Harvard Medical School Research Articles

Tapinarof ameliorates rejection in a human skin grafted model of face transplantation

Abstract T cell mediated immune rejection is the primary barrier to broader implementation of face transplants (vascularized composite allografts, VCA). Our bulk and single cell transcriptional profiling of human face transplant rejection demonstrated that VCA rejection is an INFγ driven cytotoxic process with unique induction of skin specific immunoregulatory pathways including SOCS1, KIR3DL2, and LY9. Tapinarof is a novel small-molecule topical aryl hydrocarbon receptor agonist and antioxidant that is effective in treating psoriasis and atopic dermatitis. Patients who cleared on once a day topical tapinarof remained clear for an average of four months after discontinuation, suggesting it has durable immunoregulatory effects in skin. We modeled VCA by grafting NSG mice with freshly excised, living, immunologically intact adult human skin. Once healed, 5×10 6allogeneic PBMCs from a second unrelated human donor were infused via tail vein. The inflamed skin mimicked VCA rejection after 21 days, with grafts showing epidermal injury, T cell infiltration, dyskeratosis, and genetic signatures of cytotoxicity, antigen presentation, and INFγ signaling. Topical tapinarof ameliorated this inflammation, with fewer T cells and reduced antigen-specific T cell activation. Induction of immunoregulatory pathways was also noted, including upregulation of SOCS1 signaling, TREX1 mediated reductions in cytosolic nucleotide sensing, and IL1RN inhibition of IL-1 mediated inflammation. Tapinarof could be a novel therapy for VCA rejection that does not require systemic immune suppression. Our results suggest that strengthening immunoregulatory networks in skin is a viable approach to combat inflammation and promote tolerance in VCA rejection. NIH T32 Training Grant 2T32AR007098-47 Dept. of Dermatology, Harvard Medical School RT170025 (P.I. Rachael A. Clark) Department of Defense - congressionally Directed Medical Research Programs; "T cells and Rejection in Vascularized Composite Allografts).

Salt diet Induces Neuroinflammatory Response, Microbiome Dysregulation and Associated with Long-term Anxiety Following Repetitive Closed Head Injury. (S28.003)

<h3>Objective:</h3> Investigate the effects of salt diet on neuroinflammatory response, behavior, and microbiome dysregulation following repetitive closed head injury model. <h3>Background:</h3> Concussions continue to be a prominent public health concern, with an estimated 1.6–3.8 million incidences annually in the United States. Younger populations are experiencing the highest rates of concussion and nearly all athletic endeavors have some risk of concussive injury. Concerns surrounding the potential risks of long-term cognitive and medical outcomes made adolescent traumatic brain injury (TBI) a central focus of public attention. Coupled to these events, recent clinical studies have shown that lifestyle factors, including salt diet, constitute additional risk affecting TBI consequences and neuropathophysiological outcomes. However, the impact of salt diet on the pathophysiology of TBI and whether it exacerbates post-injury outcomes is still largely unknown. <h3>Design/Methods:</h3> We investigated if the exposure to a high salt diet (HSD) would alter hemodynamics, behavior, innate immune response and microbiome diversity after repetitive mild closed head injury in adolescent mice. Mice were injured with a three hit model (3HD) and then maintained on a HSD or standard diet (STD) for 12 weeks. <h3>Results:</h3> We found that HSD didn’t change systolic and diastolic blood pressure, and heart rate compared with STD group. HSD group was associated with worsening anxiety-like behavior at 12 weeks post diet administration. HSD induced microgliosis and proinflammatory microglial transcriptomic signature including upregulation in interferon gamma, Interferon beta, T cells proliferation pathways. Consistently, we found upregulation of proinflammatory Tumor necrotic factor (TNF) in brain compared to Sham-HSD and TBI-STD groups. HSD was the main driver of microbiome dysregulation in both TBI and Sham groups. We found that Eubacterium xylanophilum and Lachnospiraceae bacterium associated with an anxiety phenotype following injury at 12 weeks post diet administration. <h3>Conclusions:</h3> Salt diet associated with increasing risk of worsening anxiety and exacerbating chronic neuroinflammation post repetitive head injury. <b>Disclosure:</b> Dr. Izzy has received publishing royalties from a publication relating to health care. Taha Yahya has nothing to disclose. Dr. Cao has nothing to disclose. Mr. Albastaki has nothing to disclose. Dr. Waed has nothing to disclose. Ms. Chopra has nothing to disclose. Miss EKWUDO has nothing to disclose. Miss Kurdeikaite has nothing to disclose. Ms. Moraes Verissimo has received personal compensation for serving as an employee of Brigham and Women’s Hospital. Ms. Moraes Verissimo has received personal compensation for serving as an employee of Brigham and Women’s Hospital and Harvard Medical School. Ms. Moraes Verissimo has received personal compensation for serving as an employee of Von Medical, Inc.. Ms. Moraes Verissimo has received personal compensation for serving as an employee of Nova Southeastern University. Ms. Moraes Verissimo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Montachem Company. Dr. Cox has received personal compensation for serving as an employee of Anaerobe Systems. The institution of Dr. Cox has received research support from Infectious Disease Society. The institution of Dr. Cox has received research support from BrightFocus Foundation. Dr. Cox has received intellectual property interests from a discovery or technology relating to health care. Dr. Zafonte has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MYOMO. Dr. Zafonte has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kisbee. Dr. Zafonte has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology. The institution of Dr. Zafonte has received research support from NIDILRR. The institution of Dr. Zafonte has received research support from NIH. The institution of Dr. Zafonte has received research support from FPHS study. Dr. Zafonte has received publishing royalties from a publication relating to health care. Michael J. Whalen has nothing to disclose.

