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3,356 results on '"Pollak A"'

1. TermEnsembler

Author

Vid Podpečan, Senja Pollak, Nada Lavrač, Anže Vavpetič, and Andraž Repar

Subjects
050101 languages & linguistics, Computer science, business.industry, Communication, 05 social sciences, Evolutionary algorithm, 02 engineering and technology, Library and Information Sciences, computer.software_genre, File format, Ensemble learning, Language and Linguistics, Domain (software engineering), Term (time), 0202 electrical engineering, electronic engineering, information engineering, 020201 artificial intelligence & image processing, 0501 psychology and cognitive sciences, Artificial intelligence, business, Language industry, computer, Natural language processing
Abstract

This paper describes TermEnsembler, a bilingual term extraction and alignment system utilizing a novel ensemble learning approach to bilingual term alignment. In the proposed system, the processing starts with monolingual term extraction from a language industry standard file type containing aligned English and Slovenian texts. The two separate term lists are then automatically aligned using an ensemble of seven bilingual alignment methods, which are first executed separately and then merged using the weights learned with an evolutionary algorithm. In the experiments, the weights were learned on one domain and tested on two other domains. When evaluated on the top 400 aligned term pairs, the precision of term alignment is over 96%, while the number of correctly aligned multi-word unit terms exceeds 30% when evaluated on the top 400 term pairs.

Published
2022
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2. Triadic agreement about advanced cancer treatment decisions: Perceptions among patients, families, and oncologists

Author

Pauline Lyna, Nick Bloom, Kathryn I. Pollak, Thomas W. LeBlanc, James A. Tulsky, Jennie A. Riley, and Karen E. Steinhauser

Subjects
Oncologists, Motivation, medicine.medical_specialty, Illness trajectory, Family caregivers, business.industry, media_common.quotation_subject, Decision Making, Regret, General Medicine, Decisional conflict, Advanced cancer, Cancer treatment, Caregivers, Neoplasms, Perception, Family medicine, medicine, Humans, Treatment decision making, business, media_common
Abstract

Objectives When patients make cancer treatment decisions, they consider the needs and preferences of family caregivers and clinicians. We examined how much all three triad members agreed about goals of treatment and caregivers’ influence on decision-making. Methods We surveyed 70 triads of patients, caregivers, and oncologists who had recently made an advanced cancer treatment decision. We assessed each triad member’s perception of the goal of treatment and the caregiver’s influence on the decision. Participants also completed scales related to decisional conflict, satisfaction, and regret. Results In only 28/70 triads (40%), all three agreed on the goal of treatment with the most common goal being to live longer (n = 22). Whereas patients and caregivers tended to think the goal was to cure or live longer, oncologists were less optimistic. In only 22 triads (31%), all three agreed on how much influence the caregiver had on decision-making. Oncologists tended to underestimate caregiver influence. Patients and caregivers had low decisional conflict (M=15.40, SD=4.51; M=17.09, SD=6.34, respectively). Conclusions Advanced cancer treatment decision-making occurs amid incomplete understanding among patients, caregivers, and oncologists. Practice implications Confirming agreement about goals of care and influence on treatment decision-making may increase the likelihood of goal-concordant care throughout the illness trajectory.

Published
2022
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4. Trajectories of Situational Temptations in Pregnant Smokers participating in a Scheduled Gradual Reduction Cessation Trial

Author

Kathryn I. Pollak, Devon Noonan, Danielle Kennedy, Laura J. Fish, Pauline Lyna, Santiago Bejarano Hernandez, and Xiaomei Gao

Subjects
Epidemiology, media_common.quotation_subject, Health Behavior, Craving, Temptation, Article, law.invention, Randomized controlled trial, Pregnancy, law, Intervention (counseling), Secondary analysis, medicine, Humans, Situational ethics, media_common, Motivation, Smokers, business.industry, Smoking, Public Health, Environmental and Occupational Health, Obstetrics and Gynecology, medicine.disease, Clinical trial, Pediatrics, Perinatology and Child Health, Female, Smoking Cessation, medicine.symptom, business, Clinical psychology
Abstract

OBJECTIVE The purpose of this paper was to examine changes in situational temptations to smoke among women in early to late pregnancy enrolled in a texting trial to help them quit smoking. We compared changes between (1) intervention arms, (2) those who quit, (3) those who reduced by 50% or more, and (4) those who reduced by less than 50%. We also examined cravings overtime in the intervention arm and the relationship between real-time cravings assessed via text message and situational temptations. METHODS This was a secondary analysis of the Baby Steps trial, a randomized controlled trial testing the efficacy of a text-based scheduled gradual reduction (SGR) intervention on cessation. We used t-tests to examine changes across intervention arms and repeated measured proc mixed to explore changes in situational temptations and cravings. RESULTS Among all women, situational temptations decreased from early to late pregnancy for the positive, negative, and habitual subscales, (ps

Published
2021
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5. Celiac Disease in Conjunction with Hereditary Fructose Intolerance as a Rare Cause of Liver Steatosis with Mild Hypertransaminasemia—A Case Report

Author

Natalia Kopiczko, Agnieszka Pollak, Anna Bobrus-Chociej, Marta Flisiak-Jackiewicz, Rafał Płoski, and Dariusz Marek Lebensztejn

Subjects
medicine.medical_specialty, Hereditary fructose intolerance, Dietary restrictions, Case Report, Disease, Gastroenterology, Pediatrics, RJ1-570, liver steatosis, Liver steatosis, Internal medicine, Medicine, In patient, Genetic testing, chemistry.chemical_classification, medicine.diagnostic_test, business.industry, hypertransaminasemia, medicine.disease, Gluten, chemistry, hereditary fructose intolerance, business, celiac disease
Abstract

Celiac disease (CD) has been associated with several genetic and autoimmune disorders, but its association with hereditary fructose intolerance (HFI) is very rare. The possibility of an association between CD and HFI should be considered, especially in patients with a lack of improvement after a gluten-free diet. Children with HFI often present with a wide range of symptoms, however, data about a strong aversion to fruits and sweets may be helpful to establish the diagnosis. The diagnosis of HFI should be confirmed in genetic testing. Both CD and HFI may present with liver steatosis with hypertransaminasemia. In patients with these two disorders, the dietary restrictions of gluten and fructose improve clinical symptoms and protect them from secondary complications. We report the case of a child with the concurrence of these two disorders.

Published
2021

6. Symptoms of Pediatric Feeding Disorders Among Individuals with 3q29 Deletion Syndrome: A Case-Control Study

Author

Jennifer G. Mulle, Scott Gillespie, Addam J. Wawrzonek, Rebecca M Pollak, Emory q, Teresa Lindsey Burrell, Melissa M. Murphy, and William G. Sharp

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Case-control study, medicine.disease, Food group, Psychiatry and Mental health, Autism spectrum disorder, Intervention (counseling), Pediatrics, Perinatology and Child Health, Failure to thrive, Developmental and Educational Psychology, Medicine, Feeding disorder, Early childhood, Global developmental delay, medicine.symptom, business
Abstract

OBJECTIVE The goal of this study was to evaluate symptoms of pediatric feeding disorder in a sample of individuals with 3q29 deletion syndrome (3q29Del). Previous research has found that individuals with 3q29Del may experience elevated feeding concerns in early childhood; however, the specificity of these feeding concerns is not well understood. METHODS We compared individuals with 3q29Del (N = 83) with controls (N = 59) using an 11-item survey that assessed commonly reported symptoms associated with pediatric feeding disorders. An exploratory analysis also examined individuals with 3q29Del with and without a comorbid global developmental delay (GDD) or an autism spectrum disorder diagnosis. RESULTS Caregivers of 3q29Del cases reported higher incidences of feeding concerns on 10 of the 11 items included in the survey. This included statistically significant differences in food refusal behaviors, rejection of 1 or more food groups, and a history of failure to thrive. Parents of children with comorbid GDD were more likely to report concerns regarding food selectivity and problem behaviors during mealtime. CONCLUSION The results suggest individuals with 3q29Del experience increased symptoms of pediatric feeding disorder that may require targeted evaluation and intervention for optimal outcomes. Future research should include a more thorough multidisciplinary evaluation to further elucidate symptom severity and optimal treatment strategies.

Published
2021
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8. Impact of Corticosteroids on Cardiopulmonary Bypass Induced Inflammation in Children: A Meta-Analysis

Author

Parker Nickerson, Paul A. Checchia, Rohit Loomba, Enrique G Villarreal, Ronald A. Bronicki, Saul Flores, Eric M. Graham, and Uri Pollak

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Subgroup analysis, Placebo, law.invention, Postoperative Complications, Adrenal Cortex Hormones, law, Cardiopulmonary bypass, Humans, Medicine, Prospective Studies, Child, Prospective cohort study, Randomized Controlled Trials as Topic, Inflammation, Mechanical ventilation, Cardiopulmonary Bypass, business.industry, Infant, Newborn, Infant, Confidence interval, Cardiac surgery, Treatment Outcome, Child, Preschool, Anesthesia, Meta-analysis, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract

Corticosteroids suppress the inflammatory response to cardiopulmonary bypass in children undergoing cardiac surgery. What is less clear is the impact of corticosteroids on the postoperative course.A systematic review and meta-analysis was made of prospective randomized blinded placebo-controlled trials of pediatric patients who received corticosteroids or saline placebo before surgery was performed. Ten studies met inclusion criteria for a total of 768 patients. In a prespecified subgroup analysis, studies that either were limited to The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery congenital heart surgery mortality categories 1 and 2 or excluded neonates were eliminated and a secondary analysis was conducted, which consisted of seven studies and 555 patients.Corticosteroids were associated with a significant improvement in fluid balance at 24 and 36 hours after surgery, with a mean difference of -15.2 mL/kg (95% confidence interval, 25.3 to -5.1 mL/kg; P.01) and -5.7 mL/kg (95% confidence interval, -9.8 to -1.6 mL/kg; P.01), respectively. Corticosteroids had no impact on the incidence of infection or mortality. With the secondary analysis, corticosteroids were associated with a trend toward significance in shortening the duration of mechanical ventilation (mean difference -0.7 days; 95% confidence interval, -1.7 to 0.1; P = .08).Corticosteroids were found to have a favorable impact on postoperative fluid balance and may be associated with shortening the duration of mechanical ventilation. Although corticosteroids had no impact on mortality, they may be beneficial particularly for neonates and patients undergoing highly complex surgery.

Published
2021
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9. Unilateral mimicking bilateral BPPV- a forgotten entity? Characteristics of a large cohort of patients, comparison with posterior canal BPPV and clinical implications

Author

Lea Pollak, Ronit Gilad, and Tal Michael

Subjects
Pediatrics, medicine.medical_specialty, Benign paroxysmal positional vertigo, Demographics, business.industry, Vestibular disorders, medicine.disease, Canalo- and cupulolithiasis, Large cohort, 03 medical and health sciences, 0302 clinical medicine, Otorhinolaryngology, RF1-547, medicine, otorhinolaryngologic diseases, sense organs, 030223 otorhinolaryngology, business, 030217 neurology & neurosurgery, Research Article
Abstract

Objective Unilateral mimicking bilateral benign paroxysmal positional vertigo (umb-BPPV) was attributed to inappropriate head positioning during testing of the posterior canal. Despite its inclusion in the Diagnostic criteria for the classification of vestibular disorders of the Barany Society, the clinical characteristics and treatment responsiveness of this BPPV subtype have not been intensively studied. Methods Records of patients with BPPV seen at a single outpatient dizziness clinic during the years 2000-2020 were reviewed. Eighty seven patients with umb-BPPV and 86 random patients with posterior canal BPPV (p-BPPV) were retrieved. Their demographics and BPPV characteristics were analyzed. Results Patients' and BPPV characteristics were similar in umb- and p-BPPV except for the prevalence of males in the umb-BPPV group. No differences were found between treatment responsiveness and recurrences in both groups. The recurrence rate of umb-BPPV was not influenced by age, gender, BPPV side, duration of symptoms or treatment responsiveness during the first attack. Conclusions In accordance with our hypothesis about mixed canalo- and cupulolithiasis as the underlying mechanism of umb-BPPV, patients did not differ in characteristics and treatment responsiveness from p-BPPV patients. Recognition of umb-BPPV is important since inappropriate treatment can cause an unnecessary delay in therapy success.

Published
2021

10. Mobile Application to Identify Cancer Treatment–Related Financial Assistance: Results of a Randomized Controlled Trial

Author

Ian Manners, Fred A P Friedman, George Tran, Jakob Oury, Steven Wolf, Kanan Shah, S. Yousuf Zafar, Kathryn I. Pollak, Jillian C. Thompson, Ben Gagosian, Jonathan Nicolla, Aaron Tarnasky, Anthony D. Sung, and Jesse D. Troy

Subjects
Finance, Oncology (nursing), business.industry, Health Policy, MEDLINE, Middle Aged, Mobile Applications, law.invention, Cancer treatment, 03 medical and health sciences, 0302 clinical medicine, Oncology, Randomized controlled trial, law, Neoplasms, Surveys and Questionnaires, 030220 oncology & carcinogenesis, Income, Humans, Medicine, 030212 general & internal medicine, Health Expenditures, business
Abstract

PURPOSE: Insured patients with cancer face high treatment-related, out-of-pocket (OOP) costs and often cannot access financial assistance. We conducted a randomized, controlled trial of Bridge, a patient-facing app designed to identify eligible financial resources for patients. We hypothesized that patients using Bridge would experience greater OOP cost reduction than controls. METHODS: We enrolled patients with cancer who had OOP expenses from January 2018 to March 2019. We randomly assigned patients 1:1 to intervention (Bridge) versus control (financial assistance educational websites). Primary and secondary outcomes were self-reported OOP costs and subjective financial distress 3 months postenrollment. In post hoc analyses, we analyzed application for and receipt of financial assistance at 3 months postenrollment. We used chi-square, Mann-Whitney tests, and logistic regression to compare study arms. RESULTS: We enrolled 200 patients. The median age was 57 years (IQR, 47.0-63.0). Most patients had private insurance (71%), and the median household income was $62,000 in US dollars (USD) (IQR, $36,000-$100,000 [USD]). Substantial missing data precluded assessment of primary and secondary outcomes. In post hoc analyses, patients in the Bridge arm were more likely than controls to both apply for and receive financial assistance. CONCLUSION: We were unable to test our primary outcome because of excessive missing follow-up survey data. In exploratory post hoc analyses, patients who received a financial assistance app were more likely to apply for and receive financial assistance. Ultimately, our study highlights challenges faced in identifying measurable outcomes and retaining participants in a randomized, controlled trial of a mobile app to alleviate financial toxicity.

Published
2021
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11. On-line anomaly detection with advanced independent component analysis of multi-variate residual signals from causal relation networks

Author

Alexandru-Ciprian Zavoianu, Mahardhika Pratama, Thomas Radauer, Christian Eitzinger, Helmut Zörrer, Pauline Meyer-Heye, Edwin Lughofer, Robert Pollak, Lughofer, Edwin, Zavoianu, Alexandru-Ciprian, Pollak, Robert, Pratama, Mahardhika, Meyer-Heye, Pauline, Zörrer, Helmut, Eitzinger, Christian, and Radauer, Thomas

Subjects
advanced multi-variate residual analysis, Information Systems and Management, Computer science, on-line production systems, 02 engineering and technology, Latent variable, Residual, Fuzzy logic, Theoretical Computer Science, automated control limits, Artificial Intelligence, 0202 electrical engineering, electronic engineering, information engineering, on-line anomaly detection, Noise (signal processing), business.industry, 05 social sciences, 050301 education, Regression analysis, Pattern recognition, Independent component analysis, Computer Science Applications, Random variate, Control and Systems Engineering, dominant parts of independent component analysis, 020201 artificial intelligence & image processing, Anomaly detection, False alarm, Artificial intelligence, Anomaly (physics), causal relation networks, business, 0503 education, Software
Abstract

usc Refereed/Peer-reviewed Anomaly detection in todays industrial environments is an ambitious challenge to detect possible faults/problems which may turn into severe waste during production, defects, or systems components damage, at an early stage. Data-driven anomaly detection in multi-sensor networks rely on models which are extracted from multi-sensor measurements and which characterize the anomaly-free reference situation. Therefore, significant deviations to these models indicate potential anomalies. In this paper, we propose a new approach which is based on causal relation networks (CRNs) that represent the inner causes and effects between sensor channels (or sensor nodes) in form of partial sub-relations, and evaluate its functionality and performance on two distinct production phases within a micro-fluidic chip manufacturing scenario. The partial relations are modeled by non-linear (fuzzy) regression models for characterizing the (local) degree of influences of the single causes on the effects. An advanced analysis of the multi-variate residual signals, obtained from the partial relations in the CRNs, is conducted. It employs independent component analysis (ICA) to characterize hidden structures in the fused residuals through independent components (latent variables) as obtained through the demixing matrix. A significant change in the energy content of latent variables, detected through automated control limits, indicates an anomaly. Suppression of possible noise content in residuals—to decrease the likelihood of false alarms—is achieved by performing the residual analysis solely on the dominant parts of the demixing matrix. Our approach could detect anomalies in the process which caused bad quality chips (with the occurrence of malfunctions) with negligible delay based on the process data recorded by multiple sensors in two production phases: injection molding and bonding, which are independently carried out with completely different process parameter settings and on different machines (hence, can be seen as two distinct use cases). Our approach furthermore i.) produced lower false alarm rates than several related and well-known state-of-the-art methods for (unsupervised) anomaly detection, and ii.) also caused much lower parametrization efforts (in fact, none at all). Both aspects are essential for the useability of an anomaly detection approach.

