Fresnel-type solid immersion lens for efficient light collection from quantum defects in diamond.

Quantum defects in diamonds have been studied as a promising resource for quantum science. The subtractive fabrication process for improving photon collection efficiency often require excessive milling time that can adversely affect the fabrication accuracy. We designed and fabricated a Fresnel-type solid immersion lens using the focused ion beam. For a 5.8 µm-deep Nitrogen-vacancy (NV-) center, the milling time was highly reduced (1/3 compared to a hemispherical structure), while retaining high photon collection efficiency (> 2.24 compared to a flat surface). In numerical simulation, this benefit of the proposed structure is expected for a wide range of milling depths.

A postulated model for photoimmunopathogenesis of chronic actinic dermatitis around adaptive immunity, including Th17 cells, Tregs, TRMs, cytotoxic T cells, and/or common-γ chain receptor+ cells.

BACKGROUND/PURPOSE: The pathogenesis of chronic actinic dermatitis (CAD) is more complicated than other photodermatoses. However, the relationship between the clinical severity of CAD and the offending photocontact or contact allergens or both, and the correlations of CAD immunopathogenesis with the immunoregulatory molecules involved in adaptive immunity are yet to be investigated. METHODS: We performed phototesting with broad-spectrum ultraviolet (UV) B, UVA, and visible light to establish the presence of photosensitivity in 121 patients with CAD, together with photopatch and contact patch testing. Nine patients with CAD were selected according to their clinical severity score for CAD (CSS-CAD), and triple direct immunofluorescence analysis was performed with paraffin-embedded skin biopsy samples. RESULTS: As CSS-CAD was closely correlated with the multiplicity of photo(contact) allergens, particularly photoallergens, three or more photoallergens were detected in the severe CAD group (52.5%); less in the moderate group (32.8%); and only one in the mild group (14.8%; P = .025). In the groups showing greater severity of disease, the absolute numbers of IFN-γ+ , IL-17+ , CD4+, CD8+, common-γ chain receptor (common-γCR)+ , and CD69+ tissue-resident memory cells increased on average; there was also an increase in the CD4+/CD8+ cell ratio, with the more severely affected groups. However, the levels of TNF-α+ and FoxP3+ regulatory T (Treg) cells and the mean IL-17/IFN-γ cell ratio decreased in the more severely affected CSS-CAD subgroups. CONCLUSIONS: Based on the clinical analysis and immunopathogenic results, avoidance of excessive sun exposure, and topical and systemic blocking agents for photo(contact) allergens are recommended. Additionally, conventional immunomodulators and emerging agents including JAK-STAT inhibitors may be administered for CAD treatment in the future.

The long-term risk of lymphoma and skin cancer did not increase after topical calcineurin inhibitor use and phototherapy in a cohort of 25,694 patients with vitiligo.

BACKGROUND: Topical calcineurin inhibitors have been used to treat vitiligo, either alone or in combination with phototherapy; however, the long-term safety of these agents remains controversial. OBJECTIVE: To investigate the risk of lymphoma and skin cancer in vitiligo patients who received topical calcineurin inhibitors or phototherapy. METHODS: A multicenter retrospective cohort study of 25,694 vitiligo patients who received topical calcineurin inhibitors or phototherapy for 6 weeks or more between 2001 and 2019 was performed. Cumulative doses of topical calcineurin inhibitors and total phototherapy sessions were determined. Outcomes were the development of lymphoma or skin cancer after enrollment, confirmed through chart review and pathology reports. RESULTS: During 95,203 person-years, 13 cases of lymphoma, 22 of actinic keratosis, 15 of nonmelanoma skin cancer, and 5 of melanoma were observed. The risk of lymphoma and skin cancer was not significantly increased by topical calcineurin inhibitor dose or phototherapy sessions. The interaction between the topical calcineurin inhibitors and phototherapy was not associated with an increased risk of skin cancer. LIMITATIONS: Retrospective study, individual follow-up duration less than 4 years, and no adjustment for comorbidities and medication history. Not generalizable to other races. CONCLUSION: The long-term risk of skin cancer or lymphoma was not associated with the use of topical calcineurin inhibitors, phototherapy, and both treatments in combination in patients with vitiligo.

