Publications by authors named "Rachel Silver"

Pathogenic variants in NOTCH1 are associated with non-syndromic congenital heart disease (CHD) and Adams-Oliver syndrome (AOS). The clinical presentation of individuals with damaging NOTCH1 variants is characterized by variable expressivity and incomplete penetrance; however, data on systematic phenotypic characterization are limited. We report the genotype and phenotype of a cohort of 33 individuals (20 females, 13 males; median age 23.

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Acute febrile illness (AFI) is a broad clinical syndrome with a wide range of potential infectious etiologies. The lack of accessible, standardized approaches to conducting AFI etiologic investigations has contributed to significant global gaps in data on the epidemiology of AFI. Based on lessons learned from years of supporting AFI sentinel surveillance worldwide, the U.

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Lifestyle programs that reduce health risks and support weight loss (WL) in older adults face adherence and attendance challenges due to reduced energy requirements, impaired mobility, lack of transportation, and low social support. Tailored lifestyle and weight management programs are needed to better support healthy aging for older adults. Here, we developed and piloted an age-adapted, remotely delivered modification of the Diabetes Prevention Program (DPP).

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Article Synopsis
  • Autosomal recessive ROR2-Robinow syndrome is linked to mutations in the ROR2 gene, leading to various physical abnormalities.
  • A fetal ultrasound at 24 weeks revealed significant traits such as enlarged head, facial deformities, and skeletal issues in the patient.
  • Genetic testing identified two pathogenic variants in the ROR2 gene, one inherited from the mother and another that likely occurred de novo, both of which contribute to the observed symptoms and physical findings at autopsy.
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  • - The study investigates the impact of spinal anesthesia (SA) on reducing the use of multiple medications (polypharmacy) and opioid consumption in elderly patients (≥65 years) undergoing a specific spine surgery called transforaminal lumbar interbody fusion (TLIF) compared to general anesthesia (GA).
  • - Results show that patients receiving SA averaged 7.45 medications, significantly fewer than the 12.7 medications for those under GA, and had a much lower average opioid consumption (5.17 MME for SA vs. 20.2 MME for GA).
  • - The findings suggest that SA not only minimizes polypharmacy but may also lessen the need for opioid pain management; however, further studies are needed
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Mothers of infants born extremely preterm requiring prolonged medical intervention in the Neonatal Intensive Care Unit (NICU) are at high risk of developing stress. Parent-administered infant massage is a well-established, safe intervention for preterm infants with many developmental benefits, but the published literature has mostly examined its impact on infants and parents through self-reported or observational measures of stress. The aim of this study was to measure salivary cortisol, a biomarker for stress, in extremely preterm infants and their mothers immediately pre and post parent-administered infant massage in order to detect potential changes in physiologic stress.

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Identifying persons who have newly acquired HIV infections is critical for characterizing the HIV epidemic direction. We analyzed pooled data from nationally representative Population-Based HIV Impact Assessment surveys conducted across 14 countries in Africa for recent infection risk factors. We included adults 15-49 years of age who had sex during the previous year and used a recent infection testing algorithm to distinguish recent from long-term infections.

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Calorie restriction (CR) is a promising approach for attenuating the risk of age-related disease. However, the role of diet composition on adherence to CR and the effects of CR on cardiometabolic markers of healthspan remains unknown. We used the Geometric Framework for Nutrition approach to examine the association between macronutrient composition and CR adherence during the 2-year CALERIE trial.

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Objective: Ultrasound assessment of the fetal anatomy and fetal echocardiography are feasible in the first trimester of pregnancy. This study was designed to assess the performance of a comprehensive fetal anatomy assessment in a high-risk population at a tertiary fetal medicine unit.

Methods: A retrospective review of high-risk patients undergoing comprehensive fetal anatomy ultrasound assessment between 11 weeks and 13 + 6 weeks of gestation was conducted.

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Background: The study of the etiology of acute febrile illness (AFI) has historically been designed as a prevalence of pathogens detected from a case series. This strategy has an inherent unrealistic assumption that all pathogen detection allows for causal attribution, despite known asymptomatic carriage of the principal causes of acute febrile illness in most low- and middle-income countries (LMICs). We designed a semi-quantitative PCR in a modular format to detect bloodborne agents of acute febrile illness that encompassed common etiologies of AFI in the region, etiologies of recent epidemics, etiologies that require an immediate public health response and additional pathogens of unknown endemicity.

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Background: The study of the etiology of acute febrile illness (AFI) has historically been designed as a prevalence of pathogens detected from a case series. This strategy has an inherent unrealistic assumption that all pathogen detection allows for causal attribution, despite known asymptomatic carriage of the principal causes of acute febrile illness in most low- and middle-income countries (LMICs). We designed a semi-quantitative PCR in a modular format to detect bloodborne agents of acute febrile illness that encompassed common etiologies of AFI in the region, etiologies of recent epidemics, etiologies that require an immediate public health response and additional pathogens of unknown endemicity.

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Background: The effect of calorie restriction (CR) on cognitive function is not well understood, and the impact of the dietary patterns consumed during CR has not been investigated.

Objectives: We analyzed the combined association of CR and dietary quality with spatial working memory (SWM) in healthy adults without obesity.

