83 results on '"Lai, Shenghan"'
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2. Homocysteine modifies the association of coronary stenosis and HIV infection in an inner city African American population
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Leucker, Thorsten M, Harb, Tarek, Gerstenblith, Gary, Celentano, David D, Ziogos, Efthymios, Treisman, Glenn, Mandler, Raul N, Khalsa, Jag, Charurat, Man, Lai, Shenghan, and Lai, Hong
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Background and aims People with HIV (PWH) whose disease is controlled on anti-retroviral regimens remain at an increased risk for coronary artery disease (CAD). Traditional cardiovascular risk factors do not fully explain the residual risk in PWH suggesting contributions from nontraditional factors. Homocysteine (Hcy) may be one of these as prior work in adults without HIV demonstrate that Hcy may impair endothelial function by decreasing the availability of nitric oxide, promoting the development of atherosclerosis. In addition, plasma Hcy levels are higher in PWH than in individuals living without HIV. The aim of this study was to investigate whether Hcy levels influence the association between HIV and coronary stenosis in an inner city African American population.Methods African Americans from the Heart Study in Baltimore, with and without HIV, recruited from inner-city Baltimore between June 2004 and February 2015, were included in this analysis. Participants underwent coronary CT angiography to evaluate the presence of coronary stenosis, defined as luminal stenosis >10%. Hcy was measured from stored serum samples.Results In this analysis, the median [IQR] age of the 664 participants was 56 [50–66] years; 68.1% were living with HIV and 43.1% were women. Elevated Hcy (>15 µmol/L) was more prevalent in those with coronary stenosis (23.3%, 95% CI: 18.4%–28.2%) than in those without coronary stenosis (13.1%, 95% CI: 9.7%–16.5%) (p= 0.0007), and HIV was associated with coronary stenosis in those participants with an elevated Hcy (Prevalence Ratio: 1.94, 95% CI: 1.04-3.64, p= 0.0038) and not in those with a Hcy ≤15 µmol/L (Prevalence Ratio: 1.02, 95% CI: 0.83-1.25, p= 0.87).Conclusions Our data suggest an association between elevated Hcy levels (>15 µmol/L) and the prevalence of coronary stenosis in PWH from this inner city African American population.
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- 2024
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3. Elevated homocysteine levels may moderate and mediate the association between HIV and cognitive impairment among middle-aged and older adults in an underserved population in Baltimore, Maryland
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Lai, Hong, Treisman, Glenn, Celentano, David D, Gerstenblith, Gary, Mandler, Raul N, Khalsa, Jag, Charurat, Man, Lai, Shenghan, and Pearson, Godfrey
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Background:In the antiretroviral therapy (ART) era, HIV-associated neurocognitive disorders (HAND) remain a considerable challenge for people with HIV, yet not all such disorders can be attributed to HIV alone. This study aimed to: (1) identify factors influencing neurocognitive impairment (NCI) utilizing the NIH Toolbox Cognition Battery (NIHTB-CB) as per the revised research criteria for HAND; (2) ascertain the moderating role of high homocysteine levels in the association between NCI and HIV; and (3) assess the mediating effect of elevated homocysteine levels on this association.Methods:We analyzed data from 788 adults (≥45 years) participating in a study on HIV-related comorbidities in underserved Baltimore communities, using NIHTB-CB to gauge neurocognitive performance. Special attention was given to results from the Dimensional Change Card Sort (DCCS) test within the executive function domain during causal mediation analysis.Results:Overall, HIV was not associated with NCI presence. However, HIV was associated with NCI among individuals with homocysteine >14 μmol/L. Furthermore, HIV was both directly and indirectly associated with NCI in DCCS test scores. Notably, the mediating role of elevated homocysteine in DCCS scores was only observable among individuals who had never used cocaine or had used it for ≤ 10 years, suggesting that extended cocaine use may have a substantial influence on cognitive performance.Conclusions:The findings from this study suggest elevated homocysteine levels may moderate and mediate the association between HIV and neurocognitive impairment.
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- 2024
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4. Platelet activation and endothelial dysfunction biomarkers in acute coronary syndrome: the impact of PCSK9 inhibition
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Ziogos, Efthymios, Chelko, Stephen P, Harb, Tarek, Engel, Morgan, Vavuranakis, Michael A, Landim-Vieira, Maicon, Walsh, Elise M, Williams, Marlene S, Lai, Shenghan, Halushka, Marc K, Gerstenblith, Gary, and Leucker, Thorsten M
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Graphical AbstractPatients presenting with an acute coronary syndrome were randomized 1:1 to placebo or to 420 mg of evolocumab within 24 h of hospital admission. Biomarkers of platelet activation and endothelial dysfunction were measured at baseline (before randomization) and 30 days. Administration of evolocumab was associated with decreased levels of platelet factor 4 (PF4) and von Willebrand factor (vWF). In arterial specimens of participants undergoing coronary artery bypass surgery, there was a decreased interaction among PCSK9, platelets, and endothelial cells in the evolocumab group.
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- 2023
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5. High-risk Coronary Plaque Regression in Cash-based Contingency Management Intervention Among Cocaine Users With HIV-associated Subclinical Coronary Atherosclerosis.
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Lai, Hong, Bluemke, David A., Fishman, Elliot K., Gerstenblith, Gary, Celentano, David D., Treisman, Glenn, Foster, Parker, Mandler, Raul, Khalsa, Jag, Chen, Shaoguang, Bhatia, Sandeepan, Kolossváry, Márton, and Lai, Shenghan
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Background: Cocaine use exacerbates human immunodeficiency virus (HIV)–associated subclinical coronary atherosclerosis. We investigated whether cocaine abstinence or reduced use achieved with contingency management (CM) intervention would retard high-risk coronary plaque progression among cocaine users with HIV and subclinical coronary atherosclerosis. Methods: Between March 2014 and August 2017, 76 cocaine users with HIV and coronary plaques were enrolled in a study designed to decrease cocaine use and determine whether doing so impacted progression of subclinical coronary atherosclerosis as measured by coronary artery computed tomography examinations. Of the 76, 7 did not complete the study, resulting in 69 participants. A 12-month cash-based CM intervention was implemented to promote cocaine abstinence or reduced cocaine use. Generalized estimating equation approach was used to perform longitudinal data analyses. Findings: During the 12-month CM, all 69 participants reduced cocaine use, and of these, 25 (36%; 95% confidence interval, 25%–49%) achieved cocaine abstinence. After adjusting for potential confounding factors, generalized estimating equation analyses showed that (1) endothelin-1 (ET-1) levels, a proinflammatory biomarker for endothelial dysfunction, at the 6-month and 12-month visits were significantly lower compared with baseline ET-1 (P = 0.001 and P < 0.001, respectively), and (2) low-attenuation noncalcified coronary plaque volume, a predictor for myocardial infarction, at 12-month visit was significantly lower compared with baseline low-attenuation noncalcified coronary plaque volume (P < 0.05). Conclusions: The findings of this study have not only demonstrated that CM is effective in achieving a sustained reduction in cocaine use, but also provided compelling evidence that reduction in cocaine use leads to quantifiable cardiovascular health benefits, including concurrent decrease in high-risk plaque burden and ET-1, among cocaine users with HIV-associated coronary atherosclerosis. [ABSTRACT FROM AUTHOR]
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- 2023
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6. High-risk Coronary Plaque Regression in Cash-based Contingency Management Intervention Among Cocaine Users With HIV-associated Subclinical Coronary Atherosclerosis
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Lai, Hong, Bluemke, David A., Fishman, Elliot K., Gerstenblith, Gary, Celentano, David D., Treisman, Glenn, Foster, Parker, Mandler, Raul, Khalsa, Jag, Chen, Shaoguang, Bhatia, Sandeepan, Kolossváry, Márton, and Lai, Shenghan
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- 2023
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7. Association of social determinants, lifestyle, and metabolic factors with mortality in Chinese adults: A nationwide 10-year prospective cohort study
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Lu, Jieli, Li, Mian, He, Jiang, Xu, Yu, Zheng, Ruizhi, Zheng, Jie, Qin, Guijun, Qin, Yingfen, Chen, Yuhong, Tang, Xulei, Ye, Zhen, Xu, Min, Wang, Tiange, Shi, Lixin, Su, Qing, Yu, Xuefeng, Yan, Li, Zhao, Zhiyun, Wan, Qin, Chen, Gang, Gao, Zhengnan, Wang, Guixia, Shen, Feixia, Gu, Xuejiang, Luo, Zuojie, Chen, Li, Hou, Xinguo, Huo, Yanan, Li, Qiang, Qiao, Hong, Zhang, Yinfei, Zeng, Tianshu, Hu, Chunyan, Cao, Qiuyu, Jia, Xiaojing, Liu, Chao, Wang, Youmin, Wu, Shengli, Yang, Tao, Deng, Huacong, Qi, Hongyan, Wu, Xueyan, Zhang, Di, Dai, Meng, Li, Donghui, Lai, Shenghan, Chen, Lulu, Zhao, Jiajun, Mu, Yiming, Hu, Weiguo, Ning, Guang, Hu, Ruying, Bi, Yufang, and Wang, Weiqing
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Nationwide estimates of the impact of common modifiable risk factors on mortality remain crucial. We aim to assess the influence of social determinants, lifestyle, and metabolic factors on mortality in 174,004 adults aged ≥40 years from the China Cardiometabolic Disease and Cancer Cohort (4C) Study. We reveal that 17 modifiable factors are independently associated with mortality, accounting for 64.8% of all-cause mortality, 77.4% of cardiovascular mortality, and 44.8% of cancer mortality. Low education emerges as the leading factor for both all-cause and cancer mortality, while hypertension is predominant for cardiovascular mortality. Moreover, low gross domestic product per capita and high ambient particulate matter with a diameter of <2.5 μm (PM2.5) air pollution account for 7.8% and 4.3% for all-cause mortality, respectively, using a different method. Gender-specific analyses reveal distinct patterns, with women’s mortality primarily associated with social determinants and men exhibiting stronger associations with lifestyle factors. Targeted health interventions are essential to mitigate mortality risks effectively in China.
