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The association between obesity and efficacy of psoriasis therapies: An expert consensus panel
(Elsevier, 2024) Burshtein, Joshua; Armstrong, April; Chow, May; DeBusk, Lauren; Glick, Brad; Gottlieb, Alice B.; Stein Gold, Linda; Korman, Neil J.; Lio, Peter; Merola, Joseph; Rosmarin, David; Rosenberg, Angela; Van Voorhees, Abby; Lebwohl, Mark; Dermatology, School of Medicine
Background
Psoriasis is a chronic inflammatory skin disease often associated with obesity. Psoriasis therapies may be less effective in patients with obese. The purpose of this expert consensus panel is to evaluate the relationship between obesity and efficacy of psoriasis therapies, thereby optimizing patient care.
Methods
A comprehensive literature search was completed on July 19, 2024, using the keywords “psoriasis,” “obesity,” “efficacy,” “treatments,” and “therapies.” A panel of 11 dermatologists with significant expertise in treatment of psoriasis gathered to review the articles and create consensus statements. A modified Delphi process was used to approve each statement and a strength of recommendation was assigned.
Results
The literature search produced 500 articles. A screening of the studies resulted in 22 articles that met criteria. The panel unanimously voted to adopt 10 consensus statements and recommendations, 6 were given a strength of “A,” 2 were given a strength of “B,” and 2 were given a strength of “C.”
Conclusion
Psoriasis and obesity have a strong association. Obesity decreases efficacy of biologics and may decrease efficacy and potentiate side effects of conventional therapies. It also impacts drug survival. Weight control is a vital component of caring for patients with psoriasis and the number of therapeutic options available is rising.
Exceptional Points in a Non-Markovian Anti-Parity-Time Symmetric System
(MDPI, 2023-12) Wilkey, Andrew; Joglekar, Yogesh N.; Vemuri, Gautam; Physics, School of Science
By studying the eigenvalues and eigenvectors of a non-Markovian anti parity-time (APT) symmetric system, we investigate the possibility of exceptional points (EPs) that may arise within it. Our work is motivated by a recently studied APT-symmetric experimental configuration consisting of a pair of time-delay coupled semiconductor lasers (SCLs). In such a system, a single time-delay represents the memory. The time-delayed coupling makes the system’s effective Hamiltonian infinite-dimensional and leads to novel features in the corresponding eigenvalues and eigenvectors. In particular, we demonstrate analytically and numerically that unlike a typical PT-symmetric dimer with zero time-delay, which has one second-order EP, our time-delayed system has parameter regimes that give rise to either one, two, or zero second-order EPs and one third-order EP, and one can select these regimes though a judicious choice of the time-delay and coupling.
Acute Kidney Injury in Patients with Cirrhosis and Chronic Kidney Disease: Results from the HRS-HARMONY Consortium
(Elsevier, 2024) St. Hillien, Shelsea A.; Robinson, Jevon E.; Ouyang, Tianqi; Patidar, Kavish R.; Belcher, Justin M.; Cullaro, Giuseppe; Regner, Kevin R.; Chung, Raymond T.; Ufere, Nneka; Velez, Juan Carlos Q.; Neyra, Javier A.; Asrani, Sumeet K.; Wadei, Hani; Teixeira, J. Pedro; Saly, Danielle L.; Levitsky, Josh; Orman, Eric; Sawinski, Deirdre; Dageforde, Leigh Anne; Allegrietti, Andrew S.; Medicine, School of Medicine
Background & Aims
Chronic kidney disease (CKD) frequency is increasing in patients with cirrhosis and these individuals often experience acute kidney injury (AKI). Direct comparisons of outcomes between AKI-only versus AKI on CKD (AoCKD) among patients with cirrhosis are not well described.
Methods
A total of 2057 patients with cirrhosis and AKI across 11 hospital networks from the HRS-HARMONY consortium were analyzed (70% AKI-only and 30% AoCKD). The primary outcome was unadjusted and adjusted 90-day mortality, with transplant as a competing risk, using Fine and Gray analysis.
