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Oladipupo F, Stanek J, Walden J, Young J, Rose MJ, Nicol K, Villella A, Creary S. Prevalence of Duffy null and its impact on hydroxyurea in young children with sickle cell disease in the United States. Pediatr Blood Cancer 2024; 71:e30945. [PMID: 38462769 DOI: 10.1002/pbc.30945] [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: 12/19/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/12/2024]
Abstract
Consistent with studies showing a high prevalence of the Duffy null phenotype among healthy Black Americans, this retrospective study found that Duffy null was present in >75% of a young and contemporary cohort of children with sickle cell disease (SCD) in the United States. Despite the potential for this phenotype to impact absolute neutrophil counts, hydroxyurea (HU) dosing, and outcomes, it was not associated with being prescribed a lower HU dose or having increased acute SCD visits early in the HU treatment course. Future studies are needed to confirm these findings in older children with SCD.
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Affiliation(s)
- Fathia Oladipupo
- Department of Pediatrics, Center for Child Health Equity Outcomes and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Joseph Stanek
- Department of Pediatrics, Nationwide Children's Hospital, Division of Hematology/Oncology/BMT, Columbus, Ohio, USA
| | - Joseph Walden
- Department of Pediatrics, Center for Child Health Equity Outcomes and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Jennifer Young
- Department of Pediatrics, Nationwide Children's Hospital, Division of Hematology/Oncology/BMT, Columbus, Ohio, USA
| | - Melissa J Rose
- Department of Pediatrics, Nationwide Children's Hospital, Division of Hematology/Oncology/BMT, Columbus, Ohio, USA
| | - Kathleen Nicol
- Department of Pathology & Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Anthony Villella
- Department of Pediatrics, Nationwide Children's Hospital, Division of Hematology/Oncology/BMT, Columbus, Ohio, USA
| | - Susan Creary
- Department of Pediatrics, Center for Child Health Equity Outcomes and Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, Nationwide Children's Hospital, Division of Hematology/Oncology/BMT, Columbus, Ohio, USA
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2
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Reza N, Alford RL, Belmont JW, Marston N. The Expansion of Genetic Testing in Cardiovascular Medicine: Preparing the Cardiology Community for the Changing Landscape. Curr Cardiol Rep 2024; 26:135-146. [PMID: 38277082 PMCID: PMC10990779 DOI: 10.1007/s11886-023-02003-4] [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] [Accepted: 11/20/2023] [Indexed: 01/27/2024]
Abstract
PURPOSE OF REVIEW Pathogenic DNA variants underlie many cardiovascular disease phenotypes. The most well-recognized of these include familial dyslipidemias, cardiomyopathies, arrhythmias, and aortopathies. The clinical presentations of monogenic forms of cardiovascular disease are often indistinguishable from those with complex genetic and non-genetic etiologies, making genetic testing an essential aid to precision diagnosis. RECENT FINDINGS Precision diagnosis enables efficient management, appropriate use of emerging targeted therapies, and follow-up of at-risk family members. Genetic testing for these conditions is widely available but under-utilized. In this review, we summarize the potential benefits of genetic testing, highlighting the specific cardiovascular disease phenotypes in which genetic testing should be considered, and how clinicians can integrate guideline-directed genetic testing into their practice.
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Affiliation(s)
- Nosheen Reza
- Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Nicholas Marston
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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3
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Zhang K, Aung T, Yao E, Chuang PT. Lung patterning: Is a distal-to-proximal gradient of cell allocation and fate decision a general paradigm?: A gradient of distal-to-proximal distribution and differentiation of tip progenitors produces distinct compartments in the lung. Bioessays 2024; 46:e2300083. [PMID: 38010492 DOI: 10.1002/bies.202300083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/29/2023]
Abstract
Recent studies support a model in which the progeny of SOX9+ epithelial progenitors at the distal tip of lung branches undergo cell allocation and differentiation sequentially along the distal-to-proximal axis. Concomitant with the elongation and ramification of lung branches, the descendants of the distal SOX9+ progenitors are distributed proximally, express SOX2, and differentiate into cell types in the conducting airways. Amid subsequent sacculation, the distal SOX9+ progenitors generate alveolar epithelial cells to form alveoli. Sequential cell allocation and differentiation are integrated with the branching process to generate a functional branching organ. This review focuses on the roles of SOX9+ cells as precursors for new branches, as the source of various cell types in the conducting airways, and as progenitors of the alveolar epithelium. All of these processes are controlled by multiple signaling pathways. Many mouse mutants with defective lung branching contain underlying defects in one or more steps of cell allocation and differentiation of SOX9+ progenitors. This model provides a framework to understand the molecular basis of lung phenotypes and to elucidate the molecular mechanisms of lung patterning. It builds a foundation on which comparing and contrasting the mechanisms employed by different branching organs in diverse species can be made.
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Affiliation(s)
- Kuan Zhang
- Cardiovascular Research Institute, University of California, San Francisco, California, USA
| | - Thin Aung
- Cardiovascular Research Institute, University of California, San Francisco, California, USA
| | - Erica Yao
- Cardiovascular Research Institute, University of California, San Francisco, California, USA
| | - Pao-Tien Chuang
- Cardiovascular Research Institute, University of California, San Francisco, California, USA
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4
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Wambach JA, Wegner DJ, Kitzmiller J, White FV, Heins HB, Yang P, Paul AJ, Granadillo JL, Eghtesady P, Kuklinski C, Turner T, Fairman K, Stone K, Wilson T, Breman A, Smith J, Schroeder MC, Neidich JA, Whitsett JA, Cole FS. Homozygous, Intragenic Tandem Duplication of SFTPB Causes Neonatal Respiratory Failure. Am J Respir Cell Mol Biol 2024; 70:78-80. [PMID: 38156804 PMCID: PMC10768837 DOI: 10.1165/rcmb.2023-0156le] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Affiliation(s)
| | | | | | | | | | - Ping Yang
- Washington University School of MedicineSt. Louis, Missouri
| | | | | | | | | | - Tiffany Turner
- Indiana University School of MedicineIndianapolis, Indiana
| | - Korre Fairman
- Indiana University School of MedicineIndianapolis, Indiana
| | - Kristyne Stone
- Indiana University School of MedicineIndianapolis, Indiana
| | | | - Amy Breman
- Indiana University School of MedicineIndianapolis, Indiana
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5
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Ma T, Chen H, Liao YP, Li J, Wang X, Li L, Li J, Zhu Y, Xia T. Differential Toxicity of Electronic Cigarette Aerosols Generated from Different Generations of Devices In Vitro and In Vivo. Environ Health (Wash) 2023; 1:315-323. [PMID: 38028320 PMCID: PMC10660664 DOI: 10.1021/envhealth.3c00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 12/01/2023]
Abstract
Electronic cigarettes (e-cigs) have become increasingly popular, especially among youth, raising concerns about their potential health risks. JUUL and Tank devices are two common types of e-cigs that deliver aerosols with varying nicotine levels and flavors. However, the differences in the aerosols generated from different devices and their corresponding cytotoxicity and pulmonary injury effects remain poorly understood. This study addresses these knowledge gaps by characterizing the aerosols of JUUL and Tank e-cig devices and testing their toxic effects on THP-1 and BEAS-2B human cell lines as well as the C57BL/6J mouse model. In our study, the lower-voltage device, the 3.7 V JUUL generates 2.72 mg/puff aerosols by using e-liquid containing 3% nicotine salt (i.e., nicotine benzoate), which is less than the 11.06 mg/puff aerosols generated by the 7.5 V Tank using e-liquid containing 2.4% freebase nicotine. Yet, the cytotoxicity results reveal that JUUL aerosols induced higher toxicity and increased production of pro-inflammation cytokines compared to Tank aerosols per puff. Additionally, we observed that JUUL induced more severe pulmonary inflammation and DNA damage compared to Tank after normalizing for cotinine, a nicotine metabolite, in vivo. Our findings suggest that the device design plays a more important role in e-cig aerosol-induced toxicity than the composition of the e-liquid or voltage. These results provide valuable insights into the health risks associated with various electronic-cig devices and offer an approach for evaluating them.
