Publications by authors named "Janet S Lee"

E-cigarette/vaping-associated lung injury (EVALI) is strongly associated with vitamin E acetate and often occurs with concomitant tetrahydrocannabinol (THC) use. To uncover pathways associated with EVALI, we examined cytokines, transcriptomic signatures, and lipidomic profiles in bronchoalveolar lavage fluid (BALF) from THC-EVALI patients. At a single center, we prospectively enrolled mechanically ventilated patients with EVALI from THC-containing products (N = 4) and patients with non-vaping acute lung injury and airway controls (N = 5).

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Background: The management of incidental pulmonary nodules is guided by recommendations set forth by the Fleischner Society. While most pulmonary nodules are benign, timely and evidence-based follow-up can reduce morbidity and mortality. There are known socioeconomic disparities for engagement with recommended cancer screenings, however it is unclear whether disparities exist for follow-up of incidentally detected pulmonary lesions.

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Article Synopsis
  • Hypervirulent Klebsiella pneumoniae (hvKp) strains, once thought rare in the U.S., are being increasingly reported, with a study analyzing 273 respiratory isolates from patients in Western Pennsylvania between 2020 and 2022.
  • Among these, 13 (4.8%) tested positive for hypervirulent traits, with 2 strains (0.7%) confirmed to carry specific virulence genes, suggesting they can cause severe infections in the community.
  • Experiments showed these hvKp strains caused significant pneumonia in mice, indicating their potential to circulate in North America and cause severe community-associated infections.
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Antibiotic resistance is one of the most pressing threats to human health, yet recent work highlights how loss of resistance may also drive pathogenesis in some bacteria. In two recent studies, we found that β-lactam antibiotic and nutrient stresses faced during infection selected for the genetic inactivation of the () antibiotic efflux pump . Unexpectedly, efflux pump mutations increased virulence during infection; however, neither the prevalence of efflux pump inactivating mutations in real human infections, nor the mechanisms driving increased virulence of efflux pump mutants are known.

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Basic leucine zipper transcription factor ATF-like 2 (BATF2) is a transcription factor that is known to exhibit tumor-suppressive activity in cancer cells. Within recent years, however, BATF2 has also emerged as an important transcriptional regulator of the immune system. Through its immunomodulatory function, BATF2 has been implicated in a variety of (patho)physiological processes, including host defense against infection, anti-tumor immunity, and maintenance of tissue inflammatory homeostasis.

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Background: Patients with isolated traumatic subarachnoid hemorrhage (iTSAH) are managed according to the modified Brain Injury Guidelines (mBIG) class. The current study aimed to describe patients with iTSAH and analyze their clinical outcomes.

Methods: A retrospective analysis was performed on trauma patients with iTSAH.

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  • - The study focused on KPC-Kp bloodstream infections, which are deadly, and aimed to understand how these bacteria resist a key defense mechanism in our blood, called complement.
  • - Researchers tested various KPC-Kp isolates from patients, discovering that 27% of them resisted killing by human serum; a specific gene mutation (wcaJ) linked to capsule production contributed to this resistance.
  • - This mutation resulted in less capsule presence, paradoxically increasing the bacteria's ability to bind complement proteins while also improving their survival against immune responses, potentially allowing them to thrive in the bloodstream without being overly virulent in tissues.
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The severity of bacterial pneumonia can be worsened by impaired innate immunity resulting in ineffective pathogen clearance. We describe a mitochondrial protein, aspartyl-tRNA synthetase (DARS2), which is released in circulation during bacterial pneumonia in humans and displays intrinsic innate immune properties and cellular repair properties. DARS2 interacts with a bacterial-induced ubiquitin E3 ligase subunit, FBXO24, which targets the synthetase for ubiquitylation and degradation, a process that is inhibited by DARS2 acetylation.

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Article Synopsis
  • * Out of 252 trauma patients, those with SB-CT had a lower failure rate (9.2%) compared to LB-CT (22.7%) and also used fewer opioids (332 MME vs 767 MME).
  • * Overall, the results indicate that small-bore chest tubes are a safe and effective alternative to large-bore ones in trauma situations, without significant differences in failure rates or opioid use when analyzed further.
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Precision management of fibrotic lung diseases is challenging due to their diverse clinical trajectories and lack of reliable biomarkers for risk stratification and therapeutic monitoring. Here, we validated the accuracy of CMKLR1 as an imaging biomarker of the lung inflammation-fibrosis axis. By analyzing single-cell RNA sequencing datasets, we demonstrated expression as a transient signature of monocyte-derived macrophages (MDMφ) enriched in patients with idiopathic pulmonary fibrosis (IPF).

