52,691 results match your criteria: "Perelman School of Medicine at the University of Pennsylvania; jshorter@mail.med.upenn.edu.[Affiliation]"

Public health problems are complex; investigating them requires a framework that both accounts for multiple interactions among individuals and their intermediate and broader environment and also integrates equity concerns. Incorporating internal and external influences at the individual level, the health capability profile (HCP)'s 15 different health capabilities address this need.Using a systematic three-step deductive content analysis process, we examine hypothetical case studies representing leading causes of death in the USA (eg, heart disease, cancer and diabetes) as well as pressing public health issues such as COVID-19, alcohol use disorder, stigma and discrimination, intimate partner violence and firearm violence.

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Purpose: Modeling passively collected smartphone sensor data (called digital phenotyping) has the potential to detect distress among family caregivers and patients with advanced cancer and could lead to novel clinical models of cancer care. The purpose of this study was to assess the feasibility and acceptability of collecting passive smartphone data from family caregivers and their care recipients with advanced cancer over 24 weeks.

Methods: This was an observational feasibility study.

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A Rational Approach to the Treatment of Acute Pulmonary Embolism.

Annu Rev Med

January 2025

2Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; email:

Over the past decade, new modalities have emerged to treat acute pulmonary embolism (PE). However, PE remains a leading cause of morbidity and mortality worldwide. In the absence of robust clinical trial data and definitive guidelines and recommendations for a variety of clinical situations, individual patient treatment decisions have become paradoxically more challenging as innovation in the space has grown.

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Single-Cell Profiling of Lineages and Cell Types in the Vertebrate Brain.

Methods Mol Biol

January 2025

Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Article Synopsis
  • CRISPR-Cas tools have been enhanced for tracking cell lineages during development, allowing for detailed analysis at single-cell resolution.
  • scGESTALTv2 integrates CRISPR-Cas9 editing of a lineage barcode with single-cell RNA sequencing (scRNA-seq) to track cellular development.
  • This method is applied in zebrafish brains, enabling the identification of cellular relationships among thousands of brain cells and various cell types.
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Study Objectives: Physicians-in-training (residents, fellows) and Advanced Practice Providers (APPs) receive limited education on sleep disorders, including obstructive sleep apnea (OSA). They often assess patients first. We aimed to understand their views on OSA and screening for OSA in the perioperative period.

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ACG Clinical Guideline: Diagnosis and Management of Eosinophilic Esophagitis.

Am J Gastroenterol

January 2025

Kennth C. Griffin Esophageal Center, Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Article Synopsis
  • Eosinophilic esophagitis (EoE) is a chronic immune disease characterized by symptoms of esophageal dysfunction and an eosinophil-dominated infiltration in the esophagus.
  • The incidence of EoE is rising, requiring attention in various medical settings, leading to updated guidelines that focus on improved diagnosis and treatment strategies.
  • Recommended treatments include proton pump inhibitors, topical steroids, dietary elimination, and esophageal dilation, with an emphasis on monitoring patients for treatment response and managing both inflammatory and structural aspects of the disease.
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Aims: Children in foster care (CFC) have prevalent developmental health needs. Comprehensive health assessments (CHA) that include development evaluation are recommended for CFC. The impact of adding occupational therapy (OT) to multidisciplinary CHA teams is unknown.

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Macrophage Migration Inhibitory Factor and Interleukin 1-β mRNA Levels as Predictors of Antidepressant Treatment Response in Major Depression.

Psychopharmacol Bull

January 2025

Oslin, MD, Veterans Integrated Service Network 4, Mental Illness Research, Education and Clinical Center, Crescenz Veterans Affairs Medical Center and Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Article Synopsis
  • The study examined the predictive value of cytokine levels (MIF and IL-1β) in determining responses to antidepressant treatment in 1,299 patients as part of a larger trial.
  • Despite initial findings from smaller studies indicating a link between these cytokines and treatment response, the current research found no significant associations with depression score changes or treatment outcomes.
  • The lack of replication raises doubts about the usefulness of these biomarkers in clinical settings for treating depression.
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FBP1 controls liver cancer evolution from senescent MASH hepatocytes.

