Device-based physical therapies in chronic pruritus: a narrative review.

Chronic pruritus is a highly prevalent disease associated with high psychosocial and economic burdens. In addition to pharmacological treatments, device-based physical therapies also offer antipruritic effects. Phototherapy, laser treatment, electrical neurostimulation technologies, acupuncture, cryotherapy, and cold atmospheric plasma are, in part, still experimental but emerging treatment options that augment our repertoire to treat patients with chronic pruritus. In this narrative review, we provided an overview of these physical modalities and their role in itch management.

Clinical evaluation of augmented reality-based 3D navigation system for brachial plexus tumor surgery.

BACKGROUND: Augmented reality (AR), a form of 3D imaging technology, has been preliminarily applied in tumor surgery of the head and spine, both are rigid bodies. However, there is a lack of research evaluating the clinical value of AR in tumor surgery of the brachial plexus, a non-rigid body, where the anatomical position varies with patient posture. METHODS: Prior to surgery in 8 patients diagnosed with brachial plexus tumors, conventional MRI scans were performed to obtain conventional 2D MRI images. The MRI data were then differentiated automatically and converted into AR-based 3D models. After point-to-point relocation and registration, the 3D models were projected onto the patient's body using a head-mounted display for navigation. To evaluate the clinical value of AR-based 3D models compared to the conventional 2D MRI images, 2 senior hand surgeons completed questionnaires on the evaluation of anatomical structures (tumor, arteries, veins, nerves, bones, and muscles), ranging from 1 (strongly disagree) to 5 (strongly agree). RESULTS: Surgeons rated AR-based 3D models as superior to conventional MRI images for all anatomical structures, including tumors. Furthermore, AR-based 3D models were preferred for preoperative planning and intraoperative navigation, demonstrating their added value. The mean positional error between the 3D models and intraoperative findings was approximately 1 cm. CONCLUSIONS: This study evaluated, for the first time, the clinical value of an AR-based 3D navigation system in preoperative planning and intraoperative navigation for brachial plexus tumor surgery. By providing more direct spatial visualization, compared with conventional 2D MRI images, this 3D navigation system significantly improved the clinical accuracy and safety of tumor surgery in non-rigid bodies.

Diagnostic value of MRI in traumatic triangular fibrocartilage complex injuries: a retrospective study.

BACKGROUND: Triangular fibrocartilage complex (TFCC) injuries commonly manifest as ulnar-sided wrist pain and can be associated with distal radioulnar joint (DRUJ) instability and subsequent wrist functional decline. This study aimed to assess the diagnostic value of MRI compared to wrist arthroscopy in identifying traumatic TFCC injuries and to determine the distribution of different TFCC injury subtypes in a normal clinical setting. METHODS: The data of 193 patients who underwent both preoperative wrist MRI and wrist arthroscopy were retrospectively reviewed. The analysis focused on the proportion of subtypes and the diagnostic value of MRI in traumatic TFCC injuries, utilizing Palmer's and Atzei's classification with wrist arthroscopy considered as the gold standard. RESULTS: The most prevalent subtype of TFCC injuries were peripheral injuries (Palmer 1B, 67.9%), followed by combined injuries (Palmer 1 A + 1B, 14%; Palmer 1B + 1D, 8.3%). Compared with wrist arthroscopy, the diagnostic sensitivity, specificity, negative predictive value (NPV), and Kappa value of MRI was as follows: traumatic TFCC tears 0.99 (95% CI: 0.97-1), 0.90 (0.78-0.96), 0.97 (0.87-1), and 0.93; styloid lamina tears 0.93 (0.88-0.96), 0.53 (0.30-0.75), 0.47 (0.26-0.69), and 0.44; and foveal lamina tears 0.85 (0.74-0.92), 0.38 (0.29-0.49), 0.79 (0.65-0.89), and 0.21. CONCLUSIONS: The diagnostic value of MRI in traumatic TFCC injuries has been confirmed to be almost perfect using Palmer's classification. In more detailed classification of TFCC injuries, such as pc-TFCC tears classified by Atzei's classification, the diagnostic accuracy of MRI remains lower compared to wrist arthroscopy. Radiological associated injuries may offer additional diagnostic value in cases with diagnostic uncertainty.

