Representation of skin carcinomas in public awareness - Awareness worldwide and in Germany.

BACKGROUND AND OBJECTIVES: In recent years, there has been an increase in skin cancer. The aim of this study was therefore to investigate the representation of skin cancer in public awareness worldwide and in Germany, and to determine whether Skin Cancer Awareness Month is represented in the search interests of the Internet-using population in the same way as Breast Cancer Awareness Month worldwide. DATA AND METHODS: In this study, Google Trends data were used to track levels of public awareness for different tumor entities and skin cancer types worldwide and for Germany. RESULTS: The results of this analysis clearly showed a high level of relative public search interest in breast cancer worldwide in the awareness month of October. Worldwide and in Germany, there was a certain increase in search interest and a certain seasonal effect around the May awareness month for skin cancer. For example, the analysis showed a search interest in May and during the summer months in Germany. CONCLUSIONS: It is likely that the population, for example in Germany, may benefit further from an even greater emphasis on the topic of skin cancer.

Public awareness for "classic" childhood diseases and inflammatory syndromes in children during the COVID-19 pandemic.

OBJECTIVES: The objective was to analyze in silico public search interest during the COVID-19 pandemic for some classic infectious childhood diseases, e.g., measles, mumps, chickenpox, scarlet fever, and inflammatory diseases like Kawasaki disease and the pediatric inflammatory multisystem syndrome (PIMS). STUDY DESIGN: In this study, a comparison of five childhood diseases in public search trends with the pediatric inflammatory multisystem syndrome was performed. METHODS: Google Trends data for the period of five years for six childhood diseases were used. We used topics coverings all languages worldwide and all connected search queries. RESULTS: Public search interest decreased during the COVID-19 pandemic for some classic infectious childhood diseases. Search interest for the pediatric inflammatory multisystem syndrome, despite strong indication of a connection with COVID-19, remained relatively low compared to Kawasaki disease. PRACTICE IMPLICATIONS: Better understanding of Google Trends can map public awareness of childhood diseases in terms of time course and search intensity. CONCLUSIONS: Public interest during the pandemic was generated for diseases with suspected connection to COVID-19, presumably due to media triggers.

Mobile snapshot hyperspectral imaging device for skin evaluation using diffractive optical elements.

OBJECTIVE: A mobile handheld snapshot hyperspectral imaging device was developed and tested for in vivo skin evaluation using a new spectral imaging technology. METHODS: The device is equipped with four different LED light sources (VIS, 810 nm, 850 nm, and 940 nm) for illumination. Based on a diffractive optical element (DOE) combined with a CMOS sensor chip, a snapshot hyperspectral imager is achieved for the application on human skin. The diffractive optical element (DOE) consists of a two-dimensional array of identically repeated diffractive microstructures. One hyperspectral image for all wavelength regions is taken within a few seconds. Complex recalculation of the VIS spectral distribution and image information from the received DOE image requires several minutes, depending on computing performance. A risk assessment on the irradiation sources shows no risk of harm due to the LED radiation. RESULTS: Skin tone color patches experiments reproducibly deliver images and spectra of different skin tones. First in vivo use of the device identified pigmentation changes within the field of view. CONCLUSION: We present a working mobile snapshot hyperspectral imaging tool based on diffractive optical elements. This device or future developments thereof can be used for broad skin evaluation in vivo.

Multi-wavelength, handheld laser speckle imaging for skin evaluation.

OBJECTIVE: A handheld device was developed and qualified for in vivo human skin evaluation using laser speckle imaging technology. METHODS: Each laser speckle device prototype allows the choice of up to three different laser wavelengths in the range of 400 nm to 800 nm in total. Speckle pattern analysis gives various speckle parameters, for example, speckle contrast, speckle size, speckle modulation or fractal dimension. The developed laser speckle device prototypes were evaluated investigating three skin issues. RESULTS: We receive reproducible results from the speckle imaging device. For skin ageing, we found significant changes within three age groups. The effect of a methyl nicotinate treatment was clearly visible and quantifiable using a moorFLPI device as well as our speckle imaging device. In terms of basal cell carcinoma diagnosis, we found significant differences between normal and diseased skin, even though the number of samples was limited. CONCLUSION: As shown with first application examples, it was possible to demonstrate the potential of the method for skin evaluation in vivo.

