Publications by authors named "Harr M"

Background: The sport of rifle places unique physical demands on its athletes relative to other collegiate sports, including maintaining lumbar-straining positions for extended time. Anecdotal reports of low back pain (LBP) are common among collegiate rifle athletes, but the prevalence of LBP in this population has not yet been established in the literature.

Purpose: The purpose of this study was to survey collegiate rifle athletes to quantify the prevalence and impact of low back pain in this population and identify possible contributing factors including the COVID-19 pandemic.

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  • This study investigates secondary findings (SFs) from clinical next-generation sequencing in a large pediatric group, including many African-American participants, focusing on their types and frequencies.
  • It uses specific criteria to identify pathogenic and likely pathogenic variants in established genes, assessing their potential health impacts on participants.
  • The results reveal a total of 1464 pathogenic variants identified in over 16,700 participants, with notable frequencies in both ACMG and non-ACMG genes, such as TTR and CHEK2.
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The differential performance of polygenic risk scores (PRSs) by group is one of the major ethical barriers to their clinical use. It is also one of the main practical challenges for any implementation effort. The social repercussions of how people are grouped in PRS research must be considered in communications with research participants, including return of results.

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Polygenic risk scores (PRSs) have improved in predictive performance, but several challenges remain to be addressed before PRSs can be implemented in the clinic, including reduced predictive performance of PRSs in diverse populations, and the interpretation and communication of genetic results to both providers and patients. To address these challenges, the National Human Genome Research Institute-funded Electronic Medical Records and Genomics (eMERGE) Network has developed a framework and pipeline for return of a PRS-based genome-informed risk assessment to 25,000 diverse adults and children as part of a clinical study. From an initial list of 23 conditions, ten were selected for implementation based on PRS performance, medical actionability and potential clinical utility, including cardiometabolic diseases and cancer.

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  • - The study explores pre-mRNA splicing, its critical role in neurodevelopment, and how mutations in spliceosome-related genes U2AF2 and PRPF19 contribute to neurodevelopmental disorders (NDDs).
  • - Researchers found multiple pathogenic variants in U2AF2 and PRPF19 across unrelated individuals, with functional analysis showing that specific U2AF2 variants disrupted normal splicing and neuritogenesis in human neurons.
  • - Additionally, investigations in Drosophila models revealed that the loss of function in U2AF2 and PRPF19 caused severe developmental defects and social issues, pointing to a genetic network wherein splicing factors like Rbfox1 play a significant role in brain development and function. *
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  • * In a study involving 16,218 adults, those with actionable genetic findings underwent significantly more healthcare services in the year following result disclosure compared to before and to those without such findings.
  • * The annual healthcare costs for individuals with pathogenic findings nearly doubled, increasing from an average of $162 to $343, indicating a notable financial impact on healthcare payors.
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There is increasing evidence that the T-cell protein, Lck, is involved in the pathogenesis of chronic lymphocytic leukemia (CLL) as well as other leukemias and lymphomas. We previously discovered that Lck binds to domain 5 of inositol 1,4,5-trisphosphate receptors (IPR) to regulate Ca homeostasis. Using bioinformatics, we targeted a region within domain 5 of IPR-1 predicted to facilitate protein-protein interactions (PPIs).

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  • Genetic variants in the EZH1 chromatin modifier are linked to both dominant and recessive neurodevelopmental disorders in 19 individuals, highlighting its role in disease etiology.
  • EZH1 impacts histone modification and is essential for the differentiation of neural progenitor cells, with recessive variants causing loss of function and dominant variants resulting in gain of function due to mutations.
  • The findings underscore EZH1's crucial role in neurogenesis and offer a molecular basis for diagnosing certain neurodevelopmental disorders that were previously unclassified.
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  • - The text discusses the advancements in polygenic risk scores (PRS) and their potential to enhance clinical practice, but highlights challenges in effectiveness across diverse populations, which can worsen health disparities.
  • - A project funded by NHGRI called the eMERGE Network is evaluating PRS for 23 health conditions in 25,000 individuals from different backgrounds, focusing on actionable findings and relevant evidence for African and Hispanic populations.
  • - The study identified ten key health conditions for PRS assessment (like breast cancer and diabetes), and established a framework for implementing PRS in clinical settings, ensuring compliance and reliability across different genetic ancestries.
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Polygenic risk scores (PRS) have potential to improve health care by identifying individuals that have elevated risk for common complex conditions. Use of PRS in clinical practice, however, requires careful assessment of the needs and capabilities of patients, providers, and health care systems. The electronic Medical Records and Genomics (eMERGE) network is conducting a collaborative study which will return PRS to 25,000 pediatric and adult participants.

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There is increasing evidence that the T-cell protein, Lck, is involved in the pathogenesis of chronic lymphocytic leukemia (CLL) as well as other leukemias and lymphomas. We previously discovered that Lck binds to domain 5 of inositol 1,4,5-trisphosphate receptors (IP3R) to regulate Ca2+ homeostasis. Using bioinformatics, we targeted a region within domain 5 of IP3R-1 predicted to facilitate protein-protein interactions (PPIs).

