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  1. Article ; Online: Proteasome-Associated Syndromes: Updates on Genetics, Clinical Manifestations, Pathogenesis, and Treatment.

    Zhang, Jiahui / Tao, Panfeng / Deuitch, Natalie T / Yu, Xiaomin / Askentijevich, Ivona / Zhou, Qing

    Journal of clinical immunology

    2024  Volume 44, Issue 4, Page(s) 88

    Abstract: The ubiquitin-proteasome system (UPS) has a critical role in post-translational protein modification that is essential for the maintenance of all cellular functions, including immune responses. The proteasome complex is ubiquitously expressed and is ... ...

    Abstract The ubiquitin-proteasome system (UPS) has a critical role in post-translational protein modification that is essential for the maintenance of all cellular functions, including immune responses. The proteasome complex is ubiquitously expressed and is responsible for degradation of short-lived structurally abnormal, misfolded and not-needed proteins that are targeted for degradation via ubiquitin conjugation. Over the last 14 years, an increasing number of human diseases have been linked to pathogenic variants in proteasome subunits and UPS regulators. Defects of the proteasome complex or its chaperons - which have a regulatory role in the assembly of the proteasome - disrupt protein clearance and cellular homeostasis, leading to immune dysregulation, severe inflammation, and neurodevelopmental disorders in humans. Proteasome-associated diseases have complex inheritance, including monogenic, digenic and oligogenic disorders and can be dominantly or recessively inherited. In this review, we summarize the current known genetic causes of proteasomal disease, and discuss the molecular pathogenesis of these conditions based on the function and cellular expression of mutated proteins in the proteasome complex.
    MeSH term(s) Humans ; Proteasome Endopeptidase Complex/genetics ; Proteasome Endopeptidase Complex/metabolism ; Syndrome ; Ubiquitin/metabolism
    Chemical Substances Proteasome Endopeptidase Complex (EC 3.4.25.1) ; Ubiquitin
    Language English
    Publishing date 2024-04-05
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 779361-3
    ISSN 1573-2592 ; 0271-9142
    ISSN (online) 1573-2592
    ISSN 0271-9142
    DOI 10.1007/s10875-024-01692-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A framework to identify ethical concerns with ML-guided care workflows: a case study of mortality prediction to guide advance care planning.

    Cagliero, Diana / Deuitch, Natalie / Shah, Nigam / Feudtner, Chris / Char, Danton

    Journal of the American Medical Informatics Association : JAMIA

    2023  Volume 30, Issue 5, Page(s) 819–827

    Abstract: Objective: Identifying ethical concerns with ML applications to healthcare (ML-HCA) before problems arise is now a stated goal of ML design oversight groups and regulatory agencies. Lack of accepted standard methodology for ethical analysis, however, ... ...

    Abstract Objective: Identifying ethical concerns with ML applications to healthcare (ML-HCA) before problems arise is now a stated goal of ML design oversight groups and regulatory agencies. Lack of accepted standard methodology for ethical analysis, however, presents challenges. In this case study, we evaluate use of a stakeholder "values-collision" approach to identify consequential ethical challenges associated with an ML-HCA for advanced care planning (ACP). Identification of ethical challenges could guide revision and improvement of the ML-HCA.
    Materials and methods: We conducted semistructured interviews of the designers, clinician-users, affiliated administrators, and patients, and inductive qualitative analysis of transcribed interviews using modified grounded theory.
    Results: Seventeen stakeholders were interviewed. Five "values-collisions"-where stakeholders disagreed about decisions with ethical implications-were identified: (1) end-of-life workflow and how model output is introduced; (2) which stakeholders receive predictions; (3) benefit-harm trade-offs; (4) whether the ML design team has a fiduciary relationship to patients and clinicians; and, (5) how and if to protect early deployment research from external pressures, like news scrutiny, before research is completed.
    Discussion: From these findings, the ML design team prioritized: (1) alternative workflow implementation strategies; (2) clarification that prediction was only evaluated for ACP need, not other mortality-related ends; and (3) shielding research from scrutiny until endpoint driven studies were completed.
    Conclusion: In this case study, our ethical analysis of this ML-HCA for ACP was able to identify multiple sites of intrastakeholder disagreement that mark areas of ethical and value tension. These findings provided a useful initial ethical screening.
    MeSH term(s) Humans ; Workflow ; Advance Care Planning ; Ethnicity ; Qualitative Research
    Language English
    Publishing date 2023-02-24
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1205156-1
    ISSN 1527-974X ; 1067-5027
    ISSN (online) 1527-974X
    ISSN 1067-5027
    DOI 10.1093/jamia/ocad022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: The Perceived Influence of Neurofibromatosis Type 1(NF1) on the Parents' Relationship.

