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Intensive Blood Pressure Control in Type 2 Diabetes: A Systematic Review and Meta-Analysis of Cardiovascular and Microvascular Outcomes
No full textBACKGROUND: The optimal blood pressure (BP) target for adults with type 2 diabetes (T2DM) remains a topic of debate. This systematic review and meta-analysis aimed to investigate the efficacy of intensive BP control strategies compared to standard or less intensive approaches in adults with T2DM. METHODS: We comprehensively searched databases for studies comparing intensive vs. less intensive BP targets in individuals with T2DM. In this study, the group with the most intensive target was compared to the group with the least intensive target. Also, studies were analyzed based on current guideline recommendations. Outcomes of interest included major adverse cardiovascular events (MACE), all-cause mortality, cardiovascular mortality, myocardial infarction (MI), stroke, heart failure, retinopathy, neuropathy, nephropathy, and end-stage renal disease. Risk ratios with 95% confidence intervals were calculated. RESULTS: The meta-analysis included 21 studies (16 RCTs) with 290,907 participants (mean age 61.84 years, 55.03% male). Guideline-based analyses showed comparable clinical outcomes between groups with no significant differences. However, the most intensive targets vs. the least intensive targets revealed that the intensive BP control group experienced a significantly lower risk of MACE (RR = 0.75, 0.58; 0.98), nonfatal MI (RR = 0.61, 0.41; 0.91), nonfatal stroke (RR = 0.60, 0.39; 0.92), and total stroke (RR = 0.61, 0.39; 0.95). Other outcomes were similar between groups. Subgroup analysis of RCTs mirrored the overall findings. CONCLUSIONS: In adults with T2DM, intensive BP control reduces the risk of cardiovascular events, such as MACE, stroke, and MI. Additionally, it demonstrates comparable diabetes-related complications to less intensive or standard controls
Titin: The Missing Link in Cardiac Physiology
No full textTitin, an extraordinary protein known for its colossal size and multifaceted roles, is a cornerstone in the structural and functional dynamics of striated muscle tissues, including the heart and skeletal muscles. Its sheer enormity, with a molecular weight exceeding 3000 kDa, is paralleled only by the immense influence it exerts on muscle physiology. This review will delve into the remarkable structural organization of Titin and the genetics of this molecule, including the common mutations resulting in various cardiomyopathies. We will delve deeper into its role in dilated cardiomyopathy, familial restrictive cardiomyopathy, hypertrophic cardiomyopathy, and left ventricular noncompaction cardiomyopathy. This review culminates by discussing the prospects of therapeutic strategies targeting Titin. While these interventions remain primarily theoretical, the possibilities are intriguing. Patients with Titin truncation mutations present unique challenges, but innovative approaches like gene therapy or preemptive treatments with drugs such as angiotensin-converting enzyme inhibitors or beta-blockers offer hope. This multi-pronged approach highlights the significance of understanding Titin\u27s multifaceted role and its potential as a target for future therapeutic interventions
Basic Reading Instruction Grades 1-6: A 12-Module OER Course
No full text2026
As teachers of aspiring educators, we owe it to our teacher candidates to provide them with the most up-to-date information on literacy pedagogy grounded in the science of reading. The science of reading is ever-changing as new evidence comes to our attention. By creating an OER syllabus, we can easily edit and update it based on articles (scholarly and trade), webinars, podcasts, and other open sources as they become available, rather than waiting for traditional textbook publishers to update their materials. This syllabus was developed for an asynchronous online class, and could easily be adapted to other course formats. Student choice is embedded in most modules as candidates are able to choose some of the materials they use.https://touroscholar.touro.edu/opentextbooks/1018/thumbnail.jp
Symposium #34
No full textRemarks and Moderator: Edward C. Halperin, M.D., M.A. Advice for best-standard practice for the contact lens wearer: Abha Amin, M.D. Genetic testing for breast cancer risk: Gila Friedman, MGC, CGC What is best-standard practice regarding chest CT scanning for lung cancer?: Anna Rozenshtein, M.D. My child has bumped his/her head. When should the child be brought to the doctor and what is the standard-of-care for medical evaluation?: Steven Wolf, M.D.; Patricia McGoldrick, NP, MPA, MSN A decision has been made to feed the baby with formula, rather than breast milk. What do we need to know about standard-of-care for the use of commercially available formula, particularly in view of the recent recall of one brand of formula?: Jennifer Kaswick, M.D., FAAP, IBCLC Q & A: Edward C. Halperin, M.D., M.A.https://touroscholar.touro.edu/ninety_minutes/1011/thumbnail.jp
