Hunger Strikes After Restricted Housing Reform.

Hunger strikes are a common occurrence in carceral settings accompanied by serious health risks and intensive health care utilization. A 2017 study on hunger strikes within the New Jersey Department of Corrections found these events most often occurred in a disciplinary setting. We undertook this study after a new state law, the Isolated Confinement Restriction Act (ICRA), improved conditions of confinement in part by reducing the utilization, nature, and duration of disciplinary housing.

Predictive Blood Biomarkers of Targeted Intervention for Chronic Mental Health Symptoms following Traumatic Brain Injury.

The purpose of this study was to assess the performance of predictive blood biomarkers for responsiveness to targeted treatments for chronic psychological issues years after traumatic brain injury (TBI). Targeted Evaluation Action and Monitoring of TBI was a prospective 6-month interventional trial of participants with chronic TBI sequelae ( = 95). Plasma biomarkers were analyzed pre-intervention: glial fibrillary acidic protein (GFAP), tau, hyperphosphorylated tau Thr231 (p-Tau), von Willebrand factor (vWF), brain lipid-binding protein (BLBP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), vascular endothelial growth factor-a (VEGFa), and claudin-5 (CLDN5).

Practice Patterns in Prescribing Buprenorphine in the New Jersey Department of Corrections.

Inmates have high rates of opioid use disorder and are at risk for morbidity and mortality both during incarceration and after release. We conducted a retrospective chart review to assess prescribers' fidelity to the New Jersey Department of Corrections practice guideline for prescribing maintenance or prerelease buprenorphine. We compared the entire group of inmates prescribed buprenorphine at the conclusion of 2019 ( = 875) with a sample of inmates diagnosed with opioid use disorder (OUD) but not prescribed buprenorphine ( = 396) and a sample of inmates not diagnosed with OUD ( = 367).

Targeted Intervention Improves Symptoms and Impairments in Patients With Mild Traumatic Brain Injury With Chronic Symptom: A Prospective, Multiple Interventional Research Trial.

Background: Mild traumatic brain injury (mTBI) and its potential long-term consequences is a primary concern for the US military. The purpose of the study is to evaluate if participants improved in anxiety/mood symptoms, sleep quality, and vestibular/ocular symptoms following a 6-month active intervention, and to explore the effect of targeted treatment for those with specific symptoms/impairments (e.g.

[F]FDG, [C]PiB, and [F]AV-1451 PET Imaging of Neurodegeneration in Two Subjects With a History of Repetitive Trauma and Cognitive Decline.

Trauma-related neurodegeneration can be difficult to differentiate from multifactorial neurodegenerative syndromes, both clinically and radiographically. We have initiated a protocol for imaging of patients with suspected TBI-related neurodegeneration utilizing volumetric MRI and PET studies, including [F]FDG indexing cerebral glucose metabolism, [C]PiB for Aβ deposition, and [F]AV-1451 for tau deposition. To present results from a neuroimaging protocol for evaluation of TBI-related neurodegeneration in patients with early-onset cognitive decline and a history of TBI.

Jackhammer esophagus with and without esophagogastric junction outflow obstruction demonstrates altered neural control resembling type 3 achalasia.

Background: Esophageal hypercontractility can manifest with and without esophagogastric junction (EGJ) outflow obstruction. We investigated clinical presentations and motility patterns in patients with esophageal hypercontractile disorders.

Methods: Esophageal HRM studies fulfilling Chicago Classification 3.

Impact of Multi-Disciplinary Care and Clinical Coach Coordinators on Participant Satisfaction and Retention in TBI Clinical Trials: A TEAM-TBI Study.

Background: Targeted Evaluation Action and Monitoring of Traumatic Brain Injury (TEAM-TBI) is a monitored, multiple interventional research identifying clinical profiles and assigns individualized, evidence-based treatment program. The objective of the current study was to assess overall participant satisfaction of the multi-disciplinary care team and approach.

Methods: Between 2014 and 2017, 90 participants completed the 4-day TEAM-TBI clinical intake evaluation resulting in individualized treatment recommendations followed by a six-month intervention phase follow-up.

Preliminary Evidence for Improvement in Symptoms, Cognitive, Vestibular, and Oculomotor Outcomes Following Targeted Intervention with Chronic mTBI Patients.

Introduction: To determine if targeted, active interventions would improve symptoms and impairment in previously intractable patients with chronic mild traumatic brain injury (mTBI).

Materials And Methods: Twenty-six (20 males; 6 females) out of 51 (51%) former military and civilian patients with chronic (1-3 yr) mTBI enrolled in the TEAM traumatic brain injury (TBI) study completed both an initial and 6-mo post-intervention comprehensive mTBI assessment including symptoms (Post-concussion Symptom Scale [PCSS], Dizziness Handicap Inventory [DHI]), cognitive (Immediate Post-concussion Assessment and Cognitive Testing [ImPACT]), vestibular/oculomotor (Vestibular/Ocular Motor Screening [VOMS]), balance (Activities-specific Balance Confidence [ABC] scale, Balance Error Scoring System [BESS]), and cervical (Neck Disability Index [NDI]). Patients were prescribed progressive, targeted interventions and therapies (e.