Gray Matter Microstructure Alterations in People with Multiple Sclerosis Based on Cell Body and Neurite Density Imaging (P10-3.007)

<h3>Objective:</h3> To evaluate a novel compartment-based model for apparent cell body and neurite density imaging (SANDI) in gray matter (GM) in people with multiple sclerosis (MS) compared to healthy controls (HC) and its correlation with brain atrophy. <h3>Background:</h3> MS features focal cortical lesions and microstructural changes in normal-appearing GM, which can impact clinical function and disability. High gradient diffusion MRI has potential to optimize GM tissue microstructure characterization by overcoming challenges due to the complexity of underlying components. <h3>Design/Methods:</h3> 41 people with MS and 37 age- and sex-matched HC were scanned on a 3T Connectom MRI scanner equipped with 300mT/m gradients using a multi-shell acquisition protocol consisting of eight b-values at 19msec diffusion time. Microstructural metrics of SANDI, including a measure of soma density (f_soma) in the cortex and deep GM, were compared between MS and HC and correlated with cortical and thalamic atrophy, correcting for multiple comparisons. <h3>Results:</h3> Cortical cell body signal fraction (f_soma) was decreased in MS compared to HC (0.56 vs. 0.58, <i>p</i>=0.027, not surviving FDR-correction). In deep GM, f_soma and extra-cellular signal fraction were significantly decreased in MS compared to HC (<i>FDR-p</i>=0.045 in both), which was most pronounced in progressive MS. Based on spatial analysis, f_soma of caudate nucleus and thalamus were significantly decreased in MS compared to HC (<i>FDR-p</i>=0.003 and <i>FDR-p</i>=0.027, respectively). Whereas cortical atrophy in MS was poorly correlated with cortical f_soma, thalamic atrophy in MS demonstrated moderate correlation with decreased thalamic f_soma (r=0.311, <i>p</i>=0.054) and decreased cortical f_soma (r=0.474, <i>p</i>=0.008). <h3>Conclusions:</h3> SANDI metrics, in particular f_soma, provide detailed GM characterization beyond cortical and thalamic volumes and are able to characterize MS-related microstructural pathology. Decreased cortical cell density correlates with declining thalamic volume and may precede volumetric measures of cortical atrophy in people with MS. <b>Disclosure:</b> Ms. Krijnen has nothing to disclose. Andrew Russo has nothing to disclose. Dr. Salim Karam has nothing to disclose. The institution of Menno M Schoonheim has received research support from Dutch MS Research Foundation. The institution of Menno M Schoonheim has received research support from Eurostars-EUREKA. The institution of Menno M Schoonheim has received research support from ARSEP. The institution of Menno M Schoonheim has received research support from Amsterdam Neuroscience. The institution of Menno M Schoonheim has received research support from MAGNIMS. The institution of Menno M Schoonheim has received research support from ZonMW. The institution of Menno M Schoonheim has received research support from Atara Biotherapeutics. The institution of Menno M Schoonheim has received research support from Biogen. The institution of Menno M Schoonheim has received research support from Celgene/Bristol Meyers Squibb. The institution of Menno M Schoonheim has received research support from Genzyme. The institution of Menno M Schoonheim has received research support from MedDay. The institution of Menno M Schoonheim has received research support from Merck. Dr. Huang has received personal compensation in the range of $0-$499 for serving as a Consultant for Siemens Healthineers. The institution of Dr. Huang has received research support from Siemens Healthineers. The institution of Dr. Huang has received research support from Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School. Dr. Klawiter has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Galen/Atlantica. Dr. Klawiter has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Klawiter has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Banner Life Sciences. Dr. Klawiter has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Greenwich Biosciences. Dr. Klawiter has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for OM1. Dr. Klawiter has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. The institution of Dr. Klawiter has received research support from Biogen. The institution of Dr. Klawiter has received research support from Abbvie. The institution of Dr. Klawiter has received research support from Genentech.