Published
2020
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12. Initial Invasive or Conservative Strategy for Stable Coronary Disease

Author

Maron D. J., Hochman J. S., Reynolds H. R., Bangalore S., O'Brien S. M., Boden W. E., Chaitman B. R., Senior R., Lopez-Sendon J., Alexander K. P., Lopes R. D., Shaw L. J., Berger J. S., Newman J. D., Sidhu M. S., Goodman S. G., Ruzyllo W., Gosselin G., Maggioni A. P., White H. D., Bhargava B., Min J. K., John Mancini G. B., Berman D. S., Picard M. H., Kwong R. Y., Ali Z. A., Mark D. B., Spertus J. A., Krishnan M. N., Elghamaz A., Moorthy N., Hueb W. A., Demkow M., Mavromatis K., Bockeria O., Peteiro J., Miller T. D., Szwed H., Doerr R., Keltai M., Selvanayagam J. B., Gabriel Steg P., Held C., Kohsaka S., Mavromichalis S., Kirby R., Jeffries N. O., Harrell F. E., Rockhold F. W., Broderick S., Bruce Ferguson T., Williams D. O., Harrington R. A., Stone G. W., Rosenberg Y, ISCHEMIA Research Group: Joseph Ricci, A Tello Montoliu, A I Robero Aniorte, Abbey Mulder, Abhay A Laddu, Abhinav Goyal, Abhishek Dubey, Abhishek Goyal, Abigail Knighton, Abraham Oomman, Adam J Jaskowiak, Adam Kolodziej, Adam Witkowski, Adnan Hameed, Adriana Anesini, Afshan Hussain, Agne Juceviciene, Agne Urboniene, Agnes Jakal, Agnieszka Szramowska, Ahmad Khairuddin, Ahmed Abdel-Latif, Ahmed Adel, Ahmed Aljzeeri, Ahmed Kamal, Ahmed Talaat, Aimee Mann, Aira Contreras, Ajit Kumar, V K Kumar, Akemi Furukawa, Akshay Bagai, Akvile Smigelskaite, Alain Furber, Alain Rheault, Alaine Melanie Loehr, Alan Rosen, Albert Varga, Albertina Qelaj, Alberto Barioli, Aldo Russo, Alec Moorman, Alejandro Gisbert, Aleksandra Fratczak, Aleksandras Laucevicius, Alena Kuleshova, Alessandro Sionis, Alexander A Sirker, Alexander M Chernyavskiy, Alexandra Craft, Alexandra Vazquez, Alexandre Ciappina Hueb, Alexandre S Colafranseschi, Alexandre Schaan de Quadros, Alexandre Tognon, Ali Alghamdi, Alice Manica Muller, Aline Nogueira Rabaça, Aline Peixoto Deiro, Alison Hallam, Allegra Stone, Allison Schley, Almudena Castro, Alvaro Rabelo Ales, Amanda Germann, Amanda O'Malley, Amar Uxa, Amarachi Ojajuni, Amarino C Oliveira Jr, Amber B Hull, Ambuj Roy, Amer Zarka, Amir Janmohamed, Ammani Brown, Ammy Malinay, Amparo Martinez Monzonis, Amy J Richards, Amy Iskandrian, Amy Ollinger, Ana D Djordjevic-Dikic, Ana Fernández Martínez, Ana Gomes Almeida, Ana Paula Batista, Ana Rita Francisco, Ana S Mladenovic, Ana Santana, Anam Siddiqui, Anastasia M Kuzmina-Krutetskaya, Andras Vertes, Andre S Sousa, Andre Gabriel, André Schmidt, Andrea M Lundeen, Andrea Bartykowszki, Andrea Lorimer, Andrea Mortara, Andrea Pascual, Andreia Coelho, Andreia Rocha, Andrés García-Rincón, Andrew G Howarth, Andrew J Moriarty, Andrew Docherty, Andrew Starovoytov, Andrew Zurick, Andrzej Łabyk, Andrzej Swiatkowski, Andy Lam, Anelise Kawakami, Angela Hoye, Angela Kim, Angelique Smit, Angelo Nobre, Anil V Shah, Anja Ljubez, Anjali Anand, Ankush Sachdeva, Ann Greenberg, Ann Luyten, Ann Ostrander, Anna Di Donato, Anna Cichocka-Radwan, Anna Fojt, Anna Plachcinska, Anna Proietti, Anna Teresinska, Anne Marie Webb, Anne Cartwright, Anne Heath, Anne Mackin, Anong Amaritakomol, Anong Chaiyasri, Anoop Chauhan, Anoop Mathew, Anthony Gemignani, Anto Luigi Andres, Antonia Vega, Antonietta Hansen, Antonino Ginel Iglesias, Antonio Carlos Carvalho, Antonio Di Chiara, Antonio Serra Peñaranda, Antonio Carvalho, Antonio Colombo, Antonio Fiarresga, Anupama Rao, Aquiles Valdespino-Estrada, Araceli Boan, Areef Ishani, Ariel Diaz, Arijit Ghosh, Arintaya Prommintikul, Arline Roberts, Arnold H Seto, Arnold P Good, Arshed Quyyumi, Arthur J Labovitz, Arthur Kerner, Arturo S Campos-Santaolalla, Arunima Misra, Ashok Mukherjee, Ashok Seth, Ashraf Seedhom, Asim N Cheema, Asker Ahmed, Atul Mathur, Atul Verma, Audrey W Leong, Axel Åkerblom, Axelle Fuentes, Aynun Naher, Badhma Valaiyapathi, Baljeet Kaur, Bandula Guruge, Barbara Brzezińska, Barbara Nardi, Bartosz Czarniak, Bebek Singh, Begoña Igual, Bela Merkely, Belen Cid Alvarez, Benjamin J Spooner, Benjamin J W Chow, Benjamin Cheong, Benoy N Shah, Bernard de Bruyne, Bernardas Valecka, Bernhard Jäger, Beth A Archer, Beth Abramson, Beth Jorgenson, Bethany Harvey, Betsy O'Neal, Bev Atkinson, Bev Bozek, Bevin Lang, Bijulal Sasidharan, Bin Yang, Bin Zhang, Binoy Mannekkattukudy Kurian, Bjoern Goebel, Bob Hu, Bogdan A Popescu, Bogdan Crnokrak, Bolin Zhu, Bonnie J Kirby, Brandi D Zimbelman, Brandy Starks, Branko D Beleslin, Brenda Hart, Brian P Shapiro, Brian McCandless, Brianna Wisniewski, Brigham R Smith, Brooks Mirrer, Bruce McManus, Bruce Rutkin, Bruna Edilena Paulino, Bruna Maria Ascoli, Bryn Smith, Byron J Allen, C Michael Gibson, C Noel Bairey Merz, Calin Pop, Cameron Hague, Camila Thais de Ormundo, Candace Gopaul, Candice P Edillo, Carísi A Polanczyk, Carita Krannila, Carla Vicente, Carl-Éric Gagné, Carlo Briguori, Carlos Peña Gil, Carlos Alvarez, Carly Ohmart, Carmen C Beladan, Carmen Ginghina, Carol M Kartje, Caroline Alsweiler, Caroline Brown, Caroline Callison, Caroline Pinheiro, Caroline Rodgers, Caroline Spindler, Carolyn Corbett, Carrie Drum, Casey Riedberger, Catherine Bone, Catherine Fleming, Catherine Gordon, Catherine Jahrsdorfer, Catherine Lemay, Catherine Weick, Cathrine Patten, Cecilia Goletto, Cezary Kepka, Chandini Suvarna, Chang Xu, Chantale Mercure, Charle A Viljoen, Charlene Wiyarand, Charles Jia-Yin Hou, Charles Y Lui, Charles Cannan, Charles Cornet, Charlotte Pirro, Chataroon Rimsukcharoenchai, Chen Wang, Cheng-Ting Tsai, Chen-Yen Chien, Cheryl A Allardyce, Chester M Hedgepeth, Chetan Patel, Chiara Attanasio, Chih-Hsuan Yen, Chi-Ming Chow, Ching Min Er, Ching-Ching Ong, Cholenahally Nanjappa Manjunath, Chris Beck, Chris Buller, Christel Vassaliere, Christian Hamm, Christiano Caldeira, Christie Ballantyne, Christina Björklund, Christine R Hinton, Christine Bergeron, Christine Masson, Christine Roraff, Christine Shelley, Christophe Laure, Christophe Thuaire, Christopher Kinsey, Christopher McFarren, Christopher Spizzieri, Christopher Travill, Chun-Chieh Liu, Chung-Lieh Hung, Chunguang Li, Chun-Ho Yun, Chunli Xia, Ciarra Heard, Cidney Schultz, Clare Venn-Edmonds, Claudia P Hochberg, Claudia Wegmayr, Claudia Cortés, Claudia Escobar, Cláudia Freixo, Claudio T Mesquita, Clemens T Kadalie, Colin Berry, Constance Philander, Corine Thobois, Costantino Costantini, Courtney Page, Craig Atkinson, Craig Barr, Craig Paterson, Cristina Bare, Cynthia Baumann, Cynthia Burman, Dalisa Espinosa, Damien Collison, Dan Deleanu, Dan Elian, Dan Gao, Dana Oliver, Daniel P Vezina, Daniel O'Rourke, Daniele Komar, Danielle Schade, Darrel P Francis, Dastan Malaev, David A Bull, David E Winchester, David P Faxon, David Booth, David Cohen, David DeMets, David Foo, David Schlichting, David Taggart, David Waters, David Wohns, Davis Vo, Dawid Teodorczyk, Dawn Shelstad, Dawn Turnbull, Dayuan Li, Dean Kereiakes, Deborah O'Neill, Deborah Yip, Debra K Johnson, Debra Dees, Deepak L Bhatt, Deepika Gopal, Deepti Kumar, Deirdre Mattina, Deirdre Murphy, Delano R Small, Delsa K Rose, Dengke Jiang, Denis Carl Phaneuf, Denise Braganza, Denise Fine, Derek Cyr, Desiree Tobin, Diana Cukali, Diana Parra, Diane Camara, Diane Minshall Liu, Diego Adrián Vences, Diego Franca de Cunha, Dimitrios Stournaras, Dipti Patel, Dongze Li, Donna Exley, Dorit Grahl, Dragana Stanojevic, Duarte Cacela, Dwayne S G Conway, E Pinar Bermudez, Eapen Punnoose, Edgar L Tay, Edgar Karanjah, Edoardo Verna, Eduardo Hernandez-Rangel, Edward D Nicol, Edward O McFalls, Edward T Martin, Edyta Kaczmarska, Ekaterina I Lubinskaya, Elena A Demchenko, Elena Refoyo Salicio, Eli Feen, Elihú Durán-Cortés, Elisabeth M Janzen, Elise L Hannemann, Elise van Dongen, Elissa Restelli Piloto, Eliza Kaplan, Elizabeta Srbinovska Kostovska, Elizabeth Capasso-Gulve, Elizabeth Congdon, Elizabeth Ferguson, Elizaveta V Zbyshevskaya, Ellen Magedanz, Ellie Fridell, Ellis W Lader, Elvin Kedhi, Emanuela Racca, Emilie Tachot, Emily DeRosa, Encarnación Alonso-Álvarez, Eric Nicollet, Eric Peterson, Erick Alexánderson Rosas, Erick Donato Morales, Erin Orvis, Ermina Moga, Estelle Montpetit, Estevao Figueiredo, Eugene Passamani, Eugenia Nikolsky, Eunice Yeoh, Evgeniy I Kretov, Ewa Szczerba, Ewelina Wojtala, Expedito Eustáquio Ribeiro Silva, F Marin Ortuño, Fabio R Farias, Fabio Fimiani, Fabrizio Rolfo, Fa-Chang Yu, Fadi Hage, Fadi Matar, Fahim Haider Jafary, Fang Feng, Fang Liu, Fatima Ranjbaran, Fatima Rodriguez, Fausto J Pinto, Fauzia Rashid, Federica Ramani, Fei Wang, Fernanda Igansi, Filipa Silva, Filippo Ottani, Fiona Haines, Firas Al Solaiman, Flávia Egydio, Flavio Lyra, Florian Egger, Fran Farquharson, Frances Laube, Francesc Carreras Costa, Francesca de Micco, Francesca Bianchini, Francesca Pezzetta, Francesca Pietrucci, Francesco Orso, Francesco Pisano, Francis Burt, Francisca Patuleia Figueiras, Francisco Fernandez-Aviles, Francois Pierre Mongeon, Frans Van de Werf, Franziska Guenther, Fraser N Witherow, Fred Mohr, Frederico Dall'Orto, Fumiyuki Otsuka, G De La Morena, G Karthikeyan, Gabor Dekany, Gabor Kerecsen, Gabriel Galeote, Gabriel Grossmann, Gabriel Vorobiof, Gabriela Sanchez de Souza, Gabriela Guzman, Gabriela Zeballos, Gabriele Gabrielli, Gabriele Jakl-Kotauschek, Gail A Shammas, Gail Brandt, Gang Chen, Gary E Lane, Gary J Luckasen, Gautam Sharma, Gelmina Mikolaitiene, Gennie Yee, Georg Nickenig, George E Revtyak, George J Juang, Gerald Fletcher, Gerald Leonard, Gerard Patrick Devlin, Gerard Esposito, Gergely Ágoston, Gervasio Lamas, Geza Fontos, Ghada Mikhail, Gia Cobb, Gian Piero Perna, Gianpiero Leone, Giles Roditi, Gilles Barone-Rochette, Girish Mishra, Giuseppe Tarantini, Glenda Wong, Glenn S Hamroff, Glenn Rayos, Gong Cheng, Gonzalo Barge-Caballero, Goran Davidović, Goran Stankovic, Gordana Stevanovic, Grace Jingyan Wang, Grace M Young, Graceanne Wayser, Graciela Scaro, Graham S Hillis, Graham Wong, Grazyna Anna Szulczyk, Gregor Simonis, Gregory Kumkumian, Gretchen Ann Peichel, Grzegorz Gajos, Gudrun Steinmaurer, Guilherme G Rucatti, Guilherme Portugal, Guilhermina Cantinho Lopes, Guillem Pons Lladó, Gunnar Frostfelt, Gurpreet S Wander, Gurpreet Gulati, Gustavo Pucci, Hafidz Abd Hadi, Haibo Zhang, Haitao Wang, Halina Marciniak, Han Chen, Hanan Kerr, Hani Najm, Hanna Douglas, Hannah Phillips, Hao Dai, Haojian Dong, Haqeel Jamil, Harikrishnan Sivadasanpillai, Harry Suryapranata, Hassan Reda, Hayley Pomeroy, Heather Barrentine, Heather Golden, Heather Hurlburt, Heidi Wilson, Helen C Tucker, Helene Abergel, Hemalata Siddaram, Hermine Osseni, Herwig Schuchlenz, Hesong Zeng, Hicham Skali, Hilda Solomon, Hollie Horton, Holly Hetrick, Holly Little, Holly Park, Hongjie Chi, Hossam Mahrous, Howard A Levite, Hristo Pejkov, Huajun Li, Hugo Bloise-Adames, Hugo Marques, Hui Zhong, Hui-Min Zhang, Humayrah Hashim, Hung-I Yeh, Hussien El Fishawy, Ian Webb, Iftikhar Kullo, Igor O Grazhdankin, Ihab Hamzeh, Ikraam Hassan, Ikuko Ueda, Ileana L Pina, Ilona Tamasauskiene, Ilse Bouwhuis, Imran Arif, Ina Wenzelburger, Inês Zimbarra Cabrita, Ines Rodrigues, Inga H Robbins, Inga Soveri, Ingela Schnittger, Iqbal Karimullah, Ira M Dauber, Iram Rehman, Irena Peovska Mitevska, Irene Marthe Lang, Irina Subbotina, Irma Kalibataite-Rutkauskiene, Irni Yusnida, Isabel Estela Carvajal, Isabella C Palazzo, Isabelle Hogan, Isabelle Roy, Ishba Syed, Ishita Tejani, Ivan A Naryshkin, Ivana Jankovic, Iwona Niedzwiecka, J David Knight, Jacek Kusmierek, Jackie M White, Jackie Chow, Jacob Udell, Jacqueline E Tamis-Holland, Jacqueline Fannon, Jacquelyn A Quin, Jacquelyn Do, Jaekyeong Heo, Jakub Maksym, James E Davies, James H O'Keefe Jr, James J Jang, James Cha, James Harrison, James Hirsch, James Stafford, James Tatoulis, Jamie Rankin, Jan Henzel, Jan Orga, Jana Tancredi, Janaina Oliveira, Jane Burton, Jane Eckstein, Jane Marucci, Janet P Knight, Janet Blount, Janet Halliday, Janetta Kourzenkova, Janitha Raj, Jan-Malte Sinning, Jaqueline Pozzibon, Jaroslaw Drozdz, Jaroslaw Karwowski, Jason D Glover, Jason Loh Kwok, Jason T Call, Jason Linefsky, Jassira Gomes, Jati Anumpa, Javier J Garcia, Javier Courtis, Jay Meisner, K Jayakumar, Jayne Scales, Jean E Denaro, Jean Michel Juliard, Jean Ho, Jeanette K Stansborough, Jean-Michel Juliard, Jeanne Russo, Jeannette J M Schoep, Jeet Thambyrajah, Jeff Leimberger, Jeffery A Breall, Jeffrey A Kohn, Jeffrey C Milliken, Jeffrey Anderson, Jeffrey Blume, Jeffrey Kanters, Jeffrey Lorin, Jeffrey Moses, Jelena J Stepanovic, Jelena Celutkiene, Jelena Djokic, Jelena Stojkovic, Jenne M Jose, Jenne Manchery, Jennifer A Mull, Jennifer H Czerniak, Jennifer L Stanford, Jennifer Gillis, Jennifer Horst, Jennifer Isaacs, Jennifer Langdon, Jennifer Thomson, Jennifer Tomfohr, Jennifer White, Jen-Yuan Kuo, Jeremy Rautureau, Jerome Fleg, Jessica Berg, Jessica Rodriguez, Jessica Waldron, Jhina Patro, Jia Li, Jiajia Mao, Jiamin Liu, Jian'an Wang, Jianhua Li, Jianxin Zhang, Jie Qi, Jihyun Lyo, Jill Marcus, Jim Blankenship, Jing Zhang, Jingjing Liu, Jing-Yao Fan, Jiun-Yi Li, Jiwan Pradhan, Jiyan Chen, J M Rivera Caravaca, Jo Evans, Joan Garcia Picart, Joan Hecht, Joanna Jaroch, Joanna Zalewska, Joanne Kelly, Joanne Taaffe, João Reynaldo Abbud, João V Vitola, Joaquín V Peñafiel, Jocelyne Benatar, Jody Bindeman, Joe Sabik, Joel Klitch, Johann Christopher, Johannes Aspberg, John D Friedman, John F Beltrame, John F Heitner, John Joseph Graham, John R Davies, John Doan, John Kotter, John Kurian, John Mukai, John Pownall, Jolanta Sobolewska, Jon Kobashigawa, Jonathan L Goldberg, Jonathan