Diverse long-term potentiation and depression based on multilevel LiSiOxmemristor for neuromorphic computing.

Memristor-based neuromorphic computing is expected to overcome the bottleneck of von Neumann architecture. An artificial synaptic device with continuous conductance variation is essential for implementing bioinspired neuromorphic systems. In this work, a memristor based on Pt/LiSiOx/TiN structure is developed to emulate an artificial synapse, which shows non-volatile multilevel resistance state memory behavior. Moreover, the high nonlinearity caused by abrupt changes in the set process is optimized by adjusting the initial resistance. 100 levels of continuously modulated conductance states are achieved and the nonlinearity factors are reduced to 1.31. The significant improvement is attributed to the decrease in the Schottky barrier height and the evolution of the conductive filaments. Finally, due to the improved linearity of the long-term potentiation/long-term depression behaviors in LiSiOxmemristor, a robust recognition rate (∼94.58%) is achieved for pattern recognition with the modified National Institute of Standards and Technology handwriting database. The Pt/LiSiOx/TiN memristor shows significant potential in high-performance multilevel data storage and neuromorphic computing systems.

Load-Bearing Radioulnar Distances to Evaluate an Unstable Distal Radioulnar Joint in Patients With Triangular Fibrocartilage Complex Tears.

PURPOSE: Tears of the proximal component of the triangular fibrocartilage complex (pc-TFCC) lead to instability in the distal radioulnar joint. The aim of this study was to measure the load-bearing radioulnar distances (RaUls) and to evaluate its diagnostic suitability in patients with pc-TFCC tears. METHODS: We retrospectively assessed and compared the lateral wrist radiographs of 61 adult patients with arthroscopically confirmed tears of pc-TFCC with those of a control group of 64 healthy participants. The RaUl was measured on lateral radiographs, and the difference in RaUl (D-value) between load-bearing and nonloading conditions was calculated in the 2 groups. Receiver operator characteristic curves were plotted to determine the diagnostic accuracy and optimal cutoff-score of load-bearing RaUl and RaUl D-value. The diagnostic performance was verified in a validation sample of patients (30 wrists) with pc-TFCC tears and a control group of healthy individuals (30 wrists). RESULTS: In the training sample, load-bearing RaUls of the affected wrists were higher than the same side of the controls (12.0 mm vs 7.1 mm). The TFCC-injury group showed a significantly higher RaUl D-value than the control group (8.5 mm vs 3.4 mm). Using a receiver operator characteristic curve, the cutoff value of load-bearing RaUl was 10 mm (sensitivity = 97.6%, specificity = 85.7%) and that of RaUl D-value was 6.5 mm (sensitivity = 90.2%, specificity = 78.5%). The areas under the curve of load-bearing RaUl and RaUl D-value were 0.96 and 0.88, respectively. In the test sample, the sensitivity, specificity, and accuracy of RaUl were 0.93, 0.70, and 0.82 and those of RaUl D-value were 0.77, 0.83, and 0.80 respectively. CONCLUSIONS: Load-bearing RaUl measurement is a simple method to diagnose an unstable distal radioulnar joint in patients with TFCC injury. The load bearing RaUl of >10 mm or RaUl D-value of >6.5 mm can be used to differentiate TFCC injuries and showed acceptable accuracy. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II.

Eliminating mcr-1-harbouring plasmids in clinical isolates using the CRISPR/Cas9 system.

