P, Guinan E, Lakhani KR. Engineering serendipity: When does knowledge sharing lead to knowledge production? Strateg Manag J 2021; 42:1215-1244. [PMID: 34326562 PMCID: PMC8297436 DOI: 10.1002/smj.3256] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 10/27/2020] [Accepted: 11/10/2020] [Indexed: 06/03/2023]
Abstract
RESEARCH SUMMARY We investigate how knowledge similarity between two individuals is systematically related to the likelihood that a serendipitous encounter results in knowledge production. We conduct a field experiment at a medical research symposium, where we exogenously varied opportunities for face-to-face encounters among 15,817 scientist-pairs. Our data include direct observations of interaction patterns collected using sociometric badges, and detailed, longitudinal data of the scientists' postsymposium publication records over 6 years. We find that interacting scientists acquire more knowledge and coauthor 1.2 more papers when they share some overlapping interests, but cite each other's work between three and seven times less when they are from the same field. Our findings reveal both collaborative and competitive effects of knowledge similarity on knowledge production outcomes. MANAGERIAL SUMMARY Managers often try to stimulate innovation by encouraging serendipitous interactions between employees, for example by using office space redesigns, conferences and similar events. Are such interventions effective? This article proposes that an effective encounter depends on the degree of common knowledge shared by the individuals. We find that scientists who attend the same conference are more likely to learn from each other and collaborate effectively when they have some common interests, but may view each other competitively when they work in the same field. Hence, when designing opportunities for face-to-face interactions, managers should consider knowledge similarity as a criteria for fostering more productive exchanges.
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Affiliation(s)
- Jacqueline N. Lane
- Laboratory for Innovation Science at HarvardHarvard Business SchoolBostonMassachusettsUSA
| | - Ina Ganguli
- Department of EconomicsUniversity of Massachusetts AmherstAmherstMassachusettsUSA
| | | | - Eva Guinan
- Dana‐Farber Cancer InstituteBostonMassachusettsUSA
| | - Karim R. Lakhani
- Laboratory for Innovation Science at HarvardHarvard Business SchoolBostonMassachusettsUSA
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25
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Lin A, Andronesi O, Bogner W, Choi I, Coello E, Cudalbu C, Juchem C, Kemp GJ, Kreis R, Krššák M, Lee P, Maudsley AA, Meyerspeer M, Mlynarik V, Near J, Öz G, Peek AL, Puts NA, Ratai E, Tkáč I, Mullins PG. Minimum Reporting Standards for in vivo Magnetic Resonance Spectroscopy (MRSinMRS): Experts' consensus recommendations. NMR Biomed 2021; 34:e4484. [PMID: 33559967 PMCID: PMC8647919 DOI: 10.1002/nbm.4484] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 11/24/2020] [Accepted: 01/12/2021] [Indexed: 05/08/2023]
Abstract
The translation of MRS to clinical practice has been impeded by the lack of technical standardization. There are multiple methods of acquisition, post-processing, and analysis whose details greatly impact the interpretation of the results. These details are often not fully reported, making it difficult to assess MRS studies on a standardized basis. This hampers the reviewing of manuscripts, limits the reproducibility of study results, and complicates meta-analysis of the literature. In this paper a consensus group of MRS experts provides minimum guidelines for the reporting of MRS methods and results, including the standardized description of MRS hardware, data acquisition, analysis, and quality assessment. This consensus statement describes each of these requirements in detail and includes a checklist to assist authors and journal reviewers and to provide a practical way for journal editors to ensure that MRS studies are reported in full.
