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author:("WANG, dongen")
1.  Epigenetic Regulation of Elf5 Is Associated with Epithelial-Mesenchymal Transition in Urothelial Cancer 
PLoS ONE  2015;10(1):e0117510.
E74-like factor 5 (Elf5) has been associated with tumor suppression in breast cancer. However, its role in urothelial cancer (UC) is completely unknown. Immunohistochemistry (IHC) and methylation specific PCR (MSP) were done to detect Elf5 expression level and its promoter methylation. Results revealed that low expression of Elf5 on protein and mRNA levels were associated with tumor progression, early relapse and poor survival. In vitro, down-regulation of Elf5 can increase epithelial-mesenchymal transition (EMT). Aberrant Elf5 methylation was identified as major mechanism for Elf5 gene silence. Accordingly, restoration of Elf5 by infection or demethylating treatment effectively reversed EMT processes. In conclusion, we identified Elf5 as a novel biomarker of UC on several biological levels and established a causative link between Elf5 and EMT in UC.
PMCID: PMC4309403  PMID: 25629735
2.  Willingness of Parkinson's Disease Patients to Participate in Research Using Internet-Based Technology 
Telemedicine Journal and e-Health  2012;18(9):684-687.
Motor impairment and travel time have been shown to be important barriers to recruitment for Parkinson's disease (PD) clinical trials. This study determined whether use of Internet-based video communication for study visits would improve likelihood of participating in PD clinical trials. Subjects and Methods: University of Utah PD clinic patients were invited to complete a survey asking if they would be willing to participate in a hypothetical research study under four different scenarios. McNemar's test was used to test the hypothesis that remote assessments would improve willingness to participate. Results: Willingness to participate was 101/113 (87%) in the standard scenario. Willingness to participate was highest (93%; p=0.046) with most visits occurring via telemedicine at a local clinic, followed by some visits occurring via telemedicine at a local clinic (91%; p=0.157). Willingness to participate was lower with some (80%; p=0.008) or most (82%; p=0.071) visits occurring by home telemonitoring. Conclusions: Use of telemedicine may be an acceptable means to improve participation in clinical trials. This would need to be confirmed with the use of a larger-scale inquiry involving rural populations. Future research should assess subject or caregiver comfort and trainability with respect to computer-based technology in the home and systems barriers for wider implementation of telemedicine in neurology.
PMCID: PMC3491628  PMID: 22954069
Parkinson's disease; clinical trials; telemedicine; telemonitoring; neurodegenerative disease
3.  CTSA-IP: A solution to identifying and aggregating intellectual property across the NIH Clinical-Translational Science Award (CTSA) consortium of biomedical research institutes 
CTSA-IP ( is a web-based, open access intellectual property (IP) search tool that aggregates and promotes technologies from member institutions of the National Institutes of Health’s (NIH) Clinical Translational Science Awards (CTSA) consortium. Its ultimate aim is to stimulate collaborative research activity by encouraging the formation of public-private partnerships with CTSA institutions and the NIH. First launched in 2009, CTSA-IP has grown rapidly and met its first objectives of developing wide member institution participation and site usage. This article will discuss the strategy employed in the initiative of aggregating IP across institutional boundaries, the promise that lies therein, as well as the challenges encountered and lessons learned in promoting CTSA-wide engagement.
PMCID: PMC3670705  PMID: 22029803
4.  Immunogenicity of Trivalent Influenza Vaccine in Extremely-Low-Birth-Weight, Premature versus Term Infants 
Influenza vaccine immunogenicity in premature infants is incompletely characterized.
To assess the immunogenicity of trivalent, inactivated influenza vaccine (TIV) in extremely low-birth-weight (ELBW, ≤1000 grams birth weight), premature (<30 weeks gestation) infants. We hypothesized that geometric mean titers (GMT) of influenza antibody would be lower in premature than in full-term (≥37 week) infants.
In this prospective, multicenter study, former premature and full-term infants ages, 6–17 months, received 2 doses of TIV during the 2006–7 or 2007–8 influenza seasons. Sera were drawn before dose 1 and 4–6 weeks after dose 2. Antibody was measured by hemagglutination inhibition.
Over two years, 41 premature and 42 full-term infants were enrolled; 36 and 33 of these infants, respectively, had post-vaccination titers available. Premature infants weighed less (mean 1.3 – 1.8 kg difference) at the time of immunization than full-term infants. Pre-vaccination titers did not differ between groups. Premature infants had higher post-vaccination antibody GMT than full-term infants to H1 (2006–7, 1:513 v. 1:91, P=0.03; 2007–8, 1:363 v. 1:189, P=0.02) and B/Victoria (2006–7, 1:51 v. 1:10, P=0.02). More premature than full-term infants had antibody titers ≥ 1:32 to B/Victoria (85% v. 60%, p=0.04) in 2007–8. Two (5%) premature and 8 (19%) full-term infants had adverse events, primarily fever, within 72 hours after vaccination. No child had medically-diagnosed influenza.
