Navigating herpes simplex encephalitis: Family medicine perspectives from Jharkhand, India.

Background: Herpes simplex encephalitis (HSE), caused by herpes simplex virus (HSV) is the most common cause of sporadic encephalitis that often presents as an emergency case of acute or sub-acute nature associated with poor prognosis. Early suspicion and prompt diagnostic testing with adequate antiviral therapy can only reduce morbidity and mortality associated with the disease. This study aims to evaluate the role of serological and molecular diagnosis of encephalitis caused by HSV 1 and 2 for timely detection of the disease.

Enhancing milk quality assessment with watermelon (Citrullus lanatus) urease immobilized on VS-chitosan nanocomposite beads using response surface methodology.

An eco-friendly hydrothermal method synthesized VS nanosheets. Several spectroscopic and microscopic approaches (TEM) were used to characterize the produced VS nanosheet microstructure. VS, Chitosan, and nanocomposite were used to immobilize watermelon (Citrullus lanatus) urease.

Advancements in Nanotechnology for Enhanced Antifungal Drug Delivery: A Comprehensive Review.

Infections caused by fungi can be mildly bothersome or fatal, causing life-threatening conditions or even death. Antifungal drugs have used synthetic chemicals, organic compounds, and phytoconstituents in their formulations to treat fungal infections. Research into novel antifungal drugs has progressed more rapidly than into antibacterial treatments.

Building a Roadmap for Surveillance of Renal Masses Using a Modified Delphi Method to Help Achieve Consensus.

Objective: To establish a consensus for initial evaluation and follow-up of patients on active surveillance (AS) for T1 renal masses (T1RM).

Methods: A modified Delphi method was used to gather information about AS of T1RM, with a focus on patient selection, timing/type of imaging modality, and triggers for intervention. A consensus panel of Michigan Urological Surgery Improvement Collaborative-affiliated urologists who routinely manage renal masses was formed.

Antibiotic Stewardship and Treatment of Uncomplicated Urinary Tract Infection (UTI) in Children and Adolescents in the Emergency Department of a Community Hospital.

A retrospective, cross-sectional study of children with suspected urinary tract infections (UTIs) 3 months to 18 years of age who had a urinalysis and urine culture (UC) during an emergency department (ED) visit between 2019 and 2020 was performed. Chi-square, Fisher exact, and independent samples tests were used as appropriate. Median age was 6.

Initial Management of Indeterminate Renal Lesions in a Statewide Collaborative: A MUSIC-KIDNEY Analysis.

Purpose: Renal masses can be characterized as "indeterminate" due to lack of differentiating imaging characteristics. Optimal management of indeterminate renal lesions remains nebulous and poorly defined. We assess management of indeterminate renal lesions within the MUSIC-KIDNEY (Michigan Urological Surgery Improvement Collaborative-Kidney mass: Identifying and Defining Necessary Evaluation and therapY) collaborative.

Utilization of Renal Mass Biopsy for T1 Renal Lesions across Michigan: Results from MUSIC-KIDNEY, A Statewide Quality Improvement Collaborative.

Background: Renal mass biopsy (RMB) has had limited and varied utilization to guide management of renal masses (RM).

Objective: To evaluate utilization of RMB for newly diagnosed cT1 RMs across diverse practice types and assess associations of outcomes with RMB.

Design Setting And Participants: MUSIC-KIDNEY commenced data collection in September 2017 for all newly presenting patients with a cT1 RM at 14 diverse practices.

Initial Observation of a Large Proportion of Patients Presenting with Clinical Stage T1 Renal Masses: Results from the MUSIC-KIDNEY Statewide Collaborative.

Background: While surgical excision remains the principal management strategy for clinical T1 renal masses (cT1RMs), the rates of noninterventional approaches are not well known. Most single-institution and population-based series suggest rates below 10%.

Objective: To evaluate the use of observation for newly diagnosed cT1RM patients in academic and community-based practices across a statewide collaborative.

Inhibition of GCK-IV kinases dissociates cell death and axon regeneration in CNS neurons.

Axon injury is a hallmark of many neurodegenerative diseases, often resulting in neuronal cell death and functional impairment. Dual leucine zipper kinase (DLK) has emerged as a key mediator of this process. However, while DLK inhibition is robustly protective in a wide range of neurodegenerative disease models, it also inhibits axonal regeneration.

Quality of Care for Renal Masses: The Michigan Urological Surgery Improvement Collaborative-Kidney Mass: Identifying & Defining Necessary Evaluation & Therapy (MUSIC-KIDNEY).

Introduction: We describe the establishment of the Michigan Urological Surgery Improvement Collaborative-Kidney mass: Identifying and Defining Necessary Evaluation and therapY (MUSIC-KIDNEY) to improve the quality of care that patients in Michigan receive for localized, 7 cm or smaller (T1) renal masses.

Methods: The MUSIC-KIDNEY collaborative is comprised of 45 urologists from 8 group practices. From June 2017 to November 2018 surgeons collected data for 821 patients with newly diagnosed T1 renal masses.

Improving Point-of-Care Ultrasound Documentation and Billing Accuracy in a Pediatric Emergency Department.

Objective: The performance and interpretation of point-of-care ultrasound (POCUS) should be documented appropriately in the electronic medical record (EMR) with correct billing codes assigned. We aimed to improve complete POCUS documentation from 62% to 80% and improve correct POCUS billing codes to 95% or higher through the implementation of a quality improvement initiative.

Methods: We collected POCUS documentation and billing data from the EMR.

Carotid Artery Flow Time Measured by Point-of-Care Ultrasound Correlates with Volume Changes in Pediatric Hemodialysis Patients.

