101
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Huang Y, Shin JE, Xu AM, Yao C, Joung S, Wu M, Zhang R, Shin B, Foley J, Mahov SB, Modes ME, Ebinger JE, Driver M, Braun JG, Jefferies CA, Parimon T, Hayes C, Sobhani K, Merchant A, Gharib SA, Jordan SC, Cheng S, Goodridge HS, Chen P. Evidence of premature lymphocyte aging in people with low anti-spike antibody levels after BNT162b2 vaccination. iScience 2022; 25:105209. [PMID: 36188190 PMCID: PMC9510055 DOI: 10.1016/j.isci.2022.105209] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/22/2022] [Accepted: 09/22/2022] [Indexed: 11/26/2022] Open
Abstract
SARS-CoV-2 vaccines have unquestionably blunted the overall impact of the COVID-19 pandemic, but host factors such as age, sex, obesity, and other co-morbidities can affect vaccine efficacy. We identified individuals in a relatively healthy population of healthcare workers (CORALE study cohort) who had unexpectedly low peak anti-spike receptor binding domain (S-RBD) antibody levels after receiving the BNT162b2 vaccine. Compared to matched controls, "low responders" had fewer spike-specific antibody-producing B cells after the second and third/booster doses. Moreover, their spike-specific T cell receptor (TCR) repertoire had less depth and their CD4+ and CD8+T cell responses to spike peptide stimulation were less robust. Single cell transcriptomic evaluation of peripheral blood mononuclear cells revealed activation of aging pathways in low responder B and CD4+T cells that could underlie their attenuated anti-S-RBD antibody production. Premature lymphocyte aging may therefore contribute to a less effective humoral response and could reduce vaccination efficacy.
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Affiliation(s)
- Yapei Huang
- Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Juliana E. Shin
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Research Division of Immunology in the Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Alexander M. Xu
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Changfu Yao
- Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sandy Joung
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Min Wu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ruan Zhang
- Comprehensive Transplant Center, Transplant Immunology Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Bongha Shin
- Comprehensive Transplant Center, Transplant Immunology Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Joslyn Foley
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Simeon B. Mahov
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Matthew E. Modes
- Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Joseph E. Ebinger
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Matthew Driver
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jonathan G. Braun
- Research Division of Immunology in the Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Caroline A. Jefferies
- Research Division of Immunology in the Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Department of Medicine, Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Tanyalak Parimon
- Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Chelsea Hayes
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Kimia Sobhani
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Akil Merchant
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Division of Hematology and Cellular Therapy, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sina A. Gharib
- Computational Medicine Core at Center for Lung Biology, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA 98109, USA
| | - Stanley C. Jordan
- Comprehensive Transplant Center, Transplant Immunology Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Corresponding author
| | - Helen S. Goodridge
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Research Division of Immunology in the Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Corresponding author
| | - Peter Chen
- Women’s Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA,Corresponding author
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102
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Ebinger JE, Lan R, Driver MP, Rushworth P, Luong E, Sun N, Nguyen T, Sternbach S, Hoang A, Diaz J, Heath M, Claggett BL, Bairey Merz CN, Cheng S. Disparities in Geographic Access to Cardiac Rehabilitation in Los Angeles County. J Am Heart Assoc 2022; 11:e026472. [PMID: 36073630 PMCID: PMC9683686 DOI: 10.1161/jaha.121.026472] [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: 04/28/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022]
Abstract
Background Exercise-based cardiac rehabilitation (CR) is known to reduce morbidity and mortality for patients with cardiac conditions. Sociodemographic disparities in accessing CR persist and could be related to the distance between where patients live and where CR facilities are located. Our objective is to determine the association between sociodemographic characteristics and geographic proximity to CR facilities. Methods and Results We identified actively operating CR facilities across Los Angeles County and used multivariable Poisson regression to examine the association between sociodemographic characteristics of residential proximity to the nearest CR facility. We also calculated the proportion of residents per area lacking geographic proximity to CR facilities across sociodemographic characteristics, from which we calculated prevalence ratios. We found that racial and ethnic minorities, compared with non-Hispanic White individuals, more frequently live ≥5 miles from a CR facility. The greatest geographic disparity was seen for non-Hispanic Black individuals, with a 2.73 (95% CI, 2.66-2.79) prevalence ratio of living at least 5 miles from a CR facility. Notably, the municipal region with the largest proportion of census tracts comprising mostly non-White residents (those identifying as Hispanic or a race other than White), with median annual household income <$60 000, contained no CR facilities despite ranking among the county's highest in population density. Conclusions Racial, ethnic, and socioeconomic characteristics are significantly associated with lack of geographic proximity to a CR facility. Interventions targeting geographic as well as nongeographic factors may be needed to reduce disparities in access to exercise-based CR programs. Such interventions could increase the potential of CR to benefit patients at high risk for developing adverse cardiovascular outcomes.
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Affiliation(s)
- Joseph E. Ebinger
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
| | - Roy Lan
- College of MedicineUniversity of Tennessee Health Science CenterMemphisTN
| | - Matthew P. Driver
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
| | | | - Eric Luong
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
| | - Nancy Sun
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
| | - Trevor‐Trung Nguyen
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
| | - Sarah Sternbach
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
| | - Amy Hoang
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
| | - Jacqueline Diaz
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
| | - Mallory Heath
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
| | | | - C. Noel Bairey Merz
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
| | - Susan Cheng
- Department of CardiologySmidt Heart Institute, Cedars‐Sinai Medical CenterLos AngelesCA
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103
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Liang X, Hou TP, Zhang D, Luo WD, Cheng S, Zheng YH, Wu KM. New evaluation of the thermodynamics stability for bcc-Fe. J Phys Condens Matter 2022; 34:455801. [PMID: 36007519 DOI: 10.1088/1361-648x/ac8cc6] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
The thermodynamic properties for bcc-Fe were predicted by combination of the first-principles calculations, the quasiharmonic approximation, the CALPHAD method and the Weiss molecular field theory. The hybrid method considers the effects of the lattice vibration, electron, intrinsic magnetism and external magnetic fields on the thermodynamic properties at finite temperature. Combined with experimental data, the calculated heat capacity without external magnetic fields was used to verify the validity of the hybrid method. Close to the Fermi level the high electronic density of states leads to a significant electronic contribution to free energy. Near the Curie temperature lattice vibrations dominant the Gibbs free energy. The order of the other three excitation contributions to Gibbs free energy from high to low is: intrinsic magnetism > electron > external magnetic fields. The investigation suggests that all the excitation contributions to Gibbs free energy are not negligible which provides a correct direction for tuning the thermodynamic properties for Fe-based alloy.
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Affiliation(s)
- X Liang
- The State Key Laboratory for Refractories and Metallurgy, International Research Institute for Steel Technology, Collaborative Innovation Center for Advanced Steels, Wuhan University of Science and Technology, Wuhan 430081, People's Republic of China
| | - T P Hou
- The State Key Laboratory for Refractories and Metallurgy, International Research Institute for Steel Technology, Collaborative Innovation Center for Advanced Steels, Wuhan University of Science and Technology, Wuhan 430081, People's Republic of China
| | - D Zhang
- The State Key Laboratory for Refractories and Metallurgy, International Research Institute for Steel Technology, Collaborative Innovation Center for Advanced Steels, Wuhan University of Science and Technology, Wuhan 430081, People's Republic of China
| | - W D Luo
- The State Key Laboratory for Refractories and Metallurgy, International Research Institute for Steel Technology, Collaborative Innovation Center for Advanced Steels, Wuhan University of Science and Technology, Wuhan 430081, People's Republic of China
| | - S Cheng
- The State Key Laboratory for Refractories and Metallurgy, International Research Institute for Steel Technology, Collaborative Innovation Center for Advanced Steels, Wuhan University of Science and Technology, Wuhan 430081, People's Republic of China
| | - Y H Zheng
- The State Key Laboratory for Refractories and Metallurgy, International Research Institute for Steel Technology, Collaborative Innovation Center for Advanced Steels, Wuhan University of Science and Technology, Wuhan 430081, People's Republic of China
| | - K M Wu
- The State Key Laboratory for Refractories and Metallurgy, International Research Institute for Steel Technology, Collaborative Innovation Center for Advanced Steels, Wuhan University of Science and Technology, Wuhan 430081, People's Republic of China
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104
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Hoxha T, Pienkowski M, Khan K, Moore A, Balaratnam K, Chowdhury M, Walia P, Sabouhanian A, Herman J, Strom E, Hueniken K, Corke L, Leighl N, Shepherd F, Bradbury P, Sacher A, Cheng S, Brown M, Mai V, Garcia M, Zhan L, Xu W, Liu G. EP02.04-009 Real World Survival Outcome Analysis of Adjuvant Therapies in Non-EGFR, Non-ALK Early Stage Resected NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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105
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Lee J, Mai V, Garcia M, Cheng S, Khan K, Balaratnam K, Thakral A, Brown M, Zhan L, Corke L, Leighl N, Shepherd F, Bradbury P, Sacher A, Liu G. EP08.02-082 Treatment Patterns and Outcomes of First-line Osimertinib-treated Advanced EGFR Mutated NSCLC Patients: A Real-world Study. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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106
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Schmid S, Zhan L, Garcia M, Cheng S, Khan K, Chowdhury M, Sabouhanian A, Herman J, Walia P, Strom E, Brown M, Patel D, Xu W, Shepherd F, Sacher A, Leighl N, Bradbury P, Shultz D, Liu G. 1144P Clinical outcomes of NSCLC patients (pts) who had brain-only metastasis at time of stage IV diagnosis, by presence versus absence of EGFR/ALK mutations. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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107
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Moore S, Zhan L, Liu G, Rittberg R, Patel D, Chowdhury D, Leung B, Cheng S, Mckinnon M, Khan K, Agulnik J, Cheung W, Dawe D, Fung A, Snow S, Cohen V, Yan M, Lok B, Wheatley-Price P, Ho C. EP14.05-020 Population-based Outcomes for Patients with Extensive-Stage Small-cell Lung Cancer from the Canadian SCLC Database (CASCADE). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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108
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Moore S, Zhan L, Liu G, Rittberg R, Patel D, Chowdhury D, Leung B, Cheng S, Mckinnon M, Khan K, Snow S, Fung A, Dawe D, Cheung W, Agulnik J, Yan M, Cohen V, Wheatley-Price P, Ho C, Lok B. EP14.04-001 Treatment and Outcomes of Patients with Limited-Stage Small-cell Lung Cancer in the Canadian SCLC Database (CASCADE). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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109
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Labidi S, N. Meti, R. Barua, Riromar J, Hansen A, Jiang D, Fallah-Rad N, Sridhar S, Ferrario C, Pezo R, Cheng S, Sacher A, Rose A. 1754P Association between body mass index (BMI) and anti-PD1/L1 immune checkpoint inhibitor (ICI) outcomes in patients with metastatic urothelial carcinoma (mUC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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110
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Moore S, Zhan L, Liu G, Rittberg R, Patel D, Chowdhury D, Leung B, Cheng S, Mckinnon M, Khan K, Agulnik J, Fung A, Cheung W, Snow S, Dawe D, Cohen V, Yan M, Ho C, Lok B, Wheatley-Price P. EP03.01-016 The Canadian Small Cell Lung Cancer Database (CASCADE): Results from a Multi-Institutional Real-World Evidence Collaboration. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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111
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Yang Y, Wang Z, Wu B, Cheng S, Fan H. [Role of type 2 innate lymphoid cells in helminth infections: a review]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2022; 35:184-190. [PMID: 37253569 DOI: 10.16250/j.32.1374.2022041] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Helminth infections may trigger host innate and adaptive immune responses. Group 2 innate lymphoid cells (ILC2) are an important factor involved in type 2 immune responses, and produce a large number of T helper 2 cell (Th2) cytokines following stimulation by interleukin (IL)-25, IL-33 and thymic stromal lymphopoietin (TSLP), which play a critical role in parasite clearance and tissue repair. Following helminth infections, autocrine factors, mast cells, enteric nervous system and Th2 cells have been recently found to be involved in regulation of ILC2. Unraveling the role of ILC2 in immune response against helminth infections is of great value for basic research and drug development. This review summarizes the research progress on ILC2 and its role in helminth infections.
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Affiliation(s)
- Y Yang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, China
- Qinghai Provincial Key Laboratory for Echinococcosis Research, Xining, Qinghai 810001, China
| | - Z Wang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, China
- Qinghai Provincial Key Laboratory for Echinococcosis Research, Xining, Qinghai 810001, China
| | - B Wu
- Qinghai Provincial Key Laboratory for Echinococcosis Research, Xining, Qinghai 810001, China
| | - S Cheng
- Qinghai Provincial Key Laboratory for Echinococcosis Research, Xining, Qinghai 810001, China
| | - H Fan
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai 810001, China
- Qinghai Provincial Key Laboratory for Echinococcosis Research, Xining, Qinghai 810001, China
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112
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Joung SY, Ebinger JE, Sun N, Liu Y, Wu M, Tang AB, Prostko JC, Frias EC, Stewart JL, Sobhani K, Cheng S. Awareness of SARS-CoV-2 Omicron Variant Infection Among Adults With Recent COVID-19 Seropositivity. JAMA Netw Open 2022; 5:e2227241. [PMID: 35976645 PMCID: PMC9386542 DOI: 10.1001/jamanetworkopen.2022.27241] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
IMPORTANCE Some individuals who were infected by the SARS-CoV-2 Omicron variant may have been completely unaware of their infectious status while the virus was actively transmissible. OBJECTIVE To examine awareness of infectious status among individuals during the recent Omicron variant surge in a diverse and populous urban region of Los Angeles County. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed the records of adult employees and patients of an academic medical center who were enrolled in a longitudinal COVID-19 serological study in Los Angeles County, California. These participants had 2 or more serial anti-nucleocapsid IgG (IgG-N) antibody measurements at least 1 month apart, with the first occurring after the end of a regional Delta variant surge (September 15, 2021) and a subsequent one occurring after the start of a regional Omicron variant surge (December 15, 2021). Adults with evidence of new SARS-CoV-2 infection occurring during the Omicron variant surge period through May 4, 2022, were included in the present study sample. EXPOSURES Recent Omicron variant infection as evidenced by SARS-CoV-2 seroconversion. MAIN OUTCOMES AND MEASURES Awareness of recent SARS-CoV-2 infection was ascertained from review of self-reported health updates, medical records, and COVID-19 testing data. RESULTS Of the 210 participants (median [range] age, 51 (23-84) years; 136 women [65%]) with serological evidence of recent Omicron variant infection, 44% (92) demonstrated awareness of any recent Omicron variant infection and 56% (118) reported being unaware of their infectious status. Among those who were unaware, 10% (12 of 118) reported having had any symptoms, which they attributed to a common cold or other non-SARS-CoV-2 infection. In multivariable analyses that accounted for demographic and clinical characteristics, participants who were health care employees of the medical center were more likely than nonemployees to be aware of their recent Omicron variant infection (adjusted odds ratio, 2.46; 95% CI, 1.30-4.65). CONCLUSIONS AND RELEVANCE Results of this study suggest that more than half of adults with recent Omicron variant infection were unaware of their infectious status and that awareness was higher among health care employees than nonemployees, yet still low overall. Unawareness may be a highly prevalent factor associated with rapid person-to-person transmission within communities.