A Phase II, Randomized, Double-blind, Sham-Controlled Clinical Trial of Transcutaneous Electrical Nerve Stimulation (TENS) Therapy for the Treatment of Neuropathic Pain in Neuromyelitis Optica Spectrum Disorders (P13-5.005)

<h3>Objective:</h3> To determine whether Transcutaneous Electrical Nerve Stimulation (TENS) therapy is a safe, tolerable, and effective therapy for neuropathic pain in patients with Aquaporin-4 (AQP4) IgG positive Neuromyelitis Optica Spectrum Disorders (NMOSD). <h3>Background:</h3> NMOSD is a chronic relapsing neuroinflammatory disorder that preferentially targets the optic nerves and spinal cord. Pain due to the longitudinally extensive spinal cord lesions seen in NMOSD is a frequent, disabling, and difficult to treat component of the disease with up to 91% of patients reporting symptoms of central neuropathic pain. TENS therapy is a non-invasive pain-modifying intervention that utilizes transcutaneous electrical stimulation of ascending sensory fibers that has been investigated for the amelioration of peripheral neuropathic pain in several other conditions. <h3>Design/Methods:</h3> We conducted a 4-week, randomized, double-blind, sham-controlled, fully remote trial of the QUELL TENS in patients with NMOSD who have central neuropathic pain, followed by a 12-week open label extension period. The Numeric Rating Scale for Pain (NRS-P) was used as the primary outcome measure and was assessed at baseline and at weeks 1, 2, 3, 4, 5, 6, 7, 8, 12, and 16. <h3>Results:</h3> Forty-six patients (23 per arm) were enrolled in this trial, of which 37 completed the trial (3 in the intervention arm and 1 in the sham arm withdrew for adverse events possibly related to the device). Both the sham and intervention arms demonstrated a significant decrease in average pain, worst pain, and current pain between the baseline and 4 week periods, however there was no significant difference between the two arms on intention-to-treat primary or secondary efficacy outcomes. <h3>Conclusions:</h3> Both arms demonstrated significant decreases in reported pain between baseline and 4-week follow-up, however there was no demonstrated benefit of TENS over sham. Further trial analysis will be conducted analyzing responder groups, adverse events, and per-protocol results based on device usage data. <b>Disclosure:</b> The institution of Dr. Vishnevetsky has received research support from National MS Society. The institution of Dr. Vishnevetsky has received research support from NIH (NeuroNext). Ms. Romanow has received research support from Freeman Pain Award @ Harvard Medical School. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.

Automated Drawing Process Metrics for Evaluating Cognitive Impairment from Human Drawing Behavior (S15.004)

