A versatilely high fidelity electric machines emulator for rapid testing of motor controller.

Electric machines emulators (EMEs) based on hardware-in-the-loop (HIL), which effectively act as emulators to mimic the actual motor behavior of Interior Permanent Magnet (IPM) machines. EME is frequently used to evaluate motor controller and motor control methodologies prior to development. The inverse magnetization motor model, which is used as the basis for real-time simulation in this paper's proposal for an electric machine emulator system based on HIL, uses FEA to create the motor model data. The nonlinear features of the motor may be successfully replicated with this motor model, and the accuracy of the electric machine emulator can be enhanced by using a straightforward and trustworthy motor controller. The real-time simulation tool typhoon HIL is used in the study to develop a hardware-in-the-loop simulation platform for an IPM electric machines emulator.

Selective S-Arylation of Sulfenamides with Arynes: Access to Sulfilimines.

Sulfilimines, the aza analogues of sulfoxides, are of increasing interest in medicinal and agrochemical research programs. However, the development of efficient routes for their synthesis has remained relatively unexplored. In this study, we report a transition metal-free, selective S-arylation reaction between sulfenamides and arynes, enabling the facile preparation of structurally diverse sulfilimines under mild and redox-neutral conditions in good yields. The application value of our method was further demonstrated by scale-up synthesis, downstream derivatization, and robustness screen.

Safety and efficacy of Pimecrolimus in atopic dermatitis among Chinese infants: a sub-group analysis of a five-year open-label study.

INTRODUCTION: Atopic dermatitis (AD) exhibits difference in immune polarization between Caucasians and Asian races due to which an evaluation of the efficacy and safety of Pimecrolimus (PIM) in Asian population is called for. The current study addresses the need via a sub-group analysis of the PETITE study (NCT00120523) to evaluate the safety and efficacy of PIM in Chinese infants. MATERIALS AND METHODS: Patients with AD (≥3 months-<12 months of age) were randomized in a 1:1 ratio to either PIM 1% cream or topical corticosteroids (TCS). The primary endpoint was safety. The secondary endpoint was efficacy. RESULTS: 120 patients were randomized to either PIM 1% or TCS (n = 61 for PIM, n = 59 for TCS). The most often reported adverse events were reported by similar proportions of patients treated with PIM or TCS. There was a progressive increase in overall IGA treatment success in infants treated with PIM (82.9%, p < .05, 95% CI: 70.4, 95.3) after 26 weeks which was comparable to the TCS group (88.5%, p < .05, 95% CI: 79.8, 97.1). CONCLUSION: PIM showed an early and sustained efficacy in the Chinese sub-population with a substantial corticosteroid-sparing effect in patients with AD.

Hierarchical Perception Adversarial Learning Framework for Compressed Sensing MRI.

The long acquisition time has limited the accessibility of magnetic resonance imaging (MRI) because it leads to patient discomfort and motion artifacts. Although several MRI techniques have been proposed to reduce the acquisition time, compressed sensing in magnetic resonance imaging (CS-MRI) enables fast acquisition without compromising SNR and resolution. However, existing CS-MRI methods suffer from the challenge of aliasing artifacts. This challenge results in the noise-like textures and missing the fine details, thus leading to unsatisfactory reconstruction performance. To tackle this challenge, we propose a hierarchical perception adversarial learning framework (HP-ALF). HP-ALF can perceive the image information in the hierarchical mechanism: image-level perception and patch-level perception. The former can reduce the visual perception difference in the entire image, and thus achieve aliasing artifact removal. The latter can reduce this difference in the regions of the image, and thus recover fine details. Specifically, HP-ALF achieves the hierarchical mechanism by utilizing multilevel perspective discrimination. This discrimination can provide the information from two perspectives (overall and regional) for adversarial learning. It also utilizes a global and local coherent discriminator to provide structure information to the generator during training. In addition, HP-ALF contains a context-aware learning block to effectively exploit the slice information between individual images for better reconstruction performance. The experiments validated on three datasets demonstrate the effectiveness of HP-ALF and its superiority to the comparative methods.

Analysis of the Role of Informatization, Based on Data Analyses, in Hospitals to Improve Hospital Management.

