Search

Cannabis is among the most used recreational and medicinal drugs in the United States. The effects of chronic use on hypertension remain poorly understood. Our study retrospectively evaluated data collected by the National Health and Nutrition Examination Survey from 2017 to 2018. Cannabis use was measured with five metrics: (1) sustained use at any point in the past, (2) sustained use within the past year, (3) frequency of use, (4) age of first cannabis use, and (5) current use. Hypertension status was determined by individuals reporting having been diagnosed in the past. Multivariable logistic regressions were performed, controlling for age, race, and gender. A total of 4565 respondents were identified, of which 867 (19.0%) reported sustained cannabis use in the past. Participants who reported past sustained cannabis use did not have statistically different odds of having hypertension (OR: 1.12; 95% CI: .66-1.91; p = .6). Moderate (OR: 1.08; 95% CI: .36-3.25; p = .8) and highly-frequent users (OR: 1.30; 95% CI: .56-3.03; p = .4) did not have different odds of having hypertension than infrequent users. No relationship between the age of first cannabis use and hypertension was observed. The recency of sustained cannabis use was not associated with hypertension status. Current cannabis users had similar odds of hypertension as past users (OR: 1.03; 95% CI: .59-1.79; p = .9). The findings of this study indicate that neither past nor current cannabis use is associated with clinical hypertension.

Sunscreen use is an important modifiable behavior to protect against skin cancer, photoaging, and sunburn. Product costs and characteristics may influence accessibility and usage of sunscreen. This study aims to determine preferences for sunscreen attributes and willingness to pay (WTP) for an ideal sunscreen product.Adult volunteers 18 years or older were contacted on ResearchMatch. Of 670 responses, 489 surveys were completed and 2 were excluded based on the inclusion criterion. Online survey responses were collected in REDCap from July-September 2019. The online survey queried sunscreen attribute preferences and then respondent preferences were compiled into individualized descriptions of ideal products. Respondents were then asked to make purchasing decisions on these products. WTP was determined by analyzing product attributes and purchasing decisions. Attribute preferences were reported as numerical ratings of Importance and Desirability. WTP was calculated by linear regression of purchasing decision data. Qualitative comments about sunscreen preferences were also collected.The study involved 487 participants aged 18-85 years (mean 43.6, SD 15.7) and 84.4% (N = 411) female. The most popular attributes included complete prevention of skin cancer and sunburn. WTP for an ideal product was $30.10 ± 2.11 for one month of use.Consumers provide high values in WTP for sunscreen. Dermatologists should consider cost and variability in attribute preferences when recommending sunscreens to patients. Further study is required to determine the effects, if any, of cost and attributes on adherence to sunscreen use in specific populations.

The skin barrier is essential for protection against allergens, irritants, and pathogens and is intimately involved in a variety of inflammatory conditions. As such, approaches to treating these inflammatory skin conditions could involve the repair and protection of the skin barrier. This form of treatment can be delivered in the form of skin protectants, though their protective value remains questionable. Evidence suggests that skin protectants could form an additional layer of protection against harmful substances that could penetrate the skin barrier. However, although several studies support the efficacy of skin protectants, others suggest potentially aggravating effects instead. The range of active ingredients included in skin protectant formulas varies widely, which could account for these observed differences. While the use of skin protectants could prove beneficial in populations at higher risk of exposure to irritants, their effectiveness may be hindered by a lack of proper adherence. The findings gathered from the existing literature on skin protectants appear promising, though further investigation must be conducted to better understand their protective effects against conventional barrier repair approaches. J Drugs Dermatol. 2022;21(9):977-982. doi:10.36849/JDD.6705.

