Publications by authors named "J-P Gonzalez"

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  • Access to safe surgery is a human right, but significant disparities exist between high-income and low-to-middle-income countries in terms of surgical care.* -
  • The LASOS-Peds study is a 14-day international research project exploring the rates of complications after pediatric surgeries in Latin America, focusing on both elective and emergency cases.* -
  • Approved by an Institutional Review Board, the findings will be published in peer-reviewed journals and shared at international conferences, with the aim of improving pediatric surgical outcomes.*
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Purpose: The optimal treatment sequence for hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) after progression on first-line cyclin-dependent kinase 4/6 inhibitor (CDKi) and endocrine therapy is unclear. Clinical and biological factors influencing treatment choices and outcomes in the second-line setting need to be elucidated.

Materials And Methods: This is a retrospective analysis of a real-world cohort including patients with HR+/HER2- ABC who received CDKi and endocrine therapy in the first-line setting and progressed, requiring second-line treatment.

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Duchenne muscular dystrophy (DMD) is a progressive muscle wasting disorder affecting 1:3500 male births and is associated with myofiber degeneration, regeneration, and inflammation. Glucocorticoid treatments have been the standard of care due to immunomodulatory/immunosuppressive properties but novel genetic approaches, including exon skipping and gene replacement therapy, are currently being developed. The identification of additional biomarkers to assess DMD-related inflammatory responses and the potential efficacy of these therapeutic approaches are thus of critical importance.

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  • * Data from 670 patients revealed that while IVT may improve some outcomes, such as higher chances of achieving a modified Rankin Scale score of 0-2 in univariable analysis, this benefit was not consistently observed in more rigorous multivariable analyses.
  • * Overall, the findings suggest that adjunctive IVT may not significantly enhance clinical outcomes or safety compared to MT alone for this patient population.
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  • The study aimed to evaluate the accuracy of 40 predictive equations for estimating resting energy expenditure (REE) in women with breast cancer, comparing these predictions to measurements taken by indirect calorimetry.
  • The analysis included data from 90 participants (24% survivors, 61.1% early-stage cancer), revealing that none of the equations provided accurate REE estimates both at the group and individual levels, with significant biases observed.
  • These findings highlight the importance of using precise methods for calculating energy needs in women with breast cancer, as inaccuracies can impact treatment and recovery by influencing energy intake.
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  • A study was conducted to address the disparity in access to mechanical thrombectomy (MT) in low- to middle-income countries by organizing team-based workshops aimed at improving knowledge and skills related to MT for stroke treatment.
  • The workshops, held in Jamaica and the Dominican Republic, included didactic and hands-on training for neurointerventional teams, resulting in significant improvements in test scores and practical skills in managing strokes due to large vessel occlusion.
  • Feedback from participants indicated high satisfaction rates, with a majority believing that the training would positively impact their clinical practice.
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  • In a study comparing neoadjuvant (before surgery) and adjuvant (after surgery) immunotherapy for stage III melanoma, neoadjuvant treatment showed greater effectiveness.
  • The trial involved random assignment of 423 patients to receive either two cycles of neoadjuvant ipilimumab plus nivolumab followed by surgery, or surgery followed by 12 cycles of adjuvant nivolumab.
  • Results indicated a significantly higher 12-month event-free survival rate in the neoadjuvant group (83.7%) compared to the adjuvant group (57.2%), with neoadjuvant therapy leading to better patient outcomes and more major pathological responses despite a higher incidence of severe adverse events.
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Background: Optimal anesthetic strategy for the endovascular treatment of stroke is still under debate. Despite scarce data concerning anesthetic management for medium and distal vessel occlusions (MeVOs) some centers empirically support a general anesthesia (GA) strategy in these patients.

Methods: We conducted an international retrospective study of MeVO cases.

