Publications by authors named "Kyriakides T"

Background: Women involved in the criminal legal system have elevated rates of opioid use disorder, which is treatable, and HIV, which is preventable with pre-exposure prophylaxis (PrEP). There are significant social and structural barriers to integrated delivery of PrEP and medications for opioid use disorder (MOUD), limiting women's ability to access these life-saving interventions. In a two parallel-arm randomized controlled trial, we are assessing an innovative eHealth delivery model that integrates PrEP with MOUD and is tailored to meet the specific needs of women involved in the criminal legal system.

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Fibroblasts display complex functions associated with distinct gene expression profiles that influence matrix production and cell communications and the autonomy of tissue development and repair. Thrombospondin-2 (TSP-2), produced by fibroblasts, is a potent angiogenesis inhibitor and negatively associated with tissue repair. Single-cell (sc) sequencing analysis on WT and TSP2KO skin fibroblasts demonstrate distinct cell heterogeneity.

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Objective: Most pragmatic trials follow the PRagmatic Explanatory Continuum Indicator Summary (PRECIS-2) criteria. The criteria specify unobtrusive measurement of participants' protocol adherence and practitioners' intervention fidelity but suggest no special monitoring strategies to assure trial integrity. We present experience with adherence/fidelity monitoring in the Pain Management Collaboratory (PMC) and provide recommendations for their monitoring in pragmatic trials to preserve inferences of treatment comparisons.

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Article Synopsis
  • The study aimed to assess how COVID-19 impacted pain management clinical trials using the PICOTS framework, focusing on patient demographics, intervention methods, and trial outcomes.
  • Researchers utilized rapid qualitative methods to gather insights from trial leaders across various study designs, uncovering significant disruptions primarily related to the shift from in-person to virtual care.
  • Findings revealed that while patient populations remained stable, the transition created issues with intervention fidelity and posed challenges for ongoing care access, affecting the reliability of research outcomes and the overall conduct of the trials.
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  • Best practices for clinical trials require that statistical analysis plans (SAPs) be finalized prior to any analysis, but there is little guidance on when and how to make changes to these plans during the research process.
  • A survey of 12 pragmatic clinical trials in pain management found that most included details on SAPs and made changes after trial initiation, often due to COVID-19, affecting aspects like sample size and study design.
  • The study recommends that changes to SAPs are acceptable until data lock/unblinding, emphasizing the importance of transparent documentation, including details and justifications for any modifications, along with approval from oversight bodies.
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  • Impaired wound healing in diabetic patients leads to high rates of hospitalizations and lower limb amputations due to factors like high glucose levels and cell dysfunction.
  • * Research shows that excess levels of the protein thrombospondin-2 (TSP2) in diabetic wounds can hinder healing, but reducing TSP2 levels through various methods improved recovery in diabetic mice.
  • * A compound called DMOG, which stabilizes a key protein (HIF-1α), helped lower TSP2 levels and promote better blood vessel formation in wounds, suggesting a potential treatment strategy for improving wound healing in diabetic patients.
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The biggest challenge in current isolation methods for lipid bilayer-encapsulated vesicles, such as exosomes, secretory, and synthetic vesicles, lies in the absence of a unified approach that seamlessly delivers high purity, yield, and scalability for large-scale applications. To address this gap, we have developed an innovative method that utilizes photosensitive lipid nanoprobes specifically designed for efficient isolation of vesicles and sorting them into subpopulations based on size. The photosensitive component in the probe undergoes cleavage upon exposure to light, facilitating the release of vesicles in their near-native form.

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Background: Clostridioides difficile infection (CDI) is the most common cause of healthcare-associated infections in US hospitals with 15%-30% of patients experiencing recurrence. The aim of our randomized, double-blind clinical trial was to assess the efficacy of capsule-delivered fecal microbiota transplantation (FMT) versus placebo in reducing recurrent diarrhea and CDI recurrence. The secondary aim was FMT safety assessment.

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Bone extracellular matrix (ECM) has been shown to mimic aspects of the tissue's complex microenvironment, suggesting its potential role in promoting bone repair. However, current ECM-based therapies suffer from limitations such as inefficient scale-up, lack of mechanical integrity, and sub-optimal efficacy. Here, we fabricated hydrogels from decellularized ECM (dECM) from wild type (WT) and thrombospondin-2 knock-out (TSP2KO) mouse bones.

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Background: There is conflicting evidence on the efficacy of primary prevention implantable cardioverter-defibrillator (ICD) implantation in the elderly.

Objective: The purpose of this study was to determine the efficacy and safety of ICD implantation in patients 70 years and older.

Methods: Patients (n = 167) aged 70 years or older and eligible for ICD implantation were randomly assigned (1:1) to receive either optimal medical therapy (OMT) (n = 85) or OMT plus ICD (n = 82).