OBJECTIVES: To eliminate mcr-1-harbouring plasmids and MDR plasmids in clinical Escherichia coli isolates. METHODS: Plasmid pMBLcas9 expressing Cas9 was constructed and used to clone target single-guide RNAs (sgRNAs) for plasmid curing. The recombinant plasmid pMBLcas9-sgRNA was transferred by conjugation into two clinical E. coli isolates. The curing efficiency of different sgRNAs targeting conserved genes was tested. The elimination of targeted plasmids and the generation of transposase-mediated recombination of p14EC033a variants were characterized by PCR and DNA sequencing. RESULTS: In this study, four native plasmids in isolate 14EC033 and two native plasmids in isolate 14EC007 were successfully eliminated in a step-by-step manner using pMBLcas9. Moreover, two native plasmids in 14EC007 were simultaneously eliminated by tandemly cloning multiple sgRNAs in pMBLcas9, sensitizing 14EC007 to polymyxin and carbenicillin. In 14EC033 with two mcr-1-harbouring plasmids, IncI2 plasmid p14EC033a and IncX4 plasmid p14EC033b, a single mcr-1 sgRNA mediated the loss of p14EC033b and generated a mutant p14EC033a in which the mcr-1 gene was deleted. An insertion element, IS5, located upstream of mcr-1 in p14EC033a was responsible for transposase-mediated recombination, resulting in mcr-1 gene deletion instead of plasmid curing. CONCLUSIONS: CRISPR/Cas9 can be used to efficiently sensitize clinical isolates to antibiotics in vitro. For isolates with multiple plasmids, the CRISPR/Cas9 approach can either remove each plasmid in a stepwise manner or simultaneously remove multiple plasmids in one step. Moreover, this approach can be used to delete multiple gene copies by using only one sgRNA. However, caution must be exercised to avoid unwanted recombination events during genetic manipulation.

Efficient Ethane and Propane Separation from Natural Gas Using Heterometallic Metal-Organic Frameworks with Interpenetrated Structures.

The development of efficient technology for natural gas separation in industrial processes has become imperative. In this regard, the exploration of novel and effective adsorbents has gained significant attention. One promising approach is the metal regulation of metal-organic frameworks (MOFs), particularly heterometallic MOFs, which offer greater potential for gas separation due to their diverse composition. This study presents the synthesis of a series of iron- and vanadium-based heterometallic MOFs (MIL-126), featuring interpenetrated structures, and investigates their adsorption performance for methane (CH4), ethane (C2H6), and propane (C3H8). Experimental results reveal that the choice of metal combinations within the MOF framework significantly influences the adsorption performance of MIL-126. Notably, heterometallic MIL-126(Fe/Ni) exhibits a stronger binding affinity for C3H8, with an impressive uptake of 177 cm3/g. The C3H8/CH4 ideal adsorbed solution theory selectivity of MIL-126(Fe/Ni) surpasses that of MIL-126(Fe) by a factor of 7, reaching a value of 853, second only to the highest reported value. Furthermore, MIL-126(Fe/Ni) exhibits remarkable potential for the recovery of pure CH4 from the equimolar C3H8/CH4 mixture, with the amount of pure CH4 approaching the maximum reported value for MOFs. Insights from isosteric heat at zero loading and Henry's coefficients indicate that the transformation of metal types leads to a change in the interaction energy between C3H8 and the framework. Furthermore, breakthrough experiments validate the effective separation capability of MIL-126(Fe/Ni) for CH4/C2H6/C3H8 mixtures. These findings underscore the remarkable potential of heterometallic MOFs in constructing a wide range of new MOFs with tailorable properties, thereby enhancing their gas separation performance.

Unveiling the role of dorsal root ganglia in spasticity reduction: Insights from contralateral seventh cervical nerve cross transfer surgery.

BACKGROUND: Central nervous system (CNS) disorders, such as stroke, often lead to spasticity, which result in limb deformities and significant reduction in quality of life. Spasticity arises from disruptions in the normal functioning of cortical and descending inhibitory pathways in the brainstem, leading to abnormal muscle contractions. Contralateral seventh cervical nerve cross transfer (CC7) surgery has been proven to effectively reduce spasticity, but the specific mechanism for its effectiveness is unclear. METHODS: This study aimed to investigate the changes in the dorsal root ganglia (DRG) following CC7 surgery. A comprehensive anatomical analysis was conducted through cadaveric study and magnetic resonance imaging (MRI) study, to accurately measure the regional anatomy of the C7 DRG. DRG perfusion changes were quantitatively assessed by comparing pre- and postoperative dynamic contrast-enhanced (DCE) MRI. RESULTS: In CC7 surgery, the C7 nerve root on the affected side is cut close to the DRG (3.6 ± 1.0 mm), while the C7 nerve root on the healthy side is cut further away from the DRG (65.0 ± 10.0 mm). MRI studies revealed that after C7 proximal neurotomy on the affected side, there was an increase in DRG volume, vascular permeability, and perfusion; after C7 distal neurotomy on the healthy side, there was a decrease in DRG volume, with no significant changes in vascular permeability and perfusion. CONCLUSION: This study provides preliminary insights into the mechanisms of spasticity reduction following CC7 surgery, indicating that changes in the DRG, such as increased vascular permeability and perfusion, could disrupt abnormal spinal γ-circuits. The resulting high-perfusion state of DRG, possibly due to heightened neuronal activity and metabolic demands, necessitating further research to verify this hypothesis.

