Randi Johnson, PhD, MPH

Assistant Professor, Biomedical Informatics


FacultyPhoto
Graduate Schools
  • MPH, Colorado School of Public Health (2015)
  • PhD, Colorado School of Public Health (2019)
Undergraduate School
  • BS, Lipscomb University (TN) (2006)
Languages
English, Spanish
Department
Biomedical Informatics

Research Interests

I work at the intersection of epidemiology and precision medicine, striving to impact population health through equity-minded personalized prevention. My lab accomplishes this goal by leveraging high-dimensional -omics data (metabolomics, genetics, DNA methylation, gene expression) from large consortia and population-based studies to elucidate factors contributing to immune and autoimmune disease development and progression.

Publications

  • Jacoby E, Quan D, Todd E, Shortt J, Smith H, Rafaels N, Crooks K. Prevalence of Pathogenic Transthyretin Gene Variants in the Rocky Mountain Region. Muscle Nerve. 2025 Feb;71(2):252-256. PubMed PMID: 39655870
  • Stoneman HR, Price AM, Trout NS, Lamont R, Tifour S, Pozdeyev N, Crooks K, Lin M, Rafaels N, Gignoux CR, Marker KM, Hendricks AE. Characterizing substructure via mixture modeling in large-scale genetic summary statistics. Am J Hum Genet. 2025 Jan 11. [Epub ahead of print] PubMed PMID: 39824191
  • Naylor RN, Patel KA, Kettunen JLT, Männistö JME, Støy J, Beltrand J, Polak M, Vilsbøll T, Greeley SAW, Hattersley AT, Tuomi T. Precision treatment of beta-cell monogenic diabetes: a systematic review. Commun Med (Lond). 2024 Jul 18;4(1):145. PubMed PMID: 39025920
  • Francis EC, Kechris K, Johnson RK, Rawal S, Pathmasiri W, Rushing BR, Du X, Jansson T, Dabelea D, Sumner SJ, Perng W. Maternal Serum Metabolomics in Mid-Pregnancy Identifies Lipid Pathways as a Key Link to Offspring Obesity in Early Childhood. Int J Mol Sci. 2024 Jul 11;25(14). PubMed PMID: 39062861
  • Carry PM, Vanderlinden LA, Johnson RK, Buckner T, Steck AK, Kechris K, Yang IV, Fingerlin TE, Fiehn O, Rewers M, Norris JM. Longitudinal changes in DNA methylation during the onset of islet autoimmunity differentiate between reversion versus progression of islet autoimmunity. Front Immunol. 2024;15:1345494. PubMed PMID: 38915393
  • Szczesny B, Boorgula MP, Chavan S, Campbell M, Johnson RK, Kammers K, Thompson EE, Cox MS, Shankar G, Cox C, Morin A, Lorizio W, Daya M, Kelada SNP, Beaty TH, Doumatey AP, Cruz AA, Watson H, Naureckas ET, Giles BL, Arinola GA, Sogaolu O, Falade AG, Hansel NN, Yang IV, Olopade CO, Rotimi CN, Landis RC, Figueiredo CA, Altman MC, Kenny E, Ruczinski I, Liu AH, Ober C, Taub MA, Barnes KC, Mathias RA. Multi-omics in nasal epithelium reveals three axes of dysregulation for asthma risk in the African Diaspora populations. Nat Commun. 2024 May 28;15(1):4546. PubMed PMID: 38806494
  • Takele WW, Vesco KK, Josefson J, Redman LM, Hannah W, Bonham MP, Chen M, Chivers SC, Fawcett AJ, Grieger JA, Habibi N, Leung GKW, Liu K, Mekonnen EG, Pathirana M, Quinteros A, Taylor R, Ukke GG, Zhou SJ, Lim S. Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis. Commun Med (Lond). 2024 Apr 20;4(1):75. PubMed PMID: 38643248
