466 results on '"Ginsburg GS"'
Search Results
2. Primary care physiciansʼ knowledge of and experience with pharmacogenetic testing
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Haga, SB, Burke, W, Ginsburg, GS, Mills, R, and Agans, R
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- 2012
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3. The oral microbiome in health and disease and the potential impact on personalized dental medicine
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Zarco, MF, Vess, TJ, and Ginsburg, GS
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- 2012
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4. A more rapid approach to systematically assessing published associations of genetic polymorphisms and disease risk: type 2 diabetes as a test case
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Cho AH, Jiang X, Mann DM, Kawamoto K, Robinson TJ, Wang N, McCarthy JJ, Woodward M, and Ginsburg GS
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lcsh:Public aspects of medicine ,lcsh:RA1-1270 - Abstract
Alex H Cho1, Xiaolei Jiang2, Devin M Mann3, Kensaku Kawamoto4, Timothy J Robinson5, Nancy Wang6, Jeanette J McCarthy2, Mark Woodward7, Geoffrey S Ginsburg1,21Center for Personalized Medicine and Department of Medicine, Duke University, Durham, NC, 2Institute for Genome Sciences and Policy, Duke University, Durham, NC, 3Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA, 4Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, 5Medical College of Virginia, Richmond, VA, 6School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA; 7George Institute for Global Health and University of Sydney, AustraliaBackground: Comparative effectiveness research and research in genomic medicine are not orthogonal pursuits. Both require a robust evidence base, and each stands to benefit from applying the methods of the other. There is an exponentially growing literature reporting associations between single nucleotide polymorphisms (SNPs) and increased risk for diseases such as type 2 diabetes. Literature-based meta-analysis is an important method of assessing the validity of published gene-disease associations, but a traditional emphasis on exhaustiveness makes it difficult to study multiple polymorphisms efficiently. Here we describe a novel two-step search method for broadly yet systematically reviewing the literature to identify the "most-studied" gene-disease associations, thereby selecting those with a high possibility of replication on which to conduct abbreviated, simultaneous meta-analyses. This method was then applied to identify and evaluate the validity of SNPs reported to be associated with increased type 2 diabetes risk, to demonstrate proof of principle.Methods: A two-step MEDLINE search (1950 to present) was conducted in September 2007 for published genetic association data related to SNPs associated with risk of type 2 diabetes. The top 10 "most-studied" genes were selected for focused searches and final inclusion/exclusion determinations. To demonstrate the ability to efficiently update this two-step search for additions to the literature, an update of the second-step search was conducted 9 months later. Abstracted data were sorted based on study design, risk model, and specific SNPs. Meta-analyses were performed for individual SNPs, with separate analyses done for case-control and prospective studies, and were compared with the results of more recent genome-wide association studies.Results: The first-step search found 1116 articles covering 108 different genes. The top ten "most-studied" genes were: ABCC8 (or SUR1), ACE, CAPN10, KCNJ11 (or Kir6.2), HNF1 alpha, HNF4 alpha, IL-6, PGC-1 alpha, PPAR gamma 2, and TCF7L2. The second-step search found a total of 658 articles, yielding 124 articles for initial data abstraction and analysis. We also demonstrated the ability to update this search as newer studies appeared, using the same method almost a year later to find an additional 107 articles (77 were ultimately excluded), bringing the number of included studies to 154. From these studies, data on 90 different DNA variants within the ten genes were abstracted. Simultaneous meta-analyses found that higher-risk alleles for SNPs rs7903146 and rs12255372 in TCF7L2, rs1801282 in PPAR gamma 2, rs5219 in KCNJ11, rs3792267 in CAPN10, rs2144909 in HNF4 alpha, and rs1800795 in IL-6 appeared to be associated with increased type 2 diabetes risk. These findings were generally highly concordant with the results of traditional literature-based meta-analyses performed for individual genes.Conclusions: The methodology described in this manuscript represents a reasonable approach to more rapidly identifying and evaluating frequently studied genetic-risk markers for diseases such as type 2 diabetes. Comparison with results of traditional meta-analyses suggests that these gains in efficiency do not necessarily come at the price of reduced accuracy. Given the quickening pace of discovery of such markers, more efficient, unbiased, and readily updatable methods for systematically assessing and re-assessing a changing literature could prove valuable. Good methods for evidence evaluation are also important to the potential application of genetic markers to comparative effectiveness research, and vice versa.Keywords: meta-analyses, genes, inclusion/exclusion, data, genetic risk 
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- 2012
5. Studying genetic resilience to improve human health
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Cirulli, ET, primary and Ginsburg, GS, additional
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- 2016
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6. The Pediatric Anxiety Rating Scale (PARS): Development and psychometric properties
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Riddle, Ma, Ginsburg, Gs, Walkup, Jt, Labellarte, Mj, Pine, Ds, Davies, M, Greenhill, L, Sweeney, M, Klein, R, Abikoff, H, Hack, S, Klee, B, Bergman, L, March, J, Compton, S, Robinson, J, O'Hara, T, Baker, S, Vitiello, B, Ritz, L, and Roper, M
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children ,anxiety ,adolescents ,rating scales ,assessment - Published
- 2002
7. Abstract P3-06-07: Ki67 as a Predictive Marker of Response to Neoadjuvant Chemotherapy in Patients with Early-Stage Breast Cancer (ESBC): A Systematic Review and Evidence Summary
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Lyman, GH, primary, Culakova, E, additional, Poniewierski, MS, additional, Wogu, AF, additional, Barry, W, additional, Ginsburg, GS, additional, Marcom, PK, additional, Ready, N, additional, Abernethy, A, additional, Geradts, J, additional, Hwang, S, additional, and Kuderer, NM, additional
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- 2012
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8. Abstract P2-10-03: A cross-platform comparison of genomic signatures and OncotypeDx score to discover potential prognostic/predictive genes and pathways
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Kuderer, NM, primary, Barry, WT, additional, Geradts, J, additional, Ginsburg, GS, additional, Lyman, GH, additional, Datto, M, additional, Liotcheva, V, additional, Isner, P, additional, Veldman, T, additional, Agarwal, P, additional, Hwang, S, additional, Ready, N, additional, and Marcom, PK, additional
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- 2012
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9. P3-14-04: Assessment of Genomic Prognostic Signatures as Predictors of Response to Neoadjuvant Chemotherapy in Patients with Early Stage Breast Cancer.
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Culakova, E, primary, Poniewierski, MS, additional, Huang, M, additional, Kuderer, NM, additional, Ginsburg, GS, additional, Barry, W, additional, Marcom, PK, additional, Ready, N, additional, Abernethy, A, additional, and Lyman, GH, additional
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- 2011
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10. Genome technologies and personalized dental medicine
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Eng, G, primary, Chen, A, additional, Vess, T, additional, and Ginsburg, GS, additional
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- 2011
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11. The oral microbiome in health and disease and the potential impact on personalized dental medicine
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Zarco, MF, primary, Vess, TJ, additional, and Ginsburg, GS, additional
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- 2011
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12. Genome technologies and personalized dental medicine.
