Long-Term Follow-Up of Intensive Integrative Treatment including Motion Style Acupuncture Treatment (MSAT) in Hospitalized Patients with Lumbar Disc Herniation: An Observational Study.

This study aimed to investigate the long-term effects of and satisfaction with integrative Korean medicine treatment and motion style acupuncture treatment (MSAT) in patients with lumbar disc herniation (LDH). We retrospectively analyzed medical charts and prospectively surveyed adult patients aged between 19 and 64 years treated for lumbar disc herniation for at least 6 days at three Korean hospitals from 1 January 2015 to 31 December 2020. The primary outcome was the Numeric Rating Scale (NRS) for back pain. Secondary outcome measures included the NRS for radiating leg pain, the Oswestry Disability Index (ODI), and the European Quality of Life-5 Dimension-5 Level (EQ-5D-5L) questionnaire. The NRS scores for low back pain decreased from 5.40 ± 1.58 to 2.92 ± 2.09, NRS for radiating leg pain from 5.57 ± 1.56 to 1.78 ± 2.36, and ODI from 46.39 ± 16.72 to 16.47 ± 15.61 at baseline and survey, respectively. The EQ-5D-5L increased from 0.57 ± 0.19 to 0.82 ± 0.14. In conclusion, Korean medicine and MSAT could be effective treatment methods for patients with LDH. The results of this study can be used as helpful information for clinicians who treat patients with LDH in real clinical settings.

Limited Access to Facial Feminization Geographically Despite Nationwide Expansion of Other Gender-Affirming Surgeries.

Facial feminization surgery (FFS) is an integral aspect of gender-affirming surgery (GAS) for individuals seeking to align secondary sex characteristics and gender identity. Despite the importance of FFS in treating gender dysphoria, current trends and prevalence remain unknown. We sought to examine trends in GAS and FFS and investigate the payer status of facial feminization procedures in the United States. Methods: Data was extracted from the National Inpatient Sample from 2008 to 2017 by using International Classification of Diseases Ninth or Tenth diagnosis codes for gender identity disorder and procedure codes for FFS. Results: From 2008 to 2017, 3015 patients underwent GAS. The yearly number of cases increased as did the average cost of GAS, which rose from $13,657 in 2008 to $50,789 in 2017. From 2015 to 2017, when FFS data was available, 110 of 1215 (9.1%) GAS patients had FFS. Most were non-Hispanic White (66.7%) or Black (23.8%). Fifty percent of FFS cases occurred in the West, followed by the Northeast (31.8%), South (13.6%), and Midwest (4.8%) (P = 0.015). By payer the cases were, 36.4% self-pay, 31.8% Medicaid, and 27.3% private insurance (P < 0.0001). Approximately, 18% of patients undergoing male-to-female transition received FFS. Conclusions: From 2008 to 2017, GAS cases increased nationwide while the average cost of surgery rose steeply. FFS cases were primarily in the Western and Northeast United States. Despite high cost, roughly 18% of transgender women in our sample received FFS, highlighting the importance of FFS in gender transition.

Plasticized PVC-Gel Single Layer-Based Stretchable Triboelectric Nanogenerator for Harvesting Mechanical Energy and Tactile Sensing.

Triboelectric nanogenerators have garnered significant attention as alternative power sources for wearable electronics owing to their simple structure, easy fabrication, low cost, and superior power output. In this study, a transparent, stretchable, and attachable triboelectric nanogenerator (TENG) is built with an advanced power output using plasticized polyvinyl chloride (PVC)-gel. The PVC-gel exhibit very high negative triboelectric properties and electrically insulating PVC became an electrically active material. It is found that a single layer of PVC-gel can act as a dielectric and as a conducting layer. The PVC-gel based single layer of triboelectric nanogenerator (S-TENG) creates output signals of 24.7 V and 0.83 µA, i.e., a 20-fold enhancement in the output power compared to pristine PVC-based TENGs. In addition, the S-TENG can stably generate output voltage and current under stretching condition (80%). The S-TENG can be implemented as a tactile sensor that can sense position and pressure without combining multiple elements or electrode grid patterns. This study provides new applications of power sources and tactile sensors in wearable electronics.

Peptide Specific Nanoplastic Detection Based on Sandwich Typed Localized Surface Plasmon Resonance.

