Recent Research Articles from UNTHSC

Recent research articles indexed in PubMed from authors affiliated with the UNT Health Science Center.

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NCBI: db=pubmed; Term="University of North Texas Health Science Center"[All Fields] OR "Univ. of North Texas Health Science Center"[All Fields] OR "UNT Health Science Center"[All Fields] OR "Osteopathic Research Center"[All Fields] OR "University of North Texas System College of Pharmacy"[All Fields] OR "UNT System College of Pharmacy"[All Fields] OR "College of Pharmacy, University of North Texas System"[All Fields]
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On the possibility of direct triplet state excitation of indole.

Mon, 05/25/2020 - 06:17

On the possibility of direct triplet state excitation of indole.

J Photochem Photobiol B. 2020 May 16;208:111897

Authors: Chavez J, Ceresa L, Kitchner E, Kimball J, Shtoyko T, Fudala R, Borejdo J, Gryczynski Z, Gryczynski I

Abstract
We studied the luminescence properties of indole in poly (vinyl alcohol) (PVA) film. The indole molecules are effectively immobilized in this polymer film and display both fluorescence and phosphorescence emission at room temperature. We noticed that the phosphorescence of indole in PVA film can be effectively excited at a longer wavelength than its typical singlet to triplet population route involving intersystem crossing. The maximum of the phosphorescence excitation is about 410 nm which corresponds to the energy of indole's triplet state. Interestingly, the phosphorescence anisotropy excited with the longer wavelength (405 nm) is positive and reaches a value of about 0.25 in contrast to the phosphorescence anisotropy excited within the indole singlet absorption spectrum (290 nm), which is negative. Very different temperature dependences have been observed for fluorescence and phosphorescence of indole in PVA film. While fluorescence depends minimally, the phosphorescence decreases with temperature dramatically. The fluorescence lifetime was measured to be a single component 4.78 ns while the intensity weighted average phosphorescence lifetime with 290 nm and 405 nm excitations were 6.57 and 5.62 ms, respectively. We believe that the possibility of the excitation of indole phosphorescence in the blue region of visible light and its high anisotropy opens a new avenue for future protein studies.

PMID: 32447191 [PubMed - as supplied by publisher]

QTc monitoring in adults with medical and psychiatric comorbidities: Expert consensus from the Association of Medicine and Psychiatry.

Sat, 05/23/2020 - 05:52
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QTc monitoring in adults with medical and psychiatric comorbidities: Expert consensus from the Association of Medicine and Psychiatry.

J Psychosom Res. 2020 May 11;135:110138

Authors: Xiong GL, Pinkhasov A, Mangal JP, Huang H, Rado J, Gagliardi J, Demoss D, Karol D, Suo S, Lang M, Stern M, Spearman EV, Onate J, Annamalai A, Saliba Z, Heinrich T, Fiedorowicz JG

Abstract
OBJECTIVE: Several psychiatric medications have the potential to prolong the QTc interval and subsequently increase the risk for ventricular arrhythmias such as torsades de pointes (TdP). There is limited guidance for clinicians to balance the risks and benefits of treatments.
METHODS: After a review of the existing literature, clinical-educators from the Association of Medicine and Psychiatry developed expert consensus guidelines for ECG monitoring of the QTc interval for patients with medical and psychiatric comorbidities who are prescribed medications with the potential to prolong the QTc interval. A risk score was developed based on risk factors for QTc prolongation to guide clinical decision-making.
RESULTS: A baseline ECG may not be necessary for individuals at low risk for arrythmia. Those individuals with a risk score of two or more should have an ECG prior to the start of a potentially QTc-prolonging medication or be started on a lower risk agent. Antipsychotics are not equivalent in causing QTc prolongation. A consensus-based algorithm is presented for the management of those identified at high (QTc >500 msec), intermediate (males with QTc 450-499 msec or females with QTc > 470-499 msec), or low risk.
CONCLUSIONS: The proposed algorithm can help clinicians in determining whether ECG monitoring should be considered for a given patient. These guidelines preserve a role for clinical judgment in selection of treatments that balance the risks and benefits, which may be particularly relevant for complex patients with medical and psychiatric comorbidities. Additional studies are needed to determine whether baseline and serial ECG monitoring reduces mortality.

PMID: 32442893 [PubMed - as supplied by publisher]

Medical Malpractice Trends in Thyroidectomies among General Surgeons and Otolaryngologists.

Fri, 05/22/2020 - 05:42

Medical Malpractice Trends in Thyroidectomies among General Surgeons and Otolaryngologists.