Cytocompatibility testing of cyclodextrin-functionalized antimicrobial textiles-a comprehensive approach.

Functionalized textiles can be used in wound management to reduce the microbial burden in the wound area, to prevent wound infections, and to avoid cross-contamination between patients. In the present study, a comprehensive in vitro approach to enable the assessment of antibacterial activity of functionalized textiles and cytotoxicity of cyclodextrin (CD)-complexes with chlorhexidine diacetate (CHX), iodine (IOD), and polihexanide (PHMB) is suggested to evaluate their properties for supporting optimal conditions for wound healing. For all ß-CD-antiseptic functionalized cotton samples a strong antibacterial effect on the Gram-positive bacteria Staphylococcus aureus and Staphylococcus epidermidis as well as on the Gram-negative bacteria Klebsiella pneumoniae and Escherichia coli was proven. In addition, ß-CD-CHX and ß-CD-PHMB were effective against the yeast Candida albicans. The growth of Pseudomonas aeruginosa could be reduced significantly by ß-CD-IOD and ß-CD-PHMB. The established comprehensive testing system for determination of biocompatibility on human HaCaT keratinocytes is suitable for obtaining robust data on cell viability, cytotoxicity and mode of cell death of the ß-CD-antiseptic-complexes. The promising results of the high antimicrobial activity of these functionalized textiles show the high potential of such materials in medical applications.

Maximum generable interest: A universal standard for Google Trends search queries.

The coronavirus or COVID-19 pandemic represents a health event with far-reaching global consequences, triggering a strong search interest in related topics on the Internet worldwide. The use of search engine data has become commonplace in research, but a universal standard for comparing different works is desirable to simplify the comparison. The coronavirus pandemic's enormous impact and media coverage have triggered an exceptionally high search interest. Consequently, the maximum generable interest (MGI) on coronavirus is proposed as a universal reference for objectifying and comparing relative search interest in the future. This search interest can be explored with search engine data such as Google Trends data. Additional standards for medium and low search volumes can also be used to reflect the search interest of topics at different levels. Size standards, such as reference to MGI, may help make research more comparable and better evaluate relative search volumes. This study presents a framework for this purpose using the example of stroke.

Evaluation of weekly COVID-19 vaccination and case data supports negative correlation between incidence and vaccination in German federal states and cities during 4th wave.

Global efforts have been made to end the COVID-19 pandemic. Among other things, various vaccines against SARS-CoV-2, partly based on novel principles, have been developed internationally within a short time. While initially the hardly available vaccines were distributed according to criteria according to defined priorities, in Germany, after the prioritization has been lifted, attempts are being made to provide as many people as possible with vaccinations. The study examines the relationship between vaccination and incidence in 16 German federal states and city states using data from the Robert Koch Institute (RKI). Clear trends became apparent, showing a negative correlation between the vaccination rate and the infection incidence. This indicates that during the 4th corona wave in Germany, the lower the incidence, the higher the vaccination rate.

Representation of long COVID syndrome in the awareness of the population is revealed by Google Trends analysis.

In some COVID-19 patients, symptoms persist for several weeks and sometimes, after the acute disease phase, these patients develop new symptoms, which then represents a transition into the so-called long COVID. The exact demarcation of the terms and generally applicable definitions are still discussed, but the phenomenon is most commonly referred to as long COVID. In this study, Google Trends data have been used to track levels of public awareness for long COVID and some important symptoms during the course of the COVID-19 pandemic. The results of this analysis clearly demonstrate the public interest in the new topic of long COVID, as documented by a corresponding search volume. This is related to the disease COVID-19, which is being spread by the corona pandemic. Relevant symptoms for COVID-19 or long COVID, for example ageusia and anosmia, only started to receive more public attention during the pandemic. Therefore, Google Trends is a useful tool to demonstrate the population's awareness of certain infodemiological topics like long COVID.

