What's the best test for HSV-2 after exposure?

Enzyme-linked immunosorbent assay (ELISA ) tests based on herpes simplex virus 2's (HSV -2) glycoprotein G have demonstrated high sensitivity and specificity in determining seropositivity for HSV-2 antibodies (strength of recommendation [SOR]: C, based on cross-sectional studies). ELISA tests not based on glycoprotein G are also highly sensitive, but they are less specific for HSV-2 and are prone to false-positive results because of cross-reactivity with HSV -1 antibodies (SOR: C, based on cross-sectional studies)

Which interventions are best for alleviating nipple pain in nursing mothers?

The best intervention is education on proper positioning and attachment of the infant (strength of recommendation [SOR]: A, a systematic review of randomized controlled trials [RCTs]). No single topical preparation has been consistently demonstrated to be superior to others for relieving nipple pain (SOR: B, inconsistent RCTs). Topical agents that show some evidence of benefit include expressed breast milk, lanolin, warm water compresses, tea bag compresses, hydrogel dressings, a chlorhexidinealcohol spray, and a polyethylene film dressing (SOR: B, inconsistent RCTs). Several studies found these interventions to be equivalent to basic breast care, including keeping the nipple clean and dry (SOR: B, RCTs)

Do allergy shots help seasonal allergies more than antihistamines and nasal steroids?

Multiple randomized controlled trials (RCTs) demonstrate the effectiveness of both allergen immunotherapy and antihistamines, with or without nasal steroids, in the treatment of seasonal allergic rhinitis (strength of recommendation [SOR]: A). No RCTs directly compare immunotherapy with conservative management. Treatment decisions are driven by the clinical presentation, patient and physician preferences, practice guidelines, and expert opinion (SOR: C, based on expert opinion). In standard practice, immunotherapy is not recommended for most patients with seasonal allergic rhinitis

What is the best surveillance for hepatocellular carcinoma in chronic carriers of hepatitis B?

Screening patients with chronic hepatitis B infection (HBsAg+) for hepatocellular carcinoma by alpha-fetoprotein (AFP) or by AFP plus ultrasound (AFP/US) detects hepatocellular carcinoma tumors at earlier stages and increases resection rates (strength of recommendation [SOR]: B, based on a systematic review of fair-quality randomized controlled trials). It is unclear whether screening with AFP or AFP/US improves disease-specific or all-cause mortality (SOR: B)

How effective are lifestyle changes for controlling hypertension?

Regular aerobic exercise, weight loss of 3% to 9% of body weight, reduced dietary salt, the DASH diet, and moderation of alcohol intake are all lifestyle interventions that lower blood pressure. Average blood pressure decreases range from 3 to 11 mm Hg systolic and 2.5 to 5.5 mm Hg diastolic, depending on the particular intervention (strength of recommendation [SOR]: A, based on systematic reviews of randomized controlled trials [RCTs]). Studies of community-based interventions advocating combinations of the above have had mixed results with less reduction in blood pressure noted than for the individual interventions described above (SOR: B, RCTs with inconsistent results)

Martial Arts in the Pandemic

This study examines the impact of the Covid-19 pandemic on martial arts training worldwide. A mixed-method online questionnaire consisting of 28 items was used as a survey instrument. 306 martial artists responded. These were mainly from the United Kingdom, the USA, Germany, Italy and Japan. The questionnaire focused on pragmatic adaptations of training volume, training rhythm, training location, training mode (individual or group) and training methods. The survey sought to gain insights into modifications that martial artists made as a result of the Covid-19 pandemic in relation to their training, curriculum, alternative fitness, strength and health activities, as well as training goals. The results suggest that the training restrictions implemented by governments in order to try to combat the pandemic transformed the practice of martial arts on a massive and fundamental scale. Specifically, they led to two seemingly opposing developments: increasing digitisation and an increased focus on the importance of embodiment. The article concludes with a suggestion that these lines of development will mould the post-pandemic landscape of martial arts