Context: The informatization of the medical system is increasingly closely linked with people's daily life. As people pay more and more attention to the quality of life, it's very necessary to closely integrate the management information and clinical information systems to promote the steady improvement of a hospital's service level. In the process of modernization Chinese hospitals, comprehensive promotion of hospital informatization is very important. Objective: The study intended to examine the role in China of informatization for hospital management, analyze its shortcomings in that role, and explore its role based on an analysis of hospital data, and propose effective measures to continuously improve the level of informatization, promote the steady improvement of hospital management and services, and fully demonstrate the application advantages of information construction. Design: The research team discussed: (1) China's informatization, including hospitals' roles, current informatization, the information community, and medical and information-technology (IT) staff; (2) methods of analysis, including system composition, theoretical basis, definition of the problem as well as data evaluation, collection, processing, mining and model evaluation and knowledge presentation; (3) the procedures the team followed to perform a case study, including types of hospital data and the process framework, and (4) the study's results from informatization based on data analysis, including satisfaction surveys for outpatients, inpatients, and medical staff. Setting: The study took place at Nantong First People's Hospital in Jiangsu Province in Nantong, China. Conclusions: In the process of hospital management, it's imperative to strengthen hospital informatization, which can continuously strengthen a hospital's service capacity, ensure good-quality medical service, further improve the discipline of the database construction, enhance the satisfaction of employees and patients, and achieve a high-quality and benign development for the hospital.

Validation of diagnostic criteria for atopic dermatitis and proposal of novel diagnostic criteria for adult and elderly Chinese populations: a multicentre, prospective, clinical setting-based study.

BACKGROUND: A previous validation study showed a very low sensitivity and higher specificity associated with Hanifin and Rajka criteria (H&R) and the UK Working Party criteria (UKWP) in diagnosing AD vs. the Chinese criteria of atopic dermatitis (AD) for children (CCAD). However, their diagnostic efficacy in adult and elderly Chinese populations remains unknown. OBJECTIVES: To validate the diagnostic efficacy of three sets of AD criteria in adult and elderly Chinese populations in a hospital setting. METHODS: A total of 1034 patients (aged 19-95 years) from five university hospital dermatological clinics were recruited. Medical history, dermatological examination, AD diagnosis and evaluation of AD severity were done by dermatologists. Each patient was investigated by two dermatologist panels, one to establish a clinical diagnosis, and the other to identify and record the major or minor signs of H&R criteria, UKWP criteria and CCAD. Taking clinical diagnosis as the reference, the diagnostic efficacy of three sets of diagnostic criteria was evaluated. The χ2 test or rank sum test were used for between-groups comparisons. RESULTS: CCAD had a higher sensitivity (84.0%), especially among mild and moderate cases of AD (72.7% and 90.3%, respectively), than the H&R (58.0%; P < 0.001) and UKWP criteria (56.0%; P < 0.001) in diagnosing AD. The specificity of CCAD (92.7%) was slightly lower than the H&R (97.3%; P < 0.001) or UKWP criteria (97.4%; P < 0.001). The CCAD had the highest Youden index (0.77), accuracy rate (0.90) and Kappa value (0.76) of the three sets of diagnostic criteria. CONCLUSIONS: Consistent with results in a population of Chinese children, although the H&R and UKWP criteria had a high specificity for diagnosing AD, their low sensitivity limited their use in adult and elderly Chinese patients. Based on the high sensitivity and favourable diagnostic efficacy, the CCAD is proposed for AD diagnosis in adult and elderly Chinese populations, especially for cases of mild and moderate AD.

Lidocaine alleviates inflammation and pruritus in atopic dermatitis by blocking different population of sensory neurons.