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Eng, G, Chen, A, Vess, T, and Ginsburg, GS
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TECHNOLOGY ,GENOMES ,ORAL hygiene - Abstract
Oral Diseases (2012) 18, 223-235 The addition of genomic information to our understanding of oral disease is driving important changes in oral health care. It is anticipated that genome-derived information will promote a deeper understanding of disease etiology and permit earlier diagnosis, allowing for preventative measures prior to disease onset rather than treatment that attempts to repair the diseased state. Advances in genome technologies have fueled expectations for this proactive healthcare approach. Application of genomic testing is expanding and has already begun to find its way into the practice of clinical dentistry. To take full advantage of the information and technologies currently available, it is vital that dental care providers, consumers, and policymakers be aware of genomic approaches to understanding of oral diseases and the application of genomic testing to disease diagnosis and treatment. Ethical, legal, clinical, and educational initiatives are also required to responsibly incorporate genomic information into the practice of dentistry. This article provides an overview of the application of genomic technologies to oral health care and introduces issues that require consideration if we are to realize the full potential of genomics to enable the practice of personalized dental medicine. [ABSTRACT FROM AUTHOR]
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- 2012
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13. Parental anxiety and child symptomatology: an examination of additive and interactive effects of parent psychopathology. [corrected].
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Burstein M, Ginsburg GS, Tein J, Burstein, Marcy, Ginsburg, Golda S, and Tein, Jenn-Yun
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The current study examined relations between parent anxiety and child anxiety, depression, and externalizing symptoms. In addition, the study tested the additive and interactive effects of parent anxiety with parent depression and externalizing symptoms in relation to child symptoms. Forty-eight parents with anxiety disorders and 49 parents without any psychiatric disorder participated with one of their children (ages 6 to 14 years; 46.4% male; 75.8% Caucasian). Parent anxiety was related to both child anxiety and depression, but not child externalizing symptoms. Hierarchical regression analyses showed that only parent externalizing symptoms had additive effects, beyond parent anxiety symptoms, in relation to child anxiety symptoms. Further, parent anxiety symptoms moderated the relationship between parent and child externalizing symptoms, such that the strength of this relationship was reduced in the presence of high levels of parent anxiety symptoms. Results of this study illuminate the role of parent comorbidity in understanding relations between parent and child symptoms. [ABSTRACT FROM AUTHOR]
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- 2010
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14. Behavior therapy for children with Tourette disorder: a randomized controlled trial.
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Piacentini J, Woods DW, Scahill L, Wilhelm S, Peterson AL, Chang S, Ginsburg GS, Deckersbach T, Dziura J, Levi-Pearl S, Walkup JT, Piacentini, John, Woods, Douglas W, Scahill, Lawrence, Wilhelm, Sabine, Peterson, Alan L, Chang, Susanna, Ginsburg, Golda S, Deckersbach, Thilo, and Dziura, James
- Abstract
Context: Tourette disorder is a chronic and typically impairing childhood-onset neurologic condition. Antipsychotic medications, the first-line treatments for moderate to severe tics, are often associated with adverse effects. Behavioral interventions, although promising, have not been evaluated in large-scale controlled trials.Objective: To determine the efficacy of a comprehensive behavioral intervention for reducing tic severity in children and adolescents.Design, Setting, and Participants: Randomized, observer-blind, controlled trial of 126 children recruited from December 2004 through May 2007 and aged 9 through 17 years, with impairing Tourette or chronic tic disorder as a primary diagnosis, randomly assigned to 8 sessions during 10 weeks of behavior therapy (n = 61) or a control treatment consisting of supportive therapy and education (n = 65). Responders received 3 monthly booster treatment sessions and were reassessed at 3 and 6 months following treatment.Intervention: Comprehensive behavioral intervention.Main Outcome Measures: Yale Global Tic Severity Scale (range 0-50, score >15 indicating clinically significant tics) and Clinical Global Impressions-Improvement Scale (range 1 [very much improved] to 8 [very much worse]).Results: Behavioral intervention led to a significantly greater decrease on the Yale Global Tic Severity Scale (24.7 [95% confidence interval {CI}, 23.1-26.3] to 17.1 [95% CI, 15.1-19.1]) from baseline to end point compared with the control treatment (24.6 [95% CI, 23.2-26.0] to 21.1 [95% CI, 19.2-23.0]) (P < .001; difference between groups, 4.1; 95% CI, 2.0-6.2) (effect size = 0.68). Significantly more children receiving behavioral intervention compared with those in the control group were rated as being very much improved or much improved on the Clinical Global Impressions-Improvement scale (52.5% vs 18.5%, respectively; P < .001; number needed to treat = 3). Attrition was low (12/126, or 9.5%); tic worsening was reported by 4% of children (5/126). Treatment gains were durable, with 87% of available responders to behavior therapy exhibiting continued benefit 6 months following treatment.Conclusion: A comprehensive behavioral intervention, compared with supportive therapy and education, resulted in greater improvement in symptom severity among children with Tourette and chronic tic disorder.Trial Registration: clinicaltrials.gov Identifier: NCT00218777. [ABSTRACT FROM AUTHOR]- Published
- 2010
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15. Identifying patients at high risk of a cardiovascular event in the near future: current status and future directions: report of a national heart, lung, and blood institute working group.
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Eagle KA, Ginsburg GS, Musunuru K, Aird WC, Balaban RS, Bennett SK, Blumenthal RS, Coughlin SR, Davidson KW, Frohlich ED, Greenland P, Jarvik GP, Libby P, Pepine CJ, Ruskin JN, Stillman AE, Van Eyk JE, Tolunay HE, McDonald CL, and Smith SC Jr
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- 2010
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16. Predictors of treatment response in pediatric obsessive-compulsive disorder.
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Ginsburg GS, Kingery JN, Drake KL, and Grados MA
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- 2008
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17. Peripheral blood expression of nuclear factor-kappaB-regulated genes is associated with rheumatoid arthritis disease activity and responds differentially to anti-tumor necrosis factor-alpha versus methotrexate.
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Parker A, Izmailova ES, Narang J, Badola S, Le T, Roubenoff R, Ginsburg GS, Maier A, Coblyn JS, Shadick NA, and Weinblatt ME
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- 2007
18. Parenting behaviors among anxious and non-anxious mothers: relation with concurrent and long-term child outcomes.
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Ginsburg GS, Grover RL, and Ialongo N
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The present study addressed two specific questions: (1) Are there differences in parenting behaviors between anxious and non-anxious mothers? and (2) Are parenting behaviors within these two groups associated with adverse outcomes in children (i.e., internalizing and externalizing symptoms)? The above questions were examined concurrently (when children were in first grade) and at a six-year follow-up among a predominately African American community-based high-risk sample. Twenty-five anxious and matched non-anxious (N = 50) mothers were videotaped with their children (mean age 5.8 years) engaging in a challenging task. Blind raters coded parent behaviors. Parents and children completed measures of anxiety and/or externalizing symptoms at both time points. Contrary to expectations, results indicated no group differences in parenting behaviors in the first grade and no relation between parenting behaviors and concurrent levels of anxiety or externalizing symptoms. At the six-year follow-up, however, higher levels of criticism and lower levels of granting of autonomy were significantly related to higher anxiety (but not externalizing) symptoms in children of anxious parents. Findings are discussed in the context of existing developmental models of childhood anxiety and suggest that the interaction of parental anxiety and parenting behavior may increase children's risk for anxiety disorders. [ABSTRACT FROM AUTHOR]
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- 2004
19. The evaluation of chest pain in women.
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Douglas PS and Ginsburg GS
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- 1996
20. The long and winding road to warfarin pharmacogenetic testing.
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Ginsburg GS, Voora D, Ginsburg, Geoffrey S, and Voora, Deepak
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- 2010
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21. Regression of atherosclerosis with therapeutic antibodies pipe cleaner or pipe dream?
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Ginsburg GS
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- 2007
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22. Microarrays coming of age in cardiovascular medicine: standards, predictions, and biology.
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Ginsburg GS, Seo D, and Frazier C
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- 2006
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23. Novel-and 'Neu'-Therapeutic Possibilities for Heart Failure.