Development of evidence-based consensus on critical issues in the management of patients with vitiligo: A modified Delphi study.

BACKGROUND/PURPOSE: Vitiligo remains a major challenge in dermatology. However, much of the treatment remains unclear, because little evidence is available. We sought to answer some critical questions pertaining to management of vitiligo patients. METHODS: A modified Delphi process among 31 vitiligo experts was conducted. A total of 12 clinical vitiligo treatment questions without clear answers were collected via a vote. To address each question, two members performed systematic literature reviews and prepared draft statements along with the levels of evidence and strength of recommendation. After reviewing the draft, all expressed their extent of agreement from 1 (strong disagreement) to 9 (strong agreement) for each item. The drafts were revised to reflect suggested comments. Discussion continued until all members agreed with the ultimate decision. RESULTS: The consensus process was completed after five rounds. We identified the best answers to 12 key questions, including issues on long-term phototherapy, systemic and topical corticosteroids, topical calcineurin inhibitors, immunosuppressants, excimer laser treatment, and surgical interventions. CONCLUSION: This consensus would complement current guidelines and aid both physician and patient decision-making in the treatment of vitiligo.

Health-related quality of life in adult males with lower urinary tract symptoms.

PURPOSE: To assess the status and impact of lower urinary tract symptoms (LUTS) on health-related quality of life (HRQoL) in a community-based sample of Korean adult males. METHODS: We analyzed the data of 101,606 adult males aged ≥ 19 years of age obtained during the 2011 Korean Community Health Survey. Subject data were assessed for LUTS and HRQoL using international prostate symptom scores, and EuroQol-five-dimensions three-level version (EQ-5D-3L) and EuroQol-visual analogue scale (EQ-VAS) scores. RESULTS: Of the 101,606 subjects, 53,323 (52.5%) reported having at least one LUTS and 3116 (3.1%) had an IPSS of ≥ 20, indicating severe LUTS. In those aged 19-39 years, 28.7% (8343/29,072) reported they had mild to severe LUTS. The prevalence of LUTS was high among those aged 40-59 years (47.7%), 60-79 years (80.5%), and ≥ 80 years (91.2%). In addition, EQ-5D-3L and EQ-VAS scores decreased as LUTS severity and frequency increased. CONCLUSIONS: Adult men of all ages with mild to severe LUTS have poorer health statuses and quality of life. Even among young males, LUTS severity and was found to negatively affect HRQoL.

Effect of Surface Modifications and Their Reaction Conditions on Multi-Walled Carbon Nanotubes for Thermal Conductive Composite Material.

Thermally conductive composite materials were fabricated using Al2O3 and surface-modified MWCNTs on an ETDS matrix. The MWCNT surfaces were modified using a solution containing H2O2 and H2SO4/HNO3 and examined at various reaction times. After surface modification, the ratios of the functional groups introduced were compared. The changes in MWCNT morphology and thermal conductivity were also investigated for various reaction times. It was observed from the results that the MWCNTs exposed to 1 h acid treatment had the highest thermal conductivity without any decrease in their length. Based on the optimum oxidization of MWCNTs, further surface modification was performed using APTES, a silane coupling agent, using two different reactions. After the reaction, large particle aggregations were observed on the amine-terminated MWCNTs, which reacted with a mixture of EtOH and DI water. These agglomerates did not re-disperse after long-time sonication. However, the silanol-terminated MWCNTs were easily dispersed in EtOH via sonication, and their composite materials had outstanding thermal conductivities. Moreover, more amount of MWCNTs were processable using the same Al2O3 and ETDS concentrations, which also led to enhanced thermal conductivities compared to the other surface modification methods.

