Now showing items 21-40 of 12797

    • Novel CaF2 nanocomposites with antibacterial function and fluoride and calcium ion release to inhibit oral biofilm and protect teeth

      Mitwalli, Heba; Balhaddad, Abdulrahman A.; AlSahafi, Rashed; Oates, Thomas W.; Melo, Mary Anne S.; Xu, Hockin H.K.; Weir, Michael D. (MDPI AG, 2020-09-01)
      (1) Background: The objective of this study was to develop a novel dental nanocomposite containing dimethylaminohexadecyl methacrylate (DMAHDM), 2-methacryloyloxyethyl phosphorylcholine (MPC), and nanoparticles of calcium fluoride (nCaF2) for preventing recurrent caries via antibacterial, protein repellent and fluoride releasing capabilities. (2) Methods: Composites were made by adding 3% MPC, 3% DMAHDM and 15% nCaF2 into bisphenol A glycidyl dimethacrylate (Bis-GMA) and triethylene glycol dimethacrylate (TEGDMA) (denoted BT). Calcium and fluoride ion releases were evaluated. Biofilms of human saliva were assessed. (3) Results: nCaF2+DMAHDM+MPC composite had the lowest biofilm colony forming units (CFU) and the greatest ion release; however, its mechanical properties were lower than commercial control composite (p < 0.05). nCaF2+DMAHDM composite had similarly potent biofilm reduction, with mechanical properties matching commercial control composite (p > 0.05). Fluoride and calcium ion releases from nCaF2+DMAHDM were much more than commercial composite. Biofilm CFU on composite was reduced by 4 logs (n = 9, p < 0.05). Biofilm metabolic activity and lactic acid were also substantially reduced by nCaF2+DMAHDM, compared to commercial control composite (p < 0.05). (4) Conclusions: The novel nanocomposite nCaF2+DMAHDM achieved strong antibacterial and ion release capabilities, without compromising the mechanical properties. This bioactive nanocomposite is promising to reduce biofilm acid production, inhibit recurrent caries, and increase restoration longevity. © 2020 by the authors.
    • Lymphocyte landscape after chronic hepatitis C virus (HCV) cure: The new normal

      Ghosh, Alip; Romani, Sara; Kottilil, Shyam; Poonia, Bhawna (MDPI AG, 2020-10-02)
      Chronic HCV (CHC) infection is the only chronic viral infection for which curative treatments have been discovered. These direct acting antiviral (DAA) agents target specific steps in the viral replication cycle with remarkable efficacy and result in sustained virologic response (SVR) or cure in high (>95%) proportions of patients. These treatments became available 6–7 years ago and it is estimated that their real impact on HCV related morbidity, including outcomes such as cirrhosis and hepatocellular carcinoma (HCC), will not be known for the next decade or so. The immune system of a chronically infected patient is severely dysregulated and questions remain regarding the immune system’s capacity in limiting liver pathology in a cured individual. Another important consequence of impaired immunity in patients cleared of HCV with DAA will be the inability to generate protective immunity against possible re-infection, necessitating retreatments or developing a prophylactic vaccine. Thus, the impact of viral clearance on restoring immune homeostasis is being investigated by many groups. Among the important questions that need to be answered are how much the immune system normalizes with cure, how long after viral clearance this recalibration occurs, what are the consequences of persisting immune defects for protection from re-infection in vulnerable populations, and does viral clearance reduce liver pathology and the risk of developing hepatocellular carcinoma in individuals cured with these agents. Here, we review the recent literature that describes the defects present in various lymphocyte populations in a CHC patient and their status after viral clearance using DAA treatments.
    • Opportunities and challenges to integrating mental health into HIV programs in a low- and middle-income country: insights from the Nigeria implementation science Alliance