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Freedman NJ and Ginsburg GS
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- 2006
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24. The effective rate of influenza reassortment is limited during human infection
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Sobel Leonard, A, McClain, MT, Smith, GJD, Wentworth, DE, Halpin, RA, Lin, X, Ransier, A, Stockwell, TB, Das, Gilbert, AS, Lambkin-Williams, R, Ginsburg, GS, Woods, CW, Koelle, K, and Illingworth, CJR
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haplotypes ,viral evolution ,alleles ,genetic loci ,natural selection ,influenza ,influenza viruses ,linkage disequilibrium ,3. Good health - Abstract
We characterise the evolutionary dynamics of influenza infection described by viral sequence data collected from two challenge studies conducted in human hosts. Viral sequence data were collected at regular intervals from infected hosts. Changes in the sequence data observed across time show that the within-host evolution of the virus was driven by the reversion of variants acquired during previous passaging of the virus. Treatment of some patients with oseltamivir on the first day of infection did not lead to the emergence of drug resistance variants in patients. Using an evolutionary model, we inferred the effective rate of reassortment between viral segments, measuring the extent to which randomly chosen viruses within the host exchange genetic material. We find strong evidence that the rate of effective reassortment is low, such that genetic associations between polymorphic loci in different segments are preserved during the course of an infection in a manner not compatible with epistasis. Combining our evidence with that of previous studies we suggest that spatial heterogeneity in the viral population may reduce the extent to which reassortment is observed. Our results do not contradict previous findings of high rates of viral reassortment in vitro and in small animal studies, but indicate that in human hosts the effective rate of reassortment may be substantially more limited.
25. Depressive symptoms among reservation-based pregnant American Indian adolescents.
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Ginsburg GS, Baker EV, Mullany BC, Barlow A, Goklish N, Hastings R, Thurm AE, Speakman K, Reid R, and Walkup J
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Objectives To examine rates and correlates of depressive symptoms among pregnant reservation-based American Indian (AI) adolescents from the Southwestern United States ( N = 53). Methods Data were derived from a study evaluating a home-visiting program designed to promote positive parenting among young families. Participants included a volunteer, convenience sample of expectant mothers who completed behavioral and mental health self-report questionnaires. Depressive symptoms were assessed using the Center for Epidemiological Studies-Depression scale (CES-D). Three risk domains were analyzed in relation to depressive symptoms: sociodemographics, family relations, and psychosocial functioning. Results Forty-seven percent of expectant mothers scored at or above the widely accepted clinical cutoff score of 16 on the CES-D; 30% scored at or above 20, a score more likely to reflect elevated depressive symptoms among adolescents; and almost 20% scored at or above 28 (one standard deviation above the mean), a score suggestive of clinical depression. Higher levels of depressive symptoms were associated with less use of public assistance, external locus of control, less social support, and lower self-esteem. Conclusions Data suggest that a large proportion of pregnant AI adolescents reported elevated depressive symptoms, though rates are similar to non-pregnant AI adolescent samples. [ABSTRACT FROM AUTHOR]
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- 2008
26. A genomic strategy to refine prognosis in early-stage non-small-cell lung cancer.
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Potti A, Mukherjee S, Petersen R, Dressman HK, Bild A, Koontz J, Kratzke R, Watson MA, Kelley M, Ginsburg GS, West M, Harpole DH Jr., Nevins JR, Potti, Anil, Mukherjee, Sayan, Petersen, Rebecca, Dressman, Holly K, Bild, Andrea, Koontz, Jason, and Kratzke, Robert
- Abstract
Background: Clinical trials have indicated a benefit of adjuvant chemotherapy for patients with stage IB, II, or IIIA--but not stage IA--non-small-cell lung cancer (NSCLC). This classification scheme is probably an imprecise predictor of the prognosis of an individual patient. Indeed, approximately 25 percent of patients with stage IA disease have a recurrence after surgery, suggesting the need to identify patients in this subgroup for more effective therapy.Methods: We identified gene-expression profiles that predicted the risk of recurrence in a cohort of 89 patients with early-stage NSCLC (the lung metagene model). We evaluated the predictor in two independent groups of 25 patients from the American College of Surgeons Oncology Group (ACOSOG) Z0030 study and 84 patients from the Cancer and Leukemia Group B (CALGB) 9761 study.Results: The lung metagene model predicted recurrence for individual patients significantly better than did clinical prognostic factors and was consistent across all early stages of NSCLC. Applied to the cohorts from the ACOSOG Z0030 trial and the CALGB 9761 trial, the lung metagene model had an overall predictive accuracy of 72 percent and 79 percent, respectively. The predictor also identified a subgroup of patients with stage IA disease who were at high risk for recurrence and who might be best treated by adjuvant chemotherapy.Conclusions: The lung metagene model provides a potential mechanism to refine the estimation of a patient's risk of disease recurrence and, in principle, to alter decisions regarding the use of adjuvant chemotherapy in early-stage NSCLC. [ABSTRACT FROM AUTHOR]- Published
- 2006
27. Cardiac troponin T and I, echocardiographic [correction of electrocardiographic] wall motion analyses, and ejection fractions in athletes participating in the Hawaii Ironman Triathlon.
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Rifai N, Douglas PS, O'Toole M, Rimm E, Ginsburg GS, Rifai, N, Douglas, P S, O'Toole, M, Rimm, E, and Ginsburg, G S
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Cardiac troponin T (cTnT) and troponin I (cTnI) are highly sensitive and specific for detecting myocardial damage even in the presence of skeletal muscle injury. In this study, we assessed whether ultraendurance exercise induced cardiomyocyte injury using plasma cTnT and cTnI measurements, quantitative echocardiographic wall-motion analysis, and ejection fraction measurement in athletes who participated in the Hawaii Ironman Triathlon. Twenty-three athletes (11 men) who completed the triathlon (3.9 km swim, 180.2 km bike, and 42.2 km run) participated in this study. Blood samples were obtained 2 days before and immediately after the triathlon for the determination of cTnT (Enzymun, Roche Diagnostics) and cTnI (Dade Behring) concentrations. Quantitative echocardiographic wall motion analysis and ejection fraction were obtained on 12 of the 23 participants before and immediately after the race. No subject had detectable cTnT or cTnI or abnormal echo score before the race. Following the race, 2 subjects (9%) had marked increases in both cTnT (0.15 and 0.33 microg/L) and cTnI (2.09 and 4.44 microg/L). Four additional subjects (17%) had moderate increases in cTnT (0.04 to 0.05 microg/L) but no detectable cTnI. Race time correlated inversely with cTnT (r = -0.65, p <0.01). Mean change in the number of abnormal echo segments after the race was 6.5 in those with a marked increase in cTnT and cTnI, 2.3 in those with a moderate increase in cTnT, and 1.7 in those with no increase. Ejection fraction decreased by an average of 24% after the race (p <0.002). Thus, ultraendurance exercise may cause myocardial damage as indicated by biochemical cardiac-specific markers and echocardiography. The cellular nature of this damage and whether it is transient or permanent is unclear at present. [ABSTRACT FROM AUTHOR]
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- 1999
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28. Weight, habitual fibre intake, and microbiome composition predict tolerance to fructan supplementation.
