Med (New York, N.y.)最新文献

{"title":"Patient-centered trials in oncology: Time for a change.","authors":"Daniel V Araujo,&nbsp;Joao A Soler,&nbsp;Vladmir C Cordeiro de Lima","doi":"10.1016/j.medj.2022.06.007","DOIUrl":"https://doi.org/10.1016/j.medj.2022.06.007","url":null,"abstract":"<p><p>Patient-centered trials are pivotal to advancing the oncology field efficiently. However, in recent years, there has been a shift away from patient-centered approaches. In this commentary, we describe common non-patient-centric practices of contemporary trials, discuss their implications, and propose potential solutions to relocate patients to the center of trials where they belong.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"445-449"},"PeriodicalIF":17.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40601687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum ceramides could predict durable diabetes remission following gastric bypass surgery.","authors":"Eric Hajduch,&nbsp;Hervé Le Stunff","doi":"10.1016/j.medj.2022.06.005","DOIUrl":"https://doi.org/10.1016/j.medj.2022.06.005","url":null,"abstract":"<p><p>Morbid obesity is a major risk factor for the development of type 2 diabetes (T2D). One strategy to both lose weight and counteract T2D is bariatric surgery (RYGB). In a study published in this issue of Med, Poss et al. revealed that circulating ceramides could predict the durability of T2D remission independently of weight loss following RYGB.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"440-441"},"PeriodicalIF":17.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40578224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-day perfusion of transplant organs: The how and the why.","authors":"Alexander Sagar,&nbsp;Peter Friend","doi":"10.1016/j.medj.2022.06.008","DOIUrl":"https://doi.org/10.1016/j.medj.2022.06.008","url":null,"abstract":"<p><p>In a recent paper, Clavien et al. demonstrate the successful transplant of a sub-optimal donor liver using multi-day normothermic machine perfusion. This technological milestone opens up exciting new avenues for liver transplantation with the potential to ameliorate donor organ shortages and permit targeted therapeutic interventions.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"442-444"},"PeriodicalIF":17.0,"publicationDate":"2022-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40578225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal sampling sheds light on SARS-CoV-2 fecal shedding dynamics","authors":"M. Coryell, P. Carlson","doi":"10.1016/j.medj.2022.05.015","DOIUrl":"https://doi.org/10.1016/j.medj.2022.05.015","url":null,"abstract":"","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122346979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity of convalescent and vaccinated sera against clinical isolates of ancestral SARS-CoV-2, Beta, Delta, and Omicron variants","authors":"A. Banerjee, Jocelyne M. Lew, A. Kroeker, Kaushal Baid, P. Aftanas, K. Nirmalarajah, F. Maguire, R. Kozak, R. McDonald, A. Lang, V. Gerdts, S. Straus, L. Gilbert, A. Li, Mohammad Mozafarihasjin, S. Walmsley, A. Gingras, J. Wrana, T. Mazzulli, K. Colwill, A. McGeer, S. Mubareka, D. Falzarano","doi":"10.1016/j.medj.2022.04.002","DOIUrl":"https://doi.org/10.1016/j.medj.2022.04.002","url":null,"abstract":"","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129975597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A monocyte/dendritic cell molecular signature of SARS-CoV-2-related multisystem inflammatory syndrome in children with severe myocarditis.","authors":"Camille de Cevins,&nbsp;Marine Luka,&nbsp;Nikaïa Smith,&nbsp;Sonia Meynier,&nbsp;Aude Magérus,&nbsp;Francesco Carbone,&nbsp;Víctor García-Paredes,&nbsp;Laura Barnabei,&nbsp;Maxime Batignes,&nbsp;Alexandre Boullé,&nbsp;Marie-Claude Stolzenberg,&nbsp;Brieuc P Pérot,&nbsp;Bruno Charbit,&nbsp;Tinhinane Fali,&nbsp;Vithura Pirabakaran,&nbsp;Boris Sorin,&nbsp;Quentin Riller,&nbsp;Ghaith Abdessalem,&nbsp;Maxime Beretta,&nbsp;Ludivine Grzelak,&nbsp;Pedro Goncalves,&nbsp;James P Di Santo,&nbsp;Hugo Mouquet,&nbsp;Olivier Schwartz,&nbsp;Mohammed Zarhrate,&nbsp;Mélanie Parisot,&nbsp;Christine Bole-Feysot,&nbsp;Cécile Masson,&nbsp;Nicolas Cagnard,&nbsp;Aurélien Corneau,&nbsp;Camille Brunaud,&nbsp;Shen-Ying Zhang,&nbsp;Jean-Laurent Casanova,&nbsp;Brigitte Bader-Meunier,&nbsp;Julien Haroche,&nbsp;Isabelle Melki,&nbsp;Mathie Lorrot,&nbsp;Mehdi Oualha,&nbsp;Florence Moulin,&nbsp;Damien Bonnet,&nbsp;Zahra Belhadjer,&nbsp;Marianne Leruez,&nbsp;Slimane Allali,&nbsp;Christèle Gras-Leguen,&nbsp;Loïc de Pontual,&nbsp;Alain Fischer,&nbsp;Darragh Duffy,&nbsp;Fredéric Rieux-Laucat,&nbsp;Julie Toubiana,&nbsp;Mickaël M Ménager","doi":"10.1016/j.medj.2021.08.002","DOIUrl":"https://doi.org/10.1016/j.medj.2021.08.002","url":null,"abstract":"<p><strong>Background: </strong>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is generally milder than in adults, but a proportion of cases result in hyperinflammatory conditions often including myocarditis.