Cosmetic and functional outcomes of excisional surgical wounds healed by secondary intention: A systematic review

BackgroundData regarding short-term and long-term cosmesis and functional outcomes of excisional surgical wounds healed by secondary intention healing (SIH) are limited.ObjectiveTo conduct a systematic review and assess the cosmetic and functional acceptability of SIH for acute excisional surgical wounds.MethodsFull-text articles queried from PubMed and Embase databases between January 1964 and April 2024 with cosmetic outcome data of human subjects with acute surgical wounds healed by SIH were included. Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed.ResultsA total of 1655 surgical wounds, of which 1518 (91.7%) healed by SIH, from 35 studies, were included in this review. The most frequent indication for SIH was a defect resulting from excision of nonmelanoma skin cancer (keratinocyte carcinoma), which was identified in 1439 (86%) of patients. Common sites for SIH included the nose (23.3%), periocular region (15.46%), and forehead (13.5%). The majority of wounds on the forehead, medial canthus, lower eyelid, nasal ala, cheeks, lips, postauricular area, and feet resulted in good to excellent cosmetic results, whereas those on the scalp, nasal dorsum, nasal tip, nasal sidewall, and chin yielded less acceptable cosmetic results. Given the baseline variability in cosmesis of primarily closed wounds in some anatomic locations, however, these data suggest the need for future prospective studies.SummarySIH may produce an acceptable cosmetic and functional outcome for selected defects and may be of clinical benefit in the appropriate setting. This must be weighed against the potentially improved cosmesis and more rapid healing seen with primarily closed defects

Influence of crank length and crank-axle height on standing arm-crank (grinding) power

To determine the optimal crank length and crank-axle height for maximum power production during standing arm-cranking (‘grinding’). Nine elite professional America’s Cup grinders (age: 36 ± 2 y; body mass: 104 ± 1 kg; body fat 13 ± 2%) performed eight maximal 6 s sprints on an adjustable standing arm-crank ergometer fitted with an SRM powercrank. The protocol included crank lengths of 162, 199, 236 and 273 mm and crank-axle heights of 850, 950, 1050 and 1150 mm. Peak power, ground reaction forces (GRF) and joint angles were determined and compared for different crank lengths and crank-axle heights with repeated-measures ANOVA. Results: Peak power was significantly different between crank lengths (P=0.006), with 162 mm lower than all others (P<0.03). Optimal crank length was 12.3% of arm-span, or 241 ± 9 mm for this cohort of athletes. Peak power was significantly less for the crank-axle height of 850 mm compared to 1150 mm (P=0.01). The optimal crank-axle height for peak power was between 50 and 60% of stature (950-1150 mm in this study). Hip flexion was greater at the lowest crank-axle height (850 mm) than at 1050 and 1150 mm (P<0.01), and the resultant GRF was also reduced compared to all other heights, indicating greater weight bearing by the upper body. Changes in crank length and crank-axle height influence performance during maximal standing arm-crank ergometry. These results, suggest that standard leg-cycle crank lengths are inappropriate for maximal arm-cranking performance. In addition, a crank-axle height of <50% of stature, which is typically used in America’s Cup sailing, may attenuate performance

The Oxford Needle Experience (ONE) scale: a UK-based and US-based online mixed-methods psychometric development and validation study of an instrument to assess needle fear, attitudes and expectations in the general public

Objectives: To develop and validate the Oxford Needle Experience (ONE) scale, an instrument to assess needle fear, attitudes and expectations in the general population. Design: Cross-sectional validation study. Setting: Internet-based with participants in the UK and USA. Participants: UK and US representative samples stratified by age, sex, and ethnicity using the Prolific Academic platform. Main outcome measures: Exploratory factor analysis with categorical variables and a polychoric correlation matrix followed by promax oblique rotation on the UK sample for the ONE scale. Confirmatory factor analysis (CFA) with a Satorra-Bentler scaled test statistic evaluating the root mean squared error of approximation (RMSEA), standardised root mean squared residual (SRMR) and comparative fit index (CFI) on the US sample. Reliability as internal consistency using McDonald’s omega. Convergent validity using the Pearson correlation coefficient. Predictive and discriminant validity using logistic regression ORs of association (OR). Results: The population included 1000 respondents, 500 in the UK and 500 in the USA. Minimum average partial correlation and a scree plot suggested four factors should be retained: injection hesitancy, blood-related hesitancy, recalled negative experiences and perceived benefits, yielding a 19-question scale. On CFA, the RMSEA was 0.070 (90% CI, 0.064 to 0.077), SRMR 0.053 and CFI 0.925. McDonald’s omega was 0.92 and 0.93 in the UK and US samples, respectively. Convergent validity with the four-item Oxford Coronavirus Explanations, Attitudes and Narratives Survey (OCEANS) needle fear scale demonstrated a strong correlation (r=0.83). Predictive validity with a single-question COVID-19 vaccination status question demonstrated a strong association, OR (95% CI) 0.97 (0.96 to 0.98), p<0.0001 in the US sample. Discriminant validity with a question regarding the importance of controlling what enters the body confirmed the ONE score does not predict this unrelated outcome, OR 1.00 (0.99, 1.01), p=0.996 in the US sample. Conclusions: The ONE scale is a reliable and valid multidimensional scale that may be useful in predicting vaccine hesitancy, designing public health interventions to improve vaccine uptake and exploring alternatives to needles for medical procedures

