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Angiogenesis is critical for tissue healing and regeneration. Promoting angiogenesis in materials implanted within dental pulp after pulpectomy is a major clinical challenge in endodontics. We demonstrate the ability of acellular self-assembling peptide hydrogels to create extracellular matrix mimetic architectures that guide in vivo development of neovasculature and tissue deposition. The hydrogels possess facile injectability, as well as sequence-level functionalizability. We explore the therapeutic utility of an angiogenic hydrogel to regenerate vascularized pulp-like soft tissue in a large animal (canine) orthotopic model. The regenerated soft tissue recapitulates key features of native pulp, such as blood vessels, neural filaments, and an odontoblast-like layer next to dentinal tubules. Our study establishes angiogenic peptide hydrogels as potent scaffolds for promoting soft tissue regeneration in vivo. A major challenge to endodontic tissue engineering is the lack of in situ angiogenesis within intracanal implants, especially after complete removal of the dental pulp. The lack of a robust vasculature in implants limit integration of matrices with the host tissue and regeneration of soft tissue. We demonstrate the development of an acellular material that promotes tissue revascularization in vivo without added growth factors, in a preclinical canine model of pulp-like soft-tissue regeneration. Such acellular biomaterials would facilitate pulp revascularization approaches in large animal models, and translation into human clinical trials. [Display omitted] [ABSTRACT FROM AUTHOR]

Approximately one in four people will develop psychosis in their lifetime. Late-life psychosis carries significant risks of isolation, caregiver distress, polypharmacy, and mortality. Unfortunately, there is a gap between the prevalence of psychotic disorders in older adults and the strategies available for assessment and intervention. There are scarce reliable pathognomonic signs to diagnose primary or secondary psychosis. Therefore, a comprehensive evaluation to establish the correct diagnosis is crucial for developing appropriate treatment. There is a consensus to categorize late-life psychosis as either primary or secondary psychosis. Primary psychoses include schizophrenia (early, late, or very late onset), affective psychosis, and delusional disorders. Secondary psychoses can be due to delirium, disease, drugs or dementia. Each condition would benefit from further diagnostic testing, psychosocial and environmental interventions, and judicious use of pharmacotherapy. This session will present an updated review of the assessment of psychotic spectrum disorders of late-life, as well as evidence-based psychosocial and pharmacological interventions. Dr. Michael will emphasize strength-based assessment and goals of care. Dr. Hashem will provide an overview of longitudinal trajectories and outcomes of late-life psychosis, as well as judicious use of pharmacotherapy when indicated. Dr. Kumar will review evidence-based psychosocial interventions in primary and secondary late-life psychotic disorders. Dr. Reinhardt will serve as a discussant and introduce the panel to the participants. [ABSTRACT FROM AUTHOR]

Unlabelled: Interactions between exogenous and endogenous opioids are not commonly investigated as a basis for sexually dimorphic opioid analgesia. We investigated the influence of spinal endomorphin 2 (EM2), an endogenous mu-opioid receptor (MOR) ligand, on the spinal antinociception produced by intrathecally administered opioids. Activation of spinal MORs facilitated spinal EM2 release. This effect was sexually dimorphic, occurring in males but not in females. Although activational effects of testosterone were required for opioid facilitation of spinal EM2 release in males, the absence of this facilitation in females did not result from either insufficient levels of testosterone or mitigating effects of estrogens. Strikingly, in males, the contribution of spinal EM2 to the analgesia produced by intrathecally applied MOR agonists depended on their analgesic efficacy relative to that of EM2. Spinal EM2 released by the higher efficacy MOR agonist sufentanil diminished sufentanil's analgesic effect, whereas EM2 released by the lower efficacy morphine had the opposite effect on spinal morphine antinociception. Understanding antithetical contributions of endogenous EM2 to intrathecal opioid antinociception not only enlightens the selection of opioid medications for pain management but also helps to explain variable sex dependence of the antinociception produced by different opioids, facilitating the acceptance of sexually dimorphic antinociception as a basic tenet.Perspective: The male-specific MOR-coupled enhancement of spinal EM2 release implies a parallel ability to harness endogenous EM2 antinociception. The inferred diminished ability of females to utilize the spinal EM2 antinociceptive system could contribute to their greater frequency and severity of chronic pain syndromes. [ABSTRACT FROM AUTHOR]

