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  • 1
    In: Iproceedings, JMIR Publications Inc., Vol. 4, No. 2 ( 2018-09-17), p. e11881-
    Type of Medium: Online Resource
    ISSN: 2369-6893
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2018
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  • 2
    Online Resource
    Online Resource
    JMIR Publications Inc. ; 2019
    In:  Iproceedings Vol. 5, No. 1 ( 2019-10-2), p. e15203-
    In: Iproceedings, JMIR Publications Inc., Vol. 5, No. 1 ( 2019-10-2), p. e15203-
    Abstract: Wellness devices for health tracking have gained popularity in recent years. Additionally, portable and readily accessible wellness devices have several advantages when compared to traditional medical devices found in clinical environments. Building tools for patients to manage their health independently may benefit their health in the long run by improving health care providers’ (HCPs) awareness of their patients’ health information outside of the clinic. Increased access to portable wellness devices that track vital signs may increase how patients and HCPs track and monitor chronic conditions which can improve health outcomes. The VitalWellness is a portable wellness device that can potentially aid vital sign measuring for those interested in tracking their health. Objective In this diagnostic accuracy study, we evaluated the clinical performance of the VitalWellness, a wireless, compact, non-invasive device that measures four vital signs using the index finger and forehead against reference vital signs devices used in the hospital setting. Methods Volunteers age ≥18 years were enrolled to provide blood pressure (BP), heart rate (HR), respiratory rate (RR), and body temperature. We recruited volunteers with vital signs that fell within and outside of the normal physiological range, depending on the measurements they consented to undergo. A subgroup of eligible volunteers were asked to undergo an exercise test, aerobic step test and/or a paced breathing test to analyze the VitalWellness device's performance on vital signs outside of the normal physiological ranges for HR and RR. Vital signs measurements were collected with the VitalWellness device and FDA-approved reference devices. Mean, standard deviation, mean difference, standard deviation of difference, standard error of mean difference, and correlation coefficients were calculated for measurements collected; these measurements were plotted on a scatter plot and a Bland-Altman plot. Sensitivity analyses were performed to evaluate the performance of the VitalWellness device by gender, skin color, finger size, and in the presence of artifacts. Results We enrolled 265 volunteers in the study and 2 withdrew before study completion. The majority of volunteers were female (62%), predominately white (63%), graduated from college or post college (67%), and employed (59%). There was a moderately strong linear relationship between VitalWellness BP and reference BP (r=0.7, P 〈 .05) and bewteen VitalWellness RR and reference RR measurements (r=0.7, P 〈 .05). The VitalWellness HR readings were significantly in line with the reference HR readings (r=0.9, P 〈 .05). There was a weaker linear relationship between VitalWellness temperature and reference temperature (r=0.3, P 〈 .05). There were no differences in performance of the VitalWellness device by gender, skin color or in the presence of artifacts. Finger size was associated with differential performance for RR. Conclusions Overall, the VitalWellness device performed well in taking BP, HR and RR when compared to FDA-approved reference devices and has potential serve as a wellness device. To test adaptability and acceptability, future research may evaluate user’s interactions and experiences with the VitalWellness device at home. In addition, the next phase of the study will evaluate transmitting vital sign information from the VitalWellness device to an online secured database where information can be shared with HCPs within seconds of measurement.