      Ezeanolue, Echezona E; Iheanacho, Theddeus; Adedeji, Isaac A; Itanyi, Ijeoma Uchenna; Olakunde, Babayemi; Patel, Dina; Dakum, Patrick; Okonkwo, Prosper; Akinmurele, Timothy; Obiefune, Michael; et al. (2020-09-29)
      Background: In Nigeria, there is an estimated 1.9 million people living with HIV (PLHIV), 53% of whom utilize HIV care and services. With decreasing HIV-related deaths and increasing new infections, HIV with its associated comorbidities continue to be a key public health challenge in Nigeria. Untreated, comorbid mental disorders are a critical but potentially modifiable determinant of optimal HIV treatment outcomes. This study aimed to identify the challenges and opportunities related to integrating mental health care into existing HIV programs in Nigeria. Method: Attendees at the Nigeria Implementation Science Alliance (NISA)'s 2019 conference participated in nominal group technique (NGT) exercise informed by the "Exploration, Preparation, Implementation, and Sustainment (EPIS)"framework. The NGT process was conducted among the nominal groups in two major sessions of 30-min phases followed by a 30-min plenary session. Data analysis proceeded in four steps: transcription, collation, theming and content analysis. Results: The two major theoretical themes from the study were - opportunities and challenges of integrating mental health treatment into HIV services. Three sub-themes emerged on opportunities: building on health care facilities for HIV services (screening, counseling, task-sharing monitoring and evaluation frameworks), utilizing existing human resources or workforce in HIV programs (in-service training and including mental health in education curriculum) and the role of social and cultural structures (leveraging existing community, traditional and faith-based infrastructures). Four sub-themes emerged for challenges: double burden of stigma and the problems of early detection (HIV and mental health stigma, lack of awareness), existing policy gaps and structural challenges (fragmented health system), limited human resources for mental health care in Nigeria (knowledge gap and burnout) and dearth of data/evidence for planning and action (research gaps). Conclusions: Potential for integrating treatments for mental disorders into HIV programs and services exist in Nigeria. These include opportunities for clinicians' training and capacity building as well as community partnerships. Multiple barriers and challenges such as stigma, policy and research gaps would need to be addressed to leverage these opportunities. Our findings serve as a useful guide for government agencies, policy makers and research organizations to address co-morbid mental disorders among PLHIV in Nigeria. © 2020 The Author(s).
    • In Memory of Mark Shirtliff, PhD: Modern Concepts in Diagnosis, Treatment, Prevention, and Cost of Infection after Fracture Surgery

      O'Toole, Robert V.; Harro, Janette; Johnson, Aaron J.; O'Hara, Nathan N.; Natoli, Roman M.; Joshi, Manjari (Lippincott Williams and Wilkins, 2020-01-01)
    • Medical Illustrators and Illustrations in the HS/HSL’s Historical Collections

      Wink, Tara (2020-09-21)
      The Historical Collections Department in the HS/HSL houses the library’s rare books, special collections, and some UMB archives. Included in the rare book collection are works by influential and early anatomists and medical illustrators. The collections date back to the 15th century. This post highlights a selection of the medical illustrators in the digital archive and historical collections at UMB.
    • 1920: A look back at the Graduate School 100 Years Ago

      Wink, Tara (2020-10-16)
      In 1920 the University of Maryland Graduate School was only a two-year-old institution (the school was established during the 1918-1919 academic year). The Graduate School was founded at the Maryland State College of Agriculture in College Park, which merged with the University of Maryland (Baltimore) in 1920 forming two campuses under the UM name. The Graduate School oversaw all students taking graduate coursework at the University of Maryland and remained at College Park after the merger in 1920. The post describes the expectations of students for the graduate school as well as the costs associated with the school.
    • 1920: A Look Back at the School of Nursing (SON) 100 Years Ago

      Wink, Tara (2020-10-09)
      The School of Nursing was founded in 1889 in the University of Maryland University Hospital. The school was under the leadership of a superintendent of nurses and was part of the School of Medicine. When the Maryland State College of Agriculture (College Park) and the University of Maryland (Baltimore) merged in 1920, the School of Nursing became its own entity but remained under the administrative control of the University Hospital. This post outlines the cost of attendance, matriculation requirements, and the makeup of the student and faculty body in the 1920-21 academic year.
    • 1920: A Look back at the School of Pharmacy 100 Years ago