Optimization of Subthreshold Swing and Hysteresis in Hf0.5Zr0.5O2-Based MoS2 Negative Capacitance Field-Effect Transistors by Modulating Capacitance Matching.

Negative capacitance field effect transistors made of Hf0.5Zr0.5O2 (HZO) are one of the most promising candidates for low-power-density devices because of the extremely steep subthreshold swing and high open-state currents resulting from the addition of ferroelectric materials in the gate dielectric layer. In this paper, HZO thin films were prepared by magnetron sputtering combined with rapid thermal annealing. Their ferroelectric properties were adjusted by changing the annealing temperature and the thickness of HZO. Two-dimensional MoS2 back-gate negative capacitance field-effect transistors (NCFETs) based on HZO were prepared as well. Different annealing temperatures, thicknesses of HZO thin films, and Al2O3 thicknesses were studied to achieve optimal capacitance matching, aiming to reduce both the subthreshold swing of the transistor and the hysteresis of the NCFET. The NCFET exhibits a minimum subthreshold swing as low as 27.9 mV/decade, negligible hysteresis (∼20 mV), and the ION/IOFF of up to 1.58 × 107. Moreover, a negative drain-induced barrier lowering effect and a negative differential resistance effect have been observed. This steep-slope transistor is compatible with standard CMOS manufacturing processes and attractive for 2D logic and sensor applications as well as future energy-efficient nanoelectronic devices with scaled power supplies.

Substrate stiffness affects the morphology, proliferation, and radiosensitivity of cervical squamous carcinoma cells.

Cervical cancer is associated with the highest morbidity rate among gynecological cancers. Radiotherapy plays an important role in the treatment of cervical cancer. However, a considerable number of patients are radiation resistant, leading to a poor prognosis. Matrix stiffness is related to the occurrence, development, and chemoresistance of solid tumors. The association between matrix stiffness and radiosensitivity in cervical cancer cells remains unknown. Here, we sought to determine the effect of matrix stiffness on the phenotype and radiosensitivity of cervical cancer cells. Cervical squamous carcinoma SiHa cells were grown on substrates of different stiffnesses (0.5, 5, and 25 kPa). Cell morphology, proliferation, and radiosensitivity were examined. Cells grown on hard substrates displayed stronger proliferative activity, larger size, and higher differentiation degree, which was reflected in a more mature skeleton assembly, more abundant pseudopodia formation, and smaller nuclear/cytoplasmic ratio. In addition, SiHa cells exhibited stiffness-dependent resistance to radiation, possibly via altered apoptosis-related protein expression. Our findings demonstrate that matrix stiffness affects the morphology, proliferation, and radiosensitivity of SiHa cells. Tissue stiffness may be an indicator of the sensitivity of a patient to radiotherapy. Thus, the data provide insights into the diagnosis of cervical cancer and the design of future radiotherapies.

Prevalence and genotypes of human papilloma virus infection in CIN3 in Beijing, China.

BACKGROUND: To investigate the incidence of single and multiple human papillomavirus (HR-HPV) infection in CIN3 patients before operation. METHODS: The complete clinical data of patients with CIN3 by biopsy were collected. HPV23 typing in the first 3 months of the treatment was detected. The infection rate of HPV was analyzed. RESULTS: One thousand and fifty-one HPV subtypes were detected in 679 patients with HPV (+) CIN3 with primary conization, of which the top ten were HPV16, 33, 31, 58, 6, 52, 18, 43, 51, 11, 68, respectively. Among them, single subtype HPV infection accounted for 64.36%, while multiple HPV infection accounted for 35.64%. For multiplex HPV infection, there were 2, 3, 4 species, and 148 (21.80%), 69 (10.16%), 16 (2.36%), 9 (1.33%) cases of multiple HPV infection of 5 and above HPV subtypes respectively. The incidence of multiple HPV infection in CIN3 patients in 2015 was higher than that in 2012 (39.01% vs. 30.08%, P=0.019), and the proportion of multiple infections in HPV was higher than that in the 2014 group. CONCLUSIONS: The top 10 HPV subtypes of the CIN3 patients were included in HPV nine valence vaccines except HPV43 and 51.

