Application of moisturizer to neonates prevents development of atopic dermatitis.

BACKGROUND: Recent studies have suggested that epidermal barrier dysfunction contributes to the development of atopic dermatitis (AD) and other allergic diseases. OBJECTIVE: We performed a prospective, randomized controlled trial to investigate whether protecting the skin barrier with a moisturizer during the neonatal period prevents development of AD and allergic sensitization. METHODS: An emulsion-type moisturizer was applied daily during the first 32 weeks of life to 59 of 118 neonates at high risk for AD (based on having a parent or sibling with AD) who were enrolled in this study. The onset of AD (eczematous symptoms lasting >4 weeks) and eczema (lasting >2 weeks) was assessed by a dermatology specialist on the basis of the modified Hanifin and Rajka criteria. The primary outcome was the cumulative incidence of AD plus eczema (AD/eczema) at week 32 of life. A secondary outcome, allergic sensitization, was evaluated based on serum levels of allergen-specific IgE determined by using a high-sensitivity allergen microarray of diamond-like carbon-coated chips. RESULTS: Approximately 32% fewer neonates who received the moisturizer had AD/eczema by week 32 than control subjects (P = .012, log-rank test). We did not show a statistically significant effect of emollient on allergic sensitization based on the level of IgE antibody against egg white at 0.34 kUA/L CAP-FEIA equivalents. However, the sensitization rate was significantly higher in infants who had AD/eczema than in those who did not (odds ratio, 2.86; 95% CI, 1.22-6.73). CONCLUSION: Daily application of moisturizer during the first 32 weeks of life reduces the risk of AD/eczema in infants. Allergic sensitization during this time period is associated with the presence of eczematous skin but not with moisturizer use.

Effect of a plantar perceptual learning task on walking stability in the elderly: a randomized controlled trial.

OBJECTIVE: To determine whether the plantar perceptual learning task, using a hardness discrimination training, efficiently improves walking stability in the elderly. DESIGN: A randomized controlled trial. SETTING: Elder day-care center. PARTICIPANTS: Eighty-six elderly people (73.84 SD 5.98 years) who went to an elder day-care center were randomly assigned evenly to either an intervention or a control group. INTERVENTION: The intervention group performed a task to discriminate hardness differences while standing on sponge mats of different levels of hardness. The control group underwent the same task except that they were not instructed to discriminate hardness levels of the mats. The tasks were carried out over a four-week period for 10 days for both groups. OUTCOME MEASURES: Outcome was assessed by determining root mean squares of trunk acceleration during walking. RESULTS: Plantar perception was significantly improved in the intervention group after training (F = 26.24, p < 0.01). In addition, changes in root mean square values of acceleration were significantly greater after training in the intervention group (medial-lateral, 0.36 SD 0.26; vertical, 0.32 SD 0.24; anterio-posterior, 0.26 SD 0.24) than in the control group (medial-lateral, 0.14 SD 0.28, vertical, 0.16 SD 0.35, anterio-posterior, 0.12 SD 0.29) (p < 0.05). Changes in walking speed were not significantly different (p = 0.13) between the intervention (0.06 SD 0.13) and control groups (0.02 SD 0.14). CONCLUSION: The plantar perceptual learning task might efficiently stabilize postural control during walking in the elderly.

Barrier Factors of Adherence to Dupilumab Self-Injection for Severe Allergic Disease: A Non-Interventional Open-Label Study.

Purpose: The status of dupilumab self-injection at home is not well understood. We therefore aimed to identify the barriers to adherence to dupilumab self-injection. Patients and Methods: This non-interventional open-label study was conducted between March 2021 and July 2021. Patients with atopic dermatitis, bronchial asthma, and chronic rhinosinusitis with nasal polyps receiving dupilumab, from 15 sites, were requested to complete a self-administered questionnaire regarding the frequency and effectiveness of dosing as well as their use and satisfaction with dupilumab. Barriers to adherence were assessed using the Adherence Starts with Knowledge-12. Results: We included 331 patients who used dupilumab for atopic dermatitis (n = 164), chronic rhinosinusitis with nasal polyps (n = 102), and bronchial asthma (n = 65). The median efficacy of dupilumab scored 9.3 on the visual analog scale. Overall, 85.5% of the patients self-injected dupilumab, and 70.7% perfectly complied with the established injection dates. The pre-filled pen was significantly superior to the conventional syringe in terms of usability, operability, ease of pushing the plunger, and patient satisfaction. However, the pre-filled pen caused more pain during self-injection than did the syringe. Multivariate logistic regression analysis showed that adherence decreased with longer dupilumab treatment duration (p = 0.017) and was not associated with age, sex, underlying disease, or device type. There was a difference in responses related to "inconvenience/forgetfulness" between the good and poor adherence groups. Conclusion: The pre-filled dupilumab pen was superior to the syringe in terms of usability, operability, ease of pushing the plunger, and satisfaction. Repetitive instructions are recommended for preventing poor adherence to dupilumab self-injection.

Development of an ab initio protein structure prediction system ABLE.

An ab initio protein structure prediction system called ABLE is described. It is based on the fragment assembly method, which consists of two steps: dividing a target sequence into overlapping subsequences (fragments) of short length and assigning a local structure to each fragment; and generating models by assembling the local structures and selecting the models with low potential energy. One of the most important problems in conventional fragment assembly methods is the difficulty of selecting native-like structures by energy minimization only. ABLE thus employs a structural clustering method to select the native-like models from among the generated models. By applying the unit-vector root mean square distance (URMS) as a measure of structure similarity, we achieve more robust, effective structural clustering. When no enough clusters of good quality are obtained, ABLE runs the energy minimization procedure again by incorporating structural restraint conditions obtained from the consensus substructures in the previously generated models. This approach is based on our observation that there is a high probability that the consensus substructures of the generated models have native-like structures. Another feature of ABLE is that in assigning local structures to fragments, it assigns mainchain dihedral angles (phi, psi) to the central residue of each fragment according to a probability distribution map built from candidate sequences similar to each fragment. This enables the system to generate appropriate local structures that may not already exist in a protein structure database. We applied our system to 25 small proteins and obtain near-native folds for more than half of them. We also demonstrate the performance of our structural clustering method, which can be applied to other protein structure prediction systems.