Hoffmannoneal1633

We present the case of an 82-year-old female with acantholytic squamous cell carcinoma affecting vulvar skin. The patient had a history of perineal lichen sclerosus for 5 years before presentation. She was referred to a dermatologist for intractable severe pain associated with the lesions. Biopsies showed an infiltrative squamous cell carcinoma with histology consistent with the acantholytic subtype. Acantholytic squamous cell carcinoma is a rare histologic variant characterized by dyscohesive keratinocytes with pseudoglandular formation and dyskeratosis. It is associated with sun-damaged skin and most commonly occurs in the head and neck of elderly men. Few cases have been reported at nondermal sites and non-sun-exposed dermis. The patient underwent a radical vulvectomy and bilateral inguinal node dissection. The 1.6 cm tumor was diffusely acantholytic and pseudoglands were present. The tumor cells were diffusely positive for p63 immunohistochemical stain. As expected at this site, there was no solar elastosis identified histologically. However, vulvar intraepithelial neoplasia and chronic lichen sclerosus were apparent. This case represents a rare histologic subtype of squamous cell carcinoma in an unusual site associated with lichen sclerosus instead of solar elastosis.Adenomatoid tumor is a benign neoplasm of mesothelial origin. Adenomatoid tumor in female genital tract shows typical morphologic features with bland nuclei. Deciduoid morphology has not been reported in adenomatoid tumor. Tumors with deciduoid cells and atypical nuclear features may pose a diagnostic challenge and raise the suspicion of malignancy. We present a case of fallopian tube adenomatoid tumor with deciduoid morphology and atypical nuclear features in a 39-year-old woman with prolonged progestin therapy. We hypothesize that the unusual morphological changes in adenomatoid tumor, like deciduoid morphology and nuclear atypia, may be secondary to hormone effects.

The effect of lithium therapy during Electroconvulsive Therapy (ECT) on cognition and treatment effectiveness is unclear. In this study, we compare the cognitive and symptomatic outcomes of patients undergoing ECT with and without lithium in a large tertiary psychiatric institution.

Patients with predominantly manic or mixed episodes on lithium were propensity score matched with controls. Cognition was assessed using the Montreal Cognitive Assessment (MoCA), while severity of symptoms was assessed using the Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression-Severity Scale. Quality of life was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF) and EuroQol Five Dimension (EQ-5D). Linear mixed-effects modeling and conditional logistic regression were conducted as appropriate.

87 patients were included in the study. There was no significant difference in cognitive and symptomatic outcomes for patients receiving ECT with or without lithium after 6 sessions of ECT.

Concurrent lithium administration during the initial acute ECT course was not associated with differential cognitive or symptomatic outcomes. Lithium administration should not be a contraindication for appropriate acute ECT treatment in patients. Larger controlled studies to confirm these findings are warranted.

Concurrent lithium administration during the initial acute ECT course was not associated with differential cognitive or symptomatic outcomes. Lithium administration should not be a contraindication for appropriate acute ECT treatment in patients. Larger controlled studies to confirm these findings are warranted.

Despite the established efficacy of electroconvulsive therapy (ECT), negative perceptions and inaccurate knowledge about ECT in the United States and other countries persist. This study examined ECT perceptions and knowledge in the 3 most populous countries in the world.

We recruited participants who screened positive for depression on the Patient Health Questionnaire 9 (PHQ-9) in the United States (n = 1643), India (n = 1469), and China (n = 328) and compared responses on the ECT-Perception and Knowledge Scale.

Although the US sample had significantly higher PHQ-9 scores than the India and China samples, the US sample was less likely to have been offered ECT or to have ever received ECT. Moreover, the US sample scored lower on the ECT Perception and Knowledge subscales than the other samples indicating more negative perceptions and inaccurate knowledge about ECT. Across samples, there were moderate fears about ECT being painful or causing brain damage, and misconceptions about ECT being outdated and adverse effects of induced seizures. Higher PHQ-9 scores were correlated with more negative perceptions.

Greater public education is needed about ECT, particularly in the United States. Misperceptions and lack of knowledge may hinder utilization of ECT in India, China, and the United States.

Greater public education is needed about ECT, particularly in the United States. Misperceptions and lack of knowledge may hinder utilization of ECT in India, China, and the United States.

Preliminary data suggest that focal electrically administered seizure therapy (FEAST) has antidepressant effects and less adverse cognitive effects than traditional forms of electroconvulsive therapy (ECT). This study compared the impact of FEAST and ultrabrief pulse, right unilateral (UB-RUL) ECT on suicidal ideation.

At 2 sites, patients in a major depressive episode were treated openly with FEAST or UB-RUL ECT, depending on their preference. The primary outcome measure was scores on the Beck Scale for Suicide Ideation (SSI). Scores on the suicide item of the Hamilton Rating Scale for Depression (HRSD-SI) provided a secondary outcome measure.