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- 2024
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8. A randomized, placebo-controlled, double-blinded clinical trial of colchicine to improve vascular health in people living with HIV
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Hays, Allison G., Schär, Michael, Barditch-Crovo, Patricia, Bagchi, Shashwatee, Bonanno, Gabriele, Meyer, Joseph, Afework, Yohannes, Streeb, Valerie, Stradley, Samuel, Kelly, Shannon, Anders, Nicole M., Margolick, Joseph B., Lai, Shenghan, Gerstenblith, Gary, and Weiss, Robert G.
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Supplemental Digital Content is available in the text
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- 2021
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9. Contribution of Risk Factors to the Development of Coronary Atherosclerosis as Confirmed via Coronary CT Angiography: A Longitudinal Radiomics-based Study
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Kolossváry, Márton, Gerstenblith, Gary, Bluemke, David A., Fishman, Elliot K., Mandler, Raul N., Kickler, Thomas S., Chen, Shaoguang, Bhatia, Sandeepan, Lai, Shenghan, and Lai, Hong
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Radiomics-based precision phenotyping indicates that conventional risk factors, cocaine use, and HIV infection each have different effects on CT angiographic morphologic changes in coronary atherosclerosis over 4 years.
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- 2021
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10. Association of insulin resistance and β-cell dysfunction with incident diabetes among adults in China: a nationwide, population-based, prospective cohort study
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Wang, Tiange, Lu, Jieli, Shi, Lixin, Chen, Gang, Xu, Min, Xu, Yu, Su, Qing, Mu, Yiming, Chen, Lulu, Hu, Ruying, Tang, Xulei, Yu, Xuefeng, Li, Mian, Zhao, Zhiyun, Chen, Yuhong, Yan, Li, Qin, Guijun, Wan, Qin, Dai, Meng, Zhang, Di, Gao, Zhengnan, Wang, Guixia, Shen, Feixia, Luo, Zuojie, Qin, Yingfen, Chen, Li, Huo, Yanan, Li, Qiang, Ye, Zhen, Zhang, Yinfei, Liu, Chao, Wang, Youmin, Wu, Shengli, Yang, Tao, Deng, Huacong, Zhao, Jiajun, Lai, Shenghan, Bi, Yufang, DeFronzo, Ralph A, Wang, Weiqing, and Ning, Guang
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National investigations on the interaction of insulin resistance, β-cell dysfunction, and obesity with the development of diabetes are scarce in China. We aimed to investigate the individual and joint associations of insulin resistance and β-cell dysfunction with incident diabetes, and to examine the modifying effect of BMI and waist circumference on these associations among adults with normal glucose tolerance and with prediabetes.
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- 2020
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11. The influence of febuxostat on coronary artery endothelial dysfunction in patients with coronary artery disease: A phase 4 randomized, placebo-controlled, double-blind, crossover trial.
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Hays, Allison G., Iantorno, Micaela, Schär, Michael, Lai, Shenghan, Czarny, Matthew, Breton, Elayne, Palmer, Robert N., Whelton, Andrew, Weiss, Robert G., and Gerstenblith, Gary
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Background: The xanthine oxidase (XO) system is a significant source of vascular oxidative stress, which is believed to impair endothelial function, an important contributor to atherosclerotic disease. We tested whether febuxostat, a potent XO inhibitor, improves coronary endothelial function (CEF) in patients with stable coronary artery disease (CAD) in a single-center, randomized, placebo-controlled, double-blind crossover trial.Methods: CEF was measured using noninvasive magnetic resonance imaging (MRI) assessment of changes in 30 patients with stable CAD and baseline impaired CEF. Patients received either febuxostat or placebo for 6 weeks and then were crossed over to the alternative for an additional 6 weeks. MRI-detected changes in coronary flow and in coronary cross-sectional area from rest to isometric handgrip exercise, a known endothelial-dependent stressor, were measured at the end of each 6 week period.Results: Mean serum urate levels were lower at the end of the 6-week febuxostat period (2.9±0.8mg/dL) than at the end of the 6-week placebo period (5.9±0.04, P<.001). However, there were no significant differences in any of the CEF parameters measured at the end of the febuxostat and placebo periods.Conclusions: In summary, although XO inhibition with febuxostat was well tolerated and lowered serum urate, it did not improve the primary end point of the study, CEF measured using MRI after 6 weeks of treatment. In conclusion, these findings suggest that short-term inhibition of XO does not significantly improve impaired CEF in patients with stable CAD. [ABSTRACT FROM AUTHOR]- Published
- 2018
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12. Age and Gender Differences in the Association between Serum 25-Hydroxyvitamin D and Stroke in the General US Population: The National Health and Nutrition Examination Survey, 2001-2006.
