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OBJECTIVES: Emergency medical services (EMS) provide health care in situations with limited time and resources. Challenges arise when introducing novel medications, treatments, or technologies or modifying existing practices in these settings. Effective implementation strategies are pivotal for their success. This study aims to identify and categorize potential facilitators and barriers in the implementation of prehospital EMS through a review of relevant research articles. METHODS: We searched PubMed and EMbase to identify studies published before December 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for our search strategy and scoping review. We included original articles written in English that report on the factors that influence the implementation in prehospital settings. We extracted and categorized the factors into different themes. RESULTS: Out of the 371 retrieved papers, we selected 19 (5%) for inclusion in this review. We extracted 46 influencing factors from the selected articles and categorized them into ten themes: (1) Outer system, (2) Inner system, (3) Practitioner characteristics, (4) Resources, (5) Communication and collaboration, (6) Patient factors, (7) Intervention characteristics, (8) De-implementation of prior practices, (9) Logistical issues, and (10) Quality improvement. CONCLUSIONS: This study examined the literature on EMS implementation factors and proposed a 10-theme EMS model framework. Key factors include training/education, equipment/tools, communication with hospitals, and practitioners' attitudes.
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Intricate signaling cascades involving chemokines and their cognate receptors on neoplastic and immune constituents within tumor microenvironment have garnered substantial research interest. Our investigation delineates the contribution of Chemokine (C-C motif) ligand 16 (CCL16) to the clinico-pathological features and tumorigenesis of hepatocellular carcinoma (HCC). Analysis of 237 pairs of HCC specimens unraveled a significant association between CCL16 expression and vascular invasion, early-stage clinicopathological features, and diminished recurrence-free survival among HCC patients. Immunohistochemical (IHC) assays of the clinical HCC specimens indicated elevated CCL16 in tumorous versus normal hepatic tissues. Our in vivo experiments demonstrated CCL16 overexpression fostered tumor proliferation, whereas in vitro assays elucidated that CCL16-mediated chemotactic recruitment of monocytes and M2 macrophages was orchestrated via CCR1 and CCR5. In contrast to previous claims that CCL16 is physiologically irrelevant and has minimal affinity for its receptors (CCR1, CCR2, CCR5, CCR8), our findings unravel that inhibition of CCL16/CCR1 and CCL16/CCR5 interactions through receptor-specific antagonists markedly impeded CCL16-directed chemotaxis, migration, adhesion, and leukocyte recruitment. Moreover, CCL16-overexpression in HCCs significantly augmented levels of several cytokines implicated in tumor progression, namely IL-6, IL-10 and VEGFA. IHC analysis of CCL16-overexpressing xenografts elicited greatly enhanced levels of VEGFA and IL-6, while assessments of HCC specimens confirmed a positive correlation between CCL16 expression and IL-6 and VEGFA levels. Collectively, our study highlights oncogenic role of CCL16 in hepatocarcinogenesis and provides a foundational basis for novel therapeutic interventions targeting the CCL16/CCR1/CCR5 axis.
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Best practices in postpartum care encourage rooming-in to promote early breastfeeding and mother-newborn bonding. However, when the medical records of mothers and newborns are stored separately in the postpartum ward and the neonatal nursery, respectively, nurses encounter difficulties in accessing complete information about the mother-infant dyad, which results in suboptimal care quality. Accordingly, the authors designed an integrated electronic information (e-information) system linking the medical records of newborns and their mothers and implemented it in April 2022 at a medical center in Taiwan. System effectiveness assessment results indicated that before the implementation of the e-information system, the nursing care completion scored 72.4 out of 100, and the nurse satisfaction scored 80.9 out of 100. After the implementation of the system, the nursing care completion increased to 97.8 (p < .001), while the nurse satisfaction rose to 95.8 (p < .001), demonstrating significant improvements.
