1,677 results match your criteria: "San Francisco VA Medical Center.[Affiliation]"

Autism spectrum disorder (ASD) is a common neurological disorder. Although the etiologies of ASD have been widely speculated, evidence also supports the pathogenic role of cutaneous inflammation in autism. The prevalence of ASD is higher in individuals with inflammatory dermatoses than in those without inflammatory diseases.

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Modification of Association of Cystatin C With Kidney and Cardiovascular Outcomes by Obesity.

Am J Kidney Dis

April 2024

Division of Nephrology, Department of Medicine, University of California at San Francisco, San Francisco; Kidney Health Research Collaborative, San Francisco VA Medical Center & University of California, San Francisco; Division of Nephrology, San Francisco VA Medical Center, San Francisco; Department of Medicine, San Francisco VA Medical Center, San Francisco. Electronic address:

Rationale & Objective: Cystatin C-based estimated glomerular filtration rate (eGFR) has stronger associations with adverse clinical outcomes than creatinine-based eGFR (eGFR). Obesity may be associated with higher cystatin C levels, independent of kidney function, but it is unknown whether obesity modifies associations of eGFR with kidney and cardiovascular outcomes.

Study Design: Cohort study.

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Peer Support to Enhance Type 2 Diabetes Prevention Among African American and Latino Adults.

Endocrinol Metab Clin North Am

December 2023

University of California San Francisco, San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA. Electronic address:

Social support occurs within complex social networks that are diffusely embedded within the social determinants of health. Social networks operate through five primary interconnected pathways: (1) provision of social support; (2) social influence; (3) social engagement; (4) social capital; and (5) social cohesion. Research has demonstrated that increased social support can have a beneficial impact on Type 2 Diabetes (T2DM) prevention and outcomes through culturally tailored Diabetes Prevention Programs in minority communities.

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Non-abstinent recovery in alcohol use disorder is associated with greater regional cortical volumes than heavy drinking.

Alcohol Clin Exp Res (Hoboken)

October 2023

Mental Illness Research, Education and Clinical Center (MIRECC), Palo Alto Veterans Affairs Health Care System, Palo Alto, California, USA.

Background: Harm-reduction (i.e., non-abstinent recovery) approaches to substance use treatment have garnered increasing attention.

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ApoE enhances mitochondrial metabolism via microRNA-142a/146a-regulated circuits that suppress hematopoiesis and inflammation in hyperlipidemia.

Cell Rep

October 2023

Department of Veterans Affairs, Surgical Service (112G), San Francisco VA Medical Center, San Francisco, CA 94121, USA; Northern California Institute for Research and Education, San Francisco, CA 94121, USA; Department of Surgery, Division of Endovascular and Vascular Surgery, University of California, San Francisco, San Francisco, CA 94143, USA. Electronic address:

Apolipoprotein E (ApoE) is recognized for its pleiotropic properties that suppress inflammation. We report that ApoE serves as a metabolic rheostat that regulates microRNA control of glycolytic and mitochondrial activity in myeloid cells and hematopoietic stem and progenitor cells (HSPCs). ApoE expression in myeloid cells increases microRNA-146a, which reduces nuclear factor κB (NF-κB)-driven GLUT1 expression and glycolytic activity.

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Little is known whether engagement in sexual behaviors associated with potential HIV risks differs by subgroups of men who have sex with men (MSM), who are distinct regarding patterns of use of online tools for partner-seeking. Using latent class analysis, we revealed four classes of app-using MSM (n = 181, 18-34 y.o.

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Muscle Mass and Serum Creatinine Concentration by Race and Ethnicity among Hemodialysis Patients.

J Am Soc Nephrol

January 2024

Department of Medicine, Division of Nephrology, Hennepin Healthcare, Minneapolis, Minnesota.

Significance Statement: Serum creatinine is a product of skeletal muscle metabolism. Differences in serum creatinine concentration between Black and non-Black individuals have been attributed to differences in muscle mass but have not been thoroughly examined. Furthermore, other race and ethnic groups have not been considered.

