Clinical applicability of quantitative nailfold capillaroscopy in differential diagnosis of connective tissue diseases with Raynaud's phenomenon

Background/PurposeNailfold capillaroscopy is a useful tool to distinguish primary from secondary Raynaud's phenomenon (RP) by examining the morphology of nailfold capillaries but its role in disease diagnosis is not clearly established. The purpose of this study was to evaluate the roles of quantitative nailfold capillaroscopy in differential diagnosis of connective tissue diseases (CTDs) with RP.MethodsThe data between the year 2005 and 2009 were retrieved from the nailfold capillaroscopic database of National Taiwan University Hospital (NTUH). Only the data from the patients with RP were analyzed. The criteria for interpretation of capillaroscopic findings were predefined. The final diagnoses of the patients were based on the American College of Rheumatology classification criteria for individual diseases, independent of nailfold capillaroscopic findings. The sensitivity and the specificity of each capillaroscopic pattern to the diseases were determined.ResultsThe data from a total of 67 patients were qualified for the current study. We found the sensitivity and specificity of scleroderma pattern for systemic sclerosis (SSc) were 89.47% and 80%, and the specificity of the early, active, and late scleroderma patterns for SSc reached 87.5%, 97.5%, and 95%, respectively. The sensitivity/specificity of systemic lupus erythematosus (SLE) pattern for SLE and polymyositis/dermatomyositis (PM/DM) pattern for PM/DM were 33.33%/95.45% and 60%/96.3%, respectively. The sensitivity/specificity of mixed connective tissue disease (MCTD) pattern for MCTD were 20%/100%.ConclusionThe nailfold capillaroscopic (NC) patterns may be useful in the differential diagnosis of CTDs with RP. The NC patterns for SSc and PM/DM are both sensitive and specific to the diseases, while the SLE and MCTD patterns exhibit high specificity but relatively low sensitivity

A multiscale picture of the magnetic field and gravity from a large-scale filamentary envelope to core-accreting dust lanes in the high-mass star-forming Region W51

We present 230 GHz continuum polarization observations with the Atacama Large Millimeter/Submillimeter Array at a resolution of 0.″1 (∼540 au) in the high-mass star-forming regions W51 e2 and e8. These observations resolve a network of core-connecting dust lanes, marking a departure from earlier coarser, more spherical continuum structures. At the same time, the cores do not appear to fragment further. Polarized dust emission is clearly detected. The inferred magnetic field orientations are prevailingly parallel to dust lanes. This key structural feature is analyzed together with the local gravitational vector field. The direction of local gravity is found to typically align with dust lanes. With these findings, we derive a stability criterion that defines a maximum magnetic field strength that can be overcome by an observed magnetic field–gravity configuration. Equivalently, this defines a minimum field strength that can stabilize dust lanes against a radial collapse. We find that the detected dust lanes in W51 e2 and e8 are stable, hence possibly making them a fundamental component in the accretion onto central sources, providing support for massive star formation models without the need of large accretion disks. When comparing to coarser resolutions, covering the scales of envelope, global, and local collapse, we find recurring similarities in the magnetic field structures and their corresponding gravitational vector fields. These self-similar structures point at a multiscale collapse-within-collapse scenario until finally the scale of core-accreting dust lanes is reached where gravity is entraining the magnetic field and aligning it with the dust lanes

Milky Way Supermassive Black Hole: Dynamical Feeding from the Circumnuclear Environment

The supermassive black hole (SMBH), Sgr A*, at the Galactic Center is surrounded by a molecular circumnuclear disk (CND) lying between 1.5-4 pc radii. The irregular and clumpy structures of the CND, suggest dynamical evolution and episodic feeding of gas towards the central SMBH. New sensitive data from the SMA and GBT, reveal several >5-10 pc scale molecular arms, which either directly connect to the CND, or may penetrate inside the CND. The CND appears to be the convergence of the innermost parts of largescale gas streamers, which are responding to the central gravitational potential well. Rather than being a quasi-stationary structure, the CND may be dynamically evolving, incorporating inflow via streamers, and feeding gas towards the center.Comment: 9 pages, 7 figures, accepted to Ap

Women with endometriosis have higher comorbidities: Analysis of domestic data in Taiwan

AbstractEndometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases. Concerning malignant tumors, we identified four studies on the links between endometriosis and ovarian cancer, one on breast cancer, two on endometrial cancer, one on colorectal cancer, and one on other malignancies, as well as one on associations between endometriosis and irritable bowel syndrome, one on links with migraine headache, three on links with pelvic inflammatory diseases, four on links with infertility, four on links with obesity, four on links with chronic liver disease, four on links with rheumatoid arthritis, four on links with chronic renal disease, five on links with diabetes mellitus, and five on links with cardiovascular diseases (hypertension, hyperlipidemia, etc.). The data available to date support that women with endometriosis might be at risk of some chronic illnesses and certain malignancies, although we consider the evidence for some comorbidities to be of low quality, for example, the association between colon cancer and adenomyosis/endometriosis. We still believe that the risk of comorbidity might be higher in women with endometriosis than that we supposed before. More research is needed to determine whether women with endometriosis are really at risk of these comorbidities

A Study on Location-Based Priority of Soil and Groundwater Pollution Remediation

Under the circumstances of limited government funds, the future pollution remediation policies and practical implementation may need contemplation from the perspective of maximized efficacy, in order to pursue the most effective resource allocation. In fact, different pollution sources and types affect the value of surrounding properties differently in significance and scope. Therefore, benefits from the remediation may vary depending on the polluted locations. Currently, however, decision-making on the location-based priority of pollution remediation still seems to be in need of a clear index system to evaluate the post-remediation benefits. Therefore, this article discusses the use of the fuzzy Delphi method to determine factors of the location-based priority of soil and groundwater pollution remediation and an analytic network process to determine the weights of each factor. The empirical results show that the top 3 priority indicators are resident population, land value and natural resources. Hopefully, this finding can be used in future decision-making on the priority of pollution remediation to maximize the effect of limited funds

Molecular Engineering of Push-Pull Porphyrin Dyes for Highly Efficient Dye-Sensitized Solar Cells: The Role of Benzene Spacers

Porphyrins have drawn much attention as sensitizers owing to the large absorption coefficients of their Soret and Q bands in the visible region. In a donor and acceptor zinc porphyrin we applied a new strategy of introducing 2,1,3-benzothiadiazole (BTD) as a π-conjugated linker between the anchoring group and the porphyrin chromophore to broaden the absorption spectra to fill the valley between the Soret and Q bands. With this novel approach, we observed 12.75% power-conversion efficiency under simulated one-sun illumination (AM1.5G, 100 mW cm(-2)). In this study, we showed the importance of introducing the phenyl group as a spacer between the BTD and the zinc porphyrin in achieving high power-conversion efficiencies. Time-resolved fluorescence, transient-photocurrent-decay, and transient-photovoltage-decay measurements were employed to determine the electron-injection dynamics and the lifetime of the photogenerated charge carriers