</p><p><strong>Methods: </strong>To better understand these cases, we applied a multiparametric approach to the study of blood cells of 56 children hospitalized with suspicion of SARS-CoV-2 infection. Plasma cytokine and chemokine levels and blood cellular composition were measured, alongside gene expression at the bulk and single-cell levels.</p><p><strong>Findings: </strong>The most severe forms of multisystem inflammatory syndrome in children (MIS-C) related to SARS-CoV-2 that resulted in myocarditis were characterized by elevated levels of pro-angiogenesis cytokines and several chemokines. Single-cell transcriptomics analyses identified a unique monocyte/dendritic cell gene signature that correlated with the occurrence of severe myocarditis characterized by sustained nuclear factor κB (NF-κB) activity and tumor necrosis factor alpha (TNF-α) signaling and associated with decreased gene expression of NF-κB inhibitors. We also found a weak response to type I and type II interferons, hyperinflammation, and response to oxidative stress related to increased HIF-1α and Vascular endothelial growth factor (VEGF) signaling.</p><p><strong>Conclusions: </strong>These results provide potential for a better understanding of disease pathophysiology.</p><p><strong>Funding: </strong>Agence National de la Recherche (Institut Hospitalo-Universitaire Imagine, grant ANR-10-IAHU-01; Recherche Hospitalo-Universitaire, grant ANR-18-RHUS-0010; Laboratoire d'Excellence ''Milieu Intérieur,\" grant ANR-10-LABX-69-01; ANR-flash Covid19 \"AIROCovid\" and \"CoVarImm\"), Institut National de la Santé et de la Recherche Médicale (INSERM), and the \"URGENCE COVID-19\" fundraising campaign of Institut Pasteur.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"1072-1092.e7"},"PeriodicalIF":17.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39328550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex species and strain ecology of the vaginal microbiome from pregnancy to postpartum and association with preterm birth.","authors":"Ryan M Pace,&nbsp;Derrick M Chu,&nbsp;Amanda L Prince,&nbsp;Jun Ma,&nbsp;Maxim D Seferovic,&nbsp;Kjersti M Aagaard","doi":"10.1016/j.medj.2021.06.001","DOIUrl":"https://doi.org/10.1016/j.medj.2021.06.001","url":null,"abstract":"<p><strong>Background: </strong><i>Lactobacillus</i> was described as a keystone bacterial taxon in the human vagina over 100 years ago. Using metagenomics, we and others have characterized lactobacilli and other vaginal taxa across health and disease states, including pregnancy. While shifts in community membership have been resolved at the genus/species level, strain dynamics remain poorly characterized.</p><p><strong>Methods: </strong>We performed a metagenomic analysis of the complex ecology of the vaginal econiche during and after pregnancy in a large U.S. based longitudinal cohort of women who were initially sampled in the third trimester of pregnancy, then validated key findings in a second cohort of women initially sampled in the second trimester of pregnancy.</p><p><strong>Findings: </strong>First, we resolved microbial species and strains, interrogated their co-occurrence patterns, and probed the relationship between keystone species and preterm birth outcomes. Second, to determine the role of human heredity in shaping vaginal microbial ecology in relation to preterm birth, we performed a mtDNA-bacterial species association analysis. Finally, we explored the clinical utility of metagenomics in detection and co-occurrence patterns for the pathobiont Group B <i>Streptococcus</i> (causative bacterium of invasive neonatal sepsis).</p><p><strong>Conclusions: </strong>Our highly refined resolutions of the vaginal ecology during and post-pregnancy provide insights into not only structural and functional community dynamics, but highlight the capacity of metagenomics to reveal finer aspects of the vaginal microbial ecologic framework.</p><p><strong>Funding: </strong>NIH-NINR R01NR014792, NIH-NICHD R01HD091731, NIH National Children's Study Formative Research, Burroughs Wellcome Fund Preterm Birth Initiative, March of Dimes Preterm Birth Research Initiative, NIH-NIGMS (K12GM084897, T32GM007330, T32GM088129).</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"1027-1049"},"PeriodicalIF":17.