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Affiliation(s)
- Sandy Y. Joung
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Joseph E. Ebinger
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Nancy Sun
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Yunxian Liu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Min Wu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Amber B. Tang
- David Geffen School of Medicine, UCLA (University of California, Los Angeles)
| | - John C. Prostko
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, Illinois
| | - Edwin C. Frias
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, Illinois
| | - James L. Stewart
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, Illinois
| | - Kimia Sobhani
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
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113
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Trasolini A, Erker C, Cheng S, Crowell C, McFadden K, Moineddin R, Sargent MA, Mata-Mbemba D. MR Imaging of Pediatric Low-Grade Gliomas: Pretherapeutic Differentiation of BRAF V600E Mutation, BRAF Fusion, and Wild-Type Tumors in Patients without Neurofibromatosis-1. AJNR Am J Neuroradiol 2022; 43:1196-1201. [PMID: 35863783 PMCID: PMC9575425 DOI: 10.3174/ajnr.a7574] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/24/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The prognosis and treatment of pediatric low-grade gliomas is influenced by their molecular subtype. MR imaging remains the mainstay for initial work-up and surgical planning. We aimed to determine the relationship between imaging patterns and molecular subtypes of pediatric low-grade gliomas. MATERIALS AND METHODS This was a retrospective bi-institutional study for patients diagnosed from 2004 to 2021 with pathologically confirmed pediatric low-grade gliomas molecularly defined as BRAF fusion, BRAF V600E mutant, or wild-type (which is neither BRAF V600E mutant nor BRAF fusion). Two neuroradiologists, blinded, independently reviewed imaging parameters from diagnostic MRIs, and discrepancies were resolved by consensus. Bivariate analysis was used followed by pair-wise comparison of the Dwass-Steel-Critchlow-Fligner method to compare the 3 molecular subtypes. Interreader agreement was assessed using κ. RESULTS We included 70 patients: 30 BRAF fusion, 19 BRAF V600E mutant, and 21 wild-type. There was substantial agreement between the readers for overall imaging variables (κ = 0.75). BRAF fusion tumors compared with BRAF V600E and wild-type tumors were larger (P = .0022), and had a greater mass effect (P = .0053), increased frequency of hydrocephalus (P = .0002), and diffuse enhancement (p <.0001). BRAF V600E mutant tumors were more often hemispheric (P < .0001), appeared more infiltrative (P = .0002), and, though infrequent, were the only group demonstrating diffusion restriction (qualitatively; P = .0042) with a lower ADC ratio (quantitatively) (P = .003). CONCLUSIONS BRAF fusion and BRAF V600E mutant pediatric low-grade gliomas have unique imaging features that can be used to differentiate them from each other and wild-type pediatric low-grade glioma using a standard radiology review with high interreader agreement. In the era of targeted therapy, these features can be useful for therapeutic planning before surgery.
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Affiliation(s)
- A Trasolini
- From the IWK Health Centre (A.T., C.E., C.C., K.M., D.M.-M.), Halifax, Nova Scotia, Canada
- Dalhousie University Medical School (A.T.), Halifax, Nova Scotia, Canada
| | - C Erker
- From the IWK Health Centre (A.T., C.E., C.C., K.M., D.M.-M.), Halifax, Nova Scotia, Canada
- Departments of Pediatrics (C.E.)
| | - S Cheng
- Division of Hematology, Oncology, and Bone Marrow Transplant (S.C.), Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - C Crowell
- From the IWK Health Centre (A.T., C.E., C.C., K.M., D.M.-M.), Halifax, Nova Scotia, Canada
- Faculty of Science (C.C.), Dalhousie University, Halifax, Nova Scotia, Canada
| | - K McFadden
- From the IWK Health Centre (A.T., C.E., C.C., K.M., D.M.-M.), Halifax, Nova Scotia, Canada
- Pathology (K.M.)
| | - R Moineddin
- University of Toronto Dalla Lana School of Public Health (R.M.), Toronto, Ontario, Canada
| | - M A Sargent
- Department of Radiology (M.A.S.), British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - D Mata-Mbemba
- From the IWK Health Centre (A.T., C.E., C.C., K.M., D.M.-M.), Halifax, Nova Scotia, Canada
- Diagnostic Radiology (D.M.-M.)
- Department of Diagnostic Imaging (D.M.-M.), IWK Health Centre, Halifax, Nova Scotia, Canada
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114
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Cai S, Miao K, Tan XY, Cheng S, Li DT, Zeng XY, Yang Y, Meng RR, Liu ZK, Li Y, Li KL, Sun F, Zhan SY. [Clinical research progress and implications of therapeutic vaccines for cervical cancer and precancerous lesions: a qualitative systematic review]. Zhonghua Zhong Liu Za Zhi 2022; 44:743-760. [PMID: 35880341 DOI: 10.3760/cma.j.cn112152-20210824-00638] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To systematically summarize and analyze the clinical research progress of therapeutic vaccines for cervical cancer or precancerous lesions. Methods: English databases (PubMed, Embase, Web of Science, Cochrane library, Proquest, and ClinicalTrails.gov) and Chinese databases (SinoMed, CNKI, WanFang, and VIP Database) were systematically searched to collect literature on therapeutic vaccines for cervical cancer or precancerous lesions from inception to February 18, 2021. After screening, we evaluated the risk of bias of included studies, and combed the basic information of the literature, research designs, information of vaccines, study patients, outcome indicators and so on, qualitatively summarized the clinical research progress. Results: A total of 71 studies were included in this systematic review, including 14 random controlled trials, 15 quasi-random controlled trials, 4 cohort studies, 1 case-control study, 34 case series studies and 3 case reports. The study patients included women aged 15~79 with cervical cancer or precancerous lesions in 18 countries from 1989 to 2021. On the one hand, there were 40 studies on therapeutic vaccines for cervical precancerous lesions (22 867 participants), involving 21 kinds of vaccines in 6 categories. Results showed 3 marketed vaccines (Cervarix, Gardasil, Gardasil 9) as adjuvant immunotherapies were significant effective in preventing the recurrence of precancerous lesions compared with the conization only. In addition, MVA E2 vaccine had been in phase Ⅲ clinical trials as a specific therapeutic vaccine, with relative literature showing it could eliminate most high-grade precancerous lesions. Therapeutic vaccines for precancerous lesions all showed good safety. On the other hand, there were 31 studies on therapeutic vaccines for cervical cancer (781 participants), involving 19 kinds of vaccines in 7categories, with none had been marketed. 25 studies were with no control group, showing the vaccines could effectively eliminate solid tumors, prevent recurrence, and prolong the median survival time. However, the vaccines effectiveness couldn't be statistically calculated due to the lack of a control group. As for the safety of therapeutic vaccines for cervical cancer, 9 studies showed that patients experienced serious adverse events after treatments, where 7 studies reported that serious adverse events occurred in patients couldn't be ruled out as the results of therapeutic vaccines. Conclusions: The literature review shows that the literature evidence for the therapeutic vaccines for cervical precancerous lesions is relatively mature compared with the therapeutic vaccines for cervical cancer. The four kinds of vaccines on the market are all therapeutic vaccines for precancerous lesions, but they are generally used as vaginal infection treatments or adjuvant immunotherapies for cervical precancerous lesions, not used for the specific treatments of cervical precancerous lesions. Other specific therapeutic vaccines are in the early stage of clinical trials, mainly phase Ⅰ/Ⅱ clinical trials with small sample size. The effectiveness and safety data are limited, and further research is still needed.
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Affiliation(s)
- S Cai
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - K Miao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - X Y Tan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - D T Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
| | - X Y Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y Yang
- National Institute of Health Data Science, Peking University, Beijing 100191, China
| | - R R Meng
- National Institute of Health Data Science, Peking University, Beijing 100191, China
| | - Z K Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y Li
- National Center for Disease Control and Prevention, Beijing 100050, China
| | - K L Li
- National Center for Disease Control and Prevention, Beijing 100050, China
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S Y Zhan
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
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Hoshi RA, Liu Y, Luttmann-Gibson H, Tiwari S, Giulianini F, Andres AM, Watrous JD, Cook NR, Costenbader KH, Okereke OI, Ridker PM, Manson JE, Lee IM, Vinayagamoorthy M, Cheng S, Copeland T, Jain M, Chasman DI, Demler OV, Mora S. Association of Physical Activity With Bioactive Lipids and Cardiovascular Events. Circ Res 2022; 131:e84-e99. [PMID: 35862024 PMCID: PMC9357171 DOI: 10.1161/circresaha.122.320952] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND To clarify the mechanisms underlying physical activity (PA)-related cardioprotection, we examined the association of PA with plasma bioactive lipids (BALs) and cardiovascular disease (CVD) events. We additionally performed genome-wide associations. METHODS PA-bioactive lipid associations were examined in VITAL (VITamin D and OmegA-3 TriaL)-clinical translational science center (REGISTRATION: URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT01169259; N=1032) and validated in JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin)-NC (NCT00239681; N=589), using linear models adjusted for age, sex, race, low-density lipoprotein-cholesterol, total-C, and smoking. Significant BALs were carried over to examine associations with incident CVD in 2 nested CVD case-control studies: VITAL-CVD (741 case-control pairs) and JUPITER-CVD (415 case-control pairs; validation). RESULTS We detected 145 PA-bioactive lipid validated associations (false discovery rate <0.1). Annotations were found for 6 of these BALs: 12,13-diHOME, 9,10-diHOME, lysoPC(15:0), oxymorphone-3b-D-glucuronide, cortisone, and oleoyl-glycerol. Genetic analysis within JUPITER-NC showed associations of 32 PA-related BALs with 22 single-nucleotide polymorphisms. From PA-related BALs, 12 are associated with CVD. CONCLUSIONS We identified a PA-related bioactive lipidome profile out of which 12 BALs also had opposite associations with incident CVD events.
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Affiliation(s)
- Rosangela A Hoshi
- Center for Lipid Metabolomics, Division of Preventive Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., P.M.R., O.V.D., S.M.).,Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.)
| | - Yanyan Liu
- Center for Lipid Metabolomics, Division of Preventive Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., P.M.R., O.V.D., S.M.).,Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.)
| | - Heike Luttmann-Gibson
- Center for Lipid Metabolomics, Division of Preventive Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., P.M.R., O.V.D., S.M.).,Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.).,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (H.L.-G., O.I.O., J.E.M., I.-M.L., M.J.)
| | - Saumya Tiwari
- Department of Pharmacology, University of California San Diego, La Jolla (S.T., A.M.A., J.D.W.)
| | - Franco Giulianini
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.)
| | - Allen M Andres
- Department of Pharmacology, University of California San Diego, La Jolla (S.T., A.M.A., J.D.W.)
| | - Jeramie D Watrous
- Department of Pharmacology, University of California San Diego, La Jolla (S.T., A.M.A., J.D.W.)
| | - Nancy R Cook
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.)
| | - Karen H Costenbader
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (K.H.C.)
| | - Olivia I Okereke
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (H.L.-G., O.I.O., J.E.M., I.-M.L., M.J.).,Department of Psychiatry, Massachusetts General Hospital, Boston (O.I.O.)
| | - Paul M Ridker
- Center for Lipid Metabolomics, Division of Preventive Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., P.M.R., O.V.D., S.M.).,Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.)
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.).,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (H.L.-G., O.I.O., J.E.M., I.-M.L., M.J.)
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.).,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (H.L.-G., O.I.O., J.E.M., I.-M.L., M.J.)
| | - Manickavasagar Vinayagamoorthy
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.)
| | - Susan Cheng
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (S.C.)
| | - Trisha Copeland
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.)
| | - Mohit Jain
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (H.L.-G., O.I.O., J.E.M., I.-M.L., M.J.)
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.)
| | - Olga V Demler
- Center for Lipid Metabolomics, Division of Preventive Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., P.M.R., O.V.D., S.M.).,Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.).,Department of Computer Science, ETH Zurich, Switzerland (O.V.D.)
| | - Samia Mora
- Center for Lipid Metabolomics, Division of Preventive Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., P.M.R., O.V.D., S.M.).,Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. (R.A.H., Y.L., H.L.-G., F.G., N.R.C., P.M.R., J.E.M., I.-M.L., M.V., T.C., D.I.C., O.V.D., S.M.)
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Cheng S, Battaglia AM, Imperiale CJ, Lough A, Wilson MWB, Seferos DS. Synthesis and optoelectronic properties of radical conjugated polyfluorenes. Chem Commun (Camb) 2022; 58:8630-8633. [PMID: 35833569 DOI: 10.1039/d2cc02406c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A novel redox-active fluorene monomer is synthesized and copolymerized with 9,9-dioctylfluorene and benzo[c][1,2,5]thiadiazole via Suzuki cross-coupling to produce alternating and tertiary copolymers. Electrochemical and chemical reduction of the copolymers generates organic polymeric radical anions. Electrochemical, spectroscopic, and photophysical characterization grant insight into the structure-property relationship for open-shell conjugated polymers.
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Affiliation(s)
- Susan Cheng
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Alicia M Battaglia
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | | | - Alan Lough
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Mark W B Wilson
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada
| | - Dwight S Seferos
- Department of Chemistry, University of Toronto, Toronto, Ontario M5S 3H6, Canada.,Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, Ontario M5S 3E5, Canada.