OTO Open. 2020 Apr-Jun;4(2):2473974X20921141

Authors: Swonke ML, Shakibai N, Chaaban MR

Abstract
Objectives: This study aims to examine litigation trends with thyroidectomies in the United States from 1984 to 2018.
Methods: We used the Westlaw legal database to collect data on the defendant, plaintiff, case demographics, alleged reasons for malpractice, additional complications, and case outcomes.
Results: The most common reason for litigation was vocal cord paralysis (51%, n = 28), with the majority ruling in favor of the defendant (64%, P = .042). Of those, 43% of cases (n = 12) were due to unilateral recurrent laryngeal nerve (RLN) injury, and 39% (n = 11) were due to bilateral RLN injury. Of the claims due to vocal cord paralysis that resulted in indemnity payment (36%), the majority included additional damages, such as lack of informed consent (30%) or subsequent damages from permanent tracheostomy (40%), which is usually a result of bilateral nerve paralysis.
Conclusion: RLN injury was the most common complication leading to trial, with most cases ruling in favor of the defense. However, most verdicts that favored the plaintiff or those that settled were due to subsequent damages from bilateral nerve paralysis, such as permanent tracheostomy. We encourage surgeons to consider a staged procedure in high-risk cases or cases with signal loss. There needs to be a bigger emphasis on informed consent in the training of surgeons. Surgeons should educate patients at high risk on potential surgical complications that may drastically affect their quality of life.

PMID: 32435722 [PubMed]

Discovery of a bone-like blood particle in the peripheral circulation of humans and rodents.

Fri, 05/22/2020 - 05:42
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Discovery of a bone-like blood particle in the peripheral circulation of humans and rodents.

Microcirculation. 2019 11;26(8):e12579

Authors: Prisby R, Ross J, Opdenaker L, McLane MA, Lee S, Sun X, Guderian S

Abstract
OBJECTIVE: To characterize ossified bone marrow blood vessels and confirm the presence of ossified particles (OSP) in humans and rodents.
METHODS: Human bone marrow blood vessels were processed for scanning and transmission electron microscopy. Whole blood samples were collected from younger (26-39 years; n = 6) and older (55-63 years; n = 6) volunteers and male Fischer-344 rats (1 month, n = 7; 6 months, n = 7; 12 months, n = 7; 18-months, n = 6; 24 months, n = 8). OSP in the whole blood samples were sorted and imaged with microscopy to determine diameter, circularity, and solidity. Additionally, the chemical composition of OSP was determined via elemental analysis.
RESULTS: SEM revealed two types of ossified bone marrow blood vessels: that is, "transitioning" and "ossified." OSP were adhered to the surface of transitioning vessels and theoretically gain access to and circulate within the blood. The majority of OSP were ≤15 μm in diameter, but many were of sufficient size to serve as emboli (ie, >15 μm).OSP were predominately oblong in shape and several had jagged tips and edges.
CONCLUSIONS: We introduce a novel, bone-like blood particle that may be diagnostic of bone marrow blood vessel ossification. Further, OSP may associate with several disease states (eg, atherosclerosis).

PMID: 31246334 [PubMed - indexed for MEDLINE]

An Objective Structured Clinical Examination to Assess Competency Acquired During an Introductory Pharmacy Practice Experience.

Thu, 05/21/2020 - 05:26

An Objective Structured Clinical Examination to Assess Competency Acquired During an Introductory Pharmacy Practice Experience.

Am J Pharm Educ. 2020 Apr;84(4):7625

Authors: Martin RD, Ngo N, Silva H, Coyle WR

Abstract
Objective. To evaluate the use of an objective structured clinical examinations (OSCE) to assess clinical competency acquired during an off-campus introductory pharmacy practice experience (IPPE). Methods. Third-year pharmacy students completed an IPPE in transitions of care and completed 24 experiential contact hours at one of 17 practice sites. Students were assessed using two OSCEs, the first occurring prior to beginning an off-site IPPE (pre-experience OSCE) and the second occurring after completion of the off-site IPPE (post-experience OSCE). Each OSCE consisted of 10 stations and covered five graded competency domains. The primary outcome was the degree of change in student performance from the pre-experience OSCE to the post-experience OSCE. Secondary outcomes included changes in each graded domain, OSCE pass rate, and failure conversion rate. Results. Of 111 students, 109 completed both the pre- and post-experience OSCE. Significant improvements were observed in overall score and cohort pass rate. Overall scores improved from 80 for the pre-experience OSCE to 87 for the post-experience OSCE. The OSCE pass rate also improved from 47% to 84%. Conclusion. Although preceptor evaluations have traditionally served as the primary summative assessment for IPPE and APPE, this study indicates that OSCEs may be a reliable alternative to assess clinical competency acquired from off-site practice experiences.