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Affiliation(s)
- Tiancong Ma
- Division
of Nanomedicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1772, United
States
- Department
of Environmental Health Sciences, Jonathan and Karin Fielding School
of Public Health, University of California,
Los Angeles, Los Angeles, California 90095-1772, United States
| | - Haoxuan Chen
- Department
of Environmental Health Sciences, Jonathan and Karin Fielding School
of Public Health, University of California,
Los Angeles, Los Angeles, California 90095-1772, United States
| | - Yu-Pei Liao
- Division
of Nanomedicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1772, United
States
| | - Jiulong Li
- Division
of Nanomedicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1772, United
States
| | - Xiang Wang
- Division
of Nanomedicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1772, United
States
| | - Liqiao Li
- Department
of Environmental Health Sciences, Jonathan and Karin Fielding School
of Public Health, University of California,
Los Angeles, Los Angeles, California 90095-1772, United States
| | - Jing Li
- Department
of Environmental Health Sciences, Jonathan and Karin Fielding School
of Public Health, University of California,
Los Angeles, Los Angeles, California 90095-1772, United States
| | - Yifang Zhu
- Department
of Environmental Health Sciences, Jonathan and Karin Fielding School
of Public Health, University of California,
Los Angeles, Los Angeles, California 90095-1772, United States
| | - Tian Xia
- Division
of Nanomedicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095-1772, United
States
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Soto B, Ahmed H, Pillai M, Park SS, Ploszaj M, Reece J, Taluru H, Bobrow D, Yu H, Lafortune P, Jundi B, Costanzo L, Dabo AJ, Foronjy RF, Mueller C, Ohlmeyer M, Geraghty P. Evaluating Novel Protein Phosphatase 2A Activators as Therapeutics for Emphysema. Am J Respir Cell Mol Biol 2023; 69:533-544. [PMID: 37526463 PMCID: PMC10633843 DOI: 10.1165/rcmb.2023-0105oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/31/2023] [Indexed: 08/02/2023] Open
Abstract
The activity of PP2A (protein phosphatase 2A), a serine-threonine phosphatase, is reduced by chronic cigarette smoke (SM) exposure and α-1 antitrypsin (AAT) deficiency, and chemical activation of PP2A reduces the loss of lung function in SM-exposed mice. However, the previously studied PP2A-activator tricyclic sulfonamide compound DBK-1154 has low stability to oxidative metabolism, resulting in fast clearance and low systemic exposure. Here we compare the utility of a new more stable PP2A activator, ATUX-792, versus DBK-1154 for the treatment of SM-induced emphysema. ATUX-792 was also tested in human bronchial epithelial cells and a mouse model of AAT deficiency, Serpina1a-e-knockout mice. Human bronchial epithelial cells were treated with ATUX-792 or DBK-1154, and cell viability, PP2A activity, and MAP (mitogen-activated protein) kinase phosphorylation status were examined. Wild-type mice received vehicle, DBK-1154, or ATUX-792 orally in the last 2 months of 4 months of SM exposure, and 8-month-old Serpina1a-e-knockout mice received ATUX-792 daily for 4 months. Forced oscillation and expiratory measurements and histology analysis were performed. Treatment with ATUX-792 or DBK-1154 resulted in PP2A activation, reduced MAP kinase phosphorylation, immune cell infiltration, reduced airspace enlargements, and preserved lung function. Using protein arrays and multiplex assays, PP2A activation was observed to reduce AAT-deficient and SM-induced release of CXCL5, CCL17, and CXCL16 into the airways, which coincided with reduced neutrophil lung infiltration. Our study indicates that suppression of the PP2A activity in two models of emphysema could be restored by next-generation PP2A activators to impact lung function.
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Affiliation(s)
| | | | | | - Sangmi S. Park
- Department of Cell Biology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | | | | | | | | | | | | | | | | | - Abdoulaye J. Dabo
- Department of Medicine and
- Department of Cell Biology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Robert F. Foronjy
- Department of Medicine and
- Department of Cell Biology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Christian Mueller
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, Massachusetts
- Cummings School of Veterinary Medicine, Tufts University, Grafton, Massachusetts; and
| | | | - Patrick Geraghty
- Department of Medicine and
- Department of Cell Biology, State University of New York Downstate Health Sciences University, Brooklyn, New York
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Carpenter CM, Gillenwater L, Bowler R, Kechris K, Ghosh D. TreeKernel: interpretable kernel machine tests for interactions between -omics and clinical predictors with applications to metabolomics and COPD phenotypes. BMC Bioinformatics 2023; 24:398. [PMID: 37880571 PMCID: PMC10601228 DOI: 10.1186/s12859-023-05459-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/30/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND In this paper, we are interested in interactions between a high-dimensional -omics dataset and clinical covariates. The goal is to evaluate the relationship between a phenotype of interest and a high-dimensional omics pathway, where the effect of the omics data depends on subjects' clinical covariates (age, sex, smoking status, etc.). For instance, metabolic pathways can vary greatly between sexes which may also change the relationship between certain metabolic pathways and a clinical phenotype of interest. We propose partitioning the clinical covariate space and performing a kernel association test within those partitions. To illustrate this idea, we focus on hierarchical partitions of the clinical covariate space and kernel tests on metabolic pathways. RESULTS We see that our proposed method outperforms competing methods in most simulation scenarios. It can identify different relationships among clinical groups with higher power in most scenarios while maintaining a proper Type I error rate. The simulation studies also show a robustness to the grouping structure within the clinical space. We also apply the method to the COPDGene study and find several clinically meaningful interactions between metabolic pathways, the clinical space, and lung function. CONCLUSION TreeKernel provides a simple and interpretable process for testing for relationships between high-dimensional omics data and clinical outcomes in the presence of interactions within clinical cohorts. The method is broadly applicable to many studies.
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Affiliation(s)
- Charlie M Carpenter
- Department of Biostatistics and Informatics, University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA.
| | - Lucas Gillenwater
- Computational Bioscience Program, University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA
| | - Russell Bowler
- Department of Medicine, National Jewish Health, Denver, USA
- University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA
| | - Katerina Kechris
- Department of Biostatistics and Informatics, University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA
| | - Debashis Ghosh
- Department of Biostatistics and Informatics, University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA
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8
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Shi N, Zhang J, Chen SY. DOCK2 Promotes Asthma Development by Eliciting Airway Epithelial-Mesenchymal Transition. Am J Respir Cell Mol Biol 2023; 69:310-320. [PMID: 36883952 PMCID: PMC10503310 DOI: 10.1165/rcmb.2022-0273oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/06/2023] [Indexed: 03/09/2023] Open
Abstract
Epithelial-mesenchymal transition (EMT) contributes to airway remodeling, a predominant feature of asthma. DOCK2 (dedicator of cytokinesis 2) is an innate immune signaling molecule involved in vascular remodeling. However, it is unknown if DOCK2 plays a role in airway remodeling during asthma development. In this study, we found that DOCK2 is highly induced in both normal human bronchial epithelial cells treated with house dust mite (HDM) extract and human asthmatic airway epithelium. DOCK2 is also upregulated by TGF-β1 (transforming growth factor β1) during EMT of human bronchial epithelial cells. Importantly, knockdown of DOCK2 inhibits, and overexpression of DOCK2 promotes, TGF-β1-induced EMT. Consistently, DOCK2 deficiency suppresses the EMT of airway epithelium, attenuates the subepithelial fibrosis, and improves pulmonary function in HDM-induced asthmatic lungs. These data suggest that DOCK2 plays an important role in EMT and asthma development. Mechanistically, DOCK2 interacts with transcription factor FoxM1 (forkhead box M1), which enhances FoxM1 binding to mesenchymal marker gene promoters and further promotes mesenchymal marker gene transcription and expression, leading to EMT. Taken together, our study identifies DOCK2 as a novel regulator for airway EMT in an HDM-induced asthma model, thus providing a potential therapeutic target for treatment of asthma.
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Affiliation(s)
- Ning Shi
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri
| | - Jing Zhang
- Department of Neurological Intensive Care Unit, Taihe Hospital, Shiyan, China; and
| | - Shi-You Chen
- Department of Surgery, University of Missouri School of Medicine, Columbia, Missouri
- The Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri
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Zeng S, Luo G, Lynch DA, Bowler RP, Arjomandi M. Lung volumes differentiate the predominance of emphysema versus airway disease phenotype in early COPD: an observational study of the COPDGene cohort. ERJ Open Res 2023; 9:00289-2023. [PMID: 37727675 PMCID: PMC10505951 DOI: 10.1183/23120541.00289-2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/19/2023] [Indexed: 09/21/2023] Open
Abstract
Rationale Lung volumes identify the "susceptible smokers" who progress to develop spirometric COPD. However, among susceptible smokers, development of spirometric COPD seems to be heterogeneous, suggesting the presence of different pathological mechanisms during early establishment of spirometric COPD. The objective of the present study was to determine the differential patterns of radiographic pathologies among susceptible smokers. Methods We categorised smokers with preserved spirometry (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 0) in the Genetic Epidemiology of COPD (COPDGene) cohort based on tertiles (low, intermediate and high) of lung volumes (either total lung capacity (TLC), functional residual capacity FRC or FRC/TLC) at baseline visit. We then examined the differential patterns of change in spirometry and the associated prevalence of computed tomography measured pathologies of emphysema and airway disease with those categories of lung volumes. Results The pattern of spirometric change differed when participants were categorised by TLC versus FRC/TLC: those in the high TLC tertile showed stable forced expiratory volume in 1 s (FEV1), but enlarging forced vital capacity (FVC), while those in the high FRC/TLC tertile showed decline in both FEV1 and FVC. When participants from the high TLC and high FRC/TLC tertiles were partitioned into mutually exclusive groups, compared to those with high TLC, those with high FRC/TLC had lesser emphysema, but greater air trapping, more self-reported respiratory symptoms and exacerbation episodes and higher likelihood of progressing to more severe spirometric disease (GOLD stages 2-4 versus GOLD stage 1). Conclusions Lung volumes identify distinct physiological and radiographic phenotypes in early disease among susceptible smokers and predict the rate of spirometric disease progression and the severity of symptoms in early COPD.