BACKGROUND AND PURPOSE: Atopic dermatitis is a common chronic pruritic inflammatory disease of the skin involving neuro-immune communication. Neuronal mechanism-based therapeutic treatments remain lacking. We investigated the efficacy of intravenous lidocaine therapy on atopic dermatitis and the underlying neuro-immune mechanism. EXPERIMENTAL APPROACH: Pharmacological intervention, immunofluorescence, RNA-sequencing, genetic modification and immunoassay were performed to dissect the neuro-immune basis of itch and inflammation in atopic dermatitis-like mouse model and in patients. KEY RESULTS: Lidocaine alleviated skin lesions and itch in both atopic dermatitis patients and calcipotriol (MC903)-induced atopic dermatitis model by blocking subpopulation of sensory neurons. QX-314, a charged NaV blocker that enters through pathologically activated large-pore ion channels and selectivity inhibits a subpopulation of sensory neurons, has the same effects as lidocaine in atopic dermatitis model. Genetic silencing NaV 1.8-expressing sensory neurons was sufficient to restrict cutaneous inflammation and itch in the atopic dermatitis model. However, pharmacological blockade of TRPV1-positive nociceptors only abolished persistent itch but did not affect skin inflammation in the atopic dermatitis model, indicating a difference between sensory neuronal modulation of skin inflammation and itch. Inhibition of activity-dependent release of calcitonin gene-related peptide (CGRP) from sensory neurons by lidocaine largely accounts for the therapeutic effect of lidocaine in the atopic dermatitis model. CONCLUSION AND IMPLICATIONS: NaV 1.8+ sensory neurons play a critical role in pathogenesis of atopic dermatitis and lidocaine is a potential anti-inflammatory and anti-pruritic agent for atopic dermatitis. A dissociable difference for sensory neuronal modulation of skin inflammation and itch contributes to further understanding of pathogenesis in atopic dermatitis.

Intravenous immunoglobulin therapy in children with severe atopic dermatitis.

Children with severe atopic dermatitis (AD) can benefit from intravenous immunoglobulin (IVIG) therapy. This study aimed to identify the efficacy and safety of IVIG therapy in children with severe AD. Twenty pediatric AD patients were enrolled in this study. Patients with an Investigator's Global Assessment score of 0 or 1 or a reduction of 2 points after treatment were defined as high-responders (HRs), otherwise, they were defined as low-responders (LRs). Twelve patients (60%) achieved an excellent treatment response after 2 months, while eight (40%) had a low response. The Scoring Atopic Dermatitis index had improved significantly at 2 months post-treatment compared with baseline (p < 0.001). Baseline total serum IgE levels and eosinophil counts were elevated in all subjects and decreased significantly at 2 months post-treatment (p = 0.004 and 0.021, respectively). Baseline IgE levels were significantly higher in the HR group compared with the LR group (p = 0.020). The treatment was well tolerated. Fever was the most common adverse event and occurred in five patients (25%). In conclusion, IVIG could be a safe and effective therapy for children with severe AD and may be more effective in patients with higher IgE levels. Further studies are needed to investigate the different therapeutic responses in patients with different AD phenotypes.

Frequency measurement of microwave signals in a wide frequency range based on an optical frequency comb and channelization method.

We propose a new, to the best of our knowledge, scheme for the frequency measurement of wideband microwave signals by applying the optical frequency comb (OFC) and channelization technique. Unlike the usual method of using radio-frequency driving signals to generate an OFC, our scheme uses digital driving signals, which makes the comb spacing adjustable and the comb bandwidth wider. In the measurement process, multiple sets of beat signals can be obtained at the same time, and multiple frequency components of the microwave signals can be measured at the same time. The theoretical analysis model of the scheme is established, and the scheme is validated by VPI simulation software. The results show that the range of frequency measurement is 0∼50GHz, and it can be further expanded by extending the width of the OFC.

Woolly hair nevus caused by somatic mutation and Costello syndrome caused by germline mutation in HRAS: Consider parental mosaicism in prenatal counseling.

Germline mutations in HRAS cause Costello syndrome (CS), while mosaic mutations in HRAS show a variability of phenotypes, ranging from mild features such as keratinocytic epidermal nevus (KEN), sebaceous nevus (SN), woolly hair nevus (WHN) with KEN, to severe manifestations of CS with cutis laxa. We report two individuals. The first was a 2-year-old boy with woolly hair nevus (WHN) without any other cutaneous involvement, in whom somatic HRAS mutation (c.34G>A; p.Gly12Ser) was identified in his affected scalp and hair follicle specimens. This is the first reported WHN type 1 (no cutaneous involvement) patient caused by somatic HRAS mutation. The other individual was a 12-year-old girl with CS caused by germline HRAS mutation (c.34G>A), that manifested with coarse face, palmoplantar keratoderma, deep palmar and plantar creases, hyperpigmented patches, asymmetry and deformity of lower limbs, atopic dermatitis, as well as mental retardation. Of note, a linear hyperpigmented plaque was observed in her father's lumbosacral region. Although the father refused to provide semen and skin tissue for further examination, this reminds us of possible mosaicism in parents of individuals with germline de novo HRAS mutation and underlines the importance of parental evaluation for prenatal counseling.

