Rapid Implementation of Inpatient Telepalliative Medicine Consultations During COVID-19 Pandemic.

As coronavirus disease 2019 cases increase throughout the country and health care systems grapple with the need to decrease provider exposure and minimize personal protective equipment use while maintaining high-quality patient care, our specialty is called on to consider new methods of delivering inpatient palliative care (PC). Telepalliative medicine has been used to great effect in outpatient and home-based PC but has had fewer applications in the inpatient setting. As we plan for decreased provider availability because of quarantine and redeployment and seek to reach increasingly isolated hospitalized patients in the face of coronavirus disease 2019, the need for telepalliative medicine in the inpatient setting is now clear. We describe our rapid and ongoing implementation of telepalliative medicine consultation for our inpatient PC teams and discuss lessons learned and recommendations for programs considering similar care models

Temporal and regional intestinal changes in permeability, tight junction, and cytokine gene expression following ovariectomy-induced estrogen deficiency

The work presented within this study was funded in part by NCCIH (R01AT007695) and NIDDK (R01DK101050Peer reviewedPublisher PD

REST Controls Self-Renewal and Tumorigenic Competence of Human Glioblastoma Cells

The Repressor Element 1 Silencing Transcription factor (REST/NRSF) is a master repressor of neuronal programs in non-neuronal lineages shown to function as a central regulator of developmental programs and stem cell physiology. Aberrant REST function has been associated with a number of pathological conditions. In cancer biology, REST has been shown to play a tumor suppressor activity in epithelial cancers but an oncogenic role in brain childhood malignancies such as neuroblastoma and medulloblastoma. Here we examined REST expression in human glioblastoma multiforme (GBM) specimens and its role in GBM cells carrying self-renewal and tumorigenic competence. We found REST to be expressed in GBM specimens, its presence being particularly enriched in tumor cells in the perivascular compartment. Significantly, REST is highly expressed in self-renewing tumorigenic-competent GBM cells and its knock down strongly reduces their self-renewal in vitro and tumor-initiating capacity in vivo and affects levels of miR-124 and its downstream targets. These results indicate that REST contributes to GBM maintenance by affecting its self-renewing and tumorigenic cellular component and that, hence, a better understanding of these circuitries in these cells might lead to new exploitable therapeutic targets

COVID-19 Lessons: The Alignment of Palliative Medicine and Trauma-Informed Care.

As the COVID-19 pandemic wears on, its psychological, emotional, and existential toll continues to grow and indeed may now rival the physical suffering caused by the illness. Patients, caregivers, and health-care workers are particularly at risk for trauma responses and would be well served by trauma-informed care practices to minimize both immediate and long-term psychological distress. Given the significant overlap between the core tenets of trauma-informed care and accepted guidelines for the provision of quality palliative care (PC), PC teams are particularly well poised to both incorporate such practices into routine care and to argue for their integration across health systems. We outline this intersection to highlight the uniquely powerful role PC teams can play to reduce the long-term psychological impact of the COVID-19 pandemic

Rapid Implementation of Inpatient Telepalliative Medicine Consultations During COVID-19 Pandemic.

As coronavirus disease 2019 cases increase throughout the country and health care systems grapple with the need to decrease provider exposure and minimize personal protective equipment use while maintaining high-quality patient care, our specialty is called on to consider new methods of delivering inpatient palliative care (PC). Telepalliative medicine has been used to great effect in outpatient and home-based PC but has had fewer applications in the inpatient setting. As we plan for decreased provider availability because of quarantine and redeployment and seek to reach increasingly isolated hospitalized patients in the face of coronavirus disease 2019, the need for telepalliative medicine in the inpatient setting is now clear. We describe our rapid and ongoing implementation of telepalliative medicine consultation for our inpatient PC teams and discuss lessons learned and recommendations for programs considering similar care models

Narrowband, angle-tuneable, helicity-dependent terahertz emission from nanowires of the topological Dirac semimetal Cd3As2

All-optical control of terahertz pulses is essential for the development of optoelectronic devices for next-generation quantum technologies. Despite substantial research in THz generation methods, polarisation control remains difficult. Here, we demonstrate that by exploiting bandstructure topology, both helicity-dependent and helicity-independent THz emission can be generated from nanowires of the topological Dirac semimetal Cd3As2. We show that narrowband THz pulses can be generated at oblique incidence by driving the system with optical (1.55 eV) pulses with circular polarisation. Varying the incident angle also provides control of the peak emission frequency, with peak frequencies spanning 0.21 – 1.40 THz as the angle is tuned from 15° - 45°. We therefore present Cd3As2 nanowires as a promising novel material platform for controllable terahertz emission

Terahertz characterization of charge carrier dynamics in 3D Dirac semi-metal Cd3As2 nanowires

Optical Pump Terahertz Probe (OPTP) spectroscopy is a well-established measurement technique with which charge-carrier dynamics of semiconductor nanowires (NW) can be extracted in a noncontact manner. Here in this work, we employ OPTP spectroscopy for measuring temperature-dependent photoconductivity spectra of 3D Dirac Cd 3 As 2 semi-metal nanowires, revealing a high Extrinsic carrier concentration of ∼2.0x1017cm−3 and ultrahigh carrier mobility of up to ∼13x103cm2V−1s−1 at a temperature of 5 K

Proactive Identification of Palliative Care Needs Among Patients With COVID-19 in the ICU.

In the setting of the coronavirus disease 2019 (COVID-19) pandemic, new strategies are needed to address the unique and significant palliative care (PC) needs of patients with COVID-19 and their families, particularly when health systems are stressed by patient surges. Many PC teams rely on referral-based consultation methods that can result in needs going unidentified and/or unmet. Here, we describe a novel system to proactively identify and meet the PC needs of all patients with COVID-19 being cared for in our hospital's intensive care units. Patients were screened through a combination of chart review and brief provider interview, and PC consultations were provided via telemedicine for those with unmet needs identified. In the first six weeks of operation, our pilot program of proactive screening and outreach resulted in PC consultation for 12 of the 29 (41%) adult patients admitted to the intensive care unit with COVID-19 at our institution. Consultations were most commonly for patient and family support as well as for goals of care and advance care planning, consistent with identified PC needs within this unique patient population

Topological materials for helicity-dependent THz emission

Topological insulator (TI) materials are emerging as novel materials for spintronic applications. Here, we demonstrate helicity-dependent THz emission from Dirac semi-metal Cd 3 As 2 nanowires and used scattering-type scanning optical microscopy (s-SNOM) to identify potential single nanowire candidates for device applications. The preliminary investigation data of a candidate nanowire shows a homogenous topography and constant dielectric function in the MIR range. Indicating high-quality crystalline growth ideal for topological characterization