Nature

January 2025

Laboratory of Gene Regulation and Signal Transduction, Departments of Pharmacology and Pathology, School of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA.

Hepatocellular carcinoma (HCC) originates from differentiated hepatocytes undergoing compensatory proliferation in livers damaged by viruses or metabolic-dysfunction-associated steatohepatitis (MASH). While increasing HCC risk, MASH triggers p53-dependent hepatocyte senescence, which we found to parallel hypernutrition-induced DNA breaks. How this tumour-suppressive response is bypassed to license oncogenic mutagenesis and enable HCC evolution was previously unclear.

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Whole Exome Sequencing in a Population of Fetuses With Structural Anomalies.

Prenat Diagn

January 2025

Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Objective: To investigate the exome sequencing (ES) detection rate among fetuses with congenital anomalies and describe the rates in the setting of multiple versus isolated anomalies, perinatal autopsy, and family history of a previously affected child.

Methods: A single-center retrospective chart review was conducted on 397 anomalous fetuses that underwent ES from May 2012 through December 2023. Medical record review included demographics, imaging, and genetic testing.

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Prediction of good neurological outcome after return of circulation following paediatric cardiac arrest: a systematic review and meta-analysis.

Resuscitation

December 2024

Department of Critical Care Medicine, Hospital for Sick Children, Department of Paediatrics, University of Toronto, Neurosciences and Mental Health Program, Research Institute Toronto, ON, Canada.

Aim: To evaluate the ability of blood-biomarkers, clinical examination, electrophysiology, or neuroimaging, assessed within 14 days from return of circulation to predict good neurological outcome in children following out- or in-hospital cardiac arrest.

Methods: Medline, EMBASE and Cochrane Trials databases were searched (2010-2023). Sensitivity and false positive rates (FPR) for good neurological outcome (defined as either 'no, mild, moderate disability or minimal change from baseline') in paediatric survivors were calculated for each predictor.

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Emergency department utilization of the methadone "72-hour rule" to bridge or initiate and link to outpatient treatment.

Am J Emerg Med

December 2024

Cooper University Health Care, Center for Healing, Division of Addiction Medicine, Camden, NJ, United States; Cooper Medical School of Rowan University, Camden, NJ, United States; Cooper University Health Care, Department of Emergency Medicine, Division of Addiction Medicine and Medical Toxicology, Camden, NJ, United States.

Article Synopsis
  • The study explores a program in emergency departments (ED) that allows doctors to provide methadone as a temporary treatment for opioid addiction, aiming to improve access and linkage to ongoing care.
  • In a review of patient encounters from January to August 2021, it was found that 91% of patients who received methadone as a "guest dose" continued treatment after leaving the ED, indicating a strong retention rate.
  • The results suggest that ED-based methadone treatment can effectively bridge patients to opioid treatment programs, with certain factors like the chief complaint helping predict successful patient linkage to continued care.
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Lipid nanoparticles (LNPs) have emerged as pivotal vehicles for messenger RNA (mRNA) delivery to hepatocytes upon systemic administration and to antigen-presenting cells following intramuscular injection. However, achieving systemic mRNA delivery to non-hepatocytes remains challenging without the incorporation of targeting ligands such as antibodies, peptides, or small molecules. Inspired by comb-like polymeric architecture, here we utilized a multiarm-assisted design to construct a library of 270 dendron-like degradable ionizable lipids by altering the structures of amine heads and multiarmed tails for optimal mRNA delivery.

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G6PC2 controls glucagon secretion by defining the set point for glucose in pancreatic α cells.

Sci Transl Med

January 2025

Institute of Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

Elevated glucagon concentrations have been reported in patients with type 2 diabetes (T2D). A critical role for α cell-intrinsic mechanisms in regulating glucagon secretion was previously established through genetic manipulation of the glycolytic enzyme glucokinase (GCK) in mice. Genetic variation at the glucose-6-phosphatase catalytic subunit 2 () locus, encoding an enzyme that opposes GCK, has been reproducibly associated with fasting blood glucose and hemoglobin A1c.

