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Emergency department management of acute agitation in the reproductive age female and pregnancy

World Journal of Emergency Medicine 2024年第2期15卷 83-90页

作者： Ariella Gartenberg Kayla Levine Alexander Petrie Department of Emergency Medicine Jacobi Medical Center and Montefiore Medical CenterNY 10461USA Department of Psychiatry and Behavioral Sciences Albert Einstein College of Medicine and Montefiore Medical CenterNY 10461USA Department of Emergency Medicine Jacobi Medical Center and North Central Bronx HospitalNY 10461USA

BACKGROUND:Agitation is a common presentation within emergent departments(EDs).Agitation during pregnancy should be treated as an obstetric emergency,as the distress may jeopardize both the patient and *** safety of psychotropic medications in the reproductive age female has not been well *** review aimed to explore a summary of general agitation recommendations with an emphasis on ED management of agitation during ***:A literature review was conducted to explore the pathophysiology of acute agitation and devise a preferred treatment plan for ED management of acute agitation in the reproductive age or pregnant ***:While nonpharmacological management is preferred,ED visits for agitation often require medical *** should be selected based on the etiology of agitation and the clinical setting to avoid major adverse *** effects are common in pregnant *** mild to moderate agitation in pregnancy,diphenhydramine is an effective sedating agent with minimal adverse *** moderate to severe agitation,high-potency typical psychotropics are preferred due to their neutral effects on *** has become the most frequently utilized psychotropic for agitation during *** generation psychotropics are often utilized as second-line therapy,including *** and ketamine have demonstrated adverse fetal ***:While randomized control studies cannot be ethically conducted on pregnant patients requiring sedation,animal models and epidemiologic studies have demonstrated the effects of psychotropic medication exposure in *** the fetal risk associated with multiple doses of psychotropic medications remains unknown,weighing the risks and benefits of each agent,while utilizing the lowest effective dose remains critical in the treatment of acute agitation within the EDs.

关键词： Agitation Pregnancy Haloperidol Ketamine Benzodiazepines

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Ocular cicatricial pemphigoid:diagnosis and systemic management

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Annals of Eye Science 2024年第2期9卷 38-52页

作者： Claudia Castiblanco Department of Ophthalmology and Visual Sciences Albert Einstein College of MedicineMontefiore Medical CenterBronxNYUSA

Ocular cicatricial pemphigoid(OCP)is a subcategory of mucous membrane pemphigoid(MMP)where the conjunctiva is the main site of *** is a chronic and autoimmune disease characterized by acute and chronic conjunctivitis that can progress to severe conjunctival cicatrization,corneal opacification,ocular surface keratinization,and eyelid *** can lead to structural damage that can result in visual impairment,visual loss,and blindness,and can have a significant impact in a patient’s quality of *** may manifest with varying symptoms,degrees of severity and may have different rates of *** diagnosis and appropriate systemic immunosuppression are of utmost importance for prompt and adequate disease *** systemic immunomodulatory therapies(IMTs),including anti-metabolites,alkylating,and biologic agents have been utilized to achieve inflammation control and *** monitoring of disease progression is important to assess response and to modify and escalate therapy if *** to alleviate symptoms of dry eye disease and address trichiasis and other eyelid abnormalities is recommended as well.A multidisciplinary approach to optimize clinical care is recommended in the management of patients with *** review will address the immunopathogenesis,clinical features,keys to diagnosis and staging of patients with *** will highlight the current immunomodulators utilized for disease management and proposed stepladder *** review will discuss the updated roles of combination therapy,novel use of biologics as well as the recent use of adrenocorticotropic hormone(ACTH)analog in severe recalcitrant cases.

关键词： Ocular cicatricial pemphigoid(OCP) mucous membrane pemphigoid(MMP) basement membrane zone(BMZ) symblepharon immunomodulatory therapy(IMT)

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Retrospective analysis of discordant results between histology and other clinical diagnostic tests on helicobacter pylori infection

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World Journal of Gastrointestinal Endoscopy 2024年第2期16卷 64-71页

作者： Xiaohua Qi Kevin Kuan Tony El Jabbour Yungtai Lo Qiang Liu Yanan Fang Department of Pathology Albert Einstein College of Medicine/Montefiore Medical CenterBronxNY 10467United States Department of Pathology Albert Einstein College of Medicine/Montefiore Medical CenterNew YorkNY 10467United States Department of Epidemiology&Population Health Albert Einstein College of MedicineBronxNY 10461United States Department of Pathology Montefiore Medical Center/Albert Einstein College of MedicineBronxNY 10467United States