      Wink, Tara (2020-10-02)
      When the 1920 merger between the University of Maryland (Baltimore) and the Maryland State Agricultural School (College Park) occured the Department of Pharmacy became the School of Pharmacy. The academic year 1920-21 was a year of growth and advancement for the new school. This post describes the School of Pharmacy's student and faculty body, the cost of attendance, as well as matriculation requirements.
    • 1920: A Look back at the School of Dentistry 100 Years ago

      Wink, Tara (2020-09-25)
      In the 1920-21 academic year the University of Maryland School of Dentistry was entering into its 39th session. It was established as a department in the School of Medicine in 1882. In 1920 the University of Maryland (in Baltimore) had merged with the Maryland State College of Agriculture. The post describes the school in 1920 including costs associated with attending, matriculation requirements and the makeup of the student body.
    • 1920: A look back at the School of Medicine 100 Years Ago

      Wink, Tara (2020-09-18)
      In 1920 the School of Medicine (SOM) was beginning its 113th academic year. The 1920-21 academic year marked the first as a public institution following its merger with the Maryland State College of Agriculture (College Park). The post describes the matriculation requirements and cost of attendance as well as the make-up of the student body and faculty in 1920.
    • 1920: A look back at the University of Maryland 100 Years Ago

      Wink, Tara (2020-09-11)
      This post marks the beginning of a series of posts looking at UMB in the academic school year 1920-1921. It describes the merger of the University of Maryland (Baltimore) and the Maryland State College of Agriculture (College Park) under the University of Maryland name. The post outlines the student and faculty body and describes the Baltimore campus.
    • Biological insights from multi-omic analysis of 31 genomic risk loci for adult hearing difficulty

      Kalra, Gurmannat; Milon, Beatrice; Casella, Alex M; Herb, Brian R; Humphries, Elizabeth; Song, Yang; Rose, Kevin P; Hertzano, Ronna; Ament, Seth A (Public Library of Science, 2020-09-28)
      Age-related hearing impairment (ARHI), one of the most common medical conditions, is strongly heritable, yet its genetic causes remain largely unknown. We conducted a meta-analysis of GWAS summary statistics from multiple hearing-related traits in the UK Biobank (n = up to 330,759) and identified 31 genome-wide significant risk loci for self-reported hearing difficulty (p < 5x10-8), of which eight have not been reported previously in the peer-reviewed literature. We investigated the regulatory and cell specific expression for these loci by generating mRNA-seq, ATAC-seq, and single-cell RNA-seq from cells in the mouse cochlea. Risk-associated genes were most strongly enriched for expression in cochlear epithelial cells, as well as for genes related to sensory perception and known Mendelian deafness genes, supporting their relevance to auditory function. Regions of the human genome homologous to open chromatin in sensory epithelial cells from the mouse were strongly enriched for heritable risk for hearing difficulty, even after adjusting for baseline effects of evolutionary conservation and cell-type non-specific regulatory regions. Epigenomic and statistical fine-mapping most strongly supported 50 putative risk genes. Of these, 39 were expressed robustly in mouse cochlea and 16 were enriched specifically in sensory hair cells. These results reveal new risk loci and risk genes for hearing difficulty and suggest an important role for altered gene regulation in the cochlear sensory epithelium.
    • Mental health management of elite athletes during COVID-19: a narrative review and recommendations.

