Quantitative Analysis of the Cellular Microenvironment of Glioblastoma to Develop Predictive Statistical Models of Overall Survival.

Glioblastomas, the most common primary malignant brain tumors, have a distinct tissue microenvironment. Although non-neoplastic cells contribute to glioblastoma progression, very few quantitative studies have shown the effect of tumor microenvironmental influences on patient survival. We examined relationships of the cellular microenvironment, including astrocytes, microglia, oligodendrocytes, and blood vessels, to survival in glioblastoma patients.

Geographic Concentration Of Home-Based Medical Care Providers.

The United States faces a shortage of providers who care for homebound patients. About 5,000 primary care providers made 1.7 million home visits to Medicare fee-for-service beneficiaries in 2013, accounting for 70 percent of all home-based medical visits.

"Basal Cell Blanche": A Diagnostic Maneuver to Increase Early Detection of Basal Cell Carcinomas.

Basal cell carcinomas represent one of the most common skin cancers and often present initially in the primary care setting. Subtle basal cell carcinomas may be difficult to detect, and early detection of these carcinomas remains important in limiting patient morbidity. In this article, we present a simple diagnostic maneuver, "basal cell blanche," to increase early detection of basal cell carcinomas.

Clinical associations with immature breathing in preterm infants: part 2-periodic breathing.

Background: Periodic breathing (PB) is a normal immature breathing pattern in neonates that, if extreme, may be associated with pathologic conditions.

Methods: We used our automated PB detection system to analyze all bedside monitor chest impedance data on all infants <35 wk' gestation in the University of Virginia Neonatal Intensive Care Unit from 2009-2014 (n = 1,211). Percent time spent in PB was calculated hourly (>50 infant-years' data).

Clinical associations of immature breathing in preterm infants: part 1-central apnea.

Background: Apnea of prematurity (AOP) is nearly universal among very preterm infants, but neither the apnea burden nor its clinical associations have been systematically studied in a large consecutive cohort.

Methods: We analyzed continuous bedside monitor chest impedance and electrocardiographic waveforms and oxygen saturation data collected on all neonatal intensive care unit (NICU) patients <35 wk gestation from 2009 to 2014 (n = 1,211; >50 infant-years of data). Apneas, with bradycardia and desaturation (ABDs), defined as central apnea ≥10 s associated with both bradycardia <100 bpm and oxygen desaturation <80%, were identified using a validated automated algorithm.

Priorities of Care Among Older Adults in the Emergency Department: A Cross-sectional Study.

Objectives: Emergency departments (EDs) are an increasingly important site of care for older adults, but little is known about the priorities of emergency care in this population. We sought to describe and rank priorities of care among older adults receiving care in the ED.

Methods: We conducted a cross-sectional study of cognitively intact patients aged 65 years and older receiving care in two U.

Direct inhibition of c-Myc-Max heterodimers by celastrol and celastrol-inspired triterpenoids.

Many oncogenic signals originate from abnormal protein-protein interactions that are potential targets for small molecule inhibitors. However, the therapeutic disruption of these interactions has proved elusive. We report here that the naturally-occurring triterpenoid celastrol is an inhibitor of the c-Myc (Myc) oncoprotein, which is over-expressed in many human cancers.

Rate of lower-extremity ultrasonography in trauma patients is associated with rate of deep venous thrombosis but not pulmonary embolism.

Background: Disparate lower-extremity ultrasonography (LUS) screening practices among trauma institutions reflecta lack of consensus regarding screening indications and whether screening improves outcomes. We hypothesized that LUS screening for deep-vein thrombosis (DVT) is not associated with a reduced incidence of pulmonary embolism (PE).

Methods: The 2012 ACS National Trauma Data Bank Research Data Set was queried to identify 442,108 patients treated at institutions reporting at least one LUS and at least one DVT.

Sedentary Behavior as a Risk Factor for Physical Frailty Independent of Moderate Activity: Results From the Osteoarthritis Initiative.

Objectives: This prospective longitudinal study investigated the association between baseline objectively measured sedentary time and 2-year onset of physical frailty.

Methods: We studied 1333 Osteoarthritis Initiative participants 55 to 83 years of age who were at risk for physical frailty, as assessed via low gait speed (< 0.6 m per second) or inability to perform a single chair stand.

Building healthy communities: establishing health and wellness metrics for use within the real estate industry.

It is increasingly well recognized that the design and operation of the communities in which people live, work, learn, and play significantly influence their health. However, within the real estate industry, the health impacts of transportation, community development, and other construction projects, both positive and negative, continue to operate largely as economic externalities: unmeasured, unregulated, and for the most part unconsidered. This lack of transparency limits communities' ability to efficiently advocate for real estate investment that best promotes their health and well-being.

