Traumatic brain injury (TBI) is a major contributor to morbidity and mortality experienced by those soldiers subjected to improvised explosive devices (IED) as well as in military and civilian high speed collisions. Traumatic cerebral vasospasm (TCV) is a major contributor to morbidity and mortality experienced by those TBI patients. Aggressive neurosurgical treatment motivated by early diagnosis appears to improve the clinical outcome for these patients. Early transcranial Doppler (TCD) measurements of blood flow speed within major cerebral arteries produces the initial diagnosis, hence motivates the rapid treatment of TCV. However, the skill necessary to deploy TCD limits its availability relative to its need. PhysioSonics, Inc, a local company in Seattle, created an automatic TCD system (called Presto or aTCD) that minimizes the skill necessary to perform TCD assays. Our long-term goal is to optimize Presto for patients in vasospasm, through optimization of its spectral Doppler envelope analyzer, its headset and supporting software so it can track blood flow in the internal carotid artery as well as middle cerebral artery.

关键词：动脉,血液循环;颈动脉;大脑;临床医学;医疗服务;发病率;死亡率;神经系统;手术;创伤性脑损伤;创伤和损伤

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The overall objective of this research effort is to identify biomarkers following articular fracture that may be predictive of the development of post-traumatic arthritis (PTA). PTA is a clinically important complication of joint injury with life-long effects for the patient. While PTA can occur rapidly after moderate to severe articular injuries, not every patient will go on to develop this condition. There are no effective screening methods to determine who is at risk. This proposal includes both a clinical observational study and a series of murine experiments, both with the goal of identifying biomarkers that are associated with development of PTA. Patients with knee joint fractures will be enrolled, and we will collect serum, urine, and synovial fluid early after injury. Radiographic imaging will be performed early after injury, again at 18 months, and analyzed to determine which patients developed PTA from those who did not. We will assess the ability of identified biomarkers in serum, urine, and synovial fluid to predict PTA following joint injury. Additionally, biomarkers will be assessed in a murine model of articular fracture using two strains in which one strain develops PTA and the other does not. Comparison of the human and mouse response to knee joint fracture will allow assessment of the potential use of the mouse model to evaluate future therapies to prevent PTA.

关键词：关节炎;生物标志物;血清;骨折;临床医学;比较;人类;图像;关节(解剖);膝盖(解剖);标志;模型;患者;Pta(创伤后关节炎);放射学;反应;治疗;示踪研究;创伤和损伤

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During the first year of this project, we have made significant progress in our proposed work. We developed and tested two cell models to induce cancer dormancy: metabolic stress and Petaka incubation. We found that metabolic stress enriched quiescence population but caused spontaneous DNA breaks. Given that the goal of this project is to determine if and how DNA damage repairs play a critical role in dormancy state, metabolic stress-induced dormancy appears not to be appropriate for our study. In Petaka-induced dormancy, we found that cell dormancy facilitated DNA damage repair when cells were pre-treated with DNA damage agents, and promoted transformation phenotype and drug resistance after exited from dormant state. These observations are consistent with the fact that recurrent breast cancers are usually more malignant and more resistant to original therapy. Finally, we applied microarray analysis in cells before dormancy, maintaining in dormancy, and exited from dormancy. Further analysis of these expression profiles will help us to identify the key molecular determinants that control dormancy at different stages.

关键词：乳腺癌;癌症休眠;临床医学;一致性;损害;脱氧核糖核的酸;休眠;药物;代谢性应激;代谢;Petaka设备;静止;耐药性;压力(生理)

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This pilot study tests the effects on individual performance of dyadic versus individual practice in a 3D virtual world (VW) home safety assessment. Sixty medical students in three conditions (dyadic spatially separated with paired avatars DPA; individual with avatar IND; and dyadic spatially together with single avatar DSA) participated in a geriatric home safety simulation. The participants, via avatars, conducted an assessment of physical hazards. Participants then worked individually in a separate 3D VW home assessment. Dyadic practice, spatially together with a single avatar (DSA), improved individual performance in the subsequent 3D VW home assessment.

关键词：计算机仿真;远程教育学习;家庭安全仿真

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In living organisms, many processes are executed through tightly regulated networks of multi-component macromolecular complexes. Knowledge of structure and dynamics of such assemblies is essential to understanding their biological mechanisms. Solid-state NMR spectroscopy is a prime method for studying macromolecular assemblies, at atomic-level resolution, particularly in systems that are insoluble and lack long-range order. In this report, we review the contemporary magic-angle-spinning (MAS) NMR methods for investigation of proteins assemblies. We describe the progress in multidimensional correlation spectroscopy, recoupling, and decoupling techniques. We discuss emerging methods for recording spectra at MAS frequencies of 40 kHz and faster. We review techniques for sensitivity enhancement and fast data collection. We address isotopic labelling approaches to alleviate spectral congestion, facilitate assignments, and highlight specific intra- and intermolecular interactions. Finally, we present recent case studies on exciting and challenging systems, including assemblies of bacterio-phages and HIV-1 proteins, cytoskeleton-associated proteins, gas vesicles, type Ⅲ secretion system, and protein-RNA complexes.