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Article Synopsis
  • T-lineage acute lymphoblastic leukemia (ALL) presents as an aggressive cancer with diverse subtypes, making traditional classification difficult.
  • A multiomics analysis of bone marrow samples revealed a specific subset of T-lineage ALL with active inflammatory and stem gene programs, showing unique biological and treatment response characteristics.
  • A computational inflammatory gene signature scoring system was developed to better classify patients, identifying a high-risk subtype that could guide targeted therapies for more effective treatment approaches.
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Greater Fatigue and Reduced Neurocognitive Speed With Symptomatic Crohn's Disease.

Crohns Colitis 360

January 2025

Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Article Synopsis
  • The study explored the link between Crohn's disease activity, fatigue, and neurocognitive function in adults, comparing 25 patients with Crohn's to 26 healthy controls.
  • Patients with Crohn's disease reported significantly higher levels of fatigue, particularly when symptomatic, but showed no differences in neurocognitive accuracy or speed compared to healthy individuals.
  • However, those with active Crohn's disease had slower response times in social cognition and episodic memory tasks, indicating a relationship between disease activity and cognitive processing, regardless of fatigue levels.
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Localized cystic lung lesions in pediatric patients encompass a spectrum of benign and rare malignant conditions that are quite distinct from cystic lung disease arising in adulthood. The majority have historically fallen under the diagnostic category of "congenital pulmonary airway malformation," a term that has been used to denote a diverse group of diseases ranging in etiology from ectopia to bronchial atresia to mosaic oncogenic mutation or neoplasia. This article reviews the clinical characteristics, gross and histologic features, and pathogenetic underpinnings of congenital pulmonary airway malformation as well as lesions that enter its histologic differential diagnosis.

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Background: New surgeons experience heavy workload during robot-assisted surgery partially because they must use vision to compensate for the lack of haptic feedback. We hypothesize that providing realistic haptic feedback during dry-lab simulation training may accelerate learning and reduce workload during subsequent surgery on patients.

Methods: We conducted a single-blinded study with 12 general surgery residents (third and seventh post-graduate year, PGY) randomized into haptic and control groups.

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A comprehensive evaluation for cognitive impairment should culminate with the communication of the diagnosis to patients and their care partners. This diagnostic disclosure sets the stage for subsequent care. Diagnostic disclosure for individuals with cognitive impairment due to Alzheimer's disease (AD) or AD-related dementias (ADRD) is particularly nuanced and requires a conscientious approach.

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Associations of Traumatic Brain Injury and Hearing: Results From the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS).

J Head Trauma Rehabil

December 2024

Author Affiliations: Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Schneider); Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Schneider); Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland (Dr Kamath); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland (Drs Reed, Sharrett, Lin, and Deal); The MIND Center, University of Mississippi Medical Center, Jackson, Mississippi (Dr Mosley); National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, Maryland (Dr Gottesman); Department of Otolaryngology, School of Medicine, Johns Hopkins University, Baltimore, Maryland (Drs Lin and Deal); and Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Drs Lin and Deal).

Objective: To examine associations of traumatic brain injury (TBI) with self-reported and clinical measures of hearing function.

Setting: Four US communities.

Participants: A total of 3176 Atherosclerosis Risk in Communities Study participants who attended the sixth study visit in 2016-2017, when hearing was assessed.

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Blood-based biomarkers (BBBMs) for Alzheimer's disease (AD) have the potential to revolutionize the detection and management of cognitive impairment. AD BBBMs are not currently recommended for use in primary care but may soon be as research demonstrates their clinical utility for differential diagnosis and patient management. To prepare for the incorporation of AD BBBMs into primary care, several practical challenges must be addressed.

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Rapid identification and phenotyping of nonalcoholic fatty liver disease patients using a machine-based approach in diverse healthcare systems.

Clin Transl Sci

January 2025

Division of Digestive and Liver Diseases, Department of Medicine, Center for Liver Disease and Transplantation, Columbia University Irving Medical Center, New York, New York, USA.

Nonalcoholic fatty liver disease (NAFLD) is the most common global cause of chronic liver disease and remains under-recognized within healthcare systems. Therapeutic interventions are rapidly advancing for its inflammatory phenotype, nonalcoholic steatohepatitis (NASH) at all stages of disease. Diagnosis codes alone fail to recognize and stratify at-risk patients accurately.

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