About

Dr. John Lai is an Assistant Professor of Agribusiness in the Food and Resource Economics Department at the University of Florida, Institute of Food and Agricultural Sciences. His teaching and research program focuses on the market development of agricultural business operations. He teaches an online undergraduate course in selling strategically and a graduate course in agribusiness risk management. Dr. Lai holds a Master of Science degree in Agricultural Economics from Purdue University, earned in 2012. His work emphasizes the strategic aspects of selling and risk management within the agribusiness sector, contributing to the education of students in these critical areas of agricultural economics.

Research topics

• Medicine
• Internal medicine
• Gastroenterology
• Pathology
• Cancer research
• Bioinformatics
• Biology
• Pediatrics
• Biochemistry
• Genetics

Selected publications

• Development and validation of an ultrasensitive qPCR method to identify and quantify EGFR T790M in cell-free DNA

  Bioanalysis · 2025-01-02

  articleOpen access

  BACKGROUND: Circulating tumor DNA (ctDNA) is a promising biomarker for cancer prognosis and drug development. A major challenge in the ctDNA determination method is discriminating ctDNA from highly similar but significantly more abundant wild-type DNA sensitively and accurately. METHOD: An ultrasensitive qPCR method termed Triple Enrichment Amplification of Mutation PCR (TEAM-PCR) was developed to detect EGFR T790M mutation. RESULTS: wild-type copies. This method was fully validated following the essential bioanalysis guidance, with the limit of detection (LOD) being five copies/reaction. CONCLUSION: This study established and validated a qPCR-based strategy to detect EGFR T790M mutation with ultra-high sensitivity and reliability.

  PublisherOA PDFDOI

• OP0322 ANTI-MITOCHONDRIAL M2 ANTIBODY IS ASSOCIATED WITH CARDIAC INVOLVEMENTS AND IMMUNE-MEDIATE NECROTIZING MYOPATHY IN IDIOPATHIC INFLAMMATORY MYOPATHIES: A LONG-TERM RETROSPECTIVE COHORT STUDY