BACKGROUND A reliable test is essential for diagnosing Helicobacter pylori(***)infection,and crucial for managing ***-related *** as an excellent method for detecting *** infection,histologic examination is a test that clinicians heavily rely on,especially when complemented with immunohistochemistry(IHC).Additionally,other diagnostic tests for ***,such as the rapid urease test(CLO test)and stool antigen test(SA),are also highly sensitive and ***,the results of histology and other tests align with each ***,on rare occasions,discrepancy between histopathology and other *** diagnostic tests *** To investigate the discordance between histology and other *** tests,the underlying causes,and the impact on clinical *** Pathology reports of gastric biopsies were retrieved spanning August 2013 and July *** were included in the study only if there were other *** tests within seven days of the *** additional tests include CLO test,SA,and *** *** between histopathology and other tests was determined based on the consistency of *** instances where histology results were negative while other tests were positive,the slides were retrieved for re-assessment,and the clinical chart was *** Of 1396 pathology reports were identified,each accompanied by one additional *** *** concordance rates in detecting *** infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments.117 discrepant cases were *** 20 cases(9 with CLO test and 11 with SA)had negative biopsy but positive results in other *** cases initially stained with Warthin-Starry turned out to be positive for *** with subsequent IHC *** the remaining 16 true discrepant cases,10 patients were on proton pump inhibitors before the biopsy and/or other *** patients underwe

关键词： Helicobacter pylori Discordance Gastric biopsy Histology Rapid urease test Stool antigen test Helicobacter pylori culture

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The initial stages of Li_(2)O_(2) formation during oxygen reduction reaction in Li-O_(2) batteries:The significance of Li_(2)O_(2) in charge-transfer reactions within devices

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Journal of Energy Chemistry 2024年第1期88卷 223-231,I0006页

作者： Daniela M.Josepetti Bianca P.Sousa Simone A.J.Rodrigues Renato G.Freitas Gustavo Doubek Advanced Energy Storage Division LABCenter for Innovation on New EnergiesSchool of Chemical EngineeringUniversity of CampinasAv Albert Einstein 50013083-852CampinasSPBrazil Institute of Physics&Department of Chemistry Laboratory of Computational MaterialsFederal University of Mato Grosso78060-900CuiabáMTBrazil

Lithium-oxygen batteries are a promising technology because they can greatly surpass the energy density of lithium-ion ***,this theoretical characteristic has not yet been converted into a real device with high *** with air contamination,metallic lithium reactivity,and complex discharge and charge reactions are the main issues for this technology.A fast and reversible oxygen reduction reaction(ORR)is crucial for good performance of secondary batteries',but the partial knowledge of its mechanisms,especially when devices are concerned,hinders further *** this perspective,the present work uses operando Raman experiments and electrochemical impedance spectroscopy(EIS)to assess the first stages of the discharge processes in porous carbon electrodes,following their changes cycle by cycle at initial operation.A growth kinetic formation of the discharge product signal(Li_(2)O_(2))was observed with operando Raman,indicating a first-order reaction and enabling an analysis by a microkinetic *** solution mechanism in the evaluated system was ascribed for an equivalent circuit with three time *** the time constant for the anode interface reveals to remain relatively constant after the first discharge,its surface seemed to be more *** model indicated that the reaction occurs at the Li_(2)O_(2) surface,decreasing the associated resistance during the initial discharge ***,the growth of Li_(2)O_(2) forms a hetero-phase between Li_(2)O_(2)/electrolyte,while creating a more compact and homogeneous on the Li_(2)O_(2)/cathode *** methodology here described thus offers a way of directly probing changes in surface chemistry evolution during cycling from a device through EIS analysis.

关键词： Li-O_(2)battery Operando Raman analysis Equivalent circuit modeling Time-constant distribution

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Disease clearance in ulcerative colitis:A new therapeutic target for the future

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World Journal of Gastroenterology 2024年第13期30卷 1801-1809页

作者： Syed Adeel Hassan Neeraj Kapur Fahad Sheikh Anam Fahad Somia Jamal Division of Digestive Disease and Nutrition University of KentuckyLexingtonKY 40536United States Department of Pathology and Laboratory Medicine Montefiore Medical CenterAlbert Einstein College of MedicineNew YorkNY 10461United States Division of Primary Care Essen HealthcareNew YorkNY 10457United States Department of Internal Medicine Karachi Medical and Dental CollegeKarachi 74700SindhPakistan

Advancements in murine modeling systems for ulcerative colitis have diversified our understanding of the pathophysiological factors involved in disease onset and *** has fueled the identification of molecular targets,resulting in a rapidly expanding therapeutic ***,management strategies have evolved from symptomatic resolution to well-defined objective endpoints,including clinical remission,endoscopic remission and mucosal *** the incorporation of these assessment modalities has permitted targeted intervention in the context of a natural disease history and the prevention of complications,studies have consistently depicted discrepancies associated with ascertaining disease status through clinical and endoscopic *** recommendations lack consideration of histological *** simultaneous achievement of clinical,endoscopic,and histologic remission has not been fully *** has laid the groundwork for a novel therapeutic outcome termed disease clearance(DC).This article summarizes the concept of DC and its current evidence.