Fabrication of Water Soluble Polymer Capsules for Protecting Mineral Admixtures in Groundwater for Emergency Recovery of Sinkhole.

Polyethylene glycol (PEG) based water-soluble polymer composites were fabricated for mineral admixture encapsulants to be used in underground sinkhole restoration. Linear low-density polyethylene (LLDPE) and talc were added to the composites to increase their mechanical strengths and heat resistances. PEG/LLDPE/Talc composites were manufactured via melt mixing using a twin extruder. Blending PEG and LLDPE increased the mechanical properties and heat resistances of the composite, but decreased the water solubility. Talc was added to the composite to increase mechanical properties and heat resistance. The addition of talc increased the water solubilities of PEG-based composites. The highest tensile strength and impact strength were 2.89 MPa and 2.86, respectively, the increase rate being 9.63-fold relative to that of pristine PEG.

Increased incidence of chronic actinic dermatitis in relation to climate changes and air pollution during the past 15 years in Korea.

BACKGROUND: Chronic actinic dermatitis (CAD) develops in seasons where there is high sun exposure, such as summer, and can persistent throughout the year in severely affected cases. The authors noted that CAD prevalence increased in relation to climate changes and air pollutants. METHODS: We retrospectively analyzed 294 patients with newly diagnosed CAD between December 2000 and November 2016. We investigated the annual trend of sun hours, humidity, and ground-level ozone and respirable particles (PM10) in Pusan, Korea; correlations between climate change and/or air pollution and the incidence of patient with CAD were analyzed. RESULTS: The incidence of patients with CAD apparently increased annually during the period of the study. The majority of patients presented in summer. Pearson's correlation analysis showed an increasing tendency of CAD occurrence to be correlated with sun hours (R = .706, P = .002), ground-level ozone (R = .542, P = .03), and mean air humidity (R = .608, P = .012). Inversely, PM10 showed a negative correlation with CAD occurrence (R = -.713, P = .002). The correlations identified by multiple regression analysis showed a strong positive association between the incidence of CAD and sun hours (P = .029) and a negative association between the incidence of CAD and PM10 (P = .027) (adjusted R2  = .778). CONCLUSION: The increased incidence of CAD may be related to sun hours and inversely related to PM10.

The clinical severity score of chronic actinic dermatitis correlates with in vivo photoallergic reactions and the immunologic parameters related to a shift towards Th2 immunity from the Th2/Th1 balanced status in patients with chronic actinic dermatitis.

BACKGROUND: Chronic actinic dermatitis (CAD) has a more complicated pathogenetic basis than others. The clinical grading system and its correlations with the clinical and immunological parameters still remained to be investigated to define the nature of CAD in a more detailed manner. OBJECTIVES: We investigated correlations of the clinical severity score of CAD (CSS-CAD) with the clinical and immunological parameters. METHODS: We evaluated 72 patients with CAD and classified them into three groups according to the CSS-CAD. We analysed total IgE level, peripheral blood (PB) eosinophil count, the ratio of Th2cell (CCR4 + CD4 +) percentage over Th1 cell (CXCR3 + CD4 +) percentage (Th2/Th1) and/or the sum of suppressor/cytotoxic T cells. RESULTS: The total IgE levels and the percentage of PB eosinophils were higher in the severer group than other groups. A shift towards Th2 from Th2/Th1 balanced status may be affected by total counts of suppressor T cells, and the patient with higher Th2/Th1 ratio than balanced status had the more proportion in the severer CSS-CAD group than other groups. CONCLUSION: The CSS-CAD correlates with total IgE level, PB eosinophil count and a shift towards Th2 immunity from Th2/Th1. So we suggest the Th1/Th2 dysbalance may be affected by the CSS-CAD.

The influence of attention toward facial expressions on size perception.