<h3>Objective:</h3> To evaluate four novel tablet-based drawing assessments for detecting cognitive impairment (CI) using automated analysis of traditional and Boston Process Approach (BPA) features. <h3>Background:</h3> The digital Clock Drawing Task extracts cognitive- and motor-related features, enabling automatic CI detection in 3 minutes. Here, we applied the BPA to 4 other assessments to expand upon that capability. <h3>Design/Methods:</h3> Novel process-based metrics captured during drawing/writing of Trails A/B, Symbol Digit Modalities Test (SDMT), Spiral Tracing, and Pathfinding were analyzed in two independent datasets: (1) 170 cognitively normal (CN) subjects to calculate test-retest reliability of features, and (2) 1000 CN and cognitively impaired (CI) subjects to quantify their group differences. <h3>Results:</h3> Average reliability was good across features; SDMT: r=0.54 (s.d.=0.2, range=−0.02–0.92), Trails B: r=0.42 (s.d.=0.25, range=−0.19–0.87), Spiral Tracing: r=0.5 (s.d.=0.19, range=−0.07–0.78), Pathfinding: r=0.47 (s.d.=0.2, range=0.07–0.78). Trails: CN drew faster and spent less time in each circle (|T|’s&gt;2.8, p’s&lt;0.001); SDMT: CI spent less time thinking/pausing (T=−4.01, p&lt;0.0001) and more time writing (T=9.73, p&lt;0.001); Pathfinding: CI drew faster with higher acceleration (T=3.51, p&lt;0.0001) and drew less (T=−6.48, p&lt;0.0001); Spiral Tracing: CN deviated less (T=−2.88, p&lt;0.0001), had lower velocity (T=−5.22, p&lt;0.0001), and spent a larger portion of time drawing (T=11.57, p&lt;0.0001) with less variability (T=−3.83, p&lt;0.0001). <h3>Conclusions:</h3> Our results demonstrate the value of process-based metrics during neuropsychological tasks in distinguishing between CN and CI individuals with fair-to-good test-retest reliability, thereby identifying specific processes that can lead to actionable recommendations. <b>Disclosure:</b> Dr. Toro-Serey has received personal compensation for serving as an employee of Linus Health. Mr. Higgins has received personal compensation for serving as an employee of Infosys Ltd. Mr. Banks has received personal compensation for serving as an employee of Linus Health Inc. Dr. Jannati has received personal compensation for serving as an employee of Linus Health. Dr. Jannati has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Children’s Hospital, Harvard Medical School. Dr. Gomes-Osman has received personal compensation for serving as an employee of Linus Health. Dr. Gomes-Osman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neurologic Physical Therapy. Dr. Pascual-Leone has received personal compensation for serving as an employee of Linus Health. Dr. Pascual-Leone has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Magstim. Dr. Pascual-Leone has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neuroelectrics. Dr. Pascual-Leone has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TetraNeuron. Dr. Pascual-Leone has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MedRhythms. Dr. Pascual-Leone has received personal compensation in the range of $100,000-$499,999 for serving as an officer or member of the Board of Directors for Linus Health. Dr. Pascual-Leone has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Annals of Neurology. Dr. Pascual-Leone has stock in TI Solutions. The institution of Dr. Pascual-Leone has received research support from NIH. The institution of Dr. Pascual-Leone has received research support from NSF. The institution of Dr. Pascual-Leone has received research support from Brightfocus Foundation . Dr. Pascual-Leone has received intellectual property interests from a discovery or technology relating to health care. Dr. Pascual-Leone has received publishing royalties from a publication relating to health care. Dr. Bates has received personal compensation for serving as an employee of Linus Health. Dr. Bates has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for TMCity Foundation. Dr. Bates has received stock or an ownership interest from Linus Health, Inc.. Dr. Bates has received intellectual property interests from a discovery or technology relating to health care. Dr. Bates has received intellectual property interests from a discovery or technology relating to health care. Dr. Showalter has received personal compensation for serving as an employee of Linus Health. Dr. Showalter has stock in Linus Health. Dr. Tobyne has received personal compensation for serving as an employee of Linus Health. Dr. Tobyne has received personal compensation for serving as an employee of Charles River Analytics. Dr. Tobyne has received stock or an ownership interest from Charles River Analytics. The institution of Dr. Tobyne has received research support from National Institutes of Health. The institution of Dr. Tobyne has received research support from Department of Defense.