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117
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Goh SN, Fan G, Cheng S, Khaing N. COVID 19 pandemic: Impact of changes experienced on social workers' professional quality of life in Singapore. Soc Work Health Care 2022; 61:298-322. [PMID: 35819057 DOI: 10.1080/00981389.2022.2092582] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/19/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
COVID-19 has impacted all spheres of life massively. Among the emerging studies on the psychosocial impact of the pandemic, few studies look specifically at how social workers are impacted. To understand this gap, this study surveyed 337 social workers. The findings showed that changes experienced in the workplace were enormous and caused secondary traumatic stress while engendering compassion satisfaction among social workers, but the presence of social support moderated to keep the secondary traumatic stress at bay. Resilience mediated association between social and workplace support and compassion fatigue. Social support seemed to have the largest effect on reducing stress through resilience. Workplace support also helped mitigate burnout. In conclusion, continued social and workplace support will be key to supporting social workers during a pandemic.
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Affiliation(s)
- S N Goh
- Medical Social Services, Changi General Hospital, Singapore, Singapore
| | - G Fan
- Psychosocial Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - S Cheng
- Medical Social Services, Sengkang General Hospital, Singapore, Singapore
| | - Nee Khaing
- Health Services Research, Changi General Hospital, Singapore, Singapore
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118
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Le S, Zhang Y, Voutilainen A, Tan X, Laukkanen J, Wang C, Cheng S. Differences in cardiometabolic risk profiles between Chinese and Finnish older adults with glucose impairment and central obesity. J Endocrinol Invest 2022; 45:1427-1437. [PMID: 35325446 PMCID: PMC9184414 DOI: 10.1007/s40618-022-01777-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 11/08/2021] [Accepted: 02/23/2022] [Indexed: 12/06/2022]
Abstract
BACKGROUND Obesity and ethnicity play important roles in cardiovascular complications in patients with type 2 diabetes mellitus (T2DM). This study aimed to compare cardiometabolic risk profiles between Chinese and Finnish older adults of central obesity with prediabetes or T2DM. METHODS Study subjects were 60-74 years old and originated from two population samples. The Finnish subjects came from the Kuopio Ischemic Heart Disease (KIHD) study (n = 1089), and the Chinese subjects came from the Shanghai High-risk Diabetic Screen (SHiDS) study (n = 818). The KIHD and SHiDS studies used similar questionnaires to determine participants' baseline characteristics regarding the history of medication use and diseases and lifestyle factors. All study subjects participated in glucose tolerance tests and anthropometry assessments, including waist circumference measurements. RESULTS Among study subjects of central obesity with prediabetes (n = 298), fasting and 2-h glucose, and fasting insulin and insulin resistance were significantly higher in Chinese than in Finnish (p < 0.0001-0.016). In addition, triglyceride (TG) level was higher and the low-density lipoprotein cholesterol (LDL) and LDL to high-density lipoprotein cholesterol (HDL) ratio were lower in Chinese than in Finnish (p < 0.0001-0.003). Among subjects of central obesity with T2DM (n = 251), Chinese subjects had significantly less proportions of antihypertensive, glycaemic control medication, and statin users as well as lower level of physical activity (p < 0.0001 for all), while higher blood pressure (p = 0.002 for systolic blood pressure and p < 0.0001 for diastolic blood pressure), TG levels (p < 0.05) and HDL (p = 0.002) than the Finnish counterparts. There were no differences in β-cell function (HOMA-β) between Chinese and Finnish both in prediabetes and T2DM. CONCLUSIONS Our results indicated that Chinese and Finnish older adults of central obesity with prediabetes and T2DM had similar β-cell function. However, Chinese individuals with prediabetes are prone to insulin resistance. Meanwhile, lipid metabolism dysfunction is also different between Chinese and Finnish. Chinese older adults of central obesity with prediabetes showed higher TG, but Finnish showed higher LDL and LDL/HDL. Strategic for T2DM prevention and treatment should be ethnically specific.
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Affiliation(s)
- S Le
- Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, 200240, Shanghai, China
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, 200240, China
- Department of Physical Therapy, Taihe Hospital, Hubei University of Medicine, Shiyan, 442099, China
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014, Jyväskylä, Finland
| | - Y Zhang
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, The Metabolic Disease Biobank, Shanghai, 200233, China
| | - A Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211, Kuopio, Finland
| | - X Tan
- Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, 200240, Shanghai, China
- Department of Neuroscience, Uppsala University, BMC, Box 593, 75124, Uppsala, Sweden
| | - J Laukkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014, Jyväskylä, Finland.
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211, Kuopio, Finland.
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, 70211, Kuopio, Finland.
| | - C Wang
- Department of Endocrinology and Metabolism, School of Medicine, Shanghai Fourth People's Hospital Affiliated to Tongji University, Tongji University, 1279 Sanmen Road, Shanghai, 200434, China.
| | - S Cheng
- Exercise Translational Medicine Center, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, 200240, Shanghai, China.
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, 200240, China.
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014, Jyväskylä, Finland.
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119
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Kwan AC, Navarrette J, Botting P, Chen MT, Wei J, Bairey Merz CN, Ebinger JE, Cheng S. Mortality Risk in Takotsubo Syndrome Versus Myocarditis. J Am Heart Assoc 2022; 11:e025191. [PMID: 35766264 PMCID: PMC9333398 DOI: 10.1161/jaha.121.025191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Alan C Kwan
- Department of Cardiology Barbra Streisand Women's Heart Center Smidt Heart InstituteCedars Sinai Medical Center Los Angeles CA
| | - Jesse Navarrette
- Department of Cardiology Barbra Streisand Women's Heart Center Smidt Heart InstituteCedars Sinai Medical Center Los Angeles CA
| | - Patrick Botting
- Department of Cardiology Barbra Streisand Women's Heart Center Smidt Heart InstituteCedars Sinai Medical Center Los Angeles CA
| | - Melanie T Chen
- Department of Cardiology Barbra Streisand Women's Heart Center Smidt Heart InstituteCedars Sinai Medical Center Los Angeles CA
| | - Janet Wei
- Department of Cardiology Barbra Streisand Women's Heart Center Smidt Heart InstituteCedars Sinai Medical Center Los Angeles CA
| | - C Noel Bairey Merz
- Department of Cardiology Barbra Streisand Women's Heart Center Smidt Heart InstituteCedars Sinai Medical Center Los Angeles CA
| | - Joseph E Ebinger
- Department of Cardiology Barbra Streisand Women's Heart Center Smidt Heart InstituteCedars Sinai Medical Center Los Angeles CA
| | - Susan Cheng
- Department of Cardiology Barbra Streisand Women's Heart Center Smidt Heart InstituteCedars Sinai Medical Center Los Angeles CA
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Wenger NK, Lloyd-Jones DM, Elkind MSV, Fonarow GC, Warner JJ, Alger HM, Cheng S, Kinzy C, Hall JL, Roger VL. Call to Action for Cardiovascular Disease in Women: Epidemiology, Awareness, Access, and Delivery of Equitable Health Care: A Presidential Advisory From the American Heart Association. Circulation 2022; 145:e1059-e1071. [PMID: 35531777 PMCID: PMC10162504 DOI: 10.1161/cir.0000000000001071] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Addressing the pervasive gaps in knowledge and care delivery to reduce sex-based disparities and achieve equity is fundamental to the American Heart Association's commitment to advancing cardiovascular health for all by 2024. This presidential advisory serves as a call to action for the American Heart Association and other stakeholders around the globe to identify and remove barriers to health care access and quality for women. A concise and current summary of existing data across the areas of risk and prevention, access and delivery of equitable care, and awareness and education provides a framework to consider knowledge gaps and research needs critical toward achieving significant progress for the health and well-being of all women.
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Gladman DD, Coates L, Gossec L, Aelion J, Vasandani J, Cheng S, Tang L, Jardon S, Richter S, Mease PJ. POS1080 CHARACTERIZATION OF JOINT DISTRIBUTION AND DISEASE BURDEN IN PATIENTS WITH EARLY OLIGOARTICULAR PSORIATIC ARTHRITIS: RESULTS FROM THE ONGOING FOREMOST STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundOligoarticular psoriatic arthritis (PsA) is commonly reported in early disease. Although fewer joints are involved, there may be significant impact on patients’ (pts) quality of life. The ongoing FOREMOST study (NCT03747939) is investigating the efficacy of apremilast vs placebo for treatment of early oligoarticular PsA (>1 but ≤4 tender and swollen joints involved).ObjectivesTo characterize disease burden in pts with early oligoarticular PsA and disease phenotype including location and size of involved joints and presence of certain baseline clinical PsA manifestations in FOREMOST pts.MethodsBaseline swollen and tender joint distribution was analyzed. Baseline disease burden was assessed in the overall group and a subgroup with small joint involvement only (for context) using clinical disease activity measures, pt-reported outcomes, and additional PsA manifestations.ResultsAt data cut-off for analysis, 220 pts of 285 planned were enrolled. In the overall group, disease duration was <1 year and joint distribution for swollen or tender joints involved predominantly small joints, with ~48% of joint involvement observed in finger proximal interphalangeal (PIP) joints and <2% in temporomandibular and clavicular joints across swollen or tender joints (Figure 1). Mean Physician’s and Patient Global Assessment of Disease Activity (PhGA and PtGA, respectively) scores were 43.9 and 51.3; mean pt pain assessment score was 50.7. Mean Health Assessment Questionnaire Disability Index (HAQ-DI) functional assessment score was 1.0; 25.5% of pts had HAQ-DI ≤0.5. Pts reported an average PsA Impact of Disease (PsAID-12) domain score of 4.7. Additional manifestations of PsA at baseline included dactylitis (14.5%), enthesitis (32.7%), nail involvement (67.3%), and skin disease (47.7% with body surface area [BSA] ≥3%). Within the overall group, 59% had >1 joint size involved (small [metacarpophalangeal, metatarsophalangeal, distal interphalangeal, PIP, hand carpometacarpal and mid-tarsal]; intermediate [wrist, elbow, ankle, temporomandibular, acromioclavicular, sternoclavicular]; large [shoulder, hip, knee]). Of those with only 1 joint size involved (41% of pts), the majority had small joint involvement predominantly in PIPs (n=84 for small joints; n=1 for intermediate joints; n=5 for large joints). The overall pattern of clinical and disease presentation indicated elevated burden for pts with early oligoarticular PsA, including those pts with only small joints involved (Table 1).Table 1.CharacteristicsOverall Population (PBO + APR), N=220Small Joints Only (PBO + APR), N=84Age, mean, y49.651.3Men, n (%)98 (44.5)40 (47.6)Europe/Russia, n (%)47 (21.4)/66 (30.0)22 (26.2)/11 (13.1)Canada/United States, n (%)8 (3.6)/99 (45.0)1 (1.2)/50 (59.5)Body mass index, mean, kg/m230.429.3Duration of disease, mean, y0.690.71Previous cDMARD use, n (%)143 (65.0)48 (57.0)Tender joint count (0–68), mean3.23.1Swollen joint count (0–66), mean2.62.8PhGA (VAS 0–100)a, mean43.939.0PtGA (VAS 0–100)a, mean51.345.6Patient’s Assessment of Pain (VAS 0–100)a, mean50.746.3Dactylitis present, n (%)32 (14.5)14 (16.7)Enthesitis present, n (%)72 (32.7)21 (25.0)BSA ≥3%, n (%)105 (47.7)34 (40.5)Nail involvement present, n (%)148 (67.3)53 (63.1)HAQ-DI (0–3)a, mean1.020.84HAQ-DI ≤0.5, n (%)56 (25.5)31 (36.9)PsAID-12 (0–10)a, mean4.733.98cDMARD, conventional disease-modifying antirheumatic drugs; VAS, visual analog scale.aHigher scores indicate greater burden/worse status. Early oligoarticular = ≤2 years in the initial protocol; ≤5 years in the current protocol for inclusion.Figure 1.FOREMOST population: baseline demographics and disease burden in the overall population and pts with involvement in small joints onlyConclusionIn FOREMOST, despite few joints involved, pts with early oligoarticular PsA experienced high disease burden and impaired quality of life. Small joint involvement, although less commonly expected in oligoarticular PsA, was the most frequently observed pattern.AcknowledgementsThe authors thank the patients, their families, and all investigators involved in this study. This study was funded by Amgen Inc. Writing support was funded by Amgen Inc. and provided by Kristin Carlin, BSPharm, MBA, of Peloton Advantage, LLC, an OPEN Health company, and Cathryn M. Carter, MS, employee of and stockholder in Amgen Inc.Disclosure of InterestsDafna D Gladman Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, and UCB – grant/research support or consulting fees, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, and UCB – grant/research support or consulting fees, Laura Coates Speakers bureau: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Celgene Corporation, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Medac, Moonlake, Novartis, Pfizer, and UCB –grant/research support, consulting fees, and/or speaker/honoraria, Consultant of: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Celgene Corporation, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Medac, Moonlake, Novartis, Pfizer, and UCB –grant/research support, consulting fees, and/or speaker/honoraria, Grant/research support from: AbbVie, Amgen, Biogen, Bristol Myers Squibb, Celgene Corporation, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Medac, Moonlake, Novartis, Pfizer, and UCB –grant/research support, consulting fees, and/or speaker/honoraria, Laure Gossec Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene Corporation, Galapagos, Gilead, GSK, Janssen, Lilly, Novartis, Pfizer, Samsung Bioepis, Sanofi-Aventis, and UCB, Grant/research support from: Amgen, Galapagos, Lilly, Pfizer, and Sandoz, Jacob Aelion Grant/research support from: AbbVie, Celgene, Eli Lilly and Regeneron – speakers bureau. AbbVie, Ardea Biosciences, AstraZeneca, Bristol Myers Squibb, Celgene, Centocor, Eli Lilly, Galapagos, Genentech, GlaxoSmithKline, Human Genome Sciences, Janssen, Merck, Mesoblast, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi-Aventis, Takeda, UCB, and Vertex, Jitendra Vasandani: None declared, Sue Cheng Shareholder of: Stock ownership in Amgen Inc., Employee of: Employment by Amgen Inc., Lihua Tang Shareholder of: Stock ownership in Amgen Inc., Employee of: Employment by Amgen Inc., Shauna Jardon Shareholder of: Stock ownership in Amgen Inc., Employee of: Employment by Amgen Inc., Sven Richter Shareholder of: Stock ownership in Amgen at time of study, Employee of: Employment by Amgen at time of study., Philip J Mease Speakers bureau: AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, Sun, and UCB – grant/research support and consultant; Boehringer Ingelheim and GlaxoSmithKline – consultant, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, Sun, and UCB
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Bello NA, Cheng S. Sex Differences in Blood Pressure-A Measured Relook at Measures. JAMA Netw Open 2022; 5:e2215521. [PMID: 35671059 PMCID: PMC9870029 DOI: 10.1001/jamanetworkopen.2022.15521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- Natalie A. Bello
- Department of Cardiology, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
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Ebinger JE, Driver M, Ouyang D, Botting P, Ji H, Rashid MA, Blyler CA, Bello NA, Rader F, Niiranen TJ, Albert CM, Cheng S. Variability independent of mean blood pressure as a real-world measure of cardiovascular risk. EClinicalMedicine 2022; 48:101442. [PMID: 35706499 PMCID: PMC9112125 DOI: 10.1016/j.eclinm.2022.101442] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 01/06/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 11/07/2022] Open
Abstract
Background Individual-level blood pressure (BP) variability, independent of mean BP levels, has been associated with increased risk for cardiovascular events in cohort studies and clinical trials using standardized BP measurements. The extent to which BP variability relates to cardiovascular risk in the real-world clinical practice setting is unclear. We sought to determine if BP variability in clinical practice is associated with adverse cardiovascular outcomes using clinically generated data from the electronic health record (EHR). Methods We identified 42,482 patients followed continuously at a single academic medical center in Southern California between 2013 and 2019 and calculated their systolic and diastolic BP variability independent of the mean (VIM) over the first 3 years of the study period. We then performed multivariable Cox proportional hazards regression to examine the association between VIM and both composite and individual outcomes of interest (incident myocardial infarction, heart failure, stroke, and death). Findings Both systolic (HR, 95% CI 1.22, 1.17-1.28) and diastolic VIM (1.24, 1.19-1.30) were positively associated with the composite outcome, as well as all individual outcome measures. These findings were robust to stratification by age, sex and clinical comorbidities. In sensitivity analyses using a time-shifted follow-up period, VIM remained significantly associated with the composite outcome for both systolic (1.15, 1.11-1.20) and diastolic (1.18, 1.13-1.22) values. Interpretation VIM derived from clinically generated data remains associated with adverse cardiovascular outcomes and represents a risk marker beyond mean BP, including in important demographic and clinical subgroups. The demonstrated prognostic ability of VIM derived from non-standardized BP readings indicates the utility of this measure for risk stratification in a real-world practice setting, although residual confounding from unmeasured variables cannot be excluded. Funding This study was funded in part by National Institutes of Health grants R01-HL134168, R01-HL131532, R01-HL143227, R01-HL142983, U54-AG065141; R01-HL153382, K23-HL136853, K23-HL153888, and K99-HL157421; China Scholarship Council grant 201806260086; Academy of Finland (Grant no: 321351); Emil Aaltonen Foundation; Finnish Foundation for Cardiovascular Research.