Characteristics of Inmates Who Initiate Hunger Strikes.

A hunger strike is a common, expensive, and potentially lethal event within a correctional institution. In this study, we describe the characteristics of inmates who initiated hunger strikes in a state prison system. Electronic medical records for a state prison system were reviewed for documentation of hunger strikes from January 2005 through September 2015.

Abnormal Color Flow Signal Traversing the Myocardial Wall: Not Everything is What it Appears to Be.

A case of a patient presenting with an acute myocardial infarction is presented. A transthoracic echocardiographic examination revealed an abnormal color flow signal that traversed the myocardial wall from a large inferior aneurysm and initially considered to be a ventricular septal defect. However, further echocardiographic manipulation utilizing modified views along with sequential injections of both agitated saline and Definity proved very useful to identify a pseudoaneurysm.

Amyloid-Beta Deposition is Associated with Increased Medial Temporal Lobe Activation during Memory Encoding in the Cognitively Normal Elderly.

Background: Much is unknown about changes that occur in the brain in the years preceding the cognitive and functional impairment associated with Alzheimer disease (AD). This period before mild cognitive impairment is present has been referred to as preclinical AD, and is thought to begin with amyloid-beta deposition and then progress to neurodegeneration and functional brain circuit alterations. Prior studies have shown that there is increased medial temporal lobe activation on functional magnetic resonance imaging (fMRI) early in the course of mild cognitive impairment.

White Matter Hyperintensity Accumulation During Treatment of Late-Life Depression.

White matter hyperintensities (WMHs) have been shown to be associated with the development of late-life depression (LLD) and eventual treatment outcomes. This study sought to investigate longitudinal WMH changes in patients with LLD during a 12-week antidepressant treatment course. Forty-seven depressed elderly patients were included in this analysis.

Machine learning approaches for integrating clinical and imaging features in late-life depression classification and response prediction.

Objective: Currently, depression diagnosis relies primarily on behavioral symptoms and signs, and treatment is guided by trial and error instead of evaluating associated underlying brain characteristics. Unlike past studies, we attempted to estimate accurate prediction models for late-life depression diagnosis and treatment response using multiple machine learning methods with inputs of multi-modal imaging and non-imaging whole brain and network-based features.

Methods: Late-life depression patients (medicated post-recruitment) (n = 33) and older non-depressed individuals (n = 35) were recruited.

Predictors of left ventricular function deterioration in patients with left bundle branch block and ejection fraction >50%.

Resynchronization therapy has become standard of care in patients with left bundle branch block (LBBB), congestive heart failure (CHF), and low ejection fraction (EF). In order to characterize the left ventricular (LV) function evolution in patients with LBBB and baseline preserved LVEF, records of all patients who visited an academic echocardiography laboratory during a period of 4 years were retrospectively investigated. Patients were included if they had a baseline EF >50%, LBBB on surface electrocardiography, and at least one follow-up echocardiogram no earlier than 3 months after the baseline study.

White matter hyperintensity burden and disability in older adults: is chronic pain a contributor?

Objective: To primarily explore differences in global and regional white matter hyperintensities (WMH) in older adults with self-reported disabling and nondisabling chronic low back pain (CLBP) and to examine the association of WMH with gait speed in all participants with CLBP. To secondarily compare WMH of the participants with CLBP with the pain-free controls.

Design: A cross-sectional, case-control study.

Right ventricular outflow tract systolic excursion: a distinguishing echocardiographic finding in acute pulmonary embolism.

Background: Even though chronic pulmonary hypertension (cPH) and acute pulmonary embolism (aPE) increase pulmonary vascular resistance and result in right ventricular (RV) dilatation and systolic dysfunction; both conditions operate through drastically different mechanisms. Unfortunately, simple echocardiographic examination might be insufficient to distinguish both entities. This study attempted to determine which objective measures would be useful in differentiating aPE from cPH.

Role of baseline echocardiography in the preoperative management of liver transplant candidates.

Liver transplantation (LT) has not traditionally been offered to patients with intracardiac shunts (ICSs) or pulmonary hypertension (PH). There is a paucity of data regarding cardiac structural characteristics in LT candidates. We examined echocardiographic characteristics and their role in managing LT candidates diagnosed with ICS and PH.

Temporal differences in ejection between right and left ventricles in chronic pulmonary hypertension: a pulsed Doppler study.

