HIV transcription persists in the brain of virally suppressed people with HIV.

HIV persistence in the brain is a barrier to cure, and potentially contributes to HIV-associated neurocognitive disorders. Whether HIV transcription persists in the brain despite viral suppression with antiretroviral therapy (ART) and is subject to the same blocks to transcription seen in other tissues and blood, is unclear. Here, we quantified the level of HIV transcripts in frontal cortex tissue from virally suppressed or non-virally suppressed people with HIV (PWH).

Relevance of instrumented gait analysis in the prediction of the rebound phenomenon after guided growth intervention.

Predictors of rebound after correction of coronal plane deformities using temporary hemiepiphysiodesis (TH) are not well defined. The following research questions were tested: (1) Is the dynamic knee joint load useful to improve rebound prediction accuracy? (2) Does a large initial deformity play a critical role in rebound development? (3) Are BMI and a young age risk factors for rebound? Fifty children and adolescents with idiopathic knee valgus malalignment were included. A deviation of the mechanical femorotibial angle (MFA) of ≥ 3° into valgus between explantation and the one-year follow-up period was chosen to classify a rebound.

A Quality Improvement Initiative for Echocardiogram Ordering Patterns in an Academic Hospital.

Background Appropriate Use Criteria (AUC) for echocardiography are a useful tool to deliver quality healthcare. Our quality-based interventional study was designed to assess the trends in appropriate utilization rates for echocardiography in our institution and improve adherence to the AUC criteria for transthoracic echocardiograms (TTE). Methodology A prospective, time series analysis was conducted at the Upstate University Hospital for the months of July 2019 and August 2020.

Regional Analysis of Intact and Defective HIV Proviruses in the Brain of Viremic and Virally Suppressed People with HIV.

Here, we provide the first regional analysis of intact and defective HIV reservoirs within the brain. Brain tissue from both viremic and virally suppressed people with HIV (PWH) harbored HIV pol DNA in all regions tested, with lower levels present in basal ganglia and cerebellum relative to frontal white matter. Intact proviruses were primarily found in the frontal white matter but also detected in other brain regions of PWH, demonstrating frontal white matter as a major brain reservoir of intact, potentially replication competent HIV DNA that persists despite antiretroviral therapy.

Chronic immune activation and gut barrier dysfunction is associated with neuroinflammation in ART-suppressed SIV+ rhesus macaques.

HIV-associated neurocognitive disorders (HAND) affect ~40% of virally suppressed people with HIV (PWH), however, the precise viral dependent and independent changes to the brain are unclear. Here we characterized the CNS reservoir and immune environment of SIV-infected (SIV+) rhesus macaques during acute (n = 4), chronic (n = 12) or ART-suppressed SIV infection (n = 11). Multiplex immunofluorescence for markers of SIV infection (vRNA/vDNA) and immune activation was performed on frontal cortex and matched colon tissue.

Acute ST-Segment Elevation Myocardial Infarction as a Rare Postoperative Complication of Biventricular Implantable Cardioverter-Defibrillator Placement.

We present a rare case of an 84-year-old woman who suffered an acute ST-segment elevation myocardial infarction as a postoperative complication of biventricular implantable cardioverter-defibrillator placement, caused by the left ventricular lead impinging onto the second obtuse marginal artery. ().

Non-Human Primate Models of HIV Brain Infection and Cognitive Disorders.

Human Immunodeficiency virus (HIV)-associated neurocognitive disorders are a major burden for people living with HIV whose viremia is stably suppressed with antiretroviral therapy. The pathogenesis of disease is likely multifaceted, with contributions from viral reservoirs including the brain, chronic and systemic inflammation, and traditional risk factors including drug use. Elucidating the effects of each element on disease pathogenesis is near impossible in human clinical or ex vivo studies, facilitating the need for robust and accurate non-human primate models.

Frontal plane knee moment in clinical gait analysis: A systematic review on the effect of kinematic gait changes.

Introduction: The frontal plane knee moment (KAM1 and KAM2) derived from non-invasive three-dimensional gait analysis is a surrogate measure for knee joint load and of great interest in clinical and research settings. Many aspects can influence this measure either unintentionally or purposely in order to reduce the knee joint load to relieve symptoms and pain. All these aspects must be known when conducting a study or interpreting gait data for clinical decision-making.

Intact HIV Proviruses Persist in the Brain Despite Viral Suppression with ART.

