Topical timolol for treatment of persistent granulation tissue in the setting of severe hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a potentially debilitating dermatological disease that negatively impacts patients' quality of life. Severe cases can be further complicated by persistent granulation tissue at the ostia of sinus tracts, which may prove recalcitrant to standard interventions. Herein we report such a case in which a patient experienced significant improvement from severe HS but was left with persistent granulation tissue that complicated his course of recovery. When standard interventions failed, we elected to begin treatment with topical timolol. After three months, the majority of the granulation tissue had regressed and has remained quiescent after 12 months of follow up. The patient has tolerated the treatment well and continues to use topical timolol daily as needed for flares. We believe that topical timolol can provide a practical and painless alternative to current invasive and expensive therapies for persistent granulation tissue associated with severe HS

Learning curves and long-term outcome of simulation-based thoracentesis training for medical students

<p>Abstract</p> <p>Background</p> <p>Simulation-based medical education has been widely used in medical skills training; however, the effectiveness and long-term outcome of simulation-based training in thoracentesis requires further investigation. The purpose of this study was to assess the learning curve of simulation-based thoracentesis training, study skills retention and transfer of knowledge to a clinical setting following simulation-based education intervention in thoracentesis procedures.</p> <p>Methods</p> <p>Fifty-two medical students were enrolled in this study. Each participant performed five supervised trials on the simulator. Participant's performance was assessed by performance score (PS), procedure time (PT), and participant's confidence (PC). Learning curves for each variable were generated. Long-term outcome of the training was measured by the retesting and clinical performance evaluation 6 months and 1 year, respectively, after initial training on the simulator.</p> <p>Results</p> <p>Significant improvements in PS, PT, and PC were noted among the first 3 to 4 test trials (p < 0.05). A plateau for PS, PT, and PC in the learning curves occurred in trial 4. Retesting 6 months after training yielded similar scores to trial 5 (p > 0.05). Clinical competency in thoracentesis was improved in participants who received simulation training relative to that of first year medical residents without such experience (p < 0.05).</p> <p>Conclusions</p> <p>This study demonstrates that simulation-based thoracentesis training can significantly improve an individual's performance. The saturation of learning from the simulator can be achieved after four practice sessions. Simulation-based training can assist in long-term retention of skills and can be partially transferred to clinical practice.</p

Emergence of Fatal PRRSV Variants: Unparalleled Outbreaks of Atypical PRRS in China and Molecular Dissection of the Unique Hallmark

Porcine reproductive and respiratory syndrome (PRRS) is a severe viral disease in pigs, causing great economic losses worldwide each year. The causative agent of the disease, PRRS virus (PRRSV), is a member of the family Arteriviridae. Here we report our investigation of the unparalleled large-scale outbreaks of an originally unknown, but so-called “high fever” disease in China in 2006 with the essence of PRRS, which spread to more than 10 provinces (autonomous cities or regions) and affected over 2,000,000 pigs with about 400,000 fatal cases. Different from the typical PRRS, numerous adult sows were also infected by the “high fever” disease. This atypical PRRS pandemic was initially identified as a hog cholera-like disease manifesting neurological symptoms (e.g., shivering), high fever (40–42°C), erythematous blanching rash, etc. Autopsies combined with immunological analyses clearly showed that multiple organs were infected by highly pathogenic PRRSVs with severe pathological changes observed. Whole-genome analysis of the isolated viruses revealed that these PRRSV isolates are grouped into Type II and are highly homologous to HB-1, a Chinese strain of PRRSV (96.5% nucleotide identity). More importantly, we observed a unique molecular hallmark in these viral isolates, namely a discontinuous deletion of 30 amino acids in nonstructural protein 2 (NSP2). Taken together, this is the first comprehensive report documenting the 2006 epidemic of atypical PRRS outbreak in China and identifying the 30 amino-acid deletion in NSP2, a novel determining factor for virulence which may be implicated in the high pathogenicity of PRRSV, and will stimulate further study by using the infectious cDNA clone technique