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Li, Ji, Lai, Hong, Yang, Lifang, Zhu, Hong, Chen, Shaoguang, and Lai, Shenghan
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Background: Previous findings on the association between serum 25(OH)D level and stroke have been controversial. We aimed to examine whether these controversial findings could be possibly due to difference in study participant characteristics, especially age and gender differences in these studies, by analyzing the data from a representative sample of the general US population.Methods: Data of 13,642 adults 20 years or older who participated in the 2001-2006 National Health and Nutrition Examination Survey were analyzed in this study. Serum 25(OH)D was used to reflect vitamin D status. Stroke history was self-reported using questionnaires. Unadjusted and adjusted logistic regression models were fitted using SAS survey procedures to investigate the associations between 25(OH)D level and stroke for the pooled sample and age-gender subgroups (men versus women, <50 years old versus ≥50 years old), respectively.Results: After adjusting for demographic and lifestyle covariates, vitamin D deficiency (defined as serum 25(OH)D < 12 ng/mL) was significantly associated with increased risk of stroke (adjusted odds ratio [OR] = 1.62, 95% confidence interval [CI] = 1.11, 2.36), and higher vitamin D levels were significantly associated with reduced risk of stroke (adjusted OR = .70, 95% CI = .51, .96). The association between high levels of serum 25(OH)D and stroke was particularly evident among young females (age ≤20 years to <50 years) (adjusted OR = .26, 95% CI = .14, .49).Conclusions: The findings add to the evidence suggesting maintaining ideal 25(OH)D levels may reduce the risk of stroke among US adults, particularly in adult women younger than 50 years. [ABSTRACT FROM AUTHOR]- Published
- 2017
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13. Ideal Cardiovascular Health Metrics and Major Cardiovascular Events in Patients With Prediabetes and Diabetes
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Wang, Tiange, Lu, Jieli, Su, Qing, Chen, Yuhong, Bi, Yufang, Mu, Yiming, Chen, Lulu, Hu, Ruying, Tang, Xulei, Yu, Xuefeng, Li, Mian, Xu, Min, Xu, Yu, Zhao, Zhiyun, Yan, Li, Qin, Guijun, Wan, Qin, Chen, Gang, Dai, Meng, Zhang, Di, Gao, Zhengnan, Wang, Guixia, Shen, Feixia, Luo, Zuojie, Qin, Yingfen, Chen, Li, Huo, Yanan, Li, Qiang, Ye, Zhen, Zhang, Yinfei, Liu, Chao, Wang, Youmin, Wu, Shengli, Yang, Tao, Deng, Huacong, Li, Donghui, Lai, Shenghan, Bloomgarden, Zachary T., Shi, Lixin, Ning, Guang, Zhao, Jiajun, and Wang, Weiqing
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IMPORTANCE: Whether optimal cardiovascular health metrics may counteract the risk of cardiovascular events among patients with prediabetes or diabetes is unclear. OBJECTIVE: To investigate the associations of ideal cardiovascular health metrics (ICVHMs) with subsequent development of cardiovascular disease (CVD) among participants with prediabetes or diabetes as compared with participants with normal glucose regulation. DESIGN, SETTING, AND PARTICIPANTS: The China Cardiometabolic Disease and Cancer Cohort Study was a nationwide, population-based, prospective cohort study of 20 communities from various geographic regions in China. The study included 111 765 participants who were free from CVD or cancer at baseline. Data were analyzed between 2011 and 2016. EXPOSURES: Prediabetes and diabetes were defined according to the American Diabetes Association 2010 criteria. Seven ICVHMs were adapted from the American Heart Association recommendations. MAIN OUTCOMES AND MEASURES: The composite of incident fatal or nonfatal CVD, including cardiovascular death, myocardial infarction, stroke, and hospitalized or treated heart failure. RESULTS: Of the 111 765 participants, 24 881 (22.3%) had normal glucose regulation, 61 024 (54.6%) had prediabetes, and 25 860 (23.1%) had diabetes. Mean (SD) age ranged from 52.9 (8.6) years to 59.4 (8.7) years. Compared with participants with normal glucose regulation, among participants with prediabetes, the multivariable-adjusted hazard ratio for CVD was 1.34 (95% CI, 1.16-1.55) for participants who had 1 ICVHM or less and 0.57 (95% CI, 0.43-0.75) for participants who had at least 5 ICVHMs; among participants with diabetes, the hazard ratios for CVD were 2.05 (95% CI, 1.76-2.38) and 0.80 (95% CI, 0.56-1.15) for participants who had 1 ICVHM or less and at least 5 ICVHMs, respectively. Such pattern of association between ICVHMs and CVD was more prominent for participants younger than 55 years (prediabetes and at least 5 ICVHMs: hazard ratio [HR], 0.32; 95% CI, 0.16-0.63; 1 ICVHM or less: HR, 1.58; 95% CI, 1.13-2.21; diabetes and at least 5 ICVHMs: HR, 0.99; 95% CI, 0.44-2.26; 1 ICVHM or less: HR, 2.46; 95% CI, 1.71-3.54; compared with normal glucose regulation) than for participants 65 years or older (prediabetes and at least 5 ICVHMs: HR, 0.80; 95% CI, 0.50-1.26; 1 ICVHM or less: HR, 1.01; 95% CI, 0.79-1.31; diabetes and at least 5 ICVHMs: HR, 0.79; 95% CI, 0.46-1.35; 1 ICVHM or less: HR, 1.73; 95% CI, 1.36-2.22, compared with normal glucose regulation; P values for interaction ≤.02). Additionally, the hazard ratio for CVD per additional ICVHM was 0.82 (95% CI, 0.79-0.86) among participants with prediabetes and was 0.85 (95% CI, 0.80-0.89) among participants with diabetes. CONCLUSIONS AND RELEVANCE: Participants with prediabetes or diabetes who had 5 or more ICVHMs exhibited lower or no significant excess CVD risks compared with the participants with normal glucose regulation.
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- 2019
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14. Gut microbiome and serum metabolome alterations in obesity and after weight-loss intervention
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Liu, Ruixin, Hong, Jie, Xu, Xiaoqiang, Feng, Qiang, Zhang, Dongya, Gu, Yanyun, Shi, Juan, Zhao, Shaoqian, Liu, Wen, Wang, Xiaokai, Xia, Huihua, Liu, Zhipeng, Cui, Bin, Liang, Peiwen, Xi, Liuqing, Jin, Jiabin, Ying, Xiayang, Wang, Xiaolin, Zhao, Xinjie, Li, Wanyu, Jia, Huijue, Lan, Zhou, Li, Fengyu, Wang, Rui, Sun, Yingkai, Yang, Minglan, Shen, Yuxin, Jie, Zhuye, Li, Junhua, Chen, Xiaomin, Zhong, Huanzi, Xie, Hailiang, Zhang, Yifei, Gu, Weiqiong, Deng, Xiaxing, Shen, Baiyong, Xu, Xun, Yang, Huanming, Xu, Guowang, Bi, Yufang, Lai, Shenghan, Wang, Jian, Qi, Lu, Madsen, Lise, Wang, Jiqiu, Ning, Guang, Kristiansen, Karsten, and Wang, Weiqing
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Emerging evidence has linked the gut microbiome to human obesity. We performed a metagenome-wide association study and serum metabolomics profiling in a cohort of lean and obese, young, Chinese individuals. We identified obesity-associated gut microbial species linked to changes in circulating metabolites. The abundance of Bacteroides thetaiotaomicron, a glutamate-fermenting commensal, was markedly decreased in obese individuals and was inversely correlated with serum glutamate concentration. Consistently, gavage with B. thetaiotaomicron reduced plasma glutamate concentration and alleviated diet-induced body-weight gain and adiposity in mice. Furthermore, weight-loss intervention by bariatric surgery partially reversed obesity-associated microbial and metabolic alterations in obese individuals, including the decreased abundance of B. thetaiotaomicron and the elevated serum glutamate concentration. Our findings identify previously unknown links between intestinal microbiota alterations, circulating amino acids and obesity, suggesting that it may be possible to intervene in obesity by targeting the gut microbiota.
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- 2017
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15. Coronary artery endothelial dysfunction is present in HIV-positive individuals without significant coronary artery disease
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Iantorno, Micaela, Schär, Michael, Soleimanifard, Sahar, Brown, Todd T., Moore, Richard, Barditch-Crovo, Patricia, Stuber, Matthias, Lai, Shenghan, Gerstenblith, Gary, Weiss, Robert G., and Hays, Allison G.
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Supplemental Digital Content is available in the text
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- 2017
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16. Gender differences in the associations between urinary bisphenol A and body composition among American children: The National Health and Nutrition Examination Survey, 2003–2006
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Li, Ji, Lai, Hong, Chen, Shaoguang, Zhu, Hong, and Lai, Shenghan
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As an endocrine disruptor, bisphenol A (BPA) exposure has been implicated as a potential risk factor in childhood obesity, which is defined using percentiles of body mass index for age. We aimed to examine the associations between BPA exposure, reflected by urinary BPA concentration, and body composition in American children.
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- 2017
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17. Coronary Plaque Progression and Regression in Asymptomatic African American Chronic Cocaine Users With Obstructive Coronary Stenoses: A Preliminary Study
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Sandfort, Veit, Bluemke, David A., Vargas, Jose, Brinker, Jeffrey A., Gerstenblith, Gary, Kickler, Thomas, Zheng, Gang, Li, Ji, Chen, Shaoguang, Lai, Hong, Fishman, Elliot K., and Lai, Shenghan
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- 2017
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18. Metabolic Syndrome Among Adults in China: The 2010 China Noncommunicable Disease Surveillance.
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Lu, Jieli, Wang, Limin, Li, Mian, Xu, Yu, Jiang, Yong, Wang, Weiqing, Li, Jianhong, Mi, Shengquan, Zhang, Mei, Li, Yichong, Wang, Tiange, Xu, Min, Zhao, Zhiyun, Dai, Meng, Lai, Shenghan, Zhao, Wenhua, Wang, Linhong, Bi, Yufang, and Ning, Guang
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In China, data on the prevalence of metabolic syndrome have been rare recently.
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- 2017
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19. Chronic Cocaine Use and Its Association With Myocardial Steatosis Evaluated by 1H Magnetic Resonance Spectroscopy in African Americans.