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Letourneau J, Neubert BC, Dayal D, Carrion VM, Durand HK, Dallow EP, Jiang S, Kirtley M, Ginsburg GS, Doraiswamy PM, and David LA
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- Humans, Male, Adult, Female, Young Adult, Body Weight, Middle Aged, Flatulence, Dietary Fiber pharmacology, Gastrointestinal Microbiome drug effects, Dietary Supplements, Fructans pharmacology, Inulin pharmacology
- Abstract
Fructans are commonly used as dietary fibre supplements for their ability to promote the growth of beneficial gut microbes. However, fructan consumption has been associated with various dosage-dependent side effects. We characterised side effects in an exploratory analysis of a randomised trial in healthy adults ( n = 40) who consumed 18 g/day inulin or placebo. We found that individuals weighing more or habitually consuming higher fibre exhibited the best tolerance. Furthermore, we identified associations between gut microbiome composition and host tolerance. Specifically, higher levels of Christensenellaceae R-7 group were associated with gastrointestinal discomfort, and a machine-learning-based approach successfully predicted high levels of flatulence, with [Ruminococcus] torques group and ( Oscillospiraceae ) UCG-002 sp. identified as key predictive taxa. These data reveal trends that can help guide personalised recommendations for initial inulin dosage. Our results support prior ecological findings indicating that fibre supplementation has the greatest impact on individuals whose baseline fibre intake is lowest.
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- 2024
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29. Predictive signature of murine and human host response to typical and atypical pneumonia.
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McCravy M, O'Grady N, Khan K, Betancourt-Quiroz M, Zaas AK, Treece AE, Yang Z, Que L, Henao R, Suchindran S, Ginsburg GS, Woods CW, McClain MT, and Tsalik EL
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- Animals, Humans, Mice, Female, Pneumonia, Pneumococcal microbiology, Orthomyxoviridae Infections immunology, ROC Curve, Gene Expression Profiling, Pneumonia, Viral diagnosis, Pneumonia, Viral immunology, Mice, Inbred C57BL, Pneumonia, Bacterial microbiology, Pneumonia, Bacterial diagnosis, Host-Pathogen Interactions, Streptococcus pneumoniae genetics, Streptococcus pneumoniae isolation & purification, Pneumonia, Mycoplasma diagnosis, Mycoplasma pneumoniae genetics, Mycoplasma pneumoniae isolation & purification, Disease Models, Animal
- Abstract
Background: Pneumonia due to typical bacterial, atypical bacterial and viral pathogens can be difficult to clinically differentiate. Host response-based diagnostics are emerging as a complementary diagnostic strategy to pathogen detection., Methods: We used murine models of typical bacterial, atypical bacterial and viral pneumonia to develop diagnostic signatures and understand the host's response to these types of infections. Mice were intranasally inoculated with Streptococcus pneumoniae , Mycoplasma pneumoniae , influenza or saline as a control. Peripheral blood gene expression analysis was performed at multiple time points. Differentially expressed genes were used to perform gene set enrichment analysis and generate diagnostic signatures. These murine-derived signatures were externally validated in silico using human gene expression data. The response to S. pneumoniae was the most rapid and robust., Results: Mice infected with M. pneumoniae had a delayed response more similar to influenza-infected animals. Diagnostic signatures for the three types of infection had 0.94-1.00 area under the receiver operator curve (auROC). Validation in five human gene expression datasets revealed auROC of 0.82-0.96., Discussion: This study identified discrete host responses to typical bacterial, atypical bacterial and viral aetiologies of pneumonia in mice. These signatures validated well in humans, highlighting the conserved nature of the host response to these pathogen classes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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30. Implementing a pragmatic clinical trial to tailor opioids for chronic pain on behalf of the IGNITE ADOPT PGx investigators.
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Skaar TC, Myers RA, Fillingim RB, Callaghan JT, Cicali E, Eadon MT, Elwood EN, Ginsburg GS, Lynch S, Nguyen KA, Obeng AO, Park H, Pratt VM, Rosenman M, Sadeghpour A, Shuman S, Singh R, Tillman EM, Volpi S, Wiisanen K, Winterstein AG, Horowitz CR, Voora D, Orlando L, Chakraborty H, Van Driest S, Peterson JF, Cavallari LA, Johnson JA, and Dexter PR
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- Adult, Female, Humans, Male, Middle Aged, Pain Management methods, Pain Measurement, Pharmacogenomic Testing, Precision Medicine methods, Analgesics, Opioid therapeutic use, Analgesics, Opioid adverse effects, Chronic Pain drug therapy, Cytochrome P-450 CYP2D6 genetics, Cytochrome P-450 CYP2D6 metabolism
- Abstract
Chronic pain is a prevalent condition with enormous economic burden. Opioids such as tramadol, codeine, and hydrocodone are commonly used to treat chronic pain; these drugs are activated to more potent opioid receptor agonists by the hepatic CYP2D6 enzyme. Results from clinical studies and mechanistic understandings suggest that CYP2D6-guided therapy will improve pain control and reduce adverse drug events. However, CYP2D6 is rarely used in clinical practice due in part to the demand for additional clinical trial evidence. Thus, we designed the ADOPT-PGx (A Depression and Opioid Pragmatic Trial in Pharmacogenetics) chronic pain study, a multicenter, pragmatic, randomized controlled clinical trial, to assess the effect of CYP2D6 testing on pain management. The study enrolled 1048 participants who are taking or being considered for treatment with CYP2D6-impacted opioids for their chronic pain. Participants were randomized to receive immediate or delayed (by 6 months) genotyping of CYP2D6 with clinical decision support (CDS). CDS encouraged the providers to follow the CYP2D6-guided trial recommendations. The primary study outcome is the 3-month absolute change in the composite pain intensity score assessed using Patient-Reported Outcomes Measurement Information System (PROMIS) measures. Follow-up will be completed in July 2024. Herein, we describe the design of this trial along with challenges encountered during enrollment., (© 2024 The Author(s). Clinical and Translational Science published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)
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- 2024
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31. Substance use outcomes from the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS).
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Rabner J, Olino TM, Albano AM, Keeton CP, Sakolsky D, Birmaher B, Piacentini J, Peris TS, Compton SN, Gosch E, Ginsburg GS, Pinney EL, and Kendall PC
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- Humans, Adolescent, Child, Male, Female, Combined Modality Therapy, Follow-Up Studies, Sertraline therapeutic use, Young Adult, Adult, Comorbidity, Outcome Assessment, Health Care statistics & numerical data, Cognitive Behavioral Therapy, Substance-Related Disorders epidemiology, Substance-Related Disorders therapy, Anxiety Disorders epidemiology, Anxiety Disorders therapy
- Abstract
Background: Substance use problems and anxiety disorders are both highly prevalent and frequently cooccur in youth. The present study examined the benefits of successful anxiety treatment at 3-12 years after treatment completion on substance use outcomes (i.e. diagnoses and lifetime expected use)., Methods: The sample was from the Child/Adolescent Anxiety Multimodal Extended Long-term Study (CAMELS), a naturalistic follow-up study to the Child/Adolescent Anxiety Multimodal Study (CAMS) which randomized youth to cognitive behavioral therapy (CBT; Coping cat), medication (sertraline), their combination, or pill placebo. The first CAMELS visit occurred an average of 6.5 years following CAMS randomization. Participants were 319 youth (65.4% of the CAMS sample), aged 7-17 years at CAMS baseline assessment with a mean age of 17.6 years (range: 11-26 years) at the time of the first CAMELS follow-up. Substance use outcomes included diagnoses as well as lifetime substance use (i.e. alcohol and tobacco use)., Results: Eleven of 319 (3.4%) CAMELS participants were diagnosed with a substance use disorder at the initial follow-up visit. When compared to the population lifetime rate of 11.4%, the rate of diagnoses in the posttreated sample was significantly lower. Additionally, rates of lifetime alcohol use were lower than population rates at the initial and final follow-up visits. Rates of lifetime tobacco use were similarly lower than lifetime population rates at the initial visit (driven by significantly lower rates in the CBT treatment condition), but higher by the final visit. Furthermore, treatment remission (but not treatment response) was associated with a lower rate of substance use diagnoses at the initial follow-up visit, although rates of lifetime alcohol and tobacco use did not differ by treatment outcome., Conclusions: Anxiety treatments confer a beneficial impact on problematic substance use (i.e. diagnoses) as well as on expected substance use (i.e. alcohol and tobacco use) for on average, a period of 6.5 years., (© 2024 Association for Child and Adolescent Mental Health.)
