Lidocaine inhibits migration of tenocytes by downregulating focal adhesion kinase and paxillin phosphorylation

Lidocaine is the most frequently applied local infiltration anesthetic agent for treating tendinopathies. However, studies have discovered lidocaine to negatively affect tendon healing. In the current study, the molecular mechanisms and effects of lidocaine on tenocyte migration were evaluated. We treated tenocytes intrinsic to the Achilles tendons of Sprague-Dawley rats with lidocaine. The migration ability of cells was analyzed using electric cell-substrate impedance sensing (ECIS) and scratch wound assay. We then used a microscope to evaluate the cell spread. We assessed filamentous actin (F-actin) cytoskeleton formation through immunofluorescence staining. In addition, we used Western blot analysis to analyze the expression of phospho-focal adhesion kinase (FAK), FAK, phospho-paxillin, paxillin, and F-actin. We discovered that lidocaine had an inhibitory effect on the migration of tenocytes in the scratch wound assay and on the ECIS chip. Lidocaine treatment suppressed cell spreading and changed the cell morphology and F-actin distribution. Lidocaine reduced F-actin formation in the tenocyte during cell spreading; furthermore, it inhibited phospho-FAK, F-actin, and phospho-paxillin expression in the tenocytes. Our study revealed that lidocaine inhibits the spread and migration of tenocytes. The molecular mechanism potentially underlying this effect is downregulation of F-actin, phospho-FAK, and phospho-paxillin expression when cells are treated with lidocaine.

Can a prolonged healing pressure injury be benefited by using an AI mattress? A case study

BACKGROUND

Pressure injuries are a common and serious issue for bedridden residents in long-term-care facilities. Areas of bony prominences, such as the scapula, sacrum, and heels, are more likely to develop pressure injuries. The management of pressure injury wounds include dressing changes, repositioning, away from moisture, decreasing the occurrence of friction and shear, and more. Some supportive surfaces are also used for pressure injury cases such as gel pads, alternating pressure air mattresses, and air-fluidized beds. The aim of this case study was to determine whether the use of an artificial intelligent mattress can improve a nursing home resident with prolonged pressure injury.

CASE PRESENTATION

A retrospective study design was conducted for this case study. A 79-year-old male developed a pressure injury in the sacrum. His pressure injury was initially at stage 4, with a score of 12 by the Braden scale. The PUSH score was 16. During 5.5 months of routine care plus the use of the traditional alternative air mattress, in the nursing home, the wound stayed in stage 3 but the PUSH score increased up to 11. An artificial intelligence mattress utilizing 3D InterSoft was used to detect the bony prominences and redistribute the external pressure of the skin. It implements a color guided schematic of 26 colors to indicate the amount of pressure of the skin.

RESULTS

The wound size was decreased and all eczema on the resident's back diminished. The PUSH score was down to 6, as the artificial intelligent mattress was added into the routine care. The staff also reported that the resident's quality of sleep improved and moaning decreased. The hemiplegic side is at greater risk of developing pressure injury.

CONCLUSIONS

This novice device appeared to accelerate wound healing in this case. In the future, more cases should be tested, and different care models or mattress can be explored.

Recent Advances in Engineering Carriers for siRNA Delivery

RNA interference (RNAi) technology has been a promising treatment strategy for combating intractable diseases. However, the applications of RNAi in clinical are hampered by extracellular and intracellular barriers. To overcome these barriers, various siRNA delivery systems have been developed in the past two decades. The first approved RNAi therapeutic, Patisiran (ONPATTRO) using lipids as the carrier, for the treatment of amyloidosis is one of the most important milestones. This has greatly encouraged researchers to work on creating new functional siRNA carriers. In this review, the recent advances in siRNA carriers consisting of lipids, polymers, and polymer-modified inorganic particles for cancer therapy are summarized. Representative examples are presented to show the structural design of the carriers in order to overcome the delivery hurdles associated with RNAi therapies. Finally, the existing challenges and future perspective for developing RNAi as a clinical modality will be discussed and proposed. It is believed that the addressed contributions in this review will promote the development of siRNA delivery systems for future clinical applications.

Leukocyte-poor platelet-rich plasma and leukocyte-rich platelet-rich plasma promote myoblast proliferation through the upregulation of cyclin A, cdk1, and cdk2

Muscle injuries are common among athletes and often treated with platelet-rich plasma (PRP). However, whether the leukocyte concentration affects the efficacy of PRP in treating muscle injuries remains unclear. This study investigated the effects of leukocyte-poor platelet-rich plasma (LP-PRP) and leukocyte-rich platelet-rich plasma (LR-PRP) on myoblast proliferation and the molecular mechanisms underlying these effects. Myoblasts were treated with 0.5% LP-PRP, 0.5% LR-PRP, 1% LP-PRP, or 1% LR-PRP for 24 h. The gene expression of the LP-PRP- and LR-PRP-treated myoblasts was determined using RNA sequencing analysis. Cell proliferation was evaluated using an bromodeoxyuridine (BrdU) assay, and cell cycle progression was assessed through flow cytometry. The expression of cyclin A, cyclin-dependent kinase 1 (cdk1), and cdk2 was examined using Western blotting. The expression of myoblast determination protein 1 (MyoD1) was examined through Western blotting and immunofluorescence staining. The LP-PRP and LR-PRP both promoted the proliferation of myoblasts and increased differential gene expression of myoblasts. Moreover, the LP-PRP and LR-PRP substantially upregulated the expression of cyclin A, cdk1, and cdk2. MyoD1 expression was induced in the LP-PRP and LR-PRP-treated myoblasts. Our results corroborate the finding that LP-PRP and LR-PRP have similar positive effects on myoblast proliferation and MyoD1 expression.

Attenuation of epithelial-mesenchymal transition via SGLT2 inhibition and diabetic cataract suppression by dapagliflozin nanoparticles treatment

AIMS

Chronic hyperglycemia triggers overproduction of AKR1B1 (aldo-keto reductase family 1 member B) and receptor for advanced glycation end product (RAGE), which causes epithelial-mesenchymal transition (EMT) in the lens epithelial cells (LECs) of diabetic mellitus (DM) cataracts. However, it is unclear whether EMT in LECs is related to abnormal increase of SGLT2. Sodium glucose cotransporter 2 (SGLT2) inhibitor, also known as dapagliflozin (Dapa) can be used to treat diabetes. Here, we examined how Dapa or nano eye-drops (DapaN) reduce EMT in LECs of DM cataracts. The nano eye-drop provides an ophthalmic treatment that suppressed diabetic cataract progression and improved potency with reduced side effects.

MAIN METHODS

SD rats were injected with streptozocin (STZ) (65 mg/kg, ip), nano-Dapa drops (0.456 mg/10 ml/eye) or Dapa (1.2 mg/kg/day) treatment for 6-12 weeks. Immunofluorescence staining was used for protein quantification of RAGE, SGLT2, N-cadherin and E-cadherin in the LECs of rats.