      Reardon, Claudia L; Bindra, Abhinav; Blauwet, Cheri; Budgett, Richard; Campriani, Niccolo; Currie, Alan; Gouttebarge, Vincent; McDuff, David; Mountjoy, Margo; Purcell, Rosemary; et al. (BMJ Publishing Group, 2020-09-23)
      Elite athletes suffer many mental health symptoms and disorders at rates equivalent to or exceeding those of the general population. COVID-19 has created new strains on elite athletes, thus potentially increasing their vulnerability to mental health symptoms. This manuscript serves as a narrative review of the impact of the pandemic on management of those symptoms in elite athletes and ensuing recommendations to guide that management. It specifically addresses psychotherapy, pharmacotherapy and higher levels of care. Within the realm of psychotherapy, crisis counselling might be indicated. Individual, couple/family and group psychotherapy modalities all may be helpful during the pandemic, with novel content and means of delivery. Regarding pharmacotherapy for mental health symptoms and disorders, some important aspects of management have changed during the pandemic, particularly for certain classes of medication including stimulants, medications for bipolar and psychotic disorders, antidepressants and medications for substance use disorders. Providers must consider when in-person management (eg, for physical examination, laboratory testing) or higher levels of care (eg, for crisis stabilisation) is necessary, despite potential risk of viral exposure during the pandemic. Management ultimately should continue to follow general principles of quality health care with some flexibility. Finally, the current pandemic provides an important opportunity for research on new methods of providing mental health care for athletes, and consideration for whether these new methods should extend beyond the pandemic.
    • Early Stage Investigators: Emerging Research Supporting Health Equity

      Echeverria, Sandra; Onukwugha, Eberechukwu (International Society on Hypertension in Blacks, 2020-09-01)
    • Vitamin K Intake in Chronic Stroke: Implications for Dietary Recommendations.

      Wessinger, Chad; Hafer-Macko, Charlene; Ryan, Alice S. (MDPI AG, 2020-10-06)
      Previous research has identified a possible association between vitamin K intake and cardiometabolic disease. This could mean that the assessment of vitamin K intake is a meaningful tool when monitoring individuals with preexisting cardiovascular disease. Sixty chronic stroke survivors (men and women, body mass index (BMI) 30.36 ± 6.61 kg/m2, age 61.7 ± 7.2 years) completed food records which were analyzed for energy, macronutrient, micronutrient, and food group servings. Participants were divided into two groups: below vitamin K recommendation (BEL, n = 49) and met vitamin K recommendation (MET, n = 11). Energy and macronutrient intake did not differ between groups (all p > 0.127). Vegetable intake was higher in the MET group (p = 0.0001). Vitamin K intake was higher in the MET group (p = 0.0001). Calcium (p = 0.003), vitamin A (p = 0.007), and vitamin E (p = 0.005) intakes were higher in the MET group. There were no differences in sodium, potassium, vitamin D, vitamin C, and iron intakes between groups (all p > 0.212). In this sample of chronic stroke survivors, 82% reported consuming below the Dietary Reference Intake (DRI) for vitamin K. Given that the majority of this study population did not reach the DRI for vitamin K, it is advisable to promote the adequate intake of food rich in vitamin K. Further work is needed to determine the significance of low vitamin K intake in this population.
    • Vascular control of the CO2/H+ dependent drive to breathe

      Cleary, Colin M.; Moreira, Thiago S.; Takakura, Ana C.; Nelson, Mark T.; Longden, Thomas A.; Mulkey, Daniel K. (eLife Sciences Publications, 2020-09-14)
      Respiratory chemoreceptors regulate breathing in response to changes in tissue CO2/ H+. Blood flow is a fundamental determinant of tissue CO2/H+, yet little is known regarding how regulation of vascular tone in chemoreceptor regions contributes to respiratory behavior. Previously, we showed in rat that CO2/H+-vasoconstriction in the retrotrapezoid nucleus (RTN) supports chemoreception by a purinergic-dependent mechanism (Hawkins et al., 2017). Here, we show in mice that CO2/H+ dilates arterioles in other chemoreceptor regions, thus demonstrating CO2/H+ vascular reactivity in the RTN is unique. We also identify P2Y2 receptors in RTN smooth muscle cells as the substrate responsible for this response. Specifically, pharmacological blockade or genetic deletion of P2Y2 from smooth muscle cells blunted the ventilatory response to CO2, and re-expression of P2Y2 receptors only in RTN smooth muscle cells fully rescued the CO2/H+ chemoreflex. These results identify P2Y2 receptors in RTN smooth muscle cells as requisite determinants of respiratory chemoreception.
    • Intracranial and subcortical volumes in adolescents with early-onset psychosis: A multisite mega-analysis from the ENIGMA consortium