关键词： Inflammatory bowel disease Ulcerative colitis Clinical remission Endoscopic remission Histological remission Mucosal healing Disease clearance

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Evolution of heart transplant donor characteristics in the 21st century: A United States single center’s experience

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World Journal of Transplantation 2024年第3期14卷 22-29页

作者： Alexander M Spring Christiana Gjelaj Shivank Madan Snehal R Patel Omar Saeed Sandhya Murthy Yogita Rochlani Daniel B Sims Sasha Vukelic Stephen J Forest Jamil F Borgi Daniel J Goldstein Ulrich P Jorde Montefiore-einstein center for Heart and Vascular Care Montefiore Medical CenterAlbert Einstein College of MedicineBronxNY 10467United States Division of Cardiothoracic Surgery Tulane UniversityNew OrleansLA 70112United States

Despite a record setting number of heart transplants performed annually,the national donor shortage continues to plague transplant teams across the United *** we describe the barriers to adaptation of numerous“non-traditional”orthotopic heart transplant donor characteristics including donors with hepatitis C virus,those meeting criteria for donation after cardiac death,donors with coronavirus disease 19 infection,donors with the human immunodeficiency virus,and grafts with left ventricular systolic *** center’s objective was to increase our transplant volume by expanding our donor pool from“traditional”donors to these“non-traditional”*** detail how medical advances such as certain laboratory studies,pharmacologic interventions,and organ care systems have allowed our center to expand the donor pool thereby increasing transplantation volume without adverse effects on outcomes.

关键词： Orthotopic heart transplantation Hepatitis C virus COVID-19 Left ventricular systolic dysfunction Human immunodeficiency virus Donation after cardiac death

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Thrombotic microangiopathy after kidney transplantation: Expanding etiologic and pathogenetic spectra

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World Journal of Transplantation 2024年第1期14卷 84-95页

作者： Muhammed Mubarak Amber Raza Rahma Rashid Fnu Sapna Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Nephrology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Thrombotic microangiopathy(TMA)is an uncommon but serious complication that not only affects native kidneys but also transplanted *** review is specifically focused on post-transplant TMA(PT-TMA)involving kidney transplant *** reported prevalence in the latter population varies from 0.8%to 14%with adverse impacts on both graft and patient *** has many causes and associations,and the list of etiologic agents and associations is growing *** pathogenesis is equally varied and a variety of pathogenetic pathways lead to the development of microvascular injury as the final common ***-TMA is categorized in many ways in order to facilitate its ***,more than one causes are contributory in PT-TMA and it is often difficult to pinpoint one particular cause in an individual ***,the hallmark lesions are endothelial cell injury and intravascular thrombi affecting the *** diagnosis and classification of PT-TMA are imperative for optimal outcomes but are challenging for both clinicians and *** Banff classification has addressed this issue and has developed minimum diagnostic criteria for pathologic diagnosis of PT-TMA in the first *** of the condition is also challenging and still largely *** varies from simple maneuvers,such as plasmapheresis,drug withdrawal or modification,or dose reduction,to lifelong complement blockade,which is very expensive.A thorough understanding of the condition is imperative for an early diagnosis and quick treatment when the treatment is potentially *** review aims to increase the awareness of relevant stakeholders regarding this important,potentially treatable but under-recognized cause of kidney allograft dysfunction.

关键词： Thrombotic microangiopathy Microvascular injury Anemia Thrombocytopenia Kidney allograft failure

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Particle elasticity influences polymeric artificial antigen presenting cell effectiveness in vivo via CD8+T cell activation,macrophage uptake,and the protein corona

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Nano Research 2024年第10期17卷 9052-9064页

作者： Savannah E.Est-Witte Sydney R.Shannon Dennis H.Gong Kaitlyn G.Calabresi Jawaun J.Harris Kaitlyn Storm Edwin J.Yoo Ariel Isser Vivek P.Jani Natalie K.Livingston Mary O.Omotoso Kelly Rhodes Elana Ben-Akiva Randall A.Meyer Zoe T.Hsieh Simone Sidoli Stephany Y.Tzeng Jonathan P.Schneck Jordan J.Green Translational Tissue Engineering center Institute for NanobiotechnologyDepartment of Biomedical EngineeringJohns Hopkins School of Medicine400 N BroadwayBaltimoreMD 21231USA Institute for Cell Engineering Department of PathologyJohns Hopkins School of Medicine733 N BroadwayBaltimoreMD 21205USA Department of Biochemistry Albert Einstein College of MedicineThe BronxNew York CityNY 10461USA