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Registros Electrónicos de Salud , Atención Posnatal , Humanos , Taiwán , Femenino , Recién Nacido , Alojamiento ConjuntoRESUMEN
Injurious behaviors (i.e., aggressive pecking, feather pecking, and cannibalism) in laying hens are a critical issue facing the egg industry due to increased social stress and related health and welfare issues as well as economic losses. In humans, stress-induced dysbiosis increases gut permeability, releasing various neuroactive factors, causing neuroinflammation and related neuropsychiatric disorders via the microbiota-gut-brain axis, and consequently increasing the frequency and intensity of aggression and violent behaviors. Restoration of the imbalanced gut microbial composition has become a novel treatment strategy for mental illnesses, such as depression, anxiety, bipolar disorder, schizophrenia, impulsivity, and compulsivity. A similar function of modulating gut microbial composition following stress challenge may be present in egg-laying chickens. The avian cecum, as a multi-purpose organ, has the greatest bacterial biodiversity (bacterial diversity, richness, and species composition) along the gastrointestinal tract, with vitally important functions in maintaining physiological and behavioral homeostasis, especially during the periods of stress. To identify the effects of the gut microbiome on injurious behaviors in egg-laying chickens, we have designed and tested the effects of transferring cecal contents from two divergently selected inbred chicken lines on social stress and stress-related injurious behaviors in recipient chicks of a commercial layer strain. This article reports the outcomes from a multi-year study on the modification of gut microbiota composition to reduce injurious behaviors in egg-laying chickens. An important discovery of this corpus of experiments is that injurious behaviors in chickens can be reduced or inhibited through modifying the gut microbiota composition and brain serotonergic activities via the gut-brain axis, without donor-recipient genetic effects.
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Comprehensive and dynamic studies of cellulose pyrolysis reaction mechanisms are crucial in designing experiments and processes with enhanced safety, efficiency, and sustainability. The details of the pyrolysis mechanism are not readily available from experiments but can be better described via molecular dynamics (MD) simulations. However, the large size of cellulose molecules challenges accurate ab initio MD simulations, while existing reactive force field parameters lack precision. In this work, precise ab initio deep learning potentials field (DPLF) are developed and applied in MD simulations to facilitate the study of cellulose pyrolysis mechanisms. The formation mechanism and production rate of both valuable and greenhouse products from cellulose at temperatures larger than 1073 K are comprehensively described. This study underscores the critical role of advanced simulation techniques, particularly DLPF, in achieving efficient and accurate understanding of cellulose pyrolysis mechanisms, thus promoting wider industrial applications.
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Celulosa , Aprendizaje Profundo , Pirólisis , Simulación de Dinámica Molecular , TemperaturaRESUMEN
We have designed and developed novel and selective TLR7 agonists that exhibited potent receptor activity in a cell-based reporter assay. In vitro, these agonists significantly induced secretion of cytokines IL-6, IL-1ß, IL-10, TNFa, IFNa, and IP-10 in human and mouse whole blood. Pharmacokinetic and pharmacodynamic studies in mice showed a significant secretion of IFNα and TNFα cytokines. When combined with aPD1 in a CT-26 tumor model, the lead compound showed strong synergistic antitumor activity with complete tumor regression in 8/10 mice dosed using the intravenous route. Structure-activity relationship studies enabled by structure-based designs of TLR7 agonists are disclosed.
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BACKGROUND: Competency-based medical education (CBME) is an outcomes-oriented approach focused on developing competencies that translate into clinical practice. Entrustable professional activities (EPAs) bridge competency assessment and clinical performance by delineating essential day-to-day activities that can be entrusted to trainees. EPAs have been widely adopted internationally, but not yet implemented for medical radiation professionals in Taiwan. MATERIALS AND METHODS: A nationwide consensus process engaged 97 experts in radiation technology education representing diagnostic radiography, radiation therapy, and nuclear medicine. Preliminary EPAs were developed through the focus group discussion and the modified Delphi method. The validity of these EPAs was evaluated using the QUEPA and EQual tools. RESULTS: Through iterative consensus building, six core EPAs with 18 component observable practice activities (OPAs) in total were developed, encompassing routines specific to each radiation technology specialty. QUEPA and EQual questionnaire data verified these EPAs were valid, and of high quality for clinical teaching and evaluation. CONCLUSION: The consensus development of tailored EPAs enables rigorous competency assessment during medical radiation technology education in Taiwan. Further expansion of EPAs and training of clinical staff could potentially enhance care quality by producing competent professionals.