  • Felton JL, Redondo MJ, Oram RA, Speake C, Long SA, Onengut-Gumuscu S, Rich SS, Monaco GSF, Harris-Kawano A, Perez D, Saeed Z, Hoag B, Jain R, Evans-Molina C, DiMeglio LA, Ismail HM, Dabelea D, Johnson RK, Urazbayeva M, Wentworth JM, Griffin KJ, Sims EK. Islet autoantibodies as precision diagnostic tools to characterize heterogeneity in type 1 diabetes: a systematic review. Commun Med (Lond). 2024 Apr 6;4(1):66. PubMed PMID: 38582818
  • Ahmad A, Lim LL, Morieri ML, Tam CH, Cheng F, Chikowore T, Dudenhöffer-Pfeifer M, Fitipaldi H, Huang C, Kanbour S, Sarkar S, Koivula RW, Motala AA, Tye SC, Yu G, Zhang Y, Provenzano M, Sherifali D, de Souza RJ, Tobias DK, Gomez MF, Ma RCW, Mathioudakis N. Precision prognostics for cardiovascular disease in Type 2 diabetes: a systematic review and meta-analysis. Commun Med (Lond). 2024 Jan 22;4(1):11. PubMed PMID: 38253823
  • Semnani-Azad Z, Gaillard R, Hughes AE, Boyle KE, Tobias DK, Perng W. Precision stratification of prognostic risk factors associated with outcomes in gestational diabetes mellitus: a systematic review. Commun Med (Lond). 2024 Jan 12;4(1):9. PubMed PMID: 38216688
  • Misra S, Wagner R, Ozkan B, Schön M, Sevilla-Gonzalez M, Prystupa K, Wang CC, Kreienkamp RJ, Cromer SJ, Rooney MR, Duan D, Thuesen ACB, Wallace AS, Leong A, Deutsch AJ, Andersen MK, Billings LK, Eckel RH, Sheu WH, Hansen T, Stefan N, Goodarzi MO, Ray D, Selvin E, Florez JC, Meigs JB, Udler MS. Precision subclassification of type 2 diabetes: a systematic review. Commun Med (Lond). 2023 Oct 5;3(1):138. PubMed PMID: 37798471
  • Benham JL, Gingras V, McLennan NM, Most J, Yamamoto JM, Aiken CE, Ozanne SE, Reynolds RM. Precision gestational diabetes treatment: a systematic review and meta-analyses. Commun Med (Lond). 2023 Oct 5;3(1):135. PubMed PMID: 37794196
  • Semple RK, Patel KA, Auh S, Brown RJ. Genotype-stratified treatment for monogenic insulin resistance: a systematic review. Commun Med (Lond). 2023 Oct 5;3(1):134. PubMed PMID: 37794082
  • Jacobsen LM, Sherr JL, Considine E, Chen A, Peeling SM, Hulsmans M, Charleer S, Urazbayeva M, Tosur M, Alamarie S, Redondo MJ, Hood KK, Gottlieb PA, Gillard P, Wong JJ, Hirsch IB, Pratley RE, Laffel LM, Mathieu C. Utility and precision evidence of technology in the treatment of type 1 diabetes: a systematic review. Commun Med (Lond). 2023 Oct 5;3(1):132. PubMed PMID: 37794113
  • Murphy R, Colclough K, Pollin TI, Ikle JM, Svalastoga P, Maloney KA, Saint-Martin C, Molnes J, Misra S, Aukrust I, de Franco E, Flanagan SE, Njølstad PR, Billings LK, Owen KR, Gloyn AL. The use of precision diagnostics for monogenic diabetes: a systematic review and expert opinion. Commun Med (Lond). 2023 Oct 5;3(1):136. PubMed PMID: 37794142