Results
Compared with patients with AKI-only, patients with AoCKD had higher median admission creatinine (2.25 [interquartile range, 1.7–3.2] vs 1.83 [1.38–2.58] mg/dL) and peak creatinine (2.79 [2.12–4] vs 2.42 [1.85–3.50] mg/dL) but better liver function parameters (total bilirubin 1.5 [interquartile range, 0.7–3.1] vs 3.4 [1.5–9.3] mg/dL; and international normalized ratio 1.4 [interquartile range, 1.2–1.8] vs 1.7 [1.39–2.2]; P < .001 for all). Patients with AoCKD were more likely to have metabolic dysfunction associated steatotic liver disease cirrhosis (31% vs 17%) and less likely to have alcohol-associated liver disease (26% vs 45%; P < .001 for both). Patients with AKI-only had higher unadjusted mortality (39% vs 30%), rate of intensive care unit admission (52% vs 35%; P < .001 for both), and use of renal-replacement therapy (20% vs 15%; P = .005). After adjusting for age, race, sex, transplant listing status, and Model for End-Stage Liver Disease–Sodium score, AoCKD was associated with a lower 90-day mortality compared with AKI-only (subhazard ratio, 0.72; 95% confidence interval, 0.61–0.87).
Conclusions
In hospitalized patients with AKI and cirrhosis, AoCKD was associated with lower 90-day mortality compared with AKI-only. This may be caused by the impact of worse liver function parameters in the AKI-only group on short-term outcomes. Further study of the complicated interplay between acute and chronic kidney disease in cirrhosis is needed.
Weakening amplification of grassland greening to transpiration fraction of evapotranspiration over the Tibetan Plateau during 2001-2020
(Elsevier, 2023-10) Jin, Zheng; You, Qinglong; Zuo, Zhiyan; Li, Mingcai; Sun, Guodong; Pepin, Nick; Wang, Lixin; Earth and Environmental Sciences, School of Science
Evapotranspiration plays a key role in regulating the water cycle in terrestrial ecosystems. Transpiration fraction to evapotranspiration (TF) characterizes the role of vegetation function in evapotranspiration and is a pivot feature for the interactions between soil, ecosystem, and the atmosphere. Generally, the amount of vegetation has the most direct impact to TF, but the sensitivity of TF to vegetation change is not known, which could be a metric to evaluate the role of greening in land-atmosphere water transportation. To address this key knowledge gap, we used remote sensing observations of leaf area index (LAI) as a proxy for vegetation amount and derived the sensitivity of TF to LAI (θ = ∂TF/∂LAI)) for the grasslands over the Tibetan Plateau (TP). Results showed there is a substantial decline of θ over the TP during 2001–2020, decreasing from over 4% m−2 m2 to below 1.5% m−2 m2. To analyze the drivers of θ, we introduced a diagnosis framework for soil-atmosphere hydraulic stress shifts based on trends in soil moisture and atmospheric vapor pressure deficit. Results implicated the θ decline over the TP is likely not induced by the dry-wet balance shifts by soil and atmosphere, nor by the vegetation's stomal conductance. Instead, we speculate that the θ decline is induced by a marginal damping effect in case the TF rise is approaching to grassland's limit over the TP. Our finding appeals future studies on terrestrial evapotranspiration to consider the role of vegetation in controlling transpiration and emphasize that greening may not lead to higher TF.
Experiences in maintaining high school students’ motivation in a summer research program in virtual environments during the COVID-19 pandemic
(Taylor & Francis, 2024) Wang, Lixin; Nyarko, Samuel Cornelius; Lanning, Matthew; Earth and Environmental Sciences, School of Science
The COVID-19 pandemic has created numerous disruptions for educators and researchers, especially in 2020 and 2021. Critical in-person activities, including research, have been postponed or canceled throughout the academic and professional communities of the world. The Project SEED (Summer Experiences for the Economically Disadvantaged) program for high school students in the Ecohydrology Lab at Indiana University-Purdue University Indianapolis was no exception. The 2020 and 2021 programs, originally scheduled for in person (2 months in the summer) was moved online with a similar time frame. The goals of Project SEED are to provide high school students with the opportunity to explore a career in the sciences and be involved in research at industries and universities. The goals remained the same during the virtual years and we had a total of two students who participated in the program in 2020 and 2021. In this commentary, we outline the experiences of moving the program to a virtual environment, and reflect on the experiences that motivated students’ participation and success in the program with adjusted project designs. According to student reflections and our discussions with the students, changing the research experiences to include data gathering and analysis (data mining) from published literature rather than the usual hands-on experiments, regular online interactions, enhancing student independence, and making mentors easily accessible were effective in fostering students’ participation and success in the program. With these new practices, the educational outcome of the virtual version of the Project SEED program is similar to the pre-pandemic program based on the quality of the final products (i.e., presentations) and students’ reflections. Informed by these experiences, this commentary makes recommendations for developing virtual research environments to assist students in realizing their potential and research goals. The suggested practices have implications for other educational settings (e.g., international programs through virtual environments).