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Well-ordered perpendicular cylinders of star-block copolymers (BCPs) composed of polystyrene and poly(dimethylsiloxane) blocks with high aspect ratio can be achieved by using a combination of architecture effect (entropy effect) and surface air plasma treatment (enthalpy effect). An interesting morphological evolution from disordered texture to hexagonally packed cylinders with perpendicular orientation has been observed, in which perpendicular cylinders are initiated at the top surface and bottom substrate of the thin film, followed by a self-alignment process, resulting in span-thru cylinders through the thin film. The self-alignment process is systematically examined by a combination of real space imaging using transmission electron microscopy, reciprocal space imaging using grazing incidence small-angle X-ray scattering, and three-dimensional tomography. The experimental results reveal a unique mechanism for the formation of highly ordered BCP thin films via surface-induced nucleation of perpendicular...

Improving the degree of assistance given by in-car navigation systems is an important issue for the safety of both drivers and passengers. There is a vast body of research that assesses the usability and interfaces of the existing navigation systems but very few investigations study the impact on the brain activity based on navigation-based driving. In this paper, a real-world experiment is designed to acquire the electroencephalography (EEG) and in-car information to analyze the dynamic brain activity while the driver is performing the lane-changing task based on the auditory instructions from an in-car navigation system. The results show that auditory cues can influence the speed and increase the frontal EEG delta and beta power, which is related to motor preparation and decision making during a lane change. However, there were no significant results on the alpha power. A better lane-change assessment can be obtained using specific vehicle information (lateral acceleration and heading angle) with EEG features for future naturalized driving study.

Supplemental Digital Content is available in the text., Background: Management of facial rejuvenation has evolved over past decades. Facelift with barbed suture is a minimally invasive surgical technique for facial rejuvenation. This study examined the efficacy and associated complications of a new thread-looping procedure called minimal access multiple plane suspension. Methods: A total of 103 thread lifts were performed between 2014 and 2017. Patient satisfaction and adverse effects were evaluated. Results: In the majority of patients (88/103, 85.4%), the results obtained were considered satisfactory 3 months after the procedure. The incidence of complications was low. Only 5.8% of the patients had slight postoperation asymmetry that was easily corrected. Minor complications experienced by patients included palpable suture knots (12.6%), persistent facial swelling (7.88%), and facial dimpling (2.9%). The causes of procedure-related complications were reviewed and discussed. Conclusion: Reinforced by select anchoring points, "minimal access multiple plane suspension" suspends ptotic anatomic tissues, serving as an effective facial rejuvenation procedure with minimal downtime and satisfactory cosmetic results.

Background Calcium channel blocker (CCB) or two renin angiotensin aldosterone system blockades (RAAS), angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), are major potent and prevalently used as initial antihypertensive agents for mild to moderate hypertension, but no uniform agreement as to which antihypertensive drugs should be given for initial therapy, especially among chronic kidney disease (CKD) patients. Design A systematic review and meta-analysis comparing CCBs and the two RAAS blockades for hypertensive patients with CKD stage 3 to 5D. The inclusion criteria for this systematic review was RCT that compared the effects of CCBs and the two RAAS blockades in patients with hypertension and CKD. The exclusion criteria were (1) renal transplantation, (2) CKD stage 1 or 2, (3) combined therapy (data cannot be extracted separately). Outcomes were blood pressure change, mortality, heart failure, stroke or cerebrovascular events, and renal outcomes. Results 21 randomized controlled trials randomized 9,492 patients with hypertensive and CKD into CCBs and the two RAAS blockades treatments. The evidence showed no significant differences in blood presser change, mortality, heart failure, stroke or cerebrovascular events, and renal outcomes between CCBs group and the two RAAS blockades group. The publication bias of pooled mean blood presser change that was detected by Egger’s test was non-significant. Conclusions CCBs has similar effects on long term blood pressure, mortality, heart failure, stroke or cerebrovascular events, and renal function to RAAS blockades in patients CKD stage 3 to 5D and hypertension.