Influence of the COVID-19 pandemic measures on incidence and representation of other infectious diseases in Germany: a lesson to be learnt.

Aim: The COVID-19 pandemic resulted in a wide range of serious health, social and economic consequences. To counteract the pandemic, various measures and restrictions such as lockdowns, closures, social distancing, hygiene, and protective measures such as wearing face masks have been enforced. Apart from the COVID-19 pandemic, these measures also had effects on other transmittable diseases. This study therefore determined the impact on case numbers and interest for other infectious diseases as well. Subject and methods: Anonymized data on reported case numbers from the German Robert Koch Institute and data from Google Trends about the search interest have been used in this study to track courses of infectious diseases before and during the coronavirus pandemic in Germany. Results: The results of this analysis clearly demonstrated that the case numbers of influenza, whooping cough, measles, mumps, scarlet fever and chicken pox decreased in the pandemic years, most probably due to anti-pandemic measures in Germany. Additionally, the Google Trends analysis demonstrated public awareness, documented by a corresponding search interest, for the new topic COVID-19 and for other infectious diseases. Conclusion: Online available data provided valuable sources for research purposes in infodemiology or infoveillance.

Proteomic analysis of endothelial cold-adaptation.

BACKGROUND: Understanding how human cells in tissue culture adapt to hypothermia may aid in developing new clinical procedures for improved ischemic and hypothermic protection. Human coronary artery endothelial cells grown to confluence at 37°C and then transferred to 25°C become resistant over time to oxidative stress and injury induced by 0°C storage and rewarming. This protection correlates with an increase in intracellular glutathione at 25°C. To help understand the molecular basis of endothelial cold-adaptation, isolated proteins from cold-adapted (25°C/72 h) and pre-adapted cells were analyzed by quantitative proteomic methods and differentially expressed proteins were categorized using the DAVID Bioinformatics Resource. RESULTS: Cells adapted to 25°C expressed changes in the abundance of 219 unique proteins representing a broad range of categories such as translation, glycolysis, biosynthetic (anabolic) processes, NAD, cytoskeletal organization, RNA processing, oxidoreductase activity, response-to-stress and cell redox homeostasis. The number of proteins that decreased significantly with cold-adaptation exceeded the number that increased by 2:1. Almost half of the decreases were associated with protein metabolic processes and a third were related to anabolic processes including protein, DNA and fatty acid synthesis. Changes consistent with the suppression of cytoskeletal dynamics provided further evidence that cold-adapted cells are in an energy conserving state. Among the specific changes were increases in the abundance and activity of redox proteins glutathione S-transferase, thioredoxin and thioredoxin reductase, which correlated with a decrease in oxidative stress, an increase in protein glutathionylation, and a recovery of reduced protein thiols during rewarming from 0°C. Increases in S-adenosylhomocysteine hydrolase and nicotinamide phosphoribosyltransferase implicate a central role for the methionine-cysteine transulfuration pathway in increasing glutathione levels and the NAD salvage pathway in increasing the reducing capacity of cold-adapted cells. CONCLUSIONS: Endothelial adaptation to mild-moderate hypothermia down-regulates anabolic processes and increases the reducing capacity of cells to enhance their resistance to oxidation and injury associated with 0°C storage and rewarming. Inducing these characteristics in a clinical setting could potentially limit the damaging effects of energy insufficiency due to ischemia and prevent the disruption of integrated metabolism at low temperatures.

The rise of infodemiology and infoveillance during COVID-19 crisis.

We noticed an increase in the relative number of published papers on topics such as infoveillance, infodemiology and Google Trends. Collected PubMed data are from the period of January 2020 to March 2021 and were searched with the use of five keywords: infoveillance, infodemiology, Google Trends, diabetes and in silico. We compared an increase in the number of papers from PubMed with search interest expressed in Google Trends. Collected Google Trends data is from the same period, covering fifteen months starting January 2020 and were searched with the use of three search topics: coronavirus, lockdown and social distancing. The geographic setting for search engine users was worldwide. We propose a hypothesis that after increased interest in searches during the pandemic's initial months came an increased number of published papers on topics such as infoveillance, infodemiology and Google Trends.

