Now showing items 1-20 of 13199

    • Canalicular adenoma with unicystic morphology. A rare entity.

      Pettas, Efstathios; Theofilou, Vasileios-Ionas; Georgaki, Maria; Daskalopoulos, Argyrios; Kalyvas, Demos; Lazaris, Andreas C; Younis, Rania H; Nikitakis, Nikolaos G (Medicina Oral S.L., 2021-01-01)
      To our knowledge, only 11 additional cases of unicystic CA have been reported in the English-language literature. Although the exact clinical significance of unicystic morphology in CA is unknown, a tendency for occurrence within the context of multifocal tumors has been detected.
    • COVID-19 and Solid Organ Transplantation: A Review Article.

      Azzi, Yorg; Bartash, Rachel; Scalea, Joseph; Loarte-Campos, Pablo; Akalin, Enver (Wolters Kluwer Health, 2021-01)
      The coronavirus pandemic has significantly impacted solid organ transplantation (SOT). Early in the outbreak period, transplant societies recommended suspending living kidney transplant programs in communities with widespread transmission to avoid exposing recipients to increased risk of immunosuppression, while recommendations were made to reserve deceased-donor kidney transplantation for likely life-saving indications. SOT recipients may be at high risk from COVID-19 disease due to chronic immunosuppressive treatment and other medical comorbidities. Mortality rates reported between 13 to over 30% in SOT recipients. In addition to high rates of complications and mortality attributable to COVID-19 infections, the pandemic has also led to additional complexities in transplantation including new questions regarding screening of donors and recipients, decision making to accept a patient for kidney transplant or wait after pandemic. The clinical implications of COVID-19 infection may also differ depending on the type of the transplanted organ and recipient comorbidities which further impacts decisions on continuing transplantation during the pandemic. Transplant activity during a pandemic should be tailored with careful selection of both donors and recipients. Furthermore, while tremendous strides have been made in treatment strategies and vaccinations, the impact of these in transplant recipients may be attenuated in the setting of their immunosuppression. In this review, we aim to summarize several aspects of COVID-19 in transplantation, including the immune response to SARS-CoV-2, SARS-CoV-2 diagnostics, clinical outcomes in SOT recipients, and end-stage kidney disease patients, transplant activity during the pandemic, and treatment options for COVID-19 disease.
    • Pain modulatory network is influenced by sex and age in a healthy state and during osteoarthritis progression in rats.

      Da Silva, Joyce T; Tricou, Christina; Zhang, Youping; Tofighbakhsh, Amir; Seminowicz, David A; Ro, Jin Y (Wiley-Blackwell, 2021-01-05)
      Old age and female sex are risk factors for the development of osteoarthritis (OA) and chronic pain. We investigated the effects of sex and age on pain modulatory networks in a healthy state and during OA progression. We used functional MRI to determine the effects of sex and age on periaqueductal gray functional connectivity (PAG FC) in a healthy state (pre-OA) and during the early and late phases of monosodium iodoacetate-induced OA in rats. We then examined how sex and age affect longitudinal changes in PAG FC in OA. In a healthy state, females exhibited more widespread PAG FC than males, and this effect was exaggerated with aging. Young males had moderate PAG FC changes during the early phase but recruited additional brain regions, including the rostral anterior cingulate cortex (ACC), during the late phase. Young females exhibited widespread PAG FC in the early phase, which includes connections to insula, caudal ACC, and nucleus accumbens (NAc). Older groups had strong PAG FC with fewer regions in the early phase, but they recruited additional brain regions, including NAc, in the late phase. Overall, our findings show that PAG FC is modulated by sex and age in a healthy state. A widespread PAG network in the early phase of OA pain may contribute to the transition from acute to chronic OA pain and the increased risk of developing chronic pain for females. Enhanced PAG FC with the reward system may represent a potential mechanism underlying chronic OA pain in elderly patients.
    • Evolution toward beta common chain receptor usage links the matrix proteins of HIV-1 and its ancestors to human erythropoietin.