Background Generalized bullous fixed drug eruption (GBFDE), a particular form of fixed drug eruption (FDE), is characterized by widespread blisters and erosions and can be confused with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Objective We sought to analyze specific features of GBFDE and differentiate it from SJS/TEN. Methods We retrospectively studied patients with GBFDE and SJS/TEN during a period of 10 years. GBFDE was defined as typical FDE lesions with blisters involving at least 10% body surface area on at least 3 of 6 different anatomic sites. Clinical presentations; histopathological features; immunohistochemical patterns of cluster-of-differentiation (CD)3, CD4, CD8, CD56, Fas, Fas ligand, granzyme B, perforin, granulysin, and forkhead box P3 (Foxp3); and serum granulysin levels were compared. Results Twenty-three cases of GBFDE were collected. Patients with GBFDE had shorter latent periods, less mucosal involvement, more eosinophil infiltration, and dermal melanophages. Lesional infiltrates in GBFDE had more dermal CD4 + cells including Foxp3 + regulatory T cells, fewer intraepidermal CD56 + cells, and fewer intraepidermal granulysin + cells. The serum level of granulysin in GBFDE was also significantly lower than in SJS/TEN. Limitations The number of cases in this study is small. Conclusion GBFDE is a distinct disease distinguishable from SJS/TEN by particular features such as granulysin, CD56, and Foxp3 expressions.

Exploring the ordering mechanism and dynamics of self-assembled block copolymer (BCP) thin films under confined conditions are highly essential in the application of BCP lithography. In this study, it is aimed to examine the self-assembling mechanism and kinetics of silicon-containing 3-arm star-block copolymer composed of polystyrene (PS) and poly(dimethylsiloxane) blocks as nanostructured thin films with perpendicular cylinders and controlled lateral ordering by directed self-assembly using topographically patterned substrates. The ordering process of the star-block copolymer within fabricated topographic patterns with PS-functionalized sidewall can be carried out through the type of secondary (i.e., heterogeneous) nucleation for microphase separation initiated from the edge and/or corner of the topographic patterns, and directed to grow as well-ordered hexagonally packed perpendicular cylinders. The growth rate for the confined microphase separation is highly dependent upon the dimension and also the geometric texture of the preformed pattern. Fast self-assembly for ordering of BCP thin film can be achieved by lowering the confinement dimension and also increasing the concern number of the preformed pattern, providing a new strategy for the design of BCP lithography from the integration of top-down and bottom-up approaches.

Background. The cutaneous manifestations of human enterovirus (HEV) infection are usually limited, such as hand-foot-mouth disease. By comparison, Stevens-Johnson syndrome (SJS) is a life-threatening severe cutaneous adverse reaction (SCAR), mainly caused by drugs. During the HEV outbreaks in 2010–2012 in Taiwan, we identified 21 patients who developed widespread blistering mucocutaneous reactions without any suspected drug causality. Methods. We screened possible pathogen(s) for detecting human herpes virus (HHV1–HHV7), HEV, or Mycoplasma pneumoniae infections using throat swab virus cultures, real-time PCR, DNA sequencing, immunochemistry and electron microscopy analyses. Results. Coxsackievirus A6 (CVA6) DNA was identified in the blistering skin lesions in 6 of 21 patients. Cytotoxic T lymphocytes and natural killer cells expressing granulysin predominantly infiltrated into the skin lesions, sharing the histopathological features with SJS. Intact CVA6 viral particles were identified in the blister fluids and skin lesions by electron microscopy. The phylogenetic analysis of the viral genome showed the CVA6 DNA sequence sharing higher similarity (97.6%–98.1%) to CVA6 strains reported from Finland at 2008. Conclusions. This study identifies a new variant of CVA6 as the causative agent for severe mucocutaneous blistering reactions mimicking SCAR. An awareness of this unusual presentation of HEV infection is needed in the epidemic area.

Peripheral blood hypereosinophilia reflects various underlying disorders. However, its thromboembolic consequences are not often highlighted. We report a case of acute pulmonary embolism in a 42 year-old male prisoner hospitalized for erythrodermic psoriasis who presented with generalized edema and shortness of breath. Severe eosinophilia (absolute eosinophil count 6232/ΜL) was also noted. Although severe psoriasis can be associated with eosinophilia and metabolic syndrome, acute pulmonary embolism is very rare in these patients. Immobilization secondary to severe psoriatic arthritis and prolonged use of leg cuffs can exacerbate the formation of thromboembolism. Although investigating the underlying causes of eosinophilia is important, we would like to highlight the importance of being aware of thromboembolic events, especially in patients with other thrombotic risk factors.