Unbearable wearables

As wearable devices play an increasing role in the management of health and disease, adverse skin reactions to wearables have become more common. However, the management of allergic contact dermatitis is challenging and new treatment options more compatible with wearable devices are needed. In a 40-year-old woman with contact dermatitis to a continuous glucose monitoring device, topical clobetasol propionate 0.05% spray proved to be an effective treatment that was compatible with the application of adhesive wearables. This case demonstrates that spray formulations of topical steroids are a good option for the treatment of dermatitis under wearable devices such as continuous glucose monitors or ostomy appliance

Lateral transport of thermal capillary waves

We demonstrate that collective motion of interfacial fluctuations can occur at the interface between two coexisting thermodynamic phases. Based on computer simulation results for driven diffusive Ising and Blume-Capel models, we conjecture that the thermal capillary waves at a planar interface travel along the interface if the lateral order parameter current j_op(y) is an odd function of the distance y from the interface and hence possesses opposite directions in the two phases. Such motion does not occur if j_op(y) is an even function of y. A discrete Gaussian interface model with effective dynamics exhibits similiar transport phenomena but with a simpler dispersion relation. These findings open up avenues for controlled interfacial transport on the nanoscale.Comment: 4 pages, 6 figure

On finitely ambiguous B\"uchi automata

Unambiguous B\"uchi automata, i.e. B\"uchi automata allowing only one accepting run per word, are a useful restriction of B\"uchi automata that is well-suited for probabilistic model-checking. In this paper we propose a more permissive variant, namely finitely ambiguous B\"uchi automata, a generalisation where each word has at most $k$ accepting runs, for some fixed $k$. We adapt existing notions and results concerning finite and bounded ambiguity of finite automata to the setting of $\omega$-languages and present a translation from arbitrary nondeterministic B\"uchi automata with $n$ states to finitely ambiguous automata with at most $3^n$ states and at most $n$ accepting runs per word

Cholangiographic Features in the Diagnosis and Management of Obstructive Icteric Type Hepatocellular Carcinoma

In 11 years and 3 months, 2037 patients with HCC were seen and 48 patients (2.4%) were diagnosed to have obstructive icteric type HCC. Five patients were terminally ill and were not investigated further. Forty three patients were initially investigated by endoscopic retrograde cholangiography (ERC) or percutaneous transhepatic cholangiogram (PTC) and classified as having obstructive icteric type 1, 2, or 3 HCC based on the cholangiographic findings. The obstruction in type 1 HCC was due to intraluminal tumour casts and/or tumour fragments obstructing the hepatic ductal confluence or common bile duct, while intraluminal blood clots, from haemobilia, filling the biliary tree was the cause in type 2 HCC. The pathology in type 3 HCC was extraluminal obstruction by extensive tumour encasement of the intra–hepatic biliary ductal system and/or extrinsic compression of the hepatic and common bile ducts by tumour(s) and/or malignant lymph nodes. At the initial ERC/PTC, 10 patients (5 resected, 50%) had obstructive icteric type 1 and 23 patients (0 resected) had obstructive icteric type 3 HCC. Of the 10 patients initially classified according to cholangiography to have obstructive icteric type 2 HCC, subsequent investigations revealed that 6 patients had type 1 HCC (4 resectable, 67%) and 4 patients had type 3 HCC (0 resectable). The classification of the obstructive icteric type HCC into types 1, 2, and 3, based on the initial cholangiographic appearances has simplified and rationalized our management strategy for this condition

Left ventricular function after valve repair for chronic mitral regurgitation: Predictive value of preoperative assessment of contractile reserve by exercise echocardiography

