Publications by authors named "Stephanie Lee"

Nanotechnology and engineered nanomaterials have been at the forefront of technological breakthroughs of the 21st century. With the challenges of increasingly complex and emergent environmental pollution, nanotechnology offers exciting complementary approaches to achieve high efficiencies with low or green energy input. However, unknown and unintended hazardous effects and health risks associated with nanotechnology hinder its full-scale implementation.

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Purpose: Endoplasmic reticulum (ER) stress, mitochondrial dysfunction, mitophagy/autophagy are known to contribute independently to corneal endothelial (CE) apoptosis in Fuchs' endothelial corneal dystrophy (FECD). However, the role of a well-studied specific ER stress pathway (PERK-ATF4-CHOP) in regulating mitochondrial dysfunction, mitophagy/autophagy, and apoptosis is unknown. The purpose of this study is to explore the role of ATF4 in regulating mitochondrial dysfunction and mitophagy/autophagy, leading to CEnC apoptosis in FECD.

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Cerebral palsy (CP) is a pediatric onset disorder with poorly understood molecular causes and progression, making early diagnosis difficult. Circular RNAs are regulatory RNAs that show promise as biomarkers in various diseases but the role of circular RNAs in CP is beginning to be understood. This study identified the role of circNFIX in regulating the expression of myocyte-specific enhancer factor 2C (MEF2C), an important transcription factor for sarcomere development.

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Background: When human leukocyte antigen (HLA)-matched donors are not available for hematopoietic stem cell transplants (HSCT), there are no well-accepted guidelines for ranking 7/8 HLA-matched unrelated donors to achieve optimal transplant outcomes. A novel scoring system for ranking HLA mismatches for these donors was investigated.

Methods: High-resolution HLA types were used to determine amino acid mismatches located in the HLA antigen-recognition domain.

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Article Synopsis
  • After allogeneic hematopoietic cell transplantation (HCT), only a small fraction of donor stem cells help reconstitute the recipient's blood system, while the donor maintains a nearly normal stem cell pool.
  • Researchers studied blood samples from 16 donor-recipient pairs, focusing on potential clonal hematopoiesis (CH) variants that could arise due to extra stress on donor cells post-transplant.
  • Results showed similar mutation rates in both donors and recipients, with a small percentage of shared variants showing a significant increase in recipients over time, indicating that the human hematopoietic system has strong regenerative abilities even many years after HCT.
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Revaccination to restore immunity to vaccine-preventable diseases (VPDs) is essential risk mitigation in the prevention of infectious morbidity and mortality after hematopoietic cell transplantation (HCT). However, revaccination rates have been shown to be insufficient and to what extent vaccine hesitancy contributes to survivors not becoming fully revaccinated is unknown. We performed a cross-sectional, mixed methods survey-based study to explore how vaccine hesitancy influences revaccination among US adult HCT survivors who were 2 to 8 years after transplant.

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Context: Little is known about how patients' emotions impact the choice between hemi- and total thyroidectomy (TT) for low-risk thyroid cancer (LR-TC) and how these emotions change after treatment.

Objective: To investigate thyroid cancer-specific fear and worry both before and after treatment of LR-TC with hemi- or TT.

Methods: This prospective cohort study enrolled adults with confirmed or likely LR-TC at 15 institutions.

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Background: Infants with small for gestational age (SGA) have an increased risk of short and long-term health outcomes, with potentially modifiable risk factors. This study aims to determine the prenatal risk factors associated SGA and evaluate the clinical management of affected infants.

Methods: An observational retrospective study of medical records of infants born at Nepean Hospital and discharged with a diagnosis of SGA over 5 years (1 January 2015 to 31 December 2019).

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The sustainable control of weed populations, particularly resistant species, is a significant challenge in agriculture around the world. The α-aryl-keto-enol (aryl-KTE) class of acetyl-CoA carboxylase (ACCase)-inhibiting herbicides represent a possible solution for the control of resistant grasses even though achieving crop selectivity remains a challenge. Herein, we present some of our investigations into identifying the most promising structural features within the aryl-KTE class that give the highest chance of achieving soybean crop selectivity, whilst also maintaining strong and broad efficacy against problematic weed species.

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Background: Hematopoietic cell transplant (HCT) survivorship care includes recommendations for post-HCT revaccination to restore immunity to vaccine-preventable diseases (VPDs). However, not all survivors agree to be vaccinated. No existing studies have comprehensively reported barriers and facilitators to adult HCT survivors completing revaccination.