N-Terminal Phosphorylation of the Dopamine Transporter Is Required for Amphetamine-Induced Efflux

Amphetamine (AMPH) elicits its behavioral effects by acting on the dopamine (DA) transporter (DAT) to induce DA efflux into the synaptic cleft. We previously demonstrated that a human DAT construct in which the first 22 amino acids were truncated was not phosphorylated by activation of protein kinase C, in contrast to wild-type (WT) DAT, which was phosphorylated. Nonetheless, in all functions tested to date, which include uptake, inhibitor binding, oligomerization, and redistribution away from the cell surface in response to protein kinase C activation, the truncated DAT was indistinguishable from the full-length WT DAT. Here, however, we show that in HEK-293 cells stably expressing an N-terminal-truncated DAT (del-22 DAT), AMPH-induced DA efflux is reduced by approximately 80%, whether measured by superfusion of a population of cells or by amperometry combined with the patch-clamp technique in the whole cell configuration. We further demonstrate in a full-length DAT construct that simultaneous mutation of the five N-terminal serine residues to alanine (S/A) produces the same phenotype as del-22—normal uptake but dramatically impaired efflux. In contrast, simultaneous mutation of these same five serines to aspartate (S/D) to simulate phosphorylation results in normal AMPH-induced DA efflux and uptake. In the S/A background, the single mutation to Asp of residue 7 or residue 12 restored a significant fraction of WT efflux, whereas mutation to Asp of residues 2, 4, or 13 was without significant effect on efflux. We propose that phosphorylation of one or more serines in the N-terminus of human DAT, most likely Ser7 or Ser12, is essential for AMPH-induced DAT-mediated DA efflux. Quite surprisingly, N-terminal phosphorylation shifts DAT from a “reluctant” state to a “willing” state for AMPH-induced DA efflux, without affecting inward transport. These data raise the therapeutic possibility of interfering selectively with AMPH-induced DA efflux without altering physiological DA uptake

Explaining Filipino Households’ Declining Saving Rate

From 1994 to 2006, the average household saving rate in the Philippines declined by 5.2 percentage points to about a mere 5% of disposable income. Using data from income and expenditure survey at the household level, this paper explains why households' consumption growth had been higher than income growth during this period. Tracing cohorts shows that saving declined across all demographic groups. A simple test that provides the strength of the precautionary saving motive yields a plausible explanation that households are financially constrained and less prudent in the recent years. This paper argues that these patterns are best explained by the extended coverage of social security system during the 1990s in the Philippines. Less prudent behavior may have been amplified by the severe financial constraint leading to the sharp fall in the saving rate

Deconvoluting Post-Transplant Immunity: Cell Subset-Specific Mapping Reveals Pathways for Activation and Expansion of Memory T, Monocytes and B Cells

A major challenge for the field of transplantation is the lack of understanding of genomic and molecular drivers of early post-transplant immunity. The early immune response creates a complex milieu that determines the course of ensuing immune events and the ultimate outcome of the transplant. The objective of the current study was to mechanistically deconvolute the early immune response by purifying and profiling the constituent cell subsets of the peripheral blood. We employed genome-wide profiling of whole blood and purified CD4, CD8, B cells and monocytes in tandem with high-throughput laser-scanning cytometry in 10 kidney transplants sampled serially pre-transplant, 1, 2, 4, 8 and 12 weeks. Cytometry confirmed early cell subset depletion by antibody induction and immunosuppression. Multiple markers revealed the activation and proliferative expansion of CD45RO+CD62L− effector memory CD4/CD8 T cells as well as progressive activation of monocytes and B cells. Next, we mechanistically deconvoluted early post-transplant immunity by serial monitoring of whole blood using DNA microarrays. Parallel analysis of cell subset-specific gene expression revealed a unique spectrum of time-dependent changes and functional pathways. Gene expression profiling results were validated with 157 different probesets matching all 65 antigens detected by cytometry. Thus, serial blood cell monitoring reflects the profound changes in blood cell composition and immune activation early post-transplant. Each cell subset reveals distinct pathways and functional programs. These changes illuminate a complex, early phase of immunity and inflammation that includes activation and proliferative expansion of the memory effector and regulatory cells that may determine the phenotype and outcome of the kidney transplant