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- 2024
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32. Rationale and design for a pragmatic randomized trial to assess gene-based prescribing for SSRIs in the treatment of depression.
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Hines LJ, Wilke RA, Myers R, Mathews CA, Liu M, Baye JF, Petry N, Cicali EJ, Duong BQ, Elwood E, Hulvershorn L, Nguyen K, Ramos M, Sadeghpour A, Wu RR, Williamson L, Wiisanen K, Voora D, Singh R, Blake KV, Murrough JW, Volpi S, Ginsburg GS, Horowitz CR, Orlando L, Chakraborty H, Dexter P, Johnson JA, Skaar TC, Cavallari LH, Van Driest SL, and Peterson JF
- Subjects
- Adult, Female, Humans, Male, Antidepressive Agents therapeutic use, Antidepressive Agents administration & dosage, Antidepressive Agents adverse effects, Pharmacogenomic Variants, Pragmatic Clinical Trials as Topic, Prospective Studies, Cytochrome P-450 CYP2C19 genetics, Cytochrome P-450 CYP2D6 genetics, Depression drug therapy, Depression genetics, Depression diagnosis, Pharmacogenomic Testing, Selective Serotonin Reuptake Inhibitors administration & dosage, Selective Serotonin Reuptake Inhibitors therapeutic use
- Abstract
Specific selective serotonin reuptake inhibitors (SSRIs) metabolism is strongly influenced by two pharmacogenes, CYP2D6 and CYP2C19. However, the effectiveness of prospectively using pharmacogenetic variants to select or dose SSRIs for depression is uncertain in routine clinical practice. The objective of this prospective, multicenter, pragmatic randomized controlled trial is to determine the effectiveness of genotype-guided selection and dosing of antidepressants on control of depression in participants who are 8 years or older with ≥3 months of depressive symptoms who require new or revised therapy. Those randomized to the intervention arm undergo pharmacogenetic testing at baseline and receive a pharmacy consult and/or automated clinical decision support intervention based on an actionable phenotype, while those randomized to the control arm have pharmacogenetic testing at the end of 6-months. In both groups, depression and drug tolerability outcomes are assessed at baseline, 1 month, 3 months (primary), and 6 months. The primary end point is defined by change in Patient-Reported Outcomes Measurement Information System (PROMIS) Depression score assessed at 3 months versus baseline. Secondary end points include change inpatient health questionnaire (PHQ-8) measure of depression severity, remission rates defined by PROMIS score < 16, medication adherence, and medication side effects. The primary analysis will compare the PROMIS score difference between trial arms among those with an actionable CYP2D6 or CYP2C19 genetic result or a CYP2D6 drug-drug interaction. The trial has completed accrual of 1461 participants, of which 562 were found to have an actionable phenotype to date, and follow-up will be complete in April of 2024., (© 2024 The Author(s). Clinical and Translational Science published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)
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- 2024
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33. Lipoprotein subclasses are associated with Hepatic steatosis: insights from the prospective multicenter imaging study for the evaluation of chest pain (PROMISE) clinical trial.
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Karady J, McGarrah RW, Nguyen M, Giamberardino SN, Meyersohn N, Lu MT, Staziaki PV, Puchner SB, Bittner DO, Foldyna B, Mayrhofer T, Connelly MA, Tchernof A, White PJ, Nasir K, Corey K, Voora D, Pagidipati N, Ginsburg GS, Kraus WE, Hoffmann U, Douglas PS, Shah SH, and Ferencik M
- Abstract
Objectives: To determine the relationship between lipoprotein particle size/number with hepatic steatosis (HS), given its association with traditional lipoproteins and coronary atherosclerosis., Methods: Individuals with available CT data and blood samples enrolled in the PROMISE trial were studied. HS was defined based on CT attenuation. Lipoprotein particle size/number were measured by nuclear magnetic resonance spectroscopy. Principal components analysis (PCA) was used for dimensionality reduction. The association of PCA factors and individual lipoprotein particle size/number with HS were assessed in multivariable regression models. Associations were validated in an independent cohort of 59 individuals with histopathology defined HS., Results: Individuals with HS (n=410/1,509) vs those without (n=1,099/1,509), were younger (59±8 vs 61±8 years) and less often females (47.6 % vs 55.9 %). All PCA factors were associated with HS: factor 1 (OR:1.36, 95 %CI:1.21-1.53), factor 3 (OR:1.75, 95 %CI:1.53-2.02) and factor 4 (OR:1.49; 95 %CI:1.32-1.68) were weighted heavily with small low density lipoprotein (LDL) and triglyceride-rich (TRL) particles, while factor 2 (OR:0.86, 95 %CI:0.77-0.97) and factor 5 (OR:0.74, 95 %CI:0.65-0.84) were heavily loaded with high density lipoprotein (HDL) and larger LDL particles. These observations were confirmed with the analysis of individual lipoprotein particles in PROMISE. In the validation cohort, association between HS and large TRL (OR: 8.16, 95 %CI:1.82-61.98), and mean sizes of TRL- (OR: 2.82, 95 %CI:1.14-9.29) and HDL (OR:0.35, 95 %CI:0.13-0.72) were confirmed., Conclusions: Large TRL, mean sizes of TRL-, and HDL were associated with radiographic and histopathologic HS. The use of lipoprotein particle size/number could improve cardiovascular risk assessment in HS., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier B.V.)
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- 2024
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34. Remote digital health technologies for improving the care of people with respiratory disorders.
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Dunn J, Coravos A, Fanarjian M, Ginsburg GS, and Steinhubl SR
- Subjects
- Humans, Digital Health, Respiratory Tract Diseases therapy
- Abstract
Respiratory diseases are a leading cause of morbidity and mortality globally. However, existing systems of care, built around scheduled appointments, are not well designed to support the needs of people with chronic and acute respiratory conditions that can change rapidly and unexpectedly. Home-based and personal digital health technologies (DHTs) allow implementation of new models of care catering to the unique needs of individuals. The high number of respiratory triggers and unique responses to them require a personalised solution for each patient. The real-world, repetitive monitoring capabilities of DHTs enable identification of the normal operating characteristics for each individual and, therefore, recognition of the earliest deviations from that state. However, despite this potential, the number of clinical efficacy studies of DHTs is quite small. Evaluation of clinical effectiveness of DHTs in improving health quality in real-world settings is urgently needed., Competing Interests: Declaration of interests JD reports personal fees as a Scientific Advisor to Veri and grant support from AstraZeneca. AC is the CEO, co-founder, and a shareholder of HumanFirst; and was a board member of the Digital Medical Society until 2023. MF is an advisor and shareholder of HumanFirst. SRS reports financial compensation as a consultant for physIQ; declares research grant support from Janssen Research & Development; and received reimbursement as an Executive Committee member for the Heartline Study, which is a trial on wearables to detect atrial fibrillation. GSG declared no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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35. Key Issues as Wearable Digital Health Technologies Enter Clinical Care.
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Ginsburg GS, Picard RW, and Friend SH
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- Humans, Digital Health, Telemedicine, Wearable Electronic Devices, Patient Care methods
- Published
- 2024
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36. Implementation of a Prospective Index-Cluster Sampling Strategy for the Detection of Presymptomatic Viral Respiratory Infection in Undergraduate Students.