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Article Synopsis
  • - The study investigates how positive psychological well-being (PPWB) relates to mood and quality of life in people who have undergone hematopoietic stem cell transplantation (HSCT), using data from 158 recipients.
  • - Results indicate that older age, greater social support, and certain health conditions correspond with higher PPWB levels, which are linked to improved quality of life and reduced symptoms of PTSD, anxiety, and depression.
  • - The researchers suggest that future studies should explore these associations over time to better understand how PPWB affects HSCT recovery and to develop targeted interventions for improving patient outcomes.
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Article Synopsis
  • Patients needing allogeneic hematopoietic cell transplantation have different chances of finding an 8/8 HLA-matched unrelated donor, which can be estimated using a Search Prognosis calculator.
  • The study aimed to see if a search algorithm could equalize transplant rates between patients with a high likelihood (>90%) and low likelihood (<10%) of finding a matched donor.
  • Out of 2225 enrolled patients, 1751 were evaluable for the study, and results indicated that 55% were Very Likely, 30% Less Likely, and 16% Very Unlikely to find a match, with a follow-up median
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Although peer support interventions are associated with improved patient-reported outcomes in diverse cancer populations, structured peer support programs tailored to the needs of patients undergoing hematopoietic stem cell transplantation (HSCT) are lacking. This single-arm, proof-of-concept trial aimed to refine the Supporting Transplant Experiences with Peer Program (STEPP), a structured, five-session, manualized, phone-delivered peer support intervention for patients undergoing HSCT, informed by qualitative feedback from patients. Adult patients with hematologic malignancies scheduled to undergo allogeneic or autologous HSCT were eligible to participate in the study approximately two weeks prior to their HSCT hospitalization.

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Comprehensive survivorship care after hematopoietic cell transplantation (HCT) includes revaccination to restore immunity to vaccine-preventable diseases (VPDs). There is complexity to revaccination in this setting, and revaccination rates are sub-optimal. HCT survivors are at high-risk for morbidity and mortality from infections including VPDs, underscoring the importance of interventions to improve revaccination rates among survivors.

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Article Synopsis
  • The study investigates the effectiveness of axatilimab, a CSF1R-blocking antibody, for treating chronic graft-versus-host disease (GVHD) in patients post-hematopoietic stem-cell transplantation.
  • In a phase 2 trial involving 241 participants, different doses of axatilimab were tested, with overall response rates of 74%, 67%, and 50% across three dose groups.
  • Alongside substantial improvement in GVHD symptoms measured by patient-reported outcomes, the most frequent side effects were temporary lab abnormalities linked to the treatment.
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Children with medical complexity have medical fragility, chronic disease, technology dependence, and high healthcare use. Their transition to adult health care at age 18 involves medical and social elements and follows no standardized process. Our goal was to improve transition readiness in children with medical complexity using a transition intervention within a Complex Care program.

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Since 2005, there has been a steady decline in chronic graft-versus-host disease (cGVHD) at the Fred Hutchinson Cancer Center. To better understand this phenomenon, we studied the risk of cGVHD requiring systemic immunosuppression (cGVHD-IS) as a function of hematopoietic cell transplantation (HCT) date in 3066 survivors from 2005 through 2019. Cox regression models were fit to assess associations of HCT date (as a continuous linear variable) with cause-specific hazards of cGVHD using unadjusted and adjusted models.

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Background: The sustainable control of weed populations is a significant challenge facing farmers around the world. Although various methods for the control of weeds exist, the use of small molecule herbicides remains the most effective and versatile approach. Striving to find novel herbicides that combat resistant weeds via the targeting of plant specific modes of action (MoAs), we further investigated the bicyclic class of acyl-acyl carrier protein (ACP) thioesterase (FAT) inhibitors in an effort to find safe and efficacious lead candidates.

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Purpose: Sclerotic chronic graft-versus-host disease (cGVHD) represents a highly morbid and refractory form of cGVHD, and novel therapies for sclerotic cGVHD are critically needed. This study aimed to determine the efficacy of ruxolitinib in patients with corticosteroid refractory sclerotic cGVHD.

Patients And Methods: In a single-arm multicenter phase II trial (N = 47), adults with sclerotic cGVHD refractory to corticosteroids and ≥one additional line of systemic therapy for cGVHD received ruxolitinib for ≥six months (ClinicalTrials.

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  • The Southern Arizona VA Health Care System introduced a delirium prevention and treatment protocol in 2019 to assess its impact on medication use among hospitalized elderly veterans.
  • A study analyzed data from 5,491 veterans aged 65 and older, comparing their experiences before and after the protocol's implementation across several metrics, including medication use and delirium diagnosis rates.
  • Results showed no significant differences in deliriogenic medication usage, delirium diagnosis rates, or hospital length-of-stay before and after the protocol, suggesting its limited effectiveness on these outcomes.
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  • - Protoporphyria, a type of porphyria, causes extreme skin reactions to certain light wavelengths, but patients typically avoid sunlight rather than phototherapy.
  • - A case report details a neonate who, unbeknownst to have X-linked protoporphyria, experienced severe complications after brief phototherapy, including a rash, acute liver failure, and respiratory issues.
  • - This situation highlights the need for healthcare providers to promptly recognize and address unusual reactions to phototherapy in neonates, considering protoporphyria as a possible cause.
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Article Synopsis
  • Chronic graft-versus-host disease (GVHD) is a serious complication after allogeneic stem cell transplants, and the PQRST study aims to find predictors for how patients respond to different treatments.
  • The study involves a prospective cohort of patients receiving systemic therapy for chronic GVHD, with assessments taken at the start and throughout treatment to track responses.
  • As of March 2024, 137 patients have been enrolled in the study, which started in July 2020, and researchers are inviting collaboration to use the collected data.
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