Artificial Intelligence in Multiphoton Tomography: Atopic Dermatitis Diagnosis.

The diagnostic possibilities of multiphoton tomography (MPT) in dermatology have already been demonstrated. Nevertheless, the analysis of MPT data is still time-consuming and operator dependent. We propose a fully automatic approach based on convolutional neural networks (CNNs) to fully realize the potential of MPT. In total, 3,663 MPT images combining both morphological and metabolic information were acquired from atopic dermatitis (AD) patients and healthy volunteers. These were used to train and tune CNNs to detect the presence of living cells, and if so, to diagnose AD, independently of imaged layer or position. The proposed algorithm correctly diagnosed AD in 97.0 ± 0.2% of all images presenting living cells. The diagnosis was obtained with a sensitivity of 0.966 ± 0.003, specificity of 0.977 ± 0.003 and F-score of 0.964 ± 0.002. Relevance propagation by deep Taylor decomposition was used to enhance the algorithm's interpretability. Obtained heatmaps show what aspects of the images are important for a given classification. We showed that MPT imaging can be combined with artificial intelligence to successfully diagnose AD. The proposed approach serves as a framework for the automatic diagnosis of skin disorders using MPT.

Translation of two-photon microscopy to the clinic: multimodal multiphoton CARS tomography of in vivo human skin.

Two-photon microscopes have been successfully translated into clinical imaging tools to obtain high-resolution optical biopsies for in vivo histology. We report on clinical multiphoton coherent anti-Stokes Raman spectroscopy (CARS) tomography based on two tunable ultrashort near-infrared laser beams for label-free in vivo multimodal skin imaging. The multiphoton biopsies were obtained with the compact tomograph "MPTflex-CARS" using a photonic crystal fiber, an optomechanical articulated arm, and a four-detector-360 deg measurement head. The multiphoton tomograph has been employed to patients in a hospital with diseased skin. The clinical study involved 16 subjects, 8 patients with atopic dermatitis, 4 patients with psoriasis vulgaris, and 4 volunteers served as control. Two-photon cellular autofluorescence lifetime, second harmonic generation (SHG) of collagen, and CARS of intratissue lipids/proteins have been detected with single-photon sensitivity, submicron spatial resolution, and picosecond temporal resolution. The most important signal was the autofluorescence from nicotinamide adenine dinucleotide [NAD(P)H]. The SHG signal from collagen was mainly used to detect the epidermal-dermal junction and to calculate the ratio elastin/collagen. The CARS/Raman signal provided add-on information. Based on this view on the disease-affected skin on a subcellular level, skin areas affected by dermatitis and by psoriasis could be clearly identified. Multimodal multiphoton tomographs may become important label-free clinical high-resolution imaging tools for in vivo skin histology to realize rapid early diagnosis as well as treatment control.

Integrated sensing and delivery of oxygen for next-generation smart wound dressings.

Chronic wounds affect over 6.5 million Americans and are notoriously difficult to treat. Suboptimal oxygenation of the wound bed is one of the most critical and treatable wound management factors, but existing oxygenation systems do not enable concurrent measurement and delivery of oxygen in a convenient wearable platform. Thus, we developed a low-cost alternative for continuous O2 delivery and sensing comprising of an inexpensive, paper-based, biocompatible, flexible platform for locally generating and measuring oxygen in a wound region. The platform takes advantage of recent developments in the fabrication of flexible microsystems including the incorporation of paper as a substrate and the use of a scalable manufacturing technology, inkjet printing. Here, we demonstrate the functionality of the oxygenation patch, capable of increasing oxygen concentration in a gel substrate by 13% (5 ppm) in 1 h. The platform is able to sense oxygen in a range of 5-26 ppm. In vivo studies demonstrate the biocompatibility of the patch and its ability to double or triple the oxygen level in the wound bed to clinically relevant levels.

Reduced artefacts and improved assessment of hyperintense brain lesions with BLADE MR imaging in patients with neurofibromatosis type 1.

