Evaluation of encapsulating and microporous nondegradable hydrogel scaffold designs on islet engraftment in rodent models of diabetes

Islet transplantation is a promising therapeutic option for type 1 diabetes mellitus, yet the current delivery into the hepatic portal vasculature is limited by poor engraftment. Biomaterials have been used as a means to promote engraftment and function at extrahepatic sites, with strategies being categorized as encapsulation or microporous scaffolds that can either isolate or integrate islets with the host tissue, respectively. Although these approaches are typically studied separately using distinct material platforms, herein, we developed nondegradable polyethylene glycol (PEG)‐based hydrogels for islet encapsulation or as microporous scaffolds for islet seeding to compare the initial engraftment and function of islets in syngeneic diabetic mice. Normoglycemia was restored with transplantation of islets within either encapsulating or microporous hydrogels containing 700 islet equivalents (IEQ), with transplantation on microporous hydrogels producing lower blood glucose levels at earlier times. A glucose challenge test at 1 month after transplant indicated that encapsulated islets had a delay in glucose‐stimulated insulin secretion, whereas microporous hydrogels restored normoglycemia in times consistent with native pancreata. Encapsulated islets remained isolated from the host tissue, whereas the microporous scaffolds allowed for revascularization of the islets after transplant. Finally, we compared the inflammatory response after transplantation for the two systems and noted that microporous hydrogels had a substantially increased presence of neutrophils. Collectively, these findings suggest that both encapsulation and microporous PEG scaffold designs allow for stable engraftment of syngeneic islets and the ability to restore normoglycemia, yet the architecture influences islet function and responsiveness after transplantation.Non‐degradable PEG hydrogels were developed for islet encapsulation or islet seeding to compare engraftment. Using a syngeneic rodent model of diabetes, normoglycemia was restored using either encapsulating or microporous scaffolds containing 700 islet equivalent, with microporous hydrogels achieving lower blood glucose levels at earlier time points. Characterization of the inflammatory response demonstrated microporous scaffolds had a substantially increased presence of neutrophils. These studies confirm both scaffold designs allow for engraftment, yet the architecture influences islet function and responsiveness post‐transplantation.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146483/1/bit26741.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146483/2/bit26741_am.pd

Thermographic Imaging of the Space Shuttle During Re-Entry Using a Near Infrared Sensor

High resolution calibrated near infrared (NIR) imagery of the Space Shuttle Orbiter was obtained during hypervelocity atmospheric re-entry of the STS-119, STS-125, STS-128, STS-131, STS-132, STS-133, and STS-134 missions. This data has provided information on the distribution of surface temperature and the state of the airflow over the windward surface of the Orbiter during descent. The thermal imagery complemented data collected with onboard surface thermocouple instrumentation. The spatially resolved global thermal measurements made during the Orbiter s hypersonic re-entry will provide critical flight data for reducing the uncertainty associated with present day ground-to-flight extrapolation techniques and current state-of-the-art empirical boundary-layer transition or turbulent heating prediction methods. Laminar and turbulent flight data is critical for the validation of physics-based, semi-empirical boundary-layer transition prediction methods as well as stimulating the validation of laminar numerical chemistry models and the development of turbulence models supporting NASA s next-generation spacecraft. In this paper we provide details of the NIR imaging system used on both air and land-based imaging assets. The paper will discuss calibrations performed on the NIR imaging systems that permitted conversion of captured radiant intensity (counts) to temperature values. Image processing techniques are presented to analyze the NIR data for vignetting distortion, best resolution, and image sharpness. Keywords: HYTHIRM, Space Shuttle thermography, hypersonic imaging, near infrared imaging, histogram analysis, singular value decomposition, eigenvalue image sharpnes

Assessing bowel preparation quality using the mean number of adenomas per colonoscopy