KEY FINDINGS

In this study, Dapa applies nanotechnology-based delivery system and it contains polyvinylpyrrolidone (PVP) and HPBCD. Dapa showed therapeutic effect on DM cataracts, wherein it targeted EMT biomarker, E-cadherin. The nano-Dapa drops or oral Dapa inhibited SGLT2, suppressed AKR1B1 expression, decreased AcSOD2- and RAGE-induced EMT in diabetic cataracts. Our findings suggest that nanotechnology-based Dapa eye drops (Dapa-PVP-HPBCD) can effectively improve solubility of Dapa in aqueous solution.

SIGNIFICANCE

Taken together, results suggest that the SGLT2-mediated DM cataract therapy may involve the AKR1B1-RAGE-AcSOD2-EMT pathway. The nano eye drops and Dapa show potential beneficial effects for cataract prevention. This study conveys new insights into cataract treatment and supplementation of nano-Dapa drops shows promising result in preventing diabetic cataracts.

Creation of Chitosan-Based Nanocapsule-in-Nanofiber Structures for Hydrophobic/Hydrophilic Drug Co-Delivery and Their Dressing Applications in Diabetic Wounds

Nanofiber meshes (NFMs) loaded with therapeutic agents are very often employed to treat hard-to-heal wounds such as diabetic wounds. However, most of the NFMs have limited capability to load multiple or hydrophilicity distinctive-therapeutic agents. The therapy strategy is therefore significantly hampered. To tackle the innate drawback associated with the drug loading versatility, a chitosan-based nanocapsule-in-nanofiber (NC-in-NF) structural NFM system is developed for simultaneous loading of hydrophobic and hydrophilic drugs. Oleic acid-modified chitosan is first converted into NCs by the developed mini-emulsion interfacial cross-linking procedure, followed by loading a hydrophobic anti-inflammatory agent Curcumin (Cur) into the NCs. Sequentially, the Cur-loaded NCs are successfully introduced into reductant-responsive maleoyl functional chitosan/polyvinyl alcohol NFMs containing a hydrophilic antibiotic Tetracycline hydrochloride. Having a co-loading capability for hydrophilicity distinctive agents, biocompatibility, and a controlled release property, the resulting NFMs have demonstrated the efficacy on promoting wound healing either in normal or diabetic rats.

Recovery of walking ability in stroke patients through postacute care rehabilitation

BACKGROUND

Walking entails orchestration of the sensory, motor, balance, and coordination systems, and walking disability is a critical concern after stroke. How and to what extent these systems influence walking disability after stroke and recovery have not been comprehensively studied.

METHODS

We retrospectively analyzed patients with stroke in the Post-acute care-Cerebrovascular Diseases (PAC-CVD) program. We compared the characteristics of patient groups stratified by their ability to complete the 5-m walk test across various time points of rehabilitation. We then used stepwise linear regression to examine the degree to which each stroke characteristic and functional ability could predict patient gait performance.

RESULTS

Five hundred seventy-three patients were recruited, and their recovery of walking ability was defined by the timing of recovery in a 5-m walk test. The proportion of patients who could complete the 5-m walk test at admission, at 3 weeks of rehabilitation, at 6 weeks of rehabilitation, between 7 and 12 weeks of rehabilitation, and who could not complete the 5-m walk test after rehabilitation was 52.2%, 21.8%, 8.7%, 8.7%, and 8.6%, respectively. At postacute care discharge, patients who regained walking ability earlier had a higher chance of achieving higher levels of walking activity. Stepwise linear regression showed that Berg Balance Scale (BBS) (β: 0.011, p < .001), age (β: -0.005, p = .001), National Institutes of Health Stroke Scale (NIHSS) (6a + 6b; β: -0.042, p = .018), Mini-Nutritional assessment (MNA) (β: -0.007, p < .027), and Fugl-Meyer upper extremity assessment (FuglUE) (β: 0.002, p = .047) scores predicted patient's gait speed at discharge.

CONCLUSION

Balance, age, leg strength, nutritional status, and upper limb function before postacute care rehabilitation are predictors of walking performance after stroke.

Rational Design of Bifunctional Microporous Organic Polymers Containing Anthracene and Triphenylamine Units for Energy Storage and Biological Applications

In this study, we synthesized two conjugated microporous polymers (CMPs), An-Ph-TPA and An-Ph-Py CMPs, using the Suzuki cross-coupling reaction. These CMPs are organic polymers with p-conjugated skeletons and persistent micro-porosity and contain anthracene (An) moieties linked to triphenylamine (TPA) and pyrene (Py) units. We characterized the chemical structures, porosities, thermal stabilities, and morphologies of the newly synthesized An-CMPs using spectroscopic, microscopic, and N₂ adsorption/desorption isotherm techniques. Our results from thermogravimetric analysis (TGA) showed that the An-Ph-TPA CMP displayed better thermal stability with T_d10 = 467 °C and char yield of 57 wt% compared to the An-Ph-Py CMP with T_d10 = 355 °C and char yield of 54 wt%. Furthermore, we evaluated the electrochemical performance of the An-linked CMPs and found that the An-Ph-TPA CMP had a higher capacitance of 116 F g^-1 and better capacitance stability of 97% over 5000 cycles at 10 A g^-1. In addition, we assessed the biocompatibility and cytotoxicity of An-linked CMPs using the MTT assay and a live/dead cell viability assay and observed that they were non-toxic and biocompatible with high cell viability values after 24 or 48 h of incubation. These findings suggest that the An-based CMPs synthesized in this study have potential applications in electrochemical testing and the biological field.

Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs and the Risk of Vascular Dementia in Patients with Spondyloarthritis: A Database Cohort Study

Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease that mainly affects the axial bones, and dementia is characterized by a decline in cognitive function, leading to dependence in everyday activity. Although the association between dementia and ankylosing spondylitis has been investigated, the influence of axSpA medication on dementia risk is unclear. The aim of this study was to investigate the risk of dementia among axSpA patients and if the conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) can reduce the risk of dementia. Patients with axSpA whose data were recorded during 2004-2008 and who were followed up until the end of 2010 were recruited. A control cohort was matched by age and sex. A Cox multivariate proportional hazards model was applied to analyze the risk factors for dementia. The hazard ratio (HR) and adjusted HR (aHR) were estimated between the study and control cohorts. The effects of csDMARDs and steroid use on the risk of different types of dementia were also analyzed. In total, 2341 and 11,705 patients constituted the axSpA and control cohort, respectively. The axSpA cohort had a greater risk of vascular dementia (aHR = 2.09 (1.36-3.20). The risk of dementia (aHR = 1.01 (0.55-1.85) did not significantly differ between patients with axSpA who received csDMARDs. In conclusion, patients with axSpA are at a risk of vascular dementia, which could be reduced by csDMARDs.