Summary: Background: The rate of carotid plaque progression is believed to be related to blood flow hemodynamics and shear stress. Our objective was to determine if wall shear rate (WSR) and the energy loss coefficient (ELC) measured by Doppler ultrasound could predict atherosclerotic carotid disease progression. Patients and methods: Patients at a large tertiary center with an initial ultrasound between 2016 and 2018 with a significant carotid plaque were included if they had at least one 6 months follow-up comparative study. Stenosis progression was assessed according to the NASCET (The North American Symptomatic Carotid Endarterectomy Trial) percentage criterion. Results: The average annual progression rate for the 74 plaques included was 5.7% NASCET per year. We identified 18 plaques with ≥10% NASCET progression and 56 plaques without significant progression −1 [5813–8974] in plaques with progression and 6564 s−1 [5285–8766] in stable plaques (p=0.643). Median ELC was 3.86 m2 [2.78–5.53] in plaque with progression and 4.32 m2 [3.42–6.81] in stable plaques (p=0.296). Conclusions: Although it is a widely accepted hypothesis that shear stress and hemodynamics of the carotid bifurcation contribute to plaque progression, we found that WSR and ELC estimated by Doppler ultrasound do not reliably predict atherosclerotic plaque progression in the carotid artery. Other ultrasound modalities, such as 3D imaging, may be used to assess the influence of plaque geometry and hemodynamics in plaque progression.

Real time PCR (RT-PCR) detection method is the widely used for COVID-19 virus detection. This includes sample collection in viral transport medium (VTM), viral RNA extraction followed by detection of virus using fluorescence dye-based system using RT-PCR machine. Several studies have demonstrated a new method which replaces the extraction step by a simple method involving DTT and Proteinase-K and heat treatment. ICMR and few other governing bodies have approved such protocols but are they appropriate in clinical context? In present study, we tried to evaluate one such protocol by using ICMR and WHO approved COVID-19 detection protocol (of CoviPath™ COVID-19 RT-PCR Kit) by replacing RNA extraction step. We used 228 clinical COVID-19 samples for studying method which includes 176 positive (CT values from 14 to 23; 24 to 31 and 32 to 37 were considered as high, moderate and low positive respectively) and 52 negative nasopharyngeal and oropharyngeal swabs samples. We got 100% concordant results with negative samples and 92% concordant and 8% non-concordant results for positive samples. Non-concordant results are with low positive samples. Low level of positivity in the samples could indicate the initial/end stage of COVID-19 disease. If they are at the initial stage, they can be the potential carrier and spread the disease. Authors believe that direct methods can be used for screening bit not for diagnosis of COVID-19 disease.

Purpose Sonodynamic therapy (SDT) is emerging as a cancer treatment alternative with significant advantages over conventional therapies, including its minimally invasive and site-specific nature, its radical antitumour efficacy with minimal side effects, and its capacity to raise an antitumour immune response. The study explores the efficacy of SDT in combination with nanotechnology against pancreatic ductal adenocarcinoma. Methods A nanoparticulate formulation (HPNP) based on a cathepsin B-degradable glutamate-tyrosine co-polymer that carries hematoporphyrin was used in this study for the SDT-based treatment of PDAC. Cathepsin B levels in BxPC-3 and PANC-1 cells were correlated to cellular uptake of HPNP. The HPNP efficiency to induce a sonodynamic effect at varying ultrasound parameters, and at different oxygenation and pH conditions, was investigated. The biodistribution, tumour accumulation profile, and antitumour efficacy of HPNP in SDT were examined in immunocompetent mice carrying bilateral ectopic murine pancreatic tumours. The immune response profile of excised tumour tissues was also examined. Results The HPNP formulation significantly improved cellular uptake of hematoporphyrin for both BxPC-3 and PANC-1 cells, while increase of cellular uptake was positively correlated in PANC-1 cells. There was a clear SDT-induced cytotoxicity at the ultrasound conditions tested, and the treatment impaired the capacity of both BxPC-3 and PANC-1 cells to form colonies. The overall acoustic energy and pulse length, rather than the power density, were key in eliciting the effects observed in vitro. The SDT treatment in combination with HPNP resulted in 21% and 27% reduction of the target and off-target tumour volumes, respectively, within 24 h. A single SDT treatment elicited an antitumour effect that was characterized by an SDT-induced decrease in immunosuppressive T cell phenotypes. Conclusion SDT has significant potential to serve as a monotherapy or adjunctive treatment for inoperable or borderline resectable PDAC.