  Annals of the Rheumatic Diseases · 2025-06-01

  articleOpen access

  <h2>Abstract</h2><h3>Background:</h3> Cardiac involvement (CI) in idiopathic inflammatory myopathies (IIM) is uncommon but can lead to severe complications. Anti-mitochondrial antibodies (AMAs), the well-recognized biomarkers for primary biliary cholangitis (PBC), are also detected in IIM but their role remains under-explored. While previous studies suggest a potential link between AMAs and CI [1], the evidence remains limited due to small sample sizes and inconsistent findings. <h3>Objectives:</h3> This study aims to evaluate the clinical characteristics, pathological features, and long-term prognosis of anti-mitochondrial M2 antibody (AMA-M2) positive IIM patients, focusing on its association with CI and its potential role as a marker for immune-mediated necrotizing myopathy (IMNM). <h3>Methods:</h3> We conducted a single-center retrospective cohort study involving 987 hospitalized IIM patients between January 2008 and November 2020. Demographic, clinical, laboratory, and pathological data were collected from the hospital's digital record system, and IIM diagnoses were retrospectively confirmed using the 2017 EULAR/ACR criteria. Propensity score matching was used to balance baseline heterogeneity between AMA-M2-positive and negative groups. Univariate and multivariate COX regression model were applied to identify independent risk factors with CI and mortality. Survival analyses were performed to evaluate the impact of AMA-M2 positivity on the endpoints. <h3>Results:</h3> Among 987 IIM patients, 55 (5.6%) tested positive for AMA-M2. These patients had a higher proportion of polymyositis subtype (56.4% vs. 23.5%, p<0.001), as well as elevated baseline levels of gamma-glutamyl transferase (GGT) (78.0 vs. 35.0, p<0.001) and alkaline phosphatase (ALP) (85.0 vs. 64.0, p<0.001) (Table 1). Throughout disease courses, AMA-M2 positive patients showed a significantly higher prevalence of CI (60% vs. 12.9%, p<0.001), including arrhythmias (52.7%), heart failure (41.8%), and pulmonary hypertension (30.9%) (Figure 1). Skeletal muscle biopsies of AMA-M2 positive patients predominantly exhibited IMNM features, while none of these patients were positive for anti-SRP or anti-HMGCR antibodies. Cardiac biopsies revealed varying degrees of myocardial degeneration and fibrosis but minimal inflammatory features, and all liver biopsies confirmed stage I or II PBC. Notably, in AMA-M2 positive subgroup, patients with comorbid hepatic involvement tend to have higher incidence of CI compared to those without (27/33 [81.8%] vs. 8/22 [36.4%], p<0.001). AMA-M2 positivity and elevated gamma-glutamyl transferase (GGT) levels were identified as independent risk factors for cardiac involvement (HR 3.156, p<0.001 and HR 1.622, p=0.026, respectively). Despite clinically significant CI, AMA-M2 positivity was not associated with worsened survival compared to the AMA-M2 negative group (mean survival: 103.9 months vs. 98.0 months, p=0.86). Figure 1Cardiac involvements of AMA-M2 positive and negative IIM patients <h3>Conclusion:</h3> AMA-M2 positivity identifies a distinct subset of IIM patients with clinically significant cardiac involvement and hepatic involvement, but does not worsen the long-term survival. The overlap between cardiac and hepatic manifestations in AMA-M2 positive IIM raises questions about underlying mitochondrial dysfunction, which warrants further exploration on disease mechanisms. <h3>REFERENCES:</h3> [1] Maeda, M., et al., Prevalence and risk surveillance of anti-mitochondrial antibody-positive myositis: Outcomes of a nationwide survey. J Neurol Sci, 2024. 467: p. 123287. Table 1Demographical, clinical, and laboratory features of AMA-M2 positive and negative IIM patientsAMA-M2 positive(n=55)AMA-M2 negative(n=932)P-valueDemographics and comorbiditiesAge at onset, years (median [IQR])51.0 [15.0]49.0 [20.0]0.239Gender, female (n, %)36 (65.5)633 (67.9)0.704Coronary artery disease (n, %)12 (21.8)6.3 (59)<0.001Clinical manifestations (n, %)Polymyositis subtype31 (56.4)219 (23.5)<0.001Skin involvements¹16 (29.1)618 (66.3)<0.001Digits vasculitis0 (0)118 (12.7)0.005Muscle weakness39 (70.9)625 (67.1)0.554Diaphragmatic muscle paralysis8 (14.5)18 (1.9)<0.001Interstitial lung disease21 (38.2)590 (63.3)<0.001Cardiac involvements33 (60.0)120 (12.9)<0.001Pulmonary hypertension17 (30.9)74 (7.9)<0.001Heart failure23 (41.8)34 (3.6)<0.001Arrhythmia29 (52.7)48 (5.2)<0.001Laboratory results (n, %)CK elevation47 (87)536 (58.3)<0.001GGT elevation33/52 (63.5)325/863 (37.3)<0.001ALP elevation19/51 (37.3)106/858 (12.4)<0.001[1] Skin involvements are defined as the presence of heliotrope rash, Gottron's sign or papule, Shawl and V sign, or Mechanic's hands. <h3>Acknowledgements:</h3> This study was supported by the Chinese National Key Technology R&D Program, Ministry of Science and Technology (2022YFC2504603), CAMS Innovation Fund for Medical Sciences (CIFMS) (2021-I2M-1-005, 2023-I2M-C&T-B-035, 2023-I2M-2-005) and National High Level Hospital Clinical Research Funding (2022-PUMCH-C-020, 2022-PUMCH-D-009). <h3>Disclosure of Interests:</h3> <b>None declared</b>. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

  PublisherDOI

• The Role of TP53 Mutations in the Malignant Progression of Mucinous Borderline Ovarian Tumors: A Case Report and Literature Review