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Educación Médica , Internado y Residencia , Humanos , Competencia Clínica , Taiwán , Educación Basada en Competencias/métodos , Calidad de la Atención de SaludRESUMEN
Covalent organic frameworks (COFs), a new and developing class of porous framework materials, are considered a type of promising carrier for the integration and delivery of bioactives, which have diverse fascinating merits, such as a large specific surface area, designable and specific porosity, stable and orderly framework structure, and various active sites. However, owing to the significant differences among bioactives (including drugs, proteins, nucleic acid, and exosomes), such as size, structure, and physicochemical properties, the interaction between COFs and bioactives also varies. In this review, we firstly summarize three strategies for the construction of single or hybrid COF-based matrices for the delivery of cargos, including encapsulation, covalent binding, and coordination bonding. Besides, their smart response release behaviors are also categorized. Subsequently, the applications of cargo@COF biocomposites in biomedicine are comprehensively summarized, including tumor therapy, central nervous system (CNS) modulation, biomarker analysis, bioimaging, and anti-bacterial therapy. Finally, the challenges and opportunities in this field are briefly discussed.
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Exosomas , Estructuras Metalorgánicas , Ácidos Nucleicos , Sistema Nervioso Central , Empleos en SaludRESUMEN
The aim of this study was to examine effects of various daylight exposure during the 24-h light-dark (L-D) cycle on growth performance, skeletal health, and welfare state in broilers. Environmental photoperiod and related circadian clock, the 24-h L-D cycle, are important factors in maintaining productive performance, pathophysiological homeostasis, and psychological reaction in humans and animals. Currently, various lighting programs as management tools for providing a satisfactory environmental condition have been used in commercial broiler production. Four hundred thirty-two 1-day-old Rose 308 broiler chicks were assigned to 24 pens (18 birds/pen). The pens were randomly assigned to 1 of 4 thermal and lighting control rooms, then the birds were exposed to (n = 6): 1) 12L, 2) 16L, 3) 18L, or 4) 20L at 15 d of age. Lighting program effects on bird body weight, behavioral patterns, bone health, and stress levels were evaluated from d 35 to d 45, respectively. The birds of 12L as well as 16L groups, reared under short photoperiods close to the natural 24-h L-D cycle, had improved production performance, leg bone health, and suppressed stress reaction compared to the birds of both 18L and 20L groups. Especially, 12L birds had heavier final body weight and averaged daily weight gain (P < 0.05), higher BMD and BMC with longer and wider femur (P < 0.05), lower H/L ratio (P < 0.05), and more birds reached the observer during the touch test (P < 0.05) but spent shorter latency during the tonic immobility test (P < 0.05). Taken together, the data suggest that supplying 12 h as well as 16L of daily light improves performance and health while decreasing stress levels in broilers, making it a potentially suitable approach for broiler production.
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Conducta Animal , Pollos , Relojes Circadianos , Fotoperiodo , Animales , Peso Corporal , Pollos/fisiología , Relojes Circadianos/fisiología , Miedo , Aumento de Peso , Conducta Animal/fisiologíaRESUMEN
In order to attain phosphor ceramics with a high Color-Rendering Index (CRI), samples with the composition of Y0.997-xRexCe0.003)3(Al0.9748 Mn2+0.024Cr3+0.0012)5O12(Rex = 0, Gd0.333, Gd0.666, Gd0.997, Tb0.333, Tb0.666, Tb0.997 and Lu0.997 were prepared by solid-state reaction and vacuum sintering, and exhibited potential for high-quality, solid-state lighting. Doping with Cr3+ and Mn2+ effectively enhanced the red component of Ce3+ spectra through the intense energy transfer from Ce3+ ions to Mn2+/Cr3+ ions. The crystal field splitting of [GdO8] and [TbO8] was more extensive than that of [YO8], causing a massive redshift in the Ce3+ emission peaks from 542 to 561 and 595 nm, while [LuO8] had an opposite effect and caused a blueshift with a peak position at 512 nm. White LED devices incorporating Ce/Mn/Cr: (Gd0.333Y0.664)3Al5O12 phosphor ceramic exhibited a high CRI of 83.97, highlighting the potential for enhancing the red-light component of white LED lighting.
