86 research outputs found
Storytelling of Interprofessional Teamwork
We are an interprofessional team that worked together to discuss and treat a patient suffering from Long COVID-19. At the beginning, we came in with assumptions of other professions and carried our biases into the group. However, as we witnessed these professions interact with our Long COVID-19 patient, Amanda, our views and biases began to change. We were privileged to see how interprofessional teams interact and come together for the betterment of our patient.https://dune.une.edu/cecespring2022/1012/thumbnail.jp
A Cross-Correlation Analysis of Mg II Absorption Line Systems and Luminous Red Galaxies from the SDSS DR5
We analyze the cross-correlation of 2,705 unambiguously intervening Mg II
(2796,2803A) quasar absorption line systems with 1,495,604 luminous red
galaxies (LRGs) from the Fifth Data Release of the Sloan Digital Sky Survey
within the redshift range 0.36<=z<=0.8. We confirm with high precision a
previously reported weak anti-correlation of equivalent width and dark matter
halo mass, measuring the average masses to be log M_h(M_[solar]h^-1)=11.29
[+0.36,-0.62] and log M_h(M_[solar]h^-1)=12.70 [+0.53,-1.16] for systems with
W[2796A]>=1.4A and 0.8A<=W[2796A]<1.4A, respectively. Additionally, we
investigate the significance of a number of potential sources of bias inherent
in absorber-LRG cross-correlation measurements, including absorber velocity
distributions and the weak lensing of background quasars, which we determine is
capable of producing a 20-30% bias in angular cross-correlation measurements on
scales less than 2'. We measure the Mg II - LRG cross-correlation for 719
absorption systems with v<60,000 km s^-1 in the quasar rest frame and find that
these associated absorbers typically reside in dark matter haloes that are
~10-100 times more massive than those hosting unambiguously intervening Mg II
absorbers. Furthermore, we find evidence for evolution of the redshift number
density, dN/dz, with 2-sigma significance for the strongest (W>2.0A) absorbers
in the DR5 sample. This width-dependent dN/dz evolution does not significantly
affect the recovered equivalent width-halo mass anti-correlation and adds to
existing evidence that the strongest Mg II absorption systems are correlated
with an evolving population of field galaxies at z<0.8, while the non-evolving
dN/dz of the weakest absorbers more closely resembles that of the LRG
population.Comment: 21 pages, 19 figures; Published in Astrophysical Journa
A Patient-Centered Prescription Drug Label to Promote Appropriate Medication Use and Adherence
BACKGROUND: Patient misunderstanding of prescription drug label instructions is a common cause of unintentional misuse of medication and adverse health outcomes. Those with limited literacy and English proficiency are at greater risk.
OBJECTIVE: To test the effectiveness of a patient-centered drug label strategy, including a Universal Medication Schedule (UMS), to improve proper regimen use and adherence compared to a current standard.
DESIGN: Two-arm, multi-site patient-randomized pragmatic trial.
PARTICIPANTS: English- and Spanish-speaking patients from eight community health centers in northern Virginia who received prescriptions from a central-fill pharmacy and who were 1) â„30Â years of age, 2) diagnosed with type 2 diabetes and/or hypertension, and 3) taking â„2 oral medications.
INTERVENTION: A patient-centered label (PCL) strategy that incorporated evidence-based practices for format and content, including prioritized information, larger font size, and increased white space. Most notably, instructions were conveyed with the UMS, which uses standard intervals for expressing when to take medicine (morning, noon, evening, bedtime).
MAIN MEASURES: Demonstrated proper use of a multi-drug regimen; medication adherence measured by self-report and pill count at 3 and 9Â months.
KEY RESULTS: A total of 845 patients participated in the study (85.6Â % cooperation rate). Patients receiving the PCL demonstrated slightly better proper use of their drug regimens at first exposure (76.9Â % vs. 70.1Â %, pâ=â0.06) and at 9Â months (85.9Â % vs. 77.4Â %, pâ=â0.03). The effect of the PCL was significant for English-speaking patients (OR 2.21, 95Â % CI 1.13-4.31) but not for Spanish speakers (OR 1.19, 95Â % CI 0.63-2.24). Overall, the intervention did not improve medication adherence. However, significant benefits from the PCL were found among patients with limited literacy (OR 5.08, 95Â % CI 1.15-22.37) and for those with medications to be taken â„2 times a day (OR 2.77, 95Â % CI 1.17-6.53).