The clinical efficacy and safety of anti-IgE therapy in recessive dystrophic epidermolysis bullosa.

The treatment of recessive dystrophic epidermolysis bullosa (RDEB) remains challenging. Elevated IgE levels have previously been reported in several RDEB patients. In this prospective, single-centre, open intervention study, elevated IgE levels were seen in 11 out of 12 patients with intense pruritus, and the patients with elevated IgE levels received anti-IgE therapy every 4 weeks for at least three cycles. Compared with the baseline, 10 patients with RDEB had good clinical outcomes with enhanced wound healing, a reduction in Birmingham (epidermolysis bullosa) EB severity score by 15%, a reduction in affected body surface area by 23.3%, amelioration of skin inflammation, and an increase in type VII collagen deposition by 13.1-fold. All the patients had a good tolerance to anti-IgE therapy. Furthermore, patients with higher IgE levels tended to have higher disease severity and more favorable clinical outcomes. Our report also suggested the potential role of IgE in the pathogenesis of inflammatory conditions associated with RDEB. (ChiCTR1900021437).

The anti-tumor effects of the combination of microwave hyperthermia and lobaplatin against breast cancer cells in vitro and in vivo.

BACKGROUND: Breast cancer is the main lethal disease among females. The combination of lobaplatin and microwave hyperthermia plays a crucial role in several kinds of cancer in the clinic, but its possible mechanism in breast cancer has remained indistinct. METHODS: Mouse models were used to detect breast cancer progression. Cell growth was explored with MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulphonyl)-2H-tetrazolium) and colony formation assays. Cell migration and invasion were investigated with a transwell assay. Cell apoptosis was probed with flow cytometry. The expression of apoptosis-associated proteins was examined with Western blots. RESULT: Combination treatment decreased breast cancer cell viability, colony formation, cell invasion and metastasis. In addition, the treatment-induced breast cancer cell apoptosis and autophagy, activated the c-Jun N-terminal kinase (JNK) signaling pathway, suppressed the protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling pathway, and down-regulated IAP and Bcl-2 family protein expression. CONCLUSION: These results indicate that lobaplatin is an effective breast cancer anti-tumor agent. Microwave hyperthermia was a useful adjunctive treatment. Combination treatment was more efficient than any single therapy. The possible mechanism for this effect was mainly associated with activation of the JNK signaling pathway, inactivation of the AKT/mTOR signaling pathway and down-regulation of the Bcl-2 and IAP families.

Update on the Pathogenesis and Therapy of Atopic Dermatitis.

Atopic dermatitis (AD) is a common inflammatory skin disorder characterized by recurrent eczematous lesions and intense itch. Although it most often starts in infancy and affects children, it is also highly prevalent in adults. In this article, the main aspects of AD have been updated, with a focus on the pathogenetic and therapeutic aspects. The pathogenesis of AD is complex, and it is evident that a strong genetic predisposition, epidermal dysfunction, skin microbiome abnormalities, immune dysregulation, and the neuroimmune system are critical in AD development. Mutations in the genes associated with disrupted epidermal barrier, exaggerated pathological inflammation and inadequate antimicrobial peptides can promote enhanced Th2 inflammation and mediate pruritus. Current understanding of etiology highlights gut microbial diversity, NK cell deficiency, and different immunological phenotype with age and race. For topical anti-inflammatory treatment for mild-to-severe AD, phosphodiesterase 4 inhibitors (PDE-4), JAK inhibitors, and microbiome transplantation with Roseomonas mucosa provided more management selections. The treatment of moderate-to-severe AD has been limited to merely symptomatic and relatively nonspecific immunosuppressive approaches. In-depth understanding of the pathogenesis of AD has led to the development of innovative and targeted therapies, such as biologic agents targeting interleukin (IL)-4, IL-13 and JAK/STAT inhibitors. Other potential therapeutic agents for AD include agents targeting the T helper (Th) 22 and Th17/IL23 pathway. Antipruritic therapy and complementary probiotics therapy have also been reviewed.