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Breast cancer is a leading cause of death in women worldwide, and early detection is crucial for successful treatment. Computer-aided diagnosis (CAD) systems have been developed to assist doctors in identifying breast cancer on ultrasound images. In this paper, we propose a novel fuzzy relative-position-coding (FRPC) Transformer to classify breast ultrasound (BUS) images for breast cancer diagnosis. The proposed FRPC Transformer utilizes the self-attention mechanism of Transformer networks combined with fuzzy relative-position-coding to capture global and local features of the BUS images. The performance of the proposed method is evaluated on one benchmark dataset and compared with those obtained by existing Transformer approaches using various metrics. The experimental outcomes distinctly establish the superiority of the proposed method in achieving elevated levels of accuracy, sensitivity, specificity, and F1 score (all at 90.52%), as well as a heightened area under the receiver operating characteristic (ROC) curve (0.91), surpassing those attained by the original Transformer model (at 89.54%, 89.54%, 89.54%, and 0.89, respectively). Overall, the proposed FRPC Transformer is a promising approach for breast cancer diagnosis. It has potential applications in clinical practice and can contribute to the early detection of breast cancer.
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Aims: Upregulation of Ca2+/calmodulin-dependent protein kinase II (CaMKII) contributes to the pathogenesis of cardiovascular disease, including hypertension. Transgenic rats expressing the human angiotensinogen gene [TGR (hAGT)L1623] are a new novel humanized model of hypertension that associates with declines in cardiac contractile function and ß-adrenergic receptor (AR) reserve. The molecular mechanisms are unclear. We tested the hypothesis that in TGR (hAGT)L1623 rats, left ventricular (LV) myocyte CaMKIIδ and ß3-AR are upregulated, but ß1-AR is down-regulated, which are important causes of cardiac dysfunction and ß-AR desensitization. Main methods: We compared LV myocyte CaMKIIδ, CaMKIIδ phosphorylation (at Thr287) (pCaMKIIδ), and ß1-and ß3-AR expressions and determined myocyte functional and [Ca2+]I transient ([Ca2+]iT) responses to ß-AR stimulation with and without pretreatment of myocytes using an inhibitor of CaMKII, KN-93 (10-6 M, 30 min) in male Sprague Dawley (SD; N = 10) control and TGR (hAGT)L1623 (N = 10) adult rats. Key findings: Hypertension in TGR (hAGT)L1623 rats was accompanied by significantly increased LV myocyte ß3-AR protein levels and reduced ß1-AR protein levels. CaMKIIδ phosphorylation (at Thr287), pCaMKIIδ was significantly increased by 35%. These changes were followed by significantly reduced basal cell contraction (dL/dtmax), relaxation (dR/dtmax), and [Ca2+]iT. Isoproterenol (10-8 M) produced significantly smaller increases in dL/dtmax, dR/dtmax, and [Ca2+]iT. Moreover, only in TGR (hAGT)L1623 rats, pretreatment of LV myocytes with KN-93 (10-6 M, 30 min) fully restored normal basal and isoproterenol-stimulated myocyte contraction, relaxation, and [Ca2+]iT. Significance: LV myocyte CaMKIIδ overactivation with associated contrast changes in ß3-AR and ß1-AR may be the key molecular mechanism for the abnormal contractile phenotype and ß-AR desensitization in this humanized model of hypertension.
