Notes

MesoNet enables programmed scaling as well as segmentation involving mouse mesoscale cortical routes using device studying.
We measured change in ED-provider prescribing rate of opioids for patients discharged from the ED, by provider and aggregated up to facility-level, pre- and post-implementation. RESULTS Interrupted time series analysis of provider-level data from the program implementation sites indicated a significant decrease in the trend for proportion of opioid prescriptions relative to the pre-intervention trend. The results of the analysis suggest that the intervention was associated with accelerating the rate at which ED provider prescribing rates decreased. CONCLUSION Due to the high volume of patients and the vital role the ED plays in patient treatment and hospital admissions, it is evident that the ED is an important site for QI programs as well as the implementation of opioid safety measures. Given the findings of this pilot, we believe implementation of a national Veterans Affairs (VA) ED OSI implementation is feasible practice. This article is protected by copyright. All rights reserved.Over the past 20 years, multiple studies have demonstrated the superiority of percutaneous catheter-based pulmonary vein isolation (PVI) in the management of atrial fibrillation (AF). Unfortunately, the results of catheter ablation can be limited by arrhythmia recurrence, which is often a result of a failure to achieve durable lesions around the pulmonary vein ostia. In response, significant efforts have been directed toward developing technologies to achieve safer and more durable PVI, including the development of dedicated catheters capable of achieving PVI with a single ablation lesion (eg, the Arctic Front Cryoballoon; Medtronic CryoCath, Pointe-Claire, Canada). The purpose of this review is to discuss the contemporary role of cryoballoon ablation in the invasive management of AF, with a focus on the characteristics that differentiate cryoballoon from radiofrequency ablation. © 2020 Wiley Periodicals, Inc.High-energy Li-rich layered cathode materials (≈900 Wh kg-1 ) suffer from severe capacity and voltage decay during cycling, which is associated with layered-to-spinel phase transition and oxygen redox reaction. Current efforts mainly focus on surface modification to suppress this unwanted structural transformation. However, the true challenge probably originates from the continuous oxygen release upon charging. Here, the usage of dielectric polarization in surface coating to suppress the oxygen evolution of Li-rich material is reported, using Mg2 TiO4 as a proof-of-concept material. The creation of a reverse electric field in surface layers effectively restrains the outward migration of bulk oxygen anions. Meanwhile, high oxygen-affinity elements of Mg and Ti well stabilize the surface oxygen of Li-rich material via enhancing the energy barrier for oxygen release reaction, verified by density functional theory simulation. Benefited from these, the modified Li-rich electrode exhibits an impressive cyclability with a high capacity retention of ≈81% even after 700 cycles at 2 C (≈0.5 A g-1 ), far superior to ≈44% of the unmodified counterpart. In addition, Mg2 TiO4 coating greatly mitigates the voltage decay of Li-rich material with the degradation rate reduced by ≈65%. This work proposes new insights into manipulating surface chemistry of electrode materials to control oxygen activity for high-energy-density rechargeable batteries. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Psoriasis is a common inflammatory skin condition, affecting 2-4% of the worldwide population. Psoriasis remains an important public health challenge because there are many clinical forms of psoriasis in particular sites, probably related to the dysregulation of different cytokines. Therefore, there is a continuous need to improve treatment options with mechanisms of action different from those of the currently known therapies. Advances in knowledge of the molecular bases of pathogenesis lead to a better understanding of the disease, thus influencing the development and management of effective treatments. Moreover, data from recent published work indicate that psoriasis coexists with cardiovascular diseases, metabolic syndrome, diabetes mellitus and psychiatric disorders. We present results from our 52-week open-label trial in a cohort of psoriatic and psoriatic arthritis patients treated with daily p.o. doses of apremilast 60 mg. We confirmed the efficacy and safety of the drug in favoring the improvement of skin and joint disease as well as the modulation of metabolic biomarkers in diabetic and non-diabetic psoriatic patients. Apremilast could be used successfully in psoriatic patients affected by cardiometabolic comorbidities, ensuring an improvement in both diseases. © 2020 Japanese Dermatological Association.INTRODUCTION The macroscopic dynamic of fetal penis development presents a pattern resembling the unfolding of a spiral, so congenital ventral penile curvature could indicate that this natural sequence has been interrupted. Our aim in this article is to offer a mathematical model of congenital ventral curvature of the penis. MATERIALS AND METHODS Five individuals who presented with congenital ventral penile curvature and three who presented with acquired penile ventral curvature due to Peyronie's disease were evaluated. The penises were photographed during an induced erection test and the penile curvature patterns were compared with an equiangular spiral. When an association was found, a potential relationship to the golden spiral-a type of equiangular spiral-was also assessed. The mathematical spiral relationships were analyzed using Wolfram CDF Player® (Logarithmic Spiral) and PhiMatrix® software. The Wolfram software generated logarithmic spirals equivalent to the penile curvature with appropriate mathematical values. The PhiMatrix software, which builds any golden spirals from golden rectangles, was used to check whether the spiral was golden as well as equiangular. RESULTS An