Recently, various waste microplastics sensors have been introduced in response to environmental and biological hazards posed by waste microplastics. In particular, the detrimental effects of nano-sized plastics or nanoplastics have been reported to be severe. Moreover, there have been many difficulties for sensing microplastics due to the limited methodologies for selectively recognizing nanoplastics. In this study, a customized gold nanoparticles (Au NPs) based localized surface plasmon resonance (LSPR) system having bio-mimicked peptide probes toward the nanoplastics was demonstrated. The specific determination through the oligo-peptide recognition was accomplished by chemical conjugation both on the LSPR chip's 40~50 nm Au NPs and sandwiched 5 nm Au NPs, respectively. The peptide probe could selectively bind to polystyrene (PS) nanoplastics in the forms of fragmented debris by cryo-grinding. A simple UV-Vis spectrophotometer was used to identify the LSPR sensing by primarily measuring the absorbance change and shift of absorption peak. The sandwich-binding could increase the LSPR detection sensitivity up to 60% due to consecutive plasmonic effects. In addition, microwave-boiled DI water inside of a styrofoam container was tested for putative PS nanoplastics resource as a real accessible sample. The LSPR system could be a novel protocol overcoming the limitations from conventional nanoplastic detection.

Highly Sensitive Colorimetric Assay of Cortisol Using Cortisol Antibody and Aptamer Sandwich Assay.

In this study, cortisol, which is a key stress hormone, could be detected sensitively via the colorimetric assay of a polycarbonate (PC) and glass substrate by the sandwich assay of cortisol monoclonal antibody (c-Mab) and cortisol specific binding aptamer (c-SBA). A highly sensitive change in colorimetry with a limit of detection (LOD) of cortisol of 100 fM could be attained on the optically transparent substrate using the antibody aptamer sandwich (AAS) assay by corresponding stacks of 5 nm gold nanoparticles (Au NPs). The Au NPs were conjugated by the c-SBA and the c-Mab was tethered on the PC and glass substrates. For the AAS method, a simple UV-Vis spectrophotometer was adopted to quantify the cortisol concentrations at an absorbance wavelength of 520 nm. Therefore, this study demonstrates the versatility of the AAS method to measure very low concentrations of cortisol in diagnostic applications.

The Use of Visible-Light Hyperspectral Imaging in Evaluating Burn Wounds: A Case Report.

Burn depth is a critical factor in determining the healing potential of a burn as the extent of injury ultimately guides overall treatment. Visible-Light Hyperspectral Imaging is an FDA-approved, noninvasive, and noncontrast imaging technology that uses light waves within the visible spectrum to evaluate skin and superficial soft tissue perfusion. In this case report, visible-light hyperspectral imaging was used to evaluate a 37-year-old male who presented to the Emergency Department with a thermal burn of the trunk, back, and right upper extremity. Images were taken at initial evaluation, 6 hours postinjury, and again during daily dressing changes until hospital day 5 when the patient underwent surgical debridement. In this patient, operative treatment was postponed until 89.7 hours postinjury, at which point the clinical examination showed clear visual demarcation in regions of irreversible damage. Comparatively, visible-light hyperspectral imaging analysis of the permanently injured tissue demonstrated acute but varying changes in both oxygenated hemoglobin and deoxygenated hemoglobin at the time of initial evaluation. The most dramatic change in tissue oxygenation occurred between 6.5 and 39.3 hours, demonstrating visible-light hyperspectral imaging's ability to detect significant differences in oxygenation values between areas of second-degree superficial burns and areas of second-degree deep and third-degree burns in the acute period. The data suggest that the utilization of visible-light hyperspectral imaging in this 6.5- to 39.3-hour window may help predict final burn depth before clinical assessment, potentially allowing for surgical intervention within the first 48 hours following injury.

Electrically Adaptive and Shape-Changeable Invertible Microlens.

Existing soft actuators for adaptive microlenses suffer from high required input voltage, optical loss, liquid loss, and the need for assistant systems. In this study, we fabricate a polyvinyl chloride-based gel using a new synergistic plasticization method to achieve simultaneously a high optical transparency and an ultrasoft rubber-like elastic behavior with a large voltage-induced deformation under a weak electric field. By compressing the smooth gel between two sets of annular electrodes, a self-contained biconvex microlens is realized that is capable of considerable shape changes in the optical path. Each surface of the dual-curvature microlens can be independently adjusted to focus or scatter light to capture real or virtual images, yield variable focal lengths (+31.8 to -11.3 mm), and deform to various shapes to improve aberrations. In addition to simple fabrication, our microlens operates silently and consumes low power (0.52 mW), making it superior to existing microlenses.

