Publications by authors named "Gelb B"

Purpose: Telehealth genetic counseling is comparable to in-person visits in terms of satisfaction, knowledge, and psychological outcomes, but using visual aids can be challenging on telehealth platforms. This pilot study assessed if the "screen-sharing" feature via Zoom to display visual aids during results disclosure session positively impacted parental experience and comprehension of their child's genomic results especially in underrepresented groups and those with limited English proficiency.

Methods: In the TeleKidSeq pilot study, 409 children with suspected genetic conditions underwent genome sequencing.

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Purpose: Genomic ascertainment of electronic health record-linked exome data in two large biobanks was used to quantify germline pathogenic/likely pathogenic (P/LP) variant prevalence, cancer prevalence, and survival in adults with non- RAS/mitogen-activated protein kinase genes (RASopathies).

Patients And Methods: Germline RASopathy variants were examined from adult participants in UK Biobank (UKBB; n=469,802), Geisinger MyCode (n=167,050) and Mount Sinai Bio (n=30,470). Variants were classified as per American College of Medical Genetics/Association for Molecular Pathology criteria and reviewed by a RASopathy variant expert.

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  • - The study investigates laterality defects, focusing on the genetic variations linked to congenital heart disease (CHD) by analyzing sequencing data from three cohorts, uncovering a higher occurrence of digenic variants compared to control groups.
  • - A digenic model involving 115 known laterality defect genes revealed significant rates of trans-heterozygous digenic variants in affected individuals, particularly in the Baylor, Kids First, and PCGC cohorts (ranging from 2.8% to 13.5%).
  • - The results suggest that epistatic interactions between genes play a crucial role in the genetics of laterality defects, with 23% of identified digenic pairs found in structural complexes of motile
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  • The study highlights how underrepresentation in clinical genomics research diminishes the relevance of findings and benefits, particularly emphasizing the importance of diverse participant inclusion.
  • Researchers implemented patient-centered, data-driven strategies, such as using relatable and flexible recruitment methods, to ensure a diverse sample of parents and children in a pediatric genome sequencing study.
  • As a result, a high percentage of eligible participants agreed to enroll (93.5% acceptance) and the majority of those who enrolled completed the study, demonstrating the effectiveness of engaging with underrepresented communities.
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Background: Kidney transplant (KT) candidates often experience hospitalizations, increasing their delirium risk. Hospitalizations and delirium are associated with worse post-KT outcomes, yet their relationship with pre-KT outcomes is less clear. Pre-KT delirium may worsen access to KT due to its negative impact on cognition and ability to maintain overall health.

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Background: A deeper understanding of acute rejection in vascularized composite allotransplantation is paramount for expanding its utility and longevity. There remains a need to develop more precise and accurate tools for diagnosis and prognosis of these allografts, as well as alternatives to traditional immunosuppressive regimens.

Methods: Twenty-seven skin biopsies collected from 3 vascularized composite allotransplantation recipients, consisting of face and hand transplants, were evaluated by histology, immunohistochemistry staining, and gene expression profiling.

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Importance: Since 2005, a total of 50 face transplants have been reported from 18 centers in 11 countries. The overall survival of the grafts has not yet been established.

Objective: To assess the survival of the face transplant grafts and evaluate factors potentially influencing it.

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Efforts to implement and evaluate genome sequencing (GS) as a screening tool for newborns and infants are expanding worldwide. The first iteration of the BabySeq Project (2015-2019), a randomized controlled trial of newborn sequencing, produced novel evidence on medical, behavioral, and economic outcomes. The second iteration of BabySeq, which began participant recruitment in January 2023, examines GS outcomes in a larger, more diverse cohort of more than 500 infants up to one year of age recruited from pediatric clinics at several sites across the United States.

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  • Congenital heart defects (CHDs) are prevalent in children with Down syndrome, affecting 40-50% of this population.
  • A study sequenced the genomes of a diverse group of children with Down syndrome, both with CHD and with normal hearts, to explore the genetic factors associated with these heart defects.
  • While no specific genetic variants reached significant levels, several loci were identified with suggestive links to risk factors for different types of CHD, providing insights into potential genetic contributors to these defects.
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Due to improvements in recognition and management of their multisystem disease, the long-term survival of infants, children, and adolescents with trisomy 21 and congenital heart disease now matches children with congenital heart disease and no genetic condition in many scenarios. Although this improved survival is a triumph, individuals with trisomy 21 and congenital heart disease have unique and complex care needs in the domains of physical, developmental, and psychosocial health, which affect functional status and quality of life. Pulmonary hypertension and single ventricle heart disease are 2 known cardiovascular conditions that reduce life expectancy in individuals with trisomy 21.

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  • - Phelan-McDermid syndrome (PMS) is a rare genetic disorder linked to the loss of the SHANK3 gene, and while many of its clinical features are known, cardiovascular issues, particularly aortic root dilation (ARD), are less explored.
  • - A study of 59 PMS participants aimed to determine the prevalence of ARD and its potential links to specific genetic variations, particularly focusing on the size of deletions on chromosome 22.
  • - Findings revealed that 14% of participants had ARD, with a statistically significant association between larger chromosome 22 deletions and an increased incidence of ARD, indicating that genetic factors may help identify those at higher risk.
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Importance: Catastrophic facial injury with globe loss remains a formidable clinical problem with no previous reports of reconstruction by whole eye or combined whole eye and facial transplant.

Objective: To develop a microsurgical strategy for combined whole eye and facial transplant and describe the clinical findings during the first year following transplant.