  International Journal of Women s Health · 2025-09-01

  articleOpen access

  Background: Mucinous ovarian carcinoma (MOC) is characterized by aggressive behavior and limited responsiveness to standard chemotherapeutic regimens. The infrequent occurrence of MOC arising from mucinous borderline ovarian tumors (MBOTs) and the lack of readily identifiable diagnostic markers pose significant challenges to the development of effective treatment strategies. This report presents a case of a 26-year-old woman with MBOT progression to metastatic MOC despite aggressive surgical intervention and adjuvant chemotherapy, aiming to identify potential diagnostic and therapeutic improvements. Results: A review of the literature revealed fewer than 30 comparable cases, underscoring the absence of established guidelines for diagnosing and treating the progression of MBOT to invasive MOC, particularly with respect to the role of TP53 mutations. In our patient’s case, we observed some changes in immunohistochemical marker expression between the MBOT and the subsequent invasive MOC, including altered p53 expression. Although these changes, considered in the context of existing literature, hint at a complex transformation process potentially involving genetic and epigenetic alterations, including TP53 mutations, further detailed genomic or transcriptomic analyses would be required to confirm this in our specific case. The diagnostic process was further complicated by clinical and pathological similarities with gastrointestinal malignancies. Ultimately, disease progression necessitated adjustments to the treatment plan, despite the use of a multi-agent chemotherapy regimen consisting of paclitaxel, carboplatin, and bevacizumab. Conclusion: The transition from MBOT to MOC is characterized by intricate genetic and epigenetic alterations, especially involving TP53 mutations. This progression presents considerable diagnostic challenges due to similarities with gastrointestinal cancers. Therefore, given the strong correlation between TP53 mutations and chemoresistance, there is a pressing need to develop targeted therapies and enhance diagnostic strategies. Keywords: mucinous borderline ovarian tumors, mucinous ovarian carcinoma, TP53 mutations, chemotherapy, targeted therapy

  PublisherOA PDFDOI

• OP0206 EFFICACY AND SAFETY OF GENAKUMAB IN ACTIVE SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS (sJIA): A MULTICENTER, RANDOMIZED, OPEN-LABEL PHASE 2 CLINICAL STUDY