Objectives.We evaluated the value of preoperative assessment of left ventricular contractile reserve in predicting ventricular function after valve repair for minimally symptomatic mitral regurgitation.Background.The optimal timing for operation in minimally symptomatic patients with significant mitral regurgitation is controversial. Accurate preoperative assessment of left ventricular function is difficult, and the ability to predict postoperative function is limited. Previous studies in patients undergoing mitral valve replacement may not be applicable in the present era of valve repair.Methods.We performed exercise echocardiography in 139 patients with isolated mitral regurgitation and no coronary disease, 74 of whom subsequently underwent uncomplicated valve repair. We measured rest left ventricular end-systolic dimension, end-systolic wall stress and positive first derivative of left ventricular pressure (dP/dt). End-diastolic and end-systolic volumes and ejection fraction were measured preoperatively at rest, immediately after exercise and postoperatively.Results.Ejection fraction decreased postoperatively to 55 ± 10% from a rest preoperative value of 64 ± 9% (p < 0.001). Compared with patients with a postoperative ejection fraction ≥50% (n = 56), patients with postoperative ejection fraction <50% (n = 18) had a significantly lower preoperative exercise ejection fraction (57 ± 11% vs. 73 ± 9%, p < 0.0005), a larger exercise end-systolic volume index (32 ± 8 vs. 18 ± 7 cm3/m2, p < 0.0005) and a lower change in ejection fraction with exercise (−4 ± 8% vs. 9 ± 10%, p < 0.005). Preoperative rest indexes, including dP/dt, end-systolic wall stress and end-systolic volume index were less predictive, whereas exercise capacity, rest ejection fraction and end-systolic dimension were not predictive of postrepair ejection fraction. An exercise end-systolic volume index >25 cm3/m2 was the best predictor of postoperative dysfunction, with a sensitivity and specificity of 83%.Conclusions.In minimally symptomatic patients with mitral regurgitation, latent ventricular dysfunction may be indicated by a limited contractile reserve, manifest at exercise as an inadequate increase in ejection fraction and a larger end-systolic volume. These variables may also be used to predict left ventricular function after repair

Complexity of decoupling and time-reversal for n spins with pair-interactions: Arrow of time in quantum control

Well-known Nuclear Magnetic Resonance experiments show that the time evolution according to (truncated) dipole-dipole interactions between n spins can be inverted by simple pulse sequences. Independent of n, the reversed evolution is only two times slower than the original one. Here we consider more general spin-spin couplings with long range. We prove that some are considerably more complex to invert since the number of required time steps and the slow-down of the reversed evolutions are necessarily of the order n. Furthermore, the spins have to be addressed separately. We show for which values of the coupling parameters the phase transition between simple and complex time-reversal schemes occurs.Comment: Completely rewritten, new lower bounds on the number of time steps, applications and references adde

The Spin Temperature of Warm Interstellar H I

Collisional excitation of the 21cm HI hyperfine transition is not strong enough to thermalize it in warm neutral (``intercloud'') interstellar gas, which we show by simultaneously solving the equations of ionization and collisional equilibrium under typical conditions. Coupling of the 21cm excitation temperature and local gas motions may be established by the Ly-alpha radiation field, but only if strong Galactic Ly-alpha radiation permeates the gas in question. The Ly-alpha radiation tends to impart to the gas its own characteristic temperature, which is determined by the range of gas motions that occur on the spatial scale of the Ly-alpha scattering. In general, the calculation of H I spin temperatures is a more difficult and interesting problem than might have been expected, as is any interpretation of H I spin temperature measurements.Comment: 11 pages, 8 figures, accepted for A&

IL28B SNP screening and distribution in the French Canadian population using a rapid PCR-based test

Single nucleotide polymorphisms (SNPs) in the proximity of the interleukin-28B (IL28B) gene can predict spontaneous resolution of hepatitis C virus (HCV) infection and response to interferon therapy. Screening for this polymorphism has become part of the standard criteria for the management of HCV-infected patients, hence the need for a rapid, cost-effective screening method. Here, we describe a rapid PCR-based test to screen for two IL28B SNPs (rs12979860 and rs8099917). We used this test to investigate IL28B polymorphism and prevalence in a cohort of French Canadian injection drug users who are part of a unique population known to have a strong genetic founder effect. This population had lower linkage disequilibrium between the two tested SNPs as compared to other cohorts (|d′| = 0.68, r = 0.59). The special genetic makeup should be considered in the management of HCV-infected patients within that population

Achieving Stability of Lipopolysaccharide-Induced NF-κB Activation

The activation dynamics of the transcription factor NF-κB exhibit damped oscillatory behavior when cells are stimulated by tumor necrosis factor–α (TNFα) but stable behavior when stimulated by lipopolysaccharide (LPS). LPS binding to Toll-like receptor 4 (TLR4) causes activation of NF-κB that requires two downstream pathways, each of which when isolated exhibits damped oscillatory behavior. Computational modeling of the two TLR4-dependent signaling pathways suggests that one pathway requires a time delay to establish early anti-phase activation of NF-κB by the two pathways. The MyD88-independent pathway required Inferon regulatory factor 3–dependent expression of TNFα to activate NF-κB, and the time required for TNFα synthesis established the delay