The Impact of Psychosocial Influences on Chronic Wound Healing

This comprehensive review explores the intricate dynamics between psychosocial factors and chronic wound healing processes, specifically focusing on prevalent conditions such as pressure ulcers, diabetic foot ulcers, and venous leg ulcers. By examining the roles of psychiatric conditions, including depression, anxiety, and post-traumatic stress disorder (PTSD), this paper illuminates how these factors intricately influence wound healing dynamics, including mechanisms of pain perception and inflammatory responses. Furthermore, we evaluate the effectiveness of integrated biopsychosocial interventions, which encompass a holistic approach to wound care, thereby enhancing healing outcomes for dermatology patients. Future studies should focus on investigating the specific psychosocial determinants that significantly influence wound healing, exploring novel therapeutic strategies, and implementing personalized interventions to meet the unique needs of each patient. Such endeavors hold promise in advancing the fields of psychodermatology and wound management, fostering a deeper understanding and application of psychosocial considerations in dermatological care.

Hepatic Adenoma Secondary to Long-Term Oral Contraception Use in a Young Female

Hepatic adenomas are a rare byproduct of oral contraceptive pill (OCP) use. Laboratory workup is often inconclusive. Diagnosis can be made via MRI;however, select cases may require further testing such as fine needle aspiration or core needle biopsy. We report a case of a 36-year-old female who was referred to gastroenterology for further evaluation of several liver lesions found incidentally on imaging. Due to risk factors, such as age, long-term oral contraceptive use and obesity, adenoma was high on the differential. Although infrequent, this case emphasizes the importance of a detailed history, including medication review, and physical examination.

A system dynamics model for billion trees tsunami afforestation project of Khyber Pakhtunkhwa in Pakistan:Model application to afforestation activities

As part of the global effort to plant billion trees,an afforestation project is launched in Pakistan in Khyber Pakhtunkhwa(KP)province to conserve existing forests and to increase area under forest cover.The present study is designed to build a Systems'model by incorporating major activities of the Billion Tree Tsunami Afforestation Project(BTTAP)with special focus on afforestation activities to estimate the growth in forest area of KP.Availability of complete dataset was a challenge.To fix the model,the raw data taken from the project office has been utilized.Planning Commission Form 1-Phase I&II helped us with additional information.We relied on the data available for one and half period of the project as rest of the data is subject to the completion of the project.Our results show that the project target to enhance area under forest differs from the target to afforest area under the project.The system dynamics'model projection shows that the forest area of KP would be 23.59 million hectares at the end of the BTTA project,thus having an increase of 3.29%instead of 2%that has been initially proposed.However,the results show that the progress to meet the target in some afforestation classes is slow as compared to other categories.Farm forestry,plantation on communal lands and owners'plantation need special focus of the authority.Deforestation would affect 0.02 million hectares area of the project.The model under study may be used as a reference model that can be replicated to other areas where billion tree campaigns are going on.

Using induced pluripotent stem cells derived neurons to model brain diseases

The ability to use induced pluripotent stem cells（i PSC）to model brain diseases is a powerful tool for unraveling mechanistic alterations in these disorders.Rodent models of brain diseases have spurred understanding of pathology but the concern arises that they may not recapitulate the full spectrum of neuron disruptions associated with human neuropathology.iPSC derived neurons,or other neural cell types,provide the ability to access pathology in cells derived directly from a patient＇s blood sample or skin biopsy where availability of brain tissue is limiting.Thus,utilization of iPSC to study brain diseases provides an unlimited resource for disease modelling but may also be used for drug screening for effective therapies and may potentially be used to regenerate aged or damaged cells in the future.Many brain diseases across the spectrum of neurodevelopment,neurodegenerative and neuropsychiatric are being approached by iPSC models.The goal of an iPSC based disease model is to identify a cellular phenotype that discriminates the disease-bearing cells from the control cells.In this mini-review,the importance of iPSC cell models validated for pluripotency,germline competency and function assessments is discussed.Selected examples for the variety of brain diseases that are being approached by iPSC technology to discover or establish the molecular basis of the neuropathology are discussed.

Exact Solution for a Class of Stiff Systems by Differential Transform Method

In this paper, Differential Transform Method (DTM) is proposed for the closed form solution of linear and non-linear stiff systems. First, we apply DTM to find the series solution which can be easily converted into exact solution. The method is described and illustrated with different examples and figures are plotted accordingly. The obtained result confirm that DTM is very easy, effective and convenient.