Interaction between antibiotic use and MS4A2 gene polymorphism on childhood eczema: a prospective birth cohort study.

BACKGROUND: Eczema is usually the first allergic manifestation to appear in life attributed to gene-environment interactions. IL13, IL4, MS4A2 and ILR4A are four key inflammatory genes associated with atopy. This study aimed to explore gene-environment interactions on eczema in early life among the above four genes and environmental factors in Chinese Han children. METHODS: Five hundred ninety-seven children from a birth cohort who completed two-year follow-up were enrolled and their cord blood was collected. Subjects were genotyped for six polymorphisms in the aforementioned four genes. The children were followed at 6, 12 and 24 months, with epidemiologic information and medical history of eczema collected by questionnaire and eczema assessed by dermatologists. RESULTS: Among the 597 children, 168 were diagnosed with eczema and the others were not after 2 years of follow-up. MS4A2 rs569108 GG genotype (P = 1.68E-02, odds ratio (OR) = 4.66) and antibiotic use (P = 3.75E-4, OR = 2.02) were found independently associated with development of childhood eczema. Children with both antibiotic use and MS4A2 rs569108 GG genotype were more likely to develop eczema than those with only antibiotic use or GG homozygote (OR = 6.24 VS. 2.04 or 4.68). CONCLUSIONS: MS4A2 rs569108 polymorphism and antibiotic use were solely associated with eczema, and they interacted with each other to increase the risk of developing the disease in Chinese Han toddlers. Long-term follow-up along with functional and replication studies are still needed.

Factors associated with persistence of early-onset atopic dermatitis up to the age of 12 years: a prospective cohort study in China.

Atopic dermatitis (AD) can remit as age increases. However, long-term follow-up studies evaluating disease evolution and related factors of persistence of early-onset AD are sparse. This study aimed to identify factors associated with the persistence of early-onset AD. In this prospective cohort study, 260 patients with onset of AD before age two years old were enrolled. Clinical examination was performed and a questionnaire survey completed at enrolment. In addition, the filaggrin gene (FLG) of all participants was sequenced to identify mutations within this gene. Patients were followed at age six and 12. The remission rate was 50.8% at age six and 70.3% at age 12. Persistent AD was associated with a higher SCORAD index at baseline (p < 0.001), a family history of asthma (p = 0.003) and food allergen sensitization (p = 0.033). However, the presence or absence of FLG mutation did not show any significant association with persistent AD. Prognostic factors for persistence of AD were analysed by logistic regression analysis. Disease severity according to SCORAD index at baseline (OR: 1.039; 95% CI: 1.018-1.059; p < 0.001) and family history of asthma (OR: 3.008; 95% CI: 1.297-7.007; p = 0.011) were risk factors that may predict persistent AD based on multivariate regression analysis. It is important to stratify early-onset AD according to severity and investigate family allergic history in order to establish appropriate individual management. Moreover, genetic factors other than FLG mutation may play more important roles in persistent early-onset AD.

Ultra-flat optical frequency comb generation based on a polarization modulator and a Butterworth band-stop filter.

A new, to the best of our knowledge, scheme for the generation of ultra-flat optical frequency combs (OFCs) is proposed, which mainly uses a polarization modulator (PolM) and a first-order Butterworth band-stop filter. The PolM is driven by a digital periodic square-wave signal, and the output of the PolM is an uneven OFC. The function of the Butterworth band-stop filter is to obtain flat and stable OFCs by changing its bandwidth. The comb spacing of the OFCs can be adjusted by changing the period of the square-wave signal. The theoretical model for the scheme is also established. The simulation results show that the generator constructed according to the proposed scheme can produce 64, 128, and 256 comb lines with 200 MHz comb spacing and with spectral flatness lower than 0.3 dB. The comb spacing can be further increased by using the square-wave signal at GHz rates, and the generated OFCs exhibit good frequency tunability.