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Background: Community-based violence intervention (CVI) programs are considered important strategies for preventing community violence and promoting health and safety. Mixed and inconclusive results from some prior CVI evaluations, as well as our general lack of understanding about the reasons for such varied findings, may be explained in part by misalignment of program theories of change and evaluation measures. Furthermore, most prior evaluations have focused solely on deficit-based outcomes; this narrow focus is inconsistent with the premise of CVI and may fail to capture improvements in health and well-being that are on the hypothesized pathway from intervention to violence reduction.

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Introduction: Sex influences neurodegeneration, but it has been poorly investigated in dementia with Lewy bodies (DLB). We investigated sex differences in brain atrophy in DLB using magnetic resonance imaging (MRI).

Methods: We included 436 patients from the European-DLB consortium and the Mayo Clinic.

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Background: Immunotherapy is effective, but current biomarkers for patient selection have proven modest sensitivity. Here, we developed VIGex, an optimized gene signature based on the expression level of 12 genes involved in immune response with RNA sequencing.

Methods: We implemented VIGex using the nCounter platform (Nanostring) on a large clinical cohort encompassing 909 tumor samples across 45 tumor types.

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  • A phase 4 study in Brazil evaluated the effectiveness of fractional doses of heterologous COVID-19 vaccines in adults who had received two doses of the CoronaVac vaccine at least four months prior.
  • Participants were divided into three groups, receiving either a full or half dose of ChAdOx1-S or a half dose of BNT162b2, but the study did not achieve the primary objective of an 80% seroresponse rate, with recorded rates being 34.3%, 27.1%, and 71.2% respectively.
  • Despite the lower than expected seroresponse rates, all vaccine types showed robust immune responses and were well tolerated, indicating that these heterologous boosters are safe and
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The HNRNPH2 proline-tyrosine nuclear localization signal (PY-NLS) is mutated in HNRNPH2-related X-linked neurodevelopmental disorder, causing the normally nuclear HNRNPH2 to accumulate in the cytoplasm. We solved the cryoelectron microscopy (cryo-EM) structure of Karyopherin-β2/Transportin-1 bound to the HNRNPH2 PY-NLS to understand importin-NLS recognition and disruption in disease. HNRNPH2 RPGPY is a typical R-X-P-Y motif comprising PY-NLS epitopes 2 and 3, followed by an additional Karyopherin-β2-binding epitope, we term epitope 4, at residues DRP; no density is present for PY-NLS epitope 1.

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Nonsense mutations are the underlying cause of approximately 11% of all inherited genetic diseases. Nonsense mutations convert a sense codon that is decoded by tRNA into a premature termination codon (PTC), resulting in an abrupt termination of translation. One strategy to suppress nonsense mutations is to use natural tRNAs with altered anticodons to base-pair to the newly emerged PTC and promote translation.

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Background: We sought to identify protein biomarkers of new-onset heart failure (HF) in 3 independent cohorts (HOMAGE cohort [Heart Omics and Ageing], ARIC study [Atherosclerosis Risk in Communities], and FHS [Framingham Heart Study]) and assess if and to what extent they improve HF risk prediction compared to clinical risk factors alone.

Methods: A nested case-control design was used with cases (incident HF) and controls (without HF) matched on age and sex within each cohort. Plasma concentrations of 276 proteins were measured at baseline in ARIC (250 cases/250 controls), FHS (191/191), and HOMAGE cohort (562/871).

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  • Inborn errors affecting the immune response to IFN-γ lead to mycobacterial diseases, while errors in IFN-α/β impact defense against viral infections.
  • A study of children with complete IRF1 deficiency showed they suffered from severe mycobacterial infections but displayed normal responses to various viruses, including SARS-CoV-2.
  • IRF1 plays a crucial role in the immune response to mycobacteria, enhancing IFN-γ responses, while its absence does not significantly hinder antiviral defenses associated with IFN-α/β.
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Background: Dystrophic epidermolysis bullosa is a rare genetic blistering skin disease caused by mutations in , which encodes type VII collagen (C7). Beremagene geperpavec (B-VEC) is a topical investigational herpes simplex virus type 1 (HSV-1)-based gene therapy designed to restore C7 protein by delivering .