Objective: Human immunodeficiency virus (HIV) persistence in blood and tissue reservoirs, including the brain, is a major barrier to HIV cure and possible cause of comorbid disease. However, the size and replication competent nature of the central nervous system (CNS) reservoir is unclear. Here, we used the intact proviral DNA assay (IPDA) to provide the first quantitative assessment of the intact and defective HIV reservoir in the brain of people with HIV (PWH).

Antibody Screening Results for Anti-Nucleocapsid Antibodies Toward the Development of a Lateral Flow Assay to Detect SARS-CoV-2 Nucleocapsid Protein.

The global COVID-19 pandemic has created an urgent demand for large numbers of inexpensive, accurate, rapid, point-of-care diagnostic tests. Analyte-based assays are suitably rapid and inexpensive and can be rapidly mass-produced, but for sufficiently accurate performance, they require highly optimized antibodies and assay conditions. We used an automated liquid handling system, customized to handle arrays of lateral flow (immuno)assays (LFAs) in a high-throughput screen, to identify anti-nucleocapsid antibodies that will perform optimally in an LFA.

The role of oxidative stress in HIV-associated neurocognitive disorders.

HIV-associated neurocognitive disorders (HAND) are a leading cause of morbidity in up to 50% of individuals living with HIV, despite effective treatment with antiretroviral therapy (ART). Current evidence suggests that chronic inflammation associated with HIV is especially attributed to the dysregulated production of reactive oxygen species (ROS) that contribute to neurodegeneration and poor clinical outcomes. While ROS have beneficial effects in eliciting immune responses to infection, chronic ROS production causes damage to macromolecules such as DNA and lipids that has been linked to altered redox homeostasis associated with antioxidant dysregulation.

Clinical validation of an open-access SARS-COV-2 antigen detection lateral flow assay, compared to commercially available assays.

Rapid tests for SARS-COV-2 infection are important tools for pandemic control, but current rapid tests are based on proprietary designs and reagents. We report clinical validation results of an open-access lateral flow assay (OA-LFA) design using commercially available materials and reagents, along with RT-qPCR and commercially available comparators (BinaxNOW® and Sofia®). Adult patients with suspected COVID-19 based on clinical signs and symptoms, and with symptoms ≤7 days duration, underwent anterior nares (AN) sampling for the OA-LFA, Sofia®, BinaxNOW ™, and RT-qPCR, along with nasopharyngeal (NP) RT-qPCR.

Multiplexed and Extraction-Free Amplification for Simplified SARS-CoV-2 RT-PCR Tests.

The rapid onset of the global COVID-19 pandemic has led to challenges for accurately diagnosing the disease, including supply shortages for sample collection, preservation, and purification. Currently, most diagnostic tests require RNA extraction and detection by RT-PCR; however, extraction is expensive and time-consuming and requires technical expertise. With these challenges in mind, we report extraction-free, multiplexed amplification of SARS-CoV-2 RNA from 246 clinical samples, resulting in 86% sensitivity and 100% specificity.

Effects of idiopathic flatfoot deformity on knee adduction moments during walking.

Introduction: Flatfoot deformity is commonly characterized by a subtalar valgus, a low medial longitudinal arch, and abduction of the forefoot. Although flatfoot deformity has been associated with lower first (KAM1) and second (KAM2) peak knee adduction moments during walking, the biomechanical connection remains unknown.

Research Question: We hypothesized that hindfoot eversion, lateral calcaneal shift correlate with KAM1 and forefoot abduction and arch height with KAM2, due to the lateralization of the ground reaction force vector resulting from shifted heel and forefoot in flatfoot deformity.

Constrictive pericarditis decades after aortic valve repair.

Constrictive pericarditis is rare after cardiac surgery, with a time to presentation ranging from 82 days to 204 months. We report a 75-year-old man who underwent aortic valve replacement and developed constrictive pericarditis 21 years later. He underwent a pericardiectomy with pericardial stripping, which confirmed constrictive pericarditis and improved his symptoms.

Identification of a High-risk Subgroup With Malignant Mitral Valve Prolapse Who Are Predisposed to Sudden Cardiac Death: A Review.

Mitral valve prolapse (MVP) affects approximately 170 million people worldwide; however, phenotypically, there is a wide variety of heterogeneity. In particular subsets, the incidence of sudden cardiac death is calculated to be 998 per 100,000 person-years, which is significantly increased when compared with the general population of MVP patients. Individuals with high-risk features have been identified as young females with bileaflet MVP and electrocardiogram findings of frequent complex ectopy, ST-T wave changes, and inferior T wave inversions.