W Bazeley, Jonathan Byrne, Jonathan Himmelfarb, Jonathan Leipsic, Jonean Thorsen, Jorge F Trejo Gutierrez, Jorge Escobedo, Jorik Timmer, José A Ortega-Ramírez, José Antonio Marin-Neto, Jose D Salas, Jose Enrique Castillo, Jose Francisco Saraiva, José J Cuenca-Castillo, Jose L Diez, José Luis Narro Villanueva, José Luiz da Vieira, José M Flores-Palacios, Jose Ramon Gonzalez, Jose Seijas Amigo, Jose Fragata, Josep Maria Padró, Josheph F X McGarvey Jr, Joseph Hannan, Joseph Sacco, Joseph Sweeny, Joseph Wiesel, Josephine D Abraham, Joshua P Loh, Joy Burkhardt, Joyce R White, Joyce Riestenberg-Smith, Judit Sebo, Judith L Meadows, Judith Wright, Judy Mae Foltz, Judy Hung, Judy Otis, Juergen Stumpf, Jui-Peng Tsai, Julia S Dionne, Julia de Aveiro Morata, Julie Bunke, Julie Morrow, Julio César Figal, Jun Fujita, Jun Jiang, Junhua Li, Junqing Yang, Juntima Euathrongchit, Jyotsna Garg, K Manjula Rani, K Preethi, Kaatje Goetschalckx, Kai Eggers, Kamalakar Surineni, Kanae Hirase, T R Kapilamoorthy, Karen Calfas, Karen Gratrix, Karen Hallett, Karen Hultberg, Karen Nugent, Karen Petrosyan, Karen Swan, Karolina Kryczka, Karolina Wojtczak-Soska, Karolina Wojtera, Karsten Lenk, Karthik Ramasamy, Katarzyna Łuczak, Katarzyna Malinowska, Kate Pointon, Kate Robb, Katherine Martin, Kathleen Claes, Kathryn Carruthers, Kathy E Siegel, Katia Drouin, Katie Fowler-Lehman, Kavita Rawat, Kay Rowe, Keiichi Fukuda, Keith A A Fox, Ken Mahaffey, Kendra Unterbrink, Kenneth Giedd, Kerrie Van Loo, Kerry Lee, Kerstin Bonin, Kevin R Bainey, Kevin T Harley, Kevin Anstrom, Kevin Chan, Kevin Croce, Kevin Landolfo, Kevin Marzo, Keyur Patel, Khaled Abdul-Nour, Khaled Alfakih, Khaled Dajani, Khaled Ziada, Khaula Baloch, Khrystyna Kushniriuk, Kian-Keong Poh, Kim F Ireland, Kim Holland, Kimberly Ann Byrne, Kimberly E Halverson, Kimberly Elmore, Kimberly Miller-Cox, Kiran Reddy, Kirsten J Quiles, Kirsty Abercrombie, Klaus Matschke, Konrad Szymczyk, Koo Hui Chan, Kotiboinna Preethi, Kozhaya Sokhon, Krissada Meemuk, Kristian Thygesen, Kristin M Salmi, Kristin Newby, Kristina Wippler, Kristine Arges, Kristine Teoh, Krystal Etherington, Krystyna Łoboz-Grudzień, Krzysztof W Reczuch, Krzysztof Bury, Krzysztof Drzymalski, Krzysztof Kukuła, Kuo-Tzu Sung, Kurt Huber, Ladda Douangvila, Lance Sullenberger, Larissa Miranda Trama, Laszlone Matics, Laura Drew, Laura Flint, Laura Keinaite, Laura Sarti, Laurel Kolakaluri, Lawrence M Phillips, Lawrence Friedman, Lawrence Phillips, Lazar Velicki, Leah Howell, Leandro C Maranan, Leanne Cox, Ledjalem Daba, Lei Zhang, Lekshmi Dharmarajan, Leo Bockeria, Leonardo Pizzol Caetano, Leonardo Bridi, Leonid L Bershtein, Leszek Sokalski, Li Hai Yan, Li Li, Lia Nijmeijer, Lidia Sousa, Lihong Xu, Lihua Zhang, Lili Zhang, Lilia Schiavi, Lilian Mazza Barbosa, Lillian L Khor, Lina Felix-Stern, Linda L Hall, Linda M Hollenweger, Linda Arcand, Linda Davidson-Ray, Linda Schwarz, Lindsey N Sikora, Lingping Chi, Lino Patricio, Liping Zhang, Lisa Chaytor, Lisa Hatch, Lisa McCloy, Lisa Wong, Liselotte Persson, Lixin Jiang, Liz Low, Ljiljana Pupic, Loïc Bière, Lorenzo Monti, Lori Christensen, Lori Pritchard, Loriane Black, Lori-Ann Desimone, Lori-Ann Larmand, Lorraine McGregor, Louise Morby, Louise Thomson, Luc Harvey, Luciana de Pádua Baptista, Lucilla Garcia, Ludivine Eliahou, Ludmila Helmer, Luis F Smidt, Luis Bernanrdes, Luis Guzman, Luiz A Carvalho, Luyang Xiong, Lynette L Teo, Lynn M Neeson, Lynne Winstanley, M Barbara Srichai-Parsia, M Quintana Giner, M Sowjanya Reddy, M Valdés Chávarri, M Grazia Rossi, Maarten Simoons, Maayan Konigstein, Maciej Lesiak, Maciej Olsowka, Mafalda Selas, Magalie Corfias, Magdalena Madero Rovalo, Magdalena Łanocha, Magdalena Miller, Magdalena Misztal-Teodorczyk, Magdalena Rantinella, Magdy Abdelhamid, Magnolia Jimenez, Mahboob Alam, Mahevamma Mylarappa, Mahfouz El Shahawy, Mahmoud Mohamed, Mahmud Al-Bustami, Majo X Joseph, Malgorzata Frach, Małgorzta Celińska-Spodar, Malte Helm, Manas Chacko, Mandy Murphy, Manitha Vinod, Manjula Rani, Manu Dhawan, Manuela Mombelli, Marcel Weber, Marcello Galvani, Marcelo Jamus Rodrigues, Marcia F Dubin, Marcia F Werner Bayer, Marcin Szkopiak, Marco Antonio Monsalve, Marco Bizzaro Santos, Marco Magnoni, Marco Marini, Marco Sicuro, Marco Zenati, Marcos Valério Coimbra Resende, Marek Roik, Margalit Bentzvi, Margaret Gilsenan, Margaret Iraola, Margot C 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Jr, Matthew Budoff, Matthew Jezior, Matthew Luckie, Matthias Friedrich, Mauren P Haeffner, Maximilian Tscharre, Max-Paul Winter, Mayana Almeida, Mayil S Krishnam, Mayuri Patel, Meenakshi Mishra, Megan Manocchia, Meghana Kakade, Melanie J Munro, Melissa D Chaplin, Melissa LeFevre, Mervyn Andiapen, Michael A Gibson, Michael B Rubens, Michael C Turner, Michael D Shapiro, Michael W Lee, Michael Berlowitz, Michael Davidson, Michael Mack, Michael McDaniel, Michael Mumma, Michal Wlodarczyk, Michel G Khouri, Michel S Slama, Michele Rawlins, Michelle M Bonner, Michelle M Seib, Michelle Chang, Michelle Crowder, Michelle Dixon, Michelle Mayon, Michelle McEvoy, Michelle Yee, Miguel M Fernandes, Miguel Nobre Menezes, Miguel Souto Bayarri, Miguel Barrero, Mikhail T Torosoff, Milan R Dobric, Milan Dobric, Milica Nikola Dekleva, Milind Avdhoot Gadkari, Millie Gomez, Min Tun Kyaw, Miriam Brooks, Miroslav Stevo Martinovic, Mitchel B Lustre, Mohammad Tariq Vakani, Mohammad El-Hajjar, Mohammed Al-Amoodi, Mohammed Hussain, Mohammed Saleem, Moisés Blanco-Calvo, Moisés Jiménez-Santos, Mona Bhatia, Monica Rosca, Monika Laukyte, Montserrat Gracida Blanca, Montserrat Vila Perales, Mouaz H Al-Mallah, Moysés de Oliveira Filho, Mpiko Ntsekhe, Muhamed Saric, Mulei Chen, Myriam Brousseau, Myrthes Emy Takiuti, Nada Cemerlic-Adjic, Nadia Asif, Nadia Gakou, Nafisa Hussain, Nana O Katamadze, Nancy L Clapp, Nancy Aedy, Nandita Nataraj, Nanette K Wenger, Naomi Uchida, Nasrul Ismail, Natalia S Oliveira, Natalia de Carvalho Maffei, Natalie Spitzer, Natasha C Putnam, Naved Aslam, Neamat Mowafy, Neeraj Pandit, Neeraj Parakh, Nevena Garcevic, Ngaire Meadows, Nhi N Tran, Nicholas Danchin, Nicki Lakeman, Nicola Johnston, Nicolas W Shammas, Nicole Saint Vrestil, Nicole Deming, Nier Zhong, Niket Patel, Nikola N Boskovic, Nikolaos Karogiannis, Nikos Werner, Nina Johnston, Ning Zhang, Ning Zhou, Niree Hindoyan, Nirmal Kumar, Nitika Chadha, Nitish Naik, Nodira Aripova, Noloyiso Mtana, Nona A Eskelson, Noor Syamira Mokhtar, Noppon Taksaudom, Nor Asiah Basri, Nora Marchelletta, Norma Hogg, Nungshi Jungla, Nuno Ferreira, Oksana A Lubyanaya, Olga B Nikolaeva, Olga Cañavate, Olga Sobrino, Olga Walesiak, Olga Walter, Olga Zdończyk, Olivia J Lim, Olivia Anaya, Olivia Mancilla, Olivier Dubourg, Olugbenga Bello, Omar Almousalli, Omar Thompson, Oni Olurinde, Or Harel, Osama Raheem, Oscar Méndiz, Óscar Prada-Delgado, Oz Shapira, P Christian Schulze, Pachara Panpunuan, Pal Maurovich-Horvat, Pallav Garg, Paloma Moraga, Pam Singh, Pamela Julian, Pamela Ouyang, Pamela Sigel, Pamela Woodard, Panpan Zhou, Paola Emanuela Poggio, Paola Smanio, Paolo Calabro, Paramjit Jeetley, Pascal Goube, Patricia K Nguyen, Patricia Alarie, Patricia Arakelian, Patricia Arsenault, Patricia Blaise, Patricia Brito, Patricia Cowper, Patricia Endsley, Patricia Mieses, Patrick B Alexander, Patrick Donnelly, Patrick Wilmot, Patrycja Lebioda, Paul C Gordon, Paul Der Mesropian, Paul Galiwango, Paul Hauptman, Paul Kennedy, Paula Beardsley, Paula García-González, Paulo Cury Rezende, Paulo Ricardo Caramori, Pavel S Kozlov, Pedro Canas Silva, Pedro Gabriel Melo Barros E Silva, Pedro Píccaro de Oliveira, Pedro Carvalho, Pedro Modas, Pedro Rio, Peeyush Jain, Peiyu He, Peter A McCullough, Peter H Stone, Peter M Pollak, Peter Douglass, Peter Henriksen, Peter OKane, Peter Ong, Philip Jones, Philip Rogal, Philippe Généreux, Philippe Menasche, Philippe Rheault, Phoebe Goold, Pierre Gervais, Pierre Michaud, Pilar Calvillo, Ping Chai, Piotr Jakubowski, Piotr Pruszczyk, Piotr Slomka, Piyamitr Sritara, Poay-Huan Loh, Poonam Sonawane, Pouneh Samadi, Pragnesh P Parikh, Prakash Deedwania, Pranav M Patel, Praneeth Polamuri, Pratiksha Sharma, Precilia Vasquez, Preeti Kamath, Prince Thomas, Priyadarshani Arambam, Puja K Mehta, Purvez Grant, Pushpa Naik, Qi Zhong, Qian Zhao, Qiang Zhou, Qianqian Yuan, Qin Yu, Qingxian Li, Qiulan Xie, Qiutang Zeng, R J Vindhya, R James Gerlach, Rachel King, Rada Vučić, Radmila Lyubarova, Radoslaw Pracon, 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Riezebos, Robert M Donnino, Robert Bojar, Robert Chilton, Robert Guyton, Robert Henderson, Robert Kornberg, Robert Leber, Robert Mao, Robert Stenberg, Roberta P Santos, Roberto René Favaloro, Roberto Amati, Rodolfo G S D Lima, Rodrigo J Cerci, Rogerio Tumelero, Rohit Tandon, Roma Tewari, Romalisa Miranda-Peats, Ron Wald, Ronald A Mastouri, Ronald G Morford, Ronald G Schwartz, Ronald P Pedalino, Rongrong Hu, Ronnell A Hansen, Ronny A Cohen, Rory Hachamovitch, Rosa Homem, Rosa Sandonato, Rosane Laimer, Rosann Gans, Roxanne Yost, Roy Mathew, Rubén Baleón-Espinosa, Ruben Ramos, Rubine Gevorgyan, Rui Ferreira, Rui Jing, Ruth Pérez-Fernández, S K Dwivedi, S Ramakrishnan, Saadat Khan, Sabahat Bokhari, Sabu Thomas, Sadath Lubna, Sajeeda Parveen Khan, Sajeev Chakanalil Govindan, Saket Girotra, Saleem Kassam, Sallie Canada, Salvador Cruz-Flores, Samaa Mohamed, Samantha Ly, Sameh El Kaffas, Samia Massalha, Sampoornima Setty, Samuel Nwosu, Sandeep Seth, Sandeep Singh, Sander R Niehe, Sandra M Rivest, Sandra S Zier, Sandra Ahoud, Sandy Carr, Sanjay Ganapathi, Sanjay Shetty, Sanjeev Sharma, Santa Jimenez, Santhosh Satheesh, Santiago A Garcia, Sara Fernandez, Sara Karlsson, Sara Salkind, Sara Temiyasathit, Sarah Medina Rodriguez, Sarah Beaudry, Sarah Hadjih, Sarah Williams, Sarah Zahrani, Sarju Ralhan, Sasa Hinic, Sasko Kedev, Satinder Singh, Satoshi Yasuda, Satvic Cholenahally Manjunath, Sau Lee, Scott M Kaczkowski, Scott Kinlay, Sean W Hayes, Sebastian Sobczak, Senait Asier, Sergey A Sayganov, Seth I Sokol, Shaheen Pandie, Shaiful Azmi Yahaya, Shamir Mehta, Shao-Ping Nie, Sharad Chandra, Sharder Islam, Sharon Tai, Sheetal Rupesh Karwa, Sheri Ussery, Sheromani Bajaj, Sherron C Crook, Shigeyuki Nishimura, Shintaro Nakano, Shirin Heydari, Shiv Kumar Choudhary, Shivali Patel, Shobana Ganesan, Shruti Pandey, Shuyang Zhang, Shweta Hande, Siddharth Gadage, Sik-Yin V Tan, Silvia Zottis Poletti, Silvia Riera, Silvia Valbuena, Simon Walsh, Simona Maspoli, Simone Savaris, Si-Ting Feng, 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S.G., Ruzyllo W., Gosselin G., Maggioni A.P., White H.D., Bhargava B., Min J.K., John Mancini G.B., Berman D.S., Picard M.H., Kwong R.Y., Ali Z.A., Mark D.B., Spertus J.A., Krishnan M.N., Elghamaz A., Moorthy N., Hueb W.A., Demkow M., Mavromatis K., Bockeria O., Peteiro J., Miller T.D., Szwed H., Doerr R., Keltai M., Selvanayagam J.B., Gabriel Steg P., Held C., Kohsaka S., Mavromichalis S., Kirby R., Jeffries N.O., Harrell F.E., Rockhold F.W., Broderick S., Bruce Ferguson T., Williams D.O., Harrington R.A., Stone G.W., Rosenberg Y, and ISCHEMIA Research Group: Joseph Ricci, A Tello Montoliu, A I Robero Aniorte, Abbey Mulder, Abhay A Laddu, Abhinav Goyal, Abhishek Dubey, Abhishek Goyal, Abigail Knighton, Abraham Oomman, Adam J Jaskowiak, Adam Kolodziej, Adam Witkowski, Adnan Hameed, Adriana Anesini, Afshan Hussain, Agne Juceviciene, Agne Urboniene, Agnes Jakal, Agnieszka Szramowska, Ahmad Khairuddin, Ahmed Abdel-Latif, Ahmed Adel, Ahmed Aljzeeri, Ahmed Kamal, Ahmed Talaat, Aimee Mann, 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Charles Y Lui, Charles Cannan, Charles Cornet, Charlotte Pirro, Chataroon Rimsukcharoenchai, Chen Wang, Cheng-Ting Tsai, Chen-Yen Chien, Cheryl A Allardyce, Chester M Hedgepeth, Chetan Patel, Chiara Attanasio, Chih-Hsuan Yen, Chi-Ming Chow, Ching Min Er, Ching-Ching Ong, Cholenahally Nanjappa Manjunath, Chris Beck, Chris Buller, Christel Vassaliere, Christian Hamm, Christiano Caldeira, Christie Ballantyne, Christina Björklund, Christine R Hinton, Christine Bergeron, Christine Masson, Christine Roraff, Christine Shelley, Christophe Laure, Christophe Thuaire, Christopher Kinsey, Christopher McFarren, Christopher Spizzieri, Christopher Travill, Chun-Chieh Liu, Chung-Lieh Hung, Chunguang Li, Chun-Ho Yun, Chunli Xia, Ciarra Heard, Cidney Schultz, Clare Venn-Edmonds, Claudia P Hochberg, Claudia Wegmayr, Claudia Cortés, Claudia Escobar, Cláudia Freixo, Claudio T Mesquita, Clemens T Kadalie, Colin Berry, Constance Philander, Corine Thobois, Costantino Costantini, Courtney Page, Craig Atkinson, Craig Barr, Craig Paterson, Cristina Bare, Cynthia Baumann, Cynthia Burman, Dalisa Espinosa, Damien Collison, Dan Deleanu, Dan Elian, Dan Gao, Dana Oliver, Daniel P Vezina, Daniel O'Rourke, Daniele Komar, Danielle Schade, Darrel P Francis, Dastan Malaev, David A Bull, David E Winchester, David P Faxon, David Booth, David Cohen, David DeMets, David Foo, David Schlichting, David Taggart, David Waters, David Wohns, Davis Vo, Dawid Teodorczyk, Dawn Shelstad, Dawn Turnbull, Dayuan Li, Dean Kereiakes, Deborah O'Neill, Deborah Yip, Debra K Johnson, Debra Dees, Deepak L Bhatt, Deepika Gopal, Deepti Kumar, Deirdre Mattina, Deirdre Murphy, Delano R Small, Delsa K Rose, Dengke Jiang, Denis Carl Phaneuf, Denise Braganza, Denise Fine, Derek Cyr, Desiree Tobin, Diana Cukali, Diana Parra, Diane Camara, Diane Minshall Liu, Diego Adrián Vences, Diego Franca de Cunha, Dimitrios Stournaras, Dipti Patel, Dongze Li, Donna Exley, Dorit Grahl, Dragana