PMID: 32431310 [PubMed - in process]

Rhode Island Human Papillomavirus Vaccine School Entry Requirement Using Provider-Verified Report.

Thu, 05/21/2020 - 05:26

Rhode Island Human Papillomavirus Vaccine School Entry Requirement Using Provider-Verified Report.

Am J Prev Med. 2020 May 16;:

Authors: Thompson EL, Livingston MD, Daley EM, Saslow D, Zimet GD

Abstract
INTRODUCTION: Human papillomavirus vaccine school entry requirements may be an opportunity to improve the low rates of human papillomavirus vaccination among adolescents. This study evaluates changes in provider-verified human papillomavirus vaccine uptake by age 13 years for adolescents in Rhode Island compared with all other states from 2011 to 2017.
METHODS: The National Immunization Survey-Teen 2011-2017, a population-based cross-sectional survey, was analyzed in 2019. The survey included telephone interviews and provider-verified reports of vaccination among U.S. adolescents aged 13-17 years. The sample was subset to participants with provider-verified human papillomavirus vaccination reports (n=145,153). A difference-in-differences approach evaluated the Rhode Island human papillomavirus vaccination school entry requirement enacted in 2015. The main outcome was provider-verified human papillomavirus vaccine uptake by age 13 years.
RESULTS: Compared with boys in other states, boys in Rhode Island had an increase of 14 percentage points in the probability of uptake of human papillomavirus vaccination by age 13 years (β=0.139, 95% CI=0.073, 0.205). No such differences were observed on comparing girls in Rhode Island with girls in other states (β=0.009, 95% CI= -0.068, 0.086).
CONCLUSIONS: The Rhode Island school entry requirement for human papillomavirus vaccination improved rates of vaccine uptake among boys and may be a useful option for improving human papillomavirus vaccination nationally.

PMID: 32430223 [PubMed - as supplied by publisher]

What does hand rehabilitation look like in 50 years?

Thu, 05/21/2020 - 05:26

What does hand rehabilitation look like in 50 years?

J Hand Ther. 2020 May 16;:

Authors: Patterson RM, Priganc V

PMID: 32430166 [PubMed - as supplied by publisher]

Mitochondrial tRNA methylation in Alzheimer's disease and progressive supranuclear palsy.

Thu, 05/21/2020 - 05:26

Mitochondrial tRNA methylation in Alzheimer's disease and progressive supranuclear palsy.

BMC Med Genomics. 2020 May 19;13(1):71

Authors: Silzer TK, Pathak GA, Phillips NR

Abstract
BACKGROUND: Methylation of mitochondrial tRNAs (mt-tRNA) at the 9th position ("p9 site") is known to impact translational efficiency and downstream mitochondrial function; however, direct assessment of mt-RNA methylation is challenging. Recent RNA sequence-based methods have been developed to reliably identify post-transcriptional methylation. Though p9 methylation has been studied in healthy human populations and in the context of cancer, it has not yet been analyzed in neurodegenerative disease, where mitochondrial dysfunction is a prominent and early hallmark of disease progression.
METHODS: Mitochondrial p9 methylation was inferred from multi-allelic calls in RNA-seq data. Gene-based association studies were performed in FUMA. Correlations between nuclear gene expression and p9 methylation were tested using Spearman's rho. Fisher's Exact test was used in PANTHER and IPA to test for overrepresentation and enrichment of biological processes and pathways in the top nuclear genes correlated with p9 methylation.
RESULTS: Variable methylation was observed at 11 p9 sites in post-mortem cerebellar tissue of elderly subjects who were either healthy or diagnosed with Alzheimer's disease (AD), progressive supranuclear palsy (PSP) or pathological aging (PA). Similarities in degree of methylation were observed between AD and PSP. Certain nuclear encoded genes were identified as significantly associated with p9 methylation. Expression of 5300 nuclear encoded genes was significantly correlated with p9 methylation, with AD and PSP subjects exhibiting similar expression profiles. Overrepresentation and enrichment testing using the top transcripts revealed enrichment for a number of molecular processes, terms and pathways including many of which that were mitochondrial-related.
CONCLUSION: With mitochondrial dysfunction being an established hallmark of neurodegenerative disease pathophysiology, this work sheds light on the potential molecular underpinnings of this dysfunction. Here we show overlap in cerebellar pathophysiology between common tauopathies such as Alzheimer's disease and progressive supranuclear palsy. Whether p9 hypermethylation is a cause or consequence of pathology remains an area of focus.

