Stretchable Composite Acoustic Transducer for Wearable Monitoring of Vital Signs

A highly flexible, stretchable, and mechanically robust low-cost soft composite consisting of silicone polymers and water (or hydrogels) is reported. When combined with conventional acoustic transducers, the materials reported enable high performance real-time monitoring of heart and respiratory patterns over layers of clothing (or furry skin of animals) without the need for direct contact with the skin. The approach enables an entirely new method of fabrication that involves encapsulation of water and hydrogels with silicones and exploits the ability of sound waves to travel through the body. The system proposed outperforms commercial, metal-based stethoscopes for the auscultation of the heart when worn over clothing and is less susceptible to motion artefacts. The system both with human and furry animal subjects (i.e., dogs), primarily focusing on monitoring the heart, is tested; however, initial results on monitoring breathing are also presented. This work is especially important because it is the first demonstration of a stretchable sensor that is suitable for use with furry animals and does not require shaving of the animal for data acquisition

Disposable sensors in diagnostics, food and environmental monitoring

Disposable sensors are low‐cost and easy‐to‐use sensing devices intended for short‐term or rapid single‐point measurements. The growing demand for fast, accessible, and reliable information in a vastly connected world makes disposable sensors increasingly important. The areas of application for such devices are numerous, ranging from pharmaceutical, agricultural, environmental, forensic, and food sciences to wearables and clinical diagnostics, especially in resource‐limited settings. The capabilities of disposable sensors can extend beyond measuring traditional physical quantities (for example, temperature or pressure); they can provide critical chemical and biological information (chemo‐ and biosensors) that can be digitized and made available to users and centralized/decentralized facilities for data storage, remotely. These features could pave the way for new classes of low‐cost systems for health, food, and environmental monitoring that can democratize sensing across the globe. Here, a brief insight into the materials and basics of sensors (methods of transduction, molecular recognition, and amplification) is provided followed by a comprehensive and critical overview of the disposable sensors currently used for medical diagnostics, food, and environmental analysis. Finally, views on how the field of disposable sensing devices will continue its evolution are discussed, including the future trends, challenges, and opportunities

Cortisol Responses to Mental Stress and the Progression of Coronary Artery Calcification in Healthy Men and Women

Background: Psychosocial stress is a risk factor for coronary heart disease (CHD). The mechanisms are incompletely understood, although dysfunction of the hypothalamic pituitary adrenal (HPA) axis might be involved. We examined the association between cortisol responses to laboratory-induced mental stress and the progression of coronary artery calcification (CAC). Methods and Results: Participants were 466 healthy men and women (mean age = 62.7±5.6 yrs), without history or objective signs of CHD, drawn from the Whitehall II epidemiological cohort. At the baseline assessment salivary cortisol was measured in response to mental stressors, consisting of a 5-min Stroop task and a 5-min mirror tracing task. CAC was measured at baseline and at 3 years follow up using electron beam computed tomography. CAC progression was defined as an increase >10 Agatston units between baseline and follow up. 38.2% of the sample demonstrated CAC progression over the 3 years follow up. There was considerable variation in the cortisol stress response, with approximately 40% of the sample responding to the stress tasks with an increase in cortisol of at least 1 mmol/l. There was an association between cortisol stress reactivity (per SD) and CAC progression (odds ratio = 1.27, 95% CI, 1.02–1.60) after adjustments for age, sex, pre-stress cortisol, employment grade, smoking, resting systolic BP, fibrinogen, body mass index, and use of statins. There was no association between systolic blood pressure reactivity and CAC progression (odds ratio per SD increase = 1.03, 95% CI, 0.85–1.24). Other independent predictors of CAC progression included age, male sex, smoking, resting systolic blood pressure, and fibrinogen. Conclusion: Results demonstrate an association between heightened cortisol reactivity to stress and CAC progression. These data support the notion that cortisol reactivity, an index of HPA function, is one of the possible mechanisms through which psychosocial stress may influence the risk of CHD