Stanojevic, Duarte Cacela, Dwayne S G Conway, E Pinar 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George J Juang, Gerald Fletcher, Gerald Leonard, Gerard Patrick Devlin, Gerard Esposito, Gergely Ágoston, Gervasio Lamas, Geza Fontos, Ghada Mikhail, Gia Cobb, Gian Piero Perna, Gianpiero Leone, Giles Roditi, Gilles Barone-Rochette, Girish Mishra, Giuseppe Tarantini, Glenda Wong, Glenn S Hamroff, Glenn Rayos, Gong Cheng, Gonzalo Barge-Caballero, Goran Davidović, Goran Stankovic, Gordana Stevanovic, Grace Jingyan Wang, Grace M Young, Graceanne Wayser, Graciela Scaro, Graham S Hillis, Graham Wong, Grazyna Anna Szulczyk, Gregor Simonis, Gregory Kumkumian, Gretchen Ann Peichel, Grzegorz Gajos, Gudrun Steinmaurer, Guilherme G Rucatti, Guilherme Portugal, Guilhermina Cantinho Lopes, Guillem Pons Lladó, Gunnar Frostfelt, Gurpreet S Wander, Gurpreet Gulati, Gustavo Pucci, Hafidz Abd Hadi, Haibo Zhang, Haitao Wang, Halina Marciniak, Han Chen, Hanan Kerr, Hani Najm, Hanna Douglas, Hannah Phillips, Hao Dai, Haojian Dong, Haqeel Jamil, Harikrishnan Sivadasanpillai, Harry Suryapranata, Hassan Reda, Hayley Pomeroy, Heather Barrentine, Heather Golden, Heather Hurlburt, Heidi Wilson, Helen C Tucker, Helene Abergel, Hemalata Siddaram, Hermine Osseni, Herwig Schuchlenz, Hesong Zeng, Hicham Skali, Hilda Solomon, Hollie Horton, Holly Hetrick, Holly Little, Holly Park, Hongjie Chi, Hossam Mahrous, Howard A Levite, Hristo Pejkov, Huajun Li, Hugo Bloise-Adames, Hugo Marques, Hui Zhong, Hui-Min Zhang, Humayrah Hashim, Hung-I Yeh, Hussien El Fishawy, Ian Webb, Iftikhar Kullo, Igor O Grazhdankin, Ihab Hamzeh, Ikraam Hassan, Ikuko Ueda, Ileana L Pina, Ilona Tamasauskiene, Ilse Bouwhuis, Imran Arif, Ina Wenzelburger, Inês Zimbarra Cabrita, Ines Rodrigues, Inga H Robbins, Inga Soveri, Ingela Schnittger, Iqbal Karimullah, Ira M Dauber, Iram Rehman, Irena Peovska Mitevska, Irene Marthe Lang, Irina Subbotina, Irma Kalibataite-Rutkauskiene, Irni Yusnida, Isabel Estela Carvajal, Isabella C Palazzo, Isabelle Hogan, Isabelle Roy, Ishba Syed, Ishita Tejani, Ivan A Naryshkin, Ivana Jankovic, Iwona 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Jeffrey Kanters, Jeffrey Lorin, Jeffrey Moses, Jelena J Stepanovic, Jelena Celutkiene, Jelena Djokic, Jelena Stojkovic, Jenne M Jose, Jenne Manchery, Jennifer A Mull, Jennifer H Czerniak, Jennifer L Stanford, Jennifer Gillis, Jennifer Horst, Jennifer Isaacs, Jennifer Langdon, Jennifer Thomson, Jennifer Tomfohr, Jennifer White, Jen-Yuan Kuo, Jeremy Rautureau, Jerome Fleg, Jessica Berg, Jessica Rodriguez, Jessica Waldron, Jhina Patro, Jia Li, Jiajia Mao, Jiamin Liu, Jian'an Wang, Jianhua Li, Jianxin Zhang, Jie Qi, Jihyun Lyo, Jill Marcus, Jim Blankenship, Jing Zhang, Jingjing Liu, Jing-Yao Fan, Jiun-Yi Li, Jiwan Pradhan, Jiyan Chen, J M Rivera Caravaca, Jo Evans, Joan Garcia Picart, Joan Hecht, Joanna Jaroch, Joanna Zalewska, Joanne Kelly, Joanne Taaffe, João Reynaldo Abbud, João V Vitola, Joaquín V Peñafiel, Jocelyne Benatar, Jody Bindeman, Joe Sabik, Joel Klitch, Johann Christopher, Johannes Aspberg, John D Friedman, John F Beltrame, John F Heitner, John Joseph Graham, John R Davies, John Doan, John Kotter, John Kurian, John Mukai, John Pownall, Jolanta Sobolewska, Jon Kobashigawa, Jonathan L Goldberg, Jonathan W Bazeley, Jonathan Byrne, Jonathan Himmelfarb, Jonathan Leipsic, Jonean Thorsen, Jorge F Trejo Gutierrez, Jorge Escobedo, Jorik Timmer, José A Ortega-Ramírez, José Antonio Marin-Neto, Jose D Salas, Jose Enrique Castillo, Jose Francisco Saraiva, José J Cuenca-Castillo, Jose L Diez, José Luis Narro Villanueva, José Luiz da Vieira, José M Flores-Palacios, Jose Ramon Gonzalez, Jose Seijas Amigo, Jose Fragata, Josep Maria Padró, Josheph F X McGarvey Jr, Joseph Hannan, Joseph Sacco, Joseph Sweeny, Joseph Wiesel, Josephine D Abraham, Joshua P Loh, Joy Burkhardt, Joyce R White, Joyce Riestenberg-Smith, Judit Sebo, Judith L Meadows, Judith Wright, Judy Mae Foltz, Judy Hung, Judy Otis, Juergen Stumpf, Jui-Peng Tsai, Julia S Dionne, Julia de Aveiro Morata, Julie Bunke, Julie Morrow, Julio César Figal, Jun Fujita, Jun Jiang, Junhua Li, Junqing Yang, Juntima 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Natalia S Oliveira, Natalia de Carvalho Maffei, Natalie Spitzer, Natasha C Putnam, Naved Aslam, Neamat Mowafy, Neeraj Pandit, Neeraj Parakh, Nevena Garcevic, Ngaire Meadows, Nhi N Tran, Nicholas Danchin, Nicki Lakeman, Nicola Johnston, Nicolas W Shammas, Nicole Saint Vrestil, Nicole Deming, Nier Zhong, Niket Patel, Nikola N Boskovic, Nikolaos Karogiannis, Nikos Werner, Nina Johnston, Ning Zhang, Ning Zhou, Niree Hindoyan, Nirmal Kumar, Nitika Chadha, Nitish Naik, Nodira Aripova, Noloyiso Mtana, Nona A Eskelson, Noor Syamira Mokhtar, Noppon Taksaudom, Nor Asiah Basri, Nora Marchelletta, Norma Hogg, Nungshi Jungla, Nuno Ferreira, Oksana A Lubyanaya, Olga B Nikolaeva, Olga Cañavate, Olga Sobrino, Olga Walesiak, Olga Walter, Olga Zdończyk, Olivia J Lim, Olivia Anaya, Olivia Mancilla, Olivier Dubourg, Olugbenga Bello, Omar Almousalli, Omar Thompson, Oni Olurinde, Or Harel, Osama Raheem, Oscar Méndiz, Óscar Prada-Delgado, Oz Shapira, P Christian Schulze, Pachara Panpunuan, Pal Maurovich-Horvat, Pallav Garg, Paloma Moraga, Pam Singh, Pamela Julian, Pamela Ouyang, Pamela Sigel, Pamela Woodard, Panpan Zhou, Paola Emanuela Poggio, Paola Smanio, Paolo Calabro, Paramjit Jeetley, Pascal Goube, Patricia K Nguyen, Patricia Alarie, Patricia Arakelian, Patricia Arsenault, Patricia Blaise, Patricia Brito, Patricia Cowper, Patricia Endsley, Patricia Mieses, Patrick B Alexander, Patrick Donnelly, Patrick Wilmot, Patrycja Lebioda, Paul C Gordon, Paul Der Mesropian, Paul Galiwango, Paul Hauptman, Paul Kennedy, Paula Beardsley, Paula García-González, Paulo Cury Rezende, Paulo Ricardo Caramori, Pavel S Kozlov, Pedro Canas Silva, Pedro Gabriel Melo Barros E Silva, Pedro Píccaro de Oliveira, Pedro Carvalho, Pedro Modas, Pedro Rio, Peeyush Jain, Peiyu He, Peter A McCullough, Peter H Stone, Peter M Pollak, Peter Douglass, Peter Henriksen, Peter OKane, Peter Ong, Philip Jones, Philip Rogal, Philippe Généreux, Philippe Menasche, Philippe Rheault, Phoebe Goold, Pierre Gervais, Pierre Michaud, Pilar Calvillo, Ping Chai, Piotr Jakubowski, Piotr Pruszczyk, Piotr Slomka, Piyamitr Sritara, Poay-Huan Loh, Poonam Sonawane, Pouneh Samadi, Pragnesh P Parikh, Prakash Deedwania, Pranav M Patel, Praneeth Polamuri, Pratiksha Sharma, Precilia Vasquez, Preeti Kamath, Prince Thomas, Priyadarshani Arambam, Puja K Mehta, Purvez Grant, Pushpa Naik, Qi Zhong, Qian Zhao, Qiang Zhou, Qianqian Yuan, Qin Yu, Qingxian Li, Qiulan Xie, Qiutang Zeng, R J Vindhya, R James Gerlach, Rachel King, Rada Vučić, Radmila Lyubarova, Radoslaw Pracon, Raewyn Fisher, Rafael Beyar, Rafael Diaz, Rafael Selgas, Raffaele Bugiardini, Raffaele Fanelli, Raisa Kavalakkat, V S Rajalekshmi, Rajat S Barua, Rajeev Menon, Rajesh Gopalan Nair, Rajesh Francis, Rajiv Narang, Rakesh Yadav, Ralph Alan Huston, T Ramakrishnan, Ramesh de Silva, Rami El Mahmoud, Ramiro Carvalho, Ramon de Jesús-Pérez, Ramona Stevens, Ran Leng, Ranjan Kachru, Ranjit Kumar Nath, Raquel Sanchez, Raven R Dwyer, Raven Lee, Ray Wyman, Raymond C Wong, Raymond W Little, Raymundo Ocaranza Sanchez, Rebecca J Wimmer, Rebecca Bariciano, Rebecca Otis, Rebekah R Herrmann, Reem Yunis, Reinette Hampson, Renato Abdala Karam, Renee C Hessian, Renee Kaneshiro, Reshma Ravindran, Reto Andreas Gamma, Reyna Bhandari, Reza Arsanjani, Ricardo L Lopes, Ricardo Mendes Oliveira, Ricardo Costa, Richa Bhatt, Richard F Davies, Richard H J Trimlett, Richard Goldweit, Rik Hermanides, Rine Nakanishi, Rinu R Sidh, Risha Patel, Rita Coram, Rizwan A Siddiqui, Rob S Beanlands, Robert J Hamburger, Robert K Riezebos, Robert M Donnino, Robert Bojar, Robert Chilton, Robert Guyton, Robert Henderson, Robert Kornberg, Robert Leber, Robert Mao, Robert Stenberg, Roberta P Santos, Roberto René Favaloro, Roberto Amati, Rodolfo G S D Lima, Rodrigo J Cerci, Rogerio Tumelero, Rohit Tandon, Roma Tewari, Romalisa Miranda-Peats, Ron Wald, Ronald A Mastouri, Ronald G Morford, Ronald G Schwartz, Ronald P Pedalino, Rongrong Hu, Ronnell A Hansen, Ronny A Cohen, Rory Hachamovitch, Rosa Homem, Rosa Sandonato, Rosane Laimer, Rosann Gans, Roxanne Yost, Roy Mathew, Rubén Baleón-Espinosa, Ruben Ramos, Rubine Gevorgyan, Rui Ferreira, Rui Jing, Ruth Pérez-Fernández, S K Dwivedi, S Ramakrishnan, Saadat Khan, Sabahat Bokhari, Sabu Thomas, Sadath Lubna, Sajeeda Parveen Khan, Sajeev Chakanalil Govindan, Saket Girotra, Saleem Kassam, Sallie Canada, Salvador Cruz-Flores, Samaa Mohamed, Samantha Ly, Sameh El Kaffas, Samia Massalha, Sampoornima Setty, Samuel Nwosu, Sandeep Seth, Sandeep Singh, Sander R Niehe, Sandra M Rivest, Sandra S Zier, Sandra Ahoud, Sandy Carr, Sanjay Ganapathi, Sanjay Shetty, Sanjeev Sharma, Santa Jimenez, Santhosh Satheesh, Santiago A Garcia, Sara Fernandez, Sara Karlsson, Sara Salkind, Sara Temiyasathit, Sarah Medina Rodriguez, Sarah Beaudry, Sarah Hadjih, Sarah Williams, Sarah Zahrani, Sarju Ralhan, Sasa Hinic, Sasko Kedev, Satinder Singh, Satoshi Yasuda, Satvic Cholenahally Manjunath, Sau Lee, Scott M Kaczkowski, Scott Kinlay, Sean W Hayes, Sebastian Sobczak, Senait Asier, Sergey A Sayganov, Seth I Sokol, Shaheen Pandie, Shaiful Azmi Yahaya, Shamir Mehta, Shao-Ping Nie, Sharad Chandra, Sharder Islam, Sharon Tai, Sheetal Rupesh Karwa, Sheri Ussery, Sheromani Bajaj, Sherron C Crook, Shigeyuki Nishimura, Shintaro Nakano, Shirin Heydari, Shiv Kumar Choudhary, Shivali Patel, Shobana Ganesan, Shruti Pandey, Shuyang Zhang, Shweta Hande, Siddharth Gadage, Sik-Yin V Tan, Silvia Zottis Poletti, Silvia Riera, Silvia Valbuena, Simon Walsh, Simona Maspoli, Simone Savaris, Si-Ting Feng, So Yang Cho, Solomon Yakubov, Songlin Zhu, Songtao Wang, Sonia Guerrero, Sonika Gupta, Sonja Salinger Martinovic, Sonya Brons, Sorin Brener, Sothinathan Gurunathan, Souheil Saba, Soundarya Nayak, Sowjanya Reddy, Srinivasa Potluri, Sriram Sudarshan, Srun Kuanprasert, Stacie Van Oosterhout, Stamatios Lerakis, Stanley E Cobos, Stefan C Bertog, Stefan M Simović, Stefan Weikl, Stefano Di Marco, Stefano Provasoli, Stephanie A Tirado, Stephanie C Boer, Stephanie M Lane, Stephanie Ferket, Stephanie Kelly, Stephanie Wasmiller, Stephen H McKellar, Stephen P Hoole, Stephen Fremes, Stephen Preston, Steve Leung, Steven A Fein, Steven J Lindsay, Steven P Sedlis, Steven Giovannone, Steven Michael, Steven Weitz, Stijn van Vugt, Subhash Banerjee, Sudhir Naik, Suellen Hosino, Sukie Desire, Sukit Yamwong, Suku T Thambar, Sulagna Mookherjee, Suman Singh, Sundeep Mishra, Sunil Kumar Verma, Supap Kulthawong, Supatchara Khwakhong, Surendra Naik, Suresh Babu, Surin Woragidpoonpol, Suryaprakash Narayanappa, Susan Derbyshire, Susan Gent, Susan Mathus, Susan Milbrandt, Susan Moore, Susan Regan, Susan Stinson, Susan Webber, Susana Silva, Susanna Stevens, Susanne Gruensfelder, Suthara Aramcharoen, Suvarna Kolhe, Suzana Tavares, Suzanne Arnold, Suzanne Welsh, Svetlana Apostolovic, Swapna Kunhunny, Ta-Chuan Hung, Taissa Zappernick, Tali Sharir, Talita Silva, Tamara Colaiácovo Soares, Tapan Umesh Pillay, Tarun K Mittal, Tatiana Trifonova, Tauane Bello Duarte, Tauqir Huk, Téodora Dutoiu, Terrance Chua, Terry Weyand, Thabitha Charles, Theodoros Kofidis, Theresa McCreary, Thierry Lefevre, Thippeekaa Arumairajah, Thitipong Tepsuwan, Thomas J Mulhearn, Thomas M Meyer, Thomas P Rocco, Thomas R Downes, Thomas Crain, Thomas Haldis, Thomas Mathew, Thomas Redick, Thounaojam Indira Devi, Thuraia Nageh, Tia Cauthren, Tiago Silva, Tiffany Little, Tijana Andric, Tina Harding, Titus Lau, Tiziana Formisano, Tiziano Moccetti, Tomasz Ciurus, Tomasz Mazurek, Tomasz Tarchalski, Toshiyuki Nagai, Tri Tran, Tricia Youn, Trish Tucker, Trudie Milner, Tuhina Bose, Tushar Kotecha, Udo Sechtem, Uma S Valeti, Umberto Cucchini, Umesh Badami, Upendra Kaul, V K Bahl, V S Narain, Valentina Casali, Valeria Godoy, Valerie Robesyn, Vamshi P Priya, Vandana Yadav, Vera McKinney, Veronica De Lenges, Veronica Tinnirello, Vicente Miro, Victor Navarro, Victoria Gumerova, Victoria Hernandez, Vidya Seeratan, Vijay Kumar, Vikentiy Y Kozulin, Viktoria Bulkley, Vilmar Veiga Jr, Vincent Setang, C P Vineeth, Virginai Pubull Nuñez, Virginia Fernández-Figares, Vitor Gomes, Viviana Gabriel, Viviane Dos Santos, Viviane Almeida, Vlad A Iliescu, Vladan Mudrenovic, Vladimir Dzavik, Vojislav L Giga, Walter Enrique Mogrovejo, Wan Xian Chan, Wanda C Marfori, Wanda Parker, Warangkana Mekara, Wassim Nona, Wayne Old, Wayne Pennachi, Weerachai Nawarawong, Wei Chen, Wei Su, Weibing Xing, Wei-Ren Lan, Wenda Crawford, Wendy L Stewart, Wendy Drewes, Wenhua Lin, William B Abernethy, William D Salerno, William F Fearon, William Vergoni, William Weintraub, Winnie C Sia, Wlodzimierz J Musial, Xacobe Flores-Ríos, Xavier Garcia-Moll Marimon, Xi Su, Xiang Ma, Xiangqiong Gu, Xiao Wang, Xiaomei Li, Xiaowei Yao, Xin Fu, Xin Su, Xin Zeng, Xinchun Yang, Xiuhong Li, Xuehua Fang, Xutong Wang, Yaming Geng, Yan Yan, Yanek Pépin-Dubois, Yanfu Wang, Yang Wang, Yanmeng Tian, Yaping Huang, Yechen Han, Yesenia Zambrano, Yi-Hsuan Yang, Ying Tung Sia, Yining Yang, Yitong Ma, Yolayfi Peralta, Yongjian Wu, Yu Kunwu, Yu Zhao, Yudong Peng, Yueh-Hung Lin, Yulan Zhao, Yumei Dong, Yunhai Zhao, Yutthaphan Wannasopha, Yvonne Taul, Zakir Sahul, Zalina Kudzoeva, Zbigniew Kalarus, Zeljko Z Markovic, Zhen Huang, Zheng Ji, Zhenyu Liu, Zhou Yue, Zhulin Zhang, Zhuxi Li, Zile Singh Meharwal, Ziliang Bai, Zixiang Yu, Zohra Huda, Zoltan Davidovits