A Framework Integrating Multiscale in Silico Modeling and Experimental Data Predicts CAR-NK Cell Cytotoxicity Across Target Cell Types
No full textNatural killer (NK) cells may be engineered with chimeric antigen receptors (CARs) to recognize tumor-associated antigens which bolsters their antitumor activity. More so than CAR-T cells, CAR-NK cell responses result from an integration of signals from a wider range of innate activating cytotoxic receptors, inhibitory receptors, and adhesion receptors in addition to the engineered CAR, making computational modeling of CAR-NK cell cytotoxicity more difficult than CAR-T cells. Uncovering mechanisms and predicting tumor cell responses to CAR-NK cytotoxicity is essential for improving therapeutic efficacy. The complexity of these effector-target interactions and the donor-to-donor variations in NK cell receptor (NKR) repertoire preclude the use of predictive models based on a single receptor, requiring function to be determined experimentally for each donor, CAR, and target combination. Computational modeling generates frameworks that allow the relationships of these factors to biologic outcomes to be explored without resource-consuming experiments. Here, we developed a computational mechanistic multiscale model which considers heterogenous expression of CARs, NKRs, adhesion receptors, and their cognate ligands, signal transduction, and NK cell-target cell population kinetics. The model is trained with quantitative flow cytometry and in-vitro cytotoxicity data and accurately predicts the short-term, long-term, and in-vivo cytotoxicity of CAR-NK cells. Furthermore, using Pareto optimization we explored the effect of CAR proportion and NK cell signaling on the differential cytotoxicity of CD33CAR-NK cells to cancer and healthy cells. This model can be extended to predict CAR-NK cytotoxicity across many antigens and tumor targets and serves as a tool to mechanistically explore CAR-NK signaling and biology
Time-Dependent Efficacy of Drag-Reducing Polymers in the Treatment of Permanent Middle Cerebral Artery Occlusion Injury in Rats
No full textCurrent treatments for ischemic stroke are not focused on microvascular cerebral blood flow (mvCBF), which actually delivers oxygen to tissue and is significantly impaired during a stroke. We previously showed that drag-reducing polymers (DRPs, 2 μg/ml), injected just after permanent middle cerebral artery occlusion (pMCAO) in rats, effectively restored mvCBF and tissue oxygenation. The aim of this work was to assess the efficiency of DRPs administered at various time points post-onset. DRPs (2 μg/ml) or saline was i.v. injected 0.5, 3, or 6 h after pMCAO induction in rats (n = 10/group). Laser speckle contrast imaging (LSCI) was used to evaluate regional cerebral blood flow in the parietal cortex and estimate the ischemic area. In vivo 2-photon laser scanning microscopy (2PLSM) was used to assess the effects on mvCBF and tissue hypoxia (NADH). Two-way ANOVA for multiple comparisons was used to test intergroup differences with the statistical significance level set at p \u3c 0.05. PMCAO progressively decreased cortical mvCBF, causing tissue hypoxia (p \u3c 0.05). Intravenous administration of DRPs at 0.5, 3, and 6 h post-pMCAO effectively improved cerebral microcirculation and oxygen delivery to tissue in a time-dependent manner compared to the saline-treated group (p \u3c 0.05). DRPs efficacy reduced with the time of application from 0.5 to 6 h after pMCAO but remained significant compared to the saline-treated group (p \u3c 0.05). DRPs augment collateral microcirculatory flow through leptomeningeal and pial anastomoses that interconnect the middle, anterior, and posterior cerebral artery watershed territories. We demonstrated that DRPs can be used as a new effective adjunct therapy for ischemic stroke, even without reperfusion and after delayed administration following the stroke onset
Menopause and Common Dermatoses: A Systematic Review