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Affiliation(s)
- Siyang Zeng
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
- Medical Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Gang Luo
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
| | | | | | - Mehrdad Arjomandi
- Medical Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
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Heley K, Popova L, Moran MB, Ben Taleb Z, Hart JL, Wackowski OA, Westling E, Smiley SL, Stanton CA. Targeted tobacco marketing in 2020: the case of #BlackLivesMatter. Tob Control 2023; 32:530-533. [PMID: 34907090 PMCID: PMC9295306 DOI: 10.1136/tobaccocontrol-2021-056838] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Kathryn Heley
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Meghan Bridgid Moran
- Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, USA
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, Kentucky, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | | | - Sabrina L Smiley
- Tobacco Center of Regulatory Science, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Cassandra A Stanton
- Behavioral Health & Health Policy, Westat, Rockville, Maryland, USA
- Georgetown University Medical Center, Washington, District of Columbia, USA
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Liguori CA, Sharma NP, Documét PI, Gibbs BB, Taverno Ross SE. Prevalence of healthy diet and activity behaviours among U.S. Latino preschool children living in an emerging Latino community. J Nutr Sci 2023; 12:e67. [PMID: 37396455 PMCID: PMC10311221 DOI: 10.1017/jns.2023.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
This pilot study provides preliminary insights into whether Latino preschool children living in an emerging Latino community (ELC) are meeting recommendations for healthy diet and activity behaviours and whether those behaviours are associated with sociodemographic or home environment variables. Secondary data analysis was conducted utilising cross-sectional baseline survey data from ANDALE Pittsburgh, a home-based intervention study. Measures included parent-reported information on child dietary intake, screen time and the home environment, and objectively measured physical activity and anthropometry. χ2 and Fischer's exact tests were used to determine associations. The study was conducted in an ELC in western Pennsylvania in the US. Fifty-one Latina mothers (age: 33⋅5 ± 6⋅1 years; 63 % Mexican origin; 86 % low acculturation) and their children (age: 3⋅9 ± 1⋅3 years; 55 % male) 2-5 years of age. On average, children consumed 2⋅25 ± 1⋅44 cups of fruits/vegetables, viewed 98⋅7 ± 74⋅2 min of screen time, accumulated 12⋅9 ± 2⋅9 min/h of total physical activity and consumed 15⋅5 ± 26⋅0 kcals of sugar-sweetened beverages per day. Forty-one percent met the fruit/vegetable recommendation, 54 % met the screen time recommendation, 27 % met the physical activity recommendation and 58 % met the sugary drink recommendation. Country of origin (P = 0⋅032) and acculturation (P = 0⋅048) were significantly associated with children meeting sugary drink recommendations. No other relationships were significant. The proportion of children in this sample meeting diet and activity recommendations was mixed. More research with larger sample sizes is needed in ELCs to identify effective intervention strategies for improving health behaviours.
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Affiliation(s)
- Carli A. Liguori
- Department of Health and Human Development, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA 15261, USA
| | - Neil P. Sharma
- Department of Health and Human Development, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA 15261, USA
| | - Patricia I. Documét
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Bethany B. Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, WV 26506, USA
| | - Sharon E. Taverno Ross
- Department of Health and Human Development, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA 15261, USA
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Hager K, Shi P, Li Z, Chui K, Berkowitz SA, Mozaffarian D, Chhabra J, Wilken J, Vergara C, Becker E, Small S, Ling B, Cash SB, Folta SC, Zhang FF. Evaluation of a Produce Prescription Program for Patients With Diabetes: A Longitudinal Analysis of Glycemic Control. Diabetes Care 2023; 46:1169-1176. [PMID: 36812470 PMCID: PMC10234740 DOI: 10.2337/dc22-1645] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/27/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVE Produce prescriptions have shown promise in improving diabetes care, although most studies have used small samples or lacked controls. Our objective was to evaluate the impacts of a produce prescription program on glycemic control for patients with diabetes. RESEARCH DESIGN AND METHODS Participants included a nonrandom enrollment of 252 patients with diabetes who received a produce prescription and 534 similar control participants from two clinics in Hartford, Connecticut. The start of the COVID-19 pandemic in March 2020 coincided with program implementation. Produce prescription enrollees received vouchers ($60 per month) for 6 months to purchase produce at grocery retail. Controls received usual care. The primary outcome was change in glycated hemoglobin (HbA1c) between treatment and control at 6 months. Secondary outcomes included 6-month changes in systolic (SBP) and diastolic blood pressure (DBP), BMI, hospitalizations, and emergency department admissions. Longitudinal generalized estimating equation models, weighted with propensity score overlap weights, assessed changes in outcomes over time. RESULTS At 6 months, there was no significant difference in change in HbA1c between treatment and control groups, with a difference of 0.13 percentage points (95% CI -0.05, 0.32). No significant difference was observed for change in SBP (3.85 mmHg; -0.12, 7.82), DBP (-0.82 mmHg; -2.42, 0.79), or BMI (-0.22 kg/m2; -1.83, 1.38). Incidence rate ratios for hospitalizations and emergency department visits were 0.54 (0.14, 1.95) and 0.53 (0.06, 4.72), respectively. CONCLUSIONS A 6-month produce prescription program for patients with diabetes, implemented during the onset of the COVID-19 pandemic, was not associated with improved glycemic control.
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Affiliation(s)
- Kurt Hager
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Zhongyu Li
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Kenneth Chui
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA
| | - Seth A. Berkowitz
- Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
- Tufts University School of Medicine, Boston, MA
- Division of Cardiology, Tufts Medical Center, Boston, MA
| | | | | | - Cunegundo Vergara
- Hartford Healthcare, Hartford, CT
- University of Connecticut (UConn) Internal Medicine Residency Program, UConn Health Center, Farmington, CT
| | | | | | | | - Sean B. Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
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13
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Beshar I, Milki AA, Gardner RM, Zhang WY, Johal JK, Bavan B. Elevated body mass index in modified natural cycle frozen euploid embryo transfers is not associated with live birth rate. J Assist Reprod Genet 2023; 40:1055-1062. [PMID: 37000344 PMCID: PMC10239415 DOI: 10.1007/s10815-023-02787-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
PURPOSE To assess the impact of elevated BMI on the success of modified natural cycle frozen embryo transfers (mNC-FET) of euploid embryos. METHODS This retrospective cohort study at a single academic institution reviewed mNC-FET involving single euploid blastocysts from 2016 to 2020. Comparison groups were divided by pre-pregnancy BMI (kg/m2) category: normal weight (18.5-24.9), overweight (25-29.9) or obese (≥ 30). Underweight BMI (< 18.5) was excluded from the analysis. The primary outcome was live birth rate (LBR) and secondary outcome was clinical pregnancy rate (CPR), defined as presence of fetal cardiac activity on ultrasound. Absolute standardized differences (ASD) were calculated to compare descriptive variables and p-values and multivariable logistic regressions with generalized estimating equations (GEE) were used to compare pregnancy outcomes. RESULTS 562 mNC-FET cycles were completed in 425 patients over the study period. Overall, there were 316 transfers performed in normal weight patients, 165 in overweight patients, and 81 in obese weight patients. There was no statistically significant difference in LBR across all BMI categories (55.4% normal weight, 61.2% overweight, and 64.2% obese). There was also no difference for the secondary outcome, CPR, across all categories (58.5%, 65.5%, and 66.7%, respectively). This was confirmed in GEE analysis when adjusting for confounders. CONCLUSION While increased weight has commonly been implicated in poor pregnancy outcomes, the effect of BMI on the success of mNC-FET remains debated. Across five years of data from a single institution using euploid embryos in mNC-FET cycles, elevated BMI was not associated with reduced LBR or CPR.