Subjects
Male, Cardiac Catheterization, Computed Tomography Angiography, medicine.medical_treatment, Myocardial Ischemia, Coronary Disease, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Coronary Angiography, ISCHEMIA Research Group, law.invention, Angina, Coronary artery disease, 0302 clinical medicine, Randomized controlled trial, law, Cardiovascular Disease, Myocardial Revascularization, 030212 general & internal medicine, Coronary Artery Bypass, 11 Medical and Health Sciences, Cardiac catheterization, General Medicine, Middle Aged, humanities, Cardiovascular Diseases, Cardiology, Female, Human, medicine.medical_specialty, Ischemia, Article, 03 medical and health sciences, Geriatric cardiology, Percutaneous Coronary Intervention, General & Internal Medicine, Internal medicine, medicine, Humans, Angina, Unstable, Aged, business.industry, Coronary Artery Bypa, Percutaneous coronary intervention, Bayes Theorem, medicine.disease, Heart failure, Quality of Life, business
Abstract

BACKGROUND: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS: We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS: Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, -1.8 percentage points; 95% CI, -4.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS: Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, NCT01471522.).

Published
2020
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13. Things we hold dear

Author

Catalina Pollak Williamson

Subjects
Value (ethics), business.industry, Context (language use), Citizen journalism, Public relations, Local community, Work (electrical), Urban planning, Premise, General Earth and Planetary Sciences, Sociology, business, Set (psychology), General Environmental Science
Abstract

This paper reflects on Common-places (2019), a project that was developed in Sheffield on the invitation of Site Gallery to participate in their ‘City of Ideas’ programme. Amidst the urban regeneration processes that are reshaping the city, this programme offered the opportunity to think about novel approaches that art and interdisciplinary practices could bring to processes of urban change. Common-places was proposed as a participatory workshop that engaged the local community, by inviting them to recognise the things they ‘hold dear’ about the areas in which they live or work. The premise was to identify forms of material and immaterial value that would reveal the ‘character’ of a place and its forms of use-value that are important to a local community. The intention was to develop a set of tools to highlight, map, commemorate and ultimately protect this intangible heritage in the context of urban regeneration in Sheffield. The project addressed some of the existing challenges of integrating an expanded notion of heritage in urban planning. Moveover, it reflects on the importance of identifying the use-value of intangible heritage and embraces a more integral and holistic approach to city planning.

Published
2021
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14. A Yet Unrealized Promise: Structured Advance Care Planning Elements in the Electronic Health Record

Author

Charlotta Lindvall, Daniel A. Gundersen, Elise N Brannen, Acp-Peace Investigators, Michael K. Paasche-Orlow, Danielle Kennedy, Kathryn I. Pollak, Jody-Ann McLeggon, Jeremiah Stout, Angelo E. Volandes, Joshua R Lakin, and James A. Tulsky

Subjects
Advance care planning, Quality management, Data management, Pilot Projects, Documentation, Advance Care Planning, 03 medical and health sciences, 0302 clinical medicine, 030502 gerontology, Health care, Electronic Health Records, Humans, Medicine, General Nursing, Aged, business.industry, Medical record, General Medicine, medicine.disease, Clinical trial, Cross-Sectional Studies, Anesthesiology and Pain Medicine, 030220 oncology & carcinogenesis, Brief Reports, Medical emergency, 0305 other medical science, business, End-of-life care
Abstract

Background: Electronic health records (EHRs) may help enable reliable, rapid data management for many uses, such as facilitating communication of advance care planning (ACP). However, issues with validity and accuracy of EHRs hinder the use of ACP information for practical applications. Design: We present a cross-sectional pilot study of 433 older adults with cancer from three large health care systems, participating in an ongoing multisite pragmatic trial (4UH3AG060626-02). We compared data extracted from dedicated structured EHR fields for ACP to a chart review of corresponding ACP documentation contained in the medical chart. Results: Structured ACP data existed for 43.2% of patients and varied by site (25.7% −48.9%). Of the identified structured ACP data elements, 59.2% of recorded elements were correct, 23.7% were incorrect, and 17.1% were duplicates with heterogeneity across sites. Conclusion: Structured ACP data in EHRs were frequently incorrect. This represents a problem for patients and their families, as well as quality improvement and research efforts. Clinical Trials Registration: NCT03609177.

Published
2021
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15. Quantitative Evaluation of Embolic Load in Femoral and Tibial Shaft Fractures Treated With Reamed Intramedullary Fixation

Author

Mary Hyder, Nathan N O'Hara, Joshua Rudnicki, Christopher Lee, Daniel Connelly, Robert V O'Toole, Bianca Conti, Andrew N. Pollak, Aresh Sepehri, Mitchell Baker, and Zachary D. Hannan

Subjects
medicine.medical_specialty, Femoral shaft, Bone Nails, law.invention, Intramedullary rod, law, Humans, Medicine, Orthopedics and Sports Medicine, Femur, Guide-wire placement, Tibia, Fixation (histology), business.industry, Trauma center, General Medicine, Confidence interval, Fracture Fixation, Intramedullary, Surgery, Tibial Fractures, Treatment Outcome, business, Femoral Fractures
Abstract

OBJECTIVES To compare the volume of embolic load during intramedullary fixation of femoral and tibial shaft fractures. Our hypothesis was that tibial intramedullary nails (IMNs) would be associated with less volume of intravasation of marrow than IM nailing of femur fractures. DESIGN Prospective observational study. SETTING Urban Level I trauma center. PATIENTS/PARTICIPANTS Twenty-three patients consented for the study: 14 with femoral shaft fractures and 9 with tibial shaft fractures. INTERVENTION All patients underwent continuous transesophageal echocardiography, and volume of embolic load was evaluated during 5 distinct stages: postinduction, initial guide wire, reaming (REAM), nail insertion, and postoperative. MAIN OUTCOME MEASUREMENTS Volume of embolic load was measured based on previously described luminosity scores. The embolic load based on fracture location and procedure stage was evaluated using a mixed effects model. RESULTS The IMN procedure increased the embolic load by 215% (-12% to 442%, P = 0.07) in femur patients relative to tibia patients after adjusting for baseline levels. Of the 5 steps measured, REAM was associated with the greatest increase in embolic load relative to the guide wire placement and controlling for fracture location (421%, 95% confidence interval: 169%-673%, P < 0.01). CONCLUSIONS Femoral shaft IMN fixation was associated with a 215% increase in embolic load in comparison with tibial shaft IMN fixation, with the greatest quantitative load during the REAM stage; however, both procedures produce embolic load. LEVEL OF EVIDENCE Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Published
2021
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16. Blood biomarkers reflect the effects of obesity and inflammation on the human breast transcriptome

Author

Monica Morrow, Michael Pollak, Andrew J. Dannenberg, Olivier Elemento, Byuri Angela Cho, Neil M. Iyengar, Dilip Giri, Xi Kathy Zhou, and Akanksha Verma

Subjects
Cancer Research, Carcinogenesis, Adipose Tissue, White, Adipose tissue, Breast Neoplasms, Inflammation, White adipose tissue, Transcriptome, Breast cancer, medicine, Humans, Obesity, Aromatase, skin and connective tissue diseases, biology, Adiponectin, business.industry, Leptin, General Medicine, medicine.disease, biology.protein, Cancer research, Female, medicine.symptom, business, Biomarkers
Abstract

Obesity is a risk factor for the development of post-menopausal breast cancer. Breast white adipose tissue (WAT) inflammation, which is commonly found in women with excess body fat, is also associated with increased breast cancer risk. Both local and systemic effects are probably important for explaining the link between excess body fat, adipose inflammation and breast cancer. The first goal of this cross-sectional study of 196 women was to carry out transcriptome profiling to define the molecular changes that occur in the breast related to excess body fat and WAT inflammation. A second objective was to determine if commonly measured blood biomarkers of risk and prognosis reflect molecular changes in the breast. Breast WAT inflammation was assessed by immunohistochemistry. Bulk RNA-sequencing was carried out to assess gene expression in non-tumorous breast. Obesity and WAT inflammation were associated with a large number of differentially expressed genes and changes in multiple pathways linked to the development and progression of breast cancer. Altered pathways included inflammatory response, complement, KRAS signaling, tumor necrosis factor α signaling via NFkB, interleukin (IL)6-JAK-STAT3 signaling, epithelial mesenchymal transition, angiogenesis, interferon γ response and transforming growth factor (TGF)-β signaling. Increased expression of several drug targets such as aromatase, TGF-β1, IDO-1 and PD-1 were observed. Levels of various blood biomarkers including high sensitivity C-reactive protein, IL6, leptin, adiponectin, triglycerides, high-density lipoprotein cholesterol and insulin were altered and correlated with molecular changes in the breast. Collectively, this study helps to explain both the link between obesity and breast cancer and the utility of blood biomarkers for determining risk and prognosis.

Published
2021
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17. Anatomic Approach to Transseptal Puncture for Structural Heart Interventions

Author

Mackram F. Eleid, Mohamad Alkhouli, Jeremy J. Thaden, Peter M. Pollak, Colleen E. Lane, Paul A. Friedman, Charanjit S. Rihal, Ammar M. Killu, Abdallah El Sabbagh, and Trevor Simard

Subjects
Cardiac Catheterization, medicine.medical_specialty, business.industry, Psychological intervention, Punctures, Surgery, Treatment Outcome, Left atrial, Cardiac interventions, Atrial Fibrillation, Catheter Ablation, Humans, Medicine, Heart Atria, Cardiac Surgical Procedures, Cardiology and Cardiovascular Medicine, business
Abstract

The use of transseptal puncture continues to rise given the increase in left atrial cardiac interventions. The authors review an anatomic approach to transseptal puncture incorporating multimodality imaging both pre- and intraprocedurally with stepwise escalation algorithms to ensure safe and efficacious large-bore transseptal puncture.

Published
2021
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18. Depression, anxiety and PTSD symptoms before and during the COVID-19 pandemic in the UK

Author

A Martineau, Brett N. Adey, Gerome Breen, Papadia S, Maughan B, Alicia J. Peel, Jessica Mundy, Stirrups K, Matthew Richardson, Linger R, Ammar Al-Chalabi, Holt H, Melanie J. Davies, David Veale, Alish B. Palmos, Kirstin L. Purves, Y. Lin, Huebel C, Bristow S, Katherine N. Thompson, Evangelos Vassos, Ward C, Bradley J, Young Ks, Colette R. Hirsch, ter Kuile A, Gursharan Kalsi, Kingston N, Andrea Danese, Timothy R Nicholson, Georgina Krebs, Chaudhuri Kr, Sharon Stevelink, Thalia C. Eley, Bright S, Christopher Rayner, Pollak T, Chinnery P, Matthew Hotopf, Lee Yt, York K, Hegemann L, Dina Monssen, Moukhtarian T, Christine E. Parsons, Henry C. Rogers, and Schmidt U

Subjects
Psychiatry and Mental health, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Pandemic, Medicine, Anxiety, medicine.symptom, business, Psychiatry, Applied Psychology, Depression (differential diagnoses)
Abstract

Background The impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health is still being unravelled. It is important to identify which individuals are at greatest risk of worsening symptoms. This study aimed to examine changes in depression, anxiety and post-traumatic stress disorder (PTSD) symptoms using prospective and retrospective symptom change assessments, and to find and examine the effect of key risk factors. Method Online questionnaires were administered to 34 465 individuals (aged 16 years or above) in April/May 2020 in the UK, recruited from existing cohorts or via social media. Around one-third (n = 12 718) of included participants had prior diagnoses of depression or anxiety and had completed pre-pandemic mental health assessments (between September 2018 and February 2020), allowing prospective investigation of symptom change. Results Prospective symptom analyses showed small decreases in depression (PHQ-9: −0.43 points) and anxiety [generalised anxiety disorder scale – 7 items (GAD)-7: −0.33 points] and increases in PTSD (PCL-6: 0.22 points). Conversely, retrospective symptom analyses demonstrated significant large increases (PHQ-9: 2.40; GAD-7 = 1.97), with 55% reported worsening mental health since the beginning of the pandemic on a global change rating. Across both prospective and retrospective measures of symptom change, worsening depression, anxiety and PTSD symptoms were associated with prior mental health diagnoses, female gender, young age and unemployed/student status. Conclusions We highlight the effect of prior mental health diagnoses on worsening mental health during the pandemic and confirm previously reported sociodemographic risk factors. Discrepancies between prospective and retrospective measures of changes in mental health may be related to recall bias-related underestimation of prior symptom severity.

Published
2022
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19. A Collaborative Intervention Between Emergency Medicine and Infectious Diseases to Increase Syphilis and HIV Screening in the Emergency Department

Author

Jose A. Bazan, Susan L. Koletar, Mohammad Mahdee Sobhanie, Michael Dick, Brandon Pollak, Sommer Lindsey, Kushal Nandam, Mark E. Lustberg, Carlos Malvestutto, and Ashley A Lipps

Subjects
Microbiology (medical), medicine.medical_specialty, Gonorrhea, Sexually Transmitted Diseases, HIV Infections, Dermatology, Hiv testing, Original Studies, HIV Testing, Intervention (counseling), medicine, Humans, Mass Screening, Syphilis, Infectious disease (athletes), Chlamydia, business.industry, Public Health, Environmental and Occupational Health, virus diseases, HIV screening, Emergency department, Chlamydia Infections, medicine.disease, humanities, Infectious Diseases, Emergency medicine, Emergency Medicine, Emergency Service, Hospital, business
Abstract

This study reports that focused collaboration between infectious diseases and emergency medicine providers results in increased identification of patients with syphilis and HIV in the emergency department., Background Sexually transmitted infections (STIs) are a common reason for evaluation in the emergency department (ED). Given the overlapping risk factors for STIs, patients screened for gonorrhea and chlamydia should be tested for syphilis and HIV. Syphilis and HIV testing rates in the ED have been reported to be low. The study objective was to examine whether collaboration between emergency medicine (EM) and infectious disease (ID) providers improved syphilis and HIV testing in the ED. Methods A multidisciplinary team of EM and ID providers was formed to identify and address barriers to syphilis and HIV testing in the ED. Syphilis, HIV, chlamydia, and gonorrhea testing and infection rates were calculated and compared during 2 time periods: preintervention (January 1, 2012–December 30, 2017) and postintervention (November 1, 2018–November 30, 2019). We also extracted clinical and laboratory data from patients with positive syphilis and HIV results during the study period. Results The most commonly cited barrier to syphilis and HIV testing was concern about follow-up of positive results. Compared with the preintervention period, syphilis and HIV testing rates increased significantly in the postintervention period (incidence rate ratios, 30.70 [P < 0.0001] and 28.99 [P < 0.0001] for syphilis and HIV, respectively). The postintervention period was also associated with a significant increase in the identification of patients with positive syphilis and HIV results (incidence rate ratios, 7.02 [P < 0.0001] and 2.34 [P = 0.03], respectively). Conclusions Collaboration between EM and ID providers resulted in a significant increase in syphilis and HIV testing and diagnosis in the ED.

Published
2021
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20. Prescribing Errors With Direct Oral Anticoagulants and Their Impact on the Risk of Bleeding in Patients With Atrial Fibrillation

Author

Ilan Matok, Arthur Pollak, Yevgeni Erlichman, Mordechai Muszkat, and Bruria Hirsh Raccah

Subjects
Male, medicine.medical_specialty, Administration, Oral, Hemorrhage, Risk Factors, Atrial Fibrillation, Humans, Medication Errors, Medicine, Pharmacology (medical), In patient, Israel, Intensive care medicine, Aged, Aged, 80 and over, Pharmacology, business.industry, Anticoagulants, Atrial fibrillation, medicine.disease, Potential harm, Harm, Case-Control Studies, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Introduction: Anticoagulants are associated with significant harm when used in error, but there are limited data on potential harm of inappropriate treatment with direct oral anticoagulants (DOACs). We conducted a matched case-control study among atrial fibrillation (AF) patients admitting the hospital with a chronic treatment with DOACs, in order to assess factors associated with the risk of major bleeding. Methods: Patient data were documented using hospital’s computerized provider order entry system. Patients identified with major bleeding were defined as cases and were matched with controls based on the duration of treatment with DOACs and number of chronic medications. Appropriateness of prescribing was assessed based on the relevant clinical guidelines. Conditional logistic regression was used to evaluate the potential impact of safety-relevant prescribing errors with DOACs on major bleeding. Results: A total number of 509 eligible admissions were detected during the study period, including 64 cases of major bleeding and 445 controls. The prevalence of prescribing errors with DOACs was 33%. Most prevalent prescribing errors with DOACs were “drug dose too low” (16%) and “non-recommended combination of drugs” (11%). Safety-relevant prescribing errors with DOACs were associated with major bleeding [adjusted odds ratio (aOR) 2.17, 95% confidence interval (CI) 1.14-4.12]. Conclusion: Prescribers should be aware of the potential negative impact of prescribing errors with DOACs and understand the importance of proper prescribing and regular follow-up.