Nanocellulose-reinforced, multilayered poly(vinyl alcohol)-based hydrophobic composites as an alternative sealing film

A flexible, hydrophobic, and multilayered poly(vinyl alcohol) (PVA) film evolved to replace a commercially available nonbiodegradable easy seal-paper (ES-PAPER) sealing film. First, environmentally friendly fillers, such as cellulose nanocrystals (CNCs) or cellulose nanofibers (CNFs), were added to produce PVA + CNC/CNF composites via blade coating and solution casting to strengthen the mechanical properties of PVA. Subsequently, biodegradable and hydrophobic materials, such as poly(ethylene glycol)-poly(lactic acid) (PEG-PLA) and neat PLA, were added to prepare multilayered PEG-PLA and PLA hydrophobic composites using double-sided solution casting. The hydrophobicity of PVA was enhanced through heat treatment. Finally, the mechanical properties of the as-prepared PVA film were compared with those of a commercially available ES-PAPER sealing film. PVA + CNC/CNF composites exhibit excellent transparency and mechanical properties, whereas PVA + CNCs 3.0 wt% have the highest Young's modulus and tensile strength, which are, respectively, 3% and 96% higher than the Young's modulus and tensile strength of an ES-PAPER sealing film. With regard to strain at break, the prepared PVA film also exhibited a value many times larger than that of the ES-PAPER sealing film because of good filler dispersibility, which significantly enhanced the durability of the sealing film.

Biodegradable Carbon Dioxide-Derived Non-Viral Gene Vectors for Osteosarcoma Gene Therapy

Osteosarcoma often occurs in children and adolescents with high invasiveness and high mortality. Polo-like kinase 1 (PLK1) overexpressed in most tumors promotes cancer cell proliferation and transformation. PLK1 is considered as a therapeutic target for osteosarcoma. RNA interference-based therapies are employed to combat osteosarcoma through silencing PLK1 gene expression. However, the treatment results remain unsatisfactory due to the lack of a safe and efficient nonviral gene vector. To tackle this hurdle, biodegradable and CO₂ -derivative cationic poly(vinylcyclohexene carbonates) (CPCHCs) are used as gene vectors to perform a siPLK1 therapeutic strategy for osteosarcoma treatment. Of those CPCHCs, CPCHC60 demonstrates the most excellent performance in gene transfection efficiency, endo-lysosome escaping, biodegradability, and biosafety. With the treatment of CPCHCs/siRNA nanoparticles, the expression level of PLK1 gene in osteosarcoma cells is significantly down-regulated. Subsequently, cells are arrested in the G₂ /M phase and subsequently dead in the form of apoptosis, resulting in significant tumor regression both in vitro and in vivo. This study brings a new insight into the development of superior nonviral gene vectors for practical cancer treatment. Based on the results, the resulting nanoparticle-based gene drug formation is considered to have a highly successful chance in further translational nanomedicine applications.

Improvement of Pain and Function by Using Botulinum Toxin Type A Injection in Patients with an Osteoarthritic Knee with Patellar Malalignment: An Electromyographic Study

Objective: To determine the pain and electromyographic (EMG) amplitude ratio of the vastus medialis oblique (VMO) to the vastus lateralis (VL) after botulinum toxin type A (BTA) was injected in the bilateral osteoarthritic knee of patients with patellar malalignment for analysis. Material and methods: A total of fifteen patients were recruited; the more symptomatic knee of each patient received a BTA injection (BTA side). The other set of patients were left untreated. In all, fifteen healthy participants comprised the control group. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and numeric rating scale (NRS) for pain were assessed. The EMG amplitude of VL and VMO activity was recorded using an isokinetic dynamometer and synchronized using the BIOPAC MP100. The data were collected before and at 4, 8, and 12 weeks post−BTA injection. Results: The EMG ratios of the patient group were lower than those of the control group at all testing velocities (p < 0.05). The VMO/VL ratio improved significantly on the BTA side only. The VMO/VL ratios on the BTA side were higher than those on the untreated side (p < 0.05). Knee pain decreased significantly after the BTA injection. The EMG ratios were negatively correlated with the NRS and WOMAC scores. Conclusion: BTA injection effectively reduces knee pain and restores the EMG ratio between the VMO and VL.

Preparation of CO2 -based Cationic Polycarbonate/Polyacrylonitrile Nanofibers with an Optimal Fibrous Microstructure for Antibacterial Applications

Utilizing CO₂ as one of the monomer resource, poly(vinylcyclohexene carbonates) (PVCHCs) are used as the precursor for preparing cationic PVCHCs (CPVCHCs) via thiol-ene click functionalization. Through the functionalization, CPVCHC-43 with a tertiary amine density of 43% relative to the backbone is able to display a significantly antibacterial ability against Staphylococcus aureus (S. aureus). Blending CPVCHC-43 with polyacrylonitrile (PAN), CPVCHC/PAN nanofiber meshes (NFMs) have been successfully prepared by electrospinning. More importantly, two crucial fibrous structural factors including CPVCHC/PAN weight ratio and fiber diameter have been systematically investigated for the effects on the antibacterial performance of the NFMs. Sequentially, a quaternization treatment has been employed on the NFMs with an optimal fibrous structure to enhance the antibacterial ability. The resulting quaternized NFMs have demonstrated the great biocidal effects against Gram-positive and Gram-negative bacteria. Moreover, the excellent biocompatibility of the quaternized NFMs have also been thoroughly evaluated and verified. This article is protected by copyright. All rights reserved.

Organic/Inorganic Self-Assembled Hybrid Nano-Architectures for Cancer Therapy Applications

Since the conceptualization of nanomedicine, numerous nanostructure-mediated drug formulations have progressed into clinical trials for treating cancer. However, recent clinical trial results indicate such kind of drug formulations has a limited improvement on the antitumor efficacy. This is due to the biological barriers associated with those formulations, for example, circulation stability, extravasation efficiency in tumor, tumor penetration ability, and developed multi-drug resistance. When employing for nanomedicine formulations, pristine organic-based and inorganic-based nanostructures have their own limitations. Accordingly, organic/inorganic (O/I) hybrids have been developed to integrate the merits of both, and to minimize their intrinsic drawbacks. In this context, the recent development in O/I hybrids resulting from a self-assembly strategy will be introduced. Through such a strategy, organic and inorganic building blocks can be self-assembled via either chemical covalent bonds or physical interactions. Based on the self-assemble procedure, the hybridization of four organic building blocks including liposomes, micelles, dendrimers, and polymeric nanocapsules with five functional inorganic nanoparticles comprising gold nanostructures, magnetic nanoparticles, carbon-based materials, quantum dots, and silica nanoparticles will be highlighted. The recent progress of these O/I hybrids in advanced modalities for combating cancer, such as, therapeutic agent delivery, photothermal therapy, photodynamic therapy, and immunotherapy will be systematically reviewed.