Predictors of Conversion from Positive to Negative Myelin Oligodendrocyte Glycoprotein (MOG) Antibody Status (P9-3.011)

<h3>Objective:</h3> The goal of this study is to characterize the clinical course of patients with Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) who seroconvert from a positive to negative MOG antibody status, and to determine predictors of seroconversion. <h3>Background:</h3> MOGAD is a neuroinflammatory disorder characterized by demyelination of the optic nerve, brain, or spinal cord, and can be either relapsing or monophasic. Persistent MOG antibody positivity has been identified as a potential predictor of disease-related relapses, however there has been limited research regarding what determines whether patients remain seropositive or convert to a negative MOG antibody status. <h3>Design/Methods:</h3> The Massachusetts General Hospital Neuroimmunology Clinic maintains a list of patients with MOGAD based on queries of the Massachusetts General Brigham Research Patient Data Registry database and updated with clinic visits. Patients evaluated through July 2022 were included in a chart review focused on MOG serostatus, titer levels, and potential predictors of MOG serostatus. Data analysis was conducted in Stata/SE 17.0. <h3>Results:</h3> We identified 66 patients who had at least 2 MOG antibody tests 6 months apart (60.6% females and 39.4% males). Of these, 47 had persistently positive MOG titers, and 18 had positive titers that became negative. 5 individuals had negative titers that later converted to positive. Of the 18 patients that developed negative titers, only 1 had a subsequent documented relapse, which was associated with discontinued immunotherapy and titers which became positive again at the time of relapse. Predictors of conversion to negative IgG on multivariate logistic regression included low initial MOG titers (defined as titers &lt;1:100), male sex, and childhood onset of disease. <h3>Conclusions:</h3> Low initial MOG titers, male sex, and childhood onset of disease can help predict future conversion to negative MOG serostatus. Further analysis of this cohort will focus on the effect of various immunotherapies and their timing on MOG antibody status. <b>Disclosure:</b> Ms. Hayman has nothing to disclose. The institution of Dr. Vishnevetsky has received research support from National MS Society. The institution of Dr. Vishnevetsky has received research support from NIH (NeuroNext). Ms. Romanow has received research support from Freeman Pain Award @ Harvard Medical School. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.

Global Research Trends in Endometrial Hyperplasia (2002–2021): A Bibliometric Analysis and Visualization Study

Abstract Objectives This article quantifies the research contribution related to endometrial hyperplasia (EH). Methods We searched the Scopus database in 2002 to 2021. Results A total of 6,422 were retrieved; 1,906 were open access; 5,602 in English. The number of published papers showed rising productivity over the last 20 years ranging from 261 to 425. There were 5,034 research articles and 1,388 reviews. The most prolific authors were Zullo, F (30), Mirkin, S (28), Archer, DF (27), and Insabato, L (26). The top involved journals were the Gynecologic Oncology Journal (144), European Journal of Gynaecological Oncology (114), and International Journal of Gynecological Pathology (105). The United States was the most dominant country, with 1,592 articles, followed by China (601) and Italy (435). The most actively involved institutions were the University of Texas MD Anderson Cancer Center (77), followed by Fudan University (63) and Harvard Medical School (62). The top funding sponsors were the National Cancer Institute (178), the National Institutes of Health (177), and the National Natural Science Foundation of China (107). The top three most cited articles received 1,182, 746, and 600 citations, respectively. Conclusion This study defines the prolific researchers, institutions, journals, and countries as a good starting to bridge gaps in research activity.

In the light: towards developing metrics of light regularity.

Journal Article Accepted manuscript In the Light: Towards Developing Metrics of Light Regularity Get access Danielle A Wallace Danielle A Wallace Division of Sleep Medicine, Harvard Medical School, Boston MA, USADivision of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston MA, USA Corresponding author: Danielle A. Wallace Email: dclarkson-townsend@bwh.harvard.edu Brigham and Women's Hospital, Department of Medicine, 221 Longwood Ave, Suite BL-252, Boston, MA 02115, USA. https://orcid.org/0000-0001-7033-2172 Search for other works by this author on: Oxford Academic Google Scholar Sleep, zsad114, https://doi.org/10.1093/sleep/zsad114 Published: 19 April 2023 Article history Received: 17 January 2023 Published: 19 April 2023

In Memoriam: J. Randall Curtis, MD

Journal of Palliative MedicineAhead of Print In MemoriamJ. Randall Curtis, MDSusan D. BlockSusan D. BlockAddress correspondence to: Susan D. Block, MD, Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02138, USA. E-mail Address: susan_block@dfci.harvard.eduDepartment of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.Search for more papers by this authorPublished Online:18 Apr 2023https://doi.org/10.1089/jpm.2023.0202AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"J. Randall Curtis, MD." Journal of Palliative Medicine, , pp. –FiguresReferencesRelatedDetails Volume 0Issue 0 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:Susan D. Block.J. Randall Curtis, MD.Journal of Palliative Medicine.ahead of printhttp://doi.org/10.1089/jpm.2023.0202Online Ahead of Print:April 18, 2023PDF download