An Assessment of the Social, Cultural, and Economical Barriers to Option B+Retention and Their Solutions in Malawi: A Review

Malawi has one of the highest rates of HIV prevalence in the world, and accounts for 4% of the total number of people living in sub-Saharan Africa with HIV. Approximately one million people in Malawi were living with HIV in 2016, with 24,000 HIV-related deaths. The Option B+ program, first implemented in Malawi, aimed to initiate ART for all pregnant women, regardless of their CD4 cell count or disease stage. This study serves to analyze and assess the effectiveness of Option B+ retention, in relation to the facilitation of how various social and cultural barriers were handled. A literature review of 29 publications was conducted. Careful evaluation of various studies indicates that although there is a myriad of reasons explaining low levels of retention, the women who were at the highest risk for low retention were young pregnant women who were treated on the same day of HIV-diagnosis. Solutions focused around women and their partners or communities showed promising evidence of success in increasing adherence, as these strategies likely provided women reliable social and emotional support to address major barriers to retention such as a lack of support from male partners, ineffective education from healthcare workers, or stigma towards their HIV disclosure statue.

Weight Management of Young Women with Down Syndrome: <i>C-ICAN</i>Meal Plan

Primary care physicians are in a unique position to provide a holistic and individualized care to their patients with Down Syndrome. These patients share common medical problems with general population;however, they often are medically complex and present with cardiac, orthopedic, and endocrine challenges such as overweight-obesity and related comorbidities that occur with more frequency in this unique population. The prevention of overweight-obesity is an important public health issue for both the general population and for the population of individuals with Down Syndrome. If abnormal weight gain is treated early and effectively many secondary comorbidities can be prevented or ameliorated. This case report discusses the impact of implementing a Consistent Individualized Carbohydrate controlled Anti-inflammatory Nutrition plan (C-ICAN) as part of the treatment plan for a young woman with Down Syndrome (DS). The C-ICAN meal plan is a low glycemic load meal plan with 30% to 35% calories from fat, 20% to 25% calories from protein, 40% to 45% calories from carbohydrate, and goal of 25 gm fiber per day. The C-ICAN meal plan combines the Mediterranean diet because of its well-established anti-inflammatory, and cardiovascular benefits, with a high protein and low glycemic-load meal plan to improve satiety and glycemic control. In this case the patient and her caregivers adjusted to a structured meal pattern well, weight balance resulted, and mealtime stress was reduced.

Hypercalcemia and Granulomatous-Like Lesions in a Patient with Melanoma after Treatment with Immunotherapy: Case Report

Checkpoint inhibitors, a subset of immunotherapies, are effective treatment modalities for cancers such as melanoma. However, they are not without possible adverse effects. Drug-induced reactions may present with similar symptoms of sarcoidosis. We present the case of a 73-year-old female with a recent diagnosis of anorectal melanoma treated with checkpoint inhibitors who developed subsequent episodes of hypercalcemia. Her clinical symptoms along with her surgical cytology and radiologic results are characteristic of a drug-induced sarcoidosis-like reaction. With the increasing usage of immunotherapies in cancer treatment, it is important for clinicians to be aware of which patient population they are ideal for and possible adverse effects.

The COVID-19 Outbreak in South Korea: Lessons to Be Learned

The Coronavirus 2019 (COVID-19) is a novel type of coronavirus-related disease that has over 4 million confirmed cases worldwide as of May 13th, 2020. With over 200 countries impacted by the pandemic, many countries have taken drastic measures such as temporary closure of international borders. The purpose of this thesis is to examine the South Korean response to COVID-19 and the keys to successful containment of the disease. Real time analysis was performed on data provided by the Centers for Disease Control (CDC). Comparisons of disease containment among countries with the highest confirmed cases were normalized for population size differences by taking the proportion of confirmed cases to population size. We further compared the disease outbreak in Seoul, a very urban environment, to the whole country of South Korea, to compare public health in urban and rural environments. We found that the efficient partnership between the private sector and the state led to rapid development in testing kits, which was integral to the South Korean response to COVID-19. In addition, the South Koreans’ community spirit, approval of government-led interventions, and societal norm of wearing masks were also efficient social responses to the spreading disease. In this paper, we navigate the impacts of a universal healthcare system and its ability to battle infectious diseases and the efficacy of various governmental actions in response to a public health crisis.

Analysis of various semi-numerical schemes for magnetohydrodynamic(MHD)squeezing fluid flow in porous medium

In this article comparative analysis of various semi-numerical schemes has beenmade for the case of squeezing flow of an incompressible viscous fluid between two largeparallel plates having no-slip at the boundaries.The medium of flow contains magnetohy-drodynamic(MHD)effect and having small pores.Modeled boundary value problem is solvedanalytically using Optimal homotopy asymptotic method(OHAM),homotopy perturbationmethod(HPM),differential transform method(DTM),Daftardar Jafari method(DIM)andAdomian decomposition method(ADM).For comparison purpose,residuals of these schemeshave been found and analyzed for accuracy.Analytical study indicates that DTM and DJM arequite good in tem of accuracy near the center of domain[—1,1]but the accuracy reducesconsiderably near the start and end of the given interval.HPM and OHAM residuals indicatethat OHAM surpasses HPM in terms of accuracy in the present case.