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Lai, Shenghan, Gerstenblith, Gary, Ji Li, Hong Zhu, Bluemke, David A., Chia-Ying Liu, Zimmerman, Stefan L., Shaoguang Chen, Hong Lai, and Treisman, Glenn
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- 2015
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20. Combined berberine and probiotic treatment as an effective regimen for improving postprandial hyperlipidemia in type 2 diabetes patients: a double blinded placebo controlled randomized study
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Wang, Shujie, Ren, Huahui, Zhong, Huanzi, Zhao, Xinjie, Li, Changkun, Ma, Jing, Gu, Xuejiang, Xue, Yaoming, Huang, Shan, Yang, Jialin, Chen, Li, Chen, Gang, Qu, Shen, Liang, Jun, Qin, Li, Huang, Qin, Peng, Yongde, Li, Qi, Wang, Xiaolin, Zou, Yuanqiang, Shi, Zhun, Li, Xuelin, Li, Tingting, Yang, Huanming, Lai, Shenghan, Xu, Guowang, Li, Junhua, Zhang, Yifei, Gu, Yanyun, and Wang, Weiqing
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ABSTRACTNon-fasting lipidemia (nFL), mainly contributed by postprandial lipidemia (PL), has recently been recognized as an important cardiovascular disease (CVD) risk as fasting lipidemia (FL). PL serves as a common feature of dyslipidemia in Type 2 Diabetes (T2D), albeit effective therapies targeting on PL were limited. In this study, we aimed to evaluate whether the therapy combining probiotics (Prob) and berberine (BBR), a proven antidiabetic and hypolipidemic regimen via altering gut microbiome, could effectively reduce PL in T2D and to explore the underlying mechanism. Blood PL (120 min after taking 100 g standard carbohydrate meal) was examined in 365 participants with T2D from the Probiotics and BBR on the Efficacy and Change of Gut Microbiota in Patients with Newly Diagnosed Type 2 Diabetes (PREMOTE study), a random, placebo-controlled, and multicenter clinical trial. Prob+BBR was superior to BBR or Prob alone in improving postprandial total cholesterol (pTC) and low-density lipoprotein cholesterol (pLDLc) levels with decrement of multiple species of postprandial lipidomic metabolites after 3 months follow-up. This effect was linked to the changes of fecal Bifidobacterium brevelevel responding to BBR alone or Prob+BBR treatment. Four fadDgenes encoding long-chain acyl-CoA synthetase were identified in the genome of this B. brevestrain, and transcriptionally activated by BBR. In vitroBBR treatment further decreased the concentration of FFA in the culture medium of B. brevecompared to vehicle. Thus, the activation of fadDby BBR could enhance FFA import and mobilization in B. breveand diliminish the intraluminal lipids for absorption to mediate the effect of Prob+BBR on PL. Our study confirmed that BBR and Prob (B. breve) could exert a synergistic hypolipidemic effect on PL, acting as a gut lipid sink to achieve better lipidemia and CVD risk control in T2D.
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- 2022
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21. Diabetes-related metabolic risk factors in internal migrant workers in China: a national surveillance study
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Bi, Yufang, Wang, Limin, Xu, Yu, Jiang, Yong, He, Jiang, Zhang, Mei, Zhou, Maigeng, Li, Yichong, Xu, Min, Lu, Jieli, Wang, Tiange, Ding, Lin, Dai, Meng, Zhang, Di, Chen, Chung-Shiuan, Lai, Shenghan, Wang, Weiqing, Wang, Linhong, and Ning, Guang
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Little is known about the cardiometabolic health of internal migrant workers in China. We aimed to examine the prevalence of diabetes-related cardiometabolic risk factors in this large, but little-studied population.
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- 2016
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22. Diabetes Genetic Risk Score Modifies Effect of Bisphenol A Exposure on Deterioration in Glucose Metabolism
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Bi, Yufang, Wang, Weiqing, Xu, Min, Wang, Tiange, Lu, Jieli, Xu, Yu, Dai, Meng, Chen, Yuhong, Zhang, Di, Sun, Wanwan, Ding, Lin, Chen, Ying, Huang, Xiaolin, Lin, Lin, Qi, Lu, Lai, Shenghan, and Ning, Guang
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Context:Epidemiology studies showed inconsistent results regarding the relationship between bisphenol A (BPA) exposure and risk of type 2 diabetes (T2D).Objective:This study sought to prospectively investigate associations of BPA with incident T2D risk and the longitudinal changes in glycemic traits, particularly examining the interaction between gene and BPA exposure on the associations.Design, Setting, and Participants:A community-based study was conducted at baseline in 2009, including 2209 nondiabetic middle-age and elderly subjects followed for 4 y. Urinary BPA levels were measured at baseline. A genetic risk score (GRS) based on 34 T2D common variants that identified and validated in East Asians was created.Main Outcome Measures:Incident T2D was defined according to the 1999 World Health Organization criteria. Fasting (FPG) and 2-h post-loading plasma glucose were measured at baseline and followup.Results:Multivariable logistic regression analysis demonstrated no significant association of risk of incident T2D with BPA while with increase in the weighted T2D-GRS (odds ratio, 1.89; 95% confidence interval, 1.31–2.72 for each 10-point increment). Similar results were found in 4-y changes of FPG and 2-h post-loading plasma glucose. The GRS modified the effect of BPA exposure on 4-y changes in FPG (Pfor interaction = .01). Each 1 unit of Log_BPA was associated with 0.1 mmol/L increase in FPG (P= .007) in the highest quartile of GRS; no associations were found in the lower three quartiles of GRS.Conclusions:The T2D genetic susceptibility significantly modulated the association of BPA exposure with longitudinal increase in FPG levels.
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- 2016
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23. Coronary Plaque Burden at Coronary CT Angiography in Asymptomatic Men and Women
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Rodriguez, Karen, Kwan, Alan C., Lai, Shenghan, Lima, João A. C., Vigneault, Davis, Sandfort, Veit, Pattanayak, Puskar, Ahlman, Mark A., Mallek, Marissa, Sibley, Christopher T., and Bluemke, David A.
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Total and noncalcified plaque indexes were associated with Framingham Risk Score and the 2013 American Heart Association risk score in asymptomatic individuals.
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- 2015
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24. Amino acids, microbiota-related metabolites, and the risk of incident diabetes among normoglycemic Chinese adults: Findings from the 4C study
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Wang, Shuangyuan, Li, Mian, Lin, Hong, Wang, Guixia, Xu, Yu, Zhao, Xinjie, Hu, Chunyan, Zhang, Yi, Zheng, Ruizhi, Hu, Ruying, Shi, Lixin, Du, Rui, Su, Qing, Wang, Jiqiu, Chen, Yuhong, Yu, Xuefeng, Yan, Li, Wang, Tiange, Zhao, Zhiyun, Liu, Ruixin, Wang, Xiaolin, Li, Qi, Qin, Guijun, Wan, Qin, Chen, Gang, Xu, Min, Dai, Meng, Zhang, Di, Tang, Xulei, Gao, Zhengnan, Shen, Feixia, Luo, Zuojie, Qin, Yingfen, Chen, Li, Huo, Yanan, Li, Qiang, Ye, Zhen, Zhang, Yinfei, Liu, Chao, Wang, Youmin, Wu, Shengli, Yang, Tao, Deng, Huacong, Zhao, Jiajun, Lai, Shenghan, Mu, Yiming, Chen, Lulu, Li, Donghui, Xu, Guowang, Ning, Guang, Wang, Weiqing, Bi, Yufang, and Lu, Jieli
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Although previous studies suggest that amino acids (AAs) and microbiota-related metabolites (MRMs) are associated with type 2 diabetes mellitus (T2DM), the results remain unclear among normoglycemic populations. We test 28 serum AAs and 22 MRMs in 3,414 subjects with incident diabetes and matched normoglycemic controls from the China Cardiometabolic Disease and Cancer Cohort (4C) Study. In fully adjusted logistic regression models, per SD increment of branched-chain AAs, aromatic AAs, asparagine, alanine, glutamic acid, homoserine, 2-aminoadipic acid, histidine, methionine, and proline are positively associated with incident T2DM. In the MRM panel, serum carnitines, N-acetyltryptophan, and uric acid are positively associated with incident T2DM. Causal mediation analyses indicate 34 significant causal mediation linkages, with 88.2% through obesity and lipids. Variances explained in the serum metabolites are modestly limited in the comprehensive catalog of risk factor–metabolite–diabetes associations. These findings reveal that systematic AAs and MRMs change profile before T2DM onset and support a potential role of metabolic alterations in the pathogenesis of diabetes.