Published
2021
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21. National trends in extremity fracture hospitalizations among older adults between 2003 and 2017

Author

Andrew N. Pollak, Joseph F. Levy, Jay Magaziner, Lisa Reider, and Jennifer L. Wolff

Subjects
Male, High energy, Time Factors, Population, Arm Bones, Cohort Studies, Fractures, Bone, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Femur, Leg Bones, Longitudinal Studies, National trends, Longitudinal cohort, education, Aged, Retrospective Studies, Aged, 80 and over, 030222 orthopedics, education.field_of_study, business.industry, Incidence, Incidence (epidemiology), 030208 emergency & critical care medicine, United States, Hospitalization, Extremity fractures, Female, Geriatrics and Gerontology, Lower extremity fracture, business, Demography
Abstract

BACKGROUND Fractures in late life are highly consequential for health, services use, and spending. Little is known about trends in extremity fracture hospitalizations among older adults in the United States. DESIGN Retrospective longitudinal cohort study. SETTING The 2003-2017 National Inpatient Sample (NIS), a representative sample of U.S. community hospitals. PARTICIPANTS Hospitalized adults aged 65 and older with a diagnosis of upper or lower extremity fracture. MEASUREMENTS Incidence of extremity fracture hospitalization and mortality, using NIS discharge and trend weights, and population denominators derived from the U.S. Census Bureau. Incidence was reported separately for men and women by age, fracture diagnosis, and injury mechanism. Weighted linear regression was used to test for significant trends over time. RESULTS Incidence of extremity fracture hospitalizations declined in both women (15.7%, p trend

Published
2021
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22. Increasing physical activity in Cancer Survivors through a Text-messaging Exercise motivation Program (ICanSTEP)

Author

Gary G. Bennett, Martin Streicher, Donna Niedzwiecki, Tykeytra Dale, Frances McSherry, Linda Sutton, Christel Rushing, Kathryn I. Pollak, Bridget F. Koontz, Lynda Owen, William E. Kraus, and Erica Levine

Subjects
Self-efficacy, Activity level, medicine.medical_specialty, business.industry, Activity tracker, Physical activity, Cancer, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, Completion rate, Intervention (counseling), Physical therapy, Medicine, 030212 general & internal medicine, business, Depression (differential diagnoses)
Abstract

Cancer survivors are often sedentary. Self-monitoring may promote physical activity through self-activation. We conducted a pilot trial to evaluate whether wearable activity tracker with personalized text message feedback would increase physical activity. We enrolled 30 patients with solid tumor cancers into a non-randomized prospective intervention trial (NCT02627079): 15 had completed treatment in the past year and 15 under active treatment. Each participant received an activity tracker and daily text messages personalized to their activity level. We assessed patient-reported outcomes and 6-min walk (6 MW) at baseline and 3 months. Twenty-six participants completed the study. There was substantial variation in baseline activity. Overall, 39% of participants increased their steps taken by at least 20%, and 23% increased their 6 MW distance by 20% or more. More participants who had completed treatment strongly agreed (73%) that the intervention increased their exercise levels than those receiving active treatment (47%). At 3 months, there was a significant improvement in median Beck Depression Inventory-II and Godin Leisure Index composite scores. At 6 months, 72% still wore their activity tracker at least 4 days per week. We found that the intervention was well-accepted with a high completion rate at 3 months and continued self-use at 6 months. In this pilot study of combined activity tracker and motivational messaging, we found a signal for increased physical activity over a 3-month period. Future research is needed to study this technique for its impact on activity and other physical and psychological measures of well-being. Activity tracker with personalized motivational messaging may be useful in promoting physical activity in cancer survivors.

Published
2021
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23. Evaluation of biomarkers related to zinc nutritional status, antioxidant activity and oxidative stress in rheumatoid arthritis patients

Author

Silvia Maria Franciscato Cozzolino, Marcelo Macedo Rogero, Kátia Rau de Almeida Callou, Graziela Biude Silva Duarte, Kaluce Gonçalves de Sousa Almondes, and Daniel Feldman Pollak

Subjects
0301 basic medicine, Antioxidant, medicine.medical_treatment, Nutritional Status, Medicine (miscellaneous), chemistry.chemical_element, Zinc, 030204 cardiovascular system & hematology, Pharmacology, medicine.disease_cause, Antioxidants, Arthritis, Rheumatoid, Superoxide dismutase, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030109 nutrition & dietetics, Nutrition and Dietetics, biology, business.industry, Nutritional status, General Medicine, medicine.disease, Pathophysiology, ANT, Oxidative Stress, chemistry, SUPERÓXIDO DISMUTASE, Case-Control Studies, Rheumatoid arthritis, biology.protein, Female, business, Biomarkers, Brazil, Oxidative stress
Abstract

Background: Oxidative stress (OS) is an important process related to the pathophysiology of rheumatoid arthritis and can be increased by the low intake of antioxidants. Zinc (Zn) is an important antioxidant trace-element for human health and the assessment of the nutritional status of this micronutrient in these patients is of relevance. Aim: This study aimed to evaluate Zn nutritional status in rheumatoid arthritis patients and its relation to OS. Methods: A case–control study was carried out with 51 patients diagnosed with rheumatoid arthritis (RA group) recruited in Hospital São Paulo (São Paulo, Brazil) and 55 healthy women (CO group) from the campus of the University of São Paulo. Blood and 24-hour urine collection were used for biochemical parameters related to Zn status and OS. The assessment of dietary Zn was performed by three 24-hour dietary recalls. Results: The RA group presented significative low Zn intake ( p < 0.001) and plasma concentration ( p = 0.040) of this mineral compared to the CO group. However, both groups were Zn deficient and the disease activity (DAS28 score) for RA patients did not influence Zn biomarkers. In addition, the antioxidant enzymes (superoxide dismutase and glutathione peroxidase) activity and the urinary 8-isoprostanes were reduced in RA patients. Conclusion: The evaluation of dietary intake and biochemical biomarkers indicates that rheumatoid arthritis patients are zinc deficient and have increased OS.

Published
2021
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24. Mutations in HOGA1 do Not Confer a Dominant Phenotype Manifesting as Kidney Stone Disease

Author

Ruth Belostotsky, Shay Tzur, Efrat Ben-Shalom, Martin R. Pollak, Yaacov Frishberg, David B. Mount, Roi Bar, Ruth Bar-Gal, Mordechai Duvdevani, Ehud Gnessin, and Gary C. Curhan

Subjects
Pathology, medicine.medical_specialty, business.industry, Urology, Calcium oxalate, medicine.disease, Phenotype, Oxalate, Primary hyperoxaluria, chemistry.chemical_compound, chemistry, Kidney stone disease, Etiology, medicine, Kidney stones, business
Abstract

Purpose:The etiology of calcium-oxalate kidney stone formation remains elusive. Biallelic mutations in HOGA1 are responsible for primary hyperoxaluria type 3 and result in oxalate overproduction an...

Published
2021
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25. What Is the Long-Term Impact of an Implant Stewardship Program on Orthopaedic Trauma Implant Pricing?

Author

John Morellato, Mitchell Baker, Robert V O'Toole, Nathan N O'Hara, and Andrew N. Pollak

Subjects
medicine.medical_specialty, External Fixators, law.invention, Proximal tibia, Intramedullary rod, 03 medical and health sciences, 0302 clinical medicine, law, medicine, Humans, Orthopedics and Sports Medicine, Orthopaedic trauma, health care economics and organizations, 030222 orthopedics, business.industry, Trauma center, 030208 emergency & critical care medicine, Prostheses and Implants, General Medicine, Confidence interval, Fracture Fixation, Intramedullary, Surgery, Orthopedics, Costs and Cost Analysis, Implant, Level iii, business, Cost containment
Abstract

Objectives To analyze the effectiveness of an implant stewardship program on implant cost containment and to estimate surgeon responsiveness to implant price changes. Design Interrupted time series. Setting Level I trauma center. Patients/participants Monitored usage of 5 trauma constructs by 10 surgeons over a 5-year period. Intervention Red-Yellow-Green (RYG) implant pricing comparison chart. Main outcome measurements Primary outcomes were changes in the mean price, minimum price, and the number of price changes. The secondary outcome was surgeon responsiveness to RYG/cost changes. Results The study consisted of 2468 procedures. A mean construct price decrease of $66 per year (95% confidence interval [CI], $-170 to $-151), with distal femoral plates demonstrating the largest mean annual price decline ($486; 95% CI, $-540 to $-432). The minimum construct price decreased by $131 per year (95% CI, $-155 to $-111), with the largest reductions observed for distal femoral plates (-$436 per year; 95% CI, $-516 to $-354) and external fixators (-$122 per year; 95% CI, $-258 to $-136). The median price decrease was $407 (range: $6 to $2491), or 12.5% of the previous price. Positive changes in RYG levels increased surgeon usage of tibial nails by 115%, femoral nails by 106%, and external fixators by 104%. Surgeon implant selection was insensitive to RYG changes for distal femoral plates (RYG elasticity [ERYG]: -0.74) and proximal tibia plates (ERYG: -0.21). Conclusions The implant stewardship program was associated with substantial implant price reductions. Surgeon implant selection was especially sensitive to price changes for intramedullary nails and external fixators. Level of evidence Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Published
2021
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26. Results of Polish Adult Leukemia Study Group (PALG) project assessing TP53 mutations with next-generation sequencing technology in relapsed and refractory chronic lymphocytic leukemia patients — an 18-month update

Author

Bartosz Pula, Ewa Bodzenta, Dorota Zdunczyk, Małgorzata Rydzanicz, Iwona Sokolowska-Giezgala, Katarzyna Warzybok, Marcin M Machnicki, Magdalena Olszewska-Szopa, Anna Labedz, Jolanta Wieczorek, Dominika Wisniewska-Organek, Tomasz Stoklosa, Kamila Kruczkowska-Tarantowicz, Krzysztof Jamroziak, Marek Dudziński, Zofia Spyra-Gorny, Rafał Płoski, Dariusz Kumorek, Monika Pepek, Alina Urbanowicz, Elzbieta Morawiec-Szymonik, Agnieszka Szeremet, Pawel Bernatowicz, Agnieszka Pollak, Ryszard Wichary, and Waldemar Tomczak

Subjects
Oncology, medicine.medical_specialty, business.industry, Chronic lymphocytic leukemia, Refractory CLL, Hematology, medicine.disease, Molecular diagnostics, Tp53 mutation, DNA sequencing, Leukemia, hemic and lymphatic diseases, Internal medicine, medicine, Refractory Chronic Lymphocytic Leukemia, Routine analysis, business, neoplasms
Abstract

Indtroduction and methods: In chronic lymphocytic leukemia (CLL), molecular and cytogenetic diagnostics are crucial for the determination of accurate prognosis and treatment choice. Among different genetic aberrations, del(17p13) or TP53 mutations constitute high-risk factors, and early identification of such defects is a high priority for CLL patients. While cytogenetic diagnostics is well-established and accessible for the majority of CLL patients in Poland, molecular diagnostics of TP53 mutations is performed only in a few ERIC-certified centers (eight as of September 2020), and only two of these employ next-generation sequencing (NGS) for routine analysis of TP53 status in CLL patients. Here we report the interim results of a project assessing TP53 mutations with NGS technology in relapsed or refractory CLL patients with confirmed negative del(17p13) status. 249 patients from 32 clinical centers were included in the study. Results: NGS analysis revealed TP53 mutations in 42/249 (17%) patients, half of whom (21/249, 8.5%) had subclonal mutations (VAF ≤10%). These results are in line with published data in relapsed/refractory CLL patients. Conclusions: The results of the project demonstrated the feasibility and accuracy of NGS testing in CLL patients despite several initial logistical and technical obstacles. Our study also proved that, with appropriate funding, CLL patients from any hematological center in Poland can have access to state-of-the-art molecular diagnostics

Published
2021
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27. Discordance between dementia caregivers’ goal of care and preference for life-extending treatments

Author

Chetna Malhotra, Rahul Malhotra, Ka-Mun Tong, Allyn Yin Mei Hum, Sungwon Yoon, Truls Østbye, Bharathi Balasundaram, Jing Rong Yong, Kathryn I. Pollak, Dennis Seow, Hazirah Mohamad, and John Carson Allen

Subjects
Aging, medicine.medical_specialty, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Dementia, Family, 030212 general & internal medicine, Aged, Singapore, Withholding Treatment, business.industry, Regret, General Medicine, medicine.disease, Preference, Caregivers, Severe dementia, 030220 oncology & carcinogenesis, Family medicine, Geriatrics and Gerontology, Thematic analysis, business, Goals, End-of-life care, Qualitative research
Abstract

BackgroundMany older adults with severe dementia receive potentially life-extending treatments even when caregivers do not wish to prolong their life inappropriately.ObjectiveExplore factors that influence caregiver preferences for potentially life-extending treatments for older adults with severe dementia, and reasons for discordance between overall end-of-life care goal and treatment preferences.DesignSemi-structured in-depth interviews asking caregivers their overall end-of-life care goal for older adults and preferences for intravenous (IV) antibiotics, tube feeding and cardiopulmonary resuscitation (CPR).ParticipantsA total of 26 caregivers of community-dwelling older adults with severe dementia in Singapore.ApproachReflexive thematic analysis.ResultsMost caregivers’ (77%) overall end-of-life care goal was ‘no life extension’. Yet, 80% preferred IV antibiotics for a life-threatening infection, 60% preferred tube feeding and 45% preferred CPR. Caregivers preferred these treatments because they (1) perceived letting go by withholding treatments as unethical, (2) felt they had no choice as they deferred to the health care provider, (3) wanted to alleviate suffering rather than extend life and (4) desired trying minimally invasive treatments that had the potential to be withdrawn. Themes explaining discordance were (1) feared regret about making the ‘wrong’ decision, (2) considered treatments to address immediate needs even when long-term goal did not match providing that treatment and (3) anticipated disagreement with other family members on overall goal of care.ConclusionTo reduce discordance between caregivers’ overall end-of-life care goal and preferences for life-extending treatments, clinicians can use a shared decision-making approach involving discussions of both their overall end-of-life care goal and treatment preferences.

Published
2021
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28. autoBOT: evolving neuro-symbolic representations for explainable low resource text classification

Author

Nada Lavrač, Senja Pollak, Matej Martinc, and Blaž Škrlj

Subjects
Computer science, Evolutionary algorithm, 02 engineering and technology, Neuro-symbolic computing, Space (commercial competition), Machine learning, computer.software_genre, Article, Representation learning, Artificial Intelligence, 020204 information systems, 0202 electrical engineering, electronic engineering, information engineering, Representation (mathematics), AutoML, Hyperparameter, Ensemble forecasting, business.industry, Natural language processing, 020201 artificial intelligence & image processing, Language model, Artificial intelligence, business, computer, Feature learning, Software, Word (computer architecture)
Abstract

Learning from texts has been widely adopted throughout industry and science. While state-of-the-art neural language models have shown very promising results for text classification, they are expensive to (pre-)train, require large amounts of data and tuning of hundreds of millions or more parameters. This paper explores how automatically evolved text representations can serve as a basis for explainable, low-resource branch of models with competitive performance that are subject to automated hyperparameter tuning. We present autoBOT (automatic Bags-Of-Tokens), an autoML approach suitable for low resource learning scenarios, where both the hardware and the amount of data required for training are limited. The proposed approach consists of an evolutionary algorithm that jointly optimizes various sparse representations of a given text (including word, subword, POS tag, keyword-based, knowledge graph-based and relational features) and two types of document embeddings (non-sparse representations). The key idea of autoBOT is that, instead of evolving at the learner level, evolution is conducted at the representation level. The proposed method offers competitive classification performance on fourteen real-world classification tasks when compared against a competitive autoML approach that evolves ensemble models, as well as state-of-the-art neural language models such as BERT and RoBERTa. Moreover, the approach is explainable, as the importance of the parts of the input space is part of the final solution yielded by the proposed optimization procedure, offering potential for meta-transfer learning.

Published
2021
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29. The Effect of In-Person Primary and Secondary School Instruction on County-Level Severe Acute Respiratory Syndrome Coronavirus 2 Spread in Indiana

Author

Babar A. Khan, Rebekah Roll, Micah Pollak, Gabriel T. Bosslet, Jeong Hoon Jang, and Mark Sperling

Subjects
Microbiology (medical), 2019-20 coronavirus outbreak, medicine.medical_specialty, education.field_of_study, Coronavirus disease 2019 (COVID-19), business.industry, Public health, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Population, Percentage point, Infectious Diseases, Primary outcome, medicine, County level, education, business, Demography
Abstract

Background Our goal was to determine the county-level effect of in-person primary and secondary school reopening on daily cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Indiana. Methods In this county-level, population-based study, we used a panel data regression analysis of the proportion of in-person learning to evaluate an association with community-wide daily new SARS-CoV-2 cases. The study period was 12 July 2020–6 October 2020. We included 73 of 92 (79.3%) Indiana counties in the analysis, accounting for 85.7% of school corporations and 90.6% of student enrollment statewide. The primary exposure was the proportion of students returning to in-person instruction. The primary outcome was the daily new SARS-CoV-2 cases per 100 000 residents at the county level. Results There is a statistically significant relationship between the proportion of students attending K-12 schools in-person and the county level daily cases of SARS-CoV-2 28 days later. For all ages, the coefficient of interest (β) is estimated at 3.36 (95% confidence interval, 1.91 to 4.81; P Conclusions In-person primary and secondary school is associated with a statistically significant but proportionally small increase in the spread of SARS-CoV-2 cases.

Published
2021
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30. Identification of significant PVC clusters through PPG waveform review

Author

Francis Christian, Alexandra Pollak, and Robert J. Thomas

Subjects
business.industry, Signal Processing, Computer-Assisted, Pattern recognition, General Medicine, Electrocardiography, Identification (information), Heart Rate, Humans, Waveform, Medicine, Artificial intelligence, Photoplethysmography, business, Algorithms
Published
2021
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31. Effects of obesity on breast aromatase expression and systemic metabo-inflammation in women with BRCA1 or BRCA2 mutations

Author

Dilip Giri, Xi Kathy Zhou, Hillary Mendieta, Andrew J. Dannenberg, Lisle A. Winston, Lingsong Meng, Omar El-Hely, Hanhan Wang, Domenick J. Falcone, Neil M. Iyengar, Taehoon Ha, Monica Morrow, and Michael Pollak

Subjects
0301 basic medicine, medicine.medical_specialty, White adipose tissue, Article, 03 medical and health sciences, Breast cancer, 0302 clinical medicine, Internal medicine, medicine, Pharmacology (medical), Radiology, Nuclear Medicine and imaging, Aromatase, Prospective cohort study, skin and connective tissue diseases, RC254-282, biology, Adiponectin, business.industry, Leptin, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Obesity, 030104 developmental biology, Endocrinology, Oncology, 030220 oncology & carcinogenesis, biology.protein, business, Body mass index
Abstract

Obesity is associated with an increased risk of breast cancer in post-menopausal women and decreased risk in pre-menopausal women. Conversely, in BRCA1/2 mutation carriers, pre-menopausal obesity is associated with early-onset breast cancer. Here we show that obese, pre-menopausal BRCA1/2 mutation carriers have increased levels of aromatase and inflammation in the breast, as occurs in post-menopausal women. In a prospective cohort study of 141 women with germline BRCA1 (n = 74) or BRCA2 (n = 67) mutations, leptin, and aromatase expression were higher in the breast tissue of obese versus lean individuals (P P P BRCA1/2 mutation carriers.