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Affiliation(s)
- Joseph E. Ebinger
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Matthew Driver
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - David Ouyang
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Patrick Botting
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Hongwei Ji
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Mohamad A. Rashid
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ciantel A. Blyler
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Natalie A. Bello
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Division of Cardiology, Columbia University Medical Center, New York, NY, USA
| | - Florian Rader
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Teemu J. Niiranen
- University of Turku, Turku University Hospital, Turku, Finland
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Turku, Finland
| | - Christine M. Albert
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Ouyang D, Cheng S. Extracting More From Less: A New Frontier for High-Throughput Clinical Phenotyping. Circ Cardiovasc Qual Outcomes 2022; 15:e009055. [PMID: 35477258 DOI: 10.1161/circoutcomes.122.009055] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- David Ouyang
- Department of Cardiology, Smidt Heart Institute (D.O., S.C.), Cedars-Sinai Medical Center, Los Angeles, CA.,Division of Artificial Intelligence in Medicine (D.O.), Cedars-Sinai Medical Center, Los Angeles, CA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute (D.O., S.C.), Cedars-Sinai Medical Center, Los Angeles, CA
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Ebinger JE, Joung S, Liu Y, Wu M, Weber B, Claggett B, Botting PG, Sun N, Driver M, Kao YH, Khuu B, Wynter T, Nguyen TT, Alotaibi M, Prostko JC, Frias EC, Stewart JL, Goodridge HS, Chen P, Jordan SC, Jain M, Sharma S, Fert-Bober J, Van Eyk JE, Minissian MB, Arditi M, Melmed GY, Braun JG, McGovern DPB, Cheng S, Sobhani K. Demographic and clinical characteristics associated with variations in antibody response to BNT162b2 COVID-19 vaccination among healthcare workers at an academic medical centre: a longitudinal cohort analysis. BMJ Open 2022; 12:e059994. [PMID: 35613792 PMCID: PMC9130668 DOI: 10.1136/bmjopen-2021-059994] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/11/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES We sought to understand the demographic and clinical factors associated with variations in longitudinal antibody response following completion of two-dose regiment of BNT162b2 vaccination. DESIGN This study is a 10-month longitudinal cohort study of healthcare workers and serially measured anti-spike protein IgG (IgG-S) antibody levels using mixed linear models to examine their associations with participant characteristics. SETTING A large, multisite academic medical centre in Southern California, USA. PARTICIPANTS A total of 843 healthcare workers met inclusion criteria including completion of an initial two-dose course of BNT162b2 vaccination, complete clinical history and at least two blood samples for analysis. Patients had an average age of 45±13 years, were 70% female and 7% with prior SARS-CoV-2 infection. RESULTS Vaccine-induced IgG-S levels remained in the positive range for 99.6% of individuals up to 10 months after initial two-dose vaccination. Prior SARS-CoV-2 infection was the primary correlate of sustained higher postvaccination IgG-S levels (partial R2=0.133), with a 1.74±0.11 SD higher IgG-S response (p<0.001). Female sex (beta 0.27±0.06, p<0.001), younger age (0.01±0.00, p<0.001) and absence of hypertension (0.17±0.08, p=0.003) were also associated with persistently higher IgG-S responses. Notably, prior SARS-CoV-2 infection augmented the associations of sex (-0.42 for male sex, p=0.08) and modified the associations of hypertension (1.17, p=0.001), such that infection-naïve individuals with hypertension had persistently lower IgG-S levels whereas prior infected individuals with hypertension exhibited higher IgG-S levels that remained augmented over time. CONCLUSIONS While the IgG-S antibody response remains in the positive range for up to 10 months following initial mRNA vaccination in most adults, determinants of sustained higher antibody levels include prior SARS-CoV-2 infection, female sex, younger age and absence of hypertension. Certain determinants of the longitudinal antibody response appear significantly modified by prior infection status. These findings offer insights regarding factors that may influence the 'hybrid' immunity conferred by natural infection combined with vaccination.
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Affiliation(s)
- Joseph E Ebinger
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Sandy Joung
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Yunxian Liu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Min Wu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Brittany Weber
- Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Brian Claggett
- Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Patrick G Botting
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nancy Sun
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Matthew Driver
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Yu Hung Kao
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Briana Khuu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Timothy Wynter
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Trevor-Trung Nguyen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mona Alotaibi
- Division of Pulmonary and Critical Care Medicine, University of California San Diego, San Diego, California, USA
| | - John C Prostko
- Applied Research and Technology, Abbott Laboratories, Abbott Park, Illinois, USA
| | - Edwin C Frias
- Applied Research and Technology, Abbott Laboratories, Abbott Park, Illinois, USA
| | - James L Stewart
- Applied Research and Technology, Abbott Laboratories, Abbott Park, Illinois, USA
| | - Helen S Goodridge
- Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Peter Chen
- Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Stanley C Jordan
- Transplant Immunology Laboratory and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mohit Jain
- Department of Medicine, School of Medicine, University of California, San Diego, San Diego, California, USA
| | - Sonia Sharma
- La Jolla Institute for Allergy and Immunology, La Jolla, California, USA
| | - Justyna Fert-Bober
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jennifer E Van Eyk
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Advanced Clinical Biosystems Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Margo B Minissian
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Brawerman Nursing Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Moshe Arditi
- Smidt Heart Institute; Department of Pediatrics, Division of Infectious Diseases and Immunology; Infectious and Immunologic Diseases Research Center (IIDRC); Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Gil Y Melmed
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jonathan G Braun
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dermot P B McGovern
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Kimia Sobhani
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Plummer JT, Contreras D, Zhang W, Binek A, Zhang R, Dezem F, Chen SS, Davis BD, Sincuir Martinez J, Stotland A, Kreimer S, Makhoul E, Heneidi S, Eno C, Shin B, Berg AH, Cheng S, Jordan SC, Vail E, Van Eyk JE, Morgan MA. US Severe Acute Respiratory Syndrome Coronavirus 2 Epsilon Variant: Highly Transmissible but With an Adjusted Muted Host T-Cell Response. Clin Infect Dis 2022; 75:1940-1949. [PMID: 35438777 PMCID: PMC9383744 DOI: 10.1093/cid/ciac295] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The multiple mutations comprising the epsilon variant demonstrate the independent convergent evolution of severe acute respiratory syndrome coronavirus (SARS-CoV-2), with its spike protein mutation L452R present in the delta (L452R), kappa (L452R), and lambda (L452Q) variants. METHODS Coronavirus disease 2019 (COVID-19) variants were detected in 1017 patients using whole-genome sequencing and were assessed for outcome and severity. The mechanistic effects of the epsilon versus non-epsilon variants were investigated using a multiomic approach including cellular response assays and paired cell and host transcriptomic and proteomic profiling. RESULTS We found that patients carrying the epsilon variant had increased mortality risk but not increased hospitalizations (P < .02). Cells infected with live epsilon compared with non-epsilon virus displayed increased sensitivity to neutralization antibodies in all patients but a slightly protective response in vaccinated individuals (P < .001). That the epsilon SARS-CoV-2 variant is more infectious but less virulent is supported mechanistically in the down-regulation of viral processing pathways seen by multiomic analyses. Importantly, this paired transcriptomics and proteomic profiling of host cellular response to live virus revealed an altered leukocyte response and metabolic messenger RNA processing with the epsilon variant. To ascertain host response to SARS-CoV-2 infection, primary COVID-19-positive nasopharyngeal samples were transcriptomically profiled and revealed a differential innate immune response (P < .001) and an adjusted T-cell response in patients carrying the epsilon variant (P < .002). In fact, patients infected with SARS-CoV-2 and those vaccinated with the BNT162b2 vaccine have comparable CD4+/CD8+ T-cell immune responses to the epsilon variant (P < .05). CONCLUSIONS While the epsilon variant is more infectious, by altering viral processing, we showed that patients with COVID-19 have adapted their innate immune response to this fitter variant. A protective T-cell response molecular signature is generated by this more transmissible variant in both vaccinated and unvaccinated patients.
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Affiliation(s)
- Jasmine T Plummer
- Correspondence: Jasmine T. Plummer, Cedars Sinai Medical Center, 8700 Beverly Blvd, SSB365, Los Angeles, CA 90048 ()
| | | | | | | | | | - Felipe Dezem
- Center for Bioinformatics and Functional Genomics, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Stephanie S Chen
- Center for Bioinformatics and Functional Genomics, Cedars-Sinai Medical Center, Los Angeles, California, USA,Applied Genomics, Computation & Translational Core, Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Brian D Davis
- Center for Bioinformatics and Functional Genomics, Cedars-Sinai Medical Center, Los Angeles, California, USA,Applied Genomics, Computation & Translational Core, Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jorge Sincuir Martinez
- Department of Pathology & Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Molecular Pathology Laboratory, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Aleksandr Stotland
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Advanced Clinical Biosystems Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Simion Kreimer
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Advanced Clinical Biosystems Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Elias Makhoul
- Department of Pathology & Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Molecular Pathology Laboratory, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Saleh Heneidi
- Department of Pathology & Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Molecular Pathology Laboratory, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Celeste Eno
- Department of Pathology & Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Molecular Pathology Laboratory, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Bongha Shin
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,HLA and Transplant Immunology Laboratory, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Anders H Berg
- Department of Pathology & Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Susan Cheng
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - CORALE Study Group
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Barsky L, Speier W, Fuller G, Cheng S, Kim A, Joung S, Arnold C, Dhawan S, Lopez M, Mastali M, van den Broek I, Wei J, Spiegel B, Van Eyk JE, Bairey Merz CN, Shufelt C. Sex-based differences in remote monitoring of biometric, psychometric and biomarker indices in stable ischemic heart disease. Biol Sex Differ 2022; 13:15. [PMID: 35410392 PMCID: PMC8996611 DOI: 10.1186/s13293-022-00423-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sex-based differences are crucial to consider in the formulation of a personalized treatment plan. We evaluated sex-based differences in adherence and remotely monitored biometric, psychometric, and biomarker data among patients with stable ischemic heart disease (IHD). METHODS The Prediction, Risk, and Evaluation of Major Adverse Cardiac Events (PRE-MACE) study evaluated patients with stable IHD over a 12-week period. We collected biometric and sleep data using remote patient monitoring via FitBit and psychometric data from Patient-Reported Outcomes Measurement Information System (PROMIS), Kansas City Cardiomyopathy (KCC) and Seattle Angina Questionnaire-7 (SAQ-7) questionnaires. Serum biomarker levels were collected at the baseline visit. We explored sex-based differences in demographics, adherence to study protocols, biometric data, sleep, psychometric data, and biomarker levels. RESULTS There were 198 patients enrolled, with mean age 65.5 ± 11 years (± Standard deviation, SD), and 60% were females. Females were less adherent to weekly collection of PROMIS, KCC and SAQ-7 physical limitations questionnaires (all p < 0.05), compared to males. There was no difference in biometric physical activity. There was a statistically significant (p < 0.05) difference in sleep duration between sexes, with females sleeping 6 min longer. However, females reported higher PROMIS sleep disturbance scores (p < 0.001) and poorer psychometric scores overall (p < 0.05). A higher proportion of males had clinically significant elevations of median N-terminal pro-brain natriuretic peptide (p = 0.005) and high-sensitivity cardiac troponin levels (p < 0.001) compared to females. CONCLUSIONS Among females and males with stable IHD, there are sex-based differences in remote monitoring behavior and data. Females are less adherent to psychometric data collection and report poorer psychometric and sleep quality scores than males. Elevated levels of biomarkers for MACE are more common in males. These findings may improve sex-specific understanding of IHD using remote patient monitoring.