Former premature infants had antibody responses to two TIV doses greater than or equal to those of full-term children. Two TIV doses are immunogenic and well tolerated in ELBW, premature infants 6–17 months old.
PMCID: PMC3090695  PMID: 21273938
Premature infant; very low birth weight infant; influenza vaccines; immunization; vaccines
5.  Assessing Patient Preferences for Delivery of Reminders on Scheduled Visits in a Psychiatry Ambulatory Service 
Reminder systems can improve compliance with care standards, yet the reminder delivery parameters and associations with other success factors have not been fully understood. In this study, we assessed patient preferences for reminder delivery in a psychiatry ambulatory service, using both quantitative and qualitative analyses. Results from a survey showed that most patients had a positive attitude to reminders for both scheduled (76%) and missed (89%) visits. Phone call (61%) delivered two days before an appointment (47%) was the most preferred type and time of reminder delivery. Logistic regressions on survey data showed that preferences of reminder delivery parameters were associated with service types and patient populations, which was cross-validated by the follow-up interviews with the staff at two ambulatory sites. A single-mode reminder delivering method cannot satisfy different types of patients. Intervention designs that involve building a system with a variety of methods customized to patient needs and balanced with administrative simplicity need to be further studied.
PMCID: PMC2655869  PMID: 18693942
6.  The InterMed Approach to Sharable Computer-interpretable Guidelines: A Review 
InterMed is a collaboration among research groups from Stanford, Harvard, and Columbia Universities. The primary goal of InterMed has been to develop a sharable language that could serve as a standard for modeling computer-interpretable guidelines (CIGs). This language, called GuideLine Interchange Format (GLIF), has been developed in a collaborative manner and in an open process that has welcomed input from the larger community. The goals and experiences of the InterMed project and lessons that the authors have learned may contribute to the work of other researchers who are developing medical knowledge-based tools. The lessons described include (1) a work process for multi-institutional research and development that considers different viewpoints, (2) an evolutionary lifecycle process for developing medical knowledge representation formats, (3) the role of cognitive methodology to evaluate and assist in the evolutionary development process, (4) development of an architecture and (5) design principles for sharable medical knowledge representation formats, and (6) a process for standardization of a CIG modeling language.
PMCID: PMC305452  PMID: 14527977
7.  GESDOR – A Generic Execution Model for Sharing of Computer-Interpretable Clinical Practice Guidelines 
We developed the Guideline Execution by Semantic Decomposition of Representation (GESDOR) model to share guidelines encoded in different formats at the execution level. For this purpose, we extracted a set of generalized guideline execution tasks from the existing guideline representation models. We then created the mappings between specific guideline representation models and the set of the common guideline execution tasks. Finally, we developed a generic task-scheduling model to harmonize the existing approaches to guideline task scheduling. The evaluation has shown that the GESDOR model can be used for the effective execution of guidelines encoded in different formats, and thus realizes guideline sharing at the execution level.
PMCID: PMC1480330  PMID: 14728262
8.  Extended attributes of event monitor systems for criteria-based notification modalities. 
The efficacy of event monitors (EMs) at reducing morbidity and mortality of certain clinical conditions (CCs) is well established. In addition, studies have shown that user inverted exclamation mark s preferences on the modality of notification are correlated to the type of reminder or alert. Nonetheless, few institutions have implemented large scale automated monitoring of a considerable number of distinct CCs, and to our knowledge, none of these sizable projects also offer user-customizable communication modalities (CMs) over all monitored conditions. As both the numbers of CMs and CCs increase, the complexity of customizing user preferences amplifies following a geometric progression. This paper demonstrates an automated approach, based on generic notification attributes (NAs) and notification criteria (NC), which significantly simplifies the management and personalization of the CMs for institutions where the manual assignment of a CM for every alert is forbidding. The methods by which these NAs were developed, their significance for existing CCs and their implementation using the Arden Syntax and Guideline interchange format (GLIF) are described. The proposed Criteria-Based Notification is shown to improve two facets of the management of event monitors: 1) the assignment of CMs becomes independent from clinical conditions, de-facto removing institution-specific CMs from the knowledge bases of the event monitors and inserting CC-specific and institution-independent NAs, thus increasing their reusability and sharability; 2) knowledge-based independent NAs facilitate both institution-level management and user-level preference configuration.
PMCID: PMC2244499  PMID: 12463927
9.  GLEE--a model-driven execution system for computer-based implementation of clinical practice guidelines. 
We have developed the GLEE system for execution of guidelines encoded in the GLIF3 format. This system can be integrated with a local clinical information system through standard interfaces to EMRs and clinical applications. The execution model of GLEE takes the "system suggests, user controls" approach. A tracing system is used to record the state of guideline steps and their transitions. GLEE provides an internal event-driven execution model that can be hooked up with the clinical event monitor in a local environment. We discuss the execution flexibility provided by GLEE and issues related to its integration in a local environment. Potential use of GLEE includes clinical decision support, quality assurance, guideline development and medical education.
PMCID: PMC2244320  PMID: 12463946

Results 1-10 (10)