Colistin Resistance Gene mcr-1 Mediates Cell Permeability and Resistance to Hydrophobic Antibiotics.

Colistin is considered the last-resort antibiotic used to treat multidrug resistant bacteria-related infections. However, the discovery of the plasmid-mediated colistin resistance gene, mcr-1, threatens the clinical utility of colistin antibiotics. In this study, the physiological function of MCR-1, which encodes an LPS-modifying enzyme, was investigated in E. coli K-12. Specifically, the impact of mcr-1 on membrane permeability and antibiotic resistance of E. coli was assessed by constructing an mcr-1 deletion mutant and by a complementation study. The removal of the mcr-1 gene from plasmid pHNSHP45 not only led to reduced resistance to colistin but also resulted in a significant change in the membrane permeability of E. coli. Unexpectedly, the removal of the mcr-1 gene increased cell viability under high osmotic stress conditions (e.g., 7.0% NaCl) and led to increased resistance to hydrophobic antibiotics. Increased expression of mcr-1 also resulted in decreased growth rate and changed the cellular morphology of E. coli. Collectively, our results revealed that the spread of mcr-1-carrying plasmids alters other physiological functions in addition to conferring colistin resistance.

Antimicrobial Resistance Profile of mcr-1 Positive Clinical Isolates of Escherichia coli in China From 2013 to 2016.

Multidrug-resistant (MDR) Escherichia coli poses a great challenge for public health in recent decades. Polymyxins have been reconsidered as a valuable therapeutic option for the treatment of infections caused by MDR E. coli. A plasmid-encoded colistin resistance gene mcr-1 encoding phosphoethanolamine transferase has been recently described in Enterobacteriaceae. In this study, a total of 123 E. coli isolates obtained from patients with diarrheal diseases in China were used for the genetic analysis of colistin resistance in clinical isolates. Antimicrobial resistance profile of polymyxin B (PB) and 11 commonly used antimicrobial agents were determined. Among the 123 E. coli isolates, 9 isolates (7.3%) were resistant to PB and PCR screening showed that seven (5.7%) isolates carried the mcr-1 gene. A hybrid sequencing analysis using single-molecule, real-time (SMRT) sequencing and Illumina sequencing was then performed to resolve the genomes of the seven mcr-1 positive isolates. These seven isolates harbored multiple plasmids and are MDR, with six isolates carrying one mcr-1 positive plasmid and one isolate (14EC033) carrying two mcr-1 positive plasmids. These eight mcr-1 positive plasmids belonged to the IncX4, IncI2, and IncP1 types. In addition, the mcr-1 gene was the solo antibiotic resistance gene identified in the mcr-1 positive plasmids, while the rest of the antibiotic resistance genes were mostly clustered into one or two plasmids. Interestingly, one mcr-1 positive isolate (14EC047) was susceptible to PB, and we showed that the activity of MCR-1-mediated colistin resistance was not phenotypically expressed in 14EC047 host strain. Furthermore, three isolates exhibited resistance to PB but did not carry previously reported mcr-related genes. Multilocus sequence typing (MLST) showed that these mcr-1 positive E. coli isolates belonged to five different STs, and three isolates belonged to ST301 which carried multiple virulence factors related to diarrhea. Additionally, the mcr-1 positive isolates were all susceptible to imipenem (IMP), suggesting that IMP could be used to treat infection caused by mcr-1 positive E. coli isolates. Collectively, this study showed a high occurrence of mcr-1 positive plasmids in patients with diarrheal diseases of Guangzhou in China and the abolishment of the MCR-1 mediated colistin resistance in one E. coli isolate.