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- 2022
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25. Cocaine Abstinence and Reduced Use Associated With Lowered Marker of Endothelial Dysfunction in African Americans: A Preliminary Study
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Lai, Hong, Stitzer, Maxine, Treisman, Glenn, Moore, Richard, Brinker, Jeffrey, Gerstenblith, Gary, Kickler, Thomas S., Li, Ji, Chen, Shaoguang, Fishman, Elliot, and Lai, Shenghan
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- 2015
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26. Chronic Cocaine Use and Its Association With Myocardial Steatosis Evaluated by 1H Magnetic Resonance Spectroscopy in African Americans
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Lai, Shenghan, Gerstenblith, Gary, Li, Ji, Zhu, Hong, Bluemke, David A., Liu, Chia-Ying, Zimmerman, Stefan L., Chen, Shaoguang, Lai, Hong, and Treisman, Glenn
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Cardiac steatosis is a manifestation of ectopic fat deposition and is associated with obesity. The impact of chronic cocaine use on obesity measures and on the relationship between obesity measures and cardiac steatosis is not well-characterized. The objectives of this study were to compare obesity measures in chronic cocaine users and nonusers, and to explore which factors, in addition to obesity measures, are associated with myocardial triglyceride in African Americans, using noninvasive magnetic resonance spectroscopy.
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- 2015
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27. Urinary bisphenol a concentration and thyroid function in Chinese adults.
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Wang, Tiange, Lu, Jieli, Xu, Min, Xu, Yu, Li, Mian, Liu, Yu, Tian, Xiaoguang, Chen, Yuhong, Dai, Meng, Wang, Weiqing, Lai, Shenghan, Bi, Yufang, and Ning, Guang
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- 2013
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28. Increased left ventricular mass and decreased left ventricular systolic function have independent pathways to ventricular arrhythmogenesis in coronary artery disease.
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Reinier, Kyndaron, Dervan, Celia, Singh, Tejwant, Uy-Evanado, Audrey, Lai, Shenghan, Gunson, Karen, Jui, Jonathan, and Chugh, Sumeet S.
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Background: Following myocardial infarction, individual patients can have wide variations in the extent of left ventricular systolic dysfunction (LVSD) and increased left ventricular (LV) mass. Both affect the risk for sudden cardiac death, but only LV ejection fraction is used for risk prediction. Objective: The purpose of this study was to evaluate the independent as well as the additive contributions of increased LV mass and decreased LV ejection fraction to sudden cardiac death in the general population. Methods: In the ongoing Oregon Sudden Unexpected Death Study, we studied consecutive SCD cases (n = 191) and coronary artery disease controls (n = 203) from the Portland, Oregon, metropolitan area (population approximately 1,000,000; 2002–2008). Comparisons of echocardiographic LV mass obtained prior and unrelated to sudden cardiac death (SCD) were conducted, and a logistic regression model was used to evaluate the relationship between SCD, severe LVSD, LV mass, and other relevant clinical variables. Results: In a multivariate model, both severe LVSD and left ventricular hypertrophy (LVH) were associated with increased SCD risk (odds ratio [OR] 1.9, 95% confidence interval [CI] 1.1–3.2 for severe LVSD; OR 1.8, 95% CI 1.1–2.9 for LVH). In patients with coexisting severe LVSD and LVH, risk of SCD was additive (OR 3.5, 95% CI 1.7–7.2). In the same model, increased age, atrial fibrillation/flutter, elevated creatinine, and diabetes independently increased risk, and use of angiotensin receptor blockers attenuated risk. Conclusion: Reduced LV ejection fraction and increased LV mass had independent and additive effects on risk of sudden death. Despite the significant overlap between the two conditions, these findings point toward the existence of independent mechanistic pathways for ventricular arrhythmias that occur due to LVSD and LVH. [Copyright &y& Elsevier]
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- 2011
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29. HIV, HCV, and HBV Co-Infections in a Rural Area of Shanxi Province with a History of Commercial Blood Donation.
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DONG, RuiLing, QIAO, XiaoChun, JIA, WangQian, WONG, Michelle, QIAN, HanZhu, ZHENG, XiWen, XING, WenGe, LAI, ShengHan, WU, ZhengLai, JIANG, Yan, and WANG, Ning
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Abstract: Background: Unhygienic blood collection in the early 1990s led to blood-borne infections in Central China. This study aimed to estimate human immunodeficiency virus (HIV) co-infection with hepatitis C and B viruses (HCV and HBV) and their risk factors in a rural area of Shanxi Province with a history of commercial blood donation. Methods: A cross-sectional study was conducted in 2004. All adult residents in the target area were invited to participate in the study. Face-to-face interviews were completed and blood specimens were tested for HIV, HCV, and HBV surface antigen (HBsAg). Results: Prevalence rates of HIV, HCV, and HBsAg were 1.3% (40/3 062), 12.7% (389/3 062), and 3.5% (103/2982), respectively. Of the 40 HIV-positive specimens, 85% were HCV positive and 2.5% were HBsAg positive. The history of commercial blood donation was positively associated with HIV, HCV, and HIV/HCV co-infections, but was negatively associated with HBsAg seropositivity. Migration for employment in the last 5 years was positively related to HIV, HBsAg, and HIV/HCV co-infections. Univariate logistic analysis showed that illegal drug use, number of sex partners, extramarital sex behavior, commercial sex behavior, and condom use rate were not related to anti-HIV, anti-HCV, HBsAg seropositivity or their co-infections. Conclusion: The history of commercial blood donation was the main risk factor for HIV, HCV, and HIV/HCV co-infections in this former commercial blood donation area. HIV and HCV prevention and treatment interventions are important in this area. [Copyright &y& Elsevier]
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- 2011
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30. HIV and Coronary Atherosclerosis: Research Separates Association from Causation
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Lai, Shenghan
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- 2021
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31. Failure in short-term prediction of ventricular tachycardia and ventricular fibrillation from continuous electrocardiogram in intensive care unit patients.
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Sachdev, Molly, Fetics, Barry J., Lai, Shenghan, Dalal, Darshan, Insel, Jerald, and Berger, Ronald D.
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Abstract: Background: Patients in the intensive care unit (ICU) setting are prone to malignant ventricular arrhythmias. We sought to test whether electrocardiographic (ECG) markers of autonomic tone, ventricular irritability, and repolarization lability could be used in short-term prediction of ventricular arrhythmias in this patient population. Methods: We studied 38 patients with sustained (>30 seconds) monomorphic ventricular tachycardia, polymorphic ventricular tachycardia, or ventricular fibrillation while monitored in the ICU and 30 patients without arrhythmia in the ICU who served as controls. All patients had at least 12 hours of continuously recorded multilead ECG before arrhythmic event. Mean heart rate and measures of heart rate variability, QT variability, and ventricular ectopy were quantified in 1-hour epochs for the 12 hours before the arrhythmic event and in 5-minute epochs for the last hour preevent (and using a random termination time point in controls). Results: A modest downward trend in QT variability and a rise in heart rate were observed hours before polymorphic ventricular tachycardia and ventricular fibrillation events, although no significant changes heralded monomorphic ventricular tachycardia and no changes in any parameter predicted imminent ventricular arrhythmia of any type. There were no significant differences in ECG parameters between arrhythmia patients and controls. Conclusions: In ICU patients, sustained ventricular arrhythmias are not preceded by change in ECG measures of autonomic tone, repolarization variability, and ventricular ectopy. Short-term arrhythmia prediction may be difficult or impossible in this patient population based on ECG measures alone. [ABSTRACT FROM AUTHOR]
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- 2010
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32. Risk factor associations with the presence of a lipid core in carotid plaque of asymptomatic individuals using high-resolution MRI: the multi-ethnic study of atherosclerosis (MESA).
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Wasserman BA, Sharrett AR, Lai S, Gomes AS, Cushman M, Folsom AR, Bild DE, Kronmal RA, Sinha S, Bluemke DA, Wasserman, Bruce A, Sharrett, A Richey, Lai, Shenghan, Gomes, Antoinette S, Cushman, Mary, Folsom, Aaron R, Bild, Diane E, Kronmal, Richard A, Sinha, Shantanu, and Bluemke, David A
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- 2008
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33. Regional diastolic dysfunction in individuals with left ventricular hypertrophy measured by tagged magnetic resonance imaging—The Multi-Ethnic Study of Atherosclerosis (MESA).