PMID: 32429992 [PubMed - in process]

Retina-Targeted Delivery of 17β-Estradiol by the Topically Applied DHED Prodrug.

Thu, 05/21/2020 - 05:26

Retina-Targeted Delivery of 17β-Estradiol by the Topically Applied DHED Prodrug.

Pharmaceutics. 2020 May 16;12(5):

Authors: Prokai-Tatrai K, Nguyen V, De La Cruz DL, Guerra R, Zaman K, Rahlouni F, Prokai L

Abstract
The purpose of this study was to explore retina-targeted delivery of 17β-estradiol (E2), a powerful neuroprotectant, by its bioprecursor prodrug 10β,17β-dihydroxyestra-1,4-dien-3-one (DHED) administered as eye drops in animal models. Compared to the parent hormone, DHED displayed increased transcorneal flux ex vivo both with and without the presence of 2-hydroxypropyl-β-cyclodextrin used as a penetration-enhancing excipient in rat, rabbit, and pig. In vitro, the prodrug also showed facile bioactivation to E2 in the retina but not in the cornea. After topical administration to rats and rabbits, peak DHED-derived E2 concentrations reached 13 ± 5 ng/g and 18 ± 7 ng/g in the retina of female rats and rabbits, respectively. However, the prodrug remained inert in the rest of the body and, therefore, did not cause increase in circulating hormone concentration, as well as wet uterine and anterior pituitary weights as typical markers of E2's endocrine impact. Altogether, our studies presented here have demonstrated the premise of topical retina-selective estrogen therapy by the DHED prodrug approach for the first time and provide compelling support for further investigation into the full potential of DHED for an efficacious and safe ocular neurotherapy.

PMID: 32429388 [PubMed]

Tenofovir Plasma Concentration from Preexposure Prophylaxis at the Time of Potential HIV Exposure: a Population Pharmacokinetic Modeling and Simulation Study Involving Serodiscordant Couples in East Africa.

Thu, 05/21/2020 - 05:26
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Tenofovir Plasma Concentration from Preexposure Prophylaxis at the Time of Potential HIV Exposure: a Population Pharmacokinetic Modeling and Simulation Study Involving Serodiscordant Couples in East Africa.

Antimicrob Agents Chemother. 2019 08;63(8):

Authors: Mallayasamy S, Chaturvedula A, Fossler MJ, Sale M, Goti V, Bumpus NN, Marzinke MA, Hendrix CW, Haberer JE, Partners Demonstration Project Team

Abstract
The Partners Demonstration Project was a prospective, open-label, implementation science-driven study of preexposure prophylaxis (PrEP) among heterosexual HIV serodiscordant couples in Kenya and Uganda. Adherence data were collected using the Medication Event Monitoring System (MEMS), and time of sexual activity was collected using the mobile phone short message service (SMS). Two plasma samples were collected at a single study visit. We integrated adherence, pharmacokinetics, and SMS data using a population pharmacokinetic (PopPK) model to simulate tenofovir plasma concentrations from PrEP at the time of sexual activity. In the first stage of this analysis, we used data from the current study to update a prior PopPK model of tenofovir (TFV) developed with data from the Partners PrEP Study (a phase III clinical trial). The second stage involved simulating plasma concentrations at the time of sexual activity using empirical Bayes estimates (EBEs) derived from the final model. In addition, EBEs from a previously published parent metabolite model of TFV (MTN-001, an open-label 3-way crossover study in healthy women) was used to simulate tenofovir diphosphate (TFV-DP) concentrations. We estimated percent PrEP "coverage" as the number of reported sexual events during which simulated concentrations were above an a priori threshold concentrations associated with a high degree of protection from HIV infection: plasma TFV of >40 ng/ml and peripheral blood mononuclear cell (PBMC) TFV-DP concentration of >36 fmol/million cells. The levels of coverage were 72% for TFV and 81% for TFV-DP. These levels are consistent with a high degree of protection against HIV acquisition in this study of a pragmatic delivery model for antiretroviral-based HIV prevention.