Right Coronary Artery Pseudoaneurysm With Hemopericardium: A Rare Complication of Percutaneous Coronary Intervention.

While percutaneous coronary intervention (PCI) is a commonly performed procedure, it still has many serious complications. Coronary artery pseudoaneurysms can form after PCI and can progress to cardiac tamponade. We report the case of an 80-year-old male who presented for an inferior wall ST elevation myocardial infarction, had drug-eluting stents placed to the right coronary artery (RCA), and subsequently suffered a RCA pseudoaneurysm with hemopericardium.

Compensatory mechanisms in children with idiopathic lower extremity internal rotational malalignment during walking and running.

Background: Noticeable in-toeing gait is present in most children with internal rotational malalignment and often a reason to consult an orthopedic specialist. The risk of tripping may be higher for these patients.

Research Question: The aim of this study was to determine compensatory mechanisms adopted by children with internal rotational deformities to avoid tripping and falling during walking and running.

Functional limitations after lateral column lengthening osteotomy of the calcaneus are associated with lower quality of life.

Purpose: The purpose of this study was to quantify limitations in sagittal ankle range of motion (ROM) at least two years after lateral column lengthening osteotomy of the calcaneus (LLC) and their implications regarding quality of life.

Methods: Fifteen patients with a mean follow-up of 80 ± 27 months after LLC and 15 age-matched healthy persons participated in this study. Ankle joint complex ROM in plantarflexion and dorsiflexion was measured bilaterally using a goniometer and fluoroscopy (patients only).

Surface-emitting electroholographic SAW modulator.

We report the design and operation of a surface-emitting surface acoustic wave (SAW) acousto-optical modulator which behaves as a cm-scale linear hologram in response to an applied electronic waveform. The modulator is formed by an optical waveguide, transducer, and out-coupling surface grating on a 1 mm-thick lithium niobate substrate. We demonstrate the ability to load and illuminate a 9-region linear hologram into the modulator's 8 mm-long interaction region using applied waveforms of 280-320 MHz.

Wash-Free, Digital Immunoassay in Polydisperse Droplets.

Immunoassays are important for the detection of proteins to enable disease identification and monitor treatment, but many immunoassays suffer from sensitivity limitations. The development of digital assays has enabled highly sensitive biomarker detection and quantification, but the necessary devices typically require precisely controlled volumes to reduce biases in concentration estimates from compartment size variation. These constraints have led to systems that are often expensive, cumbersome, and challenging to operate, confining many digital assays to centralized laboratories.

General methods for quantitative interpretation of results of digital variable-volume assays.

In digital assays, devices are typically considered to require precisely controlled volumes since variation in compartment volumes causes biases in concentration estimates. To enable more possibilities in device design, we derived two methods to accurately calculate target concentrations from raw results when the compartment volume may vary and may not follow known parametrically described distributions. The Digital Variable Volume (dvv) method uses volumes of ON compartments (those with positive signals) and the total sample volume, while the Digital Variable Volume Approximation (dvva) method uses the number of ON compartments, the total number of compartments, and a set of separately measured volumes.

Severity of degenerative lumbar spinal stenosis affects pelvic rigidity during walking.

Background Context: To understand the role of compensation mechanisms in the development and treatment of symptomatic degenerative lumbar spinal stenosis (DLSS), pelvic stability during walking should be objectively assessed in the context of clinical parameters.

Purpose: To determine the association among duration of symptoms, lumbar muscle atrophy, disease severity, pelvic stability during walking, and surgical outcome in patients with DLSS scheduled for decompression surgery.

Study Design/setting: Prospective observational study with intervention.

Inertial Sensor-Based Gait and Attractor Analysis as Clinical Measurement Tool: Functionality and Sensitivity in Healthy Subjects and Patients With Symptomatic Lumbar Spinal Stenosis.

To determine if the attractor for acceleration gait data is similar among healthy persons defining a reference attractor; if exercise-induced changes in the attractor in patients with symptomatic lumbar spinal stenosis (sLSS) are greater than in healthy persons; and if the exercise-induced changes in the attractor are affected by surgical treatment. Twenty-four healthy subjects and 19 patients with sLSS completed a 6-min walk test (6MWT) on a 30-m walkway. Gait data were collected using inertial sensors (RehaGait) capturing 3-dimensional foot accelerations.