CONCLUSIONS: A simple modification to pharmacy-generated labeling, with minimal investment required, can offer modest improvements to regimen use and adherence, mostly among patients with limited literacy and more complex regimens. Trial Registration (ClinicalTrials.gov): NCT00973180, NCT01200849
A Randomized Trial of a Prenatal Genetic Testing Interactive Computerized Information Aid
To determine whether an interactive computer program could improve patient knowledge regarding genetic screening and diagnostic concepts
Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context
Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts
Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas
Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN
Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas
This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing
molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin
Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images
Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images
of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL
maps are derived through computational staining using a convolutional neural network trained to
classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and
correlation with overall survival. TIL map structural patterns were grouped using standard
histopathological parameters. These patterns are enriched in particular T cell subpopulations
derived from molecular measures. TIL densities and spatial structure were differentially enriched
among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial
infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic
patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for
the TCGA image archives with insights into the tumor-immune microenvironment
Ebola virus epidemiology, transmission, and evolution during seven months in Sierra Leone
The 2013-2015 Ebola virus disease (EVD) epidemic is caused by the Makona variant of Ebola virus (EBOV). Early in the epidemic, genome sequencing provided insights into virus evolution and transmission and offered important information for outbreak response. Here, we analyze sequences from 232 patients sampled over 7 months in Sierra Leone, along with 86 previously released genomes from earlier in the epidemic. We confirm sustained human-to-human transmission within Sierra Leone and find no evidence for import or export of EBOV across national borders after its initial introduction. Using high-depth replicate sequencing, we observe both host-to-host transmission and recurrent emergence of intrahost genetic variants. We trace the increasing impact of purifying selection in suppressing the accumulation of nonsynonymous mutations over time. Finally, we note changes in the mucin-like domain of EBOV glycoprotein that merit further investigation. These findings clarify the movement of EBOV within the region and describe viral evolution during prolonged human-to-human transmission
Phase I study of the aurora A kinase inhibitor alisertib with induction chemotherapy in patients with acute myeloid leukemia
Aberrant expression of aurora kinase A is implicated in the genesis of various neoplasms, including acute myeloid leukemia. Alisertib, an aurora A kinase inhibitor, has demonstrated efficacy as monotherapy in trials of myeloid malignancy, and this efficacy appears enhanced in combination with conventional chemotherapies. In this phase I, dose-escalation study, newly diagnosed patients received conventional induction with cytarabine and idarubicin, after which alisertib was administered for 7 days. Dose escalation occurred via cohorts. Patients could then receive up to four cycles of consolidation, incorporating alisertib, and thereafter alisertib maintenance for up to 12 months. Twenty-two patients were enrolled. One dose limiting toxicity occurred at dose level 2 (prolonged thrombocytopenia), and the recommended phase 2 dose was established at 30mg twice daily. Common therapy-related toxicities included cytopenias and mucositis. Only three (14%) patients had persistent disease at mid-cycle, requiring â5+2â reinduction. The composite remission rate (complete remission and complete remission with incomplete neutrophil recovery) was 86% (nineteen of twenty-two patients; 90% CI 68â96%). Among those over age 65 and those with high-risk disease (secondary acute leukemia or cytogenetically high-risk disease), the composite remission rate was 88% and 100%, respectively. The median follow up was 13.5 months. Of those treated at the recommended phase 2 dose, the 12-month overall survival and progression-free survival were 62% (90% CI 33â81%) and 42% (90% CI 17â65%), respectively. Alisertib is well tolerated when combined with induction chemotherapy in acute myeloid leukemia, with a promising suggestion of efficacy. (clinicaltrials.gov Identifier:01779843)
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