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  • * The OVER trial analyzed data from 881 participants to identify risk factors for incisional hernias following AAA repair and highlighted that 5.2% developed this complication within an average of 3.5 years after surgery.
  • * Key technical details examined included the type of repair performed, suture methods used, and patient demographics, ultimately contributing to understanding hernia development risks post-surgery.
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Background: Fermented soy products have shown to possess inhibitory effects on prostate cancer (PCa). We evaluated the effect of a fermented soy beverage (Q-Can®), containing medium-chain triglycerides, ketones and soy isoflavones, among men with localized PCa prior to radical prostatectomy.

Methods: We conducted a placebo-controlled, double-blind randomized trial of Q-Can®.

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Volumetric muscle loss (VML) represents a clinical challenge due to the limited regenerative capacity of skeletal muscle. Most often, it results in scar tissue formation and loss of function, which cannot be prevented by current therapies. Decellularized extracellular matrix (DEM) has emerged as a native biomaterial for the enhancement of tissue repair.

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Background: Med-Index is a one-health front-of-pack (FOP) label, based on Mediterranean diet (MedDiet) principles, developed to summarize information about the nutritional properties and related-health benefits of any food as well as its sustainable production processes, and the associated food company's social responsibility parameters in a new "Planeterranean" perspective. Thus, Med-Index can be adopted in and by any European region and authority as well as worldwide; this is achieved by consumption and cooking of locally available and sourced foods that respect MedDiet principles, both in terms of healthy nutrition and sustainable production. The huge body of scientific evidence about the health benefits of the MedDiet model and principles requires a comprehensive framework to encompass the scientific reliability and robustness of this tool.

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Adolescents who engage in non-opioid substance misuse and/or experience mental health symptoms are at greater risk of misusing opioids and/or developing opioid use disorder. Adolescence is a critical developmental period to both prevent the initiation of opioid misuse and target mental health. To date, there are no digital health games targeting both conditions.

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Introduction: The objective of this study was to describe the correlation between the commercially available assay for anti-S1/RBD IgG and protective serum neutralizing antibodies (nAb) against SARS-CoV-2 in an adult population after SARS-CoV-2 vaccination, and determine if clinical variables impact this correlation.

Methods: We measured IgG anti-S1/RBD using the IgG-II CMIA assay and nAb IC50 values against SARS-CoV-2 WA-1 in sera serially collected post-mRNA vaccination in veterans and healthcare workers of the Veterans Affairs Connecticut Healthcare System (VACHS) between December 2020 and January 2022. The correlation between IgG and IC50 was measured using Pearson correlation.

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Article Synopsis
  • The CONFIRM trial aimed to compare the effectiveness of annual fecal immunochemical tests (FIT) versus colonoscopies in reducing colorectal cancer mortality, enrolling over 50,000 veterans between May 2012 and December 2017.
  • The study analyzed participant demographics and examined reasons for those who chose not to participate, highlighting a mix of preferences for either colonoscopy or stool tests based on geographic and temporal factors.
  • Among the 50,126 participants recruited, there was a diverse representation, and the study also noted that 11,109 eligible individuals opted out of participation for various reasons, with insights gathered via case report forms.
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Background: Published reports suggest that exclusion of antegrade hypogastric artery flow may have deleterious effects on erectile function after abdominal aortic aneurysm (AAA) repair. Off-label and open surgical hybrid procedures and, more recently, purpose-built branched devices have been developed to maintain antegrade pelvic perfusion in patients undergoing endovascular repair. Maintaining antegrade perfusion may reduce a spectrum of risks, including buttock claudication, colorectal ischemia, and spinal cord ischemia when patients undergo subsequent thoracic aortic procedures, as well as erectile dysfunction (ED).

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  • The text highlights the importance of expanding tuberculous preventive therapy (TPT) for people with HIV, noting that implementation has been sluggish and calling for innovative strategies, particularly in rural South Africa where TB is prevalent.* -
  • The study evaluated a community-based approach where nurses and lay workers identified and referred people with HIV for a six-month course of isoniazid, measuring adherence and treatment completion rates in this group compared to those already receiving HIV care.* -
  • Results showed that the community-based group had a significantly higher treatment completion rate (90%) compared to the clinic-based group (79.2%), with female participants and community referral being key factors in successful TPT completion.*
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Implementation assessment plans are crucial for clinical trials to achieve their full potential. Without a proactive plan to implement trial results, it can take decades for one-fifth of effective interventions to be adopted into routine care settings. The Veterans Health Administration Office of Research and Development is undergoing a systematic transformation to embed implementation planning in research protocols through the Cooperative Studies Program, its flagship clinical research program.

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