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Article ; Online: Navigating Uncertainty in Clinical Practice: A Structured Approach.

Patel, Badar / Gheihman, Galina / Katz, Joel T / Begin, Arabella Simpkin / Solomon, Sonja R

2024 Volume 39, Issue 5, Page(s) 829–836

Abstract: The practice of clinical medicine is imbued with uncertainty. The ways in which clinicians and patients think about, communicate about, and act within situations of heightened uncertainty can have significant implications for the therapeutic alliance and ...

Abstract	The practice of clinical medicine is imbued with uncertainty. The ways in which clinicians and patients think about, communicate about, and act within situations of heightened uncertainty can have significant implications for the therapeutic alliance and for the trajectory and outcomes of clinical care. Despite this, there is limited guidance about the best methods for physicians to recognize, acknowledge, communicate about, and manage uncertainty in clinical settings. In this paper, we propose a structured approach for discussing and managing uncertainty within the context of a clinician-patient relationship. The approach involves four steps: Recognize, Acknowledge, Partner, and Seek Support (i.e., the RAPS framework). The approach is guided by existing literature on uncertainty as well as our own experience as clinicians working at different stages of career. We define each component of the approach and present sample language and actions for how to implement it in practice. Our aim is to empower clinicians to regard situations of high uncertainty as an opportunity to deepen the therapeutic alliance with the patient, and simultaneously to grow and learn as practitioners.
MeSH term(s)	Humans ; Uncertainty ; Physician-Patient Relations ; Communication
Language	English
Publishing date	2024-01-29
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-023-08596-4
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Article ; Online: Hepatitis B Prevalence and Risk Factors in Foreign-Born Asians and Pacific Islanders at a Federally Qualified Health Center in Hawai'i, 2015-2020.

Vyas, Yash / Tsai, Naoky C / Katz, Alan R / Pham, Thaddeus

Hawai'i journal of health & social welfare

2024 Volume 83, Issue 2, Page(s) 48–53

Abstract: The objective of this study was to estimate the prevalence of chronic hepatitis B infection in foreign-born Asians and Pacific Islanders at Kalihi-Palama Health Center in Honolulu, Hawai'i, and to assess the association between both chronic and resolved ... ...

Abstract	The objective of this study was to estimate the prevalence of chronic hepatitis B infection in foreign-born Asians and Pacific Islanders at Kalihi-Palama Health Center in Honolulu, Hawai'i, and to assess the association between both chronic and resolved hepatitis B infection and risk factors such as household exposure to hepatitis B virus and geographic location of birthplace. The study involved cross-sectional data from 997 participants who accessed medical services at Kalihi-Palama Health Center between September 2015 and July 2020. The prevalence of chronic hepatitis B was 10.7%. On multivariable logistic regression analysis, the adjusted prevalence odds ratio of chronic hepatitis B infection was 3.3 times greater (95% confidence interval: 1.1, 9.2) for those who reported household contact with a person with hepatitis B infection than those who reported no such contact. No association was found with place of birth in this study population. Age was a significant predictor of chronic hepatitis B, with participants between 35-44 years of age having the highest prevalence. Age was also a significant predictor of resolved hepatitis B infection, with participants 65 years of age or older having the highest prevalence. These findings emphasize the need for targeted screening and appropriate follow-up-including vaccination or treatment-in this at-risk population.
MeSH term(s)	Adult ; Humans ; Asia/ethnology ; Asian/statistics & numerical data ; Cross-Sectional Studies ; Hawaii/epidemiology ; Hepatitis B/epidemiology ; Hepatitis B, Chronic/epidemiology ; Hepatitis B, Chronic/prevention & control ; Pacific Island People/statistics & numerical data ; Pacific Islands/ethnology ; Prevalence ; Risk Factors ; Aged ; Emigrants and Immigrants/statistics & numerical data
Language	English
Publishing date	2024-01-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2983566-5
ISSN	2641-5224 ; 2641-5216
ISSN (online)	2641-5224
ISSN	2641-5216
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Article ; Online: Calibration of the sub-aperture backscatter system on OMEGA EP.

Filkins, T / Rosenberg, M J / Bahr, R E / Katz, J / Ivancic, S T

The Review of scientific instruments

2023 Volume 94, Issue 5

Abstract: The sub-aperture backscatter (SABS) diagnostic on the OMEGA EP Laser System [Waxer et al., Opt. Photonics News 16, 30 (2005)] is a diagnostic that is used to measure the backscattered and sidescattered light during laser-plasma interaction experiments [W. ...