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Affiliation(s)
- Isabel Beshar
- Department of Obstetrics & Gynecology, Stanford Hospital, Center for Academic Medicine, MC 5317, 453 Quarry Road, Palo Alto, CA 94304 USA
| | - Amin A. Milki
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Stanford University, 1195 W Fremont Avenue, Sunnyvale, CA 94087 USA
| | - Rebecca M. Gardner
- Department of Epidemiology & Population Health, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305 USA
| | - Wendy Y. Zhang
- Department of Obstetrics & Gynecology, Stanford Hospital, Center for Academic Medicine, MC 5317, 453 Quarry Road, Palo Alto, CA 94304 USA
| | - Jasmyn K. Johal
- Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, 1305 York Avenue, 6th Floor, New York, NY 10021 USA
| | - Brindha Bavan
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Stanford University, 1195 W Fremont Avenue, Sunnyvale, CA 94087 USA
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14
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Noly PE, Duggal N, Jiang M, Nordsletten D, Bonini M, Lei I, Ela AAE, Haft JW, Pagani FD, Cascino TM, Tang PC. Role of the mitral valve in left ventricular assist device pathophysiology. Front Cardiovasc Med 2022; 9:1018295. [PMID: 36386343 PMCID: PMC9649705 DOI: 10.3389/fcvm.2022.1018295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/29/2022] [Indexed: 08/27/2023] Open
Abstract
Functional mitral regurgitation (MR) in the setting of heart failure results from progressive dilatation of the left ventricle (LV) and mitral annulus. This leads to leaflet tethering with posterior displacement. Contrary to common assumptions, MR often does not resolve with LVAD decompression of the LV alone. The negative impact of significant (moderate-severe) mitral regurgitation in the LVAD setting is becoming better recognized in terms of its harmful effect on right heart function, pulmonary vascular resistance and hospital readmissions. However, controversies remain regarding the threshold for intervention and management. At present, there are no consensus indications for the repair of significant mitral regurgitation at the time of LVAD implantation due to the conflicting data regarding potential adverse effects of MR on clinical outcomes. In this review, we summarize the current understanding of MR pathophysiology in patients supported with LVAD and potential future management strategies.
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Affiliation(s)
- Pierre-Emmanuel Noly
- Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montréal, QC, Canada
| | - Neal Duggal
- Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Mulan Jiang
- Massachusetts Institute of Technology, Cambridge, MA, United States
| | - David Nordsletten
- Department of Biomedical Engineering and Cardiac Surgery, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, United States
| | - Mia Bonini
- Department of Biomedical Engineering and Cardiac Surgery, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, United States
| | - Ienglam Lei
- Department of Cardiac Surgery, School of Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Ashraf Abou El Ela
- Department of Cardiac Surgery, School of Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Jonathan W. Haft
- Department of Cardiac Surgery, School of Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Francis D. Pagani
- Department of Cardiac Surgery, School of Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Thomas M. Cascino
- Division of Cardiovascular Medicine, Department of Internal Medicine, School of Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Paul C. Tang
- Department of Biomedical Engineering and Cardiac Surgery, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, United States
- Department of Cardiac Surgery, School of Medicine, University of Michigan, Ann Arbor, MI, United States
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15
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Lehmkuhl S, Fleischer S, Lohmann L, Rosen MS, Chekmenev EY, Adams A, Theis T, Appelt S. RASER MRI: Magnetic resonance images formed spontaneously exploiting cooperative nonlinear interaction. Sci Adv 2022; 8:eabp8483. [PMID: 35857519 PMCID: PMC9278855 DOI: 10.1126/sciadv.abp8483] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/27/2022] [Indexed: 05/27/2023]
Abstract
The spatial resolution of magnetic resonance imaging (MRI) is limited by the width of Lorentzian point spread functions associated with the transverse relaxation rate 1/T2*. Here, we show a different contrast mechanism in MRI by establishing RASER (radio-frequency amplification by stimulated emission of radiation) in imaged media. RASER imaging bursts emerge out of noise and without applying radio-frequency pulses when placing spins with sufficient population inversion in a weak magnetic field gradient. Small local differences in initial population inversion density can create stronger image contrast than conventional MRI. This different contrast mechanism is based on the cooperative nonlinear interaction between all slices. On the other hand, the cooperative nonlinear interaction gives rise to imaging artifacts, such as amplitude distortions and side lobes outside of the imaging domain. Contrast mechanism and artifacts are explored experimentally and predicted by simulations on the basis of a proposed RASER MRI theory.
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Affiliation(s)
- Sören Lehmkuhl
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, 76344 Eggenstein-Leopoldshafen, Germany
- Department of Chemistry, North Carolina State University, Raleigh, NC 27606, USA
| | - Simon Fleischer
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, 52056 Aachen, Germany
| | - Lars Lohmann
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, 52056 Aachen, Germany
| | - Matthew S. Rosen
- Massachusetts General Hospital, A. A. Martinos Center for Biomedical Imaging, Boston, MA 02129, USA
- Department of Physics, Harvard University, Cambridge, MA 02138, USA
| | - Eduard Y. Chekmenev
- Department of Chemistry, Integrative Biosciences (IBio), Karmanos Cancer Institute (KCI), Wayne State University, Detroit, MI 48202, USA
- Russian Academy of Sciences, Leninskiy Prospekt 14, Moscow 119991, Russia
| | - Alina Adams
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, 52056 Aachen, Germany
| | - Thomas Theis
- Department of Chemistry, North Carolina State University, Raleigh, NC 27606, USA
- Department of Physics, North Carolina State University, Raleigh, NC 27695, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, NC 27695, USA
| | - Stephan Appelt
- Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, 52056 Aachen, Germany
- Central Institute for Engineering, Electronics and Analytics – Electronic Systems (ZEA-2), Forschungszentrum Jülich GmbH, D-52425 Jülich, Germany
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16
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Peraramelli S, Zhou Q, Zhou Q, Wanko B, Zhao L, Nishimura T, Leung TH, Mizuno S, Ito M, Myles T, Stulnig TM, Morser J, Leung LL. Thrombin cleavage of osteopontin initiates osteopontin's tumor-promoting activity. J Thromb Haemost 2022; 20:1256-1270. [PMID: 35108449 PMCID: PMC9289821 DOI: 10.1111/jth.15663] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/21/2022] [Accepted: 01/31/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Osteopontin (OPN) is a multifunctional proinflammatory matricellular protein overexpressed in multiple human cancers and associated with tumor progression and metastases. Thrombin cleavage of OPN reveals a cryptic binding site for α4 β1 and α9 β1 integrins. METHODS Thrombin cleavage-resistant OPNR153A knock-in (OPN-KI) mice were generated and compared to OPN deficient mice (OPN-KO) and wild type (WT) mice in their ability to support growth of melanoma cells. Flow cytometry was used to analyze tumor infiltrating leukocytes. RESULTS OPN-KI mice engineered with a thrombin cleavage-resistant OPN had reduced B16 melanoma growth and fewer pulmonary metastases than WT mice. The tumor suppression phenotype of the OPN-KI mouse was identical to that observed in OPN-KO mice and was replicated in WT mice by pharmacologic inhibition of thrombin with dabigatran. Tumors isolated from OPN-KI mice had increased tumor-associated macrophages with an altered activation phenotype. Immunodeficient OPN-KI mice (NOG-OPN-KI) or macrophage-depleted OPN-KI mice did not exhibit the tumor suppression phenotype. As B16 cells do not express OPN, thrombin-cleaved fragments of host OPN suppress host antitumor immune response by functionally modulating the tumor-associated macrophages. YUMM3.1 cells, which express OPN, showed less tumor suppression in the OPN-KI and OPN-KO mice than B16 cells, but its growth was suppressed by dabigatran similar to B16 cells. CONCLUSIONS Thrombin cleavage of OPN, derived from the host and the tumor, initiates OPN's tumor-promoting activity in vivo.
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Affiliation(s)
- Sameera Peraramelli
- Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Qi Zhou
- Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Qin Zhou
- Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Bettina Wanko
- Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, Austria
| | - Lei Zhao
- Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Toshihiko Nishimura
- Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Thomas H. Leung
- Department of Dermatology, University of Pennsylvania School of Medicine, PA 19104, USA
| | - Seiya Mizuno
- Laboratory Animal Resource Center, Trans-Border Medical Research Center, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Mamoru Ito
- Central Institute for Experimental Animals (CIEA), Kawasaki, Japan
| | - Timothy Myles
- Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Thomas M. Stulnig
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University Vienna, Vienna, Austria
- Third Medical Department and Karl Landsteiner Institute for Metabolic Diseases and Nephrology, Clinic Hietzing, Vienna, Austria
| | - John Morser
- Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
| | - Lawrence L.K. Leung
- Division of Hematology, Stanford University School of Medicine, Stanford, CA 94305, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
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17
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Gambahaya ET, Rana R, Bagchi S, Sharma G, Sarkar S, Goerlich E, Cupido B, Mukherjee M, Hays AG. The Role of Multimodality Imaging in HIV-Associated Cardiomyopathy. Front Cardiovasc Med 2022; 8:811593. [PMID: 35155615 PMCID: PMC8826063 DOI: 10.3389/fcvm.2021.811593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/30/2021] [Indexed: 11/13/2022] Open
Abstract
Despite marked advances in therapeutics, HIV infection remains a leading cause of morbidity and mortality worldwide. HIV infection is associated with cardiovascular complications including myocardial dysfunction. The description of HIV-associated cardiomyopathy (HIVAC) has evolved over time from a predominantly dilated cardiomyopathy with systolic dysfunction to one of subclinical diastolic dysfunction. Multimodality cardiovascular imaging plays an integral role in our understanding of the etiology and pathogenesis of HIVAC. Such imaging is also essential in the evaluation of individuals with chronic HIV disease who present with cardiac symptoms, especially of heart failure. In the present review, we will highlight current evidence for the role of multimodality imaging in establishing the diagnosis, etiology and pathophysiology of HIVAC as well as guiding treatment and assessing prognosis.
