Publications by authors named "Alex Chang"

Background: Loneliness is a quality-of-life (QoL) concern for patients facing serious, life-limiting illnesses. Discerning risk factors of loneliness in palliative care patients allows providers to take preventative action and develop holistic treatment plans.

Methods: A planned sub-study of patients who completed the previously developed Three-Item Loneliness Scale upon enrollment into the multicenter, randomized clinical trial Emergency Medicine Palliative Care Access (EMPallA) with the objective of investigating the association of multimorbidity with loneliness in patients with late-stage illnesses.

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The accurate assessment of platelet activity is crucial in clinical practice and scientific research owing to the pivotal role of platelets in the progression of cardiovascular conditions, such as arterial thrombotic diseases. However, conventional platelet activity assessment methods are currently limited by their requirement of substantial blood samples and inadequate high-throughput capabilities, and therapeutic resistance induced by antiplatelet agents impedes treatment efficacy. In this study, we developed a microdroplet-based platelet function detection method, referred to as NebulaPlate, to achieve miniaturized and robust platelet activity assessment, thereby overcoming current challenges.

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Metastatic castration-resistant prostate cancer (mCRPC) is a heterogeneous disease. Several studies have identified transcriptional subtypes of mCRPC, but comprehensive analysis of prognostic gene expression pathways has been limited. Therefore, we aggregated a cohort of 1012 mCRPC tissue samples from 769 patients and investigated the association of gene expression-based pathways with clinical outcomes and intrapatient and intratumor heterogeneity.

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Introduction: CAR-T cell therapy has revolutionized the therapeutic landscape for relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL), and bridging with allogeneic hematopoietic stem cell transplantation (allo-HSCT) has the potential to lower relapse rates. Nevertheless, the majority of existing studies have exclusively focused on short-term outcomes, resulting in a lack of comprehensive understanding of the long-term sustainability of overall prognosis.

Objectives: Our study aimed to provide real-world, long-term follow-up data for patients who underwent sequential therapy.

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Doxorubicin, an anthracycline commonly used for treating cancer patients, is known for its cardiotoxic side-effects. Although dose-dependent, but susceptibility remains variable among patients, and childhood-exposure-adult-onset remains challenging. Besides topoisomerase toxicity, Doxorubicin is also toxic to the mitochondria yet the underlying late onset mechanism remains elusive.

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The development of treatment resistance remains universal for patients with metastatic prostate cancer, driven by AR alterations and lineage state transitions. Identifying the evolution of lineage transitions in treatment resistance has been limited by the challenges of collecting serial tissue biopsies on treatment, which can be overcome using blood-based liquid biopsies. Utilizing a novel circulating tumor cell (CTC) isolation approach, we collected 273 CTC samples from 117 patients with metastatic prostate cancer for RNA sequencing.

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Background: Sequential CD19 and CD22 chimeric antigen receptor (CAR)-T cell therapy offers a promising approach to antigen-loss relapse in relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL); however, research in adults remains limited.

Methods: This study aimed to evaluate the efficacy and safety of sequential CD19 and CD22 CAR-T cell therapy in adult patients with R/R B-ALL between November 2020 and November 2023 (ChiCTR2100053871). Key endpoints included the adverse event incidence, overall survival (OS), and leukemia-free survival (LFS).

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Purpose: To assess trends in continuity of care (COC) by geographic context (i.e., rural vs urban) among a cohort of persons with prediabetes prior to and after diagnosis of prediabetes.

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Natural language processing (NLP) is a burgeoning field of machine learning/artificial intelligence that focuses on the computational processing of human language. Researchers and clinicians are using NLP methods to advance the field of medicine in general and in heart failure (HF), in particular, by processing vast amounts of previously untapped semi-structured and unstructured textual data in electronic health records. NLP has several applications to clinical research, including dramatically improving processes for cohort assembly, disease phenotyping, and outcome ascertainment, among others.

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Background: Low-income, rural pregnant women are at disproportionate risk for adverse pregnancy outcomes as well as future cardiovascular risk. Currently, less than half of eligible women enroll in the Women, Infants, and Children's (WIC) Program. This study aims to evaluate whether integrating clinical care and social care may advance health equity and reduce health disparities by directly linking women receiving obstetric care to the Special Supplemental Nutrition Program for WIC and/or a Registered Dietitian/Nutritionist (RDN).

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Abdominal aortic aneurysm (AAA) is characterized by localized structural deterioration of the aortic wall, leading to progressive dilatation and rupture. Protease activated receptor 2 (PAR2) dependent signaling has been implicated in the pathophysiology of atherosclerosis through the regulation of smooth muscle cell function. However, its role in AAA remains unclear.