Patients who recover from infection with SARS-CoV-2 (COVID-19) are at risk for a range of neuropsychiatric conditions, among which anxiety spectrum disorders have been frequently observed. In this report we present two cases of older adults with no past psychiatric history who developed panic disorder after recovering from COVID-19. Patient A is a 51-year-old Haitian American woman who was admitted to inpatient psychiatry with symptoms of anxiety, insomnia, disorganized behavior, and suicidal ideation, as well as intermittent hypertensive episodes. After discharge, the hypertensive episodes persisted and were associated with feelings of impending doom, palpitations, and shortness of breath. While undergoing blood pressure management from her cardiologist, she was admitted to outpatient psychiatry, diagnosed with panic disorder, and tried on multiple medications (Mirtazapine, Trazodone, Hydroxyzine, Escitalopram, Sertraline). None of these medications relieved her symptoms, which gradually evolved from panic/anxiety/depression to derealization/depersonalization. Eventually, all her symptoms abated without medication. Patient B is a 61-year-old African American woman who was admitted to outpatient psychiatry with episodes of chest tightness, palpitations, and trembling, as well as insomnia and depressed mood; she too was diagnosed with panic disorder. She had previously been treated by her primary care doctor and in the emergency room with various benzodiazepines (Diazepam, Alprazolam, Lorazepam), but she was eventually stabilized on a regimen of Sertraline, Trazodone, and Gabapentin. Here we examine the rationale and effectiveness of various medication trials for COVID-19-induced panic disorder, as well as how psychosocial risk factors may predict the course of illness. We also discuss some hypothesized mechanisms by which SARS-CoV-2 could produce neuropsychiatric sequelae (e.g. direct viral injury, cytokine storm, molecular mimicry). These mechanisms could affect both peripheral and central nervous systems, resulting in the combination of autonomic instability and mood disturbance classically associated with panic disorder. New York State Department of Health, Center of Excellence Grant [ABSTRACT FROM AUTHOR]

Highlights: [•] 79 Local events analyzed for source parameters and f max in Arunachal Lesser Himalaya. [•] Source parameters found to be consistent with other studies from different regions. [•] Dependence of f max is studied on the basis of comparative dependency of f c and f max. [•] f max Controlled by source process and independent of distance and focal depth. [•] A scaling relation derived for Kameng region. [Copyright &y& Elsevier]

Illness awareness in dementia has a substantial impact on psychopathology, daily functioning, and treatment adherence. Although there is an extensive literature on illness awareness in dementia, there are still many inconsistencies and knowledge gaps that have implications for clinical practice. One such inconsistency is that illness awareness is characterized in different terms: as anosognosia (the lack of awareness of having a disorder or disability), metacognition (a patient's knowledge about their perceptions, memories, decisions, and actions), or insight (a multidimensional construct). Illness awareness is also complicated by cultural and psychological factors: for instance, denial may serve as both an impediment to care (reducing treatment adherence) and a protective factor (mitigating depression/anxiety about having a chronic illness). The task of defining illness awareness and its role in dementia is complex, as is the prospect of developing interventions that might improve illness awareness and subsequent clinical outcomes. This poster will review the current literature with four primary aims: (1) To examine the various definitions of illness awareness and to explore the potential for developing a brief, valid instrument to assess illness awareness during routine clinic visits. (2) To identify specific neurocognitive and demographic variables that serve as predictors of illness awareness in dementia. (3) To address how impairments of illness awareness affect patient-caregiver interactions, patient well-being, symptom severity, the trajectory of illness, treatment adherence, morale, and the willingness to accept help. (4) To explore whether illness awareness and/or its predictor variables have been found to be modifiable by intervention, which interventions are most effective, and what clinical benefits they could provide. For each of the above aims, we will summarize the principal findings in the literature and identify steps for future research. New York State Department of Health, Center of Excellence Grant. [ABSTRACT FROM AUTHOR]

Source parameters of the small to moderate earthquakes are significant for understanding the dynamic rupture process, the scaling relations of the earthquakes and for assessment of seismic hazard potential of a region. In this study, the source parameters were determined for 58 small to moderate size earthquakes (3.0 ≤ M w  ≤ 5.0) occurred during 2007–2015 in the Garhwal-Kumaun region. The estimated shear wave quality factor (Q β ( f )) values for each station at different frequencies have been applied to eliminate any bias in the determination of source parameters. The Q β ( f ) values have been estimated by using coda wave normalization method in the frequency range 1.5–16 Hz. A frequency-dependent S wave quality factor relation is obtained as Q β ( f ) = (152.9 ± 7) f (0.82±0.005) by fitting a power-law frequency dependence model for the estimated values over the whole study region. The spectral (low-frequency spectral level and corner frequency) and source (static stress drop, seismic moment, apparent stress and radiated energy) parameters are obtained assuming ω −2 source model. The displacement spectra are corrected for estimated frequency-dependent attenuation, site effect using spectral decay parameter “Kappa”. The frequency resolution limit was resolved by quantifying the bias in corner frequencies, stress drop and radiated energy estimates due to finite-bandwidth effect. The data of the region shows shallow focused earthquakes with low stress drop. The estimation of Zúñiga parameter (ε) suggests the partial stress drop mechanism in the region. The observed low stress drop and apparent stress can be explained by partial stress drop and low effective stress model. Presence of subsurface fluid at seismogenic depth certainly manipulates the dynamics of the region. However, the limited event selection may strongly bias the scaling relation even after taking as much as possible precaution in considering effects of finite bandwidth, attenuation and site corrections. Although, the scaling can be improved further with the integration of large dataset of microearthquakes and use of a stable and robust approach. [ABSTRACT FROM AUTHOR]