Carbon Dioxide-Derived Biodegradable and Cationic Polycarbonates as a New siRNA Carrier for Gene Therapy in Pancreatic Cancer

Pancreatic cancer is an aggressive malignancy associated with poor prognosis and a high tendency in developing infiltration and metastasis. K-ras mutation is a major genetic disorder in pancreatic cancer patient. RNAi-based therapies can be employed for combating pancreatic cancer by silencing K-ras gene expression. However, the clinical application of RNAi technology is appreciably limited by the lack of a proper siRNA delivery system. To tackle this hurdle, cationic poly (cyclohexene carbonate) s (CPCHCs) using widely sourced CO₂ as the monomer are subtly synthesized via ring-opening copolymerization (ROCOP) and thiol-ene functionalization. The developed CPCHCs could effectively encapsulate therapeutic siRNA to form CPCHC/siRNA nanoplexes (NPs). Serving as a siRNA carrier, CPCHC possesses biodegradability, negligible cytotoxicity, and high transfection efficiency. In vitro study shows that CPCHCs are capable of effectively protecting siRNA from being degraded by RNase and promoting a sustained endosomal escape of siRNA. After treatment with CPCHC/siRNA NPs, the K-ras gene expression in both pancreatic cancer cell line (PANC-1 and MiaPaCa-2) are significantly down-regulated. Subsequently, the cell growth and migration are considerably inhibited, and the treated cells are induced into cell apoptotic program. These results demonstrate the promising potential of CPCHC-mediated siRNA therapies in pancreatic cancer treatment.

Ergosta-7,9(11),22-trien-3β-ol Alleviates Intracerebral Hemorrhage-Induced Brain Injury and BV-2 Microglial Activation

Intracerebral hemorrhage (ICH) is a devastating neurological disorder characterized by an exacerbation of neuroinflammation and neuronal injury, for which few effective therapies are available at present. Inhibition of excessive neuroglial activation has been reported to alleviate ICH-related brain injuries. In the present study, the anti-ICH activity and microglial mechanism of ergosta-7,9(11),22-trien-3β-ol (EK100), a bioactive ingredient from Asian medicinal herb Antrodia camphorate, were evaluated. Post-treatment of EK100 significantly attenuated neurobehavioral deficit and MRI-related brain lesion in the mice model of collagenase-induced ICH. Additionally, EK100 alleviated the inducible expression of cyclooxygenase (COX)-2 and the activity of matrix metalloproteinase (MMP)-9 in the ipsilateral brain regions. Consistently, it was shown that EK100 concentration-dependently inhibited the expression of COX-2 protein in Toll-like receptor (TLR)-4 activator lipopolysaccharide (LPS)-activated microglial BV-2 and primary microglial cells. Furthermore, the production of microglial prostaglandin E₂ and reactive oxygen species were attenuated by EK100. EK100 also attenuated the induction of astrocytic MMP-9 activation. Among several signaling pathways, EK100 significantly and concentration-dependently inhibited activation of c-Jun N-terminal kinase (JNK) MAPK in LPS-activated microglial BV-2 cells. Consistently, ipsilateral JNK activation was markedly inhibited by post-ICH-treated EK100 in vivo. In conclusion, EK100 exerted the inhibitory actions on microglial JNK activation, and attenuated brain COX-2 expression, MMP-9 activation, and brain injuries in the mice ICH model. Thus, EK100 may be proposed and employed as a potential therapeutic agent for ICH.

Synthesis of functional CO2-based polycarbonates via dinuclear nickel nitrophenolate-based catalysis for degradable surfactant and drug-loaded nanoparticle applications

Functional CO₂-based polycarbonates via efficient catalysis strategies using well-defined dinickel catalysts and their biomedical applications for the synthesis of drug-loaded nanoparticles were reported.

Antimicrobial Activity of Electrospun Polyvinyl Alcohol Nanofibers Filled with Poly[2-(tert-butylaminoethyl) Methacrylate]-Grafted Graphene Oxide Nanosheets

A novel cationic polymer, poly[2-(tert-butylaminoethyl) methacrylate] (PTA), effectively kills various strains of bacteria with low toxicity to tissue cells. Graphene-based materials demonstrate exceptional electron transport capability, antibacterial activity, favorable nontoxicity, and versatile applicability. PTA can be grafted onto the graphene oxide (GO) surface (GO-g-PTA) to enhance the antimicrobial efficiency of the latter against Staphylococcus aureus (S. aureus). In this study, GO-g-PTA powders were successfully synthesized via free radical polymerization (GO-g-PTA-F) and atom transfer radical polymerization (GO-g-PTA-A). The antimicrobial efficiencies of graphene nanosheets (GNSs), GO-g-PTA-F, and GO-g-PTA-A were then investigated. Addition of GNS, GO-g-PTA-F, and GO-g-PTA-A to the PVA nanofibers was carried out elucidate the effects of filler amount and physical treatment on the morphology, microstructure, crystallization behaviors, antimicrobial efficiency, and cytotoxicity of the composite fibers. Finally, the potential applications of electrospun PVA/GNS, PVA/GO-g-PTA-F, and PVA/GO-g-PTA-A composite nanofiber mats to chronic wound care were evaluated. The resulting PVA/GO-g-PTA-A composite nanofiber mats showed enhanced antimicrobial ability against S. aureus compared with the PVA/GNS and PVA/GO-g-PTA-F composite nanofiber mats at the same filler volume percentage.

Comparison of the effects between lasers applied to myofascial trigger points and to classical acupoints for patients with cervical myofascial pain syndrome

Background

To compare the immediate effectiveness of low-level laser therapy (LLLT) applied to classical acupoints versus trigger points for patients with cervical myofascial pain syndrome (MPS).

Methods

This was a single-blinded, randomized, placebo-controlled trial. This study was performed in a university-affiliated medical center. One hundred participants with cervical myofascial pain syndrome were randomly allocated to four treatment groups, including (1) acupoint therapy (AcuT), (2) acupoint control (AcuC), (3) trigger point therapy (TriT), and (4) trigger point control (TriC) groups. Low-level laser (810-nm) therapy was used in both therapy groups, while the same procedure was performed without laser in the acupoint control groups. The patients were evaluated based on visual analogue scale (VAS) pain score, pressure pain threshold, and cervical range of motion (ROM) before and after the therapy.

Results

Immediate pain relief was observed in the TriT group (p < 0.01). The TriT group showed improved cervical ROM in ipsilateral bending (p < 0.01), while the AcuT group did not.

Conclusions

LLLT applied to trigger points could significantly relieve myofascial pain and was effective in relieving cervical ROM limitations. Considering the risk of pneumothorax, laser therapy at trigger points for patients with cervical MPS may be a choice when acupuncture therapy is unavailable.

Trial registration

ClinicalTrials.gov ID: NCT01516502.

Biodegradable Polymers for Gene-Delivery Applications

Gene-based therapies have emerged as a new modality for combating a myriad of currently incurable diseases. However, the fragile nature of gene therapeutics has significantly hampered their biomedical applications. Correspondingly, the development of gene-delivery vectors is of critical importance for gene-based therapies. To date, a variety of gene-delivery vectors have been created and utilized for gene delivery. In general, they can be categorized into viral- and non-viral vectors. Due to safety issues associated with viral vectors, non-viral vectors have recently attracted much more research focus. Of these non-viral vectors, polymeric vectors, which have been preferred due to their low immunogenicity, ease of production, controlled chemical composition and high chemical versatility, have constituted an ideal alternative to viral vectors. In particular, biodegradable polymers, which possess advantageous biocompatibility and biosafety, have been considered to have great potential in clinical applications. In this context, the aim of this review is to introduce the recent development and progress of biodegradable polymers for gene delivery applications, especially for their chemical structure design, gene delivery capacity and additional biological functions. Accordingly, we first define and categorize biodegradable polymers, followed by describing their corresponding degradation mechanisms. Various types of biodegradable polymers resulting from natural and synthetic polymers will be introduced and their applications in gene delivery will be examined. Finally, a future perspective regarding the development of biodegradable polymer vectors will be given.