  • Young KG, McInnes EH, Massey RJ, Kahkoska AR, Pilla SJ, Raghavan S, Stanislawski MA, Tobias DK, McGovern AP, Dawed AY, Jones AG, Pearson ER, Dennis JM. Treatment effect heterogeneity following type 2 diabetes treatment with GLP1-receptor agonists and SGLT2-inhibitors: a systematic review. Commun Med (Lond). 2023 Oct 5;3(1):131. PubMed PMID: 37794166
  • Lim S, Takele WW, Vesco KK, Redman LM, Hannah W, Bonham MP, Chen M, Chivers SC, Fawcett AJ, Grieger JA, Habibi N, Leung GKW, Liu K, Mekonnen EG, Pathirana M, Quinteros A, Taylor R, Ukke GG, Zhou SJ, Josefson J. Participant characteristics in the prevention of gestational diabetes as evidence for precision medicine: a systematic review and meta-analysis. Commun Med (Lond). 2023 Oct 5;3(1):137. PubMed PMID: 37794119
  • Bodhini D, Morton RW, Santhakumar V, Nakabuye M, Pomares-Millan H, Clemmensen C, Fitzpatrick SL, Guasch-Ferre M, Pankow JS, Ried-Larsen M, Franks PW, Tobias DK, Merino J, Mohan V, Loos RJF. Impact of individual and environmental factors on dietary or lifestyle interventions to prevent type 2 diabetes development: a systematic review. Commun Med (Lond). 2023 Oct 5;3(1):133. PubMed PMID: 37794109
  • Francis EC, Powe CE, Lowe WL Jr, White SL, Scholtens DM, Yang J, Zhu Y, Zhang C, Hivert MF, Kwak SH, Sweeting A. Refining the diagnosis of gestational diabetes mellitus: a systematic review and meta-analysis. Commun Med (Lond). 2023 Dec 18;3(1):185. PubMed PMID: 38110524
  • Tobias DK, Merino J, Ahmad A, Aiken C, Benham JL, Bodhini D, Clark AL, Colclough K, Corcoy R, Cromer SJ, Duan D, Felton JL, Francis EC, Gillard P, Gingras V, Gaillard R, Haider E, Hughes A, Ikle JM, Jacobsen LM, Kahkoska AR, Kettunen JLT, Kreienkamp RJ, Lim LL, Männistö JME, Massey R, Mclennan NM, Miller RG, Morieri ML, Most J, Naylor RN, Ozkan B, Patel KA, Pilla SJ, Prystupa K, Raghavan S, Rooney MR, Schön M, Semnani-Azad Z, Sevilla-Gonzalez M, Svalastoga P, Takele WW, Tam CH, Thuesen ACB, Tosur M, Wallace AS, Wang CC, Wong JJ, Yamamoto JM, Young K, Amouyal C, Andersen MK, Bonham MP, Chen M, Cheng F, Chikowore T, Chivers SC, Clemmensen C, Dabelea D, Dawed AY, Deutsch AJ, Dickens LT, DiMeglio LA, Dudenhöffer-Pfeifer M, Evans-Molina C, Fernández-Balsells MM, Fitipaldi H, Fitzpatrick SL, Gitelman SE, Goodarzi MO, Grieger JA, Guasch-Ferré M, Habibi N, Hansen T, Huang C, Harris-Kawano A, Ismail HM, Hoag B, Johnson RK, Jones AG, Koivula RW, Leong A, Leung GKW, Libman IM, Liu K, Long SA, Lowe WL Jr, Morton RW, Motala AA, Onengut-Gumuscu S, Pankow JS, Pathirana M, Pazmino S, Perez D, Petrie JR, Powe CE, Quinteros A, Jain R, Ray D, Ried-Larsen M, Saeed Z, Santhakumar V, Kanbour S, Sarkar S, Monaco GSF, Scholtens DM, Selvin E, Sheu WH, Speake C, Stanislawski MA, Steenackers N, Steck AK, Stefan N, Støy J, Taylor R, Tye SC, Ukke GG, Urazbayeva M, Van der Schueren B, Vatier C, Wentworth JM, Hannah W, White SL, Yu G, Zhang Y, Zhou SJ, Beltrand J, Polak M, Aukrust I, de Franco E, Flanagan SE, Maloney KA, McGovern A, Molnes J, Nakabuye M, Njølstad PR, Pomares-Millan H, Provenzano M, Saint-Martin C, Zhang C, Zhu