Methods: The Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trial was a 2-y, multisite clinical trial.

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Objective: Lifestyle interventions have had limited effectiveness in work sites when evaluated in randomized trials. This study assessed the effectiveness of a novel lifestyle intervention for weight loss (Healthy Weight for Living [HWL]) implemented with or without meal replacements (MR) in work sites. HWL used a new behavioral approach emphasizing reducing hunger and building healthy food preferences, and, unlike traditional lifestyle interventions, it did not require calorie counting.

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Article Synopsis
  • Existing acute febrile illness (AFI) surveillance systems can be adapted to identify new diseases like COVID-19 by testing patients who show symptoms.
  • The CDC worked with health ministries in five countries (Belize, Ethiopia, Kenya, Liberia, and Peru) to integrate COVID-19 testing into their AFI systems from March 2020 to October 2021, enrolling over 5,500 patients.
  • Testing results showed varying positivity rates for SARS-CoV-2 across countries, demonstrating that AFI surveillance can effectively enhance monitoring and response to emerging infectious diseases.
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Introduction: Hazardous alcohol use (HAU), defined as a pattern of alcohol consumption that increases the risk of harmful consequences for the user or others, is associated with an elevated risk of human immunodeficiency virus (HIV) infection and poor health outcomes. We describe the association between people living with HIV (PLHIV) who report HAU and key HIV indicators. Gaps in current literature in estimating HAU on HIV outcomes at the regional level of Eastern and Southern Africa still exist and our analysis aims to address this issue.

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Background: Lifestyle interventions are the first-line treatment for obesity, but participant weight loss is typically low.

Objectives: We evaluated the efficacy of an alternative lifestyle intervention [Healthy Weight for Living (HWL)] compared with a modified Diabetes Prevention Program (m-DPP). HWL was based on a revised health behavior change model emphasizing hunger management and the development of healthy food preferences.

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The amount of time spent in poor health at the end of life is increasing. This narrative review summarizes consistent evidence indicating that healthy dietary patterns and maintenance of a healthy weight in the years leading to old age are associated with broad prevention of all the archetypal diseases and impairments associated with aging including: noncommunicable diseases, sarcopenia, cognitive decline and dementia, osteoporosis, age-related macular degeneration, diabetic retinopathy, hearing loss, obstructive sleep apnea, urinary incontinence, and constipation. In addition, randomized clinical trials show that disease-specific nutrition interventions can attenuate progression-and in some cases effectively treat-many established aging-associated conditions.

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Background And Objective: Community mitigation strategies could help reduce COVID-19 incidence, but there are few studies that explore associations nationally and by urbanicity. In a national county-level analysis, we examined the probability of being identified as a county with rapidly increasing COVID-19 incidence (rapid riser identification) during the summer of 2020 by implementation of mitigation policies prior to the summer, overall and by urbanicity.

Methods: We analyzed county-level data on rapid riser identification during June 1-September 30, 2020 and statewide closures and statewide mask mandates starting March 19 (obtained from state government websites).

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During early August 2020, county-level incidence of coronavirus disease 2019 (COVID-19) generally decreased across the United States, compared with incidence earlier in the summer (1); however, among young adults aged 18-22 years, incidence increased (2). Increases in incidence among adults aged ≥60 years, who might be more susceptible to severe COVID-19-related illness, have followed increases in younger adults (aged 20-39 years) by an average of 8.7 days (3).

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  • - The study investigated the spread of SARS-CoV-2 in a Louisiana detention facility during an outbreak, testing detained individuals in quarantined dormitories over time.
  • - Out of 143 detainees tested, 78% were found positive for the virus, with many cases emerging after the initial testing period, highlighting the rapid transmission potential.
  • - The research suggests that proactive, serial testing and immediate isolation can significantly reduce transmission rates, emphasizing the need for early intervention and strong infection control measures in such facilities.
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  • The study analyzed the impact of weight loss counselors on participant weight loss and engagement in an 11-week structured lifestyle program with 575 adults, focusing on how counselor characteristics influenced outcomes.
  • Results showed significant differences in participant weight loss based on which counselor led their group, with counselors holding a nutrition degree leading to greater weight loss.
  • Higher body mass index (BMI) of counselors was linked to better weight loss performance from participants, suggesting that counselor traits can notably affect the success of weight loss interventions.
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Background: Coronavirus disease 2019 (COVID-19) continues to cause significant morbidity and mortality worldwide. Correctional and detention facilities are at high risk of experiencing outbreaks. We aimed to evaluate cohort-based testing among detained persons exposed to laboratory-confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in order to identify presymptomatic and asymptomatic cases.

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  • * The use of core genome multilocus sequence typing (cgMLST) provided better resolution without needing a reference genome, successfully categorizing outbreak isolates into two clades, while predicting high antimicrobial resistance across the isolates.
  • * WGS facilitated the genetic identification of antimicrobial resistance and linked human cases to pet store puppies despite limited canine exposure information, enhancing the overall epidemiological investigation.
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Objective: To assess the effects of food supplementation on improving working memory and additional measures including cerebral blood flow in children at risk of undernutrition.

Design: Randomized controlled trial.

Setting: 10 villages in Guinea-Bissau.

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