      Gurholt, Tiril P; Lonning, Vera; Nerland, Stener; Jørgensen, Kjetil N; Haukvik, Unn K; Alloza, Clara; Arango, Celso; Barth, Claudia; Bearden, Carrie E; Berk, Michael; et al. (Wiley-Blackwell, 2020-10-05)
      Early-onset psychosis disorders are serious mental disorders arising before the age of 18 years. Here, we investigate the largest neuroimaging dataset, to date, of patients with early-onset psychosis and healthy controls for differences in intracranial and subcortical brain volumes. The sample included 263 patients with early-onset psychosis (mean age: 16.4 ± 1.4 years, mean illness duration: 1.5 ± 1.4 years, 39.2% female) and 359 healthy controls (mean age: 15.9 ± 1.7 years, 45.4% female) with magnetic resonance imaging data, pooled from 11 clinical cohorts. Patients were diagnosed with early-onset schizophrenia (n = 183), affective psychosis (n = 39), or other psychotic disorders (n = 41). We used linear mixed-effects models to investigate differences in intracranial and subcortical volumes across the patient sample, diagnostic subgroup and antipsychotic medication, relative to controls. We observed significantly lower intracranial (Cohen's d = −0.39) and hippocampal (d = −0.25) volumes, and higher caudate (d = 0.25) and pallidum (d = 0.24) volumes in patients relative to controls. Intracranial volume was lower in both early-onset schizophrenia (d = −0.34) and affective psychosis (d = −0.42), and early-onset schizophrenia showed lower hippocampal (d = −0.24) and higher pallidum (d = 0.29) volumes. Patients who were currently treated with antipsychotic medication (n = 193) had significantly lower intracranial volume (d = −0.42). The findings demonstrate a similar pattern of brain alterations in early-onset psychosis as previously reported in adult psychosis, but with notably low intracranial volume. The low intracranial volume suggests disrupted neurodevelopment in adolescent early-onset psychosis. © 2020 The Authors.
    • Bone health effects of androgen-deprivation therapy and androgen receptor inhibitors in patients with nonmetastatic castration-resistant prostate cancer

      Hussain, Arif; Tripathi, Abhishek; Pieczonka, Christopher; Cope, Diane; McNatty, Andrea; Logothetis, Christopher; Guise, Theresa (Springer Nature, 2020-01-01)
      Background: Osteoporosis is a skeletal disorder characterized by compromised bone strength, resulting in increased fracture risk. Patients with prostate cancer may have multiple risk factors contributing to bone fragility: advanced age, hypogonadism, and long-term use of androgen-deprivation therapy. Despite absence of metastatic disease, patients with nonmetastatic castrate-resistant prostate cancer receiving newer androgen receptor inhibitors can experience decreased bone mineral density. A systematic approach to bone health care has been hampered by a simplistic view that does not account for heterogeneity among prostate cancer patients or treatments they receive. This review aims to raise awareness in oncology and urology communities regarding the complexity of bone health, and to provide a framework for management strategies for patients with nonmetastatic castrate-resistant prostate cancer receiving androgen receptor inhibitor treatment. Methods: We searched peer-reviewed literature on the PubMed database using key words “androgen-deprivation therapy,” “androgen receptor inhibitors,” “bone,” “bone complications,” and “nonmetastatic prostate cancer” from 2000 to present. Results: We discuss how androgen inhibition affects bone health in patients with nonmetastatic castrate-resistant prostate cancer. We present data from phase 3 trials on the three approved androgen receptor inhibitors with regard to effects on bone. Finally, we present management strategies for maintenance of bone health. Conclusions: In patients with nonmetastatic castrate-resistant prostate cancer, aging, and antiandrogen therapy contribute to bone fragility. Newer androgen receptor inhibitors were associated with falls or fractures in a small subset of patients. Management guidelines include regular assessment of bone density, nutritional guidance, and use of antiresorptive bone health agents when warranted. © 2020, The Author(s).