    Wiener, Lori / Bedoya, Sima Zadeh / Goyal, Archita / Gordon, Mallorie / Deuitch, Natalie / Widemann, Brigitte

    Children (Basel, Switzerland)

    2023  Volume 10, Issue 3

    Abstract: Neurofibromatosis type 1 (NF1) is a genetic condition affecting 1 in 3000 individuals. Having a child with a chronic illness can introduce both practical and emotional challenges to a parental relationship. This cross-sectional study was administered to ... ...

    Abstract Neurofibromatosis type 1 (NF1) is a genetic condition affecting 1 in 3000 individuals. Having a child with a chronic illness can introduce both practical and emotional challenges to a parental relationship. This cross-sectional study was administered to 50 parents of children with NF1, diagnosed between the ages of 1-24. Each participant was provided a 50-item self-report survey to complete during an inpatient or outpatient visit. The survey gathered information on the participants' views of the spouse/partner relationship, coping mechanisms, and elements that supported emotional connections. While the majority of parental relationships were reported to remain strong, the mean relationship quality was perceived to have decreased compared to prior to the child's diagnosis. Compassionate and open communication, shared perspective, having time alone with their partner outside of medical situations, and dyadic coping were identified as strategies that could strengthen the relationship. The identified stressors to the parental relationship during the NF1 illness trajectory can inform interventions and help guide development of a couple's intervention. The National Cancer Institute, NIH Institutional Review Board approved this study (12-C-0206).
    Language English
    Publishing date 2023-02-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2732685-8
    ISSN 2227-9067
    ISSN 2227-9067
    DOI 10.3390/children10030448
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Revisiting TNF Receptor-Associated Periodic Syndrome (TRAPS): Current Perspectives.

    Cudrici, Cornelia / Deuitch, Natalie / Aksentijevich, Ivona

    International journal of molecular sciences

    2020  Volume 21, Issue 9

    Abstract: Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal dominant autoinflammatory syndrome characterized by prolonged and recurrent episodes of fever, abdominal and/or chest pain, arthralgia, myalgia, and erythematous rash. ... ...

    Abstract Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal dominant autoinflammatory syndrome characterized by prolonged and recurrent episodes of fever, abdominal and/or chest pain, arthralgia, myalgia, and erythematous rash. TRAPS is associated with heterozygous variants in the
    MeSH term(s) Biomarkers ; Disease Management ; Disease Susceptibility ; Fever/diagnosis ; Fever/etiology ; Fever/metabolism ; Fever/therapy ; Genetic Predisposition to Disease ; Genetic Variation ; Hereditary Autoinflammatory Diseases/diagnosis ; Hereditary Autoinflammatory Diseases/etiology ; Hereditary Autoinflammatory Diseases/metabolism ; Hereditary Autoinflammatory Diseases/therapy ; Humans ; Molecular Diagnostic Techniques ; Molecular Targeted Therapy ; Phenotype ; Receptors, Tumor Necrosis Factor, Type I/genetics ; Receptors, Tumor Necrosis Factor, Type I/metabolism
    Chemical Substances Biomarkers ; Receptors, Tumor Necrosis Factor, Type I
    Language English
    Publishing date 2020-05-05
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms21093263
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: TNF-Blockade for Primary Stroke Prevention in Adenosine Deaminase 2 Deficiency: A Case Series.