    Type of Medium: Online Resource
    ISSN: 2369-6893
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2019
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  • 3
    In: JMIR Medical Informatics, JMIR Publications Inc., Vol. 7, No. 2 ( 2019-04-26), p. e10020-
    Type of Medium: Online Resource
    ISSN: 2291-9694
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2019
    detail.hit.zdb_id: 2798261-0
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  • 4
    In: Molecular Cancer Research, American Association for Cancer Research (AACR), Vol. 15, No. 6 ( 2017-06-01), p. 753-764
    Abstract: Tyro3, Axl, and Mertk (collectively TAM receptors) are three homologous receptor tyrosine kinases that bind vitamin K–dependent endogenous ligands, Protein S (ProS), and growth arrest–specific factor 6 (Gas6), and act as bridging molecules to promote phosphatidylserine (PS)-mediated clearance of apoptotic cells (efferocytosis). TAM receptors are overexpressed in a vast array of tumor types, whereby the level of expression correlates with the tumor grade and the emergence of chemo- and radioresistance to targeted therapeutics, but also have been implicated as inhibitory receptors on infiltrating myeloid-derived cells in the tumor microenvironment that can suppress host antitumor immunity. In the present study, we utilized TAM-IFNγR1 reporter lines and expressed TAM receptors in a variety of epithelial cell model systems to show that each TAM receptor has a unique pattern of activation by Gas6 or ProS, as well as unique dependency for PS on apoptotic cells and PS liposomes for activity. In addition, we leveraged this system to engineer epithelial cells that express wild-type TAM receptors and show that although each receptor can promote PS-mediated efferocytosis, AKT-mediated chemoresistance, as well as upregulate the immune checkpoint molecule PD-L1 on tumor cells, Mertk is most dominant in the aforementioned pathways. Functionally, TAM receptor–mediated efferocytosis could be partially blocked by PS-targeting antibody 11.31 and Annexin V, demonstrating the existence of a PS/PS receptor (i.e., TAM receptor)/PD-L1 axis that operates in epithelial cells to foster immune escape. These data provide a rationale that PS-targeting, anti–TAM receptor, and anti–PD-L1-based therapeutics will have merit as combinatorial checkpoint inhibitors. Implications: Many tumor cells are known to upregulate the immune checkpoint inhibitor PD-L1. This study demonstrates a role for PS and TAM receptors in the regulation of PD-L1 on cancer cells. Mol Cancer Res; 15(6); 753–64. ©2017 AACR.
    Type of Medium: Online Resource
    ISSN: 1541-7786 , 1557-3125
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
    detail.hit.zdb_id: 2097884-4
    SSG: 12
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  • 5
    In: Cells, MDPI AG, Vol. 9, No. 10 ( 2020-09-29), p. 2207-
    Abstract: The physiological fate of cells that die by apoptosis is their prompt and efficient removal by efferocytosis. During these processes, apoptotic cells release intracellular constituents that include purine nucleotides, lysophosphatidylcholine (LPC), and Sphingosine-1-phosphate (S1P) that induce migration and chemo-attraction of phagocytes as well as mitogens and extracellular membrane-bound vesicles that contribute to apoptosis-induced compensatory proliferation and alteration of the extracellular matrix and the vascular network. Additionally, during efferocytosis, phagocytic cells produce a number of anti-inflammatory and resolving factors, and, together with apoptotic cells, efferocytic events have a homeostatic function that regulates tissue repair. These homeostatic functions are dysregulated in cancers, where, aforementioned events, if not properly controlled, can lead to cancer progression and immune escape. Here, we summarize evidence that apoptosis and efferocytosis are exploited in cancer, as well as discuss current translation and clinical efforts to harness signals from dying cells into therapeutic strategies.
    Type of Medium: Online Resource
    ISSN: 2073-4409
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2661518-6
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  • 6
    Online Resource
    Online Resource
    JMIR Publications Inc. ; 2019
    In:  Iproceedings Vol. 5, No. 1 ( 2019-10-2), p. e16250-
    In: Iproceedings, JMIR Publications Inc., Vol. 5, No. 1 ( 2019-10-2), p. e16250-
    Abstract: Wellness devices for health tracking have gained popularity in recent years. Additionally, portable and readily accessible wellness devices have several advantages when compared to traditional medical devices found in clinical environments The VitalWellness device is a portable wellness device that can potentially aide vital sign measuring for those interested in tracking their health. Objective In this diagnostic accuracy study, we evaluated the performance of the VitalWellness device, a wireless, compact, non-invasive device that measures four vital signs (blood pressure (BP), heart rate (HR), respiratory rate (RR), and body temperature using the index finger and forehead. Methods Volunteers age ≥18 years were enrolled to provide blood pressure (BP), heart rate (HR), respiratory rate (RR), and body temperature. We recruited participants with vital signs that fell within and outside of the normal physiological range. A sub-group of eligible participants were asked to undergo an exercise test, aerobic step test and/or a paced breathing test to analyze the VitalWellness device’s performance on vital signs outside of the normal physiological ranges for HR and RR. Vital signs measurements were collected with the VitalWellness device and FDA-approved reference devices. Mean, standard deviation, mean difference, standard deviation of difference, standard error of mean difference, and correlation coefficients were calculated for measurements collected; these measurements were plotted on a scatter plot and a Bland-Altman plot. Sensitivity analyses were performed to evaluate the performance of the VitalWellness device by gender, skin color, finger size, and in the presence of artifacts. Results 265 volunteers enrolled in the study and 2 withdrew before study completion. Majority of the volunteers were female (62%), predominately white (63%), graduated from college or post college (67%), and employed (59%). There was a moderately strong linear relationship between VitalWellness BP and reference BP (r=0.7, P 〈 .05) and VitalWellness RR and reference RR measurements (r=0.7, P 〈 .05). The VitalWellness HR readings were significantly in line with the reference HR readings (r=0.9, P 〈 .05). There was a weaker linear relationship between VitalWellness temperature and reference temperature (r=0.3, P 〈 .05). There were no differences in performance of the VitalWellness device by gender, skin color or in the presence of artifacts. Finger size was associated with differential performance for RR. Conclusions Overall, the VitalWellness device performed well in taking BP, HR, and RR when compared to FDA-approved reference devices and has potential serve as a wellness device. To test adaptability and acceptability, future research may evaluate user’s interactions and experiences with the VitalWellness device at home. In addition, the next phase of the study will evaluate transmitting vital sign information from the VitalWellness device to an online secured database where information can be shared with HCPs within seconds of measurement.