Published
2021

32. Sacral neuromodulation - when and for who

Author

Howard B. Goldman, Marcelo Mass-Lindenbaum, D. Calderón-Pollak, and Javier Pizarro-Berdichevsky

Subjects
Sacrum, business.industry, Urinary Bladder, Overactive, Urology, Lumbosacral Plexus, Electric Stimulation Therapy, Expert Opinion, Diseases of the genitourinary system. Urology, Sacral nerve stimulation, Medicine, Humans, RC870-923, business, Neuroscience
Published
2021

33. A Neanderthal OAS1 isoform protects individuals of European ancestry against COVID-19 susceptibility and severity

Author

David R. Morrison, Elsa Brunet-Ratnasingham, Marc Afilalo, Nardin Rezk, Michael Hultström, Maik Pietzner, Hugo Zeberg, Tala Abdullah, Nicola D. Kerrison, Daniel Kaufmann, Celia M. T. Greenwood, Tomoko Nakanishi, Guillaume Butler-Laporte, Elin Thysell, Claudia Langenberg, Kaiqiong Zhao, Danielle Henry, Michaël Chassé, Vincenzo Forgetta, Madeleine Durand, Miklos Lipcsey, Clare Paterson, Michael Pollak, Jonathan Afilalo, Yiheng Chen, Vincent Mooser, Xiaoqing Xue, Zaman Afrasiabi, Louis Petitjean, Meriem Bouab, J. Brent Richards, Johan Normark, Branka Vulesevic, Nofar Kimchi, Charlotte Guzman, Noor Almamlouk, Chris Tselios, Sirui Zhou, Robert Frithiof, Olumide Adeleye, and Laetitia Laurent

Subjects
0301 basic medicine, Innate immune system, business.industry, Confounding, Case-control study, Mendelian Randomization Analysis, General Medicine, Odds ratio, Quantitative trait locus, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, 030220 oncology & carcinogenesis, Severity of illness, Mendelian randomization, Immunology, Medicine, business
Abstract

To identify circulating proteins influencing Coronavirus Disease 2019 (COVID-19) susceptibility and severity, we undertook a two-sample Mendelian randomization (MR) study, rapidly scanning hundreds of circulating proteins while reducing bias due to reverse causation and confounding. In up to 14,134 cases and 1.2 million controls, we found that an s.d. increase in OAS1 levels was associated with reduced COVID-19 death or ventilation (odds ratio (OR) = 0.54, P = 7 × 10−8), hospitalization (OR = 0.61, P = 8 × 10−8) and susceptibility (OR = 0.78, P = 8 × 10−6). Measuring OAS1 levels in 504 individuals, we found that higher plasma OAS1 levels in a non-infectious state were associated with reduced COVID-19 susceptibility and severity. Further analyses suggested that a Neanderthal isoform of OAS1 in individuals of European ancestry affords this protection. Thus, evidence from MR and a case–control study support a protective role for OAS1 in COVID-19 adverse outcomes. Available pharmacological agents that increase OAS1 levels could be prioritized for drug development. A variant of the OAS1 gene, which encodes an enzyme that is critical for the innate immune response to viral infections, is associated with decreased risk of death in patients with COVID-19.

Published
2021
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34. Cell death induction (extrinsic versus intrinsic apoptotic pathway) by intestinal ischemia–reperfusion injury in rats is time-depended

Author

Yoav Ben-Shahar, Yulia Pollak, Gregory Gorelik, Igor Sukhotnik, Tal Koppelmann, and Zaid Abassi

Subjects
medicine.diagnostic_test, business.industry, Cell growth, Ischemia, General Medicine, medicine.disease, Fas ligand, Andrology, 03 medical and health sciences, 0302 clinical medicine, Western blot, Apoptosis, 030225 pediatrics, Pediatrics, Perinatology and Child Health, medicine, Immunohistochemistry, 030211 gastroenterology & hepatology, Surgery, Tumor necrosis factor alpha, business, Reperfusion injury
Abstract

We investigate the mechanism of intestinal cell apoptosis and its relation to the time of reperfusion in a rat model of intestinal ischemia–reperfusion (IR). Rats were divided into 4 groups: Sham-24 and Sham-48 rats underwent laparotomy without an intentional ischemic intervention and were sacrificed 24 or 48 h hours later; IR-24 and IR-48 rats underwent occlusion of SMA and portal vein for 20 min followed by 24 or 48 h of reperfusion, respectively. Park’s injury score, cell proliferation and apoptosis were determined at sacrifice. Proliferation and apoptosis-related gene and protein expression were determined using Real-Time PCR, Western Blot and Immunohistochemistry. IR-24 rats demonstrated a strong increase in cell apoptosis along with an elevated Bax and decreased Bcl-2 expression and a decrease in cell proliferation (vs Sham-24). IR-48 group showed an increase in cell proliferation and a decrease in cell apoptosis compared to IR-24 animals. IR-48 rats demonstrated an increase in apoptotic rate that was accompanied by greater TNF-α mRNA, Fas mRNA and FasL mRNA compared to Sham-48 animals. While cell apoptosis in IR-24 rats is regulated mainly by intrinsic apoptotic pathway, 48 h followed ischemia extrinsic apoptotic pathway is responsible for pro-apoptotic effects of IR injury.

Published
2021
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35. 30‐day patient reported outcomes can be predicted by change in left atrial pressure and not change in transmitral gradient following MitraClip

Author

William R. Miranda, Abdallah El Sabbagh, Demilade Adedinsewo, Charanjit S. Rihal, Mohamad Alkhouli, Peter M. Pollak, Keniel F. Pierre, Mayra Guerrero, Mohammed Al-Hijji, and Mackram F. Eleid

Subjects
Cardiac Catheterization, medicine.medical_specialty, Demographics, Diastole, 030204 cardiovascular system & hematology, Age and sex, Nyha class, 03 medical and health sciences, Atrial Pressure, 0302 clinical medicine, Internal medicine, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Patient Reported Outcome Measures, 030212 general & internal medicine, Aged, 80 and over, business.industry, MitraClip, Mitral Valve Insufficiency, General Medicine, Left atrial pressure, Treatment Outcome, Symptom improvement, Cardiology, Mitral Valve, Female, Functional status, Cardiology and Cardiovascular Medicine, business
Abstract

BACKGROUND Change in left atrial pressure (LAP) has been shown to be associated with symptom improvement post-MitraClip; however, the association between acute procedural changes in transmitral diastolic mean gradient (MG) compared to LAP and symptom improvement is not well established. METHODS 164 consecutive patients undergoing MitraClip at Mayo Clinic between June 2014 and May 2018 were included. Preclip and postclip MG and LAP were recorded. Baseline demographics, clinical, and echocardiographic outcomes, including 30-day New York Heart Association (NYHA) functional status were obtained from patient charts. RESULTS Median age was 81.5 years (IQR: 76.3, 87), 34% were female and 94.5% had NYHA class III and IV functional status at baseline. At baseline, median MG was 4 mmHg (IQR: 3, 5) and LAP was 19 mmHg (IQR: 16, 23.5). Following MitraClip deployment, the median MG was 4 mmHg (IQR: 3, 6) and the median LAP was 17 mmHg (IQR: 14, 21), 69.5% of patients had less than moderate MR. There was no statistically significant association between change in MG and NYHA functional class at 30 days (OR = 0.95, 95% CI: 0.76-1.20). However, a reduction in LAP following MitraClip deployment was significantly associated with improvement in NYHA functional status at 30 days following adjustments for age and sex (aOR 3.36, 95% CI: 1.34-8.65). There was no significant correlation between change in mean LAP and change in MG (p = .98). CONCLUSION Unlike change in left atrial pressure, change in MG post-MitraClip was not associated with patient reported outcomes at 30 days and did not correlate with change in left atrial pressure. Long-term follow up is needed to evaluate the impact of LA pressure on symptoms.

Published
2021
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36. Virtueller Praktikumstag Urologie

Author

Marc Kidess, Sebastian Pollak, Jürgen E. Gschwend, Michael Autenrieth, Pascal O. Berberat, and Sebastian Schmid

Subjects
business.industry, Urology, Medicine, business, Humanities
Abstract

Zusammenfassung Hintergrund und Einleitung Die COVID-19-Pandemie stellte die Universitätskliniken vor eine große Herausforderung: Wie kann eine praktische Ausbildung angehender Mediziner ohne deren Präsenz in der Klinik erfolgen? Als Alternative zum regulären Praktikumstag haben wir innerhalb kurzer Zeit ein virtuelles Ersatzangebot mittels Lehrvideos zu unterschiedlichen urologischen Themen auf einer universitären Online-Plattform geschaffen. Ziel der Videos war die Vermittlung des Fachs Urologie in Theorie und Praxis. Material und Methoden Die Videos wurden durch Mitarbeiter der Klinik anhand eines ausgearbeiteten Konzepts gefilmt und bearbeitet. Anschließend wurden diese Videos auf der universitären Online-Lehrplattform Moodle zur Verfügung gestellt. Zur Erfolgskontrolle mussten die Studierenden zu jedem Themenkomplex eine Frage beantworten. Eine Teilnahmebescheinigung wurde generiert, sobald die Studierenden mindestens 60 % aller Fragen richtig beantwortet hatten und an einer abschließenden Evaluation teilgenommen haben. Ergebnisse Der virtuelle Praktikumstag wurde von 164 Teilnehmern absolviert. Die Evaluationen sind mit einem sehr positiven Gesamturteil ausgefallen – mit einer Schulnote von 1,2. Insgesamt war die Akzeptanz des Ersatzangebotes hoch. Diskussion Das virtuelle Format als Alternative zum Präsenzunterricht wurde von den Studierenden sehr gut angenommen. Mit dem virtuellen Praktikumstag wurde eine schnelle und kontaktlose Alternative zum Präsenzunterricht geschaffen.

Published
2021
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37. Translational control of enzyme scavenger expression with toxin-induced micro RNA switches

Author

Justin J. Cooper-White, Nina M. Pollak, and Joanne Macdonald

Subjects
0301 basic medicine, Time Factors, Computer science, medicine.disease_cause, Biochemistry, Synthetic biology, 0302 clinical medicine, Inducer, chemistry.chemical_classification, Regulation of gene expression, Multidisciplinary, biology, Biological activity, Enzymes, 030220 oncology & carcinogenesis, Toxicity, Medicine, Science, Computational biology, Article, 03 medical and health sciences, Theophylline, Cytochrome P-450 CYP1A2, In vivo, Detoxification, microRNA, medicine, Humans, Molecule, Gene Silencing, Biological computation, Toxins, Biological, Base Sequence, business.industry, Toxin, Modular design, Scavenger (chemistry), Enzyme assay, Enzyme Activation, MicroRNAs, HEK293 Cells, 030104 developmental biology, Enzyme, chemistry, Protein Biosynthesis, biology.protein, Nucleic Acid Conformation, RNA, business
Abstract

Biological computation requires in vivo control of molecular behavior to progress development of autonomous devices. miRNA switches represent excellent, easily engineerable synthetic biology tools to achieve user-defined gene regulation. Here we present the construction of a synthetic network to implement detoxification functionality. We employed a modular design strategy by engineering toxin-induced control of an enzyme scavenger. Our miRNA switch results show moderate synthetic expression control over a biologically active detoxification enzyme molecule, using an established design protocol. However, following a new design approach, we demonstrated an evolutionarily designed miRNA switch to more effectively activate enzyme activity than synthetically designed versions, allowing markedly improved extrinsic user-defined control with a toxin as inducer. Our straightforward new design approach is simple to implement and uses easily accessible web-based databases and prediction tools. The ability to exert control of toxicity demonstrates potential for modular detoxification systems that provide a pathway to new therapeutic and biocomputing applications.

Published
2021

38. Harnessing the potential of the environmental microbiome in forensic science

Author

Agnieszka Pollak, Małgorzata Rydzanicz, Andrzej Ossowski, Kamila Marszałek, Agata Jagiełło, Rafał Płoski, Alina Frolova, Michał Kowalski, Błażej Szczerba, Ardigen Sa, Anna Woźniak, Wojciech Branicki, Paweł P. Łabaj, Renata Zbieć-Piekarska, and Kinga Herda

Subjects
Forensic science, Engineering, business.industry, Engineering ethics, Microbiome, business
Abstract

A scientific consortium led by the Central Forensic Laboratory of the Police has undertaken to develop a method for DNA analysis of the soil microbiome to be used in forensic investigations. The aim of the project entitled Soil Microbiome Analysis Forensic Tool – SMAFT (http://smaft.eu/), financed by the National Center for Research and Development (DOB-BIO10/03/01/2019), is to develop a new tool that enables the association of a trace in the form of a soil sample with a specific geographical location. The first part of the paper introduces the concept of the microbiome and presents the possibilities of using microbiome DNA analysis in forensic science. In the second part, the stages of the SMAFT project are described in detail, beginning from the collection of soil samples from different sites in Poland across all seasons and isolation of microbiome DNA through massively parallel sequencing (MPS) technology-based analysis of isolates and the development of a genetic test containing a set of metagenomic markers allowing for effective individualization of soil samples, up to the creation of an IT system enabling analysis and interpretation of the obtained results, which includes a database of soil microbiome DNA profiles from various locations in Poland.

Published
2021
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39. Crisis Management of Corporate Reputation- Analysis of selected E-Commerce Entities in Times of Global Pandemics

Author

Ján Dobrovič, Jarmila Straková, Petra Pártlová, Jan Váchal, and Frantisek Pollak

Subjects
business.industry, 0502 economics and business, 05 social sciences, Pandemic, 050211 marketing, Accounting, General Medicine, E-commerce, Crisis management, business, 050203 business & management, Corporate reputation
Abstract

The main aim of the paper is to present selected results of a comprehensive analysis of crisis management of corporate reputation of the best e-commerce entities operating on the Slovak internet market. On the sample of selected winners of the Heureka Group Shop of the year 2019 Quality Award poll, we conducted an in-depth analysis of their online reputation at the peak time of an ongoing pandemic. As part of the analysis, we examined the online environment from the perspective of all relevant determinants of reputation, the results were then clearly interpreted and offer a comprehensive view of crisis management of reputation in the online environment. The findings can serve as a basis for further research, or as a benchmark in the event of a recurrence of crises of a similar nature and magnitude in the future in order to eliminate shortcomings and maximize the effectiveness of marketing communication in brand building and brand protection.

Published
2021
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40. PD-L1 Expression in Normal Endocrine Tissues Is Not Increased Despite High Incidence of PD-1 Inhibitor-Associated Endocrinopathies

Author

Rivka Dresner-Pollak, Maayan Kagan, Rena Pollack, and Tzahi Neuman

Subjects
Pathology, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Endocrine System Diseases, B7-H1 Antigen, Pathogenesis, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Neoplasms, PD-L1, medicine, Humans, Endocrine system, 030212 general & internal medicine, Immune Checkpoint Inhibitors, biology, business.industry, Incidence, Thyroid, General Medicine, medicine.anatomical_structure, CTLA-4, biology.protein, Immunohistochemistry, Pancreas, business, Immunostaining
Abstract

Objective Treatment with immune-checkpoint inhibitors often results in endocrine immune-related adverse events (irAEs), affecting the pituitary, thyroid, adrenal, and parathyroid glands and pancreas. The mechanism underlying the endocrine irAEs has not been fully elucidated, and it remains unclear why endocrine organs are so commonly affected. In the present study, we evaluated immunostaining patterns of programmed death-ligand 1 (PD-L1) in normal endocrine tissues to determine whether increased expression may explain the predilection of endocrinopathies in patients treated with programmed cell death-1 inhibitors. Methods Normal formalin-fixed paraffin-embedded endocrine tissues (pituitary, thyroid, adrenal, pancreas, and parathyroid) were collected from our hospital’s pathology tissue archive. The tissues were assessed for membranous and cytoplasmic PD-L1 immunostaining using the Dako 22C3 pharmDx assay on an automated staining platform. Results We examined 49 endocrine tissues, including 12 thyroid, 5 pancreatic, 17 adrenal, 5 parathyroid, and 10 pituitary samples. Samples with less than 1% membranous PD-L1–positive cells were considered negative, while those with more than 1% of PD-L1 membranous staining were considered positive. Immunostaining result of immune-related cells was also evaluated, considering the cytoplasmic PD-L1–positive cells with the same cutoff of 1%. None of the endocrine tissues demonstrated PD-L1 positivity higher than 1% in the relevant cells. Conclusion While our results do not suggest a role of PD-L1 expression in the pathogenesis of endocrine irAEs, they may serve as a basis for future studies further investigating the mechanisms of autoimmune, inflammatory, or malignant endocrine conditions.

Published
2021
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41. Cognitive impact of neuronal antibodies: encephalitis and beyond

Author

Anna McKeever, Thomas A Pollak, C Finke, E Coutinho, Lucy L. Gibson, Pollak, TA [0000-0002-6171-0810], Apollo - University of Cambridge Repository, and Pollak, T. A. [0000-0002-6171-0810]

Subjects
0301 basic medicine, Diseases, Review Article, Hashimoto Disease, Receptors, N-Methyl-D-Aspartate, lcsh:RC321-571, Prognostic markers, 03 medical and health sciences, Cellular and Molecular Neuroscience, Cognition, 0302 clinical medicine, 692/53/2422, medicine, Animals, Clinical significance, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, Biological Psychiatry, Autoantibodies, Autoimmune encephalitis, 692/699, biology, business.industry, review-article, Autoantibody, medicine.disease, Psychiatry and Mental health, 030104 developmental biology, Schizophrenia, biology.protein, Encephalitis, Animal studies, Antibody, business, Neuroscience, 030217 neurology & neurosurgery
Abstract

Cognitive dysfunction is a common feature of autoimmune encephalitis. Pathogenic neuronal surface antibodies are thought to mediate distinct profiles of cognitive impairment in both the acute and chronic phases of encephalitis. In this review, we describe the cognitive impairment associated with each antibody-mediated syndrome and, using evidence from imaging and animal studies, examine how the nature of the impairment relates to the underlying neuroimmunological and receptor-based mechanisms. Neuronal surface antibodies, particularly serum NMDA receptor antibodies, are also found outside of encephalitis although the clinical significance of this has yet to be fully determined. We discuss evidence highlighting their prevalence, and association with cognitive outcomes, in a number of common disorders including cancer and schizophrenia. We consider mechanisms, including blood-brain barrier dysfunction, which could determine the impact of these antibodies outside encephalitis and account for much of the clinical heterogeneity observed.