      Caccuri, Francesca; D'Ursi, Pasqualina; Uggeri, Matteo; Bugatti, Antonella; Mazzuca, Pietro; Zani, Alberto; Filippini, Federica; Salmona, Mario; Ribatti, Domenico; Slevin, Mark; et al.
      The HIV-1 matrix protein p17 (p17) is a pleiotropic molecule impacting on different cell types. Its interaction with many cellular proteins underlines the importance of the viral protein as a major determinant of human specific adaptation. We previously showed the proangiogenic capability of p17. Here, by integrating functional analysis and receptor binding, we identify a functional epitope that displays molecular mimicry with human erythropoietin (EPO) and promotes angiogenesis through common beta chain receptor (βCR) activation. The functional EPO-like epitope was found to be present in the matrix protein of HIV-1 ancestors SIV originated in chimpanzees (SIVcpz) and gorillas (SIVgor) but not in that of HIV-2 and its ancestor SIVsmm from sooty mangabeys. According to biological data, evolution of the EPO-like epitope showed a clear differentiation between HIV-1/SIVcpz-gor and HIV-2/SIVsmm branches, thus highlighting this epitope on p17 as a divergent signature discriminating HIV-1 and HIV-2 ancestors. P17 is known to enhance HIV-1 replication. Similarly to other βCR ligands, p17 is capable of attracting and activating HIV-1 target cells and promoting a proinflammatory microenvironment. Thus, it is tempting to speculate that acquisition of an epitope on the matrix proteins of HIV-1 ancestors capable of triggering βCR may have represented a critical step to enhance viral aggressiveness and early human-to-human SIVcpz/gor dissemination. The hypothesis that the p17/βCR interaction and βCR abnormal stimulation may also play a role in sustaining chronic activation and inflammation, thus marking the difference between HIV-1 and HIV-2 in term of pathogenicity, needs further investigation.
    • Clinicopathological characteristics and outcomes of gastrointestinal stromal tumors with high progranulin expression.

      Do, In-Gu; Jung, Kyung Uk; Koo, Dong-Hoe; Lee, Yun-Gyoo; Oh, Sukjoong; Kim, Kyungeun; Kim, Dong-Hoon; Sohn, Jin Hee; Son, Byung Ho; Lee, Sung Ryol; et al. (Public Library of Science, 2021-01-07)
      Background & aims Progranulin (PGRN) is known to promote tumorigenesis and proliferation of several types of cancer cells. However, little is known about the clinicopathological features of patients with gastrointestinal stromal tumors (GISTs) with regard to PGRN expression. Methods A retrospective analysis was performed on patients with GISTs who underwent curative surgical resection between 2007 and 2017. PGRN expression was evaluated by immunohistochemical (IHC) analysis and semi-quantitatively categorized (no expression, 0; weak, 1+; moderate, 2+; strong, 3+). Tumors with a staining intensity of 2+ or 3+ were considered high PGRN expression. Results Fifty-four patients were analyzed; 31 patients (57%) were male. The median age at surgery was 60 years (range, 33–79), and the most common primary site was the stomach (67%). Thirty-five patients (65%) had spindle histology; 42 patients (78%) were separated as a high-risk group according to the modified National Institutes of Health (NIH) classification. High PGRN-expressing tumors were observed in 27 patients (50%), had more epithelioid/mixed histology (68% vs. 32%; p = 0.046), and KIT exon 11 mutations (76% vs. 24%; p = 0.037). Patients with high PGRN-expressing tumors had a worse recurrence-free survival (RFS) (36% of 5-year RFS) compared to those with low PGRN-expressing tumors (96%; p<0.001). Multivariate analysis showed that high PGRN expression and old age (>60 years) were independent prognostic factors for poor RFS. Conclusions High PGRN-expressing GISTs showed more epithelioid/mixed histology and KIT exon 11 mutations. PGRN overexpression was significantly associated with poor RFS in patients with GISTs who underwent curative resection.
    • Far-field optical imaging of surface plasmons with a subdiffraction limited separation

      Xiang, Yifeng; Chen, Junxue; Tang, Xi; Wang, Ruxue; Zhan, Qiwen; Lakowicz, Joseph R.; Zhang, Douguo (De Gruyter Open Ltd, 2020-12-18)
      When an ultrathin silver nanowire with a diameter less than 100 nm is placed on a photonic band gap structure, surface plasmons can be excited and propagate along two side-walls of the silver nanowire. Although the diameter of the silver nanowire is far below the diffraction limit, two bright lines can be clearly observed at the image plane by a standard wide-field optical microscope. Simulations suggest that the two bright lines in the far-field are caused by the unique phase distribution of plasmons on the two side-walls of the silver nanowire. Combining with the sensing ability of surface plasmons to its environment, the configuration reported in this work is capable of functioning as a sensing platform to monitor environmental changes in the near-field region of this ultrathin nanowire.
    • Enhanced Training Benefits of Video Recording Surgery With Automated Hand Motion Analysis.