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Identifying canonical and replicable multi-scale intrinsic connectivity networks in 100k+ resting-state fMRI datasets.

Hum Brain Mapp

December 2023

Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, Georgia, USA.

Despite the known benefits of data-driven approaches, the lack of approaches for identifying functional neuroimaging patterns that capture both individual variations and inter-subject correspondence limits the clinical utility of rsfMRI and its application to single-subject analyses. Here, using rsfMRI data from over 100k individuals across private and public datasets, we identify replicable multi-spatial-scale canonical intrinsic connectivity network (ICN) templates via the use of multi-model-order independent component analysis (ICA). We also study the feasibility of estimating subject-specific ICNs via spatially constrained ICA.

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Aging-Related Mitochondrial Dysfunction Is Associated With Fibrosis in Benign Prostatic Hyperplasia.

J Gerontol A Biol Sci Med Sci

June 2024

Department of Urology, George M. O'Brien Center of Research Excellence, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Background: Age is the greatest risk factor for lower urinary tract symptoms attributed to benign prostatic hyperplasia (LUTS/BPH). Although LUTS/BPH can be managed with pharmacotherapy, treatment failure has been putatively attributed to numerous pathological features of BPH (eg, prostatic fibrosis, inflammation). Mitochondrial dysfunction is a hallmark of aging; however, its impact on the pathological features of BPH remains unknown.

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Differing time trends for alcohol misuse and alcohol use disorder among Veteran men: A comparison of population surveillance and clinical data.

Addict Behav

January 2024

VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 16111 Plummer Street (Mailcode 152), Sepulveda, CA 91343, USA; University of California, Los Angeles (UCLA), Fielding School of Public Health and Geffen School of Medicine, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA. Electronic address:

Introduction: Data on time trends are important to track the health burden of alcohol use disorder (AUD) and plan for alcohol-related healthcare needs. Our aim was to estimate time trends in AUD for male VA patients and to assess whether trends in documented diagnosis rates were similar to trends in unhealthy alcohol use measured through clinical screening or trends in AUD prevalence among US veterans in the general population.

Materials And Methods: We used VA electronic health record data (10/1/2009-9/30/2019) to measure AUD diagnosis rates and clinical alcohol screening data to measure unhealthy alcohol use.

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This multi-site, randomized, double-blind, confirmatory phase 3 study evaluated the efficacy and safety of 3,4-methylenedioxymethamphetamine-assisted therapy (MDMA-AT) versus placebo with identical therapy in participants with moderate to severe post-traumatic stress disorder (PTSD). Changes in Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) total severity score (primary endpoint) and Sheehan Disability Scale (SDS) functional impairment score (key secondary endpoint) were assessed by blinded independent assessors. Participants were randomized to MDMA-AT (n = 53) or placebo with therapy (n = 51).

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Background: Cardiac rehabilitation (CR) improves outcomes in heart disease yet remains vastly underutilized. Remote CR enhanced with a digital health intervention (DHI) may offer higher access and improved patient-centered outcomes over non-technology approaches. We sought to pragmatically determine whether offering a DHI improves CR access, cardiac risk profile, and patient-reported outcome measures.

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Sexual assault is a form of violence disproportionately perpetrated against women by men; however, men also experience high rates of sexual victimization. While recent research exploring victimization of sexual assault among men does exist, little is known about situational characteristics and consequences surrounding men's assault experiences. Therefore, the current study examines narratives of men's sexual assault to further understand the unique experiences of men receiving a sexual assault medical forensic examination.

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Importance: Understanding how socioeconomic factors are associated with cognitive aging is important for addressing health disparities in Alzheimer disease.

Objective: To examine the association of neighborhood disadvantage with cognition among a multiethnic cohort of older adults.

Design, Setting, And Participants: In this cross-sectional study, data were collected between September 1, 2017, and May 31, 2022.