    Soldatos, Ariane / Toro, Camilo / Hoffmann, Patrycja / Romeo, Tina / Deuitch, Natalie / Brofferio, Alessandra / Aksentijevich, Ivona / Kastner, Daniel L / Ombrello, Amanda K

    Neurology(R) neuroimmunology & neuroinflammation

    2023  Volume 10, Issue 3

    Abstract: Objectives: Adenosine deaminase 2 deficiency (DADA2) is a genetic, neurologic, and systemic vasculitis syndrome, which can lead to recurrent strokes, typically lacunar. In the cohort of now 60 patients followed up at the NIH Clinical Center (NIH CC), no ...

    Abstract Objectives: Adenosine deaminase 2 deficiency (DADA2) is a genetic, neurologic, and systemic vasculitis syndrome, which can lead to recurrent strokes, typically lacunar. In the cohort of now 60 patients followed up at the NIH Clinical Center (NIH CC), no patient has had a stroke since starting tumor necrosis factor (TNF) blockade. We present a family with multiple affected children to highlight the importance of TNF blockade not just as secondary stroke prevention but also as primary stroke prevention in genetically affected but clinically asymptomatic patients.
    Methods: A proband with recurrent cryptogenic strokes was referred for evaluation at the NIH CC. The parents and 3 clinically asymptomatic siblings were also evaluated.
    Results: The proband was diagnosed with DADA2 based on biochemical testing; her antiplatelet therapies were discontinued, and she was started on TNF blockade for secondary stroke prevention. Her 3 asymptomatic siblings were subsequently tested and 2 were found to be biochemically affected. One of them elected to start TNF blockade for primary stroke prevention and the other sibling declined this approach and experienced a stroke. A second genetic sequence variant was subsequently identified in the
    Discussion: This family illustrates the importance of testing for DADA2 in young patients with cryptogenic stroke, given the hemorrhagic risks with antiplatelet drugs in these patients and effectiveness of TNF blockade as secondary stroke prevention. In addition, this family highlights the importance of screening all siblings of affected patients because they may be presymptomatic, and we advocate starting TNF blockade for primary stroke prevention in those who are found to be genetically or biochemically affected.
    MeSH term(s) Humans ; Child ; Female ; Adenosine Deaminase/genetics ; Intercellular Signaling Peptides and Proteins ; Stroke/prevention & control ; Tumor Necrosis Factor-alpha
    Chemical Substances Adenosine Deaminase (EC 3.5.4.4) ; Intercellular Signaling Peptides and Proteins ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2023-03-20
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Intramural
    ZDB-ID 2767740-0
    ISSN 2332-7812 ; 2332-7812
    ISSN (online) 2332-7812
    ISSN 2332-7812
    DOI 10.1212/NXI.0000000000200073
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Translating genomic testing results for pediatric critical care: Opportunities for genetic counselors.

    Deuitch, Natalie / Soo-Jin Lee, Sandra / Char, Danton

    Journal of genetic counseling

    2019  Volume 29, Issue 1, Page(s) 78–87

    Abstract: Genomic sequencing (GS), such as whole genome and exome sequencing, is rapidly being integrated into pediatric critical care settings. Results are being used to make high impact decisions including declarations of futility, withdrawal of care, and ... ...

