592 research outputs found

    Hypertrophic scar therapy : pressure-induced remodelling and its determinents

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    Hypertrophic scars are cosmetically unattractive products of abnormal wound healing and, if they occur over flexor aspects of joints, considerable functional impairment often results. Pressure, as a therapy for hypertrophic- scarring has considerable attraction since it is effective and nonsurgical. Previous reports of this therapy have not quantified magnitudes or durations of pressure required to induce remodelling. Correlation of these parameters is necessary to define guidelines to optimise pressure therapy. Measurement of pressure applied to hypertrophic scars by garments with elastic properties was achieved using a monitoring system based on a thin (0.2mm) flat (1cm²) capacitive transducer. Pressures of 15 - 40mnmHg produced, in general, accelerated scar remodelling with superior cosmesis resulting from higher pressures. Clinical studies suggested that 6-9 months pressure is sufficient to induce permanent remodelling, although studies of rates of collagen biosynthesis in pressure-treated and untreated scars indicated 9- 12 months pressure was necessary. Two types of pressure applying garments, Tubigrip and Lycra, were studied and compared. Tubigrip garments demonstrated superior elastic properties for maintaining pressure with-time. Investigations of two hypotheses for pressure-induced remodelling were performed. A first hypothesis that pressure induces ischaemia in scars, implying remodelling by autolysis, was investigated with vital microscopy using a hamster cheek pouch model. Pressure magnitudes which induced scar remodelling did not disturb the microcirculation sufficiently to cause permanent damage, therefore this hypothesis was thought unlikely to be correct. A second hypothesis that pressure-induced vascular changes produce scar resorption via a collagen-based mechanism was investigated using a radioactive isotope assay of the rate of collagen biosynthesis. The time for which the rate of collagen biosynthesis approached normal scar levels was reduced by half in pressure-treated compared to untreated scars. A two-phase scar remodelling theory was introduced comprising a pressure-magnitude dependent phase followed by a time-dependent phase. The second hypothesis was thought to be partially correct and the complexity of the pressure-induced remodelling mechanism is discussed.Hypertrophic scars are cosmetically unattractive products of abnormal wound healing and, if they occur over flexor aspects of joints, considerable functional impairment often results. Pressure, as a therapy for hypertrophic- scarring has considerable attraction since it is effective and nonsurgical. Previous reports of this therapy have not quantified magnitudes or durations of pressure required to induce remodelling. Correlation of these parameters is necessary to define guidelines to optimise pressure therapy. Measurement of pressure applied to hypertrophic scars by garments with elastic properties was achieved using a monitoring system based on a thin (0.2mm) flat (1cm²) capacitive transducer. Pressures of 15 - 40mnmHg produced, in general, accelerated scar remodelling with superior cosmesis resulting from higher pressures. Clinical studies suggested that 6-9 months pressure is sufficient to induce permanent remodelling, although studies of rates of collagen biosynthesis in pressure-treated and untreated scars indicated 9- 12 months pressure was necessary. Two types of pressure applying garments, Tubigrip and Lycra, were studied and compared. Tubigrip garments demonstrated superior elastic properties for maintaining pressure with-time. Investigations of two hypotheses for pressure-induced remodelling were performed. A first hypothesis that pressure induces ischaemia in scars, implying remodelling by autolysis, was investigated with vital microscopy using a hamster cheek pouch model. Pressure magnitudes which induced scar remodelling did not disturb the microcirculation sufficiently to cause permanent damage, therefore this hypothesis was thought unlikely to be correct. A second hypothesis that pressure-induced vascular changes produce scar resorption via a collagen-based mechanism was investigated using a radioactive isotope assay of the rate of collagen biosynthesis. The time for which the rate of collagen biosynthesis approached normal scar levels was reduced by half in pressure-treated compared to untreated scars. A two-phase scar remodelling theory was introduced comprising a pressure-magnitude dependent phase followed by a time-dependent phase. The second hypothesis was thought to be partially correct and the complexity of the pressure-induced remodelling mechanism is discussed

    Neuropsychological and functional outcomes in recent-onset major depression, bipolar disorder and schizophrenia-spectrum disorders: a longitudinal cohort study

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    Functional disability is the lead contributor to burden of mental illness. Cognitive deficits frequently limit functional recovery, although whether changes in cognition and disability are longitudinally associated in recent-onset individuals remains unclear. Using a prospective, cohort design, 311 patients were recruited and assessed at baseline. One hundred and sixty-seven patients met eligibility criteria (M = 21.5 years old, s.d. = 4.8) and returned for follow-up (M = 20.6 months later, s.d. = 7.8). Two-hundred and thirty participants were included in the final analysis, comprising clinically stable patients with major depression (n = 71), bipolar disorder (BD; n = 61), schizophrenia-spectrum disorders (n = 35) and 63 healthy controls. Neuropsychological functioning and self-rated functional disability were examined using mixed-design, repeated-measures analysis, across diagnoses and cognitive clusters, covarying for relevant confounds. Clinical, neuropsychological and functional changes did not differ between diagnoses (all P40.05). Three reliable neuropsychological subgroups emerged through cluster analysis, characterized by psychomotor slowing, improved sustained attention, and improved verbal memory. Controlling for diagnosis and changes in residual symptoms, clusters with improved neuropsychological functioning observed greater reductions in functional disability than the psychomotor slowing cluster, which instead demonstrated a worsening in disability (Po0.01). Improved sustained attention was independently associated with greater likelihood of follow-up employment (Po0.01). Diagnosis of BD uniquely predicted both follow-up employment and independent living. Neuropsychological course appears to be independently predictive of subjective and objective functional outcomes. Importantly, cognitive phenotypes may reflect distinct pathophysiologies shared across major psychiatric conditions, and be ideal targets for personalized early intervention

