Jackson College

Hypertriglyceridemia (HTG) increases cardiovascular and pancreatitis risk. Antisense oligonucleotide (ASO) therapies like volanesorsen and olezarsen target ApoC-III mRNA to reduce ApoC-III, enhancing lipoprotein lipase activity and lowering triglycerides (TGs). This meta-analysis evaluates the efficacy and safety of these ASOs in severe HTG. A systematic review (PROSPERO: CRD42024577110) was conducted following PRISMA, sourcing studies from PubMed, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov until July 2024. Randomized controlled trials (RCTs) involving severe HTG (≥200 mg/dL) treated with volanesorsen or olezarsen vs. placebo were included. Data were synthesized using a random effects model in RevMan 5.4, and bias was assessed with the Cochrane tool. Of 31 identified articles, 9 RCTs (341 patients treated with ASOs, 209 controls) were included. ASOs significantly reduced TG levels [mean difference (MD): -53.72; 95% confidence interval (CI): -77.04 to -30.40; p<0.00001]. Reductions were also seen in very low-density lipoprotein cholesterol (MD: -55.76; p<0.00001), ApoC-III (MD: -74.78; p<0.00001), and APOB48 (MD: -69.45; p<0.00001). Olezarsen uniquely reduced APOB (MD: -15.60; p<0.00001). Non-high-density lipoprotein cholesterol (HDL-C) decreased (MD: -23.25; p<0.00001), while HDL-C increased (MD: +42.14; p<0.00001). Volanesorsen was linked to higher low-density lipoprotein-cholesterol (MD: +62.74; p=0.004). For safety, local injection reactions, thrombocytopenia, and nausea were more common with volanesorsen. Acute pancreatitis occurred only in the placebo group (relative risk: 0.15; p=0.0004), indicating ASO protection. This meta-analysis confirms that ASOs effectively lower TGs and improve lipid profiles in severe HTG.

A diagnosis of breast carcinoma or atypia is stressful and often life-altering for patients. Institutional goals for all cancer centers include rapid access to oncology care and optimal patient experience. Collaboration among doctorally prepared advanced practice clinicians (APCs) may contribute to enhanced clinical operations and affect patient satisfaction. The objective was to decrease time between breast biopsy and initial clinician visit by implementing an expedited APC-led visit within days of diagnosis. PhD- and DNP-prepared leaders designed a pilot project in response to delays in scheduling new patient appointments, which was implemented from September 2024 to February 2025. Patients were scheduled with breast oncology APCs prior to seeing oncology surgeons. Patient access metrics highlighted earlier appointment availability with increased uptake in APC visits, breast magnetic resonance imaging, and genetic services. Monthly patient satisfaction scores improved, and qualitative patient feedback noted reduced anxiety as well as gratitude for immediate access to care and navigation.

IgG4-related disease (IgG4-RD) is a subacute, progressive, multisystemic autoinflammatory condition which presents with nonspecific symptoms like weight loss, fatigue and myalgia, and is marked by lymphoplasmacytic infiltrates rich in IgG4-positive plasma cells. IgG4-RD can involve various organs including the pancreas, bile ducts, thyroid, salivary and lacrimal glands, retroperitoneum, kidneys, lungs and CNS, often mimicking malignancy. A rigorous literature review was conducted. Articles on IgG4 disease, CD-19 and the MITIGATE trials were studied and included in the review. Glucocorticoids remain first-line therapy, but adverse effects and relapses are common. Rituximab, an anti-CD20 agent, is effective but may leave CD20-negative plasmablasts intact, contributing to relapse. In contrast, CD19-targeting therapies like inebilizumab offer more comprehensive B-cell depletion, including plasmablasts, potentially reducing relapses, fibrosis progression and long-term organ damage. MITIGATE trials showed promise in the use of an anti-CD-19 agent in preventing IgG4 disease flares and prolonging the time to first flare.

Abstract Swimmer’s itch (SI) is a dermatitis in humans caused by cercariae of avian and mammalian schistosomes which emerge from infected snails on a daily basis. Mitigation methods for SI have long been sought with little success. Copper sulfate application to the water to kill the snail hosts is the historically employed method, but is localized, temporary, and harmful to many aquatic species. Here, we test an alternative method to controlTrichobilharzia stagnicolae, a species well-known to cause SI in northern Michigan and elsewhere in North America. Summer relocation of broods of the only known vertebrate host, common merganser (Mergus merganser),greatly reduced snail infection prevalence the following year on two large, geographically separated lakes in northern Michigan. Subsequent years of host relocation achieved and maintained snail infection prevalence at ∼0.05%, more than an order of magnitude lower than pre-intervention. A Before – After – Control – Intervention (BACI) study design using multiple-year snail infection data from two intervention lakes and three control lakes demonstrates that substantial lake-wide reduction of an avian schistosome can be achieved and is not due to natural fluctuations in the parasite populations. The relevance of reducing snail infection prevalence is demonstrated by a large seven-year data set of SI incidence in swimmers at a high-use beach, which showed a remarkable reduction in SI cases in two successive years after relocation began. In addition, data from another Michigan lake where vertebrate-host based intervention occurred in the 1980’s is analyzed statistically and shows a remarkably similar pattern of reduction in snail infection prevalence. Together, these results demonstrate a highly effective SI mitigation strategy that avoids the use of environmentally suspect chemicals and removes incentive for lethal host removal. Biologically, the results strongly suggest thatT. stagnicolaeis reliant on the yearly hatch of ducklings to maintain populations at high levels on a lake and that the role of migratory hosts in the spring and fall is much less significant.