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Edvardsen, Thor, Rosen, Boaz D., Pan, Li, Jerosch-Herold, Michael, Lai, Shenghan, Hundley, W. Gregory, Sinha, Shantanu, Kronmal, Richard A., Bluemke, David A., and Lima, João A.C.
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CONGESTIVE heart failure ,CARDIAC arrest ,DIAGNOSTIC imaging ,HEART failure - Abstract
Background: Impairment of global diastolic function is considered to be the mechanism of congestive heart failure in individuals with preserved systolic left ventricular (LV) function. Left ventricular hypertrophy (LVH) is known to be a risk factor for congestive heart failure with preserved systolic function, and this process may begin as a regional process. We investigated whether regional LV diastolic function measured by magnetic resonance tagging is altered in asymptomatic participants of the MESA with LVH and preserved systolic LV function. Methods: Regional systolic and diastolic strain rates were calculated from strain data in 218 participants of the MESA study. Circumferential strain was calculated from the midwall layer of the septum, anterior, lateral, and inferior walls at mid-LV level. Global LV function measures were studied by magnetic resonance imaging in 4291 MESA participants. Left ventricular hypertrophy for men and women was defined from the MESA population using previously established Framingham criteria. Results: Global systolic function was slightly less in the LVH (ejection fraction = 0.66 ± 0.10) versus the non-LVH group (ejection fraction = 0.69 ± 0.07, P < .001). Stepwise regression analyses showed a direct relationship between regional diastolic dysfunction and increasing LV mass. Regional systolic strain and strain rate measures from participants with LVH were not significantly different from those without LVH. However, regional diastolic strain rate was significantly reduced in participants with LVH (1.5 ± 1.1 s
−1 ) compared with the non-LVH group (2.2 ± 1.1 s−1 , P < .001) regardless of age or sex. Conclusions: Left ventricular hypertrophy is associated with regional diastolic dysfunction in individuals without evidence of clinical cardiovascular disease and preserved systolic function. Magnetic resonance imaging tagging provides detailed quantification of regional diastolic function noninvasively. [Copyright &y& Elsevier]- Published
- 2006
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34. Drug treatment, health, and social service utilization by substance abusing women from a community-based sample.
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Hansen H, Alegria M, Cabán CA, Peña M, Lai S, Shrout P, Hansen, Helena, Alegría, Margarita, Cabán, Carmen Ana, Peña, Marisol, Lai, Shenghan, and Shrout, Patrick
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Background: Substance abuse is an escalating problem among poor urban Latina women; little is known about their access to drug treatment and to needed social and health services.Objective: Our objectives were to (1) examine the need and use of substance abuse treatment, health services, government entitlement programs, and social service programs among cocaine and heroin using Puerto Rican women and (2) identify whether service use predicts their prospective entry into drug treatment.Research Design: This was a 3-wave longitudinal study of community substance abusing women evaluated on substance abuse and dependence using diagnostic measures, and hair and urine toxicological screens. Information was collected on self-reported need and receipt of substance abuse treatment, social services, general health services, and government entitlement programs.Subjects: A community sample of cocaine-, crack-, and/or heroin-using women from copping areas in low-income urban centers of Puerto Rico were interviewed in 1997-1998 with 2 follow-up periods.Results: Drug treatment, health, and social service utilization were low relative to need for services throughout all data waves. Social service utilization predicted prospective entry into drug treatment but not contacts with general health services or government entitlement programs.Conclusion: Drug-abusing women in low-income urban areas in Puerto Rico have substantial unmet substance abuse treatment, health, and social service needs. Mandated treatment by social service agencies may explain their clients' higher likelihood of entering drug treatment. Building linkages between service sectors to augment entry into drug treatment is essential for meeting the complex needs of this underserved population. [ABSTRACT FROM AUTHOR]- Published
- 2004
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35. Understanding caregivers' help-seeking for Latino children's mental health care use.
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Alegria M, Canino G, Lai S, Ramirez RR, Chavez L, Rusch D, Shrout PE, Alegría, Margarita, Canino, Glorisa, Lai, Shenghan, Ramirez, Rafael R, Chavez, Ligia, Rusch, Dana, and Shrout, Patrick E
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Background: Latino children have persistent low rates of mental health service use. Understanding the factors that influence caregivers' decisions about whether to use mental health care for their children can help explain why.Objective: The objective of this study was to investigate the factors reported by the primary caregiver that could help classify Puerto Rican children into users versus nonusers of mental health services and mental health versus school sector care, among users.Subjects: Data were collected from a random Puerto Rican community sample of caregiver-child dyads.Measures: Version-IV of the Computerized Diagnostic Interview for Children (DISC) was used to assess psychiatric disorders in children. The Service Assessment for Children and Adolescents (SACA) was used to examine the types of services used for mental health problems.Statistical Methods: The Classification and Regression Tree (CART) approach was used to develop a simple model simulating caregivers' decision-making around taking children for mental health care and the setting for care.Results: The classification model of use versus no use of mental health service suggested 3 significant predictors: child's level of impairment, parental concern, and child's difficulty in performing schoolwork. The classification model of sector of care, mental health versus school setting, identified 1 significant predictor, any disruptive disorder diagnosis.Conclusion: : Assisting caregivers in linking a child's impairment with need for mental health care might be a mechanism to reduce children's unmet need. Approaches such as CART, used to identify factors predicting consumer choices in marketing, might be useful to select strategies for social campaigns targeted toward decreasing unmet need. [ABSTRACT FROM AUTHOR]- Published
- 2004
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36. Urinary Bisphenol A Concentration and Thyroid Function in Chinese Adults
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Wang, Tiange, Lu, Jieli, Xu, Min, Xu, Yu, Li, Mian, Liu, Yu, Tian, Xiaoguang, Chen, Yuhong, Dai, Meng, Wang, Weiqing, Lai, Shenghan, Bi, Yufang, and Ning, Guang
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Bisphenol A (BPA) is an endocrine disruptor that in animal studies can bind to the thyroid hormone receptor and affect thyroid function. Relevant epidemiologic studies are limited and results are inconsistent. We explored the relationship between urinary BPA and thyroid function in a Chinese population.
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- 2013
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37. Vitamin D Deficiency is Associated with the Development of Subclinical Coronary Artery Disease in African Americans with HIV Infection: A Preliminary Study
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Lai, Hong, Detrick, Barbara, Fishman, Elliot K., Gerstenblith, Gary, Brinker, Jeffrey A., Hollis, Bruce W., Bartlett, John, Cofrancesco, Joseph, Tong, Wenjing, Tai, Hong, Chen, Shaoguang, Bhatia, Sandeepan, and Lai, Shenghan
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Background Premature coronary artery disease (CAD) is a major concern in human immunodeficiency virus (HIV)-infected African Americans. The objectives of the study were to estimate the incidence of subclinical CAD, defined by the presence of coronary plaque and/or calcification on cardiac computed tomography (CT), and to identify the associated risk factors in this vulnerable population.Subjects and Methods Between August 2003 and September 2010, 188 HIV-infected African Americans without known, or symptoms of, CAD underwent cardiac CT. The subset without demonstrable disease underwent a second cardiac CT approximately 2 years later. The incidence of disease over that period and the effects of antiretroviral treatment and other known and hypothesized risk factors were investigated.Results Sixty-nine of these 188 African Americans had evidence of subclinical disease on the initial cardiac CT, confirming prior high prevalence reports. A second cardiac CT was performed on 119 African Americans without disease approximately 2 years later. The total person-years of follow-up was 284.4. Subclinical CAD was detected in 14 of these, yielding an overall incidence of 4.92/100 person-years (95% confidence interval, 2.69–8.26). Among the factors investigated, only male sex and vitamin D deficiency were independently associated with the development of subclinical CAD. The study did not find significant associations between CD4 count, HIV viral load, antiretroviral treatment use, or cocaine use and the incidence of subclinical CAD.Conclusions The incidence of subclinical CAD in African Americans with HIV infection is provocatively high. Larger studies are warranted to confirm the role of vitamin D deficiency in the development of CAD in HIV-infected African Americans.
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- 2012
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38. Multiple imputation for missing cardiac magnetic resonance imaging data: Results from the Multi-Ethnic Study of Atherosclerosis (MESA)
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Chris Delaney, Joseph A., McClelland, Robyn L., Brown, Elizabeth, Bluemke, David A., Vogel-Claussen, Jens, Lai, Shenghan, and Heckbert, Susan R.