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Article Synopsis
  • Heart failure (HF) is a growing global health issue, linked to aging populations and various health conditions, shifting the focus from treatment to prevention.
  • The American Heart Association introduced the PREVENT models for estimating the long-term risk of cardiovascular diseases and HF, although they still have limitations in various demographics and risk factors.
  • New medications like SGLT2 inhibitors and GLP1 receptor agonists show promise in preventing HF, necessitating a refined approach in risk assessment to effectively allocate these costly treatments to those most in need.
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Chimeric antigen receptor (CAR)-T cell therapy showed preliminary activity in patients with refractory or relapsed T cell acute lymphoblastic leukemia (r/r T-ALL). However, many obstacles remain, including manufacturing difficulties and risk of infections. This phase I study (NCT04840875) evaluated autologous CD7 CAR-T cells manufactured without pre-selection of healthy T cells in r/r T-ALL.

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Background: Some challenges still exist with single-target B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell therapies due to variable or negative BCMA expression, although they have yielded remarkable efficacy in relapsed or refractory multiple myeloma. We developed anti-BCMA/GPRC5D bispecific CARs to mitigate the limitations and potentiate the functions of CAR T cells.

Methods: This single-arm, phase 1 trial was conducted at the Affiliated Hospital of Xuzhou Medical University (Xuzhou, China).

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Article Synopsis
  • Natural killer (NK) cells are vital in the body's defense against cancer, and new antibody formats that enhance their activation are showing promise for immunotherapy, particularly through antibody-dependent cell-mediated cytotoxicity (ADCC).
  • Scientists have isolated two specific antibody clones, #1A2 and #2-2A2, that effectively target the CD16a receptor on NK cells without significantly affecting the related CD16b receptor on neutrophils, which may reduce unwanted side effects.
  • These antibodies can be combined with other tumor-associated antigens as bispecific antibodies, leading to effective NK cell activation and tumor cell destruction, offering potential for innovative cancer treatments that are less impacted by circulating human IgG.
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Objectives: Obesity is recognized for its adverse impact on brain health and related behaviors; however, the specific longitudinal effects of a high-fat diet (HFD) from juvenile stages of development through late adulthood remain poorly understood, particularly sex-specific outcomes. This study aimed to determine how prolonged exposure to HFD, commencing during periadolescence, would differentially predispose male and female mice to an elevated risk of dopaminergic dysregulation and associated behavioral deficits.

Methods: One-month-old C57BL/6J male and female mice were subjected to either a control diet or an HFD for 5 and 9 months.

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Background: The demand for liver transplants (LT) in the United States far surpasses the availability of allografts. New allocation schemes have resulted in occasional difficulties with allograft placement and increased intraoperative turndowns. We aimed to evaluate the outcomes related to use of late-turndown liver allografts.

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Cardiomyocytes derived from human induced pluripotent stem cells (hiPSC-CMs) are powerful in vitro models to study the mechanisms underlying cardiomyopathies and cardiotoxicity. Quantification of the contractile function in single hiPSC-CMs at high-throughput and over time is essential to disentangle how cellular mechanisms affect heart function. Here, we present CONTRAX, an open-access, versatile, and streamlined pipeline for quantitative tracking of the contractile dynamics of single hiPSC-CMs over time.

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Acute myocardial infarction is mainly caused by a lack of blood flood in the coronary artery. Angiopoietin-like protein 2 (ANGPTL2) induces platelet activation and thrombus formation in vitro through binding with immunoglobulin-like receptor B, an immunoglobulin superfamily receptor. However, the mechanism by which it regulates platelet function in vivo remains unclear.

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Diabetic cardiomyopathy (DbCM) is characterized by diastolic dysfunction, which progresses into heart failure and aberrant electrophysiology in diabetic patients. Dyslipidemia in type 2 diabetic patients leads to the accumulation of lipid droplets (LDs) in cardiomyocytes and results in lipid toxicity which has been suggested to drive DbCM. It is aimed to explore potential pathways that may boost LDs degradation in DbCM and restore cardiac function.

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Article Synopsis
  • The study examines the safety and effectiveness of donor-derived CLL-1 CAR-T therapy for patients with relapsed or refractory acute myeloid leukemia (R/R AML) as a bridge to stem cell transplantation.
  • An adult patient received CLL-1 CAR-T cells and was monitored post-therapy, achieving complete remission in bone marrow by day 11 and successful transplantation shortly after.
  • Results showed the patient had a good recovery outcome with no signs of relapse or complications like graft-versus-host disease four months post-transplant, suggesting this therapy may enhance long-term outcomes for R/R AML patients.
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Article Synopsis
  • The study investigates the safety, tolerability, and efficacy of high-intensity care (HIC) for heart failure using the MAGGIC risk score, which is a risk assessment tool for patients with chronic heart failure.
  • Patients in the STRONG-HF trial were divided into two groups, one receiving HIC with rapid medication uptitration and the other receiving usual care, with the main goal of comparing outcomes such as death and hospitalization rates at 180 days.
  • Results showed that while HIC led to higher medication use, the overall death or readmission rates varied according to the MAGGIC risk score, suggesting that the severity of heart failure risk impacts treatment outcomes.
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