Functional Recovery Patterns of Hemorrhagic and Ischemic Stroke Patients Under Post-Acute Care Rehabilitation Program

BACKGROUND

Tailored rehabilitation programs for stroke patients cannot be made without knowledge of their recovery potential. The aim of this study is to characterize the functional recovery patterns of ischemic stroke (IS) and intracerebral hemorrhage (ICH) patients under post-acute care stroke rehabilitation.

METHODS

This retrospective study analyzed the data of patients enrolled in the Post-Acute Care-Cerebrovascular Disease (PAC-CVD) rehabilitation program, which provides an individualized 1- to 3-hour intensive physical, occupational, and speech and language therapy for post-acute stroke patients in Taoyuan Chang Gung Memorial hospital in Taiwan. Our primary endpoint measure was Barthel Index (BI), and secondary endpoint measures included other 12 functional measures.

RESULTS

A total of 489 patients were included for analysis. Patients with stroke history had less BI improvement than those who suffered their first-ever stroke. In first-ever stroke patients who had completed 6 to 12 weeks of PAC-CVD program, subcortical ICH patients had greater BI, quality of life, sensation, and balance improvements, and had greater late-phase recovery than their IS counterparts. In IS patients, those with age >75 had less BI improvement; those with National Institute of Health Stroke Scale (NIHSS) score 1-5 had greater Motor Activity Log quality of use (MAL-quality) improvement than those with NIHSS score >5; those with Mini-Mental State Examination (MMSE) score ≥24 had greater BI and instrumental activities of daily living (IADL) improvement. Using the general linear model, previous stroke (ß: -6.148, p=0.01) and subcortical ICH (ß: 5.04, p=0.03) were factors associated with BI improvement.

CONCLUSION

Subcortical ICH patients have greater functional improvement and greater late-phase recovery than their IS counterparts following PAC rehabilitation. More studies are needed to validate our findings and unravel the underlying mechanisms of stroke recovery to optimize the treatment strategy following a stroke.

Biodegradable Polymer-Coated Multifunctional Graphene Quantum Dots for Light-Triggered Synergetic Therapy of Pancreatic Cancer

In this work, we reported the synthesis of an engineered novel nanocarrier composed of biodegradable charged polyester vectors (BCPVs) and graphene quantum dots (GQDs) for pancreatic cancer (MiaPaCa-2 cells) therapy applications. Such a nanocarrier was utilized to co-load doxorubicin (DOX) and small interfering ribonucleic acid (siRNA), resulting in the formation of GQD/DOX/BCPV/siRNA nanocomplexes. The resulting nanocomplexes have demonstrated high stability in physiologically mimicking media, excellent K-ras downregulation activity, and effective bioactivity inhibition for MiaPaCa-2 cells. More importantly, laser light was used to generate heat for the nanocomplexes via the photothermal effect to damage the cells, which was further employed to trigger the release of payloads from the nanocomplexes. Such triggered release function greatly enhanced the anticancer activity of the nanocomplexes. Preliminary colony formation study also suggested that GQD/DOX/BCPV/siRNA nanocomplexes are qualified carrier candidates in subsequent in vivo tests.

Intensifying the Antimicrobial Activity of Poly[2-( tert-butylamino)ethyl Methacrylate]/Polylactide Composites by Tailoring Their Chemical and Physical Structures

Poly[2-( tert-butylaminoethyl) methacrylate] (PTA), an important class of antimicrobial polymers, has demonstrated its great biocidal efficiency, favorable nontoxicity, and versatile applicability. To further enhance its antimicrobial efficiency, an optimization of the chemical structure of PTA polymers is performed via atom transfer radical polymerization (ATRP) in terms of the antimicrobial ability against Escherichia coli ( E. coli) and Staphylococcus aureus ( S. aureus). After the optimization, the resulting PTA is blended into a polylactide (PLA) matrix to form PTA/PLA composite thin films. It is first found, that the antimicrobial efficiency of PTA/PLA composites was significantly enhanced by controlling the PLA crystallinity and the PLA spherulite size. A possible mechanistic route regarding this new finding has been rationally discussed. Lastly, the cytotoxicity and mechanical properties of a PTA/PLA composite thin film exhibiting the best biocidal effect are evaluated for assessing its potential as a new material for creating antimicrobial biomedical devices.

Acceptance of different design exergames in elders

For promoting the successful aging of elderly residents of Chang Gung Silver Village in Taiwan, five interactive exergames were developed to promote the well-being of the elderly. The exergames included both physical games and cognitive games, and were implemented using various computer-based technologies in the Chang Gung Silver Village. The exergames were trialed by 39 elderly residents (15 male, 24 female; mean age 79.5 ± 17.5 years) of Chang Gung Silver Village. Following the trials, the participants were requested to complete a Technology Acceptance Model 2 (TAM2) questionnaire. The results showed that the perceived playfulness and perceived usefulness of the exergames were significantly related to the users’ usage behavior and intention to use for both the physical games and the cognitive games. However, a relationship between the output quality of the game and the usage behavior was apparent only in the case of the cognitive exergames. Finally, the impact of social influence on the intention to use and the usage behavior was more pronounced for the physical exergames. Overall, the results revealed that the acceptance of exergames by the elderly depends not so much on the awareness of fun in using the game, but the perceived usefulness of the related physical and cognitive abilities.

Predicting post-stroke activities of daily living through a machine learning-based approach on initiating rehabilitation

OBJECTIVES

Prediction of activities of daily living (ADL) is crucial for optimized care of post-stroke patients. However, no suitably-validated and practical models are currently available in clinical practice.

METHODS

Participants of a Post-acute Care-Cerebrovascular Diseases (PAC-CVD) program from a reference hospital in Taiwan between 2014 and 2016 were enrolled in this study. Based on 15 rehabilitation assessments, machine learning (ML) methods, namely logistic regression (LR), support vector machine (SVM), and random forest (RF), were used to predict the Barthel index (BI) status at discharge. Furthermore, SVM and linear regression were used to predict the actual BI scores at discharge.

RESULTS

A total of 313 individuals (men: 208; women: 105) were enrolled in the study. All the classification models outperformed single assessments in predicting the BI statuses of the patients at discharge. The performance of the LR and RF algorithms was higher (area under ROC curve (AUC): 0.79) than that of SVM algorithm (AUC: 0.77). In addition, the mean absolute errors of both SVM and linear regression models in predicting the actual BI score at discharge were 9.86 and 9.95, respectively.

CONCLUSIONS

The proposed ML-based method provides a promising and practical computer-assisted decision making tool for predicting ADL in clinical practice.

Psychiatrists' Attitude and Use of Second-generation Antipsychotics for the Treatment of Schizophrenia in Taiwan

OBJECTIVES

This survey aimed to understand the attitude of psychiatrists and their use of commonly prescribed second-generation antipsychotics (SGAs) for the treatment of schizophrenia in Taiwan. It also attempted to identify the factors that might influence their preference for selecting SGAs.