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Affiliation(s)
- Alexander Lin
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Ovidiu Andronesi
- Department of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Wolfgang Bogner
- High Field MR Center, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
| | - In‐Young Choi
- Department of Neurology, Hoglund Biomedical Imaging CenterUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Eduardo Coello
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Cristina Cudalbu
- Center for Biomedical Imaging (CIBM), Ecole Polytechnique Fédérale de LausanneLausanneSwitzerland
| | - Christoph Juchem
- Departments of Biomedical Engineering and RadiologyColumbia UniversityNew YorkNew YorkUSA
| | - Graham J. Kemp
- Department of Musculoskeletal and Ageing Science and Liverpool Magnetic Resonance Imaging Centre (LiMRIC)University of LiverpoolLiverpoolUK
| | - Roland Kreis
- Departments of Radiology and Biomedical ResearchUniversity of BernBernSwitzerland
| | - Martin Krššák
- Department of Medicine III and Department of Biomedical Imaging and Image guided TherapyMedical University of ViennaViennaAustria
| | - Phil Lee
- Department of Radiology, Hoglund Biomedical Imaging CenterUniversity of Kansas Medical CenterKansas CityKansasUSA
| | | | - Martin Meyerspeer
- High Field MR Center, Center for Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
| | - Vladamir Mlynarik
- Magnetic Resonance Centre of Excellence. Medical University of ViennaViennaAustria
| | - Jamie Near
- Brain Imaging Centre, Douglas Research Centre, Department of PsychiatryMcGill UniversityMontrealQuebecCanada
| | - Gülin Öz
- Center for Magnetic Resonance Research, Department of RadiologyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Aimie L. Peek
- Faculty of Health SciencesUniversity of SydneySydneyAustralia
| | - Nicolaas A. Puts
- Department of Forensic and Neurodevelopmental SciencesSackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
| | - Eva‐Maria Ratai
- A.A. Martinos Center for Biomedical Imaging, Neuroradiology Division, Department of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Ivan Tkáč
- Faculty of Health SciencesUniversity of SydneySydneyAustralia
| | - Paul G. Mullins
- Bangor Imaging Unit, School of PsychologyBangor UniversityBangorGwyneddUK
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26
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Quilichini E, Fabre M, Nord C, Dirami T, Le Marec A, Cereghini S, Pasek RC, Gannon M, Ahlgren U, Haumaitre C. Insights into the etiology and physiopathology of MODY5/HNF1B pancreatic phenotype with a mouse model of the human disease. J Pathol 2021; 254:31-45. [PMID: 33527355 PMCID: PMC8251562 DOI: 10.1002/path.5629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/18/2020] [Accepted: 01/19/2021] [Indexed: 12/12/2022]
Abstract
Maturity-onset diabetes of the young type 5 (MODY5) is due to heterozygous mutations or deletion of HNF1B. No mouse models are currently available to recapitulate the human MODY5 disease. Here, we investigate the pancreatic phenotype of a unique MODY5 mouse model generated by heterozygous insertion of a human HNF1B splicing mutation at the intron-2 splice donor site in the mouse genome. This Hnf1bsp2/+ model generated with targeted mutation of Hnf1b mimicking the c.544+1G>T (T) mutation identified in humans, results in alternative transcripts and a 38% decrease of native Hnf1b transcript levels. As a clinical feature of MODY5 patients, the hypomorphic mouse model Hnf1bsp2/+ displays glucose intolerance. Whereas Hnf1bsp2/+ isolated islets showed no altered insulin secretion, we found a 65% decrease in pancreatic insulin content associated with a 30% decrease in total large islet volume and a 20% decrease in total β-cell volume. These defects were associated with a 30% decrease in expression of the pro-endocrine gene Neurog3 that we previously identified as a direct target of Hnf1b, showing a developmental etiology. As another clinical feature of MODY5 patients, the Hnf1bsp2/+ pancreases display exocrine dysfunction with hypoplasia. We observed chronic pancreatitis with loss of acinar cells, acinar-to-ductal metaplasia, and lipomatosis, with upregulation of signaling pathways and impaired acinar cell regeneration. This was associated with ductal cell deficiency characterized by shortened primary cilia. Importantly, the Hnf1bsp2/+ mouse model reproduces the pancreatic features of the human MODY5/HNF1B disease, providing a unique in vivo tool for molecular studies of the endocrine and exocrine defects and to advance basic and translational research. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Evans Quilichini
- Centre National de la Recherche Scientifique (CNRS)UMR7622, Institut de Biologie Paris‐Seine (IBPS)ParisFrance
| | - Mélanie Fabre
- Centre National de la Recherche Scientifique (CNRS)UMR7622, Institut de Biologie Paris‐Seine (IBPS)ParisFrance
| | | | - Thassadite Dirami
- Centre National de la Recherche Scientifique (CNRS)UMR7622, Institut de Biologie Paris‐Seine (IBPS)ParisFrance
- Sorbonne UniversitéUMR7622‐IBPSParisFrance
| | - Axelle Le Marec
- Centre National de la Recherche Scientifique (CNRS)UMR7622, Institut de Biologie Paris‐Seine (IBPS)ParisFrance
- Sorbonne UniversitéUMR7622‐IBPSParisFrance
| | - Silvia Cereghini
- Centre National de la Recherche Scientifique (CNRS)UMR7622, Institut de Biologie Paris‐Seine (IBPS)ParisFrance
- Sorbonne UniversitéUMR7622‐IBPSParisFrance
| | - Raymond C Pasek
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Maureen Gannon
- Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Ulf Ahlgren
- Umeå Centre for Molecular MedicineUmeå UniversityUmeåSweden
| | - Cécile Haumaitre
- Centre National de la Recherche Scientifique (CNRS)UMR7622, Institut de Biologie Paris‐Seine (IBPS)ParisFrance
- Sorbonne UniversitéUMR7622‐IBPSParisFrance
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