Introduction: The quality of the bowel preparation directly influences colonoscopy effectiveness. Quality indicators are widely employed to monitor operator performance and to gauge colonoscopy effectiveness. Some have suggested that the enumeration of the mean number of adenomas per colonoscopy (MNA) may be a more useful measure of bowel preparation quality, but evidence of the utility of this metric is limited. The relationship between bowel preparation quality and MNA was assessed. Methods: Records of adult patients, aged 50–74 years, who had undergone a screening colonoscopy in a 6 month period at a hospital-based endoscopy suite in New York City were examined. Excluded were those who were symptomatic or having a colonoscopy for surveillance. Patient and procedural characteristics and clinical findings were abstracted from the endoscopy database. Bowel preparation quality was recorded as excellent, good, fair and poor. Histology and size of polyps removed were gathered from pathology reports. MNA was calculated and incident rate ratios assessing the relationship between bowel preparation quality, MNA, and covariates was calculated using Poisson regression. Results: A total of 2422 colonoscopies were identified; 815 (33.6%) were screening colonoscopies among average risk individuals, 50–74 years; 203 (24.9%) had ≥1 adenomas; and 666 (81.7%) had excellent/good preparation quality. Overall MNA was 0.34 [standard deviation (SD) 0.68] and MNA was greater among those >60 years [incident rate ratio (IRR) 1.89, 95% confidence interval (CI) 1.48–2.42), males (IRR 1.60, 95%CI 1.26–2.04) and those with good bowel preparation (IRR 2.54, 95%CI 1.04–6.16). Among those with ≥1 adenomas, MNA was 1.48 (SD 1.05) for excellent and 1.00 (SD 0.00) for poor quality preparation (p = 0.55). Conclusions: We found that MNA is sensitive to changes in bowel preparation with higher MNA among those with good bowel preparation compared with those with poor preparation. Our evidence suggests MNA was particularly sensitive when restricted to only those in whom adenomas were seen

Rapidly progressive heart failure resulting from cardiac sarcoidosis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27288/1/0000307.pd

Comparison of electrical CD measurements and cross-section lattice-plane counts of sub-micrometer features replicated in Silicon-on-Insulator materials

Electrical test structures of the type known as cross-bridge resistors have been patterned in (100) epitaxial silicon material that was grown on Bonded and Etched-Back Silicon-on-Insulator (BESOI) substrates. The CDs (Critical Dimensions) of a selection of their reference segments have been measured electrically, by SEM (Scanning-Electron Microscopy) cross-section imaging, and by lattice-plane counting. The lattice-plane counting is performed on phase-contrast images made by High-Resolution Transmission-Electron Microscopy (HRTEM). The reference-segment features were aligned with <110> directions in the BESOI surface material. They were defined by a silicon micromachining process which results in their sidewalls being atomically-planar and smooth and inclined at 54.737{degree} to the surface (100) plane of the substrate. This (100) implementation may usefully complement the attributes of the previously-reported vertical-sidewall one for selected reference-material applications. The SEM, HRTEM, and electrical CD (ECD) linewidth measurements that are made on BESOI features of various drawn dimensions on the same substrate is being investigated to determine the feasibility of a CD traceability path that combines the low cost, robustness, and repeatability of the ECD technique and the absolute measurement of the HRTEM lattice-plane counting technique. Other novel aspects of the (100) SOI implementation that are reported here are the ECD test-structure architecture and the making of HRTEM lattice-plane counts from both cross-sectional, as well as top-down, imaging of the reference features. This paper describes the design details and the fabrication of the cross-bridge resistor test structure. The long-term goal is to develop a technique for the determination of the absolute dimensions of the trapezoidal cross-sections of the cross-bridge resistors reference segments, as a prelude to making them available for dimensional reference applications

Borderline Personality Disorder, Exposure To Interpersonal Trauma, And Psychiatric Comorbidity In Urban Primary Care Patients