MHealth and COVID-19: A Bibliometric Study.

mHealth, i.e., using mobile computing and communication technologies in health care, has played an increasingly important role in the provision of medical care and undertaking self-health monitoring and management in the past two decades. Specifically, it becomes critically important for health care delivery when governments have been forced to impose quarantines and lockdowns during the spikes in COVID-19 cases. Therefore, this research focuses on academic publications including journal articles, reviews, and conference papers on the use of mHealth during the COVID-19 pandemic. Using a keyword search on "mHealth" (or "mobile health") and "COVID-19" on 7 January 2023 in Scopus, it was found that 1125 documents were officially published between 2020 and 2022. Among these 1125 documents, 1042 documents were journal articles, reviews, and conference papers. Researchers in the US produced 335 articles, followed by UK researchers with 119 articles, and Chinese researchers with 79 articles. Researchers affiliated with Harvard Medical School published the largest number of articles (31), followed by researchers of University College London with 21 articles and Massachusetts General Hospital with 20 articles. Co-occurrence of keywords analysis revealed four clusters, namely "COVID-19, mHealth, mobile applications, and public health", "adult, adolescent, mental health, and major clinical study", "human, pandemic, and epidemiology", and "telemedicine, telehealth, and health care delivery". Implications of this study are given.

Quality of Life After Critical Illness.

1 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA. 2 Harvard Medical School, Boston, MA. 3 Ariadne Labs, Boston, MA. *See also p. 632. The views expressed in this article are those of the authors and do not necessarily represent the views of others. Support was provided solely from institutional sources. Dr. Arriaga is the recipient of: 1) a mentored research training grant from the Anesthesia Patient Safety Foundation (APSF) and the Foundation for Anesthesia Education and Research (FAER) and 2) a Career Development Award from the Center for Diversity and Inclusion of the Brigham and Women’s Hospital. He is also a member of the Patient Safety Editorial Board for the American Society of Anesthesiologists and Question Editor/Examiner for the American Board of Anesthesiology, where he receives a stipend for work that is otherwise done in a volunteer capacity. He received funding from the American Society of Anesthesiologists Patient Safety Editorial Board, the American Board of Anesthesiology, the Minority Faculty Career Development Award from the Center for Diversity and Inclusion of the Brigham and Women’s Hospital, the APSF, and the FAER. Dr. Allen has disclosed that he does not have any potential conflicts of interest.

Bibliometric evaluation of publications on inflammasomes in atherosclerosis from 2002 to 2022.

Inflammasomes have emerged as an important and promising area of investigation in atherosclerosis. This field, however, lacks bibliometric studies. To help understand how basic and clinical research on inflammasomes in atherosclerosis will develop in the future, we used bibliometric analysis to visualize hotspots and trends. Studies related to inflammasomes in atherosclerosis were collected from the Web of Science Core Collection database. Each study was analyzed bibliometrically and visually. CiteSpace and VOSviewer software were used to generate knowledge maps. A total of 894 articles were identified. Sixty-two countries and 338 institutions led by China and the United States contributed to these publications. The leading research institutions were Harvard Medical School and Columbia University. Circulation was the most frequently cited journal in this field. Among the 475 authors determined, Eicke Latz authored the most studies, and Peter Duewell has been cocited the most. NLRP3 inflammasome, NF-kappa B, macrophage and oxidative stress are the most commonly used keywords. There has been a blooming of research on inflammasomes in atherosclerosis during the last two decades. Future studies will likely explore the molecular mechanism of inflammasomes in cell death. More compellingly, researchers may further delve into the potential clinical value of affecting pathological changes in atherosclerosis by modulating the initial transcription immune response and intracellular multiprotein assembly process of the NLRP3 inflammasome. Our research will be helpful to scholars focusing on inflammation-a much-needed breakthrough in the pathophysiological alterations of atherosclerosis-with a novel perspective.

Applicant Flow Data

Massachusetts General Hospital, Harvard Medical School, Boston, MA The author declares no conflict of interest. Correspondence to: Adaugo Amobi, MD, MPH, Blake 15, Massachusetts General Hospital, 55 Fruit Street, Boston 02115, MA 02115. E-mail: [email protected].