Chronic pulmonary hypertension (cPH) is known to alter right ventricular (RV) deformation and cause mechanical dyssynchrony. Since not all echocardiographic laboratories are equipped with sophisticated imaging tools, we decided to determine if Doppler would be useful to detect temporal differences between the ejection of the right and left ventricle (LV) as a result of cPH using pulsed outflow tract (RVOT and LVOT) spectral signals. Data was collected from 30 patients without PH (Group I: 53 ± 7 years and 31 ± 5 mmHg) and from 40 patients with cPH (Group II: 53 ± 13 years; P = NS and 82 ± 24 mmHg; P < 0.

Conducting metallopolymers as precursors to fabricate palladium nanoparticle/polymer hybrids for oxygen reduction.

The novel conducting metallopolymer [N,N'-((2,2'-dimethyl)propyl)bis(5-(2,2'-bithiophene-5-yl)salcylideniminato-palladium(II)](n) prepared by electropolymerization provides a polymer matrix in which the palladium metal centers are evenly distributed. The metal centers embedded directly in the conducting metallopolymer backbone serve as seed points for size-controlled palladium nanoparticle (NP) growth of 3.8 to 4.

Chronic pulmonary hypertension causes significant interventricular spatiotemporal dyssynchrony when onset of diastolic flow signals are assessed by color m-mode.

Background: Color M-mode (CMM) has been useful in characterizing left ventricular (LV) relaxation as well as providing information regarding right ventricular (RV) filling dynamics and pressure gradients. The spatiotemporal resolution of CMM offers a unique opportunity to study the effect of chronic pulmonary hypertension (cPH) on biventricular diastolic function.

Methods: Propagation velocities of LV and RV diastolic flows were obtained from 20 individuals with normal pulmonary artery systolic pressures, designated Group I (mean age 50 ± 12 years and 32 ± 6 mmHg) and from 30 patients with cPH, designated Group II (mean age 55 ± 14 years and 81 ± 25 mmHg).

Shape of the right ventricular outflow Doppler envelope and severity of pulmonary hypertension.

Background: It is now well known that timing of right ventricular outflow tract (RVOT) spectral Doppler signals change with increasing pulmonary hypertension severity. We devised a study to determine whether visual assessment of these RVOT Doppler signals can be useful identifying the severity of pulmonary hypertension.

Methods: Visual inspection of pulsed RVOT Doppler signals from 120 consecutive patients (mean age of 55 ± 12, range 29-89 years; 45 males); with a mean pulmonary artery systolic pressure (PASP) of 59 ± 29, (ranging from 18 to 150 mmHg), of whom 78 patients had PASP >40 mmHg, was performed and correlated with standard echo Doppler variables of right ventricular performance.

fMRI correlates of white matter hyperintensities in late-life depression.

Objective: This study tests whether or not the structural white matter lesions that are characteristic of late-life depression are associated with alterations in the functional affective circuits of late-life depression. This study used an emotional faces paradigm that has been shown to engage the affective limbic brain regions.

Method: Thirty-three elderly depressed patients and 27 nondepressed comparison subjects participated in this study.

Constrictive-like physiology in severe pulmonary hypertension: the effect of the Valsalva maneuver.

We describe the case of a 37-year-old female with severe pulmonary hypertension on intravenous Remodulin and Tracleer who experienced presyncope following a six-minute walk. A transthoracic echocardiogram, in addition to showing the usual findings of chronic pulmonary hypertension, also demonstrated a noticeable increase in both mitral annular systolic and early diastolic (E') velocities while performing the Valsalva maneuver. Most importantly, a significant increase in the propagation velocity to an almost perpendicular tilt was noted with Valsalva, resembling the propagation velocity profile that has only been previously described in cases of constrictive pericarditis.

Differences in the duration of total ejection between right and left ventricles in chronic pulmonary hypertension.

Background: Chronic pulmonary hypertension (cPH) is known to delay pulmonic valve closure resulting in a closely split second heart sound. We decided to measure total duration of right (RV) and left ventricular (LV) outflow tract (RVOT and LVOT) spectral signals using pulsed Doppler to determine if this approach was useful in identifying this narrowing in auscultation that should then result in a shorter temporal difference between the ejection of both ventricles.

Methods: Standard measures of RV and LV performance as well as Doppler data was collected from 85 patients divided into two groups according to their estimated pulmonary artery systolic pressure obtained at the time of their echocardiographic examination.

Ratio of right to left ventricular ejection: a pilot study using Doppler to detect interventricular dyssynchrony.

Background: Chronic pulmonary hypertension (cPH) is known to delay maximal right ventricular (RV) deformation, causing mechanical dyssynchrony, which previously has been identified only through the use of myocardial tissue Doppler imaging. However, alterations between RV and left ventricular (LV) ejection should be easily identified during routine echocardiographic examinations.

Hypothesis: We hypothesized that assessment of differences in ejection fraction between left and right ventricles would be detected using pulsed Doppler.