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  • Scientists found that a small dose of a substance called lipopolysaccharide (LPS) can help protect mice from a serious lung infection caused by a germ called Pseudomonas aeruginosa.
  • The LPS helps boost certain immune cells called neutrophils and macrophages, which are important for fighting off infections by eating bacteria and killing them.
  • In people with serious lung issues, higher levels of a protein called galectin-3, found in survivors, suggest that this protein could play a big role in helping the immune system fight these infections.
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Background: Clinical practice guidelines recommend adjuvant therapy for patients with early non-small cell lung cancer (eNSCLC), especially those with lymph node metastasis. This study evaluated the prevalence of lymph node examination and its association with adjuvant treatment rates, overall survival (OS), and healthcare costs among United States (US) Medicare patients with resected eNSCLC.

Methods: This retrospective observational cohort study used Surveillance, Epidemiology, and End Results cancer registry data linked with Medicare claims data.

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The X-linked A variant (rs1050828, Val68Met) in accounts for glucose-6-phosphate (G6PD) deficiency in approximately 11% of African American males. This common, hypomorphic variant may impact pulmonary host defense and phagocyte function during pneumonia by altering levels of reactive oxygen species produced by host leukocytes. We used CRISPR-Cas9 technology to generate novel mouse strain with "humanized" G6PD A- variant containing non-synonymous Val68Met single nucleotide polymorphism.

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Background: Kaiser Permanente Southern California began offering a 4-week supplemental benefit of home-delivered meals to Medicare Advantage members after discharge from a hospitalization for heart failure and other medical conditions in 2021. The purpose of this study is to explore the associations between socioeconomic disadvantage and food insecurity with patient uptake of and satisfaction with the meals.

Methods: Data for this cross-sectional study were drawn from survey and electronic medical record data for members referred for the meals benefit (n = 6169) and linked to a hospitalization encounter (n = 2254) between January and December 2021.

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Purpose: Real-world lung cancer data in administrative claims databases often lack staging information and specific diagnostic codes for lung cancer histology subtypes. This study updates and validates Turner's 2017 treatment-based algorithm using more recent claims and electronic health record (EHR) data.

Methods: This study used Optum's deidentified Market Clarity Data of linked medical and pharmacy claims with EHR data.

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Gaps remain in our understanding of the intensity and timing of specialty palliative care (SPC) exposure on end-of-life (EOL) outcomes. Examine the association between intensity and timing of SPC and hospice (HO) exposure on EOL care outcomes. Data for this cohort study were drawn from 2021 adult decedents from Kaiser Permanente Southern California and Colorado ( = 26,251).

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Background: The effectiveness and safety of mineralocorticoid receptor antagonists (MRA) in acute heart failure (HF) is uncertain. We sought to describe the prescription of spironolactone during acute HF and whether early treatment is effective and safe in a real-world setting.

Methods: We performed a retrospective cohort study of adult (≥18 years) nonpregnant patients hospitalized with new-onset HF with reduced ejection fraction (HFrEF, defined by ejection fraction ≤40%) within 15 Kaiser Permanente Southern California medical centers between 2016 and 2021.

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The antibiotic cefiderocol hijacks iron transporters to facilitate its uptake and resists β-lactamase degradation. While effective, resistance has been detected clinically with unknown mechanisms. Here, using experimental evolution, we identified cefiderocol resistance mutations in Pseudomonas aeruginosa.

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Background: Donor genetic variation is associated with red blood cell (RBC) storage integrity and post-transfusion recovery. Our previous large-scale genome-wide association study demonstrated that the African G6PD deficient A- variant (rs1050828, Val68Met) is associated with higher oxidative hemolysis after cold storage. Despite a high prevalence of X-linked G6PD mutation in African American population (>10%), blood donors are not routinely screened for G6PD status and its importance in transfusion medicine is relatively understudied.

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GDF15 (growth differentiation factor 15) is a stress cytokine with several proposed roles, including support of stress erythropoiesis. Higher circulating GDF15 levels are prognostic of mortality during acute respiratory distress syndrome, but the cellular sources and downstream effects of GDF15 during pathogen-mediated lung injury are unclear. We quantified GDF15 in lower respiratory tract biospecimens and plasma from patients with acute respiratory failure.

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Article Synopsis
  • Klebsiella pneumoniae is a Gram-negative bacterium that can cause serious infections, and STAT1 is a key transcription factor that helps regulate T cell activity during infection.
  • Researchers used a mouse model to show that a lack of STAT1 leads to increased neutrophil activity and early recruitment to the lungs, which precedes serious bacterial infection and lung damage.
  • They also discovered that while IL-17 from other immune cells is crucial for combating the infection, dysfunctional CD4+ T cell responses due to STAT1 deficiency may worsen the situation, highlighting the complex role of STAT1 in managing immune responses during bacterial infections.
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