    Abstract Genomic sequencing (GS), such as whole genome and exome sequencing, is rapidly being integrated into pediatric critical care settings. Results are being used to make high impact decisions including declarations of futility, withdrawal of care, and rationing of scarce resources. In this qualitative study, we conducted interviews with clinicians involved in the care of critically ill children with congenital heart disease (CHD) to investigate their views on implementation of GS into clinical practice. Interviews were transcribed and inductively analyzed for major themes using grounded theory and thematic analysis. Three major themes emerged surrounding the use of genomic information in the high-stakes, time pressured decision making that characterizes clinical care of critically ill children with CHD: (a) that clinicians felt they did not have sufficient training to accurately assess genetic results despite pressure to incorporate results into clinical decisions; (b), that they desire knowledge support from genetic specialists, such as genetic counselors, who both understand the critical care context and are available within the time constraints of critical care clinical pressures; and (c), that clinicians feel a pressing need for increased genetics education to be able to safely and appropriately incorporate GS results into clinical decisions Our data suggest that genetics specialists may need a stronger presence in the pediatric critical care setting.
    MeSH term(s) Child ; Counselors ; Critical Care ; Female ; Genetic Counseling ; Genetic Testing ; Grounded Theory ; Humans ; Male ; Pediatrics ; Qualitative Research ; Whole Exome Sequencing
    Language English
    Publishing date 2019-11-07
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1117799-8
    ISSN 1573-3599 ; 1059-7700
    ISSN (online) 1573-3599
    ISSN 1059-7700
    DOI 10.1002/jgc4.1182
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Novel ADA2 Compound Heterozygous Mutations Resulting in Deficiency of Adenosine Deaminase 2 in a Pair of Siblings.

    Guo, Li / Wang, Jun / Yang, Xinghui / Zheng, Rongjun / Deuitch, Natalie / Tao, Panfeng / Zhou, Qing

    Journal of clinical immunology

    2021  Volume 41, Issue 4, Page(s) 837–842

    MeSH term(s) Adenosine Deaminase/chemistry ; Adenosine Deaminase/deficiency ; Biomarkers ; Child ; DNA Mutational Analysis ; Genetic Association Studies/methods ; Genetic Predisposition to Disease ; Heterozygote ; Humans ; Intercellular Signaling Peptides and Proteins/chemistry ; Intercellular Signaling Peptides and Proteins/deficiency ; Magnetic Resonance Imaging ; Male ; Mutation ; Pedigree ; Phenotype ; Siblings ; Structure-Activity Relationship ; Tomography, X-Ray Computed
    Chemical Substances Biomarkers ; Intercellular Signaling Peptides and Proteins ; ADA2 protein, human (EC 3.5.4.4) ; Adenosine Deaminase (EC 3.5.4.4)
    Language English
    Publishing date 2021-01-30
    Publishing country Netherlands
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 779361-3
    ISSN 1573-2592 ; 0271-9142
    ISSN (online) 1573-2592
    ISSN 0271-9142
    DOI 10.1007/s10875-021-00981-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Revisiting TNF Receptor-Associated Periodic Syndrome (TRAPS)

    Cornelia Cudrici / Natalie Deuitch / Ivona Aksentijevich

    International Journal of Molecular Sciences, Vol 21, Iss 3263, p

    Current Perspectives

    2020  Volume 3263

    Abstract: Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal dominant autoinflammatory syndrome characterized by prolonged and recurrent episodes of fever, abdominal and/or chest pain, arthralgia, myalgia, and erythematous rash. ... ...

