Development of a digital tool for home-based monitoring of skin disease for older adults.

We developed a digital tool for home-based monitoring of skin disease, our digital tool. In the current observational pilot study, we found that DORA is feasible to use in practice, as it has a high patient compliance, retention and satisfaction. Clinicans rated the photos generally good quality or perfect quality. These results show that the digital health tool DORA can easily be used by patients to send photos to their dermatologist, which could reduce unnecessary clinical visits. It may also be used in other settings where digital literacy barriers and unequal access to dermatologists contribute to healthcare disparities.

Human pegivirus viremia in HCV/HIV co-infected patients: Direct acting antivirals exert anti-pegivirus effects.

BACKGROUND: Human pegivirus (HPgV) is a single-stranded RNA virus​ that is closely related to hepatitis C virus (HCV)​. HPgV has also been shown to infect patients with human immunodeficiency virus (HIV). The mechanisms and disease outcomes of HPgV infections are largely unknown, although it has been implicated in both cancer and neurological diseases. There are no established therapies for HPgV. OBJECTIVES: To estimate the prevalence of HPgV in a cohort of HCV/HIV co-infected patients undergoing treatment for HCV with direct acting antivirals (DAA) and investigate the effect of DAA therapy on HPgV infection. STUDY DESIGN: RNA was extracted from plasma samples collected at time points before, during, and after DAA. HPgV RNA abundance was quantified by droplet digital PCR assays targeting the NS5A and 5'UTR domains and confirmed by RT-qPCR. Clinical, demographic and treatment data were analysed. RESULTS: HPgV RNA was detected and quantified in 26 of 100 patients' plasma (26%) before starting DAA. Patients with detectable HPgV were more likely to be male, had higher peak HIV plasma levels, and a history of injection drug use. Patients receiving sofosbuvir/ledipasvir (n = 9) displayed significantly lower HPgV levels at time of DAA completion and had lower post-DAA HPgV rebound​ levels compared to patients receiving sofosbuvir/velpatasvir (n = 11) although both regimens significantly reduced viremia directly following DAA completion. Sustained suppression of HPgV was â€‹also observed among patients (n = 2) receiving pegylated-interferon. CONCLUSIONS: HPgV RNA ​was frequently detected in HCV/HIV co-infected patients and ​was​ supressed by DAA and pegylated interferon therapies with sofosbuvir-ledipasvir showing greatest antiviral activity. These findings suggest potential treatment strategies for HPgV infections​.

Large-scale preparation of Co nanoparticles as an additive in carbon fiber for microwave absorption enhancement in C band.

Recent studies have found that the core-shell structured metal nanoparticles and porous carbon nanofibers (PCNF) are combined into a microwave absorbing material through electrospinning, which exhibits excellent microwave absorption performance. In this study, the core-shell structure Co nanoparticles prepared by the self-developed HEIBE process (production rate of > 50 g/h) were combined with porous carbon fibers, and their absorbing properties were greatly improved. The morphology of Co/PCNF demonstrated that CoNPs are randomly dispersed in the porous carbon nanofibers and carbon nanofiber form complex conductive network which enhances the dielectric loss of the materials. Meanwhile, the Co/PCNF has a low graphitization and shows a significant improvement in permittivity due to the combination of CoNPs and high conductivity of carbon material. The maximum reflection loss (RL) of Co/PCNF reaches - 63.69 dB at 5.28 GHz with a thickness of 5.21 mm and the absorption bandwidth (RL ≤ - 10.0 dB) is 12.92 GHz. In terms of 5.60 mm and 6.61 mm absorber, there are two absorption peaks of - 47.64 dB and - 48.30 dB appear around 12.50 GHz and 14.10 GHz, respectively. The results presented in this paper may pave a way for promising applications of lightweight and high-efficiency microwave absorbing materials (MAMs).

Synchrony of Respiratory Sinus Arrhythmia in Parents and Children with Autism Spectrum Disorder: Moderation by Interaction Quality and Child Behavior Problems.