  Annals of the Rheumatic Diseases · 2025-06-01

  articleOpen access

  <h2>Abstract</h2><h3>Background:</h3> Systemic juvenile idiopathic arthritis (sJIA) is an autoinflammatory disorder that affects children aged 16 years and younger. Biologic agents, including IL-1 and IL-6 receptor antagonists, play a pivotal role in the treatment of sJIA. Genakumab is a high-affinity, fully human monoclonal antibody targeting IL-1β, which selectively binds to and neutralizes IL-1β, effectively inhibiting its pro-inflammatory effects and providing therapeutic benefit in the treatment of sJIA. Results from a completed phase 1b/2a study have shown that genakumab rapidly alleviates the clinical symptoms of active sJIA and provides sustained efficacy over time. <h3>Objectives:</h3> The objective of this study was to evaluate the efficacy and safety of genakumab in patients with active sJIA. <h3>Methods:</h3> This multicenter, randomized, open-label phase 2 trial (NCT05925452) was conducted in China, enrolling patients aged ≥ 2 to < 18 years with active sJIA. Starting from the 4-week induction phase, eligible patients were randomly assigned (1:1:1) to receive either genakumab 3.0 mg/kg, genakumab 4.0 mg/kg (administered subcutaneously every 4 weeks), or tocilizumab (8-12 mg/kg, intravenously every 2 weeks). Patients who achieved an adapted JIA ACR Ped30 response by Day 28 proceeded to the 20-week maintenance phase, during which corticosteroid tapering was implemented according to the study protocol. Non-responders discontinued treatment and entered the 4-week follow-up phase. The primary endpoint was the proportion of patients achieving an adapted JIA ACR Ped30 response at Day 28. Secondary endpoints included adapted JIA ACR Ped50/70/90 responses, corticosteroid tapering over time, and safety outcomes. The data were analyzed up to the completion of the primary endpoint assessment (Day 28 visit) for the last enrolled patient. <h3>Results:</h3> A total of 50 patients were enrolled in the study and randomized into three treatment groups: genakumab 3.0 mg/kg (n=17), genakumab 4.0 mg/kg (n=16), and tocilizumab (n=17). The mean (SD) age was 9.8 (4.00) years, and the mean (SD) baseline body weight was 37.3 (17.74) kg. Approximately 58% (29/50) of patients were male. The demographic and baseline characteristics were well-balanced across the treatment groups. The primary endpoint analysis showed that 94.1% (16/17) of patients in the genakumab 3.0 mg/kg group, 75.0% (12/16) in the genakumab 4.0 mg/kg group, and 82.4% (14/17) in the tocilizumab group achieved the adapted JIA ACR Ped30 response at Day 28. Secondary efficacy endpoints showed consistent trends across all treatment groups. The response rates for adapted JIA ACR Ped50/70/90 at Day 28 were 76.5%, 64.7%, and 47.1%, respectively, for the genakumab 3.0 mg/kg group; 62.5%, 62.5%, and 43.8% for the genakumab 4.0 mg/kg group; and 64.7%, 47.1%, and 35.3% for the tocilizumab group (see Figure 1). Treatment emergency adverse events (TEAEs) were reported in 66.0% (33/50) of patients, with 52.9% (9/17) in the genakumab 3.0 mg/kg group, 68.8% (11/16) in the genakumab 4.0 mg/kg group, and 76.5% (13/17) in the tocilizumab group. Treatment-related adverse events (TRAEs) were observed in 23.5% (4/17) and 50.0% (8/16) of patients in the genakumab 3.0 mg/kg and 4.0 mg/kg groups, respectively, compared to 76.5% (13/17) in the tocilizumab group. Serious adverse events (SAEs) were observed in 18.8% (3/16) of the genakumab 4.0 mg/kg group and 17.6% (3/17) of the tocilizumab group, while no SAE was reported in the genakumab 3.0 mg/kg group. The most common TEAEs reported (defined as ≥3 patients in any treatment group, given the small sample size) across the genakumab dose groups by Day 28 visit for the last enrolled patient were upper respiratory tract infection, hyperuricemia and anemia. The TEAEs in both genakumab groups were predominantly of grade 1-2 severity. In the tocilizumab group, the most common TEAEs included upper respiratory tract infection, hypercholesterolemia, decreased blood cell counts (neutrophils, white blood cells, and lymphocytes), and alanine aminotransferase increased. <h3>Conclusion:</h3> Genakumab demonstrated comparable efficacy to tocilizumab with a favorable safety profile in the treatment of active sJIA. Common TEAEs were consistent with the expected effects of IL-1 receptor antagonists. Both doses of genakumab showed promising therapeutic effects, with a lower incidence of TEAEs compared to tocilizumab. These findings advocate further clinical development of genakumab for active sJIA. <h3>REFERENCES:</h3> <b>NIL</b>. Figure 1<b>Response to Treatment at Day 28 (FAS</b>) <h3>Acknowledgements:</h3> This study is sponsored by Changchun GeneScience Pharmaceutical Co., Ltd. <h3>Disclosure of Interests:</h3> Caifeng Li: None declared, Junmei Zhang: None declared, HAIGUO yu: None declared, Meiping Lu: None declared, Sirui Yang: None declared, Cuihua Liu: None declared, Ping zeng: None declared, Bo Zhao: None declared, Xiaoqing Li: None declared, Wenjie Zheng: None declared, Yue Du: None declared, Wei Zhang: None declared, ZhiHui li: None declared, Xiufen Hu: None declared, Jianming Lai: None declared, Qian Xu Employee of Changchun GeneScience Pharmaceutical Co., Ltd., Tianhong Luo Employee of Changchun GeneScience Pharmaceutical Co., Ltd. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

  PublisherDOI

• Intraoperative Frozen Section Diagnosis of Brain Rosai-Dorfman Disease Clinically and Radiologically Mimicking Meningioma

  In Vivo · 2025-10-29

  articleOpen accessSenior author

  BACKGROUND/AIM: Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare, benign, histiocytic proliferative disorder characterized by nonpainful lymphadenopathy. Nonmalignant histiocytes can also infiltrate extranodal sites such as in the skin and central nervous system. On imaging, RDD can mimic other disorders such as meningioma, which is more common, and requires histology and immunohistochemistry to elucidate diagnosis. CASE REPORT: Herein we report a case of a 20-year-old female who presented to the emergency department (ED) after near-syncope episode following methamphetamine and opioid use. Initial computed tomography (CT) found a 2.3 cm mass in the right frontoparietal region. Further examinations with magnetic resonance imaging (MRI) revealed findings compatible with meningioma. After one month of persistent symptoms, the "meningioma" was resected and the intraoperative frozen sections (FS) and touch preparation cytopathology of the mass showed mixed inflammatory infiltrates and scattered large, atypical appearing cells that display emperipolesis, raising suspicions of an RDD diagnosis instead of meningioma. The permanent sections confirmed the histological findings on FS. The large atypical lesional histiocytes showing emperipolesis with engulfment of lymphocytes, plasma cells and neutrophils. The lesional cells were immunoreactive for protein S100, cluster of differentiation 163 (CD163), and B cell lymphoma 1 (BCL-1), negative for CD1a. Based on histology and immunohistochemical profile, the final diagnosis was Rosai-Dorfman Disease. Postoperatively, there was immediate improvement in patient's strength and symptoms. At the 9-month follow up post-surgery, she was doing well, and MRI revealed no evidence of residual or recurrent disease. CONCLUSION: This case is a rare example of RDD clinically and radiologically mimicking meningioma and illustrates the importance of rigorous histological analysis for accurate diagnosis, particularly during the intraoperative consultation, to ensure proper treatment.