METHODS

Psychiatrists were interviewed face-to-face using a structured questionnaire. The questionnaire addressed various issues involved in the treatment of patients with schizophrenia, including the reasons for selecting SGAs, psychiatrists' level of satisfaction with commonly prescribed SGAs, and their current use of SGAs in clinical practice.

RESULTS

Gender and age of the psychiatrists, and practice setting were not related to SGA selection. The selection of a SGA might be influenced by characteristics of the psychiatrist, properties of the drugs, and the healthcare insurance system. Most psychiatrists agreed that the performance of brand-name drugs was superior to that of generic drugs. Better symptom control, improvement in cognition, and higher tolerability were among the major factors considered by psychiatrists in Taiwan when prescribing antipsychotics.

CONCLUSION

Selection of a SGA in Taiwan is potentially influenced by the characteristics of the psychiatrist, properties of the drug, and the healthcare insurance system. Efficacy and tolerability were among the major determining factors when prescribing antipsychotics for the treatment of patients with schizophrenia.

The Novel HDAC8 Inhibitor WK2-16 Attenuates Lipopolysaccharide-Activated Matrix Metalloproteinase-9 Expression in Human Monocytic Cells and Improves Hypercytokinemia In Vivo

Dysregulated human monocytes/macrophages can synthesize and secrete matrix metalloproteinases (MMPs), which play important roles in the progression of sepsis. In this study, we investigated the effects and mechanism of a novel histone deacetylase (HDAC8) inhibitor, (E)-N-hydroxy-4-methoxy-2-(biphenyl-4-yl)cinnamide (WK2-16), on MMP-9 production and activation in stimulated human monocytic THP-1 cells. Our results demonstrated that the acetylation level of structural maintenance of chromosomes 3 (SMC3) was up-regulated by WK2-16 in THP-1 cells. Consistently, an in vitro enzyme study demonstrated that WK2-16 selectively inhibited HDAC8 activity. Moreover, the WK2-16 concentration dependently suppressed MMP-9-mediated gelatinolysis induced by tumor necrosis factor-α (TNF-α) or lipopolysaccharide (LPS). Additionally, WK2-16 significantly inhibited both MMP-9 protein and mRNA expression without cellular toxicity. Nevertheless, WK2-16 suppressed the extracellular levels of interleukin (IL)-6 from LPS-stimulated THP-1 cells. For the signaling studies, WK2-16 had no effect on LPS/TLR4 downstream signaling pathways, such as the NF-κB and ERK/JNK/P38 MAPK pathways. On the other hand, WK2-16 enhanced the recruitment of acetylated Yin Yang 1 (YY1) with HDAC1. Finally, in vivo studies indicated that WK2-16 could reduce the serum levels of TNF-α and IL-6 in endotoxemic mice. These results suggested that HDAC8 inhibition might provide a novel therapeutic strategy of hypercytokinemia in sepsis.

Nanotherapy silencing the interleukin-8 gene produces regression of prostate cancer by inhibition of angiogenesis

Interleukin-8 (IL-8) is a pro-angiogenic cytokine associated with aggressive prostate cancer (CaP). We detected high levels of IL-8 in sera from patients with CaP compared with healthy controls and patients with benign prostatic hypertrophy. This study examines the role of IL-8 in the pathogenesis of metastatic prostate cancer. We developed a biocompatible, cationic polylactide (CPLA) nanocarrier to complex with and efficiently deliver IL-8 small interfering RNA (siRNA) to CaP cells in vitro and in vivo. CPLA IL-8 siRNA nanocomplexes (nanoplexes) protect siRNA from rapid degradation, are non-toxic, have a prolonged lifetime in circulation, and their net positive charge facilitates penetration of cell membranes and subsequent intracellular trafficking. Administration of CPLA IL-8 siRNA nanoplexes to immunodeficient mice bearing human CaP tumours produced significant antitumour activities with no adverse effects. Systemic (intravenous) or local intra-tumour administration of IL-8 siRNA nanoplexes resulted in significant inhibition of CaP growth. Magnetic resonance imaging and ultrasonography of experimental animals demonstrated reduction of tumour perfusion in vivo following nanoplex treatment. Staining of tumour sections for CD31 confirmed significant damage to tumour neovasculature after nanoplex therapy. These studies demonstrate the efficacy of IL-8 siRNA nanotherapy for advanced, treatment-resistant human CaP.

Biodegradable nanoparticles as siRNA carriers for in vivo gene silencing and pancreatic cancer therapy

Biodegradable charged polyester-based vectors (BCPVs) were utilized for efficiently delivering mutatedK-Ras-targeting siRNA and successfully inhibiting tumor growth in a pancreatic xenograft modelin vivo.

Synthesis of Polylactide-Based Core-Shell Interface Cross-Linked Micelles for Anticancer Drug Delivery

Well-defined poly(ethylene glycol)-b-allyl functional polylactide-b-polylactides (PEG-APLA-PLAs) are synthesized through sequential ring-opening polymerization. PEG-APLA-PLAs that have amphiphilic properties and reactive allyl side chains on their intermediate blocks are successfully transferred to core-shell interface cross-linked micelles (ICMs) by micellization and UV-initiated irradiation. ICMs have demonstrated enhanced colloidal stability in physiological-mimicking media. Hydrophobic molecules such as Nile Red or doxorubicin (Dox) are readily loaded into ICMs; the resulting drug-ICM formulations possess slow and sustained drug release profiles under physiological-mimicking conditions. ICMs exhibit negligible cytotoxicity in human uterine sarcoma cancer cells by using biodegradable aliphatic polyester as the hydrophobic segments. Relative to free Dox, Dox-loaded ICMs show a reduced cytotoxicity due to the late intracellular release of Dox from ICMs. Overall, ICMs represent a new type of biodegradable cross-linked micelle and can be employed as a promising platform for delivering a broad variety of hydrophobic drugs.

The antalgic effects of non-invasive physical modalities on central post-stroke pain: a systematic review

[Purpose] This study systematically reviewed the antalgic effects of non-invasive physical modalities (NIPMs) on central post-stroke pain (CPSP). [Subjects and Methods] Clinical studies were sought on September 2015 in 10 electronic databases, including Medline and Scopus. The searching strings were “central pain and stroke” and “treatment, and physical or non-pharmacological”. The inclusion and exclusion criteria were set for screening the clinical articles by two reviewers. Pain scores on visual analog scale in an article were used as the outcome measure for resulting judgment. The NIPMs intervention summarized from the eligible articles was rated from Levels A to C according to Evidence Classification Scheme for Therapeutic Interventions. [Results] Over 1200 articles were identified in the initial searches and 85 studies were retrieved. Sixteen studies were eligible and judged. Caloric vestibular stimulation (n=3), heterotopic noxious conditioning stimulation (n=1), and transcutaneous electrical stimulation (n=1) were rated below Level C. Transcranial direct current stimulation (TDCS; n=2) and transcranial magnetic stimulation (TMS; n=9) were rated as Level B. [Conclusion] The findings suggest that TMS and TDCS were better than other treatments for CPSP relief but the studies were of insufficient quality.