Parent-child physiological synchrony, the matching of physiological states between parents and children, is theorized to be important for typically developing (TD) children, but less is known about this process in families of children with autism spectrum disorder (ASD). In a sample of 29 children (M age = 8.00 years, SD = 1.51 years) with ASD and 39 TD-matched children (M age = 7.32 years, SD = 1.36 years) and their primary caregivers (n = 68), we examined whether parent-child dyads showed physiological synchrony indexed by respiratory sinus arrhythmia (RSA) during an interaction, and whether RSA synchrony differed by parent-child interaction quality and child behavior problems. Results indicated that dyads with TD children showed stronger positive RSA synchrony than dyads with children with ASD. Furthermore, for families of children with ASD, RSA synchrony was stronger in families with higher interaction quality and fewer child internalizing problems. These results provide preliminary evidence of parent-child RSA synchrony in families of children with ASD and identify factors that may influence this physiological process. Implications of these findings for social and emotional development in children with ASD are discussed. LAY SUMMARY: Parents and children can get "in tune" with one another at the biological level - a process called physiological synchrony. We studied physiological synchrony in families of children with autism spectrum disorder (ASD) in comparison to same-aged children who had no mental health disorders. We also examined how physiological synchrony might be associated with parent-child interaction quality and child behavior problems. We found that families with a child with ASD showed weaker physiological synchrony than families with a child who was typically developing. Further, we found that physiological synchrony was stronger when parents and children with ASD showed higher interaction quality and when children with ASD had lower internalizing problems. These findings contribute to our understanding of family functioning in the context of ASD and have potential implications for future work.

Relationship between enteric pathogens and acute gastroenteritis disease severity: a prospective cohort study.

OBJECTIVES: To evaluate the relationship between individual bacterial and viral pathogens and disease severity. METHODS: Children <18 years with three or more episodes of vomiting and/or diarrhoea were enrolled in two Canadian paediatric emergency departments between December 2014 and August 2016. Specimens were analysed employing molecular panels, and outcome data were collected 14 days after enrolment. The primary outcome was severe disease over the entire illness (symptom onset until 14-day follow-up), quantified employing the Modified Vesikari Scale (MVS) score. The score was additionally analysed in two other time periods: index (symptom onset until enrolment) and follow-up (enrolment until 14-day follow-up). RESULTS: Median participant age was 20.7 (IQR: 11.3, 44.2) months; 47.4% (518/1093) and 73.4% (802/1093) of participants had index and total MVS scores ≥11, respectively. The most commonly identified pathogens were rotavirus (289/1093; 26.4%) and norovirus (258/1093; 23.6%). In multivariable analysis, severe disease over the entire illness was associated with rotavirus (OR = 9.60; 95%CI: 5.69, 16.19), Salmonella (OR = 6.61; 95%CI: 1.50, 29.17), adenovirus (OR = 2.53; 95%CI: 1.62, 3.97), and norovirus (OR = 1.43; 95%CI: 1.01, 2.01). Pathogens associated with severe disease at the index visit were: rotavirus only (OR = 6.13; 95%CI: 4.29, 8.75), Salmonella (OR = 4.59; 95%CI: 1.71, 12.29), adenovirus only (OR = 2.06; 95%CI: 1.41, 3.00), rotavirus plus adenovirus (OR = 3.15; 95%CI: 1.35, 7.37), and norovirus (OR = 0.68; 95%CI: 0.49, 0.94). During the follow-up period, rotavirus (OR = 2.21; 95%CI: 1.50, 3.25) and adenovirus (OR = 2.10; 95%CI: 1.39, 3.18) were associated with severe disease. CONCLUSIONS: In children presenting for emergency department care with acute gastroenteritis, pathogens identified were predominantly viruses, and several of which were associated with severe disease. Salmonella was the sole bacterium independently associated with severe disease.

Evaluation of Serum α-Fetoprotein Levels During Different Infection Phases of CHB Patients.