    Type of Medium: Online Resource
    ISSN: 2369-6893
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2019
    Location Call Number Limitation Availability
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  • 7
    In: Iproceedings, JMIR Publications Inc., Vol. 5, No. 1 ( 2019-10-2), p. e16298-
    Abstract: Type 2 diabetes (T2D) is the seventh leading cause of death (2017) in the United States, and by 2030 it is estimated that it will affect 439 million globally. Effective glycemic control can be challenging for patients. A tool to guide patients’ in their self-management behaviors and share this data with their physician may improve insulin adherence leading to lower HbA1c. We examined an integrated diabetes management (IDM) system that utilizes a Bluetooth-enabled insulin event capture device, a Bluetooth-enabled glucometer, and an Android smartphone app. IDM data can be viewed by clinicians in the electronic medical record (EMR). Objective The primary aim of this study is to describe how app use is related to insulin adherence, blood glucose measurements, meal snapshots, and step count. Secondarily, we assessed the impact on HbA1c levels over a 3- and 6-month period. Methods Thirty-five participants were enrolled from Boston-area hospitals in this single-arm pilot study. Use of the IDM system was defined as the number of days per week participants logged into the app and moved past the home screen. Three app use groups were created: low app use (0.33-2.46 days per week), medium app use (2.54-5.08 days per week), and high app use ( 〉 5.4 days per week). Adherence to insulin, blood glucose measurements, and meal snapshots were defined as a ratio of actual weekly events recorded by participants’ app use divided by their physician’s recommendation. Step count was defined as the total weekly steps for each participant. Daily app-generated data on app use and indicators of diabetes management were collected. HbA1c levels were assessed via blood test at enrollment, 3-months, and 6-months. Using a hierarchical linear mixed model, we examined changes in outcome measures while accounting for random intercepts and slopes to control for variation in individual outcomes over the study. Results Overall app use (average unique days using the app per week) declined from 6.19 days to 3.00 days (at 1 and 24 weeks, respectively). Participants with high app use had significant improvement in bolus and basal insulin adherence per week (0.009 P=.041 [95% CI 0.0004 to 0.018] and 0.016 P 〈 .001 [95% CI 0.0079 to 0.023], respectively), but participants had no significant improvements in blood glucose and meal snapshot adherence or absolute step count. HbA1c significantly decreased per week (coefficient –0.025 [95% CI –0.044 to –0.007] , P=.007) with an overall change of 0.6. Participants with high app use significantly improved their HbA1c per week (–0.037 P=.016 [–0.066 to –0.0067]) compared to participants with medium and low app use, yielding a total improvement of 0.88 over 24 weeks. Conclusions Results show that bolus and basal insulin may have increased with higher app use. HbA1c significantly improved over the course of the study, along with significantly greater improvement in HbA1c among participants with higher app use compared to participants in the middle or low app use groups. This study is not designed or intended to evaluate efficacy but provides results to guide the future design and development of this prototype IDM system.
    Type of Medium: Online Resource
    ISSN: 2369-6893
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2019
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  • 8
    In: Digital Medicine, Medknow, Vol. 5, No. 3 ( 2019), p. 109-
    Type of Medium: Online Resource
    ISSN: 2226-8561
    Language: English
    Publisher: Medknow
    Publication Date: 2019
    detail.hit.zdb_id: 2987761-1
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