The Possible Role of the Angiotensin System in the Pathophysiology of Schizophrenia: Implications for Pharmacotherapy.

A growing body of literature has elucidated the involvement of the central renin-angiotensin system (RAS) in various neuropsychiatric diseases. While consensus on the exact mechanism of the central RAS in schizophrenia pathophysiology does not currently exist, increasing evidence reveals promise in harnessing the therapeutic potential of RAS modulation in the treatment of schizophrenia. In this review, we examine how the central RAS affects inflammation, glutamate, dopamine, gamma-aminobutyric acid (GABA), and peroxisome proliferator-activated receptor (PPAR)-γ, all of which are associated with schizophrenia etiology. In addition, a recent study has demonstrated the therapeutic potential of RAS modulators, especially angiotensin II type 1 receptor blockers (ARBs), as adjunctive therapy to the currently available antipsychotic medications for schizophrenia treatment. With a greater understanding of how RAS inhibition directly modulates neurotransmitter balance in the brain, it is possible that compounds with RAS-inhibiting properties could be used to optimize physiological levels of glutamate, dopamine, and GABA, and the balance among the three neurotransmitters, analogously to how antipsychotic medications mediate the dopaminergic pathways. It can be hoped that a novel approach based on this concept, such as adjunctive telmisartan therapy, may offer practical interventional strategies to address currently unmet therapeutic needs in patients with schizophrenia, especially those with treatment-resistant schizophrenia.

Emerging immunotherapy for the treatment of esophageal cancer.

INTRODUCTION: Esophageal cancer is the third most common cancer of the gastrointestinal tract. Despite new therapies, the prognosis for patients with these cancers remains poor with 5-year survival rates lower than 15%. Recently, immunotherapy has increasingly gained attention as a novel treatment strategy for advanced esophageal cancer. AREAS COVERED: Recent success of immunotherapy in treating other solid tumors has shed light on the utility of these approaches for esophageal cancers. Here, the authors focus on antibody-based, adoptive-cell-therapy-based, and vaccine-based immunotherapies, and briefly address their rationale, clinical data, and implications. EXPERT OPINION: Immunotherapy is now established to be a key treatment modality that can improve the outcomes of many cancer patients and appears to be ushering in a new era in cancer treatment. Checkpoint inhibitor drugs have shown preliminary favorable results in esophageal cancer treatment. Adoptive cell therapy and vaccine studies have also shown some promise in various clinical studies. Future endeavors will need to focus on identifying patients who are likely to benefit from immunotherapy, monitoring and managing immune responses and designing optimal combination strategies where immunotherapy agents are combined with other traditional treatment modalities.

Radio frequency-compensated Langmuir probe with auxiliary double probes.

A radio frequency (rf) compensation design using auxiliary double probes connected in parallel with a main measurement probe was developed for Langmuir probe diagnostics. This probe structure can reduce the sheath impedance of the main probe. In our probe design, the sheath capacitance of the probe can be increased and its sheath resistance can be decreased with increasing dc bias differential voltage between the auxiliary double probes. The I-V characteristic curve and electron energy distribution functions measured by our probe system had sufficient rf compensation performance in inductively coupled plasmas.

Regulation of cyclization for the stereoselective synthesis of substituted tetrahydrofurans and tetrahydrooxepines.

Dramatic solvent effect is observed during the cyclization of 1. Synthesis of 2 is achieved from the reaction of 1 with a hexamethylditin-catalyzed palladium complex followed by aldehydes in the presence of TMSOTf in THF, whereas 3 is formed in CH2Cl2. The method described herein is successful with various substrates 1 in good yields and high levels of diastereoselectivity.

A diastereoselective carbocyclisation of allene-hydrazones through the intramolecular allylic transfer reaction.

A diastereoselective synthesis of cyclic hydrazines was achieved from a carbocyclisation of allene-hydrazones by the Pd-catalyzed distannylation of an allene moiety, followed by the transmetallation of allylic stannane intermediates with TiCl4.