equiangular spiral that was also golden was found in all cases of congenital ventral penile curvature. selleck chemicals In contrast, none of the acquired penile ventral curvature cases showed a specific pattern. CONCLUSION Congenital ventral penile curvature has the mathematical pattern of a golden spiral. Our results offer a mathematical algorithm for potential use in surgical reconstruction procedures, regenerative medicine, tissue engineering, robotics, and body-machine interfaces. © 2020 Wiley Periodicals, Inc.Sexually dimorphic bone structure emerges largely during puberty. Sex steroids are critical for peak bone mass acquisition in both genders. In particular, the biphasic effects of estrogens mediate the skeletal sexual dimorphism. However, so far the stimulatory vs inhibitory actions of estrogens on bone mass are not fully explained by direct effects on bone cells. Recently, it has become evident that there is possible neuroendocrine action of estrogen receptor alpha (ERα) on the skeleton. Based on these considerations, we hypothesized that neuronal ERα-signaling may contribute to the skeletal growth during puberty. Here, we generated mice with tamoxifen-inducible Thy1-Cre mediated ERα inactivation during late puberty specifically in extrahypothalamic neurons (N-ERαKO). Inactivation of neuronal ERα did not alter the body weight in males, whereas N-ERαKO females exhibited a higher body weight and increased body and bone length compared to their control littermates at 16 weeks of age. Ex vivo microCT analysis showed increased radial bone expansion of the midshaft femur in female N-ERαKO along with higher serum levels of insulin-like growth factor (IGF)-1 as well as IGF-binding protein (IGFBP)-3. Furthermore, the 3-point bending test revealed increased bone strength in female N-ERαKO. In contrast, inactivation of neuronal ERα had no major effect on bone growth in males. In conclusion, we demonstrate that central ERα-signaling limits longitudinal bone growth and radial bone expansion specifically in females potentially by interacting with the GH/IGF-1 axis. © 2020 The Authors. The FASEB Journal published by Wiley Periodicals LLC on behalf of Federation of American Societies for Experimental Biology.Atopic dermatitis (AD) is a chronic inflammatory skin disease that predominantly affects children (1), but that can persist or start in adulthood (2,3). The diagnosis of adult AD is sometimes difficult; indeed, it can present with atypical clinical phenotypes (4). Dupilumab, is a recent valid therapeutic option for adult AD patients (5,6). As AD is a chronic disease, it is important for clinicians following patient's response to treatments. This article is protected by copyright. All rights reserved.Vibratory urticaria/angioedema refers to evanescent reactions elicited by vibratory stimuli. In 1972, Patterson coined the term "vibratory angioedema", to name a hereditary variant involving one family showing angioedema features. It also applies to sporadic cases. An autosomal dominant variant of "vibratory urticaria" with hives involving Lebanese families with ADGRE2 mutations has also been described. This article is protected by copyright. All rights reserved.OBJECTIVE Incisura angularis is one of the important parts for evaluating mucosal atrophy and cancer risk. We determined the type of mucosa at incisura angularis in Helicobacter pylori-naïve normal stomach. METHODS Subjects aged 40 years or older who underwent esophagogastroduodenoscopy for dyspepsia or a routine health checkup were recruited in 24 facilities between March 2008 and February 2009. Serum antibody to H. pylori was measured. Endoscopic atrophy was evaluated according to Updated Kimura-Takemoto classification. Five biopsy specimens were taken from the incisura angularis and greater and lesser curvatures of the antrum and corpus. These specimens were histologically classified as fundic, pyloric or transitional. H. pylori-naïve normal stomach was defined with the strictest criterion among various combinations of histological, endoscopic and serum findings. We determined histological type of mucosa at incisura angularis in H. pylori-naïve normal stomach. RESULTS 270 subjects (122 men, mean 64.6yo) were analyzed. The strictest criterion consists of serum antibody less then =3.0U/mL, endoscopic atrophy C-1 and histological grade 0 in all of the five items in Updated Sydney System. The numbers having fundic, transitional and pyloric mucosa at incisura angularis under the strictest criterion were 13 (50%), 13 (50%) and 0, respectively. The probability that the type of mucosa at incisura angularis would be pyloric was almost zero (97.5% confidence interval 0-0.132). CONCLUSIONS Incisura angularis of stomach may not belong to pyloric, but fundic or transitional mucosa in H. pylori-naïve normal stomach. UMIN000018218. This article is protected by copyright. All rights reserved.AIM Our objectives were to measure the vaccine coverage rates for children with chronic diseases as well as the prevalence of potentially harmful delays for generally recommended vaccines. We also identified the factors influencing non-adherence to vaccines specifically recommended for chronic conditions. METHODS Three non-interventional point-prevalence surveys were performed in 2014 in all paediatric units at Lille University Hospital among children aged two months to 18 years with chronic diseases and vaccination data. Vaccine coverage and delays for generally recommended vaccines were studied. The children who were up-to-date and those under-vaccinated for specifically indicated vaccines were compared and the factors potentially associated with under-vaccination were studied with multivariable analysis. RESULTS We screened 682 patients of 207 with chronic diseases, mainly neurological, muscular and respiratory disorders, 146 had vaccination data. Only 47% (95% confidence interval 39-55) were up-to-date for all generally recommended vaccinations; potentially harmful vaccination delays were high (26-75%).
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