\u3ci\u3eMedicine Meets Virtual Reality 15\u3c/i\u3e

Chapter, Virtual Reality for Robotic Laparoscopic Surgical Training, co-authored by Nicholas Stergiou, UNO faculty member. Our culture is obsessed with design. Sometimes designers can fuse utility and fantasy to make the mundane appear fresh—a cosmetic repackaging of the same old thing. Because of this, medicine—grounded in the unforgiving realities of the scientific method and peer review, and of flesh, blood, and pain—can sometimes confuse “design” with mere “prettifying.” Design solves real problems, however. This collection of papers underwrites the importance of design for the MMVR community, within three different environments: in vivo, in vitro and in silico. in vivo: we design machines to explore our living bodies. Imaging devices, robots, and sensors move constantly inward, operating within smaller dimensions: system, organ, cell, DNA. in vitro: Using test tubes and Petri dishes, we isolate in vivo to better manipulate and measure biological conditions and reactions. in silico: We step out of the controlled in vitro environment and into a virtual reality. The silica mini-worlds of test tubes and Petri dishes are translated into mini-worlds contained within silicon chips. The future of medicine remains within all three environments: in vivo, in vitro, and in silico. Design is what makes these pieces fit together—the biological, the informational, the physical/material—into something new and more useful.https://digitalcommons.unomaha.edu/facultybooks/1235/thumbnail.jp

Comparative Metabolomics Reveals Biogenesis of Ascarosides, a Modular Library of Small-Molecule Signals in C. elegans

In the model organism Caenorhabditis elegans, a family of endogenous small molecules, the ascarosides function as key regulators of developmental timing and behavior that act upstream of conserved signaling pathways. The ascarosides are based on the dideoxysugar ascarylose, which is linked to fatty-acid-like side chains of varying lengths derived from peroxisomal β-oxidation. Despite the importance of ascarosides for many aspects of C. elegans biology, knowledge of their structures, biosynthesis, and homeostasis remains incomplete. We used an MS/MS-based screen to profile ascarosides in C. elegans wild-type and mutant metabolomes, which revealed a much greater structural diversity of ascaroside derivatives than previously reported. Comparison of the metabolomes from wild-type and a series of peroxisomal β-oxidation mutants showed that the enoyl CoA-hydratase MAOC-1 serves an important role in ascaroside biosynthesis and clarified the functions of two other enzymes, ACOX-1 and DHS-28. We show that, following peroxisomal β-oxidation, the ascarosides are selectively derivatized with moieties of varied biogenetic origin and that such modifications can dramatically affect biological activity, producing signaling molecules active at low femtomolar concentrations. Based on these results, the ascarosides appear as a modular library of small-molecule signals, integrating building blocks from three major metabolic pathways: carbohydrate metabolism, peroxisomal β-oxidation of fatty acids, and amino acid catabolism. Our screen further demonstrates that ascaroside biosynthesis is directly affected by nutritional status and that excretion of the final products is highly selective

Comparative Metabolomics Reveals Endogenous Ligands of DAF-12, a Nuclear Hormone Receptor, Regulating C. elegans Development and Lifespan

SummarySmall-molecule ligands of nuclear hormone receptors (NHRs) govern the transcriptional regulation of metazoan development, cell differentiation, and metabolism. However, the physiological ligands of many NHRs remain poorly characterized, primarily due to lack of robust analytical techniques. Using comparative metabolomics, we identified endogenous steroids that act as ligands of the C. elegans NHR, DAF-12, a vitamin D and liver X receptor homolog regulating larval development, fat metabolism, and lifespan. The identified molecules feature unexpected chemical modifications and include only one of two DAF-12 ligands reported earlier, necessitating a revision of previously proposed ligand biosynthetic pathways. We further show that ligand profiles are regulated by a complex enzymatic network, including the Rieske oxygenase DAF-36, the short-chain dehydrogenase DHS-16, and the hydroxysteroid dehydrogenase HSD-1. Our results demonstrate the advantages of comparative metabolomics over traditional candidate-based approaches and provide a blueprint for the identification of ligands for other C. elegans and mammalian NHRs

Development of Improved Iron-Aluminide Filter Tubes and Elements

The purpose of this Cooperative Research and Development Agreement (CRADA) was to explore and develop advanced manufacturing techniques to fabricate sintered iron-aluminide intermetallic porous bodies used for gas filtration so as to reduce production costs while maintaining or improving performance in advanced coal gasification and combustion systems. The use of a power turbine fired with coal-derived synthesis gas requires some form of gas cleaning in order to protect turbine and downstream components from degradation by erosion, corrosion, and/or deposition. Hot-gas filtration is one form of cleaning that offers the ability to remove particles from the gases produced by gasification processes without having to substantially cool and, possibly, reheat them before their introduction into the turbine. This technology depends critically on materials durability and reliability, which have been the subject of study for a number of years