Biodegradable charged polyester-based vectors (BCPVs) as an efficient non-viral transfection nanoagent for gene knockdown of the BCR-ABL hybrid oncogene in a human chronic myeloid leukemia cell line

First-line therapy of chronic myelogenous leukemia (CML) has always involved the use of BCR-ABL tyrosine-kinase inhibitors which is associated with an abnormal chromosome called Philadelphia chromosome. Although the overall survival rate has been improved by the current therapeutic regime, the presence of resistance has resulted in limited efficacy. In this study, an RNA interference (RNAi)-based therapeutic regime is proposed with the aim to knockdown the BCR-ABL hybrid oncogene using small interfering RNA (siRNA). The siRNA transfection rates have usually been limited due to the declining contact probability among polyplexes and the non-adherent nature of leukemic cells. Our work aims at addressing this limitation by using a biodegradable charged polyester-based vector (BCPV) as a nanocarrier for the delivery of BCR-ABL-specific siRNA to the suspension culture of a K562 CML cell line. BCR-ABL siRNAs were encapsulated in the BCPVs by electrostatic force. Cell internalization was facilitated by the BCPV and assessed by confocal microscopy and flow cytometry. The regulation of the BCR-ABL level in K562 cells as a result of RNAi was analyzed by real-time polymerase chain reaction (RT-PCR). We observed that BCPV was able to form stable nanoplexes with siRNA molecules, even in the presence of fetal bovine serum (FBS), and successfully assisted in vitro siRNA transfection in the non-adherent K562 cells. As a consequence of downregulation of BCR-ABL, BCPV-siRNA nanoplexes inhibited cell proliferation and promoted cell apoptosis. All results were compared with a commercial transfection reagent, Lipofectamine2000™, which served as a positive control. More importantly, this class of non-viral vector exhibits biodegradable features and negligible cytotoxicity, thus providing a versatile platform to deliver siRNA to non-adherent leukemia cells with high transfection efficiency by effectively overcoming extra- and intra-cellular barriers. Due to the excellent in vitro transfection results from BCPV-siRNA, a newly developed biodegradable transfection agent, BCPV, is being probed for transfection performance in an animal model.

Overcoming Gene-Delivery Hurdles: Physiological Considerations for Nonviral Vectors

With the use of contemporary tools and techniques, it has become possible to more precisely tune the biochemical mechanisms associated with using nonviral vectors for gene delivery. Consequently, nonviral vectors can incorporate numerous vector compositions and types of genetic cargo to develop diverse genetic therapies. Despite these advantages, gene-delivery strategies using nonviral vectors have poorly translated into clinical success due to preclinical experimental design considerations that inadequately predict therapeutic efficacy. Furthermore, the manufacturing and distribution processes are critical considerations for clinical application that should be considered when developing therapeutic platforms. In this review, we evaluate potential avenues towards improving the transition of gene-delivery technologies from in vitro assessment to human clinical therapy.

Evaluating Prussian blue analogues MII3[MIII(CN)6]2 (MII = Co, Cu, Fe, Mn, Ni; MIII = Co, Fe) as activators for peroxymonosulfate in water

[Fe(CN)₆] and [Co(CN)₆]-based Prussian blue analogues (PBAs) were prepared with various metal ions (i.e., Co, Cu, Fe, Mn and Ni) and evaluated as catalysts to activate an important oxidant, peroxymonosulfate (PMS).

Preparation and identification of an antiserum against recombinant UL31 protein of pseudorabies virus

Pseudorabies virus (PRV) early protein UL31 is a homologue of herpes simplex virus 1 (HSV-1) UL31, which is a multifunctional protein important for HSV-1 infection. However, the precise roles of PRV UL31 in virus life cycle are still poorly understood. A relatively crucial tool for uncovering the function of UL31 is an antiserum that specifically detects UL31 in the PRV-infected cells. For this purpose, a recombinant UL31 protein consisting of N-terminal 27 aa of UL31 fused to EYFP and His-tag was expressed, purified and used for the preparation of antiserum in BALB/c mice. Our results show that Western blot analysis and immunofluorescence assay showed that this antiserum could specifically detect the purified recombinant UL31 as well as full-length UL31 in the PRV infected cells. These results demonstrate that the prepared antiserum could serve as a valuable tool for further studies of UL31 functions in PRV infection.

Polypropylene/Short Glass Fibers Composites: Effects of Coupling Agents on Mechanical Properties, Thermal Behaviors, and Morphology

This study uses the melt compounding method to produce polypropylene (PP)/short glass fibers (SGF) composites. PP serves as matrix while SGF serves as reinforcement. Two coupling agents, maleic anhydride grafted polypropylene, (PP-g-MA) and maleic anhydride grafted styrene-ethylene-butylene-styrene block copolymer (SEBS-g-MA) are incorporated in the PP/SGF composites during the compounding process, in order to improve the interfacial adhesion and create diverse desired properties of the composites. According to the mechanical property evaluations, increasing PP-g-MA as a coupling agent provides the composites with higher tensile, flexural, and impact properties. In contrast, increasing SEBS-g-MA as a coupling agent provides the composites with decreasing tensile and flexural strengths, but also increasing impact strength. The DSC results indicate that using either PP-g-MA or SEBS-g-MA as the coupling agent increases the crystallization temperature. However, the melting temperature of PP barely changes. The spherulitic morphology results show that PP has a smaller spherulite size when it is processed with PP-g-MA or SEBS-g-MA as the coupling agent. The SEM results indicate that SGF is evenly distributed in PP matrices, but there are distinct voids between these two materials, indicating a poor interfacial adhesion. After PP-g-MA or SEBS-g-MA is incorporated, SGF can be encapsulated by PP, and the voids between them are fewer and indistinctive. This indicates that the coupling agents can effectively improve the interfacial compatibility between PP and SGF, and as a result improves the diverse properties of PP/SGF composites.

A genome-wide association study of growth trait-related single nucleotide polymorphisms in Chinese Yancheng chickens

Chicken (Gallus gallus) growth traits are important economic traits, and many studies have been conducted on genetic selection for body weight. However, most of these studies have detected functional chromosome mutations or regions by conventional molecular markers or gene chips. In this study, we performed a new genome-wide association study using specific-locus amplified fragment sequencing (SLAF-seq) technology in purebred Yancheng chickens. Single nucleotide polymorphisms (SNPs) that were significantly associated with phenotypic traits were identified by GAPIT-compressed mixed linear models. Eighteen SNP markers reached 5% Bonferroni genome-wide significance. A region spanning 72.3 to 82.1 Mb on GGA4 had a strong influence on growth traits. Four genes (FAM184B, KCNIP4, MIR15A, and GLI3) were closely associated with body weight. Some SNPs were coincident with previously reported quantitative trait locus regions. Our results would promote the researches of Chinese chickens and accelerate the utilization of Chinese chicken, specially Yancheng chicken.