According to the New Look theory, size perception is affected by emotional factors. Although previous studies have attempted to explain the effects of both emotion and motivation on size perception, they have failed to identify the underlying mechanisms. This study aimed to investigate the underlying mechanisms of size perception by applying attention toward facial expressions using the Ebbinghaus illusion as a measurement tool. The participants, female university students, were asked to judge the size of a target stimulus relative to the size of facial expressions (i.e., happy, angry, and neutral) surrounding the target. The results revealed that the participants perceived angry and neutral faces to be larger than happy faces. This finding indicates that individuals pay closer attention to neutral and angry faces than happy ones. These results suggest that the mechanisms underlying size perception involve cognitive processes that focus attention toward relevant stimuli and block out irrelevant stimuli.

Palladium(II)-Catalyzed Tandem Synthesis of Acenes Using Carboxylic Acids as Traceless Directing Groups.

A straightforward synthetic strategy for generating useful anthracene derivatives was developed involving palladium(II)-catalyzed tandem transformation with carboxylic acids as traceless directing groups. Carboxyl-directed C-H alkenylation, carboxyl-directed secondary C-H activation and rollover, intramolecular C-C bond formation, and decarboxylative aromatization are proposed as the key steps in the tandem reaction pathway. This novel synthetic route utilizes a broad range of substrates and provides a convenient synthetic tool that allows access to acenes.

Correlation between obesity and clinicopathological factors in patients with papillary thyroid cancer.

PURPOSE: Epidemiological studies have shown that obesity is associated with an increased risk of thyroid cancer. However, the exact nature of the relationship, especially with respect to the behavior of the cancer, remains uncertain. The objective of this study was to evaluate the correlation between the body mass index (BMI) and clinicopathological features of thyroid cancer patients. METHODS: From January 2009 to April 2010, 716 consecutive patients (602 females and 114 males; mean age 47.02 ± 11.73 years) with papillary thyroid cancer (PTC) were analyzed retrospectively. Patients were divided into two subgroups according to age (<45 years, ≥45 years). The BMI groupings were based on standardized categories set by the World Health Organization. The relationships between the BMI and these parameters were assessed. RESULTS: A non-overweight BMI was associated with a younger age and female gender. Tumor multiplicity was related to a higher BMI. In an age-related subgroup analysis, a higher BMI was correlated with more lymph node involvement (p = 0.004), lymphatic invasion (p = 0.003) and tumor multiplicity (p = 0.008) in patients ≥45 years of age. The absence of an association between the BMI and T stage, nodal status, vascular invasion, lymphatic invasion, and extrathyroidal extension was noted in a statistical analysis. In the subgroup of patients <45 years of age, no positive associations were observed between the BMI and any parameters other than age and sex. CONCLUSIONS: In PTC patients ≥45 years of age, a higher BMI was associated with more aggressive tumor features, such as lymph node metastasis, lymphatic invasion, and tumor multiplicity.

A copper-mediated cross-coupling approach for the synthesis of 3-heteroaryl quinolone and related analogues.

An efficient and practical method for the direct cross-coupling between quinolones and a range of azoles was developed via copper-mediated C-H functionalization. This synthetic strategy provides a convenient access to a variety of C3-heteroaryl quinolones, quinolinone, nalidixic acid, uracil, pyridone and chromone derivatives, which are prominent structural motifs in many biologically active compounds.

Efficacy of fluorescence diagnosis-guided Mohs micrographic surgery for pigmented vs non-pigmented basal cell carcinoma.

Pigmented basal cell carcinoma (PBCC) occurs more frequently in Asian population. The efficacy of fluorescence diagnosis (FD) for PBCCs treated with Mohs micrographic surgery has not yet been determined. This study enrolled 255 patients with 258 biopsy-proven BCC lesions: 199 PBCCs (77.1%) and 59 non-PBCCs (22.9%). We compared the clinicopathological and surgical features of the PBCCs and non-PBCCs. Each group was divided into 2 sub-groups, those assessed and not assessed by FD, to retrospectively analyse surgical features. Aggressive histological subtypes were less prevalent in PBCCs than in non-PBCCs. PBCCs required significantly fewer stages of Mohs excision, with significantly smaller surgical margins and surgical depth, than non-PBCCs. FD did not confer any benefits on PBCCs during Mohs micrographic surgery. However, non-PBCCs assessed by FD required significantly fewer Mohs stages, with significantly smaller surgical margins, than lesions not assessed by FD. These findings suggest that FD should be performed before Mohs micrographic surgery to delineate the margins of non-PBCCs in Asians.