Y, Auh S, de Souza R, Fawcett AJ, Gruber C, Mekonnen EG, Mixter E, Sherifali D, Eckel RH, Nolan JJ, Philipson LH, Brown RJ, Billings LK, Boyle K, Costacou T, Dennis JM, Florez JC, Gloyn AL, Gomez MF, Gottlieb PA, Greeley SAW, Griffin K, Hattersley AT, Hirsch IB, Hivert MF, Hood KK, Josefson JL, Kwak SH, Laffel LM, Lim SS, Loos RJF, Ma RCW, Mathieu C, Mathioudakis N, Me... Second international consensus report on gaps and opportunities for the clinical translation of precision diabetes medicine. Nat Med. 2023 Oct;29(10):2438-2457. PubMed PMID: 37794253
  • Felton JL, Griffin KJ, Oram RA, Speake C, Long SA, Onengut-Gumuscu S, Rich SS, Monaco GSF, Evans-Molina C, DiMeglio LA, Ismail HM, Steck AK, Dabelea D, Johnson RK, Urazbayeva M, Gitelman S, Wentworth JM, Redondo MJ, Sims EK. Disease-modifying therapies and features linked to treatment response in type 1 diabetes prevention: a systematic review. Commun Med (Lond). 2023 Oct 5;3(1):130. PubMed PMID: 37794169
  • Felton JL, Griffin KJ, Oram RA, Speake C, Long SA, Onengut-Gumuscu S, Rich SS, Monaco GS, Evans-Molina C, DiMeglio LA, Ismail HM, Steck AK, Dabelea D, Johnson RK, Urazbayeva M, Gitelman S, Wentworth JM, Redondo MJ, Sims EK. Type 1 Diabetes Prevention: a systematic review of studies testing disease-modifying therapies and features linked to treatment response. medRxiv. 2023 Apr 17. PubMed PMID: 37131690
  • Elhassan S, Dong F, Buckner T, Johnson RK, Seifert JA, Carry PM, Vanderlinden L, Waugh K, Rewers M, Norris JM. Investigating iron intake in risk of progression from islet autoimmunity to type 1 diabetes: The diabetes autoimmunity study in the young. Front Immunol. 2023;14:1124370. PubMed PMID: 37056761
  • Buckner T, Johnson RK, Vanderlinden LA, Carry PM, Romero A, Onengut-Gumuscu S, Chen WM, Kim S, Fiehn O, Frohnert BI, Crume T, Perng W, Kechris K, Rewers M, Norris JM. Genome-wide analysis of oxylipins and oxylipin profiles in a pediatric population. Front Nutr. 2023;10:1040993. PubMed PMID: 37057071
  • Buckner T, Johnson RK, Vanderlinden LA, Carry PM, Romero A, Onengut-Gumuscu S, Chen WM, Fiehn O, Frohnert BI, Crume T, Perng W, Kechris K, Rewers M, Norris JM. An Oxylipin-Related Nutrient Pattern and Risk of Type 1 Diabetes in the Diabetes Autoimmunity Study in the Young (DAISY). Nutrients. 2023 Feb 14;15(4). PubMed PMID: 36839302
  • Brice AN, Vanderlinden LA, Marker KM, Mayer D, Lin M, Rafaels N, Shortt JA, Romero A, Lowery JT, Gignoux CR, Johnson RK. COVID-19 Mortality in the Colorado Center for Personalized Medicine Biobank. Int J Environ Res Public Health. 2023 Jan 29;20(3). PubMed PMID: 36767733
  • Johnson, R. K., A. J. Ireton, P. M. Carry, L. A. Vanderlinden, F. Dong, A. Romero, D. R. Johnson, D. Ghosh, F. Yang, B. Frohnert, I. V. Yang, K. Kechris, M. Rewers, J. M. Norris. (2023). "DNA Methylation Near DLGAP2 May Mediate the Relationship between Family History of Type 1 Diabetes and Type 1 Diabetes Risk." Pediatric Diabetes. DOI: 10.1155/2023/5367637.