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39492446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breathing more breadth into COVID-19 T cell responses.","authors":"David A Bejarano,&nbsp;Andreas Schlitzer","doi":"10.1016/j.medj.2021.08.009","DOIUrl":"https://doi.org/10.1016/j.medj.2021.08.009","url":null,"abstract":"<p><p>Innate and adaptive heterologous immunity confers resistance to pathogens. However, its impact on resistance and the course of human infection have remained largely elusive, hampering the use of this phenomenon to enhance vaccine efficacy. In this issue of <i>Med</i>, Mysore et al. show that T cell responses elicited by SARS-CoV-2 infection or vaccination correlate with those induced by MMR and Tdap immunization, revealing the transcriptomic basis of these correlations and find that heterologous adaptive immunity contributes to a better prognosis of COVID-19 disease.¹.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"999-1001"},"PeriodicalIF":17.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.08.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39417195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forecasting cancer: from precision to predictive medicine.","authors":"Elana J Fertig,&nbsp;Elizabeth M Jaffee,&nbsp;Paul Macklin,&nbsp;Vered Stearns,&nbsp;Chenguang Wang","doi":"10.1016/j.medj.2021.08.007","DOIUrl":"https://doi.org/10.1016/j.medj.2021.08.007","url":null,"abstract":"<p><p>Tumor evolution drives tumor progression, therapeutic resistance, and metastasis. Therefore, new predictive medicine strategies that adapt with a tumor are needed to improve patient outcomes. The techniques used in weather prediction are mathematically proven to enable prediction of evolving systems, and thus provide a framework for a new predictive medicine paradigm for cancer.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"1004-1010"},"PeriodicalIF":17.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.08.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40325591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FDA-authorized mRNA COVID-19 vaccines are effective per real-world evidence synthesized across a multi-state health system.","authors":"Colin Pawlowski,&nbsp;Patrick Lenehan,&nbsp;Arjun Puranik,&nbsp;Vineet Agarwal,&nbsp;A J Venkatakrishnan,&nbsp;Michiel J M Niesen,&nbsp;John C O'Horo,&nbsp;Abinash Virk,&nbsp;Melanie D Swift,&nbsp;Andrew D Badley,&nbsp;John Halamka,&nbsp;Venky Soundararajan","doi":"10.1016/j.medj.2021.06.007","DOIUrl":"https://doi.org/10.1016/j.medj.2021.06.007","url":null,"abstract":"<p><strong>Background: </strong>Two US Food and Drug Administration (FDA)-authorized coronavirus disease 2019 (COVID-19) mRNA vaccines, BNT162b2 (Pfizer/BioNTech) and mRNA-1273 (Moderna), have demonstrated high efficacy in large phase 3 randomized clinical trials. It is important to assess their effectiveness in a real-world setting.</p><p><strong>Methods: </strong>This is a retrospective analysis of 136,532 individuals in the Mayo Clinic health system (Arizona, Florida, Iowa, Minnesota, and Wisconsin) with PCR testing data between December 1, 2020 and April 20, 2021. We compared clinical outcomes for a vaccinated cohort of 68,266 individuals who received at least one dose of either vaccine (n_BNT162b2 = 51,795; n_mRNA-1273 = 16,471) and an unvaccinated control cohort of 68,266 individuals propensity matched based on relevant demographic, clinical, and geographic features. We estimated real-world vaccine effectiveness by comparing incidence rates of positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR testing and COVID-19-associated hospitalization and intensive care unit (ICU) admission starting 7 days after the second vaccine dose.</p><p><strong>Findings: </strong>The real-world vaccine effectiveness of preventing SARS-CoV-2 infection was 86.1% (95% confidence interval [CI]: 82.4%-89.1%) for BNT162b2 and 93.3% (95% CI: 85.7%-97.4%) for mRNA-1273. BNT162b2 and mRNA-1273 were 88.8% (95% CI: 75.5%-95.7%) and 86.0% (95% CI: 71.6%-93.9%) effective in preventing COVID-19-associated hospitalization. Both vaccines were 100% effective (95% CI_BNT162b2: 51.4%-100%; 95% CI_mRNA-1273: 43.3%-100%) in preventing COVID-19-associated ICU admission.</p><p><strong>Conclusions: </strong>BNT162b2 and mRNA-1273 are effective in a real-world setting and are associated with reduced rates of SARS-CoV-2 infection and decreased burden of COVID-19 on the healthcare system.</p><p><strong>Funding: </strong>This study was funded by nference.</p>","PeriodicalId":272244,"journal":{"name":"Med (New York, N.y.)","volume":" ","pages":"979-992.e8"},"PeriodicalIF":17.0,"publicationDate":"2021-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.medj.2021.06.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39150767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}