PMID: 31182536 [PubMed - indexed for MEDLINE]

On the Origin and Correction for Inner Filter Effects in Fluorescence. Part I: Primary Inner Filter Effect -The Proper Approach for Sample Absorbance Correction.

Wed, 05/20/2020 - 08:14

On the Origin and Correction for Inner Filter Effects in Fluorescence. Part I: Primary Inner Filter Effect -The Proper Approach for Sample Absorbance Correction.

Methods Appl Fluoresc. 2020 May 19;:

Authors: Kimball J, Chavez JL, Ceresa L, Kitchner E, Nurekeyev Z, Doan H, Szabelski M, Borejdo J, Gryczynski I, Gryczynski Z

Abstract
Fluorescence technologies have been the preferred method for detection, analytical sensing, medical diagnostics, biotechnology, imaging, and gene expression for many years. Fluorescence becomes essential for studying molecular processes with high specificity and sensitivity through a variety of biological processes. A significant problem for practical fluorescence applications is the apparent non-linearity of the fluorescence intensity resulting from inner-filter effects, sample scattering, and absorption of intrinsic components of biological samples. Sample absorption can lead to the primary inner filter effect (Type I inner filter effect) and is the first factor that should be considered. This is a relatively simple factor to be controlled in any fluorescence experiment. However, many previous approaches have given only approximate experimental methods for correcting the deviation from expected results. In this part we are discussing the origin of the primary inner filter effect and presenting a universal approach for correcting the fluorescence intensity signal in the full absorption range. Importantly, we present direct experimental results of how the correction works. One considers problems emerging from varying absorption across its absorption spectrum for all fluorophores. We use Rhodamine 800 and demonstrate how to properly correct the excitation spectra in a broad wavelength range. Second is the effect of an inert absorber that attenuates the intensity of the excitation beam as it travels through the cuvette, which leads to a significant deviation of observed results. As an example, we are presenting fluorescence quenching of a tryptophan analog, NATA, by acrylamide and we show how properly corrected results compare to the initial erroneous results. The procedure is generic and applies to many other applications like quantum yield determination, tissue/blood absorption, or acceptor absorption in FRET experiments.

PMID: 32428893 [PubMed - as supplied by publisher]

Thymic Function Associated With Cancer Development, Relapse, and Antitumor Immunity - A Mini-Review.

Wed, 05/20/2020 - 08:14

Thymic Function Associated With Cancer Development, Relapse, and Antitumor Immunity - A Mini-Review.

Front Immunol. 2020;11:773

Authors: Wang W, Thomas R, Sizova O, Su DM

Abstract
The thymus is the central lymphoid organ for T cell development, a cradle of T cells, and for central tolerance establishment, an educator of T cells, maintaining homeostatic cellular immunity. T cell immunity is critical to control cancer occurrence, relapse, and antitumor immunity. Evidence on how aberrant thymic function influences cancer remains largely insufficient, however, there has been recent progress. For example, the involuted thymus results in reduced output of naïve T cells and a restricted T cell receptor (TCR) repertoire, inducing immunosenescence and potentially dampening immune surveillance of neoplasia. In addition, the involuted thymus relatively enhances regulatory T (Treg) cell generation. This coupled with age-related accumulation of Treg cells in the periphery, potentially provides a supportive microenvironment for tumors to escape T cell-mediated antitumor responses. Furthermore, acute thymic involution from chemotherapy can create a tumor reservoir, resulting from an inflammatory microenvironment in the thymus, which is suitable for disseminated tumor cells to hide, survive chemotherapy, and become dormant. This may eventually result in cancer metastatic relapse. On the other hand, if thymic involution is wisely taken advantage of, it may be potentially beneficial to antitumor immunity, since the involuted thymus increases output of self-reactive T cells, which may recognize certain tumor-associated self-antigens and enhance antitumor immunity, as demonstrated through depletion of autoimmune regulator (AIRE) gene in the thymus. Herein, we briefly review recent research progression regarding how altered thymic function modifies T cell immunity against tumors.

PMID: 32425946 [PubMed - in process]

A pilot study on the design and validation of a hybrid exoskeleton robotic device for hand rehabilitation.

Wed, 05/20/2020 - 08:14
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A pilot study on the design and validation of a hybrid exoskeleton robotic device for hand rehabilitation.