    Abstract Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal dominant autoinflammatory syndrome characterized by prolonged and recurrent episodes of fever, abdominal and/or chest pain, arthralgia, myalgia, and erythematous rash. TRAPS is associated with heterozygous variants in the TNFRSF1A gene, which encodes the TNFR1 (tumor necrosis factor receptor 1) receptor. Disease-causing variants are found exclusively in the extracellular domain of TNFR1 and affect receptor structure and binding to the TNF ligand. The precise mechanism of the disease is still unclear, but it is thought that intracellular accumulation of misfolded mutant protein leads to endoplasmic reticulum stress and enhanced inflammatory responses through constitutive activation of various immune pathways. Other possible mechanisms contributing to the disease pathogenesis include defective receptor shedding, TNF-induced cell death, production of reactive oxygen species, and autophagy impairment. Patients’ leucocytes are hyperresponsive to stimulation and produce elevated levels of proinflammatory cytokines. Systemic autoimmune (AA) amyloidosis is an important cause of morbidity and mortality in TRAPS. Over the last two decades, new therapies have changed the progression and outcome of the disease. In this review, we summarize clinical data from 209 patients with validated pathogenic variants reported in the literature and discuss TRAPS diagnosis, pathogenesis, and treatment options.
    Keywords tumor necrosis factor receptor-associated periodic syndrome (TRAPS) ; TNFR1 ; AA amyloidosis ; autoinflammatory disorders ; misfolding disease ; TNF inhibitors ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Subject code 610
    Language English
    Publishing date 2020-05-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article: Parental Attitudes Toward Clinical Genomic Sequencing in Children With Critical Cardiac Disease.

    Gal, Dana B / Deuitch, Natalie / Lee, Sandra Soo Jin / Simon, Rosalie Tang / Char, Danton S

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2021  Volume 22, Issue 8, Page(s) e419–e426

    Abstract: Objectives: Through improving diagnostics and prognostics genomic sequencing promises to significantly impact clinical decisions for children with critical cardiac disease. Little is known about how families of children with critical cardiac disease ... ...

    Abstract Objectives: Through improving diagnostics and prognostics genomic sequencing promises to significantly impact clinical decisions for children with critical cardiac disease. Little is known about how families of children with critical cardiac disease perceive the impact of genomic sequencing on clinical care choices.
    Design: Qualitative interview study.
    Setting: A high-volume, tertiary pediatric heart center.
    Subjects: Families of children with critical cardiac disease.
    Interventions: None.
    Measurements and main results: Thematic analysis of interview response content. Thirty-five families were interviewed. Three themes emerged: 1) benefits versus challenges of having genomic sequencing results, and 2) fears of clinical applications of genomic sequencing, and 3) nonclinical fears related to genomic sequencing. Participants struggled with perceived uses of genomic sequencing-derived knowledge. They described comfort in foreknowledge of their child's likely disease course but articulated significant apprehension around participating in care decisions with limited knowledge of genomic sequencing, genomic sequencing uses to inform clinical resource rationing decisions, and genomic sequencing uses by third parties impacting financial pressures families experience caring for a child with critical cardiac disease.
    Conclusions: Families' perceptions of genomic sequencing uses in critical cardiac disease appear to strain their overall trust in the health system. Erosion of trust is concerning because the potential of genomic sequencing in critical cardiac disease will be unrealized if families are unwilling to undergo genomic sequencing, let alone to participate in the ongoing research needed to link genomic sequencing variants to clinical outcomes. Our findings may have implications for genomic sequencing use in children with other critical, high-acuity diseases.
    MeSH term(s) Attitude ; Child ; Family ; Genomics ; Heart Diseases/diagnosis ; Heart Diseases/genetics ; Humans ; Parents ; Qualitative Research
    Language English
    Publishing date 2021-02-04
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000002669
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Genomic Landscape of Patients with Germline

    Yu, Kai / Deuitch, Natalie / Merguerian, Matthew / Cunningham, Lea / Davis, Joie / Bresciani, Erica / Diemer, Jamie / Andrews, Elizabeth / Young, Alice / Donovan, Frank / Sood, Raman / Craft, Kathleen / Chong, Shawn / Chandrasekharappa, Settara / Mullikin, Jim / Liu, Paul P

    bioRxiv : the preprint server for biology

    2023  

    Abstract: Germline : Key points: Comprehensive genomic profile of patients with FPDMM with ... ...

    Abstract Germline
    Key points: Comprehensive genomic profile of patients with FPDMM with germline
    Language English
    Publishing date 2023-01-17
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2023.01.17.524290
    Database MEDical Literature Analysis and Retrieval System OnLINE

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