    Age differences in the association between sleep and Alzheimer\u27s disease biomarkers in the EPAD cohort

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    INTRODUCTION: We aimed to determine the independent association between sleep quality and Alzheimer\u27s disease (AD) biomarkers, and whether the associations differ with age. METHODS: We included 1240 individuals aged ≥50, without dementia from the RESULTS: For the youngest age tertile, shorter sleep duration and higher sleep efficiency were associated with greater p-tau/Aβ42 ratio. For the oldest tertile, longer sleep latency was associated with greater p-tau/Aβ42. DISCUSSION: Differential relationships between sleep and AD pathology depend on age. Short sleep duration and sleep efficiency are relevant in middle age whereas time taken to fall asleep is more closely linked to AD biomarkers in later life. HIGHLIGHTS: This study shows age differences in the link between sleep and AD biomarkers.Shorter sleep was associated with greater p-tau/Aβ42 ratio in middle age.The association was independent of genetic, vascular, and neuroimaging markers of AD

    Crystallization and preliminary diffraction analysis of Wzi, a member of the capsule export and assembly pathway in Escherichia coli

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    Wzi is a membrane protein from E. coli thought to be involved in the attachment of capsular polysaccharides to the bacterial surface. This reports describes recombinant Wzi’s purification, crystallization and the results of initial diffraction studies

    A prospective evaluation of the predictive value of faecal calprotectin in quiescent Crohn’s disease

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    Background: The faecal calprotectin (FC) test is a non-invasive marker for gastrointestinal inflammation. Aim: To determine whether higher FC levels in individuals with quiescent Crohn’s disease are associated with clinical relapse over the ensuing 12 months.<p></p> Methods: A single centre prospective study was undertaken in Crohn's disease patients in clinical remission attending for routine review. The receiver operating characteristic (ROC) curve for the primary endpoint of clinical relapse by 12 months, based on FC at baseline, was calculated. Kaplan-Meier curves of time to relapse were based on the resulting optimal FC cutoff for predicting relapse.<p></p> Results: Of 97 patients recruited, 92 were either followed up for 12 months without relapsing, or reached the primary endpoint within that period. Of these, 10 (11%) had relapsed by 12 months. The median FC was lower for non-relapsers, 96µg/g (IQR 39-237), than for relapsers, 414µg/g (IQR 259-590), (p=0.005). The area under the ROC curve to predict relapse using FC was 77.4%. An optimal cutoff FC value of 240µg/g to predict relapse of quiescent Crohn’s had sensitivity of 80.0% and specificity of 74.4%. Negative predictive value was 96.8% and positive predictive value was 27.6%. FC≥240μg/g was associated with likelihood of relapse 5.7 (95% CI 1.9-17.3) times higher within 2.3 years than lower values (p=0.002).<p></p> Conclusions: In this prospective dataset, FC appears to be a useful, non-invasive tool to help identify quiescent Crohn’s disease patients at a low risk of relapse over the ensuing 12 months. FC of 240µg/g was the optimal cutoff in this cohort.<p></p&gt

    Using TanDEM-X to measure pyroclastic flow source location, thickness and volume: Application to the 3rd June 2018 eruption of Fuego volcano, Guatemala

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    The estimation of the volume of volcanic flows during an ongoing eruption is challenging but this information is crucial for improving risk assessment and for forecasting future events. Although previous studies have shown the ability of TanDEM-X satellite data to derive the thickness and the volume of lava flow fields during effusive eruptions, the method has not been explored yet for pyroclastic flows. Using bi-static interferometry, we produce TanDEM-X DEM on Fuego volcano (Guatemala) to measure the significant topographic changes caused by the 3rd June 2018 eruption, which destroyed the town of San Miguel Los Lotes. We estimate the volume of the Pyroclastic Density Currents (PDCs) to be 15.1 ± 4.2 × 106 m3. The deposits are likely to be the source of lahars during future rainy seasons. We identify the main channel of deposition (positive elevation changes) and the source region of pyroclastic material, areas of significant substrate erosion, and vegetation destruction (negative elevation changes). Our results show that the June 3rd 2018 pyroclastic flow was predominantly composed of material which had gravitationally collapsed from a location close to the vent. The eroded material increased the volume of the flow (bulking) and likely caused the run-out distance of the 2018 PDC to be larger than previous eruptions (1999–2017). This study highlights the potential of remote sensing techniques for actively monitoring topography changes in inaccessible locations and to rapidly derive deposit volumes

    Bacterial mechanosensitive channels : progress towards an understanding of their roles in cell physiology

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    Open Access funded by Wellcome Trust Under a Creative Commons license Thanks to all members of the Aberdeen group, collaborators and friends whose discussions have spurred the development of the MS channel field. Special thanks to Doug Rees, Diane Newman and Rob Phillips for their support and hospitality at Caltech. Unique insights have been provided by members of the Newman and Phillips research groups, particularly, Caj Neubauer, Gargi Kulkarni and Megan Bergkessel, Heun Jin Lee and Maja Bialecka-Fornal. The author's research on MS channels is supported by a grant from The Wellcome Trust (WT092552MA) and the BBSRC (BB/H017917/1). The author is a Leverhulme Emeritus Fellow and this work was supported in part by a CEMI Visiting Faculty Fellowship from Caltech.Peer reviewedPublisher PD
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