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Affiliation(s)
- Lili Barsky
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - William Speier
- Medical Imaging and Informatics Group, University of California, Los Angeles, CA, USA
| | - Garth Fuller
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
| | - Susan Cheng
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - Andy Kim
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - Sandy Joung
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - Corey Arnold
- Medical Imaging and Informatics Group, University of California, Los Angeles, CA, USA
| | - Shivani Dhawan
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - Mayra Lopez
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
| | - Mitra Mastali
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA.,Cedars-Sinai Medical Center, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - Irene van den Broek
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA.,Cedars-Sinai Medical Center, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - Janet Wei
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - Brennan Spiegel
- Cedars-Sinai Medical Center, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - Jennifer E Van Eyk
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA.,Cedars-Sinai Medical Center, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA.
| | - Chrisandra Shufelt
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
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Li D, Xu A, Mengesha E, Elyanow R, Gittelman RM, Chapman H, Prostko JC, Frias EC, Stewart JL, Pozdnyakova V, Debbas P, Mujukian A, Horizon AA, Merin N, Joung S, Botwin GJ, Sobhani K, Figueiredo JC, Cheng S, Kaplan IM, McGovern DPB, Merchant A, Melmed GY, Braun J. The T-Cell Response to SARS-CoV-2 Vaccination in Inflammatory Bowel Disease is Augmented with Anti-TNF Therapy. Inflamm Bowel Dis 2022; 28:1130-1133. [PMID: 35397000 PMCID: PMC9047232 DOI: 10.1093/ibd/izac071] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Indexed: 12/12/2022]
Abstract
Lay Summary
T-cell and antibody responses to severe acute respiratory syndrome coronavirus 2 vaccination in inflammatory bowel disease patients are poorly correlated. T-cell responses are preserved by most biologic therapies, but augmented by anti-tumor necrosis factor (anti-TNF) treatment. While anti-TNF therapy blunts the antibody response, cellular immunity after vaccination is robust.
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Affiliation(s)
- Dalin Li
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alexander Xu
- Cedars Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Emebet Mengesha
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | | | | - John C Prostko
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL
| | - Edwin C Frias
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL
| | - James L Stewart
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL
| | - Valeriya Pozdnyakova
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Philip Debbas
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Angela Mujukian
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Noah Merin
- Cedars Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sandy Joung
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Gregory J Botwin
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kimia Sobhani
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jane C Figueiredo
- Cedars Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ian M Kaplan
- Cedars Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Dermot P B McGovern
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Akil Merchant
- Cedars Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Gil Y Melmed
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jonathan Braun
- Address correspondence to: Jonathan Braun, MD, PhD, Inflammatory Bowel and Immunobiology Research Institute, Karsh Division of Digestive and Liver Diseases, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA ()
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130
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Xu AM, Li D, Ebinger JE, Mengesha E, Elyanow R, Gittelman RM, Chapman H, Joung S, Botwin GJ, Pozdnyakova V, Debbas P, Mujukian A, Prostko JC, Frias EC, Stewart JL, Horizon AA, Merin N, Sobhani K, Figueiredo JC, Cheng S, Kaplan IM, McGovern DPB, Merchant A, Melmed GY, Braun J. Differences in SARS-CoV-2 Vaccine Response Dynamics Between Class-I- and Class-II-Specific T-Cell Receptors in Inflammatory Bowel Disease. Front Immunol 2022; 13:880190. [PMID: 35464463 PMCID: PMC9024211 DOI: 10.3389/fimmu.2022.880190] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 02/21/2022] [Accepted: 03/18/2022] [Indexed: 12/01/2022] Open
Abstract
T-cells specifically bind antigens to induce adaptive immune responses using highly specific molecular recognition, and a diverse T-cell repertoire with expansion of antigen-specific clones can indicate robust immune responses after infection or vaccination. For patients with inflammatory bowel disease (IBD), a spectrum of chronic intestinal inflammatory diseases usually requiring immunomodulatory treatment, the T-cell response has not been well characterized. Understanding the patient factors that result in strong vaccination responses is critical to guiding vaccination schedules and identifying mechanisms of T-cell responses in IBD and other immune-mediated conditions. Here we used T-cell receptor sequencing to show that T-cell responses in an IBD cohort were influenced by demographic and immune factors, relative to a control cohort of health care workers (HCWs). Subjects were sampled at the time of SARS-CoV-2 vaccination, and longitudinally afterwards; TCR Vβ gene repertoires were sequenced and analyzed for COVID-19-specific clones. We observed significant differences in the overall strength of the T-cell response by age and vaccine type. We further stratified the T-cell response into Class-I- and Class-II-specific responses, showing that Ad26.COV2.S vector vaccine induced Class-I-biased T-cell responses, whereas mRNA vaccine types led to different responses, with mRNA-1273 vaccine inducing a more Class-I-deficient T-cell response compared to BNT162b2. Finally, we showed that these T-cell patterns were consistent with antibody levels from the same patients. Our results account for the surprising success of vaccination in nominally immuno-compromised IBD patients, while suggesting that a subset of IBD patients prone to deficiencies in T-cell response may warrant enhanced booster protocols.
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Affiliation(s)
- Alexander M. Xu
- Cedars Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Dalin Li
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Joseph E. Ebinger
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Emebet Mengesha
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | | | | | - Heidi Chapman
- Adaptive Biotechnologies, Seattle, WA, United States
| | - Sandy Joung
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Gregory J. Botwin
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Valeriya Pozdnyakova
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Philip Debbas
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Angela Mujukian
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - John C. Prostko
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, United States
| | - Edwin C. Frias
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, United States
| | - James L. Stewart
- Applied Research and Technology, Abbott Diagnostics, Abbott Park, IL, United States
| | - Arash A. Horizon
- Center for Rheumatology Medical Group, Los Angeles, CA, United States
| | - Noah Merin
- Cedars Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Kimia Sobhani
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Jane C. Figueiredo
- Cedars Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Ian M. Kaplan
- Adaptive Biotechnologies, Seattle, WA, United States
| | - Dermot P. B. McGovern
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Akil Merchant
- Cedars Sinai Cancer and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Gil Y. Melmed
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Jonathan Braun
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
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131
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Salvy SJ, Datta GD, Yu Q, Lauzon M, Hussain SK, Cheng S, Ebinger JE, Goodarzi MO, Figueiredo JC. How useful are body mass index and history of diabetes in COVID-19 risk stratification? PLoS One 2022; 17:e0265473. [PMID: 35390025 PMCID: PMC8989225 DOI: 10.1371/journal.pone.0265473] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 03/02/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE This study examines the value of risk stratification by documented diagnosis of diabetes and objectively measured height and weight (BMI) in COVID-19 severity and mortality in a large sample of patients in an urban hospital located in Southern California. METHODS Data from a retrospective cohort study of COVID-19 patients treated at Cedars-Sinai Medical Center between March 8, 2020, and January 25, 2021, was analyzed. Sociodemographic characteristics and pre-existing conditions were extracted from electronic medical records. Univariable and multivariable logistic regression models identified associated risk factors, and a regression causal mediation analysis examined the role of diabetes in the association between obesity and illness severity. All analyses were stratified by age (<65 and ≥65). RESULTS Among individuals <65yo, diabetes accounted for 19-30% of the associations between obesity and COVID-19 illness severity. Among patients ≥65yo, having a BMI <18.5 was a risk factor for mortality regardless of diabetes history. CONCLUSION Our findings have clinical implications in documenting which patients may be at elevated risk for adverse outcomes. More in-depth prospective studies are needed to capture how glycemic regulation may influence prognosis.
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Affiliation(s)
- Sarah-Jeanne Salvy
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, United States of America
| | - Geetanjali D. Datta
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, United States of America
| | - Qihan Yu
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, United States of America
| | - Marie Lauzon
- Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, United States of America
| | - Shehnaz K. Hussain
- Department of Public Health Sciences, UC Davis School of Medicine and Comprehensive Cancer Center, Davis, CA, United States of America
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute and Barbra Streisand Women’s Heart Center Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - Joseph E. Ebinger
- Department of Cardiology and Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - Mark O. Goodarzi
- Division of Endocrinology, Diabetes and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - Jane C. Figueiredo
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, United States of America
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132
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Kwan AC, Salto G, Nguyen TT, Kim EH, Luong E, Hiremath P, Ouyang D, Ebinger JE, Li D, Berman DS, Kittleson MM, Kobashigawa JA, Patel JK, Cheng S. Cardiac microstructural alterations in immune-inflammatory myocardial disease: a retrospective case-control study. Cardiovasc Ultrasound 2022; 20:9. [PMID: 35369883 PMCID: PMC8978375 DOI: 10.1186/s12947-022-00279-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/28/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Immune-inflammatory myocardial disease contributes to multiple chronic cardiac processes, but access to non-invasive screening is limited. We have previously developed a method of echocardiographic texture analysis, called the high-spectrum signal intensity coefficient (HS-SIC) which assesses myocardial microstructure and previously associated with myocardial fibrosis. We aimed to determine whether this echocardiographic texture analysis of cardiac microstructure can identify inflammatory cardiac disease in the clinical setting. METHODS We conducted a retrospective case-control study of 318 patients with distinct clinical myocardial pathologies and 20 healthy controls. Populations included myocarditis, atypical chest pain/palpitations, STEMI, severe aortic stenosis, acute COVID infection, amyloidosis, and cardiac transplantation with acute rejection, without current rejection but with prior rejection, and with no history of rejection. We assessed the HS-SIC's ability to differentiate between a broader diversity of clinical groups and healthy controls. We used Kruskal-Wallis tests to compare HS-SIC values measured in each of the clinical populations with those in the healthy control group and compared HS-SIC values between the subgroups of cardiac transplantation rejection status. RESULTS For the total sample of N = 338, the mean age was 49.6 ± 20.9 years and 50% were women. The mean ± standard error of the mean of HS-SIC were: 0.668 ± 0.074 for controls, 0.552 ± 0.049 for atypical chest pain/palpitations, 0.425 ± 0.058 for myocarditis, 0.881 ± 0.129 for STEMI, 1.116 ± 0.196 for severe aortic stenosis, 0.904 ± 0.116 for acute COVID, and 0.698 ± 0.103 for amyloidosis. Among cardiac transplant recipients, HS-SIC values were 0.478 ± 0.999 for active rejection, 0.594 ± 0.091 for prior rejection, and 1.191 ± 0.442 for never rejection. We observed significant differences in HS-SIC between controls and myocarditis (P = 0.0014), active rejection (P = 0.0076), and atypical chest pain or palpitations (P = 0.0014); as well as between transplant patients with active rejection and those without current or prior rejection (P = 0.031). CONCLUSIONS An echocardiographic method can be used to characterize tissue signatures of microstructural changes across a spectrum of cardiac disease including immune-inflammatory conditions.
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Affiliation(s)
- Alan C. Kwan
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Gerran Salto
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA ,grid.62560.370000 0004 0378 8294Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, MA USA ,grid.510954.c0000 0004 0444 3861Framingham Heart Study, Framingham, MA USA
| | - Trevor-Trung Nguyen
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Elizabeth H. Kim
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Eric Luong
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Pranoti Hiremath
- grid.411935.b0000 0001 2192 2723Division of Cardiology, Johns Hopkins Hospital, Baltimore, MD USA
| | - David Ouyang
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Joseph E. Ebinger
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Debiao Li
- grid.50956.3f0000 0001 2152 9905Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Daniel S. Berman
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA ,grid.50956.3f0000 0001 2152 9905Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Michelle M. Kittleson
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Jon A. Kobashigawa
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Jignesh K. Patel
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Susan Cheng
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA ,grid.62560.370000 0004 0378 8294Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, MA USA ,grid.510954.c0000 0004 0444 3861Framingham Heart Study, Framingham, MA USA
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Duffy G, Cheng PP, Yuan N, He B, Kwan AC, Shun-Shin MJ, Alexander KM, Ebinger J, Lungren MP, Rader F, Liang DH, Schnittger I, Ashley EA, Zou JY, Patel J, Witteles R, Cheng S, Ouyang D. High-Throughput Precision Phenotyping of Left Ventricular Hypertrophy With Cardiovascular Deep Learning. JAMA Cardiol 2022; 7:386-395. [PMID: 35195663 PMCID: PMC9008505 DOI: 10.1001/jamacardio.2021.6059] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE Early detection and characterization of increased left ventricular (LV) wall thickness can markedly impact patient care but is limited by under-recognition of hypertrophy, measurement error and variability, and difficulty differentiating causes of increased wall thickness, such as hypertrophy, cardiomyopathy, and cardiac amyloidosis. OBJECTIVE To assess the accuracy of a deep learning workflow in quantifying ventricular hypertrophy and predicting the cause of increased LV wall thickness. DESIGN, SETTINGS, AND PARTICIPANTS This cohort study included physician-curated cohorts from the Stanford Amyloid Center and Cedars-Sinai Medical Center (CSMC) Advanced Heart Disease Clinic for cardiac amyloidosis and the Stanford Center for Inherited Cardiovascular Disease and the CSMC Hypertrophic Cardiomyopathy Clinic for hypertrophic cardiomyopathy from January 1, 2008, to December 31, 2020. The deep learning algorithm was trained and tested on retrospectively obtained independent echocardiogram videos from Stanford Healthcare, CSMC, and the Unity Imaging Collaborative. MAIN OUTCOMES AND MEASURES The main outcome was the accuracy of the deep learning algorithm in measuring left ventricular dimensions and identifying patients with increased LV wall thickness diagnosed with hypertrophic cardiomyopathy and cardiac amyloidosis. RESULTS The study included 23 745 patients: 12 001 from Stanford Health Care (6509 [54.2%] female; mean [SD] age, 61.6 [17.4] years) and 1309 from CSMC (808 [61.7%] female; mean [SD] age, 62.8 [17.2] years) with parasternal long-axis videos and 8084 from Stanford Health Care (4201 [54.0%] female; mean [SD] age, 69.1 [16.8] years) and 2351 from CSMS (6509 [54.2%] female; mean [SD] age, 69.6 [14.7] years) with apical 4-chamber videos. The deep learning algorithm accurately measured intraventricular wall thickness (mean absolute error [MAE], 1.2 mm; 95% CI, 1.1-1.3 mm), LV diameter (MAE, 2.4 mm; 95% CI, 2.2-2.6 mm), and posterior wall thickness (MAE, 1.4 mm; 95% CI, 1.2-1.5 mm) and classified cardiac amyloidosis (area under the curve [AUC], 0.83) and hypertrophic cardiomyopathy (AUC, 0.98) separately from other causes of LV hypertrophy. In external data sets from independent domestic and international health care systems, the deep learning algorithm accurately quantified ventricular parameters (domestic: R2, 0.96; international: R2, 0.90). For the domestic data set, the MAE was 1.7 mm (95% CI, 1.6-1.8 mm) for intraventricular septum thickness, 3.8 mm (95% CI, 3.5-4.0 mm) for LV internal dimension, and 1.8 mm (95% CI, 1.7-2.0 mm) for LV posterior wall thickness. For the international data set, the MAE was 1.7 mm (95% CI, 1.5-2.0 mm) for intraventricular septum thickness, 2.9 mm (95% CI, 2.4-3.3 mm) for LV internal dimension, and 2.3 mm (95% CI, 1.9-2.7 mm) for LV posterior wall thickness. The deep learning algorithm accurately detected cardiac amyloidosis (AUC, 0.79) and hypertrophic cardiomyopathy (AUC, 0.89) in the domestic external validation site. CONCLUSIONS AND RELEVANCE In this cohort study, the deep learning model accurately identified subtle changes in LV wall geometric measurements and the causes of hypertrophy. Unlike with human experts, the deep learning workflow is fully automated, allowing for reproducible, precise measurements, and may provide a foundation for precision diagnosis of cardiac hypertrophy.