No full textBACKGROUND: Menopause is a universal physiological transition, marked by a decline in estrogen, which has important effects on skin and mucosal health. The impact of menopause and menopausal hormone therapy (MHT) on chronic dermatoses remains incompletely defined. OBJECTIVE: The aim was to investigate the relationship between menopause, MHT, and common dermatological conditions. METHODS: PubMed, Embase, and Web of Science were searched from inception to September 2024 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies evaluated menopause or MHT in relation to alopecia, psoriasis, acne, rosacea, melasma, and hidradenitis suppurativa (HS). Investigational cohorts largely consisted of menopausal women, although participant characteristics varied. Data on study design, population, hormonal status, and dermatological outcomes were extracted and synthesized. RESULTS: A total of 40 studies met inclusion criteria. Alopecia, particularly frontal fibrosing alopecia (FFA) and female pattern hair loss (FPHL), showed the strongest postmenopausal associations, with most cases presenting after menopause and earlier or surgical menopause conferring greater risk. Psoriasis frequently persisted or worsened after menopause, though objective assessments are limited. Acne and rosacea generally improved, whereas melasma showed mixed outcomes, including greater extra-facial involvement post menopause. HS responses to menopause were inconsistent. MHT was linked to increased risk of FFA and rosacea, whereas findings for other dermatoses were more variable or absent. Most of the studies involved MHT formulations that are less commonly used in current clinical practice. CONCLUSION: Menopause influences the onset and course of several chronic dermatoses, while data on MHT remain more limited and inconsistent. Dermatologists should consider menopausal status and hormone therapy exposure when evaluating skin disease. Longitudinal, dermatology-focused studies-particularly those integrating diverse populations and updated hormone therapies-are needed to inform individualized care
InTouch Week of February 9, 2026
No full textShaun Desai, M.D., to Lead Department of Otolaryngology NYMC Supports National Heart Month NYMC Alums Share Marriage, Memories, and a Lifetime Together CDM Strengthens Emergency Response Skills Through TECC and RTF Courses TCDM Celebrates Match Day Success Student Spotlight: SOM Student Juliet Manu Named SEQUINS Scholarhttps://touroscholar.touro.edu/in_touch/1390/thumbnail.jp
InTouch Week of January 19, 2026
No full textCelebrating a Landmark Oncology Text and Progress in Cancer Care SOM Student Aryan Malhotra Sets Research Presentation Records at Neurosurgery Conference Love at NYMC Student Spotlight: From Athlete to Aspiring Orthopedic Surgeon Faculty Spotlight: From Pupil to Professor: Alumni Lighting the Way at NYMChttps://touroscholar.touro.edu/in_touch/1387/thumbnail.jp
Middle Meningeal Artery Embolization for Subdural Hematoma: CT/MRI End Points of the EMBOLISE Trial
No full textBackground Chronic subdural hematomas (cSDHs) are associated with high recurrence risks following surgical evacuation. The EMBOLISE trial demonstrated that, compared with surgery alone, adjunctive middle meningeal artery embolization (MMAE) significantly reduced reoperation rates. However, given the limitations of the clinical end points of the trial, which may be subject to interrater variability and certain biases, the quantitative imaging metrics need to be evaluated. Purpose To evaluate the prespecified imaging end points of the EMBOLISE trial and assess the long-term resolution of cSDH through quantitative imaging analyses. Materials and Methods EMBOLISE was a multicenter, randomized, interventional trial conducted across 39 U.S. sites between December 2020 and August 2023. Prespecified secondary imaging end points included changes in hematoma volume and thickness and midline shifts from 24 hours to 90 days after the procedure at CT and MRI. The post hoc analyses performed herein extended the assessment to 180 days and included absolute hematoma metrics. Mixed-effects modeling was employed to adjust for confounders. Results Four hundred patients were enrolled in the EMBOLISE study, among whom 352 were included (mean age, 72 years ± 10.4 [SD]; 256 men). The mean cSDH volume was 126 mL at screening, with no intergroup differences. At 90 and 180 days, the MMAE plus surgery group had lower cSDH volumes (20.6 mL vs 28.9 mL [P = .03] and 19.4 mL vs 31.5 mL [P = .04], respectively). Mixed-effects models revealed a 6.9 mL (95% CI: -13.5, -0.40; approximately 25%) greater volume reduction and an 8.4 mL (95% CI: -15.2, -1.6; approximately 30%) lower absolute volume at 90 days in the MMAE group There was no evidence of a difference in the prespecified secondary imaging end points between the groups. Conclusion While the prespecified secondary imaging end points did not significantly differ, the absolute 90- and 180-day hematoma volumes were significantly lower in patients who received MMAE and surgery. Confounder-adjusted mixed-effects analysis indicated a greater reduction in hematoma volume with adjunctive MMAE. ClinicalTrials.gov identifier NCT04402632 © RSNA, 2026 Supplemental material is available for this article. See also the editorial by Ramasamy and Baker in this issue