MicroRNA-let-7a promotes E2F-mediated cell proliferation and NFKB activation in vitro

Epigenetic factors, including altered microRNA （miRNA） expression, may contribute to aberrant immune cell function in systemic lupus erythematosus （SLE）. MiRNA-let-7a （let-7a） has been shown to directly alter cell cycle progression and proinflammatory cytokine production. Due to the crucial role of let-7a in cell division and inflammation, we investigated let-7a-mediated proliferation and NFKB translocation in J774A. 1 macrophages and MES 13 mesangial cells in vitro. In immune-stimulated cells transfected with let-7a, cell proliferation was significantly increased over time. There was a significant increase in the number of immune-stimulated cells in S and G2 phases. Immune-stimulated cells overexpressing let-7a had increased nuclear translocation of NFKB. Bioinformatical analysis revealed that the E2F family, critical regulators of the G1-S transition, has potential binding sites for let-7a in their mRNA transcripts. Let-7a overexpression significantly increased the expression of the cell cycle activator E2F2 and increased retinoblastoma protein （Rb） phosphorylation in immune-stimulated cells. The cell cycle inhibitor E2F5 was significantly decreased in let-7a-transfected cells that were immune-stimulated. Bioinformatical analysis revealed E2F2 and NFKB are transcription factors predicted to regulate the let-7a promoter. We analyzed transcriptional regulation of let-7a by real-time RT-PCR using chromatin immunoprecipitation with E2F2 and NFKB antibodies. There was an increase in E2F2 and NFKB binding in DNA enriched for the let-7a promoter in immune-stimulated cells. Silencing E2F2 or NFKB significantly decreased let-7a expression and IL-6 production in immune-stimulated cells. Taken together, our results suggest that overexpression of let-7a may contribute to hyperplasia and the proinflammatory response in SLE.

Heat shock protein 90 inhibition by 17-DMAG lessens disease in the MRL/Ipr mouse model of systemic lupus erythematosus

Elevated expression of heat shock protein 90 （HSP90） has been found in kidneys and serum of systemic lupus erythematosus （SLE） patients and MRLIMp-FasIprIFasJpr（MRLIIpr） autoimmune mice. We investigated if inhibition of HSP90 would reduce disease in MRL/ Ipr mice. In vitro, pretreatment of mesangial cells with HSP90 inhibitor Geldanamycin prior to immune-stimulation showed reduced expression of IL-6, IL-12 and NO. In vivo, we found HSP90 expression was elevated in MRL/Ipr kidneys when compared to C57BL/6 mice and MRIJIpr mice treated with HSP90 inhibitor 17-DMAG. MRIJIpr mice treated with 17-DMAG showed decreased proteinuria and reduced serum anti-dsDNA antibody production. Glomerulonephritis and glomerular IgG and C3 were not significantly affected by administration of 17-DMAG in MRIJIpr. 17-DMAG increased CD8＋ T cells, reduced double-negative T cells, decreased the CD4/CD8 ratio and reduced follicular B cells. These studies suggest that HSP90 may play a role in regulating T-cell differentiation and activation and that HSP90 inhibition may reduce inflammation in lupus.

Autoimmune Hepatitis Induced after Treatment of Syphilitic Hepatitis

We present a unique case of biopsy-proven syphilitic hepa-titis which presented as severe acute liver injury with sig-nificant elevation in aminotransferases and bilirubin,and improved with antibiotic therapy.However,the patient re-turned weeks after initial presentation with new-onset acute liver injury and had developed hypergammaglobulinemia,positive autoantibody titers,and repeat liver biopsy dem-onstrating interface hepatitis,supporting a diagnosis of autoimmune hepatitis.He had an otherwise unrevealing etiologic workup,and responded to glucocorticoid therapy.We believe that syphilitic hepatitis and its treatment sub-sequently triggered an immunogenic response,leading to autoimmune hepatitis.Autoimmune hepatitis is a chronic liver disease thought to manifest as a result of predisposing genetic factors in combination with environmental insults,especially hepatotropic pathogens.Syphilis is a sexually transmitted disease caused by Treponema pallidum that has been associated with autoimmunity and the develop-ment of autoantibodies.We propose that in the setting of syphilitic hepatitis,a molecular mimicry event resulting from structural similarities between T.pallidum and liver antigens,as well as impaired regulatory T-cell function,led to the breakdown of immune tolerance and the onset of au-toimmune hepatitis.To support this hypothesis,further mo-lecular analyses and case series are necessary to determine if syphilitic hepatitis and its treatment are risk factors for the onset of autoimmune hepatitis.Autoimmune hepatitis should be considered early as the cause of acute liver injury in susceptible patients with risk factors for the disease,as prompt recognition and appropriate treatment may prevent progression of liver injury and result in improved outcomes.