73 research outputs found

    International Collaboration: Promises and Challenges

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    Rambam Maimonides Medical Journal 2015 April; 6(2): e0012. ISSN: 2076-9172 Published online 2015 April 29. Special Issue on the Rambam-Mayo Collaboration Guest Editor: John H. Davidson, M.D., M.A.H.L. doi: 10.5041/RMMJ.10196. International Collaboration: Promises and Challenges R. Jay Widmer, M.D., Ph.D.,1 Jocelyn M. Widmer, Ph.D., M.P.H.,2 and Amir Lerman, M.D.1* 1Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN, USA; 2Department of Urban and Regional Planning, College of Design, Construction and Planning, University of Florida, Gainesville, FL, USA Conflict of interest: No potential conflict of interest relevant to this article was reported. * To whom correspondence should be addressed. E-mail: [email protected] Copyright: © 2015 Widmer et al. This is an open-access article. All its content, except where otherwise noted, is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract We currently face a myriad of grand global challenges in fields such as poverty, the environment, education, science, and medicine. However, our current means of dealing with such challenges has fallen short, and ingenious solutions are required to overcome the inherent resistance to progress toward ameliorating such difficulties. Here, we highlight the promises and challenges of international collaboration in achieving success toward these trials. We note prior successes in fields such as education, medicine, science, and environmental issues made to date, yet at the same time we do note deficiencies and shortcomings in these efforts. Hence, the notion of international collaboration should be strengthened and encouraged by governments, non-profit organizations, and others moving forward using creative means to bring talented teams together to tackle these challenges across the globe

    The association between circulating microRNA levels and coronary endothelial function.

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    Human microRNAs (miRs) have been implicated in human diseases presumably through the downregulation and silencing of targeted genes via post-translational modifications. However, their role in the early stage of coronary atherosclerosis is not known. The aim of this study was to test the hypothesis that patients with early atherosclerosis and coronary endothelial dysfunction (CED) have alterations in transcoronary miR gradients. Patients underwent coronary angiography and endothelial function testing in the cardiac catheterization laboratory. Patients were divided into abnormal (n = 26) and normal (n = 22) microvascular coronary endothelial function based on intracoronary response to infused acetylcholine measured as a percent change in coronary blood flow (CBF) and arterial diameter. Blood samples were obtained simultaneously from the aorta and coronary sinus at the time of catheterization for RNA isolation, and miR subsequently assessed. Baseline characteristics were similar in both groups. Patients with microvascular CED displayed transcoronary gradients significantly elevated in miR-92a and miR-133 normalized to C-elegans-39 miR. Percent change in CBF and the transcoronary gradient of miR-133 displayed a significant inverse correlation (r2 = 0.11, p = 0.03). Thus, we present novel data whereupon selected miRs demonstrate elevated transcoronary gradients in patients with microvascular CED. The current findings support further studies on the mechanistic role of miRs in coronary atherosclerosis and in humans

    A Digital Health Weight Loss Program in 250,000 Individuals

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    Importance. Obesity is a worsening epidemic worldwide. Effective and accessible weight loss programs to combat obesity on a large scale are warranted, but a need for frequent face-to-face care might impose a limitation. Objective. To evaluate whether individuals following a weight loss program based on a mobile application, wireless scale, and nutritional program but no face-to-face care can achieve clinically significant weight loss in a large cohort. Design. Retrospective observational analysis. Setting. China from October 2016 to December 2017. Participants. Mobile application users with a minimum of 2 weights (baseline and ≥35 days). Intervention. A commercial (Weijian Technologies) weight loss program consisting of a dietary replacement, self-monitoring using a wireless home scale, and frequent guidance via mobile application. Main Outcome. Mean weight change around 42, 60, 90, and 120 days after program initiation with subgroup analysis by gender, age, and frequency of use. Results. 251,718 individuals, with a mean age of 37.3 years (SD: 9.86) (79% female), were included with a mean weight loss of 4.3 kg (CI: ±0.02) and a mean follow-up of 120 days (SD: 76.8 days). Mean weight loss at 42, 60, 90, and 120 d was 4.1 kg (CI: ±0.02), 4.9 kg (CI: ±0.02), 5.6 kg (CI: ±0.03), and 5.4 kg (CI: ±0.04), respectively. At 120 d, 62.7% of participants had lost at least 5% of their initial weight. Both genders and all usage frequency tertiles showed statistically significant weight loss from baseline at each interval (P<0.001), and this loss was greater in men than in women (120 d: 6.5 vs. 5.2 kg; P<0.001). The frequency of recording (categorized as high-, medium-, or low-frequency users) was associated with greater weight loss when comparing high, medium, and low tertile use groups at all time intervals investigated (e.g., 120 d: −8.6, −5.6, and −2.2 kg, respectively; P<0.001). Conclusions. People following a commercially available hybrid weight loss program using a mobile application, wireless scale, and nutritional program without face-to-face interaction on average achieved clinically significant short- and midterm weight loss. These results support the implementation of comparable technologies for weight control in a large population

    Associations between aortic miR levels and surrogate markers of cardiovascular disease.

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    <p>Multivariable analysis of miR levels and certain surrogate markers of CHD. Spearman's rank correlation coefficient are given with asterisks indicating significant positive or negative correlations set by a p-value <0.05 (*).</p><p>Associations between aortic miR levels and surrogate markers of cardiovascular disease.</p

    Baseline characteristics of participants divided into groups based on microvascular endothelial function.

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    <p>Endothelial dysfunction was described as a percent increase in blood flow below 50% in response to maximum acetylecholine. Most of the general demographics were not statistically significant between the groups with the exception of a higher number of diabetics in the normal microvascular function group.</p><p>Baseline characteristics of participants divided into groups based on microvascular endothelial function.</p

    Associations between coronary sinus miR levels and surrogate markers of cardiovascular disease.

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    <p>Multivariable analysis of miR levels and certain surrogate markers of CHD. Spearman's rank correlation coefficient are given with asterisks indicating significant positive or negative correlations set by a p-value <0.05 (*).</p><p>Associations between coronary sinus miR levels and surrogate markers of cardiovascular disease.</p
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