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  • The study aims to assess the risk of common diseases by considering clinical, monogenic, and polygenic factors, which may be reflected in an individual's family history.
  • The eMERGE network is enrolling 25,000 individuals in a prospective study to create and return a comprehensive risk assessment report (GIRA) that includes various genetic risk factors and care recommendations.
  • The GIRA report provides actionable guidelines for health care based on genetic data, highlighting the importance of integrating genetic risk assessment into routine health care practices.
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The electronic MEdical Records and GEnomics (eMERGE) consortium will return risk reports pertaining to specific diseases, a key component of which will be polygenic risk scores (PRS), to 25,000 participants, including 5000 children. Understanding comprehension and the perceived value of these PRS-based reports among parents will be critical for effective return of results in children. To address this issue, we conducted semi-structured interviews with 40 African American and Hispanic parents at The Children's Hospital of Philadelphia and Boston Children's Hospital.

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Purpose: The electronic Medical Records and Genomics (eMERGE) Phase III study was undertaken to assess clinical utility of returning medically actionable genomic screening results. We assessed pediatric clinical outcomes following return of pathogenic/likely pathogenic (P/LP) variants in autosomal dominant conditions with available effective interventions.

Methods: The two eMERGE III pediatric sites collected outcome data and assessed changes in medical management at 6 and 12 months.

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Background: Fluoropyrimidines (fluorouracil [5-FU], capecitabine) and irinotecan are commonly prescribed chemotherapy agents for gastrointestinal (GI) malignancies. Pharmacogenetic (PGx) testing for germline and variants associated with reduced enzyme activity holds the potential to identify patients at high risk for severe chemotherapy-induced toxicity. Slow adoption of PGx testing in routine clinical care is due to implementation barriers, including long test turnaround times, lack of integration in the electronic health record (EHR), and ambiguity in test cost coverage.

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Purpose: The goal of Electronic Medical Records and Genomics (eMERGE) Phase III Network was to return actionable sequence variants to 25,084 consenting participants from 10 different health care institutions across the United States. The purpose of this study was to evaluate system-based issues relating to the return of results (RoR) disclosure process for clinical grade research genomic tests to eMERGE3 participants.

Methods: RoR processes were developed and approved by each eMERGE institution's internal review board.

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Activating Signal Cointegrator 1 Complex, Subunit 3 (ASCC3) is part of the four-part ASC-1 transcriptional cointegrator complex. This complex includes ASCC1 (associated with spinal muscular atrophy with congenital bone fractures 2), TRIP4 (associated with spinal muscular atrophy with congenital bone fractures 1), and ASCC2 (not yet associated with human disease.) encodes a DNA helicase responsible for generating single-stranded DNA as part of the DNA damage response.

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Pyruvate kinase isoform M2 (PKM2) is a rate-limiting glycolytic enzyme that is widely expressed in embryonic tissues. The expression of PKM2 declines in some tissues following embryogenesis, while other pyruvate kinase isozymes are upregulated. However, PKM2 is highly expressed in cancer cells and is believed to play a role in supporting anabolic processes during tumour formation.

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The public health impact of genomic screening can be enhanced by cascade testing. However, cascade testing depends on communication of results to family members. While the barriers and facilitators of family communication have been researched following clinical genetic testing, the factors impacting the dissemination of genomic screening results are unknown.

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Background: Shooting sports are included in collegiate and Olympic events. However, there is minimal evidence examining injury prevalence and incidence for these athletes.

Hypothesis/purpose: The purpose of this study was to systematically review the literature to examine the available evidence regarding the incidence, prevalence, and types of injuries that affect athletes in Olympic-style shooting events.

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Trisomy 9 mosaic syndrome (T9M) is a rare condition characterized by multiorgan system involvement including craniofacial dysmorphisms, cardiac, genitourinary (GU), skeletal, and central nervous system (CNS) abnormalities. Although more than 100 cases have been reported in the literature, a comprehensive review has not been performed nor have clinical guidelines been established. Therefore, we describe the clinical features of 16 additional patients, review features of previously reported individuals, and suggest clinical guidelines.

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Wiedemann-Steiner syndrome (WSS) is an autosomal dominant disorder caused by monoallelic variants in KMT2A and characterized by intellectual disability and hypertrichosis. We performed a retrospective, multicenter, observational study of 104 individuals with WSS from five continents to characterize the clinical and molecular spectrum of WSS in diverse populations, to identify physical features that may be more prevalent in White versus Black Indigenous People of Color individuals, to delineate genotype-phenotype correlations, to define developmental milestones, to describe the syndrome through adulthood, and to examine clinicians' differential diagnoses. Sixty-nine of the 82 variants (84%) observed in the study were not previously reported in the literature.

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