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Uthappa DM, McClain MT, Nicholson BP, Park LP, Zhbannikov I, Suchindran S, Jimenez M, Constantine FJ, Nichols M, Jones DC, Hudson LL, Jaggers LB, Veldman T, Burke TW, Tsalik EL, Ginsburg GS, and Woods CW
- Abstract
Background: Index-cluster studies may help characterize the spread of communicable infections in the presymptomatic state. We describe a prospective index-cluster sampling strategy (ICSS) to detect presymptomatic respiratory viral illness and its implementation in a college population., Methods: We enrolled an annual cohort of first-year undergraduates who completed daily electronic symptom diaries to identify index cases (ICs) with respiratory illness. Investigators then selected 5-10 potentially exposed, asymptomatic close contacts (CCs) who were geographically co-located to follow for infections. Symptoms and nasopharyngeal samples were collected for 5 days. Logistic regression model-based predictions for proportions of self-reported illness were compared graphically for the whole cohort sampling group and the CC group., Results: We enrolled 1379 participants between 2009 and 2015, including 288 ICs and 882 CCs. The median number of CCs per IC was 6 (interquartile range, 3-8). Among the 882 CCs, 111 (13%) developed acute respiratory illnesses. Viral etiology testing in 246 ICs (85%) and 719 CCs (82%) identified a pathogen in 57% of ICs and 15% of CCs. Among those with detectable virus, rhinovirus was the most common (IC: 18%; CC: 6%) followed by coxsackievirus/echovirus (IC: 11%; CC: 4%). Among 106 CCs with a detected virus, only 18% had the same virus as their associated IC. Graphically, CCs did not have a higher frequency of self-reported illness relative to the whole cohort sampling group., Conclusions: Establishing clusters by geographic proximity did not enrich for cases of viral transmission, suggesting that ICSS may be a less effective strategy to detect spread of respiratory infection., Competing Interests: Potential conflicts of interest. M. T. M. reports grants from the Defense Advanced Research Projects Agency (DARPA) and the National Institutes of Health (NIH), and has a patent pending on “Methods to diagnose and treat acute respiratory infections.” T. W. B. reports grants from DARPA and NIH; reports owning equity in and serving as a consultant for Biomeme; and has a patent pending on Methods to diagnose and treat acute respiratory infections. E. L. T. reports consultancy fees and equity from Biomeme; has patents pending on Biomarkers for the molecular classification of bacterial infection and Methods to diagnose and treat acute respiratory infections; and is currently an employee of Danaher Diagnostics. C. W. W. and G. S. G. have patents pending on Molecular classification of bacterial infection and gene expression signatures useful to predict or diagnose sepsis and methods of using the same, and have patents issued on Methods to diagnose and treat acute respiratory disease and Methods of identifying infectious disease and assays for identifying infectious disease. C. W. W. reports owning equity in and consulting for Biomeme; reports grants from DARPA, NIH, Antibacterial Resistance Leadership Group, and Sanofi; and has received consultancy fees from bioMérieux, Roche, Biofire, Giner, and Biomeme. All other authors report no potential conflicts., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
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- 2024
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37. The All of Us Research Program is an opportunity to enhance the diversity of US biomedical research.
- Author
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Bianchi DW, Brennan PF, Chiang MF, Criswell LA, D'Souza RN, Gibbons GH, Gilman JK, Gordon JA, Green ED, Gregurick S, Hodes RJ, Kilmarx PH, Koob GF, Koroshetz WJ, Langevin HM, Lorsch JR, Marrazzo JM, Pérez-Stable EJ, Rathmell WK, Rodgers GP, Rutter JL, Simoni JM, Tromberg BJ, Tucci DL, Volkow ND, Woychik R, Zenk SN, Kozlowski E, Peterson RS, Ginsburg GS, and Denny JC
- Subjects
- Humans, Mentors, Population Health, Biomedical Research
- Published
- 2024
- Full Text
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38. Platelet RNA Biomarker of Ticagrelor-Responsive Genes Is Associated With Platelet Function and Cardiovascular Events.
- Author
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Myers RA, Ortel TL, Waldrop A, Cornwell M, Newman JD, Levy NK, Barrett TJ, Ruggles K, Sowa MA, Dave S, Ginsburg GS, Berger JS, and Voora D
- Subjects
- Humans, Ticagrelor therapeutic use, Platelet Aggregation Inhibitors adverse effects, Clopidogrel, Purinergic P2Y Receptor Antagonists adverse effects, Adenosine adverse effects, Hemorrhage chemically induced, Biomarkers, Treatment Outcome, Peripheral Arterial Disease drug therapy, Peripheral Arterial Disease genetics, Peripheral Arterial Disease chemically induced, Acute Coronary Syndrome complications
- Abstract
Background: Identifying patients with the optimal risk:benefit for ticagrelor is challenging. The aim was to identify ticagrelor-responsive platelet transcripts as biomarkers of platelet function and cardiovascular risk., Methods: Healthy volunteers (n=58, discovery; n=49, validation) were exposed to 4 weeks of ticagrelor with platelet RNA data, platelet function, and self-reported bleeding measured pre-/post-ticagrelor. RNA sequencing was used to discover platelet genes affected by ticagrelor, and a subset of the most informative was summarized into a composite score and tested for validation. This score was further analyzed (1) in CD34+ megakaryocytes exposed to an P2Y12 inhibitor in vitro, (2) with baseline platelet function in healthy controls, (3) in peripheral artery disease patients (n=139) versus patient controls (n=30) without atherosclerosis, and (4) in patients with peripheral artery disease for correlation with atherosclerosis severity and risk of incident major adverse cardiovascular and limb events., Results: Ticagrelor exposure differentially expressed 3409 platelet transcripts. Of these, 111 were prioritized to calculate a Ticagrelor Exposure Signature score, which ticagrelor reproducibly increased in discovery and validation cohorts. Ticagrelor's effects on platelets transcripts positively correlated with effects of P2Y12 inhibition in primary megakaryocytes. In healthy controls, higher baseline scores correlated with lower baseline platelet function and with minor bleeding while receiving ticagrelor. In patients, lower scores independently associated with both the presence and extent of atherosclerosis and incident ischemic events., Conclusions: Ticagrelor-responsive platelet transcripts are a biomarker for platelet function and cardiovascular risk and may have clinical utility for selecting patients with optimal risk:benefit for ticagrelor use., Competing Interests: Disclosures Coauthors (R.A. Myers, G.S. Ginsburg, and D. Voora) are listed as coinventors on an invention disclosure related to use of platelet RNA biomarkers to predict bleeding due to platelet P2Y12 inhibitors. This article was prepared while G.S. Ginsburg was employed at Duke University. The opinions expressed in this article are the author’s own and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government.
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- 2024
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39. Wearable Digital Health Technologies for Monitoring in Cardiovascular Medicine.
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Spatz ES, Ginsburg GS, Rumsfeld JS, and Turakhia MP
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- Humans, Digital Health, Wearable Electronic Devices, Monitoring, Ambulatory instrumentation, Monitoring, Ambulatory methods, Cardiovascular System
- Published
- 2024
- Full Text
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40. Host-response transcriptional biomarkers accurately discriminate bacterial and viral infections of global relevance.