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Using natural dyes in dyeing industries becomes an alternative to synthetic dyes, which are known to contain harmful chemicals that can pose risks to the environment and human health. This study involves the extraction of yellow dye from Cassia alata flower petals, optimization of the extraction process using an ultrasonic bath (40 KHz and an input power of 500), ultrasonic probe (390 W, 455 W, 520 W, 585 W, and 650 W), and conventional heating (heating mantle with 30 °C, 40 °C, 50 °C, 60 °C, and 70 °C), characterization of the dye, as well as dyeing (cotton, silk, and leather) without using a mordant. The extracted yellow dye was further evaluated to determine its antibacterial activity against skin bacteria. Dye extraction optimization using UV-Visible spectrophotometric analysis revealed that the maximum yellow color in methanol extract (287 and 479 nm) was obtained at 50 °C for 45 min using ultrasonic water bath extraction, followed by the ultrasonic probe and direct heating. Based on the FTIR spectra, it is evident that OH is present at approximately 3300 cm-1, while CH stretches at around 2900 cm-1. A characteristic peak at 1608 cm-1 bears a striking similarity to anthraquinonoid-based compounds. Also, using the ultrasonic water bath dyeing technique at 50 °C for 45 min, the yellow color of cotton, silk, and leather was dyed optimally. Due to effective color removal after two washings with boiling soap liquid, the dyed cotton and silk fabric displayed good washing and rubbing fastness. Regarding antibacterial activity, the dye was highly active against all pathogens after extraction in methanol. The maximum inhibition was observed against Pseudomonas sp. with a MIC value of 1.56 mg/ml.
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Cassia , Humanos , Colorantes/farmacología , Colorantes/química , Metanol , Seda , Flores , Antibacterianos/farmacología , Antibacterianos/química , Espectroscopía Infrarroja por Transformada de Fourier , AguaRESUMEN
The roles of tumor-infiltrating CD4+Foxp3- T cells are not well characterized due to their plasticity of differentiation, and varying levels of activation or exhaustion. To further clarify this issue, we used a model featuring subcutaneous murine colon cancer and analyzed the dynamic changes of phenotype and function of the tumor-associated CD4+ T-cell response. We found that, even at a late stage of tumor growth, the tumor-infiltrating CD4+Foxp3- T cells still expressed effector molecules, inflammatory cytokines and molecules that are expressed at reduced levels in exhausted cells. We used microarrays to examine the gene-expression profiles of different subsets of CD4+ T cells and revealed that the tumor-infiltrating CD4+Foxp3- T cells expressed not only type 1 helper (Th1) cytokines, but also cytolytic granules such as those encoded by Gzmb and Prf1. In contrast to CD4+ regulatory T cells, these cells exclusively co-expressed natural killer receptor markers and cytolytic molecules as shown by flow-cytometry studies. We used an ex vivo killing assay and proved that they could directly suppress CT26 tumor cells through granzyme B and perforin. Finally, we used pathway analysis and ex vivo stimulation to confirm that the CD4+Foxp3- T cells expressed higher levels of IL12rb1 genes and were activated by the IL-12/IL-27 pathway. In conclusion, this work finds that, in late-stage tumors, the tumor-infiltrating lymphocyte population of CD4+ cells harbored a sustained, hyper-maturated Th1 status with cytotoxic function supported by IL-12.
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Linfocitos T CD4-Positivos , Interleucina-12 , Neoplasias Experimentales , Microambiente Tumoral , Animales , Ratones , Linfocitos T CD4-Positivos/inmunología , Interleucina-12/inmunología , Agotamiento de Células T , Linfocitos Infiltrantes de Tumor/inmunología , Ratones Endogámicos BALB C , Neoplasias Experimentales/inmunología , Células T de Memoria/inmunología , Granzimas , PerforinaRESUMEN
High ambient temperature (heat stress, HS) is one of the critical environmental factors causing gut microbiota dysbiosis and increasing gut permeability, consequently inciting neuroinflammation in humans and various animals including chickens. The aim of this study was to examine if a probiotic, Bacillus subtilis, can reduce neuroinflammation in heat-stressed broiler chickens. Two hundred and forty 1-d-old broiler chicks were randomly assigned to 48 pens among 4 treatments in 2 identical, thermal-controlled rooms (n = 12): Thermoneutral (TN)-regular diet (RD), TN-PD (the regular diet mixed with a probiotic at 250 ppm), HS-RD, and HS-PD. The probiotic diet was fed from d 1, and HS at 32°C for 10-h daily was applied from d 15 for a 43-day trial. Results showed that compared to the TN broilers, the HS broilers had higher hippocampal interleukin (IL)-6, toll-like receptor (TLR)4, and heat shock protein (HSP)70 at both mRNA and protein levels regardless of dietary treatment (P < 0.05). In addition, the HS-PD broilers had higher levels of hippocampal IL-8 (P < 0.05) than the TN-PD broilers. Within the HS groups, compared to the HS-RD broilers, the HS-PD broilers had lower levels of IL-6, IL-8, HSP70, and TLR4 (P < 0.05) in the hippocampus. Within the TN groups, the TN-PD broilers had lower IL-8 at both mRNA expressions and protein levels (P < 0.05) but higher TLR4 protein levels (P < 0.05) in the hippocampus as compared to the TN-RD broilers. These results indicate that dietary supplementation of the Bacillus subtilis-based probiotic may reduce HS-induced brain inflammatory reactions in broilers via the gut-brain-immune axis. These results indicate the potential use of probiotics as a management strategy for reducing the impact of HS on poultry production.