The effects of total contact insole with forefoot medial posting on rearfoot movement and foot pressure distributions in patients with flexible flatfoot

The purpose of this study is to evaluate the therapeutic effect of total contact insole with forefoot medial posting (TCIFMP) orthosis in patients with flexible flatfoot. The TCIFMP insole was custom- mode, made from semi-rigid plastazote and PPT. Using the gait analysis and the plantar-pressure measure systems, we investigate rearfoot motion and plantar pressure redistribution in these patients. The results of this study showed that the excessive valgus movement of the rearfoot can be reduced significantly by the TCIFMP insole in these patients. Besides, there were significant decreases in the peak pressure under the toe, lateral metatarsal, lateral foot and heel areas. Therefore, we suggested that the TCIFMP insole is an effective orthotic device for rearfoot motion control, plantar pressure reduction and re-distribution in patients with flexible flatfoot.

Botulinum Toxin type A injections for patients with painful hallux valgus: a double-blind, randomized controlled study

Hallux valgus (HV) related pain and disability remains a medical challenge to date. We have evaluated the therapeutic effect of intramuscular Botulinum Toxin type A (BTX-A) injection on painful HV in a double-blind randomized controlled trial. Sixteen patients having painful HV in at least one foot from the Department of Physical Medicine and Rehabilitation at a medical center in northern Taiwan have participated. Patients were randomized into two groups to receive intramuscular injections of either BTX-A or normal saline (NS) to the oblique and transverse heads of the adductor hallucis, flexor hallucis brevis and extensor hallucis longus muscles. Primary outcome measurements were selected from the Taiwan Chinese version of the Foot Function Index subscales on pain (questions 1-6, 9) and disability (question 10-18). The secondary outcome measurement was the HV angle. Patients were assessed at baseline and at 1, 2, 3, and 6 months after treatment. The demographic data and measurements were comparable between the two groups at baseline (p>0.05). BTX-A and NS reduced pain and disability one month after injection. Pain reduction induced by BTX-A injection lasted for at least 6 months while that induced by NS lasted for only 1 month. In addition, patients in the BTX-A group showed greater improvement in pain score (p<0.001), disability score (p<0.05), and HV angle (p<0.05) than patients in the NS group. The results reflected that HV-related muscle injection of BTX-A resulted in a marked reduction in pain for up to 6 months.

Reduction of plantar pressures in leprosy patients by using custom made shoes and total contact insoles

OBJECTIVE

The purpose of this study was to observe whether our custom made shoes and total contact insoles can effectively increase the plantar contact areas and reduce peak pressures in patients with leprosy.

DESIGN

In the rehabilitation laboratory of a tertiary medical center. Six male and two female leprosy patients were recruited in this study. In this study, parameters related to foot pressures were compared between these patients wearing commercial available soft-lining kung-fu shoes and our custom made shoes with total contact insoles. The custom made shoes were made with larger toe box and were able to accommodate both the foot and the insoles. Custom made total contact insoles were made with the subtalar joints under neutral and non-weight-bearing positions. The insole force measurement system of Novel Pedar-X (Novel, Munich, Germany) was used to measure the plantar forces. The parameters of contact area (cm(2)), peak plantar pressures (kPa), contact time (s), and pressure time integral (kPa s) were measured.

RESULTS

There were significant contact area increases in the right and left foot heel areas, left medial arch, and second to fifth toes after wearing the custom made shoes and insoles. There were significant decreases in peak plantar pressures in bilateral heels, left lateral midfoot, bilateral second to fourth metatarsal areas, and left fifth metatarsal head after wearing the custom made shoes and insoles (p<0.05).

CONCLUSIONS

Plantar ulceration is a common serious disability in leprosy patients. As a result, footwear and measures able to reduce plantar pressures may be beneficial in preventing plantar ulcers from occurring in these patients. Our custom made shoes and total contact insoles were proven to be effective in increasing contact areas and decreasing peak pressures in plantar surfaces, and may therefore be a feasible treatment option in preventing leprosy patients from developing plantar ulcers.

Graphene-Gold Metasurface Architectures for Ultrasensitive Plasmonic Biosensing

Graphene-gold metasurface architectures that can provide significant gains in plasmonic detection sensitivity for trace-amount target analytes are reported. Benefiting from extreme phase singularities of reflected light induced by strong plasmon-mediated energy confinements, the metasurface demonstrates a much-improved sensitivity to molecular bindings nearby and achieves an ultralow detection limit of 1 × 10(-18) m for 7.3 kDa 24-mer single-stranded DNA.

Development and Impact of De Novo Anti-HLA Antibodies in Pediatric Heart Transplant Recipients

There is increasing evidence that de novo anti-HLA antibodies, more specifically de novo donor-specific antibodies (DSA) following solid organ transplantation may be associated with negative outcomes including rejection in the first year and graft loss. Limited data are available in pediatric heart transplant recipients. We sought to prospectively determine the incidence, class and early impact of de novo anti-HLA antibodies in a cohort of pediatric heart transplant recipients. Serial panel reactive antibody testing posttransplant was performed in 25 patients (14 males) transplanted between January 2008 and June 2010. Five patients were sensitized pretransplant; all patients had negative direct crossmatch. Seventy-two percent developed de novo anti-HLA antibodies at a median of 2.6 weeks (IQR 1.2 weeks to 6.2 months) posttransplant; 67% of these were DSA. The majority of recipients in our cohort developed de novo anti-HLA antibodies within the first year posttransplant, with two-thirds being donor-specific. Acute cellular rejection, though frequent, was not different in patients with antibody development regardless of class or specificity, and there was no antibody-mediated rejection, graft loss or early cardiac allograft vasculopathy.

PEGylated cationic polylactides for hybrid biosynthetic gene delivery

Genetic vaccination is predicated on the underlying principle that diseases can be prevented by the controlled introduction of genetic material encoding antigenic proteins from pathogenic organisms to elicit the formation of protective immune responses. Driving this process is the choice of carrier that is responsible for navigating the obstacles associated with gene delivery. In this work, we expand upon a novel class of hybrid biosynthetic gene delivery vectors that are composed of a biomaterial outer coating and a bacterial (Escherichia coli) inner core. Specifically, a series of newly developed biodegradable cationic polylactides (CPLAs) and their PEGylated variants were selected to investigate the role of low polydispersity index (PDI), charge density, and PEGylation upon hybrid vector assembly and gene delivery efficacy. Upon assembly, hybrid vectors mediated increased gene delivery beyond that of the individual bacterial vector in isolation, including assays with increasing medium protein content to highlight shielding properties afforded by the PEG-functionalized CPLA component. Furthermore, after extensive characterization of surface deposition of the polymer, results prompted a new model for describing hybrid vector assembly that includes cellular coating and penetration of the CPLA component. In summary, these results provide new options and insight toward the assembly and application of next-generation hybrid biosynthetic gene delivery vectors.

Biodegradable nanoparticle-mediated K-ras down regulation for pancreatic cancer gene therapy

Biodegradable nanoparticle-mediated K-ras siRNA delivery has shown inhibition of cell proliferation, migration and invasion in pancreatic cancer cells.