Monolayer, open-mesh, pristine PEDOT:PSS-based conformal brain implants for fully MRI-compatible neural interfaces.

Understanding brain function is essential for advancing our comprehension of human cognition, behavior, and neurological disorders. Magnetic resonance imaging (MRI) stands out as a powerful tool for exploring brain function, providing detailed insights into its structure and physiology. Combining MRI technology with electrophysiological recording system can enhance the comprehension of brain functionality through synergistic effects. However, the integration of neural implants with MRI technology presents challenges because of its strong electromagnetic (EM) energy during MRI scans. Therefore, MRI-compatible neural implants should facilitate detailed investigation of neural activities and brain functions in real-time in high resolution, without compromising patient safety and imaging quality. Here, we introduce the fully MRI-compatible monolayer open-mesh pristine PEDOT:PSS neural interface. This approach addresses the challenges encountered while using traditional metal-based electrodes in the MRI environment such as induced heat or imaging artifacts. PEDOT:PSS has a diamagnetic property with low electrical conductivity and negative magnetic susceptibility similar to human tissues. Furthermore, by adopting the optimized open-mesh structure, the induced currents generated by EM energy are significantly diminished, leading to optimized MRI compatibility. Through simulations and experiments, our PEDOT:PSS-based open-mesh electrodes showed improved performance in reducing heat generation and eliminating imaging artifacts in an MRI environment. The electrophysiological recording capability was also validated by measuring the local field potential (LFP) from the somatosensory cortex with an in vivo experiment. The development of neural implants with maximized MRI compatibility indicates the possibility of potential tools for future neural diagnostics.

Bionic artificial skin with a fully implantable wireless tactile sensory system for wound healing and restoring skin tactile function.

Tactile function is essential for human life as it enables us to recognize texture and respond to external stimuli, including potential threats with sharp objects that may result in punctures or lacerations. Severe skin damage caused by severe burns, skin cancer, chemical accidents, and industrial accidents damage the structure of the skin tissue as well as the nerve system, resulting in permanent tactile sensory dysfunction, which significantly impacts an individual's daily life. Here, we introduce a fully-implantable wireless powered tactile sensory system embedded artificial skin (WTSA), with stable operation, to restore permanently damaged tactile function and promote wound healing for regenerating severely damaged skin. The fabricated WTSA facilitates (i) replacement of severely damaged tactile sensory with broad biocompatibility, (ii) promoting of skin wound healing and regeneration through collagen and fibrin-based artificial skin (CFAS), and (iii) minimization of foreign body reaction via hydrogel coating on neural interface electrodes. Furthermore, the WTSA shows a stable operation as a sensory system as evidenced by the quantitative analysis of leg movement angle and electromyogram (EMG) signals in response to varying intensities of applied pressures.

Efficacy of photodynamic diagnosis-guided Mohs micrographic surgery in primary squamous cell carcinoma.

BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) usually has ill-defined margins because of its irregular invasive patterns. OBJECTIVE: To evaluate the surgical efficacy of photodynamic diagnosis (PDD) in primary cSCC treated using Mohs micrographic surgery (MMS). METHODS & MATERIALS: We examined 67 cases of biopsy-proven primary facial cSCC treated with MMS. The 67 SCC were divided into the two groups depending on PDD application: PDD group (n = 38, 56.7%) and non-PDD group (n = 29, 43.3%). We analyzed the differences in surgical features between the PDD and non-PDD groups. RESULTS: The PDD group required fewer Mohs stages (1.37 vs 1.83, p = .02) and smaller surgical margins (8.03 vs 11.24 mm, p = .03). PDD showed additional benefits in terms of surgical margin and Mohs stage, especially in low-risk SCC, including thin (≤4 mm), small (≤20 mm), well-differentiated, and nonulcerative tumors (p < .05) but did not show beneficial effects in high-risk SCC (p > .05) during MMS. CONCLUSION: PDD can increase surgical efficacy of primary cSCC during MMS. These benefits are more pronounced in low-risk SCC. We recommend PDD as a simple and useful technique for delineating the margins of low-risk SCC before MMS.

Diminished emotion recognition with reduced face gaze in complex situation in individuals with broad autism phenotype.

Background/objective: Individuals with broad autism phenotype (BAP) showed a diminished ability to recognize emotion. This study aims to examine whether their decline in emotion recognition ability could be more clearly identified as task complexity increased and whether their decline could be influenced by their eye-gaze patterns. Method: 41 individuals with BAP and 40 healthy controls performed two types of emotion recognition tasks. After confirming conditions wherein the BAP group did not perform well compared to the control group, we compared gaze proportion on faces and context between groups when performing the conditions. Results: The more difficult the task, the clearer the significant relationships between the level of autistic traits and emotion recognition ability. The BAP group showed lower accuracy compared to the control group when a face with mild emotional intensity was presented with context. In terms of gaze proportion, the BAP group looked less at faces when recognizing emotions compared to the control group. Conclusion: These findings indicate that diminished emotion recognition ability in individuals with BAP may be influenced by face gaze.

Refractory Bullous Pemphigoid Successfully Treated with Reslizumab: A Possible Novel Therapeutic Modality.

Bullous pemphigoid (BP) is a chronic, autoimmune blistering disease that has concerning morbidity and mortality rates. Recently, several studies have focused on eosinophils due to their significant role in the pathogenesis of BP, considering that they are ubiquitous in the serum, tissue, and blister fluids of patients with BP. With this context, precision therapy that targets mediators of eosinophil activity could be a possible novel therapeutic strategy. Interleukin (IL)-5 is crucial for B-cell maturation, which consequently results in immunoglobulin production, and promotes eosinophil differentiation, proliferation, and activation. To our best knowledge, reslizumab has not yet been reported to treat BP. Herein, we report a case of steroid- and omalizumab-resistant BP treated successfully using reslizumab. Our data suggest that IL-5 could be a novel specific biologic target within the entire immunopathogenesis of BP, and reslizumab would be a novel therapeutic modality.

Missense Variant c.3301C>T (p.R1101W) in von Willebrand Factor A Sequence in a Patient with Recessive Dystrophic Epidermolysis Bullosa Pruriginosa with Compound Heterozygous COL7A1 Variants.

Dystrophic epidermolysis bullosa (DEB) pruriginosa is a rare subtype of DEB characterized by multiple, violaceous, and severe pruritic lichenified nodules along with blisters. Here, we report the case of a Korean male who, since the age of 3 years, had multiple pruritic nodules with blisters on both lower extremities. Genetic testing is required to diagnose DEB pruriginosa because its clinical and histologic features are inconclusive. We identified compound heterozygous COL7A1 variants of c.5797C>T (p.R1933*) and c.3301C>T (p.R1101W) in the patient, leading to a diagnosis of recessive DEB pruriginosa. Among the variants identified, c.3301C>T is a novel missense variant that has not been reported previously. This variant is in exon 26, which encodes von Willebrand factor A (vWFA) in collagen type VII. vWFA is known to preserve normal dermal structures by interacting with dermal collagens and basement membranes. Considering that this variant contradicts the general concept that autosomal dominant inheritance is more common and that variants typically occur in the triple helical collagenous domain of COL7A1 in DEB pruriginosa, we focus on the rarity of this case and the possible pathogenic role of the c.3301C>T (p.R1101W) variant.