Electromagnetic Simulation of Non-Invasive Approach for the Diagnosis of Diabetic Foot Ulcers

Diabetic foot ulcers are systemic diseases that affect all blood vessels within the human body. From major blood vessels to microvasculature, hardening, thickening, and narrowing of blood vessels ultimately results to diminished blood flow to end organs. The detrimental effects of peripheral vascular disease are well recognized across medicine, particularly with regards to diabetic foot ulcers. Diabetic foot ulcers (DFU) are common across all fields of medicine, including but not limited to: orthopedics, vascular surgery, podiatry, general internal medicine, and infectious disease. As the population of the United States continues to grow in age and obesity, diabetes and DFU are becoming more and more prevalent in our medical society. Current approaches to diagnosing peripheral vascular disease ultimately result in some degree of invasiveness for the patient. Preliminary lab studies, such as the ankle-brachial index and Doppler ultrasound of peripheral arteries, provide efficient safe screening methods. However, these studies lack quantification of the degree of vascular stenosis and are unable to accurately assess the location of narrowing. In current practice, radiologists are called upon to for angiography of the blood vessels using contrast dye. This provides an additional risk for diabetic patients: a population inherently at risk for renal disease. In this study, we proposed utilizing electromagnetic simulation with boundary conditions set at various layers of human tissues. More specifically, the human foot was analyzed using COMSOL multi-physics software in attempt to visualize, analyze, and quantify the degree of peripheral vascular disease, which plays a pivotal role in the development of diabetic foot ulcers. The simulation was conducted for a patient’s foot, with bone, blood vessels, and surrounding fat layers to emulate the anatomy of a diabetic foot. A 2-D scan was obtained to assess and visualize the blood vessel’s narrowing, widening, vascular turbulence, or occlusion. The analysis was conducted at two frequencies, 2 GHz and 5 GHz, and compared to one another to assess the accuracy of clinical diagnosis. An electric field was generated throughout the 2D model at 20, 50, and 100 Joules, respectively. The simulation was able to adequately predict and stratify varying degrees of occlusion within peripheral vasculature. This study, though a simulation in nature, shows promise for being able to accurately diagnose the peripheral vasculature using electromagnetic parameters. This feasibility study proved successful for possible future implementation using MEMS/NEMS device systems to be designed to detect EM parameters to serve as a diagnostic tool for the early detection of peripheral vascular disease, and ultimately, diabetic foot ulcers

Symmetric Lipofibromatous Hamartoma Affecting Digital Nerves

Lipofibromatous hamartoma of the nerve is a benign tumor, which affects the major nerves and their branches in the human body. It is often found in the median nerve of the hand and is commonly associated with macrodactyly, but it is rarely found in the digital nerves at the peripheral level. This tumor is often found in young adults and may go through a self-limiting course. However, operation is indicated when the tumor size is large or when the associated nerve compressive symptoms are present. We have experienced a rare case of lipofibromatous hamartoma that symmetrically involved the volar digital nerves of both index fingers on the ulnar side. With the aid of a microscope, we dissected and removed the tumor as much as possible without sacrificing the nerve. No sensory change occurred in both fingers and no sign of recurrence was observed upon follow-up

Myocardial atrophy in children with mitochondrial disease and Duchenne muscular dystrophy

PurposeMitochondrial disease (MD) and Duchenne muscular dystrophy (DMD) are often associated with cardiomyopathy, but the myocardial variability has not been isolated to a specific characteristic. We evaluated the left ventricular (LV) mass by echocardiography to identify the general distribution and functional changes of the myocardium in patients with MD or DMD.MethodsWe retrospectively evaluated the echocardiographic data of 90 children with MD and 42 with DMD. Using two-dimensional echocardiography, including time-motion (M) mode and Doppler measurements, we estimated the LV mass, ratio of early to late mitral filling velocities (E/A), ratio of early mitral filling velocity to early diastolic mitral annular velocity (E/Ea), stroke volume, and cardiac output. A "z score" was generated using the lambda-mu-sigma method to standardize the LV mass with respect to body size.ResultsThe LV mass-for-height z scores were significantly below normal in children with MD (-1.02±1.52, P<0.001) or DMD (-0.82±1.61, P=0.002), as were the LV mass-for-lean body-mass z scores. The body mass index (BMI)-for-age z scores were far below normal and were directly proportional to the LV mass-for-height z scores in both patients with MD (R=0.377, P<0.001) and those with DMD (R=0.330, P=0.033). The LV mass-for-height z score correlated positively with the stroke volume index (R=0.462, P<0.001) and cardiac index (R=0.358, P<0.001).ConclusionLV myocardial atrophy is present in patients with MD and those with DMD and may be closely associated with low BMI. The insufficient LV mass for body size might indicate deterioration of systolic function in these patients