Objective: Few data are available on interpersonal trauma as a risk factor for borderline personality disorder (BPD) and its psychiatric comorbidity in ethnic minority primary care populations. This study aimed to examine the relation between trauma exposure and BPD in low-income, predominantly Hispanic primary care patients. Method: Logistic regression was used to analyze data from structured clinical interviews and self-report measures (n = 474). BPD was assessed with the McLean screening scale. Trauma exposure was assessed with the Life Events Checklist (LEC); posttraumatic stress disorder (PTSD) was assessed with the Lifetime Composite International Diagnostic Interview, other psychiatric disorders with the SCID-I, and functional impairment with items from the Sheehan Disability Scale and Social Adjustment Scale Self-Report (SAS-SR). Results: Of the 57 (14%) patients screening positive for BPD, 83% reported a history of interpersonally traumatic events such as sexual and physical assault or abuse. While interpersonal trauma experienced during adulthood was as strongly associated with BPD as interpersonal trauma experienced during childhood, noninterpersonal trauma was associated with BPD only if it had occurred during childhood. The majority (91%) of patients screening positive for BPD met criteria for at least one current DSM-IV Axis I diagnosis and exhibited significant levels of functional impairment. Conclusion: Increased awareness of BPD in minority patients attending primary care clinics, high rates of exposure to interpersonal trauma, and elevated risk for psychiatric comorbidity in this population may enhance physicians' understanding, treatment, and referral of BPD patients

The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

<p>Abstract</p> <p>Background</p> <p>Temporomandibular joint disorders (TMJD) are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1) identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2) evaluate their methodological quality, and (3) evaluate the evidence grade within the systematic reviews.</p> <p>Methods</p> <p>A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis) comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July). Exclusion criteria were: <it>in vitro </it>or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP) were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews.</p> <p>Results</p> <p>The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd). In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies.</p> <p>Conclusion</p> <p>The results indicate that in spite of the widespread impact of TMJD, and the multitude of potential interventions, clinicians have expended sparse attention to systematically implementing clinical trial methodology that would improve validity and reliability of outcome measures. With some 20 years of knowledge of evidence-based healthcare, the meager attention to these issues begins to raise ethical issues about TMJD trial conduct and clinical care.</p

Revision of the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis Classification Schema for Melanocytic Lesions: A Consensus Statement

IMPORTANCE A standardized pathology classification system for melanocytic lesions is needed to aid both pathologists and clinicians in cataloging currently existing diverse terminologies and in the diagnosis and treatment of patients. The Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) has been developed for this purpose. OBJECTIVE To revise the MPATH-Dx version 1.0 classification tool, using feedback from dermatopathologists participating in the National Institutes of Health-funded Reducing Errors in Melanocytic Interpretations (REMI) Study and from members of the International Melanoma Pathology Study Group (IMPSG). EVIDENCE REVIEW Practicing dermatopathologists recruited from 40 US states participated in the 2-year REMI study and provided feedback on the MPATH-Dx version 1.0 tool. Independently, member dermatopathologists participating in an IMPSG workshop dedicated to the MPATH-Dx schema provided additional input for refining the MPATH-Dx tool. A reference panel of 3 dermatopathologists, the original authors of the MPATH-Dx version 1.0 tool, integrated all feedback into an updated and refined MPATH-Dx version 2.0. FINDINGS The new MPATH-Dx version 2.0 schema simplifies the original 5-class hierarchy into 4 classes to improve diagnostic concordance and to provide more explicit guidance in the treatment of patients. This new version also has clearly defined histopathological criteria for classification of classes I and II lesions; has specific provisions for the most frequently encountered low-cumulative sun damage pathway of melanoma progression, as well as other, less common World Health Organization pathways to melanoma; provides guidance for classifying intermediate class II tumors vs melanoma; and recognizes a subset of pT1a melanomas with very low risk and possible eventual reclassification as neoplasms lacking criteria for melanoma. CONCLUSIONS AND RELEVANCE The implementation of the newly revised MPATH-Dx version 2.0 schema into clinical practice is anticipated to provide a robust tool and adjunct for standardized diagnostic reporting of melanocytic lesions and management of patients to the benefit of both health care practitioners and patients