Hidradenitis suppurativa (HS) is a multifactorial inflammatory disorder. Previous studies have ascertained an association between anemia and HS; however, they were limited by low sample size and lack of demographic information. The objective of this study is to address the concerns of prior research and identify specific subgroups and subtypes of anemia present in HS patients and evaluate how these subgroups impact hospital outcomes. We analyzed HS hospitalizations using the National Inpatient Sample from the years 2016 to 2019. HS was associated with the nutritional anemia, aplastic anemia, and acute posthemorrhagic anemia subgroups. Within these subgroups, HS was specifically associated with iron deficiency anemia, anemia of chronic disease, and other anemia subtypes. HS patients also displayed a lower risk of having aplastic anemia, also described as anemia from bone marrow failure. Our findings build upon previous studies evaluating HS and anemia and provide a clearer understanding of the association as well as how it impacts inpatient outcomes.

The field of bioelectronics leverages the optoelectronic properties of synthetic materials to interface with living systems. These applications require materials that are conductive, aqueous processible, biocompatible, and can be chemically modified for biofunctionalization. While conjugated polymers and polyelectrolytes have been reported that demonstrate several of these features, materials that offer each of these properties simultaneously are rare. Here, we developed copolymers of anionic polyelectrolyte poly(4-(2,3-dihydro-thieno[3,4-b][1,4]dioxin-2-ylmethoxy)-butane-1-sulfonic acid sodium salt (PEDOT-S), containing structural units with amine-reactive NHS-esters. The reported PEDOT-NHS copolymers demonstrate water-solubility and electrical conductivities similar to previously reported PEDOT-S, as well as the ability to bind important amine-rich biomaterials. Furthermore, the PEDOT-NHS copolymers were biocompatible and hemocompatible, and therefore show promise for next-generation bioelectronic and regenerative engineering applications.

BACKGROUND The objective of this observational study is to compare outcome of LTSR and LSR in terms of symptomatic relief and its complications. METHODS Forty patients were subjected to LTSR and LSR between January 2015 and January 2020. The surgical technique used was fixation of posterior rectal wall and mesorectum to the sacral promontory and presacral fascia with PDS suture with infiltration of sclerosant in between the sutures in LTSR, while in LSR posterolateral wall of rectum is sutured with sacral promontory with Prolene suture. RESULTS Postoperative hospital stay was 2-5 days in LSR, while 1-2 days in LTSR. One patient had recurrence in LTSR at 2 years, while no recurrence in LSR on 2-5 years follow up. Symptomatic relief was 25-100% in LSR, while it was >75% in LTSR. CONCLUSIONS LTSR is a simple, low cost technique with less morbidity, less hospital stay, greater improvement in post-operative symptoms in the patients of rectal prolapse, thus changing the trend from laparoscopic to minimal invasive natural orifice procedure.

Let G \mathbf {G} be the General Linear or Special Linear group with entries from the finite quotients of the ring of integers of a non-archimedean local field and U \mathbf {U} be the subgroup of G \mathbf {G} consisting of upper triangular unipotent matrices. We prove that the induced representation Ind U G ⁡ ( θ ) \operatorname {Ind}^{\mathbf {G}}_{\mathbf {U}}(\theta ) of G \mathbf {G} obtained from a non-degenerate character θ \theta of U \mathbf {U} is multiplicity free for all ℓ ≥ 2. \ell \geq 2. This is analogous to the multiplicity one theorem regarding Gelfand-Graev representation for the finite Chevalley groups. We prove that for many cases the regular representations of G \mathbf {G} are characterized by the property that these are the constituents of the induced representation Ind U G ⁡ ( θ ) \operatorname {Ind}^{\mathbf {G}}_{\mathbf {U}}(\theta ) for some non-degenerate character θ \theta of U \mathbf {U} . We use this to prove that the restriction of a regular representation of General Linear groups to the Special Linear groups is multiplicity free and also obtain the corresponding branching rules in many cases.