BACKGROUND: Chronic hepatitis B patients carry a high risk of developing hepatocellular carcinoma (HCC). α-Fetoprotein (AFP) is one of the most commonly used and reliable biomarkers for HCC. However, the AFP level during different phases of CHB is not well understood. We aimed to identify the AFP levels during the different infection phases of CHB patient and explore which phase is at high risk of developing HCC. METHODS: Three hundred and fifty-five CHB patients were divided into four groups: a. immune tolerant HBeAgpositive phase (IT); b. immune reactive HBeAg-positive phase (IR), c. inactive carrier state (IC), d. HBeAg-negative activation phase (ENA). The risk of development of HCC in different group is assessed by the serum AFP levels. An electrochemiluminescence assay was used to analyze serum AFP levels. RESULTS: Mean AFP levels were different in each phase of CHB (p < 0.001): IT (9.6 ng/mL), IR (33.7 ng/mL), IC (3.2 ng/mL), and ENA (71.6 ng/mL). The ENA phase had the highest AFP level and IC phase has the lowest. There was no correlation between serum AFP level and HBV viral load. A significant correlation between serum ALT levels and HBV viral load was observed (r = 0.272, p < 0.01). CONCLUSIONS: These findings suggest that high levels of AFP during HBeAg-negative activation phase (ENA) may be associated with a high risk of developing of HCC. Furthermore, higher burden of HBV viral load is associated with more severe liver damage.

An experimental study on the use of icariin for improving thickness of thin endometrium.

This study aimed to investigate the effect of icariin (ICA) on thin endometrium in a rat model. To this end, 6- to 8-week-old female Sprague Dawley rats (105) were randomly divided into 7 groups: untreated, vehicle-treated (lavage with NaCl), high-dose ICA (lavage with ICA at 200 mg∙kg-1∙day-1), medium-dose ICA (lavage ICA at 100 mg∙kg-1∙day-1), low-dose ICA (lavage with ICA at 50 mg∙kg-1∙day-1), sham model (injected with NaCl at uterus horn), and sample group. To induce thin endometrium, rats of all groups (except sham-model) were injected with 95% ethanol via the uterine horn. Each group underwent its respective treatment for 3 estrous cycles, after which 5 rats from each group were sacrificed, and endometrial thickness was measured. The expression of CD31, factor VIII, vascular endothelial growth factor (VEGF), cytokeratin (CK), and vimentin were detected via immunohistochemistry. The results showed that CD31, factor VIII, and VEGF were primarily expressed in the cytoplasm of endometrial and vascular epithelial cells. No difference in the expression of these factors was detected between the ICA lavage groups and the untreated groups. However, high dose ICA-treated group exhibited significantly higher expression of CD31, factor VIII, and VEGF compared to that in the low dose and vehicle-treated groups. CK and vimentin in the endometrial tissue were significantly higher in the untreated and treatment groups compared to the vehicle-treated group. This study demonstrated that ICA increases thickness of the endometrium, and it may modulate expression of VEGF, CD31, and factor VIII.

[The application of anterior segment optical coherence tomography in residual strabismus surgery].

OBJECTIVE: To evaluate the application of anterior segment optical coherence tomography (ASOCT) in surgical design for residual horizontal strabismus patients. METHODS: This article was a retrospective case series analysis. Total 20 residual strabismus patients (13 with residual exotropia and 7 with residual esotropia) in Eye Hospital of Wenzhou Medical University from Jan 2009 to Jan 2011 were studied. Routine strabismus examinations were completed preoperatively. The distance between insertion of horizontal rectus muscles and corneal limbus were measured with ASOCT preoperatively and calipers intraoperatively. Reoperational amount and method for residual strabismus patients were designed according to the limbus-insertion distance. The paired t test was used to compare the agreement between two methods of measurement of limbus-insertion distance. The cure rates of reoperation were analyzed. RESULTS: No statistical significance was observed between the measurements with ASOCT (7.7±1.7) mm and calipers (7.8±1.1)mm (t=-1.37, P=0.19). According to ASOCT image, the second surgical method was re-recession muscle for 4 patients; re-recession of original performed muscle combined with antagonist muscle resection for 10 patients and antagonist muscle resection combined with horizontal rectus muscle recession in fellow eye for 6 patients. All the surgical processes went on successfully, no severe intraoperative and postopereative complications were noted. Sixteen cases were cured (80%) . CONCLUSIONS: Horizontal rectus muscle evaluation with ASOCT preoperatively may benefit the choice of performed muscle, calculation of surgical amount, reduction of unnecessary surgical procedure and optimization second surgical design for residual strabismus patients. (Chin J Ophthalmol, 2016, 52: 568-573).

Separation of polyethylene glycols and amino-terminated polyethylene glycols by high-performance liquid chromatography under near critical conditions.