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Cardiac magnetic resonance imaging (MRI) is a non-invasive technique used to accurately and reproducibly measure biological parameters such as left ventricular mass. However, some subjects either refuse or are unable to complete testing, and the impact of excluding these missing data from predictive models is unknown.
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- 2009
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39. Abstract 12563: The Trajectory of Platelet Factor 4 in Acute Myocardial Infarction and the Impact of PCSK9-Inhibition
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Ziogos, Efthymios, Williams, Marlene S, Vavuranakis, Michael, Blaha, Michael J, Jones, Steven R, Schulman, Steven P, Lai, Shenghan, Gerstenblith, Gary, and Leucker, Thorsten M
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Introduction:Increased platelet activity during the peri- and early post-infarction period may contribute to adverse outcomes during that time. Platelet factor 4 (PF4) promotes coagulation and inflammation. The trajectory of PF4 and the impact of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition on that trajectory are unknown.Hypothesis:Early administration of the PCSK9 inhibitor evulocumab, added to dual anti-platelet therapy, inhibits a rise in PF4 during the early post-infarction period.Methods:Participants from the Evolocumab in Acute Coronary Syndrome trials (EVACS; NCT03515304, NCT04082442), with a NSTEMI and a troponin-I of >5 ng/ml or a STEMI were randomized to placebo or to 420 mg SQ of evolocumab within 24 hours of hospitalization. We performed serial ex vivo serum PF4 levels obtained at baseline (prior to study drug administration), and at days 1 and 30 and PF4 values were normalized to total platelet count. Normally distributed data were summarized using means and standard deviations and non-normally distributed data using medians and interquartile ranges.Results:Twenty-three participants were randomized to placebo and 23 to evolocumab. Mean age was 60±13 years, 48% were women, 22% were African American and 96% were on dual anti platelet therapy. Baseline PF4 concentrations (expressed as ng/1k platelets) did not differ between the two groups (placebo: 9.3 [4-12] vs evolocumab 8.0 [4-12], p=0.8). There was no significant change in PF4 in the placebo group from baseline to day 1 but a significant increase to 13.0 [11-14], p<0.01 (baseline vs 30 days) at 30 days (+32%). In contrast, there were no significant changes from baseline in the evolocumab group at either of the timepoints. At 30 days PF4 was higher in the placebo group 13.06 [11-14] than the evolocumab group 10.7 [6-13], p=0.04. Further analysis of results in the evolocumab group did not show any significant changes in PF4 based on the type of P2Y12 inhibitor used and no association with the change in LDL-cholesterol.Conclusion:A rise in PF4 levels was observed during the early post-infarction period in acute myocardial infarction patients. This rise was reversed by a single 420 mg SQ dose of evolocumab administered within 24 hours of hospital admission.
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- 2021
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40. Risk Factor Associations With the Presence of a Lipid Core in Carotid Plaque of Asymptomatic Individuals Using High-Resolution MRI
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Wasserman, Bruce A., Sharrett, A Richey, Lai, Shenghan, Gomes, Antoinette S., Cushman, Mary, Folsom, Aaron R., Bild, Diane E., Kronmal, Richard A., Sinha, Shantanu, and Bluemke, David A.
- Abstract
Atheroma vulnerability to rupture is increased in the presence of a large lipid core. Factors associated with a lipid core in the general population have not been studied.
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- 2008
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41. Mortality in Florida professional firefighters, 1972 to 1999
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Ma, Fangchao, Fleming, Lora E., Lee, David J., Trapido, Edward, Gerace, Terence A., Lai, Hong, and Lai, Shenghan
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- 2005
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42. Drug Treatment, Health, and Social Service Utilization by Substance Abusing Women From a Community-Based Sample
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Hansen, Helena, Alegría, Margarita, Cabán, Carmen Ana, Peña, Marisol, Lai, Shenghan, and Shrout, Patrick
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Substance abuse is an escalating problem among poor urban Latina women; little is known about their access to drug treatment and to needed social and health services.
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- 2004
43. Understanding Caregivers’ Help-Seeking for Latino Children's Mental Health Care Use
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Alegría, Margarita, Canino, Glorisa, Lai, Shenghan, Ramirez, Rafael R., Chavez, Ligia, Rusch, Dana, and Shrout, Patrick E.
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Latino children have persistent low rates of mental health service use. Understanding the factors that influence caregivers’ decisions about whether to use mental health care for their children can help explain why.
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- 2004
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44. Spectrum of p53 Tumor Suppressor Gene Mutations and Breast Cancer Survival
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Lai, Hong, Ma, Fangchao, Trapido, Edward, Meng, Lou, and Lai, Shenghan
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Context. p53 mutation is associated with poor prognosis in breast cancer patients. Mutations in different structural and functional domains of p53 have different effects on its biological activities. Nevertheless, few studies have examined the full spectrum of p53 gene mutations in relation to breast cancer survival. Objective. To evaluate the prognostic significance of the types, localizations, and multiplicity of p53 gene mutations in breast cancer patients. Design, setting, and participants. Prospective cohort study of a consecutive series of 271 women with histologically confirmed primary breast cancer who underwent breast resection at the Jackson Memorial Hospital, Miami, FL, between 1984 and 1986. Main outcome measures. Ten year overall and breast-cancer-specific deaths. Results. After adjustment for tumor stage, treatment regimen, and the number of mutations, patients with p53 mutations had significantly greater breast-cancer-specific mortality than did patients without p53 mutations (hazard ratio = 2.86; 95% confidence interval: 1.15–7.11). Further analysis of mutation characteristics showed that patients with the following mutations had significantly poorer breast cancer disease-free survival: silent/missense mixed mutations (7.95; 1.28–49.62), nonsense mutations (9.43; 1.29–69.12), transitions (3.79; 1.46–9.88), mutations in which guanine changed (3.32; 1.01–10.35), and mutations on exon 7 (6.46; 1.78–23.45). Conclusions. Breast-cancer-specific and all-cause mortality are increased in female breast cancer patients with the following p53 mutation characteristics: silent and missense mixed mutations, transitional mutations, mutations in which guanine changed, mutations on exon 7, or multiple mutations occurring within 60 codons. These findings indicate that not just p53 mutation per se but the full spectrum (i.e., different types, locations, and numbers) of p53 mutation needs to be examined when it is used as a prognostic marker of survival in breast cancer patients.
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- 2004
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45. Characterization of HIV Type 1 Heterosexual Transmission in Yunnan, China
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Yu, Xiao-Fang, Wang, Xueren, Mao, Penyong, Wang, Shiyi, Li, Zong, Zhang, Jinbing, Garten, Rebecca, Kong, Wei, and Lai, Shenghan
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The earliest HIV-1 epidemic in China started in Yunnan province, which continues to be one of the most severe areas affected. While HIV-1 infections are spreading rapidly among injection drug users (IDUs) in China, sexual transmission of HIV-1 has also been confirmed, threatening the general population. Recent survey data indicated that heterosexual transmission of HIV-1 in Yunnan was steadily increasing. Diverse HIV-1 strains, including subtype B, C, CRF01, and CRF08, are circulating among individuals who acquired HIV through sexual contacts. Multiple HIV-1 subtypes, including subtypes B, C, and CRF08, were also detected among IDUs. In comparison with other IDU cohorts, intersubject env sequence variation was much higher among IDUs in Yunnan. Growing evidence suggests that unprotected sex continues to occur at high rates among IDUs and their sex partners. Intervention strategies are urgently needed to target individuals at high risk for HIV heterosexual transmission and injection drug use. The complex pattern of HIV-1 distribution in the high-risk populations in Yunnan may have important implications for HIV transmission as well as vaccine development and evaluation.