We describe a rare occurrence of unilateral vocal fold paralysis associated with a cervical osteophyte abutting the course of the recurrent laryngeal nerve. Trans-nasal laryngoscopy is vital in diagnosing vocal fold paralysis, but often does not provide insight into etiology. This case highlights the importance of radiographic imaging in newly diagnosed vocal fold paralysis, and underscores the principle that a diagnosis is not idiopathic until all sources have been ruled out.

The American College of Obstetricians and Gynecologists recommends that women exercise throughout pregnancy unless they have a condition-related contraindication. This study’s purpose was to determine if pregnant women perceive receiving exercise counseling by their providers with details of frequency, intensity, type, and time (FITT principle). Women in 2 postpartum care units of a large health care system were invited to complete a voluntary, anonymous survey regarding whether they received exercise counseling during their prenatal care. Survey results were descriptively reported, stratified by demographic variables, and analyzed using Fisher’s exact tests. Of 224 postpartum women surveyed, 130 (58.0%) perceived receiving exercise counseling during pregnancy; 119 (91.5%) did not recall receiving counseling on exercise frequency. Though 165 (73.6%) exercised before becoming pregnant, 64 (38.8%) ceased exercise during pregnancy. Eighty-eight (39.3%) received advice from other sources/non–health care professionals. Privately insured women reported receiving exercise counseling at a higher rate (70.1%) than those on Medicaid (44.8%) or uninsured (40.0%; P = .004). A disproportionate number of pregnant women perceived not receiving adequate prenatal exercise counseling or received incomplete counseling. Women at a socioeconomic disadvantage may be vulnerable. As social determinants of health, structural barriers, and socioeconomic status likely contribute, women may benefit from more targeted inclusive and equitable messaging.

BACKGROUND Rectal prolapse is the protrusion of full thickness rectal wall through the anal canal. Historically it affects women more often than men, at a ratio of 6:1. 1 Patients with rectal prolapse suffer from anal incontinence, constipation, mucous or blood discharge from the protruding tissue and pain. This study analysed the results of LTSR (Laparoscopic Trans Anal Suture Rectopexy), its complications and benefits. METHODS Twenty patients were subjected to LTSR between July 2017 and June 2019. The surgical technique used was LTSR, where the posterior rectal wall and mesorectum were fixed to the sacral promontory and presacral fascia with PDS suture. RESULTS Postoperative hospital stay was 2 days. One patient had intraoperative hematoma, which was treated with local compression and antibiotics. One patient had recurrence. One patient developed difficulty in micturition. No death occurred. CONCLUSIONS LTSR is a simple, low cost technique, which has shown good efficacy in rectal prolapse control.

Background Melanoma is attributable to predisposing phenotypical factors, such as skin that easily sunburns and unprotected exposure to carcinogenic UV radiation. Reducing the proportion of young adults who get sunburned may reduce the incidence of melanoma, a deadly form of skin cancer. Advances in technology have enabled the delivery of real-time UV light exposure and content-relevant health interventions. Objective This study aims to examine the feasibility of young adults performing the following tasks daily: wearing a UV dosimeter, receiving text messages and real-time UV-B doses on their smartphone, and responding to daily web-based surveys about sunburn and sun protection. Methods Young adults aged 18-39 years (n=42) were recruited in the United States in June 2020 via social media. Participants received the UV Guard sun protection system, which consisted of a UV dosimeter and a smartphone app. During 3 consecutive periods, intervention intensity increased as follows: real-time UV-B dose; UV-B dose and daily behavioral facilitation text messages; and UV-B dose, goal setting, and daily text messages to support self-efficacy and self-regulation. Data were self-reported through daily web-based surveys for 28 days, and UV-B doses were transmitted to cloud-based storage. Results Patients’ median age was 22 years (IQR 20, 29), and all patients had sun-sensitive skin. Sunburns were experienced during the study by fewer subjects (n=18) than those in the preceding 28 days (n=30). In July and August, the face was the most commonly sunburned area among 13 body locations; 52% (22/42) of sunburns occurred before the study and 45% (19/42) occurred during the study. The mean daily UV-B dose decreased during the 3 periods; however, this was not statistically significant. Young adults were most often exercising outdoors from 2 to 6 PM, walking from 10 AM to 6 PM, and relaxing from noon to 2 PM. Sunburn was most often experienced during exercise (odds ratio [OR] 5.65, 95% CI 1.60-6.10) and relaxation (OR 3.69, 95% CI 1.03-4.67) relative to those that did not exercise or relax in each category. The self-reported exit survey indicated that participants felt that they spent less time outdoors this summer compared to the last summer because of the COVID-19 pandemic and work. In addition, 38% (16/42) of the participants changed their use of sun protection based on their app-reported UV exposure, and 48% (20/42) shifted the time they went outside to periods with less-intense UV exposure. A total of 79% (33/42) of the participants were willing to continue using the UV Guard system outside of a research setting. Conclusions In this proof-of-concept research, young adults demonstrated that they used the UV Guard system; however, optimization was needed. Although some sun protection behaviors changed, sunburn was not prevented in all participants, especially during outdoor exercise. Trial Registration ClinicalTrials.gov NCT03344796; http://clinicaltrials.gov/ct2/show/NCT03344796