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Ko ER, Reller ME, Tillekeratne LG, Bodinayake CK, Miller C, Burke TW, Henao R, McClain MT, Suchindran S, Nicholson B, Blatt A, Petzold E, Tsalik EL, Nagahawatte A, Devasiri V, Rubach MP, Maro VP, Lwezaula BF, Kodikara-Arachichi W, Kurukulasooriya R, De Silva AD, Clark DV, Schully KL, Madut D, Dumler JS, Kato C, Galloway R, Crump JA, Ginsburg GS, Minogue TD, and Woods CW
- Subjects
- Humans, Biomarkers, Cambodia, Australia, Virus Diseases diagnosis, Virus Diseases genetics, Bacterial Infections diagnosis, Bacterial Infections genetics
- Abstract
Diagnostic limitations challenge management of clinically indistinguishable acute infectious illness globally. Gene expression classification models show great promise distinguishing causes of fever. We generated transcriptional data for a 294-participant (USA, Sri Lanka) discovery cohort with adjudicated viral or bacterial infections of diverse etiology or non-infectious disease mimics. We then derived and cross-validated gene expression classifiers including: 1) a single model to distinguish bacterial vs. viral (Global Fever-Bacterial/Viral [GF-B/V]) and 2) a two-model system to discriminate bacterial and viral in the context of noninfection (Global Fever-Bacterial/Viral/Non-infectious [GF-B/V/N]). We then translated to a multiplex RT-PCR assay and independent validation involved 101 participants (USA, Sri Lanka, Australia, Cambodia, Tanzania). The GF-B/V model discriminated bacterial from viral infection in the discovery cohort an area under the receiver operator curve (AUROC) of 0.93. Validation in an independent cohort demonstrated the GF-B/V model had an AUROC of 0.84 (95% CI 0.76-0.90) with overall accuracy of 81.6% (95% CI 72.7-88.5). Performance did not vary with age, demographics, or site. Host transcriptional response diagnostics distinguish bacterial and viral illness across global sites with diverse endemic pathogens., (© 2023. The Author(s).)
- Published
- 2023
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41. Data-driven science and diversity in the All of Us Research Program.
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Ginsburg GS, Denny JC, and Schully SD
- Subjects
- Humans, United States, Data Science, National Institutes of Health (U.S.), Population Health, Biomedical Research
- Abstract
The National Institutes of Health's All of Us Research Program is an accessible platform that hosts genomic and phenotypic data to be collected from 1 million participants in the United States. Its mission is to accelerate medical research and clinical breakthroughs with a special emphasis on diversity.
- Published
- 2023
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42. Genomic medicine year in review: 2023.
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Manolio TA, Narula J, Bult CJ, Chisholm RL, Deverka PA, Ginsburg GS, Green ED, Hooker G, Jarvik GP, Mensah GA, Ramos EM, Roden DM, Rowley R, and Williams MS
- Published
- 2023
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43. Consultation as an Implementation Strategy to Increase Fidelity of Measurement-Based Care Delivery in Community Mental Health Settings: An Observational Study.
- Author
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Woodard GS, Casline E, Ehrenreich-May J, Ginsburg GS, and Jensen-Doss A
- Abstract
Regularly administering outcome measures to clients to inform clinical decision making, referred to as measurement-based care (MBC), has the potential to improve mental health treatment due to its applicability across disorders and treatment settings. Given the utility of MBC, understanding predictors of high-fidelity MBC implementation is important. Training and consultation are widely used implementation strategies to increase the fidelity of evidence-based practice delivery but have rarely been studied with MBC. The current study will examine the relationship between time clinicians spent discussing a case in consultation ("dosage") and MBC fidelity. Thirty clinicians and 56 youth were in the MBC condition of a randomized controlled trial and completed baseline questionnaires. Consultation dosage was extracted from call notes. MBC fidelity was measured using the implementation index, which combines rates of administering and viewing questionnaires, using objective data from the online MBC system. Multi-level modeling was used. Greater consultation dosage significantly predicted a higher implementation index (ß = 0.27, SE = 0.06, p < .001). For every 30 min spent discussing a case in consultation, the case's MBC fidelity increased by 8.1%. Greater consultation dosage significantly predicted higher rates of administration (ß = 0.07, SE = 0.03, p = 0.033) and feedback report viewing (ß = 0.24, SE = 0.06, p < .001). More consultation at the case level predicts greater MBC fidelity using objective measures. The greatest impact was increasing the clinician feedback report viewing rate. The results of this study can help inform future efforts to increase the fidelity with which MBC is delivered and to make consultation as efficient and effective as possible., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2023
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44. Wearable Digital Health Technology.
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Friend SH, Ginsburg GS, and Picard RW
- Subjects
- Humans, Biomedical Technology, Wearable Electronic Devices
- Published
- 2023
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45. External and Internal Validity Considerations in Youth Effectiveness Trials: Lessons Learned from the COMET Study.
- Author
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Jensen-Doss A, Woodard G, Patel-Syed Z, Ehrenreich-May J, Rosenfield D, and Ginsburg GS
- Subjects
- Adolescent, Female, Humans, Male, Community Mental Health Centers, Minority Groups, Randomized Controlled Trials as Topic, Patient Selection
- Abstract
Objective: Effectiveness trials aim to increase the generalizability and public health impact of interventions. However, challenges associated with this design present threats to external and internal validity. This paper illustrates these challenges using data from a two-site randomized effectiveness trial, the Community Study of Outcome Monitoring for Emotional Disorders in Teens (COMET) and presents recommendations for future research., Method: COMET was a randomized effectiveness trial conducted in 19 community mental health clinics in two states comparing three interventions: treatment as usual (TAU), TAU with measurement-based care (TAU+), and the Unified Protocol forTransdiagnostic Treatment of Emotional Disorders in Adolescents with MBC (UPA). Participants included 176 clinicians (mean age = 35.5; 85.8% cisgender female; 53.0% racially and/or ethnically minorized) and 196 adolescents (mean age = 14.7; 65.3% cisgender female; 69.4% racially and/or ethnically minorized). Analyses outlined participant flow from recruitment to study completion, described participant characteristics, and examined site differences., Results: Analysis of participant flow suggested that recruitment and retention of clinicians and adolescents was challenging, raising questions about whether participants were representative of participating clinics. Both the clinician and adolescent samples were racially and ethnically diverse and adolescents were low income and clinically complex. Significant site differences were observed in clinician and adolescent characteristics., Conclusions: While this study was successful in recruiting a diverse and historically under-represented sample, difficulties in recruitment and retention raise questions about external validity and site differences present challenges to internal validity of study findings. Suggestions for future effectiveness studies, drawing from implementation science approaches, are discussed.
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- 2023
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46. Anxiety symptom trajectories from treatment to 5- to 12-year follow-up across childhood and adolescence.
- Author
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Bai S, Rolon-Arroyo B, Walkup JT, Kendall PC, Ginsburg GS, Keeton CP, Albano AM, Compton SN, Sakolsky D, Piacentini J, and Peris TS
- Subjects
- Humans, Child, Adolescent, Follow-Up Studies, Treatment Outcome, Anxiety Disorders therapy, Anxiety therapy, Cognitive Behavioral Therapy
- Abstract
Objective: The current study examined trajectories of anxiety during (a) acute treatment and (b) extended follow-up to better characterize the long-term symptom trajectories of youth who received evidence-based intervention for anxiety disorders using a person-centered approach., Method: Participants were 319 youth (age 7-17 years at enrollment), who participated in a multicenter randomized controlled trial for the treatment of pediatric anxiety disorders, Child/Adolescent Anxiety Multimodal Study, and a 4-year naturalistic follow-up, Child/Adolescent Anxiety Multimodal Extended Long-term Study, an average of 6.5 years later. Using growth mixture modeling, the study identified distinct trajectories of anxiety across acute treatment (Weeks 0-12), posttreatment (Weeks 12-36), and the 4-year-long follow-up, and identified baseline predictors of these trajectories., Results: Three nonlinear anxiety trajectories emerged: "short-term responders" who showed rapid treatment response but had higher levels of anxiety during the extended follow-up; "durable responders" who sustained treatment gains; and "delayed remitters" who did not show an initial response to treatment, but showed low levels of anxiety during the maintenance and extended follow-up periods. Worse anxiety severity and better family functioning at baseline predicted membership in the delayed remitters group. Caregiver strain differentiated short-term responders from durable responders., Conclusions: Findings suggest that initial response to treatment does not guarantee sustained treatment gains over time for some youth. Future follow-up studies that track treated youth across key developmental transitions and in the context of changing social environments are needed to inform best practices for the long-term management of anxiety., (© 2023 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)
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- 2023
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47. Treatment Engagement in Adolescents: The Associations of Sociodemographic Characteristics, Caregiver Perceived Barriers, and Clinical Impairment.