Novel Diagnosis of Lyme Disease: Potential for CAM Intervention

Lyme disease (LD) is the most common tick-borne disease in the northern hemisphere, producing a wide range of disabling effects on multiple human targets, including the skin, the nervous system, the joints and the heart. Insufficient clinical diagnostic methods, the necessity for prompt antibiotic treatment along with the pervasive nature of infection impel the development and establishment of new clinical diagnostic tools with increased accuracy, sensitivity and specificity. The goal of this article is 4-fold: (i) to detail LD infection and pathology, (ii) to review prevalent diagnostic methods, emphasizing inherent problems, (iii) to introduce the usage of in vivo induced antigen technology (IVIAT) in clinical diagnostics and (iv) to underscore the relevance of a novel comprehensive LD diagnostic approach to practitioners of Complementary and Alternative Medicine (CAM). Utilization of this analytical method will increase the accuracy of the diagnostic process and abridge the time to treatment, with antibiotics, herbal medicines and nutritional supplements, resulting in improved quality of care and disease prognosis

Surfactant-Free Colloidal Syntheses of Gold-Based Nanomaterials in Alkaline Water and Mono-alcohol Mixtures [Dataset]

120 pages. -- SA. Synthesis of Au NPs using ROH. -- SB. Experimental section. -- SC. Effect of mono-alcohol, mono-alcohol content and cation. -- SD. Effect of experimental parameters: HAuCl4 concentration, volume of solution, type of container used, light. -- SE. Effect of the nature of the alcohols. -- SF. Kinetics of the reduction. -- SG. Influence of the temperature. -- SH. Influence of base concentration. -- SI. Influence of gas atmosphere. -- SJ. Influence of the order of addition of the chemicals. -- SK. Discussion of Au NP formation. -- SL. Reproducibility. -- SM. Scalability. -- SN. Mixture of mono-alcohols. -- SO. Cation and surfactant effects . -- SP. Electrochemical characterization of Au NPs. -- SQ. Supported NPs. -- SR. Pd and bimetallic NPs. -- SS. Nanocomposites. -- ST. Electrochemical characterization of AuxPdy NPs and [x Au + y Pd] nanocomposites. -- SU. Outlook into multi-metallic nanomaterials. -- SV. Comparison of different catalysts. -- SW. ReferencesGold nanoparticles (Au NPs) and gold-based nanomaterials combine unique properties relevant for medicine, imaging, optics, sensing, catalysis, and energy conversion. While the Turkevich–Frens and Brust–Schiffrin methods remain the state-of-the-art colloidal syntheses of Au NPs, there is a need for more sustainable and tractable synthetic strategies leading to new model systems. In particular, stabilizers are almost systematically used in colloidal syntheses, but they can be detrimental for fundamental and applied studies. Here, a surfactant-free synthesis of size-controlled colloidal Au NPs stable for months is achieved by the simple reduction of HAuCl4 at room temperature in alkaline solutions of low-viscosity mono-alcohols such as ethanol or methanol and water, without the need for any other additives. Palladium (Pd) and bimetallic AuxPdy NPs, nanocomposites and multimetallic samples, are also obtained and are readily active (electro)­catalysts. The multiple benefits over the state-of-the-art syntheses that this simple synthesis bears for fundamental and applied research are highlighted.Peer reviewe

Drug Resistance Mutations for Surveillance of Transmitted HIV-1 Drug-Resistance: 2009 Update

Programs that monitor local, national, and regional levels of transmitted HIV-1 drug resistance inform treatment guidelines and provide feedback on the success of HIV-1 treatment and prevention programs. To accurately compare transmitted drug resistance rates across geographic regions and times, the World Health Organization has recommended the adoption of a consensus genotypic definition of transmitted HIV-1 drug resistance. In January 2007, we outlined criteria for developing a list of mutations for drug-resistance surveillance and compiled a list of 80 RT and protease mutations meeting these criteria (surveillance drug resistance mutations; SDRMs). Since January 2007, several new drugs have been approved and several new drug-resistance mutations have been identified. In this paper, we follow the same procedures described previously to develop an updated list of SDRMs that are likely to be useful for ongoing and future studies of transmitted drug resistance. The updated SDRM list has 93 mutations including 34 NRTI-resistance mutations at 15 RT positions, 19 NNRTI-resistance mutations at 10 RT positions, and 40 PI-resistance mutations at 18 protease positions