BACKGROUND: Assessment of small brain lesions in children is often compromised by pulsation, flow or movement artefacts. MRI with a rotating blade-like k-space covering (BLADE, PROPELLER) can compensate for these artefacts. OBJECTIVE: We compared T2-weighted FLAIR images that were acquired with different k-space trajectories (conventional Cartesian and BLADE) to evaluate the impact of BLADE technique on the delineation of small or low-contrast brain lesions. MATERIALS AND METHODS: The subject group comprised 26 children with neurofibromatosis type 1 (NF 1), who had been routinely scanned at 1.5 T for optic pathway gliomas with both techniques and who had the typical hyperintense brain lesions seen in NF 1. Four experienced radiologists retrospectively compared unlabelled 4-mm axial images with respect to the presence of artefacts, visibility of lesions, quality of contour and contrast. RESULTS: Both techniques were comparable in depicting hyperintense lesions as small as 2 mm independent of contrast and edge definition. Pulsation and movement artefacts were significantly less common with BLADE k-space trajectory. In 7 of 26 patients (27%), lesions and artefacts were rated as indistinguishable in conventional FLAIR, but not in BLADE FLAIR images. CONCLUSION: BLADE imaging significantly improved the depiction of lesions in T2-W FLAIR images due to artefact reduction especially in the posterior fossa.

Hemostatic wound dressings: Predicting their effects by in vitro tests.

BACKGROUND: Application of controlled in vitro techniques can be used as a screening tool for the development of new hemostatic agents allowing quantitative assessment of overall hemostatic potential. MATERIALS AND METHODS: Several tests were selected to evaluate the efficacy of cotton gauze, collagen, and oxidized regenerated cellulose for enhancing blood clotting, coagulation, and platelet activation. RESULTS: Visual inspection of dressings after blood contact proved the formation of blood clots. Scanning electron microscopy demonstrated the adsorption of blood cells and plasma proteins. Significantly enhanced blood clot formation was observed for collagen together with ß-thromboglobulin increase and platelet count reduction. Oxidized regenerated cellulose demonstrated slower clotting rates not yielding any thrombin generation; yet, led to significantly increased thrombin-anti-thrombin-III complex levels compared to the other dressings. As hemostyptica ought to function without triggering any adverse events, induction of hemolysis, instigation of inflammatory reactions, and initiation of the innate complement system were also tested. Here, cotton gauze provoked high PMN elastase and elevated SC5b-9 concentrations. CONCLUSIONS: A range of tests for desired and undesired effects of materials need to be combined to gain some degree of predictability of the in vivo situation. Collagen-based dressings demonstrated the highest hemostyptic properties with lowest adverse reactions whereas gauze did not induce high coagulation activation but rather activated leukocytes and complement.

Rapid prototyping of a novel and flexible paper based oxygen sensing patch via additive inkjet printing process.

A novel and flexible oxygen sensing patch was successfully developed for wearable, industrial, food packaging, pharmaceutical and biomedical applications using a cost-efficient and rapid prototypable additive inkjet print manufacturing process. An oxygen sensitive ink was formulated by dissolving ruthenium dye and ethyl cellulose polymer in ethanol in a 1 : 1 : 98 (w/w/w) ratio. The patch was fabricated by depositing the oxygen sensitive ink on a flexible parchment paper substrate using an inkjet printing process. A maximum absorbance from 430 nm to 480 nm and a fluorescence of 600 nm was observed for the oxygen sensitive ink. The capability of the oxygen sensitive patch was investigated by measuring the fluorescence quenching lifetime of the printed dye for varying oxygen concentration levels. A fluorescence lifetime decay (τ) from ≈4 µs to ≈1.9 µs was calculated for the printed oxygen sensor patch, for oxygen concentrations varying from ≈5 mg L-1 to ≈25 mg L-1. A sensitivity of 0.11 µs mg L-1 and a correlation coefficient of 0.9315 was measured for the printed patches. The results demonstrated the feasibility of employing an inkjet printing process for the rapid prototyping of flexible and moisture resistant oxygen sensitive patches which facilitates a non-invasive method for monitoring oxygen and its concentration levels.