J Hand Ther. 2020 May 16;:

Authors: Haghshenas-Jaryani M, Patterson RM, Bugnariu N, Wijesundara MBJ

Abstract
STUDY DESIGN: An iterative design process was used to obtain design parameters that satisfy both kinematic and dynamic requirements for the hand exoskeleton. This design was validated through experimental studies.
INTRODUCTION: The success of hand rehabilitation after impairments depends on the timing, intensity, repetition, and frequency, as well as task-specific training. Considering the continuing constraints placed on therapist-led rehabilitation and need for better outcomes, robot-assisted rehabilitation has been explored. Soft robotic approaches have been implemented for a hand rehabilitation exoskeleton as they have more tolerance for alignment with biological joints than those of hard exoskeletons.
PURPOSE OF THE STUDY: The purpose of the study was to design, develop, and validate a soft robotic exoskeleton for hand rehabilitation.
METHODS: A motion capture system validated the kinematics of the soft robotic digit attached on top of a human index finger. A pneumatic control system and algorithms were developed to operate the exoskeleton based on three therapeutic modes: continuous passive, active assistive, and active resistive motion. Pilot studies were carried out on one healthy and one poststroke participant using continuous passive motion and bilateral/bimanual therapy modes.
RESULTS: The soft robotic digits were able to produce required range of motion and accommodate for dorsal lengthening, with trajectories of the center of rotation of the soft robotic joints in close agreement with the center of rotation of the human finger joints.
DISCUSSION: The exoskeleton showed the robust performance of the robot in applying continuous passive motion and bilateral/bimanual therapy.
CONCLUSIONS: This soft robotic exoskeleton is promising for assisting in the rehabilitation of the hand.

PMID: 32423846 [PubMed - as supplied by publisher]

Translaminar Autonomous System Model for the Modulation of Intraocular and Intracranial Pressure in Human Donor Posterior Segments.

Tue, 05/19/2020 - 05:00
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Translaminar Autonomous System Model for the Modulation of Intraocular and Intracranial Pressure in Human Donor Posterior Segments.

J Vis Exp. 2020 Apr 24;(158):

Authors: Sharma TP, Curry SM, Lohawala H, McDowell C

Abstract
There is a current unmet need for a new preclinical human model that can target disease etiology ex vivo using intracranial pressure (ICP) and intraocular pressure (IOP) which can identify various pathogenic paradigms related to the glaucoma pathogenesis. Ex vivo human anterior segment perfusion organ culture models have previously been successfully utilized and applied as effective technologies for the discovery of glaucoma pathogenesis and testing of therapeutics. Preclinical drug screening and research performed on ex vivo human organ systems can be more translatable to clinical research. This article describes in detail the generation and operation of a novel ex vivo human translaminar pressure model called the translaminar autonomous system (TAS). The TAS model can independently regulate ICP and IOP using human donor posterior segments. The model allows for studying pathogenesis in a preclinical manner. It can reduce the use of living animals in ophthalmic research. In contrast to in vitro experimental models, optic nerve head (ONH) tissue structure, complexity, and integrity can also be maintained within the ex vivo TAS model.

PMID: 32421000 [PubMed - as supplied by publisher]

Osteopathic Manipulative Treatment Alters Gastric Myoelectric Activity in Healthy Subjects.

Tue, 05/19/2020 - 05:00
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Osteopathic Manipulative Treatment Alters Gastric Myoelectric Activity in Healthy Subjects.

J Altern Complement Med. 2018 Dec;24(12):1176-1180

Authors: Shadiack E, Jouett N, van den Raadt A, Liganor R, Watters J, Hensel K, Smith M

Abstract
Objectives: It is unclear whether osteopathic manipulative treatment (OMT) affects gastric myoelectric activity (GMA), an index of gastric motility. We hypothesized that OMT significantly alters power spectral density (PSD) analyses of electrogastrography (EGG) recordings, an index of GMA, compared with time control OMT. Design: GMA data were obtained from nine subjects before and after OMT and time control on separate days in a cross-over design. Fifteen-minute EGG recordings were obtained before and after each intervention and after a water challenge (WC). Percent power in the normogastric range (PPN) was estimated from PSD analyses. Absolute percent change of PPN and dominant frequency (DF) from baseline to postintervention and baseline to post-WC was computed and compared using two-way repeated-measures ANOVA. Results: OMT altered PPN versus time control (time control: 5.3% ± 1.2%; OMT: 24.5% ± 4.5%; p = 0.015). WC altered PPN compared with time control (post-time control ΔPPN: 5.3% ± 1.2%; post-drink ΔPPN: 30.3% ± 7.2%; p < 0.01). However, WC did not alter PPN with prior OMT treatment (post-OMT ΔPPN: 24.5% ± 4.5%; post-WC ΔPPN: 19.4% ± 5.6%; p = 0.47). Nevertheless, OMT reduced the rate of change for DF compared with time control (WC post-time control: 37.9% ± 7.4%; WC post-OMT: 20.0% ± 5.9%; p = 0.02). Conclusions: We conclude that (1) OMT significantly alters GMA compared with time control and that (2) OMT reduces the rate of change in the frequency response to WC within the normal frequency range of 2-4 cycles per minute, indicating a physiological effect.