The separation and characterization of polyethylene glycols (PEGs) and amino-substituted derivatives on common silica-based reversed-phase packing columns using isocratic elution is described. This separation is achieved by liquid chromatography under the near critical conditions (LCCC), based on the number of amino functional end groups without obvious effect of molar mass for PEGs. The mobile phase is acetonitrile in water with an optimal ammonium acetate buffer. The separation mechanism of PEG and amino-substituted PEG under the near LCCC on silica-based packing columns is confirmed to be ion-exchange interaction. Under the LCCC of PEG backbone, with fine tune of buffer concentration, the retention factor ratios for benzylamine and phenol in buffered mobile phases, α(benzylamine/phenol)-values, were used to assess the ion-exchange capacity on silica-based reversed-phase packing columns. To the best of our knowledge, this is the first report on separation of amino-functional PEGs independent of the molar mass by isocratic elution using common C18 or phenyl reversed-phase packing columns.

Removal of an incarcerated intrauterine device in the sigmoid colon under the assistance of hysteroscope and laparoscope: a case report.

BACKGROUND/AIMS: To explore the value of hysteroscope and laparoscope in removing an incarcerated or ectopic intrauterine device (IUD). MATERIALS AND METHODS: A 33-year-old woman was admitted to the present hospital on May 22nd, 2013. An incarcerated IUD was proven by ultrasonography. An IUD had been implanted in October 2011. Clinical case report of an incarcerated IUD in the sigmoid colon. RESULTS: An IUD was successfully removed with the assistance of hysteroscope and laparoscope. CONCLUSION: Ultrasonography should be performed in the follow-up of the patients after IUD implantation. Ectopic or incarcerated IUD can be successfully removed with the assistance of hysteroscope and laparoscope with minimal trauma.

Insights into the stimulatory mechanism of 2-aminoethoxydiphenyl borate on TREK-2 potassium channel.

2-Aminoethoxydiphenyl borate (2-APB) has been recently identified as a common agonist of TWIK-related K(+) channel (TREK)/TRAAK channels, a subfamily of two-pore domain K(+) (K2P) channels. TREK-2 displays much higher sensitivity to 2-APB compared with TREK-1, despite that these two channels share the highest homology among K2P members. However, the structural basis for their difference in response to 2-APB still remains unknown. Here we identified that the cytosolic C-terminus (Ct) domain plays a dominant role in controlling the stimulatory effects of 2-APB on TREK-2 channel. The distal Ct region negatively regulates the effect of 2-APB, while the proximal Ct is sufficient to evoke the full 2-APB activation of the channel. Further mapping within the proximal Ct revealed that His368 is required for 2-APB activation, and the cooperation of the other non-conserved residues is also necessary. We also identified a secondary active site for 2-APB, which is located at the bottom of the transmembrane segment M2. Finally, we demonstrated that key residues or domains required for 2-APB activation are not involved in the gating mechanism of the selectivity filter. In summary, we reveal a unique modulatory model of TREK-2-Ct that distinguishes it from TREK-1 in high sensitivity to 2-APB. The cooperation of the non-conserved residues within the proximal Ct of TREK-2 plays a dominant role in the 2-APB-induced channel opening, whereas the distal Ct negatively regulates the process.

Dopamine D2/D3 but not dopamine D1 receptors are involved in the rapid antidepressant-like effects of ketamine in the forced swim test.

Major depressive disorder is one of the most prevalent and life-threatening forms of mental illnesses. The traditional antidepressants often take several weeks, even months, to obtain clinical effects. However, recent clinical studies have shown that ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, exerts rapid antidepressant effects within 2h and are long-lasting. The aim of the present study was to investigate whether dopaminergic system was involved in the rapid antidepressant effects of ketamine. The acute administration of ketamine (20 mg/kg) significantly reduced the immobility time in the forced swim test. MK-801 (0.1 mg/kg), the more selective NMDA antagonist, also exerted rapid antidepressant-like effects. In contrast, fluoxetine (10 mg/kg) did not significantly reduced the immobility time in the forced swim test after 30 min administration. Notably, pretreatment with haloperidol (0.15 mg/kg, a nonselective dopamine D2/D3 antagonist), but not SCH23390 (0.04 and 0.1 mg/kg, a selective dopamine D1 receptor antagonist), significantly prevented the effects of ketamine or MK-801. Moreover, the administration of sub-effective dose of ketamine (10 mg/kg) in combination with pramipexole (0.3 mg/kg, a dopamine D2/D3 receptor agonist) exerted antidepressant-like effects compared with each drug alone. In conclusion, our results indicated that the dopamine D2/D3 receptors, but not D1 receptors, are involved in the rapid antidepressant-like effects of ketamine.

