Wrightbartlett9944

Background The Veterans Health Administration (VHA) has an existing teleretinal screening program that uses nonmydriatic fundus photography to screen for diabetic retinopathy in primary care clinics. Concurrently, optical coherence tomography (OCT) has become a routine screening modality in eye clinics for the diagnosis and management of retinal diseases. Autophagy assay Introduction This study aimed to evaluate the first year of a pilot tele-OCT program that used existing resources within the VHA. Without the tele-OCT program, all patients would have been referred to retina clinic for an in-person evaluation. Materials and Methods This is a retrospective chart review study of patients evaluated by a retina specialist through asynchronous tele-OCT evaluation in 2019. Electronic medical records were used to assess patients' demographic and clinical characteristics, tele-OCT consult results, and patient adherence to tele-OCT follow-up plans. Results There were 158 tele-OCT consults originating from optometry and nonretinal ophthalmology clinics in 2019. After tele-OCT evaluation, 113 (71.5%) patients were recommended to be monitored in their originating eye clinic, 27 (17.1%) were referred to intravitreal injection clinic, and 12 (7.6%) were referred to retina clinic for in-person evaluation. Patient adherence to tele-OCT follow-up plans was 76.4%. Patients with decreased central vision (p = 0.007) and patients referred to intravitreal injection clinic (p = 0.043) were most adherent to follow-up. Discussion The tele-OCT program reduced unnecessary in-person clinic visits and enabled more retina clinic availability. Follow-up adherence was greatest among symptomatic patients and those requiring treatment. Conclusions Tele-OCT can extend tertiary care resources and improve patient care in a large multidisciplinary eye care practice.A compliant three-dimensional (3D)-printed soft gripper is designed based on the bioinspired spiral spring in this study. The soft gripper is then 3D-printed using a suitable thermoplastic filament material to deliver the desired performance. The sensorless mechanism introduced in this study provides adequate compliance with a single linear actuator for interacting with delicate objects, such as manipulation of human biological materials and fruit picking. The kinematic and dynamic models of the monolithic gripper are derived analytically as well as by means of finite element analysis to synthesize its functionality. The fabricated gripper module is installed on a robot arm to demonstrate the efficacy of design for picking and placing fruits without damaging them. The presented mechanism could be customized and used in the medical and agricultural sectors with diverse geometry objects.Background Usage of telemedicine for virtual dermatology care during the COVID-19 pandemic on a national scale is poorly characterized, particularly for nonvideo encounters. Objective We sought to compare utilization of telephone and asynchronous virtual care for dermatologic concerns 3 months before (December 2019-February 2020) and during the pandemic (March-May 2020) across patient populations. Methods A retrospective study was performed using a national claims database with >280 million patients within the COVID-19 Research Database to identify monthly telephone and asynchronous virtual visits by diagnosis, age, income, and patient race/ethnicity. Results Although overall visits for dermatologic concerns decreased by 27.2% during the pandemic, telephone and asynchronous visits increased significantly. Patients most likely to use telephone visits during the pandemic were of older age (relative risk ratio [RRR] = 1.043, p less then 0.001), African American race (RRR = 2.03, p less then 0.001), and household income less then $29,000 (RRR = 1.51, p less then 0.001). Limitations Racial and ethnic data were available for 39.04% of patients and income data for 38.1% of patients. Conclusions Underserved populations including African Americans, elderly, and low-income patients were more likely to utilize telephone formats during the pandemic. Further studies are needed to determine the reasons for these observed differences and whether there is differential quality between nonvideo and video telemedicine encounters to ensure that all patients are given equal access to the highest quality of virtual care.Human genome wide association studies confirm the association of the rs738409 single nucleotide polymorphism (SNP) in the gene encoding protein patatin like phospholipase domain containing 3 (PNPLA3) with nonalcoholic fatty liver disease (NAFLD); the presence of the resulting mutant PNPLA3 I148M protein is a driver of nonalcoholic steatohepatitis (NASH). While Pnpla3-deficient mice do not display an adverse phenotype, the safety of knocking down endogenous wild type PNPLA3 in humans remains unknown. To expand the scope of a potential targeted NAFLD therapeutic to both homozygous and heterozygous PNPLA3 rs738409 populations, we sought to identify a minor allele-specific small interfering RNA (siRNA). Limiting our search to SNP-spanning triggers, a series of chemically modified siRNA were tested in vitro for activity and selectivity toward PNPLA3 rs738409 mRNA. Conjugation of the siRNA to a triantennary N-acetylgalactosamine (GalNAc) ligand enabled in vivo screening using adeno-associated virus to overexpress human PNPLA3I148M versus human PNPLA3I148I in mouse livers. Structure-activity relationship optimization yielded potent and minor allele-specific compounds that achieved high levels of mRNA and protein knockdown of human PNPLA3I148M but not PNPLA3I148I. Testing of the minor allele-specific siRNA in PNPLA3I148M-expressing mice fed a NASH-inducing diet prevented PNPLA3I148M-driven disease phenotypes, thus demonstrating the potential of a precision medicine approach to treating NAFLD.Esophageal squamous cell carcinoma (ESCC) is among the most dangerous cancers with high mortality and lack of robust diagnostics and personalized/precision therapeutics. To achieve a systems-level understanding of tumorigenesis, unraveling of variations in the protein interactome and determination of key proteins exhibiting significant alterations in their interaction patterns during tumorigenesis are crucial. To this end, we have described differential protein-protein interactions and differentially interacting proteins (DIPs) in ESCC by utilizing the human protein interactome and transcriptome. Furthermore, DIP-centered modules were analyzed according to their potential in elucidation of disease mechanisms and improvement of efficient diagnostic, prognostic, and treatment strategies. Seven modules were presented as potential diagnostic, and 16 modules were presented as potential prognostic biomarker candidates. Importantly, our findings also suggest that 30 out of the 53 repurposed drugs were noncancer drugs, which could be used in the treatment of ESCC.