关键词：蛋白质总成;固态核磁共振;魔角旋转;化学位移各向异性重新挂钩;偶极重新挂钩

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In the second year of funding of the Defining Early Markers of Neurodevelopmental Disorders in Infants with TSC project, administrative set-up of the collaborative project and IRB approvals were obtained. Post IRB approval (March 28th, 2012) we have successfully recruited 63 families into the project between the two study sites. More specifically, have collected data from 39 participants with TSC as well as 24 age matched-controls between the two performance sites. To date we have completed more than 220 study visits. In keeping with our specific aims, we have begun to collect the data necessary to outline the neurocognitive and behavioral development of children with TSC. With the data that we have collected and evaluated, we have found the tasks that are part of this project appear to be appropriate to describe the pathways to neurodevelopmental disorders in this population.

关键词：异常,诊断(医学);婴儿;神经系统;神经生理学;行为;脑;儿童;临床医学;障碍;无能力;精神障碍

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1. Contingency Prepardness: Collect information from transplant centers, build awareness of the Transplant Center Contingency Planning Committee and educate the transplant community about the critical importance of establishing a nationwide contingency response plan. 2. Rapid Identification of Matched Donors : Increase operational efficiencies that accelerate the search process and increase patient access are key to preparedness in a contingency event. 3. Immunogenetic Studies: Increase understanding of the immunologic factors important in HSC transplantation. 4. Clinical Research in Transplantation: Create a platform that facilitates multicenter collaboration and data management.

关键词：临床医学;捐助者(医学);造血细胞;干细胞;有毒代理人;社区;数据管理;识别;免疫学;反应;移植

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Use of electronic alerts in clinical practice has had mixed effects on providers' prescribing practices. Little research has explored the use of electronic alerts for improving screening practices. New York City has one of the highest rates of HIV in the United States. Recent New York State legislation requires healthcare providers to offer an HIV test to patients aged 13-64 years during a clinical encounter. Adhering to this requirement is particularly challenging in emergency department (ED) settings, which are frequently overcrowded and under-resourced. The purpose of this study was to evaluate the effect of an electronic "hard-stop " alert on HIV testing rates in the ED. Approximately four months of data were reviewed before and after the implementation of the alert. We found that use of the electronic alert significantly increased documentation of offering an HIV test (O.R. = 267.27, p＜0.001) and resulted in a significant increase in HIV testing. Findings from this study add to the current knowledge about the use of electronic alerts for improving disease screening.

关键词：急诊科;艾滋病毒检测;电子提醒

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Although most prostate cancers are initially responsive to androgen ablation therapy, they become treatment resistant as tumor cells develop mechanisms to evade the treatment. Early knowledge of the androgen receptor dysfunctions will help in patient stratification for emerging therapeutic strategies. We proposed an approach for monitoring potential dysfunctions of the androgen receptor by measuring expression of a panel of genes directly regulated by androgen receptor. We examined human prostate cancer tissues (surgery or diagnostic biopsy specimens) at early stages of the disease and matched with longitudinal follow up data. Within the first reporting period we have completed the quality control of detecting PSA/KLK3, PMEPA1, NKX3.1, ODC1, AMD1 and TMPRSS2-ERG genes in VCap cell culture model monitoring kinetic and dose response to androgen. In the second reporting period we have completed the qRT-PCR evaluation of in 77 patients by monitoring ERG, PSA, PMEPA1 and GAPDH levels. Also, we have completed the evaluation of 40 whole mounted sections of RP specimens by immunohistochemistry assessing AR, ERG, NKX3.1 and PSA proteins and compared the results to corresponding GeneCHip mRNA expression levels from the same tumor foci. The result indicated remarkable accuracy of the androgen regulated gene expression at mRNA levels performed better in prediction favorable outcomes in tumors with well differentiated morphology. By the completion of the proposed research we will provide a quantitative index of AR dysfunction for enhancing prognostic accuracy and to stratify patients for specific therapeutic approaches at early stages of prostate cancer treatment.

关键词：前列腺癌雄激素;肿瘤;;受体网站(生理学);精度;活检,诊断(医学);疾病;剂量;障碍;基因;患者;预测;前列腺;蛋白质;耐药性;感觉器官;策略;分层;外科手术;治疗;雄激素衰退

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The goals of our studies in year 2 were to (a) use the most effective dosages and route of administration of GGF2 on the proliferation of NG2-expressing glia cells after SCI that we identified in year 1 in long term studies of effects on functional recovery and chronic histopathology and (b) subject spinal cords from some of these rats to MRI and Diffusion Tensor Imaging (DTI) of the spinal cord to develop MRI imaging method that can detect treatment effects that improve survival and myelination of axons after SCI for potential use in future dog studies.

关键词：临床医学;组织病理学;神经纤维;鞘(解剖);脊髓;兽药;创伤和损伤

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