      Mackenzie, Colin F; Yang, Shiming; Garofalo, Evan; Hu, Peter Fu-Ming; Watts, Darcy; Patel, Rajan; Puche, Adam; Hagegeorge, George; Shalin, Valerie; Pugh, Kristy; et al. (Springer Nature, 2021-01-03)
      Background: Hand motion analysis by video recording during surgery has potential for evaluation of surgical performance. The aim was to identify how technical skill during open surgery can be measured unobtrusively by video recording during a surgical procedure. We hypothesized that procedural-step timing, hand movements, instrument use and Shannon entropy differ with expertise and training and are concordant with a performance-based validated individual procedure score. Methods: Surgeon and non-surgeon participants with varying training and levels of expertise were video recorded performing axillary artery exposure and control (AA) on un-preserved cadavers. Color-coded gloves permitted motion-tracking and automated extraction of entropy data from recordings. Timing and instrument-use metrics were obtained through observational video reviews. Shannon entropy measured speed, acceleration and direction by computer-vision algorithms. Findings were compared with individual procedure score for AA performance Results: Experts had lowest entropy values, idle time, active time and shorter time to divide pectoralis minor, using fewer instruments. Residents improved with training, without reaching expert levels, and showed deterioration 12–18 months later. Individual procedure scores mirrored these results. Non-surgeons differed substantially. Conclusions: Hand motion entropy and timing metrics discriminate levels of surgical skill and training, and these findings are congruent with individual procedure score evaluations. These measures can be collected using consumer-level cameras and analyzed automatically with free software. Hand motion with video timing data may have widespread application to evaluate resident performance and can contribute to the range of evaluation and testing modalities available to educators, training course designers and surgical quality assurance programs. © 2021, The Author(s).
    • Clinical strategies for optimizing infusion center care through a pandemic

      Hanna, Kirollos S; Segal, Eve M; Barlow, Ashley; Barlow, Brooke (SAGE Publications Inc., 2020-09-25)
      The national pandemic resulting from the novel coronavirus, COVID-19, has made the delivery of care for patients with cancer a challenge. There are competing risks of mortality from cancer versus serious complications and higher risk of death from COVID-19 in immunocompromised hosts. Furthermore, compounding these concerns is the inadequate supply of personal protective equipment, decreased hospital capacity, and paucity of effective treatments or vaccines to date for COVID-19. Guidance measures and recommendations have been published by national organizations aiming to facilitate the delivery of care in a safe and effective manner, many of which, are permanently adoptable interventions. Given the critical importance to continue chemotherapy, there remains additional interventions to further enhance patient safety while conserving healthcare resources such as adjustments in medication administration, reduction in laboratory or drug monitoring, and home delivery of specialty infusions. In this manuscript, we outline how to implement these actionable interventions of chemotherapy and supportive care delivery to further enhance the current precautionary measures while maintaining safe and effective patient care. Coupled with current published standards, these strategies can help alleviate the numerous challenges associated with this pandemic. © The Author(s) 2020.
    • Causal Network Inference for Neural Ensemble Activity.

      Chen, Rong (Springer Nature, 2021-01-04)
      Interactions among cellular components forming a mesoscopic scale brain network (microcircuit) display characteristic neural dynamics. Analysis of microcircuits provides a system-level understanding of the neurobiology of health and disease. Causal discovery aims to detect causal relationships among variables based on observational data. A key barrier in causal discovery is the high dimensionality of the variable space. A method called Causal Inference for Microcircuits (CAIM) is proposed to reconstruct causal networks from calcium imaging or electrophysiology time series. CAIM combines neural recording, Bayesian network modeling, and neuron clustering. Validation experiments based on simulated data and a real-world reaching task dataset demonstrated that CAIM accurately revealed causal relationships among neural clusters. © 2021, The Author(s).
    • Suicide Attempts and Perceived Social Support among Chinese Drug Users: The Mediating Role of Self-Esteem and Depression.