Research has shown that three-dimensional (3D) stereoscopic virtual anatomic models can help students understand the complex spatial relationships of human structures that are not easily accessible via dissection. For instance, the cerebral cortex is located within the cranial vault;however, it can be difficult to view the relationship between the cerebral cortex and skull via dissection. This project goes into discussing the creation of a 3D stereoscopic model of the cerebral cortex. The cerebral cortex model was segmented via Amira 5.6 software from computed tomography angiography (CTA) data. Amira 5.6 surface rendering methods were used to create the cerebral cortex, and volume rendering methods were used to create the skull. The segmentations were performed using the axial view and paintbrush tools in Amira 5.6 along with the Wacom pen and tablet. After completing the initial segmentation across 155 slides, the CTA scans were compiled in Amira 5.6 to create the 3D model of the cerebral cortex. A smoothing filter was then applied to the initial surface render of the cerebral cortex to smooth the transition from slide to slide. The cerebral cortex model generated can be viewed from any angle at any magnification level. In addition, the model can also be overlayed orthoslice CTA data to allow the user to have a stronger understanding of the relationship between each individual two-dimensional CTA image and the three-dimensional model. Moreover, the cerebral cortex virtual model can be created into video clips using the Amira 5.6 movie maker, which can be inserted into PowerPoint presentations. As a result, the cerebral cortex virtual model has the potential to be used for online distance anatomical learning, which has become the adopted method of teaching due to the COVID-19 pandemic. The flexibility of this model allows it to also be used in the classroom setting as a virtual learning tool where students may view the models via a 3D screen with 3D glasses.

Virtual learning has become the popular and adopted form of teaching due to the COVID-19 pandemic, including learning the parts of the human body. As we move through this pandemic and look into the future of medical education, anatomic virtual models have the potential to be a key educational tool in learning the unique engineering of the human body. In this project, we look into the making of an anatomical structure, the cerebellum, which is located at the base of the skull in the posterior cranial fossa. The cerebellum largely controls the coordination of voluntary movement sequences of the body. Computed tomography angiography (CTA) data and surface and volume rendering technology found in the Amira 5.6 software was used in the creation of a three-dimensional (3D) stereoscopic virtual model of the cerebellum. An outlining process was used for each CTA image that comprised the cerebellum;a total of 73 slices of CTA data were outlined. Each outline was made using the paintbrush, blow, and lasso tools found in Amira 5.6. To refine the selected areas, the paintbrush tool along with the coronal and sagittal views were employed. Each segmented slice was then stacked to create the surface of the cerebellum, generating the 3D stereoscopic model. A smoothing filter was also applied to correct human error. End results show a 3D stereoscopic cerebellum model that can be integrated at various angles and magnifications with orthoslice CTA data and project as a 3D stereoscopic presentation in a virtual environment with a dim light background. We find that the cerebellum stereoscopic model can serve as a virtual learning tool in a classroom setting and allow students to view the cerebellum in a 3D stereoscopic presentation in order to better grasp the spatial relationship of the cerebellum with other structures in the cranial vault. Three-dimensional stereoscopic presentations along with video clips created within Amira 5.6 can be used for online anatomical learning, which allows for different visual perspectives than the traditional two-dimensional presentations.