PMID: 30376351 [PubMed - indexed for MEDLINE]

Improvements in Retention in Care and HIV Viral Suppression Among Persons with HIV and Comorbid Mental Health Conditions: Patient-Centered HIV Care Model.

Sun, 05/17/2020 - 16:29
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Improvements in Retention in Care and HIV Viral Suppression Among Persons with HIV and Comorbid Mental Health Conditions: Patient-Centered HIV Care Model.

AIDS Behav. 2020 May 15;:

Authors: Byrd KK, Hardnett F, Hou JG, Clay PG, Suzuki S, Camp NM, Shankle MD, Weidle PJ, Taitel MS, Patient-Centered HIV Care Model Team

Abstract
The Patient-centered HIV Care Model (PCHCM) integrated community-based pharmacists with medical providers and required sharing of patient clinical information and collaborative therapy-related action planning. We determined the proportions of participants with HIV and mental health conditions who were retained in care and the proportion virally suppressed, pre- and post-implementation. Overall, we found a relative 13% improvement in both retention [60% to 68% (p = 0.009)] and viral suppression [79% to 90% (p < 0.001)]. Notable improvements were seen among persons triply diagnosed with HIV, mental illness and substance use [+ 36% (50% to 68%, p = 0.036) and + 32% (66% to 86%, p = 0.001) in retention and viral suppression, respectively]. There were no differences in the proportions of persons adherent to psychiatric medications, pre- to post-implementation, nor were there differences in the proportions of persons retained in care or virally suppressed by psychiatric medication adherence, post-implementation. PCHCM demonstrated that collaborations between community-based pharmacists and medical providers can improve HIV care continuum outcomes among persons with mental health conditions.

PMID: 32415615 [PubMed - as supplied by publisher]

Broader Implications of Modeling and Simulation (M&S) Tools in Pharmacotherapeutic Decisions: A Cautionary Optimism.

Sat, 05/16/2020 - 07:15

Broader Implications of Modeling and Simulation (M&S) Tools in Pharmacotherapeutic Decisions: A Cautionary Optimism.

Front Pharmacol. 2020;11:571

Authors: Chaturvedula A, Palasik BN, Cho HJ, Goyal N

PMID: 32411002 [PubMed]

Approaches to Whole Mitochondrial Genome Sequencing on the Oxford Nanopore MinION.

Sat, 05/16/2020 - 07:15
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Approaches to Whole Mitochondrial Genome Sequencing on the Oxford Nanopore MinION.

Curr Protoc Hum Genet. 2019 12;104(1):e94

Authors: Zascavage RR, Hall CL, Thorson K, Mahmoud M, Sedlazeck FJ, Planz JV

Abstract
Traditional approaches for interrogating the mitochondrial genome often involve laborious extraction and enrichment protocols followed by Sanger sequencing. Although preparation techniques are still demanding, the advent of next-generation or massively parallel sequencing has made it possible to routinely obtain nucleotide-level data with relative ease. These short-read sequencing platforms offer deep coverage with unparalleled read accuracy in high-complexity genomic regions but encounter numerous difficulties in the low-complexity homopolymeric sequences characteristic of the mitochondrial genome. The inability to discern identical units within monomeric repeats and resolve copy-number variations for heteroplasmy detection results in suboptimal genome assemblies that ultimately complicate downstream data analysis and interpretation of biological significance. Oxford Nanopore Technologies offers the ability to generate long-read sequencing data on a pocket-sized device known as the MinION. Nanopore-based sequencing is scalable, portable, and theoretically capable of sequencing the entire mitochondrial genome in a single contig. Furthermore, the recent development of a nanopore protein with dual reader heads allows for clear identification of nucleotides within homopolymeric stretches, significantly increasing resolution throughout these regions. The unrestricted read lengths, superior homopolymeric resolution, and affordability of the MinION device make it an attractive alternative to the labor-intensive, time-consuming, and costly mainstay deep-sequencing platforms. This article describes three approaches to extract, prepare, and sequence mitochondrial DNA on the Oxford Nanopore MinION device. Two of the workflows include enrichment of mitochondrial DNA prior to sequencing, whereas the other relies on direct sequencing of native genomic DNA to allow for simultaneous assessment of the nuclear and mitochondrial genomes. © 2019 by John Wiley & Sons, Inc. Basic Protocol: Enrichment-free mitochondrial DNA sequencing Alternate Protocol 1: Mitochondrial DNA sequencing following enrichment with polymerase chain reaction (PCR) Alternate Protocol 2: Mitochondrial DNA sequencing following enrichment with PCR-free hybridization capture Support Protocol 1: DNA quantification and quality assessment using the Agilent 4200 TapeStation System Support Protocol 2: AMPure XP bead clean-up Support Protocol 3: Suggested data analysis pipeline.