Abstract	The sub-aperture backscatter (SABS) diagnostic on the OMEGA EP Laser System [Waxer et al., Opt. Photonics News 16, 30 (2005)] is a diagnostic that is used to measure the backscattered and sidescattered light during laser-plasma interaction experiments [W. L. Kruer, The Physics of Laser Plasma Interactions, Frontiers in Physics Vol. 73, edited by D. Pines (Addison-Wesley, Redwood City, CA, 1988) and Myatt et al., Phys. Plasmas 21, 055501 (2014)] that are relevant to high-energy-density physics and inertial confinement fusion. The diagnostic collects stimulated Brillouin scattering (SBS) UV light at around 351 nm and stimulated Raman scattering (SRS) in the visible-light regime in the 420-720-nm-wavelength range and provides spectrally and temporally resolved information. Five 1-in. light collectors, composed of a lens, ground glass diffuser, and coupling into a 300-μm fiber, are positioned behind the last steering mirror on one of the four beamlines to catch a portion of the beam cross section (∼1.5%) of the emission that is scattered into the beamline. The SRS light is collected in two light collectors, combined, and transported via graded index fibers to a streaked spectrometer. The SABS-SRS streak spectrometer has a temporal and spectral resolution of 100 ps and 1 nm, respectively. Three other light collectors collect, combine, and transport the SBS signal to a Hamamatsu high-voltage photodiode, where an oscilloscope digitizes the data, providing a time resolution of better than 1 ns. To obtain an absolute energy calibration of SRS measurements, light signals of known energy and wavelength were injected into the light collectors one at a time. The resulting counts on the streak camera charge-coupled device for SRS are then correlated with the incident fluence of scattered light at the light collector in order to allow a quantitative assessment of streak camera sensitivity to determine the energy of the scattered light during experiments. The measurements were performed in situ from the light collectors to the detectors. Additional offline measurements provided the transmission of the optics between the target chamber center and the light collectors.
Language	English
Publishing date	2023-04-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	209865-9
ISSN	1089-7623 ; 0034-6748
ISSN (online)	1089-7623
ISSN	0034-6748
DOI	10.1063/5.0101839
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Article ; Online: Medication Management After Stroke.

Fleming, Talya K / Schwartz, Jaclyn K / Belagaje, Samir R / Katz, Leanna W / Strow, Jason T

Archives of physical medicine and rehabilitation

2023 Volume 104, Issue 10, Page(s) 1739–1744

MeSH term(s)	Humans ; Medication Therapy Management ; Stroke/drug therapy ; Stroke Rehabilitation
Language	English
Publishing date	2023-04-24
Publishing country	United States
Document type	Practice Guideline
ZDB-ID	80057-0
ISSN	1532-821X ; 0003-9993
ISSN (online)	1532-821X
ISSN	0003-9993
DOI	10.1016/j.apmr.2023.03.029
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Article ; Online: Protocol to assess extravasation of fluorescent molecules in mice after ultrasound-mediated blood-brain barrier opening.

Peko, Lea / Katz, Sharon / Gattegno, Roni / Ilovitsh, Tali

STAR protocols

2023 Volume 5, Issue 1, Page(s) 102770

Abstract: ... refer to Katz et al. ...

Abstract	Blood-brain barrier disruption (BBBD) using focused ultrasound (FUS) and microbubbles (MBs) is an effective tool for therapeutic delivery to the brain. Here, we present an optimized protocol for quantifying fluorescent molecules extravasation in mice. We describe steps for ultrasound treatment, injection of MBs and fluorescent dyes, brain harvesting, microscopy imaging, and image postprocessing algorithm. Our protocol has proven to successfully conduct a diameter-dependent analysis that measures vascular leakage following FUS-mediated BBBD at a single blood vessel resolution. For complete details on the use and execution of this protocol, please refer to Katz et al.
MeSH term(s)	Mice ; Animals ; Blood-Brain Barrier/diagnostic imaging ; Brain/diagnostic imaging ; Brain/blood supply ; Ultrasonography ; Fluorescent Dyes
Chemical Substances	Fluorescent Dyes
Language	English
Publishing date	2023-12-29
Publishing country	United States
Document type	Journal Article
ISSN	2666-1667
ISSN (online)	2666-1667
DOI	10.1016/j.xpro.2023.102770
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Article ; Online: Quantitative sensory testing: identifying pain characteristics in patients with osteoarthritis.