Tuberculosis can occur during any stage of Human Immunodeficiency virus 1 (HIV) -infection including times when CD4+ T cell numbers have reconstituted and viral replication suppressed. We have previously shown that CD11b+CD33+CD14+HLA-DR-/lo monocytic myeloid-derived suppressor cells (MDSC) persist in HIV-infected individuals on combined anti-retroviral therapy (cART) and with virologic suppression. The response of MDSC to Mycobacterium tuberculosis (Mtb) is not known. In this study, we compared the anti-mycobacterial activity of MDSC isolated from HIV –infected individuals on cART with virologic suppression (HIV MDSC) and HIV-uninfected healthy controls (HIV (-) MDSC). Compared to HIV (-) MDSC, HIV MDSC produced significantly less quantities of anti-mycobacterial cytokines IL-12p70 and TNFα, and reactive oxygen species when cultured with infectious Mtb or Mtb antigens. Furthermore, HIV MDSC showed changes in the Toll-like receptor and IL-27 signaling, including reduced expression of MyD88 and higher levels of IL-27. Neutralizing IL-27 and overexpression of MyD88 synergistically controlled intracellular replication of Mtb in HIV MDSC. These results demonstrate that MDSC in fully suppressed HIV-infected individuals are permissive to Mtb and exhibit downregulated anti-mycobacterial innate immune activity through mechanisms involving IL-27 and TLR signaling. Our findings suggest MDSC as novel mediators of tuberculosis in HIV-Mtb co-infected individuals with virologic suppression.

Trigonella Foenum-graecum, commonly known as fenugreek, is documented from fifteenth century for its use as spices and smelling agent. This dicotyledonous plant of Fabaceae family (subfamily Papilionaceae) is widely used for numerous medicinal applications all over the world. Adaptability to diverse atmospheric conditions, temperatures, and soils makes this plant cultivable in different habitats. More than 260 species of fenugreek are diffused in more than 20 countries of Asia, Europe, Africa, America and in some areas of Australia. Medicinal and clinical properties of fenugreek belong to its bio-active secondary metabolites such as alkaloids, flavonoids, steroids and saponins. There are many literature available describing cultivation, ecophysiology and traditional uses, medicinal properties, phytochemical and nutrient contents of fenugreek. In the last two decades, fenugreek has caught attention from scientific community due to its one of the most valuable components—Diosgenin. The Omics approaches genomics, transcriptomics, proteomics, and metabolomics are very important to understand systems biology. This chapter summarizes the major research work conducted on fenugreek by aforementioned omics approaches and its applications. Authors have tried to touch upon the understanding of omics approaches, their methodology, analytical techniques involved and theirs usage and output along with the researches conducted on fenugreek plant.

N95 decontamination protocols and KN95 respirators have been described as solutions to a lack of personal protective equipment. However, there are a few material science studies that characterize the charge distribution and physical changes accompanying disinfection treatments, particularly heating. Here, we report the filtration efficiency, dipole charge density, and fiber integrity of N95 and KN95 respirators before and after various decontamination methods. We found that the filter layers in N95 and KN95 respirators maintained their fiber integrity without any deformations during disinfection. The filter layers of N95 respirators were 8-fold thicker and had 2-fold higher dipole charge density than that of KN95 respirators. Emergency Use Authorization (EUA)-approved KN95 respirators showed filtration efficiencies as high as N95 respirators. Interestingly, although there was a significant drop in the dipole charge in both respirators during decontamination, there was no remarkable decrease in the filtration efficiencies due to mechanical filtration. Cotton and polyester face masks had a lower filtration efficiency and lower dipole charge. In conclusion, a loss of electrostatic charge does not directly correlate to the decreased performance of either respirator.