Published
2020
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42. Autoimmune psychosis: an international consensus on an approach to the diagnosis and management of psychosis of suspected autoimmune origin

Author

Francesco Benedetti, Thomas A Pollak, Sabine Müller, Angelos Halaris, Alkomiet Hasan, David Brown, Jeffrey H. Meyer, Laurent Groc, Robert H. Yolken, Angela Vincent, Belinda R Lennox, Harald Prüss, Ebrahim Haroon, Markus Otto, Dietmar Fuchs, Hans C. Klein, Karl Bechter, Bernhard Bogerts, Dominique Endres, Souhel Najjar, Ludger Tebartz van Elst, Johann Steiner, Thomas Frodl, Marion Leboyer, Michael E. Benros, Bernhard T. Baune, Hans H. Stassen, Li Tian, Pollak, T. A., Lennox, B. R., Muller, S., Benros, M. E., Pruss, H., Tebartz van Elst, L., Klein, H., Steiner, J., Frodl, T., Bogerts, B., Tian, L., Groc, L., Hasan, A., Baune, B. T., Endres, D., Haroon, E., Yolken, R., Benedetti, F., Halaris, A., Meyer, J. H., Stassen, H., Leboyer, M., Fuchs, D., Otto, M., Brown, D. A., Vincent, A., Najjar, S., Bechter, K., University of Zurich, and Pollak, Thomas A

Subjects
Adult, Psychosis, Pediatrics, medicine.medical_specialty, Consensus, medicine.medical_treatment, 610 Medicine & health, Hashimoto Disease, Receptors, N-Methyl-D-Aspartate, 2738 Psychiatry and Mental Health, 03 medical and health sciences, 0302 clinical medicine, Electroconvulsive therapy, therapy [Psychotic Disorders], medicine, Humans, ddc:610, 030212 general & internal medicine, Biological Psychiatry, Autoimmune encephalitis, Ethical issues, business.industry, Limbic encephalitis, Autoantibody, medicine.disease, 3. Good health, 030227 psychiatry, Psychiatry and Mental health, 10072 Institute of Response Genetics, 10054 Clinic for Psychiatry, Psychotherapy, and Psychosomatics, Encephalitis, diagnosis [Psychotic Disorders], blood [Autoantibodies], Female, immunology [Neurons], business, 2803 Biological Psychiatry
Abstract

There is increasing recognition in the neurological and psychiatric literature of patients with so-called isolated psychotic presentations (ie, with no, or minimal, neurological features) who have tested positive for neuronal autoantibodies (principally N-methyl-D-aspartate receptor antibodies) and who have responded to immunotherapies. Although these individuals are sometimes described as having atypical, mild, or attenuated forms of autoimmune encephalitis, some authors feel that that these cases are sufficiently different from typical autoimmune encephalitis to establish a new category of so-called autoimmune psychosis. We briefly review the background, discuss the existing evidence for a form of autoimmune psychosis, and propose a novel, conservative approach to the recognition of possible, probable, and definite autoimmune psychoses for use in psychiatric practice. We also outline the investigations required and the appropriate therapeutic approaches, both psychiatric and immunological, for probable and definite cases of autoimmune psychoses, and discuss the ethical issues posed by this challenging diagnostic category.

Published
2020
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43. Maternally inherited diabetes and deafness (MIDD) syndrome with m.3243A>G mutation associated with renal failure — a case report

Author

Dariusz Moczulski, Sebastian Spaleniak, Bogdan Brodacki, Grzegorz Kade, Agnieszka Pollak, Marek Saracyn, and Monika Ołdak

Subjects
Kidney, Pediatrics, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Endocrinology, Diabetes and Metabolism, Cardiomyopathy, Muscle weakness, Macular dystrophy, medicine.disease, medicine.anatomical_structure, Glomerulopathy, Diabetes mellitus, Mutation (genetic algorithm), Internal Medicine, medicine, medicine.symptom, business, Genetic testing
Abstract

Maternally-inherited diabetes with deafness (MIDD) is a rare form of monogenic diabetes that results, in most cases, from an A-to-G transition at position 3243 of mitochondrial DNA (m.3243A>G). The clinical presentation of m.3243A>G mutation is variable, ranging from mild to severe phenotypes. Diabetes is often accompanied by sensorineural deafness, cardiomyopathy, neuromuscular, psychiatric disorders, macular dystrophy and renal failure (kidney manifestations in adults presenting with this mutation remain poorly defined). The study presents a case of a 40-years-old woman with a history of bilateral sensorineural deafness, renal failure and diabetes that was diagnosed due to increasing muscle weakness during exercise. MIDD was diagnosed based on the clinical picture and the results of laboratory studies including genetic testing. As far as we know, glomerulopathy with incomplete distal renal tubular acidosis has never been described before as a cause of renal failure in MIDD patients.

Published
2020
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44. Clozapine Response in Schizophrenia and Hematological Changes

Author

Robert Stewart, James H. MacCabe, Alexis E. Cullen, Jonathan Rogers, Matthew M. Nour, Kira Griffiths, Jenny E. L. Lisshammar, Anthony S. David, Thomas A Pollak, Rayyan Zafar, Graham Blackman, Megan Pritchard, Philip McGuire, and Ben Carter

Subjects
Adult, Male, medicine.medical_specialty, Treatment response, Original Contributions, Young Adult, 03 medical and health sciences, 0302 clinical medicine, White blood cell, Internal medicine, medicine, Humans, Pharmacology (medical), Platelet, psychosis, Young adult, Clozapine, Retrospective Studies, Hematologic Tests, clozapine, hematology, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, medicine.anatomical_structure, inflammation, Schizophrenia, Female, Drug Monitoring, business, Early phase, 030217 neurology & neurosurgery, Antipsychotic Agents, medicine.drug
Abstract

Background Clozapine is the only effective medication for treatment-resistant schizophrenia; however, its mechanism of action remains unclear. The present study explored whether its effectiveness is related to changes in hematological measures after clozapine initiation. Methods Patients with treatment-resistant schizophrenia commenced on clozapine between January 2007 and December 2014 by the United Kingdom’s largest mental health trust were identified from electronic patient records. Hematological data from these patients were obtained from a monitoring registry. White blood cell, neutrophil, and platelet count were assessed at baseline and during the early phase of clozapine treatment. Clozapine response at 3 months was defined as “much,” or “very much” improved on the seven-point Clinical Global Impression—Improvement (CGI-I) subscale. Results In the total sample (n = 188), clozapine initiation was associated with a significant transient increase (peaking in weeks 3 to 4) in white blood cell, neutrophil, and platelet count (P < 0.001). There were 112 (59.6%) patients that responded to treatment; however, none of the hematological factors assessed at baseline, nor changes in these factors, were directly associated with treatment response. Implications Clozapine treatment is associated with transient hematological changes during the first month of treatment; however, there was no evidence that these were related to the therapeutic response.

Published
2020
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45. The use of therapeutic plasma exchange for pediatric patients supported on extracorporeal membranous oxygenator therapy: A narrative review

Author

Reut Kassif Lerner and Uri Pollak

Subjects
Adult, medicine.medical_specialty, Multiple Organ Failure, medicine.medical_treatment, MEDLINE, 030204 cardiovascular system & hematology, Cochrane Library, Extracorporeal, Sepsis, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, 0302 clinical medicine, 030225 pediatrics, Heparin-induced thrombocytopenia, medicine, Coagulopathy, Extracorporeal membrane oxygenation, Humans, Radiology, Nuclear Medicine and imaging, Child, Intensive care medicine, Oxygenator, Oxygenators, Membrane, Advanced and Specialized Nursing, Plasma Exchange, business.industry, General Medicine, medicine.disease, Thrombocytopenia, Cardiology and Cardiovascular Medicine, business, Safety Research
Abstract

Therapeutic plasma exchange in children is increasingly recognized as a life-saving treatment and is challenged by some technical considerations. As extracorporeal membrane oxygenation has been used for nearly half a century for refractory reversible respiratory and/or cardiac failure in both pediatric and adult populations, it may serve as an extracorporeal platform for therapeutic plasma exchange. It is most commonly described in patients with sepsis with multiple organ failure or thrombocytopenia associated multi organ failure. Additional pathophysiological processes of inflammatory and immunological storms might benefit from the combination of extracorporeal membrane oxygenation and plasma exchange. This is a nonmethodological review of English-language reports of therapeutic plasma exchange performed in patients supported by extracorporeal membrane oxygenation, both pediatric and adult, searching six databases, MEDLINE, Clinical Key, GOOGLE SCHOLAR, CINAHL, Cochrane library, and EMBASE.

Published
2020
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46. First familial cases of type 2 congenital erythrocytosis (ECYT2) with a Chuvash pathogenic variant in VHL gene in Poland: example of the clinical utility of next-generation sequencing in diagnostics of orphan diseases

Author

Małgorzata Rydzanicz, Monika Radwanska, Wioletta Bal, Radosław Chaber, Monika Pepek, Tomasz Stoklosa, Piotr Stawiński, Malgorzata Kurkowiak, Agnieszka Pollak, Rafał Płoski, and Marcin M Machnicki

Subjects
Genetics, Congenital erythrocytosis, medicine.diagnostic_test, Older brother, business.industry, Hematology, Hematocrit, Orphan diseases, Genetic analysis, DNA sequencing, Oncology, Elevated hemoglobin, medicine, business, Gene
Abstract

In this article, we report familial cases of type 2 congenital erythrocytosis (ECYT2) in two siblings, a 2-year-old boy and his younger sister. Both patients were diagnosed based on laboratory findings including erythrocytosis, elevated hemoglobin levels, and hematocrit. Acquired erythrocytosis was excluded based on the clinical features and genetic analysis of JAK2/CALR/MPL genes. Next-generation sequencing was employed for older brother revealing NM_000551.4: c.598C>T, p.Arg200Trp homozygous variant in the VHL gene, the similar variant was detected in the younger sibling. Sequencing analysis confirmed the VHL c.598C>T heterozygous variant in both parents. To the best of our knowledge, these are the first confirmed cases of familial erythrocytosis type 2, also known as Chuvash type, in Poland.

Published
2020
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47. Unconventional Natural Gas Development and Hospitalization for Heart Failure in Pennsylvania

Author

Brian S. Schwartz, Erin D. Michos, Jonathan Pollak, John W. McEvoy, Tara McAlexander, Jessie P. Buckley, and Karen Bandeen-Roche

Subjects
Adult, Male, medicine.medical_specialty, Natural Gas, 030204 cardiovascular system & hematology, Article, 03 medical and health sciences, 0302 clinical medicine, Older patients, Internal medicine, medicine, Humans, Petroleum Pollution, 030212 general & internal medicine, Aged, Aged, 80 and over, Heart Failure, Ejection fraction, Hydraulic Fracking, business.industry, Mean age, Environmental Exposure, Odds ratio, Middle Aged, Pennsylvania, medicine.disease, Confidence interval, Hospitalization, Quartile, Control selection, Case-Control Studies, Heart failure, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background Growing literature linking unconventional natural gas development (UNGD) to adverse health has implicated air pollution and stress pathways. Persons with heart failure (HF) are susceptible to these stressors. Objectives This study sought to evaluate associations between UNGD activity and hospitalization among HF patients, stratified by both ejection fraction (EF) status (reduced [HFrEF], preserved [HFpEF], not classifiable) and HF severity. Methods We evaluated the odds of hospitalization among patients with HF seen at Geisinger from 2008 to 2015 using electronic health records. We assigned metrics of UNGD activity by phase (pad preparation, drilling, stimulation, and production) 30 days before hospitalization or a frequency-matched control selection date. We assigned phenotype status using a validated algorithm. Results We identified 9,054 patients with HF with 5,839 hospitalizations (mean age 71.1 ± 12.7 years; 47.7% female). Comparing 4th to 1st quartiles, adjusted odds ratios (95% confidence interval) for hospitalization were 1.70 (1.35 to 2.13), 0.97 (0.75 to 1.27), 1.80 (1.35 to 2.40), and 1.62 (1.07 to 2.45) for pad preparation, drilling, stimulation, and production metrics, respectively. We did not find effect modification by HFrEF or HFpEF status. Associations of most UNGD metrics with hospitalization were stronger among those with more severe HF at baseline. Conclusions Three of 4 phases of UNGD activity were associated with hospitalization for HF in a large sample of patients with HF in an area of active UNGD, with similar findings by HFrEF versus HFpEF status. Older patients with HF seem particularly vulnerable to adverse health impacts from UNGD activity.

Published
2020
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48. Early life stress and development: potential mechanisms for adverse outcomes

Author

Seth D. Pollak and Karen E. Smith

Subjects
Hypothalamo-Hypophyseal System, Adverse outcomes, Cognitive Neuroscience, Early life stress, Pituitary-Adrenal System, Review, 050105 experimental psychology, Pathology and Forensic Medicine, Developmental psychology, lcsh:RC321-571, 03 medical and health sciences, 0302 clinical medicine, Adverse Childhood Experiences, Neurobiological development, Humans, Neural system, Medicine, 0501 psychology and cognitive sciences, Child, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, business.industry, 05 social sciences, Stressor, Developmental disorders, Neuropsychology, Amygdala, Early life, Extreme stress, Early adversity, Pediatrics, Perinatology and Child Health, Neurology (clinical), business, Stress, Psychological, 030217 neurology & neurosurgery, Psychopathology
Abstract

BackgroundChronic and/or extreme stress in early life, often referred to as early adversity, childhood trauma, or early life stress, has been associated with a wide range of adverse effects on development. However, while early life stress has been linked to negative effects on a number of neural systems, the specific mechanisms through which early life stress influences development and individual differences in children’s outcomes are still not well understood.Main textThe current paper reviews the existing literature on the neurobiological effects of early life stress and their ties to children’s psychological and behavioral development.ConclusionsEarly life stress has persistent and pervasive effects on prefrontal–hypothalamic–amygdala and dopaminergic circuits that are at least partially mediated by alterations in hypothalamic–pituitary–adrenal axis function. However, to date, this research has primarily utilized methods of assessment that focus solely on children’s event exposures. Incorporating assessment of factors that influence children’s interpretation of stressors, along with stressful events, has the potential to provide further insight into the mechanisms contributing to individual differences in neurodevelopmental effects of early life stress. This can aid in further elucidating specific mechanisms through which these neurobiological changes influence development and contribute to risk for psychopathology and health disorders.

Published
2020

49. A novel decision aid for acute myeloid leukemia: a feasibility and preliminary efficacy trial

Author

Kris Herring, Peter A. Ubel, Jordan Danielle Hildenbrand, Thomas W. LeBlanc, Susan C. Locke, Areej El-Jawahri, Kathryn I. Pollak, Jesse D. Troy, Karen E. Steinhauser, Gregory P. Samsa, and Debra M. Davis

Subjects
medicine.medical_specialty, Poor prognosis, business.industry, Myeloid leukemia, Decisional conflict, Mean difference, 03 medical and health sciences, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, Internal medicine, Patient experience, Clinical endpoint, medicine, Hematologic malignancy, Decision aids, 030212 general & internal medicine, business
Abstract

Acute myeloid leukemia (AML) is a hematologic malignancy characterized by a poor prognosis but also a paradoxical possibility of cure. This renders decision-making complex and imminent. Unfortunately, many patients with AML misestimate their prognosis and treatment risk. While decision aids can improve illness understanding and reduce decisional conflict, there are no validated decision aids for AML. We developed and tested a novel AML decision aid (NCT03442452). Patients (n = 20) were recruited at Duke University from May 2018 to February 2019. Participants completed assessments of AML knowledge and decisional conflict, before and after using the electronic decision aid. The primary endpoint was feasibility (endpoint met if > 80% of study participants completed all study components). Secondary analyses of efficacy were conducted using paired t tests for dependent pre-/post-samples. The primary endpoint of feasibility was met (100% of participants completed all study components). Secondary analyses showed improved knowledge and reduced decisional conflict after using the decision aid. Knowledge scores improved from a mean of 11.8 (out of 18) correct items at baseline to 15.1 correct items after using the decision aid (mean difference 3.35; p < 0.0001). Decisional conflict scores reduced significantly from baseline to post-test as well (mean difference − 6.5; p = 0.02). These findings suggest that our AML decision aid is a useful tool to improve the patient experience and promote shared decision-making in AML. A randomized efficacy trial is planned.

Published
2020
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50. Genetically determined hearing loss – perspectives and diagnostic capabilities of next-generation sequencing

Author

Piotr Stawiński, Rafał Płoski, Agnieszka Pollak, Urszula Lechowicz, and Małgorzata Mueller-Malesińska

Subjects
Genetics, business.industry, Medicine, business, General Economics, Econometrics and Finance
Abstract

Przyczyną około 50–60% przypadków wystąpienia niedosłuchu są czynniki dziedziczne. Geny, w których zlokalizowane są warianty odpowiedzialne za wystąpienie niedosłuchu, najczęściej kodują białka występujące w uchu wewnętrznym. Za niedosłuch dziedziczony w sposób recesywny najczęściej odpowiedzialne są mutacje genu GJB2. Mutacje w innych genach, których produkty białkowe są bezpośrednio zaangażowane w proces słyszenia, mogą również skutkować wystąpieniem niedosłuchu. Do dziś opisano ok. 300 genów uczestniczących w procesie przetwarzania informacji słuchowej i nadal odkrywane są nowe. Efektywne poszukiwanie nieprawidłowości w ich strukturze wymaga stosowania najnowocześniejszych technik biologii molekularnej takich jak sekwencjonowanie nowej generacji. Dzięki nowatorskim technologiom o gigantycznej przepustowości możliwe są analizy całych genomów człowieka. Wysoka dokładność uzyskanych danych w połączeniu z wyrafinowaną analizą bioinformatyczną umożliwia wykrycie zmienności w sekwencji całego genomu. Otrzymane w wyniku sekwencjonowania dane poddawane są skomplikowanej obróbce bioinformatycznej pozwalającej finalnie na detekcję wariantów obecnych w badanym materiale. Wprowadzenie technologii genomowych jest przełomem w dziedzinie biologii medycznej. Ich wpływ na pogłębienie wiedzy na temat molekularnej fizjologii wielu procesów, w tym również procesu słyszenia oraz przyczyn niedosłuchu, jest rewolucyjny

Published
2020
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