  • Carry PM, Waugh K, Vanderlinden LA, Johnson RK, Buckner T, Rewers M, Steck AK, Yang I, Fingerlin TE, Kechris K, Norris JM. Changes in the Coexpression of Innate Immunity Genes During Persistent Islet Autoimmunity Are Associated With Progression of Islet Autoimmunity: Diabetes Autoimmunity Study in the Young (DAISY). Diabetes. 2022 Sep 1;71(9):2048-2057. PubMed PMID: 35724268
  • Johnson RK, Marker KM, Mayer D, Shortt J, Kao D, Barnes KC, Lowery JT, Gignoux CR. COVID-19 Surveillance in the Biobank at the Colorado Center for Personalized Medicine: Observational Study. JMIR Public Health Surveill. 2022 Jun 13;8(6):e37327. PubMed PMID: 35486493
  • Johnson RK, Manke J, Campbell M, Armstrong M, Boorgula MP, Pinheiro G, Santana CVN, Mathias RA, Barnes KC, Cruz A, Reisdorph N, Figueiredo CA. Lipid mediators are detectable in the nasal epithelium and differ by asthma status in female subjects. J Allergy Clin Immunol. 2022 Oct;150(4):965-971.e8. PubMed PMID: 35304161
  • Walker-Short E, Buckner T, Vigers T, Carry P, Vanderlinden LA, Dong F, Johnson RK, Yang IV, Kechris K, Rewers M, Norris JM. Epigenome-Wide Association Study of Infant Feeding and DNA Methylation in Infancy and Childhood in a Population at Increased Risk for Type 1 Diabetes. Nutrients. 2021 Nov 13;13(11). PubMed PMID: 34836312
  • Walker-Short E, Buckner T, Vigers T, Carry P, Vanderlinden LA, Dong F, Johnson RK, Yang IV, Kechris K, Rewers M, Norris JM. Epigenome-Wide Association Study of Infant Feeding and DNA Methylation in Infancy and Childhood in a Population at Increased Risk for Type 1 Diabetes. Nutrients. 2021 Nov 13;13(11). PubMed PMID: 34836312
  • Johnson RK, Brunetti T, Quinn K, Doenges K, Campbell M, Arehart C, Taub MA, Mathias RA, Reisdorph N, Barnes KC, Daya M. Discovering metabolite quantitative trait loci in asthma using an isolated population. J Allergy Clin Immunol. 2021 Nov 12. [Epub ahead of print] PubMed PMID: 34780848
  • Vanderlinden LA, Johnson RK, Carry PM, Dong F, DeMeo DL, Yang IV, Norris JM, Kechris K. An effective processing pipeline for harmonizing DNA methylation data from Illumina's 450K and EPIC platforms for epidemiological studies. BMC Res Notes. 2021 Sep 8;14(1):352. PubMed PMID: 34496950
  • Vigers T, Vanderlinden LA, Johnson RK, Carry PM, Yang I, DeFelice BC, Kaizer AM, Pyle L, Rewers M, Fiehn O, Norris JM, Kechris K. A Mediation Approach to Discovering Causal Relationships between the Metabolome and DNA Methylation in Type 1 Diabetes. Metabolites. 2021 Aug 14;11(8). PubMed PMID: 34436483
  • Carry PM, Vanderlinden LA, Johnson RK, Buckner T, Fiehn O, Steck AK, Kechris K, Yang I, Fingerlin TE, Rewers M, Norris JM. Phospholipid Levels at Seroconversion Are Associated With Resolution of Persistent Islet Autoimmunity: The Diabetes Autoimmunity Study in the Young. Diabetes. 2021 Jul;70(7):1592-1601. PubMed PMID: 33863802
  • Johnson RK, Tamura R, Frank N, Uusitalo U, Yang J, Niinistö S, Andrén Aronsson C, Ziegler AG, Hagopian W, Rewers M, Toppari J, Akolkar B, Krischer J, Virtanen SM, Norris JM. Maternal food consumption during late pregnancy and offspring risk of islet autoimmunity and type 1 diabetes. Diabetologia. 2021 Jul;64(7):1604-1612. PubMed PMID: 33783586
  • Webb-Robertson BM, Bramer LM, Stanfill BA, Reehl SM, Nakayasu ES, Metz TO, Frohnert BI, Norris JM, Johnson RK, Rich SS, Rewers MJ. Prediction of the development of islet autoantibodies through integration of environmental, genetic, and metabolic markers. J Diabetes. 2021 Feb;13(2):143-153. PubMed PMID: 33124145
  • Buckner T, Vanderlinden LA, Johnson RK, DeFelice BC, Carry PM, Seifert J, Waugh K, Dong F, Fiehn O, Clare-Salzler M, Rewers M, Norris JM. Predictors of oxylipins in a healthy pediatric population. Pediatr Res. 2021 May;89(6):1530-1540. PubMed PMID: 32726799