In situ electrochemically synthesized Pt-MoO3-x nanostructure catalysts for efficient hydrogen evolution reaction

Designing and preparing highly active and stable nanostructured Pt-based catalysts with ultralow Pt loading are still challenging for electrochemical applications such as water electrolysis and fuel cells. Here we report for the first time an in situ electrochemical process to synthesize Pt-MoO3-x nanoflakes (NFs) overgrown on commercial bulk MoS2 by employing a facile and simple electrochemical method without using any expensive precious metal salts. The overgrowth of Pt-MoO3-x NFs on the bulk MoS2 surface is conducted by applying electrical energy to the bulkMoS(2) and using Pt counter electrode dissolution in an acidic solution. In spite of their 10 times lower Pt loadings compared to commercial Pt black (Alfa Aesar), the synthesized Pt-MoO3-x NFs demonstrate excellent catalytic performance with a Ptmass activity of 2.83 A/mg(Pt) at the overpotential of 100 mV for electrochemical hydrogen evolution reaction (HER), an approximately 4 times higher value than the value of 0.76 A/mg(Pt) at the overpotential of 100 mVfor commercial Pt black. We hypothesize that the outstanding HER characteristics of Pt-MoO3-x NFs are related to the existence and increase of Pt-MoO3 interfacial sites and oxygen vacancy sites such as Mo5+ in the Pt-MoO3-x NF structures. In addition, our density functional theory (DFT) calculations demonstrate that Pt and O sites at Pt and MoO3 interfaces and O sites at defective MoO3-x in the Pt-MoO3-x NFs contribute to accelerate the HER. (C) 2019 Elsevier Inc. All rights reserved

Correction to: Comprehensive proteome and phosphoproteome profiling shows negligible influence of RNAlater on protein abundance and phosphorylation

In the version of this article that was originally published [1], some information in the Acknowledgements section was omitted.This study was supported by the Collaborative Genome Program for Fostering New Post-Genome Industry (NRF-2017M3C9A5031397) and the Brain Research Program (Grant No. NRF-2017M3C7A1027472) through the National Research Foundation (NRF) funded by the Ministry of Science and ICT (MSIT) of Republic of Korea. This work was also supported by the National Research Foundation of Korea (NRF) Grant funded by the Korea government (MSIT) (No. 2019R1C1C1006262). The Biospecimens and data used in this study were provided by the Biobank of Seoul National University Hospital, a member of Korea Biobank Network (SNUH2017-0021)

Spermidine-induced recovery of human dermal structure and barrier function by skin microbiome.

An unbalanced microbial ecosystem on the human skin is closely related to skin diseases and has been associated with inflammation and immune responses. However, little is known about the role of the skin microbiome on skin aging. Here, we report that the Streptococcus species improved the skin structure and barrier function, thereby contributing to anti-aging. Metagenomic analyses showed the abundance of Streptococcus in younger individuals or those having more elastic skin. Particularly, we isolated Streptococcus pneumoniae, Streptococcus infantis, and Streptococcus thermophilus from face of young individuals. Treatment with secretions of S. pneumoniae and S. infantis induced the expression of genes associated with the formation of skin structure and the skin barrier function in human skin cells. The application of culture supernatant including Streptococcal secretions on human skin showed marked improvements on skin phenotypes such as elasticity, hydration, and desquamation. Gene Ontology analysis revealed overlaps in spermidine biosynthetic and glycogen biosynthetic processes. Streptococcus-secreted spermidine contributed to the recovery of skin structure and barrier function through the upregulation of collagen and lipid synthesis in aged cells. Overall, our data suggest the role of skin microbiome into anti-aging and clinical applications

Defective Localization With Impaired Tumor Cytotoxicity Contributes to the Immune Escape of NK Cells in Pancreatic Cancer Patients