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Affiliation(s)
- Ellise T. Gambahaya
- Division of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Rimsha Rana
- Department of Medicine, Georgetown University School of Medicine, Baltimore, MD, United States
| | - Shashwatee Bagchi
- Division of Infectious Disease and Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Garima Sharma
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sudipa Sarkar
- Division of Endocrinology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Erin Goerlich
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Blanche Cupido
- Division of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Monica Mukherjee
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Allison G. Hays
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- *Correspondence: Allison G. Hays
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18
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Zheng S, Yang J, Tan TC, Belani S, Law D, Pravoverov LV, Kim SS, Go AS. Dialysis therapy and mortality in older adults with heart failure and advanced chronic kidney disease: A high-dimensional propensity-matched cohort study. PLoS One 2022; 17:e0262706. [PMID: 35061809 PMCID: PMC8782375 DOI: 10.1371/journal.pone.0262706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/03/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Heart failure (HF) and chronic kidney disease (CKD) frequently coexist, and the combination is linked to poor outcomes, but limited data exist to guide optimal management. We evaluated the outcome of dialysis therapy in older patients with HF and advanced CKD. METHODS We examined adults aged ≥70 years with HF and eGFR ≤20 ml/min/1.73 m2 between 2008-2012 and no prior renal replacement therapy, cancer, cirrhosis or organ transplant. We identified patients who initiated chronic dialysis through 2013 and matched patients who did not initiate dialysis on age, gender, diabetes status, being alive on dialysis initiation date, and a high-dimensional propensity score for starting dialysis. Deaths were identified through 2013. We used Cox regression to evaluate the association of chronic dialysis and all-cause death. RESULTS Among 348 adults with HF and advanced CKD who initiated dialysis and 947 matched patients who did not start dialysis, mean age was 80±5 years, 51% were women and 33% were Black. The crude rate of death was high overall but lower in those initiating vs. not initiating chronic dialysis (26.1 vs. 32.1 per 100 person-years, respectively, P = 0.02). In multivariable analysis, dialysis was associated with a 33% (95% Confidence Interval:17-46%) lower adjusted rate of death compared with not initiating dialysis. CONCLUSIONS Among older adults with HF and advanced CKD, dialysis initiation was associated with lower mortality, but absolute rates of death were very high in both groups. Randomized trials should evaluate net outcomes of dialysis vs. conservative management on length and quality of life in this high-risk population.
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Affiliation(s)
- Sijie Zheng
- Department of Nephrology, Kaiser Permanente Oakland Medical Center, Oakland, CA, United States of America
- Department of Medicine, University of California, San Francisco, CA, United States of America
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Jingrong Yang
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Thida C. Tan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Sharina Belani
- Department of Nephrology, Kaiser Permanente San Rafael Medical Center, San Rafael, CA, United States of America
| | - David Law
- Department of Nephrology, Kaiser Permanente Oakland Medical Center, Oakland, CA, United States of America
| | - Leonid V. Pravoverov
- Department of Nephrology, Kaiser Permanente Oakland Medical Center, Oakland, CA, United States of America
| | - Susan S. Kim
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Alan S. Go
- Department of Medicine, University of California, San Francisco, CA, United States of America
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
- Department of Health System Sciences, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States of America
- Departments of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States of America
- Departments of Medicine, Health Research and Policy, Stanford University School of Medicine, Palo Alto, CA, United States of America
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19
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Lopez-Gordo E, Orlowski A, Wang A, Weinberg A, Sahoo S, Weber T. Hydroxylation of N-acetylneuraminic Acid Influences the in vivo Tropism of N-linked Sialic Acid-Binding Adeno-Associated Viruses AAV1, AAV5, and AAV6. Front Med (Lausanne) 2021; 8:732095. [PMID: 35036407 PMCID: PMC8757481 DOI: 10.3389/fmed.2021.732095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Adeno-associated virus (AAV) vectors are promising candidates for gene therapy. However, a number of recent preclinical large animal studies failed to translate into the clinic. This illustrates the formidable challenge of choosing the animal models that promise the best chance of a successful translation into the clinic. Several of the most common AAV serotypes use sialic acid (SIA) as their primary receptor. However, in contrast to most mammals, humans lack the enzyme CMAH, which hydroxylates cytidine monophosphate-N-acetylneuraminic acid (CMP-Neu5Ac) into cytidine monophosphate-N-glycolylneuraminic acid (CMP-Neu5Gc). As a result, human glycans only contain Neu5Ac and not Neu5Gc. Here, we investigate the tropism of AAV1, 5, 6 and 9 in wild-type C57BL/6J (WT) and CMAH knock-out (CMAH−/−) mice. All N-linked SIA-binding serotypes (AAV1, 5 and 6) showed significantly lower transduction of the heart in CMAH−/− when compared to WT mice (5–5.8-fold) and, strikingly, skeletal muscle transduction by AAV5 was almost 30-fold higher in CMAH−/− compared to WT mice. Importantly, the AAV tropism or distribution of expression among different organs was also affected. For AAV1, AAV5 and AAV6, expression in the heart compared to the liver was 4.6–8-fold higher in WT than in CMAH−/− mice, and for AAV5 the expression in the heart compared to the skeletal muscle was 57.3-fold higher in WT than in CMAH−/− mice. These data thus strongly suggest that the relative abundance of Neu5Ac and Neu5Gc plays a role in AAV tropism, and that results obtained in commonly used animal models might not translate into the clinic.
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Affiliation(s)
- Estrella Lopez-Gordo
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Alejandro Orlowski
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Arthur Wang
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Alan Weinberg
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Susmita Sahoo
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Thomas Weber
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
- *Correspondence: Thomas Weber
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20
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Flythe JE, Liu S, Montez-Rath ME, Winkelmayer WC, Chang TI. Ultrafiltration rate and incident atrial fibrillation among older individuals initiating hemodialysis. Nephrol Dial Transplant 2021; 36:2084-2093. [PMID: 33561218 PMCID: PMC8826739 DOI: 10.1093/ndt/gfaa332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Higher ultrafiltration (UF) rates are associated with numerous adverse cardiovascular outcomes among individuals receiving maintenance hemodialysis. We undertook this study to investigate the association of UF rate and incident atrial fibrillation in a large, nationally representative US cohort of incident, older hemodialysis patients. METHODS We used the US Renal Data System linked to the records of a large dialysis provider to identify individuals ≥67 years of age initiating hemodialysis between January 2006 and December 2011. We applied an extended Cox model as a function of a time-varying exposure to compute adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of delivered UF rate and incident atrial fibrillation. RESULTS Among the 15 414 individuals included in the study, 3177 developed atrial fibrillation. In fully adjusted models, a UF rate >13 mL/h/kg (versus ≤13 mL/h/kg) was associated with a higher hazard of incident atrial fibrillation [adjusted HR 1.19 (95% CI 1.07-1.30)]. Analyses using lower UF rate thresholds (≤10 versus >10 mL/h/kg and ≤8 versus >8 mL/h/kg, separately) yielded similar results. Analyses specifying the UF rate as a cubic spline (per 1 mL/h/kg) confirmed an approximately linear dose-response relationship between the UF rate and the risk of incident atrial fibrillation: risk began at UF rates of ~6 mL/h/kg and the magnitude of this risk flattened, but remained elevated, at rates ≥9 mL/h/kg. CONCLUSION In this observational study of older individuals initiating hemodialysis, higher UF rates were associated with higher incidences of atrial fibrillation.