- Author
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Phillips DA, Ginsburg GS, Ehrenreich-May J, and Jensen-Doss A
- Abstract
Objective: To examine the associations between sociodemographic characteristics, perceived barriers to treatment, clinical impairment, and youth treatment engagement., Method: Participants included 196 families (youth: ages 12 to 18; 64.3% cis-gender female; 23.5% Black, 60.7% White, and 12.2% Mixed/Other race; 41.3% Hispanic or Latinx ethnicity) recruited as part of a comparative effectiveness trial for adolescent anxiety and depression. Self-report measures of sociodemographic characteristics and caregiver perceived barriers were completed at intake. Youth clinical impairment was assessed at baseline via clinical interview. Measures of engagement were collected throughout treatment, including initiation status, session attendance, and termination status. Relationships were examined using analyses of variances and hierarchal linear and logistic modeling., Results: Perceived barriers did not differ by sociodemographic characteristics. Greater perceived stressors and obstacles predicted fewer sessions attended and a lower likelihood of successful termination. Youth of caregivers with an advanced degree and those with caregivers who were employed part time attended more sessions and were more likely to initiate and terminate treatment successfully compared to youth with caregivers of a lower education level or student or unemployed status. At higher levels of youth clinical impairment, greater perceived treatment demands and issues predicted reduced likelihood of treatment initiation., Conclusions: Perceived barriers, sociodemographic characteristics, and clinical impairment were all associated with levels of engagement in the treatment process. Baseline and continued assessment of perceived and experienced barriers to treatment may promote individualized strategies for families identified as at-risk for reduced engagement.
- Published
- 2023
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48. Branched-Chain Amino Acids in Computed Tomography-Defined Adipose Depots and Coronary Artery Disease: A PROMISE Trial Biomarker Substudy.
- Author
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Zhao E, Giamberardino SN, Pagidipati NJ, Voora D, Ginsburg GS, Hoffmann U, Karády J, Ferencik M, Douglas PS, Foldyna B, and Shah SH
- Subjects
- Humans, Middle Aged, Adiposity, Amino Acids, Branched-Chain metabolism, Prospective Studies, Risk Factors, Biomarkers metabolism, Tomography, X-Ray Computed, Obesity complications, Chest Pain, Coronary Angiography methods, Adipose Tissue diagnostic imaging, Adipose Tissue metabolism, Coronary Artery Disease etiology
- Abstract
Background The interplay between branched-chain amino acid (BCAA) metabolism, an important pathway in adiposity and cardiometabolic disease, and visceral adipose depots such as hepatic steatosis (HS) and epicardial adipose tissue is unknown. We leveraged the PROMISE clinical trial with centrally adjudicated coronary computed tomography angiography imaging to determine relationships between adipose depots, BCAA dysregulation, and coronary artery disease (CAD). Methods and Results The PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) trial randomized 10 003 outpatients with stable chest pain to computed tomography angiography versus standard-of-care diagnostics. For this study, we included 1798 participants with available computed tomography angiography data and biospecimens. Linear and logistic regression were used to determine associations between a molar sum of BCAAs measured by nuclear magnetic resonance spectroscopy with body mass index, adipose traits, and obstructive CAD. Mendelian randomization was then used to determine if BCAAs are in the causal pathway for adipose depots or CAD. The study sample had a mean age of 60 years (SD, 8.0), body mass index of 30.6 (SD, 5.9), and epicardial adipose tissue volume of 57.3 (SD, 21.3) cm
3 /m2 ; 27% had HS, and 14% had obstructive CAD. BCAAs were associated with body mass index (multivariable beta 0.12 per SD increase in BCAA [95% CI, 0.08-0.17]; P =4×10-8 ). BCAAs were also associated with HS (multivariable odds ratio [OR], 1.46 per SD increase in BCAAs [95% CI, 1.28-1.67]; P =2×10-8 ), but BCAAs were associated only with epicardial adipose tissue volume (odds ratio, 1.18 [95% CI, 1.07-1.32]; P =0.002) and obstructive CAD (OR, 1.18 [95% CI, 1.04-1.34]; P =0.009) in univariable models. Two-sample Mendelian randomization did not support the role of BCAAs as within the causal pathways for HS or CAD. Conclusions BCAAs have been implicated in the pathogenesis of cardiometabolic diseases, and adipose depots have been associated with the risk of CAD. Leveraging a large clinical trial, we further establish the role of dysregulated BCAA catabolism in HS and CAD, although BCAAs did not appear to be in the causal pathway of either disease. This suggests that BCAAs may serve as an independent circulating biomarker of HS and CAD but that their association with these cardiometabolic diseases is mediated through other pathways.- Published
- 2023
- Full Text
- View/download PDF
49. Youth stress generation: an examination of the role of anxiety, anxiety symptoms and cognitive distortions.
- Author
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Harrison TJ, Ginsburg GS, Smith IC, and Orlando CM
- Subjects
- Humans, Female, Adolescent, Male, Prospective Studies, Anxiety Disorders, Cognition, Depression psychology, Anxiety psychology
- Abstract
Introduction: Stress generation suggests a reciprocal relationship between depression and prospective stressful life events. However, the applicability of stress generation to anxiety disorders has been understudied, particularly among youth. We address this gap by examining stress generation in youth at high-risk of developing anxiety disorders., Methods: Participants were one-hundred thirty-six at-risk youth ( M age = 8.69, 84.6% Caucasian; 55.9% female), each of whom had a parent with an anxiety disorder. We examined the role of an anxiety disorder diagnosis, anxiety symptoms, and cognitive distortions in youth's prospective one and six-year stressful life events (i.e., stress generation)., Results: Anxiety symptoms and cognitive distortions were significant predictors of one-year total dependent stress. Anxiety diagnosis and anxiety symptoms were significant predictors of one-year dependent interpersonal stress. Anxiety diagnosis and anxiety symptoms were significant predictors of six-year independent stress., Conclusion: Support for the stress generation model was found in high-risk youth, but only over a one-year period. This suggests important effects of anxiety and cognitive distortions on stress generation, though their implications might be time-capped.
- Published
- 2023
- Full Text
- View/download PDF
50. Author Correction: Differential chromatin accessibility in peripheral blood mononuclear cells underlies COVID-19 disease severity prior to seroconversion.
- Author
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Giroux NS, Ding S, McClain MT, Burke TW, Petzold E, Chung HA, Rivera GO, Wang E, Xi R, Bose S, Rotstein T, Nicholson BP, Chen T, Henao R, Sempowski GD, Denny TN, De Ussel MI, Satterwhite LL, Ko ER, Ginsburg GS, Kraft BD, Tsalik EL, Shen X, and Woods CW
- Published
- 2023
- Full Text
- View/download PDF
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