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Affiliation(s)
- Grant Duffy
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Paul P. Cheng
- Department of Medicine, Division of Cardiology, Stanford University, Stanford, California
| | - Neal Yuan
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Bryan He
- Department of Computer Science, Stanford University, Stanford, California
| | - Alan C. Kwan
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Matthew J. Shun-Shin
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Kevin M. Alexander
- Department of Medicine, Division of Cardiology, Stanford University, Stanford, California
| | - Joseph Ebinger
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Florian Rader
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - David H. Liang
- Department of Medicine, Division of Cardiology, Stanford University, Stanford, California
| | - Ingela Schnittger
- Department of Medicine, Division of Cardiology, Stanford University, Stanford, California
| | - Euan A. Ashley
- Department of Medicine, Division of Cardiology, Stanford University, Stanford, California
| | - James Y. Zou
- Department of Computer Science, Stanford University, Stanford, California,Department of Biomedical Data Science, Stanford University, Stanford, California
| | - Jignesh Patel
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Ronald Witteles
- Department of Medicine, Division of Cardiology, Stanford University, Stanford, California
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - David Ouyang
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California,Division of Artificial Intelligence in Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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134
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Zaliznyak M, Stern L, Cole R, Shen A, Nishihara K, Runyan C, Fishman A, Olanisa L, Olman M, Singer-Englar T, Luong E, Cheng S, Moriguchi J, Kobashigawa J, Esmailian F, Kittleson MM. Mechanical Circulatory Support as a Bridge-to-Transplant Candidacy: When Does It Work? ASAIO J 2022; 68:499-507. [PMID: 34074853 DOI: 10.1097/mat.0000000000001500] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Durable mechanical circulatory support (dMCS) devices can be offered as a bridge-to-transplant (BTT) or as a bridge-to-candidacy (BTC) strategy for candidates with contraindications to transplant listing, including pulmonary hypertension (BTC-PH), morbid obesity (BTC-Obes), social issues (BTC-Soc), or chronic illness (BTC-Illness). An understanding of the trajectory of BTC patients could guide future triage of advanced heart failure patients who are not candidates for transplantation. We performed a retrospective review all patients who underwent dMCS implantation as either BTT (206 patients) or BTC (114 patients) at our center from January 1, 2010, to March 31, 2020. There was no significant difference in mortality between BTC patients and BTT patients. Compared with the BTT group, significantly more patients in the BTC-PH group were transplanted (81% vs. 63%; p < 0.05) and significantly fewer patients in the BTC-Obes group (44%; p < 0.05) and BTC-Soc group (39%; p < 0.05) were transplanted. Additionally, the readmission rate was higher for those in the BTC-Obes (6.2 vs. 2.1; p < 0.05) and BTC-Soc (3.9 vs. 2.1; p < 0.05) groups. Bridge-to-candidacy patients generally had poorer post-dMCS trajectories than BTT patients. Centers should not be dissuaded from pursuing a BTC strategy for qualified patients; however, careful consideration of potential adverse outcomes is necessary.
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Affiliation(s)
- Michael Zaliznyak
- From the Departments of Cardiology and Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai, Los Angeles, California
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Inciardi RM, Claggett B, Gupta DK, Cheng S, Liu J, Echouffo Tcheugui JB, Ndumele C, Matsushita K, Selvin E, Solomon SD, Shah AM, Skali H. Cardiac Structure and Function and Diabetes-Related Risk of Death or Heart Failure in Older Adults. J Am Heart Assoc 2022; 11:e022308. [PMID: 35253447 PMCID: PMC9075318 DOI: 10.1161/jaha.121.022308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Whether cardiac structure and function abnormalities associated with dysglycemia are sufficient to explain the increased risk of death or heart failure (HF) remains unclear. Methods and Results We analyzed 6059 participants (mean age, 75±5 years; 58% women; and 22% Black individuals) who attended the ARIC (Atherosclerosis Risk in Communities) study visit 5 examination (2011-2013). Participants were categorized as no diabetes, pre-diabetes, and diabetes (on the basis of medical history and glycated hemoglobin values). We assessed whether diabetes modified the association between echocardiographic measures of cardiac structure and function and the composite of all-cause death or HF hospitalization and then estimated the extent to which the increased risk of the composite outcome associated with diabetes was explained by cardiac structure and function. Diabetes was prevalent in 33.5% of the subjects. Death or HF occurred in 1111 (18%) at a rate of 3.6 per 100 person-years. Both measures of cardiac structure and function and diabetes status were significantly associated with worse prognosis after accounting for clinical confounders. While diabetes was consistently associated with a higher risk of events, it did not significantly modify the association between cardiac abnormalities and the risk of death or HF, except for subjects with higher left atrial volume who showed higher relative risk of events (P for interaction <0.001). Measures of cardiac structure and function accounted for ≈16% of the increased risk of death or HF associated with diabetes. Similar results were observed analyzing subjects without prevalent heart disease. Conclusions In a biracial cohort of older adults, the increased risk of events associated with diabetes was partially explained by cardiac structure and function abnormalities.
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Affiliation(s)
- Riccardo M Inciardi
- Brigham and Women's Hospital and Harvard Medical School Boston MA.,ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia Italy
| | - Brian Claggett
- Brigham and Women's Hospital and Harvard Medical School Boston MA
| | - Deepak K Gupta
- Vanderbilt Translational and Clinical Cardiovascular Research CenterVanderbilt University Medical Center Nashville TN
| | - Susan Cheng
- Smidt Heart Institute, Cedars-Sinai Hospital Los Angeles CA
| | - Jiankang Liu
- Brigham and Women's Hospital and Harvard Medical School Boston MA
| | | | - Chiadi Ndumele
- Johns Hopkins Medical CenterJohn Hopkins University Baltimore MD
| | | | | | - Scott D Solomon
- Brigham and Women's Hospital and Harvard Medical School Boston MA
| | - Amil M Shah
- Brigham and Women's Hospital and Harvard Medical School Boston MA
| | - Hicham Skali
- Brigham and Women's Hospital and Harvard Medical School Boston MA
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136
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Mc Ardle A, Binek A, Moradian A, Chazarin Orgel B, Rivas A, Washington KE, Phebus C, Manalo DM, Go J, Venkatraman V, Coutelin Johnson CW, Fu Q, Cheng S, Raedschelders K, Fert-Bober J, Pennington SR, Murray CI, Van Eyk JE. Standardized Workflow for Precise Mid- and High-Throughput Proteomics of Blood Biofluids. Clin Chem 2022; 68:450-460. [PMID: 34687543 DOI: 10.1093/clinchem/hvab202] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 04/13/2021] [Accepted: 08/30/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Accurate discovery assay workflows are critical for identifying authentic circulating protein biomarkers in diverse blood matrices. Maximizing the commonalities in the proteomic workflows between different biofluids simplifies the approach and increases the likelihood for reproducibility. We developed a workflow that can accommodate 3 blood-based proteomes: naive plasma, depleted plasma and dried blood. METHODS Optimal conditions for sample preparation and data independent acquisition-mass spectrometry analysis were established in plasma then automated for depleted plasma and dried blood. The mass spectrometry workflow was modified to facilitate sensitive high-throughput analysis or deeper profiling with mid-throughput analysis. Analytical performance was evaluated by the linear response of peptides and proteins to a 6- or 7-point dilution curve and the reproducibility of the relative peptide and protein intensity for 5 digestion replicates per day on 3 different days for each biofluid. RESULTS Using the high-throughput workflow, 74% (plasma), 93% (depleted), and 87% (dried blood) displayed an inter-day CV <30%. The mid-throughput workflow had 67% (plasma), 90% (depleted), and 78% (dried blood) of peptides display an inter-day CV <30%. Lower limits of detection and quantification were determined for peptides and proteins observed in each biofluid and workflow. Based on each protein and peptide's analytical performance, we could describe the observable, reliable, reproducible, and quantifiable proteomes for each biofluid and workflow. CONCLUSION The standardized workflows established here allows for reproducible and quantifiable detection of proteins covering a broad dynamic range. We envisage that implementation of this standard workflow should simplify discovery approaches and facilitate the translation of candidate markers into clinical use.
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Affiliation(s)
- Angela Mc Ardle
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Aleksandra Binek
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Annie Moradian
- Precision Biomarker Laboratories, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Blandine Chazarin Orgel
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alejandro Rivas
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kirstin E Washington
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Conor Phebus
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Danica-Mae Manalo
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - James Go
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Vidya Venkatraman
- Precision Biomarker Laboratories, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Qin Fu
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Susan Cheng
- Smidt Heart Institute, Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Koen Raedschelders
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Justyna Fert-Bober
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Stephen R Pennington
- School of Medicine and Medical Sciences, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland
| | - Christopher I Murray
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jennifer E Van Eyk
- Smidt Heart Institute, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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137
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Liu EE, Suthahar N, Paniagua SM, Wang D, Lau ES, Li SX, Jovani M, Takvorian KS, Kreger BE, Benjamin EJ, Meijers WC, Bakker SJ, Kieneker LM, Gruppen EG, van der Vegt B, de Bock GH, Gansevoort RT, Hussain SK, Hoffmann U, Splansky GL, Vasan RS, Larson MG, Levy D, Cheng S, de Boer RA, Ho JE. Association of Cardiometabolic Disease With Cancer in the Community. JACC CardioOncol 2022; 4:69-81. [PMID: 35492825 PMCID: PMC9040108 DOI: 10.1016/j.jaccao.2022.01.095] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 10/07/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 11/03/2022] Open
Abstract
Background Obesity and cardiometabolic dysfunction have been associated with cancer risk and severity. Underlying mechanisms remain unclear. Objectives The aim of this study was to examine associations of obesity and related cardiometabolic traits with incident cancer. Methods FHS (Framingham Heart Study) and PREVEND (Prevention of Renal and Vascular End-Stage Disease) study participants without prevalent cancer were studied, examining associations of obesity, body mass index (BMI), waist circumference, visceral adipose tissue (VAT) and subcutaneous adipose tissue depots, and C-reactive protein (CRP) with future cancer in Cox models. Results Among 20,667 participants (mean age 50 years, 53% women), 2,619 cancer events were observed over a median follow-up duration of 15 years. Obesity was associated with increased risk for future gastrointestinal (HR: 1.30; 95% CI: 1.05-1.60), gynecologic (HR: 1.62; 95% CI: 1.08-2.45), and breast (HR: 1.32; 95% CI: 1.05-1.66) cancer and lower risk for lung cancer (HR: 0.62; 95% CI: 0.44-0.87). Similarly, waist circumference was associated with increased risk for overall, gastrointestinal, and gynecologic but not lung cancer. VAT but not subcutaneous adipose tissue was associated with risk for overall cancer (HR: 1.22; 95% CI: 1.05-1.43), lung cancer (HR: 1.92; 95% CI: 1.01-3.66), and melanoma (HR: 1.56; 95% CI: 1.02-2.38) independent of BMI. Last, higher CRP levels were associated with higher risk for overall, colorectal, and lung cancer (P < 0.05 for all). Conclusions Obesity and abdominal adiposity are associated with future risk for specific cancers (eg, gastrointestinal, gynecologic). Although obesity was associated with lower risk for lung cancer, greater VAT and CRP were associated with higher lung cancer risk after adjusting for BMI.
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Affiliation(s)
- Elizabeth E. Liu
- Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Navin Suthahar
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Samantha M. Paniagua
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Dongyu Wang
- Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Emily S. Lau
- Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shawn X. Li
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Manol Jovani
- Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Gastroenterology, University of Kentucky Albert B. Chandler Hospital, Lexington, Kentucky, USA
| | | | - Bernard E. Kreger
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
| | - Emelia J. Benjamin
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Cardiology and Preventative Medicine Sections, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Wouter C. Meijers
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Stephan J.L. Bakker
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Lyanne M. Kieneker
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Eke G. Gruppen
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Bert van der Vegt
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Geertruida H. de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Ron T. Gansevoort
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Shehnaz K. Hussain
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California, USA
| | - Udo Hoffmann
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Ramachandran S. Vasan
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Cardiology and Preventative Medicine Sections, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Martin G. Larson
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Daniel Levy
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Rudolf A. de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jennifer E. Ho
- Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Rodriguez F, Lee UJ, Barone N, Swett K, Lopez L, Cheng S, Daviglus ML, Hanna DB, Giacinto RAE, Arguelles W, Cai J, Talavera GA, Rodriguez CJ. Corrigendum to “Risk Factor Control Across the Spectrum of Cardiovascular Risk: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)” [American Journal of Preventive Cardiology, Volume 5, March 2021, 100147]. Am J Prev Cardiol 2022; 9:100302. [DOI: 10.1016/j.ajpc.2021.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Pozdnyakova V, Weber B, Cheng S, Ebinger JE. Review of Immunologic Manifestations of COVID-19 Infection and Vaccination. Cardiol Clin 2022; 40:301-308. [PMID: 35851453 PMCID: PMC8960179 DOI: 10.1016/j.ccl.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Valeriya Pozdnyakova
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, D4005, Los Angeles, CA 90048, USA
| | - Brittany Weber
- Carl J. and Ruth Shapiro Cardiovascular Center, Brigham and Women's Hospital, 70 Francis Street, Boston, MA 02115, USA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 South Vicente Boulevard, Suite A3100, Los Angeles, CA 90048, USA
| | - Joseph E Ebinger
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 South Vicente Boulevard, Suite A3100, Los Angeles, CA 90048, USA.