Thirty-nine patients were included in the intent-to-treat sample (FEAST, n = 20; UB-RUL ECT, n = 19). Scores on both the SSI and HRSD-SI were equivalently reduced with both interventions. Both responders and nonresponders to the interventions showed substantial reductions in SSI and HRSD-SI scores, although the magnitude of improvement was greater among treatment responders.

Although limited by the open-label, nonrandomized design, FEAST showed comparable effects on suicidal ideation when compared with routine use of UB-RUL ECT. These results are encouraging and support the need for further research and a noninferiority trial.

Although limited by the open-label, nonrandomized design, FEAST showed comparable effects on suicidal ideation when compared with routine use of UB-RUL ECT. These results are encouraging and support the need for further research and a noninferiority trial.

Transdermal analysis patches (TAPs) noninvasively measure soluble proteins in the stratum corneum. Ultimately, such local protein profiles could benefit the search for biomarkers to improve personalized treatment in psoriasis. This study aimed to explore the patient friendliness and protein detection by TAP in pediatric psoriasis in daily clinical practice.

In this observational study, TAPs measuring CXC chemokine ligand (CXCL)-1/2, CC chemokine ligand (CCL)-27, interleukin (IL)-1RA, IL-23, IL-1α, IL-8, IL-4, IL-22, IL-17A, vascular endothelial growth factor (VEGF), human beta-defensin (hBD)-2, hBD-1, and kallikrein-related peptidase (KLK)-5 were applied on lesional, peri-lesional, and non-lesional skin sites of psoriasis patients aged >5 to <18 years. Discomfort during TAP removal as an indicator for patient friendliness was assessed by visual analogue scale (VAS; range 0-10).

Thirty-two patients (median age 14.0 years) were included, of which 19 were treated with solely topical agents and 13 with systemic treatment. The median VAS of discomfort during TAP removal was 1.0 (interquartile range 1.0). Significantly higher levels in lesional versus non-lesional skin were found for IL-1RA, VEGF, CXCL-1/2, hBD-2, and IL-8, whereas lower levels were found for IL-1α. Skin surface proteins were measured in both treatment groups, with significant higher lesional levels of KLK-5, IL-1RA, hBD-2, IL-1α, IL-23, and CCL-27 in the systemic treatment group.

The TAP platform holds the potential for patient-friendly and noninvasive monitoring of skin-derived proteins in pediatric psoriasis patients in daily clinical practice.

The TAP platform holds the potential for patient-friendly and noninvasive monitoring of skin-derived proteins in pediatric psoriasis patients in daily clinical practice.An astonishing variety of functions has been attributed to polyphosphate (polyP) in prokaryotes. Besides being a reservoir of phosphorus, functions in exopolysaccharide formation, motility, virulence and in surviving various forms of stresses such as exposure to heat, extreme pH, oxidative agents, high osmolarity, heavy metals and others have been ascribed to polyP. In this contribution, we will provide a historical overview on polyP, will then describe the key proteins of polyP synthesis, the polyP kinases, before we will critically assess of the underlying data on the multiple functions of polyP and provide evidence that - with the exception of a P-storage-function - most other functions of polyP are not relevant for survival of Ralstonia eutropha, a biotechnologically important beta-proteobacterial species.The non-ideal contact between the metal electrode and semiconducting channel has become one of the major bottlenecks degrading the performance of field-effect transistors (FETs) based on two-dimensional (2D) materials. The formation of the Schottky barrier prohibiting the carrier injection as well as the Fermi level pinning effect have a strong impact on the device performance. In this work, we fabricated a 2D WS2FET device with engineered metallic 1T phase at the source/drain region by using Li intercalation method. As compared to the device with conventional 2H-WS2channel, the engineered FET with a 2H-WS2/1T-WS2junction has exhibited greatly improved performance such as over 10 times higher carrier mobility and steeper subthreshold slope. Such results have demonstrated the boosted carrier injection into the channel over the engineered metal contact as well as the reduced tunnel barrier width between the 2H/1T-WS2junction. CDK inhibitor This can be attractive for the large-scale integration of the 2D devices towards high-performance and high-reproducibility nanoelectronics applications.Fish median fins are extremely diverse, but their function is not yet fully understood. Various biological studies on fish and engineering studies on flapping foils have revealed that there are hydrodynamic interactions between fins arranged in tandem and that these interactions can lead to improved performance by the posterior fin. This performance improvement is often driven by the augmentation of a leading-edge vortex on the trailing fin. Past experimental studies have necessarily simplified fish anatomy to enable more detailed engineering analyses, but such simplifications then do not capture the complexities of an undulating fish-like body with fins attached. We present a flexible fish-like robotic model that better represents the kinematics of swimming fishes while still being simple enough to examine a range of morphologies and motion patterns. We then create statistical models that predict the individual effects of each kinematic and morphological variable. Our results demonstrate that having fins arranged in tandem on an undulating body can lead to more steady production of thrust forces determined by the distance between the fins and their relative motion.