PMID: 31743587 [PubMed - indexed for MEDLINE]

Will There Be an Epidemic of Corollary Illnesses Linked to a COVID-19-Related Recession?

Fri, 05/15/2020 - 06:58

Will There Be an Epidemic of Corollary Illnesses Linked to a COVID-19-Related Recession?

Am J Public Health. 2020 May 14;:e1-e2

Authors: Brenner MH

Abstract
Currently, US unemployment claims have skyrocketed to 30 million in the past six weeks, continuing in a stark upward trend, and labor economists estimate the unemployment rate at minimally 18.3%. These unemployment figures are a feature of the COVID-19 recession that is characterized by sharp gross domestic product (GDP) growth decline. Despite the greatly damaging impact of the opioid crisis over 2015 to 2017 resulting in a decrease in life expectancy over these three years, the long-term increases in average GDP per capita from 1999 to 2018 managed to save lives on average (i.e., age-adjusted mortality rates declined in the United States). For example, during 1999 to 2018, the average GDP per capita annually increased 1.2%, whereas the related age-adjusted mortality rate has shown an annual decrease of approximately 1% on average (0.99%). However, recessions erase some of this beneficial effect of GDP growth on mortality reduction.1 (Am J Public Health. Published online ahead of print May 14, 2020: e1-e2. doi:10.2105/AJPH.2020.305724).

PMID: 32407135 [PubMed - as supplied by publisher]

Effect of mobile text messages on antiretroviral medication adherence and patient retention in early HIV care: an open-label, randomized, single center study in south Florida.

Fri, 05/15/2020 - 06:58

Effect of mobile text messages on antiretroviral medication adherence and patient retention in early HIV care: an open-label, randomized, single center study in south Florida.

AIDS Res Ther. 2020 May 13;17(1):16

Authors: Sherman EM, Niu J, Elrod S, Clauson KA, Alkhateeb F, Eckardt P

Abstract
BACKGROUND: People with HIV (PHIV) with limited access to health services often experience suboptimal antiretroviral therapy (ART) adherence. We investigated whether a daily text messaging intervention improves ART adherence and retention in early HIV care in PHIV in a south Florida hospital-based clinic.
METHODS: ART-naïve PHIV receiving care through the clinic's Ryan White HIV/AIDS Program were enrolled and randomly assigned to the intervention or control groups with a 1:1 ratio. The intervention group received a 1-way text message daily and the control group received standard care without receiving text message reminders for 6 months. HIV RNA and CD4 cell count were measured at baseline and post-intervention. Adherence to ART was defined as a visual analog scale of ≥ 90%. Retention in care was defined as continued engagement at study end.
RESULTS: 94 ART-naïve patients were randomized and 83 (85.6%) completed the study, of which 44 were in the intervention group and 39 were in the control group. At the end of the 6-month study period, adherence to ART was 84.4% in the intervention group versus 73.5% in the control group (OR, 1.9; 95% CI 0.7-5.0; p = 0.194). Retention in care significantly improved in the intervention group compared to the control group with the odds of retention increasing by 20% (OR, 1.2; 95% CI 1.1-1.5; p = 0.006). Undetectable HIV RNA (< 50 copies/mL) was 86.7% in the intervention group versus 73.5% in the control group (OR, 2.3; 95% CI 0.8-6.9; p = 0.112). A significant increase in CD4 cell count and a decrease in HIV RNA were found at study end, with no differences between the two groups.
CONCLUSIONS: In this pilot study, a one-way daily text messaging intervention did not improve ART adherence over a 6-month study period, but significantly enhanced patient retention in early HIV care. Implementation of interventions to improve adherence in this population is required.

PMID: 32404130 [PubMed - in process]

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