Working Out of the Silo of Global Neurosurgery

The field of global surgery has gained attention since the publication of the Lancet Commission landmark report in 2015. The authors estimated that 5 billion people worldwide do not have access to safe, affordable surgical and anesthesia services. The paper “Global Neurosurgery: The Unmet Need,” published in 2016, launched the modern global neurosurgery era by advocating for the system-level thinking and programs required to address limited neurosurgical care in low-resource settings.&#x0D; &#x0D; At present, many individuals, academic institutions, governmental agencies, and nongovernmental organizations (NGOs) are involved in the global neurosurgery movement. These include the Program in Global Surgery and Social Change at Harvard Medical School, Duke Global Neurology and Neurosurgery, Weill Cornell Tanzania Neurosurgery Project, CURE Children’s Hospital of Uganda, and the Virtue Foundation in Mongolia. Nonetheless, as global neurosurgery efforts continue to expand, it is essential to align global neurosurgery activity in order to prevent duplication of effort.&#x0D; &#x0D; In 2019, the World Federation of Neurosurgical Societies (WFNS) established the Global Neurosurgery Committee (GNC) to promote access to safe, affordable, and timely neurosurgical care worldwide. The GNC initially included five primary objectives – Amplify, Align, Advance, Assimilate, and Advocate – with the sixth objective, Communication, added in 2021. In this manuscript, we provide an update on the Align objective team.&#x0D;

Abstract 3029: Barriers to optimal breast cancer screening modalities for high-risk patients in the primary care setting

Abstract Background: Annual screening breast MRIs are endorsed by current breast cancer screening guidelines as an adjunctive screening modality for high-risk patients (defined by more than 20% lifetime risk) in addition to a screening mammogram. Recent studies showed screening breast MRI remained underutilized despite the current recommendations. On the other hand, validated breast cancer risk models for identifying high-risk patients also remained under-recognized among primary care providers. This study aims to identify the potential barriers for primary care providers (PCPs) to using breast cancer risk models and referring high-risk patients to breast MRI for screening. Methods: An anonymous survey was distributed via email to the PCPs and OB/GYN providers in the network of Mount Auburn Hospital, a community teaching hospital affiliated with Harvard Medical School in Cambridge, Massachusetts. The survey included questions regarding breast cancer screening in average-risk and high-risk patients, providers’ understanding of breast cancer risk models, and current referral status of breast MRIs and high-risk/genetic clinics. Results: The survey was sent to 104 providers, and 43 responses were received. When asked about performing breast cancer risk assessments, 58% reported “Always (91-100%)” and 33% said “Often (71-90%)”. For factors to consider when performing risk assessments, most of the providers considered personal medical history (98%), family history (100%), genetic syndrome history (86%), and previous breast biopsy results (90%). When asked about breast cancer risk models, 58% of the providers had not heard of or used one. 33% of the providers have used the Gail model, and 26% have used the Tyrer-Cuzick model. 51% of the providers correctly identified high-risk as lifetime risk &amp;gt;20%. 56% correctly answered annual mammograms with MRI for breast cancer screening for high-risk patients. The majority of the providers (84%) would prefer to refer patients to the high-risk clinic for risk assessment and screening management. For barriers to referring to MRI, the insurance approval process (49%) was reported to be the largest barrier. 72% of the providers prefer not ordering it and defer to the high-risk/genetic clinic for ordering the test. Conclusions: Our survey has shown different barriers to breast cancer screening in high-risk patients in the primary care setting, including knowledge and logistic barriers. Further education for PCPs is needed for correctly identifying high-risk patients, utilizing risk models, and referring high-risk patients for breast MRI screening. Citation Format: Yu Jen Jan, Prudence B. Lam. Barriers to optimal breast cancer screening modalities for high-risk patients in the primary care setting [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3029.

Global research trends on COVID-19 and stroke: A bibliometric analysis.