Arant, K R / Katz, J N / Neogi, T

Osteoarthritis and cartilage

2021 Volume 30, Issue 1, Page(s) 17–31

Abstract: Objective: This review outlines the most commonly used quantitative sensory tests to identify pain sensitization. We examine cross-sectional associations between quantitative sensory testing (QST) measures and OA symptoms and severity, along with ... ...

Abstract	Objective: This review outlines the most commonly used quantitative sensory tests to identify pain sensitization. We examine cross-sectional associations between quantitative sensory testing (QST) measures and OA symptoms and severity, along with longitudinal associations between QST findings and response to surgical and non-surgical treatments for OA. Design: We conducted a search in PubMed for English language papers including 'osteoarthritis' and 'quantitative sensory testing' as search terms. Papers that did not pertain specifically to OA or QST were excluded. Results: Pressure Pain Threshold (PPT), Conditioned Pain Modulation (CPM), and Temporal Summation (TS) are the QST measures used most frequently to identify pain sensitization. Findings indicate that persons with knee OA often exhibit lower PPT thresholds, inefficient CPM, and facilitated TS as compared with controls who do not have OA, supporting the discriminant validity of QST. Pre-treatment QST has shown some success in identifying persons who experience less pain relief from surgical and non-surgical treatments for knee OA. Post-treatment QST has shown that sometimes PPT and CPM can normalize (PPT thresholds increase, and CPM becomes efficient) in patients for whom joint replacement is successful. Recent studies indicate that QST measures are more closely associated with pain severity than OA radiographic severity, suggesting that sensitization may be a trait rather than a state. Conclusions: QST may have a role in identifying persons who are susceptible to chronic pain and may offer an opportunity for personalized, more effective treatment of OA.
MeSH term(s)	Arthralgia/diagnosis ; Arthralgia/etiology ; Arthralgia/therapy ; Correlation of Data ; Humans ; Osteoarthritis/complications ; Osteoarthritis/diagnosis ; Pain Measurement/methods ; Pain Threshold
Language	English
Publishing date	2021-09-28
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	1167809-4
ISSN	1522-9653 ; 1063-4584
ISSN (online)	1522-9653
ISSN	1063-4584
DOI	10.1016/j.joca.2021.09.011
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Article ; Online: Restoring tolerance to β-cells in Type 1 diabetes: Current and emerging strategies.

Carroll, Kaitlin R / Katz, Jonathan D

Cellular immunology

2022 Volume 380, Page(s) 104593

Abstract: ... following T cell-mediated autoimmune attack. The technical feasibility of durable, functional autologous ... grafted islets' destruction by pre-existing anti-islet T cells. While advances have been made in broad ... on autologous Treg expansion, treatments to decrease antigen presentation and T effector (Teff) activation, and ...

Abstract	Type 1 diabetes (T1D) results from insulin insufficiency due to islet death and dysfunction following T cell-mediated autoimmune attack. The technical feasibility of durable, functional autologous islet restoration is progressing such that it presents the most likely long-term cure for T1D but cannot succeed without the necessary counterpart of clinically effective therapeutic strategies that prevent grafted islets' destruction by pre-existing anti-islet T cells. While advances have been made in broad immunosuppression to lower off-target effects, the risk of opportunistic infections and cancers remains a concern, especially for well-managed T1D patients. Current immunomodulatory strategies in development focus on autologous Treg expansion, treatments to decrease antigen presentation and T effector (Teff) activation, and broad depletion of T cells with or without hematopoietic stem cell transplants. Emerging strategies harnessing the intensified DNA damage response present in expanding T cells, exacerbating their already high sensitivity to apoptosis to abate autoreactive Teff cells.
MeSH term(s)	Diabetes Mellitus, Type 1/drug therapy ; Humans ; Immune Tolerance ; Insulin-Secreting Cells ; Islets of Langerhans ; T-Lymphocytes, Regulatory
Language	English
Publishing date	2022-09-05
Publishing country	Netherlands
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	80094-6
ISSN	1090-2163 ; 0008-8749
ISSN (online)	1090-2163
ISSN	0008-8749
DOI	10.1016/j.cellimm.2022.104593
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Article ; Online: When medical duty and advocacy are one-sided, both sides suffer.

Katz, Naomi T / Oratz, Ruth / Steinert, Yvonne / Wald, Ron / Carmi, Rivka

Lancet (London, England)

2024 Volume 403, Issue 10436, Page(s) 1540–1541

MeSH term(s)	Humans ; Internship and Residency ; Work Schedule Tolerance ; Patient Advocacy
Language	English
Publishing date	2024-04-09
Publishing country	England
Document type	Letter
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(24)00239-3
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Article ; Online: Far-field effects of the Nile damming on the silica cycle in the Southeastern Mediterranean Sea.