Methods: We conducted a phase 3, double-blind, intrapatient randomized, placebo-controlled trial involving patients 6 months of age or older with genetically confirmed dystrophic epidermolysis bullosa.

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  • - Blood-based biomarkers, tested in a prospective real-world memory clinic cohort, show promise for evaluating cognitive impairment, with five specific plasma biomarkers being analyzed for diagnostic performance and applicability in clinical settings.
  • - Among the 349 participants, plasma p-tau181 and GFAP were highly effective in distinguishing Alzheimer's disease from non-neurodegenerative conditions, achieving diagnostic accuracies of 94% and 92%, respectively.
  • - The study found that p-tau181 not only predicted amyloid status with 85% accuracy but also worked well with NfL to identify frontotemporal dementia, highlighting the potential of these biomarkers in everyday clinical practice.
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Introduction: This culturally tailored enrollment effort aims to determine the feasibility of enrolling 5000 older Latino adults from California into the Brain Health Registries (BHR) over 2.25 years.

Methods: This paper describes (1) the development and deployment of culturally tailored BHR websites and digital ads, in collaboration with a Latino community science partnership board and a marketing company; (2) an interim feasibility analysis of the enrollment efforts and numbers, and participant characteristics (primary aim); as well as (3) an exploration of module completion and a preliminary efficacy evaluation of the culturally tailored digital efforts compared to BHR's standard non-culturally tailored efforts (secondary aim).

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Background: The ongoing coronavirus 2019 disease (COVID-19) pandemic strained medical systems worldwide. We report on the impact on pediatric oncology care in Latin American (LATAM) during its first year.

Method: Four cross-sectional surveys were electronically distributed among pediatric onco-hematologists in April/June/October 2020, and April/2021 through the Latin American Society of Pediatric Oncology (SLAOP) email list and St Jude Global regional partners.

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is one of the lesser known and less abundant sylvatic triatomine species naturally infected by the protozoan , the etiological agent of Chagas disease. lives in sympatry with -infected rodents, but only birds, reptiles, and marine mammals have been reported as blood-meal sources of this vector species by serology. The distribution range of this kissing bug overlaps with fishers' settlements and tourist areas, and therefore the study of the blood-meal sources of this triatomine species is relevant.

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Background: For patients with suspected pulmonary embolism (PE), age- or clinically-adjusted D-dimer threshold level can be used to define a negative test that safely excludes PE and reduces the use of imaging. However, the utility of this approach in patients hospitalized for chronic obstructive pulmonary disease (COPD) exacerbation is undefined.

Methods: We ran an analysis of the patients hospitalized for COPD exacerbation and randomized to the intervention in the SLICE trial.

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  • The study explores the relationship between circadian rhythm disturbances and bipolar disorder (BD), examining how these disruptions can influence symptoms like mood and energy changes.
  • The International Society for Bipolar Disorders Chronobiology Task Force reviewed literature from various fields to create a comprehensive framework linking circadian disruptions to BD.
  • Findings suggest that while circadian disturbances are related to mood regulation in BD, they are also present in other psychiatric disorders, indicating a need for more precise research methods to clarify these associations.
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Duchenne muscular dystrophy, like other muscular dystrophies, is a progressive disorder hallmarked by muscle degeneration, inflammation, and fibrosis. Latent transforming growth factor β (TGFβ) binding protein 4 (LTBP4) is an extracellular matrix protein found in muscle. LTBP4 sequesters and inhibits a precursor form of TGFβ.

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Background: Mobile stroke units (MSUs) are ambulances with staff and a computed tomographic scanner that may enable faster treatment with tissue plasminogen activator (t-PA) than standard management by emergency medical services (EMS). Whether and how much MSUs alter outcomes has not been extensively studied.

Methods: In an observational, prospective, multicenter, alternating-week trial, we assessed outcomes from MSU or EMS management within 4.

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