The renal dopaminergic system: novel diagnostic and therapeutic approaches in hypertension and kidney disease.

Salt sensitivity of blood pressure, whether in hypertensive or normotensive subjects, is associated with increased cardiovascular risk and overall mortality. Salt sensitivity can be treated by reducing NaCl consumption. However, decreasing salt intake in some may actually increase cardiovascular risk, including an increase in blood pressure, that is, inverse salt sensitivity.

Built environment and physical activity promotion: place-based obesity prevention strategies.

This paper seeks to encourage continued innovation in translating built environment and transportation-focused physical activity research into practice. Successful strategies, policies, and tools from across the U.S.

Acellular flexor tendon allografts: a new horizon for tendon reconstruction.

Flexor tendon injuries continue to pose a significant challenge to the hand surgeon. In particular, chronic tendon ruptures with adhesions of the tendons and sheath, damage or loss of the intrasynovial flexor tendons in zone II, and combined soft tissue and bone injuries present especially difficult problems for restoring satisfactory digital function. This challenge in flexor tendon reconstruction has motivated hand surgeons to explore and develop novel solutions for nearly a century.

Cutaneous alternariosis in an adolescent patient.

Cutaneous alternariosis is a rare infection typically observed only in immunocompromised adults, but we report here that the infection can occur in apparently healthy adolescents. We saw a clinically healthy adolescent boy who presented with cutaneous alternariosis 6 weeks after suffering a laceration to his right ankle. Treatment with itraconazole resulted in significant improvement after 1 month.

Changes in exhaled nitric oxide and breath pH during fluticasone wean in asthma.

Background: Inhaled corticosteroid (ICS) therapy improves asthma outcome. Both the anti-inflammatory efficacy and toxicities of ICS therapy are dose dependent. Therefore, there is interest in monitoring airway inflammation during ICS dose adjustments.

Estrogen agonists/antagonists in combination with estrogen for prevention and treatment of menopause-associated signs and symptoms.

For several decades, clinicians have been prescribing hormone therapy to postmenopausal women for approved indications, including the alleviation of vasomotor symptoms, relief of vaginal dryness and prevention of osteoporosis. Numerous publications have demonstrated that estrogen also induces favorable effects on lipids, the endothelium, cardiovascular outcomes, quality of life, cognition, skin and urinary incontinence. As a result of these findings, clinicians began adding each of these outcomes to their list of possible benefits of hormone therapy in postmenopausal women.

Buffering airway acid decreases exhaled nitric oxide in asthma.

Background: The human airway is believed to be acidified in asthma. In an acidic environment nitrite is converted to nitric oxide (NO).

Objective: We hypothesized that buffering airway lining fluid acid would decrease the fraction of exhaled NO (F(ENO)).

Inhibiting the inflammatory response in joint sepsis.

PURPOSE: We created a rabbit model of infectious arthritis to test the effects of WRC-0470 (2-cyclohexylmethylidenehydarazinoadenosine), an adenosine analogue, and rolipram, a type IV phosphodiesterase inhibitor, on intra-articular white blood cell recruitment. Type of Study: Randomized trial involving mature rabbits. METHODS: Intra-articular injections ranging from 0 to 2,000 ng of Escherichia coli lipopolysaccharide (LPS) were tested as the infectious stimulus.

Marrow stromal cells embedded in alginate for repair of osteochondral defects.

Articular cartilage defects of sufficient size ultimately degenerate with time, leading to arthritic changes. Numerous strategies have been used to address full-thickness cartilage defects, yet none thus far has been successful in restoring the articular surface to its preinjury state. We compared the effects of agarose, alginate, and type I collagen gels on the expression of cartilage-specific markers from rabbit marrow stromal cells and then assessed the in vivo effects of cells seeded in alginate beads on the repair of full-thickness osteochondral defects in the rabbit model.

Microtubule-associated proteins, phosphorylation gradients, and the establishment of neuronal polarity.

Axonogenesis is the earliest step in acquisition of neuronal polarity. The subcellular mechanisms underlying this pivotal event are unknown. Because of the abundant presence and functional necessity of microtubule-associated proteins in growing neurites, a large effort has been directed at characterizing their role in establishment and maintenance of neuronal polarity.

Pathogenicity and immunogenicity for mice of temperature-sensitive mutants of vesicular stomatitis virus.

Temperature-sensitive (ts) mutants of vesicular stomatitis (VS) virus were tested for their pathogenicity and immunogenicity in weanling mice. Compared with the wild-type virus (ts(+)), ts mutants representing genetic complementation groups I, II, and IV were considerably less pathogenic for mice infected by the intracerebral route and caused few deaths after intranasal inoculation. Mice were completely resistant to ts(+) and ts mutants by the intraperitoneal route.