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- 2003
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46. Pediatric neurobehavioral diseases in Nevada counties with respect to perchlorate in drinking water: An ecological inquiry
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Chang, Soju, Crothers, Carol, Lai, Shenghan, and Lamm, Steven
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Contamination of drinking water with perchlorate, a known thyrotropic agent, has been demonstrated in areas in the western United States. The health consequences of that exposure have been studied, particularly in the State of Nevada. Previous studies in Nevada, comparing the area with perchlorate in the drinking water and the areas without perchlorate in the drinking water, have found no difference in neonatal thyroxine (T4) or thyrotropin (TSH) levels, or in the prevalences of thyroid diseases and thyroid cancer. This same study design has now been applied to the major neurobehavioral diseases of childhood (i.e., attention deficit‐hyperactivity disorder (ADHD) and autism) and to school performance in order to determine whether those conditions are more frequent in the area with perchlorate‐contaminated water.Medical services data on ADHD and autism were obtained from the Nevada Medicaid system for the period of January 1, 1996, to December 31, 2000, with county of residence used as the basis for residential information. Analyses of fourth‐grade school performance results for two recent time periods came from the state government. Perchlorate concentrations in drinking water had been determined by local water authorities. ADHD and autism rates for the area with perchlorate in the drinking water (Clark County) were calculated and compared with the rates for the other areas in the state, as were fourth‐grade school performances.Analysis of the data from the Nevada Medicaid program shows that the rates for ADHD and for autism in the area where perchlorate was in the drinking water did not exceed the rates in those areas where there was no perchlorate contamination in the drinking water. Fourth‐grade standardized test results for students in Clark County were not different from those of the remainder of the state.This ecological study of children in the exposure area did not find evidence of an increased risk of either ADHD or of autism caused by perchlorate contamination in the drinking water. Furthermore, no difference in overall fourth‐grade school performance was observed. No evidence was found that children from the area with perchlorate in the drinking water (up to 24 μg/liter) had either an increase in pediatric neurobehavioral disease (ADHD and autism) or a decrease in fourth‐grade academic performance. The limitations of this ecological study relate to diagnostic criteria and ascertainment of geographic and demographic differences and to data on individual residence and water consumption during pregnancy. Birth Defects Research (Part A), 2003. © 2003 Wiley‐Liss, Inc.
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- 2003
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47. Prevalence and Spectrum of p53 Mutations in White Hispanic and Non-Hispanic Women with Breast Cancer
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Lai, Hong, Lai, Shenghan, Ma, Fangchao, Meng, Lou, and Trapido, Edward
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Hispanic women differ from non-Hispanics in breast cancer incidence, stage at diagnosis, and survival. Ethnic differences in genetic makeup, reproductive patterns, diet, socioeconomic status, physical activity, and other unidentified cultural factors may be responsible for the disparity. This study investigated occurrences of p53 tumor suppressor gene mutations in South Florida white Hispanic and white non-Hispanic women with primary breast cancer. Tumor tissues were obtained from a consecutive series of women with breast cancer who underwent breast resection at the Jackson Memorial Hospital, Miami, Florida between 1984 and 1986. A total of 231 women with primary breast cancer, aged 31–85 years, were included in the study. Among them, 64 (27.7%) were white Hispanic and 167 (72.3%) were white non-Hispanic. The majority of the patients were white non-Hispanics (72.3%). Compared to white non-Hispanics, however, white Hispanics had significantly higher proportions of tumors larger than 2 cm (53.1% v.s. 28.7%, p= 0.00) as well as larger tumor size at diagnosis (mean: 4.2 v.s. 3.0 cm, p= 0.00). The p53 gene mutation rate was significantly lower in white Hispanics than in white non-Hispanics (51.6% v.s. 70.7%, p= 0.01). Furthermore, among node-negative breast cancer patients, after adjustment for tumor size at diagnosis, logistic regression results showed that white Hispanics were 71% less likely than white non-Hispanics to carry p53 mutations (OR = 0.29 and 95% CI = 0.09–0.91). We conclude that white Hispanic women with breast cancer might have lower p53 gene mutation prevalence than white non-Hispanic women.
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- 2003
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48. Lack of a Relation Between Human Neonatal Thyroxine and Pediatric Neurobehavioral Disorders
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Soldin, Offie Porat, Lai, Shenghan, Lamm, Steven H., and Mosee, Shiela
- Abstract
The growth and differentiation of the central nervous system are closely related to the presence of iodine and thyroid hormones. It has been hypothesized that neurobehavioral disabilities of childhood, such as attention deficit hyperactivity disorder (ADHD), learning disorders, and autism can be attributed to fetal thyroidal endocrine disruption in utero. To determine whether there is an association between neonatal thyroid status and a subsequent diagnosis of a neurobehavioral disability, neonatal thyroxine (T4) levels have been used as the indicator of the presence of intrauterine thyroidal dysfunction. Neonatal T4levels were obtained from the neonatal hypothyroidism screening program. All cases were diagnosed at medical school diagnostic clinics, the diagnostic categories being ADHD, autism spectrum disorder, behavioral disorder, cognitive disorder, developmental delay, emotional disorder, learning disability, and speech/language disorder. Conditional logistic regression analysis was performed for each clinical condition. Odds ratios for the conditions ranged from 0.92 to 1.13 with pvalues ranging between 0.19 and 0.84. No significant differences were detected between neonatal T4values of the cases and the controls for any of the neurobehavioral conditions. All neonatal T4values were within normal ranges. The data provide no evidence to suggest that intrauterine thyroid status as reflected by the neonatal T4values had an impact on the neurologic disorders diagnosed in childhood.
- Published
- 2003
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49. Maintaining Low HIV Type 1 Env Genetic Diversity among Injection Drug Users Infected with a B/C Recombinant and CRF01_AE HIV Type 1 in Southern China
- Author
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Yu, Xiao-Fang, Liu, Wei, Chen, Jie, Kong, Wei, Liu, Bindong, Zhu, Qiuying, Liang, Fuxiong, McCutchan, Francine, Piyasirisilp, Sucheep, and Lai, Shenghan
- Abstract
HIV-1 outbreaks in Guangxi Province, southern China were initiated from two separate border cities in 1996 and 1997. Drug users in Pingxiang City, which borders Vietnam, were infected with CRF01_AE HIV-1, and drug users in Baise City, which borders Yunan Province, were infected with a novel B/C recombinant HIV-1. Since 1997, HIV-1 has been rapidly spreading in Guangxi, including its capital city Nanning. Survey data indicated that HIV-1 prevalence among IDUs in new outbreak regions increased 8 to 42% within 1 year. The B/C recombinants obtained from five separate regions in Guangxi, which span a 4-year time frame, were remarkable for their low intersubject env V3 diversity, less than 0.2%. Similarly, the CRF01_AE from IDUs over a 3-year time frame had low intersubject env V3 diversity of less than 1.6%. Different patterns of sequence variations in the V3 and V4 regions were observed for the B/C recombinant and the CRF01_AE HIV1. The rapid spreading of homogeneous HIV-1 strains in Guangxi may have important implications for HIV transmission as well as vaccine development and evaluation.
- Published
- 2002
- Full Text
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50. Risk stratification in patients with remote prior myocardial infarction using rest-stress myocardial perfusion spect: prognostic value and impact on referral to early catheterization
- Author
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Zellweger, Michael, Dubois, Eric, Lai, Shenghan, Shaw, Leslee, Amanullah, Aman, Lewin, Howard, Friedman, John, Kang, Xingping, Germano, Guido, and Berman, Daniel
- Abstract
Abstract: Background: Little is known about the prognostic value of myocardial perfusion single photon emission computed tomography (SPECT) in patients with remote prior myocardial infarction (MI). Methods and Results: We identified 1413 consecutive patients with remote prior MI who underwent rest-stress myocardial perfusion SPECT. Semiquantitative visual analysis of 20 SPECT segments was used to define the summed stress, rest, and difference scores. The number of non-reversible segments was used as an index of infarct size. During follow-up (≥1 year), 118 hard events occurred: 64 cardiac deaths (CDs) and 54 recurrent MIs. Annual CD and hard event rates increased significantly as a function of SPECT abnormality. For summed stress scores less than 4, 4 to 8, 9 to 13, and more than 13, the annual CD rates were 0.4%, 0.9%, 1.7%, and 3.5%, respectively (P = .002). Patients with small MI (<4 non-reversible segments) and no or mild ischemia (summed difference score ≤6) had an annual CD rate of 0.6%. Patients with small MI and moderate or severe ischemia had an annual CD rate of 1.6%, and those with large MI (≥4 non-reversible segments) had moderate to high annual CD rates (3.7%-6.6%) regardless of the extent of ischemia. Nuclear testing added incremental prognostic information to pre-scan information. Compared with a strategy in which all patients are referred to catheterization, a strategy that referred only those patients with a risk for CD of greater than 1% by myocardial perfusion SPECT resulted in a 41.6% cost savings. Conclusions: Myocardial perfusion SPECT adds incremental value to pre-scan information and is highly predictive and cost-efficient in the risk stratification of patients with remote prior MI. Patients with normal or mildly abnormal scan results or small MI in combination with absent or mild ischemia have a low risk for CD.
- Published
- 2002
- Full Text
- View/download PDF
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