  • Johnson RK, Vanderlinden LA, DeFelice BC, Uusitalo U, Seifert J, Fan S, Crume T, Fiehn O, Rewers M, Kechris K, Norris JM. Metabolomics-related nutrient patterns at seroconversion and risk of progression to type 1 diabetes. Pediatr Diabetes. 2020 Nov;21(7):1202-1209. PubMed PMID: 32686271
  • Gardner JA, Johnson RK, Dong F, Hoffman M, Steck AK, Frohnert BI, Rewers M, Norris JM. Gluten intake and risk of thyroid peroxidase autoantibodies in the Diabetes Autoimmunity Study In the Young (DAISY). Endocrine. 2020 Nov;70(2):331-337. PubMed PMID: 32651851
  • Henze MM, Bemis EA, Seifert JA, Johnson RK, Dong F, Rewers M, Norris JM. Association between change in self-reported sugar intake and a sugar biomarker (d(13)C) in children at increased risk for type 1 diabetes. J Nutr Sci. 2020;9:e16. PubMed PMID: 32477498
  • Norris JM, Johnson RK, Stene LC. Type 1 diabetes-origins and epidemiology - Authors' reply. Lancet Diabetes Endocrinol. 2020 May;8(5):369-370. PubMed PMID: 32333871
  • Johnson RK, Vanderlinden LA, Dong F, Carry PM, Seifert J, Waugh K, Shorrosh H, Fingerlin T, Frohnert BI, Yang IV, Kechris K, Rewers M, Norris JM. Longitudinal DNA methylation differences precede type 1 diabetes. Sci Rep. 2020 Feb 28;10(1):3721. PubMed PMID: 32111940
  • Carry PM, Vanderlinden LA, Johnson RK, Dong F, Steck AK, Frohnert BI, Rewers M, Yang IV, Kechris K, Norris JM. DNA methylation near the INS gene is associated with INS genetic variation (rs689) and type 1 diabetes in the Diabetes Autoimmunity Study in the Young. Pediatr Diabetes. 2020 Jun;21(4):597-605. PubMed PMID: 32061050
  • Norris JM, Johnson RK, Stene LC. Type 1 diabetes-early life origins and changing epidemiology. Lancet Diabetes Endocrinol. 2020 Mar;8(3):226-238. PubMed PMID: 31999944
  • DeFelice BC, Pedersen TL, Shorrosh H, Johnson RK, Seifert JA, Norris JM, Fiehn O. Utilizing cooled liquid chromatography and chemical derivatization to separate and quantify C3-epimers of 25-hydroxy vitamin D and low abundant 1a,25(OH)(2)D3: Application in a pediatric population. J Steroid Biochem Mol Biol. 2020 Mar;197:105519. PubMed PMID: 31715316
  • Johnson RK, Lamb M, Anderson H, Pieters-Arroyo M, Anderson BT, Bolaños GA, Asturias EJ. The global school-based student health survey as a tool to guide adolescent health interventions in rural Guatemala. BMC Public Health. 2019 Feb 22;19(1):226. PubMed PMID: 30795754
  • Lund-Blix NA, Dong F, Mårild K, Seifert J, Barón AE, Waugh KC, Joner G, Størdal K, Tapia G, Stene LC, Johnson RK, Rewers MJ, Norris JM. Gluten Intake and Risk of Islet Autoimmunity and Progression to Type 1 Diabetes in Children at Increased Risk of the Disease: The Diabetes Autoimmunity Study in the Young (DAISY). Diabetes Care. 2019 May;42(5):789-796. PubMed PMID: 30796108
  • Johnson RK, Vanderlinden L, DeFelice BC, Kechris K, Uusitalo U, Fiehn O, Sontag M, Crume T, Beyerlein A, Lernmark Å, Toppari J, Ziegler AG, She JX, Hagopian W, Rewers M, Akolkar B, Krischer J, Virtanen SM, Norris JM. Metabolite-related dietary patterns and the development of islet autoimmunity. Sci Rep. 2019 Oct 15;9(1):14819. PubMed PMID: 31616039
  • Mårild K, Dong F, Lund-Blix NA, Seifert J, Barón AE, Waugh KC, Taki I, Størdal K, Tapia G, Stene LC, Johnson RK, Liu E, Rewers MJ, Norris JM. Gluten Intake and Risk of Celiac Disease: Long-Term Follow-up of an At-Risk Birth Cohort. Am J Gastroenterol. 2019 Aug;114(8):1307-1314. PubMed PMID: 31082869
  • Goldthwaite LM, Duca L, Johnson RK, Ostendorf D, Sheeder J. Adverse Birth Outcomes in Colorado: Assessing the Impact of a Statewide Initiative to Prevent Unintended Pregnancy. Am J Public Health. 2015 Sep;105(9):e60-6. PubMed PMID: 26180990