A hook can be a summons, like the attention-getting start of a musical note against the background of the world’s static. The summons implies a gathering of listeners and thus sets up our conversation about hooks. It may be coercive like the first raw guitar notes of the Beatles’ “Revolution” (fast version) or suspenseful like the polytonal opening chord of “A Hard Day’s Night.” Further, a hook appeals with a proposal for a way of living—in a song, even before words are heard, a tempo and a key and a band, or a way of handling a melodic figure. You latch onto this proposal. In comparison with most pieces of popular music, films need much more time to captivate their audience (as in the intricately developed first shot of Touch of Evil, as long as a song), while at the other extreme the opening of a literary work (“‘Twas brillig”) is typically more fateful for the whole experience of the work since you as a reader are required right away to subject yourself mentally to the writer’s construal of everything in a world.

Songs tackle the problem of American peoplehood by mobilizing the pronouns “you” (“The Star-Spangled Banner”), “you and me” (“This Land Is Your Land”), “everybody” (“For What It’s Worth,” Buffalo Springfield), and “somebody” (“Tell Somebody,” Rickie Lee Jones). “Land of 1,000 Dances” (Chris Kenner, Wilson Pickett) proclaims a liberal society of 1,000 lifestyles. The utopian creative freedom of Jimi Hendrix’s improvisation on “The Star-Spangled Banner” at Woodstock contrasts with the violent vision of “This Is America” by the dysfunctional-acting Childish Gambino. The people is bound together by geographic place naming in “Living In America” (James Brown) and more regionally in “The U.S.S. Zydecoldsmobile” (Sonny Landreth); by history in the sad reminiscence of “The Night They Drove Old Dixie Down” (The Band); and by religious hope in the imagery of “Save The Country” (Laura Nyro). We find pictorial people hooks in Delacroix’s Liberty Leading the People and the problematizing of the American flag by Jasper Johns and Faith Ringgold; a cinematic formation of peoplehood in key scenes of Eisenstein’s Battleship Potemkin and Riefenstahl’s Triumph of the Will; and a long-running literary power of the biblical “children of Abraham” hook and its inversion in Walt Whitman’s prophet-like personal assumption of American experience.

Sleep-disordered breathing (SDB), characterized by specific underlying physiological mechanisms, comprises obstructive and central pathophysiology, affects nearly 1 billion individuals worldwide, and is associated with excessive cardiopulmonary morbidity. Strong evidence implicates SDB in cardiac arrhythmogenesis. Immediate consequences of SDB include autonomic nervous system fluctuations, recurrent hypoxia, alterations in carbon dioxide/acid-base status, disrupted sleep architecture, and accompanying increases in negative intrathoracic pressures directly affecting cardiac function. Day-night patterning and circadian biology of SDB-induced pathophysiological sequelae collectively influence the structural and electrophysiological cardiac substrate, thereby creating an ideal milieu for arrhythmogenic propensity. Cohort studies support strong associations of SDB and cardiac arrhythmia, with evidence that discrete respiratory events trigger atrial and ventricular arrhythmic events. Observational studies suggest that SDB treatment reduces atrial fibrillation recurrence after rhythm control interventions. However, high-level evidence from clinical trials that supports a role for SDB intervention on rhythm control is not available. The goals of this scientific statement are to increase knowledge and awareness of the existing science relating SDB to cardiac arrhythmias (atrial fibrillation, ventricular tachyarrhythmias, sudden cardiac death, and bradyarrhythmias), synthesizing data relevant for clinical practice and identifying current knowledge gaps, presenting best practice consensus statements, and prioritizing future scientific directions. Key opportunities identified that are specific to cardiac arrhythmia include optimizing SDB screening, characterizing SDB predictive metrics and underlying pathophysiology, elucidating sex-specific and background-related influences in SDB, assessing the role of mobile health innovations, and prioritizing the conduct of rigorous and adequately powered clinical trials.