Carotid artery flow time corrected for heart rate (CFTc) correlates with intravascular volume changes in adults but has not been studied adequately in the pediatric population. We studied how fluid status changes correlate with CFTc in pediatric patients undergoing hemodialysis. This prospective observational study involved pediatric patients aged 5-18 y undergoing chronic hemodialysis at a tertiary care children's hospital in the United States.

Genetically Encodable Contrast Agents for Optical Coherence Tomography.

Optical coherence tomography (OCT) has gained wide adoption in biological research and medical imaging due to its exceptional tissue penetration, 3D imaging speed, and rich contrast. However, OCT plays a relatively small role in molecular and cellular imaging due to the lack of suitable biomolecular contrast agents. In particular, while the green fluorescent protein has provided revolutionary capabilities to fluorescence microscopy by connecting it to cellular functions such as gene expression, no equivalent reporter gene is currently available for OCT.

Targeted disruption of dual leucine zipper kinase and leucine zipper kinase promotes neuronal survival in a model of diffuse traumatic brain injury.

Background: Traumatic brain injury (TBI) is a major cause of CNS neurodegeneration and has no disease-altering therapies. It is commonly associated with a specific type of biomechanical disruption of the axon called traumatic axonal injury (TAI), which often leads to axonal and sometimes perikaryal degeneration of CNS neurons. We have previously used genome-scale, arrayed RNA interference-based screens in primary mouse retinal ganglion cells (RGCs) to identify a pair of related kinases, dual leucine zipper kinase (DLK) and leucine zipper kinase (LZK) that are key mediators of cell death in response to simple axotomy.

Wnt signaling promotes axonal regeneration following optic nerve injury in the mouse.

Adult mammalian CNS axons generally do not regenerate, creating an obstacle to effective repair and recovery after neuronal injury. The canonical Wnt/β-catenin signaling pathway is an essential signal transduction cascade that regulates axon growth and neurite extension in the developing mammalian embryo. In this study, we investigated whether a Wnt/β-catenin signaling activator could be repurposed to induce regeneration in the adult CNS after axonal injury.

Protective effects of a grape-supplemented diet in a mouse model of retinal degeneration.

Objective: Retinal degenerations are a class of devastating blinding diseases that are characterized by photoreceptor dysfunction and death. In this study, we tested whether grape consumption, in the form of freeze-dried grape powder (FDGP), improves photoreceptor survival in a mouse model of retinal degeneration.

Methods: Retinal degeneration was induced in mice by acute oxidative stress using subretinal injection of paraquat.

Defining the Relationships Among Retinal Function, Layer Thickness and Visual Behavior During Oxidative Stress-Induced Retinal Degeneration.

Purpose: The purpose of this study was to identify how changes in retinal structure and function correlate with visual deficits during increasing amounts of retinal degeneration.

Materials And Methods: Retinal degeneration was induced in adult mice by subretinal injections of paraquat (PQ) (0.2-1 mM).

Reduced photoreceptor death and improved retinal function during retinal degeneration in mice lacking innate immunity adaptor protein MyD88.

The injury inflammatory response mediated by the innate immune system is an important contributor to neurodegeneration in the central nervous system (CNS) and retina. A major branch of the innate immune system is regulated by the Toll-like receptors (TLRs), which are receptors for endogenous damage associated molecules released from injured cells as well as pathogen-derived molecules, and interleukin-1 receptors (IL-1R), which are activated by IL-1α, IL-1β and IL-18 cytokines. TLRs and IL-1R are expressed on immune and non-immune cell types and act as first responders to cell damage, which results in tissue repair, or inflammation and apoptosis.

Opacification of hydrophilic intraocular lenses after Descemet stripping automated endothelial keratoplasty.

Purpose: Opacification of hydrophilic acrylic intraocular lenses (IOLs) is an emerging complication following Descemet stripping automated endothelial keratoplasty (DSAEK). We report six cases and review the current literature.

Methods: In this retrospective, noncomparative, observational case series, patients with IOL opacification after previous DSAEK surgery were identified from corneal clinic records.

Posterior segment findings in a patient with immunotactoid glomerulonephritis.

Purpose: To present a case with posterior segment findings in a patient with cloudy corneas secondary to immunotactoid glomerulonephritis (ITG).

Methods: A 57-year-old female was known to have bilateral cloudy corneas diagnosed 12 years ago secondary to immunotactoid glomerulonephritis. Clinically, fundus examination was difficult to visualise due to the density of her corneal opacities.

Activation of Wnt/β-catenin signaling in Muller glia protects photoreceptors in a mouse model of inherited retinal degeneration.

The canonical Wnt/β-catenin ("Wnt") pathway is an essential signaling cascade in the embryonic central nervous system (CNS) that regulates neuronal differentiation and survival. Loss of Wnt signaling in developing and adult tissue has been implicated in numerous CNS diseases, but the precise role of Wnt in regulating neuronal survival, and how its absence could lead to disease, is not understood. In this study, we investigated the effect of Wnt activation on neuronal survival in the adult retina, and identified cellular and molecular mediators.

A novel protective role for the innate immunity Toll-Like Receptor 3 (TLR3) in the retina via Stat3.

The innate immune system and inflammatory pathways play key roles in numerous diseases of the central nervous system (CNS). Recent evidence indicates that innate immunity induces both pathogenesis and protection during neuronal injury. To test the possibility that the conflicting roles of innate immunity in the CNS depends on the cellular environment in which innate immunity is stimulated, we analyzed the effect of Toll-Like Receptor 3 (TLR3) activation on neuronal survival in the presence and absence of oxidative injury in a mouse model system.