Katz, Timor / Bookman, Revital / Herut, Barak / Goodman-Tchernov, Beverly / Sisma-Ventura, Guy

The Science of the total environment

2024 Volume 921, Page(s) 171274

Abstract: Silica plays a key role in the growth of silicifying primary producers (e.g., diatoms) and hence the ocean carbon pump. The Mediterranean Sea's eastern Levantine Basin (ELB) is a low silica (and low N and P) ultra-oligotrophic basin. Before 1965, Nile ... ...

Abstract	Silica plays a key role in the growth of silicifying primary producers (e.g., diatoms) and hence the ocean carbon pump. The Mediterranean Sea's eastern Levantine Basin (ELB) is a low silica (and low N and P) ultra-oligotrophic basin. Before 1965, Nile autumn floods were a major source of dissolved silica (DSi) and other nutrients to primary producers of the ELB continental shelf, also known as the Nilotic cell. The construction of the Aswan High Dam (AHD) in the mid-1960s, blocked these floods, drastically diminishing the autumn-diatom blooms offshore the Nile delta. However, the far-reaching and long-lasting effects of the Nile damming on the Si cycle in the ELB remain unclear. Here, we studied the changes in DSi in the surface water offshore Israel and the distribution of biogenic silica in deep-sea short sediment cores, collected hundreds of kilometers from the Nile outlet, at depths range of 1100-1900 m, offshore the ELB Israeli coast. We show post dam reduction and termination in flood related seasonality of DSi and a concurrent decrease (of up to 79 %) in biogenic silica (BSi) accumulation rates in surficial sediments relative to underlying sediments. These changes reflect the effects of Si (dissolved and particulate) retention by the AHD on diatoms production, export and burial in the ELB. This far-field effect was demonstrated in deep-sea areas subjected to intense lateral transport of resuspended sediments from the shelf via intermediate nepheloid layers and to coastal water intrusions, along the path of the pre-dam, flood plumes. Our core records show that the AHD worsened nutrient-diminished, exceptionally unfavorable conditions for diatoms that persisted in the deep ELB at least during the last four millennia.
Language	English
Publishing date	2024-02-24
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	121506-1
ISSN	1879-1026 ; 0048-9697
ISSN (online)	1879-1026
ISSN	0048-9697
DOI	10.1016/j.scitotenv.2024.171274
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Article ; Online: Enhanced capillary delivery with nanobubble-mediated blood-brain barrier opening and advanced high resolution vascular segmentation.

Gattegno, Roni / Arbel, Lilach / Riess, Noa / Shinar, Hila / Katz, Sharon / Ilovitsh, Tali

Journal of controlled release : official journal of the Controlled Release Society

2024 Volume 369, Page(s) 506–516

Abstract: Overcoming the blood-brain barrier (BBB) is essential to enhance brain therapy. Here, we utilized nanobubbles with focused ultrasound for targeted and improved BBB opening in mice. A microscopy technique method assessed BBB opening at a single blood ... ...

Abstract	Overcoming the blood-brain barrier (BBB) is essential to enhance brain therapy. Here, we utilized nanobubbles with focused ultrasound for targeted and improved BBB opening in mice. A microscopy technique method assessed BBB opening at a single blood vessel resolution employing a dual-dye labeling technique using green fluorescent molecules to label blood vessels and Evans blue brain-impermeable dye for quantifying BBB extravasation. A deep learning architecture enabled blood vessels segmentation, delivering comparable accuracy to manual segmentation with a significant time reduction. Segmentation outcomes were applied to the Evans blue channel to quantify extravasation of each blood vessel. Results were compared to microbubble-mediated BBB opening, where reduced extravasation was observed in capillaries with a diameter of 2-6 μm. In comparison, nanobubbles yield an improved opening in these capillaries, and equivalent efficacy to that of microbubbles in larger vessels. These results indicate the potential of nanobubbles to serve as enhanced agents for BBB opening, amplifying bioeffects in capillaries while preserving comparable opening in larger vessels.
Language	English
Publishing date	2024-04-08
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	632533-6
ISSN	1873-4995 ; 0168-3659
ISSN (online)	1873-4995
ISSN	0168-3659
DOI	10.1016/j.jconrel.2024.04.001
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