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Affiliation(s)
- Jennifer E Flythe
- Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina Kidney Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC, USA
| | - Sai Liu
- Division of Nephrology, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Maria E Montez-Rath
- Division of Nephrology, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Wolfgang C Winkelmayer
- Section of Nephrology and Selzman Institute of Kidney Health, Baylor College of Medicine, Houston, TX, USA
| | - Tara I Chang
- Division of Nephrology, Department of Medicine, Stanford University, Stanford, CA, USA
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21
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Abstract
INTRODUCTION In recent years, there has been increasing interest in the use of spirometry for the assessment of small airways obstruction (SAO) driven by the idea that these changes occur prior to development of established obstructive lung disease. Maximal mid-expiratory and distal flow rates have been widely used despite a lack of agreement regarding parameter selection or definition of an abnormal result. We aim to provide evidence from population-based studies, describing the different parameters, definitions of normal range and the resulting impact on prevalence estimates for SAO. Summarising this evidence is important to inform development of future studies in this area. METHODS AND ANALYSIS A systematic review of population-based studies will be conducted. MEDLINE, Web of Science and Google Scholar will be searched from database inception to May 2021. Primary outcomes will include the spirometry parameter used to define SAO, and the definition of an abnormal result. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be followed for study selection. Study methods will be assessed using the Newcastle-Ottawa scale and the Grading of Recommendations Assessment, Development and Evaluation working group methodology. Narrative synthesis will be conducted for all included studies. Meta-analysis will also be conducted for prevalence estimates and associated risk factors where data quality and availability allow. Random effects models will be used to conduct the meta-analysis and I2 statistics will be used to assess heterogeneity across studies. Where appropriate subgroup analysis will be conducted to explore heterogeneity. ETHICS AND DISSEMINATION There is no requirement for ethical approval for this project. Findings will be disseminated via peer-reviewed publications and other formats, for example, conferences, congresses or symposia. PROSPERO REGISTRATION NUMBER CRD42021250206.
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Affiliation(s)
- Ben Knox-Brown
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Octavia Mulhern
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andre F S Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
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22
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Wilkinson ML, Gow AJ. Effects of fatty acid nitroalkanes on signal transduction pathways and airway macrophage activation. Innate Immun 2021; 27:353-364. [PMID: 34375151 PMCID: PMC8419298 DOI: 10.1177/17534259211015330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Fatty acid nitroalkenes are reversibly-reactive electrophiles that are endogenously detectable at nM concentrations and display anti-inflammatory, pro-survival actions. These actions are elicited through the alteration of signal transduction proteins via a Michael addition on nucleophilic cysteine thiols. Nitrated fatty acids (NO2-FAs), like 9- or 10-nitro-octadec-9-enolic acid, will act on signal transduction proteins directly or on key regulatory proteins to cause an up-regulation or down-regulation of the protein's expression, yielding an anti-inflammatory response. These responses have been characterized in many organ systems, such as the cardiovascular system, with the pulmonary system less well defined. Macrophages are one of the most abundant immune cells in the lung and are essential in maintaining lung homeostasis. Despite this, macrophages can play a role in both acute and chronic lung injury due to up-regulation of anti-inflammatory signal transduction pathways and down-regulation of pro-inflammatory pathways. Through their propensity to alter signal transduction pathways, NO2-FAs may be able to reduce macrophage activation during pulmonary injury. This review will focus on the implications of NO2-FAs on macrophage activation in the lung and the signal transduction pathways that may be altered, leading to reduced pulmonary injury.
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Affiliation(s)
- Melissa L Wilkinson
- Department of Pharmacology and Toxicology, The State University of New Jersey, USA
| | - Andrew J Gow
- Department of Pharmacology and Toxicology, The State University of New Jersey, USA
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23
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Patil M, Singh S, Henderson J, Krishnamurthy P. Mechanisms of COVID-19-induced cardiovascular disease: Is sepsis or exosome the missing link? J Cell Physiol 2021; 236:3366-3382. [PMID: 33078408 PMCID: PMC7920909 DOI: 10.1002/jcp.30109] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/01/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has reached a pandemic level, spreading across the globe by affecting over 33 million people and causing over 1,009,270 deaths. SARS-CoV-2 is highly infectious with a high basic reproduction number (R0 ) of 2.2-5.7 that has led to its exponential spread. Besides, very little is known about it in terms of immunogenicity and its molecular targets. SARS-CoV-2 causes acute respiratory distress syndrome, followed by multiple organ failure and death in a small percentage of individuals. Cardiac injury has emerged as another dreaded outcome of COVID-19 complications. However, a thorough understanding of the pathogenesis of SARS-CoV-2 is lacking. In this review, we discuss the virus, possible mechanisms of COVID-19-induced cardiac injury, and potential therapeutic strategies, and we explore if exosomes could be targeted to treat symptoms of COVID-19. Furthermore, we discussed the virus-induced sepsis, which may be the cause of multiple organ failure, including myocardial injury.
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Affiliation(s)
- Mallikarjun Patil
- Department of Biomedical Engineering, Schools of Medicine and Engineering, University of Alabama at Birmingham, AL 35294, USA
| | - Sarojini Singh
- Department of Biomedical Engineering, Schools of Medicine and Engineering, University of Alabama at Birmingham, AL 35294, USA
| | - John Henderson
- Department of Biomedical Engineering, Schools of Medicine and Engineering, University of Alabama at Birmingham, AL 35294, USA
| | - Prasanna Krishnamurthy
- Department of Biomedical Engineering, Schools of Medicine and Engineering, University of Alabama at Birmingham, AL 35294, USA
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24
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Szafranski P, Stankiewicz P. Long Non-Coding RNA FENDRR: Gene Structure, Expression, and Biological Relevance. Genes (Basel) 2021; 12:177. [PMID: 33513839 PMCID: PMC7911649 DOI: 10.3390/genes12020177] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/13/2022] Open
Abstract
The FOXF1 Adjacent Noncoding Developmental Regulatory RNA (Fendrr) plays an important role in the control of gene expression in mammals. It is transcribed in the opposite direction to the neighboring Foxf1 gene with which it shares a region containing promoters. In humans, FENDRR is located on chromosome 16q24.1, and is positively regulated both by the FOXF1 distant lung-specific cis-acting enhancer and by trans-acting FOXF1. Fendrr has been shown to function as a competing endogenous RNA, sponging microRNAs and protein factors that control stability of mRNAs, and as an epigenetic modifier of chromatin structure around gene promoters and other regulatory sites, targeting them with histone methyltrasferase complexes. In mice, Fendrr is essential for development of the heart, lungs, and gastrointestinal system; its homozygous loss causes embryonic or perinatal lethality. Importantly, deregulation of FENDRR expression has been causatively linked also to tumorigenesis, resistance to chemotherapy, fibrosis, and inflammatory diseases. Here, we review the current knowledge on the FENDRR structure, expression, and involvement in development and tissue maintenance.
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Affiliation(s)
- Przemyslaw Szafranski
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA;
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25
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Gulea C, Zakeri R, Quint JK. Model-based comorbidity clusters in patients with heart failure: association with clinical outcomes and healthcare utilization. BMC Med 2021; 19:9. [PMID: 33455580 PMCID: PMC7812726 DOI: 10.1186/s12916-020-01881-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/07/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Comorbidities affect outcomes in heart failure (HF), but are not reflected in current HF classification. The aim of this study is to characterize HF groups that account for higher-order interactions between comorbidities and to investigate the association between comorbidity groups and outcomes. METHODS Latent class analysis (LCA) was performed on 12 comorbidities from patients with HF identified from administrative claims data in the USA (OptumLabs Data Warehouse®) between 2008 and 2018. Associations with admission to hospital and mortality were assessed with Cox regression. Negative binomial regression was used to examine rates of healthcare use. RESULTS In a population of 318,384 individuals, we identified five comorbidity clusters, named according to their dominant features: low-burden, metabolic-vascular, anemic, ischemic, and metabolic. Compared to the low-burden group (minimal comorbidities), patients in the metabolic-vascular group (exhibiting a pattern of diabetes, obesity, and vascular disease) had the worst prognosis for admission (HR 2.21, 95% CI 2.17-2.25) and death (HR 1.87, 95% CI 1.74-2.01), followed by the ischemic, anemic, and metabolic groups. The anemic group experienced an intermediate risk of admission (HR 1.49, 95% CI 1.44-1.54) and death (HR 1.46, 95% CI 1.30-1.64). Healthcare use also varied: the anemic group had the highest rate of outpatient visits, compared to the low-burden group (IRR 2.11, 95% CI 2.06-2.16); the metabolic-vascular and ischemic groups had the highest rate of admissions (IRR 2.11, 95% CI 2.08-2.15, and 2.11, 95% CI 2.07-2.15) and healthcare costs. CONCLUSIONS These data demonstrate the feasibility of using LCA to classify HF based on comorbidities alone and should encourage investigation of multidimensional approaches in comorbidity management to reduce admission and mortality risk among patients with HF.
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Affiliation(s)
- Claudia Gulea
- Department of Population Health, National Heart and Lung Institute, Imperial College London, London, UK.