The pandemic of COVID-19 has had a profound influence on worldwide healthcare systems. Our study aimed to conduct a bibliometric analysis to explore the impact of COVID-19 on stroke and to highlight the major research trends in this field. We searched the original articles and review articles regarding COVID-19 and stroke from the Web of Science collection (WOSCC) database between January 1, 2020 and December 30, 2022. Subsequently, we performed bibliometric analyses and visualization using VOSviewer, Citespace, and Scimago Graphica. A total of 608 original articles or review articles were included. JOURNAL OF STROKE and CEREBROVASCULAR DISEASES published the most studies on this subject (n = 76), while STROKE was the source of the most-cited references (n = 2,393). The United States is the most influential country in this field, with the highest number of publications (n = 223) and citations (n = 5,042). Shadi Yaghi from New York University is the most prolific author in the field, while Harvard Medical School is the most prolific institution. In addition, through keyword analysis and reference co-citation analysis, three major research topics were identified: (i) the impact of COVID-19 on stroke outcomes (including risk factors, clinical characteristics, mortality, stress, depression, comorbidities, etc.); (ii) the management and care of stroke patients during the COVID-19 pandemic (including thrombolysis, thrombectomy, telemedicine, anticoagulation, vaccination, etc.); and (iii) the potential relationship and pathological mechanism between COVID-19 and stroke (including renin-angiotensin system activation, SARS-CoV-2 virus-induced inflammation leading to endothelial impairment, coagulopathy, etc.). Our bibliometric analysis provides a comprehensive overview of the current state of research on COVID-19 and stroke and highlights key areas of focus in the field. Optimizing the treatment of COVID-19-infected stroke patients and elucidating the underlying pathogenic mechanisms of COVID-19 and stroke co-morbidity are key areas of future research that will be beneficial in improving the prognosis of stroke patients during the ongoing COVID-19 epidemic.

A race to the finish line

A race to the finish line

The impact of COVID-19 on online medical education: a knowledge graph analysis based on co-term analysis

BackgroundThis study aims to identify the characteristics and future directions of online medical education in the context of the novel coronavirus outbreak new through visual analytics using CiteSpace and VOSviewer bibliometric methods.MethodFrom Web of Science, we searched for articles published between 2020 and 2022 using the terms online education, medical education and COVID-19, ended up with 2555 eligible papers, and the articles published between 2010 and 2019 using the terms online education, medical education and COVID-19, and we ended up with 4313 eligible papers.ResultsBefore the COVID-19 outbreak, Medical students and care were the most frequent keywords and the most cited author was BRENT THOMA with 18 times. The United States is the country with the greatest involvement and research impact in the field of online medical education. The most cited journal is ACAD MED with 1326 citations. After the COVID-19 outbreak, a surge in the number of research results in related fields, and ANXIETY and four secondary keywords were identified. In addition, the concentration of authors of these publications in the USA and China is a strong indication that local epidemics and communication technologies have influenced the development of online medical education research. Regarding the centrality of research institutions, the most influential co-author network is Harvard Medical School in the United States; and regarding the centrality of references, the most representative journal to which it belongs is VACCINE.ConclusionThis study found that hey information such as keywords, major institutions and authors, and countries differ in the papers before and after the COVID-19 outbreak. The novel coronavirus outbreak had a significant impact on the online education aspect. For non-medical and medical students, the pandemic has led to home isolation, making it difficult to offer face-to-face classes such as laboratory operations. Students have lost urgency and control over the specifics of face-to-face instruction, which has reduced the quality of teaching. Therefore, we should improve our education model according to the actual situation to ensure the quality of teaching while taking into account the physical and psychological health of students.

Pediatric asthma and development of atopy 2023.

aAllergy Unit, Meyer Children's Hospital IRCCS, Florence bDepartment of Health Sciences, University of Florence, Florence, Italy cDivision of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, USA Correspondence to Mattia Giovannini, MD, Allergy Unit, Meyer Children's Hospital IRCCS, Department of Health Sciences, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy. Tel: +39 0555662472; e-mail: [email protected]

Invited Commentary: Hodgkin Lymphoma and Beyond: Breast Cancer Screening in Survivors of Childhood Cancer

HomeRadioGraphicsVol. 43, No. 4 PreviousNext Breast ImagingInvited Commentary: Hodgkin Lymphoma and Beyond: Breast Cancer Screening in Survivors of Childhood CancerSona A. Chikarmane Sona A. Chikarmane Author AffiliationsFrom the Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.Address correspondence to the author (email: [email protected]).Sona A. Chikarmane Published Online:Mar 16 2023https://doi.org/10.1148/rg.220203MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In