Moment Tensor solutions of 104 earthquakes which were observed at local distances in Lower Siang region of Arunachal Himalaya have been estimated using ISOLA code. The magnitude range of analyzed earthquakes lies between 1.8 ( M w ) and 5.3 ( M w ). Out of 104 earthquakes, only 32 events are having good data. The signal noise ratio of these 32 events is greater than 6 with magnitude greater than 2.5. All possible sources of non-DC such as, noise present in the data, depth of the source, low azimuthal coverage of the event and non-DC as a part of real earthquake source process are examined. The study reveals that non-DC is highly dependent on the source depth as comparatively shallow events shows high CLVD%. The CLVD is also highly affected by the noise present in the data. Another factor is the magnitude of the event. The high magnitude event shows quite high DC%. So the source mechanisms of high magnitude events are double couple (DC). [ABSTRACT FROM AUTHOR]

An offset coplanar waveguide (CPW)-fed triple-band circularly polarized tilted asymmetrical E-shaped printed antenna for multiband wireless applications is presented in this paper. The antenna mainly consists of a tilted asymmetrical E-shaped patch and excite by a 50 Ω offset CPW feed line using a transformer for impedance matching to generate wide quad operating bands. By properly embedding rectangular slots in the tilted asymmetrical E-shaped patch and triangular stubs loaded modified CPW ground plane, the antenna reveals triple-band circular polarization (CP) features. Numerical analysis and experimental validation of the antenna structure have been carried out and results are presented. The mechanism of triple-band CP operation, analysis of surface current distributions, design procedure, and parametric study of the design is discussed in details. It is well suited for the application of UMTS-2100, 3.5/5.5 GHz WiMAX, 5.2/5.8 GHz WLAN, ITS, downlink of X-band satellite communication, and ITU 8 GHz bands. [ABSTRACT FROM AUTHOR]

Abstract: The extent of task-related fMRI activation can vary as a function of task difficulty. Also the efficiency or capacity of the brain networks underlying task performance can change with aging. We asked whether the expression of a network underlying task performance would differ as a function of task demand in old and young individuals. 26 younger and 23 older healthy adults performed a delayed item recognition task that used the response signal method to parametrically manipulate the extrinsic difficulty of the task by imposing five different deadlines for recognition response. Both age groups showed a speed–accuracy trade-off, but the younger group achieved greater discriminability at the longer deadlines. We identified a spatial pattern of fMRI activation during the probe phase whose expression increased as the response deadline shortened and the task became more difficult. This pattern was expressed to a greater degree by the old group at the long deadlines, when the task was easiest. By contrast, this pattern was expressed to a greater degree by the younger group at the short deadlines, when the task was hardest. This suggests reduced efficiency and capacity of this network in older subjects. These findings suggest that neuroimaging studies comparing task-related activation across groups with different cognitive abilities must be interpreted in light of the relative difficulty of the task for each group. [Copyright &y& Elsevier]

Abstract: This functional neuroimaging (fMRI) study examined the neural networks (spatial patterns of covarying neural activity) associated with the speed-accuracy tradeoff (SAT) in younger adults. The response signal method was used to systematically increase probe duration (125, 250, 500, 1000 and 2000ms) in a nonverbal delayed-item recognition task. A covariance-based multivariate approach identified three networks that varied with probe duration—indicating that the SAT is driven by three distributed neural networks. [Copyright &y& Elsevier]

Abstract: Three competing models of cognitive aging (neural compensation, capacity limitations, neural inefficiency) were examined in relation to working memory for novel non-verbal material. To accomplish this goal young (n =25) and old (n =25) participants performed a delayed item recognition (DIR) task while being scanned with bold fMRI. The stimuli in the DIR task consisted of computer-generated closed-curve shapes with each shape presented only once in the testing conditions of each participant. This ensured that both the novelty and appearance of the shapes maximized visual demands and limited the extent of phonologic processing. Behaviorally, as expected, the old participants were slower and less accurate compared to the young participants. Spatial patterns of brain activation that corresponded to load-dependent (stimulus set size ranged from 1 to 3) fMRI signal during the three phases of the DIR task (memory set presentation, retention delay, probe presentation) were evaluated in both age groups. Support for neural compensation and capacity limitation was evident in retention delay and the probe phase, respectively. Data were inconsistent with the neural inefficiency model. The process specific support for the theories we examined is consistent with a large corpus of research showing that the substrates underlying the encoding, retention and probe phases are different. That is, cognitive aging theories can be specific to the neural networks/regions underlying the different phases of working memory. Delineating how these theories work in concert can increase knowledge of age-related effects on working memory. [Copyright &y& Elsevier]