Association of the estrogen receptor-ß gene RsaI and AluI polymorphisms with human idiopathic thin endometrium.

The aim of this study was to investigate the potential correlation between polymorphisms of the estrogen receptor (ER)-ß gene (RsaI and AluI) and ethnic Han Chinese human idiopathic thin endometrium. A total of 120 patients with idiopathic thin endometrium and 120 sterility patients with normal endometrium thickness (controls) were included in the study. RsaI and AluI polymorphisms of the ER-ß gene were analyzed with polymerase chain reaction-restriction fragment length polymorphism. The distribution of polymorphisms, genotype, allele, and haplotype was compared between the 2 groups. A significant difference in the RsaI genotype was observed between idiopathic thin endometrium patients and controls. The distribution of the R allele of the RsaI polymorphism in idiopathic thin endometrium patients was 37.1% compared with 48.3% in controls. The odds ratio was 0.630 (95% confidence interval = 0.438 to 0.907, P = 0.013). No significant difference in the genotype of the AluI polymorphism was found between the two groups. The linkage disequilibrium between RsaI and AluI haploids was not significant in either group, with D' values of 0.2036 and 0.0685 in the idiopathic thin endometrium patients and controls, respectively. The results of this study suggest a potential role of the ER-ß gene polymorphisms in the etiology of idiopathic atrophic endometrium and the R allele as a potential protective factor in ethnic Han Chinese.

Mechanism and relevance of EWS/FLI-mediated transcriptional repression in Ewing sarcoma.

Ewing sarcoma provides an important model for transcription-factor-mediated oncogenic transformation because of its reliance on the ETS-type fusion oncoprotein EWS/FLI. EWS/FLI functions as a transcriptional activator and transcriptional activation is required for its oncogenic activity. Here, we demonstrate that a previously less-well characterized transcriptional repressive function of the EWS/FLI fusion is also required for the transformed phenotype of Ewing sarcoma. Through comparison of EWS/FLI transcriptional profiling and genome-wide localization data, we define the complement of EWS/FLI direct downregulated target genes. We demonstrate that LOX is a previously undescribed EWS/FLI-repressed target that inhibits the transformed phenotype of Ewing sarcoma cells. Mechanistic studies demonstrate that the NuRD co-repressor complex interacts with EWS/FLI, and that its associated histone deacetylase and LSD1 activities contribute to the repressive function. Taken together, these data reveal a previously unknown molecular function for EWS/FLI, demonstrate a more highly coordinated oncogenic transcriptional hierarchy mediated by EWS/FLI than previously suspected, and implicate a new paradigm for therapeutic intervention aimed at controlling NuRD activity in Ewing sarcoma tumors.

Pheochromocytoma in ectopic pregnancy: a case report.

OBJECTIVE: To study pregnancy characteristics in women with pheochromocytoma and to improve awareness of this comorbidity among obstetricians and gynecologists. METHODS: The diagnosis and treatment of a case of ectopic pregnancy with pheochromocytoma is described. RESULTS: The patient was diagnosed with a ruptured left Fallopian tube isthmus due to pregnancy, with comorbid left adrenal pheochromocytoma. CONCLUSION: Ectopic pregnancy with heavy bleeding and elevated blood pressure is indicative of pheochromocytoma. Measurement of the levels of urinary vanillylmandelic acid and urinary and serum catecholamines, as well as ultrasonography, can help diagnose this comorbidity.

Physical properties of poly(N-isopropylacrylamide) hydrogel promote its effects on cardiac protection after myocardial infarction.