      Deng, Yali; Li, Xuemeng; Liu, Liu; Chui, Wing Hong (MDPI AG, 2020-12-30)
      Suicidal behavior is a severe problem among drug users. This study examines influential factors related to suicide attempts and analyzes possible mediators of the relationship between perceived social support and suicide attempts amongst Chinese drug users under compulsory institutional drug treatment. Taking perceived social support as the independent variable, we found that the relationship between suicide attempts and perceived social support is mediated by self-esteem as a protective factor and depression as a risk factor. Path analysis shows that self-esteem contributes relatively more to the indirect effects than depression does, accounting for 31.1% and 24.2% of the total effect, respectively. Generally speaking, the findings of this study point to an urgent need for addressing suicide attempts among Chinese drug users while treating self-esteem as the protective factor that deserves as substantial attention as depression receives. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
    • Proton-Coupled Conformational Activation of SARS Coronavirus Main Proteases and Opportunity for Designing Small-Molecule Broad-Spectrum Targeted Covalent Inhibitors.

      Verma, Neha; Henderson, Jack A; Shen, Jana (American Chemical Society, 2020-12-15)
      The SARS coronavirus 2 (SARS-CoV-2) main protease (Mpro) is an attractive broad-spectrum antiviral drug target. Despite the enormous progress in structure elucidation, the Mpro's structure-function relationship remains poorly understood. Recently, a peptidomimetic inhibitor has entered clinical trial; however, small-molecule orally available antiviral drugs have yet to be developed. Intrigued by a long-standing controversy regarding the existence of an inactive state, we explored the proton-coupled dynamics of the Mpros of SARS-CoV-2 and the closely related SARS-CoV using a newly developed continuous constant pH molecular dynamics (MD) method and microsecond fixed-charge all-atom MD simulations. Our data supports a general base mechanism for Mpro's proteolytic function. The simulations revealed that protonation of His172 alters a conserved interaction network that upholds the oxyanion loop, leading to a partial collapse of the conserved S1 pocket, consistent with the first and controversial crystal structure of SARS-CoV Mpro determined at pH 6. Interestingly, a natural flavonoid binds SARS-CoV-2 Mpro in the close proximity to a conserved cysteine (Cys44), which is hyper-reactive according to the CpHMD titration. This finding offers an exciting new opportunity for small-molecule targeted covalent inhibitor design. Our work represents a first step toward the mechanistic understanding of the proton-coupled structure-dynamics-function relationship of CoV Mpros; the proposed strategy of designing small-molecule covalent inhibitors may help accelerate the development of orally available broad-spectrum antiviral drugs to stop the current pandemic and prevent future outbreaks.
    • Current Psychotropic Medication Use and Contributing Factors Among Nursing Home Residents With Cognitive Impairment.

      Resnick, Barbara; Kolanowski, Ann; Van Haitsma, Kimberly; Galik, Elizabeth; Boltz, Marie; Ellis, Jeanette; Behrens, Liza; Eshraghi, Karen; Zhu, Shijun (SAGE Publications Inc., 2019-04-03)
      This study described current use and predictors of psychotropics among residents with moderate to severe cognitive impairment. This was a secondary data analysis using baseline data from the first 341 residents in an ongoing trial. Predictive measures included age, gender, race, depressive symptoms, agitation, resistiveness to care, depression, cognition, pain, comorbidities, facility factors, and state. Overall 63% (n = 211) received at least one psychotropic medication, 16% (n = 52) an anti-seizure medication, 23% (n = 77) an anxiolytic, 30% (n = 99) an antidepressant, 2% (n = 8) a sedative hypnotic, 28% (n = 93) an antipsychotic medication, and 9% (n = 29) an opioid. Testing of models explained 9% to 15% of psychotropic medication use. There were high rates of psychotropic medication use and a limited association between demographic factors, behavioral symptoms, and psychotropic medication use. Continued research is needed to explore the impact of deprescribing, person-centered behavioral interventions, and beliefs of providers on psychotropic medication use.
    • Editorial

      Lee, Bethany R. (Routledge, 2021-01-01)
    • Merry Holiday Recipes: Presented by Staff Council

      University of Maryland, Baltimore. School of Nursing (2020-12)
    • SINI 2019: Track C Wrap Up Documentation Burden What Do You Need to Move Forward

      Wilson, Marisa, D.N.Sc., M.H.Sc., R.N.-B.C.; Hulett, Shannon; Boyd, David, D.N.P., R.N., C.N.S., R.N.-B.C. (2019-07-19)
    • UMB Begins Phase 3 of Novavax COVID-19 Vaccine Trial

      University of Maryland, Baltimore. School of Medicine (2021-01-06)