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• 1385P A single-arm, multicenter, prospective Phase II study of tislelizumab in combination with nimotuzumab and GP induction followed by IMRT and tislelizumab plus nimotuzumab for high-risk locally advanced nasopharyngeal carcinoma

  Annals of Oncology · 2025-09-01

  article
  PublisherDOI

• Sellar Metastatic Follicular Thyroid Carcinoma With Novel Mutations Clinically Mimicking Pituitary Macroadenoma: Intraoperative Frozen Section Diagnosis Challenges

  Anticancer Research · 2025-09-26 · 1 citations

  articleSenior author

  BACKGROUND/AIM: Intraoperative frozen section (FS) pathologic evaluation remains an important part of neurosurgical procedure to ensure proper resection. Follicular thyroid carcinoma (FTC) is a common type of thyroid carcinoma, but metastasis to sellar turcica/pituitary fossa is rare and can be misdiagnosed as pituitary adenoma on FS diagnosis. CASE REPORT: A 72-year-old female with a history of FTC treated 11 years ago presented to critical care with a pituitary gland lesion. Magnetic resonance imaging (MRI) revealed a 2.8 cm pituitary macroadenoma with sellar expansion and upward displacement of the optic chiasm. Visualization of the lesion and the recent significant growth warranted tumor resection and the intraoperative FS diagnosis was pituitary adenoma. Given the history of FTC and pathological results with occasional follicles present on the permanent sections, immunohistochemistry was performed and the tumor cells were positive for paired box gen 8 (PAX-8), thyroid transcription factor 1 (TTF-1), and thyroglobulin. The final diagnosis was pituitary metastasis of FTC. Next-generation sequencing was performed and revealed novel gene pathogenic mutations of rapamycin-insensitive companion of mammalian target of rapamycin (RICTOR) and Fanconi anemia (FANCA) in the tumor cells. The patient completed radiation treatment without complications and was doing well six months after surgery, with no FTC recurrence or metastasis identified. CONCLUSION: This case is a rare example of FTC with novel mutations clinically and radiologically mimicking pituitary macroadenoma and illustrates the importance of rigorous histological analysis for accurate diagnosis, particularly during the intraoperative consultation, to ensure proper treatment.

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• A rapidly-growing friable nodule on the cheek

  Dermatology Online Journal · 2024-09-08

  articleOpen access

  Atypical fibroxanthoma and pleomorphic dermal sarcoma are on a spectrum of cutaneous tumors that present as ulcerated lesions in older adults. We present an 84-year-old man with pleomorphic dermal sarcoma, initially presenting as a bleeding lesion of the cheek that progressed to an eroded nodule.

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• Primary and secondary angiosarcomas of the liver: a multi-institutional study of 32 cases

  Human Pathology · 2023-04-11 · 10 citations

  article
  PublisherDOI

• Supplemental figure 3 from Efficacy of SERD/SERM Hybrid-CDK4/6 Inhibitor Combinations in Models of Endocrine Therapy–Resistant Breast Cancer

  2023-03-31

  preprintOpen access

  &lt;p&gt;Supplemental figure 3: SERDs and palbociclib inhibit breast cancer cell proliferation by independent mechanisms&lt;/p&gt;

  PublisherDOI

Frequent coauthors

• Xiuli Liu

  124 shared

• Dengfeng Cao

  Washington University in St. Louis

  99 shared

• Joeffrey Chahine

  Brigham and Women's Hospital

  85 shared

• Daniel García Sánchez

  Hospital General Universitario de Elche

  85 shared

• Feng Yin

  Boston University

  75 shared

• Sara Pusceddu

  72 shared

• Haiyan Gu

  Qingdao University

  72 shared

• Francesca Ambrosi

  University of Bologna

  72 shared