OBJECTIVE: Studies have demonstrated the protective effects of biomaterials against myocardial infarction (MI), but the relationship between their physical characteristics and their function is incompletely understood. This study investigated such relationships for a hydrogel preparation. METHODS: Two types of poly(N-isopropylacrylamide) (PNIPAAm) hydrogel with different degradation times (Gel A and Gel B) were synthesized. In vivo hydrogel formation and maintenance were observed and confirmed in mice. The solutions were also injected into the infarct area immediately after MI induction in rats. RESULTS: PNIPAAm hydrogel exhibited a three-dimensional structure resembling native extracellular matrix (ECM). Compared with phosphate-buffered saline, Gel A and Gel B increased contractility of isolated infarcted myocardium, reduced collagen deposition, increased neovascularization, inhibited left ventricle expansion and improved cardiac function. Myocardial contractility was greater with Gel B than with Gel A. CONCLUSIONS: Intramyocardial injection of PNIPAAm hydrogel provides structural support and some functional repair of damaged ECM, suggesting that it might be useful for cardiac tissue engineering.

A facile preparation of novel multifunctional vectors by non-covalent bonds for co-delivery of doxorubicin and gene.

In this study, novel multifunctional ternary complexes of biotinylated transferrin-avidin-biotin-poly(ethylene glycol)-poly(L-glutamate acid)/poly(2-(2-aminoethylamino) ethyl methacrylate)/doxorubicin-poly(L-aspartic acid)/pDNA (TAB/PIC-D/pDNA complexes) were prepared based on polyion complex micelles (PIC) and the avidin-biotin system, which aimed to target co-delivery of anti-cancer doxorubicin and gene. Cytotoxicity studies revealed that PIC-D could have anti-tumor effect on HeLa cells and HepG2 cells; TAB coating could increase the biocompatibility of PIC-D/pDNA complexes and the targeting delivery efficiency of doxorubicin. TAB/PIC-D/pDNA complexes possessed higher transfection efficiency than the unmodified complexes in serum, and transferrin could enhance luciferase expression in HeLa cells and HepG2 cells. Furthermore, confocal laser scanning microscopy showed that doxorubicin and gene could be delivered into HepG2 cells simultaneously by TAB/PIC-D/pDNA complexes. The formation of the ternary complexes provides a facile approach to constructing a multifunctional delivery system for targeted co-delivery of anticancer drugs and gene.

Ultrasound urodynamic study of urinary tract dysfunction after radical hysterectomy and pelvic lymphadenectomy in women with cervical carcinoma.

PURPOSE: To investigate the functional changes of the lower urinary tract after radical hysterectomy and pelvic lymphadenectomy node dissection using ultrasound urodynamics. METHODS: Fifty-one women with cervical carcinoma underwent pre- and postoperative B-mode ultrasound imaging urodynamics. RESULTS: Twenty-six women needed abdominal straining to void after radical surgery, and the urinary stream was intermittent. The maximum flow rate, average flow rate, and voiding volume significantly decreased, but the post-void residual volume significantly increased. Bladder sensory function deteriorated and maximum detrusor pressure decreased. The functional length decreased, but the maximum urethral pressure and urethral closure pressure did not change. Ultrasound measurement showed no significant changes regarding the depth of the bladder wall or the position of the bladder neck. CONCLUSIONS: Lower urinary tract dysfunction after radical hysterectomy is characteristic. Measurement of ultrasound urodynamics may be used as a preliminary screening method to detect voiding dysfunction following surgery.

Nanoparticles and 3D sponge-like porous networks of manganese oxides and their microwave absorption properties.

Hydrohausmannite nanoparticles (approximately 10 nm) were prepared by the hydrothermal method at 100 degrees C for 72 h. Subsequent annealing was done in air at 400 degrees C and 800 degrees C for 10 h, Mn(3)O(4) nanoparticles (approximately 25 nm) and 3D Mn(2)O(3) porous networks were obtained, respectively. The products were characterized by XRD, TEM, SAED and FESEM. Time-dependent experiments were carried out to exhibit the formation process of the Mn(2)O(3) networks. Their microwave absorption properties were investigated by mixing the product and paraffin wax with 50 vol%. The Mn(3)O(4) nanoparticles possess excellent microwave absorbing properties with the minimum reflection loss of -27.1 dB at 3.1 GHz. In contrast, the Mn(2)O(3) networks show the weakest absorption of all samples. The absorption becomes weaker with the annealing time increasing at 800 degrees C. The attenuation of microwave can be attributed to dielectric loss and their absorption mechanism was discussed in detail.