Emerging Methods to Objectively Assess Pruritus in Atopic Dermatitis.

INTRODUCTION:Atopic dermatitis (AD) is an inflammatory skin disease with a chronic, relapsing course. Clinical features of AD vary by age, duration, and severity but can include papules, vesicles, erythema, exudate, xerosis, scaling, and lichenification. However, the most defining and universal symptom of AD is pruritus. Pruritus or itch, defined as an unpleasant urge to scratch, is problematic for many reasons, particularly its negative impact on quality of life. Despite the profoundly negative impact of pruritus on patients with AD, clinicians and researchers lack standardized and validated methods to objectively measure pruritus. The purpose of this review is to discuss emerging methods to assess pruritus in AD by describing objective patient-centered tools developed or enhanced over the last decade that can be utilized by clinicians and researchers alike. METHODS:This review is based on a literature search in Medline, Embase, and Web of Science databases. The search was performed in February 2019. The keywords were used "pruritus," "itch," "atopic dermatitis," "eczema," "measurements," "tools," "instruments," "accelerometer," "wrist actigraphy," "smartwatch," "transducer," "vibration," "brain mapping," "magnetic resonance imaging," and "positron emission tomography." Only articles written in English were included, and no restrictions were set on study type. To focus on emerging methods, prioritization was given to results from the last decade (2009-2019). RESULTS:The search yielded 49 results in PubMed, 134 results in Embase, and 85 results in Web of Science. Each result was independently reviewed in a standardized manner by two of the authors (M.S., K.L.), and disagreements between reviewers were resolved by consensus. Relevant findings were categorized into the following sections: video surveillance, acoustic surveillance, wrist actigraphy, smart devices, vibration transducers, and neurological imaging. Examples are provided along with descriptions of how each technology works, instances of use in research or clinical practice, and as applicable, reports of validation studies and correlation with other methods. CONCLUSION:The variety of new and improved methods to evaluate pruritus in AD is welcomed by clinicians, researchers, and patients alike. Future directions include next-generation smart devices as well as exploring new territories, such as identifying biomarkers that correlate to itch and machine-learning programs to identify itch processing in the brain. As these efforts continue, it will be essential to remain patient-centered by developing techniques that minimize discomfort, respect privacy, and provide accurate data that can be used to better manage itch in AD

Development of a Taxonomy to be used by Business-IT Alignment Researchers

The nexus between Business and IT research is complex. Due to extended research over time, the context of business-IT alignment has resulted in many different conceptualisations that can be applied to ongoing research. It is challenging to select and adopt a suitable approach to study business-IT alignment across any given field due to the variability of the existing conceptualisations. This study reviews the existing literature to identify alignment conceptualisations and contributes to both theory and practice. Theoretically, through the uncovering of gaps in the literature a taxonomy has been developed which can be used as a guide to select an appropriate alignment lens for business-IT alignment studies. In practice, it is expected that this taxonomy will be beneficial for conceptualising the structure and philosophies underpinning future alignment studies. To validate the taxonomy, the paper presents a case study in healthcare applying the developed taxonomy to investigate alignment of big data in health

Strategies for the molecular genetic manipulation and visualization of the human fungal pathogen Penicillium marneffei

P. marneffei has been established as an experimentally amenable system to study morphogenesis and pathogenicity. This paper describes the development of a number of tools, including numerous selectable markers, to expand the ease with which it can be genetically manipulated. Combined with strains engineered for homologous recombination of exogenous DNA, these tools facilitate efficient molecular genetic studies

GARDINERIN, A BIOLOGICALLY ACTIVE ACETOGENIN FROM THE SRI LANKAN GONIOTHALAMUS GARDINERI HOOK. F. AND THOMSON

Objective: The study was undertaken to isolate biologically active compounds from Goniothalamus gardineri, a plant endemic to Sri Lanka. Methods: Roots and flowers of Goniothalamus gardineri were extracted into dichloromethane and methanol. A new acetogenin, gardinerin isolated by column chromatography of the dichloromethane extract was structurally characterized using NMR and Mass spectroscopies. It was found to be mosquito larvicidal (against 2nd instar larvae of Aedes aegypti), cytotoxic (in the brine shrimp assay) and antioxidant (DPPH assay). Results: Gardinerin exhibited potent mosquitolarvicidal activity (LC50 = 0.0744±0.37 ppm.), cytotoxicity (LC50 = 1.5±0.37 ppm) and antioxidant activity (IC50 =10.02±0.01 ppm). The same extract furnished (5R)-goniothalamin. The hexane extract of the flowers of G. gardineri yielded poriferesterol and stigmast-4, 22-dien-3-one.Conclusion: The endemic plant G. gardineri has yielded an acetogenin possessing highly potent antioxidant, cytotoxic and mosquitolarvicidal activity. Â

Fibrinogen-γ proteolysis and solubility dynamics during apoptotic mouse liver injury: Heparin prevents and treats liver damage

Fas ligand (FasL)-mediated hepatocyte apoptosis occurs in the context of acute liver injury that can be accompanied by intravascular coagulation (IC). We tested the hypothesis that analysis of selected protein fractions from livers undergoing apoptosis will shed light on mechanisms that are involved in liver injury that might be amenable to intervention. Proteomic analysis of the major insoluble liver proteins after FasL exposure for 4-5 hours identified fibrinogen-γ (FIB-γ) dimers and FIB-γ–containing high molecular mass complexes among the major insoluble proteins visible via Coomassie blue staining. Presence of the FIB-γ–containing products was confirmed using FIB-γ–specific antibodies. The FIB-γ–containing products partition selectively and quantitatively into the liver parenchyma after inducing apoptosis. Similar formation of FIB-γ products occurs after acetaminophen administration. The observed intrahepatic IC raised the possibility that heparin therapy may ameliorate FasL-mediated liver injury. Notably, heparin administration in mice 4 hours before or up to 2 hours after FasL injection resulted in a dramatic reduction of liver injury—including liver hemorrhage, serum alanine aminotransferase, caspase activation, and liver apoptosis—compared with heparin-untreated mice. Heparin did not directly interfere with FasL-induced apoptosis in isolated hepatocytes, and heparin-treated mice survived the FasL-induced liver injury longer compared with heparin-untreated animals. There was a sharp, near-simultaneous rise in FasL-induced intrahepatic apoptosis and coagulation, with IC remaining stable while apoptosis continued to increase. Conclusion: Formation of FIB-γ dimers and their high molecular mass products are readily detectable within the liver during mouse apoptotic liver injury. Heparin provides a potential therapeutic modality, because it not only prevents extensive FasL-related liver injury but also limits the extent of injury if given at early stages of injury exposure. (H EPATOLOGY 2011;)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/83742/1/24203_ftp.pd