Induction and maintenance immunosuppression protocols with or without long-term steroid therapy in kidney transplant recipients are variable and are transplant center-specific. The aim of this prospective randomized pilot study was to compare 5-year outcomes in kidney recipients maintained on 4 different calcineurin inhibitor (CNI)-based immunosuppression protocols without long-term steroid therapy. Two hundred consenting patients who received kidney transplants between June 2000 and October 2004 were enrolled in 4 immunosuppression protocol groups, with 50 patients in each group: cyclosporine (CSA)/mycophenolate mofetil (MMF), CSA/sirolimus (SRL), tacrolimus (TAC)/MMF, and TAC/SRL. Induction therapy was done with basiliximab and methylprednisolone. Steroids were withdrawn on post-transplant day 2, and long-term steroid therapy was not used. Demographic characteristics among the four groups were comparable; approximately 50% of the recipients were African American and ≥ 80% of the kidneys transplanted were from deceased donors. Clinical acute rejection (CAR) was confirmed by biopsy and treated with intravenous pulse steroid therapy. Steroid-unresponsive CAR was treated with Thymoglobulin. Surveillance biopsies were performed at 1, 6, 12, 24, 36, 48, and 60 months to evaluate subclinical acute rejection (SCAR), chronic allograft injury (CAI), and other pathological changes per the Banff 2005 schema. The primary end point was CAR, and secondary end points were 5-year patient and graft survival rates, renal function, SCAR, CAI, and adverse events. In the first year post-transplant, the incidence of CAR was 18% in the CSA/MMF group, 8% in the CSA/SRL group, 14% in the TAC/MMF group, and 4% in the TAC/SRL group (CSA/MMF vs. TAC/SRL; p = 0.05). The incidence of SCAR was 22% in the CSA/MMF group, 8% in the CSA/SRL group, 16% in the TAC/MMF group, and 6% in the TAC/SRL group (CSA/MMF vs. CSA/SRL and TAC/SRL; p = 0.05). After the first year, the incidences of CAR and SCAR decreased and were comparable in all 4 groups. At 5 years post-transplant, cumulative CAI due to interstitial fibrosis/tubular atrophy (IF/TA), hypertension (HTN), and chronic calcineurin inhibitor (CNI) toxicity was observed in 54%, 48%, and 8% of the CSA/MMF group vs. 16%, 36%, and 12% of the CSA/SRL group vs. 38%, 24% and 6% of the TAC/MMF group vs. 14%, 25% and 12% of the TAC/SLR group (IF/TA: CSA/MMF vs. CSA/SRL and TAC/SRL; p = 0.04, HTN: CSA/MMF vs. TAC/MMF and TAC/SRL; p = 0.05, CNI toxicity: TAC/SRL and CSA/SRL vs. TAC/MMF; p = 0.05). Five-year patient and graft survival rates were 82% and 60% in the CSA/MMF group, 82% and 60% in the CSA/SRL group, 84% and 62% in the TAC/MMF group, and 82% and 64% in the TAC/SRL group (p = 0.9). Serum creatinine levels and creatinine clearances at 5 years were comparable among the groups. Our data show that the rates of CAR and SCAR in the first year post-transplant were significantly lower in the CSA/SRL and TAC/SRL groups and that cumulative CAI rates due to IF/TA and HTN at 5 years were significantly lower in the TAC/MMF, TAC/SRL, and CSA/SRL groups than in the CSA/MMF group. Despite significant differences in the incidences of CAR and SCAR and prevalence of different types of CAI at 5 years, renal function and patient and graft survival rates at 5 years were comparable among kidney recipients maintained on 4 different immunosuppression protocols without long-term steroid therapy. [ABSTRACT FROM AUTHOR]

In this paper, the design, implementation, and experimental validation of a wideband circularly polarized square slot antenna (CPSSA) is presented. The proposed antenna comprises of an irregular square patch, asymmetrical grounded-L strips, an inverted-L grounded slot, a parasitic asymmetrical rectangular split ring resonator (RSRR) and inverted-L strip patches with the overall size of 0.305λ L × 0.305λ L × 0.007λ L. By appropriately embedding strips, slots and parasitic patches on the antenna structure, the measured wideband 3-dB axial ratio bandwidth (ARBW) of 83.2% (2.33–5.65 GHz) is obtained, while the measured impedance bandwidth (IBW) of 86.72% (2.165–5.48 GHz) is achieved. Overall, CP bandwidth is 80.66%. A parametric study of different design parameters is investigated, and the overall performance of the antenna is presented. [ABSTRACT FROM AUTHOR]