Topical timolol for treatment of persistent granulation tissue in the setting of severe hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a potentially debilitating dermatological disease that negatively impacts patients' quality of life. Severe cases can be further complicated by persistent granulation tissue at the ostia of sinus tracts, which may prove recalcitrant to standard interventions. Herein we report such a case in which a patient experienced significant improvement from severe HS but was left with persistent granulation tissue that complicated his course of recovery. When standard interventions failed, we elected to begin treatment with topical timolol. After three months, the majority of the granulation tissue had regressed and has remained quiescent after 12 months of follow up. The patient has tolerated the treatment well and continues to use topical timolol daily as needed for flares. We believe that topical timolol can provide a practical and painless alternative to current invasive and expensive therapies for persistent granulation tissue associated with severe HS

Imprinted plasmonic measuring nanocylinders for nanoscale volumes of materials

Optical measurement of materials at the nanoscale is important for nanotechnology. Various plasmonic nanorulers have been studied for measuring nanoscale distance and orientation of materials, but they lack the capability to contain and measure nanoscale volumes, especially for liquid or soft materials. Here, we demonstrate the use of imprinted plasmonic volumetric nanocylinders, which act as nanoscale graduated cylinders and facilitate nanomaterial measurement via visible light. Our theoretical and experimental achievements illuminate a promising method for non-destructive, low-cost and fast measurement of material volume changes at the nanoscale, which will benefit the fields of analytical chemistry, nanofabrication and biomedical sensing

Imprinted plasmonic measuring nanocylinders for nanoscale volumes of materials

Optical measurement of materials at the nanoscale is important for nanotechnology. Various plasmonic nanorulers have been studied for measuring nanoscale distance and orientation of materials, but they lack the capability to contain and measure nanoscale volumes, especially for liquid or soft materials. Here, we demonstrate the use of imprinted plasmonic volumetric nanocylinders, which act as nanoscale graduated cylinders and facilitate nanomaterial measurement via visible light. Our theoretical and experimental achievements illuminate a promising method for non-destructive, low-cost and fast measurement of material volume changes at the nanoscale, which will benefit the fields of analytical chemistry, nanofabrication and biomedical sensing

Spatiotemporal evolution and relationship between construction land expansion and territorial space conflicts at the county level in Jiangsu Province

In rapidly urbanizing areas, intense human development activities and fierce competition for spatial resources have led to apparent territorial space conflicts. This paper selects Jiangsu Province as the study area to explore the spatiotemporal evolution characteristics and response relationship between the expansion of county-level construction land and territorial space conflicts from 1985 to 2020 to provide a reference for regional territorial space optimization. The results show that the construction land expansion intensity (CEI) at the county level showed a spatial characteristic of greater power in the southeast than in the northwest. The spatial expansion mode (SEI) was mainly characterized by spread type, with construction land experiencing marginal expansion, the emergence of new independent expansion points, and then the expansion process of agglomeration distribution. From 1985 to 2020, there was a significant increase in territorial space conflicts and an increase in spatial aggregation at the county level. The regions with high space conflicts intensity index (SCII) values and high increase in space conflicts intensity changes (SCIIC) were mainly located in Xuzhou, Nanjing, and at the junction of Changzhou, Wuxi, Suzhou, and Zhenjiang. There was a positive correlation between CEI and SCIIC, and the correlation of positive correlation units increased from south to north. There was a positive correlation between SEI and SCIIC, and the units with a strong positive correlation were mainly located in Xuzhou, Nantong, Changzhou, and Wuxi. The changes in population density and GDP also affect SCIIC. This paper strengthens the understanding of the spatiotemporal evolution characteristics and related relationships of construction land expansion and territorial space conflicts at the county level over a long time, which can provide a decision-making basis and reference for the regulation of county construction land expansion, territorial space optimization in Jiangsu Province