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Pattisapu V, Hao H, LIu Y, Nguyen TT, Merz CNB, Cheng S. REGIONAL VARIATION IN TAKOTSUBO SYNDROME DIAGNOSES ACROSS THE UNITED STATES. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01516-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tuomisto K, Palmu J, Long T, Watrous JD, Mercader K, Lagerborg KA, Andres A, Salmi M, Jalkanen S, Vasan RS, Inouye M, Havulinna AS, Tuomilehto J, Jousilahti P, Niiranen TJ, Cheng S, Jain M, Salomaa V. A plasma metabolite score of three eicosanoids predicts incident type 2 diabetes: a prospective study in three independent cohorts. BMJ Open Diabetes Res Care 2022; 10:10/2/e002519. [PMID: 35361620 PMCID: PMC8971778 DOI: 10.1136/bmjdrc-2021-002519] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 08/05/2021] [Accepted: 01/18/2022] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Peptide markers of inflammation have been associated with the development of type 2 diabetes. The role of upstream, lipid-derived mediators of inflammation such as eicosanoids, remains less clear. The aim of this study was to examine whether eicosanoids are associated with incident type 2 diabetes. RESEARCH DESIGN & METHODS In the FINRISK (Finnish Cardiovascular Risk Study) 2002 study, a population-based sample of Finnish men and women aged 25-74 years, we used directed, non-targeted liquid chromatography-mass spectrometry to identify 545 eicosanoids and related oxylipins in the participants' plasma samples (n=8292). We used multivariable-adjusted Cox regression to examine associations between eicosanoids and incident type 2 diabetes. The significant independent findings were replicated in the Framingham Heart Study (FHS, n=2886) and DIetary, Lifestyle and Genetic determinants of Obesity and Metabolic syndrome (DILGOM) 2007 (n=3905). Together, these three cohorts had 1070 cases of incident type 2 diabetes. RESULTS In the FINRISK 2002 cohort, 76 eicosanoids were associated individually with incident type 2 diabetes. We identified three eicosanoids independently associated with incident type 2 diabetes using stepwise Cox regression with forward selection and a Bonferroni-corrected inclusion threshold. A three-eicosanoid risk score produced an HR of 1.56 (95% CI 1.41 to 1.72) per 1 SD increment for risk of incident diabetes. The HR for comparing the top quartile with the lowest was 2.80 (95% CI 2.53 to 3.07). In the replication analyses, the three-eicosanoid risk score was significant in FHS (HR 1.24 (95% CI 1.10 to 1.39, p<0.001)) and directionally consistent in DILGOM (HR 1.12 (95% CI 0.99 to 1.27, p=0.07)). Meta-analysis of the three cohorts yielded a pooled HR of 1.31 (95% CI 1.05 to 1.56). CONCLUSIONS Plasma eicosanoid profiles predict incident type 2 diabetes and the clearest signals replicate in three independent cohorts. Our findings give new information on the biology underlying type 2 diabetes and suggest opportunities for early identification of people at risk.
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Affiliation(s)
- Karolina Tuomisto
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Joonatan Palmu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Internal Medicine, University of Turku, Turku, Finland
| | - Tao Long
- Departments of Medicine and Pharmacology, University of California San Diego, La Jolla, California, USA
| | - Jeramie D Watrous
- Departments of Medicine and Pharmacology, University of California San Diego, La Jolla, California, USA
| | - Kysha Mercader
- Departments of Medicine and Pharmacology, University of California San Diego, La Jolla, California, USA
| | - Kim A Lagerborg
- Departments of Medicine and Pharmacology, University of California San Diego, La Jolla, California, USA
| | - Allen Andres
- Departments of Medicine and Pharmacology, University of California San Diego, La Jolla, California, USA
| | - Marko Salmi
- MediCity, InFLAMES Flagship, and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Sirpa Jalkanen
- MediCity, InFLAMES Flagship, and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Ramachandran S Vasan
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA
- Sections of Preventive Medicine and Epidemiology, and Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Michael Inouye
- Cambridge Baker Systems Genomics Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Aki S Havulinna
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- University of Helsinki Institute for Molecular Medicine Finland, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Pekka Jousilahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Teemu J Niiranen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Internal Medicine, University of Turku, Turku, Finland
| | - Susan Cheng
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mohit Jain
- Departments of Medicine and Pharmacology, University of California San Diego, La Jolla, California, USA
| | - Veikko Salomaa
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Ebinger JE, Lan R, Driver M, Sun N, Botting P, Park E, Davis T, Minissian MB, Coleman B, Riggs R, Roberts P, Cheng S. Seasonal COVID-19 surge related hospital volumes and case fatality rates. BMC Infect Dis 2022; 22:178. [PMID: 35197000 PMCID: PMC8864601 DOI: 10.1186/s12879-022-07139-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/09/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Seasonal and regional surges in COVID-19 have imposed substantial strain on healthcare systems. Whereas sharp inclines in hospital volume were accompanied by overt increases in case fatality rates during the very early phases of the pandemic, the relative impact during later phases of the pandemic are less clear. We sought to characterize how the 2020 winter surge in COVID-19 volumes impacted case fatality in an adequately-resourced health system. METHODS We performed a retrospective cohort study of all adult diagnosed with COVID-19 in a large academic healthcare system between August 25, 2020 to May 8, 2021, using multivariable logistic regression to examine case fatality rates across 3 sequential time periods around the 2020 winter surge: pre-surge, surge, and post-surge. Subgroup analyses of patients admitted to the hospital and those receiving ICU-level care were also performed. Additionally, we used multivariable logistic regression to examine risk factors for mortality during the surge period. RESULTS We studied 7388 patients (aged 52.8 ± 19.6 years, 48% male) who received outpatient or inpatient care for COVID-19 during the study period. Patients treated during surge (N = 6372) compared to the pre-surge (N = 536) period had 2.64 greater odds (95% CI 1.46-5.27) of mortality after adjusting for sociodemographic and clinical factors. Adjusted mortality risk returned to pre-surge levels during the post-surge period. Notably, first-encounter patient-level measures of illness severity appeared higher during surge compared to non-surge periods. CONCLUSIONS We observed excess mortality risk during a recent winter COVID-19 surge that was not explained by conventional risk factors or easily measurable variables, although recovered rapidly in the setting of targeted facility resources. These findings point to how complex interrelations of population- and patient-level pandemic factors can profoundly augment health system strain and drive dynamic, if short-lived, changes in outcomes.
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Affiliation(s)
- Joseph E. Ebinger
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA USA ,grid.50956.3f0000 0001 2152 9905Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Roy Lan
- grid.267301.10000 0004 0386 9246College of Medicine, University of Tennessee Health Science Center, Memphis, TN USA
| | - Matthew Driver
- grid.50956.3f0000 0001 2152 9905Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Nancy Sun
- grid.50956.3f0000 0001 2152 9905Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Patrick Botting
- grid.50956.3f0000 0001 2152 9905Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Eunice Park
- grid.50956.3f0000 0001 2152 9905Enterprise Data Intelligence, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Tod Davis
- grid.50956.3f0000 0001 2152 9905Enterprise Data Intelligence, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Margo B. Minissian
- grid.50956.3f0000 0001 2152 9905Brawerman Nursing Institute and Nursing Research Department, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Bernice Coleman
- grid.50956.3f0000 0001 2152 9905Brawerman Nursing Institute and Nursing Research Department, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Richard Riggs
- grid.50956.3f0000 0001 2152 9905Department of Medical Affairs, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Pamela Roberts
- grid.50956.3f0000 0001 2152 9905Department of Medical Affairs, Cedars-Sinai Medical Center, Los Angeles, CA USA ,grid.50956.3f0000 0001 2152 9905Department of Biomedical Sciences, Division of Informatics, Cedars-Sinai Medical Center, Los Angeles, CA USA
| | - Susan Cheng
- grid.50956.3f0000 0001 2152 9905Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA USA ,grid.50956.3f0000 0001 2152 9905Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA USA
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143
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Abstract
Peripheral artery disease (PAD) is a prevalent condition that confers substantial morbidity and mortality and remains underdiagnosed as well as undertreated in the overall population. Although PAD prevalence is similar or higher in women compared with men, associations of traditional and nontraditional risk factors with PAD and clinical manifestations of PAD differ by sex and may contribute to delayed or lack of diagnosis in women. Such sex-based differences in the manifestation of PAD may arise from sexual dimorphism in the vascular substrate in health as well as sex variation in the responses to vascular stressors. Despite the availability of proven therapies for improving symptoms and reducing risk of ischemic cardiovascular and limb events among patients with diagnosed PAD, important sex differences in treatment and outcomes have been observed. We provide an overview of current knowledge regarding sex differences in the epidemiology, pathophysiology, clinical presentation, and management of PAD.
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Affiliation(s)
- Maria Pabon
- Division of Cardiovascular Medicine, Brigham and Women's Hospital (M.P.)
| | - Susan Cheng
- Department of Cardiology, Cedars-Sinai Medical Center (S.C.)
| | - S Elissa Altin
- Division of Cardiology, Yale University School of Medicine (S.E.A.)
| | - Sanjum S Sethi
- Columbia Interventional Cardiovascular Care, Division of Cardiology, Columbia University Irving Medical Center (S.S.S.)
| | - Michael D Nelson
- Department of Kinesiology, University of Texas at Arlington (M.D.N.)
| | - Kerrie L Moreau
- Division of Geriatrics, University of Colorado School of Medicine, and Eastern Colorado Geriatric Research Education and Clinical Center (K.L.M.)
| | | | - Connie N Hess
- Division of Cardiology, University of Colorado School of Medicine (C.N.H.)
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144
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Abstract
It is well known that cardiovascular disease manifests differently in women and men. The underlying causes of these differences during the aging lifespan are less well understood. Sex differences in cardiac and vascular phenotypes are seen in childhood and tend to track along distinct trajectories related to dimorphism in genetic factors as well as response to risk exposures and hormonal changes during the life course. These differences underlie sex-specific variation in cardiovascular events later in life, including myocardial infarction, heart failure, ischemic stroke, and peripheral vascular disease. With respect to cardiac phenotypes, females have intrinsically smaller body size-adjusted cardiac volumes and they tend to experience greater age-related wall thickening and myocardial stiffening with aging. With respect to vascular phenotypes, sexual dimorphism in both physiology and pathophysiology are also seen, including overt differences in blood pressure trajectories. The majority of sex differences in myocardial and vascular alterations that manifest with aging seem to follow relatively consistent trajectories from the very early to the very later stages of life. This review aims to synthesize recent cardiovascular aging-related research to highlight clinically relevant studies in diverse female and male populations that can inform approaches to improving the diagnosis, management, and prognosis of cardiovascular disease risks in the aging population at large.
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Affiliation(s)
- Hongwei Ji
- Department of Cardiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China,Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
| | - Alan C. Kwan
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Melanie Chen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - David Ouyang
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Joseph E. Ebinger
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Susan P. Bell
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Teemu Niiranen
- Department of Internal Medicine, University of Turku, Turku, Finland,Department of Public Health Solutions, Finnish Institute for Health and Welfare, Turku, Finland
| | - Natalie A. Bello
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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145
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Affiliation(s)
- Natalie Bello
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - C. Noel Bairey Merz
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA,Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
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146
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Ebinger JE, Liu Y, Driver M, Ji H, Bairey Merz CN, Rader F, Albert CM, Cheng S. Sex-Specific Temporal Trends in Hypertensive Crisis Hospitalizations in the United States. J Am Heart Assoc 2022; 11:e021244. [PMID: 35083929 PMCID: PMC9245827 DOI: 10.1161/jaha.121.021244] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/09/2021] [Indexed: 11/29/2022]
Abstract
Background Despite recent improvements in hypertension control overall, the extent to which these trends apply to the most extreme forms of elevated blood pressure-hypertensive crises requiring hospitalization-in both women and men at risk remains unknown. Methods and Results Using data from the National Inpatient Sample, we estimated sex-pooled and sex-specific temporal trends in hypertensive crisis hospitalization and case fatality rates over serial time periods: years 2002 to 2006, 2007 to 2011, and 2012 to 2014. Over the entire study period (years 2002-2014), there were an estimated 918 392±9331 hypertensive crisis hospitalizations and 4377±157 in-hospital deaths. Hypertensive crisis represented 0.23%±0.002% of all hospitalizations during the entire study period: 0.24%±0.002% for men and 0.22%±0.002% for women. In multivariable analyses adjusting for age, race or ethnicity, and cardiovascular conditions, the odds of experiencing a hospitalization primarily for hypertensive crisis increased annually for both men (odds ratio [OR], 1.083 per year; 95% CI, 1.08-1.09) and women (OR, 1.07 per year, 95% CI, 1.07-1.08) with a higher rate of increase observed in men compared with women (P<0.001). The multivariable-adjusted odds of death during hypertensive crisis hospitalization decreased annually and similarly for men (OR, 0.89 per year; 95% CI, 0.86-0.92) and for women (0.92 per year; 95% CI, 0.90-0.94). Conclusions Hypertensive crisis hospitalizations have steadily increased, slightly more among men than women, along with an observed increase in the burden of cardiovascular conditions. These trends, observed despite contemporaneous improvements in hypertension prevention and control nationwide, warrant further investigations to identify contributing factors that could be amenable to targeted interventions.