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Article Synopsis
  • A study explored the use of a convolutional neural network (CNN) to identify mechanisms of supraventricular tachycardia (SVT) by analyzing 12-lead electrocardiogram (ECG) data.
  • The CNN was developed using data from 1505 ECGs and was tested against assessments made by experienced electrophysiologists for three types of SVT: AVNRT, AVRT, and AT.
  • Results showed that the CNN outperformed the electrophysiologists in sensitivity for all SVT classes, indicating its potential to enhance SVT mechanism identification from ECGs.
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Background: The COVID-19 pandemic increased the use of telehealth, which posed unique challenges for the provision of care to older adults who face numerous barriers to accessing and using technology. To improve older adults' online health-related abilities, the UCSF Geriatrics Workforce Enhancement Program (UCSF-GWEP) partnered with Little Brothers Friends of the Elderly-San Francisco (LBFE-SF) to develop a model telehealth training intervention.

Methods: LBFE-SF recruited older adults from their members with wi-fi and paired each one with a new device and volunteer trainer to cover seven lessons and four key tasks (emailing providers, video visits, accessing health information, and using patient portals).

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While apolipoprotein E (apoE) expression by myeloid cells is recognized to control inflammation, whether such benefits can be communicated via extracellular vesicles is not known. Through the study of extracellular vesicles produced by macrophages derived from the bone marrow of Wildtype (WT-BMDM-EV) and ApoE deficient (EKO-BMDM-EV) mice, we uncovered a critical role for apoE expression in regulating their cell signaling properties. WT-BMDM-EV communicated anti-inflammatory properties to recipient myeloid cells by increasing cellular levels of apoE and miR-146a-5p, that reduced NF-κB signalling.

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Internal medicine trainees learn a variety of clinical skills from resident clinical teachers in the inpatient setting. While diagnostic reasoning (DR) is increasingly emphasized as a core competency, trainees may not feel entirely comfortable teaching it. In this perspective article, we provide a framework for teaching DR during inpatient rounds, which includes focusing on the one-liner, structuring a reasoning-focused A&P, and performing a day of discharge reflection.

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Article Synopsis
  • Human cognitive performance is linked to biological factors, with sleep EEG emerging as a useful biomarker based on studies of older men.
  • Analysis showed that sleep EEG features can explain 2.5-10% of the variance in cognitive performance, primarily influenced by demographic variables rather than health ones.
  • Specific sleep EEG patterns, like sigma power during NREM and beta power during REM, correlate with better cognitive abilities, while theta power in REM is associated with poorer performance, indicating potential trait-like influences on cognition.
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Learning from the early careers of master clinicians.

J Eval Clin Pract

February 2024

Medical Service, San Francisco VA Medical Center, Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA.

Background: Master clinicians are recognized as multidimensional experts in clinical medicine. Studying their formative clinical activities could generate insights to guide medical trainees and early career clinicians.

Objectives: To investigate which early career activities were adopted more commonly by master clinicians than their matched peers and to characterize master clinicians' early career activities across institutions and specialties.

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Importance: Leveraging the dynamic nature of clinical variables in the clinical high risk for psychosis (CHR-P) population has the potential to significantly improve the performance of outcome prediction models.

Objective: To improve performance of prediction models and elucidate dynamic clinical profiles using joint modeling to predict conversion to psychosis and symptom remission.

Design, Setting, And Participants: Data were collected as part of the third wave of the North American Prodrome Longitudinal Study (NAPLS 3), which is a 9-site prospective longitudinal study.

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Longitudinal Follow-Up of Participants With Tobacco Exposure and Preserved Spirometry.

JAMA

August 2023

Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, School of Medicine, University of California, San Francisco.

Importance: People who smoked cigarettes may experience respiratory symptoms without spirometric airflow obstruction. These individuals are typically excluded from chronic obstructive pulmonary disease (COPD) trials and lack evidence-based therapies.

Objective: To define the natural history of persons with tobacco exposure and preserved spirometry (TEPS) and symptoms (symptomatic TEPS).

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Background: Recent advances in resting-state fMRI allow us to study spatial dynamics, the phenomenon of brain networks spatially evolving over time. However, most dynamic studies still use subject-specific, spatially-static nodes. As recent studies have demonstrated, incorporating time-resolved spatial properties is crucial for precise functional connectivity estimation and gaining unique insights into brain function.

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