- NIHR Imperial Biomedical Research Centre, London, UK.
| | - Rosita Zakeri
- British Heart Foundation Centre for Research Excellence, King's College London, London, UK
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Jennifer K Quint
- Department of Population Health, National Heart and Lung Institute, Imperial College London, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
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26
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Karhausen J, Choi HW, Maddipati KR, Mathew JP, Ma Q, Boulaftali Y, Lee RH, Bergmeier W, Abraham SN. Platelets trigger perivascular mast cell degranulation to cause inflammatory responses and tissue injury. Sci Adv 2020; 6:eaay6314. [PMID: 32206714 PMCID: PMC7080499 DOI: 10.1126/sciadv.aay6314] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/20/2019] [Indexed: 06/08/2023]
Abstract
Platelet responses have been associated with end-organ injury and mortality following complex insults such as cardiac surgery, but how platelets contribute to these pathologies remains unclear. Our studies originated from the observation of microvascular platelet retention in a rat cardiac surgery model. Ensuing work supported the proximity of platelet aggregates with perivascular mast cells (MCs) and demonstrated that platelet activation triggered systemic MC activation. We then identified platelet activating factor (PAF) as the platelet-derived mediator stimulating MCs and, using chimeric animals with platelets defective in PAF generation or MCs lacking PAF receptor, defined the role of this platelet-MC interaction for vascular leakage, shock, and tissue inflammation. In application of these findings, we demonstrated that inhibition of platelet activation in modeled cardiac surgery blunted MC-dependent inflammation and tissue injury. Together, our work identifies a previously undefined mechanism of inflammatory augmentation, in which platelets trigger local and systemic responses through activation of perivascular MCs.
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Affiliation(s)
- Jörn Karhausen
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Hae Woong Choi
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
- Department of Life Sciences, Korea University, Seoul 02841, South Korea
| | | | - Joseph P. Mathew
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Qing Ma
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Yacine Boulaftali
- Université Paris Diderot, Sorbonne Paris Cité, Laboratory of Vascular Translational Science, U1148 Institute National de la Santé et de la Recherche Medicale (INSERM), Paris, France
| | - Robert Hugh Lee
- Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill, NC, USA
| | - Wolfgang Bergmeier
- Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill, NC, USA
- UNC Center for Blood Research, University of North Carolina, Chapel Hill, NC, USA
| | - Soman N. Abraham
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
- Department of Immunology, Duke University Medical Center, Durham, NC, USA
- Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, USA
- Program in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore, Singapore
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27
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Baumann AA, Domenech Rodríguez MM, Wieling E, Parra-Cardona JR, Rains LA, Forgatch MS. Teaching GenerationPMTO, an evidence-based parent intervention, in a university setting using a blended learning strategy. Pilot Feasibility Stud 2019; 5:91. [PMID: 31338206 PMCID: PMC6626357 DOI: 10.1186/s40814-019-0476-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 12/25/2018] [Accepted: 07/05/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite the large number of evidence-based practices (EBPs) ready for implementation, they are the exception in usual care, especially for ethnic minority patients, who may not have access to trained health professionals. Providing EBP training as part of a graduate curriculum could help build the pipeline of professionals to provide quality care. METHODS We conducted a before-after study to determine whether we could implement a blended learning strategy (BL; i.e., in vivo and online training) to teach an EBP in university settings. Feasibility in this pilot was operationalized as knowledge acquisition, satisfaction, fidelity, acceptability, and usability. Using GenerationPMTO as the EBP, our aim was to train graduate students enrolled in Psychology, Social Work, and Family Therapy programs in the EBP in one academic year. Two therapists from a community agency were also students in this pilot. A total of 13 students from five universities were trained in the intervention. Adaptations were made to the intervention and training strategy to optimize training fidelity. Focus groups were conducted with the students to capture their perspective about the training. RESULTS Students demonstrated significant knowledge acquisition from baseline (Mean = 61.79, SD = 11.18) to training completion (Mean = 85.27, SD = 5.08, mean difference = - 23.48, 95% CI = - 29.62, - 17.34). They also reported satisfaction with the BL format, as measured by teaching evaluations at the end of the course. Instructors received acceptable fidelity scores (range of 7-9 in a 9-point scale). Qualitative findings from focus groups showed support for acceptability and usability of BL training. CONCLUSIONS BL training in university settings can be conducted with fidelity when provided by appropriately trained instructors. BL that integrates EBP and adaptations may be uniquely applicable for training providers in low-resource and ethnically diverse settings. The BL enhanced knowledge of GenerationPMTO was acceptable and usable to students, and was delivered with high instructor fidelity to the training model.
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Affiliation(s)
- Ana A. Baumann
- George Warren Brown School of Social Work, Washington University, St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130 USA
| | | | - Elizabeth Wieling
- Family Social Science, University of Minnesota, 290 McNeal Hall, 1985 Buford Circle, St. Paul, MN 55108 USA
| | - J. Rubén Parra-Cardona
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd 3.130F. STOP D3500, Austin, TX 78712-0358 USA
| | - Laura A. Rains
- Implementation Sciences International, Inc., 10 Shelton-McMurphey Boulevard, Eugene, OR 97401 USA
| | - Marion S. Forgatch
- Implementation Sciences International, Inc., 10 Shelton-McMurphey Boulevard, Eugene, OR 97401 USA
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28
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Gulea C, Zakeri R, Quint JK. Effect of beta-blocker therapy on clinical outcomes, safety, health-related quality of life and functional capacity in patients with chronic obstructive pulmonary disease (COPD): a protocol for a systematic literature review and meta-analysis with multiple treatment comparison. BMJ Open 2018; 8:e024736. [PMID: 30429149 PMCID: PMC6252680 DOI: 10.1136/bmjopen-2018-024736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 06/11/2018] [Revised: 09/28/2018] [Accepted: 10/04/2018] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Patients with chronic obstructive pulmonary disease (COPD) who have a clinical indication for beta-blocker therapy, are often not prescribed such medication, despite evidence suggesting that beta-blockers are not associated with adverse respiratory outcomes. The primary objective of this systematic review and meta-analysis is to examine the class effect of beta-blocker use in patients with COPD. We will focus on a broad range of endpoints including, clinical, safety, and patient-centric outcomes such as health related quality of life (HRQoL) and functional capacity. A secondary objective is to explore potential within-class variation in the effects of beta-blockers among patients with COPD, and rank individual agents according to their relative benefit(s). METHODS AND ANALYSIS MEDLINE, Embase, The Cochrane Library and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases will be systematically searched, from inception to present, to identify randomised controlled trials (RCTs) and other prospective and interventional studies of beta-blocker use in patients with COPD which report on the outcomes of interest. Relative treatment effects with respect to mortality, COPD exacerbations, all-cause hospitalisation, lung function, HRQoL and exercise capacity will be summarised by meta-analysis. Individual treatments (agents) will be compared in a Bayesian network meta-analysis including RCT and observational data, if feasible. ETHICS AND DISSEMINATION The results of the study will be submitted for publication in a peer-reviewed journal. Only previously published aggregate data will be used for the purpose of this review. PROSPERO REGISTRATION NUMBER CRD42018098983.
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Affiliation(s)
- Claudia Gulea
- Department of Respiratory Epidemiology, National Heart and Lung Institute, Imperial College London, London, UK
| | - Rosita Zakeri
- Department of Respiratory Epidemiology, National Heart and Lung Institute, Imperial College London, London, UK
- Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Jennifer K Quint
- Department of Respiratory Epidemiology, National Heart and Lung Institute, Imperial College London, London, UK
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Abstract
Nativity is not often considered in the study of health disparities. We conducted a cross-sectional, parent-reported survey of demographics, socioeconomic characteristics, healthcare access, and health conditions in New York City schoolchildren (n = 9029). US-born children with US-born parents (US/US) had higher socioeconomic status, better access to healthcare, and reported higher rates of disease diagnoses compared to US-born children with immigrant parents and to immigrant children. Dental cavities were the only condition in which US/US children reported lower prevalence. US/US children had the best healthcare access, most favorable parent-reported health status and highest rate of satisfaction with healthcare. The magnitude of racial/ethnic disparities varied based on nativity of the children being compared. Factors such as the healthy immigrant effect and differential diagnosis rates may explain the results. In conclusion, nativity influences disease burdens and should be considered in health disparities studies.