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Affiliation(s)
- Joseph E. Ebinger
- Department of CardiologySmidt Heart InstituteCedars‐Sinai Medical CenterLos AngelesCA
| | - Yunxian Liu
- Department of CardiologySmidt Heart InstituteCedars‐Sinai Medical CenterLos AngelesCA
| | - Matthew Driver
- Department of CardiologySmidt Heart InstituteCedars‐Sinai Medical CenterLos AngelesCA
| | - Hongwei Ji
- Department of CardiologyThe Affiliated Hospital of Qingdao UniversityQingdaoShandongChina
| | - C. Noel Bairey Merz
- Department of CardiologySmidt Heart InstituteCedars‐Sinai Medical CenterLos AngelesCA
| | - Florian Rader
- Department of CardiologySmidt Heart InstituteCedars‐Sinai Medical CenterLos AngelesCA
| | - Christine M. Albert
- Department of CardiologySmidt Heart InstituteCedars‐Sinai Medical CenterLos AngelesCA
| | - Susan Cheng
- Department of CardiologySmidt Heart InstituteCedars‐Sinai Medical CenterLos AngelesCA
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147
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Kwan AC, Wei J, Lee BP, Luong E, Salto G, Nguyen TT, Botting PG, Liu Y, Ouyang D, Ebinger JE, Li D, Noureddin M, Thomson L, Berman DS, Merz CNB, Cheng S. Subclinical hepatic fibrosis is associated with coronary microvascular dysfunction by myocardial perfusion reserve index: a retrospective cohort study. Int J Cardiovasc Imaging 2022; 38:10.1007/s10554-022-02546-7. [PMID: 35107770 PMCID: PMC9343468 DOI: 10.1007/s10554-022-02546-7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/27/2022] [Indexed: 11/05/2022]
Abstract
The heart-liver axis is of growing importance. Previous studies have identified independent association of liver dysfunction and fibrosis with adverse cardiac outcomes, but mechanistic pathways remain uncertain. We sought to understand the relations between the degree of hepatic fibrosis identified by the Fibrosis-4 (Fib-4) risk score and comprehensive cardiac MRI (CMR) measures of subclinical cardiac disease. We conducted a retrospective single-center cohort study of patients between 2011 and 2021. We identified consecutive patients who underwent a comprehensive CMR imaging protocol including contrast enhanced with stress/rest perfusion, and lacked pre-existing cardiovascular disease or perfusion abnormalities on CMR. We examined the association of hepatic fibrosis, using the Fib-4 score, with subclinical cardiac disease on CMR while adjusting for cardiometabolic traits. Given known associations of hepatic disease and coronary microvascular dysfunction, we prioritized analyses with the myocardial perfusion reserve index (MPRI), a marker of coronary microvascular function. Of the 66 patients in our study cohort, 54 were female (81%) and the mean age was 53.7 ± 15.3 years. We found that higher Fib-4 was associated with reduction in the MPRI (β [SE] - 1.12 [0.46], P = 0.02), after adjusting for cardiometabolic risk factors. Importantly, Fib-4 was not significantly associated with any other CMR phenotypes including measures of cardiac remodeling, inflammation, fibrosis, or dysfunction. We found evidence that hepatic fibrosis associated with coronary microvascular dysfunction, in the absence of overt associations with any other subclinical cardiac disease measures. These findings highlight a potentially important precursor pathway leading to development of subsequent heart-liver disease.
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Affiliation(s)
- Alan C Kwan
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA.
| | - Janet Wei
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Brian P Lee
- Department of Medicine, Keck School of Medicine of USC, Los Angeles, USA
| | - Eric Luong
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Gerran Salto
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Trevor-Trung Nguyen
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Patrick G Botting
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Yunxian Liu
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - David Ouyang
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Joseph E Ebinger
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Debiao Li
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Mazen Noureddin
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Louise Thomson
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Daniel S Berman
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - C Noel Bairey Merz
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
| | - Susan Cheng
- Division of Digestive and Liver Diseases, and Department of Imaging, Barbra Streisand Women's Heart Center, Biomedical Imaging Research Institute, Smidt Heart Institute Department of Cardiology, Cedars Sinai Medical Center, 127 S San Vicente Blvd #A3600, Los Angeles, CA, 90048, USA
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148
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Malhotra R, Nicholson CJ, Wang D, Bhambhani V, Paniagua S, Slocum C, Sigurslid HH, Cardenas CLL, Li R, Boerboom SL, Chen YC, Hwang SJ, Yao C, Ichinose F, Bloch DB, Lindsay ME, Lewis GD, Aragam JR, Hoffmann U, Mitchell GF, Hamburg NM, Vasan RS, Benjamin EJ, Larson MG, Zapol WM, Cheng S, Roh JD, O’Donnell CJ, Nguyen C, Levy D, Ho JE. Matrix Gla Protein Levels Are Associated With Arterial Stiffness and Incident Heart Failure With Preserved Ejection Fraction. Arterioscler Thromb Vasc Biol 2022; 42:e61-e73. [PMID: 34809448 PMCID: PMC8792238 DOI: 10.1161/atvbaha.121.316664] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Arterial stiffness is a risk factor for cardiovascular disease, including heart failure with preserved ejection fraction (HFpEF). MGP (matrix Gla protein) is implicated in vascular calcification in animal models, and circulating levels of the uncarboxylated, inactive form of MGP (ucMGP) are associated with cardiovascular disease-related and all-cause mortality in human studies. However, the role of MGP in arterial stiffness is uncertain. Approach and Results: We examined the association of ucMGP levels with vascular calcification, arterial stiffness including carotid-femoral pulse wave velocity (PWV), and incident heart failure in community-dwelling adults from the Framingham Heart Study. To further investigate the link between MGP and arterial stiffness, we compared aortic PWV in age- and sex-matched young (4-month-old) and aged (10-month-old) wild-type and Mgp+/- mice. Among 7066 adults, we observed significant associations between higher levels of ucMGP and measures of arterial stiffness, including higher PWV and pulse pressure. Longitudinal analyses demonstrated an association between higher ucMGP levels and future increases in systolic blood pressure and incident HFpEF. Aortic PWV was increased in older, but not young, female Mgp+/- mice compared with wild-type mice, and this augmentation in PWV was associated with increased aortic elastin fiber fragmentation and collagen accumulation. CONCLUSIONS This translational study demonstrates an association between ucMGP levels and arterial stiffness and future HFpEF in a large observational study, findings that are substantiated by experimental studies showing that mice with Mgp heterozygosity develop arterial stiffness. Taken together, these complementary study designs suggest a potential role of therapeutically targeting MGP in HFpEF.
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Affiliation(s)
- Rajeev Malhotra
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Christopher J. Nicholson
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Dongyu Wang
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Vijeta Bhambhani
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Samantha Paniagua
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Charles Slocum
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Haakon H. Sigurslid
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Christian L. Lino Cardenas
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Rebecca Li
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Sophie L. Boerboom
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Yin-Ching Chen
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA, and Schepens Eye Research Institute/Massachusetts Eye and Ear Infirmary, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Shih-Jen Hwang
- Framingham Heart Study, Framingham, MA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Chen Yao
- Framingham Heart Study, Framingham, MA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Fumito Ichinose
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Donald B. Bloch
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Rheumatology, Allergy, and Immunology; Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Mark E. Lindsay
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Gregory D. Lewis
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | | | - Udo Hoffmann
- Department of Radiology, Massachusetts General Hospital, Boston, MA
| | | | - Naomi M. Hamburg
- Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
| | - Ramchandran S. Vasan
- Framingham Heart Study, Framingham, MA
- Department of Epidemiology, Boston University School of Public Health & Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Emelia J. Benjamin
- Framingham Heart Study, Framingham, MA
- Department of Epidemiology, Boston University School of Public Health & Sections of Preventive Medicine and Epidemiology and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Martin G. Larson
- Framingham Heart Study, Framingham, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Warren M. Zapol
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Susan Cheng
- Framingham Heart Study, Framingham, MA
- Barbara Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jason D. Roh
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | | | - Christopher Nguyen
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA, and Schepens Eye Research Institute/Massachusetts Eye and Ear Infirmary, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Daniel Levy
- Framingham Heart Study, Framingham, MA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Jennifer E. Ho
- Cardiovascular Research Center and Corrigan Minehan Heart Center, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, MA
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149
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Qin Y, Havulinna AS, Liu Y, Jousilahti P, Ritchie SC, Tokolyi A, Sanders JG, Valsta L, Brożyńska M, Zhu Q, Tripathi A, Vázquez-Baeza Y, Loomba R, Cheng S, Jain M, Niiranen T, Lahti L, Knight R, Salomaa V, Inouye M, Méric G. Combined effects of host genetics and diet on human gut microbiota and incident disease in a single population cohort. Nat Genet 2022; 54:134-142. [PMID: 35115689 PMCID: PMC9883041 DOI: 10.1038/s41588-021-00991-z] [Citation(s) in RCA: 132] [Impact Index Per Article: 66.0] [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: 10/21/2020] [Accepted: 11/19/2021] [Indexed: 01/31/2023]
Abstract
Human genetic variation affects the gut microbiota through a complex combination of environmental and host factors. Here we characterize genetic variations associated with microbial abundances in a single large-scale population-based cohort of 5,959 genotyped individuals with matched gut microbial metagenomes, and dietary and health records (prevalent and follow-up). We identified 567 independent SNP-taxon associations. Variants at the LCT locus associated with Bifidobacterium and other taxa, but they differed according to dairy intake. Furthermore, levels of Faecalicatena lactaris associated with ABO, and suggested preferential utilization of secreted blood antigens as energy source in the gut. Enterococcus faecalis levels associated with variants in the MED13L locus, which has been linked to colorectal cancer. Mendelian randomization analysis indicated a potential causal effect of Morganella on major depressive disorder, consistent with observational incident disease analysis. Overall, we identify and characterize the intricate nature of host-microbiota interactions and their association with disease.
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Affiliation(s)
- Youwen Qin
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- School of BioSciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Aki S Havulinna
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute for Molecular Medicine Finland, FIMM-HiLIFE, Helsinki, Finland
| | - Yang Liu
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Clinical Pathology, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Pekka Jousilahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Scott C Ritchie
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Cambridge Baker Systems Genomics Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
| | - Alex Tokolyi
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
| | - Jon G Sanders
- Department of Ecology and Evolutionary Biology, Cornell University, Ithaca, NY, USA
- Cornell Institute for Host-Microbe Interaction and Disease, Cornell University, Ithaca, NY, USA
| | - Liisa Valsta
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marta Brożyńska
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Qiyun Zhu
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Anupriya Tripathi
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Division of Biological Sciences, University of California San Diego, La Jolla, CA, USA
| | - Yoshiki Vázquez-Baeza
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, USA
- Department of Computer Science & Engineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - Rohit Loomba
- NAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Susan Cheng
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mohit Jain
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, USA
| | - Teemu Niiranen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Leo Lahti
- Department of Computing, University of Turku, Turku, Finland
| | - Rob Knight
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, USA
- Department of Computer Science & Engineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
| | - Veikko Salomaa
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Michael Inouye
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
- School of BioSciences, The University of Melbourne, Melbourne, Victoria, Australia.
- Cambridge Baker Systems Genomics Initiative, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK.
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
- Health Data Research UK Cambridge, Wellcome Genome Campus & University of Cambridge, Cambridge, UK.
- The Alan Turing Institute, London, UK.
| | - Guillaume Méric
- Cambridge Baker Systems Genomics Initiative, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
- Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
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150
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Tang XJ, Duan LJ, Liang WL, Cheng S, Dong TL, Xie Z, Liu KM, Yu F, Chen ZH, Mi GD, Liang L, Yan HJ, Chen L, Lin L, Kang DM, Fu XB, Qiu MF, Jiang Z, Xu ZY, Wu Z. [Application of limiting antigen avidity enzyme immunoassay for estimating HIV-1 incidence in men who have sex with men]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:72-77. [PMID: 35130655 DOI: 10.3760/cma.j.cn112338-20210609-00463] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To estimate the incidence of HIV-1 infection in men who have sex with men (MSM) in key areas of China through HIV-1 limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA), analyze the deviation from the actual results and identify influencing factors, and provided reference for improving the accuracy of estimation results. Methods: Based on the principle of the cohort randomized study design, 20 cities were selected in China based on population size and the number of HIV-positive MSM. The sample size was estimated to be 700 according to the HIV-1 infection rate in MSM. MSM mobile phone app. was used to establish a detection appointment and questionnaire system, and the baseline cross-sectional survey was conducted from April to November 2019. LAg-Avidity EIA was used to identify the recent infected samples. The incidence of HIV-1 infection was calculated and then adjusted based on the estimation formula designed by WHO. The influencing factors were identified by analyzing the sample collection and detection processes. Results: Among the 10 650 blood samples from the participants, 799 were HIV-positive in initial screening, in which 198 samples (24.78%) missed during confirmation test. Only 621 samples were received by the laboratory. After excluding misreported samples, 520 samples were qualified for testing. A total of 155 samples were eventually determined as recent infection through LAg-Avidity EIA; Based on the estimation formula , the incidence of HIV-1 infection in MSM in 20 cities was 4.06% (95%CI:3.27%-4.85%), it increased to 5.53% (95%CI: 4.45%-6.60%)after the adjusting for sample missing rate. When the sample missing rate and misreporting rate were both adjusted, the incidence of HIV-1 infection in the MSM increased to 5.66% (95%CI:4.67%-6.65%). The actual incidence of HIV-1 infection in MSM in the 20 cities might be between 4.06% and 5.66%. Conclusions: Sample missing and misreporting might cause the deviation of the estimation of HIV-1 infection incidence. It is important to ensure the sample source and the quality of sample collection and detection to reduce the deviation in the estimation of HIV-1 infection incidence.
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Affiliation(s)
- X J Tang
- Division of Prevention and Intervention, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L J Duan
- National HIV/AIDS Reference Laboratory, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - W L Liang
- National HIV/AIDS Reference Laboratory, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - S Cheng
- Division of Prevention and Intervention, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - T L Dong
- Division of Prevention and Intervention, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Z Xie
- Division of Prevention and Intervention, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - K M Liu
- Division of Prevention and Intervention, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - F Yu
- Danlan Beijing Media Limited, Beijing 100020, China
| | - Z H Chen
- Danlan Beijing Media Limited, Beijing 100020, China
| | - G D Mi
- Danlan Beijing Media Limited, Beijing 100020, China
| | - L Liang
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang 050021, China
| | - H J Yan
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - L Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - L Lin
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - D M Kang
- Shandong Provincial Center for Disease Control and Prevention, Ji'nan 250014, China
| | - X B Fu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - M F Qiu
- National HIV/AIDS Reference Laboratory, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Z Jiang
- Division of Prevention and Intervention, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Z Y Xu
- Division of Prevention and Intervention, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Zunyou Wu
- Division of Prevention and Intervention, National Center for AIDS and STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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