Tumor-infiltrating lymphocytes (TILs), found in patients with advanced pancreatic ductal adenocarcinoma (PDAC), are shown to correlate with overall survival (OS) rate. Although majority of TILs consist of CD8+/CD4+ T cells, the presence of NK cells and their role in the pathogenesis of PDAC remains elusive. We performed comprehensive analyses of TIL, PBMC, and autologous tumor cells from 80 enrolled resectable PDAC patients to comprehend the NK cell defects within PDAC. Extremely low frequencies of NK cells (&lt;0.5%) were found within PDAC tumors, which was attributable not to the low expression of tumor chemokines, but to the lack of chemokine receptor, CXCR2. Forced expression of CXCR2 in patients' NK cells rendered them capable of trafficking into PDAC. Furthermore, NK cells exhibited impaired cell-mediated killing of autologous PDAC cells, primarily due to insufficient ligation of NKG2D and DNAM-1, and failed to proliferate within the hypoxic tumor microenvironment. Importantly, these defects could be overcome by ex-vivo stimulation of NK cells from such patients. Importantly, when the proliferative capacity of NK cells in vitro was used to stratify patients on the basis of cell expansion, patients whose NK cells proliferated &lt;250-fold experienced significantly lower DFS and OS than those with ≥250-fold. Ex-vivo activation of NK cells restored tumor trafficking and reactivity, hence provided a therapeutic modality while their fold expansion could be a potentially significant prognostic indicator of OS and DFS in such patients

Predictive value of baseline serum carbohydrate antigen 19-9 level on treatment effect of neoadjuvant chemoradiotherapy in patients with resectable and borderline resectable pancreatic cancer in two randomized trials

BACKGROUND: Guidelines suggest that the serum carbohydrate antigen (CA19-9) level should be used when deciding on neoadjuvant treatment in patients with resectable and borderline resectable pancreatic ductal adenocarcinoma (hereafter referred to as pancreatic cancer). In patients with resectable pancreatic cancer, neoadjuvant therapy is advised when the CA19-9 level is 'markedly elevated'. This study investigated the impact of baseline CA19-9 concentration on the treatment effect of neoadjuvant chemoradiotherapy (CRT) in patients with resectable and borderline resectable pancreatic cancers.METHODS: In this post hoc analysis, data were obtained from two RCTs that compared neoadjuvant CRT with upfront surgery in patients with resectable and borderline resectable pancreatic cancers. The effect of neoadjuvant treatment on overall survival was compared between patients with a serum CA19-9 level above or below 500 units/ml using the interaction test.RESULTS: Of 296 patients, 179 were eligible for analysis, 90 in the neoadjuvant CRT group and 89 in the upfront surgery group. Neoadjuvant CRT was associated with superior overall survival (HR 0.67, 95 per cent c.i. 0.48 to 0.94; P = 0.019). Among 127 patients (70, 9 per cent) with a low CA19-9 level, median overall survival was 23.5 months with neoadjuvant CRT and 16.3 months with upfront surgery (HR 0.63, 0.42 to 0.93). For 52 patients (29 per cent) with a high CA19-9 level, median overall survival was 15.5 months with neoadjuvant CRT and 12.9 months with upfront surgery (HR 0.82, 0.45 to 1.49). The interaction test for CA19-9 level exceeding 500 units/ml on the treatment effect of neoadjuvant CRT was not significant (P = 0.501).CONCLUSION: Baseline serum CA19-9 level defined as either high or low has prognostic value, but was not associated with the treatment effect of neoadjuvant CRT in patients with resectable and borderline resectable pancreatic cancers, in contrast with current guideline advice.</p

Probabilistic Modeling and Verification of Large Scale Systems

Large scale networked embedded systems are becoming increaingly popular with the technology advances in wireless network, energy efficient hardware, and cost effective manufacturing. Parameter tuning of such large scale systems has a significant effect on the performance metrics such as reliability, availability, longevity, and energy consumption. The parameter tuning should be based on a performance evaluation which requires a model that closely represents the real system. In modeling a large scale system, an abstraction of the state space of the system is necessary in order to avoid the state explosion problem. Moreover, users not only, need an expressive and accurate way to describe the performance criteria in terms of the model, they also need a way to evaluate the performance criteria against the model. They can do such evaluation manually for certain well-known properties or they can explore unknown properties with the aid of computers. Many large scale systems have a stochastic behavior. Such stochastic behavior is the result of the randomness in the systems' operating environments. It can also be the result of the use of randomized protocols that are used to reduce the need for costly synchronization. We abstract a system state as a probability mass function (pmf); a pmf is succinct in representation and is informative enough to describe many useful aggregate behaviors of the system. We model the dynamics of the state transitions as a Discrete Time Markov Chain (DTMC) and develop an on-line model estimation method as well as a goodness of fit test that statistically validates the model. We develop a probabilistic temporal logic called iLTL in order to specify aggregate behaviors of large scale systems. Many important performance criteria on DTMC models can be accurately expressed in iLTL. For the iLTL specifications, performance evaluation is systematically performed through a process of model checking. If a performance criterion is not satisfiable, the model checker returns a sequence of computations that violates the specification in order to help users fix the problem. We show the usefulness of our methodology through an experiment with a wireless sensor network of 90 nodes