Understanding how we age: insights into inflammaging

Inflammaging is characterized by the upregulation of the inflammatory response that occurs with advancing age; its roots are strongly embedded in evolutionary theory. Inflammaging is believed to be a consequence of a remodelling of the innate and acquired immune system, resulting in chronic inflammatory cytokine production. Complex interrelated genetic, environmental and age-related factors determine an individual’s vulnerability or resilience to inflammaging. These factors include polymorphisms to the promoter regions of cytokines, cytokine receptors and antagonists, age-related decreases in autophagy and increased adiposity. Anti-inflammaging describes the upregulation of the hypothalamic-pituitary axis in response to inflammaging, leading to higher levels of cortisol, which in turn may be detrimental, contributing to less successful ageing and frailty. This may be countered by the adrenal steroid dehydroepiandrosterone, which itself declines with age, leaving certain individuals more vulnerable. Inflammaging and anti-inflammaging have both been linked with a number of age-related outcomes, including chronic morbidity, functional decline and mortality. This important area of research offers unique insights into the ageing process and the potential for screening and targeted interventions

ANTİ-IL-17 TEDAVİSİNE BAĞLI FASYAL PALSİ VE YENİ BAŞLANGIÇ ÜLSERATİF KOLİT: PSORİAZİSLİ İKİ OLGU

GİRİŞSecukinumab ve ixekizumab interlökin (IL) -17A\"yı seçici olarak nötralize eden monoklonal antikorlardır. (1) Bell paralizisinin etiyolojisi bilinmemektedir, gizli bir virüsün otoimmün reaksiyonu tetikleyebileceği ve fasiyal sinirde demiyelinizasyona neden olabileceği öne sürülmüştür. (2) IL-17 inhibisyonu ile inflamatuar bağırsak hastalığı (IBD) gelişim mekanizması belirsizdir. (3) Secukinumab tedavisinden sonra gelişen bir fasiyal paralizi ve ixekizumab tedavisinden sonra yeni başlayan bir ülseratif kolit olgusu sunuyoruz.OLGU 110 yıldır kronik plak psoriazisi olan secukinumab tedavisi alan 31 yaş erkek hastada 5 haftalık indüksiyon aşamasını tamamladıktan birkaç gün sonra, dilde ve başının arkasında uyuşma gelişti. Secukinumab tedavisi sonlandırıldı. Hastanın bilateral karotis ve vertebral renkli doppler ultrason muayenesi normaldi. İki gün sonra yüzün sol tarafında uyuşma ile başvurdu ve muayene sırasında sol tarafta azalmış yüz hareketleri tespit edildi. Elektromiyografide, sol fasiyal sinirin amplitüdü sağdan %22 daha düşüktü. Hastanın diğer nörolojik muayenesi normaldi. Diğer infeksiyöz ve otoimmün hastalıklar tespit edilmedi ve hastanın başka bir sistemik hastalığı yoktu. Şikayetleri üç hafta içinde metilprednizolon tedavisi ile geriledi. İki aylık takipte nüks gözlenmedi.OLGU 25 yıl boyunca kronik plak tip ve şiddetli tırnak psoriazisi olan ve ixekizumab tedavisi alan 27 yaşında bir erkek hastada tedavinin 28. haftasından itibaren tekrarlayan karın ağrısı ve kanlı ishal atakları gelişti. Kolonoskopi ve intestinal biyopsinin histopatolojik bulguları ülseratif kolit ile uyumluydu. Ixekizumab tedavisi sonlandırıldı. Kolit atakları metilprednizolon, azatiyoprin ve mesalazin tedavisi ile kontrol edildi. 8 aydır psoriazis için tedavi almayan hastanın psoriatik lezyonları ve tırnak bulguları yeniden ortaya çıktı ve hasta için anti-IL23 biyolojik tedavi planlanıyor. Hastalardan yayın izni için bilgilendirilmiş onam alındı.TARTIŞMAPsoriazis ve psoriatik artrit için secukinumab kullanan 306 hastanın çalışmasında, tek bir fasiyal paralizi olgusu bildirilmiştir. (1) Şimdiye kadar, ixekizumab tedavisinden sonra 3 IBD geliştiği bildirilen 5 vaka raporu ve secukinumab ile tedaviden sonra IBD geliştiren 3 vaka serisi olmuştur. (4) Anti-IL-17 ajanlarına başlamadan önce, hastalardan IBD açısından ayrıntılı bir kişisel ve aile öyküsü alınlamalıdır. Hastalar bu ilişki hakkında bilgilendirilmeli ve gastrointestinal semptomlarını izlemeleri istenmelidir.Anahtar Kelimeler: psoriazis, biyolojikler, anti IL17A, fasiyal paralizi, ülseratif koli