Design of a Self-Measuring Device Based on Bioelectrical Impedance Analysis for Regular Monitoring of Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is a chronic disease, in which permanent joint deformation is largely preventable with the timely introduction of appropriate treatment strategies. However, there is no consensus for patients with RA to monitor their progress and communicate it to the rheumatologist till the condition progresses to remission. In response to this unmet need, we proposed the design of a self-measuring device based on bioelectrical impedance analysis (BIA) for regular monitoring of inflammation levels. Twenty joints of both hands were measured to monitor trends in inflammation levels. Three electrodes were used to measure two joints of each finger. A central electrode was used for two consecutive measurements. A suitable form factor for the device was proposed for the vertical placement of the hand. To ensure the stability of measurements, an air cushion was incorporated into the back of the hand, hand containers were designed on both sides, and a mobile application was designed. We conducted a convergence-assessment experiment with five air pressures to validate the consistency and convergence of bioimpedance measurements. A heuristic evaluation of the usability around the product and mobile application was conducted in parallel by six subject matter experts and validated the design. This study underscores the significance of considering patients' disease activity during intervals between hospital visits and introduces a novel approach to self-RA care.

Taurodeoxycholate, a GPCR19 agonist, ameliorates atopic dermatitis in Balb/c mice.

Keratinocytes are pivotal cells in the pathogenesis of atopic dermatitis (AD) as much as Th2 cells. In this sense, regulation of pro-inflammatory features of keratinocytes might be useful for AD patients. P2X7R-mediated activation of NLRP3 inflammasome (N3I) in keratinocytes and myeloid cells plays crucial roles in AD. Nonetheless, inhibition of P2X7R has not been feasible because of polymorphisms and ubiquitous expression of P2X7R. Here, we report that GPCR19 colocalizes with P2X7R, and a GPCR19 agonist (taurodeoxycholate [TDCA]) inhibits the activation of P2X7R. Noncistronically, TDCA inhibits NF-kB activation via the adenylate cyclase-PKA pathway and BzATP-mediated Ca++ mobilization. Cistronically, TDCA suppresses the expression of P2X7R and N3I components in keratinocytes. NLRP3 oligomerization and the production of mature IL-1ß and IL-18 was suppressed by TDCA treatment in keratinocytes. Topical TDCA treatment ameliorates proinflammatory features of AD in mice induced by DNCB, MC903, or oxazolone. Taken together, a GPCR19 agonist such as TDCA might inhibit P2X7R-mediated N3I activation of keratinocytes, which is crucial for the pathogenesis of AD.

Exchange Bias in Weakly Interlayer-Coupled van der Waals Magnet Fe3GeTe2.

van der Waals (vdW) magnetic materials provide an ideal platform to study low-dimensional magnetism. However, observations of magnetic characteristics of these layered materials truly distinguishing them from conventional magnetic thin film systems have been mostly lacking. In an effort to investigate magnetic properties unique to vdW magnetic materials, we examine the exchange bias effect, a magnetic phenomenon emerging at the ferromagnetic-antiferromagnetic interface. Exchange bias is observed in the naturally oxidized vdW ferromagnet Fe3GeTe2, owing to an antiferromagnetic ordering in the surface oxide layer. Interestingly, the magnitude and thickness dependence of the effect is unlike those expected in typical thin-film systems. We propose a possible mechanism for this behavior, based on the weak interlayer magnetic coupling inherent to vdW magnets, demonstrating the distinct properties of these materials. Furthermore, the robust and sizable exchange bias for vdW magnets persisting up to relatively high temperatures presents a significant advance for realizing practical two-dimensional spintronics.

Influence of combinatory effects of STEM setups on the sensitivity of differential phase contrast imaging.

Differential phase-contrast (DPC) imaging in the scanning transmission electron microscopy (STEM) mode has been suggested as a new method to visualize the nanoscale electromagnetic features of materials. However, the quality of the DPC image is very sensitive to the electron-beam alignment, microscope setup, and specimen conditions. Unlike normal STEM imaging, the microscope setup variables in the DPC mode are not independent; rather, they are correlated factors decisive for field sensitivity. Here, we systematically investigated the independent and combinatory effects of microscope setups on the sensitivity of the DPC image in a hard magnet, Nd2Fe14B alloy. To improve sensitivity, a smaller overlap of the electron beam with annular detectors and a greater camera length were required. However, these factors cannot be controlled independently in the two-condenser-lens system. In this linked system, the effect of the camera length on the DPC sensitivity was slightly more predominant than the overlap. Furthermore, the DPC signal was noisy and scattered at a small overlap of less than 11%. The electron-beam current does not evidently affect the sensitivity. In addition, the DPC sensitivity was examined with respect to the sample thickness, and the optimum thickness for high sensitivity was approximately 65 nm for the hard magnetic material Nd2Fe14B. This practical approach to the STEM setup and sample thickness may provide experimental guidelines for further application of the DPC analysis method.

Liver transplantation in Jehovah's Witnesses: two cases report.

Liver transplantation is especially challenging in patients who are Jehovah's Witnesses because their religious beliefs prohibit the receipt of blood products. We present two cases of living donor liver transplantation performed in adult Jehovah's Witnesses in South Korea without the use of blood products. In the first case, preoperative erythropoiesisstimulation therapy increased hemoglobin levels from 8.1 to 13.1 g/dl after 9 weeks. In the second case, hemoglobin levels increased from 7.4 to 10.8 g/dl after 6 months of erythropoiesis-stimulation therapy. With the combination of acute normovolemic hemodilution, intraoperative cell salvage, and use of transfusion alternatives, liver transplantation was successfully performed without transfusion of blood products.

Construction of a ³He magnetic force microscope with a vector magnet.