The push-to-open mechanism of the tethered mechanosensitive ion channel NompC.

NompC is a mechanosensitive ion channel responsible for the sensation of touch and balance in Drosophila melanogaster. Based on a resolved cryo-EM structure, we performed all-atom molecular dynamics simulations and electrophysiological experiments to study the atomistic details of NompC gating. Our results showed that NompC could be opened by compression of the intracellular ankyrin repeat domain but not by a stretch, and a number of hydrogen bonds along the force convey pathway are important for the mechanosensitivity. Under intracellular compression, the bundled ankyrin repeat region acts like a spring with a spring constant of ~13 pN nm-1 by transferring forces at a rate of ~1.8 nm ps-1. The linker helix region acts as a bridge between the ankyrin repeats and the transient receptor potential (TRP) domain, which passes on the pushing force to the TRP domain to undergo a clockwise rotation, resulting in the opening of the channel. This could be the universal gating mechanism of similar tethered mechanosensitive TRP channels, which enable cells to feel compression and shrinkage.

Simvastatin ointment in the treatment of seven childhood diffuse plane xanthomas.

Diffuse plane xanthomas (DPX) is a rare, chronic, metabolic skin disease which can seriously affect the appearance of the patients and result in psychological problems. Existing treatments are seriously limited. Our objective was to assess the efficacy of and tolerance to simvastatin ointment for the treatment of skin lesions in seven DPX patients. In this study, patients were treated twice daily on the right side of the lesions for 10 months with the 1% or 5% simvastatin ointment. Meanwhile, the left body was untreated as a contralateral controlled side. Efficacy was assessed via the change of rash and was further confirmed by histological study. For all seven participants, both the 1% and 5% simvastatin ointments were effective. The histological change in DPX showed significant decrease of foam cells in skin lesions. The immunohistochemical staining of CD68, macrophage scavenger receptor type 1, oxidized low-density lipoprotein receptor 1 and Oil Red O became obviously reduced after treatment. The test medicines were safe with only some skin-related side-effects. This is the first research reported on simvastatin ointment treatment in DPX. Our results are the first to suggest that simvastatin ointment is effective in improving skin lesions of DPX clinically and histopathologically.

Flat optical frequency comb generation based on a dual-parallel Mach-Zehnder modulator and a single recirculation frequency shift loop.

To generate a flat optical frequency comb (OFC), a new scheme based on a dual-parallel Mach-Zehnder modulator and a single recirculation frequency shift loop is proposed and analyzed. Compared with the traditional single loop recirculation frequency shift method, the quantity of comb lines is doubled, and the comb flatness is better when the number of cycles is the same. The theoretical analysis model is established, and the simulation results show that a 111-line OFC with frequency spacing of 10 GHz, flatness of 1.32 dB, and optical signal to noise ratio of 27.4 dB can be obtained by adopting the proposed scheme.

Attitude of Students in Shanghai University of Traditional Chinese Medicine Toward Donation After Cardiac Death.

BACKGROUND: This study aimed to investigate the attitude of students at Shanghai University of Traditional Chinese Medicine toward organ transplantation and donation after cardiac death (DCD). MATERIAL AND METHODS: A questionnaire including 16 single-choice questions about organ transplantation and donation was designed, and a survey was conducted using this questionnaire on 300 randomly selected respondents at Shanghai University of Traditional Chinese Medicine, Shanghai, China. RESULTS: The ratio of male to female was 1:2.4. Of the participants, 98.1% had heard of organ transplantation, and 68.2% had received the information through network news. Only 10.6% expressed a positive attitude toward organ transplantation in China. Further, 39.8% of the participants were willing to donate their organs after death, while 51.9% of the participants hesitated because of perceived opacity in how donated organs were used. Even among those who did not share this concern, only 46.2% considered it. However, 80.7% were in favor of organ donation between relatives. Separately, 67.4% and 60.2% of the participants were interested in participating in activities and publicity related to organ donation, respectively. CONCLUSIONS: A majority of the participants had an understanding of organ transplantation and had obtained this information through media. Most showed a positive attitude toward donation between relatives, but only some of them indicated willingness to donate their organs. Generally, acceptance and awareness of organ transplantation need to be improved. Media outreach and education might have a profound influence.