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Microbioma Gastrointestinal , Probióticos , Animales , Alimentación Animal/análisis , Bacillus subtilis/metabolismo , Encéfalo/metabolismo , Pollos/genética , Dieta/veterinaria , Suplementos Dietéticos , Respuesta al Choque Térmico , Hipocampo , Calor , Proteínas HSP70 de Choque Térmico/genética , Interleucina-8/metabolismo , Enfermedades Neuroinflamatorias/veterinaria , Probióticos/farmacología , ARN Mensajero/metabolismo , Receptor Toll-Like 4/metabolismoRESUMEN
Atopic dermatitis is featured with impaired skin barrier. The stratum corneum and the intercellular tight junctions constitute the permeability barrier, which is essential to protect water loss in the host and prevent pathogen entry. The epidermal barrier is constantly renewed by differentiating keratinocytes through cornification, during which autophagy contributes to elimination of organelles and nucleus. The human GSDMA and its mouse homologs Gsdma1-3 are expressed in the suprabasal epidermis. Although a pyroptotic role of GSDMA/Gsdma1 in host defense against Streptococcus pyogenes has been reported, the physiological function of Gsdma1/a2/a3 in epidermal homeostasis remains elusive. Here, through repeated epidermal barrier disruption, we found that tight junction formation and stratum corneum maturation were defective in the Gsdma1/a3-deficient epidermis. Using comparative gene profiling analysis, mitochondrial respiration measurement, and in vivo tracing of mitophagy, our data indicate that Gsdma1/a3 activation leads to mitochondrial dysfunction and subsequently facilitates mitochondrial turnover and epidermal cornification. In calcipotriol (MC903)-induced atopic dermatitis-like animal model, we showed that Gsdma1/a3-deficiency selectively enhanced the T helper type 2 response. Remarkably, the GSDMA expression is reduced in the epidermis of patients with atopic dermatitis compared with that of normal individuals. Gsdma1/a3-deficiency might be involved in atopic dermatitis pathogenesis, likely through GSDMA-mediated epidermal differentiation and cornification.
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Dermatitis Atópica , Humanos , Animales , Ratones , Dermatitis Atópica/patología , Gasderminas , Epidermis/patología , Queratinocitos/metabolismo , Regeneración , Proteínas Citotóxicas Formadoras de Poros/metabolismoRESUMEN
This study investigated the effect of the interaction between ultrafine slag powder (USL) and limestone (LS) on the rheology behavior, microstructure, and fractal features of UHPC. The results indicated that B2 with mass ratio of 2:1 between the USL and LS obtained the highest compressive strength and the lowest yield stress. The combination of the USL and LS facilitated the cement hydration, ettringite, and monocarboaluminate (Mc) formation, as well as the increase in the polymerization of the C-S-H. The synergistic action between the USL and LS refined the pore structure due to the formation of the Mc, compensating for the consumption of the CH by the pozzolanic reaction, which provided a denser microstructure in the UHPC. The fractal dimension (Ds) of the UHPC was strongly related to the concrete pore structures and the compressive strength, which demonstrated that a new metric called the Ds value may be used to assess the synergistic effect of the UHPC.