Adoptive cell therapy(ACT)is an immunotherapy strategy for cancer that has seen widespread clinical *** ACT,patient-derived lymphocytes are stimulated with the antigen of interest ex vivo,proliferated,then returned to the patient to initiate an antigen-specific antitumor *** effective,this process is resource-intensive and logistically impossible for many *** artificial antigen presenting cells(aAPCs)offer a potential“off-the-shelf”alternative to ex vivo *** particulate aAPCs perform well in vitro,they have had limited success in vivo due to poor bioavailability after *** to bioavailability include rapid clearance,unfavorable biodistribution,and inadequate interactions with CD8+T cells at sites of *** properties such as elasticity have been shown to vastly impact the bioavailability and particle-cell interactions,but this has yet to be investigated in the context of aAPCs for in vivo T-cell *** literature likewise indicates that biomaterial properties,especially elasticity,can modulate T-cell activation in *** the goal of creating a more biomimetic,next-generation particulate aAPC,we developed a poly(ethylene)glycol hydrogel particle platform with tunable elasticity to investigate the impact of elasticity on antigen-specific T cell activation for in vivo adoptive *** this knowledge,we were able to gain more precise control over in vivo T cell activation and investigate possible mechanisms including the effects of aAPC elasticity on T cell binding,macrophage uptake,and the protein corona.

关键词： adoptive cell therapy artificial antigen presenting cells particle drug delivery elasticity protein corona poly(ethylene glycol)

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Expanding role and scope of artificial intelligence in the field of gastrointestinal pathology

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Artificial Intelligence in Gastroenterology 2024年第2期5卷 10-19页

作者： Muhammed Mubarak Rahma Rashid Fnu Sapna Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Digital pathology(DP)and its subsidiaries including artificial intelligence(AI)are rapidly making inroads into the area of diagnostic anatomic pathology(AP)including gastrointestinal(GI)*** is poised to revolutionize the field of diagnostic ***,AP has been slow to adopt digital technology,but this is changing rapidly,with many centers worldwide transitioning to *** with advanced techniques of AI such as deep learning and machine learning,DP is likely to transform histopathology from a subjective field to an objective,efficient,and transparent *** is increasingly integrated into GI pathology,offering numerous advancements and improvements in overall diagnostic accuracy,efficiency,and patient ***,AI in GI pathology enhances diagnostic accuracy,streamlines workflows,provides predictive insights,integrates multimodal data,supports research,and aids in education and training,ultimately improving patient care and *** review summarized the latest developments in the role and scope of AI in AP with a focus on GI *** main aim was to provide updates and create awareness among the pathology community.

关键词： Gastrointestinal pathology Digital pathology Artificial intelligence Machine learning Deep learning Precision diagnostics

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Gravitational waves and primordial black hole productions from gluodynamics by holography

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Science China(Physics,Mechanics & Astronomy) 2024年第4期67卷 31-42页

作者： Song He Li Li Zhibin Li Shao-Jiang Wang center for Theoretical Physics and College of Physics Jilin UniversityChangchun 130012China Max Planck Institute for Gravitational Physics(albert einstein Institute) Golm 14476Germany CAS Key Laboratory of Theoretical Physics Institute of Theoretical PhysicsChinese Academy of SciencesBeijing 100190China School of Fundamental Physics and Mathematical Sciences Hangzhou Institute for Advanced StudyUniversity of Chinese Academy of SciencesHangzhou 310024China Peng Huanwu Collaborative center for Research and Education Beihang UniversityBeijing 100191China School of Physics and Microelectronics Zhengzhou UniversityZhengzhou 450001China

Understanding the nature of quantum chromodynamics(QCD)matter is important but challenging due to the presence of nonperturbative dynamics under extreme *** construct a holographic model describing the gluon sector of QCD at finite temperatures in the non-perturbative *** equation of state as a function of temperature is in good accordance with the lattice QCD ***,the Polyakov loop and the gluon condensation,which are proper order parameters to capture the deconfinement phase transition,also agree quantitatively well with the lattice QCD *** obtain a strong first-order confinement/deconfinement phase transition at Tc=276.5 Me V that is consistent with the lattice QCD *** on our model for a pure gluon hidden sector,we compute the stochastic gravitational waves and primordial black hole(PBH)productions from this confinement/deconfinement phase transition in the early *** resulting stochastic gravitational-wave backgrounds are found to be within detectability in the International Pulsar Timing Array and Square Kilometre Array in the near future when the associated productions of PBHs saturate the current observational bounds on the PBH abundances from the LIGO-Virgo-Collaboration O3 data.

关键词： AdS/QCD confinement/deconfinement phase transition gravitational wave primordial black hole

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