Design, Setting, And Participant: A 46-year-old man who sustained a high-voltage electrical injury with catastrophic tissue loss to his face and left globe underwent combined whole eye and face transplant using personalized surgical devices and a novel microsurgical strategy at a specialized center for vascularized composite allotransplantation.

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The gene encodes a transcription factor that plays a role in atrioventricular nodal and myocardial development. Pathogenic variants of are associated with congenital heart disease and sudden cardiac death. The missense variant in this case is one of the more common ones in Northern Europe and has high penetrance in familial cases.

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  • Individuals with congenital heart disease (CHD) face a heightened risk for neurodevelopmental impairments, and understanding this relationship could benefit from data-driven approaches.
  • Utilizing data from the Pediatric Cardiac Genomics Consortium, researchers analyzed brain structure using MRI to identify subgroups of individuals with CHD, focusing on variations related to cardiac lesions and language ability.
  • The study also examined white matter connectivity through diffusion MRI, revealing that rare genetic variants significantly influence visual-motor functions, highlighting the intricate links between cardiac conditions, genomic differences, and brain development in CHD patients.
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There is increasing evidence of the clinical utility of genetic and genomic testing (GT); however, factors influencing personal utility of GT, especially in diverse, multilingual populations, remain unclear. We explored these factors in a diverse cohort of parents/guardians (participants) whose children received clinical GT through the NYCKidSeq program. A total of 847 participants completed surveys at baseline, post-results disclosure, and 6 months (6m) post-results.

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  • Genome-wide association studies (GWAS) have successfully identified genes linked to telomere length, but previous research hadn't validated these findings until now.
  • In a large analysis involving over 211,000 people, the study discovered five new signals linked to telomere length and highlighted the importance of blood/immune cells in this area.
  • The researchers confirmed that the genes KBTBD6 and POP5 truly affect telomere length by demonstrating that manipulating these genes can lengthen telomeres and that their regulation is crucial for understanding telomere biology.
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  • The study reviews postmortem genetic testing results for cardiomyopathy and cardiac arrhythmia cases from the largest medical examiner office in the U.S., covering cases from 2015 to 2022.
  • Among 1107 decedents, 7.9% showed pathogenic/likely pathogenic variants (P/LPVs), with a higher diagnostic yield observed in those diagnosed with cardiomyopathy compared to those without.
  • The findings highlight the value of genetic testing across all ages, revealing significant rates of P/LPVs in various cardiac conditions, especially hypertrophic and arrhythmogenic cardiomyopathy.
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  • Genome sequencing has improved our understanding of genetic factors in complex disorders but is still underexplored for predicting clinical outcomes, particularly after surgery for congenital heart defects (CHD).
  • Using AI, researchers analyzed data from 2,253 CHD patients, linking harmful genotypes in specific genes to a higher risk of severe post-operative complications.
  • The findings suggest that both the presence and absence of damaging genotypes can significantly inform predictions about patient outcomes following congenital cardiac surgery.
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Purpose: To examine associations between Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales and PedsQL Infant Scales with formal health care resource utilization (HCRU) and informal caregiver burden.

Methods: We studied a pediatric cohort of 837 patients (median age: 8.

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Accurate identification of germline variants (DNVs) remains a challenging problem despite rapid advances in sequencing technologies as well as methods for the analysis of the data they generate, with putative solutions often involving filters and visual inspection of identified variants. Here, we present a purely informatic method for the identification of DNVs by analyzing short-read genome sequencing data from proband-parent trios. Our method evaluates variant calls generated by three genome sequence analysis pipelines utilizing different algorithms-GATK HaplotypeCaller, DeepTrio and Velsera GRAF-exploring the assumption that a requirement of consensus can serve as an effective filter for high-quality DNVs.

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  • Genetic testing, specifically next-generation sequencing (exome and genome sequencing), is being increasingly utilized to identify causes of cardiovascular diseases in infants and children, but the effectiveness of these tests across different types of heart conditions has been poorly researched.
  • In a study involving 500 patients with congenital heart disease (CHD), it was found that genome sequencing yielded significantly more positive diagnostic results than exome sequencing, especially in patients with syndromic heart defects compared to those with isolated defects.
  • The findings indicated varying success rates for diagnosing different subtypes of CHD, with isolated cardiomyopathy showing higher diagnostic rates than isolated CHD, highlighting the importance of genetic testing for understanding pediatric cardiovascular issues.
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Motivation: Structural variants (SVs) play a causal role in numerous diseases but can be difficult to detect and accurately genotype (determine zygosity) with short-read genome sequencing data (SRS). Improving SV genotyping accuracy in SRS data, particularly for the many SVs first detected with long-read sequencing, will improve our understanding of genetic variation.

Results: NPSV-deep is a deep learning-based approach for genotyping previously reported insertion and deletion SVs that recasts this task as an image similarity problem.

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Background: Germline gain-of-function pathogenic variants cause Costello syndrome (CS). During early childhood, 50% of patients develop multifocal atrial tachycardia, a treatment-resistant tachyarrhythmia of unknown pathogenesis. This study investigated how overactive HRAS activity triggers arrhythmogenesis in atrial-like cardiomyocytes (ACMs) derived from human-induced pluripotent stem cells bearing CS-associated variants.

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Rare coding mutations cause ∼45% of congenital heart disease (CHD). Noncoding mutations that perturb cis-regulatory elements (CREs) likely contribute to the remaining cases, but their identification has been problematic. Using a lentiviral massively parallel reporter assay (lentiMPRA) in human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs), we functionally evaluated 6,590 noncoding de novo variants (ncDNVs) prioritized from the whole-genome sequencing of 750 CHD trios.

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