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Since its discovery in 2004, graphene is increasingly applied in various fields owing to its unique properties. Graphene application in the biomedical domain is promising and intriguing as an emerging 2D material with a high surface area, good mechanical properties, and unrivalled electronic and physical properties. This review summarizes six typical synthesis methods to fabricate pristine graphene (p-G), graphene oxide (GO), and reduced graphene oxide (rGO), followed by characterization techniques to examine the obtained graphene materials. As bare graphene is generally undesirable in vivo and in vitro, functionalization methods to reduce toxicity, increase biocompatibility, and provide more functionalities are demonstrated. Subsequently, in vivo and in vitro behaviors of various bare and functionalized graphene materials are discussed to evaluate the functionalization effects. Reasonable control of dose (<20 mg kg-1 ), sizes (50-1000 nm), and functionalization methods for in vivo application are advantageous. Then, the key biomedical applications based on graphene materials are discussed, coupled with the current challenges and outlooks of this growing field. In a broader sense, this review provides a comprehensive discussion on the synthesis, characterization, functionalization, evaluation, and application of p-G, GO, and rGO in the biomedical field, highlighting their recent advances and potential.
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Grafito , Materiales BiocompatiblesRESUMEN
Conductive hydrogel (CH) as flexible electrophysiology interface has become the new trend of bioelectronics, but still challenging in synergizing the biocompatibility, mechanics and comprehensive electrical performance. Hyaluronic acid (HA), featured with abundant active sites for personalized-modification and well-known biocompatibility, is one of the alterative candidates. The obstacle lies in the unstable conductivity from the ionic conduction, and the electronic conduction by embedding conductive nanoparticles (NPs) is likely to result in inhomogeneous CH with poor stretchability and discontinuous conductive network. Herein, inspired by catechol chemistry, dopamine (DA)-modified HA was homogeneously composited with DA-modified poly (3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS, named PP), to produce particle-free conductive hydrogel (HA-DA-PP). The DA-introduced multiple bondings in HA network and PP molecules brought aqueous conductive PP into HA hydrogel to form a homogeneous crosslinking network, imparted the flexible stretchability. By accurately regulation, HA-DA-PP achieved high stretchability with large tensile deformation (over 470 %) in the category of natural polymer-based hydrogels. Moreover, the interaction between DA and PP (conformational transition and charge transfer) could effectively enhance the hydrogel's conductivity. Consequently, HA-DA-PP hydrogel showed high sensibility to human movement, epidermal and in vivo electrophysiological signals monitoring. Overall, DA-mediated multiple bonding is a powerful strategy for constructing CH with high performance for bioelectronics.
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Ácido Hialurónico , Hidrogeles , Humanos , Hidrogeles/química , Ácido Hialurónico/química , Dopamina , Polímeros/química , Conformación Molecular , Conductividad EléctricaRESUMEN
BACKGROUND: Melanoma is the most aggressive form of skin cancer, with a tendency to metastasize to any organ. Malignant melanoma is the most frequent cause of skin cancer-related deaths worldwide. Small intestine cancers especially small intestine metastases are relatively rare. Small intestine metastases are seldom described and likely underdiagnosed. Intussusception is most common in pediatric age, and in adults are almost 5% of all cases. CASE SUMMARY: A 75-year-old man with a history of acral malignant melanoma was admitted to the Gastroenterology Department of our hospital, complaining of intermittent melena for 1 mo. Magnetic resonance enterography showed partial thickening of the jejunal wall and formation of a soft tissue mass, indicating a neoplastic lesion with jejunojejunal intussusception. The patient underwent partial small bowel resection. Pathological findings and immunohistochemical staining indicated small intestine metastatic melanoma. The patient refused further anti-tumor treatment after the surgery. Ten months after the first surgery, the patient presented with melena again. Computed tomography enterography showed the anastomotic stoma was normal without thickening of the intestinal wall, and routine conservative treatment was given. Three months later, the patient developed melena again. The patient underwent a second surgery, and multiple metastatic melanoma lesions were found. The patient refused adjuvant anti-tumor treatment and was alive at the latest follow-up. CONCLUSION: Small intestine metastatic melanoma should be suspected in any patient with a history of malignant melanoma and gastrointestinal symptoms.