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Affiliation(s)
- Sasha A McGee
- District of Columbia Department of Health, Center for Policy, Planning and Evaluation, 899 North Capitol Street NE, Washington, DC, 20002, USA
| | - Luz Claudio
- Department of Preventive Medicine, Division of International Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
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30
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Li H, Bradley KC, Long JS, Frise R, Ashcroft JW, Hartgroves LC, Shelton H, Makris S, Johansson C, Cao B, Barclay WS. Internal genes of a highly pathogenic H5N1 influenza virus determine high viral replication in myeloid cells and severe outcome of infection in mice. PLoS Pathog 2018; 14:e1006821. [PMID: 29300777 PMCID: PMC5771632 DOI: 10.1371/journal.ppat.1006821] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 03/29/2017] [Revised: 01/17/2018] [Accepted: 12/15/2017] [Indexed: 12/26/2022] Open
Abstract
The highly pathogenic avian influenza (HPAI) H5N1 influenza virus has been a public health concern for more than a decade because of its frequent zoonoses and the high case fatality rate associated with human infections. Severe disease following H5N1 influenza infection is often associated with dysregulated host innate immune response also known as cytokine storm but the virological and cellular basis of these responses has not been clearly described. We rescued a series of 6:2 reassortant viruses that combined a PR8 HA/NA pairing with the internal gene segments from human adapted H1N1, H3N2, or avian H5N1 viruses and found that mice infected with the virus with H5N1 internal genes suffered severe weight loss associated with increased lung cytokines but not high viral load. This phenotype did not map to the NS gene segment, and NS1 protein of H5N1 virus functioned as a type I IFN antagonist as efficient as NS1 of H1N1 or H3N2 viruses. Instead we discovered that the internal genes of H5N1 virus supported a much higher level of replication of viral RNAs in myeloid cells in vitro, but not in epithelial cells and that this was associated with high induction of type I IFN in myeloid cells. We also found that in vivo during H5N1 recombinant virus infection cells of haematopoetic origin were infected and produced type I IFN and proinflammatory cytokines. Taken together our data infer that human and avian influenza viruses are differently controlled by host factors in alternative cell types; internal gene segments of avian H5N1 virus uniquely drove high viral replication in myeloid cells, which triggered an excessive cytokine production, resulting in severe immunopathology. Some avian influenza viruses, including highly pathogenic H5N1 virus, cause severe disease in humans and in experimental animal models associated with excessive cytokine production. We aimed to understand the virological mechanism behind the cytokine storm, and particularly the contribution of internal gene segments that encode the viral polymerase and the non-structural proteins, since these might be retained in a pandemic virus. We found that the internal genes from an H5N1 avian influenza virus allowed virus to replicate to strikingly higher levels in myeloid cells compared to internal genes of human adapted strains. The higher viral RNA levels did not lead to higher viral load but drove excessive cytokine production and more severe outcome in infected mice. The remarkable difference in viral replication in myeloid cells was not observed in lung epithelial cells, suggesting that cell type specific differences in host factors were responsible. Understanding the molecular basis of excessive viral replication in myeloid cells may guide future therapeutic options for viruses that have recently crossed into humans from birds.
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MESH Headings
- A549 Cells
- Animals
- Cells, Cultured
- Dogs
- Female
- Genes, Viral/physiology
- HEK293 Cells
- Humans
- Immunity, Innate/physiology
- Influenza A Virus, H5N1 Subtype/genetics
- Influenza A Virus, H5N1 Subtype/immunology
- Influenza A Virus, H5N1 Subtype/pathogenicity
- Influenza A Virus, H5N1 Subtype/physiology
- Influenza, Human/genetics
- Influenza, Human/immunology
- Influenza, Human/virology
- Madin Darby Canine Kidney Cells
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Mice, Knockout
- Myeloid Cells/immunology
- Myeloid Cells/metabolism
- Myeloid Cells/virology
- Orthomyxoviridae Infections/genetics
- Orthomyxoviridae Infections/immunology
- Orthomyxoviridae Infections/mortality
- Orthomyxoviridae Infections/virology
- Severity of Illness Index
- Virus Replication/genetics
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Affiliation(s)
- Hui Li
- China-Japan Friendship Hospital, Capital Medical University, Beijing, China
- Section of Virology, Department of Medicine, Imperial College London, London, United Kingdom
| | - Konrad C. Bradley
- Section of Virology, Department of Medicine, Imperial College London, London, United Kingdom
| | - Jason S. Long
- Section of Virology, Department of Medicine, Imperial College London, London, United Kingdom
| | - Rebecca Frise
- Section of Virology, Department of Medicine, Imperial College London, London, United Kingdom
| | - Jonathan W. Ashcroft
- Section of Virology, Department of Medicine, Imperial College London, London, United Kingdom
| | - Lorian C. Hartgroves
- Section of Virology, Department of Medicine, Imperial College London, London, United Kingdom
| | - Holly Shelton
- Section of Virology, Department of Medicine, Imperial College London, London, United Kingdom
| | - Spyridon Makris
- Section of Respiratory Infections, National Heart and Lung Institute, Imperial College London
| | - Cecilia Johansson
- Section of Respiratory Infections, National Heart and Lung Institute, Imperial College London
| | - Bin Cao
- Department of Respiratory Medicine, Capital Medical University; Center for Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
- * E-mail: (WSB); (BC)
| | - Wendy S. Barclay
- Section of Virology, Department of Medicine, Imperial College London, London, United Kingdom
- * E-mail: (WSB); (BC)
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Nauffal V, Zhang Y, Tanawuttiwat T, Blasco-Colmenares E, Rickard J, Marine JE, Butcher B, Norgard S, Dickfeld TM, Ellenbogen KA, Guallar E, Tomaselli GF, Cheng A. Clinical decision tool for CRT-P vs. CRT-D implantation: Findings from PROSE-ICD. PLoS One 2017; 12:e0175205. [PMID: 28388657 PMCID: PMC5384669 DOI: 10.1371/journal.pone.0175205] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 09/18/2016] [Accepted: 03/22/2017] [Indexed: 12/01/2022] Open
Abstract
Background Cardiac resynchronization therapy (CRT) devices reduce mortality through pacing-induced cardiac resynchronization and implantable cardioverter defibrillator (ICD) therapy for ventricular arrhythmias (VAs). Whether certain factors can predict if patients will benefit more from implantation of CRT pacemakers (CRT-P) or CRT defibrillators (CRT-D) remains unclear. Methods and results We followed 305 primary prevention CRT-D recipients for the two primary outcomes of HF hospitalization and ICD therapy for VAs. Serum biomarkers, electrocardiographic and clinical variables were collected prior to implant. Multivariable analysis using Cox-proportional hazards model was used to fit the final models. Among 282 patients with follow-up outcome data, 75 (26.6%) were hospitalized for HF and 31 (11%) received appropriate ICD therapy. Independent predictors of HF hospitalization were atrial fibrillation (HR = 1.8 (1.1,2.9)), NYHA class III/IV (HR = 2.2 (1.3,3.6)), ejection fraction <20% (HR = 1.7 (1.1,2.7)), HS-IL6 >4.03pg/ml (HR = 1.7 (1.1,2.9)) and hemoglobin (<12g/dl) (HR = 2.2 (1.3,3.6)). Independent predictors of appropriate therapy included BUN >20mg/dL (HR = 3.0 (1.3,7.1)), HS-CRP >9.42mg/L (HR = 2.3 (1.1,4.7)), no beta blocker therapy (HR = 3.2 (1.4,7.1)) and hematocrit ≥38% (HR = 2.7 (1.03,7.0)). Patients with 0–1 risk factors for appropriate therapy (IR 1 per 100 person-years) and ≥3 risk factors for HF hospitalization (IR 23 per 100-person-years) were more likely to die prior to receiving an appropriate ICD therapy. Conclusions Clinical and biomarker data can risk stratify CRT patients for HF progression and VAs. These findings may help characterize subgroups of patients that may benefit more from the use of CRT-P vs. CRT-D systems. Trial registration ClinicalTrials.gov NCT00733590
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Affiliation(s)
- Victor Nauffal
- Department of Medicine, Division of Cardiology, Johns Hopkins Medical Institutes, Baltimore, Maryland, United States of America
| | - Yiyi Zhang
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Tanyanan Tanawuttiwat
- Department of Medicine, Division of Cardiology, Johns Hopkins Medical Institutes, Baltimore, Maryland, United States of America
| | - Elena Blasco-Colmenares
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - John Rickard
- Department of Medicine, Division of Cardiology, Johns Hopkins Medical Institutes, Baltimore, Maryland, United States of America
| | - Joseph E. Marine
- Department of Medicine, Division of Cardiology, Johns Hopkins Medical Institutes, Baltimore, Maryland, United States of America
| | - Barbara Butcher
- Department of Medicine, Division of Cardiology, Johns Hopkins Medical Institutes, Baltimore, Maryland, United States of America
| | - Sanaz Norgard
- Department of Medicine, Division of Cardiology, Johns Hopkins Medical Institutes, Baltimore, Maryland, United States of America
| | - Timm-Michael Dickfeld
- Department of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Kenneth A. Ellenbogen
- Department of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Eliseo Guallar
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Gordon F. Tomaselli
- Department of Medicine, Division of Cardiology, Johns Hopkins Medical Institutes, Baltimore, Maryland, United States of America
| | - Alan Cheng
- Department of Medicine, Division of Cardiology, Johns Hopkins Medical Institutes, Baltimore, Maryland, United States of America
- * E-mail:
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