We constructed a (3)He magnetic force microscope operating at the base temperature of 300 mK under a vector magnetic field of 2-2-9 T in the x-y-z direction. Fiber optic interferometry as a detection scheme is employed in which two home-built fiber walkers are used for the alignment between the cantilever and the optical fiber. The noise level of the laser interferometer is close to its thermodynamic limit. The capabilities of the sub-Kelvin and vector field are demonstrated by imaging the coexistence of magnetism and superconductivity in a ferromagnetic superconductor (ErNi2B2C) at T = 500 mK and by probing a dipole shape of a single Abrikosov vortex with an in-plane tip magnetization.

The causes and treatment outcomes of 91 patients with adult nosocomial meningitis.

BACKGROUND/AIMS: Frequent pathogens of nosocomial meningitis were investigated and the adequacy of empiric antibiotic therapy was assessed. Outcomes of nosocomial meningitis were also evaluated. METHODS: Ninety-one patients, who were diagnosed and treated for nosocomial meningitis at a single tertiary hospital in Daegu, Korea for 10 years, were included. Medical record and electronic laboratory data on the causative pathogens, antibiotics used, and outcomes were retrospectively investigated. RESULTS: Coagulase-negative Staphylococcus (40.9%) was the most common pathogen, followed by Acinetobacter (32.5%). Both were cultured as a single organism in cerebrospinal fluid (CSF). Seventy-eight patients (85.7%) had infections related to external ventricular drains (EVD). The most common empirical antibiotics were extended-spectrum beta-lactam antibiotics plus vancomycin (35/91, 38.6%). Of the 27 patients who had cultured Acinetobacter in CSF, 10 (37%) were given the wrong empirical antibiotic treatment. Seven of the 27 patients (26.9%) with cultured Acinetobacter died, and overall mortality of the 91 patients was 16.5%. In the multivariate analysis, the presence of combined septic shock (p < 0.001) and a persistent EVD state (p = 0.021) were associated with a poor prognosis. CONCLUSIONS: Acinetobacter is one of the leading pathogens of nosocomial meningitis and may lead to inadequate coverage of empiric antibiotic therapy due to increasing resistance. An EVD should be removed early in cases of suspected nosocomial meningitis, and carbapenem might be required for the poor treatment response.

Causes and treatment outcomes of Stevens-Johnson syndrome and toxic epidermal necrolysis in 82 adult patients.

BACKGROUND/AIMS: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are predominantly known as medication-induced diseases. However, at our institution, we have experienced more cases of non-drug-related SJS and TEN than expected. Therefore, we studied the difference between non-drug-related and drug-related SJS and TEN in terms of clinical characteristics and prognoses. METHODS: The etiologies, clinical characteristics, and treatment outcomes for 82 adult patients with SJS and TEN were retrospectively reviewed. RESULTS: A total of 71 patients (86.6%) were classified as having SJS, and the other 11 patients (13.4%) were classified as having TEN. Drug-related cases were more common (43, 52.4%) than non-drug-related cases (39, 47.6%). Anticonvulsants (12/82, 14.6%) and antibiotics (9/82, 11%) were the most common causative medications. Anemia (p = 0.017) and C-reactive protein of ≥ 5 mg/dL (p = 0.026) were more common in the drug-related cases than in the non-drug-related cases. Intravenous steroid therapy was used as the main treatment regimen (70/82, 85.4%). Of the 82 patients, 8 (9.8%) died during the clinical course. A univariate analysis for mortality showed statistical significance for the following: kidney function abnormality, pneumonia, hemoglobin of < 10 g/dL, and combined underlying diseases. In a multivariate analysis, only pneumonia was statistically significant (odds ratio, 25.79; p = 0.009). CONCLUSIONS: Drugs were the most frequent cause of these diseases. However, non-drug-related causes also contributed to a significant proportion of cases. Physicians should keep this in mind when documenting patient history. In addition, early recognition and treatment may be important for better outcomes.

Removal of gaseous elemental mercury by dielectric barrier discharge.

The removal of elemental mercury (Hg(0)) with the reactive species produced from dielectric barrier discharge (DBD) was studied. The effects of the operating parameters, such as the applied voltage, residence time, initial concentration and co-existence of other pollutants, were investigated. The removal of Hg(0) was significantly promoted by an increase in the applied voltage of the DBD reactor system. The presence of NO gas decreased the Hg(0) removal efficiency within the range of input powers tested compared to the case of Hg(0)-only due to the competition for ozone between Hg(0) and NO gas in the DBD reactor.

Photochemical and photocatalytic degradation of gaseous toluene using short-wavelength UV irradiation with TiO2 catalyst: comparison of three UV sources.

The feasibility of the use of short-wavelength UV (254+185 nm) irradiation and TiO2 catalyst for photodegradation of gaseous toluene was evaluated. It was clear that the use of TiO2 under 254+185 nm light irradiation significantly enhanced the photodegradation of toluene relative to UV alone, owed to the combined effect of photochemical oxidation in the gas phase and photocatalytic oxidation on TiO2. The photodegradation with 254+185 nm light irradiation was compared with other UV wavelengths (365 nm (black light blue lamp) and 254 nm (germicidal UV lamp)). The highest conversion and mineralization were obtained with the 254+185 nm light. Moreover, high conversions were achieved even at high initial concentrations of toluene. Catalyst deactivation was also prevented with the 254+185 nm light. Regeneration experiments with the deactivated catalyst under different conditions revealed that reactive oxygen species played an important role in preventing catalyst deactivation by decomposing effectively the less reactive carbon deposits on the TiO2 catalyst. Simultaneous elimination of photogenerated excess ozone and residual organic compounds was accomplished by using a MnO2 ozone-decomposition catalyst to form reactive species for destruction of the organic compounds.